Objective To explore the relation between rheumatoid arthritis (RA) and the meteorological factors.Methods All RA cases in the group were followed for 12 months,patients were follow-up for every two weeks.In each followed-up,all RA cases were evaluated by the disease activity score-28 (DAS28) and the improved Jamieson questionnaire,and the correlation of the DAS28 and the average values of meteorolo-gical factors (temperature,humidity,atmospheric pressure,relative humidity,wind speed) by Pearson correlation coefficient.The moderate-severe activity cases were evaluated by chi-square test of different seasons.Results One hundred and eighty-eight cases completed the observation,One hundred and sixty-four cases were in moderate disease activities (x2=9.42,P=0.022).Sixty-eight cases were distributed in winter,which was significantly higher than other three seasons.The average temperature and wind speed was negatively related to the DAS28 (r=-0.743,P＜0.01; r=-0.576,P=0.003).Conclusion The activity of RA has the characteristics of seasonal changes,and is easily being aggravated in winter.Many factors may influence RA,including temperature and wind speed.Creating an appropriate micro-climate environment is beneficial for RA patients to reduce the disease activity.

Objective To compare the effect of GammaTM wet wipes and 75% alcohol on the disinfection of X-ray protective clothing,and provide reference for choosing rational disinfection methods.Methods 62 pieces of X-ray protective clothing were selected,30 were from operating rooms,32 from catheterization room.Protective clothing were randomly divided into trial group and control group,each had 31 pieces.Trial group disinfected clothing with GammaTM wet wipes,control group disinfected clothing with 75% alcohol,disinfection effect,drying time,and cost between both groups were compared.Results Average bacterial colony counts in trial group and control group before disinfection were 2.38 CFU/cm2 and 2.36 CFU/cm2 respectively,qualified rates were 80.64% and 83.87%respectively.Bacteria were not detected in both groups after disinfection.The average drying time in trial group was shorter than control group([352.35±9.93]s vs[676.13±10.62]s,t=123.98,P <0.01).The cost of disinfecting X-ray protective clothing in trial group was 29.60% less than control group.Conclusion Effect of GammaTM wet wipes and 75% alcohol on disinfecting X-ray protective clothing are both reliable,compared with 75% alcohol, GammaTM wet wipes are without corrosion,have shorter drying time,and save more cost.

Objective To understand the biological characteristicsand drug resistance of methicillin-resistant staphylococcus aureus (MRSA) isolated from neonatal clinic and the nose swabs of medical staff in the neonatal department.Methods Twenty-six strains of MRSA clinically isolated from the neonatal department and the nose swabs of medical staff in this department were collected and performed the multilocus sequence typing (MLST),spa typing, staphylococcus cassette chromosome mec (SCCmec) typing and pulsed-field gel electrophoresis (PFGE) typing.The Panton-Valentine leukocidin (PVL) gene was simultaneously detected.The antimicrobial susceptibility test of 14 antibacterial dugs was performed.Results Among 26 strains of MRSA,53.8% was isolated from sputum,2 strains were detected from the nase swab of medical staff.The MLST type had 5 types,ST59 accounted for 76.9%.The spa type had 8 types,t437 acoounted for 65.4%.the SCCmec type had only 2 types,20 strains were SCCmecⅣ(76.9%,20/26) and 4 strains(15.4%) were SCCmecV.In the PLV gene detection,the PVL positive rate was 15.4%.One strain of MRSA from the nose swabs of medical staff in the neonatal department was100% homologous with 1 strain from the patient by PFGE analysis.The drug susceptibility test results showed that all MRSA strains were 100% sensitive to antibacterial drugs of nitrofurantoin,quinupristin/dalfopristin,vancomycin and quinolone,while had higher resistance rates to tetracycline,erythromycin and clindamycin,which were above 50%.Conclusion In MRSA strains isolated from the neonatal department in this study,the most common clones were MRSA-ST59-SCCmecⅣ-t437.Erythromycin and clindamycin should not be preferred in the empiric treatment of newborn MRSA.

Objective To investigate protective effects of pyrrolidine dithiocarbamate (PDTC) and mycophenolate mofetil (MMF) on kidneys of diabetic rats and the possible mechanism. Methods Thirty-four streptozotocin-induced diabetic rats were randomly divided into 4 groups: diabetic aminals without treatment (D group), diabetic rats treated with PDTC (P group), diabetic rats treated with MMF (M group), diabetic rats treated with combined PDTC and MMF (P+M group), and normal rats were considered as control group (C group). Blood glucose, blood urea nitrogen (BUN), serum creatinine (Scr), and 24 h urinary protein (24 h UP) were detected at the end of treatment lasting for 8 weeks. Kidneys were weighed in order to measure kidney weight/body weight ratio (KI) after rats were killed. Pathological changes in the kidneys were observed by light microscope and electron microscope. Expressions of interleukin-18 (IL-18), intercellular adhesion molecule-1 (ICAM-1) and tumor necrosis factor-α (TNF-α) in renal glomerulus were detected by immunohistochemical staining.Results Blood glucose, BUN, Scr, 24 h UP, KI were significantly higher in D, P, M and P+M groups than those in C group (all P＜0.05). BUN, Scr, 24 h UP, KI were significantly lower in P, M and P+M groups than those in D group (all P＜0.05). 24 h UP was reduced in P+M groups compared with P,M groups (P＜0.05). Pathological changes were attenuated in P,M and P+M groups compared with D group. Expressions of IL-18, ICAM-1, TNF-α in renal glomerulus were much higher in D group than those in C group (all P＜0.05) and were reduced in P, M and P+M groups compared with D group (all P＜0.05). Expressions of IL-18, ICAM-1, TNF-α in P+M group were lower than those in P group (all P＜0.05), while expressions of IL-18, TNF-α were lower than those in M group (both P＜0.05). Conclusion The protective effects on kidneys of diabetic rats produced by combined use of PDTC with MMF were much better than by the application of either PDTC or MMF alone. The mechanism appears to be related with suppressing expressions of inflammatory cytokines.

Streptozotocin-induced diabetic rats were treated with resveratrol for 12 weeks.Compared with group of diabetic rats without treatment,the levels of urine albumin,serum creatinine,and blood urea nitrogen were significantly decreased and pathological changes in kidney were improved in treatment group ( P＜0.05 ).The mRNA expressions of FoxO1 and catalase were higher and FoxO1 phosphorylation level in diabetic rats treated with resveratrol was lower than that in diabetic rats without treatment (P＜0.05),suggesting that resveratrol may protect the kidneys of diabetic rats via regulating expression of FoxO1.

Objective To review the clinical features,etiology and differential diagnosis of hypopituitarism.Methods The clinical data of 260 patients with hypopituitarism admitted to our hospital during 2007 to 2011 were retrospectively analyzed.Results In 260 patients 96 were males and 164 were females,the average age of female patients was significantly higher than that of males[ (44 ± 16) vs.(32 ± 20) years; t =3.821,P =0.001 ].Patients under 20 years accounted for the highest proportion in male cases (38/96,39.6％) ; while patients aged 40 - 60 years were the highest proportion for female cases (86/164,52.4％).Pituitary tumor and postoperative damage was the most common cause for hypopituitarism accounting for 36.2％ (94/260),followed by Sheehan syndrome (86/260,33.1％).The most common manifestation of hypopituitarism was anemia (102 eases) ; 26 cases presented all pituitary function failure.The causes leading to hypopituitarism usually showed specific manifestations in imaging examinations.The overall misdiagnosis rate was 40.4％ (105/260)in this series,while that of etiological diagnosis was 25.4％ (66/260).Conclusions This study suggests that hypopituitarism caused by different causes can be diagnosed by disease history,clinical manifestations and pituitary imaging examination.

Objective To assess the efficacy of methylprednisolone (MP)pulse therapy in treatment of Hashimoto thyroiditis(HT) complicated with goiter.Methods 30 patients with HT complicated with goiter participated in the study and received MP pulse therapy.The patients had to be euthyroid for at least 3 months before the date of inclusion with plasma concentrations of thyroid hormones within their reference range.The goiter was still obvious and had no improvement.A dose of 250 mg MP was administered intravenously for seven consecutive days,and then treated with oral prednisone 10 mg,three times per day for 6 weeks with the dosage in each week gradually reduced at 5 mg to none.Ultrasonic was used to measure thyroid size before and after MP treatment.Results The treatment was successful at the end of the trial in all of the 30 patients receiving MP.The thyroid size from length,breadth,thickness to isthmus obviously decreased (P ＜ 0.05).The length of the left lobe was (57.42 ± 12.87) mm and (46.37 ± 7.67) mm (t =4.58) before and after treatment; The breadth of the left lobe was(26.68 ±7.71) mm and(22.21 ±6.09) mm(t =4.56) before and after treatment; The thickness of the left lobe was (27.18 ± 6.60) mm and (21.14 ± 5.67) mm(t =7.28) before and after treatment.The length of the right lobe was(58.17 ± 12.32)mm and(49.73 ±9.35) mm(t =3.84) before and after treatment; The breadth of the right lobe was (26.14 ± 7.37)mm and (23.00 ± 6.68) mm(t =3.29) before and after treatment ; The thickness of the right lobe was(27.57 ± 6.42)mm and(22.00 ±5.55)(t =5.88)before and after treatment.The isthmus before and after treatment was(9.94 ±4.15)mm and(6.19 ±2.57)mm(t =6.09).The recurrence rate was 17％ (5/30) after one year.Conclusions MP pulse therapy is an effective treatment for HT complicated with goiter.The recurrence rate is low.

Eleven male patients with pituitary stalk interruption syndrome (PSIS) at our hospital were retrospectively analyzed with respects to clinical features,endocrine status and imaging characteristics.The clinical manifestations included growth retardation and delayed puberty.All of them were deficient in growth hormone and pituitary gonadotropin secretion.Secondary hypothyroidism and hypocortisolism occurred in 8 patients and one had concurrent central diabetes insipidus.MRI with gadolinium contrast revealed no pituitary stalk or slim and anterior pituitary hypoplasia with ectopic posterior pituitary.The clinical characteristics of PSIS are growth retardation and delayed puberty,partial or complete adenohypophyseal dysfunction.The detection of hypothalamic pituitary region by MRI is an important diagnostic tool.

Objective To explore the relationship between Graves disease and hypokalemic periodic paralysis or thymus hyperplasia.Methods Sixty-two patients with Graves disease were enrolled in this study.Thirty-three patients without thymus hyperplasia were selected as group A and other 29 patients were group B.In addition,30 healthy volunteers served as control group.Results There were no significant difference between group A and group B in terms of sex,age,illness course,thyroid enlargement,exophthalmos,periodic paralysis and the levels of free triiodothyronine (FT3),free thyroxin (FT4),thyroid stimulating hormone (TSH) (P ＞ 0.05).The incidence rate of hypokalemic periodic paralysis in male Graves disease with thymus hyperplasia was 62％ (8/13),higher than that in female patients (6％ (1/16),x2 =10.24,P ＜ 0.05).The incidence rate of hypokalemic periodic paralysis in male Graves patients was 62％ (16/26),higher than in female Graves patients (6％ (2/36),x2 =22.96,P ＜ 0.05).There was no significant relationship between Graves disease patients combined with thymus hyperplasia and sex,age,illness course,thyroid enlargement,exophthalmos,periodic paralysis and the levels of FY3,FT4,TSH.Conclusion The incidence rate of hypokalemic periodic paralysis in male Graves disease patients combind with thymus hyperplasia is higher than in female,and therefore it should pay more attention of male Graves patients in case misdiagnosis.

Purpose To investigate the expression of polo-like kinase 1 (Plk1) and Cyclin B1, p21WAF1in cervical carcinoma, and to determine the relationship between the expression of the three proteins and tumor clinicopathological features. Methods The expres-sion of Plk1, Cyclin B1 and p21WAF1 was detected in 102 cases of cervical carcinoma, 20 cases of (cervical intraepithelial neoplasia, CIN) , and 20 cases of nomal cervical tissues by the technique of tissue chip and immunohistochemical staining of EliVision. Statistical analyses of the data were performed with SPSS 19. 0 software. Results The positive rates of Plk1 in cervical carcinoma and CIN were 70. 5%, 55. 0%, respectively, which were significantly higher than normal cervical tissues (10%) (P<0. 01);The positive rates of Cyclin B1 in cervical carcinoma and CIN were 52. 9% and 30. 0%, respectively, which were significantly higher than normal cervical tissues (10%)(P <0.01); The positive rates of p21WAF1 in cervical carcinoma and CIN were 23.5% and 10.0%, respectively, which were significantly higher than normal cervical tissues ( 0 ) ( P<0. 01 ) . There were no significant differences between cervical carcinoma and CIN in the positive rates of Plk1, Cyclin B1 and p21WAF1. The expression of Plk1 was associated with the depth of carci-noma invasion (P<0. 05), that of Cyclin B1 was associated with lymph node metastases and the depth of carcinoma invasion (P<0. 05)and that of p21WAF1 in cervical carcinoma was associated with histological grade (P<0. 05). In cervical carcinoma, the expres-sion of Plk1 was positively correlated with Cyclin B1 (rs =0. 297, P=0. 002) and negatively correlated with p21WAF1(rs = -0. 403, P<0. 001). Conclusion The expression of Plk1, Cyclin B1 and p21WAF1 is involved in the occurrence and development of cervical carcinoma, and the former two are also related with prognosis of cervical carcinoma. The combination of the three would provide a new target for clinical treatment.