Lymphocytic hypophysitis(LH) is a rare but increasingly recognized autoimmune endocrine condition that causes partial or total hypopituitarism and is often associated with peripartum young women.We here report a 28-year-old patient who had a spontaneous and uneventful pregnancy following LH that had been treated with transspenoidal surgery and followed by anti-inflammatory agent.The woman failed to lactate and developed frontal headaches 3 months after normal delivery of her first child 3 years ago.Lab test showed the reduced concentrations of thyroxine,estradial and cortisol,suggesting hypopituitarism.Magnetic resonance imaging of the brain with contrast was performed and showed a uniformly enhancing pituitary mass with elevated optic chiasm.She underwent transsphenoidal surgery and histological examination of the resected specimen was consistent with lymphocytic hypophysitis.Anti-inflamation was started with prednisolone 40 mg per day because of a recurrence of headache that had completely recovered after surgery and regularly withdrawn to a long term maintenance dose of 10 mg per day.Physiological thyroxine replacement therapy was maintained.Her menstruation was restored without sex hormone replacement after 3 months.Three years after surgery,she got pregnant spontaneously and had normal breastfeeding after delivery.LH did not recur during this peripartum.

Objective To investigate the relationship between the onset of lower extremity venous thrombotic disease and seasons.Methods A retrospective study was conducted, 300 patients with lower extremity venous thrombotic disease admitted to HandanCity Hospital of Traditional Chinese Medicine (TCM) from August 2012 to February 2014 were enrolled, the incidences and TCM syndromes of patients with lower extremity venous thrombotic disease in different seasons were observed, and the pathogenesis and relationships between the types of TCM syndrome and seasons were analyzed.Results There were 142 patients with lower extremity superficial thrombophlebitis, and 158 cases with lower extremity deep venous thrombosis, the incidence of lower extremity venous thrombotic disease in spring was significantly higher than that in summer and autumn [32.8% (86/262) vs. 21.3% (54/254), 18.4% (50/272), bothP < 0.01], but lower than that in winter [32.8% (86/262) vs. 37.2% (110/296)], the difference was not statistically significant (P > 0.01); while the incidence of lower extremity venous thrombotic disease in winter was significant higher than those in summer and autumn (allP < 0.01). The incidences of damp and heat downward flow type in autumn and summer were increased compared with those in winter and spring [55.6% (30/54), 60.0% (30/50) vs. 20.0% (22/110), 23.3% (20/86), allP < 0.01], while the incidences of lower extremity venous thrombotic disease with damp heat and stasis syndrome in winter and spring were increased compared with those in summer and autumn seasons [80.0% (88/110), 76.7% (66/86) vs. 44.4% (24/54), 40.0% (20/50)].Conclusions The incidence of lower extremity venous thrombotic disease is related to seasons, and the onset is high in winter and spring, damp heat and stasis syndrome being the main type; according to different seasons, clinical treatment can direct to different pathogenic factors to adopt different preventive measures interfering with the patient's constitution in order to eliminate or reduce the risk factors, achieving the effect of the disease prevention.

The noninvasive measurement of liver stiffness (LS) was evaluated by transient elastography (FibroScan) and the possible influencing factors from the patients' clinical situations including age, gender, liver inflammation represented by alanine transaminase (ALT) and total billirubin (TBIL) level, HBV replication (HBV DNA loads), portal vein pressure (portal vessel diameter, PVD), splenic thickness (SPT) and body mass index (BMI) were analyzed in patients with chronic hepatitis B (CHB). A total of 466 patients including 31 patients with acute-on-chronic liver failure (ACLF), and 435 patients with chronic hepatitis B (CHB) among which 82 patients were diagnosed with liver cirrhosis (LC) by clinical manifestations and liver B-type ultrasonic inspection were enrolled at Tongji Hospital from April to December 2009. LS was measured by a FibroScan device (EchoSens, France). Simultaneously, ALT and TBIL levels, HBV DNA loads, PVD, SPT and BMI in all patients were also tested. Forty-one healthy volunteers served as controls. The values of LS were correlated positively with ages of CHB patients and significantly higher in males than in females. In patients with BMI>28 kg/m(2) (obesity) and abnormal levels of ALT and TBIL, LS values were significantly increased as compared with those having normal levels of ALT and TBIL. The patients with ACLF had the highest LS value. Furthermore, LS values in the patients with LC were significantly higher than those in patients without LC. It is concluded that noninvasive measurement of liver fibrosis by FibroScan provides an alternative method to evaluate liver fibrosis of patients with CHB. In order to properly illustrate the stiffness value taken by transient elastography, patients' gender should be taken into consideration and it is also suggested to avoid possible influencing factors including liver inflammation (high levels of ALT and TBIL) and obesity (high BMI).

The noninvasive measurement of liver stiffness (LS) was evaluated by transient elastography (FibroScan) and the possible influencing factors from the patients' clinical situations including age,gender,liver inflammation represented by alanine transaminase (ALT) and total billirubin (TBIL) level,HBV replication (HBV DNA loads),portal vein pressure (portal vessel diameter,PVD),splenic thickness (SPT) and body mass index (BMI) were analyzed in patients with chronic hepatitis B (CHB).A total of 466 patients including 31 patients with acute-on-chronic liver failure (ACLF),and 435 patients with chronic hepatitis B (CHB) among which 82 patients were diagnosed with liver cirrhosis (LC) by clinical manifestations and liver B-type ultrasonic inspection were enrolled at Tongji Hospital from April to December 2009.LS was measured by a FibroScan device (EchoSens,France).Simultaneously,ALT and TBIL levels,HBV DNA loads,PVD,SPT and BMI in all patients were also tested.Forty-one healthy volunteers served as controls.The values of LS were correlated positively with ages of CHB patients and significantly higher in males than in females.In patients with BMI＞28 kg/m2 (obesity) and abnormal levels of ALT and TBIL,LS values were significantly increased as compared with those having normal levels of ALT and TBIL.The patients with ACLF had the highest LS value.Furthermore,LS values in the patients with LC were significantly higher than those in patients without LC.It is concluded that noninvasive measurement of liver fibrosis by FibroScan provides an alternative method to evaluate liver fibrosis of patients with CHB.In order to properly illustrate the stiffness value taken by transient elastography,patients' gender should be taken into consideration and it is also suggested to avoid possible influencing factors including liver inflammation (high levels of ALT and TBIL) and obesity (high BMI).

OBJECTIVEThe objective of this study is to review the research on the prognostic markers of idiopathic pulmonary arterial hypertension (IPAH).

DATE SOURCESWe searched literature from PubMed and CNKI databases both in English and Chinese up to 2013.

STUDY SELECTIONData about mortality and cut-off value are from clinical trials and identified by analysis.

RESULTSIPAH is an unexplained, progressive, and rare disease characterized by increased pulmonary artery pressure and pulmonary vascular resistance. The diagnosis is difficult, mortality of IPAH is high, and the survival periods are only 2-3 years after diagnosis. Investigations in recent years have identified a range of prognostic markers for IPAH, including the 6-minute walking test, red blood cell distribution width, and platelet levels, as well as imaging findings. Changes in these markers are important sources of information to predict the prognosis of patients with IPAH, which carries significant benefits for treatment planning.

CONCLUSIONEven though the prognosis of IPAH has been investigated, the mortality is also high. More accurate and meaningful assessment for the prognosis of IPAH is required.

Biomarkers ; analysis ; blood ; Familial Primary Pulmonary Hypertension ; blood ; metabolism ; pathology ; Humans ; Prognosis

OBJECTIVE: To evaluate the quality of methodology and reporting of Meta-analyses on acupuncture treating ischemic stroke in China. METHODS: The domestic literature of systematic reviews (SRs) on acupuncture treating ischemic stroke was retrieved from CBM, VIP, CNKI and WANFANG databases. The quality of methodology and reporting was measured by A Measurement Tool to Assess Systematic Reviews (AMSTAR) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). RESULTS: Seven studies involving 6 papers in Chinese and 1 paper in English were chosen from 402 papers. The deficiencies of methodology mainly contained incomplete retrieval strategy, less attention to the publication bias and the heterogeneity, etc. The shortages of reporting was on retrieval strategy reporting, the studies features and the risk of bias reporting and evidence strength level reporting, etc. CONCLUSION At present the quality of methodology and reporting of SRs on acupuncture treating ischemic stroke in China has flaws, which needs improvement.
Acupuncture Therapy ; Brain Ischemia ; therapy ; China ; Humans ; Publication Bias ; Stroke ; therapy

Objective:To establish a mice model of inflammatory bowel disease (IBD) induced by dextran sulfate sodium (DSS), and to analyze the changes in intestinal inflammation and macrophage subsets at different stages, so as to find a new target for the treatment of IBD.Methods:Thirty male C57BL/6 mice of 6-8 weeks were randomly divided into control group, activation stage group and resolution stage group.The latter 2 groups were given 25 g/L DSS for 5 consecutive days to establish the IBD model.After 5 days, the mice were given filtered and sterilized water and sacrificed on the 10 th and 15 th day, respectively.Colon inflammation in mice was evaluated, including body weight, disease activity index (DAI) score, changes in colon length, histopathology and histopathological score.Then the expression levels of interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, transforming growth factor (TGF)-β in colon tissues were detected by quantitative real-time PCR(qPCR). Finally, the changes of intestinal macrophage subsets were detected by flow cytometry. Results:The colon inflammation of mice in the activation stage group was significantly more severe than that in the control group, while the colon inflammation of mice in the resolution stage group was reduced.The colon length of mice in the activation stage group was (5.94±0.40) cm, which was significantly shorter than that in the control group [(7.25±0.29) cm], and the situation was slightly improved in the resolution stage with the colon length of [(6.87±0.95) cm], and the differences were statistically significant (all P<0.05). The mRNA expression levels of pro-inflammatory cytokines IL-1β, IL-6 and TNF-α in the activation stage were 53.40±6.58, 117.69±30.78 and 2.52±0.25, respectively, which were significantly higher than those in the control group (1.00±0.13, 1.00±0.39, 1.00±0.10); the mRNA expression levels of IL-1β, IL-6 and TNF-α in the resolution stage were 2.51±0.13, 5.43±0.51 and 1.73±0.14, respectively, which were significantly lower than those in the activation stages(all P<0.05). The expression level of anti-inflammatory cytokine TGF-β in the resolution stage was 2.41±0.17, which was significantly higher than that in the activation stage (0.94±0.12), and the diffe-rence was statistically significant ( P<0.05). During the progression of IBD, there were 3 groups of macrophages in the lamina propria of intestinal mucosa of mice, of which the number of F4/80 lowCD 64-MHCⅡ - macrophage subset with the lowest maturity increased significantly in the activation stage of IBD, accounting for (10.68±4.62)%, and it decreased and returned to the normal level in the resolution stage, accounting for (4.63±1.06)%, and the difference was statistically significant ( P<0.05). Conclusions:Macrophages play an important role in the progression of IBD, the hindrance of maturation and development may be the main cause of inflammatory injury in the activation stage of IBD, and the transformation of macrophage subsets may become a new target for the treatment of IBD.

Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; complications ; Spondylitis, Ankylosing ; complications

Tibetan is a kind of medicine which extensively absorbed and fused the Chinese Traditional Medicine, Indian medicine and food through long-term practice and form the unique medical system. At the same time, the Qinghai Tibet plateau has characteristics of high altitude and lack of resources and oxygen, which has formed its unique geographical environment and grow a lot of rare medicinal plants. Tibetan medicine has a long history and is one of the relatively complete and influential ethnic medicines in China, which has played an important role in the treatment of plateau diseases. In recent years, with the increasing of economic activities in the plateau, the plateau anoxia had greatly affected the working capacity of the plateau. According to "Chinese medicine" through the literature, the pharmacological activities, active ingredients, growing environment of Tibetan medicine with good plateau hypoxia effect were reviewed and according to the site, which could be divided into the lung protection medicine, the cardiac protection medicine, the brain protection medicine, the liver protection medicine, the improvement of fatigue medicine and other medicine, which could provide theoretical basis for finding more potential anti-hypoxia drugs.