Objective To evaluate the efficacy and safety of etoricoxib and meloxicam in the treatment of patients with acute gout. Methods A randomized,active comparator study was conducted at outpatients and inpatients in our hospital from January 2009 to July 2010.A total of 84patients aged (63.7± 11.0) years with an acute attack of gout were treated with etoricoxib 120 mg/d (n =48),or meloxicam 15 mg/d (n =36) for 7 d.The patient's assessment of joint pain (0- 4 point Likert scale) at drug treatment for 2-5 d was considered as the primary efficacy end point,4 h after firstly takiug the drug and 2-8 d after treatment as the secondary efficacy end point.The starting efficacy was determined until pain relieved by patient himself. The safety was assessed by adverse experiences and indexes including leucocyte, platelet,crcatinine, uric acid,alanine transaminase (ALT),aspartate transaminase (AST) and mean artery pressure(MAP). Results In 84 patients,3cases (8.3％) in meloxicam treatment and 15 cases (31.2％) in etoricoxib treatment (among which 13 cases finished treatment) discontinued therapy.The improvement scores of joint pain were (-0.41 ±0.35 vs.-0.19±0.30,P=0.005) at4 h after firstly taking the drug,(-1.66±0.58 vs. 1.38±0.44,P=0.018)at drug treatment for 2 -5 d,( - 1.83 ± 0.60 vs.- 1.85 ± 0.53,P=0.9) at 2 8 d after treatment,and (-2.64±0.45 vs. - 2.38±0.37,P=0.000) post-treatment higher than pre treatment.The starting time of pain relieving were (4.0 ± 4.6) h in etoricoxib treatment and (12.1±5.7) h in meloxicam treatment. The levels of leucocyte were decreased after treatment as compared with before treatment in both two drug treatments(P＜0.05),while no differences were found in platelet.creatinine,uric acid,ALT and AST.MAP after etoricoxib treatment was increased compared with pretreatment ( P ＜ 0.05 ). Drug related adverse experiences appeared in 15 cases (31.2 ％ ) in etoricoxib treatment and 12 cases(33.3 ％ ) in meloxicam treatment(P=1.000).The ratio of gastrointestinal tract-related adverse effects in meloxicam treatment was higher than in etoricoxib (22.2％ vs.6.2％,P＜ 0.05),while adverse effects on cardiovascular in etoricoxib treatment were comparable to that of meloxicam (16.7 ％ and 11.1 ％,P＞0.05). Conclusions Etoricoxib at a dose of 120 mg once daily may be more effective than meloxicam for acute gout in aspects of safety and tolerance.

OBJECTIVE: To analyze the drug use in outpatient and emergency departments of our hospital.METHODS: A total of 12 000 prescriptions in outpatient and emergency departments in 2006 were randomly sampled for the analysis of drug use.RESULTS: 43% of the drugs were used singly and 13% were combined use of 4 or more than 4 drugs.Oral administration and intravenous injection were the leading routes of administration.3.10% of the prescriptions were irrational in dosage,repeated drug use,dosage regimen,use of dissolvants,drug combination,and drug choice etc.CONCLUSION: The drug use in the outpatient and emergency departments of our hospital were rational basically,yet there are still some problems remains to be tackled.Great importance should be attached to the prescription check.

Objective To investigate the effects of metformin on plasma ghrelin and peptide YY (PYY)levels in newly-diagnosed type 2 diabetic patients,and to study the impact of metformin on body weight.Methods A prospective nested case-control study was designed as a research protocol.Sixty four newly-diagnosed type 2 diabetic patients were treated with metformin for 12 weeks.The patients were divided into two groups:weight loss group and non-weight loss group according to the changes in body weight after metformin treatment.Fasting plasma ghrelin and PYY levels and other metabolic parameters were measured before and after metformin treatment.ResultsFasting plasma ghrelin level was significantly decreased in the patients after metformin treatment [ ( 10.71 ±2.68 vs 11.81 ±3.19 )ng/ml,P＜0.05 ].Fasting plasma PYY level was significantly increased in patients after metformin treatment [ ( 136.86+39.14 vs 128.42+37.31 ) pg/ml,P＜0.05 ].After metformin treatment,43.7％ of the patients lost body weight significantly.Fasting plasma ghrelin level was decreased by 16.6％ after treatment in the weight loss group,as compared with 6.2％ in non weight loss group( P＜0.05 ).Fasting plasma PYY level was increased by 10.8％ after treatment in the weight loss group,as compared with 3.5％ in the non-weight loss group (P ＜ 0.05 ).Conclusions The fasting plasma ghrelin level in the weight loss group was lowered more significantly compared with that in the non-weight loss group after metformin treatment.The fasting plasma PYY level in the weight loss group was elevated more significantly as compared with that in the non-weight loss group after metformin treatment.The mechanism remains to be further studied.

AIM: To confirm the effects of capillary endothelium injury in the lung with ischemia reperfusion. METHODS: The rabbits pulmonary models of ischemia reperfusion (I-R)injury were established. Plasma nitric oxide and endothelin levels, arterial oxygen tension and wet/dry weight ratios were determined in different periods in control and I-R groups, and the pulmonary ultrastructure abnormities were analyzed under electromicroscope. RESULTS: The plasma levels of NO and ET-1 in I-R animals increased significantly ,compared with those in sham treated control groups. The level of ET-1 had significantly negative correlation with PaO 2 and positive correlation with the value of the wet/dry weight ratios. The swelling and karyopyknosis of capillary endothelium in the lung with I-R groups were observed in ischemia periods. The injuries of endotheliums and typeⅠandⅡ alveolar cells in 0 5 h of reperfusion were more severe than those in ischemia time, and the injuries began to repair in 2 h of reperfusion time. CONCLUSION: In the I-R group, pulmonary capillary endothelium have been injuried, which may play a prominent role in I-R injury and dysfunction of the lung.

Animals ; Brain ; metabolism ; Female ; Ginkgolides ; pharmacology ; Hypoxia ; metabolism ; Lactic Acid ; metabolism ; Male ; Malondialdehyde ; metabolism ; Rats ; Rats, Sprague-Dawley ; Sodium-Potassium-Exchanging ATPase ; metabolism

Objective To investigate the imaging characters of abdominal cocoon.Methods Six cases of abdominal cocoon proved by surgery and pathologic findings were retrospectively analyzed. Abdominal plain X-ray and CT were performed in 6 cases.The gastrointestinal barium meal series were undergone in 4 cases.The imaging findings were analyzed.Results Abdominal plain X-ray suggested intestinal obstruction in 3 of 6 cases.The gastrointestinal barium meal showed"cauliflower sign"or "concertina pattern"in all of the 4 cases;CT images revealed a conglomeration of multiple small bowel loops in all 6 cases and the intestinal loops seemed to be encapsulated in a membranelike sac.Conclusion The imaging features of gastrointestinal barium meal and CT scan could suggest the diagnose of abdominal cocoon.

Objective To summarize and discuss the diagnostic and treating experiences of chronic pancreatitis with mass in the head. Methods Eight patients of chronic pancreatitis with mass in the head who were misdiagnosised as carcinoma of head of pancreas were analyzed retrospectively in the past 10 years. Results All the patients exhibited abdominal pain,5 of whom were with jaundice and 3 with anorexia. All the patients were misdiagnosised as carcinoma of head of pancreas before the operation,but the pathology after operation indicated chronic pancreatitis. The pancreaticoduodenectomy was performed in 5 patients,the choledochojejunostomy in 2 patients,while the exploratory laparotomy in 1 patient. After the operations,the abdominal pain was relieved in 7 patients, while 2 patients who accepted pancreatoduodenectomy suffered from pancreatic fistula,1 of whom died in the end. Conclusion It’s hard to differentiate the chronic pancreatitis with mass in the head from the carcinoma of head of pancreas before operation. If the carcinoma of head of pancreas can’t be excluded during the operation,the pancreatoduodenectomy should be performed,while the duodenum-preserving total resection of the head of the pancreas or any intra-drainage operations should be done if chronic inflammation is found in the whole pancreas with a negative result of the biopsy of the pancreas through the needle aspiration.

AIM:To observe the expression of tumor necrosis factor-alpha ( TNF- α) and its receptor I ( P55 ) in different pterygium and discuss the role of TNF-α and receptor I (P55) in pterygium.
METHODS: Immunohistochemistical staining method ( PV) was adopted to detect the expression of TNF-α and receptor I in pterygium ( 72 eyes ) and para-pterygium conjunctival tissue ( 30 eyes ) . The relationship between the expression and clinical-pathological parameters was also analyzed.
RESULTS:The positive rates of TNF-αwere 65. 3% (47/72), 26. 7% (8/30) in pterygium and para-pterygium conjunctival tissue. The positive expression of TNF-α had statistic difference between the two groups (χ2=12. 706, P<0. 01). The positive rates of TNF-α receptor I were 56. 9% (41/72), 16. 7% (5/30) in pterygium and para-pterygium conjunctival tissue. The positive expression of P55 had statistic difference between the two groups (χ2=13. 875, P<0. 01). The positive rate of TNF-αin recurrent pterygium group was higher than primary pterygium group (χ2=6. 547, P=0. 011). There had no statistically significance of the expression intensity between the two groups (F=1. 288, P=0. 393); the positive rate in advanced pterygium group was higher than quiescent pterygium group (χ2=4. 082, P=0. 043). The expression intensity had no statistically significance between the two groups (F=0. 489, P=0. 708). The positive rate of P55 in recurrent pterygium group was higher than primary pterygium group (χ2 =9. 907, P= 0. 002). There had no statistically significance of the two group's expression intensity ( F = 1. 175, P = 0. 424 ); the positive rate in advanced pterygium group was higher than in quiescent pterygium group (χ2=11. 140, P=0. 001). The expression intensity had no statistically significance between the two groups (F=0. 665, P=0. 621).
CONCLUSION:The expression of TNF-α and P55 are changing according to the development of clinical staging and onset. The expression of TNF-α and P55 may be related to clinical classification, staging and patient's working conditions of pterygium. There has no significant difference expression intensity of TNF - α and P55 in clinical staging and onset of pterygium.

Objective To explore the diagnostic points and promote the checkout rate of fetal congenital cor-dis malformation. Method Analyzed the ultrasonic character by reviewing the fetal congenital cordis malformation from our hospital in recent 2 years. Result 3 cases was inaccuracy in the 28 cases of congenital cordis malformation diagnosed by antepartum. Diagnostic accuracy rate was 89.3%. Conclusion The inaccuracy was reduced greatly by gradual ultrasonic diagnosis by way of four cavity heart and three vas cross section,