OBJECTIVETo observe the short-term clinical efficacy of compound Xiatianwu combined with methotrexate (MTX) in treating rheumatoid arthritis.

METHODOne hundred and four patients with rheumatoid arthritis were randomly divided into two groups: 64 cases in the combined treatment group who was treated with compound Xiatianwu combined with MTX, and the remaining 40 cases in the control group which was only treated with MTX. The changes in ACR20, ACR50, ACR70 and laboratory indexes including anti-cyclic citrulline polypeptide, rheumatoid factor, erythrocyte sedimentation rate, high sensitivity creative protein were compared before and after treatment. Adverse reactions in the two groups were observed as well.

RESULTAfter being treated for 3 months, the ACR20 improvement rate reached 59.4% in the combined treatment group, higher than 35% in the control group, with significant statistical difference (P <0.05); The ACR50 improvement rate reached 32. 8% the treated group, also higher than 17.5% in the control group, with significant statistical difference (P <0.05). After treatment for three months, both groups showed remarkable improvement in anti-cyclic citrulline polypeptide, rheumatoid factor, erythrocyte sedimentation rate and high sensitivity creative protein compared with that before treatment, demonstrating statistical significance (P <0. 05). The combined treatment group displayed more significant improvement in erythrocyte sedimentation rate and high sensitivity creative protein as well as much less adverse reactions than the MTX group.

CONCLUSIONCompound Xiatianwu combined with MTX can effectively improve clinical symptoms of RA patients and laboratory indexes, and shows higher medication safety.

Adult ; Arthritis, Rheumatoid ; drug therapy ; Dose-Response Relationship, Drug ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Methotrexate ; therapeutic use ; Middle Aged ; Treatment Outcome

BACKGROUND: Radio frequency (RF) magnetron sputtering is a mature technique to prepare metallic (ceramic) coating on ceramic (metallic) substrate, which possesses low-amplitude temperature increasing substrate,rapid deposition rate, even coating component, stable performance, high binding intensity and other advantages.OBJECTIVE: To investigate the structure of hydroxyapatite(HA) coating prepared with RF magnetron sputtering technique and the binding performance of coating and interface of substrate.DESIGN: Single-sample observation.SETTING: College of Material Science and Engineering, Jiangsu University.MATERIALS: 30 mm×30 mm×3 mm Ti-6Al-4V plate and JGP500 MultiFunction Ultrahigh Vacuum Magnetron Sputtering System were used in this experiment.METHODS: This experiment was carried out at the Center of Material Experiment, Jiangsu University from December 2003 to September 2004.HA coating was prepared on the surface of Ti-6Al-4V substrate with RF magnetron sputtering technique, appearance of coating surface and crosssection were observed with scanning electron microscope (SEM), phase structure of coating was analyzed with X-ray diffractometer,Ca/P of coating was analyzed with Energy Dispersive X-ray Spectrometer and binding intensity of coating and interface of substrate was measured with e thoxyline resin-7 butt joint.MAIN OUTCOME MEASURES: ① Micro-appearance of HA coating.② Composition of HA coating and the effect of postprocessing. ③ Binding status and intensity of HA coating and substrate interface.RESULTS: ①Under the SEM, coating surface of HA was rough and uneven in surface, presented many pores and reticular structure. Pore area was about 30% to 40%. ② Ca/P of HA coating was 1.7. The essential component of treated HA coating was HA with high crystallization, without other calcium and phosphonium phase. ③ The binding intensity of HA coating and substrate interface was 51.2 MPa.CONCLUSION: HA coating prepared with RF magnetron sputtering technique has good appearance, high binding intensity at the interface of substrate.

Objective To analyze the overall deployment of Class-A large medical equipments in China.Methods Data of Class A large medical equipments deployed from 2007 to 2015 were collected and classified regionally,for the purpose of measuring the overall deployment,growth level and plan performance.Results There were 403 large medical equipments in China,a rapid rise of deployment,yet still far below developed countries in terms of per capita deployment.Regional differences were significant.With PET-CT as an example,the plan performance in the east(92.19%)was much higher than the west of China(68.57%);plan performance of Class-A equipments was better,conducive to regulating the increase and distribution.Conclusions The deployment level of Class-A equipments in China is low in general,and calls for better regulation regardless of the planning and management progress.

This is a report on the research of HA/Ti6Al4V composite implants that were successfully fabricated by radio frequency magnetron sputtering (RF-MS) technique. The mechanism and bioactivity of these implants immersed in simulated body fluid (SBF) were investigated. Changes in surface morphology, interfacial bond state, crystal structure and phase composition of HA coating before and after immersing in SBF were characterized by Scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), energy dispersive spectroscopy (EDS) and X-ray diffraction (XRD). Results indicate that a new substance on the surface of HA implant coatings produces accompanying with the dissolution of coatings. The substance is bone-like apatite containing CO3(2-) and lacking of Ca2+. Its ratio of n(Ca)/n(P) is about 1.56. This substance has very small grain size and similarly amorphous structure. Its structure and composition are similar to those of natural bone. Thus, it has good biocompatibility and bioactivity.
Biocompatible Materials ; Coated Materials, Biocompatible ; chemical synthesis ; Durapatite ; chemical synthesis ; Magnetics ; Materials Testing ; Prosthesis Implantation ; Radio Waves ; Titanium ; chemistry

Objective To investigate the effect of moderate treadmill exercise together with modified hydroxyapatite chitosan composite hydrogel (CS/HA-g-CS) implantation on repair of full-thickness defects of articular cartilage in rats.Methods Full-thickness cartilage defects were drilled in the patellar groove of bilateral femoral condyles in a total of 24 male SD rats before they were randomly assigned into 4 groups.The control group (BC group) was subjected to no exercise or CS/HA-g-CS implantation;the chitosan group (CHI group) to CS/HA-g-CS implantation without exercise;the moderate treadmill exercise group (MIR group) to exercise 4 weeks after modeling without CS/HA-g-CS implantation;the CHI + MIR group to moderate treadmill exercise plus CS/HA-g-CS implantation 4 weeks after modeling.Half of the animals were sacrificed at week 8 and half at week 16 after operation.Femoral condyles were harvested for gross observation and histochemical measurement by O' Driscoll scoring system.mRNA expressions of glycosaminoglycan,collagen type Ⅱ and BMP-2 were detected by RT-PCR.Results Gross observation revealed:at 8 weeks after modeling,the CHI + MIR group was significantly better than the other 3 groups,with the BC group in the poorest (P ＜ 0.05);at 16 weeks after modeling,the BC group was significantly poorer than the other 3 groups (P ＜0.05) among which there were no significant differences (P ＞ 0.05).O 'Driscoll scoring revealed:at both 8 and 16 weeks after modeling,the CHI + MIR group was significantly better than the other 2 groups and the BC group significantly poorer than the other 3 groups (P ＜ 0.05) but there was no significant difference between the MIR and CHI + MIR groups(P ＞ 0.05).The expressions of collagen type Ⅱ,glycosaminoglycan and BMP-2 were significantly higher in the CHI + MIR group than in the other 3 groups (P ＜ 0.05) and significantly lower in the BC group than in the other 3 groups (P ＜ 0.05).Conclusions Moderate treadmill exercise together with CS/HA-g-CS implantation has significant positive effects on repair of full-thickness defects of articular cartilage in rats than merely moderate treadmill exercise or CS/HA-g-CS implantation alone.The defective cartilage repaired by moderate treadmill exercise together with CS/HA-g-CS implantation contains more collagen type Ⅱ and glycosaminoglycan and shows morphology of nearly normal cartilage.

Objective To prepare a new thrombus model by fluid model method , which is suitable for evaluation of mechanical thrombectomy devices for acute stroke.Methods The fluid model adopted the Chandler loop theory , while the static model adopted conventional method.Mechanical properties of thrombi prepared by fluid model and static model were measured by manual elongation test ( 15 samples in each group) and catheter injection test (15 samples in each group ).Histological structure was compared among the above thrombus models ( 5 samples in each group ) and specimens of five patients with stroke by hematoxylin-eosin staining method.Then, thrombi in fluid model were utilized to establish embolization of vessels in swine model ( two pigs ) for evaluation of radiopacity.Independent-Sample test was performed to compare the maximum tensile length of two methods , and Fisher′s exact test was used to compare the rate of thrombus fragmentation after catheter injection test.Results The maximum tensile length of two models were (4.28 ±0.23) and (3.16 ±0.13) cm, respectively, and the difference was statistically significant (t=16.38, P<0.01);After catheter injection, the fracture rates of thrombus were 13% (2/15) and 60%(9/15), which were also statistically significant (P<0.05).As to histological structure, thrombi prepared by fluid model showed mixed thrombus structure , which similar to thrombi of stroke patients , But thrombi prepared by static model were replete with erythrocytes under the microscope .A total of eight vessels ( lingual arteries and superficial cervical arteries ) in two swines were successfully occlusive ( TIMI 0 or 1 ) , and sufficient radiopacity of each injected thrombus was observed.Conclusions The thrombi prepared by fluid model not only have good mechanical stability and sufficient radiopacity , but their histological structure is similar to thromboemboli retrieved from cerebral arteries of patients with acute stroke.

Objective To determine the audiological characteristics in 832 deaf children with biallelic causative mutations in GJB2 ,SLC26A4 gene .Methods The 832 patients received deafness gene screening ,553 were GJB2 gene biallelic causative mutations ,279 were SLC26A4 gene biallelic causative mutations .Patients were divided into four groups according to ages of hearing loss onset :<1 ,1~3 ,3~6 ,6~12 years old ,and the audiological character-istics and prevalence of GJB2 ,SLC26A4 gene mutations at different ages of onset .Results The prevalence of GJB2 gene mutations at four groups was 37 .97% (210/553) ,38 .34% (212/553) ,16 .27% (90/553) ,7 .41% (41/553) ,re-spectively ;the prevalence of SLC26A4 gene mutations at four groups was 25 .45% (71/279) ,44 .80% (125/279) , 20 .07% (56/279) ,9 .67% (27/279) ,respectively .The difference between GJB2 and SLC26A4 gene was significant(P=0 .001) .The prevalence of profound hearing loss with GJB2 gene mutations at four groups were 66 .67% (140/210) ,61 .32% (130/212) ,47 .78% (43/90) ,41 .46% (17/41) ,respectively .The difference was significant (P=0 .004) ,while the difference in 279 patients with SLC26A4 gene mutations was not statistically significant (P= 0 . 083) .Conclusion The age of hearing loss onset in patients with biallelic causative mutations in GJB 2 or SLC26A4 gene refers to 0~3 years -old ,hearing loss in patients with GJB2 ,SLC26A4 gene mutations gives priority to pro-found .The age of hearing loss onset is smaller ,the ratio of profound hearing loss is higher .Patients with severe and profound hearing impairment should be performed the genetic testing when the age of onset under 12 .

Objective To evaluate the feasibility, safety and efficacy of the treatment of chronic symptomatic internal carotid artery long?segmental occlusion. Methods Fifty?one cases of chronic symptomatic internal carotid artery long?segmental occlusion (arterial occlusion more than 2 anatomical segments) who were treated with hybrid surgery (plaque located at the carotid sinus) or endovascular revascularization (plaque located at the distal end of the internal carotid artery occlusion) from May 2015 to May 2018 were reviewed. Recanalization, perioperative complications, stroke events, and reocclusion events during the follow?up period were recorded. Results The occlusion was recanalized successfully in 45 of 51 patients (88.2%, 45/51), 6 patients failed because the guidewire could not cross the distal arterial occlusion. And the technical success rate was 96.0% (24/25) in hybrid surgery and 80.8% (21/26) in endovascular revascularization. Perioperative complications occurred in 2 patients who underwent combined endovascular treatment. One patient had a small branch embolism due to intraoperative thrombus shift, and 1 patient had large area cerebral infarction. The complications occurred in 2 patients who underwent thybrid surgery, including 1 case of internal carotid cavernous fistula and 1 case of acute reocclusion of internal carotid artery. Forty?four patients with successful operation received clinical follow?up, with the median follow?up time of 24 months (7-43 months). No recurrent stroke and death occurred during the follow?up period. Clinical symptoms were improved in 34 cases. Totally 44 patients received imaging follow?up, and during the median imaging follow?up time of 8 month (4-28 months), 6 cases had reocclusion, and 2 cases had restenosis. Conclusion The treatment of chronic symptomatic internal carotid artery long?segmental occlusion is technically feasible and safety with good short?term efficacy. However, its exact efficacy remains to be confirmed by long?term follow?up studies with large samples.

Objective:To investigate the effect and mechanism of histone methyltransferase enhancer of zeste homolog 2 (EZH2) on sepsis-induced T cell dysfunction.Methods:Twenty-four male C57BL/6 mice were divided into three groups randomly: sham operated group, sepsis model group [cecum ligation and puncture (CLP)+dimethyl sulfoxide (DMSO) group] and EZH2 selective inhibitor treated group (CLP+GSK126 group), with 8 mice in each group. Sepsis murine model was reproduced by CLP. CLP+DMSO group and CLP+GSK126 group were treated with DMSO or GSK126 (10 mg/kg) respectively right after surgery through intraperitoneal injection. The mice were sacrificed 24 hours after operation, and the mesenteric lymph nodes were collected. The expression of EZH2, apoptosis rates, cell proliferation marker ki-67 antigen positive T lymphocytes (ki-67 + cell), interferon-γ positive T lymphocytes (IFN-γ + cell), programmed death receptor-1 positive T lymphocytes (PD-1 + cell) and programmed death-ligand 1 positive T lymphocytes (PD-L1 + cell) were determined by flow cytometry. Results:Compared with sham operated group, the expression of EZH2 in T lymphocytes was up-regulated on mesenteric lymph nodes of CLP+DMSO group. Compared with CLP+DMSO group, the ratio of CD3 + T lymphocytes in CLP+GSK126 group was up-regulated (0.70±0.02 vs. 0.50±0.07, P < 0.01), indicating that the EZH2 inhibitor could increase the number of T lymphocytes in lymph nodes of septic mice; the ratio of ki-67 + cells in CD4 + and CD8 + T lymphocytes in CLP+GSK126 group was increased (CD4 +: 0.74±0.05 vs. 0.63±0.04, CD8 +: 0.82±0.06 vs. 0.70±0.04, both P < 0.05), indicating that the EZH2 inhibitor could increase the ratio of T lymphocytes with high proliferative activity in lymph nodes of septic mice. However, no significant difference was found on both CD4 + and CD8 + T lymphocytes apoptosis rates in the mesenteric lymph nodes of mice between CLP+GSK126 group and CLP+DMSO group [CD4 +: (21.53±2.87)% vs. (20.48±3.21)%, CD8 +: (8.34±1.02)% vs. (7.71±1.38)%, both P > 0.05], indicating that no extra T lymphocytes apoptosis was induced by EZH2 inhibitor. Compared with CLP+DMSO group, the ratios of IFN-γ + CD4 + and IFN-γ + CD8 + T lymphocytes were increased in CLP+GSK126 group (IFN-γ +CD4 +: 0.31±0.11 vs. 0.14±0.06, IFN-γ +CD8 +: 0.30±0.10 vs. 0.13±0.06, both P < 0.05), suggesting that secretion of IFN-γ in lymph nodes by sepsis T lymphocytes was augmented after EZH2 inhibitor administration. Furthermore, compared with CLP+DMSO group, the ratio of PD-1 + cell in CD8 + T lymphocyte was down-regulated in CLP+GSK126 group (0.092±0.006 vs. 0.135±0.004, P < 0.01), suggesting that EZH2 inhibitor restrained the PD-1 expression on sepsis lymphoid node CD8 + T lymphocytes, however, it had no significant effect on PD-L1 + cells. Conclusion:EZH2, regulates sepsis-induced T lymphocyte dysfunction, possibly through modulating the expression of PD-1.