Objective To investigate the traditional Chinese medicine ( TCM) syndromes of rheumatoid arthritis ( RA) by studying the Chinese medical patterns,and analyze the correlations of different indicators and related syndromes. Methods The questionnaires were designed according to clinical epidemiological theories. The data were collected and analyzed by multivariate statistical methods. Results The TCM symptoms of the 401 cases of RA were concluded into 3 common factors,that is,cold,heat and deficient. Their syndromes were sub-classified as 6 groups: cold syndrome,heat syndrome,deficiency,cold heat complex,deficient cold and asthenic fever. Statistical analysis showed that there were significant differences in health assessment questionnaire ( HAQ) ,platelet ( PLT) ,rheumatoid factor ( RF) ,anti-keratin antibody ( AKA) among these 6 TCM syndromes ( P

Objective To observe the effects of S100A4 siRNA on the expression of serum TNF‐α,IL‐1βand VEGF in adjuvant arthritis rats .Methods Adjuvant arthritis rat models were established and were randomly divided into model group and interfere group .On Day 11 ,rats in interfere group were injected with S100A4 siRNA fragment in articular cavity .Arthritis index (AI) chan‐ges and pathological changes of ankle joint were observed .The levels of serum TNF‐α and IL‐1β ,VEGF were detected by ELISA . Results Compared with that of model group ,the levels of serum TNF‐ α ,IL‐1β and VEGF were reduced significantly in interfere group (P< 0 .05) ;variances of AI and pathological scores in interfere group were diminished significantly (P< 0 .05) .Conclusion Inhibition of the expression of S100A4 gene can significantly reduce the expression of inflammatory factor TNF‐α ,IL‐1 β and angio‐genesis factor VEGF ,and improve the pathological injury of synovial membrane .

Objective To evaluate the efficacy and safety of alteplase (rt-PA) thrombolytic therapy on patients with acute ischemic stroke aged over 80 years old.Methods The observational cohort study were conducted.One hundred and thirty-six patients with acute cerebral infarction and received rt-PA thrombolytic treatment were selected as our subjects with incidence time of 4.5 h,and the rt-PA dose of 0.9 mg/kg.The patients were divided into ≥80 years old group(n =34) and ＜80 years old group(n =102).U.S.A national institutes of health stroke scale (NIHSS) score of two groups evaluated before thrombolysis,immediately after thrombolysis 24 h,7 d and 14 d.The incidence and mortality rate of intracranial hemorrhage (ICH) and symptomatic intracranial hemorrhage (sICH) of two group were compared; and the score of modified Rankin's Scale (mRS) followed-up of 90 d were evaluated.Results NIHSS score after thrombolysis 24 h,7 d and 14 d of two groups were significantly lower than that before thrombolysis,and the differences were statistically significant (t =4.123,9.936,9.679,5.657,8.154,6.956,P ＜0.01).The score after thrombolysis 24 h,7 d and 14 d of two groups were no statistically significant difference.The efficient rate of treatment of two group were 55.88％ and 61.76％ respectively(P =0.54).Mter follow-up of 90 d,the prognosis rate were 47.06％ and 64.71％ respectively(P =0.07),and there were no statistically significant difference.Incidence rate of ICH were 11.76％ and 5.88％ respectively(P =0.07).Occurrence rates of sICH were 5.88％ and 2.94％ (P =0.43).Mortality rate were 11.76％ and 9.80％ (P =0.33),and there were no statistically significant difference.Conclusion This study shows that 80 years of age or older patients with acute ischemic cerebral apoplexy patients using rt-PA intravenous thrombolytic therapy is safe and effective,but RCT need further study.

Objective:This study aimed to achieve the early diagnosis and active treatment of adult hemophagocytic syndrome (HPS) and investigate the clinical characteristics and prognostic factors of this syndrome. Methods:A single-center retrospective analysis was performed to analyze clinical characteristics, laboratory findings, and survival data. Results:In 58 patients, the most common clinical manifestations were fever (100%) and splenomegaly (89.7%). The most common laboratory parameters were serum ferritin 500 g/L (100%) and peripheral cytopenia in two or more lineages (96.6%). platelet count, fibrinogen, and lactate dehydrogenase in the death group were significantly lower than in the survival group (P=0.000, 0.001, and 0.000). Survival analysis results showed that infections in the rheu-matological group exhibited good prognosis [the overall survival (OS) time was not reached in 190 d]. Patients with unexplained causes had moderate prognosis (OS time was 60 d);tumor-associated HPS patients had poor prognosis (the OS time was only 30 d). Univariate analysis results showed that patients with Fbg<1.5 g/L, PLT<40×109/L, and LDH≥2000 U/L also exhibited poor prognosis (P=0.000). Multivariate analysis results showed that PLT<40 × 109/L was an independent adverse factor (HR=6.472, 95%CI:1.526-26.065, P=0.011). Conclusion:HPS exhibits complex clinical manifestations and varied etiology. Patients with infection and rheumatism-related HPS had good prognosiss compared with those manifesting tumor-associated HPS. Fbg<1.5 g/L, PLT<40×109/L, and LDH≥2 000 U/L were the univariate factors that affected the survival time of patients. PLT<40×109/L is an independent adverse factor. These patients need systemic treatments as early as possible.

Objective:Imatinib is extensively used as a first-line therapeutic agent for patients with chronic myeloid leukemia (CML) at the chronic phase (CP). Although CML patients undergoing imatinib treatment are enrolled mainly in the Glivec International Patient Assistance Program (GIPAP) in China since 2003, limited data have been reported on the long-term outcome of these patients. This study aims to compare the treatment response and prognosis of CML-CP patients who received different treatments from January 2003 to December 2013 in the First Affiliated Hospital of Nanchang University. Methods:A total of 295 patients were enrolled, includ-ing 185, 30, 50, and 30 patients for imatinib, interferon-alpha (IFN-α) plus Ara-C, hydroxycarbamide (HU), or allogeneic hematopoietic stem cell transplantation (Allo-HSCT) treatments, respectively. Results:Patients in imatinib and Allo-HSCT groups achieved excellent complete hematologic remission (CHR) (i.e., 96.7%vs. 96.7%), complete cytogenetic response (CCyR) (i.e., 89.7%vs. 93.3%), and com-plete molecular remission (CMoR) (i.e., 49.7%vs. 83.3%, P=0.001). However, significantly low rates of CHR, CCyR, McyR, and CMoR were observed in IFN-αand HU groups. Moreover, patients from imatinib group showed longer overall survival (OS) time than patients from other groups (P<0.001), even patients in Allo-HSCT group (10-year OS, 89.0%vs. 67.0%, P<0.001) because of high risk of Allo-HSCT-related complication. Multivariate analysis showed that receiving imatinib treatment (HR=5.267, 95%CI:1.054-1.940, P=0.022) and achieving CCyR (HR=9.541, 95%CI:1.692-10.513, P=0.002) were independent predictors for OS. Conclusion:Imatinib treatment may be an optimal first-line choice for Chinese patients with CML-CP who have not received any previous treatments.

Objective:To evaluate acute kidney injure ( AKI) induced by vancomycin in elderly patients by the determination of serum C ( Cys-C) , creatinine ( Cr) and urine kidney damage factor 1 ( KIM-1 ) in order to provide theoretical evidence for clinical pharmacists helping clinicians make individualized dosage regimen. Methods:A retrospective collection of 48 elderly patients admitted to ICU in our hospital from July 2016 to May 2017 treated with vancomycin for MRSA blood flow infection was carried out. The basic values of serum Cys-C, Cr and urine KIM-1 were determined before the treatment of vancomycin and 6, 12, 24h and 48h after the drug use. According to the AKI diagnostic criteria, the patients were divided into the AKI experimental group and the control group. The se-rum Cr, Cys-C and urine KIM-1 were compared between the groups after the drug use and the clinical diagnostic values of Cys-C and KIM-1 were assessed by the working characteristic curve ROC of the subjects. Results:Totally 32 cases (66. 67%) of patients were with AKI induced by vancomycin at 48h after the administration. Compared with that of the control group, the serum Cr, Cys-C and u-rine KIM-1 was significantly higher respectively at 48h, 24h and 12h after the drug use in the AKI experimental group, and the differ-ences between the groups were statistically significant(P<0. 05). Using serum Cys-C, Cr and urine KIM-1 as the AKI diagnosis, the number of AKI at 12h after the drug use had statistically significant difference (P<0. 05). The results of ROC curve analysis showed that the area under the KIM-1 curve of urine was 0. 797 with 95% confidence interval of 0. 647-0. 947), and the area under the serum Cys-c curve was 0. 582 with 95% confidence interval of 0. 364-0. 799. Conclusion: Compared with the traditional kidney damage markers Cr, serum Cys-C and urine KIM-1 can earlier predict renal function in elderly patients to provide reliable basis for early evalu-ation of renal function, which is helpful to the timely adjustment of vancomycin dosage regimen by clinicians assisted by clinical phar-macists for elderly patients.

[ ABSTRACT] AIM: To investigate the SALL4 expression, proliferation and apoptosis in the LNCaP cells after transfection of SALL4 siRNA.METHODS: The expression of SALL4 at mRNA and protein levels was detected by real-time PCR and Western blotting.MTS assay, colony formation assay and flow cytometry were used to determine the prolifer-ation, colony formation ability and apoptosis of the LNCaP cells.The effect of SALL4 on the expression of Bax and Bcl-2 was analyzed by Western blotting.RESULTS:Compared with negative control group, the expression of SALL4 at mRNA and protein levels in LNCaP cells was down-regulated by transfection of SALL4 siRNA ( P<0.05 ) .The proliferation rate and colony formation ability were decreased, while apoptosis rate increased in si-SALL4 group (P<0.05).Higher expres-sion of Bax and lower expression of Bcl-2 in si-SALL4 group were observed ( P<0.05 ) .CONCLUSION:Down-regula-tion of SALL4 by siRNA not only suppresses LNCaP cell proliferation and colony formation, but also inhibits Bcl-2 expres-sion and activates Bax expression to induce apoptosis.

Objective To establish the methodology of combining BOLD and 1H-MRS for investigating correlation between the deactivation in medial prefrontal cortex (MPFC) and gamma-aminobutyric acid (GABA) concentration by acupuncture at LI4 (Point Hegu),and to optimize the experimental technique and procedure.Methods Twenty healthy adult volunteers were enrolled.During fMRI-BOLD scanning,each subject received acupuncture at right LI4 (Point Hegu).MRS scanning was based on MEGA-PRESS sequence,and ROIs were located at bilateral MPFC.The task BOLD fMRI was block design,including 3 stimulations (30 s) with 2 intervals (2 min).Then MRS scanning was performed before and after BOLD.The quantitative values of the BOLD positive and negative activations (Pm) and GABA concentrations were calculated.Results All 20 subjects completed BOLD fMRI scanning,and met the postprocessing requirements.MRS images of 9 subjects with good image quality were included in analysis.Among all 20 subjects,positive activation (Pm=1.17± 0.16) was observed in 9,while negative activation (Pm =-1.31 ± 0.17) was observed in 11 subjects.The GABA average values before and after the acupuncture were (19.93 ±1.04) nmol/L and (20.04±0.81)nmol/L,respectively,and the average amplitude between post-and pre-acupuncture was (0.11 ± 1.60)nmol/L.Conclusion The success rate of this method for quantitative study of brain function established multimodal-functional (BOLD-fMRI and MRS) was acceptable,and the multimodal brain function changes as well as the quantitative values were observed in the brain region during acupuncture.Combined BOLD and MRS quantitative method is feasible for testing acupuncture response in the brain.

As a newly epidemic, 2019 coronavirus disease (COVID-19) with a concentrated outbreak poses a great challenge to medical treatment. The severe and critical patients are complex complicatied with the psychological problems, and the medical staff are overworked and under tremendous psychological pressure. The surgeon participated in emergency medical rescue could provide professional treatment for the patients combined with surgical diseases, as well as specialized training for the non-surgeon crew, to reduce surgical-related mortality. With the advantages of good team consciousness, strong aseptic concept and good psychological quality, the surgeons can quickly adapt to and carry out rescue work under the premise of good self-protection. Surgeons need to develop critical care management concepts and focus on the critical care support equipment. Some suggestions are put forward for the standardized training of resident surgeons to cultivate compound talents. It is hoped that this article can lead to the thinking of how to participate in the emergency medical rescue of infectious diseases among surgeons and provide some enlightenment for future surgical education.

As a newly epidemic, 2019 coronavirus disease (COVID-19) with a concentrated outbreak poses a great challenge to medical treatment. The severe and critical patients are complex complicatied with the psychological problems, and the medical staff are overworked and under tremendous psychological pressure. The surgeon participated in emergency medical rescue could provide professional treatment for the patients combined with surgical diseases, as well as specialized training for the non-surgeon crew, to reduce surgical-related mortality. With the advantages of good team consciousness, strong aseptic concept and good psychological quality, the surgeons can quickly adapt to and carry out rescue work under the premise of good self-protection. Surgeons need to develop critical care management concepts and focus on the critical care support equipment. Some suggestions are put forward for the standardized training of resident surgeons to cultivate compound talents. It is hoped that this article can lead to the thinking of how to participate in the emergency medical rescue of infectious diseases among surgeons and provide some enlightenment for future surgical education.