Objective To investigate the efficacy of tumor necrosis factor alpha (TNF-α) antagonists therapy and the possible eauses of new onset or exacerbation of psoriatic skin lesion in patients with arthritides treated with TNF-α atagonists therapy. Methods One patient with definite psoriatie arthritis and one patient with definite ankylosing spondylitis, who were treated with TNF-α antagonist therapy developed an unexpected exacerbation or new onset of psoriatic skin lesion, were investigated in this study. Furthermore, the literatures associated with psoriasis induced by anti-TNF-α therapy were reviewed. Results The patient with psoriatic arthritis experienced exacerbation of psoriatic skin lesion and the skin lesions subsided after discontinuation ofetanereept therapy. The skin lesions recurred with re-introduction of etanereept, which improved after withd-rawal of etanercept therapy. The patient with ankylosing spondylitis unexpectedly developed psoriasis vulgaris after receiving etanercept therapy. The skin lesion waxed and waned followed the administration or discon-tinuation of etanercept therapy. The same settings were reported in patients with rheumatoid arthritis receiving different types of anti-TNF-α therapy. Conclusion Blockage of TNF-α is highly effective in arthritides. Ho-wever, some patients with arthritides can unexpectedly develop either a new onset or exacerbation of psoriatic skin lesions after initiation of TNF-α antagonist therapy. The skin lesions subside after discontinuation of the TNF-α antagonist therapy, but the causes remain unclear.

Objective To investigate the effect of ketamine on the expression of HSP 70 in myocardium in severely burned rats for its possible mechanism of myocardial protection. Methods Seventy-two male Wistar rats were randomly divided into 3 groups: normal control group (group C, n=8), burn injury group (group BI, n= 32) and ketamine group (group K,n=32). 30% Wtal body surface area of Ⅲ degree burn model was developed in group BI and group K. Ketamine 20 mg/kg was injected IM in group K 15 min after the burn model was made. Equal volume of normal saline was given instead of ketamine in group BI. Group C received no treatment. The rats were sacrificed at 3, 6, 12 and 24 h after administration in group BI and group K respectively(8 rats at each time point). Myocardial samples were obtained for determination of the expression of HSP 70 by Western blot analysis. The myocardial ultrastructure was observed at 3 h after administration with electron microscope. Results The myocardial damage was milder in group K than in group BI. The expression of HSP 70 was significantly higher at 3, 6, 12 and 24 h after administration in group K and group BI than in group C(P<0.05).The HSP 70 expression was significantly higher at 3 and 6 h after administration in group K than in group BI ( P<0.05). Conclusion Ketamine can reduce the myocardial injury induced by severe burn through up-regulating the expression of HSP 70 in cardiocytes.

Objective To evaluate the value of serologic teats in patients with primary biliary cirrhosis by conducting a seroprevalence survey for anti-gp210 and anti-sp100 antibodies.Methods A total of 72 consecutive primary biliary cirrhosis (PBC) patients with or without Sj(o)gren's syndrome (SS) and 50 patho logic controls were studied.Antibodies were tested by ELISA assays with recombinant spl00 and purified gp210.Results The positive rates of anti-gp210 detected by ELISA was 31.1% and 45.5% in PBC patients with and without SS respectively.Among SS and virus hepatitis patients,none had anti-gp210 antibody (P＜0.01).The prevalence of anti-gp210 was similar in PBC patients with and without SS.The positive rates of an ti-sp100 detected by ELISA was 14.8% and 18.2% in PBC patients with and without SS respectively.Among the patients with SS,only 3.3% was positive for anti-sp100,but none had anti-sp100 reactivity in virus hep atitis patients.The prevalence of anti-sp100 was not significantly different between PBC and SS groups. Conclusion Anti-gp210 and anti-sp100 are highly specific for PBC.The sensitivity of anti-gp210 and anti sp100 is 31.1% and 14.8% respectively.They may be helpful in the diagnosis of PBC.

Carcinoembryonic Antigen ; analysis ; Humans ; Luminescence

[Objective]To explore the clinic results of the locking compression plate fixation for the acetabular fractures.[Method]Twenty-three patients were treated in the author's department, 16 of them were male and 7 were female patients.The ages ranged from 21 to 61 years, and mean age was 43.3 years.Ninteen patients had been injured in an automobile accident,3 were fell from height and 1 was crushed by a heavy object. The patients were classified according to Letournel classification.There were 7 anterior column fractures,3 posterior wall fractures,5 anterior wall fractures,2 transverse fractures,1 anterior column and posterior column fracture,1 T shape fracture, 3 posterior wall and posterior column fractures,1 transverse and posterior wall fracture.[Result]All the incisions healed during the primary procedure and all the patients were available at follow-up ranging from 3 to 24 months(average 20.1 months).The average intraoperation time was 123 minutes(50～235 minutes),and the intraoperative blood loss was 100 to 1500 ml.The patinents underwent blood transfusion from 0 ml to 1 200 ml.According to Matt's criteria, the rate of excellent and good was 73.9%(17/23).[Conclusion]The locking compression plate fixation is one of the effective methods for treatment of acetabular fractures, with the advantages of being simple and minimally traumatic.

Objective To study material basis of Zhou's prescription, components of effective parts Ⅰ in Zhou's prescription was gualitative and quantitative analyzed. Methods The components of effective part Ⅰ was identified by test-tube reaction and qualitative TLC method, the content of saponins and flavones was quantitative analyzed. Results Total content of the saponins and flavone are 1.07% and 0.85% in Zhou's Prescription. The purity of saponins and flavones in effective parts Ⅰ are 37.4% and 29.7%. Conclusion The main components of effective part Ⅰ in Zhou's Prescription were flavones and saponins.

Objective To substantiate the relationship between connective tissue diseases and lung bullae. Method In 10 years, 70 patients with lung bullae were admitted to internal medicine inpatient wards of Peking Union Medical College Hospital, among which 12 connective tissue diseases were diagnosed. Two cases were excluded because their lung bullae was secondary. Results Six cases were Sj?觟gren′s syndrome (SS), two cases were vasculitis [one Takayasu disease and one was polyarteritis nodosa (PAN)], one was rheumatoid arthritis (RA) and one was undifferentiated connective tissue disease (UCTD). Symptoms of respiratory system were present in the patients with pulmonary interstitial fibrosis (five cases) and pulmonary amyloidosis (one case). Pulmonary function tests showed restrictive ventilatory dysfunction and obstriction of small airway (two cases), diffusion dysfunction (one case), restrictive ventilatory dysfunction (one case). A trans-bronchial lung biopsy specimen showed thickening of alveolar septa, chronic inflammation, proliferation of fiberous connective tissue and inflammatory cell infiltration. Conclusion Connective tissue diseases may result in lung bullae because they cause narrow of small airways.It is definitive in the relationship between SS and lung bullae, but further study needs to be done to clarify the relationship between other connective tissue diseases and lung bullae.

Objective To observe the efficacy of extracorporeal liver support by using less fresh frozen plasma in the treat‐ment of acute‐on‐chronic liver failure.Methods A total of 45 patients with acute‐on‐chronic liver failure were divided into ob‐servation group[plasma perfusion(PP) with a small amount of plasma+ plasma exchange(PE)] ,control group 1(PE) ,control group 2(PP+PE)in terms of the amount of plasma used on the day of treatment. All the patients received artificial liver treatnts 62 times totally.Results The clinical symptoms were improved in the three groups after treatments.There were significant differences in the decrease of alanine transaminase (ALT) ,aspartate transaminase(AST) and direct bilirubin(DBil)rather than the decrease of total bilirubin(TBil)and blood ammonia among the groups.No significant difference was noted in the liver and kidney function among the three groups. The improvement of the coagulation function was poor in the observation group when compared with the control group 1 and control group 2 and there were significant differences.Conclusion During the short sup‐ply of the plasma ,plasma perfusion combined with small amount of plasma can be considered to be used in artificial liver treat‐ments ,which can effectively decrease the level of TBil ,relieve symptoms and decrease the occurrence of complications.

AlM: To investigate the efficacy of photodynamic therapy ( PDT) and intravitreal injection with ranibizumab on macular choroidal neovascularization ( CNV ) of pathologic myopia ( PM) .
METHODS: There were patients ( 32 eyes ) who were diagnosed as PM with CNV. Randomly selected 16 cases ( 16 eyes ) which were given the PDT treatment ( PDT group ) . The remaining were given both PDT and intravitreal injection with ranibizumab ( combination group) . There is no significant difference on macular edema between two groups. We analyzed the changes in the best corrected visual activity ( BCVA) , optic coherence tomograph ( OCT ) and fundus fluorescein angiography (FFA) before and 1, 6mo after treatment.
RESULTS:One month after the treatment in PDT group:the BCVA increased while the CMT decreased compared with that of pretreatment (P<0. 05). One month after the treatment in combination group: the BCVA increased while the CMT decreased significantly compared with that of pretreatment (P<0. 01);the changes of BCVA and CMT showed statistically significant between the two groups ( P<0. 05). Six month after the treatment in PDT group: the BCVA increased while the CMT decreased compared with that of pretreatment ( P <0. 05 ). Six month after the treatment in combination group: the BCVA increased while the CMT decreased significantly compared with that of pretreatment ( P <0. 01 ); compared with changes of BCVA and CMT in two groups, the difference was significant after treatment (P<0. 05). Compared 1mo with 6mo after treatment:there was no significant difference in the BCVA and CMT changes (P>0. 05). One month after treatment: in PDT group, FFA showed no leakage or reduced leakage of CNV in 11 eyes (69%), and the fundus remained leaky in 5 eyes ( 31%); in combination group, FFA showed no leakage or reduced leakage of CNV in 13 eyes (81%);the fundus remained leaky in 3 eyes (19%). Six month after treatment:in PDT group, FFA showed no leakage or reduced leakage in 10 eyes ( 62. 5%); the fundus remained leaky in 4 eyes ( 25%); two eyes ( 12. 5%) relapsed leakage; in combination group, FFA showed no leakage or reduced leakage of CNV in 15 eyes (94%);the fundus remained leaky in 1 eye (6%).
CONCLUSlON: Not only PDT but also PDT and intravitreal injection with ranibizumab can block CNV of pathologic myopia completely or partly, and reduce the danger causing descent of vision. Effects and the stability of the combination therapy is superior to PDT treatment.

Objective To study the blood routine tests results change after therapy of chlorpromazine ,clozapine ,perphenazine changed to risperidone in schizophrenic patients .Methods 100 schizophrenic patients in the hospital from March 2014 to March 2015 for treatment were enrolled in the study ,who were treated with chlorpromazine ,clozapine or perphenazine respectively for one course ,and then the therapies were replace by risperdal .Results After treatment ,mean corpuscular volume was significantly grea‐ter ,the number of lymphocytes was significantly higher and intermediate cell number was significantly lower than that before treat‐ment ,the difference was statistically significant(P<0 .05) .Conclusion Leukocyte differentiation change and mean corpuscular vol‐ume increased obviously after therapy of chlorpromazine ,clozapine or perphenazine changed to risperidone in schizophrenic patients .