Humans ; Mouth Diseases ; classification ; diagnosis ; therapy ; Mouth Mucosa ; pathology ; Oral Medicine ; standards ; Reference Standards

Objective To provide clues to diagnosis and treatment for diffuse alveolar hemorrhage (DAH)in patients with diffuse connective tissue diseases(CTD).Method To analyze restropeetively the data of clinical features,pulmonary images and bronchoalveolar lavage(BAL)in 32 patients hospitalized in Peking Union Medical College Hospital from April 2004 to June 2007.Results The data from 1O of the 17 (58.8%)patients with microscopic polyangiitis(MPA),19 of the 1267(1.5%)patients with systemic lupus erythematosus(SLE),2 of the 56(3.6%)patients with Wegener's granulomatosis(WG)and 1 of the 570(0.2%)patients with rheumatoid arthritis(RA)were consistent with the diagnosis of DAH.DAH in SLE occurred in younger patients(mean age at the time of diagnosis 27.3±13.1 years)and early in the course of disease(median duration of SLE from onset was 16.7±18.3 months),while these figures in MPA patients with DAH were 50.1±20.7 years and 10.6±18.7 months.At the time of DAH in SLE.the median systemic lupus erythematosus disease activity index(SLEDAI)score was 17.1±6.7 and anti-ds-DNA antibody titer elevated markedly,while the median C3 level was low.The levels of erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)of patients with DAH in MPA,WG and RA showed marked elevation.The titer of antieutrophil cytoplasmic antibody(ANCA,MPO/PR3)in patients with MPA and WG was highly positive.The main clinical manifestations of DAH were hemoptysis,dyspnea and rapid decrease of hemoglobulin and hematoerit(HCT)in peripheral blood.Most patients presented with difluse alveolar infiltration on chest X-ray and hish resolution CT.DAH could be confirmed by bloody bronchoscopic lavage.20 patients(62.5%)had secondary pulmonary infections at the time of DAH;fungus and combined bacterial infection were most frequently seen.The mortalitv 0f CTD with DAH was 59.4%(19 out of 32).12 patients (63.2%)with SLE,5 patients(50%)with MPA and both of the 2 patients with WG died.12 of the lethal cases(63.2%)died of respiratory failure.Conclusions CTD patients presenting with hemoptysis and dyspnea with rapid decrease of hemoglobulin,and diffuse alveolar infiltration on chest X-ray or high resolution CT should be seriously considered to be suffering from DAH.A bloody BAL may confirm the diagnosis of DAH.DAH in CTD is an acute,serious and frequently life-threatening situation resulting in respiratory hilure and pulmonary infection.It is important for CTD patients with DAH to be diagnosed early and treated vigorously.

Acupuncture Therapy ; Adult ; Behcet Syndrome ; therapy ; Female ; Humans

Objective We adopt acupuncture associating with TAX,to investigate the anti-cancer effect and mechanism.Methods 48 mice with inoculated Lewis Lung Carcinoma were divided randomly into 4 groups:model group,acupuncture group,medicine group,combination of acupuncture and medicine group.Growth state of the mice and change curve of tumour.Protein expression of apoptosis related factor p53 and Bc1-2 in tumour were observed by Western Blotting method.Results Acupuncture,TAX and the combination of acupuncture and TAX separately had anti-tumor effect,with the combination was the best and improve growth state of the mice.p53 and bc1-2 can be detected in four groups.Compared with model group,the expression of other groups was lower.Compared with acupuncture group and medicine group, the exprission of combination group of acupuncture and TAX was lower.Conclution Combination of acupuncture and TAX can prohibit p53 Mutant and decrease Bcl-2,which have co-operating effect.

Objective A comprehensive evaluation of the quality of medical service from January to December in 2007 was conducted in order to provide scientific policies for far-flung work and create bigger benefit in a certain hospital. Methods Apply factor analysis ascertains the weight,and we carry through a comprehensive evaluation of the quality of medical service combine with weighted TOPSIS to the hospital. Results The quality of medical service of hospital in 2007. The months of April,July , November better; February,May, October worse. The results accord with reality. Conclusion Research shows comprehensive evaluation of hospital medical quality needs a scientific target system. Using factor analysis and combining weighted TOPSIS in comprehensive evaluation is more objective and more scientific and authentic as take full advantage of the original source.

Objective To study the clinical value of anti-ribosomal P0 protein antibodies (anti-P0). Methods Line immuno-assay and immunoblotting methods were used to detect anti-P0 and rRNP antibodies of 49 SEE patients and 61 patients with other rheumatic diseases.The expressions of anti-P0 were compared with those of rRNP antibodies.Possible relations between anti-P0 and clinical features and other antibodies in SLE were explored.Results 36.7%and 6.1% of SEE patients showed positive anti-P0 and rRNP antibodies respectively.Anti-P0 was always negative in patients with other rheumatic diseases (P＜0.01).Among SLE pa tients,incidence of skin rash was 77.8%(35.5%) ff anti-P0 was found to be positive (negative) (P＜0.05). Besides,for patients with positive and negative anti-P0,the chance of positive anti-SmD1 was 61.1% and 19.4% respectively (P＜0.01).Sensitiviy of anti-P0 for SLE diagnosis was 36.73% with specificity and positive predictive value as high as 100%,and 66.30% as the negative predictive value.Conclusion Sera anti-P0 is highly specific for SLE and it is associated with the occurence of rash and the expression of anti-StuD 1 anti bodies in SEE.

0.05).CONCLUSIONS Levofloxacin 500mg orally administered is effective in the treatment of acute suppurative tonsillitis.

Objective To assess the value of combined detection of enterovirus nucleic acid and antibody in early etiological diagnosis for hand-foot-and-mouth disease ( HFMD).Methods A case-control study was conducted.A total of 1 066 cases of children clinically diagnosed with HFMD from Hangzhou Children′s Hospital were involved into the research group from January to June 2014, consisting of 401 common cases and 665 severe cases; Throat swabs and serum samples from these children underwent combined detection for EV71/CA16/EV of enterovirus nucleic acid by fluorescence quantitative RT-PCR and for EV71/CA16-IgM by ELISA.All data were analyzed with SPSS 16.0.Results The total positive rate of enterovirus nucleic acid EV71/CA16/EV by fluorescence quantitative RT-PCR in the 1 066 cases of children clinically diagnosed with HFMD was 75.52%( 805/1 066 ) ( 95%CI: 72.80%-78.05%).But the total positive rate of combined detection was 91.46%( 975/1 066 ) ( 95%CI:89%.58-93.04%).The total positive rate of combined detection is higher than that of RT-PCR test(χ2 =98.338,P=0.000).The positive rate of EV71 type of combined detection was 64.63%(689/1 066)(95%CI:61.67%-67.49%),which is 15.38%higher than that of RT-PCR test 49.25%(525/1 066)(95%CI:46.21%-52.29%)(χ2 =51.453, P=0.000).In 665 severe cases of HFMD, the total positive rate of combined detection was 96.69%(643/665)(95%CI:94.95%-97.87%), which is higher than that of RT-PCR test 79.25%(527/665)(95%CI:75.92%-82.22%)(χ2 =95.607, P =0.000).In the severe cases, the positive rate of EV71 type of combined detection was 87.52%( 582/665 ) ( 95%CI:84.71%-89.89%) , which is 18.95% higher than that of RT-PCR test 68.57%(456/665) (95%CI:64.87%-72.06%) (χ2 =69.665, P=0.000).In the fatal cases, the positive rate of EV71 type of combined detection was 95.92%(94/98) (95%CI:89.28%-98.68%).Conclusions The combined detection of enterovirus nucleic acid and specific IgM antibody can significantly increase the positive rate of HFMD, especially for severe cases.The combine detection increases both the total positive rate and EV71 positive rate.Thus it has a high potential for becoming a new guidelines for laboratory diagnosis of HFMD.

BACKGROUND:Drainage has been applied as a routine to hip and knee replacement surgery. However, as a potential channel, drainage could become a portal for bacteria and other pathogens to invade the joint cavity. OBJECTIVE:To evaluate the clinical significance and safety of drainage in total knee arthroplasty.
METHODS:The 80 patients were prospectively randomized into two groups:Group 1 included 38 patients with wound drainage;Group 2 included 42 patients without any drainage. According to a formula calculation, blood loss, the number of subjects requiring blood transfusion, volume of blood transfusion, complications and the recovery of function after total knee arthroplasty were statistical y analyzed.
RESULTS AND CONCLUSION:The subjects were fol owed up for 2 years after discharge. Two patients lost to fol ow up in the non-drainage group. 78 patients were involved in the result analysis. The total blood loss, the number of subjects requiring blood transfusion and volume of blood transfusion were more in the drainage group than those in the non-drainage group after surgery. At 3 days after arthroplasty, active range of motion was larger in the drainage group than that in the non-drainage group. No significant differences in hemoglobin levels and Keen Society Score scores were detected after arthroplasty between the two groups. Results suggested that draining wil increase the blood loss and blood transfusion, but it may contribute to the early recovery of knee function. No significant differences in long-period Keen Society Score scores and postoperative complications were detectable between the two groups.

BACKGROUND:How to improve effective connection strength between fiber post and resin, to reduce the failure rate of repairing, has become the focus of current researches. Without surface treatment, the fiber post surface bonding strength is relatively low, is prone to appear adhesive failure, so the surface treatment of fiber post to increase the fiber post-resin bonding strength is the key to achieve a successful repair. OBJECTIVE:To review the progress of fiber post surface treatment technology in the crown restoration. METHODS: A computer-based retrieval was performed among CNKI and PubMed databases between 2003 and 2013, by using the key words of fiber-reinforced post, surface treatment, bond strength in English and Chinese. The recent literatures concerned with the fiber post surface treatment were extensively reviewed, 32 ones were summarized and analyzed. RESULTS AND CONCLUSION: The failure of bonding between fiber post and resin is a major problem in fiber posts restoration techniques. In recent years, scholars try to use a variety of methods for processing fiber post surface, the fiber post-resin bonding strength is significantly improved. Mechanical or (and) chemical treatment on the surface of fiber post can significantly improve fiber post-resin bonding strength, which could increase the success rate of the crown restoration. Among them, H2O2+silicane coupling agent achieved the best effects. However, long-term clinical observations are needed to verify these methods.