Objective To discuss the effect of applying midnight-midday ebb-flow acupoint massage to patients of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Selected 60 patients of AECOPD in the respiratory department. They were divided into two groups randomly, the observed group and the compared group, with 30 patients in each group. The compared group applied regular treatment and care, while the observed group combined midnight-midday ebb-flow acupoint and bladder meridian between 3 pm. to 5 pm. The treatment lasted seven days. Compared the evaluation of the patients′main symptoms such as coughs,expectoration,gasp, panting and the changes of PaO2, PaCO2, and SaO2 before and after treatment, and compared the overall efficiency of treatment and average length of stay in hospital. Results After treatment, the ratings of symptoms of the observed group in coughs, expectoration, gasp, panting were (1.51 ± 0.23), (1.12 ± 0.74), (2.05 ± 0.29), (0.25 ± 0.18) points, while the compared group were (2.41 ± 0.25), (2.62 ± 0.64), (3.66 ± 0.24), (2.24 ± 0.32) points. The difference in two groups was valid in terms of statistics (t=2.884-4.147, P<0.05). After treatment, the index of PaO2,PaCO2,and SaO2 in the observed group were (80.80 ± 2.16) mmHg (1 mmHg=0.133 kPa), (50.38 ± 6.67) mmHg,0.982 ± 0.014. The compared group was (71.38 ± 1.24) mmHg, (58.42 ± 4.89) mmHg, 0.873±0.027.The difference was valid in terms of statistics (t=2.358, 3.543, 4.152, P<0.05);the overall efficiency of the the observed group was 93.3%, and the compared group was 83.3%. The difference was valid in terms of statistics (χ2=2.466, P<0.05);in terms of average length of stay in hospital, the observed group was (11.4 ± 1.8)days, and the compared group was (15.6 ± 2.0) days, and the observed group was apparently lower than the compared group (t=2.694, P<0.05). Conclusions The massage of midnight-midday ebb-flow acupoint massage can relieve the symptoms of patients of AECOPD, improve patients' index in arterial blood gas analysis and care effect, shorten the stay in hospital and better the life quality.

Objective By comparing the proliferation and the human telomerase reverse transcriptase expression of bone marrow mesenchymal stem cells (BMSCs) from rheumatoid arthritis (RA) patients and normal human to explore the existence of BMSCs defects or variation in RA patients,and whether these cells could be used in autologous transplantation.Methods BMSCs were obtained from bone marrow of eight RA patients and healthy volunteers.The cells were isolated andcultured by gradient centrifugation and adherence cultivation,and the surface markers of BMSCs were identitfied by flow cytometertry.Firstly,BMSCs reproductive activity of the two groups were compared:the auxodrome and cell cycle of BMSCs were measured respectively,then the generation doubling time of cell colony and proliferation index were calculated in order to see whether there was a difference of the proliferation capability between the two groups.Furthermore,the hTERT were measured.Results BMSCs were no significant differences between morphology of RA patients and healthy control group.The cells were obtained proof MSCs by flow cytometry.The difference was not statistically significant (P＞0.05),RA group and the healthy control group P3-generation cell population doubling time (4.7±0.3) d,(4.8±0.3) d.The difference was statistically significant (P＜0.01),P6 generation of healthy control group cell population has doubling time (5.7±0.4) d,RA group (6.3±0.3) d,buut the group RA BMSCs population doubling time is longer than the healthy control group.The difference was not statistically significant (P＞0.05),on one hand of the healthy control group P3 BMSCs proliferation index (17.9±2.1)％,on the other hand RA group is (16.9±2.1)％.The difference was statistically significant (P＜0.01).P6-generation BMSCs proliferation index in healthy control group (10.7±1.8)％,RA group (6.2±2.2)％,RA group proliferation index than the control group.The difference was also significant (P＜0.01).The healthy control group P6 generation of MSCs hTERT expression was (10.6±1.5),RA group is (3.1±1.0),hTERT RA patients expression is lower compared with normal control group.Conclusion There is no significant difference in the proliferative capacity of the two groups at P3,but the BMSCs proliferation at P6 lags behind in the normal group in RA patients,which inferred that the senescences of the BMSCs of RA patients are earlier than healthy donors.The determination results of hTERT have shown that the difference between the two groups is statistically significant,and it proves that the premature aging may be associated with hTERT expression.

Objective To optimize the extracting technology of total flavones in powder of Fagopyrum tataricum stem and leaf by enzymatic treatment. Methods The powder was treated by cellulase before extracted using water, the effects of enzyme dosage, treatment temperature, treatment time, and pH value on the extract rate of total flavones were studied. Results The optimum extracting technology was as follows: enzymatic treatment temperature: 55℃, enzyme dosage: 3.0 ?L, pH value: 6.5, treatment time: 90 min, extracting 3 times at: 90℃ for 30 min once. The extract rate of total flavones was 1.47% by this technology. Conclusion Cellulase could be applied in the assisstant extraction of total flavones in powder of F. tataricum stem and leaf.

Objective To investigate the differences in clinical, laboratory and therapeutic aspects of primary Sjogren's syndrome (pSS) between young/middle-age group and old group.Methods The 84 pSS patients were divided into the young and middle-age group (n=54) and the old group (n = 30). The differences in clinical features, laboratory indices and drug therapy were retrospectively analyzed. The chi-square test was used for statistical analysis. Results The positive incidences of xerostomia, dry eye symptom and rampant teeth were 80.0%, 76.7% and 43.3%respectively in the old group. And they were all significantly higher than in young and middle-aged group (57.4%, 51.9% and 20.4%, all P＜0. 05). The positive rates of rheumatoid factor (RF)elevation, antiRo/SSA and antiLa/SSB antibodies were 13. 0%, 36.7% and 16.7% in the old group,and significantly lower than in young and middle-age group (44.4%, 59.3% and 42.6%, all P＜0.05). The incidences of leukopenia and thyroid gland involvement were much lower in the aged group (13.3% and 10.0%) than in the young and middle-age group (48. 1% and 37.0%, P＜0. 05). The percentage of patients receiving hydroxychloroquine as the main medicine was much lower in the aged group than in the young and middle-age group (16.7% vs. 40. 7%, P＜0. 05), while percentage of treatment with exclusive glucosides of Paeony Capsules was much higher (33.3% vs. 14.8%, P＜0.05). There were no statistical differences between two groups in ophthalmological examination,immunoglobulin level and sialography. Conclusions Those pSS patients with late onset exhibit more abnormalities in clinical parameters, but fewer in immunological parameters, which may be helpful in estimating prognosis and pathogenetic factors in pSS.

Objective To evaluate the clinical efficacy and safety of methotrexate(MTX),cyclophosphamide(CTX)and MTX plus CTX in patients with active rheumatoid arthritis(RA).Methods In a randomized,single-blinded,controlled study,90 patients were randomly assigned to receive MTX(10～15 mg/w)or CTX(400 mg/2～3 w)or MTX plus CTX(MTX 10～15 mg/w+CTX 400 mg/2～3 w).The primary end point was the proportion of patients meeting the American College of Rheumatology 20% improvement criteria(achieving an ACR20 response,)at week 24.The secondary end points were responses of the ACR50 and ACR70 improvement criteria,and the European League Against Rheumatism(EULAR)response criteria.The change from baseline in duration of pain,patient's global assessment,physician's global assessment,tender joint count/index,swollen joint count/index,health assessment questionnaire(HAQ),erythrocyte sedimentation rate(ESR)were also evaluated.The clinical efficacy and safety were analyzed at baseline,6,12 and 24 weeks respectively.Results The ACR response rate was significantly higher in the MTX plus CTX treatment group compared with MTX or CTX group at week 24.The MTX plus CTX group,MTX group and CTX group showed 81%,56% and 35% in ACR20,58%,41% and 12% in ACR50 and 19%,11% and 0 in ACR70,.respectively.At week 24,the proportion of patients achieving the EULAR moderate response in those who received combination treatment were significantly higher than those who received either MTX or CTX.The incidence of adverse events(AEs)was not significantly higher in MTX plus CTX group than MTX or CTX group.Conclusion MTX plus CTX effectively reduces the signs and symptoms of RA and is generally well tolerated by patients without significant increase in the rate of adverse events compared with monotherapy.

Objective To measure serum surfactant protein (SP) A and D levels in patients with interstitial lung disease associated with rheumatoid arthritis (RA).Methods Serum SP-A and SP-D levels of RA,RA-ILD patients and healthy controls were assessed using a sensitive enzyme-linked immunosorbent assay (ELISA).The relationship between SP-A and SP-D and RA-ILD was analyzed.The serum SP-A and SP-Dpositive rate was calculated for the three groups.The correlation between SP-A and SP-D with RF,anti-CCP,antinuclear antibody,antikeratin antibody,anti-perinuclear factor,C-reactive protein,erythrocyte sedimentation rate,were analyzed.Mean value of groups were compared with variance analysis,Spearmam rank correlation test was used for correlation analysis.Results The levels of serum SP-A in RA-ILD patients and RA patients as well as in healthy controls were [ (51.2±9.2),(25.9±2.6),( 15A±0.3 ) μg/L] respectively.The level of serum SP-D of the three groups was [ ( 42.5 ±8.1 ),(20.8 ± 1.5 ),( 16.6±0.8 ) μg/L ] respectively.The levels of serum SP-A and SP-D in patients with RA complicated with ILD were higher than those simple RA patients and healthy controls (P＜0.05).The levels of serum SP-A and SP-D in patients with RA were not significantly higher than those in healthy controls (P＞0.05).The positive rate of serum SP-A and SP-D in RA-ILD patients were significantly higher than those in simple RA patients and healthy controls.The positive rate of serum SP-D of RA-ILD patients was higher than that of SP-A.The levels of serum SP-A and SP-D in patients with RA complicated with ILD were correlated positively with age,C-reactive protein.The level of serum SP-D was correlated positively with RF,anti-CCP,antikeratin antibody.There was no correlation between the level of serum SP-A and SP-D with RA-ILD and antinuclear antibody,antiperinuclear factor,erythrocyte sedimentation rate.Conclusion The levels of serum SP-A and SP-D are correlated with RA-ILD and may be useful markers for ILD in patients with RA.These two paramenters may be helpful to early diagnosis of RA-ILD.The Serum SP-D levels are more sensitive in predicting the development of RA-ILD than other parameters and can help in assessing the severity of lung damage.

Objective To investigate the prevalence of fatigue in rheumatoid arthritis (RA) and its relationship with other clinical and functional parameters used for the evaluation of disease activity and health related quality of life. Methods The fatigue was assessed in 230 patients with RA using visual analogue scale (VAS). The correlation between fatigue and the clinical disease activity including morning stiffness, pain, PGA, physician's global assessment, TJC, TJI, SJC, SJI, DAS28, HAQ and health-related quality of life were assessed. Results The prevalence of fatigue was 85.7% and the fatigue score of 51.7% patients was higher than 50 mm. After controlled for the possible confounding factors such as age, gender and disease duration, it was found that fatigue was highly correlated with pain, disease activity, functional disability, physical health and mental health. Conclusion Fatigue is an important symptom of RA and is correlated with pain, disease activity, functional disability and health-related quality of life.

Objective To assess the value of echo tracking(ET) technique on atherosclerosis in the rabbit models, and to probe the pathological foundation of its indexes changes and the usefulness in evaluating arterial elasticity. Methods Thirty New Zealand rabbits were divided into 3 groups randomly: group A was the control group;group B,C were fed with high lipid feedstuffs for 8 weeks and 12 weeks, respectively. The ET examination of abdominal aorta was performed in group A and group B at the end of 8 weeks,it was performed in group A and group C at the end of 12 weeks. The parameters of elasticity were measured including pressure-strain elastic modulus (Ep), stiffness parameters(β), pulse wave velocity (PWVβ), augmentation index (AI), arterial compliance (AC), etc. Two dimensional ultrasound and pathological examination of abdominal aorta were performed at the same time. Results No obvious plaque and arterial wall thickness were seen in the abdominal aorta. Ep,β,PWVβ of group C were higher than that of group A and B, while AC of group C was lower than that of group A and B, and the difference had statistical significance (P<0.05). AI had no significant difference in all groups (P>0.05). Pathological examinations indicated that foam cell formation was seen in the abdominal aorta intima, the elastic fiber layer and smooth muscle layer were kept well in B group. Lots of cholesterol crystal formation was seen in the abdominal aorta intima and the two layer were obvious destroyed in group C. Conclusions ET can detect the atherosclerosis earlier than two-dimensional ultrasound. ET can detect the elasticity changes only when the elastic fiber layer and smooth muscle layer were destroyed . So it can be concluded that the destroy of elastic fiber layer and smooth muscle layer may be the pathological foundation of ET elasticity parameters changes.

Objective To analyze the quality of life of patients with active rheumatoid arthritis (RA) and its relationship with other clinical and functional parameters used for the evaluation of disease activity. Methods The quality of life was assessed in 127 patients with active RA using SF-36 and was compared with non-active RA and the general population. The correlation between the quality of life and the clinical measures of disease, including morning stiffness, pain, fatigue, patient's global assessment (PGA) physician's global assessment , SJC/SJ1, TJC/TJI, DAS28, HAQ were measured. Results The patients with active RA reported significantly decreased scores in all dimensions of SF-36. Fatigue, PGA, physician's global assess-ment, DAS28 and HAQ significantly correlated with the scores in all dimensions of SF-36. Pain was correlated with the scores in all dimensions of SF-36 except RE. TJI was correlated with six dimensions. TJC was correlated with five dimensions. ESR was correlated with three dimensions. Conclusion The quality of life in patients with active RA is significantly declined compared with non-active RA and the general population. Disease activity and functional status of patients with active RA is closely correlated with the quality of life.

Objective To study the clinical characteristics and prognosis of interstitial lung disease (ILD) associated with polymyositis (PM) and dermatomyositis (DM). Methods The clinical data of 107 DM related ILD,and its frequency rate was 26.2%. Arthritis as the first symptom had a higher presenting rate in patients with ILD than in patients with non- ILD. Arthritis, dry cough and short of breath occurred more dyspnea presented in patients with DM-ILD, and there was serious myalgia and muscle weakness in patients More DM-ILD patients had high HBDH and AST than those in PM-ILD. High CK and CK-MB were more The 7 of 8 severe cases had DM-ILD in which 5 died of respiratory failure (death rate was 17.9% in PM/elevated ESR and CRP tend to complicate with ILD. The DM patients who have characteristic skin rashes and high AST level are prone to develop ILD. The PM patients who have high CK and CK-MB are susceptible to