Clinical Efficacy of Low Molecular Heparin on Unexplained Recurrent Spontaneous Abortion.

BACKGROUND: To study the clinical effect of low molecular heparin on unexplained recurrent spontaneous abortion (URSA). METHODS: A total of 120 URSA patients were collected in our hospital from October 2015 to September 2017. They were divided into two groups: control group (n = 60) and observation group (n = 60). The patients in the control group were administered with progesterone and human chorionic gonadotropin, and the observation group with low molecular heparin. Pregnancy outcomes, incidence of complications in pregnancy and adverse drug reactions were compared in the two groups. RESULTS: The pregnancy success rate of patients in the observation group (90.00%) is higher than that in the control group (68.33%) (p < 0.05). The incidence of complications in pregnancy in the observation group (90.00%) is lower than those in the control group (68.33%) (p < 0.05). The incidence of adverse drug reactions between the patients in the observation group (20.00%) and those in the control group (23.33%) showed no significant difference (p > 0.05). CONCLUSIONS: Low molecular heparin treatment can improve pregnancy success rate and reduce the incidence of complications in the URSA patients. Low molecular heparin is characterized by safety and reliability and has potential for application in clinic.

Dual liver transplantation.

Reperfusion is the key strategy in acute ST-segment elevation myocardial infarction (STEMI) care, and it is time-dependent. Shortening the time from symptom to reperfusion and choosing the optimal reperfusion strategy for STEMI patients are great challenges in practice. We need to improve upon the problems of low reperfusion rate, non-standardized treatment, and economic burden in STEMI care. This article briefly reviews the current status of reperfusion strategy in STEMI care, and also introduces what we will do to bridge the gap between the guidelines and implementation in the clinical setting through the upcoming China STEMI early reperfusion program.

Hemophagocytic syndrome secondary to adult-onset Still's disease but very similar to lymphoma.

Hemophagocytic syndrome (HPS) is a clinicopathologic entity characterized by increased proliferation and activation of benign macrophages with hemophagocytosis throughout the reticuloendothelial system. HPS may be primary, or secondary to malignancy, infections, auto-immune diseases and pharmacotherapy. In patients with adult-onset Still's disease (AOSD), HPS is a rare but life-threatening complication. Herein, we described a female patient with HPS secondary to AOSD. During the therapy, giant gastric ulcer similar to lymphoma developed after treatment with corticosteroid and nonsteroidal anti-inflammatory drugs.

Polyarthritis as a prewarning sign of occult lung cancer.

Cancer polyarthritis is an uncommon, paraneoplastic manifestation of some solid and hematological malignancies. Herein, we report the case of a 55-year-old woman who recently experienced polyarthritis for 2 months. On admission, the patient developed cough, expectoration, and fever. According to the clinical manifestations and the findings in radiological examinations and sputum cultures, pneumonia was considered. No evidence of lung cancer was noted by repeated computed tomography scan of lung, single bronchoscopy, or computed tomography-guided lung biopsy. Ultimately, the second bronchoscopy with biopsy was carried out, and lung adenocarcinoma was confirmed by pathological examination. Symptoms of polyarthritis starting 2 months before the symptoms of her lung cancer in the present case leads us to believe that polyarthritis may be a manifestation of paraneoplastic syndrome. Arthritis resolved after anticancer therapy. Our report indicates that polyarthritis of unknown cause may be suspected as a manifestation of malignancies.

[Effect of yangyin jiedu huoxue recipe on hormone withdrawal and disease activity in patients with systemic lupus erythematosus].

OBJECTIVE: To observe the effect of Yangyin Jiedu Huoxue Recipe (YJHR) on the degree of activity integral of systemic lupus erythematosus (SLEDAI) and plasma osteopontin (OPN), and its effect for hormone withdrawal in patients with systemic lupus erythematosus (SLE). METHODS: Seventy-eight patients were randomly assigned by a randomizing digital table to two groups, 42 patients in the treated group and 36 in the control group, all were treated with conventional Western medical treatment, and YJHR was given additionally to the treated group. Changes of SLEDAI and OPN, as well as the daily dosage of prednisone used were observed after 2 courses of treatment. RESULTS: SLEDAI and OPN were lowered in both groups, but the lowering in the treated group [9.17 +/- 4.12, (117.69 +/- 78.50) microg/L] was more significant than that in the control group [11.60 +/- 4.05, (151.09 +/- 83.90) microg/L, P<0.05]. The two indices were positively correlated. The dosage of prednisone daily used in the treated group (10.03 +/- 4.29) was reduced more than that in the control group (15.14 +/- 6.67, P<0.05). SLEDAI of all the patients before and after treatment had a positive relationship with OPN respectively (r=0.44, 0.39) (P<0.05). CONCLUSIONS: YJHR can suppress the activity of disease and be helpful for early withdrawal of prednisone in treating SLE. Plasma level of OPN is related with the activity of the disease.

Cerebral hemorrhage, splenic and renal embolisms due to infective endocarditis.

Infective endocarditis is occurring more and more frequently in elderly persons and it has been associated with various clinical, bacteriological, and prognostic features. We present a 63-year-old woman with infective endocarditis which is the first reported case with cerebral hemorrhage, splenic and renal embolisms.

[Effects of Chinese herbal medicine for Yiqi Yangyin Quyu in treating Sjögren's syndrome and on patients' immunologic function].

OBJECTIVE: To investigate the immuno-regulatory and therapeutic effects of Chinese herbal medicine for Yiqi Yangyin Quyu (YYQ, supplementing qi, nourishing yin, removing blood stasis) on Sjögren's syndrome (SS). METHODS: Sixty-two patients were randomly divided into the treated group (37 cases) treated with Chinese medicine and prednisone, and the control group (25 cases) treated with prednisone alone, and another 20 healthy persons were taken as the normal control group. Curative effects was observed, and immunoglobulin (Ig) and T lymphocyte subsets were detected before and after 3 months' treatment. RESULTS: Immunoglobulin (IgG, IgM and IgA) before treatment in SS patients were higher, while the proportion of natural killer (NK) cell and CD4 were lower as compared with those in the normal control group. After treatment, IgG, IgM and IgA lowered to normal levels (P < 0.05), the proportion of NK cell and CD4 rose in both groups (P < 0.05), but CD3 in the control group was still lower than that in the treated group (P < 0.05). The total curative effective rate in the treated group was 91.9%, better than that in the control group (76.0%, chi-squared = 3.92, P < 0.05). CONCLUSION: Chinese herbal medicine for YYQ could improve clinical curative effective rate and regulate immune function in SS patients.

[The clinical and pathological characteristics of histiocytic necrotizing lymphadenitis: analysis of 52 cases].

OBJECTIVE: To study the clinical manifestation and pathological features of histiocytic necrotizing lymphadenitis (Kikuchi's disease, KD). METHODS: 52 patients with KD were collected to analyze the clinical manifestation, pathological features of biopsy lymph nodes, diagnosis and treatment. RESULTS: 41 cases (79%) were female of the 52 patients. The main clinical features included persistent fever (100%), single (23%)/multi (77%)-lymphadenopathy (always in cervical region), pleomorphism erythra (35%), neutropenia (76%), elevated erythrocyte sedimentation rate (100%), insensitivity to antibiotics (100%) and sensitivity to small dosage glucocorticoid (81%). 26 cases (50%) had elevated aspartate aminotransferase and/or alanine aminotransferase, but only 7 cases (13%) had upper respiratory tract symptom like influenza. Pathological features included distinctive necrosis, loss of lymph node structure, infiltration with histiocytes and lymphocytes, absence of neutrophils. Immunohistochemical stainings showed CD(68) positive for histiocytes and CD(3), CD(45) RO positive for T lymphocytes. CONCLUSION: Diagnosis of KD relies on the pathological examination and immunohistochemical staining.

Miniature ultrasonic probes for diagnosis and treatment of digestive tract diseases.

AIM: To investigate the clinical value of miniature ultrasonic probes (MUPs) for the diagnosis and treatment of digestive tract diseases. METHODS: Endoscopic ultrasonography (EUS) was performed for patients with its indications with 7.5-20 MHz MUPs and double-cavity electronic endoscope. According to the diagnosis of MUPs, patients who had indications of treatment received endoscopic resection or surgical excision. Postoperative histological results were compared with the preoperative diagnosis of MUPs. A few patients without endoscopic resection or surgical excision were periodically followed up with MUPs. RESULTS: A total of 537 patients were examined by MUPs, of them, 256 were diagnosed with gastrointestinal submucosal lesions, 146 with pseudo-submucosal lesions, 50 with digestive tract cancers, 17 with peptic ulcer, 11 with cholecystolithiasis, 8 with chronic pancreatitis, and 2 with achalasia and 47 were diagnosed as normal. After MUPs examinations, 220 patients received endoscopic resection or surgical excision, and the postoperative histological results of 211 patients were completely consistent with the preoperative diagnosis of MUPs. The diagnostic accuracy of MUPs was 95.9%. The result of follow-up with MUPs indicated that gastrointestinal leiomyoma, lipoma, phlebangioma and cyst were unchanged within 1-2 years. The patients who received endoscopic resection or centesis did not have any complications. CONCLUSION: MUPs are of value in diagnosing gastrointestinal submucosal lesions, staging of digestive tract cancers and biliary-pancreatic diseases. They play a very important role in making therapeutic plans.