Objective To assess if there are differences in clinical features and prognosis of intersti-tial lung disease(ILD) between polymyositis(PM) and dermatomyositis(DM). Methods Medical records of 114 patients with PM/DM(31 PM-ILD, 83 DM-ILD) were reviewed retrospectively to analyze the demograph-ics , clinical manifestations, laboratory findings, high-resolution computed tomography (HRCT), pulmonary function tests (PFTs), blood gas analysis, treatments and prognosis. The differences of measured data were detected by descriptive statisitical analysis, and rates were detected by four-fold table Chi-Square test and Fisher′s exact test. Results The incidence of PM/DM-ILD was 35.8%(114/318) in this study, and DM was more prone to have ILD (χ2=5.019, P=0.025). There were significant difference in sex ratio between PM-ILD and DM-ILD(χ2=4.929, P=0.026). Arthralgia/arthritis was more common in DM-ILD than PM-ILD(χ2=7.756, P=0.005). In PM-ILD, ILD was often present before the diagnosis of PM (χ2=15.555, P<0.01),while it was opposite in DM-ILD(χ2=7.002, P=0.008). The frequency of anti-Jo-1 antibody was higher in PM-ILD than in DM-ILD(χ2=11.395, P=0.001). On HRCT, ground-glass opacity(χ2=7.940, P=0.005) and pericardial effu-
sion (χ2=6.322, P=0.012) were more frequently observed in PM-ILD, while patchy shadows were more frequent in DM-ILD (χ2=5.105, P=0.024). There was no difference in PFTs and blood gas analysis between the two groups. With the similar therapeutic regimen, the prognosis of DM-ILD was significantly worse than in PM-ILD (χ2=7.595, P =0.006). Conclusion There are significant differences in sex ratio, clinical manifestations, HRCT imaging findings, and prognosis between PM-ILD and DM-ILD. We propose that the difference in the immunopathological processes of PM and DM leads to different clinical features of ILD between PM and DM.

Objective To investigate the reverse effect and mechanism of the extracted solution of chinese medicine MBC on the drug-resistance of K562/ADM in vitro. Methods MTT assay was used to determine the IC50 of ADM on K562/ADM cell line and the reverse multiples of the drug-resistance before and after MBC treatment. Flow cytometry(FCM) was applied to assess the intracellular concentration of Rh123. Results 8?10 -1 ?g/ml MBC increased cytotoxic effect of ADM on 562/ADM cells, the reverse multiple was 6 28, and MBC could increase the intracellular concentration of Rh123. Conclusion MBC could increase killing effect of ADM on the drug-resistant K562/ADM cell and partly reverse the drug-resistance of K562/ADM cell.

ObjectiveTo evaluate the clinical application of Kugel hernioplasty via anterior approach for inguinal hernia repair.MethodsA retrospective study was made to analyze the clinical data of 851 cases(956 hernias) treated with Kugel hernioplasty via anterior approach for inguinal hernias from November 2005 to May 2011.ResultsOperative duration was(42 ± 11) minutes.The postoperative complications were detected on 21 hernias of seroma,8 hernias of hematoma,12 hernias of sub dermal ecchymosis,26 hernias of foreign body sensation and 5 hernias of recurrence.No incision infection occurred.Conclusions Kugel hernioplasty via anterior approach can repair and strengthen the whole anatomy area of myopectineal orifice.It is available for various kinds of inguinal hernias.

Objective To improve the management of blunt pancreatic trauma, and to explore the strategy of preserving the pancreatic endocrine and exocrine function to the full extent. Methods 20 cases of blunt pancreatic trauma were reviewed and analyzed retrospectively. The methods of operative treatment were analysed. Results All patients were cured. Depending on the general condition, abnomial signs and main pancreatic duct(MPD) injuries at the time of admission, patients received immediate operation or nonoperative treatment. Because of severe peritonitis and demonstrated MPD injury, 10 patients underwent immediate operations, including simple drainage in 6 cases, distal pancreatectomy in 1 patient, external drainage of the injured pancreatic duct for the second operation in 3 cases. Without the demonstrated MPD injury or clinical deterioration, 10 patients received nonoperative treatment under strict observation initially. 3 patients completed the nonoperative course and 7 patients underwent delayed operations, including Roux-en-Y pancreatic cyst-jejunostomy in 3 cases, external drainage of pseudocyst in e cases, pancreaticoduodenectomy in 1 patient because of the expanded hematoma in pancreatic head. Conclusions Blunt pancreatic trauma could receive individual pancreas-preserving treatment, which could improve the operational safety, avoid the resection of pancreas and preserve the pancreatic endocrine and exocrine function to the full extent.

Adult ; Head and Neck Neoplasms ; Humans ; Male ; Sarcoma, Synovial

Objective To investigate antibiotic resistance of Pseudomonas aeruginosa isolated from the patients'specimens in the hospital ,the carrying rate of integronⅠ and insertion sequences common area(ISCR)and provide reference for clinical treatment . Methods 106 isolates of Pseudomonas aeruginosa were collected and their bacterial antibiotic resistance and clinical distribution were analyzed by using WHONET5 .6 software .PCR and electrophoresis were used to screen integronⅠ and ISCR carried by the target strains .Results Clinical isolates of Pseudomonas aeruginosa mainly collected from department of pulmonary disease which accounted for 48 .11% ,and sputum specimens were the major source of the 106 isolates ,which accounted for 73 .58% .The sensitiv‐ities of Pseudomonas aeruginosa to tobramycin ,amikacin ,gentamicin were about 85% ,while to imipenem only 65 .09% .The carry‐ing rate of integronⅠ and ISCR in Pseudomonas aeruginosa was 84 .91% and 76 .42% ,respectively .Conclusion Pseudomonas aeruginosa distribution of hospital departments mainly concentrate in pulmonary department and the major type of specimen is spu‐tum .The sensitivity of Pseudomonas aeruginosa to aminoglycoside antibiotic is relatively good .IntegronⅠand ISCR in Pseudomonas aeruginosa could be associated with antibiotic resistance .

Objective To investigate the role of individualized and staged enteral nutrition in the treatment of severe acute pancreatitis(SAP).Methods The clinical data of 204 cases of SAP treated with individualized stage enteral nutrition in our hospital from January 2000 to March 2008 were retro-spectively analyzed, Results The liver function and serum lipid and diet returned to the normal level after the treatment.Pancreatic encephalopathy disappeared.The patients recovered and were dis-charged from the hospital with the extraction of feeding tube.Enteral nutrition was adjusted based on the monitoring results in the hospitalization period that brought less effect to the pseudocyst of pancre-as, and then discharged from the hospital with the feeding tube.The pseudocyst in 49 cases disap-peared spontaneously and it was cured with internal drainage for 3 months in other 32.The time of en-teral nutrition was 20-95 d.Conclusion Enteral nutrition is safe and necessary after the acute stage of SAP.To ensure the enteral nutrition to play a more important role in the treatment of SAP, we must pay more attention on the individualization and stage of enteral nutrition.

Objective To understand the pathogenic distribution and drug resistance in the patients with blood infections in our hospital to provide reference for the empirical medication of blood infections .Methods The cases of blood infections in our hospital during the period 2012-2014 were performed the retrospective investigation .The BD Bactec blood culture system was adopted to conduct the blood culture .The bacterial strain identification and susceptibility test was conducted by using the Microscan Walkaway 40 and the data were analyzed by adopting the WHONET5 .6 software .Results The top four of department distribution in blood infections were the digestive system department ,lung diseases department ,orthopedic department and surgery department ,account‐ing for 25 .20% ,19 .60% ,14 .70% and 10 .50% respectively .The pathogens were mainly Gram negative bacteria ,and the top three were Escherichia coli ,Klebsiella pneumoniae and non fermenting bacteria ,accounting for 44 .10% ,13 .30% and 7 .69% respective‐ly .The top three of Gram positive bacteria were coagulase negative staphylococci ,Staphylococcus aureus and Enterococcus ,account‐ing for 12 .58% ,9 .09% and 7 .69% respectively .The positive rates of ESBL in Escherichia coli and Klebsiella pneumoniae were 45 .5% and 60 .8% respectively .The detection rate of methicillin resistant coagulase negative staphylococci (MRCNS) was 55 .5% , which of methicillin-resistant staphylococcus aureus (MRSA) was 58 .0% .Conclusion The cases of blood infections in our hospi‐tal come from different wards areas ,and the digestive system department is in the majority mostly .The pathogenic bacteria are dom‐inated by Gram negative bacteria ,and the treatment should rationally use the antibacterial drugs according to the bacteria drug re‐sistance situation .

Objective To investigate the clinical efficacy of total pancreaticoduodenectomy for the pancreatic head adenocarcinoma with positive neck margin.Methods The clinical data of 15 patients with pancreatic head adenocarcinoma and had positive neck margin who received total pancreaticoduodenectomy at the Union Hospital of Fujian Medical University from August 2009 to May 2014 were retrospectively analyzed.Patients were followed up by out-patient examination or telephone interview till August 2014.Results Total pancreaticoduodenectomy was successfully carried out on the 15 patients.The operation time was 4.0-10.0 hours (mean,6.5 hours),and the volume of blood loss was 300-2 000 mL (mean,800 mL).The duration of postoperative hospital stay was 13.0-35.0 days (mean,22.3 days).The main postoperative complications included pulmonary infection (3 cases),abdominal infection (2 cases)and low blood glucose (2 cases).No interoperative death,bile leakage or gastrointestinal anastomotic fistula occurred.The blood glucose of most of the patients was controlled by insulin or pancreatin.No stomachache,steatorrhea or malnutrition occurred in all the patients.The mean time of postoperative follow-up was 21 months (range,3 months to 5 years).Three patients survived within 1 year,2 survived for 1-2 years,5 survived for more than 2 years and 1 survived for more than 5 years.Four patients with follow-up time under 6 months survived till now.Five patients had liver metastasis at postoperative month 6.Conclusion Total pancreaticoduodenectomy might be necessary for the pancreatic head adenocarcinoma with positive neck margin to achieve R0 resection.

Objective To investigate the correlation between disease severity and pleural effu sion in patients with acute pancreatitis(AP).Methods A retrospective analysis was conducted on a prospectively collected database.The demographic,clinical,and laboratory data of 246 consecutive cases of AP in patients admitted to the Affiliated Union Hospital of Fujian Medical University between January 2008 to December 2012 were reviewed.Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and computed tomography severity index (CTSI) were used to evaluate the disease severity of AP.The relationship between the severity and pleural effusion was analyzed.Receiver operator characteristic (ROC) curve was used to compare the values of APACHE Ⅱ score and CTSI in predicting the prognosis of patients with pleural effusion.Results Among the 246 patients,there were 184 patients with pleural effusion and 62 patients without pleural effusion.The incidence of pleu ral effusion in AP was 74.8％.Further study showed that the difference in the incidences of pleural effusion between the severe group and the mild group was significant (P＜0.01).There was a trend that the more serious the patient's condition,the more the pleural effusion.Moreover,the levels of pleural effusion were significantly and positively correlated with the APACHE Ⅱ score (r=0.775,P＜0.01) and CTSI (r=0.525,P＜0.05).Logistic regression analysis showed that the factors significantly associated with pleural effusion formation were a high APACHE Ⅱ score and a high CTSI.Areas under the ROC curve of the APACHE Ⅱ score,CTSI and combined assessment were 0.798,0.687 and 0.812 for predicting mortality of the patients with pleural effusion.Through comparison of the areas under the ROC curve,there was a significant difference between the APACHE Ⅱ score and CTSI as well as combined assessment and CTSI (P＜0.05).Conclusions The disease severity was closely related to pleural effusion in patients with AP.Combining the two scoring systems to evaluate the disease severity and providing active treatment were important to improve the prognosis of patients with pleural effusion.