Objective To evaluate the role of anti-cyclic citrullinated peptide antibody(ACCP) and rheumatoid factor(RF) in patients with rheumatoid arthritis.Methods ACCP antibody and RF were detected in serum samples of 90 RA patients,30 other diseases patients and 35 healthy blood donors.The sensitivity,specificity,positive predictive value,negative predictive value,agreement rate and Youden`s index of these parsmeters for the diangnosis of RA were analyzed.We maped the receiver operative characteristic curve(ROC) and calculated area under the ROC curve.Results The positive rates of ACCP and RF were higher than those of patients with other diseases or healthy controls(P0.5).Conclusion ACCP is a valuable index for RA diagnosis.It is useful in improving the diagnostic accuracy of RA.

Ascites ; Humans ; Language ; Quality of Life ; Reproducibility of Results ; Surveys and Questionnaires ; Translations

Objective To investigate the clinical and pathologic features in patients of microscopic polyangiitis (MPA) with peripheral nerve abnormality.Methods We collected clinical data of 6 patients with MPA that was confirmed by immunological,pathological and clinical findings.Electroneurophysiologic examinations and sural nerve biopsies were performed in these patients.Two normal controls were included in these studies.Results All of 6 patients developed asymmetric polyneuropathies.Electrodiagnostic studies showed reduced amplitudes of the sensory nerve action potential and compound motor action potential with mild impaired conductive velocities.The patients presented vasculitis changes with cell infiltration by monocytes and lymphocytes.Sural nerve biopsies found loss of myelinated fibers in all of the patients indicating axonal degeneration.Some of them associated with regeneration clusters of myelinated fibers.Conclusions Asymmetric neuropathy with sensory nerve injuries is the mainfeature in the MPA associated polyneuropathy.Electrodiagnostic examination indicated axonal lesions in mononeuritis multiplex.Sural nerve biopsies confirmed the active axonal lesions and vasculitis.

OBJECTIVE:To establish the method for the determination of plasma concentration of magnesium isoglycyrrhiz-inate in portal vein and peripheral venous blood of patients underwent liver resection,to further validate and evaluate pharmacoki-netic characteristics,rational and safe use of drugs in the clinic. METHODS:31 patients underwent liver resection in our hospital during Oct. 2014-Mar. 2015 were given magnesium isoglycyrrhizinate intravenously at the beginning of surgery. Portal vein and pe-ripheral venous blood of patients were drawn at 1 hour after drug use,and HPLC-UV detection method was used to determine the plasma concentration of drug. RESULTS:The retention time of isoglycyrrhizinate magnesium was 4.5 min,which showed a good peak shape,and was not interfered with the determination by plasma endogenous peak. The plasma concentration ranged from 0.55 to 55.00 mg/L. The minimum quantitative concentration was 0.55 mg/L. The extraction recoveries were 84.7%-87.1%,and method recoveries were 101.2%-105.4%,and RSDs of intra-day and inter-day were less than 6%. Plasma concentration of magnesium iso-glycyrrhizinate in portal vein blood was significantly higher than in peripheral vein blood of patients underwent liver resection (close to 2 times);and plasma concentration was not affected by primary liver diseases and underlying diseases such as cirrhosis. CONCLUSIONS:The method is simple and has high recovery rate of extraction,high accuracy and high sensitivity. It can meet the needs of pharmacokinetic study. After the application of magnesium isoglycyrrhizinate during liver resection,there is higher blood concentration of magnesium isoglycyrrhizinate in portal vein,which is beneficial to protect liver cells and improve liver func-tion. It is suitable during perioperative period of liver.

BACKGROUND: There is no study on starch/polyvinyl alcohol (PVA) as guided tissue regeneration membranes. The guided tissue regeneration membrane with porous structure were prepared, which combined with the advantages of natural polymer and synthetic polymer. OBJECTIVE: To research the effects of the preparation conditions on the properties of starch/PVA membranes. METHODS: The porous membranes of guiding tissue regeneration were prepared mainly by starch and PVA through solution mixing, casting, freezing and drying. The effects of the mass ratio of PVA and starch, solution concentration, and pre-freezing temperature on the properties of the membrane were researched. The surface morphology, tensile strength, porous ratio, water absorbance and cell cytotoxicity were characterized. RESULTS AND CONCLUSION: The aperture of the membrane was 1-50 μm, the porosity was 60%-70%, and the tensile strength was 12-26 MPa. And this membrane had the excellent biocompatibility and hydrophilicity. The pores in the surface were evenly distributed with the solution concentration of 5% and the pre-freezing temperature of -30℃. The more content of starch was, and the larger of the aperture was.

In order to compare the difference of cyp2e1 gene expression between patients with hepatic cirrhosis and obstructive jaundice,and to investigate the pharmacologic significance behind this difference,liver samples were obtained from patients undergoing hepatic surgery with hepatic cirrhosis( n =7),obstructive jaundice( n =6) and normal tissue of hepatic angioma (controls, n =6). Total hepatic RNA were extracted using the one step method, cyp2e1 cDNA probe prepared by primer randomly marked method, and difference of cyp2e1 expression was compared among patients by Northern blotting.Compared with control group, the expressions of cyp2e1 in liver tissue among patients with obstructive jaundice were evidently reduced, while expression of this gene in cirrhosis liver was unaltered. CYP2E1 isoenzyme encoded by cyp2e1 decreased among patients with obstructive jaundice as expression of cyp2e1 gene significantly reduced, liver ability for metabolism of inhalant anesthetics declined consequently, under some special conditions, hepato nephric toxicity of anesthetics might be aggravated.

Objective To investigate the clinical, electrophysiological and pathological features of critical illness polyneuropathy and myopathy (CIPNM). Methods The clinical outcomes, electromyogram Results as well as pathological features in nerves and muscles of 3 patients with CIPNM were investigated and analyzed. Results 3 patients were all provided with assisted respiration after tracheal intubation. 7～10 d after intubation, all the patients emerged muscle strength and tendon reflexes of extremities weakening; while 14 days after that, 2 patients appeared amyotrophy of extremities. Electromyogram showed that the conduction of many motor and sensory nerves for extremities decreased, while the amplitude of compound muscle action potential (CMAP) of part of motor nerves decreased. Biopsy for nerves revealed decreased medullated nerve fibers and regeneration phenomenon of auxiliary fibers; while that for muscles showed neuralgic damage and myopathy-like changes. Conclusion CIPNM can complicate after tracheal intubation. The electrophysiological and pathological examinations for nerves and muscles can be helpful for the diagnosis.

BACKGROUND: The strength and elasticity of general starch can be enhanced dramatically after plastic blends. The major characters of this material are magnitude molecular weight, many enwinded points, extreme containment of small molecules,and great gelation ability. It can be used as a biodegradable replacement of alginate. Furthermore, by adding osteoinductive factors, thermoplastics starch (TP) can be used as an organic engineering material, which can provide dual functions:anti-bleeding and bone formation. TP can also be used as intraoral tissue formation membrane and burn dressings.OBJECTIVE: To evaluate the bio-safety of TP through a cytotoxicity test.DESIGN: A controlled observation.SETTING: Beijing Research Institute of Traumatology and Orthopaedics; Beijing Jishuitan Hospital; Beijing University of Chemical Technology; Peking Univesity School of Stomatology.MATERIALS: The experiment was conducted at the laboratory of Beijing Research Institute of Traumatology and Orthopaedics from April to October in 2006. TP sample was obtained by plasticization of corn starch (12 wt % water content) with glycerol in a Haake Rhenmix at 110℃ and with 80 rounds per minute for 25 minutes, elongation at break from 115.3% to 245.3%. It was prepared by Beijing Key Laboratory for Preparation and Processing of Novel Polymeric Materials, Beijing University of Chemical Technology. Mouse fibroblast L-929 cell strain was provided by the cell bank of Peking University Health Science Center.METHODS: 1 × 107 L-1 cell aqueous suspension was cultured into leaching liquor ( 50% ), serving for TP group, and routine culture medium served for negative control group. Effect of TP on relative growth rate of L-929 cell strain was quantitatively measured by MTI" assay. The cytotoxicity of TP was evaluated according to GB/T16175-1996. Morphological changes and proliferation of cells were observed after2, 4, and 7 days of culture in the medium through an inverted phase contrast microscope.MAIN OUTCOME MEASURES: Cytotoxicity, morphological changes and proliferation of cells, and cell relative growth rate.RESULTS: Cytotoxicity: After 2 and 4 days of incubation, the absorbance (A) value was lower in the TP group than in the negative control group. After 7 days of incubation, the A value was significantly higher compared to negative control group (P＜0.01). It indicated that after 2 and 4 days of incubation, the cytotoxicity in the TP group was larger than in the negative control group, while after 7 days of incubation, it was on the opposite. All the test time, TP's cytotoxicity grade ranged from 0 to 1. Morphological change and proliferation of cells: After 2 days of incubation, both groups of cells were not extended to the outside of the scope, with a majority shape of being round, triangle, and quadrangle in the TP group or fusiform cells in the negative control respectively. Four days later, there were gaps among cells in the TP group, while in the negative control group, there were hardly any distance between cells and some cells piled up. Seven days later, cells in starch medium suddenly grew up to such a degree that all the cells lapped over and presented with more bloom than the negative control. Cell relative growth rate: After 2, 4, and 7 days of incubation, relative growth rate increased with time, being 85.63%,82.22%, and 113.05%, respectively.CONCLUSION: TP has no evidence of cytotoxicity and has good bio-safety.

Objective: To explore the utilization and effects of informatization in perfecting the community health service mode. Method:Through purposive sampling, 12 community health service centers in Beijing, Shang-hai, Chengdu, and Zhengzhou were selected for site investigation. The heads of the health administrative department and community health service centers were interviewed, with a focus on the construction and utilization of the local community health informatization and a discussion of the role of informatization in perfecting the community health service mode. Results:The information systems can be divided into core systems, core auxiliary systems, and periph-eral support systems. Informatization provides strong support to perfecting the community health service mode in opti-mizing the service process, improving work efficiency, strengthening institutional cooperation, promoting quality regu-lation, optimizing performance appraisal, and strengthening doctor-patient interaction. Conclusion: Informatization plays a key role in perfecting the community health service mode. Recommendations were proposed to strengthen community health informatization construction and utilization:optimizing service processes, promoting the efficient co-ordination of safe health services, optimizing performance appraisals, and strengthening doctor-patient interaction.

Objective:To analyze the concerning guarantee mechanisms during the transformation of the com-munity health service mode. Method:Purposive sampling was adopted. Twelve community health service centers in Beijing, Shanghai, Zhengzhou, and Chengdu, where the transformation of the community health service mode was pi-loted earlier and representative, were selected as the field survey sites. The qualitative method was used to collect da-ta accompanied by the quantitative method. Results: The guarantee mechanisms related to the transformation of the community health service mode could be concluded into four main types:collaboration mechanism, health profession-al training mechanism, incentive mechanism, and policy guarantee mechanism. All of the four mechanisms contribu-ted to the improvement of general teamwork, dual referral systems, and the development of contract and appointment services. Conclusion:During the transformation of the community health service mode, priority strategies include top-down design, health professional training mechanisms, and performance-based incentive mechanism, all of which should be implemented in the future.