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 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 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 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 identify the relationship between the concentration of endothelin and the progression of primary biliary cirrhosis (PBC) by measuring the endothelins (ET) level of PBC patients as well as the PBC patients who were treated withUDCA. In addition, the role of ET on regulating TNF-α and IL-6 secretion of PBMC is explored. Methods The ET level in serum of 24 PBC patients was measured by ELISA. Then PBMCs were stimulated by ET and the concentration of TNF-α, IL-6 levels were measured by ELISA. cDNAs from all RNA extracted from the PBMCs were synthesized, and the expression level of TNF-α was detected by semi-quantitative RT-PCR. Results ET concentration in PBC patietns was significantly higher than healthy controls [(6.0±2.8) vs(2.3±3.4) pg/ml, P<0.05]. The level of ET was not related to other serum biochemical markers.. After UDCA treatment, the level of ET in PBC patients had decreased [(7.5±1.6) vs (6.2±2.7) pg/ml, P=0.084]. After ET-1 stimulation, the secretion of TNF-α by PBMCs in PBC patients increased significantly, and the secretion of 1L-6 decreased, but without statistically significant difference. RT-PCR showed that the expression level of TNF-α mRNA increased significantly after ET-1 stimulation. Conclusion The level of ET in PBC serum is much higher than that of the healthy controls. UDCA treatment can decrease the level of ET in PBC patients. ET can increase the expression of TNF-α mRNA. The increased secretion of TNF-α further activates inflammatory cytokine cascade that plays an important role in the development of PBC.

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 explore cognitive dysfunction of sleep apnea syndrome (SAS) and compare the sensitivity of different measuring methods. METHODS Odd ball auditory P300 (2t- P300), three- tone paradigm auditory P300 (3t-P300) and mini- mental status estimate (MMSE) were performed on 24 patients with SAS and 22 healthy subjects. Results of two groups were compared. RESULTS 2t- P300 of study group:(341?14.5)ms, (342?13.8)ms; 2t- P300 of normal group:(317?14.7)ms, (318?12.8)ms; r-dT1 of study group:(327?13.0)ms,(326?14.9)ms;r-dT1 of normal group: (309?11.1)ms,(309?12.0)ms; r-dT2 of study group:(325?14.9)ms,(326?11.1)ms; r-dT2 of normal group:(306?9.7)ms, (305?11.7)ms.Latency of P300 evoked by odd-ball and 3-tone paradigm were both statistically prolonged in SAS patients than those of normal controls. SAS patients had statistically lower MMSE scores than that of normal group but all of them were above 27. On the other hand, statistical difference of abnormal rate between 3-tone P300 and odd-ball P300 was not found in SAS patients group. CONCLUSION Cognitive function impairment was found in SAS patients both by P300 and MMSE. While P300 might be more sensitive than MMSE in detecting it, different paradigm of auditory P300 did not show difference in sensitivity.

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.