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.

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.

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.

Objective To carry out further analysis and assessment of the radiation risk from DSA examinations and related factors.Methods All the online radiation dose values and associated parameters of the 107 patients examined were collected for purpose of statistical analyses according to their classification.Results The analyses of DSA examinations indicated:for coronary angiography,DAP was (22 285.5±18 682.7)μGy·m2,ESD was (2 942.1 ±2 557.3) mGy;for head angiography,DAP (25 929.6±8 302.7) μGy·m2,ESD (1 288.8 ±682.3) mGy;for abdominal angiography,DAP (12 129.7 ± 10 646.1) μGy· m2,ESD (730.1 ± 584.7) mGy.Conclusions Among total accumulated radiation dose,the dose arising form coronary angiography is the highest,followed by the head angiography,and the dose from abdominal angiography is the lowest.

Objective To evaluate the clinical value of artificial hydrothorax combined with one-lung ventilation to aid ablation treatment of liver carcinoma in the hepatic dome.Methods Twenty-one patients with liver carcinoma located in the hepatic dome and affected by the lung gas were enrolled.Double lumen endobronchial intubation anesthesia was used and thoracical tube was used to apply artificial pleural effusion.The lesions'ultrasound image were recorded for the patients without artificial hydrothorax,or with artificial hydrothorax only and artificial hydrothorax combined with one-lung ventilation.Ultrasound images were reviewed and scored as 1-5 according to the clarity and completeness of the lesion.Ablation efficacy and adverse reactions were recorded in the follow-up.Results Twenty-one patients were successfully applied artificial hydrothorax and one lung ventilation.The average normal saline used for artificial hydrothorax were (738± 260)ml.The ultrasound score for not using artificial hydrothorax,using artificial hydrothorax only and artificial hydrothorax combined with one lung ventilation were 1.13 ± 0.35 (1-2),3.00 ± 0.85 (2-5) and 4.53 ± 0.64(3-5),respectively,statistical difference was found between each method(P ＜0.05).Artificial hydrothorax combined with one-lung ventilation had much higher ultrasound score than the other 2 methods.No complication related to artificial hydrothorax or one-lung ventilation was found.CT/MRI at one month after ablation showed that all the lesions were completely ablated.In the follow-up for 2-14 months on average,1 case of local tumor progression and 1 case of intrahapetic relapse were found.Conclusions Artificial hydrothorax combine one-lung ventilation could effectively enhance ultrasound image for the lesions in the dome whose acoustic window was affected by lung gas.

Objective To investigate the clinical characteristics of tuberculous pleurisy(TP) in children in order to provide a good solution to the diagnosis and treatment of this disease.Methods Retrospective analysis was performed on the clinical data of 113 cases confirmed with TP who were admitted to Children's Hospital of Chongqing Medical University from January 2009 to December 2014.Results Among the 113 pediatric inpatients with TP,85 cases (75.2％) were sick for less than 1 month;92.9％ (105/113 cases) age ≥≥5 years old by onset;and 21.2％ (24/113 cases) patients demonstrated the contact with tuberculosis ,among whom 70.8％ (17/24 cases) attributed to linear relatives.The primary clinical manifestations included fever[96.5％ (109/113 cases)], cough [76.1％ (86/113 cases)] and chest pain[38.9％ (44/113 cases)] ,with as high as 89.0％ (87/109 cases) of the patients experiencing moderate or ardent fever.The positive rates of acid-fast bacilli smear and mycobacterium tuberculosis culture were 12.2％ (17/139 cases) and 22.7％ (15/66 cases), respectively;among the 41 patients who received pleural biopsy,40 cases (97.6％) were identified with the typical pathological changes in tuberculosis;and all 11 patients who received acid fast stain test on pleural tissues were positive to the test.Pulmonary parenchymatous lesions were revealed on CT examination in 89.1％ patients(98/113 cases),82.4％ (90/109 cases) of the patients had normal body temperature within a short period,and reduced effusion was revealed in 86 out of 98 patients who received repeated chest imaging examinations.Conclusions TP in children has acute onset typically, and the diagnosis of TP in children is more difficult than in adults,requiring considering multiple factors.Contact history with tubercular patients, etiological examination, pleural biopsy and chest CT are essential for the diagnosis of this disease.

Objective To study the anxiety and depression in patients with amyotrophic lateral sclerosis(ALS).Method One hundred and seventy-four ALS patients were evaluated by self-rating anxiety scale(SAS)and self-rating depression scale(SDS) to study the anxiety and depression in them.Results In 174 ALS patients,21 had anxiety(12.07%)and 65 the depression(37.36%). The scores of SAS and SDS in the ALS patients were significantly higher than the national norm(P<0.05).The depression incidence in the female patients was significantly higher than the male(P<0.05).Conclusions Anxiety and depression are more severe than those in ALS patients than those in normal people.Psychological support is important for these patients,especially for those female patients.

OBJECTIVE:To investigate the change in drug resistance of pseudomonas aeruginosa to imipenem bewteen Jan.2000and Jun.2005in the hospital where the authors work in order to provide the reference for rational choice of antibac-terials in clinic.METHODS:158strains of imipenem resistant pseudomonas aeruginousa had been isolated in clinic and their drug sensitivity to antibacterials was tested by KB slip diffusion method and analyzed statistically.RESULTS:Meropenem,amikacin,and ceftazidime were among the antibacterials that kept high antibacterial activity and had resistance rates less than35%included.CONCLUSIONS:Imipenem resistant pseudomonas aeruginosa strain has stronger resistance to commonly used antibacterials and its multidrug resistance is more severe.Rational use of antibacterials can help to control and lessen the drug resistance of bacteria.

Objective To investigate the clinical superiority of Chaiqin tiaogan capsule in the treatment of hepatitis B virus.Methods 126 cases of patients admitted to hospital from January 2014 to June 2015 were randomly divided into two groups, the control group (interferon and lamivudine) and the experimental group (interferon, lamivudine and Chaiqin tiaogan capsule), each group of 63 cases.The HBsAg and HBV-DNA negative rate, the changes of liver function and the incidence of adverse reactions in the experimental group were observed and compared.Results The HBsAg negative rate and the HBV-DNA negative rate after treatment three and six months in the control group were significantly higher than the experimental group ( P<0.05).The levels of ALT, AST and DBiL in the control group and the experimental group were significantly decreased, and the levels of ALT, AST and DBiL after treatment six months in the control group were significantly lower than the experimental group ( P <0.05 ) .There were no serious adverse reactions in the control group and experimental group, there was no significant difference between two groups.Conclusion Chaiqin tiaogan capsule can effectively inhibit HBV replication and improve liver function, it has good tolerability and safety applied to clinical.

[Abstract ] Objective To understand the identification and in vitro antifungal susceptibility of Penicillium marneffei(PM)in yeast phase,and guide clinic antifungal application.Methods Strains isolated from blood and bone marrow of 23 patients infected with PM in a hospital between 2009 and 2016 were collected,colony morpholo-gy of PM in yeast phase was observed,susceptibility to itraconazole,voriconazole,amphotericin B,and fluconazole were detected with E-test method.Results Colony morphology of PM were as follows:direct microscopic examina-tion of Wright’s staining of tissue specimens found visible oval or round spore with apparent septum,and mainly lo-cated in macrophage;Gram staining of blood culture specimens found that strains were with bulbous and slightly curved ends,occasionally branched and with septum. PM was dimorphic fungi,presented mycelium at 28° C,pro-duced red pigment and diffused into medium;PM presented yeast form at 35° C,there were typical colony morpholo-gy. Minimum inhibitory concentrations (MICs)of itraconazole,voriconazole,amphotericin B,and fluconazole to PM in yeast phase were 0.002-0.016,0.012-0.125,0.002-0.500,and 0.500-16.000μg/mL respectively. Conclusion Typical colony morphology and fungal spore of PM in bone marrow and peripheral blood are important features for identification. PM is most susceptible to itraconazole,followed by voriconazole and amphotericin B, while fluconazole is less susceptible.