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 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.

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.

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.

AIM: To study the role of NOS2 in the devel op ment of cardiac dysfunction after rat myocardial infarction by observing effects of S-methylisothiourea (SMT) on left ventricular morphology and haemodynamics. METHODS: An selective NOS2 inhibitor, was used. Administration o f SMT by gavage began 30 min before coronary ligation. Six weeks later, left ventricular morphologic and haemodynamic parameters were o bserved,and NOS2 expression, plasma NO 2-/NO 3- level and myocardial fibr osis were studied. RESULTS: Six weeks after myocardial infarction, NOS2 level in ra t non-infarct cardiac muscle, plasma NO 2-/NO 3- level, CVP and LVEDP were higher than that in controls. Long term administration of SMT decreased plasma NO 2-/NO 3- level [(26.6?6.1) ?mol/L vs (50.1?10.4) ?mol/L, P

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.

[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.

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