Objective To analyze the clinical manifestations,immunological characteristics,pathological changes and prognosis in primary Sj(o)gren's syndrome complicated with renal involvement.Methods Three hundred and eighty-seven patients with pSS were enrolled in this retrospective study.Among these patients,198 patients were complicated with renal involvement and 189 patients without renal involvement.The data of the two groups were analyzed for clinical manifestations,blood tests,urine tests and immunological characteristics by independent sample t test,x2 test,Fisher exact probability and Logistic regression model respectively.Seventy-two patients in the group with renal involvement had kidney biopsies.Results The average of these 387 patients (female/male 345/42 cases) were (55.3±13.2) years old.The average age of 198 patients with renal involvement (female/male 168/30 cases) was (55.3±13.2) years old.The serum RF and IgG of the group with renal volvement was significantly higher than the patients without renal involvement.In the 198 patients with renal involvement;102 patients (51.5％) developed type Ⅰ renal tubular acidosis (RTA Ⅰ).Among these RTA Ⅰ patients,54 patients presented hypokalemia;12 patients developed hypokalemic plegia,30 patients with urolithiasis,6 patients with osteoporosis;69 patients presented with overt renal glomerulus impairment,36 cases had nephrotic syndrome (NS),and 33 cases had chronic glomerulonephritis;In 81 patients with renal failure,including 27 were stage 1 CKD,18 were stage 2 CKD,9 were stage 3 CKD,15 were stage 4 CKD,12 were stage 5 CKD.Among these patients with renal biopsie,light microscopy showed chronic interstitial nephritis (IN,69/72),mesangial proliferative glomerulonephritis (36/72),hyperplastic and sclerosing glomerulonephritis (9/72),partly sclerosing glomerulonephritis (9/72) and membranous nephropathy (6/72).Immunofluorescent examination revealed:IgG deposition in 21 patients (29.1％),IgA in 21(29.1％),IgM in 33(45.8％),C3 in 12(16.6％),C4 in 18(25％) and C1q in 15(20.8％).Sixty-six cases with renal biopsies were followed for (8-30)months,except the patient died of cerebral bemorrhage,all the other patients survived,and renal functions were steady or improved.Conclusion ① The pSS patients with renal involvement mainly shows interstitial nephritis.However,the occurrence of glomerulonephritis is not rare.② Rheumatoid factor (RF) or IgG is significantly associated with renal involvement in patients with pSS.③ When renal involvement is presents,renal biopsies is a necessary for patients with pSS.

Adult ; Female ; Health Knowledge, Attitudes, Practice ; Health Promotion ; Humans ; Lead ; Male ; Middle Aged ; Occupational Exposure ; prevention & control ; Occupational Health ; Occupational Health Services ; Stearates ; Young Adult

OBJECTIVETo explore the clinical effects of minor bone anchors and palmaris longus tendon graft in treating chronic mallet fingers deformity.

METHODSFrom January 2008 to June 2013, 26 patients with chronic mallet fingers deformity were treated with minor bone anchors and palmaris longus tendon graft. There were 18 males and 8 females, aged from 18 to 52 years old with an average of (32.0±1.3) years. Among them, 8 cases caused by machine injury, 6 cases by fall injury, 6 cases by sprain from fight, 4 cases by tendon spontaneous rupture, 2 cases by knife trauma. There was no tendon attachment of extensor tendon check in 16 cases, and with 0.3 to 0.5 cm tendon attachment in 10 cases. All patients had the flexion deformity and the disability of dorsiflexion activity. During operation, the distal interphalangeal joint was fixed in 10° to 20° dorsiflexion by a Kirshner wire, the minor bone anchor was used to reconstruct the extensor tendon insertion, the palmaris longus tendon slice was transplanted the decayed area of extensor tendon insertion. Four weeks postoperatively, the Kirshner wire was removed and the plaster external fixation was used, and the patient began function exercises. Postoperative complications were observed and fingers functions were assessed according to Dargan standard.

RESULTSThe patients were followed up from 6 to 14 months with an average of (5.0±0.3) months. Wound superficial infection occurred in 2 cases, the skin pressure ulcer in 2 cases, joint activities disability in 1 case; these symptoms got improvement after symptomatic treatment. Traumatic arthritis occurred in 2 cases, 1 case was improved after treatment, and 1 case had chronic pain for a long time. No internal fixation loosening or breakage and tendon rupture were found. According to Dargan standard to evaluate the finger function, 17 cases got excellent results, 8 good, and 1 poor.

CONCLUSIONIt is an effective way to treat the chronic mallet finger deformity using minor bone anchors and palmaris longus tendon graft, and the method has advantages of reliable fixation, easy operation, satisfactory effect and less complication.

Adolescent ; Adult ; Female ; Finger Injuries ; surgery ; Fracture Fixation, Internal ; Hand Deformities, Acquired ; surgery ; Humans ; Male ; Middle Aged ; Suture Anchors ; Tendon Transfer

Objective: To investigate the differential expression of Sox9 in conventional chondrosarcoma,dedifferentiated chondrosarcoma and normal cartilage. Methods: We reported 12 cases of chondrosarcomas,which were initially diagnosed as chondrosarcomas(6 cases of conventional chondrosarcoma and 6 cases of dedifferentiated chondrosarcoma)at Peking University People's Hospital between January 2003 and January 2007.We used genechip method to identify difierentially expressed genes involved in conventional chondrosarcoma,dedifferentiated chondrosarcoma and in normal cartilage(6 cases)and found thousands of differentially expressed genes after extensive statistical analysis.With Sox9 which played crucial roles in the process of both differentiation and maturation of chondrocyte as a candidate,we used Real-time PCR,Westem blot and immunohistochemistry to confirm the results found by gene chip. Results: DNA microarray results showed that Sox9 was up-regulated about 1.6 times in conventional chondrosarcoma compared with that in normal cartilage.But in dedifferentiated chondrosarcoma,the expression level of Sox9 was significantly down-regulated,0.082 times of that in normal cartilage.Real-time PCR results showed that the expression levels of Sox9 mRNA in conventional chondrosarcomas and dedifferentiated chondrosarcomas were 1.68±0.119 and 0.088±0.017,respectively.Sox9 protein level was significantly higher in humen conventional chondrosarcomas than that in normal cartilage.Sox9 protein level in dedifferentiated chondrosarcomas was significantly lower than that in normal cartilage tissue.All of the 6 cases of conventional chondrosarcomas showed diffuse and strong staining of Sox9.However,Only scattered staining was observed in dedifferentiated chondrosarcomas. Conclusion: Compared with that in normal cartilage,Sox9 expression is up-regulated in conventional chondrosarcomas and down-regulated in dedifferentiated chondrosarcomas.Decrease of Sox9 expression in dedifferentiated chondrosarcoma is correlated with poor survival,indicating that Sox9 may serve as a molecular prognostic marker for chondrosarcomas and disease progression.

A strain of Cellulosimicrobium cellulans Ha8 was studied on its morphological, biological characteristics and its utilization of several kinds of benzoic compounds, the results showed this strain was Gram-positive, the long rod-shaped cells were changed into short rod-shape gradually. pH value from pH 6.0 to pH 9.0 and the temperature from 20 ℃ to 40 ℃ were good for its growth. It could not only hydrolyze protein and starch, use cellulose and pectin, decomposite chitin, liquify gelatin and fix nitrogen, but also use phenol, xylene, benzoic, cinnamic acids and diphenlamine as the sole carbon resource for its growth. It could tolerate 0 mmol/L~30 mmol/L, 0 mmol/L~8 mmol/L, 0 mmol/L~30 mmol/L, 0 mmol/L~15 mmol/L and 0 mmol/L ~ 40 mmol/L of benzoic acids, phenol, xylene, cinnamic acids and diphenlamine seperately, but could not use 2,4-dinitrophenol, o-Nitrophenol, 2-Methoxyphenol, aminobenzenesulfonic acid, catechol and o-Phenanthroline as its sole carbon resource.

Objective To study cancer metastasis in mesorectum and ischiorectal loss in cases of ultra-low rectal cancer and evaluate the rationale of Miles procedure. Methods Whole-mount slice and tissue mieroarray technique were used to study the dissected specimen from 23 cases of uhra-low rectal cancer for metastatic lymph nodes. Result 415 lymph nodes were harvested in 23 mesorectum specimen, 169 and 59 lymph nodes were metastasic and micrometastasie respectively. 12 eases were diagnosed with metastasis, 4 cases were found to have micrometastasis. Metastatic lymph nodes in the lateral and anterior mesorectum were 29.0% (49/169) and 17.2% (29/169) respectively. There were 2 patients with metastasis and 1 with micrometsstssis in ischiorectal fossa lymph nodes, accounting for 13% patients. Conclusion Regional metastasis exists in ultra-low rectal cancer and its incidence varies in different location of mesorectum and ischiorectal fessa. The value of Miles procedure as the standard therapy for ultra-low rectal cancer should undergo an evaluation.

Animals ; Lung ; drug effects ; metabolism ; Perchlorates ; toxicity ; Quaternary Ammonium Compounds ; toxicity ; RNA, Messenger ; genetics ; Rabbits ; Transforming Growth Factor beta1 ; genetics ; metabolism ; Tumor Necrosis Factor-alpha ; genetics ; metabolism

Objective To investigate the relationship between retinal nerve fiber layer thickness and peripheral neuropathy in elderly patients with type 2 diabetes.Methods Clinical data of elderly patients with T2DM in Endocrinology Department in Beijing Hospital were retrospectively collected.Global and sectorial retinal nerve fiber layer(RNFL)thicknesses were measured by using optical coherence tomography(OCT),and never conduction velocity measurements were performed in all patients.Diabetic peripheral neuropathy was diagnosed by the criteria in diabetic neuropathies update(2010,American Diabetes Association).RNFL thickness was compared between diabetic nonperipheral neuropathy group (control group,n =30)and diabetic peripheral neuropathy group (DPN group,n=17)and between different sub-groups.Results The RNFL thicknesses of temporal,nasal,superior and inferior visual fields and the mean RNFL thickness were less in DPN group than in control group,among which there were significant differences in the RNFL thicknesses of superior,inferior visual fields and the mean RNFL thickness [(107.7±27.4)μm vs.(128.1±17.3)μm,(112.9 ±20.8)μm vs.(130.8±21.8)μm,(88.2±15.5)μm vs.(100.5± 11.3)μm,F=7.446,7.468,7.988,respectively,P=0.009,0.009 and 0.007].RNFL thickness was decreased along with the aggravation of DPN from the control group,the subclinical DPN group to the DPN group successively(all P＜ 0.05).Conclusions Retinal nerve fiber layer thickness is associated with diabetic peripheral neuropathy in elderly patients with type 2 diabetes,and the relationship is more significant in patients with serious DPN.

OBJECTIVE To survey the Escherichia coli infection in our hospital in the field of flora distribution,structure and status quo resistance in order to guide the rational use of antibiotics.METHODS From Nov 2005 to Dec 2006 247 E.coli strains were isolated from 2940 samples with conventional method identification,K-B method was used for bacterial susceptibility,and resistance test.RESULTS The top six susceptible antibiotics were cefoperazone/sulbactam(86.84%),nitrofurantoin(55.56%),chloramphenicol(43.25%),amikacin(40.43%),ceftriaxone(27.41%),and cefoperazone(27.16%).The top six resistant antibiotics were sulfamethoxazole/trimethoprim Co-trimoxazole(93.33%),ampicillin(93.18%),amoxicillin(92.00%),cefalotin(86.67%),cefradine(85.03%),and cefuroxime(81.25%).CONCLUSIONS Strengthening antibacterial drug sensitivity test,and conduct ing timely the effective treatment and corresponding measures could guide the clinician to provide a reasonable use of antibiotics.

OBJECTIVE To give details of the resistance of Staphylococcus aureus infection to various types of drugs.METHODS The laboratory data of resistant S.aureus from Nov 2005 to Dec 2006 were investigated and analyzed and compared the results to the standard sample.RESULTS The sequence of the antibacterial agents resistant to the S.aureus in decreasing order was azithromycin(91.66%),penicillin(88.57%),ceftazidime(87.50%) and amoxicillin(73.53%) with the age distribution of the sufferers from 31-40 years old. It was found 23.86% patients(42 samples) had the positive rate in prostatic fluid of 32.95%.CONCLUSIONS Based on the patient conditions,provide the appropriate drug treatment would avoid the occurrence of resistant S.aureus.