Objective To investigate the difference and treatment strategy of malignancy-associated dermatomyositis and other para-neoplastic neurological syndromes (PNS).Methods The clinical characteristics of a patient with malignancy-associated dermatomyositis and poly radiculoneuropathy was reported and the relevant literature was reviewed.Results Patients with dermatomyositis had increased risk of malignancies,and should routinely screened.Dermatomyositis and polyradiculoneuropathy was clinically similar,but could rarely be seen in the same malignant patient.Malignancy -associated dermatomyositis and PNS had similar pathogenesis.The treatment strategy of both was similar.Malignancy specific treatment should be initiated and immune suppressive agents should be prescribed concurrently.Conclusion Rheumatolgists should aware the association between dermatomyositis and potential underlying malignancies.Multiple para-neoplastic syndromes could be seen in the same patient,but the diagnosis should be considered as one.

The aims of this paper were to define (1) criteria of cerebral palsy; (2) classification of cerebral palsy; (3) etiology, neuroimaging, and epidemiology of cerebral palsy; (4) different kinds of treatments of cerebral palsy. Data were drawn from an international survey of PUBMED (1994-2014) and CNKI (1994-2014). An expert panel used a consensus building technique. The10-point Jadad scale was used to assess the quality of the trials based on the following items, including allocation sequence generation, randomization concealment, methods of blinding, and descriptions of withdrawals and dropouts. Our clinical experience was also summarized. Below is a summary. (1) Further work is warranted to reach agreement for the classification of cerebral palsy. (2) A worldwide prevalence of 1.5-4.0 per 1 000 live births, with an average lifetime cost of 1 million dollars per person in the United States, while it is 1.8-6.0 per 1000 live births in China. (3) Comparison of clinical efficacy of different treatments. In this review, the current advances in different kind of treatments of brain injury are discussed with specific relevance to cerebral palsy.
Cerebral Palsy ; classification ; diagnosis ; therapy ; China ; Humans ; Prevalence ; United States

Objective To improve the understanding of drug-induced lupus (DIL) and the differences from systemic lupus erythematosus (SLE).Methods Clinical manifestation and treatment of patients with definite DIL were retrospectively analyzed.Results Six patients with DIL were enrolled in this study,including 4 females and 2 males.Two patients were diagnosed after receiving interferon,one after soluble tumor necrosis factor receptor fusion protein,one after propylthiouracil,one after penicillamine,and one after levofloxacin.High titer of antinuclear antibody was identified in all six patients,including 3 with positive anti-dsDNA antibody.One patient had positive anti-Sm antibody.One patient had positive anti-RNP antibody.One patient had anti-nucleosome antibody.One patient had anti-histone antibody.One patient had antimitochondrial antibodies-M2,and one patient had anticardiolipin antibodies.Conclusion Patients with DIL are not as severe as those with SLE.After cessation of suspected drugs and administration of standard treatment,the clinical outcome of DIL is satisfying.

Objective:To study the effect of Snyder's hope theory nursing on the scores of psychological stress, quality of life and neurological function in patients with acute hypertensive cerebral hemorrhage.Methods:From June 2017 to December 2018, 100 patients with acute hypertensive cerebral hemorrhage in the Second Affiliated Hospital of Xi′an Jiaotong University were selected as the study object. According to the random number table, the patients were divided into observation group (50 cases) and control group (50 cases).The patients in the control group were given routine rehabilitation nursing mode, and the patients in the observation group received Snyder′s hope theory nursing on the basis of the control group. The rescue time, the recovery time and the incidence of complications of the two groups were compared. The degree of anxiety and depression, neurological function, quality of life of the patients were evaluated by Self-rating Anxiety Scale(SAS), Self-rating Depression Scale(SDS), National Institutes of Health Stroke Scale(NHISS), Glasgow Coma Scale(GCS) and SF-36.Results:The rescue time and recovery time were (58.13±10.36) min, (12.7±5.3) d in the observation group, and (85.71±8.30) min, (21.1±3.3) d in the control group, and there were significant differences between the two groups ( t values were 14.691, 10.646, P < 0.05).There was no significant difference in SAS, SDS, NIHSS, GCS, SF-36 score before intervention between the two groups ( P> 0.05).The scores of SAS, NIHSS, GCS after intervention were (40.56±1.72), (11.23±2.85), (13.12±4.11) points in the observation group, and (46.56±1.62), (14.97±4.55), (11.13±3.15) points in the control group, and there were significant differences between the two groups ( t values were 17.956, 4.926, 3.212, P<0.01). There were significant differences in SF-36 after intervention between the two groups( t values were 7.124-13.014, all P<0.01). The incidence of complications was 8.0%(4/50) in the observation group, and 24.0%(12/50) in the control group, and there was significant difference between the two groups( χ2 value was 4.762, P<0.05). Conclusions:Snyder's hope theory nursing has a significant effect on the improvement of anxiety and depression in patients with acute hypertensive cerebral hemorrhage, which is worth popularizing.

Objective To explore the effect of community comprehensive rehabilitation on quality of life in patients with stroke sequelae under the family medical service mode. Methods From October, 2013 to October, 2014, 51 patients with stroke sequelae received compre-hensive rehabilitation intervention for three months, including rehabilitation training, rehabilitation guidance, health education and psycho-logical counseling. They were assessed with modified Barthel index (MBI), WHO-Disability Assessment Schedule (WHO-DASⅡ), Short Form 36 Health Survey Questionnaire (SF-36), Brain Injury Community Rehabilitation Outcome Scales (BICRO-39), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) before and after intervention. Results The scores of physical functionning, role physical, general health, mental health, social functioning and the total score in SF-36 increased after intervention (t>2.072, P<0.05). The scores of so-cial contact, locomotivity, self handling transaction ability and the total score in BICRO-39 decreased after intervention (t>2.434, P<0.05), as well as the scores of getting along with people, housework and society and participation in WHO-DAS II (t>2.507, P<0.05). Conclusion In the community health service, comprehensive rehabilitation guided by multidisciplinary rehabilitation team can facilitate to improve the quality of life in patients with stroke sequela.

Objective To assess the efficacy and safety of various spectrum lasers in the treatment of acne vulgaris. Methods Based on the principles and methods of Cochrane systematic reviews, we searched the Cochrane Library (2009, 6 issues), PubMcd, Embase, China Biomedical Literature Database, China Journal Full Text Database, Chinese Scientific Journals Full Text Database. Retrieval time was up to June, 2009. Randomized controlled trials (RCTs) of lasers for acne vulgaris were included. Results Twelve RCTs totaling 367 patients were included. Because the lack of clinical homogeneity, only descriptive analysis was conducted. Acne lesion counts improved significantly with laser therapy. Adverse effects were limited to transient erythema and edema at treatment sites. Treatment-related pains were well tolerated. Conclusions Current evidence demonstrates that all type lasers in treating acne vulgaris is safe and efficacy. However, higher quality RCT research would be needed to verify the effects and status of lasers on acne vulgaris.

Objective To explore the role of p16 gene methylation in fibroblasts in the occurrence and development of keloid.Methods Skin tissue specimens were resected from the lesions of patients with keloid and normal skin of healthy human controls.Fibroblasts were isolated from these tissue specimens and subjected a primary culture.An immunohistochemical analysis was performed to measure the expression of p16 protein in tissue specimens,real-time fluorescence-based quantitative PCR to determine the mRNA expression level (expressed as 2-△△Ct) of p 16 and DNA methyltransferases (DNMTs) in fibmblasts,and bisulfite sequencing PCR (BSP) to estimate the methylation status of p16 gene in the tissue specimens and primary fibroblasts.Results The keloid fibroblasts (KFbs) showed significandy lower mRNA expression of p16 gene (0.64 ± 0.18 vs.1.92 ± 0.23,t =10.54,P＜ 0.05),but significantly higher mRNA expressions of 3 DNMTs (DNMT1:2.58 ± 0.23 vs.1.13 ± 0.21,t =11.22,P ＜ 0.05; DNMT3A:4.87 ± 0.46 vs.2.38 ± 0.32,t =10.81,P＜ 0.05; DNMT3B:1.57 ± 0.12 vs.0.57 ± 0.16,t =12.45,P＜ 0.05) compared with the normal fibmblasts (NFbs).The DNA methylation rate in the p16 gene promoter region was significantly increased in keloid tissue (1.81％ ± 0.46％) and KFbs (3.15％ ± 0.94％) compared with normal skin tissue (0.90％ ± 0.35％,F =14.23,P＜ 0.01) and NFbs (0.17％ ± 0.29％,F=37.62,P＜ 0.01).Conclusions The methylation and low expression of p16 gene in KFbs may be associated with the uncontrolled growth of keloid,and DNMTs may play a role in the pathogenesis of keloid.

Objective To evaluate the effect of pharmacological postconditioning on longitudinal myocardial function in rabbits' model of myocardial inshemia-reperfusion using layer-specific strain of ultrasound speckle tracking imaging.Methods Forty healthy rabbits were randomly divided into two groups:ischemia-reperfusion group (IR) and pharmacological postconditioning group (ATP-PPost). Echocardiography examinations were performed at baseline,45 min after ligation and 30 min,60 min,120 min after reperfusion.Pathological examinations were applied in two rabbits randomly selected from each group at 45 min after ligation and 30 min,60 min after reperfusion and at the end of experiment.Results①After coronary artery ligation,left ventricular ejection fraction (LVEF) decreased in two groups(P <0.05) and longitudinal systolic strain(SLsys) of 3 myocardial layers decreased in two groups (P <0.01). And the SLsys in the endocardium had greater variation than that in the epicardium.②Compared with that after ligation,the SLsys of all myocardial layers increased at 30 min after reperfusion in ATP-PPost group (P <0.01),and the SLsys in endocardial layer kept increasing with the time of reperfusion(P <0.05). And the SLsys of 3 myocardial layers were significantly higher in ATP-PPost group than those in IR group (P <0.01).③ In two groups,the values of SLsys were decreasing from endocardial layer to epicardial layer.They were higher in the endocardium than those in the epicardium at any time(P <0.01 and P <0.05).Conclusions Layer-specific strain of STI can evaluate exactly the regional myocardial function of rabbit myocardial pharmacological-postconditioning model.SLsys of endocardial layer is more sensitive to myocardial ischemia than that of epicardial layer.

Objective To select sonogram features for the differential diagnosis of benign and malignant thyroid small nodules by Logistics regression analysis,and to contribute the binary Logistic regression model of sonogram features as independent variable and evaluate the value of conventional ultrasonography and ultrasound elastography (UE) in the differential diagnosis of benign and malignant thyroid small nodules.Methods 166 thyroid nodules (≤ 10 mm) in 140 patients were reviewed and analyzed by 2D ultrasound,color Doppler flow imaging and UE.A Logistic model was obtained based on pathology as golden diagnosis criteria.The odds ratio of variables in the equation were compared to assess various variables,especially the efficacy of elastography in the diagnosis.Results Four statistically significant features were finally entering the Logistic stepwise regression model,including shape,calcification,the internal component of nodules and elasticity score.And the odds ratio of the elasticity score was higher than other features.Conclusions The analysis of binary Logistic regression can select the valuable variables for the diagnosis of pathological nature of thyroid small nodules.UE has much more dominances than other features.The combinated application of UE and 2D ultrasonic features plays a great clinical role in the final diagnosis of thyroid small nodules.