Objective To strengthen the awareness that hematological tumors present with certain rheumatic symptoms for early diagnosis and treatment to a hidden neoplasm.Methods 15 patients admitted to rheumatic ward with suspected rheumatic disease were finally diagnosed as hematological tumors.Their rheumatic manifestations and occult malignancies were collected.Results A variety of rheumatic manifestations were presented.Among 15 patients,10(66.7%)had fever,6(40%)skin lesion,3(20%)arthritis,6(40%)vasculitis,3 adult onset of Still's disease,2 unelassified,and one of the each following disease:amyloidosis,dermatomyositis,polymyalgia rheumatica,and panniculitis.9 of lymphoma,3 leukemia,3 multiple myeloma were finny diagnosed. Conclusion Rheumatic disorders associated with hematological tumors include a variety of conditions.An extensive investigation for occult malignancies with some rheumatic symptoms is recommended when accompanied by specific findings of suggestive malignancy.

Objective To understand the acute effect of the air pollution on daily mortality of cardiovascular diseases in the old people aged over 65 years in Taiyuan, Shanxi, China. Methods Case-crossover design was used to assess the association between air pollution and daily cardiovascular disease mortality. Pollutants considered were nitrogen dioxide (NO2), carbon monoxide (CO), inhalable particles (PM10) and sulfur dioxide (SO2). Results CO exposure was significantly associated with the mortality of five kinds of cardiovascular diseases. No association was found for arrhythmia. As CO concentration increased by 100 ?g/m3, the corresponding OR of cardiovascular disease mortality were as follows, total cardiovascular disease mortality were1.000-1.013, cardiac mortality were1.000-1.024, ischemic heart disease were 1.005-1.032, cardiac failure were 1.006-1.112, myocardial infarction were 1.009-1.050 respectively. The higher OR value was found in unidirectional control design than that in the bidirectional design. Considering the lag effect of air pollution, the 24 hr and 48 hr average of air pollution levels were analyzed in the present study respectively. Conclusion The current air pollution level (PM10, CO) in Taiyuan City has a acute effect on the cardiovascular disease mortality in the local old people aged over 65 years.

0.05);between YMDD mutation and YMDD negative,there was statistical difference(P0.05),between YMDD mutation and YMDD negative, there was significant difference(t=12.76,P

Objective To investigate the effect of MOTOmed movement therapy on balance and ability in the activities of daily living (ADL) of convalescing stroke patients with hemiplegia. Methods Forty convalescent stroke patients exhibiting hemiplegia were randomly divided into a treatment group and a control group with 20 cases in each group. The control group received routine rehabilitation training; the treatment group received MOTOmed training in addition. Balance function of all the patients was assessed using Berg's balance scale (BBS) , and the Barthel Index ( BI) was used to assess ADL ability at the beginning of the program and after 6 weeks of treatment. Results Balance and ADL ability improved significantly in both groups after 6 weeks of treatment. The effect in the treatment group was significantly better than in the control group. Balance and ADL ability were positively correlated. Conclusions Applying MOTOmed therapy along with routine rehabilitation training can distinctly improve balance and the ADL ability of hemiplegics after stroke.

Objective To evaluate the effect of dexmedetomidine alternative to propofol administered in general anesthesia on maintainance and recovery in patients undergoing gynecologic laparoscopy.Methods One hundred and twenty patients undergoing gynecologic laparoscopy,were divided into group C,D1 and D2 with 40 cases each by random digits table method.Group C received propofol 100 μ g / (kg min) and remifentanil 0.10-0.25 μ g / (kg min) intravenous infusion,group D1 received propofol 100 μ g/(kg min),remifentanil 0.10-0.25 μ g/(kg min) and dexmedetomidine 0.2 μ g/(kg h) intravenous infusion,while group D2 received dexmedetomidine 2.0-3.0 μ g / (kg h) and remifentanil 0.10-0.25 μ g/ (kg min).Cis-atracurium was given on time to maintainance of anesthesia.The heart rate (HR),mean arterial pressure (MAP) were recorded at the following time points:arriving at operating room (To),anesthesia induction (T1),intubation (T2),skin incision (T3),pneumoperitoneum (T4),10 min after pneumoperitoneum (T5),20 min after pneumoperitoneum (T6),the end of operation (T7),discharge from post anesthesia care unit(T8) and the first postoperative day (T9).The time of emergence,extubation and duration in post anesthesia care unit were recorded too.Ramsay scale and Riker Sedation-Agitation Scale on emergence,extubation and discharge from post anesthesia care unit and post anesthesia recovery score at T9 were also recorded.Results The MAP in group D2 was higher at T3 to T7 time-points than that in group C and group D1 [(93 ± 10),(99 ± 11),(94 ± 13),(95 ± 10),(91 ± 10) mm Hg (1 mm Hg =0.133 kPa) vs.(88± 11),(90± 10),(87±9),(86±9),(83±8)mmHgand (87±9),(90± 10),(86±8),(85 ±7),(83 ± 7) mm Hg],there were significant difference (P ＜ 0.05).There were no significant difference among groups on the HR at each time point and the time of emergence,extubation and duration in post anesthesia care unit (P ＞ 0.05).Ramsay scale was lower on emergence and Riker Sedation-Agitation Scale was higher on emergence and extubation in group C than that in group D1 and group D2 [(3.7 ± 1.3) scores vs.(4.0 ± 0.9),(4.2 ±0.9) scores,(3.1 ± 1.0) scores vs.(2.8 ±0.6),(2.7 ±0.9) scores,(3.3 ±0.7) scores vs.(3.2 ± 0.4),(3.0 ± 0.5) scores],there were significant differences (P ＜ 0.05).Riker Sedation-Agitation Scale was higher on extubation in group D1 than that in group D2(P ＜ 0.05).Post anesthesia recovery score at T9 in group D2 was apparently increased compared with that in group C and group D1 [(108 ± 10) scores vs.(93 ± 13),(93 ± 15) scores] (P ＜ 0.05).Conclusions Dexmedetomidine 2.0-3.0 μ g/ (kg h) administered in general anesthesia on maintainance in gynecologic laparoscopy can improve the quality of extubation and promote postoperative recovery without prolonging extubation time,but have a influence on hemodynamic changes at early stage of pneumoperitoneum.

Objective To study human sperm acrosome by means of flurescein labeled pisum sativum agglutinin technique (FITC PSA) to evaluate the fertile capacity of human sperm. Methods The acrosome intact rate was assessed in 58 infertile men and in 46 fertile ones.Human zona pelucida (zp) induced acrosome reaction was detected in 7 infertile and 7 fertile men. Results The acrosome intact rate and the acrosome reaction rate were both higher in the fertile group than those in the infertile group ( P

Objective To investigate the role of sFas and sFasL in the development and progression of uterine cervix cancer(UCC)and the clinical significance of detecting them.Method Serum sFas and sFasL levels of 30 UCC patients were detected by enzyme-linked immunosobent assay (ELISA) before and after treatment (operation or chemotherapy),at the same time serum sFas and sFasL levels of 20 healthy volunteers were also detected by ELISA.Results Serum sFas and sFasL levels of UCC patients[(8.60±0.27),(2.96±0.65)μg/L] were obviously higher than those of healthy volunteers[(6.27±0.25),(0.21±0.05)μg/L],there was statistical significance (P＜0.05).Serum sFas and sFasL levels of those who had operations decreased obviously 2 weeks after the operation,serum sFas and sFasL levels of those who had chemotherapy 3 weeks later increased,there was statistical significance when compared before and after treatment (P＜0.05).Conclusions sFas and sFasL may play important roles in the development and progression of UCC,detection of serum sFas and sFasL levels may conduce to observe the changes of pathogenetic condition.

Objective To explore the effects of protective lung ventilation strategy applied from anesthesia induction period on lung compliance and oxygenation in patients undergoing gyneco-logical laparoscopic surgery.Methods A total of 60 female patients underwent gynecological laparo-scopic surgery were randomly divided into protective lung ventilation strategy beginning from induction group (group A),protective lung ventilation strategy beginning after intubation group (group B),conventional ventilation group (group C).All the three groups received intermittent posi-tive ventilation.The oxygen concentration was 100% and oxygen flow rate was 2 L/min,the inhalation and exhalation ratio was 1∶2.Group A was given low tidal volume+low PEEP+lung recruitment ma-neuver (from induction,i.e.after the disappearance of spontaneous breathing,take mask ventilation lasted for 5 minutes with a tidal volume of 6 ml/kg,respiratory rate was 1 6 times/min,PEEP was 5 cm H 2 O,which was applied every 30 min);group B was given low tidal volume+low PEEP+lung recruitment maneuver (before intubation:tidal volume was 10 ml/kg,respiratory rate was 10 times/min;after intubation:tidal volume was 6 ml/kg,respiratory rate was 1 6 times/min,PEEP was 5 cm H 2 O,which was applied every 30 min);group C:tidal volume was 10 ml/kg,respiratory rate was 10 times/min.Ppeak,Pmean,CL were recorded at induction (T0 ),after intubation (T1 ),30 min (T2 ),60 min (T3 )during operation,release of pneumoperitoneum (T4 ).The arterial blood gas analysis was performed at T0 ,T1 ,T3 and after extubation (T5 ).Then the oxygenation index (OI)and pulmonary shunt fraction (Qs/Qt)was calculated.Results The Ppeak and Pmean were significantly higher among the three groups after pneumoperitoneum (T1 ,T2 ,T3 ,T4 )compared with T0 (P <0.05),Ppeak of group C was significantly higher compared with that of group A and group B and Pmean at T2 increased significantly (P < 0.05 );The CL of three groups decreased obviously after pneumoperitoneu (P <0.05),CL of group C was lower significantly than that of group A and group B at T3 ,T4 (P <0.05)while the difference between group A and group B were not significant.The OI of the three groups decreased significantly after exthbation (P <0.05)and the difference among the three groups was not significant.Qs/Qt of three groups increased obviously at T3 and decreased at T5 (P <0.05),Qs/Qt of group C was higher significantly than that of group A and group B at T3 (P <0.05).Only one patient in group C got pulmonary infection.Conclusion Compared with conventional ventilation,the protective lung ventilation strategy can significantly improve the lung compliance and oxygenation function in the patients undergoing gynecological laparoscopic surgery.

Objective To investigate the role of 2B subunits-containing N-methyl-D-aspartate receptors (NR2B) in the arcuate nucleus in the development of inflammatory pain (IP) in rats.Methods One hundred and eight male Sprague-Dawley rats, aged 9 weeks, weighing 200-250 g, were randomly divided into 4 groups using a random number table: sham operation group (group S, n =47);group IP (n =47);dimethyl sulfoxide control group (group DMSO, n =7);selective NR2B antagonist Ro25-6981 group (group Ro25-6981, n=7).IP was induced by injecting complete Freund's adjuvant (CFA) 0.1 ml into the plantar surface of the left hindpaw.Ro25-6981 400 pmol was injected into the arcuate nucleus at 3 days after CFA injection.Seven rats in each group were selected for measurement of the mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) at 1 day before CFA injection (T1) and at 2 days after CFA injection (T2), at 30 min before administration on 3rd day (T3) , at 30 min after administration on 3rd day (T4) , and on 5th day (T5).In S and IP groups, The rats were sacrificed at T1-3 and T5 , and the arcuate nucleus of the hypothalamus was removed for determination of NR2B mRNA expression (by real-time reverse transcriptase polymerase chain reaction) and NR2B and phosphorylated NR2B (p-NR2B) expression (by Western blot).Conclusion Compared with group S, the MWT was significantly decreased, and the TWL was shortened at T2-5 in IP, DMSO and Ro25-6981 groups, and the expression of p-NR2B was up-regulated at each time point (P＜0.05) , and no significant change was found in NR2B protein and mRNA expression in group IP (P＞0.05).Compared with group IP, the MWT was significantly increased, and the TWL was prolonged at T4in group Ro25-6981 (P＜0.05) , and no significant change was found in MWT and TWL at each time point in group DMSO (P＞0.05).Conclusion The activation of NR2B in the arcuate nucleus is involved in the development of IP in rats.

Objective To investigate the correlation of the initial arterial lactate (Lac) and 6-h lactate clearance rate (LCR) with prognosis in patients with acute paraquat poisoning (APP).Methods The included 132 APP patients (70 males and 62 females,age ranging 15-71,30 (18) [M (IQR)]treated at a single center between January 2009 and December 2013.Patients were divided into two groups:group A,survivors ＞ 28 days after admission (n =64); and group B,those died ≤ 28 days after admission (n =68).The prognostic values of arterial Lac and 6-h LCR during the acute stage of poisoning were evaluated.Results Paraquat dose ranged from 5-200 mL,20 mL (37.25 mL) [M (IQR)].The average time from poisoning to arrival at the emergency department was ranging 4-312 h,6 h (8.75h) [M (IQR)].Total mortality was 51.51％.There were no differences in age,gender,and length of time elapsed from poisoning to diagnosis between two groups.Survivors had a significantly lower dose of paraquat ingested compared with nonsurvivors (P ＜ 0.05).An ROC curve analysis determined that the dose had an area of 0.86 (95％ CI:0.80-0.92) and the volume cut-off point was 27.5 mL to predict the prognosis in patients with acute paraquat poisoning (75％ sensitivity,85.9％ specificity,Youden index 0.609).The initial arterial lactate level was higher in nonsurvivors than that in survivors.The ROC curve analysis indicated that the initial arterial lactate level had an area of 0.99 (95％ CI:0.99-1.00) and the concentration cut-off point was 5.050 mmoL/L to predicti prognosis in patients with acute paraquat poisoning (sensitivity 98.5％,specificity 100％,Youden index 0.985).The 6 h LCR was lower in nonsurvivors than that in survivors.ROC curve analysis showed that the 6-h LCR had an area of 0.99 (95 ％ CI:0.97-1.00) and the concentration cut-off point was 17.28％ to predict prognosis in APP patients (sensitivity 100％,specificity 97.1％,Youden index 0.971).Conclusions In the early stages of APP,initial arterial Lac and 6-h LCR are closely related to prognosis and may serve as prognostic factors.