OBJECTIVETo observe the expression of peripheral blood CD4+ T lymphocyte apoptosis gene in rheumatoid arthritis (RA) patients with cold dampness type (CDT), and to explore its correlation with clinical indicators of RA.

METHODSSixteen RA patients with CDT (as the RA group) and 16 healthy subjects (as the normal control group) were recruited. CD4 T cell apoptosis rate was detected in the RA group and the normal control group using FCM. mRNA expressions of fas, fasL, caspase-3, caspase-8, bcl-2, and bax were detected using RT-PCR. Correlations between the expression of apoptosis gene and clinical activity indicators of RA (ESR, CRP, RF, CCP, integrals for Chinese medial symptoms, morning stiffness time, joint tenderness number, joint swelling number, DAS28-3) were analyzed.

RESULTSThe apoptosis rate of CD4+ T was significantly lower in the RA group than in the control group [(2. 6 +/- 0.9) % vs. (7.7 +/- 1.3) %, P < 0.01]. mRNA expression levels of fas, fasL, caspase-8, caspase-3, and bax mRNA of CD4+ T significantly decreased, but bcl-2 mRNA expression increased in the RA group (P < 0.01). The apoptosis rate of CD4+ T was negatively correlated with ESR (P < 0.05). The mRNA expression of caspase-8 was negatively correlated with joint swelling number (P < 0.05). The mRNA expression of bcl-2 was negatively correlated with integrals for Chinese medial-symptoms and joint function classification (P < 0.01, P < 0.05).

CONCLUSIONApoptosis obstacle exists in peripheral blood CD4 +T lymphocyte of RA patients, and is closely related to disease activity.

Apoptosis ; Arthritis, Rheumatoid ; diagnosis ; metabolism ; pathology ; CD4-Positive T-Lymphocytes ; Caspase 3 ; metabolism ; Caspase 8 ; metabolism ; Fas Ligand Protein ; Humans ; RNA, Messenger

Objective To investigate the imaging characteristics and to explore the clinical management of pancreatic duct stones. Methods The imaging characteristics and outcomes of different clinical management of 43 cases of pancreatic duct stones were retrospectively analyzed. Results In this group of patients with pancreatic duct stones, 42 cases were diagnosed by imaging examination, and 1 case was diagnosed during surgery. Among the 42 cases diagnosed by imaging, 20 cases were identified by B mode ultrasonography (BUS), 10 cases by CT, and 10 cases by ERCP. The pancreatic duct stones were located at the head of pancreas in 10 cases, at the body and tail of pancreas in 29 cases, and from the head to the tail of pancreas in 4 cases. Twenty patients with single pancreatic duct stones received conservative medical therapy, 6 patients with pancreatic duct stones located at the head of pancreas received endoscopic intervention therapy and 17 patients with multi pancreatic duct stones were successfully treated by surgery. Conclusions BUS, CT and ERCP are efficient means for diagnosing pancreatic duct stones. Choosing an appropriate management strategy based on the number, location and size of the stones is important for the successful treatment of pancreatic duct stones.

Objective To investigate the effects of case-based learning (CBL) applied in the clinical probation of anesthesiology.Methods Totally 313 undergraduates from the department of anesthesiology were randomly divided into 2 groups:CBL group (n =157) and LBL group (n =156).CBL methods were used to teach students in CBL group while traditional teaching methods were used to teach students in LBL group.After the causes being finished,a combination of theoretical examination and questionnaire were used to evaluate the teaching effectiveness between the two groups and a questionnaire was used to evaluate the recognition of teachers on CBL method.Data were managed by SPSS 17.0 software package.Quantitative data between groups were compared by t-test,enumeration data between groups were compared by chi-square test.Results Students in CBL group acquired higher score (86.7 ± 5.4) than those in LBL group (75.8 ± 4.5).82％ students in CBL group considered that their overall quality was improved while 42％ students in the LBL group thought so (P ＜ 0.05).75％ of faculties preferred the CBL methods.Conclusions Effect of CBL methods is better than traditional teaching methods and it's preferred by faculty and students.

Humans ; Lead ; urine ; Sensitivity and Specificity ; Spectrometry, Fluorescence ; methods ; Spectrophotometry, Atomic ; methods

Objective To study the effects of motor imagery therapy on functional performance of upper ex- tremity in stroke patients.Methods Sixty cases of stroke were divided into a treatment group(n=30) and a con- trol group(n=30).The control group was treated with routine rehabilitation training,while the treatment group was treated with motor imagery therapy in addition to the routine rehabilitation training.The Fugl-Meyer Assessment (FMA),upper extremity function test(UEFT)and simple test for evaluating hand function(STEF)were used to as- sess the upper extremity function before and after six months of treatment.Results After treatment,patients in both groups scored significantly better with the FMA scales,UEFT scales and STEF scales when compared to their scores obtained before the treatment(P

Aged ; Dermatomyositis ; complications ; diagnosis ; Dyspnea ; diagnosis ; etiology ; Female ; Hoarseness ; diagnosis ; etiology ; Humans

Accidents, Occupational ; prevention & control ; Emergency Medical Services ; organization & administration ; Humans ; Occupational Exposure ; prevention & control ; Occupational Health ; Poisoning ; prevention & control ; Risk Assessment

Objective To summarize and discuss the diagnostic and treating experiences of chronic pancreatitis with mass in the head. Methods Eight patients of chronic pancreatitis with mass in the head who were misdiagnosised as carcinoma of head of pancreas were analyzed retrospectively in the past 10 years. Results All the patients exhibited abdominal pain,5 of whom were with jaundice and 3 with anorexia. All the patients were misdiagnosised as carcinoma of head of pancreas before the operation,but the pathology after operation indicated chronic pancreatitis. The pancreaticoduodenectomy was performed in 5 patients,the choledochojejunostomy in 2 patients,while the exploratory laparotomy in 1 patient. After the operations,the abdominal pain was relieved in 7 patients, while 2 patients who accepted pancreatoduodenectomy suffered from pancreatic fistula,1 of whom died in the end. Conclusion It’s hard to differentiate the chronic pancreatitis with mass in the head from the carcinoma of head of pancreas before operation. If the carcinoma of head of pancreas can’t be excluded during the operation,the pancreatoduodenectomy should be performed,while the duodenum-preserving total resection of the head of the pancreas or any intra-drainage operations should be done if chronic inflammation is found in the whole pancreas with a negative result of the biopsy of the pancreas through the needle aspiration.

Objective To investigate neuroprotective mechanisms of vinpocetine by observing the effects of vinpocetine injection on the expressions of peroxisome proliferators-activated receptor γ(PPARγ),nuclear factor (NF)-κB p65,cyclooxygenase-2 (COX-2) in the ischemic cortex,and infarct volume after focal cerebral ischemia-reperfusion in rats.Methods A focal cerebral ischemia-reperfusion injury model was induced by suture method.The rats were randomly divided into a normal control,a cerebral ischemiareperfusion and a vinpocetine groups.They were also divided into either a day 7 subgroup or a day 14 subgroup (n =6 in each subgroup) according to the reperfusion time.Western blot was used to detect the expression levels of PPARγand NF-κB P65 in the ischemic cortex.Triphenyl tetrazolium staining was used to detect the volume of cerebral infarction.Results Western blot showed that at day 7 and 14 after cerebral ischemia-reperfusion,expression levels of PPARκ (all P＜0.001) and NF-κB p65 (all P＜0.001) in the cerebral ischemia-reperfusion group were significantly higher than those in the sham operation group,the expression levels of PPARκ (all P ＜0.05) in the vinpocetine group were significantly higher than those in the cerebral ischemia-reperfusion group,but the expression levels of NF-κB p65 (all P ＜0.05) were significantly lower than those in the cerebral ischemia-reperfusion group.Reverse transcription polymerase chain reaction showed that COX-2 mRNA expression levels were upregulated significantly at day 7 and 14 after cerebral ischemia-reperfusion compared with the sham operation group (all P ＜ 0.001),the expression levels of COX-2 mRNA in the vinpocetine group were significantly downregulated compared with the cerebral ischemia-reperfusion group (all P＜ 0.05).The infarct volumes at day 7 (134.308± 9.954 mm3vs.185.543 ± 9.100 mm3;q=10.659,P＜0.001) and at day 14 (137.865 ± 9.094 mm3vs.183.210±4.368 mm3;q=11.166,P＜0.001) in the vinpocetine group were significantly less than those in the cerebral ischemia-reperfusion group.Conclusions Vimpocetine significantly reduces infarct vohme after focal cerebral ischemia-reperfusion,its mechanism may be associated with upreguhtion of PPARγexpression and downreguhtion of the expressions of NF-κB p65 and COX-2.

Objective To determine the relationship between polymorphism of apolipoprotein E gene (APOE) and electroencephlogram in patients with mild/moderate traumatic brain injury. Methods (1) Venous blood for 2 ml was collected from 81 patients with mild/moderate traumatic brain injury on admission. APOE genotype was identified by PCR restriction fragment length polymorphism ( PCRRFLP). (2) All the patients were monitored by electroencephalogram for 2-3 times within a week after injury. X2 test and logistic regression analysis via SAS version 8.2 were performed to analyze the results of genotype and electroencephalogram and clinical data. Results The distributions of genetypes and alleles among 81 patients matched with Haldy-Weinberg Law. The findings of electroencephalogram were significantly different between patients with and without APOEε4 (P<0.05). Ten (63%) out of 16 patients with APOEε4 showed an aggravated electroencephalogram,while only 16 (25%) out of 65 patients without APOEε4 showed the same results of electroencephalogram. Logistic regression analyses showed that APOEε4 was a risk factor for electroencephalogram aggravation after traumatic brain injury. Conclusion APOEε4 is a risk factor for electroencephalogram aggravation during acute stage after mild/moderate traumatic brain injury.