Objective To study the characteristics of granulomatosis with polyangiitis (GPA) accompanied by pneumothorax.Methods We described a case of GPA accompanied by hydropneumothorax who was successfully treated.Relevant literature was also reviewed.Results A total of 25 cases were identified,consisting of 18 males and 7 females [the average age was (44±16)(16-70) years old].The time from disease onset to pneumothorax was 26±51 (0.83-216) weeks.Pneumothorax,hydropneumothorax,pyopneumothorax and hemopneumothorax occurred in 11,5,8 and 1 respectively.Nodules or excavated nodules on chest radiography or CT were seen in 22 cases.Erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) were elevated in all cases.Sixteen cases received glucocorticoid and immunosuppressive agents treatment.Sixteen cases received drainage and 7 received open operation.Pseudomonas aeruginosa was the most commonmicrobiology findings.Granulomatosis with active vasculitis,bronchopleural fistula,pleural bleb with intensefibrosis,rupture of subpleural nodule were seen on lung biopsy or autopsy.Nine cases died of infections,respiratory failure,sepsis and respiratory arrest.Conclusion Pneumothorax in GPA can be caused by multiple factors such as rupture of subpleural nodule and with high mortality.Patients always died of infections and respiratory failure.Regular treatment of the underlying disease,apply sensitive antibiotics for infection and reasonable surgical intervention should be considered.

AIM: To develop a method to detemine pinostrobin in Weitengning Talets (Lindera reflexae Hemsl.) by HPLC. METHODS:A C_(18) column was used,methyl alcohol-water(80∶20) was used as a mobile phase and the wavelength of UV detector was set at 290 nm. RESULTS:The linearity of this method was good with the average recovery of 97.9%,RSD was 0.74%(n=5). CONCLUSION:The methed is simple,reliable,sensitivity,and with good reproducibility.It can be used in quality control of Weitengning Tablets.

Objective To investigate the prevalence and clinical characteristics of Sj?gren′s syndrome-interstitial lung disease (SS-ILD). Methods 136 patients with SS were studied. Anti-SSA and Anti-SSB antibodies were measured by Western blot. The inpatients had chest X ray, chest HRCT and pulmonary function examined. Results ①pSS-ILD patients with postive anti-SSA antibody were proned to have interstitial lung disease and the ILD were more severe. ②HRCT showed that sSS-ILD were more severe than that of pSS-ILD. ③Lung capacity of pSS-ILD decreased more frequently than sSS-ILD. sSS-ILD mainly had venti-latory function abnormalities. The lung function impairment of both were dominated by small airways dysfunction and decrease of TLCO. Conclusion SS patients should be examined by HRCT and lung function tests should be performed in the course of the disease to find out and treat ILD.

AIM: To establish a quality control method of analysing Lajiao Fengshi Plaster qualitatively and quantitatively. METHODS: Capsaicin was identificated by TLC and menthol,borneol were determinated by GC Lajiao Fengshi Plaster,silica gel as plate,ligarine(60～90?C)-acetoacetate(3(∶)2) as mobile phase,0.5% solution of dichloroquinonechlorimide R in methanol R.as chromogenic agent to identificate capsaicin.The internal standard of GC,naphthalene was employed.10% PEG-20M as the stationary phase,column temperature at 150(?C,) and FID as the detector to determine methol and borneol. RESULTS: There were the same spot corresponding in colour and position sample and reference capsaicin,but negative control had not such colour spot in the same plate of TLC.Menthol,borneol and naphthalene had been separated well under the chromatographic condition.The average recovery of menthol,borneol were 97.44%(RSD=0.93%),98.09%(RSD=1.26%),respectively. CONCLUSION: The method is sensitive,accurate and reproducible and can be used to control the quality of Lajiao Fengshi Plaster.

The microinjection of brain nuclei and potassium iontophresis induced tail flick were used to investigate the effect of injecting oxytocin (OT) or anti-oxytocin serum (AOTS) into locus ceruleus (LC) on the pain threshold (PT) and morphine analgesia. The result showed that OT injection into LC could enhance PT, while ATOS injection could reduce PT. The OT injection could strengthen morphine analgesia, but AOTS injection could antagonize this action. These results suggest that the OT analgesia and OT-enhanced morphine analgesia were related with the locus ceruleus.

Specific to the existing problems of uneven distribution of resources in the medical industry,especially the shortage of grass-root high-quality medical resources,the paper introduces the construction objective,overall architecture and construction contents of regional medical collaboration,and normalizes the medical service process through informationalized technological means,in order to promote standardized construction of the regional medical information system and information interconnection and intercommunication.

Objective To evaluate the processing line and the range of thoracolumbar (T10-L2) vertebral pedicle channel for vertebral reconstruction.Methods The thoracolumbar vertebrae (T10-L2) of thirty fresh specimens were performed CT scan,slice thickness of 1 mm without interval.Each vertebral body was reconstructed using the software Mimics 10.0 and measured each vertebral body pedicle axis length (L),pedicle length (L0),width (W) and height (H0),vertebral height (H),pedicle entry point in the sagittal plane angle (α) and the pedicle entry point in the cross-section angle (β),and further calculated the volume through vertebral pedicle channel for vertebral reconstruction.Results The average thoracolumbar (T10,T11,T12,L1,and L2) vertebral pedicle axis length was 32.64±5.66,31.80±6.41,38.46±3.52,40.31±4.39,and 42.72±3.36 mm prospectively.The average vertebral pedicle length was 12.38±2.06,11.77±2.15,14.63±2.34,15.46±3.04 and 14.37±1.64 mm.The average pedicle width was 5.09±0.26,5.79±1.10,7.35±1.87,7.17±0.69 and 7.14±0.84 mm.The average pedicle height was 9.76±1.43,10.83±0.77,11.16±0.78,11.33±1.26 and 11.16±0.96 mm.The average vertebral height was 18.12±0.88,19.48±1.02,21.25±1.27,22.88±0.68 and 23.20±0.93 mm.The average α angle was 25.06°±3.84°,30.87°±7.28°,25.12°±5.18°,20.55°±1.54° and 21.74°±2.58°.The average β angle was 43.60°±4.52°,49.48°±10.30°,41.97°±5.19°,40.29°±6.49° and 42.85°±6.47°.The average volume of one side of vertebral body after vertebral reconstruction respectively was 1.02±0.36,1.30±0.43,1.96±0.67,1.84±0.48 and 1.94±0.41 cm3,the corresponding percentage of total vertebral volume was 53.95％,55.68％,52.67％,49.53％ and 48.14％.Conclusion It is possible to use the pedicle channels for vertebral body reconstruction,reduction the end-plates and filling bone graft inside vertebral body.

Objective To know the efficacy and safety of the blood sugar control by double-pump a-mong severe patients with duodenectomy. Methods Divided 60 severe patients with doudenectomy into the experimental group and the,control group randomly, there were 30 cases in each group. In the control group, pa-tients received intravenous infusion with the liquid containing glucose and neutral insulin (4g: 1 U), intravenous injection of 50U neutral insulin added into 50ml normal saline by micro-pump, the pump speed was In the ex-perimental group, sugar-containing liquid without insulin was infused within 24 hours by infusion pump with u-niform speed, a neutral insulin 50U mixed with 5Oral normal saline were injected by micro-pump according to the ratio fo glucose 4g: 1U neutral insulin through the same vein. Which also adjusted the pump speed according to maintaining blood sugar in the range of 4.4～8.3mmol/L. Compared the level of blood sugar control, treatment safety, efficacy and the workload of nurses between the two groups. Results The highperglycemic index and the time to achieve target values of blood sugar in the experimental group was shorter than in the control group respectively, while the time of keep blood sugar in idea level in the experimental group was longer than in the control group. There were no significant difference about incidence rale of hypoglycemia and workload of nurses between the two groups. Conclusions Double-pump can effective control blood sugar for severe patients with duodenectomy without burden nurses' workload, which is more reasonable than the traditional method.

Objective To investigate the manifestations of esophageal motility disorders and evaluate the association between them and dysphagia, laboratory tests and other accessory examinations in patients with Sj(o)gren's syndrome (SS). Methods Esophageal manometry was performed in 31 patients with SS and 18 healthy volunteers by the step pull-through method. Results Decreased upper esophageal sphincter pressure was detected in 19 of the 31 patients (61%) with SS, while 4 of 18 (22%) in controls. The frequency was significantly higher in patients than in healthy controls (P=0.008). Fifteen of 31 patients (48%) showed various patterns of esophageal dysfunction including ineffective esophageal motility in 6 patients, nutcracker esophagus in 3 patients and nonspecific dysmotility in 6 patients. No major differences were found in esophageal parameters (peak amplitude, wave duration and velocity) when comparing primary SS with secondary SS. These esophageal abnormalities were not correlated with clinical manifestations, laboratory examinations and other auxiliary examinations. Conclusion Patients with SS may have esophageal motility disorders, which can presents with different patterns.

Objective To observe the short-term efficacy and safety of sequential administration of erlotinib and chemotherapy in unselected, chemonaive patients with advanced non-small-cell lung cancer (NSCLC). Methods Previously-untreated patients (n=23) with stage Ⅲ_B/Ⅳ NSCLC and ECOG PS of 0/1 received erlotinib (150 mg/d) on days 15-28 of a 4-week cycle that included gemcitabine (1250 mg/m~2, days 1 and 8), and either cisplatin (75 mg/m~2, day 1) or carboplatin (AUC=5, day 1). The primary end points were tumor response rate and safety. Results 23 patients received a total of 95 cycles of treatment, and all were evaluable for efficacy and toxicity. The overall response rate was 30.4%, 0 case achieved complete responses (CR), 7 cases (30.4%) achieved partial responses (PR), 14 cases (60.9 %) achieved stable disease (SD), 2 cases (8.7 %) achieved progression disease (PD). The disease control rate was 91.3 %. The sequential administration of erlotinib following gemcitabine/platinum chemotherapy was well tolerated. The major grade 3 treatment-related adverse events were eutropenia (13.4%), rash (8.7%), nausea (8.7%) and thrombocytopenia (8.7%). No treatment-related interstitial lung disease. Conclusion equential administration of erlotinib following gemcitabine/platinum chemotherapy was effective, and the toxicity was tolerable. This treatment strategy warrants further investigation.