Objective To analyze the clinical characteristics, laboratory results, treatment and prognosis of adult onset Still's disease (AOSD). Methods The clinical and laboratory data of 107 AOSD patients were retrospectively analyzed. SPSS 22.0 was used for statistical analysis. Categorical data were described as frequency and percentage, and numerical data were described using x±s deviation. Chi-square test was used to compare categorical data between groups and analysis of variance test was used to compare numerical data between groups. K-W test was used to compare skewed distributed data between groups and J-T test was compared in pairwise comparison. Logistic regression was applied to examine prognostic factors. Results The average age of 107 patients (12 male and 95 female) was(39±16) years and the average disease course was (1.4±2.7) years. The patients were classified into 3 types based on their disease course: monocyclic (38 cases, 35.5%), polycyclic (29 cases, 27.1%) and chronic arthritis (40 cases, 37.4%). The clinical characteristics were high fever (107 cases , 100%), rash (97 cases, 90.7%) and arthralgia/arthritis (86 cases, 80.4%). The most common involved joints were knee (24 cases, 23.3%), wrist (19 cases, 18.4%) and proximal interphalangeal joints (14, 13.7%). The laboratory results were elevated including white blood cells count (88/105, 83.8%) and elevated serum ferritin (107, 100%). Seventy-three out of 84 patients (86.9%) had negative rheumatic factor and 9 out of 91 (9.9%) had positive ANA, which were low titre in general. Eleven patients (10.3%) had joint erosions suggested by X-ray at diagnosis. Intergroup analysis revealed that patients with polycyclic type were less likely to have abnormal liver function tests at disease onset (χ2=9, P<0.05). Twenty-five patients (23.8%) in total had complications, which were mainly pulmonary interstitial fibrosis (9 cases ) and hemophagocytic syndrome (7 cases). Male patients (n=6, χ2=5.93, P=0.015) were more likely to have complications. One hundred and two (95.3%) patients were treated with glucocorticoid and among them, 86 (84.3%) were combined with immunosuppressive agents. After 4 weeks of treatment, 89 patients (89.2%) achieved complete remission. The number of patients with glucocorticoid dependence or treatment failure was less in monocyclic group, although the differences were not significant. The analysis of prognostic factors founded that patients with Tmax>39.5 ℃ (P=0.030) were mostly fell into the monocyclic group. Compared with monocyclic type, patients with polycyclic or chronic arthritis type were less likely to have thrombocytosis (P=0.019, P=0.004). However, when compared with chronic arthritis type, patients with monocyclic or poly - cyclic type were less likely to have arthralgia/arthritis (P=0.030, P=0.000), especially the involvement of large joints (P<0.05). Conclusion AOSD mainly presents as high fever, rash, arthralgia and elevated inflammatory markers. Joint erosion may occur during the course of disease. The treatment of glucocorticoid and immunosup - pressive agent combinations is effective and most patients could achieve remission during 4 weeks of treatment. Patients with thrombocytosis at disease onset might be monocyclic type, while patients with arthritis, especially involvement of large joints at disease onset might be chronic arthritis type.

Objective To explore the changes of CRP,IL-6,and IL-10 levels after laparoscopic or open repair of inguinal hernia in children.Methods Fifty children with inguinal hernia were randomly assigned to laparoscopic repair or open surgery groups(25 in each).In the laparoscopic group(LS group),the hernia sac was closed by ligating the inner ring,while in the open surgery group(OS group),high ligation was performed.The peripheral blood samples of the two groups were collected one day before,immediately after,and one day after the operations.ELISA was used to detect the levels of CRP,IL-6,and IL-10.Results In both the groups,the levels of CRP,IL-6,and IL-10 were significantly increased immediately after the surgeries(LS Group:q=8.508,11.307,and 22.111,P0.05),while in the OS group,the levels remained significantly higher(q=3.845,10.599,and 11.379,P

Objective To investigate the changes of plasmacytoid dendritic cells (pDC) in peripheral blood of patients with systemic lupus erythematosus(SLE) and its roles in the pathogenesis of SLE.Methods The level of pDC and the expressions of CD32,CD40,CD86,CD62L and CXCR4 were analyzed by flow cytometry.The concentrations of IFN-α in serum were detected by ELISA assay.Results The levels of circulating pDC were significantly decreased in SLE patients compared with healthy controls.Moreover,the pDC levels in active SLE patients were lower than those in inactive SLE patients,and compared with the primary group,the pDC levels were increased in the treatment group.The levels of pDC showed a significant decrease in SLE patients with arthritis,proteinuria or leucopenia in comparison with patients without those manifestations,showing a negative correlation with proteinuria.The expressions of cell surface molecules including CD32,CD86,CD62L and CXCR4 on pDCs were significantly increased in SLE patients compared with healthy controls,and the levels of pDC were negatively correlated with the expressions of CD32 and CXCR4 in patients with SLE.The concentrations of IFN-α in serum of patients with SLE were significantly higher than those in healthy controls,and the levels of pDC were positively correlated with the concentrations of IFN-α in patients with SLE.Conclusion The level of circulating pDC in patients with SLE was remarkably reduced,but the expressions of molecules involved in cell activation and migration were upregulated,accompanied by enhanced IFN-α production,which might promote the onset and progression of SLE.

Aged ; Aged, 80 and over ; Cross Infection ; etiology ; Diabetes Mellitus, Type 2 ; complications ; microbiology ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; complications ; microbiology ; Retrospective Studies

Adult ; Cholesteatoma, Middle Ear ; Humans ; Male

In order to culture the qualified clinicians, we should think about how to improve the quality of clinical practice of obstetrics and gynecology. It is of great importance to emphasize the teachers and students to value the teaching work together. Importance should be attached to the advantage of subject of academy, to make the clinical practice closer to practical, which has a perfect effect and will benefit our work.

Objective To explore the teaching effect ofOrgan-system-based curriculum in-tegrated model on clinical graduation field work. Method 150 clinical medical undergraduates of Grade 2009 from Shenyang Medical College selected, were randomly divided into the experimental group (75 persons) and the control group (75 persons). The experimental group adopted the means of the Organ-system-based curriculum integrated model, namely practicing according to human organ-system and the control group accepted the traditional pattern of discipline centered practice during the clinical graduation internship. The two groups of students carried out questionnaire survey and comprehend examinations when the practice ended, and then statistics analysis (the chi square test, t test) was done by the SPSS 19.0 software between the two groups in order to explore the teaching effect. Result The students' satisfaction degree from six aspects of the questionnaire survey showed in the experimental group was significantly higher than that in the control group (the degree of recognition of practicing pattern: χ2=11.437, P=0.003; the architectonic integrality: χ2=9.881, P=0.007; the im-provement of the autonomic learning ability χ2=9.643, P=0.008; the teaching method and means: χ2=11.006, P=0.004; motivating learning interest: χ2=13.550, P=0.001; increasing the ability of clinical thinking: χ2=13.309, P=0.001), and the average test scores of students from three parts of examination results showed by comprehend examinations (speculative knowledge examination: t=2.768, P=0.006;technical skill examination: t=2.212, P=0.029; clinical capability examination: t=5.015, P=0.000) in the experimental group was obviously higher than that in the control group and the difference was sig-nificant. Conclusion Organ-system-based curriculum integrated model on clinical graduation in-ternship is generally approved by the students, which has significantly improved the students' clinical thinking ability, and the quality of graduation internship teaching.

Objective To study the protective effect of normothermic ex vivo perfusion to prevent donor-lung injury.Method After being flushed with perfadex solution through the pulmonary artery and vein,the donor lungs were divided to control group (preserved with 4℃ cold static preservation,n =8) and experimental group (preserved with ex vivo oxygenated blood continuous perfusion,n =8).Pulmonary function indexes,including pulmonary vascular resistance (PVR),lung ventilation resistance(LVR),the left inferior pulmonary vein(LIPV) blood PO2,and lung water content,were evaluated.Lung injury were studied by light microscopic observation and detecting the expression of proimflammatory factor IL-1β was detected.Result (1) Lung function evaluation:in both group,PVR,LVR and lung water content gradually increased,LIPV PO2 gradually declined;But in the same time point PVR and LVR in group were were significantly less than in control group (P＜0.05),LIPV PO2 in experimental group were were significantly more than in control group(P＜0.05).(2)Lung injury evaluation:Lung tissue edema classification in both group were significantly higher than in normal lung(P＜0.05),but classification in experimental group were significantly lower than in control group(P＜0.05).The expression of IL-1β in experimental group (0.422 ± 0.132) were significantly lower than in control group(0.578 ± 0.163,P＜0.05).Conclusion Ex vivo oxygenated blood continuous perfusion without ventilator is a feasible technique for lung preservation.It ameliorates hypothermic time-dependent ischemic injury.But further systems evaluation in complete physiologic condition is necessary.

Four hours after the spinal cord of rats was injured,the contents of malondi-aldehyde(MDA)and free fatty acid(FFA)were significantly increased,the activity of xan-thine oxidase(XOD)elevated,the activity of superoxide dismutase(SOD)reduced,and the calcium content significantly increased in the tissues of the injured cord.These facts suggest that there is the generation of calcium-mediated free radicals and lipid peroxidation in the membrane.Intravenous injection of saponins of Panax notoginseng(PNS)in the dosage of 30,90,and 270mg/kg could all inhibit the production of MDA; 270mg/kg could inhibit the release of FFA and the activity of XOD;90mg/kg could significantly decrease the calcium content.These findings indicate that the inhibition of PNS on the calcium influx might be one of the mechanisms of anti-lipid peroxidation in spinal cord injury in rats.

Objective:To investigate the LOH at regions on chromosomal arm 8p22,11p15,17p13 and its relationship with clinicopathological parameters. Methods:Thirty-four paraffin-embedded tumor and corresponding noncancerous tissues were analysed. PCR was used to amplified three microsatellite markers D8S136,D11S988 and TP53 located at these chromosomal regions. PCR products were electrophoresed on 6%polyacrylamide gel and detected using silver staining. The P53, c-erBb-2,PR,ER status were determined by immunohistochemistry. Results:Of the three markers we studied, D8S136 was detected LOH at a frequency of 12 in 34 tumors(35.29%). D11S988 and TP53 were detected LOH at a frequency of 5 in 34 tumors(14.71%). There were no obvious associations between LOH at D11S988、TP53 and clinicopathological parameters, but the tumors with LOH at D8S136 were significant larger than that without LOH(P=0.0049). Conclusion: Invasive ductal carcinoma of the breast has a frequent LOH on chromosome 8p22. The loss or inactivation of putative tumor suppressor genes on 8p22 may contribute to the excessive growth of the tumors.