Autoimmunity is influenced by genetic,immune,hormonal,and environmental factors.Viral infections may trigger autoimmunity.It has been established that autoimmunity may be a contributing factor in the pathogenesis of heart disease.Myocarditis is defined as inflammation of the heart muscle associated with impaired function of the myocardium.Myocarditis is considered as the most common cause of dilated cardiomyopathy.Myocarditis may be caused by infectious factors and noninfectious factors,noninfectious factors including autoimmune diseases with myocarditis.To gain a better understanding of autoimmune myocarditis,we summarize the pathogenesis and clinical significance of autoimmune myocarditis.

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Humans ; Medicine, Chinese Traditional ; Nephrotic Syndrome ; diagnosis ; therapy

Objective To employ intraoperative discography to determine the injured intervertebral disc segments that can not be identified on the preoperative MRI in patients with cervical spinal cord injury without fracture and dislocation for confirming the responsible segments needing surgical decompression and fusion.Methods The study involved 85 patients with cervical spinal cord injury without fracture and dislocation treated from January 2007 to December 2011,among which sixteen patients had not been identified with the responsible segments by preoperative MRI.The average preoperative Japanese Orthopedic Association (JOA) score was (9.1 ± 1.8) points.There was no obvious fracture or dislocation of the cervical spine on preoperative X-ray film,CT and MRI,but all patients displayed high intense signal in cervical spinal cord on MRI T2 weighted imaging.Besides,MRI revealed hemorrhagic swelling of anterior cervical soft tissue in nine patients and cervical intervertebral disk hernia in all patients.Annulus fibrosus rupture of cervical intervertebral disc with contrast leakage in intraoperative discography of suspected injury segments in all patients under direction of C-arm X-ray machine was set as the injury criterion.The patients with pure ruptured discs received cervical discectomy,interbody fusion and titanium plate fixation.The patients associated with multilevel cervical intervertebral disc hernia or ossification of posterior longitudinal ligament underwent anterior cervical corpectomy,bone graft with titanium cageand titanium plate fixation of ruptured discs.Results Nineteen injured discs were identified eventually by discography,including 2 discs at C3/4,4 at C4/5,8 at C5/6 and 5 at C6/7.Moreover,anterior annulus fibrosus rupture with intact anterior longitudinal ligament was found in 11 patients.The follow-up lasted for (24.4 ± 10.0) months.JOA scores were (13.3 ± 1.5) points and (14.5 ± 1.6) points at two weeks and three months after operation,and (15.1 ± 1.5) points at the last follow-up,indicating a relevant improvement rate of 53％,68％ and 76％ respectively.Mean operation time was 110 minutes and blood loss was 120 ml.Three patients had pain on shoulder and back and one patient had hoarse voice,but all the patients were relieved in two weeks after conservative treatments.No serious complications,such as deep infection,deterioration of neurological dysfunction,vertebral artery injury or internal fixation failure were noticed intra-or post-operatively.Conclusion For the intradiscal rupture that is hard to be determined by the conventional imaging methods,intraoperative discography can be used as an auxiliary method of imaging diagnosis in early surgical determination of responsible segments for cervical spinal cord injury without fracture and dislocation.

Objective To investigate the effect of clemastine fumarate on lung ischemia-reperfusion (I/R) injury in rabbits.Methods Fifty New Zealand white rabbits of both sexes,weighing 2.0-3.0 kg,were divided into 3 groups using a random number table:sham operation group (Sham group,n =10),I/R group (n =20) and clemastine fumarate group (Cle group,n =20).The model of lung I/R was established by clamping the left hilum of lung and decreasing the tidal volume followed by restoration of perfusion and ventilation 1 h later in I/R and Cle groups.At 3 h of ventilation in group Sham and 2 and 4 h of reperfusion in I/R and Cle groups,blood samples were collected for determination of serum tumor necrosis factoralpha (TNF-α) and interleukin-8 (IL-8) concentrations by enzyme-linked immunosorbent assay.The left lung was lavaged,and the broncho-alveolar lavage fluid (BALF) was colleted for determination of white blood cell count.Lung specimens were obtained for microscopic examination of the ultrastructure of lung tissues and for determination of wet/dry weight ratio (W/D ratio),expression of IL-1β and IL-6 mRNA (by real-time polymerase chain reaction) and cell apoptosis (by TUNEL).The apoptosis rate was calculated.Results Compared with Sham group,the W/D ratio,white blood cell count in BALF,serum concentrations of TNF-α and IL-8 and apoptosis rate were significantly increased,and the expression of IL-1β and IL-6 mRNA was up-regulated in I/R and Cle groups (P＜0.05 or 0.01).Compared with I/R group,the W/D ratio,white blood cell count in BALF,serum concentrations of TNF-α and IL-8 and apoptosis rate were significantly decreased,and the expression of IL-1β and IL-6 mRNA was down-regulated in Cle group (P＜0.05 or 0.01).The pathological changes of lung tissues were significantly attenuated in Cle group than in I/R group.Conclusion Clemastine fumarate can attenuate lung I/R injury in rabbits.

Objective To explore the relationships among personality,coping style and clinicians' job burnout.Methods 1569 clinicians were investigated with Chinese Maslach Burnout Inventory,Eysenck Personality Questionnaire and Simple Coping Style Questionnaire.The data were performed with regression and path analysis.Results The proportion of burnout was 72.4％,the proportion of slight burnout was 36.5 ％,the proportion of moderate burnout was 31.2％ and the proportion of high burnout was 4.7％.When taking demographic variables into consideration,more introvert and neuroticism indicated increasing tendency of emotional exhaustion.More psychoticism,neuroticism and negative coping style indicated increasing tendency of depersonalization and more introvert and negative coping style indicated increasing of reduced personal accomplishment.Coping style could partly mediate the relationship between personality and job burnout.Conclusion Chinese clinicians suffer from burnout severely,coping styles mediate between the personality factors and the burnout level.

Objective: To evaluate the clinical results of cryopreserved homografts for the treatment of complex congenital heart defects. Methods: In 420 patients with complex congenital heart diseases received surgical correction with right ventricular outflow tract (RVOT) reconstruction was done using cryopreserved homografts. Of the 420 homografts, 234 were aortic homografts and 186 were pulmonary homografts. The mean age of patients was 4.6 years (range, 5 months to 21 years). The mean body weight was 17.5 kg (range, 5.5～52 kg). The mean follow-up time was 27.8 months (range, 3 months to 12.9 years). Results: There were 19 operative deaths with a mortality rate of 4.5%. The postoperative complications occurred in 25 patients and they all recovered uneventfully. The postoperative mechanical ventilation time was 48.7±42.5 hours (range, 8～192 hours). The mean hospital stay was (12.2±9.0) days (range, 7～46 days). There were no late death and complication. Conclusion: The results of this study suggest that ROVT reconstruction with cryopreserved homografts as transannular patch can be achieved with excellent the clinical outcome.

Objective: To explore the values for rejection research of the models through observing rejection rulers following small bowel transplantation(SBT)in Inbred strain rats.Mothods: Heterotopic SBT models were established with Inbred strain F344/RT11 and BN/RT1n by microsurgical technique according to Monchik method,including Isotransplantation(F344→F344,n=8)and allotransplantation(BN→F344, n=8).Results: 1.The mean living time was over 30 days in IT x group ,which was 12 days in AT x group.2.The general conditions have no significant difference on various time points of postoperative day(POD)in IT x group,while pathological features of grafts were concided with diagnosis of nonspecific slight inflammation on POD3 and were the same as the normal grafts on POD 0?5?7 and 9.3.Significant difference of IL-2R? chain and ?-INF mRNA transcription was earlier than pathological feature appearance of rejection.4.The general conditions and pathological features of grafts were concided with diagnosis of mild,moderate and severe actute rejection in AT x group on POD 5?7and 9 respectively.Conclusion:Inbred strain BN to F344 combination is fitter for research on rejection mechanism than F344 to Wistar combination and Outbred strain Wistar to SD combination.

OBJECTIVE To study the feasibility and security of parotidectomy for parotid benign tumor by tracing cervical branch to expose facial nerve. METHODS Parotid benign tumor of 87 patients were studied.We exposed facial nerve by tracing main facial nerve branch、buccal branch、marginal mandibular branch and cervical branch in parotidectomy for parotid benign tumor and observed the function of facial nerve after operation.RESULTS The number of patients traced by main facial nerve branch- buccal branch、marginal mandibular branch and cervical branch group were 10、8、28 and 41 respctively,and the percentage of facial nerve injury after operation were 30%、37.5%、46.4%and 24.3%.The percentage of facial nerve injury was statistically different between the marginal mandibular branch group and the cervical branch group(P

Objective To replicate an ideal animal model for exploring pathogenesis and experimental treatment of malignant lymphoma of small intestine. Methods Fresh lymphoma tissues derived from primary lesion and liver metastasis of malignant lymphoma of human small intestine obtained during operation were respectively transplanted into mucosa of small intestine and subcutaneous space in the interscapular region in nude mice. Tumorigenicity, invasion and metastasis of transplanted tumors were observed. Morphology (light microscopy, electron microscopy and immunohistochemistry), karyotype analysis, DNA quantitative assay (FCM) were also studied. Results From five patients of malignant lymphoma of small intestine, tumor tissue from 3 patients was successfully transplanted. According to the new classification of the World Health Organization, a strain of high metastatic model of orthotopically transplanted malignant lymphoma in nude mice (HSIL-0101) and another of subcutaneously transplanted highly metastatic model were reproduced from the same human neoplasm (non-Hodgkin B cell type); orthotopically Pathological study showed that the tumor was high-grade large B-cell lymphoma. Histochemitry showed that it was CD19, CD20, CD22 and CD45 positive, and CD3 and CD7 negative. The number of chromosome is ranged from 55 to 59; DI (DNA Index) was 1.47～1.61 (ie, heteroploid). HSIL-0101 and HSIL-0102 had been passaged for 32 and 38 generations in nude mice separately. 357 nude mice were transplanted. Rate of growth of neoplasm transplantation and resuscitation rate of liquid nitrogen cryopreservation were both 100%. In HSIL-0101, metastasis rate of liver and lymph node was 100%. In HSIL-0102, metastasis rate of liver was 63.5% and metastasis rate of lymph node was 62.7%. Transplanted tumors invasively grew in small intestine and subcutaneous region of nude mice. Blood metastasis was found (liver and spleen metastases). There were also lymph metastasis and seeding metastasis in the peritoneal cavity. Conclusions The study first successfully established spontaneous high metastasis models of malignant lymphoma of human small intestine in nude mice by orthotopic and subcutaneous transplantation. HSIL-0101 and HSIL-0102 could be used to carry out the research on pathogenesis, invasion, metastasis, and experimental therapy of malignant lymphoma of small intestine.