Clinical characteristics of pediatric synovitis,acne, pustulosis,hyperostosis, and osteitis (SAPHO) syndrome: the first Chinese case series from a single center

Clinical Rheumatology - Pediatric SAPHO syndrome is regarded as the equivalent of chronic recurrent multifocal osteomyelitis or chronic non-bacterial osteomyelitis. This study aimed to evaluate the...     

Comparison of clinical manifestations and epidemiology between acute hepatitis A and acute hepatitis E in Taiwan

BACKGROUND AND AIMS: Acute hepatitis A (AHA) and acute hepatitis E (AHE) are endemic in developing countries. They share similar transmission routes and clinical manifestations. To compare the differences in epidemiology, clinical picture and prognosis between these two enterically transmitted forms of hepatitis, we enrolled 58 consecutive AHA or AHE patients (42 men and 16 women; age 16-74 years) from January 1990 to April 2001. RESULTS: In comparison to AHA, patients with AHE were older (56.2 +/- 15.4 vs 30.7 +/- 11.0 years, P < 0.0001), and more frequently had a history of travel within 3 months before onset of illness (68.8 vs 30.8%, P = 0.003). In laboratory data, AHE patients had lower serum levels of albumin (3.4 +/- 0.4 vs 3.8 +/- 0.4 g/dL, P = 0.016), alanine aminotransferase (1912 +/- 1587 vs 3023 +/- 1959 U/L, P = 0.015), and aspartate aminotransferase (1681 +/- 1444 vs 2374 +/- 2869 U/L, P = 0.24), but a higher serum bilirubin level (17.8 +/- 12.3 vs 8.7 +/- 5.0 mg/dL, P = 0.003) than AHA patients. Moreover, five (15.6%) patients with AHE compared with none with AHA died. This probably indicates that AHE had a worse outcome than AHA in our study. In analysis of epidemiological factors, older age of onset of illness was the only significant predicator of outcome. From an epidemiological survey, most AHE patients were imported while most AHA patients were not. However, native AHE and imported AHA did occur in Taiwan. CONCLUSION: Patients with AHE in Taiwan had older age of onset, more records of traveling history, and poorer clinical manifestations than those with AHA, and age seemed to be the most important factor to influence outcome.     

Kidney Transplantation in Patients with Chronic Hepatitis B Virus Infection

The impact of hepatitis B virus (HBV) infection on the long-term outcome of kidney transplant patients is controversial. A total of 34 chronic hepatitis B surface antigen (HBsAg) carriers among 143 renal allograft recipients were identified in this study (mean follow-up period: 5.6 ± 3.3 years; range: 1–13 years). During the follow-up, one HBsAg-positive recipient with preexisting cirrhosis died of liver failure, and seven (21%) others developed serious HBV-related complications (four fulminant hepatitis, two hepatocellular carcinoma, one cirrhosis), and four died. Although HBsAg-positive recipients had a higher rate of liver-related complications and deaths than HBsAg-negative recipients did, there were no significant differences in the long-term graft and patient survival between the two groups. The survival rates, liver-related complications, and deaths in HBsAg-positive allograft recipients and 28 HBsAg-positive uremic patients under dialysis were similar. In conclusion, HBV infection is not a contraindication to kidney transplantation. However, pretransplant candidates should be warned of potentially serious liver-related complications.     

Clinical outcomes and survival analysis in patients with psycho-cardiological disease: a retrospective analysis of 132 cases

ObjectivesThe deleterious effects of psychological problems on coronary heart disease (CHD) are not satisfactorily explained. We explored influential factors associated with mortality in psycho-cardiological disease in a Chinese sample.MethodsOf 7460 cardiac patients, we selected 132 patients with CHD and mental illness. Follow-up was conducted via telephone. We analyzed clinical characteristics, clinical outcomes, and survival.ResultsThe clinical detection rate of psycho-cardiological disease in the overall patient population was 1.8%. Of these, 113 patients completed follow-up; 18 died owing to cardiovascular diseases during follow-up. Kaplan–Meier analysis showed dysphagia, limb function, self-care ability, percutaneous coronary intervention, low-density lipoprotein, total cholesterol, pro-brain natriuretic peptide and high-sensitivity (hs) troponin T had significant associations with cumulative survival. Cox regression analysis showed total cholesterol (hazard ratio [HR]: 2.765, 95% confidence interval [CI]: 1.001–7.641), hs troponin T (HR: 4.668, 95% CI: 1.293–16.854), and percutaneous coronary intervention (HR: 3.619, 95% CI: 1.383–9.474) were independently associated with cumulative survival.ConclusionsThe clinical detection rate of psycho-cardiological disease was far lower than expected. Normal total cholesterol and hs troponin T were associated with reduced cardiovascular disease mortality over 2 years. Percutaneous coronary intervention is a prognostic risk factor in patients with psycho-cardiological disease.     

Transmissible gastroenteritis virus infection induces cell cycle arrest at S and G2/M phases via p53-dependent pathway

p53 signaling pathway plays an important role in the regulation of cell cycle. Our previous studies have demonstrated that TGEV infection induces the activation of p53 signaling pathway. In this study we investigated the effects of TGEV infection on the cell cycle of host cells and the roles of p53 activation in this process. The results showed that TGEV infection induced cell cycle arrest at S and G2/M phases in both asynchronous and synchronized PK-15 and ST cells, while UV-inactivated TGEV lost the ability of induction of cell cycle arrest. TGEV infection promoted p21 accumulation, down-regulated cell cycle-regulatory proteins cyclins B1, cdc2, cdk2 and PCNA. Further studies showed that inhibition of p53 signaling could attenuate the TGEV-induced S- and G2/M-phase arrest by reversing the expression of p21 and corresponding cyclin/cdk. In addition, TGEV infection of the cells synchronized in various stages of cell cycle showed that viral genomic RNA and subgenomic RNA, and virus titer were higher in the cells released from S-phase- or G2/M phase-synchronized cells than that in the cells released from the G0/G1 phase-synchronized or asynchronous cells after 18 h p.i. Taken together, our data suggested that TGEV infection induced S and G2/M phase arrest in host cells, which might provide a favorable condition for viral replication.     

社区康复联合药物治疗对农村社区精神分裂症患者康复的效果

目的研究社区康复联合药物治疗对农村社区精神分裂症患者康复的效果,为我国农村地区精神分裂症患者社区康复提供参考。方法选择兰州新区三个镇农村社区中符合《国际疾病分类(第10版)》(ICD-10)精神分裂症诊断标准的患者81例,按随机数字表法分为研究组(n=39)和对照组(n=42),两组均接受一般药物治疗,研究组在此基础上接受6个月的社区康复干预。于干预前后采用阳性和阴性症状量表(PANSS)、日常生活能力量表(ADL)、社会功能缺陷筛选量表(SDSS)和精神分裂症患者生活质量量表(SQLS)评定两组患者的精神病性症状、社会功能和生活质量。结果干预后,研究组PANSS总评分[(55.54±14.75)分vs.(63.52±13.95)分,t=-2.504,P=0.014]、阴性症状[(15.64±4.50)分vs.(18.38±5.13)分,t=-2.547,P=0.013]和一般精神病理分量表评分[(25.67±7.39)分vs.(30.35±6.60)分,t=-3.015,P=0.003]均低于对照组;研究组SDSS总评分[(8.21±3.78)分vs.(10.21±4.67)分,t=-2.118,P=0.037]和SQLS总评分[(18.97±6.23)分vs.(22.43±8.04)分,t=2.150,P=0.035]均低于对照组,差异均有统计学意义。结论社区康复联合药物治疗可能有助于减轻农村社区精神分裂症患者的精神病性症状,提高社会功能,改善生活质量。     

Combination of Radiological and Gray Level Co-occurrence Matrix Textural Features Used to Distinguish Solitary Pulmonary Nodules by Computed Tomography

The objective of this study was to investigate the method of the combination of radiological and textural features for the differentiation of malignant from benign solitary pulmonary nodules by computed tomography. Features including 13 gray level co-occurrence matrix textural features and 12 radiological features were extracted from 2,117 CT slices, which came from 202 (116 malignant and 86 benign) patients. Lasso-type regularization to a nonlinear regression model was applied to select predictive features and a BP artificial neural network was used to build the diagnostic model. Eight radiological and two textural features were obtained after the Lasso-type regularization procedure. Twelve radiological features alone could reach an area under the ROC curve (AUC) of 0.84 in differentiating between malignant and benign lesions. The 10 selected characters improved the AUC to 0.91. The evaluation results showed that the method of selecting radiological and textural features appears to yield more effective in the distinction of malignant from benign solitary pulmonary nodules by computed tomography.     

人工智能技术在创伤救治中的应用及研究进展

创伤引起的多发伤致残率和致死率高,救治难度大但目前创伤救治的医疗模式仍然存在不足,创伤患者的救治面临巨大挑战。人工智能(AI)是基于机器学习、强化学习和深度学习等基础算法的智能技术,现已应用于创伤患者的救治工作中,其高效精准的计算机视觉、规划决策以及大数据统计分析等技术方向既提高了创伤患者救治的安全性和效率,同时也降低了临床医师的工作负荷,弥补了传统创伤救治模式的不足。笔者对AI在创伤急诊分诊、诊断、治疗及战创伤预防等方面的应用及研究进展进行综述,为AI的临床应用提供参考。     

Platinum accumulation in oxaliplatin‐induced peripheral neuropathy

Oxaliplatin‐induced peripheral neuropathy (OIPN) is a common and dose‐limiting toxic effect that markedly limits the use of oxaliplatin and affects the quality of life. Although it is common, the underlying mechanisms of OIPN remain ambiguous. Recent studies have shown that the platinum accumulation in peripheral nervous system, especially in dorsal root ganglion, is a significant mechanism of OIPN. Several specific transporters, including organic cation transporters, high‐affinity copper uptake protein1 (CTR1), ATPase copper transporting alpha (ATP7A) and multidrug and toxin extrusion protein 1 (MATE1), could be associated with this mechanism. This review summarizes the current research progress about the relationship between platinum accumulation and OIPN, as well as suggests trend for the future research.