BACKGROUND: The efficacy of Cyclosporin A(CyA) in the treatment of psoriasis is well recongized, the dosage less than 5mg/kg per day(mg/kg/d) is recommended. OBJECTIVE: The purpose of this study is to evaluate the indication, dose, course and side-effects of CyA therapy for psoriasis, especially in China. METHODS: Forty patients with psoriasis were treated with doses of CyA 5mg/kg/d, compared with 20 patients treated with Tigason lmg/kg/d by Global PAST. RESULTS: 1. Of 40 patients 33 patients (82.5%)were cured clinically in 4-5weeks and all the patients(100%) had responses to the therapy. 2. The efficacy and the Global PASI reduction of CyA therapy were significantly better than that of Tigason therapy. 3. During the CyA therapy, no severe side-effects and obvious laboratory changes were found. CONCLUSION: CyA(5mg/kg/d) was satisfactory for psoriasis, especially for psoriasis pustulosa, arthropathica and erythroderma. CyA was found to be superior to Tigason. The therapy course and side-effects seemed to be related to the dosage.
China* ; Clinical Study* ; Cyclosporine* ; Dermatitis, Exfoliative ; Etretinate ; Humans ; Psoriasis*

Objective To explore the molecular mechanism of S100A9-induced secretion of vascular endothelial growth factor-A (VEGF-A)by monocytes.Methods Peripheral blood specimen were collected from healthy individuals undergoing physical exami-nation and the CD14 + monocytes were purified by using immunomagnetic beads and the expression of the receptor for advanced gly-cation endproducts (RAGE)was detected by flow cytomertry.In vitro CD14 + monocytes were stimulated by S100A9,and anti-RAGE antibody or NK-κB signal pathway inhibitor were pre-incubated for 1 hour and then stimulated by S100A9,the levels of VEGF-A were detected by using enzyme-linked immunosorbent assay.Results The high level of RAGE was expressed by isolated CD14 + monocytes,after S100A9 stimulation,the secretion of VEGF-A by CD14 + monocytes was significantly increased in a dose and time dependent manner.However,the inducing VEGF-A was significantly decreased(P <0.01 ),while pre-treated with anti-RAGE antibody or NK-κB inhibitor (P <0.01).Conclusion S100A9 inducing the secretion of VEGF-A by monocytes and is de-pended on RAGE-NK-κB signal pathway,suggesting that S100A9 might promote angiogenesis.

Objective To explore the relationship between the fundus vascular changes with the stage and risk stratification of essential hypertension(EH) and the cardiac function.Methods One hundred patients with EH in our hospital from April 2011 to March 2016 were selected and divided into the control group(n=29),Ⅰ-Ⅱ group(n=56) and Ⅲ-Ⅳ group(n=15) according to the Keith-Wagener fundus grading.The stage and risk stratification of EH (mild,moderate,severe),cardiac function indexes[left ventricular end-diastolic inner diameter (LVEDD),left ventricular wall thickness (LVPWT),interventricular septum thickness (LVST),left ventricular mass index (LVMI),carotid intima-media thickness (IMT),left ventricular ejection fraction (LVEF)] were compared among 3 groups.Results The proportions of mild hypertension in the control group,Ⅰ-Ⅱ group and Ⅲ-Ⅳ group were 55.17％,21.43％ and 6.67％ respectively,the proportions of moderate hypertension were 31.03％,30.36％ and 26.67 ％ respectively,which of severe hypertension were 13.79 ％,48.21 ％ and 66.67 ％ respectively,the differences were statistically significant(x2 =5.568,P=0.019).The cardiac indexes of LVEDD,LVPWT,etc.had statistical differences among the control group,Ⅰ-Ⅱ group and Ⅲ-Ⅳ group(P＜0.05).The fundus vascular changes were positively correlated with the stages and risk stratification of EH (r=0.742,P =0.002),while LVMI (r =0.674,P =0.028) and IMT (r =0.598,P =0.014) were negatively correlated with LVEF(r=-0.623,P=0.035).Conclusion The fundus vascular changes have close correlation with the stage and risk stratification of EH and cardiac function,which could be used as an important index for judging the hypertensive severity and target organ damage situation

Diagnosis, Differential ; Endophthalmitis ; diagnosis ; diagnostic imaging ; etiology ; pathology ; Humans ; Infant, Newborn ; Male ; Meningoencephalitis ; complications ; diagnosis ; diagnostic imaging ; pathology ; Suppuration ; Tomography, X-Ray Computed

Eleven type 1 diabetic patients who received fixed regime of insulin Glargine were included in the study.The levels of fasting serum insulin were measured for each subject at 6:00 in three consecutive mornings.The variability of mean fasting serum insulin in each subject was 3.3%-41.5% (mean 15.4%).The variability did not correlate with the dose of Glargine statistically.

Objective To investigate the diagnosis value of mucin 7 in plasma and urine in the detection of bladder cancer.Methods Expression of mucin 7 was detected quantitatively in plasma and urine from 23 patients with bladder cancer and 23 patients as control group by enzyme-linked immunosorbent assay(ELISA) from November 2012 to September 2013.There were 15 were male and 8 were female in the 23 bladder cancer patients,aged from 41 to 95 years,with an average of 64 years.Of the 23 bladder cancer pathology,12 with high grade,11 with low grade,11 with invasive disease and 12 with noninvasive disease.There were 19 males and 4 females in the 23 patients in control group,aged from 28 to 85 years,with an average of 61 years.Results The amount of mucin 7 in plasma was significantly higher in bladder cancer group than that in control group [(7.43±4.54) ng/ml versus (4.55±.1.98) ng/ml,P=0.017].While there was no significant difference in urine between the two groups [(12.44±7.1 1) ng/ml versus (11.96±8.41)ng/ml,P=0.840].There was no significant differences in the amount of mucin 7 had in different grades and stages of bladder cancer (P＞0.05).Conclusions Expression of mucin 7 in plasma of patients with bladder cancer is significantly higher than that in control group.Mucin 7 expression has no significant correlation with the grading and staging of bladder cancer.Detecting mucin 7 expression quantitatively with ELISA for diagnosis of bladder cancer is a method with certain value.

Objective To improve the level of diagnosis and differentiation of renal benign mass with renal cell carcinoma(RCC),so as to lower the misdiagnosis rate.Methods This study included 9 cases of benign renal mass,whose age ranged from 30 to 76 years with a mean of 54 years and included 52 patients with RCC.Three subtypes of RCC were noted,including clear cell in 37 cases,papillary RCC in 10 cases and chromophobe RCC in 5 cases.Plain scan and three phase CT(corticomedullary,nephrographic and excretory phases)were done in all patients.The CT features of RCC and benign mass were compared.Results All the cases were underwent radical nephrectomy as RCC,while they were postoperatively diagnosed as benign renal mass.There were 4 cases of angiomyolipoma (AML)with minimal fat,two cases of oncocytoma,one case of leiomyoma,one case of inflammatory pseudotumor,and one case of cyst with hematoma and organization.Fifty-two cases of RCC showed homogenous or inhomogeous,equal,slightly lower,slightly higher or mixed density on unenhanced scan,inhomogenous obvious enhancement after administration of contrast media.And the most obviously enhanced portion of renal carcinomas were isodense or slightly hyperdense relative to adjacent renal cortex in corticomedullary phase.Conclusion CT is an important radiologic approach to diagnose and differentially diagnose malignant or benign kidney mass.For those patients with benign mass that is not a typical case on radiology,the preoperative needle biopsy or intraoperative frozen section pathological diagnosis is the key to avoid misdiagnose and mistake resection of the kidney,and choose the proper treatment approach to avoid unnecessary kidney radical resection.

Objective To investigate the clinical features of urothelial carcinoma in a single center.Methods The clinical data of 2 115 urothelial carcinoma patients admitted to Peking Union Medical College Hospital from January 2003 to December 2012 were reviewed retrospectively.Of the 2 115 patients,1414 cases were bladder carcinoma,329 cases were ureter carcinoma and 372 cases were renal pelvic carcinoma.Statistical method was used to analyze the differences of distribution and pathological grading and staging of bladder,ureter and renal pelvic carcinoma among different ages,genders,and urban and rural patients.Results The proportion of low-grade carcinoma was 83.5％ for bladder,68.7％ for ureter and 46.5％ for renal pelvic carcinoma,and the proportion of non-muscle invasive carcinoma was 84.9％,74.8％ and 59.7％ respectively,and significant difference was found in pathological grading and staging among the three groups (P =0.000).In bladder and renal pelvic carcinoma patients,males were common,while females were more common in ureter carcinoma patients.There was significant difference in gender among the three groups (P =0.000),while there was no significant difference in pathological grading and staging between male and female patients(P＞0.05).89.7％ (1 898 cases) were concentrated in the 41-80 years old.The grading and staging of urothelial carcinoma in young,middle-aged and elderly groups showed significant difference (P＜ 0.05).The proportions of high-grade and muscle invasive urothelial carcinoma patients in rural areas were both higher than that in urban areas,the difference in pathological grading and staging between urban and rural patients was significant (P＜0.05).Of the 129 cases (6.1％) with multifocal urothelial carcinoma,there were 89 cases (70.0％) with high grade and 62 cases (48.1％) with muscle invasive carcinoma.Significant difference was found in pathological grading and staging between multifocal and single urothelial carcinoma (P=0.000).Conclusions In the uretholial carcinoma of Peking Union Medical College Hospital in the past ten years,the proportion of bladder carcinoma is the highest,while ureter and renal pelvic carcinoma have higher proportion of high grade and stage.The proportion of patients in the 41-80 years old is higher.The pathological grading and staging of urothelial carcinoma is positively correlated with age,but there is no significant correlation in gender.The patients with high grade and stage carcinoma in rural areas are more than that in urban areas.Multifocal urothelial carcinoma has higher malignancy.

OBJECTIVE:To shorten time consuming for dispensing mode of automatic medicine packaging machine(ATC), and improve the efficiency of ATC. METHODS:In the inpatient pharmacy of our hospital,previous dispensing mode that two ATC matched with one tablet case separately was replaced by new mode,i.e. one ATC(another ATC was on standby)matched with two tablet cases(one of them added medicine beforehand),and the information of drug-position coordinate was equipped. The time con-sumed,average daily number of packages,financial expenses and labor costs were recorded and analyzed to evaluated the effect of new mode. RESULTS & CONCLUSIONS:Compared with previous mode,new dispensing mode improve the efficiency of ATC greatly. In previous mode,two ATCs and four pharmacists work simultaneously and spend 4.5 hours for 3 850 bags of medicine, which cost 4 400 000 yuan;in new mode,only one ATC and three pharmacists work simultaneously,and spend 3.0 hours for 4 015 bags of medicine,which cost 2 350 000 yuan. Therefore,double-universal tablet cases greatly improves the efficiency of ATC and reduce the financial expenses as machine maintenance and labor cost.

OBJECTIVE To investigate the postoperative morbility of deep fungal infections and the source and composition of the pathogenic fungi.METHODS Clinical data of 816 patients with post-operative deep fungal infections from Jul 2006 to Jun 2008 were reviewed and analyzed retrospectively.RESULTS The detectable rate of post-operative deep fungal infections was 24.82%,among which Candida albicans was the most common(65.69%),followed by C.tropicalis(10.57%);the rate of broad-spectrum antibiotic application in peri-operation was 96.45%;the infection site in the descending order was cardio-thorax,gastrointestinal tract,urinary tract,female reproductive system,blood and skeleton.CONCLUSIONS Operative trauma is an important factor that causes deep fungal infections in hospital,and is closely related to broad-spectrum antibiotic application.Positive prevention,timely diagnosis and effective treatment should be highly emphasized when dealing with post-operative deep fungal infections.