SUMMARY This case report concerns a 23-year-old woman with chronic periodontitis who had been pre-viously diagnosed with Takayasu arteritis ( TA ) .Her erythrocyte sedimentation rate ( ESR ) and C-reactive protein ( CRP) level were decreased before and 3 months after non-surgical periodontal therapy with no change in her prescribed medications (ESR from 31.00 mm/h to 23.0 mm/h, CRP from 21.40 mg/L to 18.46 mm/h).Through the occasional findings , we raised a hypothetical analysis about the po-tential relationship between periodontitis and TA with respect to inflammatory factors , bacteria and medi-cation.Further studies of large samples are needed to verify the findings .

Objective Taking CNE-2Z multicellular spheroids (MCSs) as the simulation of solid tumors, to investigate the role of SAPK/JNK signaling pathway in multicellular resistance to radiotherapy for human nasopharyngeal carcinoma (NPC). Methods Human NPC cell line CNE-2Z were cultured into multicellular spheroids by using liquid overlay technique, then divided into control MCSs, irradiated MCSs (average dose in one minute: 2 Gy), sp-600125(a specific inhibitor for SAPK/JNK signaling pathway)+irradiated MCSs, sp-600125+MCSs. Western blotting was employed to analyze the activity of SAPK/JNK signaling pathway in MCSs, and the expression of Caspase-3 protein before and after sp-600125 treatment; X-ray induced cell apoptotisis in MCSs before and after sp-600125 treatment was detected by TUNEL. Results The level of SAPK/JNK phosphorylation in MCSs was a dynamic course after radiation, and the phosphorylation peaked at 2 h after irradiation; The apoptotic rate of MCSs (P

Purpose: To explore clinical therapeutic effect of Xue Niao Tai on primary glomerular hematuria. Methods: 80 cases of primary glomerular hematuria were randomly divided into the treatment group treated with Xue Nao Tai. and the control group treated with Mai Shi Bao, acertil, vitamine E and persantine. Both the treatments were given for 6 months and clinical therapeutic results were assessed. Results: The clinically cured rate and the effective rate were 72. 5% and 97. 5% in the treatment group, and 0 and 37. 5% in the control group, respectively, with significant differences between the two groups in both the clinically cured rate and the effective rate (P

Child ; Hemofiltration ; Humans ; Male ; Paraquat ; poisoning ; Poisoning ; therapy ; Treatment Outcome

Objective: To explore therapeutic effect of carvedilol combined valsartan on chronic heart failure (CHF), and its influence on cardiac function and level of high sensitive C reactive protein (hsCRP).Methods: A total of 78 CHF patients, who were treated in our hospital from Jul 2011 to Jul 2015, were selected.According to therapeutic method, they were divided into valsartan group (n=38, received valsartan based on routine treatment) and combined treatment group (n=40, received carvedilol based on valsartan group).Therapeutic effect, cardiac function, serum hsCRP level and quality of life (QOL) score before and after treatment were observed and compared between two groups.Results: Total effective rate of combined treatment group was significantly higher than that of valsartan group (92.50% vs.71.05%), P=0.022.Compared with before treatment, there were significant reductions in heart rate, cardiothoracic ratio (C/T), left ventricular end-diastolic dimension (LVEDd) and serum hsCRP level, and significant rise in left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), emotional index, health index and life satisfaction score in both groups after treatment except C/T of valsartan group, P<0.01 all;compared with valsartan group after treatment, there were significant reductions in heart rate [(124.39±10.07) beats/min vs.(101.18±8.72) beats/min], C/T [(0.63±0.15) vs.(0.53±0.12)], LVEDd [(43.32±4.02)mm vs.(40.38±3.76)mm] and serum hsCRP level [(32.12±3.99) pg/ml vs.(10.29±2.08) pg/ml], and significant rise in LVEF [(45.59±9.99)% vs.(59.97±10.02)%], LVFS [(24.58±5.67)% vs.(31.89±6.68)%], scores of emotional index [(70.20±10.02) scores vs.(86.58±12.28) scores], health index [(73.36±8.08) scores vs.(85.58±11.01) scores] and life satisfaction [(74.34±8.39) scores vs.(88.12±13.35) scores] in combined treatment group,P<0.05 or <0.01.Conclusion: Carvedilol combined valsartan possesses significant therapeutic effect on chronic heart failure.It can significantly reduce hsCRP level, improve cardiac function and quality of life in these patients, which is worth extending.

Objective To explore the possible risk factors associated with postoperative lower respiratory infections in the elderly patients with lung carcinoma,and to formulate the appropriate preventive strategies according to the results of the study.Methods From January 2014 to April 2015,182 elderly patients with lung carcinoma who were undergoing surgical treatment in Renji Hospital of Shanghai Jiaotong University were collected.All patients were divided into infection group (n =29) and control group (n =153) according to whether occuring postoperative lower respiratory infections or not.The possible risk factors associated with postoperative lower respiratory infections were analyzed by single factor analysis and multivariable Logistic regression model.Results Single factor analysis showed that the postoperative lower respiratory infections of elderly patients with lung carcinoma were associated with age (t =-3.03,P ＜ 0.05),smoking (x2 =5.69,P =0.02),albumin (t =2.40,P =0.02),forced expiratory volume (FEV) 1.0％ (t =5.85,P ＜ 0.05),lung carcinoma stage (x2 =7.06,P =0.01),small cell lung cancer (x2 =5.09,P =0.02),complication with chronic obstructive pulmonary disease (COPD) (x2 =16.28,P ＜0.01) and complication with coronary heart disease (x2 =10.13,P ＜ 0.01).Multivariable Logistic regression analysis showed that age (OR =1.34,95％CI:1.13-1.59,x2 =11.17,P＜0.01),smoking (OR=12.68,95％ CI:2.06-78.04,x2 =7.50,P=0.01),FEV1.0％ (OR =0.90,95％ CI:0.83-0.97,x2 =7.76,P =0.01),squamous-cell carcinoma (OR =6.88,95％ CI:1.41-33.56,x2 =5.70,P =0.02),complication with COPD (OR =12.44,95％ CI:1.41-109.90,x2 =5.15,P =0.02) and complication with coronary heart disease (OR =10.61,95％ CI:2.25-90.50,x2 =7.18,P =0.01) were independent risk factors for postoperative lower respiratory infections in the elderly patients with lung carcinoma.Conclusion Age,smoking,squamous-cell carcinoma,low value of FEV1.0％,complication with COPD or coronary heart disease can increase the risk of postoperative lower respiratory infections in the elderly patients with lung carcinoma.Comprehensive and effective preventive strategies should be performed to reduce the risk of postoperative respiratory infections.

Objective To evaluate the effect of flurbiprofen axetil pretreatment on the level of central β-endorphin in a rat model of incisional pain.Methods Fifty-four SPF male healthy Sprague-Dawley rats,aged 6-7 weeks,weighing 180-230 g,were divided into 3 groups (n=18 each) using a random number table:control group (group C),incisional pain group (group Ⅰ) and flurbiprofen axetil pretreatnent group (group FA).At 30 min before the model of incisional pain was established,fat emulsion 1 ml was injected via the caudal vein in group Ⅰ,and flurbiprofen axetil 6 mg/kg (diluted to 1 ml in fat emulsion) was injected via the caudal vein in group FA.The mechanical paw withdrawal threshold (MWT) was measured at 1 day before establishment of the model and 1,6 and 12 h after establishment of the model (T1-3).The rats were sacrificed after measurement of pain threshold at T1-3,and the lumbar enlargement segment of the spinal cord and hypothalamic arcuate nucleus specimens were obtained for determination of β-endorphin content (by enzyme-linked immunosorbent assay) and β-endorphin expression (by immunohistochemistry).Results Compared with group C,the MWT was significantly decreased at T1-3 in I and FA groups,the content and expression of β-endorphin in the spinal cord were significantly decreased at T2,3,and the content and expression of β-endorphin in the hypothalamic arcuate nucleus were increased at T1 in group Ⅰ,and the content and expression of β-endorphin in the spinal cord and hypothalamic arcuate nucleus were significantly increased at T1-3 in group FA (P＜0.05).Compared with group Ⅰ,the MWT was significantly increased,and the content and expression of β-endorphin in the spinal cord and hypothalamic arcuate nucleus were increased at T1-3 in group FA (P＜0.05).Conclusion The mechanism by which flurbiprofen axetil pretreatment produces analgesic effect may be related to the increased level of central β-endorphine in a rat modal of incisional pain.

Objective To measure the outcomes of the cochlear implantation for patients with Warrensburg syndrome in comparison with non-syndromic patients with sensorineural hearing loss. Methods 16 of 1 300 Waardenburg syndrome patients who received cochlear implants at PUMC hospital were reviewed in this papers. The authors will discuss the effects between Warrensburg syndrome and non- syndromic patients with sensorineural hearing loss by means of the Parents Evaluation of Aural-Oral Performance of Children (PEACH). Results There were no statistical difference in quiet, in noise, in overall results and in conversation on the phone between Warrensburg syndrome and non-syndromic patients. There was statistical difference between in quiet and in noise in every group. Conclusion The auditory perception and speech recognition between Warrensburg syndrome and non-syndromic patients with sensorineural hearing loss is same, and the results in quiet is better than that in noise.

Objective To report the clinical, myopathological and genetic features in myofibrillar myopathy (MFM) with numerous cytoplasmatic-spheroid bodies. Methods Ten patients in 5 successive generations began to present progressive proximal limbs weakness at 35 to 40 years old. Additionally, 4 cases manifested diarrhea and 6 cases accompanied with cardiorespiratory symptoms. An open biopsy was performed on the proband. In addition to histological, enzymhistochemical staining and ultrastructural examination, immunohistochemical staining with antibody against tau, desmin, ubiquitin, dysferlin, dystrophin-C', dystrophin-N' and dystrophin-R were done. All the exons of the MYOT, CRYAB, DESMIN, LDB3, LMNA, SEPNI gene and the FLNC exon 48 were analysed. Results Cytoplasmatic bodies and spheroid bodies were found in the fibers. The deposited material were positive for tau, desmin, ubiquitin, dysferlin and dystrophin-R, dystrophin-C'. Electron microscope showed granular dense Z-disc material in the inclusions which were surrounded by thin filament. There was no mutation in the above exons of the 7 candidate genes. Conclusions Myofibrillar myopathy involves multiple system impairment. Cytoplasmatic and spheroid bodies contain microtubule and membrane associated protein. The disease might be induced by some unknown genetic abnormities.

In the macrocosmic perspective,the development trend of the rights and obligations of doctors and patients is regarded as changes in the healthcare mode.In the microcosmic perspective,it is regarded as a clarification and emphasis of the informed consent of the patients as required by laws and regulations.However,medical workers tend to neglect their obligation of informing the patients of the medical expenses to be paid out of their own pocket.In this consideration,informing the patients in writing of their self-payment in medical expenses is obligatory and important,i.e,the self-payment agreement is highly important in clinical work.This paper analyzed the legal at-tributes of self-payment agreement in the aspects of both the informed consent and the signing of the medical service contract,with discussions of the tining of signature,in the hope of inspiring and helping medical workers in their clinical practice.