Objective To investigate the clinical significance of IgG subclasses in patients with primary Sj(o)gren's syndrome (pSS) patients.Methods The serum was collected from 101 pSS patients and 40 healthy subjects.The content of IgG subclasses was determined by immuno-scatter turbidmetry.The difference of IgG subclasses distribution between pSS patients and healthy subjects was analyzed.Com-bined with the clinical information of the SS patients,the difference of IgG subclasses distribution in SS patients with different characteristics was analyzed.For group comparisons,measurement data were compared using unpaired Student's t test.Results The average levels of serum IgG1-4 in 40 healthy controls were (8085±1566) mg/L,(5406±2151) mg/L,(395±233) mg/L and (566±420) mg/L.The percentage of IgG1-4 were (56.8±8.2)％,(36.6±7.8)％,(2.7±1.5)％ and (3.9±2.8)％.The average levels of serum IgG1-4 in 101 pSS patients were (14 094±5534) mg/L,(3912±1750) mg/L,(565±565) mg/L and (404±504) mg/L,The percentage of IgG1-4 were(73.0±10.9)％,(21.7±9.8)％,(3.1±2.0)％ and (2.2±2.4)％.In pSS patients,the levels of IgG1,IgG3 and IgG1/IgG were significantly higher,while the IgG2,IgG2/IgG and IgG4/IgG levels were significantly lower,compared with those of the healthy subjects (P＜0.05).There was no significant difference in the IgG subclasses distribution between the pSS patients whose had systemic involvement and the pSS patients who did not have systemic involvement(P＞0.05).The IgG subclasses distribution was abnormal in SS patients who IgG was normal,compared with the healthy subjects.Conclusion A characteristic IgG subclasses distribution abnormality exists in pSS patients,and the production of anti-SSA (Sj(o)gren's syndrome A) antibody is associated with the increase of IgG1.However,no relationship has been found between the systemic involvement of pSS patients and the abnormal distribution of IgG subclasses.

Objective To explore clinical significance of constriction of fetal ductus arteriosus diagnosed by echocardiography.Methods Seventy-one cases with constriction of fetal ductus arteriosus (DA) and one fetus with premature closure of DA were detected by fetal echocardiography among 2380 singleton fetuses.The echocardiographic characteristics and clinical outcomes were reviewed and analyzed.Results Of 71 cases with constriction of fetal DA,58 cases were found with right heart enlargement,12 cases with tricuspid regurgitation,8 cases with arrhythmia and 1 case with pericardial effusion.The echocardiographic characteristics showed narrowed diameter of DA,dilatation of pulmonary artery and descending aorta was also noted,DA was markedly curved.The peak systolic velocity(PSV) and enddiastolic velocity(EDV) in the ductus arteriosus measured by pulsed Doppler echocardiography increased (PSV≥ 180 cm/s,EDV≥35 cm/s).All cases were confirmed normal by neonate echocardiography.Conclusions Prenatal echocardiography plays important role in diagnosis of constriction of fetal DA.Early diagnosis and intimate follow-up can direct clinician to offer suitable consultation for parents and management for fetuses.

Objective To investigate the correlation between the expression of peripheral blood CD8 + T lymphocytes and the severity degree of hand,foot and mouth disease( HFMD)in children infected by enterovirus( EV)71 at different ages,and further to predict the role of the expression of CD8+ T lympho-cytes played in the occurrence of neurological complications infected by EV71. Methods A total of 138 pe-ripheral blood samples derived from the confirmed HFMD cases were collected in the department of infectious disease at Kunming Children′s Hospital between March and September in 2014,including 33 mild cases,45 severe cases,and 60 critical cases. Patient ages were 9 months to 5 years old. Flow cytometry was used to detect the expression of peripheral blood CD8 + T lymphocytes in all of above patients. Results Compared to the reference value of CD8 + T lymphocytes in normal healthy children at different age groups,the percentage of peripheral blood CD8 + T lymphocytes elevated or increased slightly in patients of all ages,except the obvi-ously increasing expression in the age group of ~2 years and decreasing expression in critical cases of the age group of ~5 years. The expression of peripheral blood CD8+ T lymphocytes significantly increased in mild and severe patients but slightly increased in critical patients of the age group of 9 to 15 months,gradually de-creased in the age group of ~2 years and slightly increased in mild and severe cases but decreased in critical patients of the age group of ~5 years. There were significant differences between the patients in mild condi-tion and in severe condition or critical condition respectively within the age group of ~2 years( P﹤0. 05 ), and there were no significant differences in other age groups between different severity of disease. Conclusion
There are correlations between the expression of CD8+ T cells and the severity of HFMD in patients at different ages. Especially,the patient′s condition developing into severe degree is associated with the rapid decreasing of CD8 + T cells in HFMD patients of the age group of ~2 years. CD8+T cells play an important role in antiviral immune response in HFMD patients of ~2 years old.

Objective To determine the causes and risk factors of antimicrobial treatment failure in patients with community-acquired pneumonia(CAP). Methods Hospitalized adults with CAP from January 2006 to December 2006 were analyzed retrospectively. Treatment failure was defined as appearance of nonresponding pneumonia and progressive pneumonia. Patient's clinical features were analyzed. Results All of 378 patients were involved in this study. Total antimicrobial treatment failure was happened in 50 patients(32 patients with non-responding pneumonia and 18 patients with progressive pneumonia). The causes were infectious (35 patients,70% ), non-infectious (11 patients,22% ) and undetermined (4 patients,8% ).Mortality of antimicrobial treatment failure was 18%(9/50, 8 patients died of infectious cause, 1 patient had no clear cause of death). Stepwise Logistic regression analysis showed that C-reactive protein, multilobar pneumonia,albumin < 30 g/L,renal function lesion,liver function lesion were related with antimicrobial treatment failure. Independent factors of treatment failure were multilobar pneumonia (P= 0.002) ,albumin <30 g/L(P = 0.001 ) and renal function lesion (P = 0.000). Conclusion The major challenge associated with antimicrobial treatment failure in hospitalized patients with CAP is infection, most of which is infection of drug resistant strain.

OBJECTIVE To study the bacteriology of pneumonia and its clinical significance in patients with lung cancer.METHODS The bacteriology and clinical features of patients with lung cancer accompanied with lung infections between 2002 and 2005 in our hospital were analyzed.RESULTS Pneumonia took place in 53.7% of 328 patients with lung cancer,the most of them were elderly people and the chemotherapy receivers,and the rates of pneumonia associated with small cell lung carcinoma(63%) and squamous cell carcinoma(59.7%) were significantly higher than those with adenocarcinoma(44.0%) and alveolar cell carcinoma(40.6%)(P

Objective To investigate the effects of A3 adenosine receptor ( A3AR) agonist on lung injury after cardiopulmonary bypass ( CPB) in rabbits. Methods Twenty-four rabbits were randomly divided into 3 groups, with 8 in each group. Rabbits in control group only received CPB, those in agonist group were given selective A3AR agonist IB-MECA intravenously 15 min before aorta clamp, and those in agonist + antagonist group were managed with selective A3AR receptor antagonist MRS-1191 intravenously before IB-MECA infusion. After CPB, serum concentrations of tumor necrosis factor-α ( TNF-α) and interleukin-8 ( IL-8), concentrations of malondialdehyde ( MDA) and myeloperoxidase ( MPO) in lung tissues, lung wet/dry weight ratio ( W/D), lung function related indexes of PaO_2/FiO_2, airway pressure (AWP) and pulmonary vascular resistance ( PVR), and histological changes of lung tissues were observed. Results Concentrations of serum TNF-a and IL-8 were significantly lower in agonist group than in control group and agonist + antagonist group (P <0.05). Compared with control group and agonist + antagonist group, W/D was much smaller, and concentrations of MDA and MPO were significantly lower in agonist group after CPB (P <0.05). PaO_2/FiO_2 was significantly higher, while AWP and PVR were significantly lower in agonist group than in control group and agonist + antagonist group (P <0.05). It was revealed by histological examinations that the pathological changes were less severe in agonist group than in control group and agonist + antagonist group. Conclusion A3AR agonist IB-MECA can reduce lung injury after CPB.

Objective To investigate the feasibility of spatiotemporal image correlation(STIC)to assess left ventricular volume in normal fetuses.Methods The volume data acquisition of 162 normal fetuses ranging between 22 and 38 weeks of gestation was achieved by automatic sweep scan.The virtual organ computer-aided analysis(VOCAL Ⅱ)was then used to evaluate end-systolic and end-diastolic volumes of left ventricle and compared with that obtained by M-mode Teichholz formula and 2D biplane Simpson's method.Results Twenty-six fetuses with poor STIC image and 2 twin pregnancies were excluded,the study subjects consisted of 134 singleton fetuses.The highest concordance correlation(r =0.968,for EDV,r =0.956 for ESV;P =0.000)was noted between 2D biplane Simpson' s and STIC VOCAL Ⅱ values with a small bias(0.282 ml for EDV,0.117 ml for ESV).The Bland-Altman analysis showed that STIC VOCAL Ⅱ had the best agreement than M-mode Teichholz formula and 2D biplane Simpson's method.The result showed that there were significant difference between Mmode Teichholz formula and Simpson's method in EDV and ESV(P＜0.05).There were significant differences between M-mode Teichholz formula and STIC VOCAL Ⅱ(P＜0.05).There were no significant differences between STIC VOCAL Ⅱ and Simpson' s method in EDV and ESV.Conclusions There is a good agreement between left ventricular volumes measured either by STIC VOCAL Ⅱ or by 2D biplane Simpson's method.STIC is a novel technique that can be more accurate than conventional Methods in quantification of fetal left ventricular volumes.All the volume data acquisition is achieved by postprocessing facilities.STIC promises to become a new method for left ventricular volume quantification.

Objective To explore the impacts of preeclampsia and the different extent of proteinuria on maternal and perinatal outcomes.Methods The retrospective analysis was conducted according to the perinatal clinical data of preelacmpsia,pregnancy-induced hypertension in pregnant women and normal pregnant women from the Fifth People's Hospital of Shanghai,excluding twins,diabetic mellitus and patients with chronic kidney disease previously.Patients were divided into three groups on the basis of their conditions:① preeclampsia patients (A group,220 cases); ② patients with gestational hypertension (B group,189 cases); ③ normal pregnant (C group,220 cases).Patients with pre-eclampsia according to the degree of proteinuria were further divided into three subgroups:A1:patients with mild proteinuria (n =109); A2:patients with moderate proteinuria (n =72); A3:patients with severe proteinuria (n =39).Results Compared with the other two groups,the patients in A group had higher blood pressure,serum creatinine,uric acid,cesarean section rate,perinatal prematurity,stillbirth,fetal distress and neonatal asphyxia in preeclampsia group.However,the serum albumin level,eGFR,neonatal birth weight,length and Apgar scores were lower in A group compared with B and C group (P ＜ 0.05).In three subgroups,serum creatinine level,uric acid level,cesarean section rate,perinatal prematurity and fetal distress were significantly increased in A3 group compared with A1 group,while the serum albumin level,eGFR,gestational age and neonatal birth weight were obviously lower in A3 group than in A1 group (P ＜ 0.05).In patients with preeclampsia,24 h urinary protein was negatively related with the levels of serum albumin and eGFR (P ＜ 0.05),and positivly related with the blood pressure,serum creatinine and caesarean production rate (P ＜ 0.05).Large amounts of proteinuria was a risk factor of adverse outcome for pregnant patients with preeclampsia (OR =2.899,P ＜ 0.05).Conclusions Preeclampsia patients with large amount of proteinuria have poor maternal and perinatal outcomes.Massive proteinuria is a risk factor of adverse outcome for patients with pre-eclampsia.

Objective To investigate the association of the expressions of glomerular nephrin, vascular endothelial growth factor (VEGF) and its receptor (VEGFR) with proteinuria in preeclampsia rats. Methods A rat model of preeclampsia was developed by inhibitor of nitric oxide synthase (L-NAME). The systolic blood pressure (SBP) and 24 h urine protein were compared among the normal female group (n=6), the normal pregnant group (n=8), nonpregnant control group (n=6) and preeclampsia group(n=8). The kidney biopsies of each group were observed by light and electron microscopy. The glomerular nephrin was detected by Western blotting and real-time PCR. Immunofluorescence was used to detect the expression of WT1. The level of glomerular VEGF and VEGFR (Flt-1 and Flk-1) were evaluated by Western blotting. Results The level of glomerular nephrin protein in the rats with preeclampsia (0.0726±0.0074) was significantly lower compared with normal female group (0.3795±0.0509), normal pregnant group (0.2361±0.0437) and nonpregnant control group (0.7265±0.0503) (P＜0.01, respectively), while the levels of nephrin mRNA were not significantly different among 4 groups. The expression of WT1 was not significantly different among 4 groups as well. The level of glomerular VEGF in preeclampsia group (1.5429±0.0898) was significantly higher compared with normal female group (1.1870±0.1160), normal pregnant group (1.3741 ±0.1165) and nonpregnant control group (1.0155±0.0742)(P＜0.01,respectively). VEGFR (Flt-1 and Flk-1) was also significantly higher in preeclampsia rats compared with other control groups (P＜0.05, respectively). Conclusions In preeclampsia rats, nephrin is decreased significantly and the glomerular VEGF-VEGFR is increased significantly compared with the other control groups. The abnormal expression of nephrin and VEGF-VEGFR may be involved in the preeclampsia proteinuria. The underlying mechanism of this phenomenon needs further research.