Objective To evaluate the role of anti-cyclic citrullinated peptide antibody(ACCP) and rheumatoid factor(RF) in patients with rheumatoid arthritis.Methods ACCP antibody and RF were detected in serum samples of 90 RA patients,30 other diseases patients and 35 healthy blood donors.The sensitivity,specificity,positive predictive value,negative predictive value,agreement rate and Youden`s index of these parsmeters for the diangnosis of RA were analyzed.We maped the receiver operative characteristic curve(ROC) and calculated area under the ROC curve.Results The positive rates of ACCP and RF were higher than those of patients with other diseases or healthy controls(P0.5).Conclusion ACCP is a valuable index for RA diagnosis.It is useful in improving the diagnostic accuracy of RA.

Objective To evaluate the safety and efficacy of three types of anesthesia methods in elderly patients with coronary heart disease undergoing unilateral lower extremity surgery.Methods Totally 65 patients with coronary heart disease of cardiac function Ⅰ-Ⅱ (NYHA),scheduled for undergoing unilateral lower limb surgery were randomly divided into three groups:local nerve block anesthesia of lumbar plexus plus the sciatic nerve (21 cases),general anesthesia (19 cases),epidural anesthesia (25 cases).Systolic blood pressure (SBP),heart rate (HR),pulse rate and blood oxygen saturation (SPO2) at 0 min,10 min,20 min,30 min,40 min after surgery at the end of the surgery were observed and recorded.The change of troponin Ⅰ (cTnI) at 3 day after surgery was observed.Visual analoguc scales (VAS) scores.movement reaction,the infortnation of muscle relax and corresponding management were recorded in order to detect anesthesia efficacy.Results The excellent and satisfactory rate of anesthesia efficacy of three groups were 17 cases (81.0％) and 4 cases (19.0％),17 eases (89.5％) and 2 cases (10.5％),22 cases (88.0％) and 3 cases (12.0％) (all P＞0.05).In epiduralgroup compared with other groups,SBP were decreased (both P＜0.05).cTnI in nerve stimulator group was decreased (all P＜0.05) at 1 and 3 day after surgery compared with general anesthesia group,and at 3 day after surgery,cTnI level in nerve stimulator group was lower than other two groups(all P＜0.05).Conclusions The nerve stimulator guided nerve block is the most safe method among general anesthesia and epidural anesthesia in elderly patients with coronary heart disease scheduled for lower extremity surgery.

Purpose To establish myocardial infarction model in rabbits and to evaluate cardiac function and pathological changes.Materials and Methods In 35 New Zealand white rabbits, the left anterior descending branch (LAD) of the coronary artery was ligated. The cardiac function was evaluated using echocardiography, and the blood serum brain natriuretic peptide (BNP) level was examined preoperatively, on postoperative day 1, and in 1 week, 2 weeks, 4 weeks and 8 weeks for comparison. Pathological sections and HE staining were performed to observe pathological changes. Results The death rate was 28.6% (10/35). There was progressive increase in left ventricular end systolic diameter (LVESD) and left ventricular end diastolic diameter (LVEDD) at 1 week, 2 weeks and 4 weeks (P<0.05). There was progressive decrease in left ventricular ejection fraction (LVEF) and left ventricular fractional shortening fraction (LVFS) at 1 day, 1 week, 2 weeks and 4 weeks (P<0.05). The BNP level started increasing in 1 day, peaked in 1 week, then gradually decreased but remained higher than preoperative level in 8 weeks (P<0.01). Pathological section showed typical myocardial cell degeneration, necrosis, ifbrosis, calciifcation and scar formation. Conclusion This myocardial infarction model is satisfactory with signiifcant decrease of cardiac function and increase of BNP level.

Objective:To establish a BALB/c mouse model of Echinococcus granulosus allergy and investigate the role of lymphocyte subsets in Echinococcus granulosus-induced sensitization. Methods:Echinococcus granulosus was isolated from the liver of sheep naturally infected with Echinococcus granulosus and cultured for 40 d. BALB/c mice were intraperitoneally injected with 50 microcapsules and sensitized by intraperitoneal injection of 0.1 ml/10 g of larval Echinococcus granulosus capsule six months after infection. According to the symptom scores 1 h after sensitization, these mice were divided into two groups: non-sensitized group ( n=6) and sensitized group ( n=6). The mice ( n=6) in control group were injected with sterile saline. Blood sample was collected from the angular vein of each mouse. Flow cytometry was used to detect B cells, NK cells and CD3 +/CD4 +/CD8 + T cells. Cytometric bead array was used to measure IL-4, IL-6 and IL-13. Results:The percentage of B cells was significantly higher in the non-sensitized group than in the control group ( P<0.001), but no significant difference was observed between the sensitized group and the control group. Compared with the non-sensitized group, the percentage of B cells in the sensitized group decreased significantly ( P<0.01). Compared with the control group, the percentages of NK cells in the non-sensitized group and the sensitized group decreased significantly ( P<0.001 and P<0.01). Compared with the non-sensitized group, the percentage of NK cells in the sensitized group increased significantly ( P<0.05). Compared with the control group, the percentage of CD3 + and CD4 + T cells in the non-sensitized group decreased significantly ( P<0.05), while the percentage of CD8 + T cells increased significantly ( P<0.01). Compared with the control group, the percentage of CD3 + and CD4 + T cells in the sensitized group increased significantly ( P<0.05 and P<0.001), while no significant change in the percentage of CD8 + T cells was detected. Compared with the non-sensitized group, the percentage of CD3 + and CD4 + T cells in the sensitized group increased significantly ( P<0.05), while the percentage of CD8 + T cells decreased significantly ( P<0.01). The levels of IL-4, IL-6 and IL-13 were significantly higher in the non-sensitized group than in the control group ( P<0.001). Compared with the control group, the sensitized group showed increased IL-4 ( P>0.05), significantly increased IL-6 ( P<0.01) and decreased IL-13 ( P>0.05). The levels of IL-4, IL-6 and IL-13 in the sensitized group were significantly lower than those in the non-sensitized group ( P<0.001). Conclusions:The BALB/c mouse model of allergy induced by larval Echinococcus granulosus was successfully established. This study proved that the humoral immune response induced by Th2 cells played an important role in Echinococcus granulosus-induced sensitization, which provides an important scientific basis for establishing a prevention and treatment strategy for patients with anaphylactic shock caused by extravasation of Echinococcus granulosus fluid.

Objective To systematically review the efficacy and adverse events of sevoflurane or propofol combined anesthesia for induction of general anesthesia. Methods We searched the PubMed, OVID, EMBASE,Cochrane Library and Chinese Biomedical Database (CBM) for studies on efficacy of sevoflurane versus propofol for anesthesia induction. The quality of the studies was evaluated by the method recommended by Cochrane Collaboration. Meta-analysis was conducted using the Cochrane Collaboration's RevMan 4.2.8 software. Results Thirteen prospective randomized controlled trials involving 968 patients were included in our meta-analysis. The results showed that the time from onset of induction to loss of consciousness and the time for induction were significantly longer, the incidence of respiratory depression lower in S group than in P group. There were no significant differences in the incidence of adverse events during induction and success rate of inserting LMA at first attempt between the 2 groups. The incidence of adverse events with LMA insertion was significantly lower in S group than in P group. Conclusion Propofol combined anesthesia is suitable for rapid induction of anesthesia, and sevoflurane combined anesthesia is indicated for slow induction of anesthesia in patients with potential respiratory difficulty and for LMA insertion.

ObjectiveTo summarize the results of stereotactic radiation therapy (SRT) with or without whole-brain radiotherapy (WBRT) in the treatment of multiple brain metastasis.MethodsFrom May 1995 to April 2010,totally 98 newly diagnosed multiple (2 - 13 lesions) brain metastases patients were treated in our centre.Forty-four patients were treated with SRT alone and 54 with SRT + WBRT.Dose fractionation schemes were 15 -26 Gy in 1 fraction or 24.0 -52.5 Gy in 2 - 15 fractions with 3.5 - 12.0 Gy per fraction,depending on the tumor volume,location,and history of prior irradiation.Kaplan-Meier and Cox proportional hazards regression analyses were used for survival analysis.The median age of the whole group was 55 years.The survival time was calculated from the date of radiation treatment to the day of death by any cause.ResultsThe median follow-up time for the whole group was 12 months,and the follow-up rate was 100％.The median overall survival time was 13.5 months for the whole group,there was no difference between SRT alone group and SRT + WBRT group ( 13.0 months vs.13.5 months,χ2 =0.31,P =0.578 ).The Karnofsky Performance Score ( KPS) at the time of treatment ( χ2 =6.25,P =0.012 ),the interval between the diagnosis of the primary tumor and brain metastases ( χ2 =7.34,P =0.025 ) and the status of extracranial metastases ( χ2 =4.20,P =0.040) were independent prognosis factors for survival in multivariate analyses.ConclusionsStereotactic radiation therapy is an effective and alternative treatment choice for multiple brain metastases.

Objective To investigate the influence of esmolol infusion on QT dispersity(QTd)in elderly patients with coronary heart disease during perioperafive period.Methods Fifty ASA Ⅱ or Ⅲ patients with coronary heart disease aged 65-80 yr undegoing non-cardiac surgery under general anesthesia were randomly divided into 2 groups(n=25 each):control group(group C)and esmolol group(group E).Anesthesia was induced with midazolam,fentanyl and vecuronium and maintained with continuous iv infusion of propofol andvecuronium and intermittent iv boluses of fentanyl.The patients were intubated and mechanically ventilated.PETCO2 was maintained at 25-35 mm Hg.In group E a loading dose of esmolol 0.5 mg/kg was given iv over 1 min at 2 min before skin incision and was followed by esmolol infusion at 25 μg·kg-1·min-1 maintained until the end of operation.Radial artery was caunulated.MAP,HR,SpO2 and PETCO2 were continuously momtored.ECG composed of 12 leads was momtored before operation,at 30 min after skin incision,immediately after operation,and at postsurgery days 1 and 2.The longest and shortest QT intervals were measured and detected by a cardiologist not involved in the study.The QTd was calculated.The ventricular arrhythmia was also recorded.Results QTd,the incidences of QTd abnormality and ventricular arrbythmia were significantly lower in group E than in group C.Conclusion The use ofesmolol during operation may decrease QTd and prevent the occurrence ofventricular arrhythmia.

BACKGROUND: Simple polyvinyl alcohol (PVA) has limited ability to cell adhesion. There are not generally accepted studies on improved effects of collagen protein modified polyvinyl alcohol on cell adhesion and proliferation.OBJECTIVE: To investigate the feasibility of PVA/type Ⅰ college (COL-Ⅰ) as anterior cruciate ligament (ACL) scaffolds in tissue engineering.DESIGN, TIME AND SETTING: The controlled observation experiment was performed at the Fourth Affiliated Hospital, Medical College. Ji'nan University, Guangzhou Red Cross Hospital, Guangzhou Institute of Trauma Surgery from August 2006 to October 2007.MATERIALS: COL-Ⅰ gel was produced by Guangzhou Institute of Trauma Surgery.METHODS: PVA filature was used to weave fascicular scaffolds. NIH-3T3 cell line and human ACL cells were in vitro incubated, amplified, and then implanted on the PVA/COL scaffolds.MAIN OUTCOME MEASURES: The growth of NIH-3T3 cell line and human ACL cells on the PVA/COL scaffolds and the secretion of extracellular matrix were observed using scanning electron microscope. Cell compatibility of PVA/COL scaffolds was assessed. Mechanics characteristic of PVA/COL scaffolds was measured by using the electric. tensile force apparatus. Mechanical property of PVA/COL scaffolds was analyzed using the SPSS 11.5 software package.RESULTS: NIH-3T3 cell line and human ACL cells on the PVA/COL scaffolds adhered, proliferated, and secreted extracellular matrix. NIH-3T3 cell line highly grew compared with human ACL cells on the PVA/COL scaffolds. The adhered number of NIH-3T3 cell line and human ACL cells was significantly increased on the PVA/COL scaffolds. NIH-3T3 cell line and human ACL cells presented well morphology on the PVA/COL scaffolds. COL-Ⅰ could promote the secretion of extracellular matrix from NIH-3T3 cells, but its effects on human ACL cells were not significant. Tensile force test showed that load-extension curve of the materials was identical to ACL of human and rabbits, and the scaffolds possessed strong flexibility. The maximal load, ultimate stress and elastic modulus were respectively 52.61 N, 14.96 MPa and 202.08 MPa.CONCLUSION: COL-Ⅰ accelerates the adhesion and proliferation of NIH-3T3 cell line and human ACL cells on the surface and in the pore of the PVA/COL scaffolds, promotes the secretion of extracellular matrix from NIH-3T3, and PVA filature material has mechanical property and good cell compatibility.

Objective To compare the disinfection efficacy of different disinfectants on dental unit waterlines (DUWLs). Methods 18 sets of DUWLs were randomly divided into 4 groups,and disinfected or treated with hydrogen peroxide (H2 O2 )disinfectant,sodium hypochlorite (NaClO)disinfectant,hydrogen peroxide silver ion disinfectant(Sanosil),and distilled water (DW)respectively.Water specimens from triple syringes and high-speed handpieces were taken,bacterial count before and after disinfection were compared.Results Before disinfection,no significant differences in bacterial counts were found among four groups (all P >0.05),bacterial counts of DUWLs of all groups severely exceeded the standard(all>3 000 CFU/mL).After disinfection,except DW group,bacterial counts of DUWLs of the other groups declined dramat-ically (all <100 CFU/mL),bacterial count after disinfection were all obviously lower than before disinfection (all P <0.001 ).One week after disinfection,bacterial counts among three disinfectant groups in different time periods were statisti-cally different (triple syringes:Day1—Day5,all P <0.05;high-speed handpieces:Day2,Day3 and Day5,all P <0.05). Day3 after disinfection of triple syringes by H2 O2 and NaClO,Day4 after disinfection of high-speed handpieces by H2 O2 and NaClO,and Day5 of triple syringes and high-speed handpieces by Sanosil all exceeded the standard of Center for Disease Control and Prevention of America.One week after disinfection,bacterial counts of three disinfection groups all exceeded or approximated to that before disinfection.Conclusion Three types of disinfectants can all effectively reduce bacterial load in DUWLs.Compared with other disinfectants,Sanosil has advantage of inhibiting bacterial growth after disinfection.

BACKGROUND:Triggering receptor expressed on myeloid cel s 2 (TREM-2) is highly expressed throughout the synovial tissue in active rheumatoid arthritis patients, but the role of TREM-2 in the pathogenesis of rheumatoid arthritis stil remains unclear.
OBJECTIVE:To explore the TREM-2 expression in the synovial tissue of col agen type II-induced arthritis rats.
METHODS:The col agen-induced arthritis models were established in rats. The activity indicators and pathological changes of arthritis synovial were dynamical y observed. The mRNA levels of TREM-2, tumor necrosis factor-α, interleukin-1β, and interleukin-10 were detected in synovial tissue of rats by RT-PCR. The protein expression and location of TREM-2 were measured with western blot assay and immunohistochemistry, respectively.
RESULTS AND CONCLUSION:At day 13 after immunization, the paws of model rats appeared red and swel ing, the arthritis index scores were increased (P<0.01). At day 19-25 after immunization, the inflammation reached the peak. Hematoxylin-eosin staining showed that, the synovium of col agen-induced arthritis rats were proliferated and were infiltrated by inflammatory cel s, cartilage was destroyed. Compared with the control group, the expression of TREM-2 mRNA and protein, the mRNA levels of tumor necrosis factor-αand interleukin-1βin synovial tissue of the model rats were significantly increased (P<0.05 or P<0.01), while interleukin-10 mRNA expression was significantly decreased (P<0.05). Experimental findings indicate that, TREM-2 is a crucial inflammatory regulator and the increasing expression of TREM-2 plays an important role in the pathogenesis of col agen-induced arthritis.