ObjectiveTo systematically review and evaluate the predictive factors of interstitial lung disease(ILD) in patients with polymyositis and dermatomyositis (PM/DM), and provide evidence for early clinical diagnosis. MethodsThe predictive factors of PM/DM-related ILD from 23 published papers were analyzed by Meta-analysis. Analysis of heterogeneity and sensitivity were performed and pooled odds ratio (OR) with 95％ confidence interval(95％CI) were calculated using either fixed or random effects models by Rev-Man 4.2 software. Stata 10.0 software was used to identify publication bias. ResultsMeta-analysis was performed to analyze seven factors including anti-Jo-1 antibody, fever, arthritis/arthralgia, Gottron's sign,antinuclear antibody(ANA), and dysphagia Raynaud's phenomenon. Factors correlated with ILD in patients with PM/DM and their OR values and 95％CI were as follows: the presence of anti-Jo-1 antibody 6.94 (4.74～10.16), fever 4.90(3.82～6.29), arthritis/arthralgia 3.93(3.21～4.80), Gottron's sign 2.52(1.24～5.14), and the presence of ANA 1.59( 1.02～2.47 ). Raynaud's phenomenon and dysphagia were not correlated with ILD in patients with PM/DM with OR values and 95％CI as 1.40 (0.97～2.01), and 1.21(0.94～1.56) respectively.ConclusionThe presence of anti-Jo-1 antibody, fever, arthritis/arthralgia, Gottron's sign and ANA are major predictive factors for ILD in patients with PM/DM.

OBJECTIVE:To analyse the situation and characteristics of use of herbal decoctions,so as to find out the rules of drug-use in treatment of tumour METHODS:By means of the software named "Management System for Chinese Medicinal Herb Pharmacy in Tumour Hospital",usage of the herbal decoctions in treating tumours in this hospital from March 1997 to February 2000 was comprehensively analyzed RESULTS:There were six main categories,271 kinds of herbs used in this hospital which accounted for 58 15% of the total categories The amount of consumption reached 188 135kg which amounted to 83 03% of total consumption Among the top 20 kinds of herb in consumption,the tonics accounted for about 1/3,of which 61 45% for invigorating qi and 29 95% for nourishing yin and the herbs for clearing away heat and toxic material amounted to 65 30% of the total consumption of those for clearing away heat CONCLUSION:The Chinese traditional medicine is one of the most effective methods in preventing and treating tumours The average dosage of the herbs mainly used in treating tumour was about 30g,which is much larger than the common dosage

Objective To investigate the effect of seretide plus montelukast on clinical symptoms、pulmonary functions and the serum IL-6 and TNF-α of patients with asthma.Methods 73 cases patients with asthma were randomly divided into seretide group and seretide plus montelukast group and were treated respectively for two weeks.The clinical symptoms,lung functions and serum IL-6,TNF-α contents of patients were measured respectively before treatment and after two weeks treatment.Results After two weeks treatment,the clinical symptom scores、FEV1.0、FVC and PEFR of two groups had significantly changed than that before treatment(P<0.05);Each index was further compared after treatment,and it was found that two groups had significant differernces statistically (P<0.05),these showed that combination of seretide and montelukast could significantly enhance the therapeutic effect.After treatment,the TNF-α and IL-6 contents in the peripheral blood of seretide group and seretide plus montelukast group had both significantly reducted (P<0.05 or P<0.01);The TNF-α and IL-6 contents of seretide plus montelukast group had reduced more significantly than that of the seretide group(P<0.05).Conclusion The seretide plus montelukast group could improve the clinical symptoms and pulmonary function of patients with asthma,and the action mechanism might be related to lower the serum IL-6 and TNF-α contents.

Objective To evaluate the regulatory role of mTOR signaling in activation of renal interstitial fibroblasts and the potential effect on interstitial fibrosis. Methods 8-week old female C57BL/6 mice (n=30) underwent unilateral ureteral obstruction (UUO) to induce renal interstitial fibrosis. Animals were randomly divided into rapamycin (2 mg·kg-1· d-1) group and UUO group (vehicle-treated) (n=15 each group). Daily intraperitoneal injection of rapamycin or saline was applied to animals from day 1 before operation to the end of experiment.Three mice were sacrificed at day 1,3,7,14 respectively and kidneys were harvested for further analysis.NIH3T3 cells were stimulated by TGF-β for 12 hours with the presence or bsence of rapamycin (100 nmol/L). Results Immunofluorescent co-staining revealed that active fibroblasts highly expressed pS6K and α-SMA in kidney interstitium.Administation of rapamycin significantly inhibited activation of mTOR signaling in fibroblasts and ameliorated interstitial fibrosis of obstructed kidneys.Real-time PCR confirmed that rapamycin decreased the mRNA expression of FSP1,TGF-β,CTGF and Col4A1 in fibrotic kidneys. In vitro experiment revealed that TGF-β induced highly expression of pS6K and αSMA in cultured NIH3T3 cells,which could be markedly inhibited by rapamycin. Conclusions mTOR signaling highly activates in interstitial fibroblasts during kidney fibrosis.Inhibition of mTOR signaling by rapamycin decreases the activation of fibroblasts and ameliorates interstitial fibrosis.

ObjectiveTo determine the serum level of anti-aminoacyl-tRNA synthetase (ARS)antibody in patients with polymyositis (PM) and dermatomyositis (DM) and to investigate the value of anti-ARS antibody for diagnosing interstitial lung diseases(ILD) in patients with PM/DM compared with anti-Jo-1 antibody.MethodsSerum anti-ARS antibody concentrations were measured by ELISA in 109 adult PM/DM patients,20 patients with SLE,20 patients with RA and 50 healthy controls.T test,Mann-Whitney U test,chi-square test or Fisher exact test were used to compare the sensitivity and specificity for diagnosing ILD in PM/DM patients between anti-ARS antibody and anti-Jo-1 antibody.Moreover,McNemar test was employed to analyze the correlation between the clinical features and anti-MDA5 antibody in PM/DM patients.Results The serum positive rate of anti-ARS antibody was 37.9％,7.8％,10％,0 and 0 in PM/DM patients with ILD and without ILD,patients with SLE and RA and healthy controls,respectively.Serum anti-ARS antibody levels and positive rate in the PM/DM patients with ILD were significantly higher when compared with PM/DM patients without ILD,patients with SLE and RA and healthy controls (X2=-13.5,5.45,10.57,15.17; P＜0.01 ).Anti-ARS antibody presented a significantly higher sensitivity for diagnosing ILD in patients with PM/DM compared to anti-Jo-1 antibody (P＜0.01).The rate of fever and ILD were significantly higher in anti-ARS positive group than anti-ARS negative group(X2=12.55,13.53; P＜0.05),while heliotrope rash and shawl sign occurred more often in anti-ARS negative group(X2=5.7,5.8; P＜0.05).Additionally,follow-up study showed that the serum anti-ARS antibody were all negative in nine patients who died of PM/DM with ILD (P＜0.05).ConclusionSerum anti-ARS antibody is a stronger predictor for early diagnosis of PM/DM with ILD compared to anti-Jo-1 antibody.The detection of anti-ARS antibody can be widely applied to clinical practice.

The formation of tumor nodules is related to lymph node metastasis,neural invasion and vas-cular invasion.Tumor nodule is a negative prognostic factor in colorectal cancer patients,which increases the probability of recurrence and metastasis in patients with colorectal cancer.The prognostic value of tumor nodules in the lymph node metastasis is greater than the seventh edition of tumor nodules staging method,which provides a more accurate basis for the clinical treatment.

BACKGROUND: With the rapid development of surgical techniques, unicompartmental knee arthroplasty has become an issue of concern in the treatment of osteoarthritis, which has achieved significant progress inreducing trauma and rapid rehabilitation.OBJECTIVE: To summarize the development history, curative effect of unicompartmental knee arthroplasty, and the research progress of lateral unicompartmental knee arthroplasty aided with computer navigation or robot system, thus providing reference for further study on unicompartmental knee arthroplasty.METHODS: Web of Science, and PubMed databases were searched for the literatures published from January 1955 to April 2017 with the keywords of unicompartmental knee arthroplasty, osteoarthritis, unilateral compartment, lateral knee arthroplasty.RESULTS AND CONCLUSION: A total of 562 articles were retrieved, and finally 75 English literatures were enrolled according to the inclusion and exclusion criteria. With the continuous improvement of unicompartmental knee arthroplasty, it can retain the cruciate ligament and more bone mass. Notably, strict indications and reasonable postoperative functional exercise are essential for obtaining optimal effectiveness. At the same time, the development of computer navigation and robot-assisted technology has opened up a new horizon for the treatment of osteoarthritis,which makes the operation more accurate and minimally invasive. But the application still needs to be studied in depth.

Objective To explore an effective method for enhancing basic clinical skill of students.Methods Selective course of basic clinical skill was launched for the fourth grade clinical medicine students by using simulation-based medical education (SBME).Elective courses have 21 class hours,involving 15 items of basic clinical skills in internal medicine,surgery and nursing.Training methods include preparation,explanation,demonstration,operation,group competition,examination and questionnaire.Selective course examination includes class activation and final examination,accounting for 20％ and 80％ of the final scores,respectively.Scores were classified into A (excellent),B (good) and C (moderate) levels.Scores and questionnaire data were processed by Microsoft Office Excel 2007 software and percentages of score and questionnaire feedback were calculated.Results Results suggested that the scores of 70％ students were more than 90.Results of questionnaire indicated that the basic clinical skills of 76.6％ of the students were improved a lot.79.2％ considered that it was useful for their clinical practices.Conclusion Clinical-skill course based on SBME is conducive to enhancing basic clinical skills of students.

Objective To explore the correlation of anticardiolipin antibody (ACL) and lupus nephritis (LN) glomerular microthrombi (GMT) in patients with systemic lupus erythematosus (SLE) and to analyze their clinical manifestations and renal pathological characteristics.Methods The clinical data of 126 LN patients treated at our hospital between January 2005 and October 2010 were retrospectively reviewed.The factors,including age,gender,the clinical manifestations in and outside of kidney were evaluated by multivariate Logistic regression analysis.Enzyme-linked immunosorbent assay (ELISA) was used to test the serum levels of ACL in all patients.Statistical analysis was conducted using x2 test and Logistic regression.Results ① All 126 patients were investigated.Thirty-eight LN patients had GMT.When compared with the LN-non-GMT group,the SLE disease activity index (SLEDAI),urinary protein quantity (24 h),serum creatinine,serum urea nitrogen,anti-dsDNA antibody (+),the incidence of severe hypertension,anemia,thrombocytopenia,arthritis were higher in the LN-GMT group (P＜0.01).Logistic regression analysis showed that SLEDAI (OR=2.486,95％CI 1.678-3.684,P=0.000),anemia (OR=4.628,95％CI 1.045～20.496,P=0.044) were correlated with GMT; ② The pathologic results of renal biopsy showed that GMT had an incidence of 30.2％ (n=38) in LN.As compared with the LN-non-GMT group,Wilcoxon test showed that the LN-GMT group suffered more severe greater renal pathological injuries (P=0.012).The pathological types of LN-non-GMT and LN-GMT groups were as follows:type Ⅳ (38％ vs 76％) and type Ⅲ (31％ vs 8％); ③ The positive rate of ACL was higher in the LN-GMT group than that in the LN-non-GMT group (n=23,61％ vs n=15,36％).The differences were statistically significant (P=0.018).Conclusion GMT is not rare in LN.SLEDAI,anemia and positive ACL are correlated with GMT,LN patients with concurrent GMT have more severe renal pathological changes.

ObjectiveTo determine the serum MDA5 levels and their clinical associations in patients with polymyositis/dermatomyositis (PM/DM).MethodsSerum anti-MDA5 antibody was detected by ELISA in 119 adult PM/DM patients,30 patients with systemic lupus erythematosus(SLE),30 patients with rheumatoid arthritis (RA),15 patients with primary Sj(O)gren's syndrome (SS),21 patients with pulmonary infection and 50 healthy controls.t-test,Mann-Whitney U test or chi-square test or Fisher exact test as well as Logistic multivariate regression analysis were carried out to compare the results of this study.ResultsSerum antiMDA5 antibody positive rate in DM patients(22.6％) were significantly higher compared with that of patients with PM (0,P＜0.01),patients with SLE (3.3％,X2=5.68,P＜0.05),RA (3.3％,X2=5.68,P＜0.05),pSS (0,P＜0.05) and pulmonary infection(0,P＜0.05) and healthy controls (0,P＜0.01).In the DM subgroup,CADM patients presented a higher positive anti-MDA5 antibody rate than classic DM patients.The incidence of arthritis,fever,vrash raised CEA and CA153 level,and serum concentration of GGT and ferritin were significantly higher in the anti-MDA5 positive DM group than anti-MDA5 negative DM group (X2=4.08,8.06,6.357,32.4,4.867; Z=-2.86,-2.44; P value of all these tests were less than 0.05 ),while the rate of serum positive ANA,serum level of CK and T,NK cell counts in the peripheral blood were much lower than those in anti-MDA5 negative DM group(X2=4.08; Z=-2.072,-2.013,-2.907; all P＜0.05).Moreover,the incidence of acute/subacute interstitial pneumonia(A/SIP) was significantly higher in anti-MDA5 positive DM patients than anti-MDA5 negative DM patients.The sensitivity and specificity of anti-MDA5 antibody for diagnosing A/SIP in DM patients were 88.2％ and 94％ respectively.Additionally,logistic multivariate analysis showed that anti-MDA5 was an independent risk factor for death of interstitial lung diseases (ILD) in DM (OR=8.46,95％CI 1.77～40.36,P＜0.01).ConclusionIn Chinese PM/DM patients,serum anti-MDA5 antibody is mainly present in DM patients and is a strong predictor for poor prognosis diagnosis of DM with A/SIP and is an independent risk factor for death of ILD in DM.