The treat-to-target (T2T) strategies has greatly improved the prognosis of rheumatoid arthritis (RA).However,the emergence of musculoskeletal ultrasound has further brought new challenges and opportunities for RA T2T treatment.It has been revealed the subclinical synovitis generally presented in RA patients who achieved clinical remission.The subclinical synovitis has been confirmed to be associated with subsequent progression of bone erosion and flare.Therefore,clinical remission or low disease activity may be inappropriate or insufficient target.The ultrasound evaluation in addition to clinical assessment can help to control the disease activity better,which may eventually improve the long-term outcomes of RA patients.

Objective To study the changes of endothelin-1(ET-1) and tumor necrosis factor alpha(TNF?) in lung homogenate and plasm when acute respiratory failure(ARF) animal models are treated by bilateral femoral arteriovenous extracorporeal membrane oxygenation(bAV-ECMO).Methods Ten ARF dog models were treated by the bAV-ECMO.Right atrium blood and lung tissues were collected at different time points,and ET-1 and TNF? were assayed by radioimmunological method.Results ET-1 content in plasm decreased at first,and at 1h it was elevated and at 2h reached the peak.ET-1 content in lung homogenate reached the peak at 2h and then started to decrease.The analysis of variance showed notable differences(P

Accidents, Occupational ; Humans ; Hydrogen Sulfide ; poisoning

Objective: This study aims to investigate the protein expressions of cyclooxygenase-2 (Cox-2) and hypoxia-inducible factor 1 alpha (HIF-1α) and their correlations with the clinicopathological features of osteosarcoma and tries to reveal the potential mechanisms for the formation and progression of osteosarcoma. Methods: We screened 59 typical samples of osteosarcoma tissues without os and decalcification treatment. They were grouped according to the clinicopathologic characteristics and were followed up post surgery. Expression of Cox-2 and HIF-1 alpha were detected by immunohistochemistry. The results were evaluated by X2 analysis and Spearman rank correlation analysis. The postoperative survival rates were calculated by Kaplan-Meier survival curve and the differences between groups were analyzed by Log-Rank method. Results: The positive expression rates of COX-2 and HIF-1α in osteosarcoma were 69.49% and 38.98%, respectively, which were significantly different compared with negative expression in control group (P<0.01 and 0.05). The expression of Cox-2 in osteosarcoma positively correlated with the clinical stage (P<0.05) and the expression of HIF-1α correlated with the age of patients (P<0.01). The expressions of Cox-2 and HIF-1α were closely associated with the histological classifications. In COX-2- and HIF-1α-positive groups, the total positive rates (16.67% and 0%) of intraosseous well-differentiated and parosteaosteosarcoma were significantly lower than that of any others (73.33%, and 43.18%), respectively. The difference was significant (and P<0.01 and P<0.05). The expression of Cox-2 had positive correlation with HIF-1alpha. The positive co-expression of both HIF-1α and Cox-2 was 38.98%. There was 30.50% osteosarcoma tissues had no expression of both Cox-2 and HIF-1 alpha. The positive expression rates of HIF-1α in Cox-2 - positive and Cox-2 - negative groups were 56.10% and 0%, respectively. The difference was significant (P<0.01). The postoperative survival period was negatively associated with the expression of Cox-2 and HIF-1α. The postoperative accumulative survival rates were significantly lower in Cox-2 - and HIF-1 alpha - positive patients compared with those in Cox-2 - and HIF-1 alpha-negative patients (P<0.05 and P<0.01, respectively). Conclusion: Cox-2 and HIF-1α were over-expressed in osteosarcoma. Their expressions are related with the formation and progression of tumor and may have synergistic effects in prompting the malignant development of osteosarcoma. The patients with positive expression of Cox-2 and HIF-1α have lower postoperative accumulative survival rates. Their expressions may be useful prognostic factors for osteosarcoma.

微小RNA（microRNA，miRNA）是一种内源性的长度为18~25个核苷酸的非编码RNA，通过与蛋白质编码基因的 mRNA结合来发挥重要的基因调控作用，与恶性肿瘤的发生发展密切相关。miR-32作为miRNA家族的重要成员，在不同肿瘤中 表达水平存在明显差异，因其与恶性肿瘤的相关性及本身表达的正反作用双向性， 在miRNA领域受到了更多的关注。近年来研 究发现，miR-32对恶性肿瘤细胞的增殖、迁移与侵袭、自噬和凋亡均有影响。此外，miR-32与其上游靶基因、肿瘤代谢及临床诊 断和治疗也有密切的关系。本文就miR-32在恶性肿瘤发生发展中的作用及其机制、临床诊治中应用等最新研究进展作一综述。

Objective To study the change of angiotensin Ⅱ in the applications of pumpless ECMO, and its effect on prognosis of the acute respiratory failure. Methods The study was performed in ten dogs [ weight 18 - 35 kg, mean weight ( 23.4 ± 4.7 ) kg].A respiratory failure animal model was established end then was treated by bilateral femoral artery-venous ECMO. Collection right atriurn blood end constitution of lung at different time (before ECMO, during ECMO 1h, 2h, 3h, 4h). Angiotensin Ⅱ content in blood and lung homogenate was detected by radio-immunity mothod. Angiotensin Ⅱ expression loci in lung were detected by immunohistochemistry mothod. Results Angiotensin Ⅱ content in plasma was decreased at completion of the model, it was back up at 1 hour and reached the peak at 3 hours, then it slowly declined. Angiotensin Ⅱ content in lung homogenate increased at the beginning, peaked by 2 hours, end then it decreased. Loci angiotensin Ⅱ in lung by immunohistochemistry were expressed in most of epithelial cells cytoplast of bronchiole dissepimont, smooth muscle cell cytoplast of small blood vessel around it end a few macrophage cytoplasts during the model time..Conclusion It is valuable to measure engiotensin Ⅱ in blood through the bilateral femoral artery-venous ECMO, because it can reflect angiotensin Ⅱ in lung and the resume of lung in certain degree.

Humans ; Otorhinolaryngologic Surgical Procedures ; methods ; Quinolones ; therapeutic use ; Respiratory System Agents ; therapeutic use

Objective To compare the clinical value of nerve stimulator-versus ultrasound-guided continuous femoral nerve block for analgesia after laparoscopic surgery.Methods Forty patients,aged 18-60 yr,with body mass index of 18-30 kg/m2,of ASA physical status Ⅰ or Ⅱ,scheduled for elective laparoscopic surgery,were randomly assigned into 2 groups (n =20 each) using a random number table:nerve stimulator group (group S) and ultrasound group (group U).Epidural anesthesia was performed with 1.73 ％ carbonated lidocaine in both groups.0.2％ ropivacaine 5 ml/h was infused continuously after surgery to perform femoral nerve block for analgesia.VAS score at rest was assessed at 2,6,24 and 48 h after surgery.At 24 and 48 h after surgery,VAS scores during active and passive movement were assessed.The time for catheter placement near the femoral nerve and development of subcutaneous hematoma at the puncture site,local anesthetic intoxication and nausea and vomiting were recorded.The postoperative requirement for analgesics was also recorded.Results There was no significant difference in the VAS scores and puncture for femoral nerve block-and local anesthetics-related adverse events between the two groups.The time for catheter placement near the femoral nerve was 8.0 ± 1.4 and (6.7 ± 0.9) min in S and U groups,respectively,and the time was significantly longer in group S than in group U.No patients required rescue analgesic after surgery in both groups.Conclusion Nerve stimulator-guided continuous femoral nerve block provides higher clinical value than ultrasound-guided continuous femoral nerve block for analgesia after laparoscopic surgery and it is more suitable for clinical application.

Objective To explore the regulatory effect of apigenin on the blood pressure of the spontaneous hypertension rat(SHR) rats and the possible mechanism.Methods The case groups of rats were fed with different dosage of apigenin(0.03,0.05,0.11 g/kg) by gavage for 4 consecutive weeks,while the control groups were treated with equal cubage of oil.The body weight,heart rate,blood pressure were measured every week.Results After 4 weeks of treatment with apigenin,the blood pressure of SHR in all doses groups decreased significantly;besides,apigenin could reduce the content of ET-1 and AngII,however,it didn't change NOS activity.Conclusion Apigenin has a regulatory effect on blood pressure,its lowest effective dose is 0.03 g/kg bw and it may decrease the blood pressure through reducing the content of ET-1 and AngII,not through the NO/NOS pathway.

Objective To observe the therapertic effect and side-e ff ect of Q-switched Nd∶YAG laser irradiation in the treatment of nevus Fusco- Caeruleus zygomaticus (NFZ). Methods A total of 350 cases were treated with 532nm wave length laser; the diameter of therapy spot was 3.0mm, p ulse duration was 5～10ns, and energy density was 1.6～1.8 J/㎝ 2. The therape utic effects were judged by comparision of the photograph before operation with that after treatment for 3～6 months. The judgement standards of therapeutic eff ect were classified into 4 grades.Results The time of therapy r anged from 1 to 5 (average 2.14). The number of cure was 133 cases (38.00 %). Th e therapeutic effect was positively related to the times of therpy. Conc lusion The 532nm wave length of Q-switch Nd∶YAG laser has fairly good therapeatic effect on NFZ. Generaly, the time of cure is 2～4. There is almost no other side-effect except hyperpigmentation in some cases.