Objective To ivestigate integrative medicine therapy for severe systemic lupus erythematosus.Methods In 2005,we successfully salvaged a severe SLE patient,who was an inpatient from the TCM Rheumatology department of China-Japan relationship hospital.The mainly clinic manifestations included severe pulmonary hypertension,gangrene and pancytopenia.We analyzed this ease.Results By integrative medicine therapy,we successfully salvaged this patient.Conclusion The key points for integrative medicine therapy for severe systemic lupus erythematosus included:1.Using strong measures to control the disease progress,including hormones,immunosuppressive agents; 2.Positive and effective symptomatic treatment aiming at pulmonary hypertension and severe gangrene; 3.Emphasizing the effect of Chinese medicine,using integrative medicine therapy.In sum,in this case,we applied integrative medicine therapy and got very perfect clinic effect at last.

Objective To explore the effect of problem-based learning method in traditional Chinese internal medicine teaching. Methods 58 students enrolled in the major of integrated traditional Chinese and western medicine in class C at the Beijing University of Chinese medicine were arranged to receive PBL(test group)or traditional teaching methods(control group)in 2 courses and complete 116 questionnaires. The teaching outcomes were evaluated by questionnaire and individual interviews. Results Compared with controls,students receiving PBL performed significantly better in terms of active classroom atmosphere, broadening their knowledge, and improving teamwork ability(χ2 were 7.16, 4.07, 4.09, P<0.05). Conclusion The PBL strategy has the advantage than the traditional teaching methods in traditional Chinese internal medicine teaching.

Acute pancreatitis (AP) is an acute inflammatory and cell-damaging process of the pancreas. In this paper, using the AP onset location and its characteristics combined with review of the ancient and modern literatures and summary of the clinical practices, the professor Chen Qiaolin's academic ideas and clinical experiences in treating AP are introduced and demonstrated. Dr. Chen believes that the development of AP is a dynamic process, the key point is to grasp the Shaoyang syndrome complicated with Yangming, the internal administration of the self-modified Dachaihu decoction is the basic therapy accompanied by applying paste-like Traditional Chinese Medicine TCM attached on the acupoints and acupuncture for comprehensive treatment of AP, the therapeutic result is confirmed and its summary is as follows.

Objective:To detect the factors related to hemocytopenia and interstitial lung disease (ILD) secondary to primary Sj?gren's syndrome (pSS) in in-patients.Methods:Clinical characteristics of patients with pSS hospitalized in China-Japan Friendship Hospital from March 2014 to October 2020 were retrospectively analyzed. Patients were divided into different groups according to hemocytopenia and ILD. Chi-square test and Mann-Whitney U test were used to compare data in subgroups, and logistic regression were used to detect factors related to hemocytopenia and ILD secondary to pSS. Results:Five hundred and seventy-one inpatients with pSS were included in this study and the female: male ratio was 8∶1. Two hundred and seventy five of included patients had hemocytopenia (48.2%) and 180 patients had ILD (31.5%). Compared with patients without hemocytopenia, patients with hemocytopenia had higher ratio in low C3 [ OR=2.326, 95% CI(1.483, 3.650), P<0.01] and elevation of erythrocyte sedimentation rate (ESR) [ OR=1.912, 95% CI(1.233, 2.964), PP<0.01) . Compared with patients without ILD, patients with ILD showed higher ratio in male[ OR=2.509, 95% CI(1.269, 4.959), P<0.01) and fatigue [ OR=5.190, 95% CI(5.190, 13.931), P<0.01) , lower positive rate of anti-SSA antibody [ OR=0.392, 95% CI(0.230, 0.668), P<0.01) and anti-CENPB [ OR=0.337, 95% CI(0.145, 0.782), P<0.01] antibodies, and lower ratio in low C3[ OR=0.332, 95% CI(0.189, 0.582), P<0.01]. Conclusion:Low C3 and high ESR may be risk factors for developing hemocytopenia in patients with pSS. Men with pSS may be susceptible to ILD, while pSS patients with ILD may have lower ratio in positive anti-SSA antibody, positive anti-CENPB antibody and low C3. All of these findings are yet to be validated by future prospective cohort studies.

Objective:To investigate the method and clinical effect of ultrasound-guided thrombin injection in the treatment of femoral pseudoaneurysm.Methods:From January 2017 to December 2019, 71 patients in Gongren Hospital with femoral pseudoaneurysm were treated by ultrasound-guided thrombin injection. There were 55 cases of fistula type and 16 cases of fissure type. The maximum diameter of the cavity and the neck of pseudoaneurysm were measured and recorded. Two groups of patients were injected thrombin under ultrasound guidance (according to the shape of the pseudoaneurysm neck, different injection methods were used). The treatments for the first time and first recurrence of the two groups were treated with the corresponding conventional injection method. For the second fracture type of the second recurrence of the patients, the method of cross injection and gradual advance to the pseudoaneurysm neck was used for the third time, and the compression time was extended after the blood flow in the cavity disappeared. Ultrasound was performed at 24 hours and 1 week after operation to observe the blood flow and thrombosis.Results:In 55 patients with pseudoaneurysm of fistula type, 54 patients were treated successfully after once injected, pseudoaneurysm recurred in 1 patient relapsed by ultrasound 24 hours after operation, and the second injection was successful. In 16 patients with pseudoaneurysm of fissure type, 10 patients were successfully treated after once injection, 6 patients recurred 24 hours after operation, 4 patients were successfully treated after the second injection, and 2 patients after the third injection. There was no correlation between the recurrence of fistula pseudoaneurysm and the diameter of the pseudoaneurysm neck( r s=0.103, P=0.455), while the recurrence of fissure pseudoaneurysm was closely related to the diameter of the pseudoaneurysm neck( r s=0.870, P<0.001). Finally, all the patients achieved satisfactory curative effect, and the cure rate was 100%. Conclusions:Ultrasound-guided thrombin injection in the treatment of femoral pseudoaneurysm has a significant clinical effect. However it is necessary to determine the shape of the pseudoaneurysm neck and measure the diameter of the pseudoaneurysm neck before operation, so as to adopt a reasonable and effective injection method, to improve the success rate of the first treatment and reduce the recurrence.

Objective:To explore the neural mechanism of language dysfunction in patients with subacute stroke using functional near-infrared spectroscopy (fNIRS).Methods:Sixteen patients with non-fluent aphasia after subacute stroke (aphasia group), 16 patients with non-aphasia after stroke (non-aphasia group), and 16 healthy middle-aged and elderly subjects (control group) were enrolled into our study. The 6-min resting-state data of fNIRS were collected. Four language-related regions, Broca area, Wernicke area, dorso lateral prefrontal cortex (DLPFC), and supplementary motor area (SMA), were selected as regions of interest (ROIs), and the whole brain functional connection strength and functional connection strength in ROIs and between each two ROIs were analyzed by NirSpark software.Results:Compared with the control group (0.53±0.15) and non-aphasia group (0.47±0.12), the aphasia group had significantly decreased whole brain functional connection strength (0.29±0.14, P<0.05). Compared with the control group and non-aphasia group, the aphasia group had significantly decreased functional connection strength in the left Wernicke area, right Wernicke area, left Broca area, left SMA area, right SMA area and left DLPFC area ( P<0.05, FDR). Compared with the control group and non-aphasia group, the aphasia group had significantly decreased functional connection strength in the right Wernicke-left Wernicke area, right Wernicke-right Broca area, right Wernicke-left Broca area, right Wernicke-right DLPFC area, right Wernicke-left DLPFC area, right Wernicke-right SMA area, right Wernicke-left SMA area, left Wernicke-right Broca area, left Wernicke-left Broca area, left Wernicke-right DLPFC area, left Wernicke-left DLPFC, left Wernicke-right SMA area, left Wernicke-left SMA area, right Broca-left Broca area, right Broca-left DLPFC area, right Broca-right SMA area, right Broca-left SMA area, left Broca-right DLPFC area, left Broca-left DLPFC area, left Broca-right SMA area, left Broca-left SMA area, right DLPFC-left DLPFC area, right DLPFC-right SMA area, right DLPFC-left SMA area, left DLPFC-right SMA area, left DLPFC-left SMA area, and right SMA-left SMA area ( P<0.05, FDR). Conclusion:Abnormal functional connectivity strength of the whole brain and language-related key brain areas might be the neural mechanism of language dysfunction in patients with non-fluent aphasia after subacute stroke.

Objective: To discuss the application of plane-shaped flaps for reconstruction of the web space in polysyndactyly of the fifth toe fused with the fourth toe. Methods: A total of 62 cases (81 feet) with polysyndactyly of the fifth toe fused with the fourth toe were involved in the study, 53 of which were incomplete and 9 were complete fusion of the fourth and fifth toe. The fifth toe showed various degrees of fibular clinodactyly and minor deformities. Excision of polydactyly and then using arthroplasty or osteotomy correction deviation was for fibular clinodactyly. All plane-shaped flaps were used for reconstruction of the web space deeply, and the lateral sides of toes were closed with flaps and the distal soft tissues of polydactyly were used lengthening the reconstructed fifth toe. Brachydactylias were improved, and nail folds were reconstructed. Thus, the appearances reached the normal level. Results: All the webs were reconstructed primarily without skingraft. After 12 months of follow-up, these reconstructed web space were satisfied with good appearances of width, depth and gradient. The fibular clinodactyly was completely corrected, and brachydactylias were corrected in various degrees. Nail folds reached the normal ones. Conclusions Plane-shaped flap in polysyndactyly of the fifth toe fused with the fourth toe for reconstruction of the web space is satisfactory. The reconstructed webs not only achieves good appearance, but also avoids skin grafts. It is one of the best choices of the polysyndactyly treatment.

Objective:To investigate the efficacy and safety of oral sirolimus in the treatment of refractory vascular anomalies.Methods:From February 2017 to February 2018, 20 cases of vascular deformity with no obvious improvements after multiple therapies in our hospital were included. Among them, 5 have Kaposiform hemangioendothelioma (KHE) with Kasabach-Merritt phenomenon (KMP), 10 have lymphatic malformation, 3 have venous malformation and 2 have lymphatic venous malformation. A single course of oral sirolimus lasted for 3 months. Initial dose was 0.8 mg/m 2 once, oral administration twice per day, and subsequent dose was adjusted to maintain the concentration of blood drug at 10-15 ng/ml. Before and after taking sirolimus, the general information, tumor changes and the adverse reactions were gathered. Efficacy was evaluated at the end of the treatment course. Effective: tumor volume reduced by more than 50% and or platelets stabilized in the normal range. Partly effective: tumor volume reduced by 25%-50%. No effect: tumor volume reduced by less than 25% or no significant change. Results:All the patients were treated with sirolimus orally for 1-3 courses, among which 11 were effective, 6 were partially effective, and 3 were ineffective. They were followed up for more than 3 months after the end of the whole course and no tumor enlargement was observed. All the 5 cases with KHE and KMP had significantly reduced tumor size and the platelets were stable in the normal range, but 2 of them suffered from severe pneumonia, one of them eventually perished. Two of the remaining children had elevated liver enzymes and high fever. The lesions of 10 patients with lymphatic malformations were reduced, and 4 of them had mild liver dysfunction. Two with lymphatic venous malformations had shrunk in different degree, and 3 with venous malformations had no effect. Three of them showed significant relief of pain symptoms, and their pain score was significantly lower than that before oral administration (8.7±1.2 vs 1.3±1.2, P=0.001). Except for 1 case with venous malformation had oral ulcer. No obvious adverse reaction were observed in the remaining 11 patients. Conclusions:Oral sirolimus may be effective and safe in the treatment of refractory vascular anomalies, but it should be treated with caution in little infants.

Objective:To investigate the efficacy and safety of oral sirolimus in the treatment of refractory vascular anomalies.Methods:From February 2017 to February 2018, 20 cases of vascular deformity with no obvious improvements after multiple therapies in our hospital were included. Among them, 5 have Kaposiform hemangioendothelioma (KHE) with Kasabach-Merritt phenomenon (KMP), 10 have lymphatic malformation, 3 have venous malformation and 2 have lymphatic venous malformation. A single course of oral sirolimus lasted for 3 months. Initial dose was 0.8 mg/m 2 once, oral administration twice per day, and subsequent dose was adjusted to maintain the concentration of blood drug at 10-15 ng/ml. Before and after taking sirolimus, the general information, tumor changes and the adverse reactions were gathered. Efficacy was evaluated at the end of the treatment course. Effective: tumor volume reduced by more than 50% and or platelets stabilized in the normal range. Partly effective: tumor volume reduced by 25%-50%. No effect: tumor volume reduced by less than 25% or no significant change. Results:All the patients were treated with sirolimus orally for 1-3 courses, among which 11 were effective, 6 were partially effective, and 3 were ineffective. They were followed up for more than 3 months after the end of the whole course and no tumor enlargement was observed. All the 5 cases with KHE and KMP had significantly reduced tumor size and the platelets were stable in the normal range, but 2 of them suffered from severe pneumonia, one of them eventually perished. Two of the remaining children had elevated liver enzymes and high fever. The lesions of 10 patients with lymphatic malformations were reduced, and 4 of them had mild liver dysfunction. Two with lymphatic venous malformations had shrunk in different degree, and 3 with venous malformations had no effect. Three of them showed significant relief of pain symptoms, and their pain score was significantly lower than that before oral administration (8.7±1.2 vs 1.3±1.2, P=0.001). Except for 1 case with venous malformation had oral ulcer. No obvious adverse reaction were observed in the remaining 11 patients. Conclusions:Oral sirolimus may be effective and safe in the treatment of refractory vascular anomalies, but it should be treated with caution in little infants.

Objective:To investigate the effects of superoxide dismutase 1 (SOD1) mutations G41D and G41S on the cognitive behavior of mice.Methods:The recombinant adeno-associated virus (rAAV) which overexpressed human SOD1WT, SOD1G41S, SOD1G41D and the blank virus without the target gene were constructed, then they were stereotaxic injected into mice bilateral medial prefrontal cortex (mPFC) area respectively.According to the difference of injected virus, they were divided into CONTROL group, SOD1WT group, SOD1G41S group and SOD1G41D group ( n=16 in each group). One month later, open field test, Y-maze spontaneous alternation experiment, three box social interaction experiment and trace fear conditioning test were conducted to observe the effect of mutant gene on cognitive behavior of mice. Results:In the open field test, the movement distance of SOD1WT group((39.67±6.04)m)was significantly higher than that of SOD1G41D group((28.47±6.92)m, P=0.034). In the Y-maze spontaneous alternations experiment, the number of arm entries and actual alternations of arm entries of SOD1WT group((40.56±10.12)times, (32.63±8.19)times)and SOD1G41S group((36.75±9.43)times, (29.06±8.32)times)were significantly higher than those of SOD1G41D group((24.50±11.30)times, (18.38±9.09)times, P<0.05). In the three-compartment social experiment, there was no statistical difference between the residence time of SOD1G41D group in the area containing mouse ((279.08±134.94) s) and the empty metal cage area ((218.54±125.63) s) ( t=1.313, P=0.199). SOD1WT group and SOD1G41S group showed no statistical difference in the residence time in the regions of the unfamiliar mouse 1((253.07±55.60)s, (253.20±57.61)s) and the unfamiliar mouse 2 ((243.44±55.33) s, (239.76±67.49) s) ( P>0.05), and SOD1WT group and SOD1G41S group presented new social barrier.In the test stage of trace fear condition task, the percentage of freezing time of SOD1G41S group was significantly higher than that of other experimental groups and CONTROL group ( P<0.05). Conclusion:SOD1G41S and SOD1G41D have significantly changed the cognitive behavior of mice, and the two types of mutations at the same site have significant differences in the cognitive behavior changes.