Objective To study the clinical features,treatment and prognosis of secondary amyloidosis.Methods All the inpatients diagnosed as secondary amyloidosis were analyzed retrospectively.Results Eight patients were diagnosed as secondary amyloidosis.Their underlying diseases were connective tissue diseases (4 cases) multiple myeloma (3 cases) and chronic hepatitis B (1 case).Average duration from the diagnosis of connective tissue diseases to secondary amyloidosis was 6 2 years.Kidney was the main involved organ with the manifestation of proteinuria (4 cases) and renal failure occurred in 1 case.Their average life span was longer than 10 years after immunosuppressive agents and/or steroid therapy.Secondary amyloidosis occurred after multiple myeloma showed a bad prognosis.Tongue and myocardium were mainly involved.Enlargement of liver and spleen is the prominent manifestation in the patients with amyloidosis secondary to chronic hepatitis.Conclusion Amyloidosis can be evolved from connective tissue diseases,multiple myeloma or chronic inflammatory diseases.There are differences in clinical manifestations and prognosis.The only treatment of secondary amyloidosis is the early management to its underlying disease.

Adolescent ; Arthritis, Juvenile ; blood ; immunology ; pathology ; Child ; Child, Preschool ; Female ; Humans ; Immunoglobulin A ; blood ; Immunoglobulin G ; blood ; Immunoglobulin M ; blood ; Interferon-gamma ; blood ; Interleukin-4 ; blood ; Male

Objective To promote preventive and therapeutic measures for osteoporosis by investigating the prevalence of low bone mineral density (BMD) in connective tissue disease patients who were taking corticosteroid and identify the associated risk factors of osteoporosis.Methods Thirty-eight female patients who had connective tissue diseases and were taking corticosteroid in PU MCH rheumatology outpatient clinic were studied and followed up from Oct 2006 to April 2007.Lumber spine and right femoral bone mineral density were determined bv dual energy X ray absortiometry (DEXA).Clinical information was obtained from a questionnaire of history and medical records.Duration and accumulative dosage of glucocorticoid intaking.menopause time were obtained retrospectively.Correlation analysis between BMD and clinical information was conducted.Results ① In 38 patients,23 (61%) patients showed a normal BMD,10 (26%) were osteopenia,3 (8%) were iu the osteoporotic range,while 2 patienLs (53%) had fragile fracture.② Compared with patients with normal BMD,subjects with low BMD had significantly older age,longer period after menopause and higher accumulated dose of corticosteroids.③ Postmenopausal women had significantly lower BMD in lumber and hip than premenopausal women.④ Either of vertebral and right hip BMD correlated negatively with the accumulated dosage of cortieosteroids by simple linear regression.⑤ The correlation between BMD and accumulated dosage of corticosteroids improved after correcting for the effect of age by partial correlation analysis (Pearson partial vertebral r=-0.8,P=0.009;right hip r=-0.3,P=0.010).⑥ A stepwise multivariate linear regression model was constructed to explore the relationship between the different clinicsl factors studied and a low BMD.Two statistically significant variables were menopause status (P=0.0000) and a higher steroid accumulated dosage (P=0.008).Conclusion Low BMD is common in connective tissue disease patients receiving corticosteroid.Risk factors for low BMD are postmenopause.duration and the accumulated dosage of glucocorticosteroid.The high prevalence of low BMD implies that more attention should be paid to the prevention and treatment of osteoporosis and fractures in connective tissue disease patients who are taking corticosteroids.

Objective:To determine a new management strategy, and create a win-win in the medical equipment maintenance outsourcing situation.Methods:Hospital with third-party manufacturers to adopt bidding game analysis, game theory is the study of the behavior of decision-making body when making a direct interaction and balance problems with this decision, its main emphasis on individual research model is rational, that is, at a given pursuit of utility maximization under constraints.Results: By studying this stage the hospital with third-party companies in game analysis equipment maintenance outsourcing, improve service quality and medical management standards, and achieve win-win cooperation between the two.Conclusion: Medical equipment maintenance outsourcing game analysis presented emphasis on service and reputation, win-win strategy to follow market rules.

Objective To detect the serum level of complement 1q (C1q) and anti-C1q autoantibodies (C1qAb) in systemic lupus erythematosus (SLE) patients to analyze the correlation of serum level of C1q and C1qAb with renal lesion and disease activity in SLE. Methods The serum level of C1q and C1qAb were detected by single radial lmnmnodiffusion and enzyme-linked immunosorbent assay respectively. Results The serum level of C1q in SLE patients was significantly lower than that of the control groups. The serum level of C1qAb in SLE patients was significantly higher than that of the control groups. There was a strong correlation between the serum level of C1q and C1qAb in SLE patients. SLE patients in flare stage showed a significantly higher level of serum C1qAb and a lower level of serum C1q than stable patients. Lupus nephritis(LN) patients showed a significantly higher level of serum C1qAb and a lower level of serum C1q than non-LN patients. Conclusions Low level of serum C1q and the high level of serum C1qAb are correlated with SLE. The serum level of C1q and C1qAb are significantly correlated with renal lesion and disease activity of SLE patients.

Prognosis and treatment of primary Sj?gren′s syndrome with renal tubular acidosis

Objective To study the clinical manifestation,treatment and prognosis of patients with primary Sjgren′s syndrome and renal tubular acidosis.Methods Sixty patients who were diagnosed as pSS complicated with RTA during the last 13 years were retrospectively analyzed and followed up for 7 5 years on average.Results Distal renal tubular acidosis ( n =53,83 3%) was much more frequeut than the proximal one ( n =7,11 7%).Hypokalemic paralysis,diabetes insipitus,and calcification of the renal tissue appeared in 49 patients (92 4%).Glomerular lesions were found in 12 of the 15 patients who underwent kidney biopsy.Renal insufficiency was developed subsequently in 4 out of 5 patients with glomerular sclerosis.Abnormal serum creatinine was detected in 11 patients (18 3%),and in 7 of them it persisted 11 5 years on average after the onset of RTA.Two of them died from renal failure and 1 received hemodialysis.Hypergammaglobulinemia was more obvious in the patients with renal insufficiency than those without ( P

Objective To propose a modified graph cut algorithm under the elliptical shape constraint to segment the ultrasonogram of cervical lymph nodes. Methods Since cervical lymph nodes were usually oval-shaped, the prior of the elliptical shape information, which was expressed as a distance function, was used to constrain the cut cost of the graph cut algorithm. The initially segmented contour was fitted with an ellipse to get the constraint. Then a certain segmentation was obtained by minimizing the cut cost function constrained with the elliptical prior. This procedure was iterated until it to be convergent. Results Under the same user input, this algorithm successfully segmented nodes on the low contrast ultrasonograms, while the traditional graph cut approach failed. For 20 ultrasonograms, with the average minimum Euclidean distance (AMINDIST) measure and the Hausdorff distance measure, these two distances between contours manually delineated by the radiologist and those segmented by this algorithm were far less than the distances resulted from the traditional graph cut algorithm. Conclusion It is indicated that utilizing the elliptical shape constraint prior can obviously improve the graph cut algorithm for segmenting cervical nodes on ultrasonograms.

Adult ; Aged ; Aged, 80 and over ; Asbestos ; adverse effects ; Environmental Exposure ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Pleural Diseases ; chemically induced ; diagnostic imaging ; Tomography, X-Ray Computed