AIM: To investigate the efficacy and safety of low-dose leflunomide (Lef) combined with methotrexate (MTX) in the treatment of rheumatoid arthritis (RA). METHODS: Sixty-four RA patients were randomly divided into two groups, with 32 patients in each group. All the patients were required to stop the treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) for 1 wk before entering the trial. Patients in the Lef+MTX group received Lef 20 mg, po, qd in the first 4 wk, followed by 10 mg,po, qd for next 20 wk. Patients also received MTX 7.5 mg,po, qw during the trial. Patients in the MTX group received MTX 15 mg,po, qw for 24 wk. Physical and laboratory examinations were performed at the beginning of the trial, after 12 wk treatment and 24 wk treatment. Entopic X-ray examination of both hands was performed before and after the treatment. RESULTS: The rate of remarkable improvement was 88% (28/32) in Lef+MTX group and 38% in MTX group (12/32). Adverse reactions were reported in 12% (4/32) patients in Lef+MTX group and 43% (14/32) patients in MTX group. The reported adverse reactions were rash and nausea in Lef+MTX group and nausea, vomiting, oral ulcer, alopecia, ALT elevation, palpitation and menoxenia in MTX group. CONCLUSION: Combination of Lef with MTX is safe and effective in treatment of RA with less adverse reactions.

Objective To investigate clinical therapeutic effect of zoledronic acid combined with chemotherapy to senile lung cancer with bone metastases.Methods Totally 80 cases of senile lung cancer patients with bone metastasis were randomly divided into control group and combined group,40 cases in each group.Limitation of activity to the situation,release of bone pain,adverse e-vents and side effects were observed.Serum Ca2+ concentration,alkaline phosphatase (AKP)levels and the levels of serum inflam-matory cytokines TNF-α,IL-1βwere detected.Results Limitation of activities and pain of patients with combined treatment was significantly ameliorated compared to control group (P <0.05).Serum Ca2+ ,AKP and TNF-α,IL-1β levels were significantly de-creased in patients with combined group in time-dependent manner,and which were significantly lower than control group.Bone ad-verse events and side effects in patients with combined treatment were significantly lower than in patients with control group.Con-clusion Zoledronic acid combined with chemotherapy can enhance the efficacy of chemotherapy,effectively relieve the limitation of activities and pain symptoms and reduce the incidence of bone adverse events and adverse reactions.The effect may be related to the decrease of serum calcium and the inflammatory cytokines.

AIM: To study the chemical components and contents of the volatile oil from the Rubia tinctorum L.. METHODS: The volatile oil was extracted by steam distillation-extract method,the chemical constituents of the volatile oil from the herb were identified by gas chromatography-mass spectrometry(GC-MS). RESULTS: Thirty compounds were identified,which accounted for over 86.32% of the volatile oil. CONCLUSION: The major components were theaspirane(17.37%),2-furaldehyde(11.10%),benzeneacetaldehyde(6.01%),eugenol(5.47%),ionone(3.87%),and so on.

Objective To investigate pharmacodynamics of propofol for smooth exchange of tracheal tube for u laryngeal mask airway after surgery in elderly patients. Methods Twenty elderly patients, ASA Ⅰ or Ⅱ, aged 65-70 yr, scheduled for elective laparoscopic cholecystectomy were enrolled in this study. Anesthesia was induced with propofol, atracurium and remifentanil. The patients were mechanically ventilated after the trachea was intubated. Anesthesia was maintained with propofol combined with remifentanil. After surgery, a predetermined propofol concentration was achieved and a steady state maintained for at least 5 min. The target plasma concentration of propofol at which the laryngeal mask airway following tracheal extubation was attempted was determined by Dixon's up-and-down method with 0.5 μg/ml as the step size, The probit model was used to calculate the EC_(50) and EC_(95) and 95% confidence interval (95% CI) of propofol for inhibiting patient's response induced by smooth excharge of tracheal tube. Results The EC50 of propofol to achieve laryngeal mask airway following tracheal extubation was 2.79 μg/ml (95% CI 2.44-3.04 μg/ml) and EC_(50) 3.61 μg/ml (95% CI 3.27-4.78 μg/ml). Conclusion The target plasma concentration of propofol for laryngeal mask airway following tracheal extubation in elderly patients is 3.61 μg/ml.

Objective To study and evaluate the inhibitory role of ?-carboxyglutamic acid(Gla)in the Gla domain of prothrombin in the formation of calcium oxalate crystals. Methods The addition of morpholine and formaldehyde to the solution of prothrombin caused the conversion of 8 Gla to ?-methyleneglutamic acid (8?-MGlu)or 2 Gla to ?-methyleneglutamic acid(2?-MGlu) ,the inhibitory activity of which to calcium oxalate crystallization was detected with seeded crystallization technique. Results The conversion of Gla to ?-MGlu leads to the decreased inhibitory activity of prothrombin to calcium oxalate crystallization,the inhibitory index being decreased from normal 14.2 to 12.8 of 2?-MGlu or 5.0 of 8 ?-MGlu prothrombin respectively. Conclusions Gla in prothrombin may play an important role to inhibit the formation of calcium oxalate calculi.

Cooperation networks of nursing techniques were constructed by way of perspective practice so as toenhance the quality of nursing critical cases, the success rate of emergency treatments and patients' life quality. Themeasures included taming in techniques for nursing critical cases, making the runds of wards and consultations, andenlarging the scope of the cooperation networks. Quantification methods were introduced into management, networks ofcritical case assessment were ed in managing patients, and the system for assessing taming in techniques for nursingcritical cases was used in managing nineing personnel, thus improving the quality of the nursing personnel, ensuringthe rational allocation of human resources and promoting the enhancement of the hospital's medical quality and its social and econondc benefits. It is therefore not difficult to see that the cooperation networks are of application and dissemination value.

Objective To observe the effect of Dahuangzhechongwan on protein excretion, serum cholesterol, TXB_2 and 6-keto-PGF_(1?) in rats with adriamycin-induced nephrosclerosis. Methods The rats received twice-intravenous injections of adriamycin after one kidney was removed, and were fed with hyperlipide food to establish an animal model for diffusion mesangioproliferation following with focal segmental glomerulosclerosis. The rats were randomly divided into shame-operated group, adriamycin nephrosclerosis group, Dahuangzhechongwan group, benazepril group. Urinary protein excretion, blood fat, TXB_2 and 6-keto-PGF_(1?) were observed. Result Proteinuria extract was decreased, the plasma cholesterol was significantly lower, the level of TXB_2 was cut down and 6-Ket-PGF_(1?) was increased by Dahuangzhechongwan. Conclusion Dahuangzhechongwan has the role of simutianeous application of elimination and tonification, promoting the circulation of Qi and blood, eliminating blood stasis, improving the hemodynamics. Dahuangzhechongwan has the renal protection on rat with adriamycin-induced nephrosclerosis, the mechanism may be relate with adjusting the balance of TXB_2 and 6-keto-PGF_(1?).

AIM: To study the effects of calcium channel blockers (CCB) on nicotinic acetylcholine receptor current (I_(NIC)) in rat adrenal medullar chromaffin cells (RAMCs). METHODS: By using the whole-cell clamp-patch technique, we have investigated the effects of nifedipine(NIF)、?-conotoxin GVIA and ?-agatoxin IVA on I_(NIC) induced by nicotine(NIC) before and after RAMCs perfusion. RESULTS: After perfusing RAMCs for 5 min, different kinds of calcium channel blockers at different concentration showed significant inhibitory effects on I_(NIC) induced by 50 ?mol/L NIC. The peak inhibition rates of 10 ?mol/L NIF、400 nmol/L ?-conotoxin GVIA and 100 nmol/L ?-agatoxin IVA were (61.7?5.1)%,(29.3?7.4)% and (17.6?7.5)%, respectively. CONCLUSION: The acute effects of different kinds of CCBs on RAMC were that they obviously inhibited I_(NIC) induced by NIC. These results suggest that CCBs may inhibit catecholamine secretion by directly blocking nicotinic acetylcholine receptor channel. [

Objective To study the effect of continuous venovenous haemodiafiltration (CVVHDF) on the clearances of various solutes in multiple organ dysfunction syndrome (MODS)dogs.Methods Dogs were subjected to hemorrhagic shock plus resuscitation and endotoxemia to set up MODS model,then they were randomly divided into 2 groups: MODS group (M group)and MODS+CVVHDF group (M+C group).A PRISMA pre-dilution system with AN-69 filter was applied.Solute clearance of nitric oxide(NO),urea nitrogen(UN),creatinine (Cr),interleukin-6 (IL-6),interleukin-10 (IL-10),tumor necrosis factor-α (TNF-α) and endotoxin (LP) was determined with same dialysate and ultrafiltrate volume during CVVHDF.The clearance of various solutes (Kd) was calculated by the concentration of the cleared solutes in effluents (E) based on the formula Kd=(ExQE)/P.Results Clearances of NO,UN,Cr were greater than those of IL-6,IL-10,TNF-α,LP during the treatment of CVVHDF.Conclusion CVVHDF could effectively reduce the levels of various solutes in the development of MODS by convection and absorption.

Objective To analyze the professional psychological pressure and coping style of male nursing students during different learning stage,and discuss effective ways to solve these problems in order to promote physical and mental health development of male nursing students.Methods Using coping style questionnaire and the professional psychological pressure of nursing students questionnaire to survey 102 undergraduate male nursing students from grade 2005 to 2008 of a nursing college of certain province.Results The professional psychological pressure of undergraduate male nursing students was moderate.Male nursing students of different grades had different professional pressure,in which male nursing students of secondyear had lower professional psychological pressure than other students.Manners they adopted to cope with pressure were mature,that is,the "problem-solving-help" approach,in which ways taken by second-year students were more than others.Conclusions Social bias to male nurses should be corrected.Professional psychological education should be carried out to relieve their mental pressure according to characteristics of students in different stage and direct them to realize role change.