Objective To investigate the effect of tunor necrosis factor alpha (TNF-α) antagonist treatment and traditional disease-modifying antirheumatic drugs treatment on the quality of life of male patients with ankylosing spondylitis (AS).Methods In 42 patients with AS open-label study,patients were grouped after consent,and divided into the TNF-α antagonist treatment group and the non-TNF-α antagonist treatment group.All patients were treated for 4 months.The clinical and laboratory indexes and quality of life changes were analyzed before and after the treatment.T test,Pearson's correlation analysis were used for statistical analysis with software version 13.0.Results There were no significant differences in age,disease course,disease activity and the quality of life between the two groups before treatment.Disease activity and the quality of life of the two groups after treatment were improved compared with that of before treatment.After treatment,the Bath ankylosing spondylitis disease activity index (BASDAI) score [(1.9±1.6) scores,(3.0±1.3) scores,t=-2.429,P=0.020],erythrocyte sedimentation rate (ESR) [(9±6) mm/1 h,(18±17) mm/1 h,t=-2.286,P=0.031] and C reactive protein(CRP) levels [(18±21) mg/L,(62±85) mg/L,t=-2.258,P=0.035] of the TNF-α antagonists treatment group decreased significantly than those non-TNF-α antagonist treatment group,while the hemoglobin (Hb) levels [(143±15) g/L,(138±18) g/L,t=2.545,P=0.015] were significantly increased in TNF-α antagonist treatment group.The improvement extent of quality of life was more evident in TNF-α antagonists treatment group,such as,the average score [(72± 15) scores,(55±19) scores,t =3.254,P=0.002].The average degree of improvement in quality of life and BASDAI score,Bath ankylosing spondylitis functional index (BASFI) score were negatively related to the improvement in the TNF-α treatment group (r=-0.497,P=0.018; r=-0.558,P=0.007).Conclusion TNF-α antagonist treatment can not only improve the AS disease activity,but can also improve the quality of sexual life of male patients,which may direct affect on male reproductive system.

The myocardial nutrition after myocardial revascu-larization was studied in 14 rabbits with the aid of Nd-YAG laser, before Ligation of the anterior descending branch of the left coronary artery (only ligated LAD in 4 rabbit), the rabbits were seperatively Killed 3 or 5 weekafter operating. Myocardial samples were abtained in the parti of 0 - 2,2 - 4,4 - 6mm from laser hole. Sample numbers were 30 in myocardial revascularization group (MRG); 20 in myocardial Infarction group(MIG); 20 in normal group (NG). Amount of ATP and CP in myocar-dia were determined with luciferase. Resalts.ATP and CP near laser holes were normal 3 week late. This far from laser holes was lower than that of normal myocardia 5 week late. Recover of CP amount was slower than that of ATP amount. Inclusion, myocardial revascularization can play role in myocardial nutrition.

Objective To discuss the repair methods for the cartilage defects of the knee joint. Methods The cylindrical osteochondral grafts were harvested from the non-weight-bearing area of the knee joint and then transplanted to the cartilage defects in 6 patients with cartilage defects of the knee joint. Results The clinical symptoms of all the patients followed up for 2-24 months disappeared and the joint mobility recovered to normal. A follow-up MRI showed consistent cartilage coverage and the excellent position of the cylindrical osteochondral grafts. Conclusions The osteochondral autograft is a practical surgical method because it is characterized by less trauma, simple performance and good maintenance of the curvature of the articular surface.

The paper states the superiority of optimizing the teaching effect of clinical medicine by making use of information technology,analyzes the problems of information technology in optimizing the classroom teaching of clinical medicine,discusses the strategy of teaching with information technology in the aspect of classroom teaching structure,and thus reaches the effect of improving teaching efficiency and quality.

Cytoskeletal Proteins ; biosynthesis ; genetics ; physiology ; Humans ; Neoplasm Metastasis ; Neoplasms ; pathology ; Signal Transduction

Endoscopy ; methods ; Humans ; Neck ; surgery

Objective　To investigate factors influencing the incidence of massive bleeding caused by stress ulcer in severe acute pancreatiti s (SAP) and explore the effectiveness of measures for its prevention and treatme nt.　Methods　Clinical data of 121 pat ients with SAP were reviewed retrospectively in our center between 1993 and 1998 .The incidence of massive bleeding caused by stress ulcer in SAP, its affecting factors and the results of prevention and treatment were evaluated.　Results　The incidence of stress ulcer massive b leeding in SAP was 11.6% (14/121). The risk factors included the age of patient s, the severity of the disease, concomitant bile duct lithiasis obstruction, pan creatic abscess, pseudocyst and a history of surgical debridement and drainage. Five out of 6 patients treated conservatively died, while only 1 out of 8 treate d surgically died (P＜0.01).　Conclusion　Massive bleeding stress ulcer most often occurred in elderly SAP p atients, especially those of biliogenic, with pancreatic abscess and pseudocyst. Somatostain administration effectively decreases the incidence of bleeding. E mergency operation is mandatory when conservative measures fail to stop the bl eeding.

Objective To explore the relationship between osteopontin (OPN),its downstream product thrombin-cleaved osteopontin (NTOPN) and radiographic changes in osteoarthritis (OA).Methods The levels of OPN and NTOPN in serum and synovial fluid were tested by enzyme-linked immuno sorbent assay (ELISA) kit in 22 OA patients and 21 health controls.The correlation between the above parameters and clinical data such as radiology changes of OA patients was analyzed.Results The serum level of OPN in the OA group was positively correlated with C reactive protein (CRP) (r =0.574,P =0.005).The serum level of OPN in the OA group was slightly lower than that in the healthy control group [(1.8 ± 0.5) μg/L vs (1.7 ± 1.1) μg/L,P ＞ 0.05].Similarly,the serum level of NTOPN in the OA group was significantly higher than that in control group [(21.1 ± 11.7) μg/L vs (14.7 ± 3.6) μg/L,P ＜ 0.05].Meanwhile,serum NTOPN level in female patients was significantly higher than that in male patients [(23.2 ± 11.80) μg/L vs (11.1 ± 4.9) μg/L,P ＜ 0.05].In synovial fluid of OA group,the level of OPN was (7.75 ± 2.33) μg/L,NTOPN was (0.91 ± 0.49) μg/L and the ratio of NTOPN/OPN was 0.12 ± 0.08.The level of OPN of synovial fluid in the OA group was positively correlated with CRP (r =0.574,P =0.005).NTOPN-to-OPN ratio of synovial fluid in the OA group was positively correlated with Kellgren-Lawrence grade (r =0.535,P =0.022).Conclusions The serum level of OPN is correlated with severity of inflammation in the OA patients.Meanwhile,NTOPN-to-OPN ratio of synovial fluid is correlated with OA severity.As a downstream bioactive product of OPN,NTOPN may play an important role in OA pathogenesis.Whether these parameters can be used as predictors of joint lesion severity and inflammatory status is worth further study.

Objective To investigate the protective efficacy of anisodamine against heart injury after ischemia reperfusion in patients with right coronary artery acute myocardial infarction during percutaneous coronary intervention,and to explore the possible mechanism. Methods Totally 80cases with ST elevation myocardial infarction (STEAMI) were received primary percutaneous coronary intervention (PCI).All patients were randomly divided into 2 groups:anisodamine group (40 cases),5 mg anisodamine was administered when the blood flow recovery after the balloon extension,and control group (40 cases) received saline. The rhythm and rate of heart were observed through the electrocardiogram (ECG) monitor in 30 min after the blood flow recovery.The pressure of aorta were observed through the pressure sensor connected to aorta through catheter.TIMI flow grade (TFG)and corrected TIMI frame count (cTFC) were used to evaluate coronary flow during PCI.Electrocardiography was performed to analysis ST segment resolution 30 min and 24 h after PCI.Venous blood was obtained before and 30 min,1 h,2 h,4 h,24 h and 48 h after PCI to test the levels of superoxide dismutase (SOD),malonyldialdehyde (MDA),creatine kinase isozymes (CKMB) and cardiac troponin I(cTNI) in plasma. Results There were 20 cases(50.0％)of sinus bradycardia,7cases(17.5 ％) of high degree atrioventricular block (AVB),20 cases (50.0 ％ )of frequent ventricular premature,14 cases (35.0％) of paroxysmal supraventricular tachycardia, 5 cases (12.5％) of ventricular fibrillation,19 cases(47.5 ％) of hypotension,3 cases (7.5 ％)of no-reflow phenomenon in anisodamine group which were lower than control group,31 cases (77.5％)of sinus bradycardia,14 cases(35.0％) of high degree AVB,17 cases(72.5％) of paroxysmal supraventricular tachycardia,8 cases (42.5％) of ventricular fibrillation,30 cases (75.0％) of hypotension,6 cases of no-reflow phenomenon (P＜0.05).There were more ST fall＞50％ after rise in anisodamine group than control group after PCI 30 min,but no difference was found after 24 h. The CKMB and cTNI peak value occurred earlier in anisodamine group than control group (P＜0.05).The level of SOD was increased,MDA decreased in anisodamine group compared with control group after PCI 30 min and 24 h (both P＜0.05). Conclusions The use of anisodamine as the blood flow recovery after the balloon extension can reduce no-reflow phenomenon,various of arrhythmia and hypotension during PCI.The underlying mechanism involves the inhibition of oxygen radicals and the improvement of microcirculation.