1.Clinical analysis of autoimmune hemolytic anemia in systemic lupus erythematosus
Haiyun LI ; Yi ZHENG ; Xiaofeng ZENG
Chinese Journal of Rheumatology 2011;15(12):803-807
Objective To determine the clinical and serological characteristics of autoimmune hemolytic anemia (AIHA) in systemic lupus erythematosus (SLE) patients.Methods Seventeen patients were studied who had clinical features of AIHA among 222 hospitalized SLE patients in the Department of Rheumatology of Beijing Chaoyang Hospital were studied.Among the SLE patients without AIHA,34 patients were chosen by random sampling as controls.The patients' demographic data,clinical manifestations,laboratory test results and other examinations were analyzed retrospectively.Student's t test was used for the comparison of continuous variables,and chi-square test was used for the comparison of proportions.Results The prevalence of AIHA was 7.6% in cohort of lupus patients.The positive rate of IgG anticardiolipin antibody in the AIHA group was significantly higher than that in the control group (71% vs 15%,x2=15.366,P<0.01 ).The occurrence of antiphospholipid antibody syndrome between the two groups had no statistical significant difference (x2=0.000,P=1.000).The frequencies of arthritis (12%,x2=4.554,P=0.033),malar rash (6%,x2=4.443,P=0.033),leukocytopenia (12%,x2=8.061,P=0.005) and lymphocytopenia (41%,x2=5.075,P=0.024) were lower in the AIHA group than those in the control group.Three patients in the AIHA group had alveolar hemorrhage in the course of SLE,while there was none in the control group (x2=3.586,P=0.058).Conclusion When lupus patients with AIHA are compared with those without AIHA,the positive rate of anticardiolipin antibody is higher,but the occurrence of antiphospholipid antibody syndrome does not increase in SLE patients with AIHA.And the frequencies of arthritis,malar rash,leukocytopenia and lymphocytopenia are lower in those patients with AIHA,however,patients with AIHA are prone to develop alveolar hemorrhage.
2.The 457th case: polyarthralgia, back pain and subcutaneous masses
Meng LI ; Di WU ; Wenjie ZHENG ; Mengtao LI ; Xiaofeng ZENG
Chinese Journal of Internal Medicine 2017;56(6):477-480
A 54-year-old man was admitted to the Department of Rheumatology in Peking Union Medic.al College Hospital due to polyarthritis.back pain and multiple subcutaneous masses.He had symmetrical polyarthritis at onset.which was diagnosed as theumatoid arthritis.His follow-up and treatment were irregular.Back pain and multiple subcutaneous masses developed 2 year ago.Erythrocyte sedimentation rate and C-reac.tive protein were elevated.Rheumatoid fac.tor and Anti-cylic citrullinated peptide antibody were positive.No evidence of infection or malignancy was detected.Chest CT suggested pulmonary fibrosis and osteolytic lesions of stemum.Spinal MRI showed paravertebral soft tissue.Biopsy of the soft tissue suggested the pathologic.al finding of a theumatoid nodule.The patient was diagnosed as theumatoid arthritis complic.ated with multiple theumatoid bursal cysts.Combination therapy of methylprednisolone (40mg/d) and cyclophosphamide (0.4g/w) lead to a rapid improvement of clinical symptoms and laboratory parameters.The patient was still in remission at 6-month follow-up.
3.Characteristics of growth and secretion in primarily cultured human pheochromocytoma cells
Xin ZHENG ; Zhengpei ZENG ; Ming LI ; Weigang YAN ; Hanzhong LI
Chinese Journal of Rehabilitation Theory and Practice 2005;11(11):922-923
ObjectiveTo investigate the characteristics of growth and secretion in primarily cultured human pheochromocytoma cells.MethodsThe human pheochromocytoma tissues were digested successively,and the tumor cells were cultured.The growth curves of three tumors were plotted by cell count.At the same time,the catecholomine in the medium was measured with high performance liquid chromatography.ResultsThe number of primarily cultured human pheochromocytoma cells increased gradually from first to sixth day after plating,and then the cell number began to decrease from seventh day.The levels of norepinephrine(NE) and epinephrine(E) in the medium of cultured cells significantly decreased on first and second day,and the levels of NE and E had no significant difference on the second to eighth day.The levels of dopamine in the medium had no significant difference on the first to eighth day.ConclusionThe primarily cultured pheochromocytoma cells differentiate obviously after plating,but have no significant proliferation.The levels of catecholomine in the medium are decreased significantly on the first and second day.
4.Influence of lactulose on the cognitive level and quality of life in patients with minimal hepatic encephalopathy
Zheng ZENG ; Yuyuan LI ; Lin JIA ; Yuqiang NIE
Chinese Journal of Tissue Engineering Research 2006;10(22):165-167
BACKGROUND: The pathogenesis of hepatic encephalopathy is still not completely clear at present, and the theory of ammonia poisoning may be the most powerful, the mechanism for lactulose in decreasing ammonia is clearer, and there are many studies on hepatic encephalopathy treated by lactulose at home and aboard, but the comparative studies on the long-term and short-term treatment of lactulose and placebo control treatment are still in lack. OBJECTIVE: To given long-term and short-term treatment of lactulose to patients with minimal hepatic encephalopathy, and compare the effect on the quality of life (QOL) of the patients with minimal hepatic encephalopa thy. DESIGN: A case-control observation. SETTING: Department of Geriatrics, Guangzhou First People's Hospital. PARTICIPANTS: Sixty patients with minimal hepatic encephalopathy, who were abnormal in the number connection test (NCT), digital symbol test (DST) and/or evoked potential examination and cooperated with the treatment, were selected from the patients with cirrhosis treated in the De partment of Geriatrics of Guangzhou First People's Hospital between June 1998 and March 2002, and they were randomly divided into control group (n=20), short-term lactulose group (n=20) and long-term lactulose group (n=20). METHODS: All the patients were given vitamin B for 24 weeks, two tablets for each time, three times a day; besides, the patients in the short term lactulose group and long-term lactulose group were orally adminis tered with lactulose (15-90 mL per day) for 8 and 24 weeks respectively. They were assessed with WHOQOL-BREF at the end of 0, 8, 16 and 24 weeks respectively, the incidence rate of hepatic encephalopathy was observed, and the ammonia conc entration in blood was detected at the same period.MAIN OUTCOME MEASURES: The changes of QOL and ammonia concentration in blood during the treatment were observed.RESULTS: During the treatment, one case in the control group lost to the follow-up, one case in the short-term lactulose group died from traffic accident, and two cases in the long -term group quitted because they could not endure the side effect of diarrhea, and totally 56 cases finished the treatment and entered the analysis of results. ① The incidence rate of hepatic encephalopathy at 6 months was 40%(8/20), 30%(6/20), 5%(1/20) in the control group, short-term lactulose group and long-term lactulose group respectively, and it was significantly lower in the long-term lactulose group than in the control group and short-term lactulose group (P < 0.05), but there was no significant difference between the short-term lactulose group and control group (P > 0.05). ② At 8, 16 and 24 weeks after treatment,the score of environment in QOL had no significant difference among the control group, short-term lactulose group and long-term lactulose group (P > 0.05), but there were significant differences in the scores of physiology,psychology and social relationship (P < 0.05); At 8 weeks, there were more obvious differences in the long-term lactulose group and short-term lactulose group than in the control group, but no significant difference between the long and short-term lactulose groups; At 16 weeks, there were more obvious differences in the long-term lactulose group than in the short-term lactulose group and control group, but no significant difference between the short-term lactulose group and control group; At 24 weeks, the long-term lactulose group had more improvements than in the control group and short-term lactulose group. ③ At 16 and 24 weeks after treatment, the ammonia concentrations in blood were significantly decreased in the long-term lactulose group as compared with the control group and short-term lactulose group.CONCLUSION: The long-term treatment of lactulose can improve the QOL of patients with minimal hepatic encephalopathy, eventually reduce the incidence of hepatic encephalopathy and decrease the ammonia concentration in blood; However, the short-term treatment of lactulose could not.
5.Clinical features of invasive pneumococcus with resistance to antimicrobial agents in Pediatric Intensive Care Unit
Jun LIU ; Quan WANG ; Jiansheng ZENG ; Zheng LI ; Suyun QIAN
Chinese Journal of Emergency Medicine 2012;21(5):467-471
Objective To study the clinical features of invasive pneumococcus disease (IPD) with resistance to antimicrobial agents in children,and to improve the diagnosis and treatment of this disease.Methods The clinical data from 21 IPD patients younger than 13 years old were collected from January 2008 through December 2010 in Pediatric Intensive Care Unit in Beijing Children's Hospital for retrospective analysis. Specimens of blood,pleural effusion,cerebrospinal fluid and soft tissue aspirated were collected from these children,and 23 strains of streptococcus pneumonia (SP) were cultured,isolated and confirmed,and the antibiotics susceptibility to penicillin and other antibiotics of these strains were assayed.Results Among the 21 IPD children,the ratio of male to female was 0.9∶1,and the age was 5 months to 13 years,with 61.9% of them under 2 years.Of them,12 patients (57.1% ) had purulent pleurisy,and 1 (4.8% )patient had an underlying disease diagnosed to be X - linked agammaglobulinemia (XLA).There was no seasonal difference in the occurrence rate of this disease. Eight (38.1%) patients were cured,11(52.4% ) were improved,while 2 (9.5% ) patients not improved without death.There was no statistically significant difference in the annual detection rate of invasive SP (x2 =3.711,P =0.156).The incidences of penicillin-intermediate susceptibility SP (PISP) and penicillin-resistant SP (PRSP) were 47.8% and 26.1% respectively.The rate of resistance to multiple antibiotics was 91.3%.Conclusions Children aged less than 5 years,especially younger than 2 years,are prone to IPD,and purulent pleurisy and septicemia are often seen in this disease. Some patients had the underlying diseases.The complications included hemophagocytic syndrome,acute respiratory distress syndrome,septic shock,bronchial pleural fistula and so on.The multidrug resistance rate was 91.3%.It is important to put great emphasis on the monitoring antibiotics resistance to invasive pneumococcal disease.
6.Establishment of a novel ring primer real-time PCR for quantification of the mRNA expression levels of HER2 gene
Yi LI ; Guoyan LIU ; Huanjing ZHANG ; Limou ZHENG ; Jimeng ZENG
Chinese Journal of Laboratory Medicine 2012;(11):1000-1005
Objective Based on real-time PCR technique and ring primers,to establish a simple,accurate,cost-effective and easily standardized quantitative assay for quantification of HER2 mRNA,and apply to provide medication guidance for clinical tumor personalized molecular targeted therapy.Methods Screening reference gene which was stable expression in breast cancer,and optimizing the PCR reaction system.Then a real-time PCR with Eva Green for quantification of the mRNA expression levels of HER2 gene was developed.The specificity,sensitivity and reproducibility of the method were evaluated 87 specimens including 55 liquid nitrogen-frozen breast cancer tissues and 32 normal tissues were detected by the real-time quantitative reverse transcription (FQ RT)-PCR and immunohistochemistry(IHC).Results The standard curve of the method indicated a good linear relationship between the Ct value and the template concentration with the correlation coefficient being 0.997.The linear range of the system was from 101 to 106 copies/μl and the lower detection limit was 101 copies/μl.It had a high sensitivity and good specificity.The inter-assay coefficients of variation of HER and RPL37A genes were (5.93 ± 0.57)% and (5.11 ± 0.59)%,(2.49 ±0.81)% and (2.98 ±0.97)% respectively.The intra-assay coefficients of variation were (5.76 ±0.58)%and (7.71 ±0.61)%,(3.75 ±0.76)% and (4.40 ±0.96)% respectively.Using the optimized FQ RTPCR system,HER2 gene of 87 specimens was quantificated.The sensitivity of the assay was 96.36% (53/55),the specificity was 78.13% (25/32),the positive predictive value was 88.33% (53/60),the negative predictive value was 92.59% (25/27),and the total coincidence rate between FQ RT-PCR and IHC was 89.66% (78/87).The correlation of the results between the FQ RT-PCR and IHC was good (Kappa =0.770,P > 0.05).Conclusions The method can quantify the mRNA expression levels of HER2 gene rapidly and cost-effictively with high sensitivity and specificity.It can be applied to clinical molecular diagnosis with attractive prospect.
7.Surgical treatment and early postoperative enteral nutrition of acute obstruction caused by colorectal cancer
Tian YANG ; Yongming ZENG ; Huaiming WANG ; Zhouhong ZHENG ; Wei LI
Clinical Medicine of China 2013;29(9):961-963
Objective To investigate the method of surgical treatment of acute intestinal obstruction caused by colorectal cancer,and affirm the feasibility and validity of the new way ofearly precolonic postoperative enteral nutritionafter operation of acute intestinal obstruction caused by colorectal cancer.Methods Retrospective analized the clinical data of 78 cases of acute intestinal obstruction caused by colorectal caner from September 2007 to September 2012 and the incidence of complications (incision infection,intra-abdominal abscess,anastomotic leakage,and pneumonia) was observed.Results Sixty-two patients received radical resection and primary anastomosis.All of them were cured and no death occurred.Two patients had complication of postoperative infection and none suffered from anastomotic or drainage leakage.Conclusion Radical resection and primary anastomosis using Intra-operative colonic lavage are safe and effective methods for patients with colorectal cancer associated with acute intestinal obstruction,and early precolonic postoperative enteral nutritioncould better eliminate perioperative malnourished patients more,reduce operation complication,prevent anastomotic leakage,and increase the success rate of the operation.
8.Clinical study on the effectiveness and safety of terazosin in the treatment of benign prostatic hyperplasia patients with concomitant hypertension
Ming ZHENG ; Jinyang CHEN ; Mingqiang ZENG ; Shuren LI
Clinical Medicine of China 2012;28(3):235-238
Objective To evaluate the effectiveness and safety of terazosin in the treatment of benign prostatic hyperplasia (BPH)patients with concomitant hypertension.Methods A singlecenter prospective clinical observational study was conducted from March,2006 to March,2010 in our center.The main endpoints were the changes of IPSS total score,diastolic and systolic blood pressures at the end of 4 weeks and 3 monthes compared with the baseline,The second endpoints were Qmax value at the end of 4 weeks and 3 monthes compared with the baseline,Safety was assessed by adverse events.Results There were 212 patients in the study recruited,and 189 patients completed the study.All patients had BPH combined with hepertension.All patients were randomly devided into two statistical analysis group,blood pressure well controled and not well controled group,In the well controlled group,the IPSS socre reduced from 22.31 ± 5.18 at baseline to 15.64 ±3.91 at the end of the 4th weeks and 13.16 ± 3.53 at the end of 3rd monthes in the blood pressure well controled group populatin( P < 0.01 ).The Qmax were improved significantly from (7.87 ± 2.41 ) % at baseline to (14.19 ±2.64)% at the end of the 4th weeks and (15.69 ±2.77)% at the end of3rd monthes in the blood pressure well controled group populatin( P < 0.01 ).Terazosin had moderate effect in blood pressure decreasing (P < 0.05 ),and all patients were within normal blood pressure range.In the uncontrolled group,the IPSS socre reduced from 21.55 ± 4.82 at baseline to 15.44 ± 3.66 at the end of the 4th weeks and 12.96 ± 3.11 at the end of 3rd monthes in the blood pressure well controled group populatin (P < 0.01 ).The Qmax were improved significantly from ( 8.27 ± 2.27 ) % at baseline to ( 14.26 ± 2.87) % at the end of the 4th weeks and ( 15.51 ±2.92) % at the end of 3rd monthes in the blood pressure well controled group populatin( P < 0.01 ).Terazosin decreased BPH patient blood pressure with controlled patients and unctrolled patients additionaly to other blood pressure medicine (P < 0.05 ),and no severe side effect occured.At the end of the study,all patients were taking drug continuously and were followed.Conclnsion Terazosin can significantly improve the symptoms and quality of life in BPH patients with hypertension with good safety and compliance.
10.Expression of HBME-1,CK19 and CD117 in papillary thyroid carcinoma and its significance
Zheng ZENG ; Ruiping LI ; Min ZHAO ; Yanhua WEI ; Zhongyuan SHI
International Journal of Laboratory Medicine 2016;37(20):2825-2827,2830
Objective To explore the value of three antibodies in the differential diagnosis of papillary thyroid carcinoma ,by de‐tecting the expression of HBME‐1 ,CK19 and CD117 in papillary thyroid cacinoma ,thyroid follicular adenoma and Hashimoto′s thy‐roiditis tissues .Methods Totally 85 cases were collected from January 2013 to December 2015 ,including papillary thyroid cacino‐ma ,thyroid follicular adenoma and Hashimoto′s thyroiditis .They were immunohistochemical stained by HBME‐1 ,CK19 and CD117 .SPSS16 .0 software was used to analyze the relationship between the staining results with different pathological changes . Results The positive rates of HBME‐1 ,CK19 and CD117 were 87 .3% ,98 .2% ,and 7 .3% ,respectively .The positive expression of them in benign and malignant groups had significant difference (P< 0 .05) and their consistency checking Kappa were 0 .582 , 0 .551 ,and 0 .874 ,respectively .Conclusion In the differential diagnosis of papillary thyroid carcinoma and benign lesions ,CD117 is better than HBM E‐1 and CK19 .It′s possible to use a combination of them in practice .