Objective To explore predictive value of spectra parameter changing of transcranial Doppler (TCD) for intracranial pressure (ICP) and cerebral perfusion pressure (CPP) in patients with intracranial infection. Methods TCD examination was taken before 128 times of lumbar puncture for pressure testing in 42 patients with intracranial infection. Meanwhile, Data of TCD and cerebrospinal fluid (CSF) pressure were recorded for later analysis and compared with control group.Results With ICP increase progressively , the TCD of above patients showed high resistance spectra, waveform sharpened, peak systolic velocity (Vs) without significant change while in end diastolic velocity (Vd) decreased and pulsatility index (PI) increased.Compared with control group, their blood flow velocity significantly increased.According to the TCD parameter and stepwise regression equations, predicted ICP and CPP ( ICPe and CPPe) were positive correlated with actual ICP and CPP (r=0.594,0.910, allP

Objective The aim of this study was to evaluate the diagnostic value of thyroglobulin(Tg)mRNA in peripheral blood samples of patients with differentiated thyroid carcinoma(DTC)after remnant ablation.Methods Tg mRNA Was detected by reverse transcription-polymerase chain reaction(RT-PCR)in peripheral blood of 162 patients.SPSS 13.0 was used for date analysis.Results The Tg mRNA assay had higher sensitivity than the conventional serum Tg measurement[86.61%(97/112)vs 53.57%(60/112),X2=29.153,P＜0.001]which Was the"gold standard"for the identification of recurrence or metastases.In the anti-Tg antibodies(TgAb)positive DTC patients,the sensitivity of Tg mRNA was higher than that of serum Tg[86.54%(45/52)vs 0]in identifying recurrent or metastatic thyroid disease(X2=79.322,P＜0.001).There was a significantly positive correlation between Tg mRNA expression and the clinical stages(Kendall correlation coefficient=0.515,P＜0.001).There was no difference of Tg mRNA expression in peripheral blood among ages,sex,pathological types and location of metastases,respectively(Kendall correlation coefficient=0.020,0.069,0.050 and 0.028;all P＞0.05).Conclusions Circulating Tg mRNA is a more sensitive marker than serum Tg in identifying recurrent or metastatic DTC,particulady in patients during levo-thyroxine(l-T4)therapy and with TgAb-positive.The DTC patients who have positive expression of Tg mRNA indicates poor prognosis.

Objective To compare the characteristics of MRI, CT, single photon emission computed tomography(SPECT) and transcranial Doppler sonography(TCD) in patients with spongiform leukoencephalopathy after inhaling heroin vapor. Methods Seventeen patients were investigated. MRI or CT was scanned in 17 patients, SPECT in 9 patients′ and TCD in 11 patients. Results MRI or CT: Brain MRI and CT revealed extensive symmetric white matter involvement of bilateral cerebral and cerebellar hemispheres and the brainstem.The lesions, which showed no contrast enhancement, were hypodense on CT and hypointense on T 1 weighted and hyperintense on T 2 weighted MRI. SPECT: The regional cerebral blood flows(rCBF) of white matter involvement on bilateral cerebral and cerebellar hemispheres was reduced obviously. The rCBF of temporal lobes, parietal lobes, occipital lobes, cerebellar hemispheres, and basal ganglion was reduced in varying degrees. TCD: The systolic peak became sharpened, and end diastolic flow velocity and mean flow velocity were reduced obviously and pulsatility index was increased markedly in patients with spongiform leukoencephalopathy after inhaling heroin vapor. Conclusion The characteristic manifestations of MRI and CT imaging may be regarded as the main foundation of diagnosing spongiform leukoencephalopathy after inhaling heroin vapor; SPECT and TCD can help comprehend the changes of hemodynamics of cerebral vessels and the degree of cerebral ischemia in patients with spongiform leukoencephalopathy after inhaling heroin vapor.

Objective To study the effects of vitamin E(VitE) on TNF-?,IL-1? and nitric oxide(NO) secretion from human monocytes stimulated by advanced glycation end products.Methods Human peripheral blood monocytes(PBMCs) from 20 hemodialysis(HD) patients and 15 normal volunteers were isolated.These PBMCs were cultured in vitro with advanced glycation end products(AGE) and vitamin E.All of these PBMCs were divided into control group,AGE-inducing group,different doses VitE group and different culture VitE group.The levels of TNF-? and IL-1? in supernatants were detected by ELISA.The levels of NO were detected by biochemical method.Results The basal secretion of TNF-?,IL-1? in monocytes from HD patients was more than those from normal volunteers.AGE induced significantly more secretion of TNF-? and IL-1?(P

Objective The techniques and early effect of perendoscopic intrasphincteric injection of botulinum toxin (BTXA) for achalasia was introduced and evaluated. Methods 13 patients with achalasia were enrolled in the study.Symptom scoring ( modified ) and esophagography ( measuring cardiac opening,height and width of contrast media retention in 5 minutes ) were performed before and one week after treatment.1 ml of BTXA (20 u) was injected endoscopically at a point of every quadrant (4 points) situated 0.5 cm above the dentate line into the lower esophageal sphincter. Results The symptoms improved remarkably the next day as chest pain,frequency and seriousness of dysphagia and regurgitation declined significantly (P

Objective To study the effect of cortisol and dehydroepiandrosterone sulfate(DHEA S)in fetal umbilical cord blood on term labor. Methods Cortisol and DHEA S concentrations were measured By radioimmunoassay in 100 term fetal umbilical cord blood. They were divided into four groups. Group A selective cesarean section without any birth pain ( n =18),Group B cesarean section in latent phase( n =10),Group C cesarean section in active phase( n =12),Group D spontaneous vaginal deliver( n =60). Results The concentrations of fetal umbilical cord cortisol in spontaneous vaginal deliver group was gradually increased with gestational week. The peak level was in the 39th gestation week,by the 42th gestation week,the concentration of cortisol declined to the 37th gestation week. DHEA S changed paralleled with cortisol ( r =0.46, P

Objective To evaluate the clinical significance of serum thyroglobulin autoantibody(TGAb) in thyroglobulin(TG)-negative and TGAb-positive patients with differentiated thyroid carcinoma(DTC)after thyroid ablation and ascertain the optimal operating point(OOP)of TGAb.Methods A total of 169 patients with histologically confirmed DTC and thyroid remnant ablation showed TG-negative and TGAb-positive results which were assessed by electrochemiluminescence immunoassay(ECLIA).The cases were divided into group A(59 cases)and group B(110 cases)with or without evidence of recurrence or metastasis,respectively.The receiver operating characteristic(ROC)curve and positive likelihood ratio of different threshold values were analysed according to their serum TGAb level.Results Serum TGAb level(1368?1343)IU/ml in group A was significantly higher than that(154?539)IU/ml in group B(P1000 IU/ml was 1.12 times that of 204 IU/ml≤TGAb≤1000 IU/ml,4.03 times that of 100 IU/ml≤TGAb

Objective:To observe the analgesic effect and nursing intervention of pulse epidural controlled analgesia on uterine contraction pain after cesarean section.Methods:A total of 100 cases of parturient with patient-controlled epidural analgesia after elective cesarean section in Central Theater General Hospital of the Chinese People's Liberation Army from January to March 2019 were selected as study subjects, and 100 cases were divided into observation group and control group, each group of 50 cases, the control group used constant speed epidural patient-controlled analgesia, the observation group used pulse epidural patient-controlled analgesia. The analgesic effect of uterine contraction pain after cesarean section was observed, at the same time, the two groups conducted a simulation test, the speed, time and infiltration area of the pumping liquid were recorded, and the Visual Analogue Scale (VAS) scores of incision pain and uterine contraction pain were recorded at 6 h, 12 h, 24 h and 48 h postoperatively. VAS score of contraction pain after single press, Motor Block score of iatrogenic uterine pain were recorded on the postoperative day, the first day and the second day after operation.The times of additional dose compression by analgesia pump, the times of incomplete analgesia intervention, nausea and vomiting, skin itching and other adverse reactions were recorded within 2 days after operation.Results:The infiltration area at 1, 5 min were (130.00±14.14), (334.00±2.83) cm 2 in the observation group and (65.00±7.07), (137.50±3.54) cm 2 in the control group, there were significant differences between the two groups( t values were 5.814, 61.376, P< 0.05 or 0.01). VAS scores of incision pain at 6 h and 12 h after operation were (2.36±1.05) and (2.42±0.95) in the observation group and (3.52±1.09) and (3.16±1.25) in the control group, respectively, there were significant differences between the two groups( t values were 5.425, 3.331, P<0.01). VAS scores of uterine contraction pain at 6,12 and 24 hours after operation were (2.66±0.80), (2.23±0.68), (2.22±0.71) in the observation group and (5.14±1.05), (4.48±0.71), (3.36±0.80) in the control group, respectively, there were significant differences between the two groups( t values were 2.489, 2.008, 5.004, P<0.01 or 0.05).VAS scores of contraction pain after single press on the postoperative day, the first day and the second day after operation in the observation group were (2.66±0.80), (2.23±0.68), (2.22±0.71) in the observation group and (5.14±1.05), (4.48±0.71), (3.36±0.80) in the control group, respectively, there were significant differences between the two groups( t values were 13.296,15.536, 7.534, P<0.01). The times of pressing and intervention were (2.28±1.36) and (0.90±0.61) in the observation group and (4.62±1.61), (0.62±0.53) in the control group, respectively, there were significant differences between the two groups( t values were 7.847, 2.439, P<0.01 or 0.05). Maternal satisfaction score was (5.92±1.37) and (2.34±0.82) in the observation group and the control group, there was significant difference ( t value was 15.856, P<0.01).The incidence of adverse reactions such as lower limb numbness, nausea and vomiting and skin pruritus in the observation group were 2.00%(1/50), 4.00%(2/50) and 4.00%(2/50) respectively, which were lower than those in the control group 14.00%(7/50), 16.00%(8/50), 18.00%(9/50), the difference was statistically significant ( χ2 values were 4.759, 4.000, 5.005, P<0.05). Conclusions:The pulse epidural controlled analgesia can effectively reduce the uterine contraction pain after cesarean section, and the active nursing intervention can accelerate the postoperative recovery of parturient.

Rheumatoid arthritis (RA) is a kind of chronic, progressive, multiple, invasive autoimmune disease with two chief cclinical manifestations arthrosynovitis and ex-arthrosis, easy to occur in middle-aged women, also occur in children and the elderly, is characterized by progressive and break out repeatedly. RA pathogenesis is complex, there is no special treatment, used in treatment of R drug varied, new drugs and new therapies also emerge in endlessly, main including non-steroidal anti-inflammatory drugs (NSAIDs), slow action anti-rheumatism medicine (SAARDs), glucocorticoids (GCs), biological agent, traditional Chinese medicine and traditional Chinese medicine preparations, domestic market for rheumatoid main drug treatment are NSAIDs, SAARDs, GCs, traditional Chinese medicine and traditional Chinese medicine preparations. Traditional Chinese medicine and traditional Chinese medi- cine preparations for the treatment of RA have its unique advantages, show the characteristics of overall adjustment, multi-level and multiple targets, and also can alleviate and against side effects of western medicine. In recent years, more and more get people's atten- tion. This paper reviewed the research progress and treatment features of commonly used therapeutic agents for the treatment of RA in recent years, which provides reference and basis for future medicine anti-RA.
Animals ; Arthritis, Rheumatoid ; drug therapy ; Biological Factors ; adverse effects ; therapeutic use ; Drug Discovery ; methods ; Glucocorticoids ; adverse effects ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; adverse effects

BACKGROUND: The main role that the osteoprotegedn (OPG) plays in bone tissues is to inhibilate the formation and the activity of osteoclast, while as for the receptor activator of nuclear factor-κB ligand (RANKL), it is to stimulate the differentiation and the activity of osteoclast. Both OPG and RANKL are important for the regulation of osteoclastic function. Recent studies have found the stimulative effects of adiponectin on the proliferation and the differentiation of osteoblast, as well as the coupling between adiponectin and bone metabolism. But effects of adiponectin on osteoclast remain unclear. OBJECTIVE: To investigate the effect of adiponectin on the expression of OPG and RANKL in osteoblast, and to further analyze its effects on the formation of osteoclast. DESIGN, TIME AND SETTING: A contrast observational experiment was conducted in the laboratory of Institute of 2008.MATERIALS: Cancellous bone in anterior superior lilac spine was obtained from adult normal by surgery for cell incubation. Clinical samples were provided by the Xiangya Hospital. METHODS: Human osteoblast was incubated with different doses of adiponcetin (0, 3, 10 and 30 mg/L) for 48 hours, after which OPG and RANKL mRNA and protein expression level was determined. In addition, adiponcetin was added into the co-culture system of osteoblast and peripheral blood monouclear cells for examing its effects on osteoclast formation. MAIN OUTCOME MEASURES: OPG and RANKL mRNA and protein expression in human osteoblast was determined using fluorescent quantitative polymerase chain reaction (PCR) and enzyme linked immunosorbent assay (ELISA). Osteoclast was detected by antitartaric acid acid phosphatase staining. RESULTS: Adiponcetin inhibited osteoblast OPG mRNA and protein expression in a dose-dependent way (P < 0.05). Adiponcetin promoted osteoblast RANKL mRNA and protein expression in a dose-dependent way (P < 0.05). Adiponectin induced the osteoclasts formation in the co-culture system of osteoblast and peripheral blood monouclear cells. CONCLUSION: Adiponectin has the effect of inducing osteoclast formation via stimulating RANKL expression and inhibiting OPG