Objective To compare the renal effects of dopamine and dobutamine in patients with sepsis.Methods 90 patients with sepsis were admitted to this study.After resuscitation,each patient was randomly given different vasoactive agent.The changes in urine output,fractional excretion of sodium(FeNa),and creatinine clearance(CCr)were observed.Results The urine output and FeNa in dopamine group were increased significantly as compared with control group and dobutamine group[(3072±480),(2038±515)and(362±522)ml/24h,(3.80±1.09),(2.06±1.14)and(2.10±0.95)%](P＜0.05).Compared with control group and dopamine group,CCr increased significantly in dobutamine group[(79.2±39.1),(50.6±21.8)and(47.4±16.7)ml/min](P＜0.05).Conclusion Dopamine infusion markedly elevates urine output and FeNa,but has no effect on CCr.Dobutamine treatment misht significantly increase CCr,but has no effect on urine output.

Obiective To observe the value of speckle tracking imaging(STI)in assessing left atrial(LA) function in patients with chronic heart failure(CHF).Methods Twenty-two patients with CHF[LVEF(37.1± 10.5)%]and twenty normal controls[LVEF(61.94±10.68)%]were studied.CHF group was subdevided into patients with normal or abnormal LV filling pressure.Velocity vector imaging(Siemens Medical Solutions)was used to acquire 2-D images at parasternallong axis and apical 4-chamber views.The LA dimension and volume,LV volume and ejection fraction,ratio of mitral valve E wave and mitral annulus velocity e'E/e')were measured. LA tangential and radial velocity(Vt-As,Vr-As)and time to peak velocity(TVt-As,TVr-As)were analysed on Syngo Workplace offline.Results Vt-As and Vr-As of the CHF group were significantly smaller than those of the controls(P＜0.05),and Vr-As was even decreased in patient with elevated LV filling pressure(P＜0.05), however,TVt-AS and TVr-AS didn't show evident impairment in the CHF group(P＞0.05).Vt-As and Vr-AS were closely correlated with LVEF,EDV and ESV(P＜0.05).Vt-As was negtively correlated with LA volume (P＜0.05).Conclusions STI can quickly and accurately assess LA function,and help to recognize patients with elevated LV filling pressure,which is useful in the risk stratification,treatment evaluation and prognosis prediction of CHF patients.

Objective To analyze the clinical features of patients with hemophagocytic syndrome (HPS) in autoimmune diseases (AID). Methods We collected the data of 11 patients with AID complicated with HPS in Peking Union Medical College Hospital from 2004 to 2009. The underlying diseases, clinical features, laboratory findings and treatment outcomes were retrospectively analyzed. Results Of the 11 patients,3 were male,8 were female. Mean age was (30. 7 ± 18. 3) years. The underlying diseases included Still disease ( n = 4 ), systemic lupus erythematosus ( n = 3 ), and rheumatoid arthritis, primary Sj(o)gren's syndrome, Wegener granulomatosis and Crohn disease in each one case. HPS was associated with the onset of AID ( n = 4), active infection alone ( n = 1 ) and both factors ( n = 6 ). HPS was clinically characterized by high fever ( 100% ), hepatosplenomegaly ( 72. 7% ) , lymphadenopathy ( 63.3% ) and central nervous system involvement (36. 3% ). 4 patients presented with disseminated intravascular coagulation(DIC) (36. 3% ). Laboratory data mainly manifested with cytopenia ( 100% ), liver dysfunction ( 100% ), hypofibrinogenemia ( 62. 5% ), hypertriglyceridemia ( 81.8% ), serum ferritin ＞ 500 μg/L (100%), low NK-cell activity(80% ) and hemophagocytosis in bone marrow( 100% ). Based on treating underlying infections and use of corticosteroids and immunosuppressive agents in combination with intravenous immunoglobulins(IVIG) therapy, 5 patients recovered , 6 patients died. The mortality rate was 54. 5%. DIC were associated with mortality ( r = 0. 69, P = 0. 019 ). Conclusion The episode of HPS always occurs simultaneously with multiple system involvement that was often difficult to distinguish from active AID. The present of DIC on HPS related with poor prognosis and high mortality. Corticosteroids and immunodepressant and IVIG may improve the prognosis of HPS, while anti-infection therapy is very important and necessary for the patients accompany with active infection.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cisplatin ; administration & dosage ; Deoxycytidine ; administration & dosage ; analogs & derivatives ; Female ; Humans ; Lymphoma, T-Cell ; drug therapy ; pathology ; Male ; Methylprednisolone Hemisuccinate ; administration & dosage ; Middle Aged ; Neoplasm Recurrence, Local ; drug therapy ; Remission Induction

Objective To compare the dosemetry between helical tomotherapy (HT) and intensity-modulated radiotherapy (IMRT) for early-stage postoperative breast cancer and provide more valuable evidences to the clinical researches. Methods Clinical trails of dosimetric comparing between HT and IMRT for early-stage breast cancer were obtained from PubMed, Embase, Sciencedirect, CNKI, VIP and Wanfang databases, evaluated and analyzed with the Cochrane Collaboration's RevMan 5.2 software. Results 10 studies were included with a total of 135 patients. Compared to IMRT plans, HT plans provided a significantly better conformity index (P<0.000 1), mean (P<0.000 01) and maximal dose (P=0.003) of the planning target volume (PTV). HT plans had a lower heart maximal dose (P=0.005), V20 (P=0.05), V30 (P=0.003), and ipsilateral lung maximal dose (P=0.003), V20 (P=0.02), as while as had a higher contralateral breast V5 (P=0.01), mean (P=0.05) and maximal dose (P<0.000 01). There was no significantly difference between HT and IMRT plans for homogeneity index of PTV, heart V5, V10, mean dose, ipsilateral lung V5, V10, V30, mean dose, contralateral breast V10, contralateral lung mean and maximal dose (all P >0.05). Conclusion Compared to IMRT plans, HT plans have the dosimetry superiority for early-stage breast cancer with significantly better coverage and dose conformity while maintaining lower doses to high risk organs.

Objective To analysis the clinical features of elderly diffuse large B-cell lymphoma (DLBCL) patients with Epstein-Barr virus (EBV) infection and their prognostic factors.Methods 250 cases of DLBCL were retrospectively studied by in situ hybridization (ISH) to detect the EBV and by immunohistochemical to evaluate the histological type and Ki-67 protein.Results 36 cases with EBVpositive included 28 elderly (aged ≥ 60 years), of which 21 cases were Han, 15 cases were Uygur, male/ female ratio was 2 : 1.There were 23 cases with nodal presentation only, 13 cases with extra-nodal presentation.Twenty-nine patients presented with advanced disease (Ann Arbor stage Ⅲ/Ⅳ), 30 patients were found with high lactate dehydrogenase (LDH), 22 patients with high IPI score (3-5).Histological observation showed a diffuse and polymorphic proliferation of large lymphoid cells with varying degrees of reactive components.These tumor cells were frequently characterized by a broad range of B-cell maturation, containingcentroblasts, immunoblasts, and Hodgkin-and Reed-Stemberg (HRS)-like giant cells.Immunohistochemical studies showed that tumor cells were positive for CD20 and (or) CD79a in almost cases, most of the cases had a high proliferative index.CD10, bcl-6, Mum-1 performed histological type, 31 cases were non-germinal center.Except the age and location (P ＜ 0.05), no other significant differences were observed in Han and Uygur elderly EBV+ DLBCL (P ＞ 0.05).Conclusion The incidence of elderly EBV+ DLBCL is low, it has some unique clinical and pathological features with poor prognosis.

Aim To explore the protective effect of Sertoli cells on the co-transplanted allogeneic renal cells in male and female recipient rats. Methods Testicular Sertoli cells were prepared by digestion with trypsin， collagenase and DNase， while renal cells were prepared by digestion with trypsin alone. FasL and Fas expressions were detected respectively by FCM before transplantation. About 106 cells were injected into the allogeneic renal subcapsule. In order to demonstrate the survival of renal cells， the expression of g-PG in graft was examined by SABC method. Apoptosis of the lymphocytes surrounding the graft was observed by TUNEL(terminal deoxynucleotidyl transferase-mediated X-dUTP nick end labeling). Results The grafts were analyzed histologically 20 days after transplantation. The renal cells transplanted alone were all rejected, while the survival rates of the mixed cell transplantation were 87.5％ and 77.8％ in male and female recipients respectively. When the renal cells co-transplanted with Sertoli cells treated by anti-FasL mAb， only 30.0％ grafts were survived. Apoptosis of lymphocytes surrounding the graft were quite evident. Conclusion Sertoli cells expressing FasL can protect renal cells from allograft rejection by inducing apoptosis of Fas expressing T cells surrounding the grafts.

OBJECTIVE:To determine the contents of salicylic acid and the related substances in salicylic acid ointment by HPLC.METHODS:The determination was performed on Kromasil ODS-C18 chromatographic column with mobile phase consisted of methanol-water(adjust pH=2.5 using acetic acid,50∶50)at a flow rate of 1.0 mL?min-1.The sample size was 20 ?L and the detection wavelength was set at 270 nm.RESULTS:The main peak and the related substances were well-separated.The linear range of salicylic acid was 10.014～100.14 ?g?mL-1(r=0.999 9)with an average recovery of 99.35%(RSD=0.99%)and a lowest detectable limit of 5 ng?mL-1,the labeled amout of related substances all less than 1.01%.CONCLUSION:The method developed in our study is simple in operation,accurate in results,specific and suitable for the content determination of salicylic acid ointment.

Objective:To investigate the relationship between the structure of TMJ and the craniofacial pattern,occlusion in ClassⅡ1mandibular retrusion children. Methods:TMJ MRI,lateral cephalometric were taken respectively from 30 ClassⅡ1 patients (14 boys and 16 girls,the average age was 10.8?1.1 years). The condyle position and disc position were measured. The correlation of condyle and disc position with craniofacial pattern and occlusion were analyzed metrically and compared with pearson test.Results:There were low positive correlation between MP-SN angle and anterial space. No correlation between posterior-anterior ratio and other data were found. The posterior facial height and Dp-Cc/Cs-Cc angle had low positive correlation. The anterior facial height and Dp-Cc/Cs-Cc、Ca-Ca'、Ca-Cp showed low negative correlation,and little correlation was found between condyle position and overbite and overjet. Overbite had no correlation with disc-condyle-fossa relationship. However,The positive correlation was found between the overjet. and Ca-Dm and Dp-Cc/Cs-Cc,and Pearson coefficient is 0.420 and 0.460.Conclusion:Vertical craniofacial patter has relation to forward displacement of condyle and backward displacement of disc. A deeper overjet is related with a higher risk of abnormal disc-condyle-fossa relationship.