Objective:To investigate the relationship of antinuclear antibody (ANA) status with clinical features and malignancy risk in adult patients with dermatomyositis.Methods:A retrospective analysis was performed to analyze clinical data from 101 inpatients with dermatomyositis in Department of Dermatology, the First Affiliated Hospital of Soochow University from April 2008 to April 2018. These patients were divided into ANA-positive group and ANA-negative group, and differences in myopathy and malignancy risks as well as other clinical features were analyzed between the 2 groups. A 2-year follow-up was undertaken among 92 patients. Chi-square test was used to analyze and compare clinical features between the 2 groups, and a multivariate regression model was used to analyze the relationship of ANA status with amyopathic dermatomyositis and malignancies.Results:Among the 101 patients with dermatomyositis, there were 42 males and 59 females, aged 55.13 ± 14.63 years; 14 patients had amyopathic dermatomyositis, 6 patients had hypomyopathic dermatomyositis, and 81 patients had myopathic dermatomyositis; 42 (41.58%) cases were positive for ANA, and 59 (58.41%) were negative for ANA. Compared with the ANA-negative group, the ANA-positive group showed significantly decreased incidence of cervical erythema (33.33% vs. 59.32%, P=0.010) and shawl sign (14.28% vs. 35.59%, P=0.017) . Twenty-eight (27.72%) patients with dermatomyositis were complicated by malignancies. Malignancies were found in 5 (11.9%) of ANA-positive patients, and in 23 (38.98%) of ANA-negative patients. Univariate analysis showed that ANA-negative patients with dermatomyositis had a higher risk of malignancies compared with ANA-positive patients with dermatomyositis, with an odds ratio of 7.52 (95% CI: 1.62-13.78, P=0.003) . In the multivariate regression model, the absence of ANA ( OR=4.34, 95% CI: 1.37-13.72, P=0.012) and cervical erythema ( OR=3.27, 95% CI: 1.20-8.91, P=0.020) were associated with high incidence of malignancies, while the absence of ANA was not significantly correlated with the occurrence of amyopathic dermatomyositis ( OR=0.99, 95% CI: 0.32-2.99, P=0.980) . Conclusions:ANA-negative adult dermatomyositis patients with cervical erythema had an increased risk of malignancies. Thus, close follow-up and regular tumor screening are necessary in these patients.

Objective Observation of the effects of Xinmailong injection on NGAL, hs-cTnT and RAAS in elderly patients with type 2 cardio-renal syndrome (CRS) , and EvaluatIon of the clinical efficacy and safety.Methods A total of 86 elderly patients who were collected from November 2015 to February 2017 were diagnosed as type 2 CRS in our department of geriatrics. According to the random number table method, they were randomly divided into two groups. Control group (43 cases) were treated with conventional medical therapy and xinmailong group (43 cases) were treated with xinmailong injection with a dose of 5 mg/kg twice a day for 15 days. The value of sneutrophil gelatin-associated apolipoprotein (NGAL) , hypersensitive troponin T (hs-cTnT) , brain natriuretic peptide (BNP) , plasma renin activity (PRA) , and angiotensin Ⅱ (Ang Ⅱ) , aldosterone (ALD) , left ventricular ejection fraction (LVEF) , six-minute walking test and other indicators were measured before and after treatment. Results After treatment, the value of NGAL, hs-cTnT, BNP, PRA, AngⅡ and ALD decreased in both groups, the value of LVEF and six-minute walking distance increased compared with those before treatment (P <0.05); The above indicators in the xinmailong group experienced a more significant alteration than in control group in the same period (P < 0.05); no side effect occurred in both two groups during the experiment. Conclusion Xinmailong injection can reduce the levels of NGAL, hs-cTnT and BNP in elderly patients with type 2 cardio-renal syndrome, improve heart and kidney function, and have curative positive effect and good safety. This study underlined the mechanism of Xinmailong injection may be related to the inhibition of RAAS activity.

Objective To compare the effects of median nerve electrical stimulation on coma patients after traumatic brain injury with different settings. Methods From 2013 to 2015, 161 patients with traumatic brain injury were randomly divided into control group (n=40), experimental group 1 (n=41), experimental group 2 (n=39) and experimental group 3 (n=41). The control group received routine conscious-ness-promoted methods, and the experimental groups received median nerve electrical stimulation with 200μs and 30 Hz, 100 Hz and 50 Hz in sequence, 60 minutes a day for 90 days. They were assessed with Glasgow Coma Scale (GCS) and Coma Recovery Scale-Revised (CRS-R) before, 30 days and 90 days after treatment. Results There was significant difference in the scores of CCS and CRS-R, times of treatment, number of sobered patients and coma time among groups (P<0.01), that the experimental groups were better than the control group (P<0.05), and no significant difference was found between the experimental groups 1 and 2 (P>0.05). The experimental group 3 was better than the experimental groups 1 and 2 (P<0.05). Conclusion Median nerve electrical stimulation with 200μs, 50 Hz could promote co-ma patients to wake up optimally.

Objective To investigate the effects of hyperbaric oxygen (HBO) on the apoptosis and ultrastructure of islet cells in rats with type 2 diabetes.Methods Twenty-four Goto-Kakizaki (GK) rats with fasting blood glucose of over 16.7 mmol/L were randomly assigned to the 3 groups:the model group,the metformin hydrochloride group,and the HBO group,each consisting of 8 animals.Another 8 healthy male Wistar rats were used as the control group.The control group,the model group and the HBO group were given 5 ml/kg of pure water a day.The metformin hydrochloride group had lavage of 250 mg/kg metformin hydrochloride solution a day,and the HBO group had one session of HBO treatment a day.After 3 weeks,following anesthesia with isoflurane,the pancreas tissue was taken from the rats of all the groups,some of the tissue was made into slides for electron-microscopic observation,and some of them was made into paraffin sections for staining with Hematoxylin-eosin (HE).Apoptosis of islet cells was detected with immunohistochemistry with TdT-mediated dUTP Nick-End Labeling (TUNEL),and islet cells were labeled with caspase-3 by using immunohistochemistry.Results Electron microscopy revealed that mitochondria in the animals of the model group was markedly swollen with degranulation,and vacuolation.Pathological changes inmitochondria of islet cells for the animals of the HBO group were lighter than those of the model group.Apoptosis of islet cells occurred in all the groups,with the apoptosis index (AI) of the HBO group being (1.57 ± 0.33) ％.IOD for caspase-3 positive cells was 10.22 ± 4.61.On the other hand,AI and IOD for the animals of the model group were (4.88 ± 0.51) ％ and 14.65 ± 4.8 respectively,and statistical significance could be seen,when comparisons were made between the 2 groups(P ＜ 0.05).No statistical significance could be noted,as compared with the data of AI (1.16 ± 0.31)％ and the data of IOD (5.36 ± 2.34) in the control group,and the data of AI(1.72 ± 0.14)％ and the data of IOD (9.37 ± 4.64) in the metformin hydrochloride group (P ＞ 0.05).Conclusions HBO could protect the mitochondrial membrane,alleviate mitochondrial lesion induced by hyperglycemia,and furthermore could inhibit apoptosis of islet cells in the rats with type 2 diabetes,and the expression of caspase-3 as well.Therefore,it would be beneficial for treatment of diabetes mellitus.

Objective To investigate the effects of hyperbaric oxygen (HBO) on the apoptosis and ultrastructure of islet cells in rats with type 2 diabetes.Methods Twenty-four Goto-Kakizaki (GK) rats with fasting blood glucose of over 16.7 mmol/L were randomly assigned to the 3 groups:the model group,the metformin hydrochloride group,and the HBO group,each consisting of 8 animals.Another 8 healthy male Wistar rats were used as the control group.The control group,the model group and the HBO group were given 5 ml/kg of pure water a day.The metformin hydrochloride group had lavage of 250 mg/kg metformin hydrochloride solution a day,and the HBO group had one session of HBO treatment a day.After 3 weeks,following anesthesia with isoflurane,the pancreas tissue was taken from the rats of all the groups,some of the tissue was made into slides for electron-microscopic observation,and some of them was made into paraffin sections for staining with Hematoxylin-eosin (HE).Apoptosis of islet cells was detected with immunohistochemistry with TdT-mediated dUTP Nick-End Labeling (TUNEL),and islet cells were labeled with caspase-3 by using immunohistochemistry.Results Electron microscopy revealed that mitochondria in the animals of the model group was markedly swollen with degranulation,and vacuolation.Pathological changes inmitochondria of islet cells for the animals of the HBO group were lighter than those of the model group.Apoptosis of islet cells occurred in all the groups,with the apoptosis index (AI) of the HBO group being (1.57 ± 0.33) ％.IOD for caspase-3 positive cells was 10.22 ± 4.61.On the other hand,AI and IOD for the animals of the model group were (4.88 ± 0.51) ％ and 14.65 ± 4.8 respectively,and statistical significance could be seen,when comparisons were made between the 2 groups(P ＜ 0.05).No statistical significance could be noted,as compared with the data of AI (1.16 ± 0.31)％ and the data of IOD (5.36 ± 2.34) in the control group,and the data of AI(1.72 ± 0.14)％ and the data of IOD (9.37 ± 4.64) in the metformin hydrochloride group (P ＞ 0.05).Conclusions HBO could protect the mitochondrial membrane,alleviate mitochondrial lesion induced by hyperglycemia,and furthermore could inhibit apoptosis of islet cells in the rats with type 2 diabetes,and the expression of caspase-3 as well.Therefore,it would be beneficial for treatment of diabetes mellitus.

Object The purpose of this study was to analyze the changes in blood rheology in paitents with hepatocirrhosis accompanied by hemorrhage of upper digestive tract,explore the effect of frequent small bllod transfusion on it,after controlled hemorrhage and its clinical singnificance.Methods Thirty-four patients with hepatocirrhosis accompanied by hemorrhage of upper digestive tract were recruited into this study,10 days after controlled hemorrhage.These patients all underwent blood transfusion(200ml fresh blood or 2-unit concentrated erythrocyte) every month.Blood rheology data were obtained before and after 3 times blood transfusion,regular observed the liver function and further hemorrhage time interval.Results There were significantly elevation of whole blood specific viscosity(SV),blood plasma SV,fibrinogen,and hematocrit after treament,The frequent small blood transfusion led to reduce significantly in erythrocyte sedimentation,ALT,AST,TBiL,and significantly prolonged hemorrhage time interval further.Conclusions Frenquent small blood transfusion to patients with hepatocirrhosis could change the blood reology,remission illness state,prolongating the time interval of hemorrhage next occured.