Objective To evaluate the long-term therapeutic effect of hyaluronic acid on adults with Kashia-Beck disease and the applicability of the joint dysfunction index.Methods A cluster-randomized,starch tablets-controlled trial was carried out depending on the joint dysfunction index of assessment for therapeutic efficacy on Kashin-Beck disease and self-assessment by patients of the Treatment Effect of Kaschin Beck Disease in Criterion.A total of 99 adults with Kashia-Beck disease were randomly divided into two groups:treatment group including 50 patients were intra-articular injected hyaluronic acid in knee weekly for 4 weeks,and the control group including 49 patients were treated with oral starch tablets for 3 months,2 tablets each time,3 times a day.We carried out 48 months follow-up and assessed the applicability of Kashia-Beck disease with treatment of hyaluronic acid.Results The improvement rates of joint dysfunction index were 80.0％ (40/50),83.0％ (39/47),86.4％ (38/44),85.7％(36/42),80.0％(36/45),and 47.1％(16/34) for 1 week and 1,2,3,6,48 months in treatment group,respectively,which were significantly higher than those of corresponding control group 25.0％ (12/48),28.3％ (13/46),33.3％ (16/48),25.0％ (10/40),30.0％ (12/40),and 21.4％ (6/28),and the differences were statistically significant between corresponding groups (x2=29.744,28.236,17.762,30.665,21.537,4.406; all P ＜ 0.05).Before treatment,the treatment group and control group in the joint dysfunction index scores were 7.59 ± 1.82 and 6.89 ± 1.97(t =1.837,P ＞ 0.05),respectively.After treatment,1 month follow up of the treatment group and control group in the joint dysfunction index scores were 3.44 ± 1.71 and 5.55 ± 2.34(t =4.972,P ＜ 0.01),respectively; 6 months follow up were 3.46 ± 2.78 and 6.10 ± 1.83(t =5.102,P ＜ 0.01),respectively; 48 months follow up were 5.13 ± 2.88 and 6.81 ± 3.07(t =2.219,P ＜ 0.05),respectively.The satisfaction of 85.1％ (40/47) in treatment group was significantly higher than that of 60.9％(28/46) in control group (Z =-4.012,P ＜ 0.01).Kappa value between joint dysfunction index and the overall evaluation of the treatment group after treatment was 0.526,which belong to moderate intensity of consistent degree (P ＜ 0.01).Conclusion The therapeutic effect of intra-articular injection of hyaluronic acid on adults with Kashia-Beck disease is significant and lasting,and the joint dysfunction index has better applicability to evaluate the long-term therapeutic effect.

Objective To evaluate the applicability of western Ontario and McMaster university osteoarthritis index (WOMAC) on Kaschin-Beck disease (KBD).Methods Clinical degree Ⅰ adult patients with KBD came from Yongshou and Linyou Counties in Shaanxi Province were investigated according to the historical diagnostic data and The Diagnosis Standard of Kashin-Beck Disease (GB 16003-1995),exclusion of other chronic diseases.Reliability of WOMAC was measured by retest reliability,1/2 coefficient and Cronbach'α reliability coefficient analysis; validity of the WOMAC was tested by the principal components,factor analysis and correlation analysis methods.Results Totally 200 adults patients with KBD were investigated,and 177 effective questionnaires were taken back (88.5 ％).Retest reliability was 0.754-0.853,1/2 coefficient was 0.886-0.971,and Cronbach'α reliability coefficient was 0.878-0.956.In three dimensions of WOMAC scale extracted a common factor,the cumulative variance contribution rate was 81.238％ through principal component factor.The pearson correlation coefficient between all items score of WOMAC and scale score and total score of WOMAC was more than 0.600.The differences of WOMAC score were not statistically significant in different ages,different grading of adult KBD patients (all P ＞ 0.05).Conclusion WOMAC scale used in KBD has good validity and reliability,but has low degree of differentiation.

Objective To investigate the improvement of quality of life of patient with Kashin-Beck disease (KBD) after knee joint cavity injection of hyaluronic acid.Methods Fifty KBD patients were selected in Yongshou County Shaanxi Province,and accepted knee joint cavity injection of hyaluronic acid (25 mg) for four times,one time a week.SF-36 health questionnaire was used to evaluate the quality of life of KBD patients,and the quality adjusted life years (QALYs) were calculated after 2 months.Results The total score of the quality of life of KBD patients was improved from 38.81 ± 17.39 to 49.35 ± 17.95 after knee joint cavity injection of hyaluronic acid.The scores of physiological function (PF),body pain (BP),general health (GH),energy (VT),social function (SF) and mental health (MH) in the eight dimensions of SF-36 scale were 54.42 ± 21.25,47.42 ± 20.80,48.00 ± 26.12,61.05 ± 19.14,68.09 ± 28.73 and 68.74 ± 14.85,respectively,after the treatment,which were higher than those before the treatment (41.51 ± 22.11,27.63 ± 11.78,38.76 ± 25.14,51.97 ± 18.14,57.89 ± 30.95 and 56.95 ± 20.47,t =-3.942,-6.344,-2.494,-2.785,-2.819 and-4.245,all P ＜ 0.05).The QALYs of KBD patients increased 0.051 ± 0.044 with 2 months followed up.Conclusion The quality of life (PF,BP,GH,VT,SF and MH) of KBD patients could be significantly improved after knee joint cavity injection of hyaluronic acid.

Through the retrieval of literatures about the research and application of ontology in the diabetes field in PubMed,IEEE/ IET Electronic Library,ACM,WANFANG,CNKI,VIP and other Chinese and English databases,as well as the search engines Google Scholar and Baidu Scholar,the paper shows the current situations and summarizes the main study contents.The result shows that the study achievements of ontology in the field of diabetes increase rapidly and there are obvious advantages in semantic comprehension in recent decade.

The paper analyzes the documents related to the foreign medical automatic Question Answering (QA) system,and compares the differences between automatic QA and traditional network information retrieval,describes the automatic QA system in the aspects of application researches,common tools and relevant technologies.Combining foreign related researches,it also discusses the current key problems of medical automatic QA system and the implications for China in order to offer reference for further research.

Taking the diet problem of diabetic patients as an example,the paper puts forward the problems classification system based on functions in the view of users,classifies the problems put forward by patients through the Support Vector Machine (SVM) algorithm,and provides important support for the construction of the deep automatic Question Answering (QA) system.

Objective To explore the clinical features and diagnosis of primary immunodeifciency disease caused byTyk2 gene mutations.Methods Clinical data from the ifrst case in China diagnosed of primary immunodeifciency disease caused by Tyk2 gene mutation were retrospectively analyzed, and related literature was reviewed.Results One year and 3 month old boy suffered with repeated pulmonary infection, chronic otitis media, intractable eczema like rash, repeated skin abscess, HSV infection, intracellular bacterial infection, and remarkedly increased total IgE. It was detected that compound heterozygous mutations of c.2269C>G in No. 16 exon and c.149delC in No. 3 exon inTyk2 gene. Literature searching found other 8 cases (5 males and 3 females) of immune deifciency patients caused byTyk2 gene defects, all of which hadTyk2 gene homozygous mutations and presented with repeated infection of paranasal sinus and lung. In the 8 cases 6 cases were combined with mycobacterium tuverculosis infection, 4 cases had repeated virus infection, 4 cases had meningonecephalitis, 3 cases had intractable eczema like rash, 2 cases had salmonella enteritis, 1 case had remarkedly increased total IgE, one case had elevated eosinophils, 5 cases were born in intermarriage family and 1 case died of meningitis caused by unknown etiology.Conclusions When patients have repeated paranasal sinus infection and lung infection, combined with intracellular bacterial infection (including mycobacterium tuberculosis infection), and repeated virus infection or intractable eczema like rash, with or without increased total IgE, immunodeifciency disease caused by Tyk2 gene defection should be considered. Gene sequence analysis can assist in early diagnosis.

Objective To evaluate the efficacy and drug-related toxicities of pemetrexed disodium in the treatment of advanced pulmonary adenocarcinoma.Methods A total of 41 patients who had received pemetrexed disodium and cisplatin therapy were retrospectively reviewed.The patients were given respectively pemetrexed disodium (500 mg/m2,1st day) and cisplatin (200 mg/m2,1-4 day) until disease progressed.The clinical outcomes and adverse reactions were observed.Results The CR rate was 7.3 ％ (3/41),PR rate was 22.0 ％ (9/41),SD rate was 31.7 ％ (13/41),PD rate was 39.0 ％ (16/41),the DRR was 29.3 ％ (12/41),DCR rate was 61.0 ％ (25/41),the median PFS was 5 months.The age,sex,smoking history,staging and timing of treatment had not the statistics difference on ORR and DCR.The sex,smoking history,staging and timing of treatment had not the statistical difference on PFS (P ＞ 0.05).The main toxicities were fatigue,nausea,vomiting and myelosuppression.Conclusion The pemetrexed disodium and cisplatin are feasible and welltolerated for advanced pulmonary adenocarcinoma patients.

As an ancient medicinal and editable resource, pomegranate has a long usage history in the Tibetan medicine, Uyghur medicine and Indian Ayurvedic medicine. Pomegranate pericarp, seeds and flowers are widely used in both TCM and other ethnic medicine. Therefore, it is important to use modern analytical and detective methods to identify the chemical components in order to clarify its material basis and improve the quality control standards. This article summarized the main chemical compositions and quality evaluation methods of pomegranate pericarp, seeds and juice. Analysis was given on questions occurred during the study process. This study provided scientific data for pharmacodynamic material basis of different parts of pomegranate. It also provided scientific references for compre-hensive development and utilization of pomegranate.

Objective To compare the degree of pain in patients after radical gastrectomy under different anesthetic regimens.Methods One hundred and two ASA Ⅰ or Ⅱ patients of both sexes,aged 50-75 yr,weighing 45-70 kg,undergoing elective radical gastrectomy,were randomly divided into 3 groups ( n =34 each):general anesthesia (GA) group,combined general-subcostal transversus abdominis plane block (CGTA) group and combined general-epidural anesthesia (CGEA) group.The patients were sent to the postanesthesia care unit (PACU) after tracheal extubation,and the VAS score on arrival in the PACU was recorded.The degree of pain was evaluated by VAS score,and when VAS scores ＞ 3,the patients received intravenous morphine titration.When VAS scores ≤ 3,morphine titration was stopped and all the patients were connected to patient-controlled intravenous analgesia and/or epidural analgesia pump.The total amount of morphine consumed was recorded at the end of titration,and the occurrence of adverse reactions was also observed.Results Compared with groups GA and CGTA,the incidence of moderate to severe postoperative pain was significantly decreased in group CGEA (P ＜0.01).The incidence of severe postoperative pain,the VAS score on arrival in the PACU and the total amount of morphine consumed were decreased gradually in groups GA,CGTA and CGEA ( P ＜ 0.01 ).The incidence of sedation was significantly lower in group CGEA than in group GA (P ＜ 0.01 ).There were no significant differences in the other adverse reactions among the three groups ( P ＞ 0.05 ).Conclusion The degree of pain is reduced gradually in patients after radical gastrectomy under GA,CGTA and CGEA.