Objective To compare and analyze the different clinical features between male and female patients with rheumatoid arthritis (RA), by detecting the gender difference to make clinical decisions. Method The clinical features of 95 male RA patients(MRA) were analyzed and compared with those of 248 female RA patients (FRA) by retrospective analysis method. Results The mean onset age of MRA [18-79 (51.40±15.55) years old] was older than that of FRA[18-75(43.54 ±15.46) years old](P=0.0002). The morning stiffness time of MRA [(1.58 ±1.34) h] was shorter than that of FRA [(2.10 ±1.51) h](P = 0.0357). There was statistical difference in the first involved joint between MRA and FRA (P=0.0170), the prevalence of knee,metatarsonphalangeal joint,shoulder and ankle of MRA was higher than those of FRA, ' but conversely the wrist prevalence of FRA was higher than that of MRA.The prevalence of secondary Sj(o)gren syndrome of MRA(13.68%, 13/95) was rather lower than that of FRA(35.08%, 87/248)(P = 0.0007). MRA had lower positive rate of ANA (2.11% ,2/95) and lower value of IgM [(1.42 ±0.75) g/L] than FRA [(10.48% ,26/248), (1.69 ±0.86) g/L] (P < 0.05). There was no statistical difference between MRA and FRA in articular radiographic changes, most extraarticular manifestations and lab results (P >0.05). Conclusions MRA patients have older onset age and milder articular symptom than FRA patients. The disease severity of MRA is similar to that of FRA. Weighted joints are more involved in MRA. FRA is more inclined to have secondary Sj(o)gren syndrome.

Objective To detect the positivity of circulating autoantibodies against cardiac troponin Ⅰ (cTnI) in acute myocardial infarction (AMI) and myocarditis patients and investigate the interference of the antibodies with the detection of cTnI. Methods cTnI ELISA was established for assessment of sera obtained from 121 patients with AMI, 24 with myocarditis and 210 healthy subjects. Binding specificity of cTnI antibody from positive sera by ELISA was confirmed with Western Blot. The recovery of cTnl studies was employed to evaluating the effects of cTnl autoantibodies on cTnI immunoassays. Results Thirteen of the 121 AMI patients (10.74%) and 2 of the 24 myocarditis patients (8.3%) had positive anti-cTnI antibodyas compared with none in the healthy subjects. The recovery of cTnI by adding cTnI-C fusion proteincorresponding to final cTnI concentration of 0.625-100 ug/L to sample with anti-cTnI antibody wasinhibited significantly (Spearman correlation coefficient r=0.943, P=0.005 ). There was no significantchange of recovery of cTnl when adding it to a normal sera(Spearman correlation coefficient r=0.377,P=0.461). When cTnI-C complex corresponding to 20 ug/L cTnI was added, 5 of the 15 sera with anti-cTnIantibody were found with the inhibition of recovery (<80%). Conclusions Autoantibodies against cTnIwere increasing in patients with AMI and myocarditis, yet it appears that these autoantibodies could interferenegatively with the cTnI immunoassay. Thus, it should be paid more attention to cTnI immunoassays.

85%) in 18 patients (21.4%) and a partial resection (

Objective To explore the clinical significance of cytokeratin(AE1/AE3) immunohistochemical staining in detecting the lymph node micrometastasis of gastric cancer.Methods Immunohistochemical S-P method was used to examine AE1/AE3 in 118 lymph nodes in 64 cases of primary gastric cancer.Results Among 118 lymph nodes,micrometastasis was found in 13 lymph nodes of 8 patients with primary gastric cancer by AE1/AE3 staining.The positive rate of micrometastasis was 12.5% and the positive rate of lymph nodes was 11.02%.The incidence of micrometastasis was related with the depth of invasion,and in the cancer with deep invasion,the positive rate of micrometastasis was higher than that in the cancer with superficial invasion(P

Objective To explore the possible negative interference of circulating cardiac troponin Ⅰ(cTnI) autoantibody on the immunoassay of cTnI in five commonly used cTnI detection systems. Methods Thirteen patients with positive cTnI autoantibodies in their serum samples were firstly screened and selected from 121acute myocardial infarction (AMI) patients using ELISA assay. The serum cTnI values and their recovery rates were then carefully measured and analyzed. Results cTnI values in these 13 samples showed amazing difference in the five detection systems, demonstrating various degrees of pseudo-drop, or even false-negative. One sample with low recovery was detected in Access-2 system. One sample with low recovery as well as one sample with moderate recovery were detected in Architect i2000 (Abbott). Two samples with moderate recovery and one sample with low recovery were detected in Axsym(Abbott). Three samples with moderate recovery and two samples with low recovery were detected in Dimension X Pand (Dade Behring)and one sample with moderate recovery together with four samples with low recovery were detected in Vidas (Biomerieux). And the serum levels of autoantibodies (A450) positively correlated with the degrees of their negative interference for the detection of cTnI. The R2 and P values on each system were 0. 841 (P <0. 01)vs Access-2, 0. 808 (P < 0. 01) vs Architect i2000 (Abbott), 0. 772 (P < 0. 01) vs Axsym (Abbott), 0. 707 (P < 0. 01) vs Dimension X Pand (Dade Behring) and 0. 424 (P < 0. 05) vs Vidas (Biomerieux), respectively. Conclusion Circulating autoantibodies of cTnI can induce considerable negative interference in all the 5 commonly used cTnI detection systems, which might then lead to incorrect judgments of the obtained results of cTnI in daily clinical work.

Objective Endoscopic ultrasound guided fine needle aspiration biopsy (EUS-FNA) was performed for diagnosis and treatment of the pelvic Lesions and safety of this method were evaluated.Methods EUS-FNA was performed in 52 patients with pelvic Lesions selected by EUS,CT or MRI between March 2009 and June 2012.Both 19 and 22 gauge needles were used for EUS-FNA.The tissue specimens were analyzed by cytologic or histologic examination.The pelvic cystic lesions were drained and in which purulent lesions were lavaged with Metronidazole repeatedly.Results All patients recieved fine needle biopsy of the pelvic lesions.Among the 52 lesions,there were 42 solid lesions,10 cystic lesions.In solid lesions,cytology and pathology demonstrated malignant tumors in 28 patients,3 cases of malignant stromal tumors,3 cases of Inflammatory mass cases,2 cases of lymphoma,1 case of dermoid cyst,5 cases of other.In cystic lesions,2 cases of serous cystadenoma,perirectal abscess in 8 cases.6 purulent lesions were lavaged with Metronidazole repeatedly.Diagnosis rates of samples for immunohistology remained similar between 22 gauge and 19 gauge needles (P ＞0.05).During the operation,8 cases of perirectal abscess patients have different degree of pain.There were no other complications after the procedures except one patient suffering from fever.Conclusion EUS-guided FNA is minimaly invasive,a safe and accurate method for diagnosis of pelvic lesions.

Objective To investigate the change and its related risk factors of cognitive function of patients with Parkinson's disease(PD).Methods The cognitive function of 70 idiopathic PD patients were assessed with Montreal cognitive assessment scale (MoCA),and other PD related neuropsychological test batteries were used to evaluate their movement symptoms and non-movement symptoms such as depression and anxiety.Patients' personal information were collected at the same time.They were reassessed after 2 years.Results As the disease progressed,the MoCA score of the PD patients significantly reduced from (24.79±4.07) points to (21.69±5.22) points (P＜0.01).Seven subdomains of MoCA were attenuated,and 5 of them reached statistical significance.Motor subtype was a main predictor of the outcome of the cognitive impairment in PD.Scores of MoCA total score,naming,language,abstract and directional domains reduced more notably in patients with postural instability gait difficulty(PIGD) than those in the tremor dominant(TD) patients.Conclusion Cognitive function of PD patients decreases obviously after 2 years.The patients' cognitive impairment should be identified and intervened as soon as possible,especially the patients with PIGD.

Objective To investigate the expression of Dickkopf-3 (Dkk-3) in esophageal cancer and normal esophageal tissue and the relationship between Dkk-3 expression and the biological behaveior of esophageal cancer. Methods Immunohistochemical method of S-P was used to examine Dkk-3 expression in 69 cases of esophageal squamous cell carcinoma and 5 cases of normal esophageal tissue with non-tumor tissue microarray and the results were analyzed and correlated with their clinical and pathological features. Results Positive Dkk-3 expression was observed in 65.7% (44/67) of the esophageal squamous cell carcinoma cases, but only one of the five cases with normal esophageal tissue showed positive microvascular expression of Dkk-3. In cases with positive expression of Dkk-3 significant differences were found in fiber membrane infiltration, depth of invasion, lymph node metastasis and TNM staging (P < 0. 05), while no significant differences were found in the age, gender and pathological grading (P > 0. 05). Conclusions The upregnlation of Dkk-3 expression in esophageal squamous cell carcinoma may contribute to tumor invasion and metastasis.

Objective To evaluate the flexible spectral imaging color enhancement (FICE) system for determine the margin of early gastric cancer and precancerous lesions.Methods From February 2008 to October 2011,a total of 51 patients with early gastric cancer or high-grade intraepithelial neoplasm who received ESD were enrolled and randomly divided into experimental group to determine lesion margin by FICE (n =26) and control group to identify lesion margin by indigo carmine (n =25).Histological complete resection rate (the lateral and vertical margins were free of cancer),operation time,complications,post-ESD ulcer-healing rates and local recurrence were assessed.Results The histological complete resection rate,acute minor bleeding rate and post-ESD abdominal pain rate in experimental group were 2.3％ (24/26),88.5％ (23/26),15.4％ (4/26) and 73.1％ (19/26),which were not significantly different from those of control group,i.e.,92.0％ (23/25),84.0％ (21/25),12.0％ (3/25)and 72.0％ (18/25) (P＞0.05).The mean operation time of in experimental group was shorter than that of control group (P ＜ 0.05).No massive bleeding,delayed bleeding or perforation occurred in either group.Follow-up showed no local residue or recurrence.Conclusion FICE is safe and effective to determine the tumor demarcation of early gastric cancer and high-grade intraepithelial neoplasm,and needs less operation time.

Objective This research puts the academic leader under the competency background to investigate the current status of academic leaders in tertiary hospitals in Shanghai,combines the theories a-nalysis with practice on the Correlative Research,takes evaluation of academic leaders as the target to deep into the discussion,studies the application value and special significance of the competency model on culti-vation,introduction and evaluation of academic leaders in tertiary hospitals in Shanghai area.Methods Core elements of competency of the academic leaders were investigated by literature reviews,expert inter-views,behavioral event interview,and questionnaires.The questionnaire of the competency of academic leaders was prepared and the numbers and induction relevant to characteristic items of the competency were obtained.Results The notion of six feature families is proposed by study of the competency model which composed 18 relative characteristic items.Six feature families are leadership,organization team with coordi-nation,innovation and implement of project,strategic thinking and overall outlook,self-control and self-management,pursuit excellence and development.Conclusions The academic leader not being lack of professional quality,it is the deep characteristics under the Iceberg Model that influenced the development degree,efficiency,effects of subjects.The study on the competency of the academic leader is helpful for e-valuation of academic leaders'comprehensive abilities and put forward some proposal about stuff rundle con-struction for reference in hospital.