The main acupoints were Shuigou (GV 26), Jiquan (HT 1) and Weizhong (BL 40). According to the diseased area, corresponding points were selected. Warmed needling, pushing, grasping, kneading,flicking and shaking of diseased joints were performed. Among 48 patients with rheumatoid arthritis,6 cases were clinically recovered; 14 cases were remarkablely effective; 24 cases were improved; and 4 cases were ineffective.

Objective To assess the clinical significance of glucose-6-phosphate isomerase in RA patients. Methods The level of serum GPI in 100 patients with RA, 98 patients with other rheumatic diseases and 108 normal controls were assessed by sandwich ELISA methods. The level of RF, CRP, anti-CCP antibodies were also assessed in RA patients. Results The level of GPI was higher in RA patients [(2.4?5.0) ?g/ml] than that of normal control group [(0.12?0.14) ?g/ml (P

Objective Normal estimation is the key step for volume visualization. Commonly used methods for normal estimation are based on interpolation and derivative. A novel normal estimation algorithm based on approximation for visualization of medical images was presented in this paper. Method It approximated the density function in local neighborhood with a second-degree polynomial function. The coefficients of the polynomial function were solved by minimizing the error of the approximation and the gradient vector at arbitrary point was obtained directly from the analytical derivative of the density function without interpolation. Because of symmetry, the solution of this equation was simplified.This method was tested in several volume data sets. The results and the generation time by different methods were obtained and compared. Result The results showed that this algorithm produced satisfactory quality images while the computational complexity was not increased. Conclusion This approach is preferable for most applications, especially for medical images reconstruction.

Objective Cancer-related fatigue (CRF) is a key in the management of cancer patients' clinic syptoms.This article investigated the status quo of nurses' knowledge and attitude towards CFR.Methods THe method of cross-sectional survey and questionnaire was used to investigate the knowledge and attitude towards CRF among nurses from related departments of three Grade III hospitals in Nanjing.Results 142 nurses answered the questionnaire.The average correct rate was 76.25%, among which nurses from the oncology department had better congition rate than nurses from other medical and surgical departments (84.3%, 75.98%, 79.57%) , representing significant difference (P<0.05).64.79% of the nurses found the relatives of cancer patients and nurses often fail to understand cancer patients;complaint of fatigue, 76.76% of nurses assumed there is lack of communication in fatigue between patients and medical staff.94.36% of nurses agreed medical institutions should strengthen the management of CRF.Conclusion At present, the clinical nurses have inadequate knowledge about CRF, which should be enhanced in future work.

Objective To establish the method of testing immunoglobulin G (IgG) with Fc sialylation, and to investigate the clinical significance of IgG with Fc sialylation in systemic lupus erythematosus (SLE), especially in those with neuropsychiatric manifestations (NPSLE). Methods Seventy-five SLE including thirty patients with neuropsychiatric manifestations (NPSLE) and forty-five non-NPSLE patients, 30 rheuma-toid arthritis (RA) patients, 32 juvenile idiopathic arthritis (JIA) patients and 41 healthy controls were recruited in this study. Standard method of testing lgG with Fc sialylation was established by a lectin based sandwiched enzyme linked immunosorbent assay (ELISA). The levels of IgG with Fc sailylation were assayed, and its clinical significance was evaluated. Results There were no difference in the levels of serum IgG with Fc sailylation in RA group (0.82±1.81) mg/ml, JIA group (0.69±1.30) mg/ml, healthy control group (0.64± 1.09) mg/ml, and the levels of IgG with Fc sailylation in SLE group (0.12±0.17) mg/ml (P<0.01), especially in NPSLE group [(0.03±0.03) mg/ml, P<0.01] was significantly lower than that of control groups. The perc-entage of IgG with Fc sialylation in control group (4.64±5.90)% were significantly higher than that in non-NPSLE (1.88±2.16)% (P<0.01) and in NPSLE (0.29±0.47)% (P<0.01). The percentage of IgG with Fc sial-ylation was negatively associated with SLEDAI score (r=-0.43, P<0.01). Conclusion Significantly low level of serum IgG with Fc sialylation was associated with disease activity in SLE patients, especially in NPSLE patients, lgG with Fc sialylation may be a new target for therapeutic strategy.

Objective:To investigate the relationship between the removal time of 0.2 mm occlusal in-terference and the recovery of masticatory muscle mechanical hyperalgesia in rats.Methods:Forty male Sprague-Dawley rats (200-220 g)were randomly assigned to eight groups,with five rats in each group:(1 )nave group:these rats were anesthetized and their mouths were forced open for about 5 min (the same duration as the other groups),but restorations were not applied;(2 )sham-occlusal interference control group:bands were bonded to the right maxillary first molars which did not interfere with occlu-sion;(3 )occlusal interference group:0.2 mm thick crowns were bonded to the right maxillary first molars;(4)2,3,4,5,and 6 d removal of occlusal interference groups:0.2 mm thick crowns were bonded to the right maxillary first molars and removed on days 2,3,4,5,and 6.The nave group and sham-occlusal interference control group were control groups.The other groups were experimental groups. Bilateral masticatory muscle mechanical withdrawal thresholds were tested on pre-application days 1 ,2, and 3,and on post-application days 1 ,3,5,7,1 0,1 4,21 and 28.The rats were weighed on pre-application day 1 and on post-application days 1 ,2,3,4,5,6,and 7.Results:Between the nave group and the sham-occlusal interference control group,there was no significant difference in the mastica-tory muscle mechanical withdrawal threshold of bilateral temporalis and masseters at each time point.No significant difference was detected between the contralateral side and ipsilateral side in experimental groups (P>0.05 ).In the 2,3,4,and 5 d removal of occlusal interference groups,the masticatory muscle mechanical withdrawal thresholds decreased after occlusal interference and increased after removal of the crowns and recovered to the baseline on days 7,1 0,1 4,and 1 4,respectively [the masticatory muscle mechanical withdrawal thresholds of right masseter muscle were (1 37.46 ±2.08)g,(1 39.02 ± 2.1 1 )g,(1 40.40 ±0.98)g,(1 38.95 ±0.98)g,respectively].In the 6 d removal of occlusal inter-ference group,the masticatory muscle mechanical withdrawal threshold increased after removal of the crowns and became stable since day 1 4.There was a significant difference between the 6 d removal of oc-clusal interference group and the sham-occlusal interference group on day 28(P<0.05),the masticatory muscle mechanical withdrawal thresholds of right masseter muscle were (1 31 .24 ±0.76 ) g and (1 41 .34 ±1 .43)g,respectively.Conclusion:After removal of the 0.2 mm thick crown within 5 days, the mechanical hyperalgesia of the rats could reverse completely.The mechanical hyperalgesia of the rats could only be relieved,but not reverse completely after removal of the 0.2 mm thick crown on day 6.As the time went on,even minor occlusal interference could cause irreversible mechanical hyperalgesia of masticatory muscles.This study suggested that occlusal interference caused by dental treatment should be eliminated as soon as possible,to avoid irreversible orofacial pain.

ObjectiveInvasive fungal infection(IFI) can be a lethal complication in patients with diffuse connective tissue diseases(DCTD).The aim of this study was to determine the characteristics of hospitalized DCTD patients with IFI,and identify the risk factors.MethodsData from 33 DCTD in patients with IFI at Shanghai Renji Hospital between Jan 2007 and Jan 2011 were collected retrospectively.DCTD patients with either active M.tuberculosis (n=33) or other bacterial infections (n=34) at the same period were taken as controls.Systemic lupus erythematosus (SLE) inpatients with IFI (n=11 ) from Jan 2002 to Dec 2006 were also considered as a historical control group.The method of univariate analysis of data depended on the data distribution type.Variables that suggested association in the univariate analysis P＜0.1 were entered into a stepwise logistic regression model.ResultsThe leading underlying diseases of DCTD with IFI were SLE(n=18,55％),systemic vasculitis(n=4,12％),and inflammatory myopathy(n=4,12％).The most frequent pathogen was Candida spp(n=13,39％ ),followed by Cryptococcus neoformans(n=10,30％ ),and Aspergillus (n=3,9％).The infection locations included lung (n=19,58％),central nervous system (n=9,27％ ),and disseminated IFI(n=4,12％ ).Six patients(18％) died from IFI.Compared with non-IFI infections,patients with IFI infection had a shorter duration of underlying disease and were exposed to high doses of prednisolone prior to infection.More patients with IFI infection had elevated alanine aminotransferase,higher fasting glucose and lower C-reactive protein levels when compared to patients with non-IFI infections.Compared with the two historical SLE-IFI groups, the short-term survival improved in lupus patients complicated with IFI infection over time(64％ vs 83％).ConclusionUnderstanding disease spectrums and risk factors of IFI in DCTD,along with advances in antifungal treatment,will help clinicians to manage those patients with invasive fungal infection effectively to achieve favourable prognosis.

OBJECTIVE To evaluate the efficacy and safety of levofloxacin in the treatment of respiratory tract infection in elderly patients. METHODS An open clinical trial was conducted for the treatment of respiratory tract infection in elderly patients.The dosage of the drug was 0.5g once daily injection,the duration of treatment was 7-14 days. RESULTS The total cure rate,the total response rate and the bacterial clearance rate were 56.7%,83.3%,and 82.1%,respectively. CONCLUSIONS Levofloxacin is a drug both effective and safe for respiratory tract infection in elderly patients.The dosage of the drug(0.5g/day) can reach higher clinical effective rate,best tolerance and compliancy.

Objective:To observe the efficacy of apatinib combined with capecitabine in the treatment of advanced esophageal cancer.Methods:A total of 101 patients with advanced esophageal cancer in Taixing People's Hospital of Jiangsu Province from June 2017 to February 2018 were enrolled, and all the patients were divided into the control group (50 cases) and the observation group (51 cases) according to the random number table. The control group was treated with capecitabine combined with radiotherapy, and the observation group was treated with apatinib on the basis of the control group. The therapeutic effects, adverse reactions and progression-free survival (PFS) time of the two groups were compared.Results:The overall response rate in the observation group was higher than that in the control group [90.2% (46/51) vs. 72.0% (36/50)], and the difference was statistically significant ( χ2 = 5.473, P = 0.019). There were no significant differences in leukopenia, neutropenia, thrombocytopenia, anemia, proteinuria and hypertension between the two groups (all P > 0.05). The median PFS time in the observation group was 18.49 months (95% CI 15.35-25.03 months), and that in the control group was 13.33 months (95% CI 10.36-18.24 months), and the difference between the two groups was statistically significant ( χ2 = 5.995, P < 0.01). Conclusions:The therapeutic effect of apatinib combined with capecitabine in the treatment of advanced esophageal cancer is accurate. No obvious adverse reaction occurs, and the PFS time is prolonged.

Posttraumatic stress disorder (PTSD), the most common mental illness after patients suffer physically or emotionally from traumatic events, can cause persistently strong, painful and terrible avoidance symptoms, emotional and cognitive changes, causing psychologically strong stimulation and heavy burden to patients and even leading to some extreme behavioral reactions. Traumatic brain injury (TBI) is an important factor in the occurrence of PTSD, both of which shares many similar pathological overlaps, and may coexist and interact with each other. The hippocampus and amygdala play a central role in the pathogenesis of PTSD, but the specific cellular and molecular and neural circuit mechanisms are still unclear. About two-thirds of the patients still meet the diagnostic criteria for PTSD after psychotherapy. However, the current treatment methods are complicated and not unified, and patients treated with medications may have adverse drug reactions, poor treatment outcomes and recurrence. Therefore, it is of great significance to further clarify the occurrence and development of PTSD in TBI patients. The authors reviewed the research progress of the pathogenesis and treatment of PTSD in TBI patients, so as to provide reference for the related research and treatment of PTSD in TBI patients.