This report presented a case of disseminated infection with nocardia in lupus erythematosus (SLE) and reviewed the current literature. Nocardiosis was a rare, sometimes life-threatening opportunistic infection in SLE patients. The isolation and identification of pathogen was fundamental for the diagnosis of nocardiosis. Sulfonamides were traditionally the agent of choice for treatment of nocardiosis; while it must be given for several months even more than one year, particularly in patients with suppressed immune function. Issues regarding the drug resistance and the toxicity of sulfonamides in long-term therapy needed to be considered. Linezolid could be an effective agent for the treatment of nocardiosis, whether it could reduce the treatment course need to be further studied.

BACKGROUND: Wnt signaling pathways can stimulate the proliferation and differentiation of neural stem cel s, and promote the repair of spinal cord injury. The electrical field stimulation can change the protein expression of Wnt signaling pathways.
QBJECTIVE: To explore the influence of oscil ating electric field on motor function recovery and the expression of Wnt-3a protein in rats with spinal cord injury.
METHODS: A total of 36 Sprague-Dawley rats models with spinal cord injury were induced by the Al en’s method. Al rats were randomly divided into oscil ating electric field stimulation group and spinal cord injury group. The stimulating electrodes were added in both groups. The oscil ating electric field stimulation group received oscil ating electric field intervention.
RESULTS AND CONCLUSION: At 3 days after model establishment, Basso, Beattie, and Bresnahan (BBB) locomotor rating scale scores and Wnt-3a expression were similar between the oscil ating electric field stimulation group and spinal cord injury group. At 7 and 14 days, significant differences in BBB scores and Wnt-3a expression were detected. These results indicate that oscil ating electric field stimulation can activate Wnt signaling protein in the early stage of spinal cord injury, which may be associated with the promoting effect of oscil ating electric field stimulation on spinal cord injury.

ObjectiveTo study the protective effects of terlipressin on the renal function of recipients afterlivertransplantation.MethodsAmong 35casesreceivingorthotopicliver transplantation (OLT),16 cases were given terlipressin (group T):continuous infusion of terlipressin (1mg) into the vein immediately after the operation,twice every day for 3-4 days;19 cases were given dopamine and procaine (group D):continuous infusion of dopamine (40 mg) and procaine (0.5 g) into the vein immediately after the operation,twice every day for 3-5 days.In both two groups,the serum creatinine and urea nitrogen levels were normal before the operation. Serum creatinine,urea nitrogen,serum β2 microglobulin and urine amount were determined.ResultsSerum creatinine,urea nitrogen,serum β2 microglobulin and urine amount were increased significantly at 5th day after operation in both two groups (P＜0.05).As compared with group D,urea nitrogen and serum β2 microglobulin were decreased,while the urine amount increased significantly at 5th day after operation in group D (P＜0.05).Three cases (18.8％) in group T,and10 cases (52.6％ ) in group D developed RFALT at 5th day after operation (P＜0.05).ConclusionTerlipressin can protect the renal function of recipients after liver transplantation,and it can more effectively provide good recovery conditions for the recipients who develop RFALT after liver transplantation.

ObjectiveTo explore causes and prevention experience for neuropsychopathic symptoms after liver transplantation.MethodsThe clinical data of 62 patients who underwent transplantation in our hospital were retrospectively analyzed for the causes of neuropsychopathy symptoms and treatment experience was Summarized.ResultsSixteen patients(25.8％ ) had psychiatric symPtoms after liver transplantation in three weeks,four of them more severe.The common clinical manifestation was sleep disorders,mania,anxiety,depression,delirium and change of cognition.The pre-operation encephalopathy history,liver function,blood loss,time in the ICU after surgery,post-operation infection and the concentration of immunosuppressive agents were risk factors for psychiatric symptoms.All patients were cured.ConclusionsPsychiatric symptoms are commonly seen after liver transplantation and have a variety of etiology and clinical manifestations.Psychological counseling should be strengthened.The appropriate therapeutic measures for different etiology can improve patient outcomes.

Objective To investigate colonoscopic presentation and explore biopsy style of lower gastrointestinal graft-versus-host disease (GI-GVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods The endoscopic findings including mucosa erythema,edema,erosion,ulcer,tortoiseshell-pattern and sloughing were observed in 36 patients with GI-GVHD and the rate of apoptotic cell yields in colon and end-ileum was calculated.Results Mucosa lesions were found in almost all of the patients both in colorectal and end-ileum (97.2％ vs 94.1％,P =0.609).Mucosa erythema was more often seen in end-ileum (47.2％ vs 79.4％,P =0.007) and tortoiseshell-pattern was mainly in colorectal mucosa (63.9％ vs 5.9％,P =0.000).Mucosa edema,erosion and oozing bleeding were the same prevalence in large intestine and end-ileum (97.2％ vs 94.1％,80.6％ vs 79.4％,47.2％ vs 47.1％,P ＞ 0.05,respectively).Sloughing was found in 76.5％ (26/34) GI-GVHD patients,and it was almost the same prevalence in large intestine and end-ileum (52.8％ vs 47.1％,P ＞0.05).Almost all of the colorectal mucosa sloughing located in the tortoiseshell-pattern mucosa.Rates of apoptotic cell in rectal,colonic and end-ileal mucosa were 88.9％,91.3％ and 75.9％,respectively,and the rates were 88.2％ and 93.9％ in ileum plus rectum and ileum plus colon respectively,showing that biopsy only in ileum was not sufficient for the pathologic diagnosis of GI-GVHD (93.9％ vs 75.9％,P =0.070).Conclusion Endoscopic presentations of GI-GVHD after allo-HSCT are not the same between colorectal and end-ileal mucosa.Sloughing with GIGVHD feature is not rarely seen in lower GI.Tortoiseshell-pattern mucosa should also be pathognomonic feature of colorectal GVHD in endoscopy.Pathologic tissue should not only be biopsied in end-ileum,but also in colorectal mucosa in the same time.

Objective To explore the value of the ultrasound contrast agent in conjunction with advanced contrast imaging techniques in the evaluation of the renal cortical perfusion. Methods The animal model was established with ligating renal artery to cause the renal cortical perfusion decrease of rabbits. Real-time harmonic gray scale imaging was performed to visualize the contrast enhancement of the renal cortex. After bolus injection of contrast agent SonoVue, dynamic image was observed and recorded during the first three minutes. According to the time-intensity curve (TIC), accelerating time (AT),Peak intensity (A), time to half of peak intensity (T), difference between peak and base (PBD), slope rate of the curve (β) and the product of A and β (A·β) were obtained before and after the renal artery operation. The t test and correlation analysis was used to examine the above parameters. Results Before the renal artery operation, renal cortex enhanced rapidly and obviously, the way of the enhancement was renal artery-cortex-pyramids. After ligation of renal artery, AT prolonged evidently (P<0.001), A decreased obviously (P<0.001), T obviously shortened (P<0.001), PBD decreased markedly (P<0.001), while the decline of βinduced (P<0.002) and A·βobvious dropped(P<0.001). AT, BPD and A·βcorrelated with stenosis level of renal artery. Compared with 31%－69% group, AT prolonged evidently (P<0.001). A decreased obviously (P<0.029), PBD decreased obviously (P<0.001), A·β was dropped markedly (P<0.02) in 70%-93% stenosis group. Conclusions Contrast agent combining with developed contrast specific imaging is able to detect changes of renal cortical microcirculation sensitively with the help of analysis of TIC.

Objective To explore the application value of ultra -high frequency ultrasound in detection of femoral artery stenosis in rabbits.Methods Twenty-four healthy male New Zealand white rabbits (body weight 2.5 -3.0 kg) were randomly divided into three groups , 8 rabbits in each group.Preparation of femoral atherosclerosis model : the rabbits were fed with high fat diet for 4 weeks, 8 weeks and 12 weeks after femoral artery balloon injury , respectively.The changes of cholesterol level were observed .We used ultra-high frequency ultrasonic probe to observe the femoral artery , to assess the diameter stenosis rate and peak systolic velocity (SPV) at the symptomatic side, and the histological areal stenosis was evaluated.Results 1.The blood cholesterol levels were increased after fed high cholesterol diet , with a significant difference among the groups (P <0.001); 2.There was a stenosis to a different degree in the modeling artery after fed high cholesterol diet for 4 wks, 8 wks, and 12 wks, and the stenosis degree was increased gradually .At 12 w, the degree of stenosis was higher than that at 4 w and 8 w, respectively, showing statistical significance ( P <0.001).At the symptomatic side, the peak systolic flow velocity was increased , and it was higher at 12 w than that at 4w and 8 w, respectively.3.With the extension of time, the arterial stenosis rate was increased along with the time course (P <0.05). Conclusions 1.High fat diet combined with balloon injury can cause varying degrees of rabbit femoral artery stenosis ; 2. Ultrahigh frequency ultrasound can clearly show different degrees of rabbit femoral artery stenosis , and can be used for detecting the lesions in animal models of peripheral vascular diseases .

Objective To study the expression and significance of Glypican-3 in Budd-Chiari syndrome (BCS) complicated with hepatocellular carcinoma (HCC).Methods The data of 46 patients with BCS complicated with HCC (the BCS + HCC group) treated in The First Affiliated Hospital of Zhengzhou University from January 2007 to December 2016 were analyzed retrospectively.Another 48 patients with HBV-related HCC (the HBV + HCC group) and 43 patients with hepatic cyst (the hepatic cyst group) were randomly selected as the control groups during the same time period.The differencesin positive rates of Glypican-3 in the liver tissues among the three groups were compared.The BCS + HCC group was further divided into the Glypican-3 positive and Glypican-3 negative subgroups according to the expression of Glypican-3.The differences in gender,age,AFP,HbsAg,Child-Pugh classification,tumor number,extrahepatic metastasis,vascular invasion,Edmondson-Steiner grading and BCLC staging between the two subgroups were compared.The survival time of the two subgroups was compared using the Kaplan-Meier method.Results The expression rates of Glypican-3 in the BCS + HCC group,HBV + HCC group and Hepatic Cyst group were 76.1％,70.8％ and 0％,respectively.The levels of Glypican-3 in the BCS + HCC group and the HCC group were significantly higher than that in the hepatic cyst group.The differences were statistically significant (P ＜ 0.05).No statistically significant difference was detected between the BCS + HCC group and the HBV + HCC group (P ＞ 0.05).In the group of patients with BCS + HCC,there was no significant difference in gender,age,AFP,HbsAg,Child-Pugh classification,tumor number and extrahepatic metastasis between the Glypican-3 positive and negative subgroups (P ＞0.05).However,vascular invasion,Edmondson-Steiner grading and BCLC staging in the Glypican-3 positive subgroup were significantly higher than those in the Glypican-3 negative group,(P ＜ 0.05).The 1-year,3-year and 5-year survival rates were 77.1％,51.0％ and 22.8％ in the Glypican-3 positive subgroup,compared with 90.9％,63.6％ and 45.5％ in the Glypican-3 negative subgroup,respectively.There were statistically significant differences between the two groups (P ＜ 0.05).Conclusion Glypican-3 has a stable expression in patients with BCS complicated with HCC,and it is closely related to malignancy of the tumor and prognosis of the patients.

ObjectiveSleep-related painful erections （SRPE） is a rare sleep disorder characterized by repeated awakening due to painful interruptions of penile erections during nighttime sleep， and its etiology is currently unclear. The purpose of this study is to explore the impact of potential risk factors on the incidence of SRPE. MethodsInformation was collected through questionnaires administered to patients who presented at the urology department and suffered from SRPE or did not suffer from SRPE. A total of 290 participants completed the study， including 145 controls and 145 cases. Logistic regression analysis was used to assess the impact of age， occupation， sleep initiation time per night， frequency of sexual intercourse per week， psychological status， erectile dysfunction， chronic prostatitis， prostate enlargement， lumbar spine disease， central nervous system disease， hypertension， diabetes and family history on the onset of SRPE. ResultsSingle-factor logistic regression analysis found that a history of chronic prostatitis， intellectual labor occupation， central nervous system disease， late sleep onset， frequency of sexual activity， and anxiety status might be related to the onset of SRPE. After incorporating these factors into a multivariate regression analysis model， it was found that having sexual activity ≥2 times/week （OR 95%CI = 0.326（0.179，0.592） and late sleep onset （after 24：00） （OR 95%CI = 0.494（0.265，0.918）might be protective factors for SRPE， while a history of chronic prostatitis（OR 95%CI = 3.779（2.082，6.859） might be a risk factor for SRPE. However， there was no significant statistical difference in the impact of central nervous system diseases and occupation on multivariate analysis. ConclusionChronic prostatitis and anxiety status may be independent risk factors for SRPE； having sexual activity ≥2 times/week and delaying sleep time appropriately may be independent protective factors.