At present, central nervous system involvement is the most common in neuropsychiatric lupus.This article discus-ses the research status of central nervous system lupus in the past few years which include characteristics of clinical presentation, etio-pathological mechanism, neuroimaging diagnosis and therapeutic strategy.Actually, the advanced technology, especially neuroimmu-nology and neuroimaging, in combination with early diagnosis, effective assessment and treat to target strategy could decrease global disease activity, ameliorate quality of life and increase life expectancy.Furthermore, the prospective researches should be paid more attention in lupus registries, neuropsychiatric questionnaires, damage index and improvement of severe refractory cases in clinic.

Ischemic stroke is a critical society-medicine-economy problem,and effective therapy is rather insufficient.Nowadays,method of promoting blood circulation and removing blood stasis was popularly adopted,but only enjoyed limited curative effect in segmental stage of illness in patients.In this article,we analyzed and discussed mainly concept and viewpoint on blood stasis syndrome in Traditional Chinese Medicine,moreover,and provided advanced data for experimental and clinical research in the future.

This article discusses the status quo of the researches on neuropsychiatric lupus,including its pathophysiological mechanism,clinical manifestation,diagnosis,treatment and prognosis.Cerebrospinal fluid examination,electroencephalography and brain imaging could improve the sensitivity of the diagnosis of neuropsychiatric lupus.Aggressive immunosuppressive agents,high-dose corticosteroids and anticoagulants remain the key to the therapy.However,future researches should focus on the control of long-term relapse and the improvement of the quality of life.

In 1999, the nomenclature and case definitions for neuropsychiatric lupus syndromes were published by American College of Rheumatology (ACR), and the cognition of neuropsychiatric damage of systemic lupus erythematosus (SLE) was gradually unified and standardized. Lupus headache is an intractable problem in SLE, especially in SLE patients complicated with multiple organ injury. In general, vascular headache is common in most SLE patients, and a small number of SLE patients complicated with nervous headache are found in clinic. Moreover, its pathophysiological mechanism is far from being understood. Although early diagnosis is essential for good outcomes, the diagnosis method is rather confused in the world. There still exist some limitations in the proposal of clinical classification of headache from ACR and International Headache Society (IHS), and the proposal does not mention the classification of headache related to psychiatric damage. Current therapeutic regimens are almost exclusively based on empirical evidence. Treatment approaches include symptomatic treatment, immunosuppressive, anticoagulant and anti-aggregant therapies. It provides enormous and hopeful space in research of combined therapy strategy, especially in the field of traditional Chinese medicine. The authors discussed the relationship between lupus headache and headache due to internal injury in the view of integrated traditional Chinese and Western medicine, and suggested that the treatment strategy for lupus headache should be made in argument with the headache due to internal injury. Syndrome differentiation treatment according to deficiency in the root and excess in the branch and the therapy for activating blood to dredge collaterals maybe have great advantages in treatment of the headache in SLE.

Objective To evaluate the potential use of a probe melting analysis (PMA) assay in detecting the embB mutations which confer resistance against ethambutol in Mycobacterium tuberculosis. Methods The analysis sensitivity and specificity of PMA were investigated by detecting a serially diluted H37 Rv DNA and a reference panel from National Institute for the Control of Pharmaceutical and Biological Product. Six hundred and thirteen sputum samples were collected from the Xiamen Center for Disease Control and Prevention, Xiamen First Hospital and Center for Zhangzhou Disease Control and Prevention from September 2009 to April 2010. The PMA assay was then evaluated by detecting 613 clinical isolates and the results were compared with the sequencing results. Results The PMA assay could specifically detect Mycobacterium tuberculosis and had a limit of detection of 3 copies per reaction. The assay results with 613 clinical isolates showed that PMA gave a 100% concordance with sequencing in the 583 qualified samples, among which 34 were mutations at embB 306,23 at embB 378-380, 3 at embB 406 and 3 at embB 497. Conclusions PMA assay is a sensitive and specific method enabling efficient detection of common embB mutations causing ethambutol-resistance. The rapidness of this method together with its reliability would facilitate its use in routine testing.

OBJECTIVE To observe therapeutic efficacy and safety of transcatheter arterial chemoembolization (TACE) com-bined with high intensity focused ultrasound (HIFU) in the treatment of middle and advanced primary hepatocellular carcinoma (HCC). METHODS:76 patients with middle and advanced primary HCC were randomly divided into treatment group(36 cases) and control group(40 cases). Control group was given TACE alone,and treatment group was additionally given HIFU 2-3 weeks after TACE. Clinical efficacy,the content of alpha-fetoprotein(AFP)before and after operation,survival rate,survival period and ADR were compared between 2 groups. RESULTS:The efficiency rate and total effective rate of treatment group were 61.1% and 94.4%,which were significantly higher than those of control group(35.0%,77.5%),with statistical significance(P<0.05). The content of AFP in 2 groups decreased significantly after operation,with statistical significance(P<0.05);there also was statistical significance between 2 groups(P<0.05). Survival rate of treatment group was higher than that of control group 24 and 36 months after operation,with statistical significance (P<0.05). The median survival time was 11.3 months in treatment group and 9.2 month in control group,with no statistical difference(P>0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Com-pared with TACE alone,TACE combined with HIFU in the treatment of middle and advanced primary HCC can improve long-term survival rate and the short-term efficacy,with good safety.

Objective:To investigate the current situation of students' academic procrastination behavior in medical colleges and universities and its influencing factors, and to put forward suggestions to reduce the academic procrastination of medical students.Methods:A total of 1 327 undergraduate students from three medical colleges and universities in Heilongjiang Province were randomly selected to receive questionnaire investigation on life satisfaction, anxiety, and academic procrastination. SPSS 23.0 was used for data analysis.Results:①The total procrastination scores of medical students were (35.00±8.92) points. ②There were statistical differences in the academic procrastination of medical students with different genders, whether the only children, the reasons for choosing the major, and the level of achievement ( P < 0.05). There was no statistical difference in academic procrastination among medical students of different ages and grades ( P > 0.05). ③Medical students' procrastination was positively correlated with their anxiety level ( r = 0.102, P < 0.01), and negatively correlated with life satisfaction ( r = -0.117, P < 0.01). ④Regression analysis showed that the following six predictive variables including the level of achievement, gender, life satisfaction, anxiety, reasons for choosing the major, and whether the only children could effectively explain the variance of 14.2% academic procrastination of medical students. Conclusion:The overall degree of academic procrastination of medical students is higher than that of non-medical students. And the students' achievement level, gender, life satisfaction, anxiety, the reasons for choosing this major and whether the only child are the influencing factors of academic procrastination.

Objective:To explore the possible related factors of Beh?et's disease complicated with tendinitis, in order to better understand the etiology and development mechanism so to guide clinical diagnosis and treatment.Methods:The clinical data of patients with Beh?et's disease complicated with tendonitis treated at Department of Rheumatology and Immunology of Lanzhou University Second Hospital from October 2018 to September 2019 were retrospectively reviewed and related literature were reviewed.Results:Two patients were diagnosed as Beh?et's disease. Foot pain occurred during the treatment. Ultrasound showed tendonitis, and the corresponding treatment relieved the symptoms.Conclusion:Tendons may be involved and presents as a chronic change in patients with Beh?et's disease. In patients with rheumatic diseases, attention should be paid to the correlation between the disease and tendonitis. Aggressive treatment can prevent adverse consequences.

OBJECTIVESTo identify predictors of survival following pneumonectomy for non-small cell lung cancer (NSCLC) and provide evidence for the revision of patient selection criteria.

METHODS81 cases of pneumonectomy for NSCLC from January 1990 to May 1996 at our hospital were reviewed retrospectively. There were 65 men (80.2%) and 16 women (19.8%), with a mean age 53.4 +/- 9.4 years (range 20 - 68 years). Predominant histological types included squamous cell carcinoma (54.3%), adenocarcinoma (24.7%), and squamoadenocarcinoma (17.3%). After follow-up for more than 5 years, data were examined using the chi-square test, Kaplan-Meier method, and Cox-mantel test. The possible factors affecting survival were tested with univariate and multivariate analysis.

RESULTSThe 5-year survival of N(0), N(1) and N(2) disease of NSCLC following pneumonectomy was (20.8 +/- 9.9)%, (15.4 +/- 10.0)% and (4.0 +/- 2.8)%, respectively. There was no perioperative death. The operative complications morbidity was 22.2%. Factors adversely affecting survival with univariate analysis included age over 60 years for right pneumonectomy, cardiopulmonary complications, adenocarcinoma, peripheral location, tumor greatest dimension more than 10 cm, chest wall involvement and N(2) disease. Factors adversely affecting survival with multivariate analysis included cardiopulmonary complications, greatest tumor dimension more than 10 cm, chest wall involvement and N(2) disease.

CONCLUSIONSPneumonectomy provides survival benefit with a high operative complications morbidity. Old age (>/= 60 years) for right pneumonectomy, cardiopulmonary complications, adenocarcinoma, and N(2) disease may be negative prognostic factors of long-term survival. Patient selection should be based on cardiopulmonary evaluation and the stage of disease.

Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; mortality ; pathology ; surgery ; Female ; Humans ; Lung Neoplasms ; mortality ; pathology ; surgery ; Male ; Middle Aged ; Neoplasm Staging ; Pneumonectomy ; Prognosis ; Retrospective Studies ; Survival Rate

The American Association for the Study of Liver Diseases (AASLD) updated and published the Practice Guidance for the Diagnosis and Management of Nonalcoholic Fatty Liver Disease (NAFLD) in July 2017, which provides recommendations for the accurate diagnosis, treatment, and effective prevention of NAFLD. Related metabolic diseases should be considered during the initial evaluation of patients suspected of NAFLD. Noninvasive diagnostic techniques including transient elastography, magnetic resonance elastography, and serum biochemical models should be used to evaluate the development and progression of liver fibrosis in patients with NAFLD. Clinical liver pathology report should clearly differentiate between nonalcoholic fatty liver (NAFL), NAFL with inflammation, and nonalcoholic steatohepatitis (NASH) and identify the presence or absence of liver fibrosis and its degree. Early medication for NAFLD can only be used in patients with pathologically confirmed NASH and liver fibrosis, and it is not recommended to use pioglitazone and vitamin E as the first-line drugs for patients with NASH which has not been proven by biopsy or non-diabetic NASH patients. Foregut bariatric surgery can be considered for obese patients with NAFLD/NASH who meet related indications. It is emphasized that the risk factors for cardiovascular disease should be eliminated for NAFLD patients. Statins can be used for the treatment of dyslipidemia in patients with NAFLD/NASH, but they cannot be used in patients with decompensated liver cirrhosis. Routine screening or hepatocellular carcinoma surveillance is not recommended for NASH patients without liver cirrhosis. Cardiovascular disease should be taken seriously during liver transplantation evaluation. There is still no adequate clinical evidence for the treatment of NAFLD in children and adolescents, and intensive lifestyle intervention is recommended as the first-line therapy for such patients.