Objective To investigate the clinical features of primary retroperitoneal fibrosis (RPF), and to find out better method for diagnosis and therapy. Methods Nine patients with primary RPF in Peking Union Medical College Hospital since 1990 to 2003 were analyzed retrospectively. Results All patients had abnormal findings in CT or MRI, and 8 of them had chronic non-specific inflammation of the retroperitoneum in pathology. Six patients had renal involvement and 2 of them had severe renal failure. Eight of the patients had received therapy with corticosteroid or tamoxifene. Conclusions RPF is an uncommon collagen vascular disease characterized by a chronic non-specific inflammation of the retroperitoneum.Because of the atypical manifestations of RPF, awareness of the disease is important.CT and (or) open biopsy remains the gold standard for diagnosis.Management typically includes surgery and drug treatment.Corticosteroid therapy or more recently,tamoxifen has been used successfully. The clinical and radiographic improvement with drug treatment has been seen in several patients and confirmed the diagnosis,thereby early diagnosis and treatment can bring the patient more excellent renal and general outcome.

Objective To compare the anti-inflammatory effects between methotrexate(MTX) and Yangqixue Qufengshi Recipe(YQXQFSR) on mice arthritis induced by collagen II.Methods The model of rheumatoid arthritis was induced by using collagen II in C_(57)BL/6?DBA/1 mice.The rats with arthritis were treated with MTX or YQXQFSR respectively.The indexes such as the onset day of collagen induced arthritis(CIA),the level of CII-reactive antibodies and the pathological scores of CIA were assessed.Results The onset day of CIA and the level of CII-reactive antibodies were not influenced in the treatment of mice arthritis with MTX and YQXQFSR respectively.But MTX could alleviate the damage of cartilage [(1.60?1.51) vs(3.56?1.33) scores,P

[ ABSTRACT] AIM:To evaluate the clinical application of single nucleotide polymorphism array ( SNP array) in prenatal diagnosis for screening the abnormality of women with Down’ s syndrome ( DS) .METHODS:The amniotic fluid samples ( n=312) collected by amniocentesis for the DS screening abnormality women were tested by karyotyping and SNP array analysis, respectively.The findings of karyotyping and SNP array analysis were compared.RESULTS:Two cases of trisomy 21 were identified by karyotyping and SNP array analysis, but SNP array analysis failed to identify 6 cases of chro-mosome balanced structural rearrangement.SNP detected 176 cases copy number variants ( CNVs) in 303 cases normal karyotype were detected by SNP, including 106 benign CNVs, 61 variants of unknown significance (VOUS), 9 de novo CNVs, and none of them was pathogenic.The distribution difference of CNVs in DS screening positive group and DS screening positive plus advanced maternal age group was not statistically significant ( P>0.05) .Furthermore, we reported 14 kinds of CNVs for the first time in population.CONCLUSION:SNP array can further assure chromosome microdupli-cation/microdeletion.In normal karyotype fetus of prenatal diagnosis, SNP can detect some clinical significant CNVs.

Objective To provide the reference basis for reducing the occurrence of nutritional risk by analyzing possible risk factors for nutritional risk status and investigating the relationship between preoperative nutritional risk status and prognosis.Methods We retrospectively analyzed the clinical data of 894 patients(nutritional risk group of 491 cases,non-nutritional risk group of 403 cases) with esophageal cancer resection.The univariate analysis was used to analyze the relationships between nutritional risk status with postoperative complications and length of hospitalization.And the multiple Logistic regression model analysis was applied to analyze the risk factors of nutritional risk status.Results The nutritional risk group had a higher rate of postoperative complications (33.60 ％ vs.19.60 ％,U =-3.429,P =0.001),higher incidence of serious complications (23.01％ vs.8.68％,U =-3.611,P =0.000) and longer hospital stays [(37.20 ± 13.89) days vs.(31.69 ± 13.49) days,t =4.124,P =0.000] than that of non-nutritional risk group.The results of the multiple logistic regression analysis showed that the preoperative nutritional risk factors were associated with the patients' age (OR =1.58,95％ CI:1.101-2.268),number of symptoms entries(OR =7.97,95 ％ CI:6.071-10.463),symptom severity (OR =0.26,95％ CI:0.186 -0.385),and dietary intake (OR =0.62,95 ％ CI:0.482-0.813),P ＜ 0.05 for all.Conclusion The older patients with more severe symptoms and poor diet are more likely to suffer from nutritional risk.Prolonged hospital stay and postoperative complications easily happen in patients with nutritional risk.So patients with preoperative nutritional risk should be given timely and effective nutrition intervention measures,in order to reduce postoperative complications and length of hospitalization.

Objective To investigate the role of expression of tall-like receptor 4 (TLR4) on medullary system cell (neutrophii, platelet) and endothelial cell surface in polymorphonuclear neutrophils (PMN) recruitment in rata with acute necrotizing pancreatitis. Methods C3H/He-J mice and C3H/He-N mice were divided into 4 groups by bone marrow transplantation: mosaic of medullary system cell TLR4-/- and endothelial cell TLR4 +/+ ; mosaic of medullary system cell TLR4 +/+ and endothelial cell TLR4-/-; mosaic of medullary system cell TLR4 +/+ and endothelial cell TLR4 -/-; mosaic of medullary system cell TLR4-/- and endothelial cell TLR4-/-, another control group was also established. ANP was induced in all these groups by intraperitoneal injection of cerulein and caudal vein injection of lipopolysaccharide. Serum amylase, pancreatic tissue naphthol AS-D chloroacetate esterase, MPO activity, TRL4 mRNA expression in peripheral blood granuloeyte was determined by RT-PCR, TRL4 protein expression in pancreatic tissue was measured by immunohistochemisty. Results Compared with that of control group, the levels of serum amylase in the 4 groups all significantly elevated and there was no difference among these 4 groups. Pathological scores of pancreas in the 4 groups were 5.52 ± 1.21, 5.18 ± 1.02, 2.03 ± 0. 82, 1.92 ± 0. 78, respectively; MPO activities were (1.834 ± 0. 170) U/g, (2. 596 ±0. 138) U/g, (0. 367 ±0. 018) U/g, (0. 202 ±0. 018) U/G, respectively; AS-D counts were 66.88 ± 2.17, 75.00 ± 2.43, 21.50 ± 2.38, 20.00 ± 2.19, respectively ; the expressions of TLR4mRNA of granular cell in peripheral blood were 0. 037 ± 1. 047 E-2, 1. 489 ± 8. 084 E-2, 1.470 ± 5. 210E-2, 0. 017 ± 6. 668 E-3, respectively; the 2 groups with endothelial eel1 TLR4 +/+ had strongly positive expression of TLR4 protein in vascular endothelial cell ; while the 2 groups with endothelial cell TLR4-/- had no expression; the pancreatic injuries, MPO activities, AS-D counts and TLR4 protein in the 2 groups with endothelial cell TLR4 +/+ were significantly higher than those in the 2 groups with endothelial cell TLR4-/-. Conclusions It was endothelial cell, not peripheral blood granulocyte, which played a key role in the process of neutrophil recruitment and pathological injure of ANP.

Objective To investigate the significance of expression of toll-like receptor on medullary system cell and endothelial cell surface in PMN recruiting in severe acute pancreatitis.Method In this study,26 C3H/He-J mice and 26 C3H/He-N mice were derided into 4 groups by bone marrow transplantation:group A, mosaic of medullary system cell TLR4-/- and endothelial cell TLR4+/+,group B, mosaic of medullary system cell TLR4+/+ and endothelial cell TLR4-/- ;group C, homozygote ofTLR4+/+ ;group D, homozygote of TLR4-/-. SAP was induced to all these mice. Amylase, TRIA of granular cell in peripheral blood,TRL4 expression in pancreas, Naphthol AS-D chloroacetate esterase, MPO activity were tested. Results Amylase level increased in all mice, there was no differences of the amylase level among groups, TRIA of granular cell in peripheral blood in group B and C was significant higher than A and D(P<0.05), TLR4 in pancreas were positive in group A and C, negative in group B and D, AS-D count and M PO activity in group A and C were higher than that in group B and D (P < 0. 05 ). Conclusions It was endothelial cell, not peripheral blood granulocyte, that plays a key role in recuiting neutrophils that triggers severe acute pancreatitis.

Objective To observe the effect of glycosides on serum indexes in elderly patients with primary nephrotic syndrome.Methods A total of 280 elderly patients with primary nephrotic syndrome were randomly divided into control group and observation group,140 cases in each group.Patients in the control group were treated with conventional western medicine,and those in the observation group were treated with additional glycosides.The efficacy and 24 h urinary protein,serum adiponectin,serum albumin,serum creatinine and immunological parameters,carbohydrate antigen levels before and after treatment were compared between two groups.Results The clinical control rate and total effective rate in the observation group were significantly higher than those in the control group (P ＜ 0.05).4,8 weeks after treatment,24 h urinary protein,serum adiponectin,serum creatinine of observation group were significantly lower than those of the control group,while the serum albumin was significantly higher than the control group (P ＜ 0.05).The serum levels of IgA,IgG and IgG/IgM in the observation group were significantly higher than those in the control group,while the IgM level was significantly lower than that in the control group (P ＜ 0.05).The serum levels of CA125,CA153 and CA199 in the observation group were significantly lower than those in the control group (P ＜ 0.05).Conclusion Glycosides can effectively increase the clinical remission rate of primary nephrotic syndrome in elderly patients,reduce the loss of albumin and protect renal function,and delay the progression of NS.

Objective To investigate the diagnostic value ofbiomarkers in cerebrospinal fluid in differentiating meningeal carcinomatosis (MC) and tubercular meningitis (TBM).Methods The clinical features and cerebrospinal fluid (CSF) test results of 34 patients with MC and 44 patients with TBM,admitted to our hospital from January 1994 to August 2014,were retrospectively analyzed and compared.Results The main clinical manifestations of MC included headache and bowel and bladder dysfunction,and those of TBM were fever and headache.The cell population of MC and TBM patients increased and the number of leucocyte of TBM patients was significantly larger than that of MC patients (P＜0.05);the CSF of all the patients presented with decreased levels of glucose and chloride,and increased protein level,and higher protein in MC patients was noted than that in TBM patients (P＜0.05).The biomarkers in CSF of MC and TBM patients increased to varying degrees,and the biomarkers,including carcinoembryonic antigen (CEA),cancer antigen (CA) 125,CA 199,CA 153 and CYFRA21-1,in MC group were significantly higher than those in TBM group (P＜0.05).The neuron-specific enolase level in the TBM patients of Ⅲ grade was significantly higher than that in the MC patients (P＜ 0.05).Conclusion The detections of tumor biomarkers in cerebrospinal fluid is a tool in differentiating MC and all stages of TBM,especially with the combined detections of CEA,CA125,CA199 and CYFRA21-1.

Objective To observe the effect of glycosides on serum indexes in elderly patients with primary nephrotic syndrome.Methods A total of 280 elderly patients with primary nephrotic syndrome were randomly divided into control group and observation group,140 cases in each group.Patients in the control group were treated with conventional western medicine,and those in the observation group were treated with additional glycosides.The efficacy and 24 h urinary protein,serum adiponectin,serum albumin,serum creatinine and immunological parameters,carbohydrate antigen levels before and after treatment were compared between two groups.Results The clinical control rate and total effective rate in the observation group were significantly higher than those in the control group (P ＜ 0.05).4,8 weeks after treatment,24 h urinary protein,serum adiponectin,serum creatinine of observation group were significantly lower than those of the control group,while the serum albumin was significantly higher than the control group (P ＜ 0.05).The serum levels of IgA,IgG and IgG/IgM in the observation group were significantly higher than those in the control group,while the IgM level was significantly lower than that in the control group (P ＜ 0.05).The serum levels of CA125,CA153 and CA199 in the observation group were significantly lower than those in the control group (P ＜ 0.05).Conclusion Glycosides can effectively increase the clinical remission rate of primary nephrotic syndrome in elderly patients,reduce the loss of albumin and protect renal function,and delay the progression of NS.

OBJECTIVETo discuss the causes and treatments of wound infections after scoliosis surgery.

METHODSNine hundred and twenty-four caes of scoliosis were reviewed, and the clinical data of 15 cases of postoperative infection were analysed retrospectively.

RESULTSAll 15 cases underwent spinal posterior fusion with autologous bone graft using instrumentations. Seven were diagnosed as early infection, and 8 were delayed infection. Radical debridement was performed in all 15 cases. The duration of antibiotics administration was 10 to 34 days with continuous closed irrigation for 2 to approximately 4 weeks and primary closure for the wounds. All patients were followed up for an average of 3.5 years (2 to 7.5 years) with good outcomes and no recurrence.

CONCLUSIONWound infection following surgical correction of scoliosis primarily results from intraoperative seeding, although host-related and operation-related factors may contribute to its development. Once the infections are diagnosed, good results can be achieved by prompt surgical debridement, irrigation and reasonably administered antibiotics. Removal of hardware may be necessary in deep infections.

Adolescent ; Adult ; Anti-Bacterial Agents ; therapeutic use ; Child ; Debridement ; Female ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies ; Scoliosis ; surgery ; Spinal Fusion ; adverse effects ; Staphylococcal Infections ; therapy ; Surgical Wound Infection ; therapy