ACUPUNCTURE TREATMENT OF INFANTILE DIARRHEA:A REPORT OF 1050 CASES

From Feb.1976 to Jan.1990 the authorused acupuncture to treat 1050 cases of in-fantile diarrhea with satisfactory results.Areport follows.SELECTION OF PATIENTS1.Subjects for observation:The pa-tients must have diarrhea as the main symp-tom with or without nausea and vomiting.

L-精氨酸能改善MELAS卒中样发作症状

Based on the hypothesis that mitochondrial myopathy, encephalopathy,lactic acidosis, and strokelike episodes (MELAS) are caused by impaired vasodilation in an intracerebral artery, the authors evaluated the effe cts of administering L-arginine, a nitricoxide precursor. Patients were adminis tered L-arginine intravenously at the acute phase or orally at the interictal p hase. L-Arginine infusions significantly improved all strokelike symptoms, sugg esting that oral administration within 30 minutes of a stroke significantly decr eased frequency and severity of strokelike episodes.

对有风湿病、皮质激素引起的生长发育迟缓和骨质减少症患儿的生长激素治疗

Background: In children with severe rheumatic disease (RD), treatment with cor ticosteroids (CS) is frequently needed and growth retardation and osteopenia may develop. A beneficial effect of human growth hormone (hGH) has been reported bu t mostly in trials without a control group. Aims: To study the effect of hGH on growth, bone mineral density (BMD), and body composition, taking the disease act ivity and CS use into account. Methods: Randomised controlled trial on 17 prepub ertal RD patients with growth retardation and/or decreased BMD. The hGH group (n = 10) received treatment with hGH 4 IU/m2/day (～0.045 mg/kg/ day) during two y ears. The controls (n = 7) received no GH treatment. Results: During the two yea r study period the disease activity, and use of CS and metho- trexate (MTX) did not differ between the groups. There was a significant mean increase in height standard deviation score (HSDS) in the hGH group (0.42±0.16 SDS) and a non-significant decrease in the controls (-0.18±0.11 SDS). Change in BMD did not differ significantly between the groups, although the increase in BMD for lumbar spine within the hGH group was significant. Lean body mass impro ved significantly in the hGH group compared to controls (0.64±0.19 SDS versus -0.20±0.17 SDS), while the decrease in percentage fat was not significant. Con clusions: There was a significant effect of hGH on growth and lean body mass, bu t a longer duration of treatment might be necessary to evaluate the effect of hG H on BMD.

HOXA10异常甲基化可能与子宫内膜异位症患者子宫内膜HOXA10表达异常有关

Objective: HOXA10, expressed in endometrium, plays an important role in uterine receptivity at the time of implantation. In the endometrium of women with endometriosis, its expression is reduced. The aim of this study was to determine whether the observed aberrant expression of HOXA10 is caused by aberrant methylation of the gene. Study design: Endometrial tissues were collected from 6 women with laparoscopically confirmed endometriosis, and 4 women who underwent tubal ligation and were confirmed to have no endometriosis. In addition, menstrual blood from 5 women with no gynecologic complaints was collected and also used as controls. Methylation-specific polymerase chain reaction (PCR) and bisulfite sequencing were performed in 3 fragments in 2 regions of HOXA10 to detect difference in methylation patterns. Real-time reverse transcriptase (RT)- PCR was also performed to measure expression levels of HOXA10 in select cases and controls. Results: In all 3 fragments, there were highly statistically significant differences in methylation patterns between women with endometriosis and those without endometriosis. The expression level of HOXA10 was lower in women with endometriosis than those without, as previously reported. Conclusion: There is aberrant methylation in the endometrium of women with endometriosis compared with those without endometriosis. The aberrant methylation at HOXA10 may be responsible for the aberrant gene expression in the endometrium of women with endometriosis. This finding suggests that endometriosis may also be an epigenetic disease.

青少年血管迷走神经性晕厥与内脏血容量过多有关

Background-The mechanisms of simple faint remain elusive. We propose that postural fainting is related to excessive thoracic hypovolemia and splanchnic hypervolemia during orthostasis compared with healthy subjects. Methods and Results-We studied 34 patients 12 to 22 years old referred for multiple episodes of postural faint and 11 healthy subjects. Subjects were studied in the supine position and during upright tilt to 70°for 30 minutes and subgrouped into S+, historical fainters who fainted during testing (n=24); S-, historical fainters who did not faint during testing (n=10); and control subjects. Supine venous occlusion plethysmography showed no differences between blood flows of the forearm and calf in S+, S-, or control. Cardiac index, total peripheral resistance, and blood volume were not different. Using impedance plethysmography, we assessed blood redistribution during upright tilt. This demonstrated decreased thoracic blood volume and increased splanchnic,pelvic, and leg blood volumes for all subjects. However, thoracic blood volume was decreased in S+compared with control volume, correlating well with the maximum upright heart rate. Splanchnic volume was decreased in the S+and S-groups, correlating with the change in thoracic blood volume. Pelvic and leg volume changes were similar for all groups and uncorrelated to thoracic blood volume. Conclusions-Enhanced postural thoracic hypovolemia and splanchnic hypervolemia are associated with postural simple faint.

糖尿病酮症酸中毒患儿的脑水肿机制

目的:糖尿病酮症酸中毒(DKA)患儿,在治疗过程中会因其脑细胞渗透性水肿而导致脑水肿。本文以治疗期DKA患儿作为研究对象,测定其脑脊液的分布和灌注情况。研究方法:根据加权MRI对脑组织进行弥散成像和灌注成像,检测14例治疗期DKA患儿,确定显著性弥散系数(ADC),同时检测相应的脑灌注量。结果:在患儿治疗期间(一般处于弥散期),除枕部灰质外,其他部位ADC均见显著性增高。从前期治疗到后期恢复, MRI图像反映的各部位弥散系数平均减少量如下:基底部(4.7±2.5)×10-5 mm2/s(P=0.002),丘脑(3.7±2.8)×10-5 mm2/s(P=0.002),导水管部灰质(4.3±5.1)×10-5 mm2/s(P=0.03),额部的白质(2.0±3.1) ×10-5 mm2/s(P=0.03)。对比整个治疗过程的MRI 图像,以枕部灰质的ADC增加最为显著[平均增加(3.9±3.9)×10-5 mm2/s(P=0.004)]。所以,在DKA 治疗期间,可利用MRI检测脑灌注值,呈现显著变化性的两个指标为:平均透过时间(MMTs)和浓度曲线峰值,前者过短,后者偏高,二者可提示大脑血流量(CBF)增多。结论:在DKA患儿治疗期间,ADC值上升,证明脑水肿形成是一个血管源性的过程,而非渗透性的细胞水肿。

血清细胞色素C、细胞因子和其他实验室检测指标对急性脑病伴多器官衰竭预后的预测价值

Aims: To evaluate the prognostic predictive values of cytochrome c, cytokines, and other laboratory measurements inserum collected during neurological onset in acute encephalopathy with multiple organ failure. Methods: In addition to general laboratory examinations, the concentrations of cytochrome c (apoptosis marker) and cytokines (inflammatory markers) were measured in serum samples collected at the initial phase in 29 patients with acute encephalopathy. The obtained values were evaluated as predictors for the development of severe encephalopathy. Results: Cytochrome c, tumour necrosis factor α(TNF-α), interleukin 6 (IL-6), soluble TNF-receptor1 (sTNF-R1), and aspartate aminotransferase (AST) concentrations at the initial phase were high and correlated well with patient outcome. High concentrations of serum cytochromec (>45 ng/ml), sTNF-R1 (>2000 pg/ml), AST (>58 IU/dl),IL-6 (>60 pg/ml), and TNF-α(>15 pg/ml) predicted an unfavourable prognosis (sequelae and death) at 93%, 79%, 82%,77%, and 60%, respectively. The specificity of those markers was 100%, 89%, 83%, 100%, and 100%, respectively. Conclusions:Serum cytochrome c is the most sensitive and specific predictor for the development of severe encephalopathy at the initial phase. Results suggest that this marker might be used to guide decisions regarding the start of the initial treatment and further intensive care.

Likelihood of hospitalization for a chronic respiratory condition following pediatric infection with enterovirus and rhinovirus strains

Background:Rhino-enteroviruses,particularly enterovirus strain D68(EV-D68),have been associated with severe respiratory distress in children.The goal of this study was to compare the long-term outcomes of children with EV-D68 infection to that of children with other enterovirus/rhinovirus.Methods:Nasopharyngeal swabs from 174 children presenting with respiratory distress were tested by PCR for respiratory viruses.The primary outcome was diagnosis of a chronic respiratory condition within the followup period.Admission to intensive care,and length of stay were recorded.Odds ratios were determined using multinomial logistic regression.Results:During 5 years of follow-up,the crude odds of diagnosis with a chronic respiratory condition were significantly more likely in EV-D68 cases(OR:1.95,95%CI:1.02,3.82),but failed to remain significant after adjusting for a past history of asthma.Upon admission for a primary concern of asthma,length of stay both in hospital and intensive care were significantly longer in EV-D68 cases(OR:2.10[95%CI:1.56,2.82,p<0.001])and(OR:5.18[95%CI:1.90,6.28,p<0.001]),respectively.After adjustment for a history of asthma,EV-D68 cases had significantly longer length of stay in hospital,admitted for 1.94 days for each day that controls were admitted(95%CI:1.40,2.68).In admissions to intensive care,EV-D68 cases spent 2.74 days for each day of admission in controls(95%CI:1.62,4.97,p<0.001).Conclusions:Ours is first study to assess prognostic respiratory outcomes of patients infected with EV-D68 in childhood.Our study finds that EV-D68 cases were significantly more likely be hospitalized for longer than other enterovirus/rhinovirus controls in subsequent admissions for respiratory distress.Need for intensive care was significantly longer in EV-D68 infections.Our next steps will be validation in a larger sample size.

Dysregulated neutrophilic cell death in SLE:a spotlight on ferroptosis

In the recent issue of Nature Immunology,Li et al.present a mechanistic insight into neutrophilic cell death and its role in systemic lupus erythematosus(SLE).1 Several groups reported an altered neutrophil function and enhanced neutrophilic cell death in SLE patients that provoke a sustained interferon(IFN)production.2 In a recent issue of Nature they report that enhanced ferroptosis in neutrophils results in a breakdown of immune tolerance in SLE.1 Ferroptosis has recently been identified as a novel type of regulated cell death that is driven by lipid peroxidation.Ferroptosis is implicated in a variety of pathological contexts such as cancer,(neuro-)degenerative diseases,but also in immune-mediated diseases such as non-alcoholic steatohepatitis(NASH),diabetes,multiple sclerosis(MS),and asthma.3 Nevertheless,cell-specific functions of ferroptosis remained less clear.Neutrophils are known to spontaneously undergo cell death,which is partially related to their high ROS production.