Objective:To improve the differential awareness of lead porsoning.Methods:A case with stomachache, anemia, myasthenia, and abnormal urine color was described. The diagnosis and treatment were analyzed and discussed.Results:A middle-aged female was admitted with a 9-month medical history, compalnied with rash, stomachache. She also had evidence of hemolytic anemia,nervous system and kidneys imvolvement, and Lab test showed a significantly elevated blood lead level. It was considered to be in line with multiple organ system damage caused by lead poisoning.Conclusion:Lead poisoning can mimic the clinical presentations of rheumatic diseases, resulting in multiple system ivolvement. When the patient's clinical manifestation cannot be fully explained, some special situations should be considered, such as toxic testing.

Objective To estimate effective and organ doses to prostate cancer patients result ing from the whole-body 18F-Choline,11C-Choline and 68Ga-PSMA PET-CT examinations.Methods A total of 150 prostate cancer patients who underwent PET-CT scanning from May 2017 to June 2018 were retrospectively analyzed.They were divided into three groups,each with 50 patients,according to the type of positron radiopharmaceuticals injected.All patients used the same PET-CT scan protocol.PET component dose was calculated by using OLINDA/EXM (version 1.1) software which was based on the MIRD method.The CTDI values were measured by the standard CT phantoms and computed by ImPACT (version 1.0.4) CT,and ImPACT was used for dose calculation from CT.The tissue weighting factors according to ICRP Report 103 were used for effective dose calculation.Results The effective dose and organ equivalent dose from 18F/11C-Choline and 68Ga-PSMA PET/CT examinations were estimated.The voltage and current of Topogram scan were 120 kV and 35 mA,respectively,as well as 120 kV and (135.6±9.4) mA for low-dose CT scan.The injected activity of 18 F-Choline,11 C-Choline and68Ga-PSMA was (279.2±13.2),(350.2±39.9) and (186.8±19.4) MBq,respectively.The effective dose was (5.0±0.2),(1.6±0.2) and (3.0±0.3) mSv,respectively (F=837.0,P＜0.001).The CT effective dose was (11.4±0.2) mSv.The total effective dose for three groups were (16.4±0.3),(13.0±0.3) and (14.4±0.4) mSv,respectively.The mean organ equivalent doses were statistically significantly different among groups (F=381.2-1 637.7,P＜0.001).The highest organ equivalent dose was to kidney for18F-Choline and68 Ga-PSMA PET/CT scans and thyroid for11 C-Choline PET/CT scan.Conclusions The effective dose to the prostate cancer patients who underwent PET-CT scanning was from 13.0 to 16.4 mSv,with vast majority of these doses coming from CT scans.The lowest radiation dose to the patients was caused by 11C-Choline PET-CT examination,suggesting that it would be a potential prostate cancer PET radiotracer.

Objective:To study the clinical effect and safety of ubenimex capsules and SOX chemotherapy on the advanced gastric cancer.Methods:90 patients with advanced gastric cancer who were treated in our hospital from September 2013 to September 2015 were selected and randomly divided into the observation group (n=45) and the control group (n=45).The patients in the control group were treated with SOX chemotherapy,while the patients in the observation group were treated with ubenimex capsules on the basis of control group.Then the serum levels of MMP-2 and MMP-9,the immune functions,the clinical efficacy,the adverse reactions and survival rate of two groups were observed and compared before and after the treatment.Results:After treatment,the CD4+,CD4+/CD8+ in the observation group were higher than those of the control group (P＜0.05);The levels of MMP2 and MMP-9 in the observation group were lower than those of the control group (P＜0.05);The total effective rate of the observation group was higher than that of the control group [68.89％(31/45) vs 48.89％(22/45)] (P＜0.05);The incidence of thrombocytopenia,leukopenia,nausea and vomiting and abnormal liver functions in the observation group was lower than that of the control group (P＜0.05);The survival rate of the observation group was higher than that of the control group at 6 months and 12 months [93.33％ (42/45) vs 77.78％ (35/45),82.22％ (37/45) vs 57.78％ (26/45)](P＜0.05).Conclusion:Compared with SOX chemotherapy alone,ubenimex capsules and SOX chemotherapy could effectively improve the immune function,enhance the long-term survival rate with high safety of patients with advanced gastric cancer.

Objective To explore the diagnostic and differential diagnostic points of patients with rheumatoid arthritis (RA) complicated with fever.Methods Full clinical analysis was performed for a 62-year old patient with RA and fever.Results Hemophagocytes were found in bone marrows smear.Significantly increased ferritin level (74 299 ng/ml),decreased hemoglobin (67 g/L) and platelet (33×109/L),decreased fibrinogen,increased serum soluble CD25 (sCD25),positive cytomegalovirus (CMV) DNA,positive CMV-PP65 antigen,were found by laboratory examination.Decreased activity of NK cells was detected by flow cytometry.Positron emission computed tomography (PET-CT) revealed splenomegaly and pulmonary inflammations.The clinical conditions were recovered with the treatment of corticosteroid,VP16,cyclosporine,anti-CMV virus therapy.Ferritin level was significantly decreased and platelet was normal.The patient was diagnosed as hemophagocytic syndrome associated with CMV infection.Conclusion The possibility of hemophagocytic syndrome should be considered in RA patients presented with fever.

OBJECTIVE: To explore the clinical characteristics and treatment skills of children with respiratory special foreign body. METHOD: To retrospectively analyze the clinical characteristics of 49 cases of special airway foreign bodies in children during 2013. 5.1-2014. 5.1 in our hospital, and the treatment methods were summarized. RESULT: Fourty-seven cases with rigid bronchoscopy foreign body cured, 1 case turned Department of thoracic sur- gery chest to remove foreign body, 1 case of death. CONCLUSION The clinical characteristics of special airway foreign bodies in children is different from ordinary foreign body, treatment of preoperative, intraoperative and postoperative is not fully equivalent to the ordinary foreign body.
Bronchoscopy ; Child ; Foreign Bodies ; diagnosis ; surgery ; Humans ; Respiratory System ; pathology ; Retrospective Studies

Objective To explore the clinical significance of anti-nuclear protein B23 antibody in systemic sclerosis. Methods Enzyme-linked immunosorbent assay was employed to detect the serum antinuclear B23 autoantibody. Mann-Whitney U test was used to compare the clinical and autoantibody profiles between SSc patients with B23 antibody and those without B23 antibody. Logistic regression analysis was employed to analyze the correlation between B23 antibody and clinical manifestations and autoantibody profiles. Results Mann-Whitney U test showed that, forced vital capacity (FVC) diffusion capacity of CO (DLco) in B23 positive SSc was significantly lower than that in B23 negative counterparts, pulmonary artery hypertension was more prevalent in B23 positive SSc patients. While anti-fibrillarin, anti-U1RNP, and antic entromere antibodies were more prevalent in B23 positive SSc. Multivariate logistic regression showed that anti-B23 antibody positivity was an independent risk factor for pulmonary artery hypertension in SSc (OR=123.92, 95％CI 26.67～575.66, P＜0.01), and a protective factor for severe gastrointestinal involvement (OR=0.08, 95％CI 0.01 ～0.70, P＜O.05). Logistic analysis showed that anti-B23 antibody was correlated with antifibrillarin (OR=11.50, 95％CI3.85～34.37, P＜0.01) and anti-U1RNP antibodies (OR=3.43, 95％CI 1.01～11.63, P＜0.05), and correlated with different degree of pulmonary artery hypertension. Conclusion The pulmonary artery pressure should be monitored closely in those SSc patients with a positive B23 antibody.

Objective To analyze the efficacy of the combination of MALDI-TOF and immunoadsorption to detect new biomarkers for lupus. Methods Twenty lupus patients at active stage (SLE group), 10 SLE patients in remission (SLE control group), 10 RA patients and 10 PSS patients (other rheumatic disease control group) and 20 healthy volunteers (healthy control group) were enrolled. The serum samples before and after immunoadsorption from SLE group and those from the control groups were co-incubated with activated chitosan copper derivative nano material. The adsorbed nano material was spotted onto the matrix used in MALDI-TOF for analysis by the Axima-CFR plus MALDI-TOF mass spectrometer. T-test was used for statistical analysis. Results MALDI-TOF MS screening showed that three potential protein biomarkers of mass-to-charge (m/z) ratio 3136, 3264, 3326 were found to be very specific for lupus patients: All of them were expressed before immunoadsorption in high quantity and none of them could be detected both after immunoadsorption and in all the three control groups. None of them (<10 000) were in the molecular weight range of the biomarkers used nowadays such as auto antibodies and complement (>50 000). Conclusion The combination of MALDI-TOF and immunoadsorption is effective in the detection of new serum protein biomarkers for lupus and it may be helpful in the screening of SLE patients at active stage from healthy people.

Objective To determine the prognostic factors in systemic sclerosis.Methods Clinical data of definite systemic sclerosis patients were collected,including disease onset age,sex,disease course,Raynaud's phenomenon,skin involvement,gastroesophageal reflux,interstitial pneumonia,cardiac lesions,kidney lesions and scleroderma renal crisis.serum antibodies to scl-70.RNP and anti-centromere antibody were detected.Pulmonary artery pressure was measured by ultrasound cardiography.Cox hazard ratio model was employed to assess the mortality risk of systemic sclerosis patients.Results No difference in Raynaud's phenomenon,gastroesophageal reflux,anti-nuclear antybody,anti-sol-70 antibody,anti-centromere antibody,interstitial pneumonia,diffusion capacity (DLco),coronary artery disease,and peripheral artery atherosclerotic disease could be found between the dead and alive systemic sclerosis patients(P>0.05).Dead systemic sclerosis patients had later disease,onset(older than 60 years old)(P=0.002).Male gender(P=0.023),more diffuse skin involvement(P=0.000),more positive anti-RNP antibody(P=0.014),more pulmonary artery hypertension(P=0.000).more cardiac lesions(P=0.000),more cerebral infarets (P=0.035),more kidney lesions(P=0.000),and more scleroderma renal crisis(P=0.000) could be found jn dead sclerosis patients.Cox regression analysis showed that,onset later than 60 years old(OR=5.441.95% CI 2.126～13.926,P=0.000),male sex (OR=5.531,95%CI 2.014～15.190,P=0.001),anti-RNP antibedy positivity (OR=2.664,95%CI 1.016～6.592,P=0.034),diffuse skin involvement(OR=3.432,95%CI 1.400～8.411,P=0.007),pulmonary artery hypertension (OR=25.718,95% CI 5.954～111.085,P=0.000),cardiac lesions (OR=4.141.95%CI 1.685～10.159,P=0.002),kidney lesions(OR=4.214,95%CI 1.654～10.737,P=0.003) and scleroderma renal crisis (OR=20.677,95% CI 4.161～102.764.P=0.000)were risk factors for mortality in systemic sclerosis.Severe pulmonary hypertension was the most strong predictive factor for mortality in systemic sclerosis (OR=55.809,95% CI 12.879～241.832.P=0.000).Conclusion Aggressive therapy should be given to those systemic sclerosis patients with onset later than 60 years old,male sex,diffuse skin involvement,anti-RNP antibody positivity,cardiac involvement,kidney lesions,scleroderma renal crisis and pulmonary artery hypertension,especially seevere pulmonary hypertension.

OBJECTIVE: To investigate the prevalence of otitis media with effusion (OME) of kindergarten children in Wuhan City. METHOD: The study subjects were 3-6-year-old children in some kindergarten children in Wuhan City . All subjects were assessed with routine otorhinolaryngologic examination, otoscopic examination and tympanometry. Chi-square test were used to analyse the difference of data. RESULT: The prevalence of children of some kindergarten in Wuhan City is 6.67%. There was no statistical difference were found between sexuality. The prevalence of OME in 3 years old group is obviously higher than that in 4-6 years old group. Previous acute otitis media episodes, feeding, high-arched palate, and nasal obstruction are risk factors of OME. CONCLUSION Children with previous acute otitis media episode and nasal obstruction should be suggested to have otorhinolaryngologic examination regularly. It is necessary to have routine otoscopic examination and tympanometry in children of kindergarten.
Child ; Child, Preschool ; China ; epidemiology ; Humans ; Otitis Media ; epidemiology ; Prevalence ; Schools, Nursery

Objective To establish the enzyme-linked immunosorbent assay (ELISA)method in detecting the anti-M3RP antibody in Sj(o)gren's syndrome (SS) patients.and to explore the significance of this autoantibody in the diagnosis of SS.Methods The synthesized M3 receptor polypeptide was used as antigen in EUSA to detect the anti-M3RP antibody in sera of patients with SS.other CTDS and healthy controls.and the association between the clinical features of SS and anti-M3RP antibody was analyzed.Results Antibodies against M3RP were detected in 84.6%patients with pSS and 81-3% with sSS.8.8%with other CTD and 1%in heahhy controls.The positive rates of antibodies in pSS and sSS were higher than those in other CTDs and healthy controls.The presence of anti-M3RP antibodies had no significant correlation with clinical manifesta-tions and internal organ involvement.Furthermore.the positive rates of anti-M3RP antibodies in anti-α-fodrin.SSA,SSB,and ANA antibodies negative SS patients were 85%.89-3%,88.9%and 95.2%,respectively.body is a complementary parameter in the diagnosis of antibody-negative SS.