Ocular cicatricial pemphigoid(OCP)is a special manifestation of mucosal pemphigoid(mucous membrane pemphigoid, MMP), and the pathogenesis is not clear at present. It can be caused by variety factors such as antigen-antibody reaction, inflammation cell infiltration, the action of various cytokines, elevated calcium ion levels and susceptibility genes. In the early period of diseases, conjunctival present chronic progressive fibrotic inflammation, later the corneal opacity and the neovascularization will eventually lose vision. Therefore, it is particularly important to carry out clinical standardized treatment for OCP patients in a timely manner. To use medicine to control the inflammation and delay the progression of the disease, for example, dapsone, intravenous immunoglobulin(IVIG), rituximab(RTX), tumor necrosis factor antagonists and adrenocorticoids. Surgical treatment can be considered appropriately when OCP patients are complicated by severe trichiasis, corneal disease and cataract.

Objective To evaluate the value of bacteria culture and antimicrobial susceptibility test of bronchoalveolar lavage fluid(BALF) in diagnosis and treatment of refractory pneumonia in children.Methods Three hundred and sixty-eight patients who failed to a 2 weeks,routine antibiotic therapy,hospitalized in Department of Respiration,Tianjin Children's Hospital from Aug.2010 to Dec.2011,were diagnosed as refractory pneumonia.They were examined with fiberoptic bronchoscopy,BALF was collected,and bacteria culture and antimicrobial susceptibility test in BALF were performed.Results One hundred and ninety-five stains of bacteria were identified from BALF of 181 cases.There were 10 (5.1％) gram-positive stains (7 Streptococcus pneumonia and 3 Staphylococcus aureus),48 stains (24.6％) were gram-negative bacterial,and the predominant were Pseudomonas aeruginosa (23 stains,11.8 ％),followed by Serratia marcescens and Stenotrophomonas maltophilia (6 stains respectively,3.1％).There were 1 Staphylococcus aureus with positive beta-lactamases and 1 Pseudomonas fluorescens with positive AmpC enzyme.There were 1 fungi (0.5％)and 136 parasitic bacteria stains(69.7％).Gram-positive stains were universally resistant to Erythromycin,Penicillin,Cefuroxime,and susceptible to Chloramphenicol,Levofloxacin,Vancomycin.Gram-negative stains were universally resistant to Ampicillin,Cefazolin,Cefuroxime,Cefotaxime,and susceptible to Amikacin,Cefepime,Cefoperazone sulbactam,Meropenem,Imipenem,Levofloxacin,Ceftazidime,Piperacillin.There were mixed infection in most children and the predominant pathogen was Mycoplasma pneumoniae.Conclusions Bacteria culture of BALF is relatively reliable and instructively recommended for the treatment of refractory pneumonia in children,meanwhile,it can help choose the antibiotics reasonably.

OBJECTIVETo study the significance and safety of flexible bronchoscopy and balloon dilatation in the diagnosis and treatment of respiratory diseases in children.

METHODSA total of 438 children (236 males and 202 females) with respiratory diseases who were aged from 17 days to 15 years, were examined and/or treated by bronchoscopy (including bronchoscopic intervention) under local anesthesia.

RESULTSOf the 438 children, 311 were diagnosed with pulmonary infection, 68 with atelectasis, 36 with recurrent cough and asthma, 6 with hemoptysis of unknown origin, 6 with bronchial foreign body, 5 with congenital bronchopulmonary dysplasia, 2 with bronchiectasis, 1 with ciliary dyskinesia syndrome, 1 with lung tumor, and 2 with congenital immunodeficiency disease. After bronchoscopic examination, local flushing or bronchoalveolar lavage, and foreign body extraction, marked response was seen in 379 cases and response was seen in 46 cases. High-pressure balloon dilatation under bronchoscopy was performed in 5 cases with inflammatory stricture and achieved satisfying clinical effect. No severe complications were found in bronchoscopy.

CONCLUSIONSBronchoscopy and balloon dilatation under local anesthesia is safe and effective for the diagnosis and treatment of respiratory diseases in children.

Adolescent ; Anesthesia, Local ; Bronchoscopy ; adverse effects ; methods ; Child ; Child, Preschool ; Dilatation ; methods ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Respiratory Tract Diseases ; diagnosis ; therapy

BACKGROUNDAdrenocorticotrophin (ACTH)-secreting pituitary adenomas account for approximately 7% - 14% of all pituitary adenomas, but its pathogenesis is still enigmatic. This study aimed to explore mechanisms underlying the pathogenesis of ACTH-secreting pituitary adenomas.

METHODSWe used fiber-optic beadarray to examine gene expression in three ACTH-secreting adenomas compared with three normal pituitaries. Four differentially expressed genes from the three ACTH-secreting adenomas and three normal pituitaries were chosen randomly for validation by reverse transcriptase-real time quantitative polymerase chain reaction (RT-qPCR). We then analyzed the differentially expressed gene profile with Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway.

RESULTSFiber-optic beadarray analysis showed that the expression of 28 genes and 8 expressed sequence tags (ESTs) were significantly increased and the expression of 412 genes and 31 ESTs were significantly decreased. Bioinformatic and pathway analysis showed that the genes HIGD1B, EPS8, HPGD, DAPK2, and IGFBP3 and the transforming growth factor (TGF)-β signaling pathway and extracellular matrix (ECM)-receptor interaction pathway may play important roles in tumorigenesis and progression of ACTH-secreting pituitary adenomas.

CONCLUSIONSOur data suggest that numerous aberrantly expressed genes and several pathways are involved in the pathogenesis of ACTH-secreting pituitary adenomas. Fiber-optic beadarray combined with pathway analysis of differential gene expression appears to be a valid method of investigating tumour pathogenesis.

ACTH-Secreting Pituitary Adenoma ; etiology ; genetics ; Adenoma ; etiology ; genetics ; Adult ; Disease Progression ; Expressed Sequence Tags ; Extracellular Matrix Proteins ; physiology ; Female ; Fiber Optic Technology ; Gene Expression Profiling ; Humans ; Male ; Middle Aged ; Oligonucleotide Array Sequence Analysis ; methods ; Real-Time Polymerase Chain Reaction ; Reverse Transcriptase Polymerase Chain Reaction ; Signal Transduction ; physiology ; Transforming Growth Factor alpha ; physiology

genes.