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Expression and significance of peripheral blood CD4 + CD28 - T cells in patients with autoimmune hepatitis

Chinese Journal of General Practitioners.2010;09(8):560-562. doi:10.3760/cma.j.issn.1671-7368.2010.08.020

The percentage of peripheral blood CD4 + CD28 - T cell in 59 patients with autoimmune hepatitis (AIH) (36 with active disease and 23 stable) and 30 normal individuals was evaluated by twocolor flowcytometry. IL-10 and TNF-α levels were assayed by double-antibody sandwich ELISA. Serum immunoglobulin were also analyzed. Patient with active AIH had significantly higher peripheral blood CD4 + CD28 - T cell and TNF-α levels than normal individuals ( P ＜ 0. 05 ), while in patients with remission they were only slightly higher than normal controls. If remission was induced in patients with active AIH,peripheral blood CD4 + CD28 - T cell percentage would be significantly reduced ( P ＜ 0. 05 ) while IL-10 increased ( P ＜ 0. 05 ). The percentage of peripheral blood CD4 + CD28 - T cell in patients with relapse was significantly higher than newly diagnosed patients and normal controls; Peripheral blood CD4 + CD28 -T cell percentage in patients with abnormal serum immunoglobulin ( IgA, IgG and IgM ) levels was significantly higher than those with normal levels and normal controls. We concluded that abnormal peripheral blood CD4 + CD28- T cells and cytokine in patients with AIH may be related to disease activity and clinical manifestations, which may also play a role in the pathogenesis of AIH.

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Analysis on risk factors for ischemic stroke in people aged 80 years and over

Yuhui CHEN ; Tao GONG

Chinese Journal of General Practitioners.2010;09(8):553-555. doi:10.3760/cma.j.issn.1671-7368.2010.08.017

A total of 94 patients aged 80 years or over diagnosed as acute ischemic stroke based on their clinical features and CT or MRI and 64 elderly people without stroke as controls were enrolled in this study. They were admitted in Beijing Hospital from September 2003 to July 2008. Blood pressure measurement, electrocardiogram (ECG) and color doppler ultrasonography in carotid arteries were performed for all of them, as well as blood glucose, lipid and fibrinogen were measured and history of hypertension,diabetes, coronary heart disease, hyperlipidemia, smoking and alcohol drinking were recorded. Univariate analysis showed that more hypertension, hyperfibrinogenemia, atrial fibrillation and carotid atherosclerosis were found in the elderly patients with ischemic stroke than in those without it ( P ＜ 0. 05 ). And, multivariate logistic regression analysis showed that hyperfibrinogenemia ( OR = 16. 23, P = 0. 009 ), atrial fibrillation ( OR = 3.47, P = 0. 080) and isolated systolic hypertension ( OR = 1.05, P ＜ 0. 01 ) all were independent risk factors for ischemic stroke in the elderly.

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Efficacy of percutaneous laser disc decompression and its correlation with plasma levels of β-endorphine and substance P in patients with protrusion of lumbar intervertebral disc

Huaping PAN ; Hui FENG ; Jian WANG ; Yuhui DING

Chinese Journal of General Practitioners.2010;09(8):540-543. doi:10.3760/cma.j.issn.1671-7368.2010.08.011

Objective To observe efficacy of percutaneous laser disc decompression (PLDD) and its correlation with plasma levels of β-endorphine and substance P in patients suffering from protrusion of lumbar intervertebral disc (PLIVD). Methods Seventy-eight patients with PLIVD were randomly divided into two groups, one group (40 patients) treated with PLDD and the other (38 patients) treated with lumbar spine traction and physical therapy as control. Their peripheral plasma levels of β-endorphine and substance P were measured before the procedure and one day, one week and four weeks after it, respectively.Meanwhile, the visual analogue scale (VAS)was applied to assess their pain index. Results Plasma level of substance P was (186±66) ng/L and (419±82) ng/L, and (127 +83) ng/L and (322 +47) ng/L,in treatment and control groups, one day and one week after the procedure, respectively, and that of β-endorphine was (313 ±27) mg/L and (187 ±56) mg/L, and (364 + 18) mg/L and (211 +39) mg/L,one day and one week after it, respectively ( all P ＜ 0. 01 ), with its clinical efficacy of 90% (36/40)and 66% (25/38) one week after it, respectively ( P ＜ 0. 01 ) . Four weeks after it, plasma level of substance P was (64 ±50) ng/L in treatment group as compare to that in controls (93 ±75) ng/L, and that of β-endorphine was (410 ± 21 ) mg/L and (317 ± 42 ) mg/L, respectively, with efficacy of 95% (38/40) and 84% (32/38), respectively. Conclusions Plasma level of substance P can be reduced and that of β-endorphine can be increased by PLDD in patients with PLIVD, thus relieving their pain.Measurements of substance P and β-endorphine can be used as objective indicators to evaluate clinical efficacy of PLDD.

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Concurrent versus sequential adjuvant radio-chemotherapy after mastectomy for breast cancer: a Meta-analysis

Qing MA ; Yali LIU ; Zhongqing ZHENG ; Yaoyao REN ; Kehu YANG ; Li MA

Chinese Journal of General Practitioners.2010;09(10):723-725. doi:10.3760/cma.j.issn.1671-7368.2010.10.023

With computer and manual search of literatures on the comparison of concurrent with sequential adjuvant radio-chemotherapy after mastectomy for breast cancer, 4 eligible randomized controlled trials were found; the RevMan 5.0 software was used for Meta-analysis. The results showed that concurrent radio-chemotherapy reduced local recurrence more prominently than sequential radio-chemotherapy in patients with positive axillary lymph nodes( P = 0. 003 ). However, differences in 5-year overall survival,5-year disease-free survival and metastasis-free survival between two groups were not significant (P =0. 670,P =0. 200, P =0. 350).

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Differentiation of prostate cancer from benign prostatic hyperplasia (BPH) in the transitional zone by magnetic resonance spectroscopic imaging

Saying LI ; Min CHEN ; Rui WANG ; Wenchao WANG ; Weifeng ZHAO ; Cheng ZHOU

Chinese Journal of General Practitioners.2010;09(10):718-720. doi:10.3760/cma.j.issn.1671-7368.2010.10.021

Twenty patients with prostate cancer and 20 patients with benign prostate hyperplasia (BPH) in the transitional zone underwent magnetic resonance imaging (MRI) /magnetic resonance spectroscopic imaging ( MRSI ) examinations. The choline + creatine/citrate (CC/Ci) ratio and the choline/creatine (Cho/Cr) ratio were evaluated in each voxel with cancer or BPH confirmed by pathological results.Discriminant analysis was used to determine the power of the two ratios in differentiation between cancer and BPH. The CC/Ci ratio and Cho/Cr ratio for cancer voxels were significantly higher than those in the voxels with BPH in the transitional zone (CC/Ci: 2.26 ± 1.35 vs. 0.81 ±0.22, t =5.17, P ＜0. 01, Cho/Cr:4. 12 ± 1.65 vs. 1.25 ±0. 35, P＜0. 01 ). As for the discriminant function with the CC/Cr ratio and the Cho/Cr ratio, the specificity, sensitivity, and accuracy were 99%, 86%, 93% respectively for the differentiation between cancer and BPH.

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Study on policies to implement proper technology of traditional Chinese medicine in communities in central city of Shanghai

Zhaohui DU ; Huizhen PENG

Chinese Journal of General Practitioners.2010;09(10):711-713. doi:10.3760/cma.j.issn.1671-7368.2010.10.018

We studied policies of traditional Chinese medicine (TCM) on four levels ( national,Shanghai city, Pudong New District and community health services (CHS)) from 2008 to 2009 with the method of literature review,questionnaire survey and group interview. 18 national, 5 Shanghai's, 4 Pudong New District's and 87 CHS' TCM related policies were identified. By defining the development target,financial capability, human resource and proper technology of TCM care, those policies ensured and prompted the progression of community TCM services. Yet TCM policy fulfill in community remained lagged,and talent cultivating, medical insurance support and TCM participating in public health needed to be improved.

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Rehabilitation management of congenital muscular torticollis coexisted with developmental dysplasia of the hip in children

Qing DU ; Li ZHAO ; Huifang WANG ; Xuan ZHOU ; Hai LI ; Pinquan SHEN ; Ting CHEN ; Nan CHEN ; Shuxin ZHANG

Chinese Journal of General Practitioners.2010;09(10):700-703. doi:10.3760/cma.j.issn.1671-7368.2010.10.013

Objective Congenital muscular torticollis (CMT) and developmental dysplasia of the hip (DDH) are common congenital problems in infants. Association between CMT and DDH has been reported in literatures. The aim of this study was to assess coexistence of DDH in infants with CMT and curative effects of its rehabilitative therapy. Methods In total, 187 infants less than two months old with CMT were recruited in the study. DDH was diagnosed and graded by Graf's bilateral hip type B ultrasonography and pelvic X-ray films. Massage manipulation, magnetic strapping, postural orthosis at home and heat compress were instituted for CMT and frog spica device and hip-flexion abduction plaster immobilization were instituted for DDH. Their early rehabilitative effects were evaluated. Results DDH was coexisted in 24 of 187 infants with CMT, with incidence of 12. 8%. The hips of 22 infants were graded as type Ⅱ b (91.7%) and two as type Ⅲ a (8.3%), and eight at the left side and seven at the right side.Comorbid hips completely recovered normal with early frog spica device and hip-flexion abduction therapy in 24 infants. Conclusions Coexistence of CMT and DDH are relatively common in infants. Type B ultrasonography can be used as a measure for screening DDH in neonates with CMT. Early rehabilitative therapy is effective for those coexisted with DDH and CMT at the same time.

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Expression of the minichromosome maintenance 2 protein and the cell surface molecule CD24 and their prognostic significance in patients with non-small cell lung cancer

Xiuhong NIE ; Yu CHEN ; Xiuyi ZHI ; Yi ZHANG

Chinese Journal of General Practitioners.2010;09(10):691-694. doi:10.3760/cma.j.issn.1671-7368.2010.10.010

Objective To explore expression of the minichromosome maintenance 2 (MCM2)protein and the mucin-like cell surface adhesion molecule CD24 in non-small cell lung cancer (NSCLC) and their relationship with its prognosis. Methods Seventy-three patients of NSCLC diagnosed for the first time and received surgical treatment in Xuanwu Hospital, Beijing were selected for the study. Expression of the MCM2 and CD24 in pathological specimens of the patients was measured by immunohistochemistry and their relationship with its prognosis was analyzed retrospectively. Results High-level expression of the MCM2 and CD24 was seen in 42 and 54 of 73 NSCLC patients, accounting for 57. 5 percent and 74. 0 percent,respectively. Risk of death for the patients with high-level expression of the MCM2 or the CD4 was significantly higher as compared to those with low-level expression ( P ＜ 0. 05 ). Risk of death for patients with both high-level expression of the MCM2 and CD24 was significantly higher than that in those with only high-level expression of the MCM2 or the CD24 (HR =2. 59, 95%CI 1.40 -4. 80, P=0. 002) and in those with both low-level expression of them ( HR = 15.32, 95 % CI = 2.07 - 113.41, P = 0. 008 ). But there was no significant difference in risk of death between patients with high-level expression of the MCM2 or CD24 and those with low-level expression of both of them ( HR = 5. 60, 95% CI 0. 79 - 44. 82, P = 0. 083 ), and cumulative survival rate of patients with both high-level expression of the MCM2 and CD24 was significantly lower than those with only high-level expression of the MCM2 or the CD24 ( P = 0. 001 ). Conclusions Both expression of the MCM2 and the CD24 are independent prognostic factors for NSCLC and combined detection of the two markers have higher prognostic value for it.

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Clinical features of renal tubular acidosis patients with and without autoimmune disease

Ningning GAI ; Weijun GU ; Jingtao DOU ; Jianming BA ; Zhaohui Lü ; Guoqing YANG ; Jin DU ; Qinghua GUO ; Xianling WANG ; Yiming MU ; Juming LU

Chinese Journal of General Practitioners.2010;09(10):687-690. doi:10.3760/cma.j.issn.1671-7368.2010.10.009

Objective To study clinical and immunological features of renal tubular acidosis (RTA) patients complicated with autoimmunity disease. Methods Data of 60 patients of RTA complicated with autoimmune disease and 40 without it during 1999 and 2009 were reviewed, including clinical features,immunological examinations and renal tubular function. Results Among 60 patients of RTA, 59 were type Ⅰ, one type Ⅱ, and 55 complicated with Sjogen's syndrome (92%), one with systemic lupus erythematosus, nine with autoimmune thyroid disease, and one with rheumatoid arthritis. Flaccid paralysis was manifested in 50 (83%) RTA patients complicated with autoimmune disease, polyuria in 28 (47%),polydipsia in 28 (47%) , bone disorder in 24 (40%) and arthralgia in 28 (47%) cases, but of those without autoimmune disease, bone disease only in eight (20%) and arthralgia in nine (22%) cases, with statistically significant difference ( P ＜0. 01 ). Serum level of parathyroid hormone increased noticeably, with prevalence of positive antinuclear antibody, anti-SSA antibody and anti-SSB antibody of 88 % (49/56),84% (47/56) and 43% (24/56), respectively in RTA patients with autoimmune disease, all significantly higher than those in the patients without it ( P ＜ 0. 05 ). Conclusions Sjogen' s syndrome is the most common and prevalence of bone disorder and arthralgia are significantly higher in patients of RTA complicated with autoimmune disease, which should be examined as early as possible for timely diagnosis and treatment.

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Clinical value of combined examination of transient and steady-state flash visual evoked potential

Fenglan ZHANG ; Ying SUN

Chinese Journal of General Practitioners.2010;09(10):720-723. doi:10.3760/cma.j.issn.1671-7368.2010.10.022

The study intended to evaluate the combined examination of transient flash visual evoked potential (T-FVEP) and steady-state flash visual evoked potential (SS-FVEP) in diagnosis of optic neuropathy and macular disease. T-FVEP and SS-FVEP were examined in 22 cases (29 eyes) with optic neuropathy, 8 cases (9 eyes) with macular disease and 32 cases (32 eyes) of controls. The positive rates of T-FVEP and SS-FVEP in diagnosis of optic neuropathy were 83% and 100% respectively; that of combined examination was 100%. The positive rates of T-FVEP and SS-FVEP in diagnosis of macular disease were 5/9 and 7/9, and that of combined examination was 8/9. The positive rates of combined examination of T-FVEP and SS-FVEP in diagnosis of optic neuropathy and macular disease are higher than that of T-FVEP and SS-FVEP alone, and should be used routinely in the diagnosis of visual pathway disease.

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