OBJECTIVETo evaluate the efficacy and safety of etanercept plus Tripterygium wilfordii polyglycoside (TWP) in elderly patients with active rheumatoid arthritis (RA).

METHODSTotally 46 elderly patients with active RA were randomly assigned to the treatment group (22 cases) and the control group (24 cases). All patients received subcutaneous injection of etanercept, 25 mg each time, twice per week. The dosage was reduced to once per week 3 months later. Patients in the treatment group took TWP Tablet (10 mg each time, three times per day), while those in the control group took methotrexate (MTX), 10 mg each time, once per week. The whole course lasted for 24 weeks. Patients' rest pain, tender joint number, swollen joint number, health assessment questionnaire (HAQ), patients' global assessment, physicians' global assessment, erythrocyte sediment rate (ESR), C reactive protein (CRP), rheumatic factor were assessed at week 0, 4, 8, 12, and 24. The curative effect was statistically evaluated by the United States Institute of Rheumatology ACR20, ACR50, and ACR70 improvement criteria. Meanwhile, any adverse event was recorded and evaluated.

RESULTSTotally 41 completed the trial, and 5 dropped off (3 in the treatment group and 2 in the control group). Compared with the control group, there was no statistical difference in ACR20, ACR50, or ACR70 in the treatment group (P > 0.05). Compared with before treatment in the same group, there was some improvement in tender joint number, swollen joint number, visual analogue scale (VAS) for patients' global assessment, VAS for physicians' global assessment, ESR, CRP, and HAQ between the two groups, showing statistical difference (P < 0.05). Compared with the control group in the same phase, there was no statistical difference in the treatment group (P > 0.05). There was no statistical difference in the occurrence of adverse events between the two groups.

CONCLUSIONSEtanercept plus TWP could achieve equivalent therapeutic effect to that of Etanercept plus MTX. The two regimens could improve clinical signs, symptoms, and QOL related to RA. They were well tolerated in the treatment of elderly patients with active RA.

Aged ; Antirheumatic Agents ; therapeutic use ; Arthritis, Rheumatoid ; drug therapy ; Drug Therapy, Combination ; Etanercept ; Female ; Glycosides ; therapeutic use ; Humans ; Immunoglobulin G ; therapeutic use ; Male ; Middle Aged ; Receptors, Tumor Necrosis Factor ; therapeutic use ; Treatment Outcome ; Tripterygium ; chemistry

Objective To understand the characteristics of problem behaviors among junior middle school students in northern Guizhou rural areas to provide reference for formulating the intervention measures .Methods The Chinese middle school students mental health scale and the self-made externalizing behavior problem questionnaire were adopted to perform the questionnaire sur-vey on left-behind kids of 6 junior middle schools .Results In the implicit problem behavior ,the scores of girls in hostility ,interper-sonal ,depression factor ,anxiety and total score were higher than those of boys ,and the each factor score was increased with grade ;in the explicit behavioral problems ,the occurrence rates of smoking ,drinking and gambling in boys were higher ,the detection rates of smoking and gambling were higher than those in students ,the occurrence rates of suicidal idea and leaving from home idea in students were 13 .1% and 22 .2% respectively ,in which the occurance rates of girls were higher than those in boys .The detection rate of sex related behaviors in boys was higher than that in girls .Conclusion The problem behaviors appear the gender and grade differences among left-behind kids in northern Guizhou rural areas .The differential mental health education should be carried out according to different target behaviors .

Objective To investigate the relations between adiponectin(APN) and lipoprotein associated phospholipase A2 (LP‐PLA2) with the development and progress of essential hypertension .Methods 60 patients with essential hypertension were collect‐ed and divided into 3 groups of the hypertension grade 1 ,2 ,3 groups according to the levels of blood pressure ,20 cases in each group .Contemporaneous 20 healthy controls were selected .The peripheral venous blood samples were collected from the cubital vein and the serum levels of APN and LP‐PLA2 were measured by ELISE .The related biochemical indicators were simultaneously detected .Results The serum APN levels in the hypertension grade 1 ,2 ,3 groups were significantly lower than that in the control group ,moreover which in the hypertension grade 3 group was significantly lower than that in the hypertension grade 1 group(P<0 .05);on the contrary ,serum levels of LP‐PLA2 in the hypertension grade 1 ,2 ,3 groups were significantly higher than that in the healthy control group ,moreover which in the hypertension grade 3 group was obviously higher than that in the hypertension grade 1 group(P<0 .05);serum APN was significantly negatively correlated with LP‐PLA2(r= -0 .772 ,P<0 .05) .Conclusion Serum levels of APN and LP‐PLA2 are closely related with the development and progress of essential hypertension .

OBJECTIVETo elucidate the effect of angiotensin II (AngII) on the expression of tissue factor (TF) by monocytes and its mechanisms.

METHODSMonocytes were isolated from healthy volunteers by Ficoll-Hypaque gradient and Percoll, and cultured in RPMI-1640. Procoagulant activity (PCA) was determined by one-stage clotting method, TF antigen by ELISA. Reverse transcriptase-polymerase chain reaction (RT-PCR) was used to detect the TF gene mRNA. The levels of IkappaBalpha was detected by Western blot. Electrophoretic mobility shift assays (EMSA) were performed to evaluate the activity of NF-kappaB.

RESULTSAngII (10(-9) - 10(-7) mol/L) significantly increased monocyte PCA, TF antigen and TF mRNA expression in a dose and time dependent manner. Losartan (10(-6) - 10(-5) mol/L) significantly inhibited the effects of AngII on TF activity, antigen and mRNA expression in a dose-dependent effects. Staurosporine (2.5 x 10(-7) mol/L) and genistein (4 x 10(-5) mol/L) lowered TF level of monocytes (P < 0.05). Western blot analysis revealed that after exposure to AngII (10(-7) mol/L), IkappaBalpha level decreased at 15 min, reached nadir at 60 min, and recovered at 180 min. EMSA showed NF-kappaB binding activity increased at 15 min, reached peak at 60 min, and recovered at 180 min. Pyrrolidine dithiocarbamate (PDTC, 10(-4) mol/L), an inhibitor of NF-kappaB, or AT1R antagonist losartan (10(-5)mol/L) inhibited AngII-induced NF-kappaB translocation.

CONCLUSIONSAngII could induce the expression of TF in human monocytes, and this effect was mediated by AT1R. The PKC pathway played the most important role in AngII-induced TF expression. The activation of NF-kappaB was involved in TF expression in monocytes.

Angiotensin II ; pharmacology ; Gene Expression Regulation ; drug effects ; Genistein ; pharmacology ; Humans ; Losartan ; pharmacology ; Monocytes ; drug effects ; metabolism ; NF-kappa B ; metabolism ; Protein Kinase C ; physiology ; RNA, Messenger ; analysis ; Receptor, Angiotensin, Type 1 ; physiology ; Staurosporine ; pharmacology ; Thromboplastin ; genetics

The chemical structures of P1 A was identified by complete acid hydrolysis, partial acid hydrolysis, periodate oxidation-Smith degradation, methylation analysis, IR and NMR. The results showed that P1 A had a backbone consisting rhamnose, mannose, glucose and galactose. The side chain possessed arabinose and xylose. 1-->, 1-->6 and non-reducing terminal linkages existed in polysaccharide P1A, but there are doubling amount of 1-->2 and 1-->4 linkages. Oxidable linkage of P1 A accounted for 45%, and inoxidable linkage of P1A accounted for 55%. Mannose, glucose and galactose were mainly linked by 1-->2 linkage. Rhamnose, arabinose and xylose were mainly linked by 1-->2 and 1-->4 linkages. PlA contained beta-Glc(1,6)-,beta-Gal(1,3)-,beta-Man(1,4)-beta-Rha,-Glc(1,4)-, Glc(1)-,-Gal(1,4)- and Man(1)-.
Acanthaceae ; chemistry ; Drugs, Chinese Herbal ; chemistry ; Magnetic Resonance Spectroscopy ; Molecular Structure ; Molecular Weight ; Polysaccharides ; chemistry

OBJECTIVETo evaluate the possible signal transduction mechanism of the mechanical stress induced by the distraction procedure in osteocytes.

METHODSAn animal model of mandibular distraction osteogenesis in rabbits was established. The expressions of c-fos, OPG and OPGL were detected by ultrasensitive S-P immunohistochemical method.

RESULTAt 4 and 8 days after distraction, distraction zone showed strong positive staining of c-fos, which were apparently higher than that in distraction zone of 2, 4 and 6 weeks after consolidation. At 4 and 8 days after distraction and 2 weeks after consolidation, the expression of OPG was strong, and then wore off gradually at 4 and 6 weeks after consolidation. Weak signals of OPGL could be detected at 6 weeks after consolidation only.

CONCLUSIONc-fos, OPG and OPGL are important regulators in distraction osteogenesis. c-fos is interrelated with the mechanical stress induced by the distraction procedure closely, OPG promotes new bone formation, while OPGL plays a more active role in bone remodeling.

Animals ; Mandible ; cytology ; metabolism ; Osteocytes ; metabolism ; Osteogenesis, Distraction ; Osteoprotegerin ; biosynthesis ; genetics ; Proto-Oncogene Proteins c-fos ; biosynthesis ; genetics ; RANK Ligand ; biosynthesis ; genetics ; Rabbits ; Random Allocation

Objective To evaluate the feasibility and safety of transumbilical laparoendoscopic sin-gle-site dismembered pyeloplasty ( U-LESS-P ) for the treatment of ureteropelvic junction obstruction (UPJO). Methods Between Mar.2011 and Mar.2012, U-LESS-P was performed in 8 consecutive pa-tients with UPJO by one experienced laparoscopic surgeon .The patients included 5 males and 3 females, with an average age of 28 (16-45) years.Of the 8 patients, six presented with flank pain , and two were a-symptomatic and discovered incidentally by health check .Of the 8 patients, seven had UPJO on the left side and one on the right side .The diagnosis was established by renal ultrasonography , diuretic renal scan , intra-venous urography (IVU) or/and computed tomography urography (CTU).Renal ultrasonography, IVU and ( or) CTU showed hydronephrosis and UPJO in the affected side , while diuretic renal scan demonstrated re-nal function deteriorated .No patients had undergone abdominal surgery previously .A 2-2.5 cm umbilical in-cision was made for single-port access .The procedures were performed using 30°5 mm or 10 mm laparoscope with a combination of conventional and bent laparoscopic instruments . Results All procedures were com-pleted successfully .None was converted to open surgery or traditional laparoscopic surgery .The mean opera-tive time was 153 (117-190) min, and the average estimated blood loss about 20 (10-40) ml.The mean time to resume oral diet was 1.5 days.The drainage remained 2-7 days.The mean hospital stay was 6 (4-8) days.With the follow-up of 3-6 months, symptom-free was investigated in all 8 cases.Ultrasonography , diuretic renal scan and IVU showed decreased or disappeared hydronephrosis .No operative complication , such as anastomotic stoma stenosis , was founded . Conclusions U-LESS-P is a safe and effective proce-dure for the treatment of UPJO , with the advantages of decreased operative morbidity , postoperative rapid re-covery and improved cosmetic result .

Abstract: Objective To analyze the occupational hazards of enterprises in Pingshan district of Shenzhen in 2017. Methods Occupational hazards were analyzed in 200 enterprises in Pingshan district of Shenzhen City selected using stratified Results random sampling method. A total of 24 industries were involved in the 200 enterprises. The declaration rate of ， occupational hazards was 91.5% and the exposure rate of occupational hazards among workers was 49.2%. The regular monitoring rate of occupational hazard factors in workplaces of the enterprises was 79.5%. There were 129 kinds of occupational ， ， hazard factors of which 19 factors exceeded the national occupational exposure limit accounting for 14.7%. The over standard ， ， ， ， ， ， ， ， rates of noise silica dust cotton dust methanol toluene and other dust were 28.7% 13.6% 11.8% 5.86% 0.5% and ， ， 0.4% respectively. There were 13 kinds of occupational hazard factors in the workplace of metal products industry all of which （ ） exceeded the occupational exposure limit. The exposure rate 56.7% of occupational hazard factors in workers was the highest. Conclusion ， ， The main occupational hazard factors were noise dust and chemical factor and the major occupational hazard industry was metal manufacturing in Pingshan district of Shenzhen City.

OBJECTIVETo repair cartilage defects at non-weight-bearing area of the femoral condyle in rabbits with invitro amplified cartilage cell using calcium alginate column scaffold combined with calcium alginate gel injection, and to study repair effects of combination with different form of the same material.

METHODSTwenty-four New Zealand rabbits were divided into 4 groups randomly. The wounds of rabbits in the Group 1 were repaired with injection of calcium alginate gel; the wounds of rabbits in the Group 2 were repaired with in planting of calcium alginate column scaffold; the wounds of rabbits in the Group 3 were repaired with in planting of calcium alginate column supporter firstly, and then injection of calcium alginate gel at the surrounding; and Group 4 is control group, the rabbits in the group were repair and without any support. The repair effects were demonstrated with Xij, and the effects of all animals were studied with statistical analysis.

RESULTSThe Xij scores of each rabbits were calculated, and the scores in four groups were compared. The statistical results showed that combination therapy was better than other methods (F = 69.0, P < 0.05).

CONCLUSIONThe calcium alginate with column shape has better shaping effects and certain mechanical strength. The calcium alginate gel has better stick nature and can be used to integrate artifical material with normal structure. They can be used together, which meeting the desire of repair and integration in cartilaginous tissue engineering.

Alginates ; administration & dosage ; Animals ; Cartilage, Articular ; pathology ; surgery ; Collagen Type II ; analysis ; Female ; Gels ; Glucuronic Acid ; administration & dosage ; Hexuronic Acids ; administration & dosage ; Immunohistochemistry ; Knee Joint ; pathology ; surgery ; Male ; Rabbits ; Tissue Engineering

Objective To explore protection mechanism of Hedysari polysaccharide (HPS) on myocardial fibrosis of db/db mice with diabetic cardiomyopathy.Methods Sixty db/db mice (7-week-old) were randomly divided into five groups:high-dose experimental group,middle-dose experimental group,low-dose experimental group (HPS:200,100,50 mg · kg-1),control group(rosiglitazone:4 mg · kg-1) and model group(0.9％ NaCl,gavege);while 12 db/m mice (7-week-old) were normal group.Each group had 12 mice.Blood glucose was detected at the baseline before intervention and at end of 2,4,6 and 8 weeks after intervention separately.The activity of blood lipid,superoxide dismutase (SOD),glutathione peroxidase (GSH-Px) and the content of malondialdehyde (MDA) were detected by biochemical method after 8 weeks.The degree of myocardial fibrosis was observed by masson staining.The qPCR method and Western blotting method were used to detect the expression of peroxisome proliferator-activated receptor γ (PPARγ),nuclear transcription factor 2 kappa B (NF-κB) mRNA in myocardial tissue.Results The activities of SOD(mg · mL-1)in model group,high-dose experimental group,middle-dose experimental group,control group were 140.70 ± 1.04,145.81 ± 0.99,142.21 ± 1.09,145.70 ± 1.10,respectively with statistical difference compared with the model (P ＜ 0.05).The activities of GSH-PX(U ·mg-1) in above four groups were 110.91 ±0.82,114.94-0.78,112.10 ±0.86,114.84 ±0.86 with statistical difference compared with the model(all P ＜0.01).The contents of MDA(nmol · mg-1) were 7.20 ±0.49,5.82 ±0.52,6.62 ±0.67,5.80 ±0.52 in the four groups which significantly decreased (P ＜ 0.05,P ＜ 0.01).The expression of PPARγ mRNA were 0.34 ± 0.11,0.68 ± 0.05,0.48 ±0.03,0.49 ±0.03,0.93 ± 0.05 and protein above were 0.75 ±0.12,1.78 ±0.08,1.44 ±0.07,1.07 ±0.05,1.63 ±0.02 in above five groups with statistical difference compared with the model(all P ＜0.05).NF-kappa B mRNA were 3.35 ±0.81,1.67 ±0.22,2.34 ±0.39,2.05 ±0.44 and protein were 1.17 ±0.04,0.56 ±0.12,0.86 ±0.13,0.55± 0.12 in the four groups with statistical difference compared with the model (all P ＜ 0.05).Conclusion HPS can reduce the development of myocardial fibrosis by increasing the expression of PPARγ and inhibiting the activity of NF-κB,controlling oxidative stress and inflammatory reaction through the PPARγ-NF-κB signaling pathway.