Objective To investigate the significance of antifilaggrin autoantibodies (AFA) in rheumatoid arthritis (RA).Methods Filaggrin was extracted from the skin of the patients who had breast cancer undergoing mammectomy.AFA were detected at the sera titer 1∶10 with Western blotting,and its clinical significance was investigated with the corresponding clinical materials.Results Antifilaggrin autoantibodies (AFA) were detected in 39 9%(71/178) of RA patients,and 6 cases of control group,with a specificity of 0 969.AFA were present in 48 4%(15/31) of the early and 29 2% of seronegative RA.AFA positive patients exhibited higher frequency of Sjgren′s syndrome;The average and onset ages of AFA positive patients were older than those of the negative ones,and there was correlation between AFA and age.The frequency and average titer of RF patients were higher in AFA positive than in negative ones.AFA was significantly correlated to RF,AKA and APF.Conclusion AFA are valuable diagnostic parameter for RA,especially in the early and seronegative RA.AFA is significantly correlated to AKA and APF,but they are not totally overlapped,None of the three antigens used bear all the epitopes recognised by antifilaggrin autoantibodies.Immunoblot detection of AFA,a simple and reliable test,may be complement to conventional IIF detection of AKA and APF.

Objective: To explore the role of clinical pharmacists in the treatment of artial fibrillation complicated with digoxin poisoning and the entry points of pharmaceutical care.Methods: Clinical pharmacists participated in the therapy for a patient with atrial fibrillation and digoxin poisoning, monitored the blood concentration of digoxin combined with the characteristics of the patient, analyzed the causes of digoxin poisoning in terms of the underlying diseases, renal function and combined medication, and performed beneficial pharmaceutical care.Results: The suggestions of clinical pharmacists were adopted by doctors, digoxin was withdrawn timely and the drug poisoning was corrected.

Objective To investigate the best pathway and safety of sacroiliac joint (SIJ) puncture.Methods The anticorrosive adult specimens were frozen after SIJ CT scan.Horizontal or coronary sectioning was done.The horizontal sectioning was done corresponding to CT scan.The structures of different sections were observed and compared with the corresponding CT scans.Results According to the horizontal sectioning,the SIJ included synovial portion and ligamentous portion.As shown by CT,only part of the space between sacrum and ilium was the synovial portion,which occupied the whole part of the lower 1/3 segment SIJ,and the posterior was not covered with bones.There are no important nerves and blood vessels passing through the route from the buttock to the posterior of SIJ.Thus,the pathway can be regarded as the best and safe one although the lumbosacral trunk and iliac blood vessels go through the anterior of SIJ in the pelvis.Conclusion The best pathway of SIJ puncture is the upper part of the lower 1/3 segment.The safety of puncture depends on not penetrating the pelvic cavity to avoid damaging the structures in pelvis.

Objective To evaluate the effectiveness of transurethral holmium laser treatment for multiple complex bladder pathological changes.Methods Clinical data of 507 cases of transurethral holmium laser resection for multiple complex bladder pathological changes under endoscope from 2001 to 2005 were retrospectively reviewed.A total of 17 types of bladder pathological changes were encountered,and 2 or more types of pathological changes occurred simultaneously in 111 cases,including 36 cases of 3 types of coexisting changes.Results Primary operation was performed in 505 patients,and two-stage operation was performed in 2 patients.The operation time was 5~35 min(mean,20 min).No obturator nerve reflex and other complications were seen.The operation was accomplished in 3 patients with cardiac pacemaker and 3 patients with coronary stent.Follow-up examinations in all the cases for 12~24 months revealed no relapse.Conclusions Transurethral holmium laser resection for multiple complex bladder pathological changes is safe and reliable.During the procedure,the degree of resection depth in the bladder wall can be precisely controlled.It can be used as the first choice for minimally invasive treatment of multiple complex bladder pathological changes.

Objective To study the diagnos tic value of mammography, color Dopp ler ultrasound and biopsy in early breast cancer and to evaluate its diagnostic accuracy. Methods 55 patients with breast cancer an d 25 patients with benign breast masses, proved pathologically, were checked by mammogra phy, color Doppler ultrasound and biopsy. Results Mammography demonstrated bre ast cancer in 45 cases, the sensitivity and specificity were 82.0% and 88.0%, re spectively, with the accuracy of 83.8%; Color Doppler ultrasound revealed breas t cancer in 43 cases, the sensitivity, specificity and accuracy were 78.2%, 84 .0% and 80.0%; Biopsy demonstrated breast cancer in 53 cases, the sensitivity, specificity and accuracy were 96.4%, 92.0% and 95.0%. When ultrasound, mammagrap hy and biopsy were combined together, the sensitivity, specificity and accuracy were 98.2%, 96.0% and 97.5%. Conclusion Mammography, color Dopp ler ultrasound combined with biopsy can increase the diagnostic sensitivity and accuracy of ear ly breast cancers.

Objective To investigate the epidemic situation and trend of brucellosis in Jinzhong City of Shanxi Province,and to provide a basis for formulating prevention and control measures.Methods Surveillance datas of human brucellosis in Jinzhong City from 2008 to 2012 were collected throng the national network straight quote system of infectious diseases and the centers for disease control and prevention of counties(districts,cities).Descriptive epidemiological method was used to analyze the distributions of region,time and population of brucellosis.Results A total of 3 627 cases were infected with brucellosis in Jinzhong City from 2008 to 2012,and the incidence of brucellosis was increased from 19.63 per 100 000 to 28.46 per 100 000.All counties(districts or cities) had reported epidemic from 2008 to 2012.The onset time focused on March-July each year,with obvious seasonal periodicity.The ratio of male to female was 5 ∶ 1.The ages were in 35-＜ 65 years old,accounting for 74.00％(2 684/3 627).Brucella infections were given priority to farmers and herdsmen,accounted for 93.63％ (3 396/3 627).Conclusions The epidemic of human brucellosis in Jinzhong City is in a spreading trend.Surveillance,timely analysis and report of the epidemic,health education,and inter-departments cooperation are in need to conduct in order to control the spread of epidemic.

Objective To evaluate the role and surgical curative effect of the holmium laser under minor-caliber ureteroscope (F4.5) for the treatment of incarcerated ureteral calculus. Methods The holmium laser under minor-caliber ureteroscope (F4.5) was used to treat the incarcerated ureteral calculus with the course more than 2 months in 286 cases (334 sides) . Results 262 patients (304 sides) were successful in operation of single cavity treatment, with success rate of 91.6%. Conclusion Long course incarcerated ureteral calculus often associated with ureteral obstruction lesions (narrow,polyp,granulation hyperplasia,ureter cyst,etc.). Compared with thick ureteroscopy, minor-caliber ureteroscope has high single success rate for the treatment of incarcerated ureteral calculus with high safety, less complications, high gravel and platoon stone rates, and simultaneous treatment of the ureteral obstruction lesions.

In order to deepen the reform of public hospitals,Beijing Tongren Hospital has carried out the pilot effort of famous experts team service model in out-patient,established a new mode of interior hierarchical medical services in the hospital.Through the adjustment of outpatient service process and the change of service model,issues of difficult medical treatment and ticket scalpers were solved.The reform has achieved the optimal utilization of outpatient resources inside the hospital,has been the beneficial exploration and practice of hospital internal hierarchical diagnosis and treatment,truly reflected the hospital service concept of taking the patient as the center,and has laid a solid foundation for the future widely hierarchical diagnosis and treatment mode.

AIM:To observe the effects of liraglutide on the level of microRNA-33 (miR-33) and the expres-sion of AMP-activated protein kinase ( AMPK ) and apoptosis-related proteins in mice with type 2 diabetes mellitus (T2DM), and to explore its possible mechanism .METHODS:High-fat diet and intraperitoneal injection of streptozocin were used to establish the type 2 diabetic model in C57BL/6 mice.The mice were randomly divided into 4 groups ( n=15 ):in control group , the normal mice were subcutaneously injected with equivalent volume of saline ;in model group , the T2DM mice were subcutaneously injected with equivalent volume of saline ; in low-and high-dose liraglutide treatment groups, the T2DM mice were subcutaneously injected with 100 and 200 μg? kg -1? d-1, respectively.After 4 weeks of administration, the levels of FBG, TG, TC, HDL-C, LDL-C, ALT and AST were determined.HE staining was used to ob-serve the pathological changes of the liver tissues .The protein level of cleaved caspase-3 in the liver tissue was detected by the technique of immunofluorescence .The protein levels of p-AMPK/AMPK and apoptosis-related proteins were detected by Western blot .The expression of miR-33 in the liver tissues was detected by real-time PCR.RESULTS: Compared with model group, the contents of FBG, TG, TC, LDL-C, ALT and AST were decreased significantly , while the content of HDL-C was increased significantly in low-dose liraglutide group and high-dose liraglutide group ( P<0.05 ) .The protein levels of phosphorylated AMPK and Bcl-2 were up-regulated significantly , and the expression of cleaved caspase-3 was down-regulated significantly (P<0.05).The level of miR-33 was decreased significantly (P<0.01).CONCLUSION:Liraglutide alleviates liver injury in type 2 diabetic mice , and the mechanism may be associated with reducing the level of miR-33 and increasing the phosphorylation of AMPK in the liver tissues , thereby inhibiting hepatocyte apoptosis .

Objective To establish osteochondral scaffolds with remained calcified cartilage zone for finding an ideal scaffold for tissue engineered repair of osteochondral defect.Methods Cartilage zone was harvested from fresh adult porcine knee to fabricate type Ⅱ collagen hydrogel.Bone blocks measuring 8 mm in diameter with calcified cartilage zone were prepared by trephine and acellular treatment was performed.Histological staining was used to identify complete removal of cells.To fabricate the osteochondral models containing calcified cartilage zone,type Ⅱ collagen was seeded onto the acellular bone blocks with calcified cartilage zone,lyophilized,and cross-linked with 10 g/L of genipin ethanol solution.Then cell seeding and scanning electron microscope were performed after the models were established.Results HE staining,toluidine blue staining,solid green staining,safranin O staining,and DAPI staining showed cells were completely removed from bone blocks by decellularized process.Porosity of type Ⅱ collagen sponge was (91.1 ±3.8) ％ and pore size was (79.7 ± 17.1) μm.Porosity of acellular bone blocks was (73.5 ±2.6)％ and pore size was (470.2 ± 158.8) μm.Cells seeded onto osteochondral scaffolds grew well by scanning electron microscope.Conclusion Osteochondral scaffolds with calcified cartilage zone provide good biocompatibility and suitable pore size and porosity and may be an ideal material for repairing osteochondral defect in tissue engineering.