Following the principles of evidence-based medicine,in accordance with the structure and drafting rules of standardized documents,based on literature research,according to the characteristics of chronic cough in children and issues that need to form a consensus,the TCM Guidelines for Diagnosis and Treatment of Chronic Cough in Children was formulated based on the Delphi method,expert discussion meetings,and public solicitation of opinions.The guideline includes scope of application,terms and definitions,eti-ology and diagnosis,auxiliary examination,treatment,prevention and care.The aim is to clarify the optimal treatment plan of Chinese medicine in the diagnosis and treatment of this disease,and to provide guidance for improving the clinical diagnosis and treatment of chronic cough in children with Chinese medicine.

OBJECTIVETo detect potential mutation of TCOF1 gene in a Chinese family affected with Treacher-Collins syndrome.

METHODSClinical data of the patient was collected. The analysis included history taking, clinical examination and genetic testing. All coding regions of the TCOF1 gene were subjected to PCR amplification and Sanger sequencing.

RESULTSA novel mutation c.2261ins G (p.E95X) of the TCOF1 gene was discovered in the patient. The same mutation was not found in his parents and 100 healthy controls.

CONCLUSIONThe c.2261insG (p.E95X) mutation of the TCOF1 gene probably underlies the disease in the patient. Genetic testing can facilitate diagnosis and genetic counseling for families affected with TCS.

China ; Humans ; Organ Transplantation ; legislation & jurisprudence

The larvae of musca domestica were put in use to discard the dead tissue of a case of severe burn. A total of 50 000 aseptic maggots were put onto the infective wound surface, and aseptic dressings overlaid the surface. Three days later, another 20 000 maggots were put onto the wound for the second therapy. After twice maggot debridement, most necrotic muscle tissues of the wound were cleaned up, and eventually fresh granulation tissue grew and later the wound was covered and healed by 3 times of skin grafting. The result demonstrates that maggot therapy is safe and effective with no adverse complications except pain.
Animals ; Burns ; Debridement ; Humans ; Larva ; Skin Transplantation ; Wound Healing

Objective To identify the epidemic characteristics and risk factors of an emerging infectious disease-severe fever with thrombocytopenia syndrome (SFTS) in Hubei province.Methods Active surveillance program on SFTS was set up in monitoring sites-hospitals,at the township level or above,in Suizhou,Huanggang and Wuhan from January to December,2010.Specific surveillance program on SFTS was launched across the province in hospitals above the county level.Cases that matched the definition of surveillance case were identified and reported to Centers for Disease Control and Prevention (CDCs).Cases were interviewed and their blood samples collected and detected using PCR and virus isolation.We also conducted serum antibody surveys among healthy population and livestock and surveillance on vector ticks in those high-epidemic areas.Results 188 cases that matched the definition of surveillance case and 21 deaths were reported in 11 cities,32 countries and 100 towns in 2010,with an incidence rate of 0.33/106.The fatality rate was 11.2％.Data showed that the patients were from hilly areas at the altitude elevated between 28-940 meters.The epidemic period was between April and December with the peak from May to September.The youngest case was an 11-year old,while the eldest was 81 with median age as 56-year old.95.3 ％ of the patients were farmers.All Patients did not have the history of traveling,two weeks before the onset of SFTS.93.6％ of the patients engaged in different kind of work which was associated with agriculture.52.8％ of the patients had been exposed to ticks.22.0％ of the patients had been bitten by ticks.Skin injury was found in 64.2％ of the patients.Samples from 129 cases (68.6％) were collected and detected,with 67.4％ of them (87 cases) showed positive by Real time-PCR for SFTS virus.An elevation in antibody titer by a factor of four or evidence of sero-conversion was observed in 11 patients; SFTS virus was isolated from 2 patients.The total antibody positive rates were 3.8％,55.0％ (6/11 ),36.7％ (2/3) and 80.0％ (4/5) respectively in healthy population,dogs,sheep and cows.Ticks from grass,cattle and sheep were detected positive by Real time-PCR.Conclusion Most cases of SFTS in Hubei were infected by SFTS virus,and cases of livestock were infected by SFTS virus.Ticks might serve as an important vector.Skin injury,exposure to tick bites seemed to be the risk factors.

Objective To describe the distribution characteristics of carotid atherosclerosis and to analyze its association with cardiovascular risk factors in middle-aged and elderly Chinese. Methods In 2007, the second cross-sectional examination for cardiovascular risk factors and B-mode ultrasound imaging on carotid arteries were performed in a Chinese population consisting of 2681 subjects aged 43-81 years old from two cohorts participants of the People's Republic of China/United States of America collaborative study (USA-PRC study) and the Chinese multi-provincial cohort study (CMCS). The association of cardiovascular risk factors with intima-media thickening (ITM) and plaque of carotid arteries was analyzed. Results ( 1 )The mean intima-media thickening (Mean-IMT) of carotid artery was 0. 68 mm, the maximal intima-media thickening (Max-IMT) was 1.07 mm. (2)The prevalence rate of carotid plaque was 60. 3% in all subjects.As for the different sites of carotid arteries, the plaque prevalence rate at carotid bulb was 61.2% for male and 51.6% for female( x~2 = 23.44 ,P <0. 01 ), and at the internal carotid artery was 24. 7% for male and 12. 2% for female( x~2 =69.57 ,P <0. 01 ) ,at the common carotid artery was 20. 9% for male and 13.8% for female(x~2 =23.18,P<0. 01 ). (3)After adjusting for age and other cardiovascular risk factors, the MeanIMT and Max-IMT increased with elevated levels of systolic blood pressure, plasma glucose and low density lipoproteins cholesterol (LDL-C)( all P < 0. 05 ). Hypertension, diabetes, smoking and high LDL-C (P <0. 05 ) were independent predict factors for the risk of carotid plaque. Conclusion The carotid atherosclerosis was common in middle and older age Chinese and was positively associated with classical cardiovascular disease risk factors.

Objective To evaluate the prediction value of blood lipid levels on the newly-identified carotid plaque in middle-aged and elderly Chinese population. Methods All study subjects were recruited from two cohorts from 2002 to 2007 [the People's Republic of China/United States of America collaborative study ( USA-PRC study) and the Chinese multi-provincial cohort study (CMCS)]. The baseline examination including cardiovascular disease risk factors and B-mode ultrasound of carotid artery was performed in 2002and the second examination was made in September to October, 2007. The relationship between baseline lipids and carotid plaque incidence was analyzed in a total of 2000 subjects aged 47 to 79 years ( mean 63years). Results (1) During these 5 years, the prevalence of carotid plaque increased from 30. 3% to 62. 2% and from 21.5% to 51.5% for men and women, respectively. The newly-identified carotid plaque incidence was 41.8% for men and 34. 1 % for women. (2) The incidence of artery plaque significantly increased in both sexes in proportion to increase of baseline total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and total to high-density cholesterol ratio (TC/HDL-C) levels ( P ＜ 0.05 or P ＜ 0. 01 ). (3) Cross-stratification analysis of LDL-C,triglyceride (TG) and HDL-C for carotid plaque incidence indicated the existence of conjoint effects between LDL-C and HDL-C, LDL and TG, as well as between TG and HDL-C, on the increased incidence of carotid plaque. (4) Multi-factorial analysis showed that higher LDL-C, non-HDL-C and TC/HDL-C were independent risk factors for development of new carotid plaque [OR = 1.44 (95% CI = 1.07 - 1. 94), OR =1.45(95% CI=1.08-1.96),OR=1.59(95% CI=1. 14-2.23) in men;OR=1.47(95% CI= 1. 13-1.92 ), OR = 1.35 (95% CI= 1.04 - 1.75), OR= 1. 64 (95% CI = 1.20 - 2. 23 ) in women]. Conclusions The prevalence of carotid plaque increased rapidly in this cohort between 2002 and 2007. Elevated LDL-C,non-HDL-C and TC/HDL-C levels were independent predictors of newly developed carotid plaque.

OBJECTIVETo establish a routine procedure for the detection of p53 mutations in hepatocellular carcinoma (HCC) surgical resections using the FASAY (functional analysis of separated alleles of p53 on yeast) procedure.

METHODSp53 status was analyzed by FASAY and cDNA sequencing in 50 cases of HCC. After the extraction of RNA from the frozen tumor and corresponding normal tissues, reverse transcription RT-PCR was carried out using these samples. The assay can detect mutations of p53 mRNA between codons 67 and 347 by the DNA-binding activity of the protein and reveal them as red colonies.

RESULTSOf the 50 specimens, 29 (58%) were positive (mutant) by FASAY. Sequencing analysis confirmed that all 29 FASAY positive tumors harbored mutations, and that no mutations were detectable in any FASAY negative tumors. In 29 p53 mutations, 22 mutations were point missense mutation, 5 were deletions and 2 were splicing mutations. A novel splice mutation on splice donor of intron 6 was reported, which could produce two different mRNAs, respectively using the nearest upstream and downstream recessive splice donor sites.

CONCLUSIONFASAY is a sensitive method for detecting the various types of p53 mutations in HCC, suggesting that the yeast functional assay for the detection of p53 mutations may be essential for elucidating their clinical significance.

Alternative Splicing ; genetics ; Carcinoma, Hepatocellular ; genetics ; DNA Mutational Analysis ; methods ; Gene Frequency ; Genetic Testing ; Humans ; Liver Neoplasms ; genetics ; Mutation ; Reproducibility of Results ; Sensitivity and Specificity ; Tumor Suppressor Protein p53 ; genetics

OBJECTIVETo investigate the effect and mechanism of Yangxincao Capsule (YXCC) in regulating lipids.

METHODSSixty rats were randomly divided into 6 groups, the normal control group (A), the hyperlipidemia model group (B), the high, middle and low dose YXCC treated groups (C, D and E), and the Shanzhajing (SZJ) treated group (F) for positive medicine control. Except for the rats in the normal control group, the other 50 were daily fed with fatty emulsion for 10 days to establish hyperlipidemic model. From the I th day on, in the same time of continually feeding with fatty emulsion they were administered with water, high (1.08 g/kg), middle (0.54 g/kg), low dose (0.27 g/kg) of YXCC and SZJ (5.4 mg/kg) respectively for 10 days, while to rats in Group A equal volume of water was given. At the 21th day, after rats were fasted for 16 h, their blood was extracted from post-orbital vein to detect the level of serum lipids, lipoprotein, apolipoprotein (apo) and lipid metabolic enzyme.

RESULTSCompared with Group A, the levels of serum total cholesterol (TC), triglyceride (TG) and low density lipoprotein-cholesterol (LDL-C) increased remarkably, and the level of high density lipoprotein-cholesterol (HDL-C) dropped obviously in Group B. While in the four treated groups the levels of TC, TG and LDL-C were significantly reduced, HDL-C and its sub-components 2 and 3 (HDL2-C and HDL3-C), as well as the ratio of HDL-C/TC were raised. Besides, the content of apo-Al was increased and apo-B was decreased significantly in Group C and D, activity of lecithin cholesterol acyltransferase (LCAT) and lipoprotein lipase (LPL) increased in the three YXCC treated groups, all showed statistical significance (P < 0.05 or P < 0.01) as compared with those in Group B.

CONCLUSIONYXCC could remarkably modulate the lipid metabolic disorder in hyperlipidemic rats, and has a certain bi-directional regulating function on lipoprotein, inferring that it could reduce the risk of occurring coronary artery diseases. The mechanism of regulating lipid metabolism might be related with the increasing activity of LCAT, LPL and eliminating of cholesterol by the elevated level of HDL2-C.

Animals ; Capsules ; Cholesterol ; blood ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Drugs, Chinese Herbal ; therapeutic use ; Hyperlipidemias ; drug therapy ; metabolism ; Lipoprotein Lipase ; metabolism ; Male ; Phosphatidylcholine-Sterol O-Acyltransferase ; metabolism ; Phytotherapy ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Triglycerides ; blood