Ankylosing spondylitis (AS) is a chronic rheumatic disease involving the spine and sacral hip.AS is the prototype disease of seronegative arthritis of the spine.Besides the violations of the spine,AS can also lead to violations of the peripheral joints,even the eyes,intestine,aortic root,and other tissues and organs.The pathogenesis of AS has remained unclear.AS,a genetic disease,is influenced by the genetic and environmental factors.Studies have suggested that HLA-B27 is the most critical genes to AS,and forming three kinds of hypotheses associated with HLA-B27.This paper reviews the molecular genetics and pathogenesis of AS.

Objective To investigate the clinical significance of plasma adrenocorticotropic hormone and cortisol changes at different time in acute cerebral infarction.Methods The clinical data of 62 patients with acute cerebral infarction (acute cerebral infarction group) were analyzed retrospectively,and 60 healthy cases in the same period were recruited as control group.The plasma adrenocorticotropic hormone and cortisol levels at 8:00,16:00 and 24:00 of two groups were detected by electrochemiluminescence immunoassay.Results Plasma adrenocorticotropic hormone and cortisol levels at 8:00,16:00 and 24:00 in acute cerebral infarction group were significantly higher than those in control group [(20.5 ± 4.2) pmol/L vs.(10.4 ±2.6) pmol/L,(18.9 ±4.9) pmol/L vs.(8.5 ± 2.1) pmol/L,(18.1 ±3.8) pmol/L vs.(7.1 ±2.4) pmol/L and (542 ± 76) nmol/L vs.(469 ± 65) nmol/L,(528 ±43) nmol/L vs.(341 ± 33) nmol/L,(499 ± 32) nmol/L vs.(196 ±27) nmol/L](P＜0.05); plasma adrenocorticotropic hormone and cortisol levels of severe degree acute cerebral infarction at different time were higher than those of light conditions (P＜0.05 ); plasma adrenocorticotropic hormone and cortisol levels at different time of acute cerebral infarction patients with good prognosis were significantly lower than those of the persons with poorprognosis(P＜0.05).Conclusion Plasma adrenocorticotropic hormone and cortisol testing at different time has clinical significance in determining the condition and prognosis of patients with acute cerebral infarction.

Objective To investigate the epidemiological situation and the mode of inheritance of ankylosing spondylitis (AS).Methods The AS prevalence investigation was carried out from three different areas in Shandong Province to investigate the incidence of the 80 patients' family members of sick group and calculate the heritability of AS.Results After the investigation and calculation we found the incidence of primary relatives was 7.23％,the heritability was 85.94％,the incidence of secondary relatives was 0.94％ and the heritability was 57.4％,the incidence of thirdly relatives was 0.39％,the heritability is 36.2％,the average heritability among primary,secondary and thirdly was 68.47％ ± 1.64％.Separation ratio was 0.088 9.Conclusion AS is a polygenic disease,its average heritability was 68.47％ ± 1.64％ and separation ratio is 0.088 9.By this research,the incidence risk of AS patients' pedigree offspring can be assessed,then strengthen protective factors to reduce the incidence of the disease to provide the basis for eugenics.

Objective To probe into the effect of nursing intervention on complications and compliance of cancer patients with PICC. Methods 86 tumor patients selected from June 2007 to June 2010were randomly divided into the intervention group and the control group with 43 patients in each group. After the two groups of patients were diagnosed they were treated with routine care, the intervention group wasgiven additional comprehensive nursing interventions aiming at PICC complications and compliance. The complications and treatment compliance of the patients were analyzed. Results Compared with the control group, the rate of full compliance significantly improved and the rate of partial compliance significantly decreased in the intervention group. At the same time, compared with the control group, the incidence rate of phlebitis, catheter-related bloodstream infection and catheter blockage and catheter off of the intervention group were significantly lower. Conclusions Nursing intervention for cancer patients with PICC can reduce complications and improve treatment compliance of them and is of great clinical significance.

Objective: To evaluate the effect of nutritional support with low carbohydrate formula (Pulmocare, Abbott, America) in patients with pulmenary disease and respiratory failure. Methods: 60 patients were randomly divided into control group and study group. The study group was given Pulmocare and the control group was given Ensure (standard enteral nutrition,Abbott, America). The lipidemia, serum protein, PaCO 2 ,PaO 2 ,VO 2 ,VCO 2 and RQ were measured before and after therapy. Results: The patients' nutritional status of the two groups was improved significantly. The index of artery blood gas analysis was significantly improved( P

Objective To study the relationship between the variation of the 20 exon of leptin receptor (LEPR) and lipid metabolism of the children with obesity. Methods Polymerase chain reaction-restricted fragments length polymorphism (PCR-RFLP) and polyacrylamide gel electrophoresis were used to analyze the variation of the 20 exon of the LEPR gene of the obesity group (120 obese children) and the control group (120 healthy children). Their serum triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), height, weight measured and the body mass index (BMI), fat percent (%fat) were calculated. Results 3 genotypes of the 20 exon of LEPR gene has been detected. Compared with the control group, the frequency of the gene variation at 3057 nucleotide G→A transversion is higher (P<0.05).The concentration of the serum TG, the level of BMI and %fat of the obese children with A/A genotype were higher than that with the G/G genotype (P<0.01),but the level of the serum HDL was lower (P<0.01).To the children with A/G genotype, only their TG level in serum are higher than that with the G/G genotype (P<0.05). Conclusion There is polymorphism at 20 exon LEPR gene in children with obesity, which may affect the lipid metabolism and the fat distribution. The obese children with A/A genotype should pay more attention to their diet to avoid some diseases followed obesity.

Objective:To analyze of hot spots and cutting-edge dynamic researches on Traditional Chinese Medicine (TCM) treatment for atopic dermatitis (AD).Methods:The data were abstracted from the literature of AD from CNKI, VIP and WanFang database, during January 1st, 2000 to May 31st, 2021. CiteSpace was used to map Knowledge and visualize information on the law, research hot spots and trendency of TCM in the treatment of atopic dermatitis in recent 20 years.Results:A total of 478 articles were included, mainly from TCM colleges and universities in various provinces. Most of the cooperative institutions have subsidiary relationships, and there is less cross-agency and cross-regional cooperation. Hot research topics included AD, clinical research, TCM therapy, TCM syndrome differentiation, compound Glycyrrhizin, TCM external treatment, and TCM formular, forming 8 main clusters. Integrated Traditional Chinese and Western Medicine was the developing trend in the treatment of AD, and the establishment of animal models to evaluate the therapeutic effect is the research frontier.Conclusion:Knowledge mapping can show the evolution path, research hotspot and frontier of TCM in the treatment of AD, and lay a foundation for high quality researches.

Objective:To retrospectively analyze the clinical characteristics of elderly patients with anti-MDA5 antibody-positive dermatomyositis.Methods:Data of 62 patients with anti-MDA5 antibody-positive dermatomyositis admitted to Second Xiangya Hospital from May 2016 to December 2019 were collected and patients were divided into an elderly group(≥60 years old, 17 cases)and a non-elderly group(<60 years old, 45 cases). The clinical manifestations, laboratory test resuls, treatment and prognosis of the patients in both groups were statistically analyzed.Results:A total of 62 patients with anti-MDA5 antibody-positive dermatomyositis were included in this study, including 17 elderly patients(27.4%)with an average age of(65.5±5.3)years and 45 non-elderly patients(72.6%)with an average age of(46.5±8.4)years.Compared with non-elderly patients, older patients had a shorter disease duration[(1.6±1.0)months vs.(3.7±3.3)months, t=3.883, P<0.001], a higher proportion of patients with exertional dyspnea(15/17 or 88.2% vs.26/45 or 57.8%, χ2=5.11, P=0.024)and with combined positive anti-Ro-52 antibodies(15/17 or 88.2% vs.26/45 or 57.8%, χ2=5.11, P=0.024), and a higher mortality rate[(12/17 or 70.6%) vs.(8/45 or 17.8%, χ2=15.748, P<0.001)]. In contrast, fewer elderly patients than non-elderly patients had the Heliotrope's sign(9/17 or 41.2% vs.38/45 or 57.8%), χ2=5.07, P=0.024). Conclusions:Elderly patients with anti-MDA5 antibody-positive dermatomyositis have a unique clinical phenotype with an acute onset, atypical rashes, severe pulmonary lesions, making treatment difficult, and have a poor prognosis.