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2012 Vol. 3, No. 4

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Original Contributions
Relationship between Insulin-like Growth Factor and Patients with Systemic Sclerosis
Wei DU, Yun LI, Xiao-fei MAO, Tao ZHANG, Kai FANG, Qiu-ning SUN
2012, 3(4): 370-374. doi: 10.3969/j.issn.1674-9081.2012.04.002
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  Objective  To analyze the role of insulin-like growth factor (IGF) in patients with systemic sclerosis (SSc) and explore the relationship between these cytokines and the clinical characteristics of SSc.  Methods  Serum samples were obtained from 24 SSc patients[12 patients with diffuse cutaneous SSc (dcSSc) and 12 patients with limited cutaneous SSc (lcSSc)], 12 healthy controls and 6 patients with systemic lupus erythematosus (SLE). The levels of circulating IGF-Ⅰ, IGF-Ⅱ, insulin-like growth factor binding protein (IGFBP)-3, IGFBP-5, IGFBP-related protein 1 (IGFBP-rP1), and transforming growth factor-β1 (TGF-β1) were measured with ELISA kits.  Results  The mean serum IGF-Ⅰ and IGFBP-3 levels were significantly higher in SSc patients than in healthy controls[(49.21±37.94) ng/ml vs. (15.54±9.07) ng/ml; (3.38±2.09) ng/ml vs. (1.00±0.83) ng/ml, both P < 0.001]. A positive correlation between serum IGF-Ⅰ and IGFBP-3 levels was found (r=0.883, P < 0.001). Serum IGF-Ⅰ and IGFBP-3 levels were not associated with age, disease course, and the modified Rodnan total skin thickness score. There were no significant differences in serum IGF-Ⅰ and IGFBP-3 levels between patients with Scl-70 antibody and patients without Scl-70 antibody. Also, the serum IGF-Ⅰ and IGFBP-3 levels showed no significant difference between patients with pulmonary interstitial fibrosis and patients without pulmonary interstitial fibrosis. There were no significant differences in serum IGF-Ⅱ, IGFBP-5, and IGFBP-rP1 levels between patients with SSc and healthy controls.  Conclusion  Serum IGF-Ⅰ and IGFBP-3 levels increase in SSc patients. IGF may play a role in pathogenesis of SSc.
Bullous Pemphigoid Complicated with Tuberculosis: Report of 4 Cases and Literature Review
Ya-gang ZUO, Hong-zhong JIN, Hong-wei WANG, Ju QIAO, Yue-hua LIU, Jie LIU, Qiu-ning SUN, Jia-bi WANG
2012, 3(4): 375-380. doi: 10.3969/j.issn.1674-9081.2012.04.003
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  Objective  To explore the clinical and laboratory characteristics of bullous pemphigoid (BP) complicated with tuberculosis.  Methods  The clinical data of 4 inpatients with BP complicated with tuberculosis, who were diagnosed and treated in Department of Dermatology, PUMC, from January 1990 to April 2012, were retrospectively analyzed, and meanwhile the relevant literature was reviewed.  Results  Purified protein derivative (PPD) test showed negative results in three patients and positive in the remaining one patient. The level of eosinophils in all these 4 cases remarkably increased and was parallel with the severity of the disease. Three patients received rifampicin and prednisone combination therapy and the remaining one patient was treated with isoniazide, ethambutal, pyrazinamide, and corticosteroid. The dose of prednisone exceeded 180 mg/d in 2 patients. Clinical complete remission of bulla was achieved in 3 patients, and tuberculosis was also controlled. Intravenous immunoglobulin showed short-term efficacy in 2 patients.  Conclusions  The potential tuberculosis infection should be carefully screened in BP patients who have received long-term steroid treatment. PPD often shows false negative results in these patients. If rifampicin and prednisone are used in combination, the dose of prednisone should be increased by at least two fold. Furthermore, intravenous immunoglobulin provides a good alternative treatment for BP with tuberculosis.
Corticosteroids plus Intravenous Immunoglobulin in the Treatment of 7 Cases with Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis
Jie LIU, Yue-ping ZENG, Chun-xia HE, Qin LONG, Hong-zhong JIN, Qiu-ning SUN
2012, 3(4): 381-385. doi: 10.3969/j.issn.1674-9081.2012.04.004
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  Objective  To summarize the clinical features and treatment of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN).  Methods  Seven patients with SJS/TEN were included in the study. The clinical data including severity of illness, eye involvement, causative drugs, treatment, and prognosis were retrospectively analyzed.  Results  The age of these patients ranged 26 to 81 years. Mucous membranes were affected in all cases. The common agents triggering SJS/TEN in these patients were nonsteroidal anti-inflammatory drugs (NSAIDs), antiepileptic drugs, and allopurinol. All these seven patients were then treated with corticosteroids plus intravenous immunoglobulin (IVIG) for their SJS/TEN. The skin lesions were healed in 6 cases, and 1 death occurred.  Conclusions  SJS/TEN is a life-threatening exfoliating disease of the skin and mucous membranes, and the mortality can be high without proper treatment. The use of adequate dose of corticosteroids plus IVIG is a main treatment for SJS/TEN, although the prognosis can be poor in patients with systemic diseases. Since ocular involvement in the acute stage may not relate to the severity of SJS/TEN, early ophthalmic assessment and proper treatment is warranted.
Dual-wavelength Laser with 595 nm and 1064 nm Combination for Resistant Port-wine Stains
Ya-gang ZUO, Hong-wei WANG, Jia-bi WANG
2012, 3(4): 386-389. doi: 10.3969/j.issn.1674-9081.2012.04.005
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  Objective  To evaluate the effectiveness and safety of dual-wavelength laser in treating the resistant port-wine stains (PWS).  Methods  Sixteen patients with single wavelength pulsed dye laser (PDL)-resistant PWS were subsequently treated with a dual-wavelength laser (595 nm and 1064 nm combination) in our department from January 2009 to December 2011. Their outcomes were recorded and retrospectively analyzed.  Results  Of the 16 patients, 2 were cured, 6 markedly effective, 6 effective, and 2 ineffective. Vesiculation and scarring were seen in 3 and 2 patients, respectively, whereas no other adverse effects were reported.  Conclusion  The novel dual-wavelength (595 nm and 1064 nm) laser is an effective and safe device for PWS that is resistant to PDL therapy alone.
Histological Evaluation of Skin In Vitro Treated by Noval Er: YSGG Ablative Fractional Laser
Hong-wei WANG, Wen-hui HUANG, Yong-liang ZHAO
2012, 3(4): 390-394. doi: 10.3969/j.issn.1674-9081.2012.04.006
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  Objective  To evaluate the ablative effects of a noval ablative erbium-doped yttrium scandium gallium garnet (Er:YSGG) 2790-nm laser treatment at different depths of the epidermis and dermis tissue.  Methods  Freshly isolated human skin specimens were obtained from surgically resected face, neck, chest, and upper limb flexor side tissues in 16 patients. The specimens were irradiated with Er:YSGG 2790-nm laser, with a focused spot diameter of 300 μm, an energy of 60-160 mJ, and a scanning area of 10 mm × 10 mm. Microarray mode was established in the skin in vitro. The depth and width of the damage were assessed by HE staining. The therapeutic effectiveness of different pulse energies on different skin tissues were evaluated.  Results  After the irradiation of Er:YSGG 2790-nm laser, ablative fractional heat damage microarrays formed in the human skin in vitro. Different depths of skin (99-456 μm), including the epidermis, superficial dermis, and deep dermis, were selectively reached when the laser was applied at different pulse energies. The cavities were separated for 294-405 μm, and the inner coking walls of cavity ranged 22-77 μm.  Conclusions  The no-val ablative Er:YSGG 2790-nm laser, when applied in fractional operations, can create thermal reaction in different body tissues. Treatment with different pulse energies, the microarray mode can be formed in the epidermis and dermis layers of different depths.
Levels of Interleukin-2 in Peripheral Blood of Patients with Secondary Syphilis
Jun LI, Lin-na WANG, He-yi ZHENG
2012, 3(4): 395-397. doi: 10.3969/j.issn.1674-9081.2012.04.007
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  Objective  To observe the change of interleukin-2 (IL-2) levels in the peripheral blood of patients with secondary syphilis.  Methods  Totally 26 patients (20 males and 6 females) with acquired syphilis aged 16-76 years (mean 40±13 years), who were treated in the Sexually Transmitted Disease Clinic of Peking Union Medical College Hospital from September to December 2010, were enrolled in this study. Definite diagnosis was based on the results of rapid plasma reagin (RPR) and Treponema pallidum particle agglutination (TPPA) assay. Serum IL-2 level was detected by enzyme-linked immunosorbent assay (ELISA) in these patients and 14 age-matched uninfected volunteers (controls).  Results  Compared with the controls, serum IL-2 level significantly increased in patients with secondary syphilis[(2.510±0.529) pg/ml vs. (2.225±0.157) pg/ml, P=0.016]. However, there were no significant differences between the secondary syphilis patients grouped with different age, gender, treatment, IgM, or RPR titers.  Conclusions  The invasion of Treponema pallidum induces the increase of serum IL-2 levels in patients with early syphilis, which may reinforce the immune response against Treponema pallidum and facilitate the clearance of this pathogen.
Serum IgE Levels in Patients with Bullous Pemphigoid and Its Correlation with the Activity of the Disease
Bing LIU, Ya-gang ZUO, Jun LI
2012, 3(4): 398-401. doi: 10.3969/j.issn.1674-9081.2012.04.008
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  Objective  To investigate serum total IgE level in bullous pemphigoid (BP) patients and its correlation with the activity of disease.  Methods  A total of 59 BP patients admitted to our department were enrolled in the study. Their clinical data were analyzed. The change of serum total IgE level before and after treatment was observed. The correlations between the total IgE level and the maximum dose of steroid during hospital stay, the number of eosinophils, and indirect immunofluorescence (IIF) titer were analyzed.  Results  Of these 59 patients, 53 (89.83%) had elevated serum IgE level. After the disease was controlled, IgE decreased but did not return to normal level. High IgE level lasted for several months or years. The serum IgE level in these BP patients was not correlated with the maximum dose of steroid, number of eosinophils, or IIF titer (all P > 0.05).  Conclusions  Serum IgE remarkably increases in BP patients, and can not return to the normal thresholds even after the disease is controlled. However, it has no correlation with the severity of BP.
Role of Direct Immunofluorescence in Diagnosis of Autoimmune Bullous Dermatoses: a Retrospective Analysis of 155 Cases
Chun-xia HE, Ya-gang ZUO, Ming YANG, Li LI, Kai FANG
2012, 3(4): 402-405. doi: 10.3969/j.issn.1674-9081.2012.04.009
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  Objective  To explore the diagnostic value of direct immunofluorescence (DIF) for autoimmune bullous dermatoses (AIBD).  Methods  The DIF features were reviewed in 155 AIBD patients who were admitted to Peking Union Medical College Hospital from January 2009 to December 2011. The diagnostic sensitivity of DIF was compared with that of histopathologic examination.  Results  Various types of AIBD showed different DIF features. The diagnostic sensitivity of DIF was 92.9%, which showed no significant difference with that of histopathologic findings (85.2%) (χ2=2.063, P=0.058).  Conclusion  DIF plays a significant role in the diagnosis and differential diagnosis of AIBD.
Clinical Characteristics of Bilateral Nevus of Ota in 59 Patients
Hong-wei WANG, Wen-hui HUANG, Yong-liang ZHAO
2012, 3(4): 406-410. doi: 10.3969/j.issn.1674-9081.2012.04.010
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  Objective  To summarize the clinical characteristics of bilateral nevus of Ota.  Methods  The clinical data of 59 patients with bilateral nevus of Ota who were treated in our department from January 1998 to June 2012 were retrospectively analyzed. In addition to routine clinical observations including age of onset, gender, color of skin rashes, range of skin lesions, existence of bilateral symmetry, and complications, some patients also received pathological examinations and Q-switched alexandrite laser treatment.  Results  These 59 cases of bilateral nevus of Ota accounted for 4.47% of the patients with nevus of Ota. All of these cases were congenital, with a male:female ratio of 1:4.9. The color of skin rashes was blue brown in 25 patients and light brown in 34 patients. Bilateral symmetry was found in 47 patients. Seventeen patients had bilateral trigeminal nerve involvement. Among patients with bilateral symmetry, the lesion was centered in 5 patients. Scleral involvement existed in 31 patients. In addition, there were 4 patients with congenital vascular malformation. Pathology of bilateral nevus of Ota showed no difference from that of unilateral nevus of Ota. Q-switched alexandrite laser treatment showed good effectiveness.  Conclusion  Bilateral nevus of Ota, as a congenital disease, is prone to large area involvement, scleral involvement, and complications.
Values of Red Green Blue and Ultraviolet Images in Diagnosis and Treatment of Vitiligo in Patients with Head or Neck Leukoplakia
Yong-liang ZHAO, Wen-hui HUANG, Hong-wei WANG
2012, 3(4): 411-414. doi: 10.3969/j.issn.1674-9081.2012.04.011
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  Objective  To investigate the role of red green blue (RGB) and ultraviolet (UV) images in the diagnosis and treatment of vitiligo in patients with head or neck leukoplakia.  Methods  RGB and UV photos of 608 patients with head or neck leukoplakia were taken using a skin analyzer. The difference of the borders of vitiligo between the RGB and UV images of these patients was qualitatively analyzed.  Results  Vitiligo lesions under UV were bright fluorescence with clear borders. Of these 608 patients with head or neck leukoplakia, vitiligo was finally confirmed in 281 patients (46.2%) and excluded in 286 patients (47.0%), although 41 (6.7%) remained uncertain. Vitiligo lesions in mucosa and scalp were not obvious, but they could be identified with UV. For borders of vitiligo that were not clear in RGB images, they could be identified in UV images. During the treatment, UV images are more effective in defining the repigmented area and indicating the lesions not visible to the naked eye.  Conclusions  Combined RGB and UV imaging is effective means for the diagnosis of vitiligo, especially for lesions in mucosa and scalp. They can also provide useful information during the decision-making and evaluation of treatment.
Clinical Characteristics of Impetigo Herpetiformis in 14 Patients
Yue-ping ZENG, Jie LIU, Tao QU, Dong-lai MA, Yue-hua LIU, Hong-zhong JIN, Qiu-ning SUN
2012, 3(4): 415-418. doi: 10.3969/j.issn.1674-9081.2012.04.012
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  Objective  To summarize the clinical characteristics of impetigo herpetiformis (IH).  Methods  The clinical and laboratory data of 14 IH patients who were treated in our department from March 1983 to March 2012 were analyzed retrospectively.  Results  All these patients met the diagnostic criteria of IH. Of these 14 patients, 7 (50%) experienced the first onset of IH during the second trimester of pregnancy and 4 (28.6%) during the third trimester. Eleven patients (78.6%) also suffered from hypocalcemia. Six (42.9%) responded well to a monotherapy of systemic corticosteroids, tripterygium glycosides, or acitretin. Eight (57.1%) were treated effectively after a combination therapy using systemic corticosteroids with methotrexate and (or) acitretin.  Conclusions  The trimesters of pregnancy in which the first onset of IH occurs may vary in different populations. Patients with severe IH have poor response to monotherapy and therefore require the application of a combination therapy with other drugs to control the condition.
Distribution Feature of Ultraviolet-induced Red Fluorescence on Facial Skin of Patients with Acne
Wen-hui HUANG, Yong-liang ZHAO, Hong-wei WANG
2012, 3(4): 419-422. doi: 10.3969/j.issn.1674-9081.2012.04.013
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  Objective  To study the distribution feature of ultraviolet (UV) -induced red fluorescence on facial skin of the patients with acne.  Methods  The (skin analysis system, SAS) is used to obtain UV images of facial skins of 74 acne patients and 68 healthy individuals, and the detection rate of red fluorescence was calculated.  Results  The detection rate of red fluorescence was 85.14% in 74 acne patients and 33.82% in 68 healthy individuals (χ2=39.064, P < 0.005). Additionally, it was significantly higher in T zone, where sebum secretion is higher, than in U zone, where sebum secretion is lower (χ2=21.806, P < 0.005; χ2=15.429, P < 0.005, respectively).  Conclusion  UV-induced red fluorescence on facial skin of the patients with acne may be related to sebum secretion.
Clinical and Pathological Characteristics of Patients with Lipodystrophia Centifugalis Abdominalis
Jie LIU, Tao ZHOU, Kai FANG, Dong-lai MA, Yue-hua LIU
2012, 3(4): 423-426. doi: 10.3969/j.issn.1674-9081.2012.04.014
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  Objective  To study the clinical and histopathological features of lipodystrophia centrifugalis abdominalis (LCA).  Methods  The clinical and histopathological data of 5 patients with LCA diagnosed at Peking Union Medical College Hospital form July 2009 to July 2012 were analyzed retrospectively.  Results  The mean age of onset was 7.2 years (4-13 years). The disease courses ranged from 1 to 3 years. In most cases, the asymptomatic, circumscribed skin atrophy involved the abdomen and inguinal fold. The underlying blood vessels were visible. Histological examination revealed decrease or loss of subcutaneous fat in the atrophic area. The patients were treated with oral traditional Chinese medicine (for promoting blood circulation) and vitamin E.  Conclusions  LCA is a rare lipodystrophic disease. The diagnosis of LCA is mainly based on clinical findings and pathological features. Unfortunately, no effective treatment for this disease has been available.
Intravenous Vecuronium Pretreatment Reduces Fentanyl-induced Cough
Zhi-yong ZHANG, Lu-lu MA, Yang XUE, Su-fang LU, Yu-guang HUANG
2012, 3(4): 427-429. doi: 10.3969/j.issn.1674-9081.2012.04.015
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  Objective  To observe the effect of intravenous vecuronium pretreatment on fentanyl-induced cough (FIC).  Methods  Totally 160 American Society of Anesthesiologists class I-II patients, aged 18-65 years within normal weight, scheduled for elective surgery, were randomly assigned to receive intravenous vecuronium 0.01 mg/kg (pretreatment group) or placebo (normal saline, control group) 5 minutes prior to the administration of fentanyl 3 μg/kg in a randomized and double-blind fashion. Any episode of cough was classified as coughing, and graded as mild (1-2), moderate (3-4), or severe (5 or more). We recorded the timing and severity of cough and monitored the vital signs and discomforts such as dizziness, tinnitus, nausea/vomiting, apnea, and dysrhythmia.  Results  The gender distribution showed no significant difference between two groups (P=0.081). The incidence of cough was 21.3% (17/80) in pretreatment group and 42.5% (34/80) in control group (P=0.004). The incidence of moderate and severe cough was significantly higher in the control group (19/34, 55.9%) than in pretreatment group (6/17, 35.3%) (P < 0.005). There was no significant difference between these two groups in the timing of cough. Vital signs were stable in both groups and no difference was shown in discomforts.  Conclusion  Vecuronium pretreatment can effectively reduce the incidence and severity of FIC.
2008—2011 Surveillance of Resistance in Bacteria Isolated from Intensive Care Units in Peking Union Medical College Hospital
Xiao-jiang ZHANG, Qi-wen YANG, Hong-li SUN, He WANG, Yao WANG, Xiu-li XIE, Hong-tao DOU, Hong-mei SONG, Ren-yuan ZHU, Yu CHEN, Ying-chun XU
2012, 3(4): 430-436. doi: 10.3969/j.issn.1674-9081.2012.04.016
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  Objective  To investigate the rates of resistance in bacteria obtained from intensive care units (ICU) in Peking Union Medical College Hospital.  Methods  A total of 3507 non-duplicate clinical isolates from ICU were collected from January 2008 to December 2011. Disc diffusion test (Kirby-Bauer method) was employed to study the antimicrobial resistance. The data were analyzed by WHONET 5.4 software according to Clinical and Laboratory Standards Institute (CLSI) 2011 breakpoints.  Results  Among these 3507 non-duplicate clinical isolates, gram-negative organisms and gram-positive cocci accounted for 74.7% and 25.3%, respectively. The 10 most common pathogens in ICU were A. baumannii (28.1%), P. aeruginosa (12.8%), S. aureus (10.0%), E. coli (7.8%), K. pneumoniae (7.7%), coagulase-negative staphylococci (7.1%), S. maltophilia (5.2%), E. faecium (4.4%), E. cloacae (2.3%), and E. faecalis (2.3%). Methicillin-resistant Staphylococcus aureus (MRSA) strains and coagulase-negative staphylococci (MRCNS) accounted for 74.9% (262/350) and 83.4% (206/247), respectively. However, 82.6% of MRSA strains were still susceptible to trimethoprim-sulfamethoxazole, while 79.6% of MRCNS strains were susceptible to rifampin. No staphylococcal strain was resistant to vancomycin, teicoplanin, or linezolid. The resistance rates of faecalis to ampicillin (18.2%), nitrofurantoin (5.6%), and fosfomycin (2.7%) were low. The resistant rates of E. faecium and E. faecalis to vancomycin were 9.5% and 1.3%, while to teicoplanin were 7.5% and 1.3%, respectively. Extended spectrum β-lactamases (ESBLs) -producing strains accounted for 60.2% (165/274) and 46.8% (126/269) in E. coli and K. pneumoniae, respectively. The rates of pan-resistant (except minocycline) A. baumannii and P. aeruginosa were 60.4% (596/987) and 5.6% (25/450). The resistance rates of A. baumannii to imipenem and meropenem were 82.8% and 83.8%, respectively. The susceptible rate to minocycline was 58.0%. The resistance rates of P. aeruginosa to imipenem and meropenem were 42.6% and 35.3%, respectively. P. aeruginosa isolates showed the lowest resistant rate (16.8%) to amikacin.  Conclusion  Carbapenems remain highly active against E. coli and K. pneumoniae. The antibiotic resistance of A. baumanii is increasing, especially those multidrug-resistant and pandrug-resistant strains.
Application of Weak Cation Exchange Magnetic Beads Combined MALDI-TOF MS in Detecting Differentially Expressed Proteins in Serum of Prostate Cancer
De-xin DONG, Han-zhong LI, Wei-gang YAN, Zhi-gang JI, Quan-zong MAO
2012, 3(4): 437-440. doi: 10.3969/j.issn.1674-9081.2012.04.017
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  Objective  To detect differentially expressed proteins in serum of prostate cancer and to establish a diagnostic model for prostate cancer.  Methods  Serum samples from 12 patients with prostate cancer and 11 controls hospitalized at our department from March to May 2010 were collected. The weak cation exchange (WCX) beads combined matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF MS) technique was used to detect the differentially expressed proteins in the serum samples of prostate cancer patients and controls. Differentially expressed proteins for prostate cancer were then screened out. Genetic algorithm was utilized to establish a diagnostic model for prostate cancer with ClinProTools 2.2 software.  Results  Totally 126 different proteins were screened out, of which 24 were significantly different between the prostate cancer patients and controls (P=0.178). Using the genetic algorithm, 15 differentially expressed proteins were screened out to establish a diagnostic model. The cross-validation of the model was 81.82% and the recognition rate was 100%.  Conclusions  A diagnostic model of prostate cancer using the WCX magnetic beads combined MALDI-TOF MS technique and genetic algorithm was successfully established. This model has high cross-validation and recognition rate and is helpful to reduce the misdiagnosis rate of prostate cancer.
Effect of Jinmaitong on Oxidative Stress in Dorsal Root Ganglion of Diabetic Rats
Qian ZHANG, Xiao-chun LIANG, Qing SUN, Pu-yan WANG, Wen-zhi HUANG, Bo-wu LI, Yan-dong ZHANG, Yun-zhou GAO
2012, 3(4): 441-447. doi: 10.3969/j.issn.1674-9081.2012.04.018
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  Objective  To investigate the influence of Chinese compound formula Jinmaitong on the Nissl's staining of dorsal root ganglion (DRG) of diabetic rats and on the expressions of NADPH oxidase and inducible nitric oxide synthase (iNOS).  Methods  Dabetic rat models were induced after the intraperitoneal injection of streptozotocin (STZ) to 70 male Sprague Dawley rats. These rats were then divided into five groups (n=14):model group (placebo), Jinmaitong high-dose group (20-fold dose recommended for human), Jinmaitong middle-dose group (10-fold dose recommended for human), Jinmaitong low-dose group (5-fold dose recommened for human), and vitamin C group (10-fold dose recommened for human). Meanwhile, 10 rats without STZ intervention were set as normal group. Drugs (or placebo) were intragastically administered once per day. Sixteen weeks later, DRG tissues were isolated for Nissl's staining as well as immunohistochemistry staining to detect the expressions of NADPH oxidase p22phox and iNOS.  Results  Nissl's bodies depleted obviously in model group. In Jinmaitong high-dose and middle-dose groups, the morphologic abnormality of Nissl's bodies was slight. Compared to model group, the expression of NADPH p22 phox and iNOS in all Jinmaitong groups reduced significantly (P < 0.05).  Conclusions  The study gives evidence that oxidative stress exists in peripheral sensory nerve ganglion of diabetic rats. Jinmaitong can counteract oxidative stress and protect neurons.
Comparison and Correlation Analysis of Corneal Topography in Myopic Children and Adults
Yu-mei JIN, Yue ZHANG, Ying LI, Feng-rong AI
2012, 3(4): 448-451. doi: 10.3969/j.issn.1674-9081.2012.04.019
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  Objective  To investigate and analyze the morphological characteristics of corneal topography in pediatric and adult patients with myopia.  Methods  Topographic measurement and refractive examination were performed respectively on 200 eyes of 100 pediatric and adult patients with myopia admitted to Peking Union Medical College Hospital from August 2008 to August 2010.  Results  The values of flat keratometric power (K2, ) surface regularity index (SRI), and surface asymmetry index (SAI) in myopic adults were significantly higher than those in myopic children (P < 0.05). However, the values of steep keratometric power (K1) and minimum keratometric power (minK) showed no such difference between these two groups (P > 0.05). Furthermore, comparison of these parameters between males and females in both two groups showed the values of K1, K2 and minK in females were significantly higher than in males (P < 0.05). The SRI and SAI in adult group were significantly correlated with age (SRI:r=0.20, P < 0.05; SAI:r=0.19, P < 0.05), no such correlation was found in children group (P > 0.05). There were no correlation between SRI or SAI and refraction in both two groups (P > 0.05). The central cornea showed bow-type graphics mostly in two groups. Most of the astigmatism was with the rule.  Conclusion  With the increase of age, the refraction, corneal surface irregularities, and asymmetry index shows certain changes, whereas the axis of astigmatism tends to be vertical.
Anesthetic Management during Percutaneous Endoscopic Gastrostomy
Jian-qing XU, Yu-guang HUANG, Ai-lun LUO, Zhi-qiang MA, Wei-ming KANG, Jian-chun YU
2012, 3(4): 452-456. doi: 10.3969/j.issn.1674-9081.2012.04.020
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  Objective  To summarize the clinical experience in anesthetic management during percutaneous endoscopic gastrostomy (PEG).  Methods  The clinical data of 90 patients with PEG in our hospital were analyzed retrospectively. Their anesthetic methods, intravenous anesthetic drugs, and anesthetic risks were summarized.  Results  A total of 85 patients underwent topical anesthesia + local anesthesia + intravenous sedation or general anesthesia, among whom only one patient was treated with endotracheal intubation under general anesthesia while five patients with topical anesthesia + local anesthesia. The main intravenous anesthetic drugs included midazolam, fentanyl (or sufentanil), and propofol (or etomidate), with different medication dosages. The hemodynamic and respiratory changes were basically stable during PEG, while adverse events such as hypoxemia, hypertention, and bradycardia occurred occasionally. The minimal systolic and diastolic blood pressures and heart rate decreased significantly and the maximal oxygen saturation by pulse oximetry increased significantly during PEG compared with those before PEG (all P < 0.05).  Conclusion  PEG can be carried out under topical anesthesia + local anesthesia + intravenous sedation or general anesthesia; nevertheless, anesthetic management should be emphasized.
Clinical Manifestations, Imaging Patterns, and Etiologies of Cortical Subarachnoid Hemorrhage
Li-xin ZHOU, Jun NI, Yao ZHANG, Bin PENG, Li-ying CUI
2012, 3(4): 457-461. doi: 10.3969/j.issn.1674-9081.2012.04.021
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  Objective  To summarize the clinical manifestations, imaging patterns, and etiologies of cortical subarachnoid hemorrhages (cSAH).  Methods  The clinical data and imaging findings of 8 cSAH patients who were treated at our department from September 2007 to December 2011 were retrospectively analyzed.  Results  Among these patients, there were four women and four men aged 21-78 years. Seizure was the most common symptom, whereas headache was unusual. Cranial CT showed linear hyperdensities localized at one or more cortical sulci at the convexity of the brain, especially in the central sulcus of the parietal lobe. The known etiologies of 5 cases included cortical venous thrombosis (n=2), venous sinus thrombosis (n=1), cerebral amyloid angiopathy (n=1), and vasculitis (n=1).  Conclusions  cSAH is an important subtype of nonaneurysmal subarachnoid hemorrhage with diverse etiologies. Cortical venous thrombosis appears to be a common cause in young patients, while cerebral amyloid angiopathy may be a more frequent cause in old patients.
2012, 3(4): 367-368. doi: 10.3969/j.issn.1674-9081.2012.04.001
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2012, 3(4): 369-369.
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2012, 3(4): 380-380.
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2012, 3(4): 389-389.
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2012, 3(4): 394-394.
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2012, 3(4): 426-426.
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2012, 3(4): 461-461.
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2012, 3(4): 462-465. doi: 10.3969/j.issn.1674-9081.2012.04.022
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