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 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 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 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.

Tumor angiogenesis is the uncontrolled growth of blood vessels in tumors,serving to supply nutrients and oxygen,and remove metabolic wastes.Kaposi's sarcoma (KS),a multifocal angioproliferative disorder characterized by spindle cell proliferation,neo-angiogenesis,inflammation,and edema,is associated with infection by Kaposi's sarcoma-associated herpesvirus (KSHV).Recent studies indicate that KSHV infection directly promotes angiogenesis and inflammation through an autocrine and paracrine mechanism by inducing pro-angiogenic and pro-inflammatory cytokines.Many of these cytokines are also expressed in KS lesions,implicating a direct role of KSI-IV in the pathogenesis of this malignancy.Several KSHV genes are involved in KSHV-induced angiogenesis.These studies have provided insights into the pathogenesis of KS,and identified potential therapeutic targets for this malignancy.

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 evaluate the clinical application of susceptibility-weighted imaging(SWI) in the early diagnosis of massive cerebral infarction with hemorrhage and analysis of collateral circulation.Methods Fifty patients with massive cerebral infarction underwent MRI (T1WI,T2WI,DWI,MRA and SWI) scan in acute stage and decubation respectively in Hanrison International Peace Hospital from January 2012 to January 2014.Analysis T1WI,T2WI,DWI,MRA and SWI differences in the delection of cerebral infarction with hemorrhage and analysis of Collateral circulation.Record the magnetic resonance angiography hemorrhagic transformation and display the ischemic area of collateral circulation in the detection of cerebral infarction remodeling differences.Results (1)SWI detected out 18 cases of cerebral infarction with hemorrhage (36％),including 14 cases of hemorrhagic infarction(HI) type(28％),4 cases of parenchymal hemorrhage(PH) type 8％).MRI detected 11 cases of cerebral infarction with hemorrhage (22％),including 7 cases of HI type 14％),4 cases of PH type (8％).SWI detected 106 focuses,the detection rate was 100％,MRI detected only 26,and the detection rate was 32.51％,and the missing mainly for micro hemorrhage.There was statistical significance between the groups(x2 =21.045,P＜0.05).(2) SWI can display the condition of micrangium in the area of cerebral infarction clearly.The number of micrangium decreased or disappeared in acute stage,but the micrangium increased in decubation.The ratio of capillary vessels increased to 66％.MRA detected 82％ of criminal vessel in patients with cerebral infarction.Conclusion SWI is more sensitive than conventional MR in the early diagnosis of massive cerebral infarction with hemorrhage.MRA combined with SWI could not only detect the criminal vessel of cerebral infarction area,but also monitor the reconstruction of collateral circulation in the infarction region,and there will be extremely valuable to the treatment massive cerebral infarction and evaluation of prognosis.

OBJECTIVE:To observe the effects and side effects of recombinant erytropoietin(rEPO)on patients with anemia in chronic renal failure(CRF).METHODS:128 patients with anemia in CRF had been given rEPO by subcutaneous injection for12weeks,the clinical effects were observed by own control method.RESULTS:Excellence cases amounted 91,efficacy cases33,and the overall efficacy rate was96.88%;The side effects included hypertension,coagulation in dialysis machine,pain in injection site and head,no severe adverse drug reactions were found;No degradation in renal function was found in non-dialysis patients during the medication.CONCLUSIONS:rEPO could improve anemia in CRF safely and effectively.

Objective To explore effects and possible mechanisms of combination therapy with methotrexate (MTX) and low dose cyclophosphamide (CTX) intermittently on the cyclin D 1 expression in the synovium of collagen induced arthritis rats.The outcome is analyzed.Methods After CIA experimental models were successfully established in female Wistar rats,they were randomly divided into CIA model group,low-dose MTX treatment group (0.9 mg·kg-1·W-1),high-dose MTX treatment group (2.7 mg·kg-1·W-1),Jowdose CTX treatment group [24 mg·kg-1·(3W)-1],and" low-dose MTX + low-dose CTX treatment group (MTX 0.9 mg·kg-1·W-1,CTX [24 mg·kg-1·(3W)-1].All of the rats were sacrificed 24 weeks after the first immunization,the specimens of ankle joints were exposed,fixed,decalcified,wrapped and cut into slices.The Cyclin D1 mRNA levels were examined by situ hybridization.Results The mRNA level of cyelin D1 in CIA synovial lining layer was significantly higher than that of normal controls,which suggested that in situ proliferation of synoviocytes might contribute to the thickening of rheumatoid synovial lining layer.The synovial expression intensity of the mRNA level of cyclin D1 in the treatment groups was decreased evidently.The mRNA level of cyclin D1 of the combination treatment group was higher than other groups,which was statistically significant (P＜0.05).Conclusion This is the first research on the effects of MTX combined with CTX intermittently based on cell cycles in CIA animal model.Combination therapy seems to be more effective than single-agent therapy.The results suggest that combining cell cycle stage specific agent MTX with cell cycle stage nonspecific agent CTX may be synergistic in the treatment of RA.Inhibition of the increased expression of the synovial cyclin D1 mRNA maybe an important mechanism of the MTX and CTX combination treatment for RA.