Objective To examine the relationship between plasma homocysteine level and status of congestive heart failure. Methods Plasma homocysteine level was determined in 106 patients with congestive heart failure(CHF).Among them,40 patients were diagnosed as having recent onset of CHF(group 1) and the remaining 66 were receiving conventional treatment(group 2).Thirty healthy subjects were served as a control group. Results(The plasma) homocysteine levels in group 1,group 2 and the control group were(14.87?5.22),(13.25?5.45) and((7.52)?1.73) ?mol/L,respectively.The plasma homocysteine level was significantly higher in group 1 and group 2 than in the control group(P

AIM To establish the expermental model in vitro for the study of mechanism of antitumor drug resistance and the screening of antitumor drug. METHODS By continuously exposing cells to gradually increasing concentration of drug and agar cell colony forming technique, using dye exclusive method for determing cytotoxic effect, a murine leukemia L1210 cell subline were established,which exhibited 40 fold resistance to Cis diamminedichloro platinum(DDP). RESULTS The doubling times, plate efficiency, cell cycle, DNA index and cell morphology of DDP resistant L1210 subline were similarto those of its parant cell line. When the cell subline was stored with DDP at -196℃ for 6 months and then was recovered, its characterization of antitumor drug resistance was still maintained to a period of 5 months without DDP. DDP resistant L1210 subline was characterized with cross resistance to Carboplatin, Mitomycin, Thio Tepa, Methotrexate, Vincristin and Mustine Hydrochloride, but with no cross resistance to Harringtonine and Adriamycin. It was seemed more sensitive to Cytarabine and Fluorouracil. CONCLUSION DDP resistant L1210 subline is a good experimental model in vitro for the study of mechanism of antitumor drug resistance and the screening of antitumor drug.

Objective To investigate the therapeutic effect of immunodepressant on Crohn's disease (CD).Methods 105 patients with CD were collected from 1983 to 2006 in Peking Union Medical College Hospital.All of their clinical manifestations and therapeutic results were analyzed retrospectively.Results (1)The application of immunedepressant was significantly increased after the year of 2000 (34.7% vs 3.0%,P=0.000).(2)The application of immunodepressant and the clinical features of these patients were as fouows：①The number of patients with modcrate to severe CD were more than that with mild CD in those using immunodepressant (28.9% vs 0).②The use of immunodepressant was not related with the diseased site of CD.because there were no difference among the groups with lesion in small intestine (20.0%),colon(27.3%)and ileocolon(27.1%),P=0.726.③The serum albumin level of CD patients using immunodepressant was significantly lower than that of those not using(31.9 g/L vs 35.1 g/L,P=0.047).④The use of immunodepressant did not decrease the incidenee of operative treatment(38.5% vs 50.0%,P=0.320).(3)The rate of remission in 19 CD patients using azathioprine is 68.4%(13/19)and the percentage of neutrophil in the group with relief was lower than that without relief(0.76 vs 0.65,P=0.032).Conclusions Immunodepressant is playing more important role in the treatment of CD.The patients with moderate and severe CD with as well as lower serum albumin should be treated with immunodepressant as early as possible.Whether immunedepressant is necessary or not is not decided by the diseased site.CD patients with higher percentage of neutrophil have less therapeutic effect than those with lower.

OBJECTIVETo evaluate the clinical efficacy of Shenfu Injection (SFI), as a adjuvant therapy, in treating patients of ischemic cardiomyopathy with heart insufficiency (ICP-HI).

METHODSOne hundred patients of ICP-HF were equally randomized into two groups, the SFI group and the control group. All received the conventional treatment, but to patients in the SFI group SFI was given additionally via intravenous injection, 60 mL once a day, 10 days each month, the treatment course was 6 months. Changes of cardial functional grading, 6-min walking distance, echocardiographic indices, plasma N terminal pro-brain natriuretic peptide (pro-BNP) level were observed before and after treatment, and the occurrence of major adverse cardiovascular events (MACE) and mortality in patients were observed as well.

RESULTSAs compared with the conventional treatment alone, additional application of SFI showed a more significant efficacy in improving NYHA functional grade and 6-min walking distance, reducing the diameters of left ventricular at end diastole and systole, increasing left ventricular ejection fraction, and decreasing plasma N terminal pro-BNP level (P <0.05). The occurrence of MACE and the mortality in the SFI group were significantly lower than those in the control group respectively (P <0.05).

CONCLUSIONSBased on the conventional treatment, the adjuvant therapy of SFI could improve the cardiac function, improve the quality of life, ameliorate ventricular reconstruction, and decrease the occurrence of cardiovascular events in patients of ICP-HI.

Aged ; Combined Modality Therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Heart Failure ; complications ; therapy ; Humans ; Injections ; Male ; Middle Aged ; Myocardial Ischemia ; complications ; therapy ; Treatment Outcome

OBJECTIVETo study the clinicopathologic characteristics of organizing pneumonia of the autopsies in elder and to analyze the possible underlying etiologic factors.

METHODSNinety-five cases of organizing pneumonia were found from 635 elderly autopsy reports of the Beijing Hospital since 1980. The morphologic and imaginal features were analyzed.

RESULTSThe foci of organizing pneumonia in our series were often small, patchy, scattered and adjacent to other lung lesion. There were, however, some variations in cases with different underlying conditions. The conditions associated with organizing pneumonia, as detected in our series, were: (1) 36 cases with suppurative inflammation, lung abscesses and chronic relapsing pneumonia; (2) 17 cases with fungal or viral infection; (3) 16 cases with aspiration pneumonia; (4) 5 cases with radiation pneumonia. We observed that it was not uncommon for organizing pneumonia coexisting with atelectasis and chronic pleuritis. The image of organizing pneumonia was varied.

CONCLUSIONSOrganizing pneumonia is a common finding in autopsies of the elder. It occurs in association with many diseases and the basic pathologic changes are similar. All of which represent secondary phenomenon. Possible etiologic factors include infection (due to bacteria, fungi or virus), aspiration and radiation. The possibility of organizing pneumonia should be considered if the shadow of lung is undisappeared in imagin.

Aged ; Cryptogenic Organizing Pneumonia ; etiology ; pathology ; Humans ; Lung ; diagnostic imaging ; pathology ; Lung Abscess ; complications ; pathology ; Lung Diseases, Fungal ; complications ; pathology ; Middle Aged ; Pneumonia, Aspiration ; complications ; pathology ; Radiography ; Retrospective Studies

Objective To study the clinical presentations,radiologic features,prognosis,and possible causes of liver injury associated umbilical venous catheter (UVC ).Methods We reviewed database of our NICU from December 2012 to November 2015 and identified preterm infants with liver injury while UVC in place.The gestational age,birth weight,gender,days of UVC in place prior to liver injury, the depth of UVC (cm),UVC tip position,ultrasound findings of liver injury,laboratory tests,treatment and outcomes were collected.Results During study period,322 infants received UVC insertion.Ten cases (3.1 %)of liver injury associated with UVC were diagnosed.Of the ten infants,nine were diagnosed as extravasation of fluid to liver parenchyma,and one was diagnosed as liver hematoma.The mean birth weight was (1184 ±207)g,mean gestational age was (28.5 ±1.7)weeks.The UVC tip was at thoracic (T) vertebrae T 9 to T 11 level,nine UVC tips were below the right diaphragm level.All UVCs were used for total parenteral nutrition before liver injury was diagnosed.Six infants had clinical manifestations,and four infants were free of clinical manifestations.The most prominent clinical signs were abdominal distension (n =5),weak bowel sounds (n =5)and hepatomegaly (n =4).One infant who was diagnosed with liver hematoma also had progressive hemoglobin decline (minimum 34 g/L)and shock.Abdominal ultrasound showed well-limited,irregular,hyperechoic rimmed lesions with heterogeneously hypoechoic centers or anechoic liquid dark space.Extravasation of fluid to liver parenchyma will restorate within one week after the UVC was remove.One baby who was diagnosed as liver hematoma passed away at 9 days of life.Liver ultrasound of eight returned to normal in 52 days to 3.5 months,and one had calcified lesions at 9 months of age.Conclusions Liver injury is an unusual complication of UVC insertion and usage.Proper positioning of the UVC tip may help to avoid this complication.Early recognition,prompt diagnosis with liver ultrasound examination and timely treatment can lead to better outcome in newborns with extravasation of fluid to liver parenchyma.

Objective:To systematically evaluate the incidence of liver injury in multi-drug resistant tu-berculosis ( MDR-TB ) patients with the treatment of second-line anti-TB drugs.Methods: Medline (January 1, 1966 to March 1, 2014), Embase (January 1, 1974 to March 1, 2014) and the Cochrane library (January 1, 1993 to March 1, 2014) with four Chinese databases including VIP ( January 1, 1989 to March 1, 2014), CBMDisc (January 1, 1978 to March 1, 2014), CNKI (January 1, 1994 to March 1, 2014)and Wanfang (January 1, 1998 to March 1, 2014), were systematically searched with the keywords including “Tuberculosis”,“multidrug-resistant”,“MDR-TB”,“side effect”,“adverse”,“safety” and “tolerability” for the follow-up studies of MDR-TB patients with liver injury during the treatment of second-line anti-TB drugs.The relevant information was extracted and the data were analyzed using the random-effects model .Subgroup and sensitivity analyses were performed based on the diagnostic criteria, study population , study design , history of anti-TB treatment and treatment length .Results: A total of 26 articles with 3 875 MDR-TB patients were included , of which 373 patients developed liver in-jury, and the weighed combined incidence of liver injury was 7.7%(95%CI:5.5%-10.8%).There was some heterogeneity among the studies .Subgroup analyses showed that the incidence of liver injury was higher in groups with treatment length≥18 months and non-Asian populations , but there was no sig-nificant difference between the groups (P>0.05).Among the 26 articles, only nine of them reported the diagnostic criteria of liver injury , while the criteria were not uniform .Conclusion:The incidence of liver injury during the treatment of second-line anti-TB drug in MDR-TB patients was high , and the diag-nostic criteria were not uniform .We should pay attention to the prevention and treatment of liver injury , and develop standard diagnostic criteria for it .

Objective To study the renal damage of patients with juvenile primary Sjgren's syndrome (pSS)and its clinical manifestations,pathologic characteristics with biopsy,treatment and prognosis.Methods Ten patients with juvenile pSS complicated with renal impairments were retrospectively analyzed.Data of these 10 patients were compared with those without renal impairments.Results Ten patients complicated with renal impairments in 24 patients with juvenile pSS,9 of them presented with type I renal tubular acidosis(RTA), 5 with hypokalemia paralysis,3 with calcification of the renal tissue,3 with positive urine protein.1 with dia- betes insipidus.There was no significant difference between patients with renal impairments and those without. Three patients underwent kidney biopsy that showed chronic interstitial nephritis(CIN)with extensive lymp- hoplasmie cell infiltration.Two patients had glomerular lesions and one of them was diagnosed as pSS over- laped with systemic lupus erythematosus(SLE).Steroid and immunosuppressive agents had significantly alle- viated symptoms and the hypergammaglobulinemia was significantly improved.Conclusion Renal impairment may be the major complication in juvenile pSS.The major clinical manifestations are RTA and the glomeruli are involved occasionally.Treatment with steroid anti immunnsuppressive agents should be given to those who have evidence of systemic involvement.

Objective To investigate the relation between the cellular immune function and unexplained recurrent spontaneous abortion(URSA) and the mechanism of active immunotherapy on URSA patients.Methods The flow cytometry(FCM) was used to detect CD3+ ,CD4+ ,CD8+ T lymphocyte and CD16+CD56+ natural killer(NK) cell subsets and the ratio of CD4+/CD8+ of peripheral blood(PBL).112 cases with URSA(76 cases treated with active immunotherapy) and 30 cases of normal fertiled(NF) women were studied.The percentages of T lymphocyte and NK cell subsets before and after therapy were compared among 76 cases wtih URSA treated by active immunotherapy.The rate of next successful pregnancy of URSA patients treated with and without active immunotherapy was compared.Results The percentages of CD3+ and CD16+CD56+ cell subsets as well as the ratio of CD4+/CD8+ of the URSA patients were significantly higher than those of NF cases(P <0.05).After active immunotherapy,the percentages of CD3+ and CD56+CD16+ cell subsets as well as the ratio of CD4+/CD8+ of URSA cases were significantly decreased(P <0.05 ).The rate of next successful pregnancy of URSA cases with and without active immunotherapy were 88.2% and 31.2% respectively,the difference was significant(P< 0.05).Conclusion The changes in the percentages of T lympyocyte and NK cell subsets have something to do with URSA.Active immunotherapy can effectively regulate the cellular immune function and increase the rate of next successful pregnancy of URSA patients.

AIM To establish a model of vascular intima hyperplasia for study the restenosis after angioplasty. METHODS Carotid artery of rat was exposed under general anesthesia. Two pieces of steel slides(13 mm?5 mm?1 mm) were set on and under the carotid artery separately. Then the slides were squeezed by two surgical forceps paralleling to the artery for 25 min. Histomorphological study was performed at the second hour or on the fourteenth day after operation. RESULTS At the second hour after operation, the loss of endothelial integrity and platelet deposition were seen under the scanning electromicroscopy. Under the light microscopy, there were infiltration of inflammatory cells in vessel wall andthrombus formation in the vessel cavity. At the fourteenth day after operation, PCNA positive cells in vessel wall of squeezed artery were significantly higher, the ratios of intima, medium and intima areas of squeezed artery were significantly increased and the ratio of cavity area of squeezed artery was significantly decreased compared with those of uninjured artery.The vascular intima hyperplasia and PCNA positive cells in squeezed arterial wall were inhibited by oral administration of heparinoid and aspirin. CONCLUSION With squeezing carotid artery in rats the vascular intima hyperplasia as restenosis after angioplasty was established.