Objective To summarize the clinical manifestations of 46, XX ovotesticular disorder of sex development (DSD) caused by a NR5A1 heterozygous mutation. Methods The first case of 46,XX ovotesticular DSD was caused by a NR5A1 heterozygous mutation in China and was reported with a review of 11 similar cases in the literatures since July 2016. Results A 5. 6-year-old child raised as female was born with ambiguous genitalia. The left gonad was palpable in the inguinal region while the right one was located in abdomen. Gonadal histology showed both ovotestis. Vaginoscopy revealed a short, blind-ending vagina. No uterine was detected by laparoscopy. Repeated karyotype results were 46, XX with SRY gene negative. A heterozygous de novo mutation ( p. Arg92Trp) in the accessory DNA-binding region of NR5A1 gene was found in that child. Conclusions We reported for the first time in China a new phenotype caused by a NR5A1 heterozygous mutation-46,XX ovotesticular DSD. According to the review of literatures, such mutation seemed with incomplete penetrance. It could cause both 46, XX DSD and 46, XY DSD with varied manifestations. The possible underlying mechanism might relate to the impairment of the binding between the mutant protein and target DNA which might lead to a decreased inhibition of the male developmental pathway through downregulation of female antitestis genes.

Posterior circulation ischemia (PCI) is a common disease and frequent encountered disease in clinical practice. It refers to the transient ischemic attack and the cerebral infarction in vertebral-basilar artery system. Vertebral aretery atherosclerosis is one of the common causes of PCI. Imaging examinations for PCI include transcranial Doppler (TCD), digital subtraction angiography (DSA), computerized tomographic angiography (CTA), magnetic resonance angiography (MRA), color Doppler ultrasound (CDU) and so on. TCD can serve as initial screening tool in diagnosis of PCI. DSA is still thegold standardin diagnosis of vertebral-basilar abnormalities, although the operation injury and photography drugs poisonousness have not been resolved. CTA has almost the same defects as DSA, while MRA is noninvasive. Some researches have reposed that MRA can exaggerate the vertebral artery depression level. The inner diameter and hemodynamics of the vertebral artery can be accurately measured by CDU, and it can be seen as a noninvasive examination for PCI,which is direct, accurate, convenient and repeatable. It can provide positive evidence for diagnosis and treatment of PCI. This article reviews the progess of CDU in diagnosis of vertebral aretery atherosclerosis.

Objective To explore the influence of self-management education on the quality of life of parents of asthma children. Methods Forty-eight parents of children with asthma underwent one-year intervention of self-management.The results were assessed on the basis of two kinds of questionnaires,the Generic Quality of Life Inventory-74(GQOLI-74)and a self-designed psychological pressure questionnaire.Results After intervention,the scores of person and family,economic burden,lifelong care,lack of sense of accomplishment and overprotection were diminished,compared to those before intervention(P<0.05).There were also significant differences between pre-and post-intervention in the four dimensions with 20 factors(P<0.05 or P<0.01).Conclusion The self-management education can ease parents' psychological pressure and increase their quality of life.

Objective To prove into the effect of parental involvement in nursing to discharged children with metabolic syndrome.Methods Forty-six children with metabolic syndrome were equally divided into the observation group and the control group according to the order of admittance.Both groups accepted health education,guide to lifestyle and so on.After leaving hospital,the observation group accepted parental involvement in nursing,while the control group accepted physical examination regularly.Then the lifestyles,physical indicators,blood pressure and biochemical indicators of both groups were compared.Results The lifestyle of the observation group was significantly greater than that of the control group(All P<0.01).The observation group had greater declines in waist,blood pressure,TC,TG and LDL-C and a greater increase in HDL-C than those of the control group.Conclusions Parental involvement in nursing can improve the lifestyle of children patients,which is good for the declines of their weigh and blood lipid.This treatment can achieve the goal of control and treatment of children metabolic syndrome.

Objective To conduct comparative study of vertebral artery blood flow of arteriosclerosis patients and healthy people using color Doppler ultrasound (CDUS),and to discuss the effect of arteriosclerosis on vertebral arterial blood flow.Methods Two hundred and eighty-five cases of vertebral artery test were collected and divided in to normal group of one hundred and thirty-five cases and vertebral artery sclerosis group of one hundred and fifty cases according to the presence of vertebral artery sclerosis.Time averaged maximum velocity (TAMV) and vertebral artery diameter(D) of vertebral artery were measured using CDUS technique.Unilateral vertebral artery blood flow and total blood flow were calculated.Results The vertebral artery TAMV and total blood flow of arteriosclerosis group was both lower than that of normal group (P＜0.05).Left side vertebral artery diameters of the two groups were higher than that of the right side.Conclusions Arteriosclerosis can reduce vertebral artery TAMV and blood flow.The inner diameter of the left side vertebral artery dominates the artery blood flow.

Objective To conduct comparative study of healthy vertebral artery (VA) blood flow of subjects from plain and plateau region using color Doppler ultrasound (CDUS) measurement,and to investigate the influence of plateau on blood flow of VA.Methods One hundred and thirty-five subjects from plain region and eighty from high altitude region were recruited.Time averaged maximum velocity and inradium (D) of VA were measured with CDUS technology.Unilateral VA blood flow and total blood flow were calculated.Peripheral blood viscosity measurement was carried out by testing low cut,mid cut,high cut,plasma viscosity and red blood cell count (RBC),hemoglobin concentration (HGB),hematocrit (HCT).Results VA diameter,blood viscosity,RBC,HGB,and HCT of plateau group are all higher than that of the plain group (P＜0.05),while the total blood flow was lower than that of plain group and the value of male was higher than that of female (P＜0.05).The inradiums of right side VA were larger than that of the left side (P＜0.05) in plain group,while no difference was observed in plateau group (P＞0.05).Conclusions Long term (＞10 years) living in plateau hypoxia (altitude＞3 000 m) environment can reduce the average flow velocity and the blood flow of VA.

Objective To study the imaging findings of disseminated pulmonary tuberculosis in patients with acquired immunodeficiency syndrome (AIDS).Methods X-ray and multi-slice CT (MSCT)data from 33 AIDS patients with disseminated pulnonary tuberculosis confirmed by clinical manifestations and laboratory tests were analyzed retrospectively.Results Thirty patients underwent initial chest radiography examination,29 patients showed abnormal appearances,including bilateral disseminations in 21 patients and unilateral multiple disseminations in 8 patients.All patients underwent MSCT examination,26 patients showed bilateral disseminations and 7 patients showed unilateral multiple disseminations.The abnormal pulmonary appearances included nodule (n =25),miliary nodule (n =22),air-space consolidation (n =22),cavity (n =11),fibrosis (n =7),ground-glass opacity (n =7),pneumatocele (n =4),calcification (n =2).There were 20 patients with more than 3 abnormal appearances and 13 patients with one or two abnormal appearances.The extra-pulmonary tuberculosis included pleural effusion (n =33),lymphadenopathy (n =30),intestinal tuberculosis (n =3),splenic tuberculosis (n =1) and cerebral tuberculosis (n =1).Conclusion Disseminated pulmonary tuberculosis should be highly suspected in AIDS patients with diffused nodules,miliary nodules,air-space consolidations or multiple cavities,accompanied with pleural effusion and lymphadenopathy.

OBJECTIVETo appraise the clinical efficacy, safety and compliance of the intervention of spleen-restoring decoction combined with dormancy hygiene education and the intervention of spleen-restoring decoction alone on sub-healthy insomnia of deficiency of both the heart and spleen pattern.

METHODStudy design took multi-centers, blind and randomized control trial, 107 participants with sub-healthy insomnia of deficiency of both the heart and spleen pattern were assigned to A group (52 cases) which was treated with the intervention of spleen-restoring decoction combined with dormancy hygiene education and B group (55 cases) which was treated with the intervention of spleen-restoring decoction single, compared by efficacy, PSQI score, CGI score, WHOQOL-BREF score and security.

RESULTThe efficacy of two group was 79.58%. There was no significant different between them. The PSQI scores before treatment was (11.80 +/- 2.08) and which afer treatment was (6.78 +/- 2.84) of A group. The PSQI scores before treatment was (11.61 +/- 2.00) and which afer treatment was (6.73 +/- 2.27) of B group. There was significant difference in PSQI scores both A group and B group after treatment (P < 0.01); the results of CGI score and WHOQOL-BREF score before and after measurement showed the same as PSQI. There were no significant difference between two groups in all scores after treatment and there was no interaction between time pots and treatment factors . Withdrawal reaction analysis: comparing CGI after withdraw 2 weeks and at the end of treatment course, there was no significant difference between two groups. The same result was in comparison among groups.

CONCLUSIONBoth the intervention of spleen-restoring decoction integrating with dormancy hygiene education and spleen-restoring decoction had obvious clinical efficacy on treating subhealthy insomnia of deficiency of both the heart and spleen pattern, and had high compliance and safety. The intervention of spleen-restoring decoction integrating with dormancy hygiene education showed no better clinical efficacy than spleen-restoring decoction did.

Adult ; Female ; Health Education ; Humans ; Hygiene ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Sleep Initiation and Maintenance Disorders ; drug therapy ; physiopathology ; Splenic Diseases ; drug therapy

Objective To investigate the correlation of ankle-brachial index( ABI)., color doppler ultrasound spectrum and toe-brachial index (TBI) of lower extremity artery in diabetic patients. Methods ABI, TBI and color doppler ultrasound spectrum measurement were carried out on 109 lower extremity artery of 55 diabetic patients. Croups were assigned according to ABI and TBI values and the correlation of ABI and color doppler ultrasound spectrum as well as ABI and TBI. Results The changes of ABI and of color doppler ultrasound spectrum in Group A1(0.9

OBJECTIVE: To analyze the indications of the therapies for rheumatoid arthritis (RA) with neural network model analysis. METHODS: Three hundred and ninety-seven patients were included in the clinical trial from 9 clinical centers. They were randomly divided into Western medicine (WM) treated group, 194 cases; and traditional Chinese herbal medicine (CM) treated group, 203 cases. A complete physical examination and 18 common clinical manifestations were prepared before the randomization and after the treatment. The WM therapy included voltaren extended action tablet, methotrexate and sulfasalazine. The CM therapy included Glucosidorum Tripterygii Totorum Tablet and syndrome differentiation treatment. The American College of Rheumatology 20 (ACR20) was taken as efficacy evaluation. All data were analyzed on SAS 8.2 statistical package. The relationships between each variable and efficacy were analyzed, and the variables with P<0.2 were included for the data mining analysis with neural network model. All data were classified into training set (75%) and verification set (25%) for further verification on the data-mining model. RESULTS: Eighteen variables in CM and 24 variables in WM were included in the data-mining model. In CM, morning stiffness, swollen joint number, peripheral immunoglobulin M (IgM) level, tenderness joint number, tenderness, rheumatoid factor (RF), C-reactive protein (CRP) and joint pain were positively related to the efficacy, and disease duration and more urination at night negatively related to the efficacy. In WM, erythrocyte sedimentation rate (ESR), weak waist, white fur in tongue, joint pain, joint stiffness and swollen joint were positively related to the efficacy, and yellow fur in tongue, red tongue, white blood negatively related to the efficacy. In the analysis with the neural network model in the patients of verification set, the predictive response rates of 20% patients would be 100% and 90% in the treatment with CM and WM, respectively. CONCLUSION: Neural network model analysis, based on the full clinical trial data with collection of both traditional Chinese medicine and modern medicine diagnostic information, shows a good predictive role for the information in the efficacy in rheumatoid arthritis.