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 Evaluate the efficacy and safety of Qingre-Huoxue Recipe ( QHR ),Qingre -Huoxue Recipe and Methotrexate(QHR+MTX) in improving clinical symptoms of dampness-heat and blood-stasis syndrome of rheumatoid arthritis.Methods According to multi-center,randomized,and control intervention design,142 RA patients were randomly divided into QHR group (71 cases) and QHR+MTX group (71 cases).With clinical symptoms as evaluation indexes,FAS set and PP set were adapted for analysis.Results FAS set analysis:Both groups can significantly reduce pain VAS score [ (4.82 ± 1.98) vs (4.31 ± 1.85) ],reduce tenderness and swollen joint number[(4.87±4.05)vs(4.20±3.36)、(8.72±6.24)vs(7.14±5.03)respectively],shorten morning stiffness [ (39.56 ± 46.68) min vs (36.65 + 42.58) min] and significantly reduce the symptoms of fatigue[ (4.13 ±2.34) vs (3.74 ±2.20) ],also with good security.But there was no statistically significant difference between the two groups.Conclusion Qingre-Huoxue Recipe with MTX had no significant advantage in improving clinical symptoms in patients with the dampness-heat and blood-stasis syndrom of RA than without MTX.

Objective To observe the effect of Jiaotai Pills ( JP) on hypothalamic neurotransmitters of Orexin A and gamma-aminobutyric acid ( GABA) in rapid eye movement ( REM) sleep deprivation rats. Methods Rat model of REM-sleep deprivation was established by water small platform method. The rats were randomized into 6 groups, namely normal control group, model group, Diazepam group (3 mg/kg), and high-, medium-and low-dose JP groups ( JP in the dosage of 18.6, 9.3 and 4.6 g/kg respectively) . Enzyme-labeled instrument was used to detect the absorbance ratio of rat hypothalamic Orexin A content, and high performance liquid phase electrochemical detection method was adopted for the detection of hypothalamic GABA content. Results Compared with the normal control group, all of the rats in the model group suffered from insomnia, and the Orexin A content was increased ( P<0.05) . Compared with the model group, insomnia in rats of high-, medium- and low-dose JP groups was markedly relieved, and Orexin A was decreased (P<0.05) . The difference of GABA was insignificant between model group and JP groups (P>0.05) . Conclusion The sedative and hypnic mechanism of JP is probably related with the inhibition of hypothalamic Orexin A.

Objective To establish the early warning model based on the control chart method for hand,foot and mouth disease (HFMD) in Wuchang District and to determine the optimum alarming threshold to provide the data support for HFMD monitoring work.Methods The data of HFMD in Wuchang District during 2009-2014 were collected from the National Infectious Diseases Notification System for constructing the data base.The mobile percentile method was adopted to establish the early alarming model,which was evaluated by the screening test.The sensitivity,specificity,positive predictive value and negative predictive value were calculated.Then the receiver operating characteristic (ROC) curve was drawn and the optimum alarming threshold was found out.Results The early alarming threshold of HFMD in Wuchang District was P90,its sensitivity,specificity,positive predictive value and negative predictive value were 75.00％,93.88％,50.00％ and 97.87％,respectively.Conclusion Determining the early warning threshold should be optimized according to onset characteristics combining with the local epidemic situation,which pays attention to regional specificity and increases the monitoring ability of infectious diseases.

Objective To evaluate the efficacy of minimally invasive percutaneous plate osteosynthesis (MIPPO) in the treatment of Neer three-part fractures of the proximal humerus in young adults. Methods A retrospective analysis was performed of the 46 patients aged < 65 years with Neer three-part fracture of the proximal humerus from March 2010 to December 2016. MIPPO with locking proximal humerus plate ( LPHP ) was used in 23 of them who were 12 men and 11 women with an average age of 41. 6 ± 1. 2 years; open reduction and internal fixation ( ORIF ) with LPHP was used in the other 23 patients who were 14 men and 9 women with an average age of 42. 2 ± 1. 6 years. The 2 groups were compared in terms of operation time, intraoperative bleed-ing, fracture healing time and shoulder function by Neer scoring at the last follow-up. Results The average follow-up ( 13. 4 ± 1. 2 months ) for the MIPPO groups was not statistically different from that for the ORIF group ( 14. 2 ± 2. 4 months ) ( P > 0. 05 ) . The MIPPO group reported significantly shorter operation time ( 105 ± 15 min ) , significantly less intraoperative bleeding ( 140 ± 50 mL ) , significantly shorter fracture healing time ( 4. 2 ± 0. 6 months ) , and significantly higher shoulder Neer scores ( 88. 6 ± 3. 4 ) than the ORIF group ( 120 ± 20 min, 320 ± 40 mL, 5. 4 ± 1. 2 months, and 81. 6 ± 2. 2, respectively ) ( P <0. 05 ) . The complication rate ( 4. 3％, 1/23 ) for the MIPPO group was not significantly different from that for the ORIF group ( 17. 4％, 4/23 ) ( P >0. 05 ) . Conclusion MIPPO with LPHP may be obviously advantageous over ORIF with LPHP in the treatment of proximal humeral fractures in young adults.

To observe the curative effect of treating small -incision cataract extraction by intraocular lens implantation combined with trabeculectomy for primary angle-closure glaucoma with cataract.
●METHODS: Totally 44 cases (52 eyes) of primary angle-closure glaucoma combined with cataract were selected to undergo the combined surgery, in order to observe the patients' pre - and postoperative eyesights, intraocular pressures and the postoperative complications.
●RESULTS: The postoperative eyesight was improved significantly as compared with the preoperative eyesight. The intraocular pressure was declined dramatically. The result was of statistical significance (P<0. 05). All the 52 cases' surgeries were performed by the same surgeon. The surgeries were processed smoothly, with 6 postoperative eyes of anterior chamber inflammation cell response, 3 eyes of anterior chamber fibrinoid exudate, 2 eyes of shallow anterior chamber through mydriasis and treatment with glucocorticoids and non - steroidal eyedrops before absorption, and no complications like malignant glaucoma, cyclodialysis, etc. were reported through mydriasis and pressure bandaging before recovery.
● CONCLUSlON: Treating the primary angle - closure glaucoma combined with cataract through the combined surgery has high reliability and desirable curative effect. The surgical method is simple to learn and applicable for promotion on the basic level.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Humans ; Hypothalamic Neoplasms ; pathology ; radiotherapy ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pituitary Neoplasms ; pathology ; radiotherapy

OBJECTIVETo explore the therapeutic efficacy of external application of Compound Tripterygium wilfordii (CTW) for treating rheumatoid arthritis (RA) on the basis of treatment by integrative medicine.

METHODSTotally 67 active RA patients of damp-heat stagnation syndrome were randomly assigned to the external application group (35 cases) and the placebo group (32 cases). The reaction standard by American College of Rheumatology and Disease Activity Score (DAS) were taken as the indices for therapeutic assessment. A randomized controlled, single blind clinical trial was performed for 4 weeks, with a 3-month follow-up. The statistical analyses were performed using intention to treat analysis set (ITT).

RESULTSAfter treatment the rate of reaching ACR20 was 34.3% and 12.5% in the external application group and the placebo group respectively. The mean for the average drop of DAS28 ratings was 1.07 in the external application group and 0.40 in the placebo group, showing statistical difference (P < 0.05, P < 0.01). As for the safety, there was no effect on the menstruation in the external application group. Only mild skin allergy occurred in 2 cases of the external application group, but they were alleviated after drug withdrawal.

CONCLUSIONSExternal application of CTW could control the condition of RA and reduce the disease activity of RA. It had better safety.

Adult ; Arthritis, Rheumatoid ; drug therapy ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; methods ; Single-Blind Method ; Treatment Outcome ; Tripterygium

Biological Warfare Agents ; China ; Disaster Planning ; Emergencies ; economics ; Laboratories ; economics ; Public Health Administration

Objective To measure the total β radioactive background level in the urine of normal adults,and to establish the method which can be universally used and satisfy the needs of rapid screening of samples in large batch.Methods A total of 83 urine samples from healthy adults were prepared by evaporation.And the gross β activity in urine was detected by using low background measuring instrument.Results The optimal experimental conditions were in place.The sampled volume was 200 ml,and the samples were turned to nitric acid salinization,ashed at 300℃ for 2 h,and the measured time was 1000 min.To get a more stable result,the urine residues were put aside for 24 h before measurement.The radioactivity in urine of healthy adults was between 9.40-55.92 Bq/L,and showed no correlation with age and sex.Conclusions When the radioactivity in urine is detected under the conditions mentioned above,the sample preparation process is simple and quickly,which can satisfy the needs of large batch sample screening.