Objective To improve the ability of rheumatologist to diagnose systemic lupus erythematosus (SLE) complicated with ureterohydronephrosis by analyzing the characteristics of clinical manifestations.Methods Patients with ureterohydronephrosis hospitalized in Peking Union Medical College Hospital between 2000 to 2008 were analyzed retrospectively. The clinical characteristics, serological findings, treatment and prognosis of these patients were reviewed. Comparisons between the groups were performed with X2 test and t-test. Results SLE patient with ureterohydronephrosis accounted for 1.26% of the SLE patients hospitalized in the same period. Twenty-eight patients presented with gastrointestinal symptoms, 14 patients suffered from bladder irritative symptoms. Nineteen patients were with bilateral ureterohydronephrosis, and 8 patients were with unilateral ureterohydronephrosis. Fourteen patients had stype positive ANA, 14 patients had positive antiSSA antibodies. All patients were treated with steroid and immune suppressive therapy, 11 patients were cured, while 3 patients had no improvement. Conclusion Ureterohydronephrosis isn't a very rare complication of SLE. SLE patients with ureterohydronephrosis often present with gastrointestinal symptoms and have high incidence of chronic intestinal pseudo obstruction. High ratio of stype ANA antibody and high positive rate of anti-SSA are most important characteristics in this subtype of SLE patients. The complications can be reversed if the patients are treated early and appropritaely.

Objective To summarize and study the features of intracranial chondroma on CT and MRI imaging.Methods CT and MRI findings of ten cases of intracranial chondroma proved by surgery and pathology from 1994.1 to 2004.9 were retrospectively analyzed.Results Among 10 cases, 4 cases were located at the skull base, 4 cases at convexity, 1 case at the region of falx cerebri, and 1 case within the brain parenchyma.CT scans showed obvious calcification and clear border of the tumors in 10 cases, mixed attenuation in 9 cases, and adjacent bone invasion in 5 cases.4 cases of MRI scans showed hypointense signal on T1 and T2-weighted images in calcified element of the tumor, intermediate to hypointense signal intensity on T1-weighted image, and hyperintense signal intensity on T2-weighted image in parenchyma of the tumor.4 cases of CT scans showed slightly enhancement.Conclusion Intracranial chondroma are often originated from synchondrosis of the skull base, convexity of brain and region of falx cerebri. Obvious calcification may be seen in most cases. Slightly enhancement and marked delayed contrast enhancement were characteristic. The accurate diagnosis still depends on pathology.

Increasing evidences have shown the existance of a mitochondrial nitric oxide synthase(mtNOS),which binds to the matrix face of the mitochondrial inner membrane and produces nitric oxide(NO) through a Ca~(2+)sensitive pathway.Under physiological condition,the NO catalyzed by mtNOS regulates mitochondrial oxygen consumption and transmembrane potential via reversible competition with cytochrome C oxidase.The reaction of NO with superoxide anion,which was produced by mitochondrial respiratory chain,yields peroxynitrite.Peroxynitrite irreversibly modifies susceptible targets in mitochondria and induces oxidative and/or nitrative stress.In addition,NO has also been implicated in the programmed cell death.This article reviews the current understanding of mtNOS's role in the regulation of mitochondrial functions.

Objective To study the changes of magnetic resonance diffusion weighted imaging(DWI) in acute cerebral ischemia and reperfusion injury. Methods Adult healthy NewZeadand rabbits(103 cases) were used to established middle cerebral ischemia and reperfusion(MCAO/R) model by intraluminal thread technique,and 58 successful models were randomly divided into permanent ischemic group(30 cases) which further divided into ischemic 1 h,3 h,6 h,12 h,24 h,48 h groups consisting 5 cases and ischemic reperfusion group 28 cases which further divided into reperfusion 0h,2h,5h,11h,23h,47h groups consisting 5,5,5,4,5,4 cases respectively.Another 10 rabbits were regarded as ischemic contrast(5 cases) and reperfusion contrast(5 cases).The changes of hyper-intensity signal area on DWI and apparent diffusion coefficient(ADC) were measured in different groups Results 1.In ischemic group rabbits,the hyper-intensity signal area on DWI with declined ADC appeared at ischemic 1h.The hyper-intensity signal areas on DWI at different times were larger than that at ischemic 1h and unchanged at 24h.The mean ADC at different times declined at first and then gradually increased.2.In reperfusion group rabbits: compared with ischemic 1h,the hyper-intensity signal area on DWI reduced while ADC increased at reperfusion 2 and 5h,but the hyper-intensity signal area on DWI enlarged with ADC high at reperfusion 11h,then the hyper-intensity signal area on DWI enlarged with ADC reduced siginificantly at 23h and 47h.Conclusion The hyper-intensity signal area on DWI and the decreasing ADC in acute cerebral ischemia could be improved by early reperfusion,but the secondary decreasing ADC would be induced with continously reperfusion.

Objective Acute exacerbations of chronic obstructive pulmonary disease (AECOPDs) are significant events which are associated with worsened quality of life and more rapid decline in lung function.And they also can increase mortality and health care costs.Pharmacologic interventions can alter the frequency of AECOPDs and COPD-related hospitalizations, mainly by focusing on three ways: antiinfective agents, antiinflammatory agents and antioxidants which also become the chief clue to the current researches for new drugs and therapies.The combination therapy of inhaled corticosteroids and long-acting β2-adrenoceptor agonists is the most widely recommended strategy for acute exacerbation prevention.But the inhaled corticosteroids possibly increase the risk for pneumonia.Further studies are needed to understand the mechanism of benefit in patient subpopulations, and to compare between efficacy of combination therapy and side-effect with inhaled corticosteroids, bronchodilators, or their combination in different patient phenotypes.We must have a better understanding of the heterogeneity implicit for COPD and the types of COPD exacerbations, and individualized treatments need to be investigated.

Objective To compare the similarities and differences in changes of cardiac muscle structure between the rat models of chronic cor pulmonale induced by hypoxia and active immunization of M2-muscarinic receptor under light microscope and electron microscope, and to explore the dependablity of the antibody effects on cardiac architecture. Methods The 48 healthy male Wistar rats were randomly divided into 4 groups: (1) Hypoxia group: the typical model of chronic cor pulmonale was established according to XUE's method; (2) Active immunization group was immunized by M2-muscarinic receptor peptide; (3) Control group was fed in normal condition; (4) Cyclosporin A group: the hypoxia group plus cyclosporin A treatment at the same time. The antibody against M2-muscarinic receptor was detected by SA-ELISA, and the pathological exemplar of cardiac muscle was observed by light microscope and transmission electron microscope. Results (1) Antibody level of M2-muscarinic receptor; the P/N values gradually increased along with the process of experiment, and the max value in active immunization group was 5. 13. At the end of the second week, the value in hypoxia group increased to 2.08, but was still less than in active immunization group (4.66). (2) Under light microscope: in hypoxia group and active immunization group, the hearts displayed significant alterations including disorder of cardiac muscle fiber, necrosis of myocardial cells together with the infiltration of inflammatory cells. There were no differences in light microscopic findings between hypoxia and cyclosporin A group. (3) Under transmission electronic microscope examination in both active immunization group and hypoxia group, the hearts showed s1imilar significant alterations such as focal cardiac muscle fiberlysis, loss of normal muscle fiber banding pattern, mitochondrial swelling and condensation, sarcoplasmic vacuolation and deposition of dense granules in both the sarcoplasmic and muscle fiber. The contour of myocyte was irregular and plasma membranes were discontinuous in some cells. All altered myocytes were fairly widely distributed throughout the myocardium. The interstitium showed edema, deposits of flocculent serum protein, activated fibroblasts and increased amounts of collagen fibers. No obvious alterations were observed in cyclosporin A group. Conclusions The positive rate and the titer of antibody against M2-muscarinic receptor are obviously increased in the rat model of chronic cor pulmonale, which indicates that there is a relationship between the antibody against M2-muscarinic receptor and the pathogenesis of chronic cor pulmonale.

Objective:to compare traditional method of applying clinical memory scale with computerized multimedia method.Method:50 volunteers were tested with the two methods in a random sequence.Result:there was no difference in MQ(memory quotation) and results of 5 subscales got by the two methods.Conclusion:results of computerized multimedia applying of clinical memory test are consistent with that got by the traditional way.

A male of 17 years old complained of bilateral nasal congestion with mouth breathing for half a year. The physical examination showed patency of bilateral nasal cavity. Nasopharyngeal fiberscope revealed a huge spherical smooth reddish mass at the nasopharyngeal posterior wall and the back-end of nasal cavity blocking the entire postnaris and contacting with bilateral tubal tori, the size of which is about 3.5 cm x 2.5 cm. The nasopharyngeal 3D-CT showed a low density cystic mass area in the nasopharynx with smooth edges, and the CT value is approximately 32.4 HU. No exact enhancement was observed. The cystic mass originated from and compressed the back end of nasal septum. A semicircular defect in the leading edge of clivus was observed, and the inferior wall of sphenoid sinus is compressed uplifted upwards. The nasopharyngeal MR showed that the nasopharyngeal lesion presented short T1 and long T2 signals with multiple small wall nodules around. Neither the lesion nor the peripheral nodules can be significantly enhanced by enhancement scan. After a nasal endoscopic surgery, the case was definitely diagnosed as nasal septum back-end huge cyst.
Adolescent ; Cysts ; Humans ; Male ; Nasal Septum ; pathology

Objective Non-small-cell lung cancer with ipsilateral mediastinal lymph node metastasis (N2) belongs to heterogeneous subgroup. We analyzed the prognosis of patients with resected N2 NSCLC to determine the clinical significance. Methods The present study comprised 146 consecutive patients whom underwent surgical resection of N2 NSCLC between January 1997 and January 2000. Histological type, location, T primary tumor status, operation mode, clinical N2 (cN2) factor, N2 level(single or multiple), number of positive nodes(N2-num), and the cycles of adjuvant chemotherapy were estimated from the date of operation using the Kaplan-Meier and Log Rank analysis. The Cox regression model evaluated the influence of factors on the survival. Results The 3-and 5-year survival rate of these N2 NSCLC patients were 19.86% and 14.56%, respectively. The patients with tumor in the right lower lobe showed a significantly longer survival than left lobes. The histological type, tumor location, cN2 factor, N2 level and N2-number were associated with survival. A multivariate analysis using Cox regression identified 4 factors of prognosis: tumor site, T status, N2 level and clinical N2 status. Conclusion This article has identified N2 NSCLC subgroups and found that patients with mN2, N2L1 and single N2 have better prognosis.

Objective To find the frequencies of FcγRIIIA polymorphisms in Chinese people and the potential role of these polymorphisms(SNPs) in systemic lupus erythermatosus(SLE) and lupus nephritis(LN).Methods The investigation covers 324 unrelated Chinese SLE patients and 319 controls.FcγRIIIA F158V polymorphism was genotyped by specific primer-polymerase chain reaction(PCR).Results The frequency of F allele of FcγRIIIA polymorphism is 60.8% in Chinese people.FcγRIIIA polymorphism revealed a significant difference of both genotype and allele distribution in SLE patients and controls.LN patients have a significant increase in carrier frequency of the FF genotype, while the VV genotype reveals a significant decreased risk of early onset of LN.ConclusionsFcγRIIIA polymorphisms is potentially related with SLE in Chinese people.The homozygous FF genotype of FcγRIIIA might be the risk factor for LN, while the homozygous VV genotype might be the protective factor for late onset lupus nephritis.