Objective To investigate the clinical manifestations and treatment regiment of children with juvenile dermatomyositis(JDM).Methods The clinical manifestation,changes of serum muscale enzyme,myopathic laboratory examination,treatment and prognosis of 15 children with JDM retrospectively admitted from Jan.1990 to Jan.2004 were analyzed.Results All of the children had symmetrical weakness of the proximal muscles.The most frequent features were heliotrope and Gottron's papules.Elevated muscle enzymes were noted in all cases.Electromyography revealed typical change of myopathic type and muscle biopsy was compalible with myositis in all cases.Most of patients achieved normal muscle enzymes within 1 month and had improved muscle strength with 2.5 monthes of the initiation of corticosteroid therapy.Conclusion It is very important to know the clinical features of JDM,and prompt diagnosis and treatment will result in an improved prognosis.

Objective To investigate the levels of trace element in calcium, magnesium, zinc, iron and copper in maternal blood of pregnant women of different pregnancy and ages of pregnant women , and its relation to the pregnancy the age of pregnant women. Methods Calcium, magnesium, zinc, iron and copper in serum in 10 131 cases of pregnant women (3 565 cases in the first pregnancy, 6 566 cases in second pregnancy) were measured. All cases (both first pregnancy and second pregnancy) were analysed according to three age periods (less than or equal to 25, 25 to 35 years old, more than or equal to 35). Results (1)Comparing to the cases in second pregnancy, Copper in serum of the cases in first pregnancy was lower, while zinc, magnesium and iron were higher (P < 0.05). But the level of calcium had no difference (P > 0.05). (2) For the cases in the first pregnancy in different age periods, all 5 kinds of trace elements were compared. Only the zinc level in serum in the groups of 25 ~ 35 years old and more than or equal to 35 years old was higher than that in the group of less than or equal to 25 years old (P < 0.05). No difference was found in the rest of trace elements in different age groups (P > 0.05). (3) For the cases in the first pregnancy in different age stages , all 5 kinds of trace elements were compared basis on the age periods. the zinc and iron levels in serum in the groups of 25 to 35 years and more than or equal to 35 years old were higher than those in less than or equal to 25 years old (P < 0.05). No difference (P > 0.05) was found in the other three kinds of trace elements in different age periods. Conclusions (1)There are differences in trace elements, magnesium, zinc, iron and copper, and no difference in calcium in the first and second pregnancy. (2)Trace elements in serum of pregnant women in different age periods are different. (3)According to the characteristics of various trace elements in serum of pregnant women of different pregnancy and age periods, trace elements shall be supplemented to meet the needs of the pregnant women and fetus.

0.05)and no significant statistical difference was found.But the successful rate of first therapy of group A was 71.42%(85/119)and group B was 56.20%(77/137)(P

Objective:To investigate the relationship between clinical effects of acupuncture for elderly patients with sensorineural deafness and ear distending sensation.Methods:A total of 120 elderly patients with sensorineural deafness were randomly divided into a comprehensive treatment group,an acupuncture group and a Western medicine group,with 40 cases in each group.The acupuncture group received acupuncture treatment,the Western medicine group received oral mecobalamin tablets and the comprehensive treatment group received acupuncture plus acupoint injection and auricular acupoint sticking.The values of pure tone hearing threshold test of the three groups were observed before and after treatment,and the relationship between clinical effects and ear distending sensation was compared.Results:The total effective rate of the comprehensive treatment group was 82.5％ versus 67.0％ in the acupuncture group and 62.5％ in the Western medicine group.The inter-group comparisons showed statistically significant differences in the comprehensive treatment group versus the Western medicine group (P＜0.01) and the acupuncture group (P＜0.05).In the comprehensive treatment group,there were 23 cases (57.5％) with ear distending sensation,the clinical total effective rate was 86.9％;there were 17 cases (42.5％) without the sensation,the clinical total effective rate was 76.5％.In the acupuncture group,there were 24 cases (60.0％) with ear distending sensation,the clinical total effective rate was 71.0％;there were 16 cases (40.0％) without the sensation,the clinical total effective rate was 63.0％.In the Western medicine group,there were 21 cases (52.5％) with ear distending sensation,the clinical total effective rate was 66.7％;there were 19 cases (47.5％) without the sensation,the clinical total effective rate was 57.9％.The total effective rate of patients with ear distending sensation were higher than the rates of those without ear distending sensation in the three groups,but the differences were insignificant (all P＞0.05).Conclusion:The comprehensive therapy is one of the effective methods to treat elderly patients with sensorineural deafness.In the three groups of elderly patients with sensorineural deafness,the relief of ear distending sensation and the hearing loss were basically simultaneous,and the hearing recovery in the patients with ear distending sensation may be slightly better than that in those without ear distending sensation.Nevertheless,further research is needed.

OBJECTIVEThe purpose of this study was to explore the relationship between originate and breakout and radiofrequency catheter ablation strategy in patients undergoing radiofrequency ablation for premature ventricular contractions originating from the aortic sinus cusp (ASC) using 3-dimensional electro anatomic mapping.

METHODSThis study included 21 consecutive patients (10 male) underwent ablation for frequent PVCs originating from ASC in our hospital between May 2009 and February 2012. Electro anatomic mapping and ablation of right ventricular outflow track (RVOT) and left ventricular outflow track (LVOT) were performed with the 7F 4-mm-tip ablation catheter from right femoral vein and artery. Activation mapping and pacing mapping were performed in all patients.

RESULTSAblation was successful in all 21 patients successful ablation target in left coronary sinus cusp (LCC, n = 17), in right coronary sinus cusp (RCC, n = 2) and in noncoronary sinus cusp (NCC, n = 2). Seven patients showed a RBBB morphology (group A) and 14 patients showed a LBBB morphology (group B). In group A, earliest ventricular activation (EVA) was recorded 22 - 34 (27.4 ± 4.6) ms earlier before QRS at the site of catheter ablation in ASC. In group B, EVA was later in RVOT than that in ASC in 5 patients and EVA at the site of catheter ablation in RVOT and ASC was 22 - 28 (25.2 ± 2.7) ms and 26 - 40 (32.8 ± 5.2) ms, respectively (t = -3.6, P = 0.024) while EVA was earlier in the remaining 9 patients and EVA recorded in RVOT and ASC was 22 - 38 (28.7 ± 5.9) ms and 18 - 28 (22.7 ± 3.6) ms, respectively (t = 3.8, P = 0.005).

CONCLUSIONPatients with premature ventricular contractions originating from the ASC often show preferential conduction to the RVOT, which may explain the LBBB morphology of ECG in these patients.

Adult ; Aged ; Bundle-Branch Block ; etiology ; pathology ; physiopathology ; Catheter Ablation ; methods ; Electrocardiography ; Female ; Humans ; Male ; Middle Aged ; Sinus of Valsalva ; physiopathology ; Ventricular Premature Complexes ; complications ; pathology ; physiopathology ; Young Adult

By reading ancient acupuncture-moxibustion literature, the authors expound the origin and development of fire needle therapy from its sprout, development and mature stage, reveal the origin of fire needle, development of needling instrument and manipulation methods, indications of fire needle therapy and so on, in order to have a better learning on fire needle therapy and make it applicative in clinic.
Acupuncture Therapy ; history ; instrumentation ; methods ; China ; History, Ancient ; Humans ; Medicine in Literature ; Needles

Objective To summarize regularities in acupoint prescriptions for acupuncture treatment of stroke disorders by using data mining techniques to analyze 150 ancient acupuncture books from the Han dynasty to the end of Qing dynasty. Method A standard database and a ancient book database were established by a manual entry and proofreading method. The sentences containing stroke disorders, acupoints, meridians and needling moxibustion method in the ancient books were selected according to the key words in the standard database using a variety of data mining techniques and a regular relation to establish corresponding disease, acupoint, needling moxibustion method and meridian databases. They were classified into two types: prescriptions for stroke disorders and acupoint indications containing stroke disorders. The results from selection were reviewed manually and standardized. A multilevel analysis of regularities in acupuncture prescriptions for stroke disorders in the ancient books was performed by statistical analysis and apriori algorithm on association rules with support degree and confidence level. Result There were a total of 536 records on acupuncture point prescription for stroke disorders. Single acupoint prescriptions accounted for 34.89% of the total number of prescriptions. The single acupoint that was used most frequently was Baihui(GV20). Thedouble acupoints that were combined most frequently were Quchi(LI11) and Baihui. In three acupoint combination, Quchi and Fengshi(GB31) were separately combined most frequently with Baihui, Jianyu(LI15) and Xuanzhong(GB39). The three meridians that were used most frequently were the Du Meridian, the Large Intestine Meridian of Hand-Yangming and the Gallbladder Meridian of Foot-Shaoyang. The two meridians that were combined most frequently were the Gallbladder Meridian of Foot-Shaoyang and the Stomach Meridian of Foot-Yangming. Crossing points and Five-Shu points were selected most frequently in specific points. He-Sea points were used most frequently in Five-Shu points. Conclusion The prescriptions for stroke disorders in ancient acupuncture books focus on selecting the confluence of all yang meridians and yang meridian points. Specific points are the important composition of the prescriptions. Crossing points and He-Sea points are mainly used in specific points.

OBJECTIVETo analyze the characteristics of atrial tachycardia originating from the atrioventricular cingulum.

METHODThe electrophysiological mechanism, ablation site graph and nerve distribution of 16 cases of atrial tachycardia originating from the atrioventricular cingulum or adjacent atrial muscle which were proved by electrophysiological monitoring and radiofrequency ablation.

RESULTSAtrial tachycardia from peri-cingulum represented 23.2% of atrial tachycardia treated by radiofrequency ablation during the same period. The ratio of left to right atrioventricular cingulum was 3:16. There was no difference of the surface ECG characteristics and electrophysiological mechanism between the atrial tachycardia originating from atrioventricular cingulum and that from other positions. Both A and V components were recorded at all the successful ablation sites. The ratio of amplitude of A to V was between 2:3 and 6:1. Atrial potential in the target site was 20-46 (38.6 +/- 6.7) ms earlier than P'wave in surface ECG. The success rate of ablation was 87.5% and the recurrent rate 7.1%.

CONCLUSIONSPeri-cingulum atrial tachycardia accounts for a certain proportion in all atrial tachycardia. The exciting sites originating from right cingulum are more common than those from left cingulum. Its electrophysiological mechanism has no difference from other positions. Cingulum mapping and ablation have important practical meanings.

Adolescent ; Adult ; Aged ; Catheter Ablation ; Child ; Electrophysiologic Techniques, Cardiac ; Female ; Humans ; Male ; Middle Aged ; Tachycardia, Ectopic Atrial ; physiopathology ; surgery ; Young Adult

A total of 231 patients aged>60 years who underwent orthopedic surgery in Department of Orthopedics of Emergency General Hospital from November 2019 to June 2022, were enrolled. All patients received a comprehensive geriatric assessment before surgery. The demographic characteristics, medical history of patients were collected, the geriatric syndrome, postoperative complications were analyzed. The risk factors of postoperative complications were analyzed with Logistic regression. The preoperative comprehensive geriatric assessment showed that the most common geriatric syndrome was cognitive impairment (29.9%, n=69), followed by frailty (14.3%, n=33), nutritional risk (10.4%, n=24), functional dependence (7.8%, n=18), depression and anxiety (3.9%, n=9). Postoperative complications occurred in 38 cases, including delirium in 18 cases (7.8%), respiratory infection in 15 cases (6.5%), heart failure in 9 cases (3.9%) and death in 1 case (0.4%). The Logistic regression analysis showed that anemia ( OR=5.278, 95% CI:1.237-22.518), frailty ( OR=2.865, 95% CI:1.049-7.829) and cognitive impairment ( OR=3.796, 95% CI:1.526-9.442) were independent risk factors for adverse postoperative outcomes ( P<0.05). The study indicates that incidence of preoperative geriatric syndrome in patients undergoing evaluation is common; and anemia, frailty and cognitive impairment may be related to adverse clinical outcomes in elderly patients after surgery.

OBJECTIVESTo explore the category, quantity and clinical significance of autoantibodies on bone marrow hematopoietic cells in patients with immunorelated cytopenia and evaluate the sensitivity of direct antiglobulin reaction (Coombs test ) of bone marrow mononuclear cells (BMMNC).

METHODSThe category and the positive rate of autoantibodies on bone marrow hematopoietic stem cells, nucleated erythrocytes, granulocytes in 32 patients with uncertain immunorelated cytopenia were investigated by using BMMNC-Coombs test and double immunofluorescence flow cytometry.

RESULTSThe positive rate of autoantibodies on bone marrow hematopoietic cells tested by flow cytometry was 90.63% which was higher than that by BMMNC-Coombs test (50.0%) (p < 0.05). In 29 positive cases, IgG autoantibody accounted for 6.90%, IgM13.8%, IgG+IgA 3.4%, IgG+IgM 31.0%, and IgG+IgM+IgA 44.8%. Of the 29 Patients, 25 (86.2%) with IgG autoantibody, 26 (89.7%) with IgM and 14 (48.3%) with IgA. The patients with IgG autoantibody alone had the lowest hemoglobin levels, and those with IgM autoantibody might have intravascular hemolytic findings. The response time of patients with IgG and IgG+IgM was shorter than that of the other patients. 91.3% of the patients had autoantibodies on bone marrow hematopoietic stem cells and showed pancytopenia, and 50% of the patients had autoantibodies on nucleated erythrocytes and granulocytes. Eleven of 13 patients with negative BMMNC-Coombs tests had autoantibodies on bone marrow hematopoietic stem cells detected by FACS. There was no significant difference of the quantities of the three categories of autoantibodies of nucleated erythrocytes and stem cells. The quantities of IgA on granulocytes were lower than that of IgG and IgM. There was no significant difference between IgG and IgM on granulocytes. The quantity of IgA on hematopoietic stem cells was significantly higher than that on nucleated erythrocytes or granulocytes.

CONCLUSIONSThe sensitivity of double immunofluorescence flow cytometry assay was higher than that of BMMNC-Coombs test for detecting autoantibodies. In immunorelated cytopenia patients, the predominant autoantibody was IgM which could cause intravascular hemolysis, and the second one was IgG which could cause severe anemia. Most immunorelated cytopenia patients had autoantibodies on hematopoietic stem cells and showed pancytopenia. IgA was more easily seen on the hematopoietic stem cells.

Adolescent ; Adult ; Aged ; Autoantibodies ; classification ; metabolism ; Autoimmune Diseases ; immunology ; Bone Marrow Cells ; immunology ; Child ; Coombs Test ; Female ; Flow Cytometry ; Humans ; Immunoglobulin A ; metabolism ; Immunoglobulin G ; metabolism ; Immunoglobulin M ; metabolism ; Male ; Middle Aged ; Pancytopenia ; immunology