Objective To analyze the influence of Bushenjiangu Capsules on rheumatoid factor (RF), hypersensitive c-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR) with rheumatoid arthritis patients. Methods 94 patients with rheumatoid arthritis in the draw method was divided into control group and experimental group the 47 cases, control group treatmented by conventional western medicine, the experimental group based on the control group treatmented by Bushenjiangu Capsules, two groups' of RF, hs-CRP, ESR, Immunoglobulin A, M, G (IgA, IgM and IgG immune globulin), density lipoprotein (HDL-C), low density lipoprotein (LDL- C), triglyceride (TG), total cholesterol (TC), blood lipid, joint swelling, joint tenderness, morning stiffness time, curative effect and adverse reactions were compared. Results After treatmented, the RF, hs-CRP, ESR of experimental group was lower than the control group (57.53±8.13) U/L, (6.30±0.78) mg/L, (21.48±3.03) mm/h vs (74.29±10.56) U/L, (13.14±1.86 )mg/L, (35.60±4.36) mm/h, the difference was statistically significant (P<0.05). The IgA, IgM and IgG, HDL, LDL - C - C, TG, TC, joint swelling count, joint tenderness, morning stiffness time of experimental group was better than control group (2.17±0.29) g/L, (1.53±0.21) g/L, (12.14±1.50) g/L, (1.25±0.15)mmol/L (2.11 ±0.26) mmol/L, (1.34±0.17) mmol/L, (4.03±0.50) mmol/L, (4.35±0.53), (6.30±0.77), (29.71±3.70) min than g/L (2.30±0.28), (2.11±0.26) g/L, (13.76±1.70) g/L, (1.16±0.14) mmol/L (2.29±0.28) mmol/L, (1.53±0.19) mmol/L, (4.50±0.55) mmol/L, (7.63±0.96), (8.51±1.21), (76.38±9.50) min (P<0.05). The total effective rate of experimental group was higher than the control group (93.61%vs 76.59%) (P<0.05).The adverse reaction of two groups was no difference. Conclusion The effect is sure of Bushenjiangu capsule treatment of rheumatoid arthritis, can reduce the levels of RF, hs-CRP, ESR.

Objective To study the use of immunosuppressives for the patients with virus C hepatitis(HCV)after renal transplantation.Methods Twenty-five cases of HCV-RNA(+)and 30 cases of HCV-RNA(-)as control group were analyzed.All patients were divided into the Aza group(n=12),MMF group(n=8)and MP(MMF+Pred)group(n=5).Results Eight casGS revealed abnormal liver function in the Aza group and 2 in MMF group.After stopping the use of CsA and Aza,the liver function all revealed good outcome in the MP group.During one week 30 cases of HCV-RNA(-)recovered due to the readjustment of the dosage of immunosupprexsives(CsA,Aza)in the control group.Conclnsions The therapy of MMF+CsA+Pred is necessary for the patients with HCV-RNA(+)and the function of the renal and liver can be stabilized by MMF.

In order to compare the therapeutics of combined use of MMF with low dose of cyclosporine A (CsA) in renal transplantation, 16 cases were randomly divided into 3 groups:MMF 2.0g group receiving MMF 2.0g per day, MMF 1.5g group receiving MMF 1.5g per day,and Aza group. All the patients in the 3 groups were given the low dosage of CsA and steroid.The results showed that no patients in MMF 2.0g group experienced acute rejection. One patient (20%) in MMF 1.5g group occurred twice acute rejections. In Aza group 3 out of 5 patients (60%) experienced acute rejections. Six months after transplantation, serum Cr level and the used dose of CsA in MMF 2.0g group was obviously lower than that of Aza group. It was concluded that the combined use of 2.0g MMF per day with low dosage of CsA and steroid was safe and efficacy for renal transplanted patients. The clinical results of MMF 2.0g group were superior to those of Aza group.

Objective To eveluate the pancreatic injury induced by smoking alone or combined with alcohol consumption,and its possible mechanism.Methods The Wistar rats were divided into control group (n=10),smoking group (n=30),drinking group (n=42) and smoking combined with drinking group (combination group,n=48).Serum levels of interleukin (IL)-6,superoxide dismutase (SOD) activities,monocyte chemoattractant protein-1 (MCP-1) and hydroxyproline were determined at 4th-,8th- and 12th- week.The pathohistological changes of the pancreas were examined using HE staining and the expression of α-smooth muscle actin (α-SMA) were measured by immunohistochemistry.ResultsIn contrast to control group,pancreatic changes including cytoplasmic vacuolation and increased levels of α-SMA and hydroxyproline were found in both smoking and drinking groups at the 8th-week (P<0.01).Whereas these changes were aggravated in combination group (P<0.05).Serum level of IL-6 and MCP-1 expression in pancreatic tissue were significantly increased in smoking group when compared with control group.But MCP-1 expression was lower in drinking group than control group.Moreover,the SOD activity in pancreatic tissue decreased in smoking and drinking groups,especially in combination group.Conclusions Long-term smoking can induce cytoplasmic vacuolation in pancreatic acinar cells,enhance inflammatory factors and chemokine expression and aggravate oxidative stress response in pancreas.These changes are aggravated when smoking and drinking coexisted.The mechanism behind it may be associated with increased oxidative stress response in pancreas.

ObjectiveTo investigate the clinical features,diagnosis and treatment of focal nodular hyperplasia (FNH) of the liver.MethodsClinical data of 42 FNH patients confirmed by pathology at our hospital between 2004 and 2011 were analyzed retrospectively.Thirty-eight cases underwent resection,and the other 4 patients were diagnosed by liver biopsy. ResultsThe 42 cases consisted of 25 males and 17 females,and age ranged from 14 to 51 years.Most of the patients (95.2％) had no significant clinical symptoms,and the liver function test was normal in 97.6％ (41/42) patients.The typical imaging features of FNH was the central scar and the radiating pattern.Thirty-eight cases underwent liver resection without any postoperative complication,and no recurrence was observed within 6 -90 months of follow up.For the other 4 cases,observation with periodic imaging follow up was performed after liver biopsy for 27 - 88 months without changes in all the lesions. ConclusionsFNH is a benign tumor of the liver.Observative follow up is recommended for asymptomatic patients with a definite diagnosis preoperatively.Surgical resection should be performed for symptomatic patients (epigastric pain or discomfort),or for patients with a suspicion of malignancy.

Objective To explore the possibility of bone marrow mesenchymal stem cells (MSCs) differentiating into active melanocytes in vitro.Methods Bone marrow stromal cells were harvested from femoral marrow of 6-week-old black male C57BL/6 mice,and subjected to a primary culture.After 6-passage subculture,an induction medium containing hydrocortisone,recombinant human insulin,transferrin and fibroblast growth factor was used to induce the differentiation of MSCs into melanocytes.Inverted light microscopy was applied to observe the process of cell differentiation,transmission electron microscopy to observe melanosome formation and maturation,and immunocytochemistry to determine the expression of melanocyte-associated epitopes,and flow cytometry to analyze cell cycles and yield of differentiated melanocytes.Results The total number of MSCs was close to 109 after 6 passages of subculture,and immunofluorescent studies showed an expression rate of 94.3％ for CD44 and 82.3％ for CD105 in these MSCs.After 180-day cultivation in the induction medium,the MSCs showed a morphological similarity to melanocytes with an increase in dendrites,formation of melanosome-like structures,and cell growth cycle was shortened to 3-4 days.Brown/black cell sediments were visualized by naked eyes.Electron microscopy revealed that intracellular melanosomes were mainly in Ⅳ phase.Immunofluorescence studies of the differentiated melanocytes showed a positive staining for tyrosinase related protein-1 (TRP-1),TRP-2,and microphthalmia-associated transcription factor (MITF).Flow cytometric analysis showed that most of the melanocytes differentiated from the MSCs were in G1 and S phases,and TRP-1-positive melanocytes amounted to 80％ of gate cells.Conclusions Bone marrow MSCs can be largely differentiated into melanocytes with a close similarity to normal melanocytes in morphology,ultrastructure and specific epitopes and a certain degree of proliferative activity.

Objective To investigate the effect of integrin-linked kinase (ILK) on inducing mesenchymal stem cells (MSCs) to neuron stem-like cell in vitro. Methods MSCs isolated from umbilical cord were transfected with plasmid DNA encoding green fluorescent protein (GFP) and GFP-fusion ILK, wild and mutant, respectively; and cultured in serum-free media with basic fibroblast growth factor, epidermal growth factor and B27. It was assessed with the proliferative activity and the efficiency of differentiation into neural stem-like cell. Results MSCs transfected with GFP-fusion wild ILK expressed ILK and kinase-dead mutant ILK stably. The activity of proliferation increased and more of them differentiated into neural stem-like cell, which express CD133 and Nestin validated by PCR and Western blotting, and more of wild than of mutant. Conclusion Integrin-linked kinase may play a positive role in MSC differentiation into neural stem-like cell, which may associate with the activity of kinase.

Objective To investigate the characteristics of falls as an adverse event in the hospitalization of elderly patients taking sedatives and hypnotics drugs.Methods Data of elderly patients treated in Department of General Internal Medicine,Beijing Chaoyang Hospital from July 2011 to July 2015 were collected.All patients were divided into medicine-taking group and non-medicinetaking group according to the history of taking sedatives and hypnotics during the hospital stay.Different characteristics of fall as an adverse event were compared between the two groups,and fall related nursing interventions were presented.Results A total of 3 834 patients were collected for analysis in this study.Of these patients,the fall as an adverse event occurred in 12 cases,the total incidence was 3.1％,in whom 8/638 (12.5％) in medicine-taking group and 4/3196 (1.3％) in nonmedicine-taking group(x2=21.72,P＜0.01).Of 8 cases with the fall as an adverse event in medicinetaking group,the fall occurred in 6 cases(75％)during 24 ∶ 00-6 ∶ 00.However,of 4 cases with the falls in non-medicine-taking group,the fall in 3 cases(75 ％)occurred during 6 ∶ 00-18 ∶ 00.In medicinetaking group,the fall occurred beside their beds in 62.5 ％ (5 cases).And in 37.5 ％ (3 cases)did in their bathrooms.In non-medicine-taking group,the fall occurred in 2 cases (50.0％) beside their beds,in 1 case did in the bathroom,1 case did in the passage.Multiple Logistic regression analysis showed that age ＞ 75 years(OR=1.26,95 ％CI:1.07-1.48),elevated nutritional risk score(NRS-2002 ≥3 scores) (OR=10.92,95％CI:1.79-66.46)and elevated risk for fall or out of bed(risk score ≥18 scores) (OR =19.08,95％ CI:4.02-90.47)were the independent risk factors for falls as an adverse event among medicine-taking group.Conclusions A use of sedatives and hypnotics is related with the increase of fall as an adverse event in elderly patients during a hospital stay.With the aim of preventing or reducing the incidence of fall as an adverse event,nursing interventions should be carried out based on the characteristics of fall as an adverse event in elderly patients taking sedatives and hypnotics.

BACKGROUND:Nickel-titanium memory-shape compression anastomosis clip (Ni-Ti CAC) has been used in gastrointestinal anastomosis, but its efficacy and safety still remain controversial.OBJECTIVE:To evaluate the efficacy and safety of Ni-Ti CAC in gastrointestinal anastomosis.METHODS:A computer-based online research of PubMed, EMbase, Cochrane Library, CBM, CNKI, and VIP databases was performed for articles published before January 15th, 2017 using the keywords of nickel-titanium, compression anastomosis clip, anastomosis, gastric, jejunum, ileum, small intestine, colon, rectum, and large intestine in English and Chinese, respectively. The randomized controled trials about Ni-Ti CACversus conventional methods for gastrointestinal anastomosis were included. Meta-analysis of the anastomosis time, time of exsufflation, and hospitalization time was performed, and sequential analysis was conducted on TSA v0.9 software.RESULTS AND CONCLUSION:A total of 18 eligible randomized controlled trials were enroled, involving 1860 patients. Ni-Ti CAC could reduce the anastomosis time [MD=-3.83, 95%CI(-6.48,-1.19),P=0.004] and time of exsufflation [MD=-0.14, 95%CI(-0.22,-0.05),P=0.002], but there was no significant difference in the hospitalization time [MD=-0.83, 95%CI(-1.82, 0.16), P=0.10]. The quality was ranked as low level based on GRADE system. The time of exsufflation of Ni-Ti CAC was superior to that of conventional method, which was confirmed by sequential analysis. One case of death was reported and incision infection was the most common adverse effects; additionaly, pulmonary embolism and abdominal pain occurred. To conclude, Ni-Ti CAC can facilitate gastrointestinal anastomosis, accelerate the time of exsufflation, and holds a good safety. However, more multicenter and high-quality randomized controlled trials are needed.

Objective To evaluate the diagnostic performance of the histogram analysis of mono-exponential and intravoxel incoherent motion(IVIM) models to the dualistic model of epithelial ovarian cancer(EOC). Methods Forty female patients with histopathologically proven epithelial ovarian cancer underwent preoperative MR examination. Scanning sequences included conventional imaging, diffusion-weighted magnetic resonance imaging with 11 b values (0, 30, 50, 100, 150, 200, 400, 600, 800, 1 000, 1 500 s/mm2) and dynamic contrast enhanced MRI (DCE-MRI). Based on the dualistic model of EOC, all patients were divided into two groups:typeⅠ(low grade, n=16) and typeⅡ(high grade, n=24). ADC, D, D*and f maps and their corresponding histograms were generated by post-processing software. Based on an entire-tumour measurement, the following histogram parameters were recorded, respectively: (a) Mean; (b) the 10th percentile (10th);(c) the mean of the top 10 percent (MeanL);(d) the 90th percentile (90th);(e) the mean of the bottom 10 percent (MeanR). Two types were compared using independent sample t test or Mann-Whitney U test. And areas under ROC curve between two groups were assessed. Results For ADC , D, and f, all indices(Mean,10th,MeanL,90th,MeanR) of the histogram were significantly lower in typeⅡthan in type Ⅰ(P<0.05). All of parameters of D* had no significant different(P>0.05). D demonstrated a comparable accuracy with ADC in differentiating the grade of EOC (area under curve: Mean, 0.898 vs. 0.893; 10th, 0.880 vs. 0.846; MeanL, 0.878 vs. 0.858; 90th, 0.895 vs. 0.839; MeanR, 0.872 vs. 0.814), and both ADC and D have better performance than f. Conclusion It is feasible to stratify the grade of EOC by mono-exponential and IVIM models with histogram metrics,diagnositic efficiency of ADC and D values are higher.