Type 1 diabetes mellitus and autoimmune thyroid disorders are the most common combination of autoimmune polyendocrine syndrome type Ⅲ(APS Ⅲ). However, APS Ⅲ combined with myasthenia gravis is rare. We described a male patient with myasthenia gravis, type 1 diabetes mellitus, and Hashimoto thyroiditis, who was diagnosed as APS Ⅲ. The human leukocyte antigen (HLA)type was analyzed in this patient. We subsequently reviewed 11 cases of APS Ⅲ combined with myasthenia gravis. This review revealed that HLA-DR9/DQ9 might be a specific HLA subtype associated with APS Ⅲ and complicated with myasthenia gravis .

Objective The incidence rate of acute pancreatitis in pregnancy (APIP) is on the rise, and yet there is no effec-tive method for its prevention and treatment .This study aimed to investigate the high risk factors of APIP and its prognostic evaluation index. Methods We retrospectively analyzed the clinical data of 35 cases of APIP ( group A) and another 35 cases of acute pancre-atitis in non-pregnancy as controls (group B).We compared the etiologic factors of acute pancreatitis , changes of laboratory indexes after onset of the disease , and clinical outcomes between the two groups . Results No statistically significant differences were found in the risk factors between the two groups (χ2 =0.233, P>0.05).Serum cholesterol and triglyceride levels were remarkably higher in group A ([15.69 ±7.71] and [15.54 ±7.82] mol) than in B ([5.07 ±2.95] and [3.82 ±2.58] mol) (P<0.05).There were significant differences between groups A and B in WBC count ([19.00 ±5.31] vs [14.98 ±9.77] 109/L), Hb ([82.77 ±11.77] vs [101.77 ±1.50] g/L), and serum Glu ([8.77 ±2.76] vs [6.23 ±1.99] mol/L)(P<0.05).Multivariate logistic regression a-nalysis showed the predictive value of cholesterol and triglyceride levels for APIP and a correlation of WBC and Hb with the clinical out -comes of the patients.The in-hospital mortality rate was significantly higher in group A than in B (χ2 =3.968, P=0.046), and so was the incidence rate of severe acute pancreatitis (χ2 =5.510, P=0.019). Conclusion Biliary diseases are the main high risk factors of APIP, followed by hyperlipidemia .Triglyceride and cholesterol levels have the predictive value for APIP .The WBC count and Hb level can be used to assess the patients′condition and predict the clinical outcomes .

Objective To evaluate the value and accuracy of M-mode color Doppler echocardiography for detecting left ventricular diastolic function in patients with cardiac disease. Methods The rate of left ventricular filling flow propagation (Vp) and the early -diastolic peak velocity of the mitral annulus(E) was measured in normal subjects(n=40)and in patients with cardiac disease (n=40). All the patients had abnormal left ventricular diastolic function confirmed by isotope-angiography test. Results ① The Vp was significantly lowered in patients with cardiac disease than in normal subjects(P

Objective To investigate the effect of placenta derived tumor necrosis factor (TNF)-α and myostatin (MSIN) in patients with preeclampsia (PE) and fetal development.Methods One hundred and twenty pregnant women who delivery from October 2008 to October 2013 were enrolled in this study.In them,40 healthy pregnant women was normal control group,40 PE and fetal growth in normal pregnant women was PE group,40 PE and fetal growth restriction (FGR) of pregnant women was PE + FGR group.The immunohistochemical localization of SABC method was used to detect for TNF-α and MSIN protein in placenta tissue in each group respectively.Real-time fluorescent quantitative PCR and Western blotting were used to detect for TNF-α and MSIN mRNA and protein in placenta tissue.Results The TNF-α mainly located in placental blood vessels surrounding stroma,decidual cells,trophoblastic cells and MSIN mainly located in placental blood vessels surrounding stroma,decidual cells and terminal villi.The TNF-α and MSIN mRNA expression quantity in PE group was 3.65 ±0.86,1.80 ±0.32 ; in PE + FGR group was 3.88 ± 0.71,2.01 ± 0.55 ; in normal control group was 1.32 ± 0.21,0.77 ± 0.39.The TNF-α and MSIN mRNA expression quantity in PE group and PE + FGR group were significantly higher than those in normal control group(P ＜ 0.01),and there were significant differences between PE group and PE + FGR group(P ＜ 0.05).The TNF-α and MSIN protein expression in normal control group was 0.56 ±0.13,1.31 ± 0.23;in PE group was 1.67 ±0.25,1.55 ±0.34 ;in PE + FGR group was 2.78 ±0.41,3.07 ±0.51.The TNF-α and MSIN protein expression in PE group and PE + FGR group were significantly higher than those in normal control group(P ＜ 0.01),and there were significant differences between PE group and PE + FGR group(P ＜ 0.05).Conclusions The placenta derived TNF-α and MSIN have more important roles in the pathogenesis of PE and normal development of fetal.It can provide coping strategies by detecting the level of placenta derived TNF-α and MSIN.

Objective To investigale the quality of life (QOL) and its influenced factors in Tibetan patients with generalized tonic clonic epilepsy.Methods QOL of 126 definit diagnosed Tibetan patients with generalized tonic clonic epilepsy were measured with the QOL in Epilepsy Inventory-31 (QOLIE-31). The influenced factors of QOL were analysed. Results The total score of QOLIE-31 was 48.58?17.29; the lowest subcomponent score was 32.92?22.97 for Seizure Worry ; the highest was 77.11?20.98 for Medication Effects. Single factor analysis results were indicated that the scores of QOL between the different gender, occupation, marital status age,education were remarkable difference(all P

In the modernization course of Chinese materia medica(CMM),two misunderstanding mistakes which are out of line with traditional Chinese medicine(TCM)theory and excessively emphasize the research of CMM compound prescription and two difficult points which are the establishment of CMM quality control system and the establishment of CMM evaluation system were pointed out.Because the main means of TCM syndrome differentiation treatment and TCM combination therapy is CMM processing pieces and the starting point of the research of CMM efficacy substantial basis should be CMM processing pieces,the priority of the modernization of CMM should be the research on modern CMM processing pieces and the conditions have been mature now.The research on modern CMM pieces were supposed to take three steps:the research on "standardized extract",the research on "effective fraction" and the research on the CMM nature of "effective fraction".

The prevalence of violence behavior in patients with schizophrenia is higher than that in common population. Data suggest that genetic factors may play a substantial role for the etiology of the behavior. Among the particular gene polymorphisms that have been considered to be involved in violence behavior, the catechol-O-methyltransferase (COMT) gene had been the focus of recent research. This article reviews the association research between COMT gene and violence behavior in patients with schizophrenia in several aspects: SNP polymorphism of COMT Val158Met and COMT Ala72Ser, haplotype of COMT gene and DNA methylation of promoter region of COMT gene. The genetic research direction is presented for patients with schizophrenia.
Aggression ; Catechol O-Methyltransferase/genetics* ; Haplotypes ; Humans ; Polymorphism, Genetic ; Schizophrenia/genetics* ; Violence

Objective To investigate the influence of indenter diameter on fracture strength and fracture mode of IPS e. max all-ceramic crowns using mechanical experiments and three-dimensional finite element (3-DFE) method, to validate the 3-DFE model using mechanical experiments, and to provide a guideline for occlnsal surface design for IPS e. max all-ceramic crowns. Methods A 3-DFE model of an all-ceramic crown on a molar was established using ANSYS10.0 software. The 3-DFE crown was loaded occlusally at three points to simulate the contact points of a hemispherical indenter loading on the crown. Two indenter diameters (4 mm and 10 mm) were designed by changing loading point, load level and its direction. The stress distribution and the principal stress in the 3-DFE model were calculated. Meanwhile, IPS e. max ceramic crowns were made on a laboratory model and loaded with indenters. The diameters of the indenters were also 4 mm and 10 mm respectively. Fracture mode and fracture-resistance of the crowns were recorded. Results The principal stress increased as load increases for both small and large indenters. Stress concentrated in the central fossa of the 3-DFE crown when loaded with the small indenter. Stress concentration appeared in the middle area of the occlusal surface mesio-distally when 3-DFE crown was loaded with large indenter. The fracture-resistance load was 600 N to 700 N for 4 mm diameter indenter, and 2500 N to 2750 N for 10 mm diameter indenter. Mechanical experiments indicated the same results as those from 3-DFE analysis. Conclusions Both the three-dimensional finite element analysis and the mechanical experiment showed the same results. When loaded with 4 mm diameter indenter, fracture occured in the central fossa of the crown, however, 10 mm diameter indenter usually caused extensive crown damage.

Objective To investigate the situation of admission nursing evaluation on elderly patients of geriatrics departments in several Shanghai comprehensive hospitals, and the results will be the base for designing elderly patient′s comprehensive admission nursing evaluation form. Methods 41 nurse managers of geriatrics department in Shanghai comprehensive hospitals were selected as research object. Self-designed questionnaire included general data, elderly patient admission nursing evaluation content and the importance of each item. Results The effective recovery rate was 97.56%(40/41). 98%(39/40) hospitals considered that elderly patients need to have a comprehensive assessment according to the elderly characteristics, only 18%(7/40) hospitals used the special nursing evaluation form for elderly patients. The score of importance of five dimensions were as follows: geriatric syndromes or problems scored (4.64 ± 0.38), physical function assessment scored (4.60 ± 0.46), physiological function assessment scored (4.53 ± 0.45), mental and psychological assessment scored (4.10 ± 0.57) and social assessment scored (4.07±0.52). The score of importance of 29 items were as follows:fall assessment scored (4.90±0.30), pressure ulcer assessment scored (4.85 ± 0.36), activities of daily living scored (4.75 ± 0.44), urinary incontinence assessment scored (4.70 ± 0.52), pain assessment scored (4.70 ± 0.46). Conclusions It is of great significance to carry on the comprehensive admission nursing evaluation for the elderly patients, which needs to be valued and strengthened.

Objective To systematically assess the effectiveness and safety of acupuncture and moxibustion for treatment of rheumatoid arthritis. Methods Articles were searched from databases, i.e., CNKI, VIP, WanFang Data, CBM, Embase, and PubMed. Articles about RCT on acupuncture and moxibustion for rheumatoid arthritis and traditional medicine therapy were under meta-analysis. Results Totally 24 articles involving 2006 patients were included. The results of meta-analysis indicated that the overall effective rate of treatment in the group receiving acupuncture and moxibustion was higher than that in the drug group, with statistical significance [OR=2.73, 95%CI (2.18, 3.41), Z=8.78, P<0.000 01]. Sub-group analysis showed that:acupuncture and moxibustion showed statistical significance in decreasing serum RF levels compared with drug therapy [MD=-2.92, 95%CI (-5.60, -0.25), P<0.05]. Acupuncture and moxibustion showed statistical significance in decreasing serum ESR levels compared with drug therapy [MD=-2.99, 95%CI (-4.78, -1.21), P<0.05]. Acupuncture and moxibustion showed statistical significance in decreasing serum CPR levels compared with drug therapy [MD=-1.44, 95%CI (-2.44, -0.44), P <0.05]. Conclusion The overall effective rates of acupuncture and moxibustion for rheumatoid arthritis and the decreasing levels of RF, ESR, CRP are superior to drug therapy, but it still needs larger samples, multi-center, and high quality RCT to verify.