Objective To investigate the role of sex hormones and interleukin (IL)-6 in the pathogenesis of primary Sjgren′s syndrome (pSS). Methods Serum specimen of 21 postmenopausal patients with pSS and 21 postmenopausal healthy women were collected. Serum estradiol (E2) and testosterone (Te) were estimated by the commercial radioimmunoassay kits, whereas serum dehydroepiandrosterone sulfate (DHEAS) were measured by enzyme-amplified chemiluminescence assay. Enzyme linked immunosorbent assay kits were used to determine levels of IL-6 in serum. Results The DHEAS and the Te level in serum were lower in postmenopausal patients with pSS than in healthy controls (P0.05). The level of IL-6 in pSS patients was higher than that in controls (P0.05). Conclusion Primary Sj(?)gren′s syndrome, in which an altered metabolism of sex hormones has occured, appears to be influenced by the change of the levels of sex hormones and IL-6 in serum.

目的探讨系统功能训练对老年人工全膝关节置换(TKR)术后康复的效果观察。方法接受TKR老年患者21例36膝,入院后随机分A、B两组,A组实施系统功能训练,B组采用骨科常规护理。采用美国特种外科医院(HSS)膝关节评分标准在术前及术后3周末对A、B两组进行膝关节评分。结果两组患者TKR术后膝关节评分有显著差异(P<0.05)。结论系统功能训练有利于促进老年TKR术后康复。

Objective To investigate expression differences of neutrophil and mononuclear phagocyte related gene mRNAs among acute myocar-dial infarction (AMI), stable angina (SA) and control groups, and then discuss their expression characteristics in the stable angina pectoris (SAP) and AMI stages of coronary artery disease (CAD). Methods Whole Human Genome Oligo Microarrays were applied to assess the differential expression characteristics of neutrophil and mononuclear phagocyte related mRNAs in patients with AMI (n=20), SA (n=20) and controls (n=20). Results (1) Almost all colony-stimulating factors (CSF) and their receptors related mRNAs was up-regulated in AMI and SA groups compared with the control group, and the expression of granulocyte-macrophage colony stimulating factor receptor (GM-CSFR) and granulocyte colony stimulating factor receptor (G-CSFR) mRNAs in the AMI group was significantly up-regulated com-pared with the other two groups (P<0.01). (2) The expression of mRNAs related to monocyte chemoattractant protein-1 (MCP-1), CCR2 (MCP-1 receptor) and CXCR2 (IL-8 receptor) was significantly up-regulated (P<0.01) in AMI group compared with SA and control groups. IL-8 mRNA expression in the AMI group was clearly higher than the controls (P<0.05). (3) All mRNAs expression related to opsonic re-ceptors (IgG FcR and C3bR/C4bR) was significantly up-regulated in AMI group compared with SA and control group (P<0.01), and the SA group showed an upward trend compared with controls. (4) Most pattern recognition receptor (PRR)-related mRNAs expression was up-regulated in AMI group compared with SA and control groups. Most toll-like receptor (TLR) mRNAs expression was significantly up-regulated (P<0.01) than the SA and control groups;macrophage scavenger receptor (MSR) mRNA was significantly up-regulated in AMI group compared with the control group (P<0.01), and the SA group showed an upward trend compared with the controls. Conclusions The expression of most neutrophil and mononuclear-macrophage function related genes mRNAs was significantly up-regulated by stages during the progression of CAD, suggesting that the adhesive, chemotactic and phagocytic functions of neutrophil and mononuclear-ma-crophage were strengthened in the occurrence and development of coronary atherosclerosis and AMI. This also showed a stepped up-ward trend as the disease progressed.

Objective To explore health knowledge needs of patients undergoing abdominal surgery, and then compare these needs with patients' needs perceived by the nurses, so as to improve contents and ways of health education. Methods From July to September 2014, 208 nurses and 492 patients undergoing abdominal surgery were surveyed about health education needs, by using a self-designed questionnaire on perioperative health education need of patients undergoing abdominal surgery and general investigation, with the results compared. Results Scores of health education needs of nurses and patients were (4.50±0.40) and (4.22±0.35) (t=-9.246, P<0.01). The nurses believed that top three ways of health education that the patients liked most were individualized guidance, health education handbooks and bulletin board, the same as patients' needs. Conclusions Nurses should take individualized health education measures with the basis of taking full consideration of the patients' actual needs. Also, training to nurses should be conducted to improve their health education ability. In this way, the patients' needs can be met to the most, and their satisfaction degree be improved.

Objective To explore the effect of neostigmine in treatment of severe acute pancreatitis (SAP) combined with intra-abdominal hypertension (IAH).Methods 42 patients diagnosed as SAP combined with IAH and meeting standard were collected from Aug.2012 to Jul.2016 in our hospital.They were randomly divided into two groups:observation group and the control group.General information of the two groups was comparable.Patients of the control group received conventional treatment methods such as fasting,gastrointestinal decompression,nutritional support,antispasmodic,analgesia,intravenous infusion of omeprazole and octreotide.Patients of the observation group received intramuscular injection of neostigmine methylsulfate on the basis of the control group for seven days.The intra-abdominal pressure,recovery time of bowel sounds,the first exhaust and defecation time,remission time of abdominal distention,modified Marshall score,APACHE-Ⅱ score,SIRS score,total hospitalization time and total hospitalization expenses,MODS rate,operation rate and mortality of the two groups were recorded during the treatment.Results The intra-abdominal pressure of the observation group was (14.25±1.03) mmHg,(13.52 ±1.23) mmHg,(12.73±1.14)mmHg respectively,lower than that of the control group (15.14± 1.12) mmHg,(14.60± 1.11) mmHg,(13.84±1.08) mmHg at the 3rd,4th,and 5th day after treat ment (P＜0.05).For the observation group,the recovery time of bowel sounds was (7.24±1.35) d,the first exhaust and defecation time was (11.33±1.51) d,(8.36±1.63) d,remission time of abdominal distention was (13.62±2.26) d,lower than those of the control group ((9.56±1.17)d,(13.42±1.26)d,(10.45±1.54)d,(16.75±3.05)d) (P＜0.05).The recovery time of bowel sounds,the first exhaust and defecation time,remission time of abdominal distention of the observation group were lower than those of the control group (P＜0.05).The modified Marshall score,APACHE-]Ⅱ score,SIRS score of the two groups had no significant difference (P＞0.05).The total hospitalizationtime and total hospitalization expenses of the two groups had no significant difference (P＞0.05).MODS rate,operation rate and mortality of the two groups had no significant difference (P＞0.05).Conclusions Neostigmine can significantly reduce intra-abdominal pressure of patients suffering from SAP combined with IAH,improve the symptoms of paralytic ileus,promoting exhaust and defecation.However,it has limited effects on prognosis of patients suffering from SAP combined with IAH.

In recent years, immunotherapy with immune checkpoint as the target has made revolutionary breakthroughs in the treatment of a variety of advanced solid tumors. Notwithstanding the impressive long-term therapeutic benefits, their efficacy is limited to a small subset of cancer patients. Some patients experienced drug resistance and immune-related adverse events (irAEs). Immune checkpoint inhibitors (ICIs) primarily include antibodies targeting CTLA-4 and antibodies targeting PD-1 and its ligands. Thus, it is of utmost importance to screen potential biomarkers in populations that may benefit from immunotherapy, to maximize therapeutic benefits. This review summarizes the mechanism of ICIs and its related efficacy biomarker, to better guide the application of immunotherapy in clinical practice.

Objective:To investigate the clinical characteristics and related risk factors of thyroid gland injury (TGI) in patients with a malignant tumor treated with a programmed death-1 (PD-1) inhibitor.Methods:A Retrospective case-control study. Data from 198 patients with a malignant tumor who received treatment with a PD-1 inhibitor in Chinese PLA General Hospital from October 2019 to October 2021 were collected and analyzed retrospectively. According to the TGI incurred after receiving treatment with a PD-1 inhibitor, patients were divided into a thyroid gland normal (TGN) group and TGI group. The prevalence, type, time of occurrence, and outcome of TGI were analyzed. The risk factors that may contribute to TGI were analyzed further by logistic regression.Results:TGI prevalence was 29.8% (59/198 cases) after treatment with a PD-1 inhibitor. There were significant differences with respect to previous radiotherapy and targeted therapy between the TGN group and TGI group ( P<0.01 for both), but there were no significant differences with regard to sex, age, tumor type, previous surgery, previous chemotherapy, tumor metastasis, or type of PD-1 inhibitor ( P>0.05 for all). Patients in the TGI group included those with subclinical hypothyroidism (32.2%, n=19), hypothyroidism (27.1%, n=16), thyrotoxicosis (23.7%, n=14), subclinical thyrotoxicosis (10.2%, n=6), and thyroiditis with normal thyroid function (6.8%, n=4), and the median time of occurrence (months) was 3.00, 3.00, 1.50, 1.50, and 0.80 after treatment with a PD-1 inhibitor, respectively. Among 20 patients who presented initially with thyrotoxicosis or subclinical thyrotoxicosis, 12 cases developed hypothyroidism or subclinical hypothyroidism subsequently. Logistic regression analysis suggested that previous radiotherapy ( OR=3.737, 95% CI 1.390-10.046), targeted therapy ( OR=3.763, 95% CI 1.553-9.117), thyroglobulin antibodies at baseline ( OR=12.082, 95% CI 1.199-121.775), and thyroid-peroxidase antibodies at baseline ( OR=10.874, 95% CI 1.010-117.047) were risk factors associated with the TGI caused by treatment with a PD-1 inhibitor. Conclusions:After treatment with a PD-1 inhibitor, TGI prevalence was high, especially in those with hypothyroidism or subclinical hypothyroidism. Some patients had a transition from thyrotoxicosis to hypothyroidism. Patients who underwent radiotherapy previously, had targeted therapy, or were thyroid autoantibody-positive at baseline may carry an increased risk of TGI following treatment with a PD-1 inhibitor.

?? [Abstract]? Objective? To analyze the clinical characteristics of lower extremity deep venous thrombosis (DVT) in elderly patients in Intensive Care Uni(t ICU) of Neurology Department, and to provide evidence for early implementation of preventive strategies. Methods? Totally 229 patients who were admitted to the ICU of Neurology Department in a hospital from March 2017 to October 2018 were collected as the participants of the study and divided into the elderly group(age≥ 60 years) and non-elderly group(age＜ 60 years) according to their ages. Self-designed questionnaire was used to collect the patients' general information, relevant factors of the lower extremity DVT, and information of commonly seen problems in elderly population such as history of hypertension and diabetes. SPSS 22.0 was used for data analysis. Results? Among the 229 patients, 97 were diagnosed as lower extremity DVT, the incidence was 42.4%. Among them, the number of lower extremity DVT in the elderly group was 62, and the incidence was 57.4%, while the number in the non-elderly group was 35, and the incidence was 28.9%, and there was statistically significant difference between the two groups (P＜0.05). There were statistically significant difference between the two groups in terms of fibrinogen value during thrombosis, hypertension history, diabetes, heart disease and hormone drug use, etc (P＜0.05). There was no statistical difference in the vascular location of DVT in lower extremities between the two groups (P＞0.05), and the main type of DVT was intramuscular venous thrombosis. Conclusions? Ischemic cerebrovascular disease, high level fibrinogen accompanied by hypertension, diabetes mellitus and heart disease are the main factors of DVT formation in the lower extremity of elderly patients in ICU of Neurology Department. Reducing hormone use is the protective factor of DVT prevention in lower extremities. Neurological ICU needs to pay early attention to the occurrence of DVT in the lower extremities of the elderly, especially the intramuscular venous thrombosis. Early prevention and interventions should be initiated to reduce the incidence of DVT in the lower extremities of elderly patients in Neurological ICU.

Objective To investigate the consistency of the lymphocyte immunophenotype between labial gland and peripheral blood of patients with primary Sj(o)gren's syndrome (pSS).Methods Seveny-one pSS patients (referred as pSS group) from rheumatology department and 35 subjects patients with maxillofacial trauma (referred as control group) from department of head and neck surgery of general hospital at tianjin medical university (Tianjin,China) during August 2013 to April 2016 were included into this study.Based on the ratio of CD20 to CD3 in labial gland from pSS patients,they were divided into CD20 high proportion group and CD20 low proportion group.Lymphocyte immunophenotypes in labial glands,course of disease,erythrocyte sedimentation rate (ESR),C-reactive protein (CRP) level,immuno-globulin (Ig) and complement levels were compared among groups.Results ① The levels of serum IgG,IgA,IgM and CRP,and ESR were higher,but C4 level was lower in pSS patients than in the control group [IgG:(22 990±8 060) mg/L vs (1 1560±1 290)mg/L,t=l 1.645,P＜0.01;IgA:(3 710±1 400) mg/L vs (2 390±800) mg/L,t=6.138,P＜0.01;IgM:(1 580±1 300)mg/L vs (920±390) mg/L,t=3.893,P＜0.01;ESR:(37±14) mm/1 h vs (14±4) mm/1 h,t=12.723,P＜0.01;CRP:(5.9±8.7) mg/L vs (2.5±1.2) mg/L,t=3.199,P＜0.01;C4:(180±60) mg/L vs (250±40) mg/L,t=-6.850,P＜0.01].② The levels of IgG,IgA,IgM and C3c in labial gland were higher (IgG:Z=-6.264,P＜0.01;IgA:Z=-1.997,P＜0.05;IgM:Z=-5.459,P＜0.01;C3c:Z=-8.533,P＜0.01),but Clq was lower in pSS group than in control group (Z=-4.363,P＜0.01).③ CD20 was detected in labial gland samples of all pSS patients,in which CD3 was positive in 66 patients,and negative in 5.④ Serum IgG level,ESR were higher in CD20 high proportion group than in low proportion group [IgG:(24 970±7 510) mg/L vs (18 860±7 740) mg/L,t=3.176,P＜0.01;ESR:(40±13) mn/1 h vs (32±15) mm/1 h,t=2.148,P＜0.05].⑤ The levels of IgG and Clq in labial gland were higher in CD20 high proportion group than in low proportion group [IgG:Z=-5.387,P＜0.01;C1q:Z=-4.724,P＜0.01].Conclusion pSS patients have a higher proportion of CD20 in infiltrating lymphocytes of the labial gland,accompanied with the changes of immunoglobulins and complements in both labia gland and peripheral blood.

Objective:To investigate the clinical and genetic characteristics of genetic and metabolic infantile cholestatic hepatopathy (ICH), and to provide evidence for its diagnosis and treatment.Methods:Clinical data and follow-up outcomes of hospitalized children diagnosed with ICH in the Department of Gastroenterology, Children′s Hospital, Capital Institute of Pediatrics from January 2014 to December 2019 were retrospectively analyzed.Among the 80 children, 27 were female and 53 were male, with a mean age of onset of (39±18) days old.Children with confirmed etiology by high-throughput sequencing analysis were included in the genetic metabolic group (44 cases), and those with idiopathic neonatal cholestasis(INC) of unknown etiology after the systematic examination were included in the INC group (36 cases). The t-test or independent sample rank sum test was used to compare the laboratory test results and biochemical indexes.The infection rate of cytomegalovirus was compared by the Chi- square test. Results:(1) A total of 80 cases were included, and 44 cases (55.0%)were confirmed as INC by high-throughput sequencing.Among those with a positive molecular diagnosis, there were 23 cases of citrin deficiency (CD), 10 cases of Alagille syndrome (ALGS), 6 cases of progressive familial intrahepatic cholestasis (PFIC), 2 cases of congenital bile acid synthesis defect, 2 cases of Nieman Pick disease, and 1 case of cystic fibrosis.(2) Serum total bile acid (TBA) and activated partial prothrombin time (APTT) levels in the genetic metabolic group were significantly higher than those in the INC group (all P<0.05). TBA and APTT levels in genetic metabolites were 180.6 (115.5, 271.6) μmol/L and 40.6 (37.1, 45.2) s, respectively, which were 123.3 (98.8, 163.4) μmol/L and 34.8 (31.7, 40.1) s in INC group, respectively.There was no significant difference in the cytomegalovirus infection rate between the 2 groups ( P>0.05). (3)The pathological examination of liver tissue in the genetic metabolic group was worse than that in the INC group, with spot-like and fusion focal-like necrosis, and 5 cases (4 cases of ALGS and 1 case of CD) showed a reduced number of bile ducts in the portal area and lumen stenosis. Conclusions:CD, ALGS and PFIC are the common causes of genetic and metabolic ICH.Fundamental cause of cholestasis should be actively examined in children with cytomegalovirus infection.High-throughput sequencing is of great significance in the accurate diagnosis of ICH.