Objective To address the clinical features of the overlap of polymyositis (PM) and primary biliary cirrhosis (PBC),as well as its similarities to and differences from PBC/nPM patients.Methods Medical charts of 10 cases of PBC/PM inpatients admitted to Peking Union Medical College Hospital (PUMCH) from October 1989 to October 2009 were systemically reviewed.Two hundred and twenty-three cases were included as controls from the database of PBC patients in PUMCH at the same period by the statistic methods of t test,x2 test or Fisher exact test.Results ① Ten (2.67%) PBC patients had concurrent PM.② Male/Female ratio in PBC/PM group was 3/7 and the age at diagnosis was (54±8) years.No significant differences between the two groupsin these data (P＞0.05).③ Clinical features and laboratory findings of PBC/PM included: cardiomyopathy in 4 cases,respiratory muscle involvement in 2 cases,level A of Child-Pugh classification in 9 cases,level C in 1 case,positive antinuclear antibody in 10 cases,positive anti-mitochondrial antibody in 10 cases,positive M2 subtype in 7 cases,elevated erythrocyte sedimentation rate(ESR)in 9 cases.④ The significant difference between the two groups was ESR (P=0.047).Conclusion The concurrence of PBC and PM is not rare,and the inflammation of PBC/PM is likely more prominent than PBC/nPM.

Objective To evaluate the efficacy of scle rotherapy (EVS) for esophageal variceal bleeding. Methods Retrospective analysis was made in 1 010 patients with es ophageal variceal bleeding who underwent sclerotherapy, among them 850 patie nts were cirrhosis and 160 patients were hepatocellular carcinoma. The total num ber of procedures of sclerotherapy were 3 203, including 602 for emergency scler otherapy and 2 601 for selective sclerotherapy. Supplementary sclerotherapy was performed in 502 cases. Average procedures of sclerotherapy for initial treatme nt were 3.18?1.1 in 710 cirrhotic patients. Follow-up was made in 579 cirrhosi s patients for 3-157 months, with an average follow-up period of (42.47?32.78) months. Results 1. The hemostasis rate in the whole group was 97.0%, the c omplication rate was 13.4%, and the mortality was 1.8%. 2. Rate of complete and nearly complete elimination of esophageal varices in cirrhotic patients was 84 .1 %, and long term rebleeding rate was 23.7%. Survival rates were (95.8?0.8)% 、(86.1?1.6)%、(74.5?2.4)%、(53.6?3.8)% at 1,3,5 and 10 year according to t he Kaplan-Meier analysis. Conclusions EVS is an important method of treatment for esophageal variceal bleeding.

Objective To investigate the effects on catgut embedding therapy combined with traditional Chinese medicine on the patients with insomnia and TCM pattern of no connection of heart and kidney.Methods One hundred and ten patients with insomnia and TCM pattern of no connection of heart and kidney were were divided into the catgut embedding therapy group and traditional Chinese medicine group (n=55, repectively). Traditional Chinese medicine group was treated by theLiuwei-Dihuang pills andJiaotaipills, while the catgut embedding therapy group was treated with catgut embedding therapy based on the treatement of TCM groups. Pittsburgh Sleep Index (PSQI) was the outcome for analysis.Results The total effect rate (89.09%vs. 67.27%,χ2=7.674,P<0.01) in catgut embedding therapy group was significantly higher than that in traditional Chinese medicine group. The catgut embedding therapy group were significantly better than the traditional Chinese medicine group in the total score of PSQI (6.71 ± 3.55vs.8.32 ± 2.48,t=2.757,P<0.05), sleep time (0.86 ± 1.11vs. 1.29 ± 0.88,t=2.251,P<0.05), sleep efficiency (0.13 ± 0.7vs. 0.43 ± 0.55,t=2.477,P<0.05), hypnotic drugs (0.93 ± 0.77vs. 1.41 ± 0.81,t=3.185,P<0.05) and daytime dysfunction(1.14 ± 0.61vs. 1.59 ± 0.60,t=3.900,P<0.05). Conclusion Catgut embedding combining traditional Chinese medicine showed better effect than the TCM alone on the patients with insomnia and TCM pattern of no connection of heart and kidney.

Objective To investigate relationship between IL-6, IL-8 and Helicobacter pylori in patients with gastric cancer.Methods 264 cases patients with gastric cancer and gastritis were selected, and divided into control group, precancerous lesion group and gastric cancer group according to the tissue biopsy, then each group were divided into positive group and negative group according to 12 C test.IL-6 and IL-8 in serum and gastric juice were detected by ELISA, while in gastric mucosa by double antibody sandwich method.Results Compared with control group, IL-6 and IL-8 in serum, gastric juiceand gastric mucosa were higher ( P<0.05 ) .Compared with precancerous lesion group, IL-6 and IL-8 in serum, gastric juice and gastric mucosa were higher(P<0.05).Compared with Hp negative group, IL-6 and IL-8 in serum, gastric juice and gastric mucosa were higher(P<0.05). Compared with gastric cancer group, Hp eradication rate of precancerous lesion group and control group was higher, respectively ( P<0.05 ) . Conclusion IL-6 and IL-8 in gastric cancer patients’ serum, gastric juice and gastric mucosa increased, which is higher in Hp positive group.The levels of IL-6, IL-8 maybe the key mechanism of the formation of gastric cancer, which has important sense of assessment and diagnosis of gastric cancer.

Objective To explore the changes of blood fat in patients with cerebral infarction complicated by metabolic syndrome (MS) receiving community path intervention treatment.Methods A total of 116 cases of cerebral infarction complicated by MS were selected and given comprehensive intervention treatment after risk assessment.Patients were divided into intervention group (60 cases) and control group (56 cases) according to their difference in compliance.Results After intervention,the total cholesterol (TC),triglyceride (TG) and low density lipoprotein cholesterol (LDL-C) in two groups were significantly decreased,high-density lipoprotein cholesterol (HDL-C) was significantly increased.There were significant differences in intervention group before and after intervention (P＜ 0.05).Compared with those in control group,differences of all index in each time point in intervention group were statistically significant (P ＜0.05).There was no significant difference in carotid plaque integral before intervention between two groups (P＞ 0.05).The carotid plaque integral 12 and 24 months after intervention in intervention group was significantly lower than that before intervention (P ＜ 0.05).The carotid plaque integral 12 and 24 months after intervention in intervention group was significantly lower than that in control group [(3.20 ± 2.01) cm vs.(4.71 ±2.87) cm,(2.98 ±2.61) cm vs.(4.60 ±2.43) cm,P＜0.05].Twelve and 24 months after intervention in intervention group,TC and carotid plaque integral was significantly positive correlation (r =0.304 and 0.317,P ＜ 0.05),TG and carotid plaque integral was significantly positive correlation (r =0.229 and 0.128,P ＜ 0.05),LDL-C and carotid plaque integral was significantly positive correlation (r =0.654 and 0.518,P ＜ 0.05),and HDL-C and carotid plaque integral was significantly negative correlation (r =-0.495 and-0.528,P ＜ 0.05).Conclusion For patients of cerebral infarction complicated by MS,great importance should be attached to early prevention and control of their major components so as to reduce the incidence of acute cerebrovascular recurrence and mortality.

Objective To discuss the effect of self-clotting cutter radiofrequency ablation in curing the hysteromyoma. Methods 96 patients with hysteromyoma were selected. Their hysteromyomas were cured by self-clotting cutter radiofrequency ablation through virgina under the direction of B-ultrasound. Then they were followed up for one month, three months and six months after the operation. Results Six months after the treatment,42.71% of the patients were eumenorrhea,44.79% of the patients' menstrual bleeding volumes were few, 12.5% has no change. The cure rate of anaemia was 100%. 1 month,3 months ,6 months after the treatment, the bulks of uterus and myoma were reduced,and the myoma reduced most after six months. 35.42% of the patients were cured,47.92% had remarkable effect, 15.6% had effect, 1.04% had no effect. Total effective rate was 98.72%. Conclusion The clinical effect of self-clotting cutter radiofrequency ablation in curing the hysteromyoma was satisfactory. It was a minimally invasive technique which could keep the integrality of uterus and it was rapid recovery,effective and safe,and easy to operate.

Objective To evaluate the parametric features of image textures on 18F-FDG PET/CT for the differentiation between malignant and benign pulmonary nodules and compare the diagnostic performance of these parameters with SUVmax.Methods 18F-FDG PET/CT images of 170 patients (102 males,68 females,age range:29-81 (mean 59)years) with pulmonary nodules were retrospectively evaluated.Eightynine pulmonary nodules (230 slices) were malignant and 81 (193 slices) were benign.The pulmonary nodules were contoured on CT images and mapped to the co-registered PET images.Thirteen parameters of textural features were extracted and SUVmax was measured.Logistic regression analysis was used to identify the significant texture parameters and create a regression model.The efficacy of the textural features and SUVmax to distinguish between malignant and benign pulmonary nodules was evaluated by ROC curve analysis.The textural features of squamous cell carcinoma and adenocarcinoma were compared via the Mann-Whitney u test.The sensitivity and specificity of the textural features and SUVmax for the differential diagnosis were compared with x2 test.Results Logistic regression model identified 4 textural features (skewness (β =1.7058),kurtosis (β =-1.0989),angular second moment (ASM,3 =-4.4140) and strength (β =0.5626) ; all P ＜ 0.05) to have significant correlation with the malignancy of lung nodules.The AUC of ROC curve was 0.775 (95％ CI0.732-0.819; P＜0.001) with the sensitivity of 89.6％ (206/230) and specificity of 50.8％ (98/193).ASM and strength had statistically significant differences between squamous cell carcinoma and adenocarcinoma [ASM:0.0303 (95％ CI 0.0392-0.0724) vs 0.0594 (95％ CI 0.0721-0.0947) ; strength:2.4714 (95％ CI 2.4632-4.1050) vs 1.5945 (95％ CI 1.9003-2.4652) ; u =3082.0 and 3115.0,both P＜0.01].The AUC of SUVmax-based diagnosis was 0.757 (95％ CI 0.711-0.802 ; P ＜ 0.001) with the sensitivity of 80.9 ％ (186/230) and specificity of 50.3 ％ (97/193) at a cut-off value of 2.5.The sensitivity of the textural features was superior to SUVmax in differentiating malignant from benign pulmonary nodules (x2 =6.903,P ＜ 0.01).Conclusions Image textural parametric features extracted from 18 F-FDG PET/CT are more sensitive to differentiate between malignant and benign pulmonary nodules compared to SUVmax.They might also be useful to discriminate between different pathological types of lung cancers.

Objective To explore the effect of butylphthalide on the prognosis of massive cerebral infarction patients.Methods We studied 92 massive cerebral infarction patients hospitalized in the Neurology department of harrison international peace hospital from February 2011 to December 2013 as the researchers.According to the treatment of patients,patients were randomly divided into control group (n=46)and treatment group(n=46),control group was given edaravone.Treatment group was given butylphthalide capsule and edaravone.Two groups were all given 2 weeks treatment continuously.Improvement of symptoms is evaluated by the National Institute of Health stroke scale (NIHSS).The effect of butylphthalide on collateral circulation in ischemic infarction area was evaluated by the standards of collateral vessels grading of susceptibility-weighted imaging(SWI)imaging sequence. Results The symptoms and signs of two groups were improved in a certain extent,but the improvement of patients in treatment group was significantly greater than control group,the difference was statistically significant (P<0.05 ).Degree of NIHSS of treatment group was lower than control group,the difference was also statistically significant (P<0.05).The SWI collateral vessels grading of the two groups were all improved,and the cases of treatment group was higher than control group,the difference was statistically significant (P <0.05 ).The two groups have no obvious adverse reaction.Conclusion Butylphthalide have good effect on massive cerebral infarction.It can effectively improve the nerve function defect,and promote the reconstruction of collateral circulation in ischemic infarction area.

Objective To investigate the role of different therapeutic regimens in primary biliary cirrhosis (PBC)complicating Sj(o)gren syndrome (SS).Methods A total of 79 patients diagnosed as PBC complicating SS were enrolled and randomly divided into three groups:Group U (29 patients) received ursodeoxycholic acid (UDCA) alone,Group UP (37 patients) received UDCA and prednisolone,Group UA (13 patients) received UDCA and azathioprine.The clinical and laboratory data were collected at 0,3,6 and 12 months after treatment.Results Fatigue and pruritus were improved in each group with no difference among them(P ＞ 0.05).The levels of ALT,AST,alkaline phophatase (ALP),gamma-glutamyl transferase (GGT),TBil,DBil,IgG,and IgM in the three groups were all decreased after treatment(P ＜0.05),while there were no statistical differences among the three groups (P ＞ 0.05).Conclusions The combination therapy of UDCA with prednisolone or azathioprine was not better than UDCA alone.The therapeutic policy of PBC complicating SS involved in the liver should settle PBC mainly.

Objective To investigate the characteristics of clinical manifestations,treatment and prognosis of patients with systemic lupus erythematosus (SLE) complicated with central nervous system (CNS) infoction.Methods The medical records of 30 patients with SLE complicated with CNS infeetion were retrospectively reviewed.Results In the cohort of 3039 SLE patients admitted during last 20-year8,30 patients (1%) were identified with CNS infection.The mean age of patients with CNS infection was (34±11) years.Twenty-seven (90%) out of the 30 patients were fomale.Patients could be divided into 3 groups based on the offending microorganisms:mycobacterium tuberculosis (TB),non-TB bacterial and fungal infection groups respectively.TB infection was identified in 11 patients (37%),non-TB bacterial infections could be confirmed in 11 (37%),and fungal infection in 8 (26%).The most common presentations of CNS infeetion were fever,headache,and conscious level changes.There was no difierence among the three groups in morta-lity rate.Conclusion The clinical presentations of SLE patients complicated with CNS are generally atypical.Tubereulosis meningitis is the most prevalent CNS infection in patients with SLE.CSF analysis should be done as soon as possible for establishing early diagnosis.A lOW sernm albumin level,low C3 level and a low intracranial pressure predicts for unfavorable outcomes.