Objective　To measure the levels of urokinase-type plasminogen activator (uPA) and its receptor (uPAR) in synovial fluid and plasma of patients with RA and investigate its clinical significance.Methods　By using ELISA sandwich method,the levels of uPA and uPAR in plasma from 46 patients with RA and 8 with osteoarthritis (OA) were measured.Those in synovial fluid (SF) from 14 patients with RA,and plasma from 12 healthy subjects were measured as controls.Results　The concentration of uPA and uPAR in SF from patients was significant higher than that in their plasma (P＜0.001,P＜0.01),and the concentration of uPA and uPAR in plasma of RA was also much higher than that in plasma of OA patients (P＜0.05,P＜0.000 1) and healthy subjects (P＜0.000 1,P＜0.001).There was no significance between plasma levels of RF＋ and RF－ in RA patients.The concentration of uPA and uPAR of plasma in RA correlated positively with CRP,RF and the number of swelling joints.Conclusion　The levels of uPA and uPAR in SF and plasma are useful parameters for monitoring disease activity of RA.These findings suggest that the uPA and uPAR genes may play an important role via proteolytic damage of the extracellular matrix during the development of RA.

Objective To investigate the role of chemokine in inducing peripheral arthritis in spondyloarthropathy(SpA).Methods Microarray was used to screen the candidates of inducing peripheral arthritis in SpA,and enzyme linked immunosorbent assay(ELISA)was used to verify the results.Peripheral blood mononuclear cells(PBMC)from 5 healthy subjects were co-incubated 1.5 hours with synovial fluid of 5 patients with SpA,total RNA were then extracted,and the samples were screened for the target genes by using superarray techniques.ELISA was used to determine CXCL1 protein levels of 54 ankylosing spondylitis(AS)patients and 30 healthy controls,also to determine the CXCL1 levels of synovial fluids from 33 SpA patients and 14 osteoarthritis(OA)patients,and to determine CXCL1 protein levels by ELISA before and after treatment with infliximab.Results The expression of CXCL1,CXCL2,CXCL3 and IL-8 were more than 2 fold higher after stimulated by synovial fluids.However,there was no change in other chemokines and cytokines,such as TNF?,IL-6 and IL-1 after stimulation.The protein level of CXCL1 was significant higher in serum of patients with AS than that of healthy control(P

To study the etiology and treatment of relapsing polychondritis, especially tracheostenosis, 3 patients with severe relapsing polychondritis complicated with severe tracheostenosis were presented. The clinical features, criteria of diagnosis, etiology, therapy and prognosis were discussed. All the 3 cases were female. They were misdiagnosed as laryngopharyngeal inflammation with severe tracheostenosis, so that their correct diagnosis and treatment were delayed. The report and discussion of such cases are helpful to its early diagnosis and improve ment of their prognosis.

Aim To observe the effect of polydatin(PD) on the activities of ?-AR in cardiomyocytes under the stimulation of LPS. Methods Cardiac myocytes were isolated and cultured from neonatal rats. Radioligand binding assay and flow cytometry were used to detect the function of ?-AR. Results In control group, the density of ?-AR (B max) was 4.14?1.41 fmol?(1?105 cells) -1 and ?-AR affinity (K d) was (4.02?0.59) nmol?L -1. In LPS group, ?-AR density was down-regulated 〔B max=1.78?0.12 fmol?(1?105 cells) -1〕 and the affinity decreased (K d=23.88?2.34 nmol?L -1). In LPS+PD group, ?-AR B max was recovered to 3.37?0.36 fmol?(1?105 cells) -1 and the affinity increased (K d=3.44?0.44 nmol?L -1). In PD group, ?-AR functions had no significant difference with normal group 〔B max=2.76?0.32 fmol?(1?105 cells) -1 and K d=4.63?1.54 nmol?L -1〕. The ?-AR amount measured by flow cytometry showed the same change tendency as the radioligand binding assay. Conclusion ?-AR activities may be down-regulated during the pathological process of LPS treatment. PD could reverse the effects of LPS by up-regulating ?-adrenoreceptors.

OBJECTIVE To compare the effect and safety of coblation plasma surgery and beclomethasone dipropionate nasal spray in the treatment of perennial allergic rhinitis. METHODS A stratified,randomized,controlled trial of surgery and medicament was performed in the treatment of perennial allergic rhinitis. A total number of 102 patients were involved in the trial,including 56 cases with swelling of inferior turbinate,28 cases in surgery group,28 cases in medicament group; and 46 cases without swelling of inferior turbinate,23 cases in surgery group,23 cases in medicament group. Coblation plasma surgery was performed in all surgery groups. Each patient was given 50?4?2 ?g/d of beclomethasone dipropionate nasal spray in all medicament groups,Treatment time was 3 months. The symptom scores (SS)and visual analogue scale(VAS)were recorded. RESULTS Effect assessment showed that both methods had significant repressive effect on allergic symptoms,the effect of surgery group was better than that of medicament group at the 14th day,28th day and 3th month in cases with swelling of inferior turbinate. Difference between the surgery group and medicament group in cases without swelling of inferior turbinate had no statistic significance. CONCLUSION Both coblation plasma surgery and beclomethasone dipropionate nasal spray are effective to treat perennial allergic rhinitis. But coblation plasma surgery is better than medicament in cases with swelling of inferior turbinate.

AIM: To investigate the chemotaxis mechanisms of polymerphonuclear leukocytes (PMNs) under the stimulation of LPS and its regulation by polydatin (PD). METHODS: Chemotactic chamber assay was used to investigate the regulatory role of formyl peptide receptor like-1 (FPRL1) in the chemotaxis of PMNs in response to LPS and PD. RESULTS: LPS increased the secretion of PMN chemotactic factor and up-regulated the function of formyl peptide receptor like-1. PD did not obviously affect the chemotactic factor secretion in normal PMN and the function of formyl peptide receptor like-1, but it significantly reduced the rise of chemotactic factor excretion in PMNs caused by LPS stimulation and PMNs transfected with formyl peptide receptor like-1. CONCLUSION: FPRL1 may mediate LPS-induced PMN chemotaxis, and PD regulates PMN chemotaxis by down-regulating the secretion of chemokine and the function of FPRL1 and may play a crucial role in the treatment of inflammation.

Objective To evaluate the clinical effect of acupotomy therapy combined with acupuncture based on distal points selection for lumbar intervertebral disc protrusion ( LIDP) . Methods Sixty-eight LIDP patients were randomly divided into treatment group (N=33) and control group(N=35). The treatment group were given acupotomy therapy on the proximal positive response points in the lumbosacral region for relaxing the tendons,and acupuncture therapy based on distal points selection of Shugu, the Shu-stream point of the foot Taiyang bladder meridian, Zulinqi and Weizhong, the shu-stream point and the blood xi-cleft point of the foot Shaoyang gallbladder meridian respectively, twice a week, 2 weeks constituting one course of treatment. The control group was given conventional electroacupuncture therapy on Huatuo clip points, Dachangshu point, bilateral Shenshu points, Yinmen point, bilateral Zibian points and bilateral Yanglingquan points, and together with TDP radiation therapy, 5 times a week, 2 weeks constituting one course of treatment. The two groups received follow-up for one month. The low back pain scores of Japanese orthopaedic society ( JOA) and visual analog scores ( VAS) of pain were used for the evaluation of therapeutic effect after the treatment. Results ( 1) After treatment, the JOA scores were increased and VAS scores were decreased in both groups compared with those before treatment ( P< 0.05) , and the increase of JOA scores and the decrease of VAS in the treatment group were superior to those in the control group ( P< 0.05) . There was statistically significant difference of VAS scores between the two groups ( P < 0.05) during the follow-up period. ( 2) The total effective rate was 87.9%in the treatment group, and was 77.1%in the control group, the difference being significant (P<0.05) . Conclusion The acupotomy therapy combined with acupuncture based on distal points selection is effective and safe for lumbar intervertebral disc protrusion, which has the advantages of reliable long-term effect and low recurrence rate, showing good prospects for extensive clinical application.

Objective To understand the content of discharge guidance for lung cancer patients ,and to provide evidence for improving the quality of lung cancer .Methods Using convenient sampling method ,a sample of 212 patients with lung cancer in the Department of Thoracic Oncology ,a third‐class hospital in Sichuan province was surveyed by general data questionnaire and dis‐charge guidance quality questionnaire .Results The total discharge guidance quality was (195 .93 ± 39 .98) points and was at a high level .The score of discharge guidance requirement(48 .69 ± 11 .51) was higher than that of discharge instruction (47 .35 ± 11 .34) , the difference was statistically significant(P<0 .05) .There was significant difference in the scores of different age ,educational lev‐el ,living style and the patients with central venous catheter (PICC/CVC) ,the difference was statistically significant (P<0 .05) . Conclusion Patients with lung cancer were discharged from the hospital with a higher level of guidance ,and the content of dis‐charge guidance from patients with lung cancer was far from meeting the requirements .It should be based on the age ,education and living style of patients with lung cancer ,especially for strengthening the guidance of discharged patients with PICC/CVC ,improving the quality of discharge guidance and promoting the rehabilitation of lung cancer patients .

Objective To compare the clinical efficacy of multi-target lateral puncture combined with intracranial pressure monitoring in treatment of basal ganglia hypertensive cerebral hemorrhage. Methods Sixty-six patients of basal ganglia hypertensive cerebral hemorrhage, with bleeding volume over 40 ml were divided into experimental group (36 cases) and control group (30 cases) by random digits table method. Patients in experimental group underwent multi-target puncture combined with routine intracerebroventricular treatment of intracranial pressure monitoring,and patients in control group underwent frontotemporal craniotomy and small hematoma decompressive craniotomy. The operation time, length of stay, hematoma evacuation rate, catheter drainage time, total amount of mannitol, Glasgow Coma Scale (GCS) scores 3 days after treatment, complication rate and 3-month Glasgow Outcome Scale (GOS) scores were recorded and compared between two groups. Results The operation time, length of stay, hematoma evacuation rate 1 day after treatment, and total amount of mannitol in experimental group were significantly lower than those in control group: (67.5±8.0) min vs. (109.3±9.6) min, (18.6±4.2) min vs. (23.3±5.9) min, (59.7±9.2)% vs. (80.4±11.6)%, (668.6±83.5) g vs. (1 430.4±107.1) g, P<0.01. The hematoma evacuation rate 3 days after treatment, catheter drainage time and GCS scores 3 days after treatment between two groups had no significant differences (P>0.05). The GOS scores in experimental group: 5 points (9 cases), 4 points (10 cases), 3 points (8 cases), 2 points(5 cases), and 1 point(4 cases). The GOS scores in control group: 5 points (4 cases), 4 points (4 cases), 3 points (7 cases), 2 points (9 cases), and 1 point (6 cases). Long curative effect in experimental group was better than that in control group (Z =2.318, P =0.020). The incidence of intracranial air in experimental group was significantly higher than that in control group: 27.8%(10/36) vs. 3.3%(1/30), P<0.05. Other complications had no significant differences between two groups (P>0.05). Conclusions Multi-target lateral puncture combined with intracranial pressure monitoring in treatment of basal ganglia hypertensive cerebral hemorrhage has more advantages, including less trauma, wide surgical indications, short operation time and hospital stay, less postoperative mannitol, and decreased mortality rate. For older, patients with organ dysfunction, and patients who can not tolerate craniotomy, it is an effective treatment, and worthy of promotion.

In order for special hospitals to survive and develop in the fierce market competitions, it is imperative for them to enhance their competitiveness, the key to which lies in accelerating personnel training. For this reason, it is necessary to take the following steps: changing concepts, identifying goals, implementing personnel training strategies and taking the initiative in selecting talented personnel; making exertions in personnel training through expanding channels and conducting classifications; creating the right circumstances, optimizing the environment and making a rational use of personnel; adopting innovative mechanisms, perfecting systems and scientifically managing personnel. It is important to take specialty advancement as the guide, personnel training as the prop, and scientific research and teaching as the driving force in achieving the sustainable development of special hospitals.