Objective To investigate the effects and adverse reactions of high-dose glucocorticoid on early active rheumatoid arthritis patients.Methods The early active rheumatoid arthritis patients were randomly divided into three groups:high dose group (16 patients,with large doses of glucocorticoid therapy),low dose group (17 patients,with small doses of glucocorticoid therapy),and control group (41 patients,with no glucocorticoid therapy).Compared the differences among the three groups.Results The changes in the three groups were different in joint pain,joint swelling,morning stiffness,erythrocyte sedimentation rate,rheumatoid factor and C-reactive protein (P ＜ 0.05).The high dose group was significantly better than the other two groups in the above variables alleviating,in the 1 week after the treatment.The changes in the three groups had no significant difference of bone mineral density,Larsen hip score (P＞ 0.05).The NSAIDs days in the control group was significantly longer than the high dose group,low dose group [(51.17 ± 2.56) d vs.(14.16 ± 0.71) d,(26.50 ± 1.59) d],the difference was statistically significant (P ＜ 0.05).Rate of weight gain in the high dose group,low dose group was significantly higher than the control group [5/16,4/17 vs.4.9％ (2/41)],the difference was statistically significant (P ＜ 0.05).Body weight increased in the high dose group and low dose group occurred mainly in the following 1.5 months of therapy,with the discontinuation of cortices-teroids,weight gradually fell to normal.Gastrointestinal discomfort incidence in the control group was significandy higher than that in the high dose group,low dose group [51.2％ (21/41) vs.2/16,3/17],the difference was statistically significant (P＜ 0.05).Conclusions High-dose glucocorticoid can rapidly relieve clinical symptoms and inflammation in early active rheumatoid arthritis patients.High-dose corticosteroids do not bring too many side effects to patients but weight gain,and it reduces the patients' gastrointestinal discomfort greatly,because of the decrease use of NSAIDs.

The clinical treatment of large-area trauma or intractable wound is very difficult. Finding a suitable wound dressing is very important for wound healing. Stem cells can secrete and express a variety of cytokines necessary for wound healing, and can grow and proliferate for a long time in three-dimensional (3D) scaffold materials to maintain their proper structure and function. A large number of studies have shown that transplanting stem cells-3D scaffold complex into the skin wound in the form of a moist dressing can significantly improve the efficiency of stem cells transplantation, shorten the wound healing time, and reduce scar formation. Stem cells-scaffold complex are likely to be a good wound dressing. This article mainly summarizes the selection of wound dressing and the research status of stem cells-3D scaffold complex as a wound dressing, aiming to provide a theoretical basis for the clinical application of stem cells-3D scaffold complex.

OBJECTIVE: To establish the quality standard of Tongtong granule. METHODS: Panax notoginseng,Ginkgo biloba and Pueraria lobata were identified qualitatively by TLC and the content of total flavonol glyconsides in G. biloba was determined by HPLC. RESULTS: The TLC spots were distinctive and specific. The linear range of quercetin, kaempferide, isorhamnetin were 5.24～83.84 ?g?mL-1(r=0.999 2), 4.56～72.96 ?g?mL-1(r=0.999 1) and 2.48～39.68 ?g?mL-1(r=0.999 4), respectively. The average recoveries were 96.21%(RSD=2.06%)、99.14%(RSD=1.19%)、95.00%(RSD=1.31%),respectively. CONCLUSION:The method is reliable, accurate, and reproducible for the quality control of Tongtong granule.

Objective To invesgate the effects of comfort care on the quality of life and the curative compliance of elderly patients undergoing hemodialysis.Methods Forty-nine elderly patients undergoing hemodialysis were managed with comfort care including comfortable settings,mental care,and care to arteriovenous fistula and intubated tubes,observation of complications and the related care.The Short Form 36 Health Survey Questionnaire(SF-36)and questionnaire on medical compliance were used for the assessments.Result The scores on SF-36 and medical compliance were both significantly higher than those before the manipulation of comfort nursing(P<0.05).Conclusion Comfort care may be helpful for the improvement of the quality of life and the medical compliance of hemodialysis in elderly patients undergoing hemodialysis.

OBJECTIVE:To establish a HPLC method for determination of total coumarins in Angelica dahurica and to develop a CO 2 supercritical fluid extraction(SFE)method for its extraction.METHODS:Orthogonal design was used to in?vestigate the influence of extraction pressure,temperature,time length and pulverized degree of medicine on extraction rate of total coumarins.The contents of imperator and isoimperator in the extract were analyzed by HPLC.RESULTS:The Liner ranges of imperator and isoimperator were29.4～235.2?10～80?g/ml respectively.The average recoveries were(100.46?1.42)%?(99.94?1.18)%(n=3)respectively.The relative standard deviations were1.76%and1.62%respectively.When alcohol was used as a modifier,the extraction rate of total coumarins was the highest when the sample was pulverized into60mesh and had been extracted at35MPa and45℃for3hours.CONCLUSIONS:The extraction pressure,pulverized degree and extraction length all have significant effects on extraction rate of total coumarins.The established method is precise,convenient and can be used for determination of imperator and isoimperator.

Objective Carboxypeptidase E ( CPE) is one of the most important carboxypeptidases in-volved in the biosynthesis of numerous peptide hormones and neurotransmitters and plays an important role in en -docrine regulation .A splice variant of CPE ( CPE-ΔN) has been detected and the mechanism of CPE -ΔN action in tumorigenesis has been studied in many different cancers .The aim of this study is to examine CPE -ΔN ex-pression in human colorectal cancer ( CRC) and to evaluate its possible application as a potential prognostic mark-er.Methods In the present study ,we have analyzed isoform expression of CPE -ΔN by qRT-PCR and West-ern blot in 219 CRC patients .Results Our results showed that CPE -ΔN was overexpressed in colorectal tumor tissue and that high CPE -ΔN mRNA expression was closely correlated with tumor differentiation ,pT classifica-tion,pN classification,tumor recurrence and lymph node metastasis .High CPE-ΔN expression was also identi-fied as an independent prognostic factor using a multivariate analysis (P=0.011).Conclusion Based on these results,we can conclude that CPE -ΔN expression might be a potential prognostic marker for CRC patients .

Objective To detect the TNFSF13 expression and to evaluate its possible use as a potential prognostic marker in breast cancer .Methods We analyzed TNFSF13 expression by Western blot and qRT -PCR in 93 breast cancer patients .Results Our results showed that TNFSF 13 was overexpressed in breast cancer tis-sue.High TNFSF13 mRNA expression was closely correlated with tumor differentiation , pN classification ( P=0.003,0.022).In addition,patients with high TNFSF13 expression had a significantly shorter survival analyzed by Kaplan-Meier(P=0.04,log-rank test).Cox proportional hazards regression multivariable analysis revealed that high expression of TNFSF13 was identified as an independent prognostic factor (P=0.03).Conclusion TNFSF13 expression might be a novel target for prognosis and intensive therapy in breast cancer patients .

OBJECTIVE:To prepare Ganciclovir vagina suppository and to establish the quality control standard of it.METHODS:Suppository was prepared with gelatin as base material and ganciclovir as main ingredients.The content of ganciclovir was determined by HPLC.RESULTS:The preparation was whitish transparent duck-bill suppository with proper hardness.The identification and test of suppository was in line with the standards stated in Chinese Pharmacopeia(2005 edition).The linear range of ganciclovir was 2.0～90.0?g.mL~(-1)(r=0.999 9)The average recovery was 99.28%(RSD=0.58%,n=9)CONCUlSION:The preparation of Ganciclovir vagina suppository is easy in technological process.The content determination method is simple and accurate.

OBJECTIVE:The aim of this study was to assess the irrational use of vancomycin to treat infections of the patients with severe renal dysfunction.METHODS:Combining the results of blood concentration monitoring for vancomycin and the clinical symptoms with Micromedex Kinetidex,we evaluated whether the vancomycin was administered rationally when the infected patients with severe renal dysfunction were treated.RESULTS:It really existed that the vancomycin was irra?tionally used among these three patients:①The first loading doses did not match the saturation principle.②Administration interval did not be regulated in time along with the T 1/2 change.③The clinical doctors did not clearly understand that the hem_ odialysis can not efficiently remove vancomycin from the blood.CONCLUSION:For the infected patients with severe renal dysfunction,it is necessary to monitor the serum concentration of vancomycin in order to insure the rational use of vancomycin to treat these infected patients.

Objective To investigate the effect of propofol on expression of cyclinD1 and apoptosis in spinal cord neurons induced by ischemia-reperfusion (I/R) .Methods Sixty male Wistar rats weighing 200-250 g were randomly divided into 2 groups ( n = 30 each): group A I/R and group B propofol + I/R. The animals were anesthetized with 7% chloral hydrate 6 ml?kg-1. The abdomen was opened and the abdominal aorta was clamped distal to the left renal artery for 20 min. The aortic cross clamp was then released to allow reperfusion. In propofol group propofol 100 mg?kg-1 was administered intraperitoneally (IP) during the operation. Neurologic function was assessed using Taylor scale (0 = unable to move hind limbs, 4 = normal function) at 6 h after operation and on postoperative day 1, 2, 3, 7 (n = 6 at each time point) . The animals were killed after neurologic function evaluation and the spinal cord was removed for microscopic examination, detection of apoptosis in the spinal cord neurons ( TUNEL) and determination of cyclinD1 expression (immuno-histochemistry) . Results The histo-pathological damage to the neurons was significantly lighter, the neurological function better and the apoptotic index and the cyclinD1 expression were significantly lower in propofol group than in I/R group. Conclusion Propofol protects spinal cord against I/R injury by reducing neuronal apoptosis through down-regulation of cyclinD1 expression.