Objective To study clinical features of liver damage in primary Sj(o)gren syndrome (pSS) and its related factors.Methods One hundred and forty-nine patients of confirmed pSS hospitalized at Peking University People's Hospital were analyzed retrospectively.Results Seventeen of 149 patients of pSS (11.4%) showed liver damage,10 diagnosed as autoimmune hepatitis and seven as primary biliary liver cirrhosis.Increased serum levels of IgG,IgM and γ-globulin accounted for 88.2% and 50.8%,35.3% and 5.3%,and 94.1% and 47.7% of those complicated with and without liver damage,respectively,with statistically significant difference (P ＜ 0.05).Positive serum anti-mitochondria antibody subtype M2 (AMA-M2) was 35.3% in pSS patients with liver damage,significantly higher than that in those without liver damage (1.5%) (P ＜ 0.05).Independent risk factors significantly associated with liver damage included age (OR = 1.013,95% CI 0.971-1.058),course of illness (OR = 1.089,95% CI 1.032-1.150),serum level of γ-globulin (OR = 4.021,95% CI 1.246-12.982),positive AMA-M2 (OR = 11.82,95% CI 0.005-0.157),and positive anti-SSA (OR = 101.333,95% CI 12.653-811.560).Conclusions Liver damage occurred rather high in pSS patients and increased serum levels of IgG,IgM,γ-globulin and anti-SSA can be used to predict their complication with liver damage.Age,course of illness,serum level of γ-globulin,positive AMA-M2 and positive anti-SSA are all significantly associated with liver damage in pSS patients.

A bacterium that contains a chitin deacetylase has been isolated from ocean soil. It has been identified Baciluus .The best suitable condition of producing this enzyme is that pH is 4.0,35℃,and the incubate time is 80 hours in the present of Ca 2+ as well as having no chitosan. The best temperature of this enzyme when it acts is 40℃～50℃ and the best pH range is 4.5～5.0.

Objective To explore the clinical values of applying contact-mode argon plasma coagulation (APC) for retroflex colonoscopic treatment of ultra-lower rectal polyps. Methods 46 wide outsole and applanate polyps smaller than 1.0 cm located at ultra-lower rectum in 17 cases of patients were treated by contact-mode APC under U-type retroflex colonoscopy after failure in regular colonoscopic treatment. Then observe the contacting rate of APC probe with polyps, success rate of curing polyps, rate of probe being adhered and blocked by the solidification structures, incidence of submucosal emphysemas, and incidence of colonoscope ambustion. Results Under U-type retroflex colonoscopy, the probe could contact with polyps in 17 patients. The polyps in every patient were cured by APC in the first time of colonoscopic treatment, whereas all 46 polyps were cured by 97 times of APC spurt. Mild adhesions occurred between the probe and solidification structures at 5 times (5.15 %) among 97 times of APC spurt, without injuries to the coagulation surface from which when the probe separated. The solidification structures blocked the probe only twice (2.06 %). When the solidification structures were cleared, efficiency of the probe restored. No sub-mucosal emphysemas and colonoscope ambustion happened. Conclusion Applying contact-mode APC for retroflex colonoscopic treatment of ultra-lower rectal polyps is safe and effective, it can prevent the damage of colonoscope from the argon knife.

Objective To explore an algorithm to define the threshold value for tumor contouring on 18F-fluorodexyglucose (FDG) PET imaging. Methods A National Electrical Manufacturing Association (NEMA)NU 2 1994 PET phantom with 5 spheres of different diameters were filled with 18F-FDG. Seven different sphere-to-background ratios were obtained and the phantom was scanned by Discovery LS 4. For each sphere-to-background ratio, the maximum standardized uptake value ( SUVmax ) of each sphere, the SUV of the border of each sphere ( SUVborder ), the mean SUV of a 1 cm region of background (SUVbg) and the diameter (D) of each sphere were measured. SPSS 13.0 software was used for curve fitting and regression analysis to obtain the threshold algorithm. The calculated thresholds were applied to delineate 29 pathologically confirmed lung cancer lesions on PET images and the obtained volumes were compared with the volumes contoured on CT images in lung window. Results The algorithm for defining contour threshold is TH% = 33.1% + 46.8% SUVbg/SUVmax + 13.9%/D ( r = 0.994) by phantom studies. For 29 lung cancer lesions, the average gross tumor volumes ( GTV ) delineated on PET and CT are ( 7.36 ± 1.62 ) ml and (8.31 ±2.05) ml, respectively (t = -1.26, P＞0.05). Conclusion The proposed threshold algorithm for tumor contouring on PET image could provide comparable GTV with CT.

Objective: By observing the differences in Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and visual analog scale (VAS) scores in moxibustion treatment for moderate-to-severe primary knee osteoarthritis (KOA) with moxa of different storage years (3-year moxa and 1-year moxa from Qichun, Huanggang City, Hubei Province, China) through a randomized clinical trial, to objectively evaluate the differences in therapeutic efficacy of moxibustion with moxa of different storage years. Methods: A total of 63 patients with moderate-to-severe KOA who met the inclusion criteria were randomized into moxibustion group 1 and moxibustion group 2 by central randomization method, with 32 cases in moxibustion group 1 and 31 cases in moxibustion group 2. Moxibustion group 1 was treated with moxa stored for 3 years, and moxibustion group 2 was treated with moxa stored for 1 year. Dubi (ST 35), Neixiyan (EX-LE 4) and Heding (EX-LE 2) were selected in both groups, and the treatment lasted 20 min per time, 3 times a week. The immediate efficacy was compared after 6 times of treatment, and long-term efficacy was compared at follow-up 4 weeks after the end of treatment. Results: During the treatment, there were 2 dropouts in moxibustion group 1, and 1 dropout in moxibustion group 2. The total effective rate in the two groups was 83.3％ and 60.0％, respectively. Followed up at 4 weeks after the end of treatment, the total effective rate in the two groups was 80.0％ and 66.7％, respectively. There were no statistical differences between the two groups (both P>0.05). After treatment and 4 weeks after the end of treatment, the WOMAC and VAS scores in both groups decreased significantly compared with those before treatment (all P<0.01); the scores of stiffness item of WOMAC in moxibustion group 1 were lower than those in moxibustion group 2 (both P<0.05); there were no statistical differences in the scores of pain item and dysfunction item of WOMAC, and VAS scores between the two groups (all P>0.05). Conclusion: Moxibustion with moxa of different storage years (stored for 3 years and 1 year) both can improve the pain, stiffness and motor function in patients with moderate-to-severe KOA. While moxa stored for 3 years has a better therapeutic efficacy in improving stiffness of the knee joint than that stored for 1 year.

To compare the clinical features and prognosis in patients with cytomegalovirus pneumonia from other pneumonia after allogeneic hematopoietic stem cell transplantation (allo-HSCT). A total of 118 patients with pulmonary complications after allo-HSCT from March 2016 to June 2019 were analyzed retrospectively, who were divided into cytomegalovirus (CMV) pneumonia group ( n=34) and the non-CMV pneumonia group ( n=84). Compared with non-CMV pneumonia group, CMV pneumonia group presented earlier median onset time (1.8 vs.6.0 months, P=0.015) after allo-HSCT, more dyspnea (41.2% vs. 19.0%, P=0.012), hypoxemia (38.2% vs. 13.1%, P=0.006), and interstitial pneumonia (82.4% vs. 23.8%, P<0.01).The incidence of CMV-viremia and serum viral load in CMV pneumonia group were significantly higher than those in non-CMV pneumonia group. Consistently, and the development of mixed infection in CMV pneumonia group was higher than that of non-CMV pneumonia group (41.2% vs. 16.7%, P=0.013). The median follow-up time was 12.8 (0.4-46.5) months. The 1-year attributable mortality in CMV pneumonia group was significantly higher than that in non-CMV pneumonia group (26.5% vs. 10.7%, P=0.004), while the 1-year overall survival rate was significantly lower than that in non-CMV pneumonia group (61.8% vs. 85.7%, P=0.001). Reduced-intensity conditioning (RIC)( P=0.036), high flow ventilation ( P=0.033) and negative CMV-viremia ( P=0.009) were unfavorable prognostic factors of patients with CMV pneumonia. Compared with those with non-CMV pneumonia, patients with CMV pneumonia had more characteristic clinical manifestations and imaging features. However, due to the higher incidence of mixed infections, the causes of pneumonia need to be identified by bronchoscopic alveolar lavage. In conclusion, patients with CMV pneumonia have worse clinical outcome. RIC, high flow ventilation and negative CMV-viremia are adverse prognostic factors for CMV pneumonia.

Pulmonary arterial hypertension (PAH), also named as a cancer of cardiovascular disease, is a rare disease and has complicated pathogenesis. Recently, there are more understandings of PAH pathogeneses. According to the pathogenesis and active pathways, the clinically used drugs are classified into several groups incluidng prostacyclin analogues and prostacyclin receptor agonists, endothelin receptor antagonists, phosphodiesterase-5 inhibitors, soluble guanylate cyclase inhibitors, etc. To elevate the efficacy of the drugs, numerous drug delivery systems are developed. This review mainly summarized the pathological mechanism of PAH, drugs and drug delivery approaches in the treatment of PAH.

Objective To observe the protective effect of progesterone on brain edema in newborn rats with hypoxic-ischemic encephalopathy(HIE).Methods Fifty-two 7-day-old neonatal rats were randomly divided into 5 groups:normol control group(group A),hypoxic-ischemic group (group B) and pretreatment groups(group C,D and E).Rats were subjected to left common carotid artery ligation,then were exposed to 8% oxygen and 92% nitrogen for 2.5 hours to establish HIE model.Progesterone was injected intraperitoneally into the groups C,D and E rats respectively at 30 minutes before hypoxia.All rats were killed at the 24 hours after operations,then the contents of water,sodium,potassium were mensurated. Results The contentation of water in group B was higher than that in group A,the contentation of water,sodium in groups C,D and E were significantly lower compared with group B, but the contents potassium were no difference between group C,E and B. Conclusion Progesterone exerts a prominent preventive and protetive effects on the hypoxic ischemic brain edema in newborn rats.

Objective To evaluate dynamic contrast-enhanced MRI (DCE-MRI) with Patlak model for depicting the perfusion and permeability characteristics of lesions and normal-appearing white matter (NAWM) regions in patients with relapsing-remitting multiple sclerosis (RRMS). Methods Twenty-three patients with clinical confirmed RRMS were retrospectively analyzed, who had underwent conventional MRI and DCE-MRI using a 3.0 T MR scanner . The clinical characteristics and imaging data were collected. Post-processing was performed using the Patlak model. Volume transfer constant (Ktrans), fractional plasma volume (Vp) and perfusion parameters including cerebral blood flow (CBF) and cerebral blood volume (CBV) were represented as median and interquartile range(IQR). The four parameters of non-enhanced(NE) lesions, NAWM regions located close to NE lesions(NAWM close) and NAWM regions located far from NE lesions (NAWM far) were compared using the Kruskal-Wallis H rank sum test. Artificial color mappings were also proceeded. Results MR imaging biomarkers Ktrans was 0.132(0.064, 0.233) min-1 for NE lesions, 0.111 (0.060, 0.233) min-1 for NAWM close and 0.077(0.044, 0.185) min-1 for NAWM far, respectively. CBV was 10.660(5.555, 22.193) ml · 100 g-1 for NE lesions, 9.359(4.883, 16.290) ml · 100 g-1 for NAWM close, 6.814 (4.699, 13.623) ml·100 g-1 for NAWM far, respectively. Ktrans and CBV of NE lesions was significantly higher than that of NAWM far(χ2=7.582,P<0.05;χ2=6.394,P<0.05, respectively). Ktrans and CBV of NAWM close showed no significant differences compared with NE lesions and NAWM far. Vp and CBF had no significant differences between NE lesions, NAWM close and NAWM far regions(P>0.05). Conclusion DCE-MRI with Patlak model can measure perfusion and permeability characteristics and hemodynamic abnormalities of NE lesions and NAWM regions in patients with multiple sclerosis.

PurposeMultiple sclerosis (MS) is characterized by time and spatial multiple, and it is the main reason for disabled young people. This paper aims to investigate the application of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with dual-compartment Tofts model in relapsing-remitting multiple sclerosis (RRMS) and its correlation with clinical scoring.Materials and MethodsThe clinical data of 25 patients with RRMS were retrospectively studied. The patients underwent the conventional MRI and the DCE-MRI examination. The result was processed by dual-compartment Tofts model and quantitative measurement was carried out in terms of volume transfer constant (Ktrans), rate constant between EES and blood plasma (Kep) and the volume of EES per unit volume of tissue (Ve), cerebral blood flow (CBF) and cerebral blood volume (CBV) of the lesions and normal-appearing white matter (NAWM) regions. The correlation between imaging biomarkers, expanded disability states scale (EDSS) and disease duration were also analyzed.Results ① The differences of MR imaging biomarkers Ktrans and Kep were significant between the regions of nonenhancing (NE) lesions, the NAWM regions near NE lesions and the NAWM regions far from NE lesions (χ2=6.777 and 22.343,P<0.05); however, Ve in the NE lesions had no significant differences compared with that in the NAWM regions near and far from NE lesions (P>0.05).②The CBF and CBV among these three groups had no signiifcant differences (P>0.05).③The CBF of NE lesions was signiifcantly correlated with disease duration (r=0.518,P<0.05);however, the other markers like Ktrans, Kep, Ve, CBF and CBV were neither signiifcantly correlated with EDSS nor with disease duration (r=-0.371-0.052,P>0.05).Conclusion DCE-MRI with Tofts model can quantitatively measure microvascular permeability and perfusion characteristics of lesions and NAWM regions, which thus reflects hemodynamic changes in patients with multiple sclerosis.