Adult ; Aged ; Aged, 80 and over ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; genetics ; metabolism ; pathology ; Polycomb Repressive Complex 1 ; genetics ; metabolism ; Prognosis ; RNA, Messenger ; genetics

Objective To summarize and evaluate the clinical feature and misdiagnosis of pulmonary granulomatosis with polyangitis (GPA).Methods The clinical data of 47 patients of pulmonary GPA were analyzed retrospectively.The clinical feature and misdiagnosis were summarized.Results These patients were most commonly misdiagnosed as pulmonary infectious disease (61.8％,34/55) and pulmonary malignancy (27.3％,15/55) was the next in line.70.2％(33/47) patients had nose and sinus involvement,40.4％(19/47) patients had kidney involvement,25.5％ (12/47) patients had rash,19.1％(9/47) patients had eyes involvement,6.4％ (3/47) patients had peripheral neuritis,6.4％ (3/47) patients had gastrointestinal bleeding,4.3％(2/47) patients had pericardial effusion,87.2％(41/47) patients had positive for antineutrophil cytoplasmic(cANCA),76.6％(36/47) patients had positive for proteinase-3.Conclusions Almost all pulmonary GPA patients have extra-pulmonary multi-systemic involvement.They are often misdiagnosed as pulmonary infectious diseases and malignancy.Educating doctors on GPA constantly and screening possible patients with cANCA testing may help reduce the misdiagnosis.

Objective To investigate the effect of perfusion and preservation with intragraft dipeptidyl peptidase Ⅳ (DPP Ⅳ) catalytic inhibitor on pulmonary function after lung transplantation in rats. Methods Pure SD rats were divided into six groups. Syngeneic rats (SD to SD) served as donors and recipients. Orthotopic lung transplantation model was used. Grafts of control groups (CONI and CON2) were flushed and preserved in LPD-glucoae exposed to 18 h of cold ischemia before transplantation. Peak airway pressure (PIP), blood gas (PO2), wet/dry weight ratio (W/D), the activity of myeloperoxidase (MPO) and the content of malonyldialdehyde (MDA) of CON1 group were analyzed at first day after transplantation. In CON2 group, the 7-day survival rate post-transplantation was observed. Experimental groups were divided into four sub-groups (EXP1-EXP4), and grafts were perfused and stored for 18 h with LPD-glueose plus DPPⅣ catalytic inhibitor. The pulmonary function was detected at 1st (EXP1), 3rd (EXP2), 5th (EXP3), and 7th day (EXP4) posttransplantation, respectively. Results The rats in CON2 were died at 7th day post-transplantation,and all rats in EXP4 group survived to the 7th day post-transplantation. As compared with CON1 group, PIP, W/D, MPO activity and MDA content were reduced (P<0. 01 or 0. 05), and PO2 increased (P<0. 05) in EXP4 group. The pulmonary function of DPPⅣ catalytic inhibitor-perfused grafts from 1 to 7 days was improved and all tested parameters were close to normal at 7th day.Conclusion Perfusion and preservation with an inhibitor of CD26/DPP Ⅳ enzymatic activity obviously reduced severity of ischemia-reperfusion injury and was beneficial to the rehabilitation of grafts'pulmonary function.

Objective To investigate the injury characteristics and prognostic risk factors of patients with craniocerebral injury so as to provide some suggestions for the improvement of medical prevention,intervention and treatment measures.Methods Trauma database system was applied to collect the medical records of 661 patients with traumatic brain injury admitted to the Department of Neurosurgery of 105th Hospital of Hefei in 2009.Their general conditions,injury characteristics and outcomes were analyzed and the risk factors affecting their outcomes were investigated by Logistic regression analysis.Results Of the patients with craniocerebral injury,the males accounted for 70％ (463/661).The patients at 45 years old or so had the highest incidence of craniocerebral injury.Patient number in the second half of one year was 1.65 times more than that in the first half of one year (412/249 ).Most patients were injured from traffic accidents (87.7％,580/661 ) and 512 patients (77.5％) suffered from multiple injuries.ISS,injury causes,age and injury incidence quarters showed close correlation with the final outcome.Conclusions The patients with craniocerebral injury demonstrates distinctive characteristics in aspects of gender,age,incidence time,injury causes,and multiple injuries,but the ultimate outcomes are related to the injury severity,injury causes,age and other factors.

Objective To investigate the distribution and drug resistance of bacterial pathogens isolated from orthopedic wounds.Methods Data of bacterial strains isolated trom orthopedic wounds in the Third Hospital of Hebei Medical University from January 2008 to December 2012 were retrospectively analyzed.Strains were identified by using French bioMérieux Vitek32 identification system,and the drug susceptibility was tested by Kirby-Bauer method.Chi-square test for linear trend was performed to reveal the changes of distribution and drug resistance of the strains.Results A total of 2 456 bacterial strains were isolated,vith 1 652 (67.26％) gram-negative bacilli,777 (31.64％) gram-positive cocci,26 (1.06％) fungi,and 1 (0.04％) gram-positive bacillus.The top five pathogens were Staphylococcus aureus (666 strains,27.12％),Pseudomonas aeruginosa (606 strains,24.67％),Acinetobacter baumannii (355 strains,14.45％),Escherichia coli(188 strains,7.65％) and Enterobacter cloacae (187 strains,7.61％).The positive rate of Acinetobacter baumannii was on the rise during 2008 and 2012 (x2 =35.266,P ＜ 0.0l).The rates of pan-drug resistant strains in Acinetobacter baumannii and Pseudomonas aeruginosa were 6.20％ (22/355) and 0.17％ (1/606),respectively.The rates of extended-spectrum β-lactamases positive strains in Escherichia coli and Klebsiella pneumoniae were 39.89％ (75/188) and 29.23％ (19/65),respectively.The rates of methicillin-resistant strains in Staphylococcus aureus and coagulasenegative Staphylococcus were 40.69％ (271/666) and 52.38％ (22/42),respectively.The rate of vancomycin-intermediate strains in Enterococci was 3.70％ (2/54).The positive rate of methicillin-resistant &aphylococcus aureus was on the rise during 2008 and 2012 (x2 =18.317,P ＜ 0.01).Staphylococcus aureus were sensitive to teicoplanin,vancomycin and linezolid; Resistance rates to rifampicin and amikacin were 11.29％-33.33％; Resistance rates to penicillins and erythromycin were 76.80％-100.00％; Resistance rates to cefazolin,cefuroxime,cefoxitin,amikacin and levofloxacin were on the rise (P ＜ 0.05) ; And resistance rates to sulfamethoxazole (28.11％-48.35％) were on the decline in the same period (P ＜ 0.01).Resistance rates of Pseudomonas aeruginosa to imipenem,meropenem and sulfamethoxazole were on the rise (P ＜ 0.05) ; Resistance rates to ciprofloxacin,levofloxacin,amikacin,gentamicin and piperacillin/ tazobactam were on the decline (P ＜ 0.05) ; Resistance rates to cefoperazone/sulbactam were the lowest (9.15％-20.51％).Resistance rates of Acinetobacter baumannii to imipenem,meropenem,levofloxacin,piperacillin/tazobactam,sulfamethoxazole were on the rise (P ＜ 0.01); Resistance rates to cefoperazone/ sulbactam were the lowest (11.86％-19.70％).Escherichia coli and Enterobacter cloacae were sensitive to imipenem and meropenem,and the resistance rates to cefoperazone/sulbactam and piperacillin/tazobactam were low (0-14.29％); Resistance rates of Escherichia coli to piperacillin,cefepime,amikacin,levofloxacin,cefoperazone/sulbactam were on the decline (P ＜ 0.05) ; Resistance rates of Enterobacter cloacae to cefoxitin were on the rise (P ＜ 0.01),while the resistance rates to piperacillin,ceftazidime,cefoperazone,ceftriaxone,levofloxacin were on the decline (P ＜ 0.05).Conclusion During 2008 and 2012,the predominant bacterial pathogens of orthopedic wound in patients of the Third Hospital of Hebei Medical University are Staphylococcus aureus,Pseudomonas aeruginosa,Acinetobacter baumannii,Escherichia coli and Enterobacter cloacae,and most strains are multiple drug resistant.

The stability of the intraocular lens ( IOL ) after cataract surgery is composed of decentration, tilt, rotation, and the change of anterior chamber depth. Its stability is an important factor affecting postoperative visual quality. By analyzing the related factors which influence the stability of intraocular lens, improvements can be identified for future cataract operations. The stability of intraocular lens is influenced by many factors: intraocular structure, the size and the symmetry of intraoperative capsulorhexis, the position of the intraocular lens, the material and design of the intraocular lens, etc. In order to improve the patient's vision, cataract surgeries have been experiencing an evolution. IOL material have also been contributing to such innovations.

Objective To study the effect of thalidomide and arsenic trioxide on the proliferation and apoptosis effect in human myelodysplastic syndrome cell line MUTZ-1 and explore its possible mechanism.Methods MUTZ-1 cells were cultured with different concentration of thalidomide alone, arsenic trioxide alone, and thalidomide plus arsenic trioxide for 48 h. The cell proliferation was analyzed by CCK-8 test, and cell apoptosis was analyzed by flow cytometry. The expression of Bmi-1 was analyzed by semi-quantitative RT-PCR. Results Thalidomide alone had no significant inhibition on growth of MUTZ-1 cells (P >0.05).Arsenic trioxide alone had obviously inhibited the cell proliferation (P <0.05). While thalidomide plus arsenic trioxide group had the great inhibition effect(CDI <0.7), and reveal was that two drugs had synergism effect on inhibiting the MUTZ-1 cells. Arsenic trioxide group of apoptosis rate was increased with higher concentrations of drug, a dose-dependent (r = 0.627, P <0.05), thalidomide in the rate of apoptosis with no increase in drug concentration significantly (r= 0.313, P> 0.05), and the combined group with the drug also increased the concentration of expression (P <0.05). In arsenic trioxide group the expression of Bmi-1 / β-actin declined with the increased concentration, a dose-dependent (r =-0.912, P<0.05), thalidomide group Bmi-1 / β-actin with the increased concentration of no significant decline (r =-0.594, P >0.05), the combined group Bmi-1 inhibition was significantly higher than arsenic trioxide, thalidomide in a separate drug group (CDI <0.7).Conclusion Thalidomide group had no significant growth inhibition. Arsenic trioxide on MUTZ-1 cells significantly inhibited the growth and increased in the combined group significantly.

Objective To evaluate the efficacy and side effects of standard-dose of dexamethasone and low-dose dexamethasone combined with thalidomide in treatment of multiple myeloma. Methods Thirtynine patients with multiple myeloma were randomly divided into 2 groups, who were treated with chemotherapy of thalidomide (200 mg/d) plus dexamethasone (40 mg d1-46728 days in standard-dose group and 20 mg dl-4d/28 days in low-dose group), for a total of 4 courses. The efficacy, survival time and adverse events were compared between the two groups. Results Complete remission rate, partial remission rate and overall response rate of the standard-dose group were 26.3 %, 35 % and 75 %, respectively; and those of the low-dose group were 15.8% , 36.8 % and 68.4 %, respectively. No statistical difference between the two groups (P >0.05 ) was observed. Lung infections, blood pressure elevation, blood glucose elevation, shingles and other adverse reactions in the standard-dose group were statistically higher than those in the low-dose group (P <0.05). Conclusion Efficacy on multiple myeloma of standard-dose and low-dose dexamethasone are similar, but adverse reactions are significantly increased.

Objective To assess the efficacy and tolerability of continuous low-dose cyclophosphamide and prednisone regimen(CP)as salvage therapy for multiple myeloma patients with severe complications.Methods The CP regimen consisted of oral cyclophosphamide at 50 mg and oral prednisone at 15 mg daily.The patients were withdrawn if the response was invalid or not improved after 6 months,and follow-up was carried on if CR maintained for 6 weeks.A total of 23 consecutive patients received the CP regimen,with 18 patients having severe complications,and 5 patients unwilling to accept conventional chemotherapy because of severe infection.All patients had received one to four regimens before.Results Among 23 patients with CP regimen,the overall response rate(CR+VGPR+PR)was 61%,with 1 CR,4 VGPR,9 PR,3 MR and 6 PD.The quality of life and physical conditions were improved significandy.Conclusion Our data showed that CP was an effective,well-tolerated,and convenient regimen as salvage therapy for MM with severe complications.

Objective To observe the quantitative relation between new subarachnoid hemorrhage (SAH) grading and scores of Garcia neurological scale in mouse models of SAH.Methods Mouse models of SAH were induced by filament perforation; neurological scale was performed 24 h after SAH; and then,these mouse models were sacrificed and performed SAH grading;the relation between scores of neurological scale and SAH grading was analyzed by SPSS 13.0 software.Results Fourteen of 21 mice survived after SAH. The higher the SAH grading, the worsen the neurological scale results; these 2 were negatively correlated (r=-0.841,P=0.000). Conclusion The scores of Garcia neurological scale and SAH grading has a quantitative negative relation and can be used to evaluate the hemorrhage in mouse models induced by filament perforation.