Objective To observe the effect of combination therapy with methotrexate,sulfasalazine and hydroxychloroquine on serum lipids in elderly patients with rheumatoid arthritis (RA).Methods 136 patients with RA were randomly divided into group A and group B (n=68,each).Patients in group A were treated with methotrexate,sulfasalazine and hydroxychloroquine sulfate plus life style intervention.Patients in group B were treated with the therapy as same as that of group A and received xuezhikang additionally.The levels of cholesterol (TC),low density lipoprotein cholesterol (LDL-C),triglyceride (TG),high density lipoprotein cholesterol (HDL-C),C-reactive protein (CRP),erythrocyte sedimentation rate (ESR) were determined before and 6 months after treatment.Disease activity was assessed by DAS28,swelling index,joint pain index,duration of morning stiffness.Results The levels of TC,TG and LDL-C were lower and HDL-C level was higher in the two groups after 6 months of the treatment than before treatment (all P＜ 0.05).DAS28,ESR,CRP,joint tenderness,joint swelling and duration of morning stiffness were significantly reduced in two groups after 6 months of the treatment as compared with pretreatment (all P＜0.05).There was no significant difference in levels of TC,TG,LDL-C,HDL-C,DAS28,ESR,CRP,joint tenderness,joint swelling and duration of morning stiffness between the two groups after treatment.There were no obvious differences in liver and kidney function between the two groups before and after treatment.Conclusions Blood lipids levels are abnormal in RA patients.The slow acting antirheumatic drugs have certain effect on blood lipids when alleviating disease symptoms.

Nonalcoholic fatty liver disease(NAFLD)has become one of the most common liver diseases in the world.Considering the important role of insulin resistance in its pathogenic mechanisms,insulin sensitizers are becoming the promising pharmacological strategies for NAFLD.We collected and analyzed the relevant articles in recent years and found that pioglitazone,rosiglitazone and metformin could improve liver enzymes and insulin sensitivity of NAFLD.However,only pioglitazine was supported in ameliorating liver histology by envidences from randomized,double-blinded,controlled clinical trials.There were no much obvious adverse effects in NAFLD patients who received insulin senitizers.Small or medium samples and no more than 2 years of treatment course may be the major limitation of current studies.Future information derived from well-designed running trials will be useful in defining the clinical implications of insulin sensitizers in the treatment of NAFLD.

0.05).There was significant difference at 6 h,24 h and 1 week(P

Objective 　To evaluate the clinical measurement of cerebral perfusion by dynamic CT. Methods　 Thirteen normal adults were examined by dynamic CT for the measurement of cerebral blood flow (CBF). Another dynamic CT scans with the measurement of CBF were performed separately to rule out cerebral ischemia in 5 cases and secondary Parkinson disease in 2. Results　 Normal cerebral cortical perfusion was measured at 59.3～96.8 ml*min-1*100g-1 with the　mean value 76.2 ml*min-1*100g-1. Normal white matter perfusion was measured at 27.1～43.1 ml*min-1*100g-1 with the mean value 33.9 ml*min-1*100g-1. In 5 cases of suspending cerebral ischemia, one showed increase of CBF and 4 presented decrease of CBF. In 2 cases of suspending secondary Parkinson disease, one appeared decrease of CBF and other one was normal. Conclusion　 Dynamic CT scan with the measurement of CBF can demonstrate the hemodynamic status of normal brain and pathological lesion. Combined with routine CT scan, measurement of cerebral perfusion by dynamic CT is an ideal method to show the morphological and functional changes of brain tissue simultaneously.

Objective To assess the efficacy of clinical intervention of early swallowing syndrome on neonates. Methods Eighty-six cases of normal newborns were enrolled in the study, including 44 cases of natural delivery,32 cases of cesarean section,8 cases of premature infant. The cases started vomitting before feeding the milk, became more severe after feeding the milk. once the pathological factors were excluded, the cases were treated with breastfeeding, warm water enema, massaging the lower abdomen, 1% sodium bicarbonate solution to the gastric lavage. Results A variety of clinical interventions on the control of neonatal swallowing syndrome results are obvious. Conclusions Early detection early intervention can prevent complications occurring.

Objective AccordingtothestandardofCochranehandbook (manual)weperformed statistics,analysis,andappraisalonatotalof 2 0volumes 15 8issuesofChineseJournalofRadiologyfrom 1980to 1999.Methods 2 0volumes 15 8issuesofChineseJournalofRadiologywereconsultedbyclinicalexpertstrained byChineseCochraneCenter,therelativerandomizedcontrolledtrial (RCT)andcontrolledclinicaltests (CCT) articleswereconsultedonebyonemanually .Results Withincreasingyears,thepercentageofRCTandCCT articlesaccountingforallclinicalexperimentalarticleswasincreasinggradually .BothRCTandCCTwere 0 %at early 80thandincreasedto 2 .17%and 7.97%respectivelyattheendof90th .Conclusion Theinvestigation levelofclinicalinterventionaltreatmentexperimentalarticlesisimprovinggradually ,butthepercentageofRCTand CCT :Forclinicaltreatmentexperimentalarticlesisstillnothighenough ,thedesign ,implementationandanalysis ofRCTarenotstandardizedsothatproblemsstillexistintermsofconfidenceofresult.

Objective:To explore the effect of integrated treatment of Chinese and western medicine on muhiple organ dysfunction syndrome (MODS).Methods:129 cases of MODS were treated by syndrome differentiation of TCM with the“four syndrome and four methods”based on the routine western medicine treatment from 1997 to 2003,and their therapeutic effects were evaluated. Results:Of the 129 cases,75 were cured and 54 died,the mortality being 41.9%.After treatment of TCM,the state of illness of the patients were ameliorated,the level of blood endotoxin decreased and the clinical syndrome improved.Conclusion:Integrated with western medicine,the“four syndrome and four methods”has obvious therapeutic effect.

Since the current worldwide medical education and clinical practice lay a particular stress on training medical students with scientific knowledge and medical technical skills,enormous medical staffs are shaped into medical technical workers who lack medical morality and emotions,leading to the contradiction between medical morality and technologies.Medical personnel should know that medicine not only observes illness closely,but also attaches importance to the patients themselves who are suffering the pain.Medical students should pay attention to the forming process of medical morality and emotion in their preparative stage,accept the exercise to prepare for medical morality,and recalls their love and concern for life.

0.05).[Conclusion]Periarticular drug injection during TKA and intra-articular drug injection after operation can relieve pain early after TKA,improve the range of motion of the knee and rehabilitation,no further side effect has been noted.