Objective To investigate the clinical value of combined detection of anti-cyclic citrullinated peptide antibody(anti-CCP antibody),rheumatoid factor(RF),C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)in the diagnosis of rheu-matoid arthritis(RA).Methods The detection results of the four serum indicators of 290 cases of patients with RA(RA group), 286 cases of patients with non-RA autoimmune diseases(non-RA group)and 1 50 cases of healthy individuals(control group),from March 2013 to August 2014 in this hospital,were retrospectively analysed.Results The serum levels of the four indicators have significant differences among the three groups,between the RA group and non-RA group,and between the RA group and control group(P =0.000).Between non-RA group and control group,there was significant difference of serum levels of anti-CCP antibodies (P =0.013),while the other three serum indicators had no significant differences (P >0.05).The sensitivity of combined detection of anti-CCP antibody and RF,combined detection of anti-CCP antibody,RF and CRP,combined detection of anti-CCP antibody,RF and ESR,and combined detection of anti-CCP antibody,RF,CRP and ESR for RA diagnosis have statistically significant differences (P <0.05),while there was no statistically significant differences of specificity (P > 0.05 ).The area under a receiver operating characteristic (ROC) curve of anti-CCP antibody,RF,CRP and ESR were 0.873,0.893,0.678 and 0.747,respectively. Conclusion Combined detection of anti-CCP antibody and RF has good specificity and sensitivity,which could improve the clinical diagnosis of RA.Combined detection of CRP and ESR could improve the detection rate of RA.

Objective To explore the clinical efficacy of tirofiban in treatment of patients with high-risk non-ST-segment elevation of acute coronary syndrome (NSTE ACS),in order to improve the level of treatment effect. Methods 90 cases with high-risk NSTE ACS from January 2011 to April 2013 were randomly divided into control group and observation group. The control group were received treatments of conventional aspirin,clopidogrel, anticoagulation,coronary angiography (CAG)and percutaneous coronary intervention (PCI),while the observation group were added tirofiban therapy an the basis of control group. After the treatment,the differences of cardiovascular adverse events,thrombolysis in myocardial infarction (TIMI)flow grade and complications in both two group were observed and compared. Results There were significant differences in major adverse cardiovascular events in the distal vascular blockage,surgery without reflux,recurrent angina and myocardial infarction and post-PCI TIMI flow grade 2 and 3 (P<0.05),but not in bleeding complications,TIMI flow grade 0 and 1 before and after PCI treatment. Conclusion Tirofiban is safe and effective in treatment of high-risk NSTE ACS in interventional procedures. It can improve TIMI flow, increase tissue perfusion and reduce postoperative complications.

Objective To evaluate the role of myosin light chain kinase(MLCK)in the increase in the permeability of human pulmonary microvascular endothelial cells(HPMVECs)induced by mechanical stretch.Methods HPMVECs were cultured in vitro and then randomly divided into 3 groups(n = 4 each): mechanical stretch group(group S),ML9 treatment group(group M)and control group(group C).In group S,the monolayer cells and magnetic beads coated with an RGD peptide were incubated in serum-free MCDB131 medium for 2 h,the unbound beads were washed out,and then the cells were exposed to magnetic twisting stimulation(MTS)for 2 h(frequency 3 Hz,intensity 4.2 mT).In group M,the monolayer cells and magnetic beads coated with an RGD peptide were incubated for 2 h in serum-free MCDB131 medium in which MLCK inhibitor ML9(50μmol/L)was added,and the other procedures were the same as in group S.In group C,the cells after washing as in group S were incubated for 2 h without exposing to MTS.Monolayer permeability was detected with FITC-dextran flux in transwell model.The distribution of integrin αVβ3 and actin was detected using the immunofluorescence assay.Results Compared with group C,the permeability of HPMVECs was significantly increased in group S,while no significant change was found in group M.Compared with group S,the permeability of HPMVECs was significantly decreased in group M.In addition,actin polymerized to form stress fiber,and integrin αVβ3 clustered at the end of stress fiber in group S,while actin mainly distributed in the surrounding area of the cell membrane and integrin αVβ3 evenly distributed on the cell surface in group C and M.Conclusion The mechanism by which mechanical stretch induces the increase in the permeability of HPMVECs is related to MLCK activation-mediated stress fiber formation and integrin αVβ3 clustering.

Rhei Radix et Rhizoma, as a commonly used traditional Chinese medicine, has been widely applied in clinic. Its major purgative constituent is anthraquinones, which are believed to be a toxic ingredient. Glycyrrhizae Radix et Rhizoma has been reputed as the best alexipharmic to moderate medicine natures. In this paper, the effect of Glycyrrhizae Radix et Rhizoma in relieving purgative activity of Rhei Radix et Rhizoma was studied in two aspects--the boiling process and intestinal metabolism; Studies on combined administration of Glycyrrhizae Radix et Rhizoma and Rhei Radix et Rhizoma in recent years were summarized according to chemical constituent, intestinal flora, I/II phase metabolism and drug transport. However, the material basis and mechanism for their compatibility remain unclear, further studies will be made in the future.
Animals ; Cathartics ; adverse effects ; analysis ; pharmacology ; Chemistry, Pharmaceutical ; Drugs, Chinese Herbal ; adverse effects ; analysis ; pharmacology ; Glycyrrhiza ; chemistry ; Humans ; Rheum ; adverse effects ; chemistry ; Rhizome ; chemistry

Humans ; Magnetic Resonance Imaging ; Neurosurgery ; trends

Objective To investigate the risk factors of hypoparathyroidism after total thyroidectomy and bilateral central lymph node dissection in patients with papillary thyroid carcinoma.Methods Data of patients with PTC who accepted total thyroidectomy and bilateral central lymph node dissection in the Department of Thyroid Surgery from Jan.2013 to Jun.2016 were collected and analyzed retrospectively.The patients were divided into normal group,transient hypoparathyroidism group and permanent hypoparathyroidism group according to the level of serum parathyroid hormone within 6 months after surgery.Clinical data were collected for comparison between the three groups.The risk factors of hypoparathyroidism were indentified with univariate analysis and multivariate analysis.Results A total of 468 patients,241 in the normal group and 227 in the hypoparathyroidism group (220 in the transient hypoparathyroidism group and 7 in the permanent hypoparathyroidism group),were included in the study.Univariate analysis showed that without application of carbon nanoparticles (P=0.04) and autotransplantation of more than one parathyroid gland (P＜0.001) were risk factors of hypoparathyroidism,and without application of carbon nanoparticles (P=0.047),incidental parathyroidectomy of one parathyroid gland (P=0.04),gross extrathyroidal extension (P=0.006) and c N1a were risk factors of permanent hypoparathyroidism.Multivariate analysis showed that without application of carbon nanoparticles (OR,0.437;95％ CI,0.243-0.789;P=0.006) and autotransplantation of more than one parathyroid gland (OR,3.025;95％ CI,1999-4579;,P=0.000) were independent risk fact ors of hypoparathyroidism,and without application of carbon nanoparticles (OR,0.197;95％ CI,0.039-0.982;P=0.048) and gross extrathyroidal extension (OR,12.381;95％ CI,1.432-107.036;P=0.022) were independent risk factors of permanent hypoparathyroidism.Conclusion When total thyroidectomy and bilateral central lymph nodes dissection were performed,carbon nanoparticles were routinely applied.Although autotransplantation of more than one parathyroid gland can increase the incidence of transient hypoparathyroidism,it can reduce the incidence of permanent hypoparathyroidism.If extrathyroidal extension is suspected,hypoparathyroidism should be emphasized to patient,and accurate operation should be done to reduce the incidence of hypoparathyroidism.

Hepatic epithelioid hemangioendothelioma is a rare and low-grade malignant tumor of vascular origin.Clinical symptoms and laboratory findings are unspecific.The definitive diagnosis can only be made by histopathalogi-cal investigation The primary treatments of choice are radical hepatic resection or liver transplantation. The role of differ-ent adjuvant therapies for patients with hepatic epithelioid hemangioendothelioma remains to be determined.

8 000 mg group was lower than the normal control's(P

Objective To explore the efficacy of laparoscopy in acute abdominal pain. Methods From March 2002 to March 2007,306 patients with acute abdominal pain were explored and treated by laparoscopy in our hospital. The patients were diagnosed with acute appendicitis in 105 cases,unidentified abdominal pain in 34,acute cholecystitis complicated with cholecystolithiasis in 64,gastrointestinal tract perforation in 51,common bile duct stones complicated with acute cholangitis in 5,intestinal obstruction in 33,and severe acute pancreatitis in 5; 9 patients were confirmed as having trauma. Results All the 306 patients were unequivocally diagnosed during the operation. Laparoscopy was successfully completed in 275 cases,including 123 cases of appendectomy,57 cases of cholecystectomy,48 cases of gastrointestinal tract perforation neoplasty,13 cases of enterodialysis,4 cases of intestinal replacement combined with indirect hernia repair,4 cases of radical resection of the sigmoid colon with precolon anastomosis,1 case of small-incision segmental resection of the small bowel,3 cases of common bile duct resection and calculus removal,2 cases of neoplasty for right-lobe hepatorrhexis,3 cases of haemostasis for splenic rupture,5 cases of debridement and clysis and drainage for severe acute pancreatitis ,and 12 cases of laparoscopic abdominal exploration (2 cases of mesentery contusion and laceration,1 case of abdominal wall punctured wound with contusion of the greater omentum,8 case of primary peritonitis,and 1 case of abdomen-type allergic purpura). The remaining 31 patients were converted to open surgery because of difficulties in laparoscopy. The patients were followed up for 1 to 18 months,during which no one showed intra-or post-operative complications.Conclusions Emergency laparoscopic exploration can not only clarify a diagnosis for acute abdominal pain with unknown causes,but also treat the cases simultaneously. Moreover,it is of great help in guiding abdominal resection and making a suitable operative incision,even if the patients can not be treated by laparoscopy alone.

Objective To explore advantages of combined laparoscopic surgery(CLS).Methods The clinical data of 728 cases of CLS from July 1992 to March 2006 were analyzed retrospectively,including 586 cases of laparoscopic cholecystectomy(LC) combined with fenestration drainage of hepatic cysts,80 cases of LC combined with appendectomy,46 cases of LC combined with oophorocystectomy,16 cases of LC combined with unroofing and drainage of renal cysts.Results 726 cases of CLS were successfully performed,and 2 cases were converted to open surgery for abdominal adherence,with no complications such as bile duct injury,hemorrhea,infection and death occurred.During a mean follow-up period of 16 months(range,2-60 months) in 512 cases,no biliary calculi,recurrence of liver,kidney and ovarian cysts occurred.Conclusions CLS for two kinds or more abdominal diseases in one operation is safe and effective,with advantages of minimal invasion,less pain,and quicker recovery and so on.