Objective To improve the understanding of autoimmune disease related panereatitis by analyzing their clinical features.Methods The clinical features were analyzed retrospectively in 28 autoimmune disease related pancreatitis cases from Peking Union Medical College Hospital(PUMCH),according to the associated autoimmune diseases.Results (1)The average age was(40.0±16.1)years,and the ratio of male to female patients Was 1:6.There were 24 acute and 4 chronic pancreatitis in the 28 cases.(2)The common related autoimmune diseases were systemic lupus erythematosus(20/28)and Sjogren's syndrome(6/28).(3)The characteristics of the autoimmune diseases was multi-system involvement,such as hematologic system,kidney,liver,etc.(4)Clinical features of those acute pancreatitis shown that no distinct trigger exist for acute pancreatitis.and the radiological changing Was not prominent.(5)In laboratory examination,an obvious increase of CA199 coaid be seen,paralleling the severity of pancreatitis.(6)Glucocorticoids or immunosuppressors was effective,and the mortality rate of acute pancreatitis cases was 33.3%.ConclusionsAutoimmune disease related pancreatitis is dominant with acute pancreatitis and females is common,which may reflect the activity of autoimmune diseases.Autoimmune disease related acute pancreatitis has a high mortality rate.Glucocorticoids and/or immunosuppressors may be useful to relieve the pancreatitis.

Objective To evaluate the clinical effect of restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) for refractory ulcerative colitis (UC).Methods In this study 60 refractory UC patients received IPAA operation during the period of 1990 to 2010.Data were collected regarding early and late postoperation complications,anal continence function,and characteristics of feces.The patients' quality of life was objectively accessed using the Clevend Global Quality of Life (CGQL)index.0ne-way analysis of variance was used.Results Mean follow-up period was 2 years.Early postoperative complication rate developed in 15％ (9/60),including abdominal or pelvic infection,anastomotic leak,pouch bleeding,pouch-vaginal fistula,and intestinal obstruction.Late postoperative complication rate was 12％ (7/60),including pouchitis,intestinal obstruction,and male sexual dysfunction.Stool frequency per 24 hours and that at night was 3.5 ± 1.3 and 1.4 ±0.6.93％ (56/60)patients differentiated gas and feces well and 3％ (2/60) needed daily pads.According to Kirwan Grading Scale,anal function outcomes were Grade Ⅰ:54 (90％),Grade Ⅱ:4 (7％),and Grade Ⅲ:2 (3％).According to Bristol Stool Form Scale,characteristics of feces were Grade Ⅳ:31 (52％),Grade Ⅴ:25(42％),and Grade Ⅵ:4 (6％).Postoperative CGQL result showed a much better quality of life than preoperative CGQL (F =12.368,P ＜ 0.05).Conclusions Refractory UC is surgically indicated and IPAA is the operation of choice with safety,satisfactory long-term outcome and improved quality of life.

Humans ; Nasal Obstruction ; Nose Diseases ; Syndrome

Coal Mining ; Humans ; Occupational Diseases ; prevention & control ; Occupational Health ; Tuberculosis ; prevention & control

Background: Inducible T-cell co-stimulator (ICOS)is a member of the B7-CD28 family, which plays roles in various biological processes including cell proliferation, differentiation and immune responses, and is closely related to immune escape in many malignant tumors. Aims: To investigate the expression and significance of ICOS in colorectal cancer (CRC). Methods: Thirty-two pairs of fresh CRC tissues and adjacent non-cancerous tissues, as well as 211 cases of paraffin-embedded CRC tissues were collected for detection of ICOS mRNA and protein expressions by real-time PCR and immunohistochemistry, respectively. Correlations between ICOS expression and clinicopathological characteristics and prognosis were analyzed. Results: In comparison with adjacent non-cancerous tissues, expression of ICOS was significantly lower in CRC tissues (P<0.05), and correlated negatively with the tumor size, serum CEA, lymph node metastasis, distal metastasis and TNM staging (P all <0.05). No significant difference in ICOS expression was found in tumors from different location (P>0.05). Kaplan-Meier survival analysis suggested a poorer prognosis in CRC patients with lower ICOS expression (P<0.05). Multivariate Cox regression analysis confirmed that ICOS expression could be an independent prognostic factor for CRC (HR=0.821, 95% CI: 0.588-0.912, P=0.034). Conclusions: ICOS is lowly expressed in CRC tissues and is associated with tumor progression and poor prognosis. It might be a promising molecular marker for predicting prognosis of CRC.

This study determined the profile of renal insufficiency in patients without chronic kidney disease(CKD)undergoing coronary revascularization and elucidated the effect of renal insufficiency of different degrees on clinical outcomes after revascularization and examined whether the reasonable choice of the mode of revasoularization could favourably influence prognosis.Methods Patients undergoing coronary revascularization were grouped by estimated creatinine clearance(CrCl)(Group Ⅰ,CrCl≥90 ml/min;Group Ⅱ,60 CrCl<90 ml/min;Group Ⅲ,30≤CrCl<60 ml/min;Group Ⅳ,CrCl<30 ml/min).We evaluated the relationship between the CrCl and the clinical outcomes of all of the patients.Results The mean Scr level of 2896 patients was(80.0±35.4)μmol/L There were 1035 patients(35.7%)in Group Ⅰ,1337 patients(46.2%)in Group Ⅱ,524 patients(18.1%)in Group Ⅲ and no patient in Group Ⅳ.During hospitalization,significant difference was found among Group Ⅰ-Ⅲ on mortality (1.0%.2.5% and 2.9%,P=0.009)and major adverse cardiar cerebra tvents(MACCE)(1.4%,3.5% and 4.6%.P=0.001).Compared with the normal renal function group,there were significantly higher rate of mortality(2.5% vs.1.0%,P=0.007).new-onset myocardial infarction(1.0% vs.0.2%,P=0.018)and MACCE(3.5% vs.1.4%,P=0.002)in miid renal insufficiency(Group Ⅱ).During follow-up,there were significant difference among Group Ⅰ-Ⅲ on mortality(2.0%,3.0% and 5.7%,P=0.002),stroke(1.0%,1.8% and 3.1%,P=0.023)and MACCE(9.9%,10.3% and 16.6%,P=0.001).The independent risk factors for all-cause death in patients after revascularization were the mode of revascularization(OR 8.332,95% CI 2.386-22.869,P=0.001).age(OR 1.184,95% CI 1.020-1.246,P=0.001).and the level of CrCl(OR 0.503,95% CI 0.186-0.988,P=0.045).In patients with normal renal function and mild renal insufficiency.the all-cause mortality after PCI was significantly lower that than after CABG(both P<0.01).Conclusions Renal insufficiency is common in patients without CKD undergoing coronary revascularization,even mild renal insufficiency is correlated with adverse clinical outcomes after revascularization.In patients with normal renal function or mild renal insufficiency,the mode of revascularization might lead to a prognostic difference.

Animals ; Calcitriol ; pharmacology ; Diabetes Mellitus, Experimental ; complications ; Diabetes Mellitus, Type 2 ; complications ; Liver ; drug effects ; Liver Diseases ; complications ; drug therapy ; Male ; Rats ; Rats, Sprague-Dawley

Objective To investigate the relationship between cerebral white matter fractional anisotropy(FA)and metabolite con-centrations measured by 1 H magnetic resonance spectroscopy(1 H-MRS)in healthy adults.Methods Diffusion tensor imaging(DTI) and 1 H-MRS were acquired from thirty-one healthy adults at 3.0 T MR system.The concentrations of N-acetylaspartate(NAA), choline(Cho),creatine(Cr),the ratios of NAA/Cr and FA values of DTI were measured in 353 voxels,covering the bilateral medium corona radiata.According to the age,all voxels were divided into two groups:the senior group (mean age=29 years),and the senior group(mean age=5 6 years).The correlations between FA values and age were analyzed using Pearson’s correlation coefficients.The correlations between FA values and metabolite concentrations were estimated using partial correlations test controlling for the age re-lated bias.Results Pearson’s correlation analysis revealed a negative correlation between FA values and age in 353 voxels(r=-0.146,P<0.05),senior group(r=-0.204,P<0.05)and senior group(r=-0.162,P<0.05).Only the correlation between NAA and FA values were significant(r=0.339,P<0.05;r=0.213,P<0.05;r=0.430,P<0.05).There were positive relation-ships between FA values and NAA/Cr among 353 voxels (r=0.166,P<0.05)and senior group(r=0.305,P<0.05).Conclusion There are correlations between cerebral white matter FA values and metabolite concentrations measured by 1 H-MRS .Combining 1 H-MRS with DTI can reveal the relationship between microscopic white matter integrity and metabolic characteristics of the white matter.

Objective:To explore the therapeutic effect and safety of thrombus aspiration catheter in young patients with acute ST-segment elevation myocardial infarction (STEMI) during primary percutaneous coronary intervention (PCI) .Methods :According to using thrombus aspiration catheter during emergency PCI or not ,a total of 79 young patients with acute STEMI were divided into aspiration group (n= 37 ,received thrombus aspiration ) and routine treatment group (n=42 ,didn't receive aspiration catheter ) .Coronary TIMI flow ,angina pectoris symptoms ,cardi-ac function and major adverse cardiovascular events (MACE) etc .after PCI were observed and compared between two groups .Results:Compared with routine treatment group after treatment ,there were significant rise in TIMI flow [ (2.33 ± 0.48) grade vs .(3.00 ± 0.00) grade] ,2h ST segment regression >50% rate (45.24% vs .70.27% ) and left ventricular ejection fraction on the first week [ (47.21 ± 9.28)% vs .(52.16 ± 7.87)% ];significant reduc-tion in angina pectoris symptom (50.00% vs .27.03% ) ,and NYHA cardiac function during follow-up [ (1.52 ± 0.71) class vs .(1.22 ± 0.42) class] in aspiration group , P<0.05 or <0.01. There was no significant difference in incidence of MACE between two groups , P>0.05 all .Conclusion:Application of thrombus aspiration catheter could improve coronary blood flow ,reduce symptoms of angina pectoris and improve cardiac function during primary PCI in young patients with acute STEMI ,and it's safe .

Objective To establish the rat model of collagen-induced arthritis and study the diagnostic value of MRI for early RA by comparing to pathological changes. Methods Thirty Wistar rats were randomly divided into normal groups and experimental groups.Fifteen rats of the experimental groups were immunized with type Ⅱ collagen and Freund's Adjuvant Incomplete. At the scheduled days, the selected rats of both experimental and normal groups underwent X-ray, 1.5T MR scan plus enhancement and histological analysis. Results Arthritis Index increased on the 14th day after immunization and reached the peak on the 28th day in the experimental group, the positivity of Anti-CⅡ antibody was significantly different from the normal group.The experiemental model was established in 93.33% of all rats. The enhanced MRI showed that 12 (12/15) rats presented with abnormal signs . The sensitivity of MRI was 85.71% and the specificity was 100%. There was no significant correlation could be found between MRI and histological changes X-ray revealed soft tissue swollen in 4 (4/15) rats, which showed that MRI had higher sensitivity in detecting abnormal signs of arthritis than X-ray. Conclusion MRI may be used in the early diagnosis of early RA.