Objective To investigate clinical characteristic of primary Sjogren's syndrome(pSS) with initial manifestations in the extra-gland organs. Methods Clinical data, including symptoms, laboratory parameters and complications of 85 pSS patients with initial manifestations of extra-gland organs hospitalized at the People's Hospital of Peking University during 2003 to 2006 were collected and analyzed retrospectively, as compared to those of pSS with xerophthalmia or xerostomia as initial ones. Results Mean time interval from onset to diagnosis in these patients with initial manifestations involved in the extra-gland organs was 94.5 months, higher than that in those with xerophthalmia or xerostomia as initial ones. Arthritis was manifested initially in 38 of the 85 patients (44.7 percent), peripheral leukopenia in 16 (18.8 percent), thrombocytopenia in nine (10.6 percent) and abnormal liver function in 13 (15.3 percent), respectively. Percentage of serum positive autoantibedies was higher in the patients with initial manifestation of the extra-gland organs than that in those with xerophthalmia or xerostomia as initial ones. Conclusions Initial manifestation of primary Sjogren's syndrome varies, and some patients can be initially involved in their extra-gland organs, with more proportion of arthritis than of other symptoms, and xerophthalmia or xerestomia could appear in them during the course of disease. And, xerophthalmia or xerostomia would not appear even as pSS was diagnosed in some other pSS patients. More attention should be paid to these clinical characteristics mentioned above in practice to avoid misdiagnosis.

Objective:To observe the clinical features of primary Sjgren syndrome(pSS) in young people(≤34 years).Methods: The data of 232 patients with pSS who were in hospital from 2004 to 2008 were analysed in a prospective study.Results: A total of 23.7%(55/232)patients' symptoms came on in youth(≤34 years),who were all females,mean age was(27.6?6.2) years.The other 177 patients' symptoms came on when they were more than 34 years old.In young group,32.73%(18/55) patients' first symptoms were xerostomia and/or keratoconjunctivitis sicca,the other 67.27%(37/55)came on without xerostomia and keratoconjunctivitis sicca,while in the middle-aged and aged group,59.32%(105/177)patients' first symptoms were xerostomia and/or keratoconjunctivitis sicca,40.67%(72/177)without xerostomia and keratoconjunctivitis sicca.There was significant difference(P=0.001).The duration from first symptom to first diagnosis of pSS in the young group was(93?107) months,which was significantly longer than those of the middle-aged and aged group [(45?59) months,P=0.001].The systemic damage of the young group was 61.8%(34/55),which was significantly greater than 41.24%(73/177)in the middle-aged and aged group(P=0.026).Conclusion: Primary Sjgren syndrome in young people is not rare,and about 2/3 of them come on without xerostomia and/or keratoconjunctivitis sicca.Not only the duration from first symptom to first diagnosis of pSS in the young group is longer,but also the systemic damage of the young group is greater than those of the middle-aged and aged group.These findings should alert the clinician to make the possible diagnosis of pSS in young patients.

Objective To analyse the clinical features and risk factors of interstitial lung disease in primary SjSgren's syndrome (pSS).Methods A retrospective study was employed.All 130 pSS patients who were hospitalized during 2004 to 2006 were enrolled into this study.Thirty-seven clinical and laboratory variables were used as the research factors and interstitial lung involvement as the related factor.The data were analyzed with the Logistic regression model.Results of 130 patients,22(16.9%) had interstitial lung involvement.Twelve patients were asymptomic when pulmonary involvement was detected.Variables in the univariate analysis which were significantly associated with lung fibrosis were age,exocrine glands(including parotid,sublingual gland and submandibular gland) swelling,oral ulceration and fever.Positive rate of antiU1RNP antibody in group of lung damage was significantly higher than non-lung damage group [5/22(22.7%)vs 6/108 (5.6%),P=0.021].In the Logistic regression model.variables which were significantly associated with pulmonary involvement were exocrine glands swelling (OR=3.739,95%CI 1.069～16.079,P＜0.05).oral ulceration (OR=3.739,95%CI 1.069～16.079,P＜0.05)and fever (OR=3.067,95%CI 1.198～20.067,P＜0.05).Conclusions This study indicates that some of the pulmonary damages of pSS are subclinical.Exocrine glands swelling,oral ulceration and fever are the risk factors for interstitial pulmonary involvements in pSS.

Objective To examine the dissimulation in memory test by event-related potentials (ERP).Methods Recording the ERP of 20 students in the choosing tasks according to Binomial Forced-Choice Digit Memory Test (BFMDT) in three situations including reality,dissimulation and forced wrong choose. Results The reaction time was lengthened gradually by the situation of reality ( 681 ± 21 ) ms, dissimulation ( 741 ± 25 ) ms and forced wrong choose( 946 ± 31 ) ms (F= 115.73, P = 0.000). The main components in ERP waveforms, N2 ( 180 ～184 ms) and P2 ( 214 ～ 243 ms) had higher amplitudes in situations of dissimulation and forced wrong choose than that of reality. The amplitude of N2 showed significant difference in three groups(F=6. 896, P＜0.01 ). The amplitudes were increased gradually by the situation with reality( -0.376 ± 0.58 )μV, dissimulation( 0. 86 ± 0.71 )μV and forced wrong choose( 1.77 ±0.82)μV. Conclusion ERP may be an electrophysiological index of the intention of dissimulation in memory test.

Objective: To develop the norms of Chinese Words and Vocabulary Discerning Test (CWVDT). Methods: According to the principle of stratified proportional sampling,a total of 1605 adult subjects from 17 cities and their surrounding rural areas of China was measured by CWVDT. Results: ①There was significant difference in two dimensions scores and total score of CWVDT between city and countryside(P0.05). Conclusion: The nationwide norms of city and countryside with educated degrees on CWVDT have been developed and with a good representation.

Endoscopes ; Endoscopy ; Epistaxis ; diagnosis ; etiology ; therapy ; Humans ; Nose

Adult ; Cytomegalovirus ; Cytomegalovirus Infections ; Humans ; Liver Failure

Disorders of sex development (DSD) is a complex disease that involves multiple traditional professional disciplines.Multidisciplinary team(MDT) mode is a particularly advantageous treatment mode that has been developed in recent years for the diagnosis and treatment of complex diseases.This article is based on the analysis of research progress at home and abroad about DSD and MDT,and the latest advances application of MDT treatment try for DSD,probe into how to establish a DSD-MDT treatment mode in theory preliminarily.

ObjectiveTo explore the feasibility of psychiatric assessment scale of cognitive and volition capacity(PASCVC) in violent crimes.MethodsThe PASCVC,criminal responsibility rating scale for violence(CRRSV) and criminal responsibility rating scale(CRRS)were used respectively in 244 forensic psychiatric cases.All cases were classified by the judicial surveyor into three grades including complete lost,partial lost and normal,the results were compared with expert's opinions.Results①PASCVC was composed of two subscales:cognitive capacity and volition capacity.There were significant differences in rating average score of three groups (complete lost,partial lost and normal) of total scale,cognitive capacity and volition capacity subscales were 9.96±7.53,69.15±10.290,101.16±6.034;20.29±4.971,37.13±5.388,2.55±2.612;18.32±2.595,30.07±4.595,48.34±4.147 respectively and there were significant differences between them.②27 items had good correlation with the scale(r=0.157~0.915).③According to the reference demarcation points of scale,12 criteria were carried out by using stepwise discriminant analysis.The accuracy of retrospective cumulative square was 97.1%.④Total scale and subscales consistency of three demarcation point grading assessment results were consistent with expert's opinions,the Kappa values were 0.925,0.848 and 0.930 respectively (P<0.01);PASCVC consistency with CRRSV and CRRS,the correlation coefficients were 0.952 and 0.961 respectively (P<0.01),the Kappa values were 0.830 and 0.881 respectively (P<0.01).Conclusion The PASCVC is feasible to be used in violent crimes.

AIM To investigate the role of serine/threonine protein phosphatases 1 and 2A (PP1/2A) in regulation of cell signal transduction involved in the tolerance of human umbilical vein endothelial cells (HUVEC) to hypoxia. METHODS HUVEC tolerance was established by hypoxic preconditioning. The tolerance of HUVEC was evaluated by the cell survival rate, lactic dehydrogenase (LDH) releasing and total antagonistic-oxidative capability (T-AOC). Subcellular localization of nuclear factor E2-related factor 2 (Nrf2) was determined by immunocytochemistry combined with Western blot. The expression of stress protein of heme oxygenase-1 (HO-1) was measured by Western blot. RESULTS Hypoxia 90 min decreased the survival rate and T-AOC of HUVEC significantly, increased the release of LDH in cultured HUVEC. Compared with the hypoxic group, hypoxic preconditioning (4, 8 and 24 h after hypoxia 10 min) up-regulated the tolerance against hypoxia in HUVEC, the survival rate of HUVEC and T-AOC increased and the release of LDH down-regulated when insulted with hypoxia (90 min) in HUVEC. Hypoxic preconditioning established the translocation of Nrf2 from cytoplasm to nucleus and up-regulated the expression of downstream protein HO-1. Pretreatment with okadaic acid (40 nmol·L-1), a powerful inhibitor of PP1/2A, for 10 min in hypoxic preconditioning HUVEC partly inhibited the translocation of Nrf2 from cytoplasm to nucleus and the expression of HO-1, abolished the tolerance of HUVEC established by hypoxic preconditioning. CONCLUSION PP1/2A at least partly take part in Regulation of translocation of Nrf2 and expression of HO-1, with is associated with the tolerance of HUVEC established by hypoxic preconditioning.