Objective To investigate the incidence,pathogens and clinical features of nosocomial infections in patients with ac-tive rheumatoid arthritis (RA).Methods A total of 2 452 active RA patients were reviewed and analyzed retrospectively in Shanghai hospitals between January 2009 and February 2011.The demographic and clinical characteristics were described.Re-sults A total of 721 episodes of infection were found in 503 patients (20.51%).About 40.97% of the infections were of respir-atory tract,22.35% of urinary tract,and 8.58% of skin and soft tissues.Major pathogens were bacteria (623,86.40%),in-cluding E.coli (226,31.35%),P .aeruginosa (40,5.55%),A.baumannii (48,5.42%),Enterococcus (144,16.25%), methicillin-resistant Staphylococcus aureus (15, 2.08%), methicillin-resistant coagulase-negative Staphylococcus (7, 0.97%).The other pathogens included fungi (74,10.26%),herpes zoster (16,2.21%),and Mycobacterium tuberculosis (8,1.10%).Conclusions Nosocomial infection is mainly seen in respiratory and urinary tracts,usually associated with E.co-li,P .aeruginosa,A.baumanii,methicillin-resistant Staphylococcus and Enterococcus .

Objective To evaluate the therapeutic effect of etanercept in patients with Behcet's disease (BD). Methods Twenty six patients with active BD were eligible for anti-TNF-α treatment, which failed previously to commonly used drugs. All the patients were stopped previous therapy and treated with etanercept 25 mg twice a week. The clinical responses and laboratory parameters were evaluated at the baseline, week 2, 4, 8, 12 and 24, and week 12 of etanercept withdrawal. Results Etanercept was effective in several clinical lesions and lab. parameters at all time points. Especially at week 2, including oral ulcers, genital ulcers, erythema nodosum, pseudofolliculitis and swollen joints (P<0.01). Two of four cases of uveitis were contro-lled with addition of topical corticosteroids; The ileocecal junction ulcer of 1 patient healed after 2 months etanercept therapy; four cases of epididymitis reached complete remission at week 4. ESR(P=0.012) and CRP (P=0.013) were also rapidly decreased at week 2. Most patients were relapsed at week 12 of etanercept withdrawal compared with baseline except for swollen joints (0.65±1.09 vs 0.31±0.60, P<0.01) after etanercept withdrawal, in which the typical rebound was CRP from (481±312) mg/L to (549±267) mg/L (P=0.013).Conclusion Etanereept has rapid efficacy onset for most of the mucocutaneous disorders and possibly effective for arthritis, ophthalmitis, epididymitis and colonic ulcer of BD.

With the development of aging population, the morbidity of Alzheimer's disease (AD) is increasing. Electroacupuncture on several acupoints, especially Baihui (GV20), may improve the cognitive function, brain morphology, and reduceβ-amyloid deposition and tau protein phosphorylation, in AD models.

Objective To investigate the relationship between apolipoprotein E(Apo E) gene poly-morphism and mild cognitive impairment (MCI) in patients with type 2 diabetes mellitus (T2DM), and e-valuate the correlative risk factors. Method 40 cases of type 2 diabetes with MCI and 80 cases of type 2 diabetes without MCI were enrolled in this study. The polymorphism of the Apo E gene was detected by PCR-restriction fragment length polymorphism(PCR-RFLP). According to the clinical data such as course of disease, plasma glucose, plasma fat and body mass index (BMI), the independent risk factors of T2DM and MCI were analyzed by non-conditional logistic regression. Results The frequency of Apo E ε_4 allele in the group of type 2 diabetes with MCI was higher than that without MCI ( 25.0% vs 10. 0% ), and the difference had statistical significance( P < 0. 01 ). The indexes of the statistical significant difference be-twcen the two groups were age, course of disease, postprandial blood glucose ( P2BG), HBA1C, BMI,family history of T2DM, hypertension, diabetic retinopathy, diabetic peripheral neuropathy, Apo E gene. The independent risk factors included diabetic retinopathy ( OR = 3. 452, P < 0. 05 ), diabetic peripheral neuropathy( OR = 3. 252, P <0. 05), Ape E gene( OR = 2. 441, P < 0.01 ), HBA1C ( OR = 1. 372, P <0.05), P2BG(OR = 1. 194, P <0.05), age(OR = 1. 194, P <0.01) and course of disease(OR =1. 142, P <0. 05). Conclusion Apo E ε_4 allele has significant relationship with T2DM and MCI. The age, course of disease, control of plasma glucose, and microvascular complication of diabetes have relation-ship with the cognitive function.

Objecfive To study the effect of fibronectin(FN)and arginine-glycine-aspartateserine tetrapeptide (RGDS)on chemotherapy sensitivity of hepatocellular carcinoma(HCC)cell lines.Methods A HCC cell lines 7721 was divided into BSA group(BO),FN group(FO),RGDS group(RO)and FN+RGDS group(FR).Mitomycin-C(MMC)was added into each group with different concentrations for 2 h,12 h and 24 h.MTT assay was used to detect the survival rate of the tumor cell at different time,and fluorescent staining method and flow cytometry was used to detect the tumor cell's apoptosis.Results The survival rate and apoptosis rate was significantly different between each group with the treatment of MMC for 12 h or 24 h,and no statistical difference was found after incubation for 2 h.Conclusions With time FN down-regulates MMC induced apoptosis of the HCC cells.making HCC cells 1ess sensitive to chemotherapy,while RGDS enhances the sensitivity of HCC cells to chemotherapy.

Objective:To investigate the relationship between tumor necrosis factor-α (TNF-α)-308A/G gene polymorphism and mild cognitive impairment(MCI)in patients with type 2 diabetes mellitus(T2DM),and their correlative risk factors thereof.Methods:Forty cases of T2DM with MCI and 80 cases of T2DM without MCI were selected for this study.The polymorphism of the TNF-α-308A/G was detected by PCR-restriction fragment length polymorphism (PCR-RFLP).According to the clinical data,such as course of disease,plasma glucose,plasma fat and body mass index(BMI),the independent risk factors of T2DM and MCI were analyzed by non-conditional logistic regression.Results:The frequency of TNF-α2 allele was significantly higher in the group of T2DM with MCI than that without MCI (P＜0.01).The indexes of the statistical significant difference between the two groups were the age,course of disease,postprandial blood glucose(P2BG),glycosylated hemoglobin,body mass index,family history of T2DM,hypertension,diabetic retinopathy,diabetic peripheral neuropathy and TNF-α.The independent risk factors included TNF-α,diabetic peripheral neuropathy,diabetic retinopathy,age and P2BG.Conclusion:There is a significant relationship between TNF-α2 allele and T2DM with MCI.There is a significant relationship between the age,control of plasma glucose and microvaseular complication of T2DM with the cognitive funotion.

To study the possible mechanism of the effect of glucagon-like peptide-1 (GLP-1) on injury to neonatal rat cardiomyocytes induced by hypoxia-reoxygenation. Lactate dehydrogenase activity [(210.0±11.5) vs (101.4±6.5) U/L] ,apoptosis rate [(8. 138±1. 512) vs(0. 575±0. 168)%] ,and caspase-3 activity [(44.52± 5.69)vs(19.98±1.97) ,all P<0.01] were all increased after hypoxia-reoxygenation. GLP-1 appears to directly act on cardiomyocytes and to protect them from hypoxia-reoxygenation injury [lactate dehydrogenase (190.2±9.0) U/ L, apoptosis rate (2.688±0.580) %, caspase-3 activity 30.34±4.18] mainly by inhibiting the apoptosis probably via the PBK/Akt signaling pathways.

This article analyzed the characteristics of data of acupuncture and moxibustion in ancient books, and put forward to a mode of diagnosis and treatments according to acupuncture and moxibustion. A variety of data mining techniques were used to extract, integrate and display the theory, methods, meridians, acupoints and techniques in ancient books to establish a database platform of ancient books based on B/S architecture, which can be used by users. Also, this article described the framework, the function of the module, and the method of realizing each function of the experience platform of acupuncture ancient books, and demonstrated an interface of the results searched by key wordsstroke, and summarized the experience of building this platform and the advantages of the platform in the research and development of data of acupuncture ancient books.

ObjectiveTo evaluate the reliahility and validity of the chronic HBV-infections related stigma scale.MethodsThe initial items and construct of the scale were developed according to theoretical analysis and interviews of experts and patients.A total of 151 patients with chronic HBV-infection were administered by convenient sampling method in this pilot study. The reliability and the validity of the scale were then evaluated.ResultsThe response rate of the scale was 94.5％.The Cronbach α coefficients of all dimeusions ranged from 0.75-0.87.The results of correlation analysis showed that there were higher correlation coefficients ( r ranged from 0.62-0.86) between items and their hypothesized subscales than those with other subscales ( r ranged from 0.14-0.55).The scale distinguished between patients with low subscale scores ( the subscale scores were ( 1.89 ±0.30 ),( 1.86 ± 0.29 ),( 1.96 ± 0.23 ),( 2.29 ± 0.45 ),( 1.59 ± 0.42 ) independently) and those with high subscale scores(the subscalc scores were (3.62 ±0.44),(3.99 ±0.41 ),(3.79 ±0.37),(4.13 ±0.34),(3.10 ±0.53 ) independently) (P ＜ 0.01 ).Confirmatory factor analysis showed that the main indices of goodness of fit CFI was 0.94,NNFI 0.92,RMSEA 0.087.ConclusionThe chronic HBV-infections related stigma has good psychometric properties regarding to reliability and validity.

BACKGROUND:The application of anterior cervical plate for anterior cervical discectomy and fusion wil induce some complications such as dysphagia after treatment.
OBJECTIVE:To observe the clinical efficacy of the new implant Zero-P system for cervical spondylosis patients and its effect on reducing complications after treatment.
METHODS:A total of 51 cervical spondylosis cases underwent anterior cervical discectomy and fusion using Zero-P system. Neurological function was evaluated by neck/arm visual analogue scale, neck disability index and Japanese Orthopaedic Association scores pretreatment, at 3 days, 3, 6 months, 1, 2 years post-treatment. The incidence of postoperative dysphagia was evaluated using dysphagia score. Anteroposterior&lateral and dynamics X-ray films were used to evaluate the efficacy of graft fusion and internal fixation-related complications.
RESULTS AND CONCLUSION:The patients were fol owed up for 6-30 months, averagely 15.4 months. After treatment, their incision achieved stage I healing. Pain was relieved and muscle force was restored in al patients after treatment. Visual analogue scale and neck disability index scores were apparently improved. Improvement rate of Japanese Orthopaedic Association score was 85.7%. At 2 days after treatment, seven patients experienced mild and moderate dysphagia. During fol ow up, implant subsidence was not observed. No complications, such as screw loose, breakage or fixator displacement, were found. Results suggested that the new cervical stand-alone anterior fusion device in anterior cervical discectomy and fusion procedure for the treatment of cervical spondylosis has offered an excellent clinical outcome. Its design has the advantages of cervical interbody fusion and anterior cervical plate. There were less relevant complications.