12E7 Antigen ; Adult ; Antigens, CD ; metabolism ; Cell Adhesion Molecules ; metabolism ; Chondrosarcoma, Mesenchymal ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Hemangiopericytoma ; pathology ; Humans ; Lymphoma ; pathology ; Male ; Nasal Cavity ; Neuroectodermal Tumors, Primitive ; pathology ; Nose Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism ; Young Adult

To report the clinical, radiological and neuropathological findings of a patient with rheuma-toid meningitis. The patient was a 71-year-old Chinese man with a two-year history of rheumatoid arthritisand no other significant medical history, who presented to our hospital recurrent weakness of his left ex-tremities, dysarthria and a continuous bilateral hand tremor. Cerebrospinal fluid (CSF) and serumexam-inations were normal apart from a mildly raised serum perinuclear antineutrophil cytoplasmic autoantibody(p-ANCA). Brain magnetic resonance imaging (MRI) showed leptomeningeal enhancementin both fron-tal and parietal lobes, in addition to several old white matter infarcts. Meningeal biopsy showed numerousinfiltrating macrophages and lymphocytes within the leptomeninges. The patient responded clinically andradiologically to corticosteroid and cyclophosphamide therapy. The patient subsequently developed herpeszoster over his left chest as a complication of his immunosuppressive treatment. His cyclophosphamidewas ceased and intravenous immunoglobulin (IVIG) therapy was commenced, with good clinical responseto both the herpes zoster and meningitis. According to the result of the biopsy, aseptic meningitis wasconsidered the MRI results and the patient’s clinical history were given, and a diagnosis of rheumatoidmeningitis was made. The patientwas p-ANCApositive. Although there was no evidence for cerebral vas-culitis on biopsy, it remains a possibility that the patient’s recurrent minor cerebral infarcts visible onMRI were vasculitic in nature.

Objective To evaluate the methods of postoperative respiratory management and complications prevention of patients with myasthenia gravis who received thymectomy. Methods According to the accumulated scores of myasthenic crisis prediction, the patients with myasthenia gravis who underwent thymectomy in the past 5 years were divided into 2 groups: high risk group(12, n=11). The time of mechanical ventilation, restoration of muscle strength and spontaneously breathing during extubation, results of arterial blood gas analysis, body temperature, chest X-ray examination and sputum culture of each patient were analyzed. Results The time of mechanical ventilation in high risk group (18~30 h, 26 h in average) was longer than that in control group(4~28 h, 14 h in average)(P

Hepatitis B ; immunology ; prevention & control ; Hepatitis B Vaccines ; immunology ; Humans ; Immunization Schedule ; Vaccination ; Vaccines, Synthetic ; immunology

OBJECTIVE:To evaluate the effect of psychological intervention based on pharmaceutical care on the communi-ty patients with essential hypertension. METHODS:172 patients with essential hypertension in a community health service certer in Nanjing Gulou area in 2013 were divided into control group(n=87)and intervention group(n=85)by simple random meth-od. Control group received conventional antihypertensive drugs and management,intervention group additionally received pharma-ceutical care and psychological intervention,it lasted 6 months. Blood pressure controlling,drug compliance,mastery of drug knowledge and health status in 2 groups before and after treatment were compared. RESULTS:Before treatment,there were no significant differences in the systolic blood pressure(SBP)and diastolic blood pressure(DBP)between 2 groups(P>0.05);af-ter treatment, SBP and DBP in 2 groups were lower than before,SBP and DBP in intervention group were lower than control group,the decrease degree of SBP and DBP was bigger than control group,the differences were statistically significant (P<0.01). 1 month after the beginning of intervention,there was no significant difference in the proportion of drug compliance be-tween 2 groups (P>0.05);1 month after the end of the intervention,the proportion of drug compliance in intervention group was higher than 1 month after the beginning of intervention and control group,the differences were statistically significant(P<0.05). Before treatment,there was no significant difference in mastery of drug knowledge between 2 groups (P>0.05);after treatment,the proportion of patients showed good and excellent mastery of drug knowledge was higher than before and control group,the differences were statistically significant (P<0.05). Before treatment,there were no significant differences in scores of physical,mental,social health subscale and SRHMS between 2 groups(P>0.05);after treatment,scores of physical health subscale and SRHMS in control group,each subscale and to-tal scale scores in intervention group were higher than be-fore, and scores of mental, social health subscale and SRHMS in intervention group were higher than control group, the differences were statistically significant (P<0.05). CONCLUSIONS: The psychological intervention based on pharmaceutical care can effectively promote the con-trol of blood pressure,improve drug compliance,mastery of drug knowledge,health status and mental situation,which is worth of popularizing and applying in community health services.

Objective To evaluate the feasibility and safety of transabdominal ultrasound-guided suction curettage to treat cesarean scar pregnancy (CSP) and investigate factors affecting prognosis of CSP. Methods This was a retrospective case study of 43 cases who were diagnosed as CSP and treated by suction curettage under transabdominal ultrasound guidance as an initial treatment of CSP in Obstetrics and Gynecology Hospital of Fudan University over past 7 years (from 2007 to 2013);factors affecting prognosis of CSP were investigated. Results 39 of the 43 cases (91%) were successfully treated. There were no statistically significant differences in maternal age, gravidity, abortion frequency, and the time interval between current CSP and last cesarean delivery, the myometrium thickness between the gestational sac and the bladder wall between the success group and the failure group (all P>0.05). Statistically significant difference was found in crown-rump length (CRL) between the two group (median of the two group was 18.5, 2.0 mm) by rank sum test (P=0.047). Univariate logistic regression analysis demonstrated that CRL was strongly associated with the prognosis and the OR for no complications was 18.50, comparing CRL≤6 mm versus CRL>6 mm (P=0.020). Conclusion Transabdominal ultrasound-guided suction curettage is effective and safe in the treatment of CSP with CRL≤6 mm.

Sacral fractures are usually caused by high-energy violence,often complicated with injury to the lumbosacral plexus.In severe cases,they may cause instability of the posterior pelvic ring or of the lumbosacral junction.Their classifications commonly used in clinic are Denis,Tile,Isler and refined Denis type Ⅲ ones proposed by Roy-Camille and Gibbons.Recently,classifications of the lumbosacral lesions and scoring systems of the injury severity have often been used clinically.At present,internal instrumentation of sacral fractures is developing along the direction of high efficiency,safety and minimal invasion,but different methods of internal fixation have their own indications which should be strictly followed.This review summarizes the classifications of sacral fractures and their treatment advances.

Objective:To explore the effect and mechanism of AMPK on apoptosis of alveolar epithelial cells induced by endoplasmic reticulum stress in COPD rats.Methods:the rats were divided into three groups:control group,model group,AICAR intervention group,establishment of rat model of chronic obstructive pulmonary disease by smoking smoke inhalation and intratracheal instillation of lipopolysaccharide.The HE staining of rat lung tissue pathological observation,immunohistochemical detection of p-AMPK /AMPK,western blot the expression of Caspase-3,ORP 150,and CHOP.Apoptosis were detected by TUNEL method.Results:the HE staining showed that the model group of pulmonary bullae formation,inflammatory cell infiltration,inflammatory ceils in AICAR group was lower than that of model group.Compared with the normal control group,immunohistochemistry and Western blot showed that p-AMPK/AMPK and ORP150 protein expression decreased in the model group,the difference was statistically significant (P＜0.05),and AICAR in the intervention group p-AMPK/AMPK and ORP150 protein expression were significantly increased compared with the model group,the difference was statistically significant (P＜0.05).Endoplasmic reticulum stress related apoptosis The expression of CHOP and caspase-3 apoptosis index increased significantly in the model group,there was significant difference compared with normal group (P＜0.05),while in group AICAR,apoptosis index down significantly compared with the model group.Conclusion:AMPK can protect alveolar epithelial cells from cigarette smoke induced endoplasmic reticulum stress and apoptosis,it was possible to achieve its protective effect the increase of ORP150.

Objective To evaluate virtual navigation assisted contrast-enhanced ultrasound(VN-CEUS) by comparing VN-CEUS with routine CEUS in detecting focal liver lesion(FLL) invisible in B-mode ultrasound(BUS).Methods Forty-seven FLLs invisible in BUS were identified by CT/MR,and received VN-CEUS and routine CEUS respectively.Results The detection rate of VN-CEUS and routine CEUS were 78.7%(37/47) and 36.2%(17/47),the former was much higher than the later (P<0.01).In all the cases,fusion of CT/MR with ultrasound was achieved successfully and average time for image fusion was 5 min.compared with routine CEUS,VN-CEUS could more easily find FLLs shadowed by lung or ribs,FLLs in inhomogeneous liver background,and FLLs with brief or inapparent abnormal enhancement.ConclusionsVN-CEUS can greatly improve the detection rate of FLL that was invisible in BUS.

To develop a core-shell structure pDNA-CaPi-PLGA nanoparticles (CS-pDNA-CaPi-PLGA-NPs), calcium phosphate-pDNA nano complexes (CaPi-pDNA) were encapsulated inside of PLGA shells. The characteristics of the nanoparticles, including morphology, average particle size, zeta potential, entrapment efficiency, loading efficiency, stability in medium, pDNA protection ability from nuclease degradation, in vitro release, cytotoxicity and cell transfection were investigated and compared with the embedded structured CaPi modified PLGA nanoparticles (embedded-pDNA-CaPi-PLGA-NPs). The results showed that the obtained CS-pDNA-CaPi-PLGA-NPs were spherical in shape with an average particle size of (155 +/- 4.5) nm, zeta potentials of (-0.38 +/- 0.1) mV, entrapment efficiency of (80.56 +/- 2.5)% and loading efficiency of (1.16 +/- 0.04)%. The CS-pDNA-CaPi-PLGA-NPs were stable in the release media and could protect pDNA against nuclease degradation. And they also exhibited sustained release of pDNA in vitro. The highest gene transfection efficiency of the CS-pDNA-CaPi-PLGA-NPs in vitro reached (24.66 +/- 0.46)% (after 72 h transfection), which was significantly higher than that of free pDNA [(0.33 +/- 0.04)%, P < 0.01] and the pDNA-PLGA-NPs [(1.5 +/- 0.07)%, P < 0.01]. Besides, the transfection lasted for longer time than that of embedded-pDNA-CaPi-PLGA-NPs and the cytotoxicity of it was significantly lower than that of PEI (P < 0.01). These results indicate that CS-pDNA-CaPi-PLGA-NPs are a promising non-viral gene vector. Key words: gene delivery system; polylactic-co-glycolic acid; calcium phosphate; nanoparticle