Objective To investigate the clinical characteristics and current condition of treatment for systemic lupus erythematosus (SLE) associated pulmonary arterial hypertension (PAH).Methods 10-year inpatients cases were reviewed and followed up.Cases were divided into 2 groups:group A:patients with baseline pulmonary arterial systolic pressure (PASP) lower than 70 mmHg； group B:patients with baseline PASP higher than 70 mm Hg.Pearson's correlation analysis,Chi-square test,Logistic regression,Cox-Mantel and Wilcoxon test were used for statistical analysis.Results There were totally 155 cases with 184 records of admission which accounted for 4.16％ among total lupus cases.The main clinical characteristics included Raynaud's phenomenon (47.3％),pericardial effusion (41.9％) and high titer of anti-RNP antibody (55.4％).There were 132 cases enrolled for prognostic statistical analysis.There were 47 cases of death (35.6％) in total,among which 9 cases (19.1％) were in group A and 38 cases (80.9％) were in group B.In group A,there was a positive correlation between PASP and lupus disease activity index score.Single therapy analysis by Chi-square test showed that cyclophosphamide (CTX) (P＜0.05) and PAH targeted drugs (P＜0.01) were significantly associated with favorable outcome but logistic regressive analysis only confirmed the efficacy of target drugs (P＜0.01).PAH target drugs significantly improved the one year survival rate of the severe cases.Conclusion The main clinical characteristics of SLE associated PAH include Raynand's phenomenon,pericardial effusion and positive anti-RNP antibody.The severity of PAH may not be related to lupus disease activity.PAH targeted drugs are effective in SLE-PAH.CTX may be effective in some cases.For severe cases,the combination therapy of CTX and PAH targeted drugs could significantly improve the prognosis.

Objective To investigate the relationship between elderly male patients with coronary heart diseases (CHD) and endogenous androgen level and other related factors.Methods 28 male patients with acute coronary syndrome (ACS) were chosen as research group,28 male patients with stable angina pectoris (SAP) were chosen as observation group,and 28 healthy male people were selected as control group.All of three groups were checked by carotid artery Doppler ultrasonography and the peripheral blood concentration of testosterone (T),TC,LDL-C,Glu,CRP were measured,BMI was calculated in all three groups.Results Peripheral blood concentration of T,TC,LDL-C,Glu in ACS group and SAP group were significantly higher than those of the control group(P ＜0.05).IMT and number,quality of plaque in patients with ACS and SAP were significantly different compared with the control group (P ＜ 0.05).T,Tc,LDL-C,CRP,BMI,IMT,unstable plaque were significantly different between ACS group and SAP group(P ＜ 0.05).Glu had no statistical difference between ACS group and SAP group (P ＞ 0.05).Conclusion Peripheral blood concentration of T was negatively correlated with arterosclerosis,unstable plaque,Tc,LDL-C,BMI in old male CHD patients

Objective To explore the clinical value of plasma NT-proBNP in evaluation of major adverse cardiac event in chronic heart failure patients.Methods 120 chronic heart failure patients who measured plasma NT-proBNP were divided into two groups according to median plasma NT-proBNP level (A group:≤ median,B group:＞ median).The incidence of major adverse cardiac events,MACE(including malignant ventricular arrhythmia and sudden cardiac death) were observed during hospitalization.Results The left ventricular end-diastolic diameters (LVEDDs) in B group was longer than that in A group [(58.80 ± 6.90) mm vs (54.32 ± 8.00) mm,P =0.035)],and the left ventricular ejection fraction(LYEF) in B group was lower than that in A group[(29.16 ± 8.31) ％ vs (33.80 ± 6.90)％,P =0.037].The incidence rate of major adverse cardiac events in A group was higher than that in B group (11.63％ vs 1.67 ％,P ＜ 0.05).The multivariate Logistic regression analysis showed that the NT-proBNP level in chronic heart failure inpatients was independently associated with major adverse cardiac event during hospitalization(OR =5.28,95％ confidence intervals 3.54 ～9.26,P＜0.05).Conclusion In chronic heart failure patients,plasma NT-proBNP level could predict the MACE incidence during hospitalization,and have important value to evaluate the prognosis of chronic heart failure.

Objective To explore the clinical prognostic value of rapid detection for plasma NT-proBNP levels on admission in patients with acute myocardial infarction.Methods 56 patients with AMI were measured plasma NT-proBNP imediately in hospital,and then they were divided into A,B and C group according to NT-proBNP levels (A group:＜ 500ng/L,B group:500-2 000ng/L,C group:＞ 2 000ng/L).The incidence of major adverse cardiac events (MACE including congestive heart failure,malignant arrhythmia,cardiogenic shock and sudden cardiac death) in subjects were observed respectively during hospitalisation and 30 days.Results The three group subjects with different NT-proBNP levels presented different incidence of MACE(A group:1,0;B group:3,1;C group:8,6) at duration of hospital stay,30days (x2 =6.705,P =0.035 ; x2 =7.957,P =0.008).With the NT-proBNP levels rising in AMI paitents,the inciedence of MACE increased.The incidence of MACE in A,B and C group were 6.6％,18.18％ and 73.69％ respectively.Conclusion In AMI patients,plasma NT-proBNP levels could predict early MACE incidence,which has an important value to evaluate the early clinical prognosis.

Objective To discuss the effect of iohexol on the renal function in the old patients undergoing coronary angiography and/or percutaneous coronary imervention(PCI).Methods The changes of plasm Cr,BUN before and after coronary angiography and/or PCI of the 60 old patients with the indicatmns of coronary angiography were compared and analyzed.Results The plasm Cr,BUN in 60 cases were fluctuated,but were not significantly changed(P＞0.05).Conclusion Iohexol has little effect on the renal function in the old patients undergoing coronary angiography and/or percutaneous coronary intervention(PCI).

Objective To discuss the effect of stress hyperglycemia on prognosis of nondiabetic patients with acute myocardial infarction. Methods 80 nondiabetic patients with acute myocardial infarction(AMI) were divided into 2 groups according to the early blood glucose level. Group A:blood glucose ≥ 8mmol/L;group B: < 8mmol/L. Serious cardiac arrhythmia, backward heart failure, cardiac shock and death incidence and so on were observed. Re-sults The incidences of serious cardiac arrhythmia,backward heart failure,cardiac shock and death were significantly higher in patients with stress hyperglycemia than those of patients without stress hyperglycemia(35% vs 13%, 38% vs 17%, 19% vs 2%, 31% vs 11%, P <0.05). Conclusion The incidences of serious cardiac arrhythmia,backward heart failure,cardiac shock and death in patients with stress hyperglycemia were significantly higher than those of pa-tients without stress hyperglycemia,which could be used as the parameters to judge the prognosis of patient.

Objective To evaluate the prevalence of atherosclerosis in Chinese premenopausal women with systemic lupus erythematosus (SLE) and study possible associations between non-traditional risk factors with premature atherosclerosis. Methods One hundred and eleven premenopausal women with SLE and 40 healthy controls without clinical cardiovascular disease were evaluated. B-mode ultrasonography was used to measure carotid plaque and intima-media wall thickness( IMT). The relationship between the patients' clinical characteristics and carotid plaque was examined. At the same time, B-mode ultrasound was used to measure flow-mediated dilation (FMD) and nitroglycerin-mediated dilation (NMD) in the brachial artery. Using this method, the difference in endothelial function between SLE patients and controls was assessed. T-test,χ2 test and logistic regression were used for statistical analysis. Results Carotid plaque was more frequently observed in patients with SLE (16 of 111 patients) than in control subjects (0 of 40 subjects) (P=0.007). The mean IMT (m-IMT) (0.62 mm vs 0.45 mm, P<0.01) and maximum IMT(M-IMT) (0.7 mm vs 0.6 mm, P<0.01) was significantly higher in patients than in controls. As compared with patients without plaque, patients with plaque were significantly older, had longer disease duration, higher body mass index (BMI), higher blood pressure, shorter prothrombin time, elevated C-reactive protein level, higher SLICC score, higher cumulative prednisone dose, less hydroxychloroquine accumulated dosage, higher m-IMT and M-IMT, lower FMD and NMD. In logistic regression analysis, older age (P=0.012, OR=1.137), higher BMI (P=0.051, OR=1.205) and higher SLICC score (P=0.000, OR=2.888) were independently related to the presence of plaque. Conclusion SLE patients have higher prevalence of carotid atherosclerosis plaque than healthy controls and the age at onset is younger than controls. In addition to traditional risk factors for cardiovascular disease, SLE itself and disease related factors play important roles in premature atherosclerosis in SLE. SLE patients have significant endothelial dysfunction. Thus, endothelial dysfunction can be regarded as one manifestation of premature atherosclerosis in SLE.

Objective To evaluate the biomechanical effects of using a new injectable calcium phosphate cement to consolidate the fixation of osteoporotic intertrochanteric fracture.Method Five matchod pairs of human cadaver femora were used to produce the model of intertrochanteric fracture.All fractures were fixed with dynamic hip screws(DHS),and divided into two groups.In the CPC consolidation group of each pair,CPC was used to grout the hip screw and to fill the posteromedial defect.All femora were subjected to biomechanical test.Results Under the loading of 500 N,in the CPC consolidation group,the mean axial stiffness is(691.93±18.90)N/mm and the horizontal shear stiffness is(5553.84±27.47)N/mm.The mean lateral and medial strength is(5.15±0.35)MPa and(4.13±0.24)MPa.The torsion stiffness was 0.41 and the ultimate loading is(3580±286)N.In the control group,the mean axiak stiffness is(453.45±19.75)N/mm,the horizontal shear stiffness is(3848.87±22.63)N/mm,the mean lateral and medial strength is(3.12±0.37)MPa and(1.80±0.21)MPa,and,the torsion stiffness is 0.35 and the ultimate loading is(2512±189)N.Consolidation fixation with CPC increased each of the biomechanical efficiency(P＜0.05).Conclusions CPC consolidation of osteoprotic femoral head and the medial defect of intertrochanteric fracture can significantly improve the overall stability and decrease the rate of postoperative complication.

Objective To investigate the clinical characteristics of children with medulloblastoma (MB). Methods The correlations amongst MB histopathological subtype,age at diagnosis,gender,primary tumor locations, relapsed tumor and relapsed tumor locations were analyzed retrospectively in 83 children who were diagnosed as MB by histopathology subtypes from February 2012 to April 2015 in Beijing Shijitan Hospital Affiliated to Capital Medical Uni-versity.The data was conducted by using SPSS 22.0 statistical software.Results Among the 83 cases (53 boys and 30 girls),there were 14 patients younger than 3 years old (9 boys and 5 girls)and 69 patients (44 boys and 25 girls)ol-der than 3 years old,including 28 relapsed (19 boys and 9 girls)and 55 non -relapsed cases (34 boys and 21 girls). The median age was 80.2 (13.1 -184.7)months at diagnosis.Of these 83 cases,48.2% (40 /83 cases)was classic medulloblastoma (CMB)(2 cases less than 3 years old),24.1 % (20 /83 cases)was desmoplastic /nodular medullo-blastoma (DMB)(6 cases less than 3 years old),12.1 % (10 /83 cases)was large cell/anaplastic medulloblastoma (LC /AMB)(1 case less than 3 years old),3.6% (3 /83 cases)was extensive nodular medulloblastoma (MBEN)(1 case less than 3 years old),and 12.1 % (10 /83 cases)(3 cases less than 3 years old)was mixed subtype.The rela-tionships between age at diagnosis and histopathological subtype,gender and primary tumor location were all statistically significant (χ2 =0.014,0.013,all P <0.05).Conclusions The incidence of boys with MB is higher than girls.CMB is the main histopathologic subtype in children over 3 years old.The primary tumor location involving the cerebellar vermis or cerebellar vermis and the fourth ventricle is higher in girls with MB.The primary tumor location involving the fourth ventricle,the fourth ventricle and other parts of the central nervous system,Cerebellar vermis and other parts of the central nervous system or other parts of the central nervous system is higher in boys with MB.

Objective To evaluate the efficacy and safety profile of a recombinant human tumor necrosis factor receptor: Fc fusion protein in ankylosing spondylitis (AS). Methods This was a multicenter,randomized, double-blind, placebo-controlled trial in the first 6 weeks and then followed by an open-labeled trial in the next 6 weeks. One hundred and forty-three patients of active AS were randomly assigned to receive 25 mg twice-weekly subcutaneous injections of rhTNFR:Fc or placebo for 6 weeks. The primary endpoint was proportion of ASAS20 responders at week 6. The secondary endpoints were the proportion of subjects achieving a BASDAI 20%, BASDAI 50% and BASDAI 70% improvement at week 6. Other secondary endpoints, related to reducing signs and symptoms of AS and improving range of motion and physical function, were evaluated.Results Treatment with rhTNFR:Fc resulted in significant improvement. At 6 weeks, 68% of the 71 patients in the rhTNFR: Fc group had a treatment response, as compared with 28% of those in the placebo group(P＜0.01). Improvements over base-line values for other measures of disease activity were significantly greater in the rhTNFR:Fc group, rhTNFR:Fc was well tolerated, The most frequently treatment related adverse event was injection site reaction. Conclusion rhTNFR:Fc has demonstrated consistent evidence of efficacy and is well tolerated in the treatment of active AS.