OBJECTIVE:To evaluate the efficacy of methotrexate(MTX) vs.gold salt in treating patients with rheumatoid arthritis(RA).METHODS:7 studies on the efficacy of methotrexate(MTX) vs.gold salt in treating patients with rheumatoid arthritis(RA) were subjected to a meta-analysis using homogeneity test and combined effect test.RESULTS:Homogeneity test showed that the cited studies were homogeneous with ?2=25.14,df=6 and P=0.0003;and by combined test,the combined OR was 2.37(95% confidence interval=1.18～4.78,Z=2.41,P=0.02).CONCLUSION:Methotrexate demonstrated better toleration than gold salt for rheumatoid arthritis.

Objective To investigate the effect of folic acid on the DNA methylation of tumorrelated genes promoters in healthy human peripheral blood mononuclear cells(PBMC). Methods Ten healthy volunteers were divided into two groups, and were randomized to receive either 5 mg folic acid (n=5)or placebo(n = 5) , one time per day for 3 months. The serum folic acid concentration was detected with chemiluminescence enzyme immunoassay kit before and after the intervention. The methylation statuses of five tumor-related genes promoter, including oncogenes c-myc, c-Ha-ras,tumor suppressor genes p16INK4A, E-cadherin and mismatch repair gene hMLH1 in PBMC were detected by bisufite sequencing. Results After folic acid intervention, the level of serum folic acid increased significantly in intervention group (t= -4. 739,P<0. 05) , however no significant difference in control group. After three-month folic acid intervention, the level of methylation of oncogene c-myc promoter increased from 4%, 3. 3%, 4. 1% before intervention, one week after intervention, one month after intervention respectively to 8%(t= -4. 079,P<0. 05), while no significant change in placebo taken group. Before and after the folic acid intervention, there was no significant difference of DNA methylation of other tumor-related genes promoter, including c-Ha-ras、E-cadherin、p16INK4Aand hMLH1. Conclusion Folic acid intervention can up-regulate DNA methylation of oncogene c-myc promoter, but can not affect the promoter methylation status of tumor suppressor genes E-cadherin,p16INK4Aand hMLH1.

Objective To investigate the enhancing effect of microbubble contrast agent SonoVue of different dosage on high-intensity focused ultrasound (HIFU) ablation in goat livers in vivo. Methods Twenty goats were divided into 4 groups randomly. Animals in group 1,2 and 3 were bolus-injected of 0.01 ml/kg,0. 03 ml/kg and 0.05 ml/kg of SonoVue intravenously before HIFU exposure, respectively,and those in group 4 were not given injections as control. After injection 20s, the livers were ablated using HIFU performed in the manner of a single dot set by a computer system using a clinical device. The frequency of HIFU was 0.8 MHz,the intensity of HIFU was 19 100 W/cm2 ,the distance from skin to the target liver tissue was 30 mm,the exposure time was set at 15 s for all animals in the four groups. All animals were euthanized 7 days after HIFU, volumes of coagulated necrosis were measured. Pathological examinations were performed to analysis the exposure regions. Results Under the same parameters of exposure, coagulated volumes in group 1,2 and 3 were larger than those in group 4, the difference was significant (P < 0.05),and the coagulated volumes increased gradually with the dosage of SonoVue increasing from group 1 to group 3, the difference was significant (P<0.05). Pathological examinations confirmed that there were no residual unaffected tissues within the exposed volume. Two remarkable changes were observed in one goat in group 37 days after HIFU:the surrounding adjacent tissue outside the reactive zone necrotized and the skin were destroyed. Conclusions The enhancing effects of microbubble contrast agent in HIFU ablation is related with the dosage of the microbubble contrast agent SonoVue. The higher the SonoVue dosage,the larger the volume destroy in the target tissue.

BACKGROUND: Transplantation of microencapsulated rabbit Schwann cells in the rat spinal cord can relieve inflammatory reaction, promote spinal cord regeneration, but the precise mechanisms remain unclear. OBJECTIVE:To observe basic fibroblast growth factor (bFGF)expression and movements recovery following transplantation of microencapsulated rabbit Schwann cells in rat spinal cord. METHODS: The sciatic nerves taken out from rabbits wore digested with mixed enzyme and were made into Schwann cells suspension. Then we used air-jet method to make Schwann cells microcapsule. Using the same method, empty microcapsule was made. Sprague Dawiey rats were randomly divided into cell group, empty microcapsule group and microcapsule group. Conducted by hemisection injury of spinal cord,the rats in cell group,empty microcapsule group and microcapsule group were implanted with gelatin sponge with 10μL Schwann cells suspension, gelatin sponge with 10 μL empty microcapsule and 10 μL microencapsulated Schwann cells. Normal group was left intact. After operation, we observed hindlimb movements recovery in rats with the Basso, Beattie, and Bresnahan (BBB) scale. Meanwhile,a set of sections were stained immunohistochemically for bFGF expression, another set of sections wore stained for hematoxylin-eosin and Nissal. RESULTS AND CONCLUSION: After spinal cord injury, rat right hindlimb affected paralysis immediately. At 7, 14 and 28 daysfollowing transplantation,motor function in rat hindlimb was significantly recovered, and the BBB scores were significantly higher in microencapsulated schwenn cells than in cell and empty microcapsule group (P < 0.05 or P < 0.01). bFGF positive products were mainly distributed in cytoplasm of the spinal neuron and nucleus of neuroglical cell. The numbers of bFGF positive glial cells mainly appeared surrounding the spinal cord injured site on days 1, 3, 7 and rose to its peak on day 3 and began to appear in neuronal calls on day 14. The number of bFGF positiv cells in microcapsule group was significantly superior to that in cell group and empty microcapsule group. From then on, the bFGF expreSsion was significantly decreased in each group. These indicated that transplantation of microencapsulated Schwann cells can inhibit the immunological rejection after xenotransplantation, suppress inflammatory reaction, improve the expression of bFGF, increase hindlimb movements recovery and spinal cord regeneration after spinal cord injury.

Objectives To investigate the clinical significance of CYP2C19 genotype detection for antiplatelet therapy of elder cardiovascular and cerebrovascular diseases(CCVD).Methods We enrolled all elderly patients with either cardiovascular or cerebrovascular disorders who received clopidogrel as mono drug or in combination with another antiplatelet drug aspirin as secondary prevention for more than 12 months in our hospital from January to August 2015.Somatotypes of CYP2C19 genotypes of all participants were assessed to analyze the relapse of cardiac-cerebral vascular diseases in these patients.Results A total of 250 patients were enrolled,including 179 male and 71 female,with average age of (85.2 ± 7.9) years.Among these patients,there were 97 (38.8％) cases with EM CYP2C19 genotypes,110 cases(44.0 ％) with IM CYP2C19 genotypes,43 cases(17.2 ％) with PM CYP2C19 genotypes.When treated with clopidogrel for antiplatelet in secondary prevention process,the rate of the relapse in cardiovascular event was 34.9％ and higher in PM CYP2C19 genotype than in EM and IM CYP2C19 genotype (19.6 ％ and 15.5 ％,respectively) (x2 =7.251,P =0.027).This phenomenon was similar to patients who received stent implantation(x2=6.393,P =0.041).However,no statistically significant difference was observed in the recurrence rate of cerebral vascular disease between three different genotypes(EM 29.9 ％,IM 20.0 ％,PM 27.9％,x2 =2.880,P =0.237).Conclusions Our results highlight that CYP2C19 genotype might be a potential guidance for secondary prevention of cardiovascular and cercbrovascular disorders among elderly patients.Clopidogrel may be less effective in patients with SM CYP2C19 genotype than those with EM or PM CYP2C19 genotype for secondary prevention of cardiovascular disease.

Objective To explore the diagnosis and treatment of isolated dissection of the superior mesenteric artery (SMA).Methods From Feb 2006 to July 2010,15 patients with isolated SMA dissection were treated in our center,there were 13 males,2 females,the mean age was(53 ± 8) years (range 43 -63).Among them,1 was caused by trauma,14 had unknown etiology,and 9 cases had a history of hypertension.Diagnosis was made by contrast-enhanced computed tomography (CT) in all cases.Management strategies inlcuded placement of self-expanding bare stent,medical treatment,and transperitoneal SMA fenestration.Results Endovascular stenting was attempted in 14 cases,with a success in 5 and a failure in 9 cases who were then given medical treatment with antiplatelet agents.One case with critical intestinal ischemia underwent open exploration and SMA fenestration.Blood vessel patency resumed.Follow-up with duplex and CT was accomplished in 13 cases,time ranging from 12 to 60 months (mean 28 ± 14mos).There was no recurrent abdominal pain or chronic intestinal ischemia developed during the follow-up.In medically treated patients,there was no aneurismal enlargement of SMA,while in the endovasculartreatmentgroup,allstentsremainedpatentthroughoutthefollow-up.Conclusions Endovascular treatment of isolated dissection of SMA appears to be feasible and effective,despite its relatively low technical success rate.For asymptomatic patients,medical treatment is the treatment of choice.In case of critical intestinal ischemia and with a suspected intestinal gangrene,emergency surgical exploration and fenestration should be performed.

Objective To develop a BP26 recombinant BCG (rBCG-BP26) vaccine,and to observe the effects of rBCG-BP26 on CD4+,CD8+ T cells in immunized mice.Methods The recombinant shuttle vector pMV261-Ag85B-BP26 was constructed by using traditional molecular biological technology.The recombinant strains were obtained by kanamycin resistance screening and PCR identification after electroporation.Western blotting was used to detect the expression of recombinant BP26 vaccine in immunized mice.Safety experiment was carried out in three different groups:the target experiment(rBCG-BP26) group,the positive control(BCG) group and the negative control(PBS) group,15 BALB/c mice in each group.Intradermal inoculations of 100 μl rBCG-BP26 [containing 106 colony forming units(CFU)],BCG,and PBS were carried out,respectively.Signs of mice in each group were observed.After immunization for 10,20,30,and 40 days,body weight was weighed,and tail blood was collected to observe the change of peripheral blood CD4+ and CD8+ T cells by flow cytometry.Results The rBCG-BP26 was successfully constructed.The expression of BP26 protein was detected in the liquid medium and the bacteria cells.The results of safety test analysis showed that there were no significant differences in signs and body weights(F=2.468,0.331,1.520,0.739,all P＞ 0.05),between PBS group[ (19.24 ± 0.54),(21.37 ± 0.66),(22.83 ± 0.62),(25.06 ± 0.37)g],BCG group[ (19.90 ± 0.02),(21.53 ± 1.57),(21.95 ± 0.55),(24.70 ± 0.39)g]and rBCG-BP26 group[ (19.16 ± 0.55 ),(20.89 ± 0.20),(22.15 ± 0.76),(24.60 ± 0.64)g].The results of flow cytometry showed that the percentages of CD4+ T cell level were lower in BCG group(26.70％,33.07％) and rBCG-BP26 group( 13.40％,26.70％) than that of the PBS group(33.85％,29.33％) and the values of CD4+/CD8+ T cells increased in rBCG-BP26 group (0.69％,1.27％,1.57％,1.70％ ) 10,20 and 30 days after immunization.Conclusions Recombinant BCG-BP26 vaccine strain can express brucella BP26 protein efficiently.Furthermore,its virulence is mild,and it can activate CD4+,CD8+ T cells in the body.It can be used as one of candidate vaccine strain against brucellosis.

Current Hui prescriptions are mostly recorded in the Arabic language. Their fussy and inconsistent names (Arabic names) result in the restriction in the clinical application of Hui prescriptions. Having collected and screened out 101 Hui prescriptions for stroke, the author further studied some of their names in literatures, in order to facilitate clinical application of these prescriptions (i. e. unification of their Arabic and Chinese names, and textual research of identical drugs with different Arabic names). This lays a foundation for the clinical application of Hui prescriptions and the analysis on compatibility regulatory, and provides scientific basis for studies on new Hui medicines.
Asian Continental Ancestry Group ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Arabic ; Medicine, Chinese Traditional ; methods ; Plant Extracts ; therapeutic use ; Stroke ; drug therapy

OBJECTIVETo assess the efficacy of tendons of minimally invasive therapy (TMIT) combined drug therapy by comparing it with treatment by drug therapy alone on patients with knee osteoarthritis (KOA).

METHODSTotally 60 KOA patients were assigned to the treatment group and the control group according to random digit table, 30 in each group. Patients in the control group took Hydrochloric Acid Glucosamine Capsule and Celecoxib Capsule. Patients in the treatment group additionally received TMIT. The treatment course for all was 4 weeks. Scores for visual analogue scale (VAS) and the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index were observed and recorded at week 1 and 4 after treatment by acupotomology mirror.

RESULTSCompared with before treatment, improvement was shown in VAS score, pain and stiffness degrees, activities and functions, and WOMAC scores at week 1 and 4 after treatment in all patients with statistical difference (P < 0.05). Besides, better effect was shown in the treatment group (P < 0.05).

CONCLUSIONSTMIT combined drug therapy could relieve KOA patients' pain, stiffness and joint activities, elevate the overall efficacy. TMIT was easily operated with less injury.

Celecoxib ; Drug Therapy, Combination ; methods ; Humans ; Knee Joint ; Osteoarthritis, Knee ; drug therapy ; Pain ; Pain Measurement ; Tendons ; Treatment Outcome

OBJECTIVETo evaluate the effect of electro-acupuncture (EA) on gastric mucosal oxygenation and systemic inflammatory response in patients undergoing endoscopic sinus surgery with controlled hypotension (CH), and to explore its protective effect on gastric mucosa.

METHODSFifty-four patients, 18-65 years old, grade I-II of American Society of Anesthesiology (ASA), who were scheduled for endoscopic sinus surgery were randomly assigned to two groups, group A (general anesthesia group) and group B (general anesthesia combined EA anesthesia group), 27 in each group. Conrolled hypotension was executed during operation, and mean arterial pressure (MAP) was maintained at 55-65 mmHg. After tracheal intubation gastric tesiometer catheter was indwelled through nasal cavity or oral cavity. After successful indwelling, it was connected with gastric mucosa monitoring mode of multifunctional parameters monitor. Patients' MAP and heart rate (HR), pHi, partial pressure of carbon dioxide (PgCO2), arterial partial pressure of carbon dioxide (Pg-aCO2) and endtidal pressure of carbon dioxide (Pg-etCO2) were measured and recorded at T, (immediately before induced hypotension), T, (20 min following induced hypotension to target MAP), T2 (40 min following induced hypotension to target MAP), T3 (20 min after ending induced hypotension), and T4(40 min after ending induced hypotension). Blood samples were intravenously collected, TNF-alpha, IL-1, and IL-6 were detected by ELISA 24 h before operation, during operation (T3), and 24 h after operation.

RESULTSAfter hypotension was induced, Pg-CO2, Pg-aCO2 and Pg-etCO2 increased significantly (P < 0.01, P < 0.05), while pHi decreased significantly (P < 0.01) in both groups at T1-T4 than those at T0. During T1-T4, PgCO2, Pg-aCO2, and Pg-etCO2 were higher (P < 0.01, P < 0.05), while pHi was lower in group A than in group B (P < 0.01). Furthermore, TNF-alpha, IL-1, and IL-6 increased significantly in both groups during operation and 24 h after operation, when compared with those 24 h before operation (P < 0.01, P < 0.05). TNF-alpha and IL-1 in group A were higher than those in group B (P < 0.05) during operation and 24 h after operation, but with no significant difference in the plasma concentration of IL-6 (P > 0.05).

CONCLUSIONEA exerted obvious protective effect of gastric mucosal injury in endoscopic sinus surgery with controlled hypotension, which might be achieved by increasing gastric mucosal blood flow, maintaining oxygen supply and demand, inhibiting inflammatory response, and alleviating injury of gastric mucosal barrier.

Acupuncture Analgesia ; methods ; Adolescent ; Adult ; Aged ; Anesthesia, General ; Arteries ; Blood Pressure ; Electroacupuncture ; methods ; Endoscopy ; Female ; Gastric Mucosa ; surgery ; Heart Rate ; Humans ; Hypotension, Controlled ; Interleukin-1 ; Interleukin-6 ; Male ; Middle Aged ; Tumor Necrosis Factor-alpha ; Young Adult