Objective To investigate the clinical and serologic features of patients with Sj(?)gren′s syndrome (SS) associated with systemic lupus erythematosus (SLE), and to compare with patients of primary Sjgren′s syndrome (pSS) and systemic lupus erythematosus. Methods Two hundred and eighteen unselected SLE patients were evaluated for the presence of SS. The SLE patients with SS (SLE-SS) were compared with SLE patients without SS on clinical and laboratory parameters. Results SS was identified in 22 SLE patients (10.1%). The SS preceded the development of SLE in 8 (36%), the SS secondary to SLE in 7 (32%), and in 7 (32%) patients, the SS and SLE occurred at the same time. Compared with the SLE patients without SS group, patients with SLE-SS were older, with a higher frequency of Raynaud′s phenomenon, pulmonary involvement, anti-SSA, anti-SSB, and rheumatoid factor, but with a significantly lower frequency of renal involvement. Compared with the pSS patients group, SLE-SS patients were younger, with a higher frequency of Raynaud′s phenomenon, arthritis, mucocutaneous involvement and anti-SSA. Conclusions SLE-SS patients have distinct clinical and laboratory features that differ from SLE or pSS patients.

BACKGROUND: Few reports concern the effects of dendritic cells-a kind of antigen presenting cells, and interleukin-10 (IL-10) on airway hyperreactivity or inflammation. OBJECTIVE: To construct mice IL-10 recombinant adenovirus vector Ad-mIL-10 to acquire the dendritic cells modified by mIL-10, which can provide a foundation for the further study. METHODS: Mouse IL-10 (mIL-10) gene comprise of enzyme cutting spot was synthesized according to the mIL-10 gene sequence and multiclone spot of adenovirus vector, connected to pMD18-T vector and sequenced. MIL-10 was subcloned to BD Adeno-X~(TM) vector, packed and augmented in HEK 293 cells, following determine the protein expression, and the vector was transfected to mice bone marrow-derived dendritic cells. RESULTS AND CONCLUSION: Recombinant adenovirus vector Ad-mIL-10 was successfully synthesized, packed and augmented, which could highly express protein IL-10. Bone marrow-derived dendritic cells were successfully cultured and transduced in vitro. It suggested that it is feasible to transfect mice dendritic cells by Ad-mIL-10 adenovirus vector. The study can provide more sufficient theoretic evidence for the possibility of correlative gene therapy.

Objective To evaluate the clinical significance of the level of [gG4 in the bronchoalveolar lavage fluid (BALF) of patients with rheumatic disease related interstitial lung disease (RD-ILD).Methods Eighteen patients with RD-ILD,14 patients with pulmonary infection and 12 patients without ILD or pulmonary infection,were recruited consecutively from the in-patient ward of Peking University People's Hospital.Clinical features and laboratory data were extracted from the medical record database of Peking University People's Hospital.The level of IgG4 was determined by ELISA.The statistical analysis of data using t test,and the correlation between the two variables were analyzed using linear regression analysis.Results The level of IgG4 was significantly higher in BALF of patients with RD-ILD than patients' without ILD or pulmonary infection,whereas there was no difference compared to patients with pulmonary infection.The level of IgG4 in BALF of patients with RD-ILD was positively correlated with the percentage of lymphocytes (r=0.53,P=0.03),and significantly negatively correlated with the percentage of macrophages (r=-0.65,P=0.005).Conclusion The level of IgG4 is significantly elevated in BALF of patients with RD-ILD,which is probably secreted from the lymphocyte of the lung.

Objective To evaluate the clinical effects of a single posterior translaminal or transforaminal debridement and internal fixation with bone graft for the treatment of lumbosacral regional spinal tuberculosis. Methods From January 2004 to October 2009, 32 patients with lumbosacral regional spinal tuberculosis were treated by a single posterior debridement and internal fixation with bone graft, including 21 males and 11 females with the mean age of 46 years (range, 32-65). The lesions located: 3 in L3,4, 19 in L4,5, 10 in L5S1. 20 cases were pedormed operation via translaminal approach, 12 via transforaminal approach. The modified Prolo scale, visual analogue scale (VAS), kyphosis angle and the vertebral body loss were measured before and after surgery, and in the final follow-up. Results All the patients were followed up for average 16 months (range, 12-24). The pre-, postoperative and final follow-up mean kyphosis angle were -24.3°,-34.8°, and -32.4° in the translaminal group, -25.4°, -35.2°, and 33.6° in the transforaminal group,respectively. According to the modified Prolo scale, the excellent and good result was 93.8%. VAS decreased significantly from 7.6 points to 2.9 after surgery. Conclusion Debridement and internal fixation with bone graft via a single posterior approach for the treatment of lumbosacral regional spinal tuberculosis was an easy and effective technique. The appropriate selection of indications, careful imaging evaluation and thorough surgical debridement played an important role in the treatment of lumbosacral regional spinal tuberculosis.

Objective:To explore the clinical efficacy and surgical indications of Y type osteotomy in the treatment of post-tuberculous thoracolumbar severe angular kyphosis.Methods:From March 2012 to June 2018, 36 patients with post-tuberculous thoracolumbar severe angular kyphosis were treated with Y type osteotomy, including 22 males and 14 females, aged 23.6±5.7 years (range, 7-57 years). The parietal vertebrae of kyphosis were located in the upper thoracic vertebra in 3 cases, the thoracic vertebra in 11 cases, the thoracolumbar segment in 17 cases, and the lumbar vertebra in 5 cases. The Cobb angle of kyphosis before the operation was 92.8°±23.3° (range, 60°-147°). The visual analogue scale (VAS), American Spinal Injury Association (ASIA) neurological function grade, and Kirkaldy-Willis function score were used to evaluate the clinical effect. The imaging evaluation indexes were interbody kyphosis angle and spinal bone fusion.Results:The operation was successful in all the 36 patients. The operation time was 210 ±25.9 min (range, 180-270 min), the intraoperative blood loss was 520 ±110 ml (range, 400-800 ml), and the postoperative follow-up time was 26.38±1.75 months (range, 22-30 months). The postoperative kyphosis Cobb angle was corrected to 16.5°±7.7° (range, 5°-35°), which was significantly improved compared with that before operation( t=25.438, P<0.01), and the correction rate was 82.2%. At the last follow-up, the kyphosis angle was 16.5°±7.1° (range, 6°-32°), which was not significantly different from that after the operation. The preoperative VAS score was 7.3±1.8 (range, 3-9), and the postoperative VAS score was 2.4±0.8 (range, 1-3), while the improvement rate was 67.1%. At the last follow-up, it was 1.1±0.6 (range, 0-2), and the improvement rate was 85.0%. According to the Kirkaldy-Willis functional score, the results were excellent in 25 cases, good in 8 cases, and fair in 3 cases at the last follow-up, with an excellent and good rate of 91.7%. Before the operation, 9 cases were accompanied by neurological dysfunction (ASIA grade: grade C in 2 cases, grade D in 7 cases). At the last follow-up, all the 9 patients recovered to grade E. During the operation, the electrophysiological nerve monitoring was abnormal in 2 patients, and the awakening test was negative in 1 case. In another patient, neuroelectrophysiological monitoring after posterior column osteotomy showed a decrease in bilateral sensory and motor function. There was no compression around the spinal cord in the osteotomy area, so the operating bed was gradually folded and partially restored to kyphosis and temporarily fixed with double rods. Neuroelectrophysiological monitoring suggested the recovery of nerve function. The awakening test showed that the nerve function of both lower limbs recovered close to the preoperative state, and further osteotomy and internal fixation was performed 2 weeks later. The nerve function of both lower limbs returned to normal after 3 months. After the operation, one patient's muscle strength of the lower limbs decreased from grade 5 to grade 3, and the sensory function was normal. After symptomatic support treatment such as neurotrophic drugs, it returned to normal 2 weeks later. 1 case developed delayed neurological dysfunction 1 year after the operation. Neurotrophic drugs and rehabilitation treatment improved it. The sinus of the incision was formed in one case 3 months after the operation and healed after debridement and suture. Conclusion:Y typeosteotomyis a safe and effective method for patients with post-tuberculous thoracolumbar severe angular kyphosis. Compared with traditional osteotomy, anterior support bone grafting can be avoided, and spinal shortening can be reduced.

Objective To study the effect of meticulous nursing on the nursing of patients with skin laceration (ST).Methods A total of 120 ST patients were divided into meticulous nursing group and conventional nursing group.The first surgery to skin grafting time,drainage time,hospitalization time and costs of treatment wererecorded and compared.On the day of admission and 7 d after nursing,the SAS and SDS scores were recorded and compared.Nursing satisfaction degree and infection rate 7 d after nursing were recorded and compared.Results In meticulous nursing group,skin grafting time,drainage time and hospital stay were significantly shorter than those in conventional nursing group (P ＜ 0.05).Seven days after nursing,SAS score and SDS score of meticulous nursing group were significantly lower than those on admission day and those of conventional nursing group (P ＜0.01).The satisfaction degree of meticulous nursing group was significantly higher than that of conventional nursing group (P ＜ 0.01).Conclusion Meticulous nursing can significantly improve the prognosis of patients with ST,psychological status and improve the patient's satisfaction degree toward nursing.

Objective To study the effect of meticulous nursing on the nursing of patients with skin laceration (ST).Methods A total of 120 ST patients were divided into meticulous nursing group and conventional nursing group.The first surgery to skin grafting time,drainage time,hospitalization time and costs of treatment wererecorded and compared.On the day of admission and 7 d after nursing,the SAS and SDS scores were recorded and compared.Nursing satisfaction degree and infection rate 7 d after nursing were recorded and compared.Results In meticulous nursing group,skin grafting time,drainage time and hospital stay were significantly shorter than those in conventional nursing group (P ＜ 0.05).Seven days after nursing,SAS score and SDS score of meticulous nursing group were significantly lower than those on admission day and those of conventional nursing group (P ＜0.01).The satisfaction degree of meticulous nursing group was significantly higher than that of conventional nursing group (P ＜ 0.01).Conclusion Meticulous nursing can significantly improve the prognosis of patients with ST,psychological status and improve the patient's satisfaction degree toward nursing.

OBJECTIVE: To analyze the data of occupational pneumoconiosis caused by bentonite dust. METHODS: The data of 2 cases of occupational pneumoconiosis caused by bentonite dust was retrospectively analyzed. RESULTS: Both 2 cases had a clear history of occupational exposure to bentonite dust. Case 1 has a 14 years and case 2 has 7 years of bentonite exposure history. The radiographic examination of chest X-ray in both cases showed diffuse miliary nodules with high density in both lungs. The small opacity total profusion of chest X-ray images in both cases belong to category 2. The small opacity of lung in case 1 distributed in 5 areas,while case 2 distributed in 4 areas. The pulmonary function test for case 1 showed that the forced vital capacity( FVC) was 81. 4%,the first second forced expiratory volume( FEV_1) was 76. 8%and FEV_1/FVC was 74. 4%,mild pulmonary ventilation damage; lung function test results for case 2 showed: FVC was84. 0%,FEV_1 was 90. 0%,FEV_1/FVC was 93. 0%,pulmonary ventilation function was in the normal range. Case 1 was diagnosed as occupational pneumoconiosis stage Ⅱ( bentonite); Case 2 was diagnosed as occupational pneumoconiosis stageⅠ( bentonite). CONCLUSION: The clinical symptoms and signs of occupational pneumoconiosis caused by bentonite dust are not obvious. Its diagnosis is mainly based on X-ray chest radiograph.

Objective To examine the cognitive status and influencing factors of spiritual care among neurosurgery nur-ses,providing a basis for developing a spiritual care management plan for neurosurgery nurses.Methods A convenience sam-pling method was used to select 741 neurosurgical nurses from 35 tertiary hospitals across 14 prefecture-level cities in Guangdong Province from October 2022 to March 2023.A self-developed general information questionnaire and the Chinese version of the Spiritual Care-Giving Scale(C-SCGS)were utilized for the questionnaire survey.Results The average cognitive score for spirit-ual care among neurosurgery nurses was 169.07±27.66.Factors influencing the total score and various dimensions of spiritual care cognition included educational background,receipt of spiritual care education,position,number of night shifts,marital sta-tus,and employment type(P＜0.05).Conclusion Neurosurgical nurses'spiritual care cognition is at a moderate level,indi-cating a need for targeted training programs to enhance their understanding and practice of spiritual care based on their status and characteristics.

OBJECTIVETo explore the technical feasibility, safety, and short-term clinical efficacy of right-to-lateral approach in laparoscopic-assisted radical gastrectomy.

METHODSClinicopathological data of 178 gastric cancer patients undergoing laparoscopic-assisted radical gastrectomy, including 92 patients with right-to-lateral approach(R-LG group) and 86 cases with left-to-lateral approach (L-LG group), in our department from October 2010 to September 2013 were analyzed retrospectively. Short-term efficacy and complication morbidity were compared between R-LG group and L-LG group according to body mass index (BMI).

RESULTSFor those patients with BMI ≥ 24 kg/m², the R-LG group (35 cases) had shorter mean operation time, less intraoperative blood loss, shorter painkiller used time than L-LG group (31 cases)[(227 ± 17) min vs. (262 ± 23) min, (73 ± 9) ml vs. (84 ± 8) ml and (2.1 ± 0.1) d vs. (2.6 ± 0.4) d, all P<0.05]. The average time to ambulation and recovery time of peristalsis in the R-LG group were faster than those in L-LG group [(2.2 ± 0.2) d vs. (2.8 ± 0.6) d and (3.6 ± 0.3) d vs. (4.2 ± 0.5) d, all P<0.05]. The R-LG group had more dissected lymph nodes per patient (35 ± 4) than the L-LG group (30 ± 5) with significant difference (P<0.05). There were no significances in postoperative hospital stay, postoperative complication morbidity and hospitalization expenses between R-LG and L-LG group (all P>0.05). For those patients with BMI<24 kg/m², there were no significant differences in all above parameters between R-LG group (57 cases) and L-LG group (55 cases). No mortality and recurrence was observed during follow-up of 3 to 24 months.

CONCLUSIONRight-to-lateral approach in laparoscopic-assisted radical gastrectomy is a safe and feasible procedure, especially for the obesity patients, which can shorten the operation time, decrease intraoperative blood loss, lead to a faster postoperative recovery and harvest more lymph nodes as compared to L-LG procedure.

Body Mass Index ; Gastrectomy ; Humans ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; Obesity ; Operative Time ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Stomach Neoplasms ; surgery