The Immunologic Profiles of Kawasaki Disease Triggered by Mycoplasma pneumoniae Infection.

OBJECTIVE: We compared the immunologic characteristics of mycoplasma pneumoniae-triggered Kawasaki disease (MP-KD) with Kawasaki disease (KD) not associated with mycoplasma pneumoniae (MP), with mycoplasma pneumoniae-triggered Henoch-Schönlein purpura (MP-HSP), and with healthy controls. METHODS: Complement levels, cellular and humoral immunity were assessed in KD, in MP-KD, in MP-HSP, and in healthy children. RESULTS: Of 622 children with KD, 74 had MP-KD. Complement C3 and CD4/CD8 ratio were significantly increased in MP-KD compared to KD. C3, C4, and the ratio of CD4/CD8 in the MP-KD group were higher than those in the MP-HSP group. IgA and CD56 were lower in the MP-KD group than the MP-HSP group. CONCLUSIONS: Both C3 and polyclonal CD4+ T lymphocytes may be activated in the patients with MP-KD.

Treatment for Thoracic Ossification of Posterior Longitudinal Ligament with Posterior Circumferential Decompression.

OBJECTIVE: To report the results of the posterior approach for thoracic ossification of posterior longitudinal ligament (TOPLL) by using a special "L" osteotome. METHODS: The present study enrolled 16 consecutive patients (9 men and 7 women) between May 2009 and September 2013. All patients underwent a posterior circumferential decompression osteotomy and segmental instrumentation with interbody fusion. The mean age at surgery was 57.3 years (range, 37-68 years). Patients' data, clinical manifestation, blood loss, length of surgery, complications, visual analog scale (VAS), Japanese Orthopedic Association (JOA), and Frankel grading system before and after surgery were collected and evaluated, retrospectively. RESULTS: The average follow-up period was 30 ± 19 months (range, 12-50 months). All patients were successfully treated with posterior compression and segmental instrumentation with interbody fusion. The average operation time was 261.6 ± 51.3 min (range, 190-310 min). The mean blood loss was 980.3 ± 370.5 mL (range, 600-2100 mL). All patients had subjective improvement of motor power and gait. Average preoperative and postoperative JOA scores were 4.2 ± 1.7 and 7.8 ± 2.5 points, respectively. Differences in the overall JOA scores showed significant postoperative improvement. At the last follow-up, all patients improved either by one or two Frankel grades. There was a significant difference between preoperative VAS scores and those 3 months after surgery (P < 0.05). No significant difference was observed between the 3-month and 12-month results (P > 0.05). Cerebrospinal fluid (CSF) leakage occurred in 3 patients. Acute neurological deterioration was encountered postoperatively in 1 patient. CONCLUSION: Treatment with posterior transpedicular osteotomy and circumferential decompression was found to be safe, effective, reliable, and technically feasible, and keeping the thoracic cavity intact avoids many shortcomings of anterior surgery and results in a satisfactory spinal decompression.

Reproductive history and risk of cognitive impairment in elderly women: a cross-sectional study in eastern China.

BACKGROUND: Epidemiological studies suggest that proxies of higher lifetime estrogen exposure are associated with better cognitive function in postmenopausal women, but this has not been found consistently. OBJECTIVE: To determine whether reproductive history, an important modifier of estrogen exposure across the lifetime, is associated with risk of cognitive impairment in postmenopausal women. METHODS: We analyzed the baseline data from Zhejiang Major Public Health Surveillance Program (ZPHS) including 4,796 postmenopausal women. Cognitive impairment was assessed through the application of Mini-Mental State Examination questionnaire. Logistic regression models, controlled for an extensive range of potential confounders, were generated to examine the associations between women's reproductive history and risk of cognitive impairment in their later life. RESULTS: The length of reproductive period was inversely associated with risk of cognitive impairment (p = 0.001). Odds ratio (OR) of cognitive impairment were 1.316 (95% CI 1.095∼1.582) for women with 5 or more times of full-term pregnancies, compared with those with 1∼4 times of full-term pregnancies. Women without incomplete pregnancy had a significant higher risk of cognitive impairment (OR = 1.194, 95% CI 1.000∼1.429), compared with the reference (1∼2 times of incomplete pregnancies). Oral contraceptive use (OR = 0.489, 95% CI 0.263∼0.910) and intrauterine device (IUD) use (OR = 0.684, 95% CI 0.575∼0.815) were associated with significantly reduced risk of cognitive impairment. CONCLUSION: Our results indicated that shorter reproductive period, higher number of full-term pregnancies and no incomplete pregnancy history were associated with an increased risk of cognitive impairment. In contrast, oral contraceptive and IUD use corresponded to reduced risk of cognitive impairment.

[Semi-quantitative risk assessment on local transmission of Dengue fever caused by introduced cases].

OBJECTIVE: To assess the risk of local transmission of Dengue caused by introduced cases with semi-quantitative method in 2015 in Zhejiang Province. METHODS: Risk indexes of local transmission of Dengue caused by introduced cases were reviewed. The weights of indexes were computed by analytic hierarchy process and further used to generate absolute risk values by multiplying indexes. Moreover, comprehensive indexes were computed to describe relative risk by combining analytic hierarchy process and TOPSIS methods. RESULTS: Four primary indexes and 19 secondary indexes were identified for risk assessment of local transmission of Dengue. The indexes with maximum and minimum weight were the number of immigration from countries with Dengue patients (weight value: 0.0678) and density of population (weight value: 0.0371) respectively. All CR values, statistics for measuring consistency of score matrix, were less than 0.1 (minimum: 0.000, maximum: 0.0922, average: 0.0251). The absolute risk of Zhejiang Province was within the range of 0.397-0.504 (the full score was 1.0). The risk orders of 11 municipalities sorted by relative comprehensive indexes and absolute risk values methods were similar. The three highest municipalities were Hangzhou, Wenzhou and Ningbo and the ranges of absolute risk value were 0.387-0.494, 0.404-0.511 and 0.392-0.499 respectively. CONCLUSION: The results provides scientific basis for preventing and controlling Dengue in Zhejiang Province. The indexes and weights may be used to assess risk of Dengue in future. In addition, the semi-quantitative method constructed in this study would be a significant reference for risk assessment of public health in emergencies.

Association of CXCL12 levels in synovial fluid with the radiographic severity of knee osteoarthritis.

OBJECTIVE: Inflammation is implicated to be involved in the pathogenesis of osteoarthritis (OA). CXCL12, also known as stromal cell-derived factor, is the unique identified natural ligand of the G-protein-coupled receptor CXCR4 and exhibits both homeostatic and proinflammatory functions. This study aims to determine whether CXCL12 levels in serum and synovial fluid (SF) of patients with knee OA are correlated with the disease severity. METHODS: This study consisted of 252 patients with knee OA and 144 healthy controls. The radiological grading of OA in the knee was performed according to the Kellgren-Lawrence grading system. CXCL12 levels in serum and SF were measured by enzyme-linked immunosorbent assay. RESULTS: Higher levels of serum CXCL12 were found in knee OA patients compared with healthy controls. The CXCL12 levels in SF of knee OA patients with KL grade 4 were significantly elevated compared with those with KL grades 2 and 3. Furthermore, knee OA patients with KL grade 3 had significantly higher SF levels of CXCL12 compared with those with KL grade 2. CXCL12 levels in SF of knee OA patients were significantly correlated with disease severity evaluated by KL grading criteria. However, there were no significant differences in the serum CXCL12 levels between patients with different KL grades. CONCLUSION: CXCL12 levels in SF were closely related to the radiographic severity of OA. CXCL12 levels in SF may be an alternative biomarker for the progression of OA.

Association of BCL-2 polymorphism with the presence and severity of lumbar disc degeneration in the Chinese Han population.

BACKGROUND: Apoptosis is involved in the mechanism of lumbar disc disease (LDD). BCL-2 has been shown to play an anti-apoptosis role. The present study aims to examine the association of -938C > A polymorphism of the BCL-2 gene with the presence and severity of LDD in the Chinese Han population. METHODS: This study consisted of 325 patients with LDD and 236 normal controls. The grade of disc degeneration was determined according to Schneiderman's classification for MRI. -938C > A polymorphism was determined by "slow-down" polymerase chain reaction (PCR) method. RESULTS: The genotype frequency of -938C > A polymorphism was consistent with Hardy-Weinberg equilibrium (p = 0.136). Higher frequencies of -938CA and AA genotypes were found in patients with LDD compared with normal controls (p = 0.019). Furthermore, there were higher frequencies of the A allele in LDD patients than in normal controls (p = 0.005). Unconditional logistic regression analysis revealed that -938CA and AA genotypes were significantly associated with the presence of LDD compared with CC genotype (p = 0.041; OR 1.449; 95% CI 1.015 - 2.067 and p = 0.015; OR 2.102; 95% CI 1.158 - 3.813, respectively). The A allele was significantly associated with the susceptibility to LDD compared with the C allele (p = 0.005; OR 1.436; 95% CI 1.113 - 1.851). In addition, -938CA and AA genotypes, as well as the A allele were found to be associated with the risk for higher degenerative grades of LDD compared with the CC genotype and C allele, respectively (p = 0.017 and p = 0.003, respectively). CONCLUSIONS: The -938C > A polymorphism of BCL-2 may be associated with the presence and severity of LDD in the Chinese Han population.