10.3969/j.issn.1000-3606.2013.06.023

Rheumatoid arthitis is a chronic idiopathic immunodeficient diease and its cause is uncertainty,it is hard to cure radically.Rescently years,the treatment of rheumatoid arthitis with supplementing and boosting the liver and kidney had got great successes.The authors will discuss the following aspects:compound formulas(including classical formula and present formula),traditional Chinese external treatment,treatment of combined traditional Chinese and Western medicine in order to lay a foundation in scientific research in the future.

Objective To study the esophageal motor function in patients with reflux esophagitis (RE) and Barrett esophagus ( BE). Methods Patients with reflux esophagitis and Barrett esophagus which were diagnosed by endoscopy were recruited for symptomatic investigation, Twenty-seven patients with RE, 18 patients with BE and 12 non-reflux patients as controls were recruited prospectively for stationary esophageal manometry and 24-hour ambulatory esophageal pH monitoring. Results Besides dysphagia, the symptom scores of heartburn, acid regurgitation and retrosternal pain in BE groups were lower than those in RE groups (P 0. 05). DeMeester score of 24-hour ambulatory esophageal pH monitoring, total times of pH

256 mg/L) are resistant to metronidazole by two tests. The level of transcripts of rdxA genes significantly reduced the total RNA in Helicobacter pylori grown with metronidazole compared to that without metronidazole. And the expression of the galE gene used as the control was unchanged. Conclusion The low expression of the rdxA gene may play a role in the development of metronidazole high resistant Helicobacter pylori isolates.

8 mg/L). The rdxA gene fragment (886 bp) of H. pylori was amplified by PCR and then sequenced. Finally polymorphism analysis was performed in the rdxA gene sequence from those strains resistant or susceptible to Mtz and standard strains H.pylori 26695. Results A total of 47 H.pylori strains were isolated from 51 patients positive for rapid urease test. Mtz resistance rate was 34% by E-test method and 31.9% by breakpoint susceptibility testing. Among them 15 strains were resistant to Mtz by the two tests. The rdxA genes of both 15 strains resistant to Mtz and 8 strains susceptible to Mtz were sequenced. Compared with that of strain H.pylori 26695, the sequence of rdxA gene nucleotide in 15 H.pyloristrains resistant to Mtz showed similarity ranging from 90% to 95% and being 92.5% on average, and the sequence of rdxA gene nucleotide in susceptible strains showed similarity ranging from 94% to 95% and being 94.5% on average. In most resistant strains, the rdxA genes occurred point mutation, single nucleotide insertion or deletion, however, the insertion or deletion of large nucleotide fragment were rare, and mutational site were variable. Conclusions The rdxA gene mutation in H.pylori strains resistant to Mtz may result from point mutations in several bases or insertional mutations or deletional mutations in one base, without insertion or deletion of large neuclectide fragment, and mutational position being variable.

Objective To explore the effect of panaxadiols saponin (PDS) on the oxidative damage in lung tissue in hemorrhage-lipopolysaccharides (LPS) two hits rats. Methods Forty Wistar rats were divided randomly into 4 groups: sham operational group(S group); two hits groups with hemorrhage-LPS(HL group);dexamethasone preventive therapy group (HLD group) ;panaxadiol saponins preventive therapy group(HLP group). The rats were made first-hit by hemorrhagic shock,LPS were administered intraperitoneally to make endotoxic shock and induce two hits in rats,then the model of acute lung injury (ALI) induced by two hits had been built up successfully. NO-2/NO-3,MDA content and NOS,iNOS,SOD activities were measured by 722S spectrophotometer. Results The results of pathological observation showed that there was obvious inflammatory reaction in lung tissues after two-hits,and the structure was destroied.Compared with HL group,the inflammatory reaction was reduced in HLD group and HLD group.NOS,iNOS activities and NO-2/NO-3,MDA contents were increased significantly,and SOD activity was significantly lower in HL group compared with S group(P

Objective To investigate the value of partial hepatectomy in the treatment of hilar cholangiocarcinama( HCC). Methods In this report, 42 patients with hilar cholangiocacinoma treated surgically were analyzed retrospectively. Results Of the 42 patients, 34 cases (81%) underwent surgical resection. In these 34 cases, 15 cases were treated by local resection, 8 cases by a combination of right lobectomy, 3 cases by left lobectomy, 4 cases by left lobectomy and caudate lobectomy, 1 case by left lateral lobectomy and caudate lobectomy, 3 cases by quadrate lobectomy. Curative resection was performed in 25 patients. The median survival rate in patients with curative resection was 28 months, while that with palliative operation was 14 months. The 1-, 2-, and 4-year survival rates of curative resection were 90% , 73% , and 28% , respectively. The 1-, and 2-year survival rates of palliative operation were 57% , and 27%. Conclusion Survival rates in patients with curative resection were better than that of palliative operation. Radical resection in many cases demands a combined liver resection.

Objective To observe the effect of catgut implantation at acupoint on treating cerebrovascular epilepsy and discuss the therapeutic mechanism. Methods 58 patients were divided into an observation group and a control group. The control group was treated with sodium valproate, and the observation group was treated with catgut implantation at acupoint on the basis of the control group.Epilepsy scoring, sodium valproate adverse reactions, the change of blood concentrations of sodium valproate and curative effect evaluation and so on were observed before and after the treatment. Results The basic control and excellent rate in the observation group were 16.7%and 73.3%, better than the control group of 10.7%and 53.6% respectively. The epilepsy scoring and sodium valproate adverse reactions after treatment in the observation group were superior to the control group [observation group is(5.05±1.5),(5.09±1.53),control group is(6.40±1.74),(10.85±1.91),P<0.05]. The number of patients with blood concentrations of sodium valproate in range 50-100 mg/L after treatment was increased in the observation group(Z=2.07, P=0.038). Conclusion Catgut implantation at acupoint combined sodium valproate was more effective than sodium valproate in treating cerebrovascular epilepsy, which can obviously alleviate the adverse reaction of drugs and increase blood concentrations of sodium valproate.

Objective To investigate the effect of estrogen replacement therapy applied in different periods to ovariectomized rats and to evaluate the cognitive function of the rats.Methods Totally 40 rats were ovariectomized to be postmenopausal models.They were divided into early hormone replacement therapy group (n =10,managed by estradiol valerate at day 3 after surgery),early control group (n =10,managed by saline at day 3 after surgery),late hormone replacement therapy (n =10,managed by estradiol valerate at day 90 after surgery for 30 days) and late control group (n =10,managed by saline at day 90 after surgery for 30 days).The behavior indicators of the rats were evaluated by Morris watermaze and hippocampal metabolite was detected by proton magnetic resonance spectroscopy,including N-acetylaspartate (NAA),choline containing compounds (Cho),creatine(Cr),myoinositol (mI),NAA/Cr,Cho/Cr and mI/Cr.Results (1) Navigation test: escape latency were (43 ± 13) s at the early control group,(28 ± 9) s at the early HRT group,(82 ±26) s at the late control group and (48 ± 18) s at late HRT group.Swimming distance were (1 404 ± 238) cm at the early control group,(878 ± 354) cm at the early HRT group,(2411 ±818) cm at the late control group and (1 310 ±434) cm at the late HRT group.The escape latency and swimming distance of the early and late HRT groups were significantly shorter than those at the control groups (P ＜ 0.05).(2) Spatial probe test: the swimming time in the target quadrant of rats in the early HRT group (34.0 ± 3.0) s were longer than those in other groups (P ＜ 0.05).(3) Proton magnetic resonance spectroscopy: NAA/Cr were 1.12 ±0.17 at the early control group,1.26 ±0.12 at the early HRT group,1.57 ±0.21 at the late control group and 1.38 ±0.28 at the late HRT group.The late HRT group and the late control group were higher than their early groups (F =6.05,P =0.040).There was no significant difference between the HRT groups and the control groups (F =0.04,P =0.860).mI/Cr were 0.69 ±0.04 at the early control group,0.46 ±0.12 at the early HRT group,0.70 ±0.03 at the late control group and 0.75 ± 0.08 at the late HRT group.There were statistically significant differences of the experimental time between the early and late groups(F =16.45,P =0.004).The differences between the early HRT group and the early control group,and the late HRT group and the late control group were significant(F =6.01,P =0.040).And there was an interaction with the experimental time and HRT measures (F =13.79,P =0.006) ; early HRT can reduce the average level of mI/Cr.Cho/Cr were 0.95 ± 0.09 at the early control group,0.80 ±0.12 at the early HRT group,0.87 ±0.09 at the late control group and 0.85 ± 0.12 at the late HRT group.There was no significant difference among those groups (P ＞0.05).NAA/mI: there was an interaction with the experimental time and HRT measures (F =12.95,P =0.007).Early HRT can elevated levels of NAA/mI,while the late results were reversed.Conclusion Earlier estrogen replacement therapy may play a positive role in improving cognitive function of the ovariectomized rats.

Objective To evaluate the effect of treating malignant biliary obstruction by expandable metallic biliary endoprosthesis(EMBE) via percutaneous transhepatic approach companied with stereotactic radiotherapy(SRT). Methods We implanted total 19 stents via percutaneous transhepatic in 15 patients with malignant biliary obstuction, then the patients received stereotactic radiotherapy.Results The stent implanting in 15 cases was successful,and followed-up for 12 months .3 cases died in the third,fourth and eleventh month respectively without jaundice,others survied formore than one year.The survival rate for one year was 80%.Conclusion Implanting stent in bile ducts companied with stereotactic radiotherapy is an effective way in treating malignant biliary obstruction.