Juvenile dermatomyositis is a systemic autoimmune disease primarily affecting muscle and skin.The recent researches on proposed criteria based on specific clinical and laboratory features are summarized,recommendations for a new criteria are provided and aggressive treatment approaches,including multiple initial therapies,new immunosuppressive and biological therapies for refractory disease are discussed as well.

Objective To evaluate the effect of different early nutrition support on nutritional status,immune function and stress condition in patients with severe craniocerebral trauma.Methods 90 postoperative patients with severe craniocerebral trauma were randomly divided into standard EN group,immune EN group and TPN group,30 cases in each group.Blood samples were obtained for measurement nutritional status,immune function and stress conditionin in patients before treatment and the first,seventh and twenty first day after surgery.Results Nutritional status,immune function and stress condition of patients in immune EN group improved significantly after seven days.Nutritional status,humoral immune function and stress condition of patients in standard EN group also improved.After 21days,nutritional status,humoral immune function and stress condition of patients in TPN group improved (P ＜ 0.05 or P ＜ 0.01).Conclusion Early immune EN nutrition support of patients with severe craniocerebral trauma can improve nutritional status,immune function and stress condition and maybe the best nutrition support method.

Lymphoid malignancies represent a heterogeneous group of malignancies with differing patterns of behaviour and response to treatment.Anaemia is common in patients with lymphoid malignancies and negatively impacts on quality of life and treatment outcomes and survival.We discuss the diagnosis and management of anaemia in patients with lymphoid malignancies.

Objective To investigate the causes of fever in systemic lupus erythematosas (SLE)patients and identify the characteristics of the fever caused by SLE fever infection after steroid therapy.Methods From January 2002 to May 2007, 487 SLE hospitalized patients with fever were admitted and their data were retrospectively studied. The clinical manifestations and medications were followed up. A case control design was carried out to identify the differences between fever caused by lupus and infection. Results Among all the 487 patients, 265 had infection, 206 had fever that was caused by SLE per se, fever caused by both lupus and concurrent infection was confirmed in 8 patients, malignancy and miscellaneous were the causes of fever in 4 respectively. The most common sites of infection were respiratory tract (61.3%), skin and mucosa (10.9%) and central nervous system (9.1%). The main microorganisms isolated were bacteria (77.4%), fungi (13.5%) and virus (7.8%). Prednisene ≤ 100 mg/d could suppress fever caused by lupus in 81.0% patients, usually within 1 to 5 days. In the case control study, lower C3, C4 and CH50, anemia, lymphocytosis, higher immunoglobulin levels, elevated anti-dsDNA antibodies, elevated anti-nuclear antibodies and higher SLEDA1 score were associated with SLE fever. Long SLE duration, old age, elevated CRP levels,leukocytosis, neutrophilia, high accumulated doses of prednisone and ever use of immunosuppressive medications were factors associated with infection. Conclusion The fever of in-patient SLE patients is mainly caused by infections and disease flare. Moderate dose of steroid therapy is effective to control the fever caused by lupus flare. The fever caused by SLE has different clinical features and laboratory results when compared to that caused by infection although both responses to steroid therapy.

Objective:To investigate the apoptosis by thiocoraline in combination with cisplatin on cervical cell line c4-1 and Hela and its mechanism. Methods:Different concentrations of thiocoraline and cisplatin alone or in combination used for cultured c4-1 and Hela cells. The inhibition of cell proliferation was detected by MTT assay,and the apoptosis was detected by Hoechst 33342 and AO-EB staining. The expressions of the protein Bax,Bcl2,p53,p21 were detected by Western blot. The cell cycle of c4-1 and Hela cells were detected by Flow cytometry. Results: The cell proliferation activity of c4-1 and HeLa cells were inhibited obviously by different concentrations of thiocoraline and cisplatin alone or in combination. The inhibition effect was in a dose-dependent manner. Meanwhile, when the concentrations of thiocoraline and cisplatin were 10 nmol/L and 4 μmol/L, respectivity the inhibitory effect was most significant (P<0. 05);Hoechst 33342 and AO-EB staining showed that the cell apoptosis effect was more obvious on thiocoraline in combination with cisplatin. The Western blot showed that the expressions of the protein Bax,p53,p21 were significantly up-regulated, and the Bcl2 was significantly down-regulated. Conclusion:Thiocoraline combination with cisplatin could up-regulate the expression of the protein Bax,p53,p21 and down-regulation the expression of Bcl2 to inhibition the proliferation and promotion apoptosis of cervical cell line c4-1 and Hela.

Objective To assess the clinical diagnostic value of left atrial function index (LAFI) for heart failure with normal left ventricular ejection fraction (HFNEF).Methods One hundred and ten patients with HFNEF were divided into 3 groups by New York Heart Association (NYHA) cardiac functional grading:NYHA Ⅱ grade group (43 cases),NYHA Ⅲ grade group (40 cases) and NYHA Ⅳ grade group (27 cases),and another 33 healthy subjects were selected as control group.The 4 groups were examined by ultrasoundcardiogram,LAFI and E/E' were calculated,and the plasma brain natriuretic peptide (BNP)levels were determined.The relation between LAFI and NYHA cardiac functional grading and the correlation between LAFI and plasma BNP,E/E' were observed.Results The worse heart function,the higher plasma BNP and E/E',and the lower LAFI,and there were statistical differences [control group:(40.9 ± 26.1) ng/L,6.4 ± 2.0,0.73 ± 0.10,NYHA Ⅱ grade group:(230.1 ± 85.9) ng/L,10.0 ± 3.7,0.46 ± 0.30,NYHA Ⅲ grade group:(398.6 ±98.7) ng/L,16.9 ±4.0,0.26 ± 0.30,NYHA Ⅳ grade group:(680.3 ± 146.6) ng/L,23.8 ± 3.9,0.17 ± 0.20,P ＜ 0.05].The correlation analysis results showed that LAFI and plasma BNP,E/E' were negatively correlated in patients with HFNEF (r =-0.868,-0.873,P ＜ 0.01).Conclusions In HFNEF patients,there is significant correlation between LAFI and left ventricular diastolic dysfunction.LAFI can well diagnose diastolic heart failure early and evaluate the diastolic function of the left ventricle.

Objective:To explore the communication problems among nursing students in early clinical prac-tice, and to provide reference for clinical nursing education .Methods:Introspecting diary of the clinical communi-cation in nursing students were classified and analyzed by using qualitative research method .Results:5 themes were extracted as following: barriers for communication between nurses and patients , reflection on patient , nurse occupation , clinical teaching and critical reflection on public opinion .Conclusion:Introspecting diary is important to help teachers in teaching , to guide and cultivate nursing students to develop their interpersonal communication competence .

Objective To estabolish an optimal animal model of oxygen-induced retinopathy(OIR) suitable for examining pathogenesis and therapeutic intervention for retinopathy of prematurity(ROP). Methods Fifty-four 7-day-old C57BL/6J mice were devided into two groups. Twenty-seven mice in hyperoxic group were exposed to 75% oxygen for 5 days and then to room air for another 5 days. Twenty-seven mice in normoxic control were exposed to room air for 10 days. The proliferative neovascular response was estimated by observing the vascular pattern in adenosine diphosphate-ase(ADPase) stained retina flat-mounts and quantitated by counting the number of new vascular cell nuclei extending into the internal limiting membrane in cross-sections. Results Angiography in ADP ase stained retina flat-mounts delineated the entire vascular pattern. Hyperoxia-induced neovascularization occurred at the junction between the vascularized and avascular retina in the mid-periphery in all mice exposed to hyperoxia. After 5 days of exposure to hyperoxia at postnatal day 12(P12),the larger central radial vessels became tortuous and constricted and central perfusion became decreased obviously. After return to room air for 2 days at P14,neovascularization was seen. This response was maximal at P17. There was a mean of 44 neovascular nuclei per cross-section extending into the vitreous in hyperoxia compared to less than 2 nuclei in the normoxia control ( P

Environmental safety technologies of dry cleaning and risk assessment of solvent residue control embody the green consumption's social environmental beneficiary. The safety assurance of dry cleaning with the combination of life cycle analysis and clean production offer dry cleaning industries an efficient way to get rid of health, environmental and social problems from hazardous solvent on the basis of pollution prevention and treatment during production and consumption period.

Objective To establish the topotecan(TPT)-resistant cell line of human oophoroma (SKOV3/TPT), and to investigate its biological features. Methods To simulate the condition in clinical chemotherapy, drug resistant SKOV3/TPT cell line of human oophoroma was established by challenging SKOV3 with a large dose of TPT (2160ng/ml). Drug sensitivity was assessed by MTT assay. Light microscopy, electronic microscopy, trypan blue staining rejection, and cell counting were employed to determine the biological features of the cell line. Flow cytometry (FCM) was used to study the cell cycle distribution, the accumulation of intracellular drug, and the expression of P glucoprotein (Pgp). Results SKOV3/TPT cells were established successfully, and the resistance index (RI) was 10.67. They showed an obvious cross-resistance to CPT-11, MX and VCR, but still sensitive to taxol, cis-platin, VP16, MTX and 5-Fluorouracil. Comparing with the parent cells, their morphology was unchanged, but multiplication time was prolonged. The apoptosis rate and the proportion of G2+M phase cells of resistant cells were significantly higher than that of their parent cells (P