Rheumatism of TCM(Traditional Chinese Medicine) is a kind of clinical frequent,common-see and refractory disease,which owns complex pathogenesis and pathogenic factors,with marginal and multi-disciplinary manifestations.The inconsistency in synopsis results in some di culties in research and impairs the development of clinical treatment.Therefore,it is a utmost important theme before us that how and by which ways to perform researches,also an important premise for normalization research on this disease.We try to explore the thinking and method of scienti c research of rheumatic disease from both basic and clinical aspects in this paper.

Objectives This study was designed to observe the correlation of the levels of serum N-terminal pro-brain natriuretic peptide(NT-proBNP) and high sensitivity C-reactive protein(hs-CRP) between the 3rd day after acute myocardial infarction(AMI) and after 3 months of left ventricular remodeling(LV remodeling) and to establish the predictive levels of NT-proBNP,hs-CRP for LV remodeling after AMI.Methods The blood samples from 106 patients with the first AMI and echocardiography were examined on the 3rd day and after 3 month.LV remodeling was estimated by the changes of left ventricular end-diastolic volume(LVEDV) during the 3rd day and after 3 month.Based on the change of LV remodeling,the 106 patients were divided into two groups:LV remodeling group(defined as the change rate of LVEDV more than 20%) and non-LV remodeling group.Results The correlation coefficients of the change of LVEDV were 0.706 for serum NT-pro BNP and 0.596 for hs-CRP.With a cutoff value of 0.20,the area under the ROC curve(AUCs) was(0.892) for NT-proBNP and 0.825 for hs-CRP.There was no statistically difference between NT-proBNP and hs-CRP.The ROC plot indicated that NT-proBNP was superior to hs-CRP for predicting LV remodeling.Conclusion The level of serum NT-proBNP appropriately reflects LV remodeling after AMI and shows more efficacious than the level of serum hs-CRP.The level of serum NT-proBNP on the 3rd day after AMI and LV remodeling were positively correlated with the level after 3 months.

Objective To investigate the value of echocardiography for assessing the right ventricular function before and af ter treatment in the patients with pulmonary embolism.Methods Ninety-six patients with pulmonary embolism in our hospital from June 2014 to December 2015 were selected as the research subjects and divided into low-risk group,intermediate-risk group and high-risk group according to the disease severity.The echocardiographic examination was performed before and after treatment in all cases.Results The pulmonary artery systolic pressure after treatment in the low-risk group was lower than that before treatment (P＜0.05).The transverse diameter of right ventricle,transverse diameter of right ventricle and pulmonary artery systolic pressure after treatment in the intermediate-risk group and high-risk group were lower than those before treatment (P＜0.05).The Tei index after treatment in the low-risk group,intermediate-risk group and high-risk group was lower than that before treatment (P＜ 0.05).The right ventricle ejection fraction (RVEF),right ventricular end-systolic volume (RVESV) and right ventricular end-dias tolic volume (RVEDV) in the low-risk group had no statistically significant difference between before and after treatment.RVEF after treatment in the intermediate-risk group and high-risk group was higher than that before treatment(P＜0.05),while RVESV and RVEDV after treatment were lower than those before treatment (P＜0.05).Conclusion Echocardiography can objectively re flect the change situation of right heart function before and after treatment in the patients with pulmonary embolism,and can be used as an evaluation method for the effect of pulmonary embolism treatment.

Objective To observe the influences of different anesthesia methods or adjuvant chemotherapy on hemorheological parameters in patients with cervical cancer.Methods Sixty pa-tients with cervical cancer were equally randomized into two groups.Patients in group A received three courses of chemotherapy preoperatively while those in group B did not.The patients of group A and B were divided respectively into two subgroups,combined epidural general anesthesia group (groups A1 and B1),general anesthesia group (group A2 and B2).Blood samples were taken for the hemorheological measurement at 5 min before induction of anesthesia,60 min after induction of anes-thesia and at the end of surgery.Results Red cell deformability index (EDI)was significantly lower in group A than that in group B;Erythrocyte rigidity index (ERI)and blood viscosity were higher in group A compared with those in group B (P <0.05).In groups A1 and B1,EDI,plasmic viscosity packed ERI,and ERI were all lower than those before anesthesia induction (P < 0.01 );while in groups A2 and B2 Hct decreased.Conclusion The patients of cervical cancer after chemotherapy showed some hemorheological changes characterized by a lowered EDI.Combined general and epidural anesthesia can significantly improve the above parameters.

Objective To investigate the changes of plasma free carnitine (FC) concentrations in preterm infants supplemented with L-carnitine, and to provide a reference for routine preterm infants L-carnitine supplements. Methods A total of 99 preterm infants supplemented with 10 mg/(kg·d) L-carnitine on days 2 and 5 after birth, and 65 full term infants from Department of Neonatology, the Fifth People′s Hospital of Dongguan during July 2014 to December 2015 were recruited in this study , and filter-paper blood spots were collected by heel prick on days 1, 3 and 7. FC was measured using electron spray ionization (ESI) tandem mass spectrometry (MS-MS). Results Concentrations of FC decreased steadily from day 1 to day 7 in full term infants , while it remained the same level during the first week after birth as at birth. Additionally, concentrations of FC were significantly higher in preterm infants than full term infants on day 1 after birth. Conclusions The reasonable L-carnitine supplements may keep the levels of plasma FC at the levels at birth , which is important for fatty acid metabolism in preterm infants.

Objective To analyze the magnetic resonance imaging(MRI)features of multiple sclerosis(MS)patients both in the brain and the spinal cord and to explore its relationship with factors such as quality of life,disability of MS patients and so on.Methods A total of 170 MS patients confirmed clinically underwent MRI examination and answered the questionnaires of Multiple Sclerosis Quality Of Life-54 instrument,Expanded Disability Status Scale,Hamilton Anxiety Scale and Hamilton Depression Scale.Results The lesions on brain MRI were usually seen in the white matter around the lateral ventricles,the centrum ovale majus and frontal lobe.The commonly seen length of the single lesions on the spinal cord was as long as that of 1-2 vertebral bodies,but that of the fused lesions was as long as that of 4-5 vertebral bodies.The distribution of the lesions was significantly correlated with the quality of life,the degrees of the disability,anxiety and depression.Conclusion MRI examination is useful for early and better diagnosis of MS and can provide guidance for treatment,and thus can improve the prognosis and the quality of life of patients.

ObjectiveTo evaluate the accuracy and value of the ultrasonography and magnetic resonance imaging (MRI) in the diagnosis of agenesis of the corpus callosum in the newborns.MethodsConventional cerebral ultrasound screening was performed in 8086 newborns admitted to NICU in our hospital from January 2012 to June 2014 and agenesis of the corpus callosum was suspected or conifrmed in 31 newborns. The diagnostic accuracy of ultrasonography was assessed through the com-parison between the results of ultrasonography and MRI.ResultsIn 31 cases with suspected agenesis of the corpus callosum, ultrasonography showed 14 cases of complete agenesis of which 13 cases had the same diagnosis with MRI except one case of partial agenesis, meanwhile, ultrasonography showed 16 cases of partial agenesis of which 15 cases had the same diagnosis with MRI except one case of complete agenesis. One case of abnormal corpus callosum determined by ultrasonography was diagnosed as partial agenesis by MRI. MRI showed there were other brain malformations in 14 cases.ConclusionsUltrasonography and MRI has a high consistency in the diagnosis of agenesis of the corpus callosum in neonates, so the former can be used as a routine screening and the latter can be used as a method of accurate diagnosis. A combination of both has an important role in early diag-nosis and clinical evaluation.

Objective To investigate the relationship between the area of corpus callosum and neurodevelopmental outcomes in very preterm infants.Methods Brain magnetic resonance (MR) images of 106 term infants with gestational age 40 weeks were obtained,which were collected in 24h after birth.Brain MR images of 130 very low birth weight (VLBW) neonates at 40-week gestational age equivalent were successfully obtained.A total of 228 eligible MR images of them were chosen,and divided into the full-term infant group (100 cases) and the premature infant group (128 cases).The whole and sub-regional corpus callosum areas were calculated.The 20-neuromotor examinations were performed at 3 months of corrected gestational age.Results The whole corpus callosum,anterior mid-body,posterior mid-body,isthmus and splenium area in very premature infant group were significantly smaller than those in full-term infant group (P ＜ 0.05),but the differences in genu and rostral body area between two groups was not statistically significant (P ＞ 0.05).The genu area in the abnormal nervimotion group was significantly smaller than that in the normal nervimotion group (P ＜ 0.05),but the differences in the whole corpus callosum,anterior mid-body,posterior mid-body,isthmus,and spleniuvm area between two groups were not statistically significant (P ＞ 0.05).Conclusions The development of very premature infant corpus callosum is affected by prematurity,especially posterior end of corpus callosum.Adverse neurodevelopmental outcomes at 3 months of corrected gestational age may be associated with decreased genu area of corpus callosum in very preterm infants.

Objective To learn the current obstetric beds allocation,obstetric service delivery and access in midwifery institutions at various levels in the localities and nationwide as well as the trends,and assess the equity of obstetric beds allocation,for the purpose of recommending on a reasonable adjustment of obstetric beds allocation in these institutions.Methods Random sampling made in 44 cities in China for questionnaire survey on obstetric beds allocation,service delivery and utilization in 2008～2010 at all midwifery institutions in these cities.Interview of health administrators and medical workers at obstetric of midwifery institutions in 6 counties.Results Every thousand square kilometers in China average 5.9 midwifery institutions,and every thousand people average 0.24 obstetric beds.During 2008 ～ 2010,the number of beds and midwifery service delivery kept a growing trend while in townships obstetric service deliveries maintain a falling trend.The fairness index of maternity beds layout nationwide is 0.021283.Obstetric beds supply and demand ratio in different regions ranges among 0.97～ 1.41.The number of deliveries made in county level hospitals is 54.1％,but the beds in such hospitals account for but 48.1％.Conclusion The equity of obstetric beds allocation is good in terms of population layout.The quantity of obstetric beds meets the current needs nationwide,while the allocation of obstetric beds is less than reasonable among obstetric institutions of various levels in the country.The authors recommend a better control and adjustment of midwifery institutions layout,especially more such hospitals at the township level to meet the need of women delivery in hospital in remote areas.

Objective To make a clinical and mycological analysis of tinea capitis in Guangzhou region. Methods A retrospective analysis was performed on 241 cases of tinea capitis collected from Feb, 1997 to Aug, 2010 in the Department of Dermatology, Sun Yet-sen Memorial Hospital. Results Among the 241 cases, 179 (74.27%) were tinea alba, 34 (14.11%) tinea kerion, 28 (11.62%) black dot ringworm, and no favus was observed. The dominant pathogenic fungi in decreasing order were Microsporum canis (182,80.89%), Trichophyton violaceum (25, 11.11%), Trichophyton mentagrophytes (10, 4.44%), Trichophyton tonsurans (3, 1.33%), Trichophyton rubrum (2, 0.89%), Microsporum gypseum (2, 0.89%) and Trichophyton verrucosum (1, 0.44%). Children were the main population (39.00%) suffering from tinea capitis. Conclusions In Guangzhou region, tinea alba is the most common type of tinea capitis, Microsporum canis is the main causative pathogen, and children are the predominate population affected by tinea capitis.