In this study, we determined the levels of 8 minerals (Na, K, Ca, Mg, Fe, Cu, Zn and Mn)in sera of 30 patients receiving total parenteral nutrition (TPN) for more than 5 d and tested the 8 mineral concentrations in the 16 drugs and solutions often usrd for TPN.The concentrations of Na, K, Ca, and Mg in the TPN drugs and solutions were much higher than those of the trace elements (Fe, Cu, Zn and Mn).Severe zinc deficiency was found in 2 patients receiving TPN for about 60 d and 171 d and their s:rum zinc concentrations lowered to 5.00 umol/L and 1.22 umol/L, respectively with clinical symptoms and signs induced by zinc deficiency.Our results show that mineral deficiencies do not occur at least within 2 weeks in short-term TPN patients, but in long-term TPN patients mineral deficiencies, especially zinc deficiency may appear.

Problem—based Learning(PBL) fit well with characteristic of military foreign medical students and the peculiarity of preventive medicine.In order to improve the self-studying and problem-solving ability of foreign students,attention should be paid to several key points to PBL,such as teaching content selection,informationization teaching tool application and teacher cultivation etc.

Objective To study the clinical features of a heterogeneous immunodeficiency disease,common vailable immunodeficiency(CVID),and to enhance the understanding of it.Methods 12 cases of CVID treated in Peking Union Medical College Hospital from January 1990 to March 2007 were analyzed retrospectively,including the clinical characteristics,laboratory results,treatment and prognosis.Results Among the 12 patients,the ratio of male to female Was 2:1,the average onset age(26±9)years old and the median time from onset to diagnosis 18 months.The main symptoms were fever(with a percentage of 67.0%),recurrent Cough and expectoration(58.3%)and diarrhea(41.6%).Anemia and leukocytopenia were the common laboratory changes.All the cases were diagnosed due to the presence of hypo- immunoglobulinemia.The tests available for subtypes of lymphocytes in 9 patients showed that B cells and CD4+ T cells decreased obviously,with an inverse ratio of CD4/CD8,indicating T cell dysfunction.Clinical improvement was demonstrated after treatment with intravenously administered immunoglobulin(IVIG)in 10 cases.Conclusions CVID is a heterogeneous group of immunologic disorders of unknown etiology,characterized by impaired antibody responses and recurrent airway and/or gastrointestinal infection and accompanied with autoimmune diseases or cancer.Hypo-immunoglobulinemia is the main evidence of its diagnosis.IVIG as a replacement therapy is an effective way of management.

Objective To discuss the value of CT guided biopsy of the retroperitoneal lymph nodes for diagnosis.MethodsTotally 18 patients with enlarged retroperitoneal lymph nodes underwent CT-guided biopsy in our hospital between June 2006 and June 2007.Results The results of CT were identified by the pathological examination in 94.4%(17/18) of the patients.The operation time of the biopsy was 20 to 40 minutes.CT scan was performed for 3 to 6 times(mean,4.1) during the procedure.No severe complications occurred in this series.Conclusion CT-guided biopsy of enlarged retroperitoneal lymph nodes is a safe and effective diagnostic method.

Several problems were existed in present military hygiene teaching.In recent years,integrated reforms were done about the improving undergraduate and teacher's activities,strictly choosing teaching contents,doing well extra curriculum,and serious examination in nursing teaching.Furthermore,the new presumptions were also discussed.

The new course standard of nursing specialty in military hygiene was established against the main problems in military hygiene teaching and considering the peacetime and wartime need of nursing post.In this paper,guiding ideology,content choosing and the request of operational skill of this standard were discussed in detail.

Objective To evaluate clinical features,predisposing factors,therapeutic regimen and prognosis of non-traumatic rhabdomyolysis.Methods Clinical picture,therapeutic regimen and prognosis were investigated in 39 cases with non-traumatic rhabdomyolysis by retrospective analysis.Results Non-traumatic rhabdomyolysis mostly presented fever,asthenia,myalgia and/or muscular tenderness,swelling of involved muscles,red urine and oliguria or anuria.The complications and comorbidity of rhabdomyolysis included acute renal failure(ARF),disorders of metabolites and electrolytes,compartmental syndrome,infection,and multiple organ dysfunction.Infection(33.3%)was the most common etiology of non-traumatic rhabdomyolysis,followed by drugs(25.6%),metabolite or electrolyte derangements(10.3%)and alcohol intoxication(7.7%)etc.Therapeutic regimen covered treatment of the underlying diseases,volume repletion,alkalization and dealing with the complications.For the patients with established renal failure,renal replacement therapy was essential.Overall mortality was 15.4%,while the mortality in the patients with ARF was 20.7%.If surviving ARF,the patients' renal function promised to be normalized consequently.Conclusion Non-traumatic rhabdomyolysis is a syndrome with a variety of causes,different clinical presentations and versatile combination of complications,which confounds the diagnosis.However,if treated properly and in time,the survivors in all probability will recover from ARF.

Objective:To analyze the epidemiological characteristics of human immunodeficiency virus (HIV) and hepatitis B virus (HBV) co-infected patients in Beijing and investigate the associated factors.Methods:The clinical data of patients with HIV infection who were treated in HIV/AIDS designated hospitals (Peking Union Medical College Hospital, Beijing Ditan Hospital and Beijing Youan Hospital) were retrospectively analyzed.Results:A total of 11 572 patients were finally included in the study, among whom 532 patients (4.6%) were co-infected with HIV and HBV. Most of the co-infected patients were young male adults (28~48 years old), accounting for 85.9%. The main transmission route was homosexual behavior (74.8%). There were 87.4% co-infected patients treated with two anti-HBV drugs, including lamivudine (3TC) and tenofovir (TDF). From 2013 to 2018, the annual prevalence of HIV and HBV co-infection decreased gradually, with the rate of 6.37%, 4.55%, 3.92%, 4.68%, 4.24% and 2.74%, respectively. In our study, The main influencing factors of HIV and HBV co-infection were age older than 28 years old versus<28 years old ( OR=2.807, 95% CI 1.241-6.345) and marriage status (married versus unmarried, OR=1.259, 95% CI 1.004-1.579). Conclusions:The proportion of HBV infection in HIV-infected patients is 4.60% (532) in our cohort. From 2013 to 2018, the prevalence of HIV and HBV co-infection in Beijing shows a decreasing trend. The risk of co-infection is higher in married young adults (28~48 years old).

ObjectiveTo analyze the clinical characteristics of Behcet's disease with intracardiac thrombus.MethodsThe data of 8 patients diagnosed as Behcet's disease with intracardiac thrombus in Peking Union Medical College Hospital from January,1990 to January,2011 were studied retrospectively.ResultsBehcet's disease with intracardiac thrombus was found in 8 patients (5 men and 3 women) with a median age of 28.5 years.Most of them were young men.Thrombus was mostly found in the right side of the heart.Most of the patients had pulmonary thromboembolism with negative anticardiolipid antibody and basically normal C-reactive protein and erythrocyte sedimentation rate.ConclusionIntracardiac thrombus associated with Behcet's disease most commonly occurs in young men and usually involves the right side of the heart.