0.05 ). However, there was a correlation between EF at peak exercise 27%?11% and maximal exercise capacity ( r = 0.42 , P

Objective To investigate the effect of DMARDs on the prevention of early-onset atherosclerosis in rheumatoid arthritis ( RA) patients for exploring an appropriate schedule to reduce cardiovascular events. Methods Seventy-two patients with early RA were included in this study. Erythrocyte sedimentation rate ( ESR) and high sensitivity C reactive protein ( hs-CRP) were detected before and after treatment to evaluate inflammation. Carotid intima-media thickness ( cIMT) and endothelium-dependent flow-mediated vasodilatation (ED-FMD) were monitored. Disease Activity Score in 28 Joints (DAS28) and health assessment questionnaire-disability index ( HAQ-DI) was used to assess severity degree of RA and life quality of the patients, respectively. The patients were treated with methotrexate (MTX), hydroxychloroquine (HCQ) and sulfasalazine (SSZ) alone or combined based on severity of RA. Results After 1 year of treatment, ESR, hs-CRP, DAS28 and HAQ-DI were significantly improved (all P<0. 01). At the same time, the serum lipid levels also had obvious changes. However, there was no obvious difference in body mass index ( BMI) after 1 year. The cIMT ratio value was significantly decreased compared to baseline (0. 43±0. 08 mm vs. 0. 50±0. 16 mm, P=0. 002), and FMD% also significantly improved from basic value of 5. 26 to 7. 57 after treatment (P=0. 041). Conclusion Early intervention of RA by using DMARDs can effectively control the disease and slow the progression of atherosclerosis, but also reduce cardiovascular mortality.

Objective To improve the recognization of hip joint lesion in ankylosing spondylitis and it's related factors.Methods Pelvis computed radiography(CR) and HLA-B27 were examined in 100 cases of ankylosing spondylitis proved by clinical.Results 58% cases appeared differed degree of narrowing of the interticular space,osteoporosis on head of femur and acctabulum,cystis under the surface of acctabulum and joint inosculated.This probability was higner at thoe patients that had diaease at youthful or HLA-B27(+).Conclusion Hip joint lesions of ankylosing spondylitis appear characteristic signs in CR.It relates with the age that the disease come on and HLA-B27.

Objective To explore the prevalence of anxiety, depression, loneliness in elderly patients with long- term hospitalization, its coping style and the correlation between them. Methods 48 hospitalized elderly patients with long- term hospitalization were investigated by Standard Scale and self- administrated questionnaire, the Pearson's correlation was used to find the correlation. Results It was concluded that anxiety, depression and other negative emotions were commonly seen in elderly patients with long term hospitalization, these patients usually adopt the avoidance and yield coping style as well,and there was a positive correlation between them, the r value was 0.438, 1.473 amd 0.501 respectively. Conclusions This research confirmed the possibility of negative emotion in elderly patients with large long- term hospitalization, but also closely related to the choice of coping styles. The nursing staff should closely observe and assess the psychological status of elderly patients, planned, targeted to help elderly patients use more positive coping style.

To analyse the effect of tetrandrine(Tet) on proliferation of aortic vascular smooth muscle cells ( AVSMC), AVSMC were isolated and cultured from sham-operated rats(Sham), renovascular hypertensive rats〔RHR, 18 weeks after two kidney one clip(2K1C) operation〕, and Tet (50 mg*kg-1*d-1 po for 9 weeks from week 9 after 2K1C operation)treated RHR. The proliferation of AVSMC was detected by MTT method, and the DNA synthesis was evaluated by ［3H］-thymidine incorporation. The results showed that ①The ultrastructure of aorta suggested that AVSMC in RHR had transferred from contractile phenotype to synthetic phenotype; ②Compared to Sham, AVSMC from RHR showed a higher proliferative property with a higher cell number and an increased growth rate stimulated by norepinephrine(NE) or angiotensinⅡ(AngⅡ); ③Compared to untreated RHR, AVSMC from Tet treated RHR showed a reduced reactivity to NE- or AngⅡ-stimulated proliferation and growth rate; ④Tet(0.1－10 μmol*L-1) treated in vitro induced a concentration-dependent depression in ［3H］ thymidine-incorporation stimulated by NE or AngⅡ in AVSMC from either RHR or Sham. This study provides an evidence of increased reactivity to NE or AngⅡ in AVSMC of RHR. Tet inhibits the proliferation and DNA synthesis in AVSMC, depresses the susceptibility of AVSMC to AngⅡ and NE, both contribute to the regression effect on hypertensive vascular remodeling.

A cerebellar afferent connection from the periaqueductal grey (PAG) has been demonstrated in the rat by means of retrograde transport of horseradish peroxidase (HRP) in the present study. The projection is bilateral, but the projection from the ipsilateral side is predominant (3:1). Its main origin is the ventromedial and ventrolateral regions of middle and caudal parts of PAG (98.8％), and the fibers reach different cerebellar cortical regions: culmen, declive, folium vermis, tuber vermis, pyramis vermis, uvula vermis, lobulus quadrangularis, crus Ⅰ, crus Ⅱ, and paraflocculus. Most labelled neurons are medium sized, but some small neurons also appear to project to cerebellum. Only a few large neurons are retrogradely labelled at the most caudal end of the caudal part. Functionally, both cerebellum and PAG are related to visceral activities. Consulting the present experiment, we discussed the significant role of the PAG-cerebellar projection.

In order to study the bifurcate projections of midbrain periaqueductal gray and nucleus raphe dorsalis to nucleus accumbens and nucleus raphe magnus, the fluorescence double-labeled method was used in the present study. Bisbenzimide (Bb) and propidium iodide (PI) were injected into nucleus raphe magnus and unilateral nucleus accumbens stereotaxically according to the time period necessary for their axonal transport. The percentages of double-labeled neurons were 21％; PI single labeled neurons were 32％; Bb single labeled neurons were 47％. Most of the labeled neurons were located in the middle and caudal parts of periaqueductal gray and the nucleus raphe dorsalis, and most were medium sized and fusiform and triangular in shape.

The distributions of 5-HT-like and Met-ENK-like immunoreactive (5-HT-LI and Met-ENK-LI) structures in the nucleus accumbens (Acb) of rats were studied by immunohistochemical technique in the present study. Under light microscope, 5-HT-LI fibers and terminals could be seen in each subnucleus at different planes of Acb, but the 5-HT-LI fibers and terminals in the medial and ventral subnuclei were more than the dorsal and lateral subnuclei, the amount of 5-HT-LI fibers and terminals in the caudal segment were more than the rostral segment. According to the diameter, pathway, and number of varicosity, 5-HT-LI fibers could be divided into 3 types: (A) thick fiber (0.35—0.40?m); (B) medium fiber(0.20—0.30?m); (C) thin fiber (about 0.10?m). These 3 types of 5-HT-LI fibers were remarkable in the medial and ventral subnuclei of Acb. 5-HT-LI neuronal bodies did not observed in the Acb. A few scattered Met-ENK-LI neuronal bodies were seen in the ventral subncleus and ventral part of the medial subnucleus. Met-ENK-LI fibers and terminals distributed in all subnuclei and predominant in the medial and ventral subnuclei. The distributions of Met-ENK-LI structures were no differences between the rostral and caudal segments. All of the Met-ENK-LI fibers were thin and irregular and villi-like in shape. There were only a few varicosities on the MetENK-LI fibers. Part of Met-ENK-LI fibers looked like discontinued varicosities. Under electron microscope, 5-HT-LI axonal boutons formed symmetric and asymmetric synapses with non-5-HT-LI dendrites. Met-ENK-LI dendrites formed symmetric and asymmetric axo-dendritc synapses with non-Met-ENK-LI axonal boutons. These synapses were mainly observed in the medial and ventral subnuclei of Acb. The identity of 5-HT-LI and Met-ENK-LI structures, especially in the medial and ventral subnuclei, supported the physiological studies that 5-HT-LI ascending efferent fibers activated the Met-ENK-LI neurons and then the latter sent descending efferent fibers to lower brainstem structures to take part in antinociceptive functions.

5-HT-, SP- and L-ENK-like (5-HT-LI, SP-LI and L-ENK-LI) immunoreactive ultrastructures of the ventrolateral subdivision (VLS) of midbrain periaqueductal gray (PAG) in the rat were observed by immunoelectron microscopical technique in the present study. 5-HT-LI neuronal cell bodies were frequently seen in the VLS of the PAG. 5-HT-LI dendrites were found to form axo-dendritic synapses with non-immunoreactive axon terminals, and the major form of this kind of synapse was asymmetric. A few 5-HT-LI axon terminals formed axo-axonic synapses with non-5-HT-LI axon boutons. 5-HT-LI and non-5-HT-LI axon boutons formed axo-dendritic and axo-somatic synapses with 5-HT-LI dendrites, non-5-HT dendrites and 5-HT-LI neuronal cell bodies, respectively. SP-LI fusiform neuronal cell bodies were only a few and formed axo-somatic synapses with non-SP-LI synaptic boutons which contained pleomorphic vesicles. SP-LI dendrites formed axo-dendritic synapses with non-SP-LI axon terminals, this kind of synapse was the main form of synapses formed by SP-LI structures. SP-LI axon boutons formed axo-somatic and axo-dendritic synapses with non-SP-LI neuronal cell bodies and SP-LI dendrites. L-ENK-LI neuronal cell bodies were also limited. The most common form of synapses of L-ENK-LI structures was L-ENK-LI dendrites formed axo-dendritic synapses with non-L-ENK axon terminals. Non-L-ENK-LI axon terminals constituted axo-somatic synapses with L-ENK-LI neuronal cell bodies. A few L-ENK-LI axon terminals formedaxo-dendritic synapses with L-ENK-LI dendrites. The majority of the synapses mentioned above contained spherical clear vesicles, but some were mixed with a few flat, oval and granular vesicles. The immunoreacrive products were located on the surface of vesicles or on the surface of membranous organelles in the cytoplasm.

The ultrastructure of the rat nucleus raphe magnus (NRM) was observed under transmission electron microscope in the present study. Most of the neurons of the NRM were medium and small sized fusiform and triangular in shape, they had spherical or ellipsoid nuclei and rather high nucleo-cytoplasmic ratio. Nuclear rodlets which composed of parallel filaments could be seen in some fusiform NRM neurons. There were numerous organelles in the cytoplasm. Axonal terminals apposed to most neuronal bodies and formed axo-somatic synapses. The predominant type of these synapses was symmetric. Sometimes, rod-like or spine-like cytoplasmic protrusions could be seen on the neuronal bodies, they often made axo-somatic synapses with axonal terminals. The neuropil of the NRM was quite complex. It was formed by transverse sections of myelinated fibers, unmyelinated fibers, synapses, and neuroglia. The axo-dendritic synapses were the major synaptic type in the neuropil. The predominant type of these axo-dendritic synapses was also symmetric and asymmetric axo-dendritic synapses. Some axonal terminals were arranged parallel with dendrites and formed symmetric synapses. Beneath subsynaptic membrane of some postsynaptic bags, there were some electrical dense spherules or bands which formed subsynaptic dense bodies. There were. no typical axo-axonic synapses in the NRM, but the parallelly arranged axonal terminals were often seen. Most of the presynaptic bags contained clear spherical vesicles or mixed with flattened and granular vesicles. Some postsynaptic bags were filled with flattened vesicles, they were also often mixed with spherical and granular vesicles.