Objective To analyze the clinical efficacy of diacerein plus methotrexate and leflunomide in the treatment of rheumatoid arthritis in elderly patients.Methods Eighty elderly patients with rheumatoid arthritis seeking treatment at our hospital from September 2010 to December 2012 were divided into the treatment group (n =40) and the control group (n =40).Patients with osteoarthritis were excluded from enrollment.The treatment group was given diacerein,in addition to methotrexate and leflunomide,whereas the control group received methotrexate and leflunomide.Results Compared with the control group,the treatment group showed a lower swollen joint count [(0.93±0.21) vs.(3.43±0.69),t=10.728,P=0.013],a lower tender joint count [(1.15±0.46)vs.(3.6110.83),t=11.443,P=0.008],shorter morning stiffness (1.6±2.2 min vs.13.5±4.2min,t=11.164,P=0.011),and greater hand grip strength [7.97±1.53) kPa vs.(5.68±2.07)kPa,t=10.562,P=0.014].When measured by health assessment questionnaire (HAQ),visual analogue scale (VAS) and DAS28 scores,the treatment group also performed better than the control group.Additionally,the treatment group displayed a more favorable laboratory profile,which included the erythrocyte sedimentation rate (ESR) (9.51±4.32 mm/h vs.26.47±6.32 mm/h,t=9.892,P=0.028),C-reactive protein (CRP) [(2.34±0.57) mg/L vs.(8.13±2.14) mg/L,t=9.427,P=0.031],and rheumatoid factors (RF) [(231.3±45.5) kU/L vs.(283.3±68.4) kU/L,t=10.023,P=0.018].Furthermore,the adverse reaction rate was significantly lower in the treatment group than in the control group (15.0％ vs.37.5％,x2 =5.230,P=0.020).Conclusions Diacerein in combination with methotrexate and leflunomide has shown clearly positive outcomes in the treatment of rheumatoid arthritis in elderly patients and should be recommended in clinical treatment.

A supportive appraisal system is needed in medical ethics construction to guarantee its persistent effect.This paper carries forward the realization of a harmonious physician-patient relationship as the final goal of medical ethics construction,and repelling medical corruption as its sub-target,so as to enhance the quality of medical service.By analyzing medical corruption with real case demonstration and ethical theories,the internal correlation of medical ethics and medical corruption is clarified,and the idea that " construction of medical ethics appraisal system calls for to carry forward medical professionalism,repel medical corruption,and construct a harmonious physician-patient relationship".

The expxprience of 8 thousand cases using contrast medium in abdomen CT scanning were reported.The results showed that it was more suitable for selecting 76% Urografin.The best oral concentration was 1.5%.In abdomen scanning intramuscular injection 654-2 conventionally could improve the image quality.The rectum and sigmoid region scanning should use tee contraast medium through the anus.Vein injection rapidly(bolus)was a best vein contrast method.When visualing badly after bolus or needing observe vessels of contin- uous several sections,continuous bolus method was used.while delay scanning was often used in defining nature of angioma.

No abstract available.
Delivery of Health Care* ; Korea*

About 30％ ～ 40％ of small cell lung cancer (SCLC) patients belong to limited disease (LD).In the setting of limited-disease small cell lung cancer (LD-SCLC),the combination of thoracic radiotherapy (TRT) with chemotherapy is the standard treatment for LD-SCLC with improved survival and local control.It is proven that prophylactic cranial irradiation can improve the prognosis of patients with SCLC.Radiotherapy should join in the early chemotherapy and individualized formulate appropriate target volume.Radiation schemes of conventional fractionation or hyperfractionation way are recommended.

BACKGROUND:To evaluate the psychological characteristics of the patients waiting for renal transplantation in order to analyze coping style, thus perform the corresponding personalized clinical psychological intervention which is conductive for patients to face reality and disease. OBJECTIVE:To investigate the psychological characteristics of the patients waiting for renal transplantation and to analyze the effect of different social factors on the coping style of patients and to explore the corresponding clinical mental intervention method METHODS:Fifty-eight patients waiting for renal transplantation and 60 patients without renal transplantation were randomly selected from Second Department of Urology, Organ transplantation Center, the 309th Hospital of PLA between February 2009 and August 2010, the patients were required to fil in a psychological questionnaire form using the currently general used medical response. The effect of social factors on the coping style and psychological stress status was analyzed with multi-factor Logistic regression analysis. RESULTS AND CONCLUSION:From the questionnaire survey, the evasive and yielding value scores of the patients waiting for renal transplantation were significantly higher than those of the patients without renal transplantation (P<0.05), but there was no significant difference of confrontation score between the patients (P>0.05). It indicated that the psychological pressure of the patients waiting for renal transplantation was bigger that of the patients with out renal transplantation, which may related with course of the disease, cost and the rejection after transplantation for the patients has to endured. Multi-factor Logistic regression analysis showed that sex, education, income, payment methods and age of the patients were al related with the confrontation, evasive and yielding scores, as those with technical secondary school education or better got the best confrontation score while those with annual income less than 60 000 yuan got the highest score in evasive and yielding styles. The results show that income and education level of patients are the main factors that affect the coping style and psychological stress status of the patients waiting for renal transplantation, treating the patients with reasonable renal clinical care interventions can help the patients face to the disease positively and can reduce the damage of transplantation to the psychology of the patients.

To evaluate CT in the diagnosis of tuber culosis of the brain． CT findings in 95 cases with tuberculosis of t he bran confirmed clinically were analyzed retrospectively． Results: The CT detectability fate was 80%． The direct CT si ngs included exudation in basal system, meningitis, enhancement and intracranial tuberculosi s． The indirect signs had hydrocephalus infarction, atrophy calcification, periventricular hypo densith and subdural fluid accumulation etc． The most usual appearance was hydrocephalus． Conclusions: (1) It was helpful to diagnose when very two kinds of direct sings or a kind of dir ect sings and more than two kinds of indirect sings appeared． (2)The plain and contrast canning s hould be routinely used in tuberculosis of the brain．

Different doses of fatty oil of Perilla frutescens var. arguta (Benth. ) Hand. -Mazz. (ig )to mice for i5 days can decrease errors in step-down test, improve percentage of accuracyand shorten the time to reach their goal in water maze experiments. lt also facilitate thesynthesis of RNA, DNA and proteins in brain and regulates the level of monoamine -like ne-urotransmitters. The above results indicated that fatty oil of P. frutescens var .arguta canimprove learning and memory in mice related to the symthesis of RNA, DNA, proteins andneurotransmitters in braiu.

Objective To study CT manifestations of the malignant pleural mesothelioma(MPM) in rat.Methods 100 Wistar rats in the test group were injected with asbestos fibrous mixed fluid into closed right chest cavity 20 mg/ml one per month,the overall volume of asbestos was 40 mg,19 rats in the control group were injected with sterilized saline water of 1 ml per time,totally 2 ml as the same way.Dying or died rats were undergone CT scanning and pathologic examination,the experiment lasted for 2 years.Results In experimental group,there were 66 rats of MPM,14 cases of pleural hyperplasia and 12 cases without pleural change.There were 4 cases of pleural hyperplasia,10 cases without pleural change and no one of MPM in the control group.According to pathologic changes,they were divide into 66 cases of MPM,26 cases of non-MPM in the experimental rats and 14 cases of non-MPM in the control group.The occurrence rate,morphology and thickness of pleural thickening were significant among MPM group,non-MPM group and the control group.The specificity of nodular pleural thickening was 100%.The mean CT number of pleural thickening had no significance.The occurrence rate of masses of MPM in the chest cavity was 94.5%.The masses included tumors,abcesses or encapsulated effusion,the masses of MPM accounted for 62.5%.The mediastinal changes included irregular widening mediastinum,mediastinal pleural changes and masses and so on.But irregular widening mediastinum and adjacent invasion were more common and specified signs.Enlarge lymph nodes were not seen.Conclusion There were some specific CT signs in induced MPM.

Objective To study relation between tumor blood vessels around hepatocellular carcinomas and metastases and try to find out probability to predict potential metastases of hepatocellular carcinomas according to CT manifestation.Methods Both CT plain scans and dynamic contrast scans were taken in 134 cases of patients with hepatocellular carcinomas.The tumor blood vessels around and in cancers were counted.CT appearances,pathology results and patient follow-up were compared and analyzed.Results 1.The possibilty to happen metastases was much higher in carcinomas with heavy enhancement than that with gently or middle.2.Those with tumor blood vessel around neoplasm were greater metastasis rate than those without them.3.The enhancement degree in tumor border is positive correlation with blood count.Conclusion The latent metastases can be estimated according to the enhancing degree and tumor blood vessels around carcinomas.