OBJECTIVE:To analyze the general patterns and characteristics of drug-induced lupus (DIL) induced by inflix-imab,and to provide reference for the safety of drug use. METHODS:Usinginfiximab,lupusas searching words,inflix-imab-induced DIL literatures included in CJFD,VIP and PubMed from Jan. 2002 to Jun. 2016 were retrieved and analyzed. RE-SULTS:Totally 30 effective literatures were retrieved,involving 31 DIL patients,there were 8 male cases (25.81%) and 23 fe-male cases(74.19%);17 patients aged more than 50(54.84%). 20 cases occurred within 5-24 weeks(64.51%). 16 patients re-ceived infliximab alone (51.61%). Main clinical manifestations were skin rash or photosensitivie enteritig (15 cases),joint pain (16 cases,multiple arthritis and synovitis)and fever(12 cases). 5 patients suffered from 3 above symptoms simultaneously. Labo-ratory examination mainly manifested as antinuclear antibody,double stranded DNA antibody and anti-histone antibody positive. Thirty patients with DIL received drug withdrawal or steroid hormones treatment,among which the symptoms of 26 patients disap-peared after drug withdrawal or treatment within 6 months,and 1 patient deteriorated. CONCLUSIONS:DIL-induced by inflix-imab invovle patients'age and gender,disease types,family history and other factors. Clinicians should be aware of rules and char-acteristics of DIL induced by infliximab,and tighten drug use monitoring to reduce ADR.

OBJECTIVE To discuss etiological factors and control strategies of hospital infection,in order to reduce the occurrence of hospital infection in the outpatient department of stomatology.METHODS According to the etiological factors of the hospital infection in outpatient department of stomatology,the corresponding control measures were presented.RESULTS The occurrence of hospital infection could be cut down by steps such as establishing the perfect rules and regulations,executing technical operation rules strictly,strengthening knowledge training for the medical staff,occupational protection,environmental disinfection management of outpatient department of stomatology,equipment disinfection management,hand hygiene of medical staff and standardizing the classification of the collection of clinical waste.CONCLUSIONS Occurrence of hospital infection has been effectively cut down by management measures of hospital infection taken in the outpatient department of stomatology.

Objective To compare the effects of target-controlled infusion (TCI) of propofol and remifentanil and inhalation anesthesia on the stress response in patients undergoing laparoscopic cholecystectomy (LC). Methods Selective LC was performed on 60 cases. Before the surgery,the patients were randomly divided into experiment (TCI of propofol and remifentanil) and control (standard general anesthesia combined with inhalation of fluorinated alkane and laughing gas) groups with 30 cases in each. The serum levels of cortisol and IL-6 were detected before the induction (t1) and 20 minutes after pneumoperitoneum (t2). In addition,the MAP and HR of the two groups were monitored at seven time points. Results The serum levels of cortisol and IL-6 in the experiment group were similar to those in the control at t1 [Cortisol:(227.48?50.81) ?g/L vs (233.21?41.02) ?g/L,t=0.481,P=0.633; IL-6:(105.99?30.65) ng/L vs (111.20?34.80) ng/L,t=-0.615,P=0.541],but significantly lower at t2 [Cortisol:(241.00?69.11) ?g/L vs (354.70?37.55) ?g/L,t=7.918,P=0.000; IL-6:(116.06?30.89) ng/L vs (172.73?23.54) ng/L,t=-7.992,P=0.000]. The MAP and HR in the experiment group were significantly lower than those in the control at t2 to t5 (5,10,15,and 20 minutes after the pneumoperitoneum; P

To identify the best inducing condition, we studied the expression of membrane protein HSP70 and mRNA of H22 cell at various temperature. Using MTT,RT-PCR, immunofluorescence and FCM techniques, we observed H22 cell survival rate, the expression of HSP70 mRNA and membrane HSP70. No effects of H22 cell survival rate under 42 ~ 43℃ was observed, but cell survival rate declined with increasing stress time at 44 ~ 45 ℃; the level of HSP70 mRNA decreased initially (0.5~4.0) hours but gradually resumed and increased from 8 to 12 hours at 42℃. Membrane HSP70 expressing cells were significently higher in heat shock treatment group than in a control group ( P

Objective To explore the difference between pressure-regulated volume controlled ventilation (PRVCV) and volume controlled ventilation (VCV) during videothoracoscopic bhb excision.Methods Consecutive 20 patients scheduled to undergo videothoracoscopic bleb excision were enrolled into the study.After induction, endotracheal blocker was advanced into endotracheal tube to establish one-lung ventilation,each patient was randomly assigned to receive successively PRVCV and VCV for 20 minutes.Ventilatory variables were kept constantly(tide volume 6 ml/kg, respiratory rate 15 breaths/min and I: E ratio 1: 2).Heart rate,blood pressure,peak airway pressure and blood gas parameters were compared.Results Peak airway pressure was significantly lower with PRVCV than that with VCV [(12.7±3.6 ) cmH_2O(1 cm H_2O =0.098 kPa) vs (18.2±4.3) cm H_2O,P < 0.01].However,there was no significant difference in arterial oxygen tension,arterlal partial pressure of carbon dioxide,heart rate and blood pressure between PRVCV and VCV.Conclusion During one-lung ventilation in videothoracoscopic bleb excision, PRVCV offers lower peak inspiratory airway pressures while maintaining equal oxygenation compared with VCV.

Objective To study the effect of endotracheal tube's resistance on the respiratory systolic variation test(RSVT).Methods The RSVT,a test to predict fluid responsiveness was performed in 20 patients.The test consisted of the delivery of three congecutive pressure-controlled breaths with incremental peak inspiratory pressures of 10,20 and 30 cm H2O(1 cm H2O=0.098 kPa).The minimal values of the systolic arterial pressure following each of these three breaths were measured and plotted against their respective airway pressures,producing the RSVT slope.RSVT slope were compared between normal airway resistance and increased resistance circumstances,and the latter was simulated by advancing a Cooperdech bronchial blocker into endotracheal tube.Results Under normal resistance,RSVT slope was(0.39±0.21) volumes were(461.5±95.9),(891.5±149.8)and(1207.5±159.1)ml,when peak inspiratory pressures of 10,20 and 30 cm H2O were dehvered.When bronchial blocker was advanced into endotrecheal tube, (0.27±0.17)mm Hg,cm H2O significantly(P<0.01),and tidal volumes decreased to(434.5±92.8), (796.5±96.6)and(1097.5±68.4)ml(P<0.05 or<0.01).Conclusion Changes in endotraeheal tube's resistance can distort the RSVT slope.

Objective To determine the long-term outcomes of cN0 papillary thyroid carcinoma without elective central compartment neck dissection. Methods The clinical data of 180 patients with clinically lymph node negative papillary thyroid carcinoma who were treated in our center between 2000 and 2005 were retrospectively analyzed. All of these patients did not receive elective central compartment neck dissection. Clinicopathological characteristics including gender,age,surgical range,pathologic type,tumor size,and extrathyroidal extension(ETE)or not were collected. Results After a median follow-up period of 90 months,only one patient died of stroke without tumor. Sixteen patients had tumor recurrence:seven patients had a recurrent disease in residual thyroid tissue,two in the thyroid bed,six in central compartment,eight in lateral cervical compartment,and one in lung. The 10-year overall survival,disease-specific survival,and recurrence-free survival was 99.4%,100%,and 87.9%,respectively. The 10-year accumulative lymph node recurrence rate in central compartment and lateral compartment was 7.8% and 7.0%,respectively. ETE was an independent risk factor for central compartment lymph node recurrence. Male gender(P=0.010)and ETE(P=0.028)were independent risk factors for lateral compartment lymph node recurrence. Conclusions The prognosis of patients with cN0 papillary thyroid carcinoma without elective central compartment neck dissection is good after ten years of follow-up. Male gender and ETE are independent risk factors for lateral compartment lymph node recurrence.

Objective To compare volume-controlled ventilation (VCV) versus pressure-controlled ventilation (PCV) improved by PEEP during one-lung ventilation (OLV).Methods Fifty ASA physical status Ⅰ-Ⅲ patients,aged 25-64 yr,weighing 40-80 kg,undergoing elective thoracotomy,were randomly divided into 2 groups (n =25 each) using a random number table:VCV + PEEP group (group Ⅴ) and PCV + PEEP group (group P).Those in group Ⅴ underwent OLV initially with VCV for 20 min followed by 4cm H2O PEEP for 20 min and then PEEP was removed.Those in group P underwent OLV initially with PCV for 20 min followed by 4cm H2O PEEP for 20 min and then PEEP was removed.At the beginning of two-lung ventilation before chest opening (T1),at 20 min of OLV before PEEP (T2),and at 20 min of ventilation with PEEP (T3),arterial blood samples were collected for blood gas analysis and the peak airway pressure (Ppeak) and development of SpO2 ＜ 95 ％ from beginning of OLV to T3 were recorded.Results Compared with group P,Ppeak at T2,3 and PaO2 at T3 were significantly increased in group Ⅴ (P ＜ 0.05).Compared with the baseline value at T1,PaO2 was significantly decreased and Ppeak was increased at T2.3 in Ⅴ and P groups (P ＜ 0.05).The incidence of SpO2 ＜ 95％ was significantly decreased and PaO2 was increased at T3 than at T2 in Ⅴ and P groups (P ＜ 0.05).Conclusion 4 cm H2O PEEP can improve VCV and PCV during OLV and the improved efficacy is better for VCV in patients undergoing thoracotomy.

Objective To investigate the appropriate surgical procedure for unilateral papillary thyroid microcarcinoma (PTMC).Methods Clinical data of 323 patients with unilateral PTMC in Cancer Hospital of Chinese Academy of Medical Sciences from 1999-2007 were retrospectively studied.Survival outcomes and prognostic factors were analyzed.Results After a median follow-up of 102 (range,12-188) months,the 10-year overall and disease-specific survival was 95.3％ and 98.9％.The 10-year recurrence-free survival was 85.5％.The 10-year cumulative recurrence rate of residue glands was 6.5％.Capsular invasion,pT stage and clinical stage were significant predictive factors for recurrence of residue glands (all P ＜ 0.05).Cox regression multivariate analysis showed that pT stage (HR 2.153,95％ CI 1.231-3.767,P =0.007) was independent predictive factor.Of the 311 patients treated with non-total thyroidectomy,the 10-year cumulative recurrence rate of residue glands was 6.8％ Conclusions Unilateral PTMC has a good prognosis and hemithyroidectomy (lobectomy and isthmusectomy) is an appropriate surgical pattern.Extrathyroidal extension is a significant predictor for recurrence.

Objective:To determine the content of cyclohexane, ethyl acetate, methanol, methylene chloride and trichloromethane in rupatadine fumarate by headspace gaschromatography. Methods:A DB-WAXETRR capillary column(30 m × 0. 32 mm,0. 25 μm)was used and the carrier gas was nitrogen. The detector was an FID and the inlet temperature was 200℃ . The column temperature program was with the initial temperature of 35℃,maintained 10 min,and then risen to 220℃ with the rate of 20℃·min -1 ,and maintained 5 min. Results:Cyclohexane,ethyl acetate,methanol,methylene chloride and trichloromethane showed a good linear relationship within the range of 77. 590 1- 698. 310 9 μg·ml -1(r = 0. 999 7),102. 166 6- 919. 499 4 μg· ml -1(r = 0. 999 8),62. 744 7- 564. 703 2μg·ml -1(r = 0. 999 9),12. 011 2- 108. 101 1 μg·ml-1(r = 0. 999 6)and 1. 262 8-11. 365 6 μg·ml -1(r = 0. 999 6). The average recovery was 103. 9% ,103. 5% ,104. 9% ,107. 1% and 103. 4% and RSD was 2. 3% ,2. 6% ,3. 1% ,2. 8% and 4. 5%(n = 9),respectively. The five residual solvents were not detected out in rupatadine fumarate. Conclusion:The method is stable,simple,sensitive and accurate,and can be used for the determination of residual solvents in rupatadine fumarate.