[ Objective ] To investigate the decisive factor of syndrome differentiation of systemic lupus erythematosus (SLE) , so as to provide its experimental evidence. [Methods] Serum levels of soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) in SLE patients with yin deficiency of the liver and kidney (group B) and with excessive toxic heat (group C) were detected by enzyme-linked immunosorbent assay (ELISA) . Serum levels of sICAM-1 and sVCAM-1 in SLE patients were compared with those in healthy volunteers (group A). Relationship of serum C-reaction protein (CRP), complement 3 ( C3) and complement 4 (C4) with sICAM-1 and sVCAM-1 as well as relationship between sICAM-1 and sVCAM-1 in SLE patients were observed. [ Results ] Serum levels of sICAM-1 and sVCAM-1 in groups B and C were higher than those of group A ( P

Objective To compare the reliability of modificatory method and traditional method in preparing ischemic stroke rat model in rehabilitation period.Methods 173 female SD rats were divided into traditional method group(n=63),modificatory method group(n=109) and control group(n=37).In the traditional method group,the thread embolus was inserted through the left external carotid artery(ECA),and then left ECA and pterygopalatine artery(PPA) were ligated.In the modificatory method group,the thread embolus was inserted through the left internal carotid artery(ICA) and only left common carotid artery(CCA) was ligated.In the control group,the thread embolus was not inserted,only CCA was ligated.Results There was no significant difference in neurofunction score between the modificatory method group and the traditional method group(P>0.05).The operating time was significantly shortened(P<0.01) and the survival time was significantly prolonged in the modificatory method group compared with that of the traditional method group(P<0.01).The two-month survival rate was 54.13% in the modificatory method group and 31.75% in the traditional method group receptively,the former was significantly longer than the latter(P<0.01).Conclusion The ischemic stroke model established by modificatory methods is not only precisely and reliable but also save operating time and improve survival rate of the animals compared with the traditional method.The main death causes of animals are large-area cerebral edema and electrolyte imbalance after operation.

Objective To study the effects of constraint-induced movement train (CIMT) on the neurological medullary sheath in the rats after middle cerebral artery occlusion (MCAO). Methods 55 SD rats were randomly divided into CIMT group and nature recovery (NR) group after MCAO. The CIMT group were trained with balance beam and rolling cage everyday, with restrictting the movement of the intact upper limbs. The NR group lived in the same condition. The rats in CIMT group were assessed with ethology 5 d, 10 d, 15 d, 30 d and 60 d after operation respectively. At last, 5 rats of each group were checked with MRI, then they were immolated for myelin staining. Results The balance and muscle strength of CIMT group improved better compared with the NR ones (P<0.05), as well as the diameter and the demyelination of neurofibril in the infarcted area. Conclusion CIMT can collect more functional neurofibra and decrease myelinolysis.

Objective To summarize the clinical characteristics , diagnosis and surgical method of intra-ductal papilloma(IP)of breast without nipple discharge .Methods The clinical data of 84 IP patients(130 le-sions)without nipple discharge admitted from Feb .2011 to Oct.2013 were analyzed retrospectively .Results The age of the 84 patients were mainly ranging from 30 to 50 years old.113(86.92%)lesions were≤10 mm in size, 84(64.42%)lesions had a distance≤20 mm to nipple, 57 accompanied by adenosis , 43 accompanied by fibro-cystic adenosis , 48 accompanied by fibroadenoma , 14 with ductal hyperplasia , and 2 with atypical ductal hyper-plasia.After a follow-up of 3 to 36 months, 5 cases had recurrence , including 4 cases of IP and 1 case of ductal carcinoma in situ.Conclusions IP without nipple discharge has no typical clinical symptoms .Ultrasound exam-ination may have positive findings , but not typical .Preoperative diagnosis is difficult and surgical biopsy is rec-ommended.Multiple and atypical ductal hyperplasia has possibility of recurrence , so follow-up is necessary.

Objective To approach the methods and effects of internal fixation for Hoffa fracture. Methods A total of 26 patients with 26 condylar Hoffa fractures ( medial condylar fractures in 13patients and lateral condylar fractures in 13) treated from August 1993 to February 2010 were retrospectively analyzed.According to the Letenneur classification,there were 16 patients with type Ⅰ fractures,four with type Ⅱ fractures and six with type Ⅲ fractures.Among them,two patients were with open fractures and 24 with closed fractures.Surgical approaches including screw fixation in 21 patients and lateral support plate fixation in five were selected based on the fracture types and affected sides. Results All patients were followed up for 12.5-48 months (average 18 months),which showed fracture healing in all the patients within 3-4 months (average 3.5 months).Two patients had slight shift together with knee joint pain,ie,one patient had ROM of knee for 95 °,and one failed the functional exercise because of pain and had ROM of knee for 60° during follow up.No complications including infection,delayed union or bone necrosis occurred.According to Letenneur' s functional assessment system,the postoperative outcomes were excellent and good in 24 condyles,fair in one and poor in one. Conclusions Surgical treatment for Hoffa fractures is safe and effective,but the key point is to choose correct screw fixation position and orientation according to the fracture types and fracture fragment size.

Objective To investigate the influence of hedysaryum polysaccharide (HPS)in the kidney function and expressions of Glut-1 mRNA and protein in kidney tissue of db/db mice with diabetic nephropathy (DN)and to elucidate its possible action mechanism.Methods 10 db/m mice were taken as normal control group(n=10);50 fueling animal model db/db mice with DN were randomly divided into model group,enalapril group and the low, middle and high doses of HPS groups(n=10).The mice in noral control group and model group were given physioloical saline by gavege;and the mice in the other groups were respectively given 10 mg·kg-1 ·d-1 enalapril, 100,200 and 400 mg·kg-1 ·d-1 HPS by gavage;lasted 8 weeks.Picric acid method was used to determine the serum creatinine(SCr)level of the mice,enzyme coupling rate method was used to determine the blood urea nitrogen (BUN)level,ELISA method was used to determine the urinary microalbumin(UMALB)level,RT-PCR method was performed to detect the expression of Glut-1 mRNA, and Western blotting and immunohistochemical methods were used to detect the expression of Glut-1 protein.Results Compared with model group,the levels of SCr, BUN, UMALB, the mRNA and protein of Glut-1 expressions were decreased, especially in 400 mg·kg-1 ·d-1 HPS and enalapril groups(P<0.01).The HE and Masson staining results showed that less inflammatory cells infiltration in glomerular of the mice were found, capillary lumens were unobstructed, and the collagen deposition was not obvious in 400 mg·kg-1 ·d-1 group.Conclusion HPS could improve the kidney function of the db/db mice and inhibit the Glut-1 mRNA and protein expressions obviously, which indicates that HPS could delay the development of DN by inhibiting the Glut-1 expression in the glomerular mesangial cell membrane.

Objective To investigate the clinical efficacy and safety of oral high-dose methylprednisolone in the treatment of infantile spasms (IS).Methods The clinical data of 38 children with infantile spasms were analyzed retrospectively who treated with oral administration of high-dose methylprednisone in Department of Neurology,Wuhan Children's Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2016 to April 2017.Results (1) Twenty patients (52.6％) of all the 38 patients were seizure-free after 2 weeks of treatment,and 16 cases (42.1％) were seizure-free at the end of treatment.(2) All the 38 cases were typical or atypical hyperarrhythmia.After treatment of 2 weeks,25 cases (65.8％) of hyperarrhythmia disappeared;at the end of the treatment,30 cases (78.9％) of hyperarrhythmia disappeared.(3) Adverse effects mainly were weight gain,Cushing signs,increased appetite,irritability,drowsiness,co-infection,electrolyte disturbance.(4) Follow-up of 3 to 12 months,the recurrence rate was low and the development quotient had improved.Conclusions Oral high dose methylprednisolone in the treatment of IS is effective,safe and has a low recurrence rate.It can be recommended in clinicalal application.

Objective To explore the effectiveness and compliance of ketogenic-diet(KD) treatment for infantile spasm(IS).Methods Ninety-eight IS patients who were treated with KD in Wuhan Children's Hospital from March 2009 to June 2015 were analyzed by using retrospective case-control study,the patients were divided into 4 groups:newly diagnosed IS patients group (group A,including 24 patients),one antiepileptic drug (AEDs) failure IS patients (group B,including 28 patients),two and more AEDs failure IS patients (group C,including 29 patients),and two or more AEDs combined with ACTH failure IS patients(group D,including 17 patients).The spasm-free andretention rates after 3,6 and 12 months KD treatment were compared among these groups.Results Overall retention rate was 80.6％ (79/98 cases),69.4％ (68/98 cases),and 42.9％ (42/98 cases)at 3,6,12 months,respectively.The 3-month retention rate in group A,B,C and D was 83.3 ％ (20/24 cases),78.6％ (22/28 cases),82.7％ (24/29 cases) and 76.4％ (13/17 cases) respectively,and there was no significant difference among these groups (P ＞ 0.05).The 6-month retention rates in each group was 75.0％ (18/24 cases),67.9％ (19/28 cases),68.8％ (20/29 cases) and 65.0％ (11/17 cases) in sequence,and there was also no significant difference among these groups(P ＞0.05).The 12-month retention rate was 54.2％ (13/24 cases),21.4％ (6/28 cases),48.3％ (14/29 cases) and 52.9％ (9/17 cases) in group A,B,C and D in sequence,the 12-month retention rate of group B was significantly lower than that of other 3 groups,and the differences were statistically significant(x2 =5.973,4.508,4.727,all P ＜ 0.05),and there was no significant difference among the A,C,D groups (all P ＞ 0.05).The spasm-free rate at 3,6,12 months of KD treatment was 19.4％ (19/98 cases),20.4％ (20/98 cases),30.6％ (30/98 cases).The 3-month spasm-free rate in A,B,C,D groups were as follow:41.7％ (10/24 cases),14.3％ (4/28 cases),10.3％ (3/29 cases),11.8％ (2/17 cases),respectively.The 3-month spasm-free rate in group A was significantly higher than that of other 3 groups,and the differences were statistically significant (x2 =10.238,9.219,6.697,all P ＜ 0.05),but there was no significant difference among the B,C,D groups (all P ＞ 0.05).The 6-month spasm-free rates were 41.7％ (10/24 cases),14.3％ (4/28 cases),13.8％ (4/29 cases),and 11.8％ (2/17 cases) in group A,B,C and D in order,and the spasm-free rate in group A was significantly higher than that of other 3 groups,and the differences were statistically significant(x2 =4.924,5.249,4.298,all P ＜ 0.05),but there was no significant difference among the A,C,D groups (all P ＞ 0.05).The 12-month spasm-free rates were 54.2％ (13/24 cases),21.4％ (6/28 cases),24.1％ (7/29 cases),and 23.5 ％ (4/17 cases) in group A,B,C and D,and the spasm-free rate in group A was significantly higher than that in other 3 groups,and the differences were statistically significant(x2 =8.354,7.923,4.364,all P ＜ 0.05),but there was no significant difference among the A,C,D groups (all P ＞ 0.05).Conclusions The spasm-free rate of KD therapy for newly-diagnosed IS is higher than that of IS patients whose drug-therapy failed.KD therapy may be the top priority for IS patients and part of those patients whose drug-therapy failed can still get seizure-free with KD diet.

Objective:To explore the difference of the efficacy, safety and recurrence rate of oral atenolol compared with oral propranolol in the treatment of infantile hemangioma, so as to provide evidence-based medicine basis and reference for clinic.Methods:A comprehensive search was conducted on the English databases Web of Science, PubMed, Cochrane Library, Embase, U. S. National Library of Medicine Clinical Trials Registry Platform (https: //clinicaltrials.gov) and on the Chinese databases CNKI, CBM, VIP, Wanfang Data from January 2008 to June 2021, according to our defined inclusion and exclusion criteria, randomized controlled trials of oral atenolol versus oral propranolol in the treatment of infantile hemangioma were selected for performing meta-analysis, and the outcome indicators were treatment efficiency, incidence of adverse reactions, and recurrence rate. Meta-analysis was performed by using RevMan 5.3 software, and sensitivity analysis of the result was performed, and the main outcome indicators were tested for publication bias (Egger’s test) by using Stata 16 software.Results:Finally, 5 randomized controlled trials references were included. Our meta-analysis showed that there was no significant difference in the effective rate between oral atenolol and oral propranolol in the treatment of infantile hemangioma ( RR=0.93, 95% CI 0.84-1.02, P=0.110). There was a statistically significant difference in the overall incidence of adverse reactions ( RR=0.78, 95% CI 0.61-0.99, P =0.040), bronch-related and central nervous system related to β 2-blockade( RR=0.55, 95% CI 0.40-0.76, P<0.001) adverse reactions, which were lower in the atenolol group than in the propranolol group; there was a statistically significant difference in the recurrence rate ( RR=0.57, 95% CI 0.39-0.84, P=0.005), which was lower in the atenolol group than in the propranolol group. The sensitivity analysis showed that the result after the exclusion of any 1 study were less variable compared with the result of the previous analysis, and the conclusion obtained were unchanged, suggesting that the result of the meta-analysis were stable and reliable. The Egger’s test showed that P=0.502, which suggested that there was no obvious publication bias. Conclusions:In the treatment of infantile hemangioma, oral atenolol has equivalent efficacy compared with oral propranolol, with less overall incidence of adverse reactions (which can reduce the incidence of bronch-related and central nervous system adverse reactions) and lower recurrence rate.

Objective:To explore the difference of the efficacy, safety and recurrence rate of oral atenolol compared with oral propranolol in the treatment of infantile hemangioma, so as to provide evidence-based medicine basis and reference for clinic.Methods:A comprehensive search was conducted on the English databases Web of Science, PubMed, Cochrane Library, Embase, U. S. National Library of Medicine Clinical Trials Registry Platform (https: //clinicaltrials.gov) and on the Chinese databases CNKI, CBM, VIP, Wanfang Data from January 2008 to June 2021, according to our defined inclusion and exclusion criteria, randomized controlled trials of oral atenolol versus oral propranolol in the treatment of infantile hemangioma were selected for performing meta-analysis, and the outcome indicators were treatment efficiency, incidence of adverse reactions, and recurrence rate. Meta-analysis was performed by using RevMan 5.3 software, and sensitivity analysis of the result was performed, and the main outcome indicators were tested for publication bias (Egger’s test) by using Stata 16 software.Results:Finally, 5 randomized controlled trials references were included. Our meta-analysis showed that there was no significant difference in the effective rate between oral atenolol and oral propranolol in the treatment of infantile hemangioma ( RR=0.93, 95% CI 0.84-1.02, P=0.110). There was a statistically significant difference in the overall incidence of adverse reactions ( RR=0.78, 95% CI 0.61-0.99, P =0.040), bronch-related and central nervous system related to β 2-blockade( RR=0.55, 95% CI 0.40-0.76, P<0.001) adverse reactions, which were lower in the atenolol group than in the propranolol group; there was a statistically significant difference in the recurrence rate ( RR=0.57, 95% CI 0.39-0.84, P=0.005), which was lower in the atenolol group than in the propranolol group. The sensitivity analysis showed that the result after the exclusion of any 1 study were less variable compared with the result of the previous analysis, and the conclusion obtained were unchanged, suggesting that the result of the meta-analysis were stable and reliable. The Egger’s test showed that P=0.502, which suggested that there was no obvious publication bias. Conclusions:In the treatment of infantile hemangioma, oral atenolol has equivalent efficacy compared with oral propranolol, with less overall incidence of adverse reactions (which can reduce the incidence of bronch-related and central nervous system adverse reactions) and lower recurrence rate.