Humans ; Nasal Obstruction ; Nose Diseases ; Syndrome

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.

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.

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 assess whether anemia is an independent predictor of poor long-term outcome after percutaneous coronary intervention(PCI).Methods The second drug-eluting stent impact on revascularization registry(DESIRE-2)is a single-center registry of 6005 patients undergoing coronary revascularization from July 2003 to September.2005.We examined the clinical data and outcome of 3809 PCI patients based on hemoglobin(Hb)value before the interventional procedure.Patients were classified as anemia using the World Health Organization deftnition(＜120 g/L in women and＜130g/L in men). 744 of the 3809 patients were anemic.We compared the clinical features and prognosis of the patients with or without anemia.Results Anemic patients were older and had a higher percentage of comorbidities as compared with the nonanemic ones.When compared with nonanemic patients,anemic patients had higher mortality(4.7%VS 1.5%,P＜0.001)and higher major adverse event end points,including nonfatal myocardial infarction,stroke and revascularization(14.0%vs10.8%,P=0.014).After adjustment for comorbidities,anemia was associated with a higher risk of mortality after percutaneous coronary intervention(RR 2.216,95%CI 1.019-4.428;P=0.024).Conclusions Anemia is an independent predictor of mortality after PCI.Since PCI iS a common procedure and anemia is a frequent condition in the general population,strategies for the management of anemic PCI patients should be developed.

Objective To investigate the gene expression difference of IFN and their receptors in peripheral blood mononuclear cells (PBMC) of pulmonary embolism (PE) patients.Methods Twenty cases of PE patients and twenty sex and age matched controls were recruited into the study.Human cDNA microarray analysis was used to detect the gene expression difference of IFN associated genes between the two groups,and random variance model corrected t test was used to analyze the statistical data.Results In comparison with the control group, mRNA expression of type Ⅰ IFN, including IFNα5 mRNA,IFNα6 mRNA,IFNα8 mRNA,IFNα14 mRNA,IFNκ mRNA,IFNω1 mRNA,IFNε1 mRNA in PBMC of PE patients Were down-regulated (P ＜ 0.05 ).There was no significant difference in gene expression of type Ⅰ IFN receptors IFNαR1 and IFNαR2 between the PE and control groups (P ＞ 0.05 ).In comparison with the control group,mRNA expression of IFNγ gene was down-regulated ( P ＜ 0.05 ).The mRNA expression of IFNγR1 and IFNγR2 genes were upregulated compared with the control (P ＞ 0.05 ).Conclusion mRNA expression of type Ⅰ and type Ⅱ IFN in PE are significantly down-regulated,but not the IFN receptors.Reduced immune function may play an important role in the PE patients who are susceptible to virus,intracellular bacteria and parasites.

ObjectiveTo observe the influence of Danshen injection on the serum levels of TNF-α,IL-6 in patients with acute pancreatitis(AP).Methods70 patients with AP were randomly divided into the experimental and control group.The two groups were given conventional anti-inflammatory,antisecretory,antispasmodic,inhibition of pancreatic secretion treatment,and the experimental group were treated with Danshen injection.Before trealment and 1,2,4,6 days after treatment,the serum TNF-α,IL-6 levels were measured in both groups.The time of blood and urine amylase(AMS) returned to normal was observed in both groups.Results2,4,6d after treatment,the serum TNF-α,IL-6 of the observation group were lower than that of the control group( all P ＜ 0.05 ) ;The blood AMS recovery time of the observation group was ( 2.55 ± 0.71 ) d,which had no significant difference with that of the control group(2.46 +0.82)d(t =0.32,P ＞0.05 ),while urinary AMS recovery time of the observation group was (4.30 ±0.72 ) d,which was shorter than that of the control group ( 6.84 ± 0.88 ) d ( t =0.02,P ＜ 0.05 ).ConclusionDanshen injection could reduce the serum TNF-α,IL-6 levels in patients with AP,and had no effect on the serum amylase,with the trend of faster lower urinary amylase.