Objective To investigate the clinical features, diagnosis, treatment and prognosis of polymyositis patients with cardiac involvement.Methods Clinical data of 41 polymyositis patients with cardiac involvement were analyzed retrospectively.Results In our group, the percentage of polymyositis with cardiac involvement was 38.3%, and 25 (60.1%) out of the 41 patients were asymptomatic. Their average age was older than the cases without cardiac involvement ( P

Objective To explore the alteration in ethology and change of muscle fibers of gastronomies of rats following spinal cord injury(SCI). Methods 108 Wistar rats were divided into sham operation group (n=38) and SCI group (n=38) and rehabilitation group (n=32).The ethology was evaluated by Basso, Beattie, and Bresnahan Locomotor Rating Scale (BBB Scale), and the alteration of muscle tissue's reactivitywas observed by immunohistochemistry staining. Results The BBB scores of rehabilitation group were higher than SCI group 3weeks after injury, but all was lower than 10. The cross section areas of gastrocnemius in both groups were getting smaller, but the rehabilitationgroup was slighter. Conclusion Spontaneous recovery occurred in some degree for rats' hind limb after spinal cord injury. Rehabilitationtraining is beneficial for the recovery of rats' motor function, and alleviates the atrophy of hind limb after spinal cord injury.

Objective To investigate the risk factors of acute exacerbation of chronic obstructive pulmonary disease(AECOPD) combined with respiratory failure.Methods The clinical data of 120 patients with AECOPD combined with respiratory failure were retrospectively analyzed.The patients were divided into disease improved group (96 cases) and disease serious group (24 cases,including death) according to the treatment outcome.Risk factor and treatment strategies of the two groups were statistically analyzed.Results There was no significant difference in age,sex,disease course and arterial blood oxygen partial pressure(P ＞ 0.05).The body mass index,albumin,pH,successful cough and expectoration rate,nutritional support rate,and noninvasive mechanical ventilation rate in disease improved group was higher than that in disease serious group[(28.5 ± 9.8) kg/m2 vs.(23.3 ± 7.4) kg/m2,(21.4 ± 7.9) g/L vs.(19.3 ± 6.8) g/L,7.23 ± 0.20 vs.7.11 ± 0.17,79.2％ (76/96) vs.25.0％ (6/24),58.3％ (56/96) vs.33.3％ (8/24),81.2％ (78/96) vs.62.5％ (15/24)],arterial blood carbon dioxide partial pressure,mild consciousness obstacle rate,multiple drug-resistant infections rate,fungal infection rate,nasal feeding rate,hormone use time and the incidence of heart failure,pulmonary encephalopathy,hepatorenal function damage and upper gastrointestinal bleeding in disease improved group was lower than that in disease serious group [(10.08 ±1.71) kPa vs.(11.98 ± 2.03) kPa,13.5％ (13/96) vs.58.3％ (14/24),22.9％ (22/96) vs.41.7％ (10/24),0 vs.29.2％ (7/24),50.0％(48/96) vs.75.0％(18/24),(5.3 ± 1.3) d vs.(11.3 ± 3.8) d,8.3％(8/96) vs.25.0％(6/24),13.5％(13/96) vs.70.8％(17/24),28.1％(27/96) vs.41.7％(10/24),5.2％(5/96) vs.12.5％(3/24)],and there was significant difference (P ＜ 0.05).Conclusion Complicating disease,nutritional status,consciousness,capability of sputum exclusion,the degree of respiratory infection,treatment with noninv asive positive pressure ventilation,arterial gas analysis index are the correlated factors of prognosis in AECOPD combined with respiratory failure.

Objective To investigate sensitivity and specificity of myositis specific autoantibodies (MSAs) in polymyositis/dematomyositis(PM/DM ) and other neuromuscular disease. Methods Taking serum from 63 patients with PM/DM (PM/DM group)and 60 definite neuromusclar disease(non-myositis) patients(control group). All the sera were detected for two kind autoantibodies:anti-Jo-1,anti-SRP by immunoblotting method. Calculating sensitivity,specificity of anti-Jo-1 and anti-SRP autoantibodies for the diagnosis PM/DM. Results Positive ratio for anti-Jo-1 and anti-SRP autoantidodies were 17% and 5% respectively in the PM/DM group, while none of the sera from control group detected positive.The specificity of both autoantibodies diagnosis for PM/DM were 100% and (95% CI:94%~100%).The sensitivity was 22%( 95%CI:13%～34%). Conclusion Anti-Jo-1 and anti-SRP autoantibodies are highly specific to PM/DM diagnosis.

Cytokines ; metabolism ; Humans ; Leukocytes, Mononuclear ; immunology ; secretion ; Ubiquitin ; blood

Objective To evaluate the non-invasive cardiac output measurements by electric impedance in critically illpatients. Methods Cardiac output measurements by impedance and Doppler ultrasonography were performed in 38 pa-tients in ICU. Results There was a significant correlation (r =0. 908 ) between impedance and ultrasonography for car-dio output measurement. Conclusion There is close agreement between electric impedance and ultrasonography in themeasurement of cardiac output in the patients. The electric impedance measurement is a noninvasive,feasible, handy, con-tinuous and cheap measurement of cardiac output.

Objective To study the clinical pathological features of Wegener's granulomatosis (WG) in middle-aged and elderly patients,and enhance understanding of this disease.Methods Totally 21 patients with WG (11 males,10 females,aged 45 to 76 years,mean age 58.1 years) in our hospial from February 1999 to July 2012 were selected.The clinical and pathological data of WG patients were retrospectively analyzed.34 biopsies including 2 autopsies from different organs were paraffin embedded and stained by hematoxylin and eosin and histochemistry.13 renal biopsies were all examined by immunofluorescence and electron microscope.Results The average time from the onset of clinical symptoms to the diagnosis was 5.3 months (from 24 days to 11.0 months).Eyes,nose and salivary glands were the most commonly involved parts at the beginning of Wegener's granulomatosis (52.4％,11 cases).The percentages of the skin,lung and renal involvement were 14.3％ (3 cases),81.0％ (17 cases) and 71.4％ (15 cases),respectively.Among 21 patients,18 patients were examined with anti-neutrophil cytoplasmic antibody (ANCA).c-ANCA was positive in 72.2 ％ patients (13 cases,13/18),p-ANCA was positive in 16.7％ patients (3 cases,3/18),and ANCA was negative in 11.1％ patients (2 cases,2/18).3 major pathological manifestations were observed:7 kinds of vasculitis including capillaritis,acute vasculitis,chronic vasculitis,fibrinoid necrosis in vasculitis,necrotizing granulomatous vasculitis,non-necrotizing granulomatous vasculitis and cicatricial vascular changes; 4 kinds of granulomatous inflammation including scattered giant cells,palisading histiocytes,poorly formed granulomas and microabscess surrounded by granulomatousinflammation;2 kinds of parenchymal necrosis including geographic necrosis and microabscess.13 kinds of histopathologic features in 3 major manifestations were found from 2 autopsies,but various kinds histopathologic features presented in small biopsy samples.Minor manifestations such as diffuse pulmonary hemorrhage were found at the periphery of WG.Conclusions The wide variation and broad spectrum of pathologic features can occur in WG.Vasculitis,granulomatous inflammation and parenchymal necrosis are the most important histopathological features.The correct diagnosis of WG requires careful correlation of pathology with complicated clinical features.

OBJECTIVETo investigate the effect of different pressure oxygen pre-breathing in preventing decompression sickness of rats.

METHODSForty male SD rats were randomly divided into 4 groups: decompression sickness (DCS) group and three oxygen pre-breathing groups with 1 ATA, 2 ATA and 3 ATA pressure respectively. The rats of DCS group were placed in the hyperbaric chamber and the chamber was compressed evenly within 3 minutes to depths of 7 absolute atmosphere(ATA) and held at the designated depth for 60 min, then decompressed (3 min) at constant speed to the surface pressure. After that, the rats were taken out for further detection. While the rats of oxygen pretreatment groups pre-breathed different pressure oxygen for 20 min before entering into chamber. The mortality and behavioral of rats were observed with 30 min post decompression. The dry/wet ratio of the lung, protein levels in the bronchoalveolar lavage fluid (BALF), and the inflammatory cytokine tumor necrosis factor (TNF-alpha) expression were also tested.

RESULTSCompared with that of the DCS group, the mortality and morbidity of oxygen pre-breathe groups didn't change obviously. But the total BALF protein level and the inflammatory cytokine TNF-alpha expression of 1 ATA oxygen pre-breathe group were obviously decreased, while the dry/wet ratio of lung as obviously increased instead (P < 0.05).

CONCLUSIONAlthough preoxygenation can' t obviously change the mortality and mobidity of rats, normal pressure oxygen pre-breathing can mitigate the protein infiltration in BALF and the expression of inflammatory cytokine in lung tissue.

Animals ; Bronchoalveolar Lavage Fluid ; chemistry ; Decompression Sickness ; Diving ; Lung ; pathology ; Oxygen ; physiology ; Pressure ; Rats ; Rats, Sprague-Dawley ; Tumor Necrosis Factor-alpha ; metabolism

Objective Platelet aggregation, activation induced by bubbles is the main cause of decompression sick-ness.Clopidogrel(Clo) can decrease platelet aggregation through inhibiting the bind of fibrinogen and ADP .This study is designed to find if Clopidogrel can paly a protective role in decompression sickness and explore the intervention mechanism . Methods Totally 111 male SD rats divided into 3 groups:normal control group (n=20), decompression sickness(DCS) group(n=46), and DCS+Clo(Clopidogrel)treated decompression sickness (DCS+Clo)group(n=45).The rats in DCS and DCS+Clo group were placed in chamber and compressed to 1.5 MPa at speed of 2t/4 , the time of compression and res-idence was 4.5 min totally, then decompressed to surface at a speed of 3 m/s.The mortality and behavioral of rats were ob-served within 30 min post decompression .The pathology and the wet/dry ratio of lung , WBC and platelet counts in periph-eral blood, the expression of activated platelets , and immunohistochemical detection of lung tissue CD 41 expression were also been tested .Results We found Clo reduces the DCS mortality risk ( mortality rate:11/45 in DCS+Clo group vs 28/46 in DCS group, P<0.01).Clo reduced the lung injury, the wet/dry ratio of lung, the accumulation of platelet and leu-kocyte in lung , the WBC counts and activated platelets in peripheral blood .Conclusion Clo can play a protective role in decompression sickness through reducing post-decompression platelet consumption and activation , decreasing the activation of leukocytes .

Objective To investigate the early change of the function of hemostasis and coagulation as well as clinical significance in the full-term newborns recoveried from stifle.Methods To detect the platelet count (PLT),prothrombin time,fibrinogen and D-dimer in early stage of 50 newborns with different degrees of asphyxia recovreied from stifle,and compared with the control group.Results Compared with the control group,there were not obvious change in PLT in asphyxiated full-term newborns(P>0.05),and the differences of prothrombin time,D-dimer and fibrinogen were statistically significant(P<0.01),the more serious degree of asphyxia,the lower of the fibrinogen and higer of the D-dimer.Conclusions The function of hemostasis and coagulation can be changed in early stage of newborns recoveried from stifle.The detection of fibrinogen and D-dimer in early stage of newborns recovefied from stifle has important clinica significance.