Humans ; Organometallic Compounds ; chemistry ; metabolism ; toxicity

Adult ; Female ; Humans ; Male ; Occupational Diseases ; Organometallic Compounds ; poisoning

Objective To investigate the clinical features of polymyositis and dermatomyositis ( PM/DM) with lym-phoma .Methods The clinical data , treatment and prognosis of PM/DM with lymphoma from 2000 to 2015 in Pe-king Union Medical College Hospital were retrospectively collected and analyzed .Results Ten cases of PM/DM patients complicated with lymphoma were recruited .6 were female and 4 was male.The mean ages of the diagnosis of PM/DM and lymphoma were 44.5 and 44.9 years old respectively .The average disease course from PM/DM to lymphoma was 4.7months.Six cases were dermatomyositis and 4 cases were polymyositis.Three cases had pulmo-nary fibrosis and 2 cases had arthritis .No case had a positive result of anti-Jo-1 antibody .The most frequent symp-toms complicated with lymphoma included as following:enlargement of lymph nodes (9 cases), fever (8 cases), splenomegaly(5 cases).The top 3 lymphoma biopsy specimen included lymph node (4 cases), skin(2 cases)and local mass(2 cases).All the 10 patients were diagnosed as non-Hodgkin lymphoma.4 cases were derived from T cell, 2 cases from B cell, and 4 cases with unknown origin .The clinical staging showed III B (4 cases) and IV B (6 cases).Immunosuppressant agents were given to treat PM/DM.During the follow-up period, 5 patients died, 4 patients received chemotherapy and 1 patient was lost .Conclusions The coincidence of PM/DM and lymphoma is not rare .The course between PM/DM and lymphoma is short , and the mortality is significant , which should arise the attention of clinicians .

Adult ; Enchondromatosis ; diagnosis ; diagnostic imaging ; Femur ; diagnostic imaging ; Humans ; Male ; Radiography

Objective:To evaluate the efficacy of remimazolam-propofol-sufentanil for anesthesia in patients undergoing painless gastroscopy.Methods:Eighty American Society of Anesthesiologists physical statusⅠor Ⅱ patients, aged 20-59 yr, weighing 44-69 kg, scheduled for elective painless gastroscopy, were divided into 2 groups ( n=40 each) using a random number table method: remimazolam-propofol-sufentanil group (group RPS) and propofol-sufentanil group (group PS). The patients in group RPS received successive intravenous injection of sufentanil 0.1 μg/kg, remimazolam 0.15 mg/kg and propofol (at a rate of 4 mg/s). The patients in group PS received intravenous injection of sufentanil 0.1 μg/kg and propofol (at a rate of 4 mg/s). When Observer′ s Assessment of Alertness/Sedation Scale score was 0, gastroscopy was performed.The consumption of propofol, time of anesthesia, time for gastroscopy, emergence time and discharge time were recorded.The number of intraoperative assisted respiration cases, body movement and occurrence of adverse reactions at the time of discharge were observed. Results:Compared with group PS, the consumption of propofol was significantly decreased, and the time of anesthesia, emergence time and discharge time were shortened in group RPS ( P<0.05). There was no significant difference in the time for gastroscopy, the number of intraoperative assisted respiration cases, body movement and the occurrence of adverse reactions at discharge time between the 2 groups ( P>0.05). Conclusion:Remimazolam-propofol-sufentanil produces better efficacy for anesthesia than propofol-sufentanil in patients undergoing painless gastroscopy.

Objective By analyzing the mortality of patients with hypertension and cerebral infarction in different blood lipid stratification,the significance of blood lipid stratification management in the treatment of hypertension was clarified.Methods 604 patients with hypertension combined with cerebral infarction were divided into middle risk group (198 cases),high risk group (n=198) and extremely high risk group (n=208) and each group of different stratification according to the serum lipid HCY level,divided into H type hypertension group (HCY=10 μmol/L) and hypertension group ((HCY＜10 μmol/L group) and comparison of the 10 year mortality in each group.Results Comparison of mortality between H type hypertension group and simple hypertension group,among them,the difference between the two groups in middle risk group was statistically significant (x2 =5.095,P =0.024 205).The difference between the two groups in extremely high risk group was statistically significant (x2 =7.859,P=0.005 056).The difference between the two groups in high risk group was statistically significant (x2 =9.961,P=0.001 599).There was a significant difference in mortality between the groups with different blood lipids in simple hypertension group.Among the high-risk group and the middle risk group,the difference was statistically significant (x2=6.575,P=0.010 343),and there was significant difference between high risk group and high risk group (x2 =6.868,P=0.008 774).Comparison of mortality between different lipid levels in H type hypertension group,the difference was statistically significant.There was significant difference between the extremely high risk group and the high risk group (x2 =4.745,P=0.029 388) and there was significant difference between the high risk group and the middle risk group (x2 =11.668,P=0.000 636).Conclusion Hyperlipidemia,especially high LDL and high HCY are the main causes of death in patients with hypertension complicated with cerebral infarction,the clinical use of blood lipid levels can reduce the level of LDL and reduce the mortality of patients by strengthening the control of HCY level.Improve the survival rate of patients.

Objective To study the prevalence rate and influential factors of diabetes among residents aged over 15 in Hubei province to provide evidences for diabetes control .Methods Through stratified cluster sampling ,20 cities and counties ,including 100 blocks and towns ,200 communities and villages were sampled .Household survey was carried out from October to November , 2013 .Data was analyzed with SPSS18 .0 .Results In total ,28 555 eligible residents were surveyed ,among which 823 (2 .88% ) self‐reported being diagnosed as diabetes .The prevalence rate for urban and rural residents were found as 4 .37% and 1 .83% respective‐ly ,that of male and female as 2 .61% and 3 .13% respectively .Residents aged 65 and above reported highest prevalence rate (6 .61% ) while those from 25 to 34 years old had the lowest (0 .06% ) .Multiple logistic regression analysis yielded results that ru‐ral‐urban residence ,age ,occupational status ,type of medical insurance ,alcohol drinking and obesity were influential factors of diabe‐tes .Conclusion Prevalence rate of diabetes among residents aged over 15 in Hubei province was at a relatively lower level and there were differences between population subgroups .

Objective To investigate the correlation between non high density lipoprotein cholesterol (non-HLD-C)and cardi-ac function in patients with coronary heart disease (heart disease cardiac,CHD).Methods 162 patients with CHD were se-lected as the experimental group of CHD,100 cases of healthy physical examination qualified as the normal control group. CHD experimental group was divided into mild impairment group and severe impairment group according to the degree of impairment of the heart function.The mild impairment group include I and II levels of cardiac function classification and the severe impairment group included III and IV levels of cardiac function classification.To measure separately total cholesterol (TC),triglyceride (TG),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),and to calculate the content of non high density lipoprotein cholesterol (non-HDL-C).To compare the differences between CHD ex-perimental group and normal control group,and the correlation between different indexes of blood lipid and the degree of loss of cardiac function.Results The serum levels of non-HDL-C,TG and LDL in the Cardiac function in mild damage group of the CHD experimental group were significantly higher than those in the normal control group,and there were statistically significant differences between the two groups(t=2.438,2.887,5.253,P<0.05).The serum levels of non-HDL-C,TG and LDL in the severe heart function impairment group of the CHD experimental group were significantly higher than those in the normal control group,and there were statistically significant differences between the two groups (t=2.438,2.887,5.253,P<0.05).The serum level of HDL in the cardiac function in mild damage group of the CHD experimental group was significantly lower than that in the normal control group (t=-3.132,P<0.05).The serum level of HDL in the severe heart function impairment group of the CHD experimental group was significantly lower than that in the normal control group (t=-6.028,P<0.05).In the CHD group,only the serum level of TC in the severe impairment group was signifi-cantly different from that in the control group (t=3.278,P<0.05).The serum levels of non-HDL-C,TG,LDL of mild im-pairment of cardiac function in the CHD experimental group were significantly different from the serum levels of the severe impairment group (t=2.051,2.057,2.281,P<0.05).Logistic regression analysed that the OR value of serum non-HDL-C in CHD group was slightly lower than that of LDL,and significantly higher than TC and TG.With the increase of the degree of cardiac function,the value of OR increased significantly.Conclusion Serum non-HDL-C had a positive correlation with severity of CHD.To a certain extent,it can reflect the severity of CHD and is an important reference index for clinical diag-nosis and treatment of CHD.

OBJECTIVETo investigate the chronic hepatic damage in acute promyelocytic leukemia (APL) patients long-term treated with tetra-arsonic tetra-sulfide (As(4)S(4)).

METHODSThe periodical liver biochemical examinations and ultrasonography results and hepatic fibrosis indicators (P III NP and type IV collagen) of patients were analysed.

RESULTS106 APL patients treated with As(4)S(4), the median follow-up time was 36 months (6 - 72). The HCV(-) group includes 84 APL patients. During the first course the abnormal rate of the alanine aminotransferase (ALT) and aspartate aminotransferase (AST) was 16.7% and 14.5% (higher than the two times of the normal value), the ALT, AST, gamma-glyoxylate aminotransferase (GGT) levels during the first course were statistically higher than As4S4 treatment before (P < 0.05). There were no statistically differences between the ALT, AST, GGT levels after and before treating with As(4)S(4) in half a year, one year, two year, more than three years (P > 0.05). Other biochemical indicators such as ALP, LDH, TBIL, DBIL, TP, ALB, A/G, BUN, CRE, there were no significantly differences before and after As(4)S(4) treatment (P > 0.05). The HCV(+) group includes 22 APL patients, during the first course, the abnormal rate of the ALT, AST were 63.6% and 59.1%, but at the 2 year, more than 3 years there were no significantly differences compared with As(4)S(4) treatment before (P > 0.05). 42 APL patients were treated with As(4)S(4) more than 3 years, in 33 HCV(-) APL patients, two APL patients had splenomegaly, one APL patient's breadth of the portal vein was wider than 1.4 cm, 21 APL patients had fatty liver (63.6%). The hepatic fibrosis indicators of the 16 APL patients were all normal. In 9 HCV(+) APL patients, 4 APL patients had splenomegaly, 2 APL patients, breadth of portal vein were wider than 1.4 cm, 6 APL patients had fatty liver (66.7%). 6 patients were examined with the hepatic fibrosis indicators, 2 patients, were higher than the normal value.

CONCLUSIONLong term As(4)S(4) treatment for APL patients had no obvious effects on hepatic function, no obvious hepatic fibrosis and portal hypertension signs at more than 3 years, excepting for the rate of fatty liver was high.

Adolescent ; Adult ; Aged ; Arsenicals ; adverse effects ; chemistry ; Collagen Type IV ; metabolism ; Fatty Liver ; chemically induced ; metabolism ; Female ; Fibrosis ; Follow-Up Studies ; Humans ; Leukemia, Promyelocytic, Acute ; drug therapy ; Liver ; drug effects ; pathology ; Male ; Middle Aged ; Sulfides ; adverse effects ; chemistry ; Young Adult

Clinical research design is the beginning and the cornerstone for clinical research,and it functions as the preliminary step of translational research.In order to improve clinical research ability,foster quality research talents team,and to promote the development of translational research,Peking Union Medical College Hospital (PUMCH) started to provide the online course Designing Clinical Research (DCR),which has greatly contributed to enhancing clinical research capacity.The management of DCR online course serves as a great exploration on training junior medical professionals and international research collaboration.This study aims at sharing the management experiences of clinical research design and junior talents training.