Objective To evaluate the clinical significance of the level of [gG4 in the bronchoalveolar lavage fluid (BALF) of patients with rheumatic disease related interstitial lung disease (RD-ILD).Methods Eighteen patients with RD-ILD,14 patients with pulmonary infection and 12 patients without ILD or pulmonary infection,were recruited consecutively from the in-patient ward of Peking University People's Hospital.Clinical features and laboratory data were extracted from the medical record database of Peking University People's Hospital.The level of IgG4 was determined by ELISA.The statistical analysis of data using t test,and the correlation between the two variables were analyzed using linear regression analysis.Results The level of IgG4 was significantly higher in BALF of patients with RD-ILD than patients' without ILD or pulmonary infection,whereas there was no difference compared to patients with pulmonary infection.The level of IgG4 in BALF of patients with RD-ILD was positively correlated with the percentage of lymphocytes (r=0.53,P=0.03),and significantly negatively correlated with the percentage of macrophages (r=-0.65,P=0.005).Conclusion The level of IgG4 is significantly elevated in BALF of patients with RD-ILD,which is probably secreted from the lymphocyte of the lung.

Objective To survey the living quality of the rural empty nest elderly in Guizhou Province,and to provide basic information for further study of how to improve the living conditions of empty nest elderly.Method Using Multi -stage stratified cluster sampling method to extract the 30 villages,which respectively surveyed 10 to 15 people of the elderly subjects who aged over 60,A self-designed questionnaire was used to investigate and collected the relevant's information, the living condition of the empty nest elderly and the non-empty-nest old people was compared,and the related factors which might affect the living quality of the empty nest elderly was analysed.Results Finally 341 rural elderly were recruited,of which empty nest elderly accounted for 63. 05%,In the survey of empty nest elderly,only 22. 33%consider themselves healthy,Lower than the non -empty -nest old people's proportion of 38. 89% (P <0. 05 ).The ratio of children visitation,comfortably fixed for money,and children given pocket money were 85. 58% and 66. 98% and 39. 53%,lower than the non-empty-nest old people 96. 03%and 75. 40%and 55. 56%(P<0. 05);the ratio of timely medical treatment and loneliness among empty-nest old people were 58. 14%and 47. 91%,higher than the non-empty-nest old people were 44. 44% and 35. 71%(P<0. 05).Conclusion The perceived health status among the empty nest elderly in rural area of Guizhou Province was generally poor.The empty nest elderly needed more life care,medical security and emotional assistance.

Objective To investigate the correlation between family cohesion and adaptability and quality of life in patients with enterostomy. Methods Using Chinese version of Family Adaptability and Cohesion Scale (FACESⅡ-CV) and Chinese version of Stoma-Quality of Life (STOMA-QOL-C) to investigate the status of family cohesion and adaptability, family type and their impact on quality of life of 110 patients with enterostomy. Results Scores of family cohesion and adaptability averaged 59.15 ± 11.94, 47.32 ± 9.40,were significantly lower than 63.90 ± 8.00 and 50.90 ± 6.20 in the norm,and the difference was statistically significant (t=-4.171,-3.990, P<0.01).The family cohesion was positively correlated with the score of quality of life, social interaction and psychological burden(r=0.274, 0.284, 0.263, P<0.05), and the family adaptability was positively correlated with the score of quality of life,social interaction and psychological burden(r=0.316, 0.338, 0.228, P<0.05 or 0.01). The balance type family was 30 cases;scores of quality of life averaged 45.10±7.26, the intermediate type family was 50 cases;scores of quality of life averaged 43.48±9.98, the extreme type family was 28 cases;scores of quality of life averaged 43.37 ± 16.68, and difference between the three was no statistically significant(F=0.442, P=0.665). Conclusions In the nursing process of patients with enterostomy, health care workers should pay attention to improve family cohesion and adaptability, as to achieve the purpose of improving the quality of life of the patients.

Objective To investigate the clinical characteristics and analyze prognostic risk factors of combined hepatocellular-cholangiocarcinoma. Methods The clinical data of 19 cases of combined hepatocellular-cholangiocarcinoma admitted in our hospital from January 1999 to December 2009 were analyzed retrospectively. The survival function was analyzed by Kaplan-Meier. The possible prognostic risk factors were tested by χ2-test. Results Hepatocellular-cholangiocarcinoma was diagnosed by pathology in the 19 patients, among which hepatic tunic was infiltrated in 13 cases, peritoneum involved in 1 case, intravascular cancer embolus in 1 case. At that time lymphocyte nodes metastasis in 2 cases were found by regional lymphadenectomy in 7cases. The 1-year and 3-year survival rates were 61% and 42%,respectively. Prognosis of patients with tumor size ＞ 5 cm ( χ2 = 4. 392, P = 0. 036 ), history of heavy drinking ( χ2 = 11.010, P = 0.001 ) or intraoperative blood transfusion ( χ2 = 4. 645,P = 0. 031 ) were worse than others. Conclusion It was difficult to get correct preoperative diagnosis of combined hepatocellularcholangiocarcinoma. Tumor size, history of heavy drinking and blood transfusion were all prognostic related risk factors.

Continued smoking following stroke is associated with adverse outcomes including increased risk of mortality and secondary stroke.The aim of this study was to examine the long-term trends in smoking behaviors and factors associated with smoking relapse among men who survived their first-ever stroke.Data collection for this longitudinal study was conducted at baseline through face-to-face interviews and follow-up was completed every 3 months via telephone,beginning in 2010 and continuing through 2014.Cox proportional hazard regression models were used to identify predictors of smoking relapse behavior.At baseline,372 male patients were recruited into the study.Totally,155 (41.7％) of these patients stopped smoking for stroke,and 61 (39.3％) began smoking again within 57 months after discharge with an increasing trend in the number of cigarettes smoked per day.Exposure to environmental tobacco smoke at places outside of home and work (such as bars,restaurants) (HR,2.34;95％ CI,1.04-5.29,P=0.04),not having a spouse (HR,0.12;95％ CI,0.04-0.36;P=0.0002) and smoking at least 20 cigarettes per day before stroke (HR,2.42;95％ CI,1.14-5.14,P=0.02) were predictors of smoking relapse.It was concluded that environmental tobacco smoke is an important determinant of smoking relapse among men who survive their first stroke.Environmental tobacco smoke should be addressed by smoke-free policies in public places.

OBJECTIVETo investigate the association among serous and cerebrospinal fluid (CSF) TNF-alpha level, gene polymorphisms of TNF-alpha and multiple sclerosis (MS) in Han nationality of southern China.

METHODSMS diagnosis was base on Poser (1983) criteria. Fifty-five patients with nonimmulogical diseases and 68 patients with MS from southern China were enrolled in the study, and their TNF-alpha level of serum and CSF were measured by double antibody sandwich ABC-ELISA. TNF-alpha -308G/A in 106 normal healthy subjects and 68 MS patients was genotyped with polymerase chain reaction-restriction fragment length polymorphism.

RESULTSThere was significant difference in the serous TNF-alpha level between nonimmune patients and active MS patients (234+/- 76 pg/mL vs 276+/- 71 pg/mL, P< 0.05), but not in the CSF (245+/- 83 pg/mL vs 265+/- 78 pg/mL, P> 0.05). The gene frequency distribution of TNF-alpha -308G/A was corresponding with Hardy-Weinberg equilibrium. The positive rate of genotype AA and the gene frequency of allele A of TNF-alpha were 4.4% and 14.0% in MS group, and 0 and 8.50% in healthy subjects, there was no statistical significance (P> 0.05).

CONCLUSIONThe TNF-alpha level in serum is associated with active MS, but not in the CSF. The gene polymorphisms of TNF-alpha -308G/A is not associated with MS in Han nationality of southern China.

Adolescent ; Adult ; Aged ; Asian Continental Ancestry Group ; genetics ; China ; Enzyme-Linked Immunosorbent Assay ; Female ; Gene Frequency ; Genotype ; Humans ; Male ; Middle Aged ; Multiple Sclerosis ; blood ; cerebrospinal fluid ; genetics ; Polymorphism, Genetic ; Tumor Necrosis Factor-alpha ; blood ; cerebrospinal fluid ; genetics

OBJECTIVETo explore the clinical efficacy of the percutaneous kyphoplasty for the treatment of osteoporotic Kummell's disease.

METHODSFrom May 2010 to February 2012, 8 patients with osteoporotic Kummell's disease were treated with percutaneous balloon kyphoplasty. There were 2 males and 6 females, with a mean age of 73.4 years. All the patients suffered from lower back pain for 4.7 months, which affected seriously the patient's quality of life. The anterior vertebral height and Cobb angel was measured on standing lateral radiograph at pre- and post-operatively (2 days after operation) and during the final follow-up. Visual analog scale (VAS), Japanese Orthopedic Association (JOA) and Oswestry disability index (ODI) were used to evaluate pain and function.

RESULTSIncision of all patients healed normally without infection. The level of back pain decreased remarkably after surgery. The mean time of ambulation was 4.3 days (ranged, 1 to 10 days). Cement leakage occurred in 1 case with no symptom. The anterior vertebral height and Cobb angel of the fractured vertebra recovered respectively from preoperative (30.4 +/- 7.4)% and (31.3 +/- 9.9) degree to (70.3 +/- 3.3)% and (9.1 +/- 3.0) degree at the 2nd day after operation. VAS and JOA scores, ODI improved from preoperative 8.7 +/- 1.2, 12.3 +/- 1.7 and (93.3 +/- 4.6)% to 3.1 +/- 1.1, 24.9 +/- 1.6 and (32.2 +/- 5.4)% respectively at the 2nd day after operation. All the patients were followed up, and the duration ranged from 3 to 24 months, with a mean of 4.7 months. At the latest follow-up, the anterior vertebral height and Cobb angel of the fractured vertebra were (69.9 +/- 3.2)% and (10.9 +/- 2.4) degree; the VAS and JOA scores and ODI were 2.2 +/- 1.0, 26.4 +/- 1.4 and (29.2 +/- 4.5)% respectively, which had no obvious difference compared to those results at the 2nd day after operation.

CONCLUSIONBalloon kyphoplasty is safe and effective treatment for osteoporotic Kummell's disease.

Aged ; Aged, 80 and over ; Female ; Humans ; Kyphoplasty ; methods ; Male ; Osteoporosis ; surgery ; Treatment Outcome

OBJECTIVECigarette smoke extract (CSE) can induce injuries of pulmonary II epithelial cells, activate nuclear factor-kappaB and increase tumor necrosis factor-alpha(TNF-alpha) secretion. This study aimed to investigate whether azithromycin can protect pulmonary II epithelial cells from injuries induced by CSE and relevant mechanisms.

METHODSPulmonary II epithelial cells (A549 cells) were cultured in vitro. After 48 hrs of culture the cells were randomly treated with serum-free DMEM only (blank control group), azithromycin + serum-free DMEM, CSE+ serum-free DMEM or CSE+azithromycin. Eight hours later the morphology of A549 cells, the activity of NF-kappaB and the levels of TNF-alpha were measured by inverted microscope, immunohistochemistry and ELISA.

RESULTSThe morphology and structure of A549 cells were changed, NF-kappaB activity increased (dark brown staining ) and TNF-alpha levels (0.307 +/- 0.036 pg/mL vs 0.234 +/- 0.028 pg/mL)increased in the CSE+ serum-free DMEM group compared with the blank control group (P < 0.01). CSE together with azithromycin treatment recovered partly the morphological injuries of A549 cells. It also attenuated NF-kappaB staining and decreased TNF-alpha levels from 0.307 +/- 0.036 pg/mL (CSE+serum-free DMEM group) to 0.269 +/- 0.009 pg/mL (P < 0.05).

CONCLUSIONSAzithromycin may inhibit NF-kappaB activity, decrease TNF-alpha secretion and thus lessen cytotoxicity of CSE to A549 cells.

Anti-Bacterial Agents ; pharmacology ; Azithromycin ; pharmacology ; Cells, Cultured ; Epithelial Cells ; drug effects ; Humans ; Immunohistochemistry ; Lung ; drug effects ; metabolism ; pathology ; NF-kappa B ; analysis ; Smoke ; adverse effects ; Tobacco ; adverse effects ; Tumor Necrosis Factor-alpha ; analysis

OBJECTIVETo analyze the characteristics of children tibial intercondylar eminence fractures, and introduce arthroscopic minimally invasive techniques for the treatment of tibial intercondylar eminence fractures in children.

METHODSFrom January 2004 to December 2008, 12 children with tibial intercondylar eminence fractures were treated with cross Kirschner wire fixation after arthroscopic reduction. According to Meyers-McKeever classification systems, there were 1 case of type I, 4 cases of type II, and 7 cases of type III. There were 10 fresh and 2 old fractures in all. Among the patients, 10 patients were boy and 2 patients were girl,ranging in age from 8 to 13 years, with an average of 10 years. All the patients underwent arthroscopic exploration, reduction and fixation. During follow-up ranging from 10 to 36 months, the union of fracture, range of motion and stabilization of the knee were assessed. One patient was combined with lesions of the menisci, 1 patient with femoral trochlea cartilage injury, and 5 patients with meniscal entrapment under the bone.

RESULTSThe heeling time averaged 5 weeks. No knee laxity or instability and no intercondylar notch impingement was detected in all cases at 3 months postoperatively. At same time, full range of motion of the affected knee returned, and the average Lysholm knee score was (92.7 +/- 2.5), the average Lysholm knee score was (96.4 +/- 1.7) at 6 months postoperatively. The Lachman test and ADT test was negative.

CONCLUSIONThe type II and type III tibial intercondylar eminence fractures occur frequently in children. Lesions of the menisci and cartilage occur seldom. The method of arthroscopic cross Kirschner wire fixation for the treatment of tibial intercondylar eminence fracture is easy to operate. Simultaneously, this technique is less invasive and allows early recovery. Also it coincidences with the characteristic rapid bone growth of children.

Adolescent ; Arthroscopy ; methods ; Child ; Female ; Humans ; Male ; Minimally Invasive Surgical Procedures ; methods ; Tibial Fractures ; surgery

Objective To evaluate the advantage of homemade negative pressure device combined with nano-silver dressing for promoting the healing of infected incision in rats,and explore its clinical curative effect.Methods In-fected incision model rats were randomly divided into conventional treatment group,and simple pressure suction group,pressure suction combined with silver ion dressing group.The healing time and healing area of rats in each group after treatment were evaluated,immunohistochemical and fluorescent quantitative analysis of inflammatory factors in incisional wound tissue were performed.Three methods were applied to patients with surgical site infec-tion(SSI),granulation coverage time,granulation recovery time,and incision healing time of three groups of pa-tients were compared.Results Immunohistochemistry and its IOD value,the relative mRNA expression levels of TNF-α,IL-2,and IL-8 in rat wound tissue treated with pressure suction combined with silver ion dressing were all inferior to conventional treatment group and simple negative pressure suction group,difference was statistically sig-nificant (P < 0.05);in clinical application,wound healing time,postoperative C-reactive protein level,and pain as-sessment scores in patients treated with pressure suction combined with silver ion dressing were all superior to con-ventional treatment group and simple negative pressure suction group,difference were all statistically significant (all P < 0.05).Conclusion Compared with conventional treatment method,pressure suction with silver ions dressing treatment can more effectively control SSI,reduce local inflammation of incision,and promote incision healing.