Objective To observe the efficacy of intra-articular (IA) blockade of TNF-α by 3 etanercept injections in patients with rheumatoid arthritis (RA).Methods Eighteen moderate activity RA patients with resistant knee synovitis underwent three monthly IA injection of etanercept (25mg).The primary outcomes were visual analogue scale of target knee general health (VAS-TKGH) and VAS target knee Pain Score,and we also collected diameter of target knee joint,VAS fatigue Score,Health Assessment Questionnaire (HAQ),the 28-joint based disease activity score (DAS28) and joint fluid volume,which were all assessed at baseline and every four weeks after IA injection.Results All those 18 patients completed the treatment with the average disease duration of was (8 4.7 ± 54.1) months.After each IA injection,VAS-TKGH was significantly improved than baseline (P =0.03,0.02,0.02).and VAS target knee pain score was also significantly improved than baseline (P =0.03,0.00,0.00).After 3rd IA injection,VAS-TKGH was further reduced compared with those after 1 st and 2nd IA injection (P =0.02,0.03) ; while,VAS target knee pain score was further reduced after 3rd IA injection (P =0.00).Knee joint diameter,VAS fatigue score,HAQ and DAS 28 were significantly lower after 1st IA injection than baseline (P =0.03,0.02,0.03).After 2nd IA injection,VAS fatigue score,HAQ,and DAS28 were significantly further improved compared to treatment once (P =0.00,0.02,0.02) ;after 3rd IA injection,HAQ and DAS28 were further improved compared to those after 2nd IA injection (P =0.01,0.02).Joint fluid volume was significantly decreased after 2nd IA injection (P =0.01).Conclusion The tailor approach of intra-articular injections of anti-TNF agent might benefit RA patients who had resistant synovitis,and the side effect was rare.However,the sample was small and further observation is needed.

OBJECTIVE:To establish the method for simultaneous determination of heavy metals in Platycodon grandiflorus, and to explore the effects of altitude on the contents of heavy metals. METHODS:The contents of As,Hg,Pb,Cu and Cd were determined by hydride generation,hydride generation method,graphite furnace method,flame spectrometry,graphite furnace meth-od. SPSS 19.0 software was adopted for clustering analysis and correlation analysis. RESULTS:The linear ranges of As,Hg,Pb, Cu and Cd were 0-16 μg/L(r=0.9960),0-18 μg/L(r=0.9996),0-50 μg/L(r=0.9997),0-0.8 μg/L(r=0.9990)and 0-4 μg/L (r=0.9980). Detection limit were 1.3×10-3,2.4×10-4,1.9×10-3,0.33,1.8×10-4 mg/kg. Quantitation limit were 4.4×10-3,8.0×10-4, 6.2 × 10-3,1.1,6.0 × 10-3 mg/kg. RSDs of precision,stability and repeatability tests were all lower than 3.0%. Recoveries were 99.1%-107.1%(RSD=3.13%,n=6),94.1%-100.5%(RSD=2.36%,n=6),98.9%-104.8%(RSD=1.81%,n=6),92.7%-100.3%(RSD=2.92%,n=6),96.6%-99.9%(RSD=1.26%,n=6). Samples with similar altitudes were clustered into a class;the con-tents of heavy metals decreased as the increase of altitude;there was significant correlation among 5 heavy metals. CONCLU-SIONS:The method is simple,precise,stable and repeatable,and can be used for simultaneous determination of heavy metals' contents in P. grandiflorus. The altitude has a certain effect on the quality of P. grandiflorus.

Epidemiologic evidence suggests that diabetes mellitus appears to be negatively associated with abdominal aortic aneurysm formation. Diabetes mellitus may affect the physiological characteristics of the aorta and reduce the prevalence, incidence and expansion rate of abdominal aortic aneurysm. But the impact of diabetes mellitus on the rupture, operative complication and clinical outcome of abdominal aortic aneurysm is unclear. Randomized controlled trials are needed before conclusions can be drawn on the link between development and expansion of abdominal aortic aneurysm and medicines for diabetes. This review aims to analyze updated evidence of the association between diabetes mellitus and abdominal aortic aneurysm.

Objective To investigate the intervention effect of Qingxin-Ⅱ Recipe on myocardial cell apoptosis and its fibrosis in viral myocarditis mice and its mechanism.Methods A total of 120 Balb/c mice were randomly divided into the model group (n=50),the treatment group (n=50) and the control group (n =20).Mice in the model and treatment groups were given intraperitoneal injection of CVB3 to establish the experimental model of viral myocarditis.The control and model groups were treated with normal saline and water by intragastric administration respectively and the treatment group was given Qingxin-Ⅱ Recipe.The expression level of nuclear factor-κB (NF-κB),tumor necrosis factor (TNF-α),interleukin-1β(IL-1β),collagen type Ⅰ-A1 (COL1-A1),collagen type Ⅲ-A1 (COL3-A1),matrix metalloproteinase-9 (MMP-9),tissue inhibitor of metallproteinase-1 (TIMP-1),myocardial interstitial collagen volume fraction (CVF) and apoptosis rate (Rapo) were assessed after treatment.Results The levels of NF-κB,TNF-α,IL-1 in cardiomyocytes,serum levels of COL1-A1,MMP-9,TIMP-1,the mRNA expression levels of COL1-A1,COL3-A1,MMP-9,TIMP-1 in cardiomyocytes,CVF and Rapo were lower in the treatment and control groups than in the model group (F=21.541,12.146,32.583,4.212,6.863,4.868,9.089,8.662,7.307,6.646,4.324,41.237,respectively,all P＜0.05).No significant differences in the levels of NF-κB,TNF-α,IL-1 of cardiomyocytes,in serum levels of COL1-A1,TIMP-1 and in mRNA expression levels of COL1-A1,COL3-A1,MMP-9,TIMP-1 of cardiomyocytes between the control group and the treatment group (all P＞0.05) were found,but serum MMP-9 level was higher in the treatment group than in the control group (P =0.033).Conclusions Qingxin-Ⅱ Recipe can effectively reduce inflammatory cytokines levels,protect myocardial cells from inflammatory damages and inhibit myocardial fibrosis in viral myocarditis.

Objective To investigate the replantation of complete severed fingertip when vein can't be repaired and only artery be repaired. Methods All 13 cases complete severed fingertips were replantated with only artery anastomosis but vein cannot be repaired.Low molecular weight heparin was applied to prevent blood clotting postoperation. Blood-letting by nail extraction or latero-incision were done in some cases.The survival fingers were observed. Results After 3-12 months followed-up,12 cases survived with satisfactory appearance and locomotion,2-PD of 2-7 mm,but 1 case was failed. Conclusion The replanted fingertip may survival with only artery anastomosis because of fewer tissue and faster recontruction of venous return.It would raise the survival rate of replanted fingertip by blood-letting by nail extraction or latero-incision according to the traumatic condition.

Objective To determine serum leptin levels and investigate its relatio nship with liver function, insulin resistance and nutritional parameters in pati ents with post-hepatitis liver cirrhosis. Methods Thirty-two ma le patients with post-hepatitis cirrhosis and fourteen male control subjects were enrolled in thi s study. Fasting blood samples were obtained, and serum leptin levels, fasting g lucose and insulin levels were determined in all subjects, and nutritional param e ters were determined in cirrhosis patients. The cirrhosis patients were divided into three groups according to Child-Pugh classification. Results Serum leptin l evels in male hepatic cirrhosis were significantly higher than those of healthy control. There was no significant difference in serum leptin levels among the th ree groups of patients with cirrhosis according to Child-Pugh classification. Se rum insulin levels in male cirrhosis were significantly higher than that of heal thy control. The insulin sensitivity index in cirrhotic patients was decreased c ompared with normal control group. Serum leptin levels in liver cirrhosis were s ignificantly correlated with BMI, TSF and fasting insulin levels, respectively ( r=0.343, 0.340 and 0.352, P

Objective To study the specific sequences in the 3'untranslated region (UTR) of the SON gene of human beings and 14 kinds of mammalian. Method The specific sequences in the 3'untranslated region (UTR) of the SON gene of human beings and 14 kinds of mammalians were amplified and directly se-quenced. The sequence data of PCR products of human beings and mammalians were declared. Results The sequences of 3'UTR of SON gene of human beings differed from 14 kinds of mammalians. The sequences of samples came from different human individuals did not show any difference. Conclusion The 3'UTR of SON gene is a good DNA region for specie identification. Using this technology, DNA of human beings can be distinguished from 14 kinds of mammalians. This technology is very useful in of forensic science.

Objective To investigate the effects of acceptance and commitment therapy on postoperative psychosocial adaptation in breast cancer patients. Methods 120 breast cancer patients were divided into two groups by random number table:58 cases in the observation group and 62 cases in the control group. They all received routine nursing care and the observation group also received acceptance and commitment therapy intervention, including acceptance, cognitive diffusion,being present, self as context, values and committed action. Psychological and Social Adaptation Questionnaire for Breast Cancer Patient (PSAQ-B) was used to investigate their psychosocial adaptation before and after the intervention. Results The intervention group was observed in patients with anxiety/depression, self-esteem and self-acceptance, attitude, sense of belonging, self-control and self-efficacy score was respectively (30.14 ± 5.08), (31.68 ± 5.77), (30.03 ± 5.35), (33.68 ± 5.56), (32.86 ± 5.63) points, the control group were (23.75 ± 3.68), (28.87±4.86), (26.12 ± 4.53), (29.18 ± 5.26), (29.06 ± 4.75) points, the difference between 2 groups was statistically significant (t = 6.016- 6.540, all P < 0.05). Conclusions Acceptance and commitment therapy can effectively improve the psychosocial adaptation status in breast cancer patients after surgery to help improve their quality of life.

Aim To evaluate the effects of notoginsen-oside R1 on store-operated calcium entry ( SOCE ) in pulmonary arterial smooth muscle cells ( PASMCs ) of chronic hypoxia ( CH)-and monocrotaline ( MCT)-in-duced pulmonary hypertension ( PH) rats. Methods Mn2+ quenching of Fura-2 and measurement of intra-cellular free calcium concentration ( [ Ca2+] i ) using fluo-3 were examined in PASMCs of CH-exposed and MCT-treated rats. Results ①CH-exposed and MCT-treated rats exhibited profound PH when examined 3 weeks after hypoxia exposure or MCT injection, respec-tively. ②In the presence of 3 μmol·L-1 nifedipine, 10 μmol · L-1 notoginsenoside R1 significantly re-duced cyclopiazonic acid ( CPA )-induced the percent reduction in Fura-2 fluorescence measured 500 sec af-ter application of Mn2+, the maximal rate of Mn2+quenching, the amplitude of the Ca2+ influx transient and the resting [ Ca2+] i in PASMCs of CH-exposed and MCT-treated rats. Conclusion Notoginsenoside R1 inhibits SOCE and reduces resting [ Ca2+] i in PASMCs of CH-and MCT-induced PH rats.

Objective To compare the short‐term clinical effects of single segment and two segments of Dynesys dynamic in‐ternal fixation system for treating lumbar degenerative disease .Methods 40 cases of degenerative lumbar disease treated by the Dynesys dynamic fixation system combined with posterior approach decompression from 2009 July to March 2012 were selected and performed the evaluation on the clinical effects by the waist and leg pain visual analogue scale (VAS) ,the Oswestry disability index (ODI) and the orthopaedic spinal association of North America (NASS) index .The imaging method was used to observe the mobili‐ty of operative segment and proximal adjacent segment and the degenerative change of intervertebral height .Results All of the 40 cases were followed up .The VAS score and ODI score at postoperative 3 months and last follow‐up were significantly decreased when compared with the pre‐operative scores (P<0 .05);there was no statistically significant differences in the VAS score and ODI score at 3 months and last follow‐up between the single segment group and the 2‐segment group (P> 0 .05) .The NASS index showed no statistically significant difference in the postoperative effect satisfaction between the two groups (P>0 .05);there was no statistically significant difference in the variation of the intervertebral height between before operation and at the last follow‐up (P>0 .05) .There was statistically significant difference in the motility of proximal adjacent segment at the last follow‐up between the two groups (P<0 .05);but comparing the motility of proximal adjacent segment between the last follow‐up and pre‐operation , only the single segment group showed statistically significant difference (P< 0 .05) .Conclusion The Dynesys dynamic fixation system combined with posterior approach decompression operation has good clinical effect in the treatment of lumbar degenerative disease .Meanwhile ,the single segment method has more significant effect on the motility of proximal adjacent segment than the double segments method .