The diagnosis of myocardial damage in systemic lupus erythematosus(SLE) is mainly based on clinical symptoms,physical examinations and electrocardiographic abnormality,echocardiographic changes,and myocardial enzymologic diversity in general.In recent years,it has been suggested that cardiac troponin I possesses high sensitivity and specificity in the diagnosis of myocardial damage.Lupus myocardial damage is diagnosed definitively depending on endomyocardial biopsy.Its treatment has been empirical,and hormone combined with immunodepressive is routine treatment.According to pathogenetic condition,there are still several therapies such as intravenous immunoglobulin therapy,blood purification and autologous hematopoietic stem cell transplantation,extracorporeal membrane oxygenation,and so on.Most often,myocardial dysfunction in SLE is of subclinical progression,and that early diagnosis and prompt treatment may play an important role in relieving patients' condition,raising quality of life and improving prognosis.

Objective To observe the effect of monochromatic infrared energy(MIRE)on diabetic periphe- ral neuropathy(DPN).Methods Seventy-four subjects with diabetic peripheral neuropathy who were tested by Semmes-Weinstein monofilaments(SWM)were randomized into 2 groups:a conventional management group and a conventional management plus MIRE group.Then the patients'sensory function and other DPN symptoms were evalu- ated by the SWME and the score of Michigan Neuropathy Screening Instrument.Results After treatments,there was a decrease(P＜0.01)in the number of the sites insensitive to SWME(grade 5.07),and MNSI scores were sig- nificantly decreased(P＜0.01).The MIRE management was more effective than conventional management.Con- clusion Monochromatic infrared energy is perhaps a safe,non-pharmaceutical and non-invasive method for the treat- ment of diabetic peripheral neuropathy.

Objective To analyze the causes of medical disputes and to find an effective way to reduce medical malpractice and medical dispute.Methods The complete identification files of 251 cases of medical malpractice obtained from corresponding Offices of Technical Identification of Medical Malpractice in three cities at prefecture level in Shandong province were analyzed to compare the cause of medical malpractice identified by patients with that identified by experts.Results The main causes that identified by patients included violation(36.41%),default(35.60%),illegality(13.05%),tort(11.89%),and absence of management(3.05%).Among the litigation claims,58.53%were identified as existed factors causing disputes.Among the identified factors,72.66%should have been prevented and controlled.Conclusion Medical malpractice and medical dispute can be effectively prevented and controlled by putting management site forward,ensuring the implemention of the policies,and strengthening the substantive responsibility of the leadership.

A 64-year old man was admitted on July 2011 with masses both in liver and right kidney.After PET-CT and blood test examination,dual primary advanced cancers were speculated to be co-existed in this patient,which having poor prognosis.By evaluation with comprehensive geriatric assessment,the patient also had hypertension,diabetes and atherosclerosis,liver and renal insufficiency.After multidisciplinary consultation and detailed discussion with the patient,the decision of no surgery and just keep the follow-up was made.The patient has been followed up for 18 months and the functional evaluation is the same as before.It is very important to evaluate the risk/benefit equation and improve the standard of care,and make the decision as patient centered rather than disease-centered in the elderly patients.

Objective To measure the macular function of the fellow eye in patients with unilateral retinal vein occlusion (RVO).Methods A total of 24 cases of unilateral RVO were diagnosed by fundus fluorescein angiography (FFA),and multifocal ERG (mfERG) was recorded by RETI scan.The mfERG data of 24 fellow eyes of those RVO patients,and 18 normal control eyes were analyzed and compared.The parameters included the amplitude density,latency of the P1 and N1 wave in 6 concentric circles and 4quadrants of the mfERG graphics.Results The amplitude densities of P1 and N1 wave in first and second concentric circles of RVO fellow eyes were significantly lower than normal eyes (t=4.520,2.147;P＜0.05).There was no significant difference (P＞0.05) of P1/N1 latency in any concentric circles or quadrants between RVO fellow eyes and normal eyes.Conclusion The central fovea of the RVO fellow eyes was functionally impaired.

Adolescent ; Adult ; Diabetes Mellitus, Type 1 ; blood ; complications ; genetics ; Diabetic Angiopathies ; blood ; complications ; Female ; Gene Frequency ; Genotype ; Homocysteine ; blood ; Humans ; Male ; Methylenetetrahydrofolate Reductase (NADPH2) ; genetics ; Mutation ; Polymorphism, Genetic ; Regression Analysis

Objective To explore the influence of XTP4 on genomic expression profile of hepatocyte through screening and cloning of genes trans-regulated by XTP4-expressing plasmid. Methods The expressive vector pcDNA3.1(-)-XTP4 was constructed by routine molecular biological methods, and suppression subtractive hybridization (SSH) method was employed to detect the mRNA differentially expressed by the HepG2 cells transfected with pcDNA3.1(-)-XTP4 and pcDNA3.1(-), respectively, using lipofectamine. The twice enriched PCR products were subcloned into T/A vectors to set up the subtractive library. Amplification of the library was carried out in E. coli strain JM109. The screened cDNA were sequenced and analyzed in GenBank with Blast search after PCR. Results The amplified subtractive library containd 21 positive clones. Colony PCR analysis showed that there were 16 clones containing 200-1000bp inserts. Sequence analysis was performed and 9 kinds of encoding sequences were achieved. These genes trans-regulated by XTP4 protein involved in hepatic fibrogenesis, tumorgenesis, mitochondrial function, and cell growth regulation. Conclusions The findings obtained by SSH provide significant data for a preliminary understanding of the biological function of a new identified gene-XTP4. These results will pave the way for the study of the molecular mechanism of the transactivating effects of HBxAg and the development of new therapy for chronic hepatitis B.

Objective To investigat the symptom burden of patients with maintenance hemodialysis (MHD) and explore the influencing factors of them,in order to provide the basis for improving the quality of life of these patients.Methods A total of 230 patients with MHD were enrolled in Xiangtan Central Hospital from January 2016 to December 2016,the general condition and disease-related data of them were collected,and the symptom burden of them over the past week was assessed by improved symptom burden scale.Results ① The average age of these patients were (56.8 ± 14.1)years,the sex ratio for men and women was 1.37∶ 1,the median time of dialysis was 24 months,and the frequency of dialysis was (9.16 ± 2.36)times;② The symptom score in MHD patients was (65.72 ± 28.46)points,the top 5 symptoms which had higher incidence were fatigue (72.2％),dry mouth (63.5％),itching (61.3％),falling asleep difficultly (54.3％),drying (49.2％),the top 5 symptoms which were more troubling were restless legs syndrome (2.54 ± 0.73),falling asleep difficultly (2.48 ± 0.83),bone/joint pain (2.45 ± 0.69),fatigue (2.31 ±0.77),easy to wake up (2.16 ±0.78);③ Age,sex,occupation,dialysis age,inorganicphosphorus and serum calcium had an effect on the symptom burden of MHD patients (P ＜ 0.05).Condusions We should focus on patients who are older,female,retired or no occupation,longer dialysis age,calcium or phosphorus metabolism disorders,provide targeted care and treatment,in order to reduce the symptom burden and improve the life quality of them.

Objective:To explore the value of clinical pharmacist in clinical treatment through the pharmaceutical care on a patient with Japanese B encephalitis complicated with pulmonary infection. Methods:Clinical pharmacist participated in the whole treatment process and gave suggestions on the selection,dosage and course of the drugs prescribed for anti-virus, anti-epilepsy and anti-infection by focusing on the drug interactions and adverse reactions. Results:The treatment course of the patient was smooth, and the pathoge-netic condition was brought under control gradually while no obvious adverse drug reactions occurred. Conclusion:The work of clinical pharmacist can help to optimize treatment programs to ensure the safety and effectiveness of medication.

Objective To construct a subtractive cDNA library of genes differentially expressed in human lymphoma cell line Jurkat cells treated with glycyrrhizin (GL), and to clone genes associated with its immunological regulation, and to further elucidate the molecular immune mechanism of GL. Methods The mRNA was isolated from Jurkat cells treated with either GL or 0.9 percent sodium chloride as a control, then cDNA was synthesized. Suppression subtractive hybridization (SSH) method was employed to analyze the differentially expressed DNA sequence between the two groups. The cDNA was sequenced and analyzed in GenBank with Blast search after the amplification of the subtractive library by PCR. Results The amplified library contained 28 positive clones. Colony PCR analysis showed that there were 22 clones containing 200-1 000 bp inserts. Sequence analysis was performed, and the full length sequences were obtained with bioinformatics method. Altogether 11 kinds of encoding sequences were achieved, including interleukin-12, interleukin-18, and thymosin ?1, etc. Conclusions A subtractive cDNA library of genes differentially expressed in Jurkat cells treated with GL using SSH technique was constructed successfully, and it might give some new clues for the study of the immune regulation mechanism of GL.