ObjectiveTo observe the clinical efficacy of acupoint thread embedding plus psychotherapy for insomnia due to disharmony betweenheart and kidney during perimenopause.MethodForty-three patients with insomnia due to disharmony between heart and kidney during perimenopause were intervened by acupoint thread embedding plus psychotherapy including cognitive and behavioral therapies,and then the therapeutic results were statistically analyzed.ResultOf the 43 subjects, 19 were clinically cured, accounting for 44.2%; 13 subjects were markedly improved, accounting for 30.2%; 9 were improved, accountingfor 20.9%; 2 subjects failed, accounting for 4.7%. The total effective rate was 95.3%. The serum E2level was significantly changed after intervention (P<0.01).ConclusionAcupoint thread embedding plus psychotherapy can produce a significant efficacy in treating insomnia due to disharmony between heart and kidney during perimenopause, and this method can up-regulate the serum E2level, enhance the production of estrogen, and improve ovary function.

Objective: To compare the therapeutic effects between the needling method by identification of deficient and excessive patterns and the needling method by routine meridian differentiation in the treatment of soft tissue injuries. Methods: 380 cases of the patients with soft tissue injuries were randomly divided into pattern identification group (200 cases, with the needling method by identification of deficient and excessive patterns) and meridian identification group (180cases, with the needling method by routine meridian differentiation), to observe and compare the therapeutic effects in the two groups. Results: The curative effect was 86% in the pattern identification group and 31.11% in the meridian identification group, with a significant difference (P＜ 0.01). In comparison with the total average treatment times in the cured and improved cases,the pattern identification group was 8.8 days and the meridian identification group was 15.6 days,with a remarkable significant difference (P＜ 0.01). The pattern identification group was better than the meridian identification group. Conclusion: In the treatment of soft tissue injuries, the needling method by identification of deficient and excessive patterns was better than the needling method by routine meridian differentiation.

Objective To investigate whether there is any consistent evidence of linkage across multiple studies,and to identify novel AS susceptibility loci by using GSMA method.Methods Genome-search Meta-analysis(GSMA)method was applied to genome scans of AS and spondyloarthropathy(SpA)to assess evidence for linkage across studies.Results Four AS genome scans including 479 families with 1151 affected individuals were used.Suggesting these BINS most likely contain AS-linked loci;BINS 6p22.3-p21.1,6pter-p22.3,17pter-p12,2p12-q22.1 and 5q34-qter.Four AS genome scans and one SpA scan including 544 families with 1,331 affected individuals were used.The GSMA produced genome-wide evidence for linkage on bin 6p22.3-p21 and 16q23.1-qter.Conclusion This GSMA added the evidence of the HLA loci as the greatest susceptibility factor to AS and shows evidences of chromosome 6,17p,2,5q and 16q as non-HLA susceptibility loci.

Objective To investigate the occurrence circumstance of acute stress disorder(ASD),clinical features and related risk factors,in the officers and soldiers who had gone to Beichuan county to provide disaster relief.Methods We used the self-general questionnaire,post-traumatic stress symptoms self-rating scale(PCL-C),perceived social support scale(PSSS),and coping style questionnaires(SCSQ)to assess the 126 subjects,combining with semi-structured interviews to determine and compare the ASD group and control group,and then analyzed the related factors.Results The prevalence rate of ASD officers and soldiers was 13.49%,with main symptoms of repeatedly breaking into painful memories,nightmares,reproducing the scenes of traumatic events,strong trouble of psychological pain,decreased interest,sleep disorders and emotional instability.These main symptoms of ASD interacts each other,and were reduced with positive response and good social support.Conclusion In the phase of acute stress(one month),the officers and soldiers taking part in earthquake relief have symptoms of ASD,so we should strengthen the necessary psychological assessment and comprehensive psychological intervention means,in order to slow down psychological trauma after disaster,prevent and reduce the possibility that ASD turns into post-traumatic stress disorder(PTSD).

Objective To evaluate the prevalence of subclinical atherosclerosis in rheumatoid arthritis (RA) and the related risk factors.Methods Fifty RA patients without overt atherosclerotic disease and 121 control subjects matched for age and sex were recruited.Duplex carotid sonography was used to measure intima-media thickness (IMT) and plaque formation assessment.Differences between RA and the control group were compared, and the risk factors were explored.RA patients then were divided into two subgroups according to IMT and the comparison between the two subgroups were completed.T test, Mann-Whitney U test, chi-square test, Pearson's correlation and Logistic regression analysis were used for statistical analysis.Results Although RA patients had lower level of serum lipids and body mass index than the control group, the mean IMT value was significantly higher in the RA group than that in the control group [(0.78±0.18) mm vs (0.62±0.14) mm, t=5.853, P=0.000], and plaque formation was more prevalent [56.0％(28/50) vs 36.4％ (44/121),x2=5.596, P=0.018].The difference was especially significant in the younger groups (＜50 years old group and 50-60 years old group).Logistic regression showed that the presence of RA [OR=7.34, 95％CI (2.53, 21.25)], male [OR=2.0, 95％CI (91.25, 3.17)] and old age [OR=1.1, 95％CI (1.04, 21.15)] were the independent risk factors for abnormal IMT (thickened or the presence of carotid plaques).The RA patients were divided into two subgroups according to IMT.Compared with patients with normal IMT, patients with abnormal IMT were older and more common in postmenopausal, and had longer RA duration and higher cholesterol level.In treatment, less patients with abnormal IMT had been taking methotrexate (MTX) for more than 3 months compared with patients with normal IMT.Among these parameters, old age [OR=1.13, 95％CI (1.03, 1.23)] was shown to be the independent risk factor for abnormal IMT in RA patients, and more than 3 months of MTX treatment [OR=0.12, 95％CI (0.02, 0.71)] was the protective factor.Conclusion Atherosclerosis occurs frequently and prematurely in patients with RA and the presence of RA is an independent risk factor for atherosclerosis.Early primary prevention for atherosclerosis should be recommended.MTX probably has a positive effect on preventing atherosclerosis for RA patients, which needs to be confirmed by further study.

Objective To explore the mental health and its relationship with mental quality of training logistic soldiers in field.Methods Symptom Checklist 90(SCL-90) and Mental Quality Questionnaire for armymen (MQQA) were employed to evaluate the mental health and mental quality of 230 training logistic soldiers in field,and then an analysis was carried out on the characteristics of the training logistic soldiers on mental health and its relationship with mental quality.Results ①The psychological problem's ratio of training soldiers was 21.3％,and the ratio of the male(22.8％) was significantly higher than that of the female(15.2％) (x2 =8.64,P=0.00).In SCL-90,the scores of somatization (1.46 ± 0.63),hostility (1.49 ± 0.75) and psychotism (1.43 ±0.68) were all higher in training soldiers than the army norm.The factor scores of somatization (1.49 ± 0.66)and psychotism(1.46 ± 0.72) in the male training soldiers were considerably higher than those of the male soldiers norm (P ＜ 0.05),but not in the female(P ＞ 0.05).②There existed a significantly negative correlation between the factor scores of the mental quality and that of SCL-90 (P ＜ 0.05,P ＜ 0.01).③The SCL-90 scores existed clear differences in obsessive-compulsive,interpersonal sensitivity,depression,hostility and paranoid ideation among different mental quality groups (P ＜ 0.05).Conclusion The mental health of training logistic soldiers is poor.The mental health is closely related to the mental quality.Therefore,the mental health education and mental quality training should be strengthened to the training logistic soldiers.

Objective To examine the predictive value of serum soluble E-selectin ( sE-selectin) levels for high risk plaques as detected by coronary computed tomography angiography ( CCTA).Methods This was a cross-sectional study.CCTA was performed for each patient.Serum levels of sE-Selectin, sVCAM-1,sICAM-1 and sP-Selectin were measured by flow fluorescence immunomicrobead assay ( FFIA). ROC curve and multivariate analysis were used to determine the predictive value for the presence of high risk plaques.Results The high risk plaques group showed higher sICAM-1 and sE-selectin levels.The multivariate Logistic analysis showed that male (OR＝2.131, P＝0.019), old age (OR＝1.053, P＝0.002), hyperlipidemia (OR＝1.960, P＝0.022), high level of apoB (OR＝2.896, P＝0.004) and high level of sE-Selectin(OR＝1.975, P＝0.008) were independently associated with the presence of high risk plaques.The AUC of the multivariate model for high risk plaques was 0.722.The sensitivity, specificity, the positive predictive value and the negative predictive value were 55.3%, 78.3%, 71.8% and 64.4%respectively.Conclusions High sE-selectin levels were associated with the presence of high risk plaques in asymptomatic populations at low to intermediate Framingham risk .sE-selectin can play an important role in plaque screening, as detected by coronary CTA.

Objective: To study the changes of monocyte cytokines in peripheral blood of n-hexane neuropathy patients induced by P₀ protein, and to explore the role of autoimmunity in n-hexane neuropathy patients. Methods: In May 2018, 5 patients with peripheral neuropathy diagnosed as n-hexane poisoning were selected as case group in Shenzhen Prevention and Treatment Center for Occupational Disease in 2017. 6 workers exposure to n-hexane and 6 workers without n-hexane exposure were selected as contact group and control group. Peripheral blood mononuclear cells(PBMC) were isolated from venous blood. Results: The number of spots produced by INF-γ and IL-10 increased after stimulation with P₀ protein in case group, and the positive rate was significantly higher than control group and the contact group. Conclusion Autoimmunity induced by P₀ protein may be involved in the occurrence of myelin sheath damage in n-hexane neuropathy patients.

Objective:To study the treatment outcomes of combining percutaneous transhepatic one-step biliary fistulation (PTOBF) followed by two stages cholangioscopic treatment for type Ⅰ and Ⅱa hepatolithiasis which developed after Roux-en-Y cholangiojejunostomy, and in treatment of cholangiojejunostomy stenosis.Methods:The clinical data of 95 patients with type Ⅰ and Ⅱa hepatolithiasis which developed after Roux-en-Y cholangiojejunostomy and were treated at Shandong Second Provincial General Hospital from September 2016 to December 2020 were analyzed retrospectively. There were 36 males and 59 females, with the age of (51.2±15.3) years (range 14 to 75 years). These patients initially underwent PTOBF rigid choledochoscopy, followed by electronic choledochoscopy via the fistula tract after 6-8 weeks. The hepatolithiasis removal, complications and hepatolithiasis recurrence rates, and the cholangio-intestinal anastomotic stenosis rate and treatments were recorded. The follow-up was performed to analyse prognosis.Results:All 95 patients successfully underwent PTOBF rigid choledochoscopy and electronic choledochoscopy via the fistula tract. In 92 patients (96.8%), stones were completely removed. In 3 patients, small amounts of peripheral bile duct stones were left behind. Of 49 patients had cholangio-intestinal anastomotic strictures. On cholangioscopic examination, the strictures were caused by anastomotic knots in the suture line in 25 patients and cicatricial stenosis in 24 patients. After biliary balloon dilation and removal of anastomotic suture line knots, the strictures were relieved in 49 patients. There were 2 patients who developed biliary bleeding and 2 patients pleural effusion after PTOBF rigid choledochoscopy. Hepatolithiasis recurred in 4 patients in 6 to 36 months later.Conclusion:PTOBF followed by two stages cholangioscopic treatment were safe and effective in treatment of type Ⅰ and Ⅱa hepatolithiasis after Roux-en-Y cholangiojejunostomy. A high hepatolithiasis removal rate was obtained. Balloon dilation and removal of biliary intestinal anastomotic suture knots effectively relieved biliary intestinal anastomotic stenosis. The long-term results needs to be further determined.

ObjectiveTo evaluate the clinical and radiographic efficacy and safety of the combination of recombinant human tumor necrosis factor-αt receptor Ⅱ IgG Fc fusion protein (rhTNFR:Fc) and methotrexate (MTX) in patients with rheumatoid arthritis (RA). MethodsThirty patients with highly active RA were treated with rhTNFR:Fc (25 mg subcutaneously twice weekly) and oral MTX (up to 15 mg weekly). Clinical efficacy was assessed using ACR response criteria and the disease activity score in 28 joints (DAS28).Radiographs of the hands and wrists were assessed with the modified Sharp score. Chi-square test, Fisher is exact test and paired t-test were performed. ResultsAt week 52, ACR20, ACR50 and ACR70 responses were achieved by 90％, 87％ and 67％ respectively. At week 52, mean DAS28 was 3.4±1.1 compared to 6.4±0.6 at base-line(P＜0.01), with 23％ patients achieving clinical remission and 17％ patients in low disease activity. Similarly, the HAQ was improved significantly, declining from 1.18±0.56 at base-line to 0.25t±0.34 at week 52 (P＜0.01). No radiographic progression was found in 22 cases. Adverse events were mild in general.ConclusionTreatment with rhTNFR:Fc plus MTX has shown good efficacy throughout 52 study period in reducing disease activity, improving function, and retarding radiographic progression. Combination therapy for 52 weeks can achieve disease remission and no radiographic progression, which are the two goals of therapy for RA.