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 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 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 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: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.

Objective To investigate the short-term improvement of life quality in patients with obstructive sleep apnea hypopnea syndrome(OSAHS)after temperature-controlled radiofrequency ablation(TCFR).Methods Totally 70 patients with OSAHS were diagnosed by polysomnography(PSG)and received TCRF in our department.The Epworth Sleepiness Scale(ESS)and Calgary Sleep Apnea Quality of Life Index(SAQLI)were surveyed before and after the therapy.The results were followed up for six months after the operation.Results The pre-operative scores of ESS was correlated with body mass index(BMI),apnea hypopnea index(AHI),lowest saturation(LSaO2)and the scores of SAQLI(correlation coefficient:0.410,0.371,-0.441,and-0.411 respectively;all P

The neuropil in the area of the nucleus intermediolateralis is compossed of dendrites, axons, axonal terminals, synapses and processes of the neuroglia passed through them. The dendrites are scattered and variant in size and shape. Small axons, on the other hand, usually have regular contours and tend to travel in bundles. Three types of synaptic connections were found, the axo-dendritic, axo-sometic and axo-axonic synapses. Some of the synapses form glomerulus in which the dendrite or the axon may be the center. The presynaptic terminals contain numerous synaptic vesicles of various patterns. The pre-and postsynaptic membranes may be asymetrical or symetrical. According to the shape of the synaptic vesicles and the relative thickness of the pre-and postsynaptic membrane the synapses may be classified into three types: 1, spheric vesicle asymetrical type, 2, flattened vesicle symetrical type, and 3, intermediate type.

Objective To discuss Magnetic Resonance Spectroscopy(MRS) on the localization diagnosis of primary epilepsy patients with hippocampal lesions before operation.Methods 50 patients with idiopathic epilepsy (epilepsy group) and 32 healthy volunteers (healthy control group) were underwent Magnetic Resonance Imaging ( MRI) and MRS examination.Results ( 1 ) MRI showed that results of examination in the healthy control group were all normal.Epilepsy group of 38 cases were found abnormal in hippocampal area,and all patients were unilateral. 27 cases of them reduced with hippocampal volume, while signal abnormality was in 7 cases, 4 cases occurred simultaneously reduced with hippocampal volume,and therer was no obvious abnormal signals in 12 cases of patients with epilepsy of hippocampus volume and signal.( 2 ) MRS examination results:the healthy control group MRS were normal.50 epileptic patients in group MRS showed that hippocampal abnormalities.The epilepsy group NAA/( Cho+Cr) ,NAA/Cho,NAA/Cr were significantly lower than those of the healthy control group;epilepsy group disease side hippocampus NAA/(Cho+Cr),NAA/Cho,NAA/Cr values have different degrees of reduction,compared with the contralateral side,the value of t were 12.716,9.155,17.476,all P<0.01.(3)50 cases of epilepsy patients in the epilepsy group disease side compared with the contralateral side,the side of hippocampus NAA/disease ( Cho+Cr) , NAA/Cho,NAA/Cr values were decreased,the test values of t were 7.295,6.303,2.761,all P<0.01.(4)50 cases of operation patients underwent postoperative pathological examination of resected tissue,resection of neurons,tissue showed different degrees of reduction,microglia proliferation and neuronophagia phenomenon.Comparison of the posi-tive rate of MRS and MRI examination,χ2 =13.636,P<0.01.Conclusion Magnetic resonance spectroscopy analy-sis can play the important role in the evaluation of epilepsy surgery preoperative epilepsy,MRS examination for preop-erative diagnosis positive rate is high,the localization diagnosis with high reliability.