BACKGROUND: It is always the key issue of rheumatoid arthritis(RA) to treat articular gall. A kind of medicine with favorable therapeutic effects and safety is urgently needed in the clinics. 99Tc-methylene diphosphonate 99(Tc-MDP) receives generalized attentions on its therapeutic effects and safety since its application into RA therapy.OBJECTIVE: To explore the characters of 99Tc-MDP in the amelioration of articular dysfunction in RA patients.DESIGN: A before-and-after controlled study by employing patients as subjects.SETTING: Department of rheumatism and immunology of an affiliated hospital of a university.PARTICIPANTS: Totally 67 patients with RA at active phase including 11males and 56 females aged between 29 and 71 years old with the course of disease between 9 and 78 months and admitted by the Department of Rheumatism of Huaxi Hospital Affiliated to Sichuan University were in accordance with the RA diagnostic criteria established by American Rheumatism Association(ARA) in 1987. Serious heart,liver or kidney dysfunction,active gastrointestinal pathological changes, hematology and endocrinology diseases,allergic complexion,and women during pregnancy or breast-feeding period were eliminated.METHODS: Clinical indicators including articular edema index, articular pain,grip,morning stiffness duration,rest pain,erythrocyte sedimentation rate (ESR) and C reactive protein(CRP) were compared before and after therapy in 67 cases received 99Tc-MDP treatment. Integrated evaluation was performed after the completion of therapy. Effective meant 30% of improvement in symptoms and physical signs,and reduction in ESR and CRP. Side effects were observed and recorded simultaneously. Data were statistically analyzed.RESULTS: After 99Tc-MDP treatment,RA condition significantly improved,as well as each clinical indicator including articular edema index,articular pain index,morning stiffness duration,rest pain,ESR and CRP(P<0.05) . The total clinical effective rate of this medicine was 81% and the incidence of side effects was small and mild.CONCLUSION: 99Tc-MDP can ameliorate the articular dysfunction of RApatients,which is a safe medicine with strong effect.

Objective To study the significance of antikeratin antibodies(AKA) in rheumatoid arthritis(RA). Method Serum samples of 98 patients with RA and 70 rheumatic disease controls were tested by indirect immunofluorescence assay.The diagnostic specificity and sensitivity of AKA were compared with rheumatoid factor(RF). The features of clinical manifestation and lab findings were compared in patients with RA who were positive for AKA with ones who were negative.Results The positive rate of AKA in RA patients was significantly higher than that in rheumatic disease controls.AKA showed a diagnostic specificity of 97.1%, higher than RF.RA patients who were positive for AKA had more active disease as assessed based on clinical, laboratory tests,and radiological variables, as compared with AKA negative patients. Conclusion AKA showes high disease specificity and has prognostic significance in patients with RA.

To evaluate the efficacy and safety of compound Decumbent Corydalis Rhizome (DCR) in treating patients with knee osteoarthritis (OA). Totally 79 patients with knee osteoarthritis were selected from out-patient and inpatient departments of West China Hospital and randomly divided into the test group and the control group. The test group (n = 41) was given Compound DCR with the dosage of 1.8 g · d(-1), while the control group (n = 38) was administered with diclofenac sodium with the dosage of 75 mg · d(-1). After 12 weeks of treatment, the total efficacy rates based on patients/physicians evaluation for experimental and control groups were 68.29%, 63.41% and 71.05%, 63.16%, respectively, without significant difference between the two groups. Both of the two groups showed significant improvements in the main efficacy indexes (pain on walking 20 m) and minor indexes (tenderness on palpation, Western Ontario and McMaster Universities OA index (WOMAC) and Short-Form Health Survey (SF-36 ), but without significant difference in efficacy between them. The incidence of related adverse events was 24.39% in the test group and 47.37% in the control group, respectively, with significant differences between the two groups (P < 0.05). In the controlled study, compound DCR is as efficient as diclofenac sodium but more tolerable, with a good clinical application prospect.
Adult ; Aged ; Corydalis ; chemistry ; Diclofenac ; administration & dosage ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Male ; Middle Aged ; Osteoarthritis, Knee ; drug therapy ; Rhizome ; chemistry ; Treatment Outcome

OBJECTIVETo explore therapeutic effects of Modified pinning combined with external tension band for the treatment of Gartland type III humeral supracondylar fractures in children.

METHODSFrom February 2009 to November 2010, 79 children with Gartland type III humeral supracondylar fractures were treated by modified pinning (pinning cross internal and external condyle assisted with lateral condyle) combined with external tension band (crossing needle end and hooking around) through lateral approach of elbow. There were 47 males and 32 females, with an average age of 8.7 years (ranging from 2.5 to 14 years). The time from injury to operation was 2 h to 8 d. The elbow joint function and Carrying angle were observed before and after treatment. The Flynn criteria were used to evaluate therapeutic effects.

RESULTSSixty-one patients were followed up (18 patients' data were lost) for 6-30 months (mean 13.5 months). According to Flynn criteria, 53 patients got excellent result, 7 good and 1 fair.

CONCLUSIONTreatment of child Gartland type III humeral supracondylar fractures with modified pinning combined with external tension band through lateral approach of elbow is believed to be an ideal method, which has advantages of reliable fixation, rapid recovery and less complications.

Adolescent ; Bone Nails ; Child ; Child, Preschool ; Female ; Fracture Fixation ; instrumentation ; methods ; Humans ; Humeral Fractures ; diagnostic imaging ; surgery ; Male ; Mechanical Phenomena ; Radiography ; Treatment Outcome

Adult ; Aged ; Angiography, Digital Subtraction ; Carcinoma, Hepatocellular ; diagnostic imaging ; therapy ; Chemoembolization, Therapeutic ; Female ; Hemangioma ; diagnostic imaging ; therapy ; Humans ; Liver Neoplasms ; diagnostic imaging ; therapy ; Male ; Middle Aged ; Radiography, Interventional ; methods ; Tomography, X-Ray Computed ; methods

Adult ; Aged ; Carcinoma, Hepatocellular ; surgery ; virology ; Female ; Follow-Up Studies ; Glutathione ; therapeutic use ; Hepatectomy ; methods ; Hepatitis B ; blood ; drug therapy ; Hepatitis B Surface Antigens ; blood ; Hepatitis C ; drug therapy ; Humans ; Liver Neoplasms ; surgery ; virology ; Male ; Middle Aged ; Prognosis

BACKGROUND: Renal tubulointerstitial fibrosis is mainly featured as the accumulation of extracellular matrix (ECM) in renal interstitium. The tubular epithelial-myofibroblast transdifferentiation (TEMT) is important to the pathogenesy of renal tubulointerstitial fibrosis. OBJECTIVE: To examine the effects of sodium ferulate (SF) on TEMT, and ECM main components such as collagen Ⅰ, collagen Ⅲ and fibronectin, in rat renal tubular epithelial cellsinduced by transforming growth factor-beta 1 (TGF- β1)- DESIGN: Randomized and controlled experimental study based on cells. SETTING: Department of Kidney in West China Hospital of Sichuan University. MATERIALS: Rat renal tubular epithelial cells (NRK-52E) originated from American Type Culture Collection (ATCC), were offered by the laboratory of Department of Nephrology in Australian Monash Medical Center. Cell strain used in this study was cultured at the 36th passage. SF white crystal with water solubility and more than 98.0% purify, was from Chengdu Hengda Pharmaceutical Co., Ltd. Different concentrations of SF (125,250, 500μreel/L) were designed in this study. Rabbit anti-rat α-smooth muscle actin (α -SMA) was produced by Wuhan Boster Company. Enzyme-linked immunosorbent assay (ELISA) kit was the produced of Shanghai Senxiong Science and Technology Co.,Ltd. Human recombinant TGF- β1 was produced by R&D Company. DNA Engine OpticonTM real-time fluorescence quantitative polymerase chain reaction apparatus was the product of MJ Research Company. METHODS: Rat renal tubular epithelial cells (NRK-52E) cultured in vitro were divided into five groups. Control group was added with serum-contained DMEM; TGF-β1-induced group was added with TGF-β1 at final concentration of 5 ng/L; SF at different concentrations groups were added with 125, 250, 500 μ mol/L SF and TGF- β1 at final concentration of 5 ng/L,respectively. MAIN OUTCOME MEASURES: The contrast phase microscope, real-time fluorescence quantitative polymerase chain reaction and ELISA method were used to detect TEMT of NRK52E cells induced by TGF-β1 and levels of collagen Ⅰ, collagen Ⅲ and fibronectin in the supernatant. RESULTS: Morphology of NRK52E cells: Compared with control group, TGF-β1 could induce the transdifferentiation of NRK52E cells, showing fibroblast-like in morphology after 3 days, which were previously the typical road stone-like epithelial cells. In three different concentration SF groups, the morphologic transformation stimulated by TGF-β1 could be partly ameliorated in a dose-dependent manner. Expression of α-SMA mRNA: Compared with control group, 5 ng/L TGF- β1 enhanced expression of α-SMA at 6 hours, and reached a peak at 72 hours; SF depressed the expression in a dose-dependent manner at 72 hours (P < 0.05). Changes of ECM: After induced by 5 ng/L TGF- β1 for 72 hours, the levels of collagen Ⅰ, collagen Ⅲ and fibronectin in the supernatant increased significantly (P < 0.05), whereas SF decreased these levels in a dose-dependent manner (P < 0.05). CONCLUSION: TGF- β1 induces the TEMT, and promotes the secretion of collagen Ⅰ, collagen Ⅲ and fibronectin. SF can inhibit TGF- β1-induced TEMT In a dose-dependent manner.

Objective To investigate the efficacy and safety of Technetium 99m Tc methylenediphos-phonate injection (Yunke) and various combination therapy on rheumatoid arthritis.Methods All 137 patients enrolled in trial group.Among them 67 patients received Technetium 99m Tc methylenediphosphonate alone,42 patients received combination therapy with methotrexate and mobik and 28 patients received calcium orally meanwhile.Clinical manifestations and lab markers were observed carefully.Results The conditions of 67 patients receiving Technetium 99m Tc methylenediphosphonate alone were improved,42 patients received combination therapy had better effect and 28 patients in middle and old-age taking calcium orally simultaneously showed superiority in remission of rest pain and descent of ESR.Conclusion Technetium 99m Tc methylenediphosphonate is an effective and safe drug in the treatment of rheumatoid arthritis.Results is suggest calcium be taken in the same time.

Objective:To explore the method of building the formative assessment (FA) system in diagnostics teaching and investigate its implementation effect.Methods:We planned and formulated the formative assessment system in diagnostics teaching of undergraduate curriculum. The correlation between the scores of the formative assessment and final exam were analyzed. A questionnaire survey on students' attitudes towards FA and an interview on teachers' perspectives were conducted. SPSS 17.0 was used for statistical analysis. Linear correlation analysis was used to compare the final exam scores with formative assessment scores, and Wilcoxon rank sum test was used to compare the scores of questionnaire items.Results:The scores of FA were significantly positive related to the scores of final exam ( r = 0.559, P < 0.001). The questionnaire analysis showed that students significantly valued the formative assessment superior to the summative assessment ( Z = -8.632, P<0.001). It was generally approved of the promotion of FA in students' self-direct learning and self-supervision and the advances in acquirement of knowledge and skills. Conclusion:It is feasible of carrying FA in diagnostics teaching which could provide better learning outcome and might have an extensive prospect of application.