Objective To investigate the effects of benazepril on plasma copeptin and N terminal brain natriuretic peptide (NT-proBNP) in the patients with chronic heart failure (CHF) in order to explore the mechanism of benazepril on ventricular remodeling.Methods Two hundred and thirty-eight patients with CHF were randomized into control group (n =118) and therapy group (n =120).Patients in control group were received regular treatment including medicine of treating cardiotonic diuretic and vasodilator for 6 months,while in therapy group were given benazepril beside regular treatment.The levels of copeptin,NT-proBNP were measured before and after treatment.The left ventricular ejection fraction (LVEF),left ventricular end systolic diameter(LVESD) and left ventricular end diastole diameter(LVEDD) were recorded and compared before and after treatment.Results In treatment group,the levels of copeptin and NT-pro BNP,LVEF,LVEDD,LVESD were (4.9 ± 1.3) pmol/L and (327.8 ± 226.8) ng/L,(33.5 ± 6.2) ％,(47.6 ± 8.9) mm,(60.2 ± 7.1) mm before treatment,different from that after treatment ((17.8 ± 7.9) pmol/L,t =7.331,P =0.008 ; (1 779.6±838.3) pg/mL,t =10.236,P =0.002; (50.5 ±5.2)％,t =3.336,P=0.009;(32.9 ±5.7) mm,t =2.767,P =0.010 ; (43.2 ± 5.6) rmm,t =2.882,P =0.009).After treatment the levels of copeptin,NT-proBNP,LVEF,LVESD and LVEDD in treatment were lower than that of control group(control group:copeptin:(10.5 ± 2.4) nmol/L; NT-proBNP:(1076.6 ± 486.6) pg/L; LVEF:(36.6 ± 5.6) ％ ; LVESD:(45.9 ± 6.8)mm; LVEDD:(57.5 ± 5.4) mm),and there was significant difference between groups (P =0.049,0.010,0.035,0.038,0.048 respectively).Conclusion Benazepril treatment could decrease the level of plasma copeptin and NT-proBNP in CHF patients,inhibit neuroendocrine and the ventricular remodeling,and then improve the heart function.

Objective To investigate the abnormality of parameters of thyroid function and incidence of autoimmune diseases in children with vitiligo.Methods A total of 363 children with vitiligo,including 198 males and 165 females were recruited into this study together with 93 normal human controls(55 males and 38 females).The serum levels of free tetraiodothyronine,free triiodothyronine,thyroid stimulating hormone,antithyroperoxidase antibody and thyroglobulin antibody were determined by chemiluminescent immunoassay in these subiects.Results The abnormality of parameters of thyroid function was observed in 43 out of 363(11.8%)patients affected by vitiligo and in 4 out of 93(4.3%)normal human controls;a significant difference was observed between the two groups (P＜0.05).Of the 43 patients wim abnormality of parameters of thyroid function,39 were diagnosed as vitiligo vulgaris,4 as segmental vitiligo.A significant increase Was observed in the incidence of abnormality of parameters of thyroid function in patients with vitiligo vulgaris compared with those with segmental vitiligo(P＜0.05).Conclusion There is an increase in tbe abnormality of parameters of thyroid function in children with vitiligo.

Objective To investigate the trend in incidence, causative drugs, clinical types and treatment of drug eruption. Methods Clinical data were collected from 922 inpatients with drug eruption in Huashan Hospital, Fudan University from January 2009 to December 2013, and analyzed retrospectively. Results From 2009 to 2013, the percentage of inpatients with drug eruption among all inpatients in the Department of Dermatology in a given year varied from 9.45% to 10.01%, and the percentage of inpatients with severe drug eruption among inpatients with drug eruption from 17.45% to 28.24%. Of the 922 cases, 371 (40.2%)were caused by single drugs, and 551 (59.8%)by multiple drugs. Among the 371 cases of drug eruption caused by single drugs, the top five causative drugs were traditional Chinese medicine(72 cases), cephalosporins(38 cases), amoxicillin(27 cases), antipyretic analgesics(26 cases)and tetanus antitoxin (24 cases)in 278 cases of non-severe drug eruption, antiepileptic agents (33 cases), allopurinol (28 cases), antipyretic analgesics (7 cases), cephalosporins (6 cases)and traditional Chinese medicine (6 cases)in 93 cases of severe drug eruption. Of the 922 patients, 422 (45.8%)presented with maculopapular eruption, 259 (28.1%)with urticaria, 135(14.6%)with Stevens-Johnson syndrome, 49(5.3%)with toxic epidermal necrolysis, 33(3.6%)with drug reaction with eosinophilia and systemic symptoms (DRESS), and 7 (0.8%)with acute generalized exanthematous pustulosis (AGEP). A total of 791 (85.8%)patients with drug eruption received glucocorticoid treatment. The dose of glucocorticoids was(47.61 ± 12.07)mg prednisone equivalent per day in 550 patients with non-severe drug eruption, and (73.10 ± 18.23)mg prednisone equivalent per day in 221 patients with severe drug eruption. Totally, 110 (11.0%) patients with drug eruption were treated with combined intravenous immunoglobulin (IVIG)because of poor response to glucocorticoids alone. Of 224 patients with severe drug eruption, only 2 (0.9%)died. Conclusions Carbamazepine and allopurinol are the main causative drugs for severe drug eruption, while traditional Chinese medicine is the first causative drug for non-severe drug eruption. From 2009 to 2013, the annual mortality of severe drug eruption decreased considerably.

Objective To study serum levels of interleukin-4,10,interferon-g amma,tumor necrosis factor alpha and soluble interleukin-2 receptor in patients with pemphigus, and their correlation with disease severity. Methods Serum leve ls of different cytokines were determined by double antibody sandwich enzyme-li nked immunosorbent assay in 31 patients with pemphigus in acute and remission st ages, and in 15 normal controls. Serum autoantibody titer was determined by indi rect immunofluorescent assay (IIF). The severity of disease was recorded by the Rule of Nine for the calculation of burn surface area. Results IL-10 level was lower in the sera of patients in their acute stage than that of controls(P0.05). Conclusion There are abnormalities of serum levels of cytokine s in patients with pemphigus. Serum levels of IL-10, sIL-2R and IFN-?are cor related with the severity of the disease.

Objective To compare clinical and laboratory characteristics between systemic lupus erythematosus (SLE) patients with and without cutaneous vasculitis,and to investigate the correlation of cutaneous vasculitis with severe visceral involvement and laboratory biomarkers.Methods A total of 152 SLE patients with various skin manifestations were enrolled from Department of Dermatology of Huashan Hospital affiliated to Fudan University from July 2011 to October 2014.The clinical and laboratory data were collected and retrospectively analyzed.SLE patients with cutaneous vasculitis were divided into upper/lower extremity vasculitis group and livedo reticularis group.A logistic regression model was used to analyze the correlation between cutaneous vasculitis and various clinical and laboratory variables.Results Of 152 SLE patients,62 (41％) presented with cutaneous vasculitis,including 55 with upper/lower extremity vasculitis and 7 with livedo reticularis,and 90 (59％) did not have cutaneous vasculitis.Patients with upper/lower extremity vasculitis showed significantly younger age (30.54 ± 12.67 years vs.37.77 ± 12.17 years),and lower prevalence of aberrantly elevated 24-hour protein excretion (39.39％ vs.64.00％) and serum urea level (2.08％ vs.16.43％),but significantly higher percentage of females (98.18％ vs.84.44％),higher proportions of patients with abnormal brain MRI (37.5％ vs.12.19％),anemia (87.03％ vs.70.93％) and positive antiribosomal P protein antibodies (77.77％ vs.53.65％),and higher SLE disease activity index (SLEDAI) (14.71 ± 7.75 vs.10.68 ± 5.61) than those without vasculitis (all P ＜ 0.05).The proportion of patients with decreased C3 level did not differ between patients with upper/lower extremity vasculitis and those without cutaneous vasculitis (P =0.362),but was significantly lower in the patients with livedo reticularis than in those without cutaneous vasculitis (28.57％ vs.79.76％,P =0.008).However,no significant differences in the other variables were observed between patients with livedo reticularis and those without cutaneous vasculitis (all P ＞ 0.05).Additionally,body mass index (BMI),abnormal lung function and other laboratory variables all did not differ among patients with upper/lower extremity vasculitis,patients with livedo reticularis and patients without cutaneous vasculitis (all P ＞ 0.05).Logistic regression analysis revealed that after exclusion of potential effects of age and gender,cutaneous vasculitis was significantly positively correlated with abnormal brain MRI (OR =4.24,95％ CI:1.17-16.13,P =0.028),and positive anti-ribosomal P protein antibodies (OR =3.97,95％ CI:1.86-8.47,P =0.0004),but negatively correlated with abnormally elevated 24-hour protein excretion (OR =0.25,95％ CI:0.09-0.69,P =0.009).Furthermore,cutaneous vasculitis showed no significant associations with abnormal serum urea level (OR =0.12,95％ CI:0.01-1.06),decreased C3 level (OR =0.93,95％ CI:0.38-2.28),anemia (OR =1.38,95％ CI:0.56-3.40) or SLEDAI (OR =1.05,95％ CI:0.98-1.14).Conclusions Cutaneous vasculitis is closely associated with central nervous system damage and emergence of anti-ribosomal P protein antibodies,so SLE patients with cutaneous vasculitis should be closely monitored for central nervous system damage.SLE patients without cutaneous vasculitis are more liable to kidney injury,so they also need to be closely monitored.

Objective To analyze the diagnosis and therapy of pemphigus and pemphigoid.Methods Clinical data were retrospectively analysed for 648 patients with pemphigus or pemphigoid admitted in Huashan Hospital,Fudan University from 2003 to 2007.Results The mean age of onset of pemphigus was younger than that of pemphigoid(47.0±16.9 years vs 65.1±13.9 years.P＜0.001).Of 175 patients with pemphigus confirmed by direct immunoflorescence(DIF),100%were positive for IgG,and 92.0%for C3,while out of 223 patients with pemphigoid,51.12%were positive for IgG,99.1%for C3.For pemphigus,the consistency reached 68.8%among clinical diagnosis.pathological diagnosis and immunological(DIF)diagnosis,80.7%between pathological and immunological diagnosis.In the case of pemphigoid,the consistency was 62.8%among clinical,pathological and immunological diagnosis,and 78.1%between pathological and immunological diagnosis.Corticosteroids were primary treatment strategy for both pemphigus and pemphigoid.and prednisone of 0.5-1.5 mg per kilogram bodyweight per day could control the condition of most patients.Conclusions DIF could be used as an important diagnostic means for patients with pemphigus or pemphigoid which can not be confirmed by clinical manifestation or pathology.In primary hospitals,IgG and C3 are recommended for DIF testing when pemphigus is suspected,and C3 is recommended for suspected pemphigoid.

To improve students' experimental research skills,innovative consciousness,promote the construction of functional experimental center,we established series of “comprehensive,contrivable,innovative” experiments in medical students.

Objective To understand the characteristics of pathogenic bacteria and drug resistance of ventilator-associated pneu-monia(VAP)in neonatal intensive care unit (NICU),and to explore the corresponding prevention and control measures,and to pro-vide the basis for the VAP antibiotic treatment.Methods A total of 80 children with respiratory failure and ventilator assisted breathing were selected from the NICU as objects in this study.The clinical data,pathogenic bacteria and drug resistance were ana-lyzed retrospectively.Results In 80 cases,the incidence of VAP was 43.75% (35/80),a total of 70 strains of pathogenic bacteria were isolated,gram negative bacilli accounted for the highest proportion,accounting for 81.43% (57/70).Pseudomonas aeruginosa, Klebsiella pneumoniae were the most common gram negative bacilli.Gram positive cocci accounted for 8.57% (13/70),which domi-nated by methicillin resistant Staphylococcus aureus,in addition to susceptible to vancomycin,but resistant to the other antibiotics. Conclusion Gram negative bacillus are the main bacteria in VAP cases,and which are multiple drug-resistant pathogens.

Objective To probe the Th cytokine pattern in pemphigus,so as to clarify the pathogenesis of pemphigus and draw up new therapy.Methods Reverse transcription-polymerase chain reaction(RT-PCR)was used to examine the interferon gamma(IFN-?)and interleukin10(IL-10)mRNA expression on peripheral blood mononuclear cells(PBMCs)of20cases of pemphigus in acute stage,20cases in stable stage,and20normal controls.Results The IFN-?mRNA expression in20cases of pemphigus in acute stage was higher than that of controls(P

Objective To study the effects of community comprehensive intervention model on osteoporosis, in order to provides a reference for osteoporosis health education work. Methods A multistage stratified random cluster sampling was applied to conduct a survey in Jiangsu province, in accordance with the economic level and geographic location. Nanjing, Nantong and Xuzhou cities were sampled, three urban streets were sampled in every district , respectively. A total of 1 500 40-69 years old community residents were screened, 619 high-risk participants for osteoporosis were arranged into the intervention group, and a total of 590 residents from the same communities were chosen as control group, who were gender- and age-matched with the intervention group. The intervention group residents received health management and comprehensive intervention, after half a year, a self-designed questionnaire was used to investigate the effects. Results Compared with control group, after six months, knowledge of intervention group related to osteoporosis awareness was improved significantly, such as the most serious harm to human body for osteoporosis (χ2=24.27), characteristic of osteoporosis (χ2=11.05), basic supplements to improve bone health (χ2=60.65) , the recommended daily calcium intake to postmenopausal women and the elderly (χ2=26.80), the difference was statistically significant (P<0.05); daily behavior related to diet and exercise of intervention group has improved significantly, such as drinking milk or itsproducts less than 3 days a week (χ2=25.83), eating beans and products for less than 3 days a week (χ2=19.20), drinking coffee for more than three days a week (χ2=7.77), not often taking outdoor activities (χ2=18.55) ,(P<0.05);Diseases and symptoms related to osteoporosis in intervention group was significantly reduced (P<0.001). Conclusions The osteoporosis is one of the most important public health problem for Jiangsu province, the work for osteoporosis prevention and control should be emphasized in community.