Characterized by chronic arthritis, juvenile idiopathic arthritis (JIA) refers to a group of rheumatic diseases in children with unknown causes and strong clinical heterogeneity.Most patients have good prognosis, while some may be involved with important extra-articular organs and tissues, including cardiac system damage, pulmonary or pleural lesions, renal amyloid degeneration, uveitis, and so on.Delay in diagnosis and treatment may lead to short-term and/or long-term involvement in vital systems, thus resulting in the aggravation of the disease or poor prognosis, which may decrease their life quality and even threaten their life.Understanding the extra-articular manifestations of JIA is very important to manage disease.

Objective:To evaluate the effect of Ginseng-Sini in early goal directed treatment septic shock under PICCO.Methods: Forty four patents with septic shock were randomly divided into control group, which treated with Ginseng-Sini on the basis of routine treatment under PICCO, observation groups, which treated with only the basis of routine treatment under PICCO. Before and after the drugs were given for 6 hours, HR, IMAP, CVP, SpO2, Lac, CI, ITBVI, SVRI were monitored.Results: Before treatment, HR, IMAP, CVP, SpO2, Lac, CI, ITBVI, SVRI of the observation group were not different from the control group(P>0.05); after 6 hours of treatment, CI of the observation group were higher than that of the control group(P<0.05).Conclusion: Ginseng-Sini in the early goal directed of septic shock is effective, especially in improving tissue perfusion.

Rheumatoid arthritis ( RA ) and systemic lupus erythematosus ( SLE ) are the most important and typical autoimmune diseases,however their exact mechanisms has not yet been clear. Autohpagy,a highly conserved process,depends on catabolism of lysosomal degradation of macromolecules or organelles within the cell itself. Autophagy exists widely in various tissues and is involved in maintaining survival and differentiation of cell or the stablility of internal environment. Recently,autophagy has gained wider attention and been one of the hot points of relative reserches. In this review we′ll sum up the development of autophagy in RA and SLE.

Objective To study the effect of surface electromyogram-triggered electrical stimulation on lower limb function in hemiplegic stroke patients. Methods Thirty hemiplegic stroke patients were divided into a treatment group ( 15 cases) and a control group ( 15 cases). Both groups were given conventional rehabilitation training.Additionally, the treatment group was given surface electromyogram-triggered electrical stimulation training, while the control group was given common low frequency electrical stimulation. Brunnstrom's recovery stages, the Fugl-Meyer assessment (FMA) and electromyographic parameters were assessed before and after 3 courses of treatment. Results After treatment both groups had significantly higher Brunnstrom and FMA scores and better integrated electromyograms(iEMG), but the effects in the treatment group were significantly better than in the control group. Conclusions Surface electromyogram-triggered electrical stimulation training can provide satisfactory rehabilitation of lower limb function in hemiplegic stroke patients.

AIM: To evaluate the relationships between maternal serum alpha-fetoprotein (MSAFP) levels and middle cerebral artery peak systolic velocity (MCA-PSV) in pregnancies with fetal anaemia and to compare the sensitivities of MSAFP and MCA-PSV for the predicting the risk of fetal anaemia. METHODS: Fifty-five measurements of MSAFP and MCA-PSV were carried out in 32 women at risk of fetal anaemia (4 cases of alloimmunisation, 11 cases of thalassemia, 10 cases of parvovirus infection and 7 cases of placental chorioangioma). The relationship between MSAFP and MCA-PSV was studied, and 19 fetal blood samples, in which MCA-PSV measurements were abnormal, were taken and the fetal heamoglobin were tested in order to evaluate the correlation of MSAFP and MCA-PSV. RESULTS: A correlation between MSAFP and MCA-PSV (n=55, r=0.57, P<0.01) was observed, in which 15 cases of fetal anaemia and 4 cases false positive (non-anaemia) were detected among the 19 fetal blood samples. The MSAFP levels of 4 false-positive cases were normal. The MSAFP levels in 15 fetal anaemia cases were higher than those in non-anaemia. The elevation of MSAFP level was 15-20 d earlier than that of MCA-PSV in the cases of alloimmunisation and thalassemia, and it was 10-12 d later in the cases of parvovirus infection and placental chorioangioma significantly (P<0.05). Both MSAFP (r=-0.87) and MCA-PSV (r=-0.67) were significantly correlated with fetal heamoglobin level. CONCLUSION: The MSAFP level is significantly correlated with both MCA-PSV measurements and fetal haemoglobin. The time and process of the elevations of MSAFP indicate that MSAFP is more sensitive than MCA-PSV to predict and monitor the pregnancies at the risk of fetal anaemia.

Objective To investigate the blood-retinal barrier(BRB)function of porcine retinal pigment epithelial(RPE)cells cultured in vitro. Methods Primary porcine RPE cells were cultured,and the third generation were inoculated in a microporous filter with the filter membrane of polyvinylpyrrolidone(PVP)-free polycarbonate membrane.After 1,2,3 and 4 weeks of culture,the surface of filter membrane was observed by light microscope,and after 2 weeks of culture,the section of filter membrane was observed by light microscope and transmission electron microscope.Transepithelial electrical resistance(TER)was detected and the permeability was measured with fluorescein sodium(FS)and horseradish peroxidase(HRP). Results Primary porcine RPE cells were cultured successfully.RPE cells converged1week after inoculation; 2 and 3 weeks after inoculation,the density of RPE cells did not changed obviously; 4 weeks after inoculation,the density of RPE cells decreased.The characteristics of polarized growth of monolayer were found in RPE cells on the surface of filter membrane; 2 weeks after inoculation,the TER of RPE cells was(97.44?11.36)?/cm~2 which maintained till the 3rd week after inocubation.After incubated for 30 minutes,only 0.27% of FS and 0.17% HRP reached the inferior filter membrane,and the permeability rate of SF with low molecular weight was higher than which of HRP with high molecular weight. Conclusions The filter with PVP-free polycarbonate membrane may be used to set up the model of RPE cells with polarized growth of monolayer and investigate the barrier function of RPE cells.

Objective To explore clinical indications and curative effects of microwave coagulation combined with submucous 5-fluorouracil (5-FU) injection in the management of early-stage lower rectal cancer. Methods Nine patients with early-stage lower rectal cancer underwent microwave coagulation with submucous 5-FU injection from January 1996 to December 2002. After the microwave treatment, a retention enteroclysis with 100~200 ml normal saline containing 1.0 g 5-FU was performed once daily for 3 days. Results In 3 patients, levels of carcinoembryonic antigen (CEA), which were preoperatively increased, were reduced below normal limits after microwave treatment. No hemorrhage or other intra- or post-operative complications was observed. Follow-up observations to January 2006 showed that all the 9 patients survived. One patient survived for 3 years and 5 months, 1 patient survived for 3 years and 8 months, and 1 patient experienced a tumor relapse at 1 year and 4 months and survived for 2 years and 9 months after a Miles procedure. Among 6 patients who survived longer than 5 years, 1 survived for 5 years and 1 month, 1 for 6 years and 3 months, 1 for 6 years and 8 months, 1 for 7 years and 6 months, and 2 for 9 years. Conclusions Surgical indications for microwave coagulation combined with submucous 5-FU injection for rectal cancer included early-stage cancer, lesions located within 7 cm away from the anus, the mass type cancer, tumor diameter at 0.5~3.0 cm or less than one third of the rectum’s circumference, well differentiated tumor, and patient’s strong anus-sparing demand. This method is minimally invasive, safe, reliable, and cost-effective.

To elucidate the change in trunk muscle performance in patients with low back pain caused by military training. The indices of trunk muscle strength (PT/BW, TAE, F/E, ER), the cross-sectional area of sacrospinalis, the amplitude and the duration of EMG, and the lumbar curvature were measured in recruits with low back pain after military training (n=40)and healthy subjects(n=40).All of the indices were compared between two groups. It was found that except PT/BW and ER of flexors and cross-sectional area of sacrospinalis, there were significant differences between other indices of the patients compared with healthy subjects(P

Objective To investigate the effect of different concentrations of arsenic trioxide (As2O3,ATO) on neurokinin A (NKA) in renal tissue of BXSB mice and explore its clinical value.Methods Fifty BXSB mice (twelve weeks old and weighted 23～26 g) were randomly divided into control group,systemic lupus erythematosus (SLE) group,and therapeutic group of three different concentrations of ATO.All biochemical indicators were analyzed before and after treatment.The pathology of renal tissue was examined by immunohistochemistry.The concentration of NKA in renal tissues was detected by ELISA and the concentration of NKA mRNA was detected by RT-PCR.Results The concentration of NKA in SLE group in renal tissue (299±26) pg/g was significantly higher than that of normal control group (122±7) pg/g (P＜0.05).The concentration of NKA in the SLE group in renal tissue was significantly higher than that of three different concentrations of ATO in low-dose group (151±14) pg/g,moderate--dose group (147±9) pg/g and in highdose group (155±14) pg/g (P＜0.05).No difference was found between three different dosages of ATO treatment groups and normal control groups (P＞0.05).There were no significant differences among three different dosages of ATO treatment group (P＞0.05).The side effects in low-dose group were significantly lower than those of moderate and high-dosage groups (P＜0.05).Conclustion NKA concentration expressed in the renal tissues in the SLE group is higher than that in the control group.Decreasing the concentrations of NKA mRNA in renal tissues may be one of the important mechanisms of ATO in treating SLE.Low-dosage ATO is safe and effective to treat SLE and has therapeutic potentials.

ObjectiveTo explore the diagnosis and surgical treatment techniques for the patients with primary presacral tumor.Methods Data from 31 patients with primary presacral tumor admitted into our Department for Surgery from Jan. 1999 to Jar. 2009 were retrospectively analyzed.All patients underwent surgical treatment,among them,10 received per-sacroiliac or per-perineum approaches to remove the tumors,18 receivedper-abdomentumorectomy, and3receivedcombinedper-peritoneumandper-perineum tumorectomy.Results Patients visited the doctor while exhibiting the compression symptoms by the the tumors.Final diagnosis could be reached with the help of rectal touch,B-mode ultrasound,computerized tomography,or magnetic resonance imaging.Complete resection was performed in 28 patients.Partial resection was performed in 3 patients.Fractionated resection was successfully performed in 2 patients with chronic infection or sinus tract.ConclusionThe primary presacral tumor should be surgically resected once final diagnosised and without surgical contraindications.Pelvic plexus should be preserved and presacral hemorrhage should be prevented.The tumor should be resected as complete as possible.