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Objective@#To observe the treatment of inflammatory myopathy-associatied cardiomyopathy and its impact on prognosis of disease.@*Methods@#In this single-center retrospective study, 29 cases of inflammatory myopathy-associated cardiomyopathy were collected in Peking Union Medical College Hospital from 1999 to 2016. The clinical data and adverse events during follow up were documented. Among 29 patients there were 11 cases of polymyositis, 8 cases of dermatomyositis, 8 cases of overlap syndrome and 2 cases of nonspecific myositis.All the patients started with sufficiene prednisone (1-2 mg·kg-1·d-1). 7 cases received intravenous immune globulin, while 12 cases were prescribed with steroid pulse therapy, 16 cases with methotrexate, 15 cases with cyclophosphamide, 6 cases with cyclosporine A, while 11 cases with combination of immune suppressors (methotrexate plus cyclophosphamide or cyclosporine A). After a median follow up of 4.8 years (2 month to 15 years), 14 cases died including 9 of cardiac death. Patients with cardiac deaths had lower usage percentages of intravenous gamma globulin (0 vs. 7/20, P=0.05) and steroid pulse therapy (1/9 vs. 11/20, P=0.043) than controls. Comparing with controls, patients in the group of adverse events were more prone to choose methotrexate alone rather than combination of immune suppressors (all-cause death: 1/14 vs. 8/15, P=0.014; cardiac death: 0 vs. 9/20, P=0.027). Kaplan-Meier survival analysis showed significant difference of survival rates between patients with combination of immune suppressors and controls (Log Rank χ2=6.001, HR=7.58, P=0.014), as well as between patients with β receptor blockers and controls (Log Rank χ2=4.589, HR=2.95, P=0.032).@*Conclusions@#We recommend a management strategy that emphasize both primary disease controlling and cardiac remodeling improvement in patients with inflammatory myopathy-associated cardiomyopathy. On the basis of sufficient glucocorticoids, intravenous gamma globulin, steroid pulse therapy, combination of methotrexate plus other immune suppressants, and β receptor blockers were worthy to be considered.
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Objective To observe the treatment of inflammatory myopathy-associatied cardiomyopathy and its impact on prognosis of disease.Methods In this single-center retrospective study,29 cases of inflammatory myopathy-associated cardiomyopathy were collected in Peking Union Medical College Hospital from 1999 to 2016.The clinical data and adverse events during follow up were documented.Among 29 patients there were 11 cases of polymyositis,8 cases of dermatomyositis,8 cases of overlap syndrome and 2 cases of nonspecific myositis.All the patients started with sufficiene prednisone (1-2 mg· kg-1· d-1).7 cases received intravenous immune globulin,while 12 cases were prescribed with steroid pulse therapy,16 cases with methotrexate,15 cases with cyclophosphamide,6 cases with cyclosporine A,while 11 cases with combination of immune suppressors (methotrexate plus cyclophosphamide or cyclosporine A).After a median follow up of 4.8 years (2 month to 15 years),14 cases died including 9 of cardiac death.Patients with cardiac deaths had lower usage percentages of intravenous gamma globulin (0 vs.7/20,P=0.05) and steroid pulse therapy (1/9 vs.11/20,P=0.043) than controls.Comparing with controls,patients in the group of adverse events were more prone to choose methotrexate alone rather than combination of immune suppressors (all-cause death:1/14 vs.8/15,P=0.014;cardiac death:0 vs.9/20,P=0.027).Kaplan-Meier survival analysis showed significant difference of survival rates between patients with combination of immune suppressors and controls (Log Rank x2=6.001,HR=7.58,P=0.014),as well as between patients with β receptor blockers and controls (Log Rank x2=4.589,HR=2.95,P=0.032).Conclusions We recommend a management strategy that emphasize both primary disease controlling and cardiac remodeling improvement in patients with inflammatory myopathy-associated cardiomyopathy.On the basis of sufficient glucocorticoids,intravenous gamma globulin,steroid pulse therapy,combination of methotrexate plus other immune suppressants,and β receptor blockers were worthy to be considered.
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Objective To investigate the qualitative diagnosis of salivary gland mass with contrastenhanced ultrasound(CEUS).Methods The CEUS manifestations in 78 cases with salivary gland mass were observed after intravenous bolus injection with contrast agent SonoVue and confirmed by histology.Results Among 78 salivary gland masses,there were 29 cases with pleomorphic adenomas (37.2％),19with Warthin's tumors (24.4 ％),7 with basal cell adenomas (8.9 ％),and 11 with the other benign masses (14.1％),12 with malignant tumors (15.4％).The intensity of contrast-enhanced masses,whether the enhanced mass margin was clear,whether the peripheral enhancement rim was complete and whether the mass was enlarged were the diagnostic criteria to differentiate the benign and malignant tumors.The accuracy,the sensitivity,specificity,positive predictive value and negative predictive value were 87.2％,95.2％,56.3％,89.4％,75.0％ respectively,and the results also displayed positive likelihood ratio and negative likelihood ratio were 2.178,0.085 respectively.Although they presented with the highest incidence among benign tumors,their CEUS manifestations showed remarkable statistical differences when the pleomorphic adenoma was compared with Warthin' s tumor and basal cell adenoma respectively in enhancement intensity(P ＜0.01) while there were no statistical differences between Warthin's tumors and basal cell adenomas (P ＞0.05).Conclusions CEUS manifestations of salivary gland mass were helpful to the differential diagnosis of various salivary gland tumors.
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<p><b>OBJECTIVE</b>To promote the diagnostic accuracy of salivary Warthin's tumor by summarizing the ultrasonographic features of salivary Warthin's tumor.</p><p><b>METHODS</b>Sixty-nine lesions (58 patients with salivary Warthin's tumor) were retrospectively studied by ultrasonography and confirmed by histopathology.</p><p><b>RESULTS</b>The ultrasonographic manifestations of salivary Warthin's tumor demonstrated in three patterns.Type I: Solid mass(34 lesions, 49.3%), the mass was solid, grid-shaped echo inside. The mass was pathologically composed of such various tissues as epithelial cells, lymphatic organization, fibrous tissue which were compactly and evenly arranged, and little mucous formed the cyst cavity in which there projected epithelial papilla. Type II: Cystic-solid mixed mass(30 lesions, 43.5%), there was no flake-like echo, cystic-solid boundary was clear. Histopathological study revealed glandular epithelium made up irregular catheter and cyst cavity with yellowish mucous, glue-frozen-like stuff or brown colloidal substances. Type III: Cystic mass (5 lesions, 7.2%), the mass manifested separated cystic echo crumbs. The histopathological study showed salivary Warthin's tumor with infarctions and infections. The coincidence of ultrasound and histopathology diagnose was 79.7%.</p><p><b>CONCLUSION</b>The ultrasonographic features of salivary Warthin's tumor are mainly based on the organization of histopathological study. The grasp of various ultrasonographic imagings and pathological changes is beneficial for increasing the accuracy rate of diagnosis higher.</p>
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Humans , Adenolymphoma , Epithelial Cells , Epithelium , Retrospective StudiesABSTRACT
OBJECTIVE@#To explore the relationship of cathepsin L (CatL) with coronary heart disease (CHD), severity of coronary stenosis and risk factors of CHD.@*METHODS@#A total of 137 CHD patients and 48 controls were included in the study, to determined the serum levels of CatL, high sensitive C reactive protein (hs-CRP), fasting glucose (FBS), total cholesterol, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C), apolipoprotein A1(Apo-A1) and apolipoprotein B. All the subjects were invited for a coronary angiography, using the sum of the Gensini scores to assess the severity of coronary artery stenosis.@*RESULTS@#Serum CatL levels were significantly higher in CHD patients (5.63 +/= 0.12 microg/L) than non-CHD subjects (3.93 +/= 0.22 microg/L, P<0.01). CatL was an independent risk factor of CHD in Logistic regression analysis [Exp(B)=2.341, 95%CI 1.567 approximately 3.496, P<0.01]. Serum CatL levels were associated positively with the Gensini scores(r=0.228, P<0.01); In fact, CatL was an independent correlator of Gensini scores (P<0.05). CatL inversely associated with HDL-C (r=-0.228, P<0.01) and ApoA1(r=-0.187, P<0.05), and positively with FBS(r=0.161, P<0.05).@*CONCLUSION@#CatL is involved in the pathogenesis of CHD. Serum CatL levels could reflect the severity of coronary luminal narrowings. CatL might participate in glucose and lipid metabolic disorders.
Subject(s)
Female , Humans , Male , Middle Aged , Case-Control Studies , Cathepsin L , Blood , Coronary Disease , Blood , Pathology , Logistic Models , Risk FactorsABSTRACT
Objective To investigate the inpatients' evaluation of quality nursing care and disucss different data collecting methods on patients's evaluation of quality nursing care. Methods Patients measure up to standard (82 cases) were divided into the questionnaire group and the interview group with 41 patients in each group. The questionnaire investigation was carried out in the questionnaire group by applying 4 themes of quality nursing care. The interview group used structured interview instead. The results of the two methods were compared and analyzed. Results The score of quality nursing care of the questionnaire group was higher than that of the interview group (P<0.01) in evaluating health education method. In humanistic environment patients in the questionnaire group thought nurses could protect their privacy, respect their personality and treat them and their family members kindly. Besides visiting institution was reasonable. All of these were the demonstration of quality nursing care. The above results were different from those of the interview group (P<0.01). Conclusions Patients had comprehensive requirement on quality nursing care. Nurses should, use this as reference, regulate their service behavior and improve nursing quality.