Objective To study the disease spectrum,clinical and lab characteristic of cryoglobulinaemia.Methods The clinical and laboratory data of 58 patients with positive cryoglobulin admitted in Peking University People's Hospital from April 2010 to May 2014 were retrospectively analyzed.Results Among 58 patients,34 were diagnosed as autoimmune disease,8 as infectious disease,4 as hematological disease and 12 as primary cryoglobulinemia.Renal involvement was the most frequent clinical presentation among all cryoglobulin positive patients.Patients with autoimmune disease presented all clinical manifestations related to cryoglobulinaemia.Renal involvement (7/8) was prominent in patients with HBV/HCV infection,while other clinical presentations were rare.Among 4 patients with hematological disease,purpura was presented in 3 cases,renal involvement in 2,arthralgia in 2,fatigue,thrombosis or hyperviscosity was presented in 1 case,respectively;however,none of these patients had elevated rheumatoid factor (RF) level.Renal lesions were the most common reason for patients with primary cryoglobulinaemia to consult doctors,and 5 of them had positive antinuclear antibodies (ANA).Conclusions There is a broad spectrum of disease in cryoglobulinaemia.Multi-system involvement was most common in patients with autoimmune disease.For patients with HBV/HCV infection,extra-hepatic presentations were rare except renal involvement.Hyperviscosity syndrome tended to occur in patients with hematological disease.Since patients with primary cryoglobulinaemia had a relatively high rate of positive antinuclear antibodies,we should keep vigilance at the occurrence of autoimmune disease.

Objective To investigate the clinical and laboratory features of autoimmune disease (AID) associated cryoglobulinaemia. Methods From April 2010 to May 2014, thirty threc patients with AID in Peking University Peopleˊs Hospital were tested positive for cryoglobulin. Their clinical and laboratory features were analyzed retrospectively. T test, Mann-Whitney U test, Chi-squaretest and Fisherˊs exact test were used for statistical analysis. Results Among the 33 patients, 26 were female, 7 were male, the average age was (47 ± 17) years old (range 12-75 years old). The spectrum of autoimmune diseases included, in order, systemic lupus erythematosus (SLE), Sj?grenˊs syndrome (SS), multiple myositis/dermatomyositis, rheumatoid arthritis (RA), systemic sclerosis (SSc), anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis, antiphospholipid syndrome and primary biliary cirrhosis. SLE and SS accounted for 84.8% (28/33) in tpatients with cryoglobulinaemia. In patients withSLE, cryoglobulinaemia occurred at 2.0 (1.0-12.0) years after disease onset, and cryoglobulinpositive patients had more frequent renal involvement (71% vs 40%, P=0.004), positive anti-RNP (56% vs21%, P=0.007) and ACL (53% vs 8%, P=0.000). However, among patients with SS, cryoglo-bulinaemia occurred at 11.0 (4.0-18.0) years after disease onset, and cryoglobulin positive patients had higher rheumatoid factors (RF) [1 170 (230.00, 2 800.00) U/ml vs 57.80 (20.00, 230.50) U/ml, U=-0.002, P=0.001], IgM [3.54 (1.83, 4.34) g/L vs 1.17 (0.81, 2.26) g/L , U=0.016, P=0.014] and lower complement C3 [0.58 (0.33, 0.68) g/L vs 0.81 (0.67, 0.98 g/L), U=0.004, P=0.003] and C4 [0.06 (0.03, 0.12) g/L vs 0.16 (0.12, 0.22), U=0.017, P=0.016]. Conclusion Autoimmune disease complicated with cryoglo-bulinaemia is not uncommon in clinical practice, in which SLE and SS account for the leading two causes. Patients with positive anti-RNP and/or ACL are positively associated with cryoglobulinaemia. renal involvement of SLE is increased by the presence of cryoglobulin.

Objective To compare the clinical efficacy of three different methods in treatment of tuberculous pleural effusion.Methods 108 patients with tuberculous pleural effusion were divided into three groups by randomized single blind methods,and each group had 36 cases.Group A was given Chinese medicine formulations and central venous catheter pleural drainage for injection,group B was given minimally invasive thoracic closed drainage,while group C was given conventional pleural puncture.The clinical efficacy,complications and hospitalization corresponding cost were compared in three groups.Results The clinical effective rates of the three groups were 97.2％,83.3％,61.1％ (x2 =12.90,14.17,15.28,all P ＜ 0.05).In group A,the tuberculous pleural effusion disappearedfastest,hospitalization corresponding cost was lowest and less complications,followed by group B,and group C was the worst,there were statistically significant differences (all P ＜ 0.05).Conclusion Chinese medicine formulations combined with central venous catheter drainage in the treatment of tuberculous pleural effusion has good clinical effecacy,and it is an effective treatment method,which is worth to be further promoted in clinical.

With GC-MS、LC-UV and gene analysis,we studied Pseudonomas sp.W2 metabolic pathway of bisphenol A(Bpa).It was discovered that 4'-(trimethylsiloxy)-Acetophenone、p-Hydroxy benzaldehyde and p-Hydroxy benzoic acid are medium metabolites and that the bacteria has pcaG.

Ear Diseases ; complications ; Ear, Inner ; Female ; Hearing Loss, Sudden ; etiology ; Hemorrhage ; complications ; Humans ; Middle Aged

OBJECTIVETo determine the recognition of healthy medical students on deqi after acupuncture, reveal the qualitative and quantitative rules of deqi and understand whether these rules are the factors of the clinical application of acupuncture therapy.

METHODSThe class questionnaires were used for the investigation study on the understanding of deqi after acupuncture at Hegu (LI 4) or Zusanli (ST 36) in 86 healthy students in the clinical medicine class.

RESULTS(1) Deqi was a kind of complicated compound feelings, with many sensation qualities such as distending pain, distension and pain. (2) Deqi was a kind of mild and moderate sensations. In 10-score credit sys tem of Massachusetts General Hospital acupuncture sensation scale (MASS), the scores of distending pain (4.69 +/- 2.83), distension (4.39 +/- 2.91) and soreness and distension (3.93 +/- 2.93) were around 5 (moderate degree), the scores of stabbing pain (1.89 +/- 2.02) were around 2 (mild degree). (3) The differences in the quantitative scores were significant for stabbing pain, distending pain, distention, soreness and distention and the others before and after treatment (all P<0.05).

CONCLUSIONDeqi of acupuncture is the mild and moderate complicated sensations manifested as distension, soreness, pain and numbness. As the invasive therapy, the filiform needle puncture will bring a certain psychological impacts on the receptors. The subjective sensation is possibly the factor for the patients' selection of acupuncture treatment.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; methods ; Adult ; China ; Female ; Humans ; Male ; Needles ; Qi ; Schools, Medical ; Sensation ; Young Adult

Objective To investigate the methylation status of Foxp3 gene and its roles in immunological pathogenesis of Kawasaki disease(KD). Methods Thirty children with KD and eighteen agematched healthy children consented to participate in this study. Quantitative methylation specific polymerase chain reaction(MSQP) was used to assess the methylation status of Foxp3 promoter and regulatory T cells specific demethylated region(TSDR) in CD4+ T cells. The proportion of CD4+ CD25 + Foxp3 + regulatory T (Tr) cells was analyzed by flow cytometry. Transcriptional levels of CD4+ CD25 + Foxp3 + Tr associating genes (Foxp3, CTLA4, GITR, LAG3 and CCR8 ) and Foxp3-dependent molecules (UBD and LGAIS3)were measured by real-time PCR. Results ( 1 ) Demethylation level of Foxp3 promoter in CD4 + T cells from patients with KD was lower significantly than that of health subjects( P ＜ 0.01 ), and increased significantly after treated with intravenous gamma globulin therapy(IVIG) (P ＜ 0.01 ). No difference of demethylation level of TSDR region was observed among all groups ( P ＞ 0. 05 ). ( 2 ) The proportion of CD4 + CD25 + Foxp3 + Tr in peripheral blood from patients with KD , as well as mRNA levels of Foxp3 gene in CD4+ T cells, was significantly lower than those of health subjects ( P ＜0. 01 ), and increases significantly after IVIG therapy (P ＜0.01 ). Significant positive correlations between demethylation level of Foxp3 promoter and the proportion of CD4 + CD25 + Foxp3 + Tr , or expression levels of Foxp3 in CD4 + T cells, were observed during acute phase of KD (CD4+CD25+ Foxp3+ Tr: r=0.76, P＜0. 01; Foxp3: r=0.89, P＜0. 01). (3)Transcription level of CD4+ CD25+ Foxp3+ Tr associating factors, such as CTLA4, GITR, LAG3 and CCR8, was significantly down-regulated in acute phase of KD(P＜0. 01 ), and up-regulated to some extent after treated with IVIG(P ＜0. 01 ). Expression levels of Foxp3-dependent molecules UBD and LGALS3 in CD4 + T cells decreased significantly during acute phase of KD (P ＜ 0.01 ), and basically recovered to the levels of health subjects( P ＜ 0.01 ). Conclusion Decrease of demethylation level of Fopx3 promoter is correlated with immune dysfunction in Kawasaki disease.

Objective To investigate the value of macrophage activity imaging (MAI) in the diagnosis of brain and spinal cord lesions in rat model of multiple sclerosis(MS). Methods Twenty LEW rats were divided into 15 model rats and 5 control rats. MS animal model, experimental autoimmune encephalomyelitis (EAE) was induced by the injection of peptide 35-55 of myelin oligodendrocyte glycoprotein ( MOG35-55 ). MRI was performed on the third day of the acute stage of disease. The brain and spinal cord of rats were scanned by 3.0 T MR scanner( Siemens Trio Tim) with quadrature wrist joint coil.The T2W and T1 W images, Gadolinium enhanced T1 W images in 3D volume were obtained respectively. The MAI were obtained at 24 hours after intravenous injection of ultra small superparamagnetic iron oxide (USPIO) as contrast medium on T2WI. The workstation with special software was used for the reconstruction images of brain and spinal cord of rat in multiple orientations. Results Fifteen MOG35-55-EAE rats model of MS were successfully induced. The great majority lesions of central nervous system in acute stage were located in the brain( 58/63 ) and less in the spinal cord (5/63). The main manifestation of EAE lesions presented was hyperintensity on T2 WI and hypointensity on T1 WI, and some lesions had enhancement after Gd-DTPA injection. The EAE lesions presented as hypointensity on MAI images, but some of them were found to be isointensity on T2 WI. The enhancement pattern was discrepant between USPIO and Gd-DTPA.The sensitivity of depicting lesions of MOG35-55-EAE rat at acute stage were higher on T2WI ( 14/15 ) and MAI ( 13/15 ), and the detection rate was 100% ( 15/15 ) if they were combined. Gd-DTPA enhanced T1 WI had a lower sensitivity (7/15). All the MAI findings were negative in the control rats. Conclusions MAI can complement the drawback of conventional MRI techniques by continuously monitoring the inflammatory activity of EAE lesions, and it could raise the detection rate of EAE lesions by combining with T2WI. Gd-DTPA enhanced T1 WI monitors the breakdown of the blood brain barrier. MAI and Gd-DTPA enhanced MR imaging are complementary in the diagnosis and monitoring of EAE lesions.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Evidence-Based Medicine ; Humans ; Lung Neoplasms ; complications ; therapy ; Neoplasms ; complications ; drug therapy ; Pain, Intractable ; drug therapy ; Phytotherapy ; Stomach Neoplasms ; complications ; therapy

Adolescent ; Adult ; Audiometry, Pure-Tone ; Ear Protective Devices ; utilization ; Humans ; Middle Aged ; Noise, Occupational ; prevention & control ; Young Adult