Objective To study the relationship between serum levels of C reactive protein,adiponectin and severity of disease,joint function in patients with rheumatoid arthritis(RA).Methods A total of 85 cases of RA treated in our hospital from September 2014 to August 2016 were selected into the RA group,and 20 healthy persons were recruited into control group.The serum C reactive protein,adiponectin were detected,compared in the two groups,and to investigate the relationship between them with severity of disease,joint function of the patients.Results C reactive protein of RA patients was(23.63±5.36) pg/mL,which was significant higher than that of the control group,the adiponectin,the ratio of C reactive protein and adiponectin were(4.64±1.74)ng/mL,0.37±0.06 respectively,which were significant lower than those of the control group,the differences were statistically significant(P<0.05).RA patients with more serious joint injury and disease status,the adiponectin,the ratio of adiponectin and C reactive protien were more lower,the C reactive protien was more higher,the differences in different joint injury and disease status groups were significant(P<0.05).Logistic analysis showed that adiponectin(P=0.04),the ratio of adiponectin and C reactive protien(P=0.01) were independent risk factors of bone damage in RA patients.Conclusion Serum C reactive protein and adiponectin level were closely related to the severity of RA and joint function.

Objective To investigate the effect of multi-channel minimally invasive percutaneous nephrolithotomy in combination with Yag laser in complex renal calculi operation. Methods Eighty six complex renal calculi patients were divided into two groups, study group (46 cases) was treated with multi-channel minimally invasive percutaneous nephrolithotomy combined with Yag laser, control group was treated with single-channel minimally invasive percutaneous nephrolithotomy combinated with extracorporeal shock wave treatment. Comparison of gravel removed time, stone clearance rate,postoperative hemoglobin decreasing rate, blood transfusion rate of surgery,length of stay time and operative complications were done between the two groups, the results were analysed statistically. Result The gravel removed time was (102±23) min in study group, and ( 121 ± 28) min in control group, there was no significant difference between the two groups(P ＞ 0.05 ). In study group, postoperative hemoglobin decreasing rate was 6.5%(3/46), blood transfusion rate of surgery was 17.4% (8/46), stone clearance rate was 82.6%( 38/46 ), length of stay time was (5.6 ± 1.7) d,while those in control group was 12.5%(5/40),22.5%(9/40),72.5%(29/40), (7.4 ± 1.8) d,respectively. There was statistical significance between the two groups(P＜ 0.05 ). Conclusion Multi-channel minimally invasive percutaneous nephrolithotomy in combination with Yag laser in the treatment of complex renal calculi has the shorter operation time, less blood loss,less complications and higher stone clearance rate, and is worthy of promotion.

Objective　To explore the possibility of R plasmid (pRST98) encoding resistance to antimicrobial agents in S. typhi mediate virulence to its host bacteria. Methods　pRST98 was transferred into a less virulent strain of S. typhimurium RIA for creating a transconjugant pRST98/RIA. The standard S. typhimurium virulence strain SR-11 which carries a 100kb virulence plasmid was used as a positive control, and RIA as a negative one. Infection with S. typhimurium was employed to assess the effect of pRST98 on the virulence of host bacteria by LD50 of peroral (p.o.) and intraperitoneal (i.p.) infection of BALB/c mice. After oral inoculation of the bacteria into BALB/c mice, mesenteric lymph nodes, spleen and liver were examined for quantity of bacteria and for the histopathological changes. The three strains were also studied for their in vitro adhesion and invasion of HEp-2, CHO and HeLa cells. Three chromosomally isogenic strains, i.e., plasmid-containing wild-type S. typhi strain, plasmid artificially cured strain and plasmid-reintroduced into the cured strain were compared for their resistance to the bactericidal activity present in human, rabbit and guinea pig sera. Results　The p.o. and i.p. LD50 of pRST98/RIA was 700 and 75 folds less than that of RIA. The bacteria counting in mesenteric lymph nodes, spleen and liver were more (P<0.05) and more severe histopathological changes were observed in pRST98 harboring S. typhimurium. However, pRST98 did not affect the adhesion and invasion of S. typhimurium to the cells. Experiments showed that pRST98 mediated resistance to serum bactericidal effect in host bacteria (P<0.05). Conclusion　This is the first report about a plasmid carrying genes coding for drug resistance and virulence in S. typhi. The data presented here suggested that novel virulence gene or related sequences, which are important in the pathogenesis of Salmonella infection could exist on pRST98.

Objective To analyze the effect of clinical pathway of nursing on health education in patients undergoing tonsil-lectomy.Methods Participants included 180 patients undergoing tonsillectomy in our hospital from September 2012 to September 2013 were randomly divided into the clinical pathway of nursing group ( experimental group) and the traditional nursing group ( control group) with 90 cases in each group.The sleep quality, heart rate, blood pressure, body weight, hemorrhage, health education com-pliance rate and nursing service satisfaction were recorded and compared between the two groups.Results The sleep quality, health education compliance rate and nursing service satisfaction in the experimental group was better than that in the control group;The inci-dence of heart rate speed up, blood pressure increase, loss weight, the standard rate of health education, hemorrhage and the satisfac-tion of nursing quality was lower than that in the control group.There was statistical significance in the difference between the two groups (p<0.05).Conclusion Health education with the clinical pathway of nursing can improve the quality of nursing, promote the rehabilitation and increase the nursing service satisfaction .

Objective To observe the clinical efficacy of grain-sized moxibustion plus acupuncture in treating plantar fasciitis. Method Forty patients with plantar fasciitis were randomized into a treatment group and a control group, 20 in each group. The treatment group was intervened by grain-sized moxibustion plus acupuncture, while the control group was by ordinary acupuncture. Visual Analogue Scale (VAS) was used to observe the morning heel pain degree before and after the treatment, and the clinical efficacies were compared.Result The VAS scores were significantly changed after treatment in the two groups (P<0.05). After treatment, VAS score in the treatment group was significantly different from that in the control group (P<0.05). The recovery rate and total effective rate were respectively 45.0% and 95.0% in the treatment group, versus 10.0% and 90.0% in the control group, and there was a significant difference in comparing the recovery rates (P<0.01).Conclusion Grain-sized moxibustion plus acupuncture is an effective method in treating plantar fasciitis.

Coronary fistulae and ventricular septal perforation are very rare clinically, and even less caused by cardiac leiomyosarcoma. A case is reported that a 67-year-old female had cardiac leiomyosarcoma with progressive heart failure and coronary fistulae and ventricular septal perforation. This case was special since all ante-mortem examinations and cardiac surgery failed to detect the presence of any abnormal car-diac mass. Therefore, the malignant cardiac tumors could appear in an invasive form without mass and be one of the causes of the coronary fistulae and ventricular septal perforation.

Objective To investigate and analyze the related factors about the occurrence of thyroid diseases induced by interfer‐on in treating the chronic hepatitis B .Methods A retrospective analysis and following up of 213 interferon‐treated patients with chronic hepatitis B were performed .They were treated for 48 weeks and Logistic regression analysis was performed to evaluate the risk factors of thyroid dysfuncion .Patients were followed up for 48 weeks after drug withdrawal .Results In 213 patients received interferon therapy ,there were 38 cases suffered thyroid dysfunction ,nine of which were hypothyroidism including six cases of Hashimoto′s disease and 3 cases of non‐autoimmune thyroid dysfunction ,six of which were hyperthyroidism including 3 cases of Grave disease and 3 cases of destructive thyroiditis ,five of which were subclinical hyperthyroidism and 18 of which were subclinical hypothyroidism .Until 48 weeks of following‐up after treatment ,all patients with thyroid function was normal .Logistic regression a‐nalysis showed that the risk factors of female(OR=3 .696) ,hepatitis C virus infection over the same period (OR=3 .675) and pre‐stored anti‐thyroid peroxidase antibody(OR=2 .008) were correlated independently with the suffering of interferon induced thyroid diseases in the chronic hepatitis B patients .Conclusion For patients with chronic hepatitis B virus using interferon therapy ,espe‐cially the woman who pre‐stored anti‐thyroid peroxidase antibody in a large number and infected with hepatitis C virus ,the clinical therapy should monitor the related index of thyroid function regularly to prevent the happening of thyroid diseases .

Objective To investigate the effects of adrenomedullin (ADM) on the expression of nuclear transcription factor-?B (NF-?B) in cultured human retinal pigment epithelial (RPE) cells. Methods Cultured human RPE cells were exposed to ADM with the concentration of 10 -7mol/L or lipopolysaccharide (LPS) with the concentration of 10 ?g/ml for 60 minutes. Nuclear translocation of NF-?B was determined by immunofluorescence staining. Western blotting analysis was used to check the expression of NF-?B protein. Results In cultured human RPE cells that were not stimulated, weak NF-?B positive green flurescence was localized in the cytoplasm. After exposed to ADM or LPS for 60 minutes, there was bright NF-?B nuclear staining in cultured human RPE cells. The results of Western blotting analysis demonstrated that in cultured human RPE cells that were not stimulated, a single weak protein strip with the relative molecular weight of 36?103 identified as immunoreative NF-?B could be observed. Both ADM and LPS could markedly increase the expression of NF-?B protein in cytoplasm. Conclusions NF-?B-dependent signal transduction pathway can be activated in cultured human RPE cells by ADM. ADM could induce NF-?B nuclear translocation and increase the expression of the protein in cytoplasm. NF-?B-dependent signal transduction pathway may play an importantrole in the function of ADM.

OBJECTIVE To evaluate the efficacy and safety of teicoplanin treatment on complicated Gram-positive urinary tract infection.METHODS The patients′ clinical manifestation,laboratory results,bacterial culture changes after intravascular administration of teicoplanin were observed.Each patient was administered teicoplanin(200 mg once a day for 10-14 days,but 400 mg in the first day).RESULTS The effective rate and the bacterial eradication rate were 90.0% and 86.7%,respectively.All patients experienced relief from clinical infective symptoms and systemic reactions.There were no abnormal laboratory findings and adverse reactions.CONCLUSIONS Teicoplanin is an effective and safe antibiotic for the treatment of patients with complicated urinary tract infection.

0.05),but the ratio of fPSA/tPSA in PC group was very lower than that in BPH group(P20.0 ?g/L,the sensitivity and the specificity was 91.6%(22/24) and 87.5%(21/24).Conclusion It can improve the differential diagnosis between PC and BPH to use the ratio of fPSA/tPSA combining with the serum tPSA.It is important for the observation of the differential diagnosis and the therapeutic effects of PC and the preparation of the high risk persons and etc.