Objective To strengthen the awareness that hematological tumors present with certain rheumatic symptoms for early diagnosis and treatment to a hidden neoplasm.Methods 15 patients admitted to rheumatic ward with suspected rheumatic disease were finally diagnosed as hematological tumors.Their rheumatic manifestations and occult malignancies were collected.Results A variety of rheumatic manifestations were presented.Among 15 patients,10(66.7%)had fever,6(40%)skin lesion,3(20%)arthritis,6(40%)vasculitis,3 adult onset of Still's disease,2 unelassified,and one of the each following disease:amyloidosis,dermatomyositis,polymyalgia rheumatica,and panniculitis.9 of lymphoma,3 leukemia,3 multiple myeloma were finny diagnosed. Conclusion Rheumatic disorders associated with hematological tumors include a variety of conditions.An extensive investigation for occult malignancies with some rheumatic symptoms is recommended when accompanied by specific findings of suggestive malignancy.

Objective To evaluate the effect of dexmedetomidine alternative to propofol administered in general anesthesia on maintainance and recovery in patients undergoing gynecologic laparoscopy.Methods One hundred and twenty patients undergoing gynecologic laparoscopy,were divided into group C,D1 and D2 with 40 cases each by random digits table method.Group C received propofol 100 μ g / (kg min) and remifentanil 0.10-0.25 μ g / (kg min) intravenous infusion,group D1 received propofol 100 μ g/(kg min),remifentanil 0.10-0.25 μ g/(kg min) and dexmedetomidine 0.2 μ g/(kg h) intravenous infusion,while group D2 received dexmedetomidine 2.0-3.0 μ g / (kg h) and remifentanil 0.10-0.25 μ g/ (kg min).Cis-atracurium was given on time to maintainance of anesthesia.The heart rate (HR),mean arterial pressure (MAP) were recorded at the following time points:arriving at operating room (To),anesthesia induction (T1),intubation (T2),skin incision (T3),pneumoperitoneum (T4),10 min after pneumoperitoneum (T5),20 min after pneumoperitoneum (T6),the end of operation (T7),discharge from post anesthesia care unit(T8) and the first postoperative day (T9).The time of emergence,extubation and duration in post anesthesia care unit were recorded too.Ramsay scale and Riker Sedation-Agitation Scale on emergence,extubation and discharge from post anesthesia care unit and post anesthesia recovery score at T9 were also recorded.Results The MAP in group D2 was higher at T3 to T7 time-points than that in group C and group D1 [(93 ± 10),(99 ± 11),(94 ± 13),(95 ± 10),(91 ± 10) mm Hg (1 mm Hg =0.133 kPa) vs.(88± 11),(90± 10),(87±9),(86±9),(83±8)mmHgand (87±9),(90± 10),(86±8),(85 ±7),(83 ± 7) mm Hg],there were significant difference (P ＜ 0.05).There were no significant difference among groups on the HR at each time point and the time of emergence,extubation and duration in post anesthesia care unit (P ＞ 0.05).Ramsay scale was lower on emergence and Riker Sedation-Agitation Scale was higher on emergence and extubation in group C than that in group D1 and group D2 [(3.7 ± 1.3) scores vs.(4.0 ± 0.9),(4.2 ±0.9) scores,(3.1 ± 1.0) scores vs.(2.8 ±0.6),(2.7 ±0.9) scores,(3.3 ±0.7) scores vs.(3.2 ± 0.4),(3.0 ± 0.5) scores],there were significant differences (P ＜ 0.05).Riker Sedation-Agitation Scale was higher on extubation in group D1 than that in group D2(P ＜ 0.05).Post anesthesia recovery score at T9 in group D2 was apparently increased compared with that in group C and group D1 [(108 ± 10) scores vs.(93 ± 13),(93 ± 15) scores] (P ＜ 0.05).Conclusions Dexmedetomidine 2.0-3.0 μ g/ (kg h) administered in general anesthesia on maintainance in gynecologic laparoscopy can improve the quality of extubation and promote postoperative recovery without prolonging extubation time,but have a influence on hemodynamic changes at early stage of pneumoperitoneum.

Objective To investigate the effect of MOTOmed movement therapy on balance and ability in the activities of daily living (ADL) of convalescing stroke patients with hemiplegia. Methods Forty convalescent stroke patients exhibiting hemiplegia were randomly divided into a treatment group and a control group with 20 cases in each group. The control group received routine rehabilitation training; the treatment group received MOTOmed training in addition. Balance function of all the patients was assessed using Berg's balance scale (BBS) , and the Barthel Index ( BI) was used to assess ADL ability at the beginning of the program and after 6 weeks of treatment. Results Balance and ADL ability improved significantly in both groups after 6 weeks of treatment. The effect in the treatment group was significantly better than in the control group. Balance and ADL ability were positively correlated. Conclusions Applying MOTOmed therapy along with routine rehabilitation training can distinctly improve balance and the ADL ability of hemiplegics after stroke.

Objective To understand the acute effect of the air pollution on daily mortality of cardiovascular diseases in the old people aged over 65 years in Taiyuan, Shanxi, China. Methods Case-crossover design was used to assess the association between air pollution and daily cardiovascular disease mortality. Pollutants considered were nitrogen dioxide (NO2), carbon monoxide (CO), inhalable particles (PM10) and sulfur dioxide (SO2). Results CO exposure was significantly associated with the mortality of five kinds of cardiovascular diseases. No association was found for arrhythmia. As CO concentration increased by 100 ?g/m3, the corresponding OR of cardiovascular disease mortality were as follows, total cardiovascular disease mortality were1.000-1.013, cardiac mortality were1.000-1.024, ischemic heart disease were 1.005-1.032, cardiac failure were 1.006-1.112, myocardial infarction were 1.009-1.050 respectively. The higher OR value was found in unidirectional control design than that in the bidirectional design. Considering the lag effect of air pollution, the 24 hr and 48 hr average of air pollution levels were analyzed in the present study respectively. Conclusion The current air pollution level (PM10, CO) in Taiyuan City has a acute effect on the cardiovascular disease mortality in the local old people aged over 65 years.

Objective To study human sperm acrosome by means of flurescein labeled pisum sativum agglutinin technique (FITC PSA) to evaluate the fertile capacity of human sperm. Methods The acrosome intact rate was assessed in 58 infertile men and in 46 fertile ones.Human zona pelucida (zp) induced acrosome reaction was detected in 7 infertile and 7 fertile men. Results The acrosome intact rate and the acrosome reaction rate were both higher in the fertile group than those in the infertile group ( P

0.05);between YMDD mutation and YMDD negative,there was statistical difference(P0.05),between YMDD mutation and YMDD negative, there was significant difference(t=12.76,P

Objective To investigate the role of sFas and sFasL in the development and progression of uterine cervix cancer(UCC)and the clinical significance of detecting them.Method Serum sFas and sFasL levels of 30 UCC patients were detected by enzyme-linked immunosobent assay (ELISA) before and after treatment (operation or chemotherapy),at the same time serum sFas and sFasL levels of 20 healthy volunteers were also detected by ELISA.Results Serum sFas and sFasL levels of UCC patients[(8.60±0.27),(2.96±0.65)μg/L] were obviously higher than those of healthy volunteers[(6.27±0.25),(0.21±0.05)μg/L],there was statistical significance (P＜0.05).Serum sFas and sFasL levels of those who had operations decreased obviously 2 weeks after the operation,serum sFas and sFasL levels of those who had chemotherapy 3 weeks later increased,there was statistical significance when compared before and after treatment (P＜0.05).Conclusions sFas and sFasL may play important roles in the development and progression of UCC,detection of serum sFas and sFasL levels may conduce to observe the changes of pathogenetic condition.

Objective To explore the incidence,features and outcomes of in-hospital sudden cardiac death (SCD) in order to determine the predictors of survival. Methods The clinical data of 69 patients with cardiac arrest hospitalized from January 2008 through December 2010 were retrospectively analyzed.Information on genders,age,types of arrhythmia was collected and further analyzed to determine these factors associated with the occurrence and outcomes of in-hospital cardiac arrest. Results The overall incidence of SCD was 47.3 / 100 000 per year and 17.4％ of them.survived at discharge.The occurrence rate was higher in male than that in female (66.7％ vs.33.3％,P ＜0.01 ),whereas difference in gender did not affect the discharge rate ( P ＞ 0.05 ). Survivors from in-hospital cardiac arrest were significantly younger than non-survivors (man:62.57 ± 12.83 years vs.75.56 ± 10.55 years; women:60.36 ± 13.24years vs.69.53 ± 11.72 years,P ＜ O.01 ).From 62 ECG records of SCD patients,the incidence of nonshockable rhythms was higher than that of shockable rhythms.Compare to the non-shockable rhythms,the shockable rhythms brought a higher rate of restoration of spontaneous circulation (ROSC) (54.5％ vs.24.5％,P ＜0.05),whereas survival rates at discharge between two groups were not statistically different ( 18.2％ vs.18.4％,P ＞ 0.05 ).Conclusions Non-shockable rhythms were more common in patients suffering from in-hospital cardiac arrest.Although defibrillation treatment contributed benefit to ROSC among patients with ventricular fibrillation or pulseless ventricular tachycardia,high-quality CPR and post-cardiac arrest care may play a more critical role in the outcomes of in-hospital sudden cardiac death.

Objective To investigate the effect of mild therapeutic hypothermia for different lengths of time on cerebral edema and hypoxia-inducible factor 1 α (HIF-1α),vascular endothelial growth factor (VEGF) expressions following intracerebral hemorrhage (ICH) so as to explore possible mechanism for better application of mild hypothermia.Methods ICH models were made in rats by stereotaxically injecting autologous artery blood into right caudate nucleus.Forty male Sprague-Dawley (SD) rats were randomly (random number) divided into 5 groups (n =8 each):sham-operated (sham),normothermic (NT),hypothermic-1 hour (MH1),hypothermic-2 hours (MH2),hypothermic-4 hours (MH3).Normothermic and sham-operated animals were kept at (37.0-± 0.2) ℃ of body temperature.Animals in the hypothermic groups received immediately and rapid cooling after ICH and kept at (33.0 ± 0.5) ℃ of body temperature for 1,2 and 4 hours respectively.Rats were sacrificed at 48 hours after cerebral hemorrhage.Then brain water content and BBB permeability were determined.Quantitative real-time PCR and Western blot were used to analyze the expression of HIF-1α and VEGF.Results The content of brain water,Evans blue concentration in brain,and the mRNA expression and protein levels of HIF-1α and VEGF were noticeably higher in NT group than those in sham group (P ＜0.01).There were statistically significant difference in the expression of HIF-lα mRNA and protein but little difference in other indicators between MH1 group and NT group.Compared with NT group,MH2 group and MH3 group brought about an improvement in BBB permeability and remarkable down-regulation of protein levels and expression of HIF-1 α and VEGF mRNA,whereas there were no statistically significant difference in expression of indicators between the two groups.Conclusions Mild therapeutic hypothermia induced rapidly and immediately after ICH could limit the development of brain edema in rats by down-regulating expression and protein levels of HIF-1 α mRNA,and in turn suppressing the evaluation of VEGF mRNA and protein expression.The brain edema was effectively reduced in animals treated with hypothermia for 2 hours' or 4 hours ' duration with little difference in magnitude of reduction in brain edema between these two modalities of hypothermia.

Objective To study the effectiveness and safety of therapeutic mild hypothermia in patients successfully resuscitated from cardiac arrest using a meta-analysis.Methods We searched the MEDLINE (1966-April 2012),OVID (1980 to April 2012),EMBASE (1980 to April 2012),Chinese bio-medical literature & retrieval system (CBM) (1978 to April 2012),Chinese medical current contents (CMCC) (1995 to April 2012),and Chinese medical academic conference (CMAC) (1994 to April 2012).Studies were included (1) the study design was a randomized controlled trial (RCT); (2) the study population included patients successfully resuscitated from cardiac arrest,and received either conventional post-resuscitation care with normothermia or mild hypothermia; (3) the study provided data about good neurologic outcome and survival till hospital discharge.Relative risk (RR) and 95％ corfidence interval (CI) were used to pool the effect.Results The study included four RCTs with a collected total of 417 patients successfully resuscitated from cardiac arrest.Compared to conventional post-resuscitation care with normothermia,patients in the hypothermia group were more likely to have good neurologic outcome (RR =1.43,95％ CI 1.14 ～ 1.80,P =0.002) and were more likely to survive till hospital discharge (RR =1.32,95％ CI 1.08 ～ 1.63,P =0.008).From all over the studies there was no significant difference in reported adverse events between the normothermia and hypothermia group (P ＞ 0.05).There did not exist heterogeneity and publication bias.Conclusions Therapeutic mild hypothermia improves neurologic outcome and survival in patients successfully resuscitated from cardiac arrest.