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.

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

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

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 observe the change of comprehensive agitating coefficient in the intracerebral hem -orrhage( ICH) patients monitoring by non-invasive cerebral edema and dynamical method ,and to find out dynamical change of cerebral edema in patients with ICH ,and to evaluate the specificity and sensitivity of non-invasive dynami-cal brain edema monitor in ICH treatment .Methods The change of comprehensive agitating coefficient in 130 patients was detected by non-invasive dynamical brain edema monitor at day 1,3,5 and 7 from ICH onset.Results The comprehensive agitating coefficient in focus side was lower than the unaffected side in both groups at the first day .The coefficient in the focus side was higher than the unaffected side at the third day ,and then became approximately equal at day 5 and basically normal at day 7.The comprehensive agitating coefficients in focus side were significantly differ-ent to unaffected side at day 3,5(P<0.01),and quite different at day 1,7(P<0.05).Conclusion The compre-hensive disturbance coefficient takes on dynamical changes in the ICH and reflects the course of edema formation . Cerebral edema monitoring by non-invasive and dynamical method can evaluate the course of cerebral edema ,and has a guiding role to the therapy of the ICH .

Objective To explore the changes in pulmonary function of patients with leukemia before and after stem cells transplantation(SCT).Methods Twenty-three patients with leukemia were assigned to group A,while 35 healthy controls to group C.All spirometric values were recorded including percentage predicted forced vital capacity(FVC),residual volume(RV),total lung capacity(TLC),forced expiratory volume in one second(FEV1),maximal expiratory flow in 50% and 75% vital capacity(MEF50%,MEF75%),diffusing capacity of the lung for carbon monoxide(DLCO),and ratio of carbon monoxide diffusion capacity to alveolar ventilation(DLCO/VA).Twenty patients with leukemia undergone stem cell transplantation were assigned to group B.Changes in lung function 7 days before and 3-12 months after transplantation were recorded.Group B was sub-grouped according to the source of stem cells and extent of anemia.Changes in lung function and infection were observed subsequently.Results Patients in group A experienced a significant decrease in predicted percentage of DLCO,DLCO/VA and MEF75%(76.25%?22.48%,83.77%?21.32% and 61.13%?19.08%,respectively),which were significantly different compared with that in group C(118.21%?19.34%,112.4%?20.96% and 81.02%?12.10%,P

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 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.

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.