BACKGROUND: Interleukin-1 (IL-1β) and intercellular adhesion molecule-1 (ICAM-1 ) can mediate neutrophilic infiltration, which is closely relevant to cerebral ischemia-reperfusion injury.OBJECTIVE: To investigate the effect of physcion on cerebral inflammatory reaction after ischemia-reperfusion injury.DESIGN: A completely randomized study based on animals.SETTING: Neurological department in a university hospital.MATERIALS: From September to December 2003, the study was conducted in the Animal Laboratory, Hebei Staff and Workers Medical College. Totally 91 healthy male SD rats, supplied by Laboratory Animal Center of Hebei Medical University, were used in the experiments. They were divided into sham operation (SO) group, ischemia-reperfusion group, normal control group, 20 mg/kg physcion group and 40 mg/kg physcion group.Each of the former two groups would be divided into 4 subgroups named as the 6th-hour-after-reperfusion group, the 12th-hour-after-reperfusion group, the 24th-hour-after-reperfusion group and the 48th-hour-after-reperfusion group. Each of the latter two groups were divided into 2 subgroups named as the 12thhour-after-reperfusion group and the 24th-hour-after-reperfusion group. Each subgroup contained 7 rats.INTERVENTIONS: Middle cerebral artery occlusion model (MCAO model) was applied, and IL-1β was measured by radioimmunoassay and ICAM-1 was detected by immunohistochemical staining.MAIN OUTCOME MEASUREMENTS: The IL-1 β level and the positive expression of ICAM-1 in the rats' cerebella were observed.RESULTS: Cerebral ischemia-reperfusion injury in the rats reached its peak 6 hours after reperfusion, and then it decreased gradually. In the 12-hour-after-reperfusion subgroup amd the 24-hour-after-reperfusion subgroup of the 40 mg/kg physcion group, and the 12-hour-after-reperfusion subgroup of the 20 mg/kg physcion group, IL-1β in the injured parts of the cerebella decreased dramatically, compared with MCAO model controls ( P＜ 0.01 ). In the normal control group and SO group, a small quantity of ICAM-1 was detected in rat' s cerebral cortex, and some fulvous staining substance was observed in the plasma and membrane of cerebral vascular endothelium cells. In the cerebral ischemia-reperfusion injury group, positive staining substance could be observed 24 hours after the reperfusion, then darkened gradually (integral absorbency value: 31.89 ± 4.38, area density value: 0. 018 5 ± 0. 003 1). In the 12-hour-after-reperfusion subgroup of the 40 mg/kg physcion group (integral absorbency value: 13.33 ±6. 12, area density value: 0. 007 6 ± 0. 002 2) and the 24-hour-after-reperfusion subgroup of the 40 mg/kg physcion group (integral absorbency value: 20.04 ±4.65,area density value: 0. 012 9 ±0. 003 6), and in the 24-hour-after-reperfusion subgroup of the 20 mg/kg physcion group (integral absorbency value:23.73 ±4.51 area density value: 0. 014 1 ±0. 003 8), expressions of ICAM-1 around the infarctions significantly decreased as compared with those in the MCAO model controls respectively ( P ＜ 0.01 or P ＜ 0.05).CONCLUSION: Physcion tends to decrease the expressing of IL-1β and ICAM-1 in a cerebellum after ischemia-reperfusion injury, thus, it may help alleviate the ischemia-reperfusion injury.

AIM: To explore the effect of physcion (P) on the level of IL-1? and expression of ICAM-1 and caspase-3 during cerebral ischemia-reperfusion injury. METHODS: The 91 healthy adult SD rats were selected, and were randomly divided into normal group, sham-operated group, cerebral ischemia-reperfusion group (model), low-dose physcion (PLD) and high-dose physcion (PHD) treatment group. The level of IL-1? was detected by radioimmunoassay. The expression of ICAM-1 and caspase-3 was detected by immunohistochemistry. The changes of tissue pathology were also investigated. RESULTS: The level of IL-1? reached the peak at 6 h after ischemia-reperfusion (IR). The protein expression of ICAM-1 and caspase-3 reached the peak at 24 h after IR. The level of IL-1? and the protein expression of ICAM-1 and caspase-3 in PHD group decreased obviously compared with those in model group (P

ObjectiveTo examine the clinical features of fractures and related risk factors in patients with rheumatoid arthritis(RA) in China.MethodsSix hundred and eighty-one RA patients were randomly selected from department of rheumatology of 18 hospitals of China.Data were obtained from the questionnaire,including age,sex,disease duration,the involvement of joints,treatment regimen,features of fractures etc.The possible risk factors of fracture in patients with RA were analyzed with a multi-variate Logistic regression analysis.Results① In 681 RA patients of the survey,48 patients had 54 fractures,and the incidence of fractures was about 8％.② Fractures occurred at various sites.Foot/ankle,femur,spine and wrist were the mostfrequent sites.③ The Logistic regression analysis showed that several factors increased the risk of fracture in RA patients,including long disease duration (OR:1.245,95％CI:0.987-1.570,P=0.065),male gender(OR:0.433,95％CI:0.199-0.942,P=0.035),more deformed joints(OR:1.042,95％CI:1.006-1.079,P=0.023),family history of RA (OR:2.201,95％CI:0.984-4.923,P=0.055),and high scores of SF-36(OR:1.017,95％CI:1.002-1.033,P=0.028).④ According to the degree of correlation from strong to weak,the risk factors of fracture were disease duration,SF-36,sex,number of deformed joints and family history of rheumatoid arthritis.ConclusionThe incidence of fracture is high in patients with rheumatoid arthritis.Several factors could increase the risk of fractures in RA patients,including long disease duration,male gender,more deformed joints,and family history of RA.In order to prevent the occurrence of fractures,cautions should be taken to prevent the development of fractures and treat the disease aggressively to suppress the disease activity of RA.

Objective To describe the distribution of medication costs of rheumatoid arthritis patients, and to analyze the factors that may affect the costs. Methods Data were obtained from a 12-month retrospective investigation of patients with rheumatoid arthritis (RA) across China. Department of Rheuma-tology of 18 hospitals were randomly selected. The data about their social conditions, clinical conditions, medications associated with RA such as disease-modifying antirheumatic drugs (DMARDs), non -steroidal anti -inflammtory drugs (NSAIDs), steroids, biologic agents were collected, and the costs of drugs were calculated. A non-parameter test and multivariate logistic regression analysis were performed. Results Six hundred and forty six patients were enrolled into the study, 435 completed data were chosen for analysis. The results demonstrated that the average costs per patient for medications in the past year was 8018 . The total medication costs were further subdivided into the following parts: DMARDs, (represented 20% of the total costs), biologic drugs (49%), NSAIDs (4%), herbal drugs (22%), steroids (1%). Data analysis showed that patients with higher education and higher incomes, with medical insurance,better health function status and outpatients paid more on DMARDs. Extra-articular manifestations increased the odds of the high-cost group (OR: 2.180, 95%CI: 1.335～3.558, P=0.002), while poor health function status increased the probability of paying high costs (OR: 1.373, 95%CI: 1.012～1.863, P=0.041). Conclusion High medication costs in RA do exist in RA patients. The costs of medication is associated with health function status and the presence of extra-articular manifestations.