[Objective] To explore the etiology and pathogenesis of rheumatoid arthritis from the perspective of the theory of Fuxie, so as to more comprehensively understand the rheumatoid arthritis, broaden the thinking of clinical diagnosis and treatment, and improve the clinical efficacy. [Methods] The theory of Fuxie theory was summarized, from the aspects of interpretation, theoretical origin, modern medical knowledge and so on, combined with the regularity of the pathogenesis of the pathogen, the etiology, pathogenesis and treatment of rheumatoid arthritis were discussed. [Results] Fuxie theory is originally derived from Huangdi Neijing, it is considered that Fuxie is divided into exogenous and endogenous Fuxie foxier, etiology of rheumatoid arthritis with hidden pathogenic objective basis, its pathogenesis with hidden pathogenic mechanism, the treatment principle and treatment method by pathogen consistentcy. [Conclusion] Understanding of rheumatoid arthritis, according to the characteristics and development of Fuxie disease transmission rules, can better grasp the nature of the disease, diagnosis and treatment of Fuxie theory of rheumatoid arthritis has important clinical significance, rheumatoid arthritis from Fuxie theory provides new ideas and methods for clinical treatment.

Objective To investigate the correlation between clinical features of breast cancer and microsatellite instability(MSI).Methods 60 samples of breast cancer were eollected and 5 microsatellite polymorphism loci were selected.MSI analysis Was made after DNA isolation,PCR amplification,electrophoresis and EB staining.Results The rate of MSI was 33.3%in breast cancer and 0%in normal breast tissues.MSI in breast cancer was associated with carcinoma differentiation degree.Conclusion MSI is an early event during breast carcinogenesis and it plays an important role in estimation of malignant degree.

Objective To research the effect of alimentary tract reconstruction after gastrectomy on the treatment of type 2 diabetes mellitus(non-insulin-dependent diabetes mellitus, NIDDM). Methods From January 2005 to January 2008, perioperative blood glucose level and insulin therapy in 24 gastric cancer or periampullary carcinoma patients with non-obesity type 2 diabetes were retrospectively analyzed. These patients underwent different alimentary tract reconstruction, including 8 patients for Billroth I, 10 for standard Whipples operation, 6 for esophageal Roux-en-Y jejunostomy after total gastrectomy. Glucose level and insulin dosage of thease patients were compared. Results In the patients underwent Billroth I operation, change of blood glucose level before and after operation was not significant(P＞0.05). The level of blood glucose in patients underwent Whipples operation and total gastrectomy were significant changed 1 and 2 months after the operation (P<0.001). In Billroth I group, 5 patients used insulin to control hyperglycemia preoperatively. After the operation, 2 patents maintained preoperative insulin dosage, 2 had to increase the use of insulin and 1 decreased the insulin dosage. In Whipples group, 6 patients used insulin preoperatively. Interestingly, 4 patents needed less insulin to control hyperglycemia and 2 were free of insulin dependance. In total gastrectomy group, there were 4 patients using insulin to control hyperglycemia. After the operation, 2 patents needed less insulin dosage and 2 stopped using insulin. Conclusions Both Whipples operation and total gastrectomy lead to decreased blood glucose level in NIDDM patients and less need of insulin.The effect of some types of alimentary tract reconstruction after gastrectomy on treatment of type 2 diabetes mellitus is assertive.

Objective To investigate the value of CT in the diagnosis of dedifferentiated liposarcoma.Methods Fifteen surgical operations of dedifferentiated liposarcoma in 11 patients, confirmed by pathology, underwent plain (n=15) and contrast enhanced (n=12) CT scans. Two of the 12 lesions underwent dynamic multi-phase contrast scans. The CT features and the corresponding pathological basis were analyzed.Results The lesions were divided into 3 groups according to the fatty component and its distribution. The CT appearances were as follows: (1)a well delineated fatty component in the lesion and a closely apposed non-fatty region in 10 cases including 5 initial (5/5, 100%) and 5 recurrent (5/10, 50%), which depicted an abrupt transition from the well-differentiated area to the high-grade sarcoma component under microscope; (2)fatty component within the lesion was less than 10% in 3 recurrent (3/10, 30%); (3)fatty masses and non-fatty masses separately distributed in 2 recurrent cases (2/10, 20%). Contrast enhanced CT scan showed moderate to marked inhomogeneous enhancement in the early phase in all 12 lesions, and delay enhancement was also observed.Conclusion Dedifferentiated liposarcoma exhibited specific appearances as well delineated fatty component and closely apposed non-fatty region with apparent enhancement. Dynamic contrast CT scans play important roles in the diagnosis and differential diagnosis of dedifferentiated liposarcoma, and help pre-surgical grading and pathological sampling.

Objective To study the changes of Na+K+-ATPase,Ca2+Mg2+-ATPase activities in erythrocyte membrane and blood viscosity in children with essential hypertension.Methods The activities of Na+K+-ATPase,Ca2+Mg2+-ATPase in erythrocyte membrane were determined by a colorimetric method.Blood viscosity was measured and analyzed with the statistic analysis SPSS 12.0 software in 50 children from Nov.2004 to Dec.2004 in the people's hospital of guizhou province and adolescents with essential hypertension.Thirty healthy children were collected as control group.Results The activities of Na+ K+-ATPase[(6.12?1.30)?molpi/(gHb?h)and(4.59?1.40)?molpi/(gHb?h)],Ca2+Mg2+-ATPase[(7.46?1.30)?molpi/(gHb?h)and(5.81?1.20)?molpi/(gHb?h)] were lower significantly in hypertension group than those in control group(Pa

ObjectiveTo study possible mechanism through investigating the pathological and ultrastructural characters of secondary injury to perihematoma in intracerebral haemorrhage (ICH) rats.MethodsSprague Dawley male rats were subjected to ICH models. They were randomly divided into test group and control group. The rats in the test group were divided into 7 subgroups at 1h,3h,12h,24h,48h,72h and 7d after ICH; while those in control group were divided into 3 subgroups at 3h,24h,72h after saline injection. Each subgroup contained 5 rats. 2 rats from each group were stained by 2% triphenyltetrazolium chloride(TTC) to observe the pathological change.3 rats were picked up from each group to do optical microscope and electric microscope investigation on perihematoma tissue and ipsilateral cortex.ResultsHematoma tissue was demonstrated as black brown by TTC staining, no white infarcted area was detected around hematoma. In addition, there was a transitional zone between hematoma and normal tissue under microscopy; the involved tissue looked loose with varied edematous cells. Astrocytes appeared swollen and neural cells looked degenerated and necrosis. Meanwhile, capillary hyperplasia around hematoma with foot plate swollen were detected, no remarkable neural cells change was observed. 24 h after blood injection, astrocytes started to swell, part of them became degenerated and necrosis. Neural cells appeared mild degenerated and blood brain barrier were destroyed. 72 h after ICH, astrocytes showed highly swollen with neural cells degenerated.ConclusionSecondary injury to perihematoma has been identified and the pathological and ultrastructural changes have been observed.

Objective:To investigate the alteration of retinal perfusion in aquaporin-4 antibody (AQP4-ab) positive neuromyelitis optica spectrum disorders (NMOSD) patients by optical coherence tomography angiography (OCTA).Methods:A case-control study. Forty-eight AQP4-ab positive NMOSD patients (96 eyes) and 20 age and gender matched healthy controls (40 eyes) were recruited from September 2015 to August 2017 at the Eye & ENT Hospital of Fudan University. Patients of both eyes were included in the groups. The patients were further divided into 4 subgroups (0 ON, 1 ON, 2 ON, 3+ ON group) according to the number of episodes of ON (0, 1, 2, or 3+) with respect to 30、22、31、13 eyes. 0 ON group had no history of ON episodes; 1 ON group, 2 ON group, and 3+ ON group had ON episodes 1, 2, ≥3 times, respectively. All patients underwent complete ophthalmological examinations including BCVA, visual field and OCTA examination. The BCVA was recorded for each eye using metric notation from the Snellen chart, and then converted to the logarithm of the minimum angle of resolution. The central visual field was assessed using a Humphrey Field Analyzer 750 and the mean deviation (MD) was determined. OCTA scans of the optic disc (4.5 mm × 4.5 mm) and macula (6 mm × 6 mm) were acquired. Radial peripapillary capillary (RPC) vessel density, superficial capillary plexus vessel density (SVD), the thickness of ganglion cell and inner plexiform layer (GCIPL) and peripapillary retinal nerve fiber layer (pRNFL) were determined. The generalized estimating equations was performed to compare the difference of BCVA, MD, pRNFL thickness, GCIPL thickness, RPC vessel density and SVD among the groups and the correlations between retinal perfusion and retinal structure, visual function were analyzed.Results:The RPC vessel density and SVD were significant lower in the 0 ON group compared with healthy group (Wald χ2=7.190, 10.134; P<0.01), however, the BCVA, pRNFL and GCIPL thickness were not significant difference between the two groups (Wald χ2=2.308, 1.020, 2.558; P>0.05). The BCVA, visual field MD, RPC vessel density, SVD, pRNFL and GCIPL were significant lower in 1 ON, 2 ON and 3+ ON groups compared with healthy group and 0 ON group (Wald χ2=12.390, 11.346, 38.860, 18.040, 45.418, 26.608; P<0.001 ), but the parameters had no significant difference among the three groups ( P>0.05). The RPC vessel density was significantly correlated with pRNFL thickness ( β=0.372, standard error=0.018, P<0.001), and the SVD was significantly correlated with GCIPL thickness ( β=0.115, standard error=0.204, P<0.001). The MD and BCVA was significantly correlated with peripapillary vessel density after adjustment for other variables (BCVA: β=0.025, standard error=0.005, P=0.000; visual field MD: β=0.737, standard error=0.185, P=0.000). Conclusions:Subclinical primary retinal vasculopathy may occur in NMOSD prior to ON attack, the ON attack may further impair visual function, retinal structure and perfusion, however, the extent of injure is not relevant with the increase of ON attack. The peripapillary vessel density might be a sensitive predictor of visual outcomes in NMOSD patients.

Endovascular Procedures ; Humans ; Ischemia ; surgery ; Knee ; blood supply

Objective To investigate the efficacy of the enhancement treatment on osteoporotic vertebral compression fracture and its complications in the elderly.Methods From September 2007 to February 2012,183 patients with osteoporotic vertebral compression fracture underwent percutaneous kyphoplasty (PKP) or percutaneous vertebroplasty (PVP) in our department.157 of them were completely followed up (PKP group,n=96; PVP group,n=61) and totally 182 vertebral bodies were fractured (PKP group,n=107; PVP group,n=75).Visual analogue scale (VAS) score and Oswestry disability index (ODI) score were evaluated before and 3 days and 3 months after the surgery.Plain film radiography was taken to evaluate the vertebral body height.ODI score was evaluated at the end of the follow-up.The leakage of polymethylmethacrylate (PMMA) during the operation and the refracture were recorded.Results The mean height of the vertebral body before operation had no difference between PVP and PKP group [(1.31±0.18) cm vs.(1.32±0.16) cm,t =0.72,P＞0.05].After the operation,the mean height of the vertebral body was lower in PVP group than in PKP group [(1.50±0.20) cm vs.(1.66±0.17) cm,t=2.28,P＜0.05].The mean amount of the PMMA injected into the vertebral bodies was less in PVP group than in PKP group [(2.93±0.34) ml vs.(3.34±0.49) ml,t=2.39,P＜0.05].In the PVP group,the VAS scores were (7.5±0.79),(3.0±0.6) and (1.9±0.9) before,3 days and 3 months after operation respectively,and there was a significant difference in VAS score before versus 3 days after operation (t =15.59,P＜0.05).In thePKPgroup,the VAS scores were (7.3±1.0),(3.0±0.8) and (2.2± 0.9)before,3 days and 3 months after operation respectively,and there was a significant difference in VAS score before versus 3 days after operation (t=10.69,P＜0.05).In the PVP group,the ODI scores were (78.9±7.3),(30.0±3.7) and (25.5±3.5) before and 3 months after operation and at the end of follow-up respectively,and there were significant differences in ODI score before operation versus 3 months after operation (t=20.83,P＜0.01) and 3 months after operation versus at the end of follow-up (t=4.03,P＜0.05).In the PKP group,the ODI scores were (78.8±6.8),(29.8±4.43) and (23.8 ± 2.7) before operation,3 months after operation and at the end of follow-up respectively,and there were significant differences in ODI score before operation versus 3 months after operation (t=21.52,P＜0.01) and 3 months after operation versus at the end of follow-up (t=3.14,P＜0.05).There were no significant differences in VAS and ODI scores between the two groups before versus after operation (t=0.34,P＞0.05).The incidence of refracture was 8.2％ in PVP group and 9.4％ in PKP group,which had no statistical difference between the two groups(x2 =0.06,P＞0.05).All the leakage was asymptomatic.The incidence of PMMA leakage was 20.0％ (15 cases) in PVP group and 9.3％ (10 cases) in PKP group,which had a statistical difference between the two groups (x2 =4.22,P ＜ 0.05).Conclusions Enhancement treatment for osteoporotic vertebral compression fracture can quickly relieve the pain and improve the quality of life.PKP and PVP show no differences in the effect of analgesia and the improvement of life quality,but PKP has the advantages in recovering vertebral height and reducing PMMA leakage.

Objective:To study the effect of B7-1 costimulatory molecule in inducing tumor immunity.Methods:The lymphocytes were examined in vitro,for both proliferation induces(PI) and specific cytotoxic activity,H22 mice were challenged subcutaneously either by the mock following which the latency,survival time and tumor mass growth were noted.Results:The H22-B7-1 cells more effectively induced the proliferation of effecter lymphocytes and the generation of specific lytic activity against H22 cells.The H22-B7-1 cells demonstrated slower rate(P