AIM: To investigate the efficacy and safety of low-dose leflunomide (Lef) combined with methotrexate (MTX) in the treatment of rheumatoid arthritis (RA). METHODS: Sixty-four RA patients were randomly divided into two groups, with 32 patients in each group. All the patients were required to stop the treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) for 1 wk before entering the trial. Patients in the Lef+MTX group received Lef 20 mg, po, qd in the first 4 wk, followed by 10 mg,po, qd for next 20 wk. Patients also received MTX 7.5 mg,po, qw during the trial. Patients in the MTX group received MTX 15 mg,po, qw for 24 wk. Physical and laboratory examinations were performed at the beginning of the trial, after 12 wk treatment and 24 wk treatment. Entopic X-ray examination of both hands was performed before and after the treatment. RESULTS: The rate of remarkable improvement was 88% (28/32) in Lef+MTX group and 38% in MTX group (12/32). Adverse reactions were reported in 12% (4/32) patients in Lef+MTX group and 43% (14/32) patients in MTX group. The reported adverse reactions were rash and nausea in Lef+MTX group and nausea, vomiting, oral ulcer, alopecia, ALT elevation, palpitation and menoxenia in MTX group. CONCLUSION: Combination of Lef with MTX is safe and effective in treatment of RA with less adverse reactions.

AIM: To study the chemical components and contents of the volatile oil from the Rubia tinctorum L.. METHODS: The volatile oil was extracted by steam distillation-extract method,the chemical constituents of the volatile oil from the herb were identified by gas chromatography-mass spectrometry(GC-MS). RESULTS: Thirty compounds were identified,which accounted for over 86.32% of the volatile oil. CONCLUSION: The major components were theaspirane(17.37%),2-furaldehyde(11.10%),benzeneacetaldehyde(6.01%),eugenol(5.47%),ionone(3.87%),and so on.

Objective To investigate clinical therapeutic effect of zoledronic acid combined with chemotherapy to senile lung cancer with bone metastases.Methods Totally 80 cases of senile lung cancer patients with bone metastasis were randomly divided into control group and combined group,40 cases in each group.Limitation of activity to the situation,release of bone pain,adverse e-vents and side effects were observed.Serum Ca2+ concentration,alkaline phosphatase (AKP)levels and the levels of serum inflam-matory cytokines TNF-α,IL-1βwere detected.Results Limitation of activities and pain of patients with combined treatment was significantly ameliorated compared to control group (P <0.05).Serum Ca2+ ,AKP and TNF-α,IL-1β levels were significantly de-creased in patients with combined group in time-dependent manner,and which were significantly lower than control group.Bone ad-verse events and side effects in patients with combined treatment were significantly lower than in patients with control group.Con-clusion Zoledronic acid combined with chemotherapy can enhance the efficacy of chemotherapy,effectively relieve the limitation of activities and pain symptoms and reduce the incidence of bone adverse events and adverse reactions.The effect may be related to the decrease of serum calcium and the inflammatory cytokines.

Objective To investigate the effects of casticin on proliferation and invasion on human breast cancer MCF-7 cells.Methods MTT assay and invasion assay were performed in MCF-7 cells treated with casticin,respectively.The expression of Bax,Caspase-3,MMP-2 and MMP-9 was analyzed by RT-PCR and Western blot.Results Casticin inhibited MCF-7 cells proliferation and invasion in a dose-dependent manner (P ＜ 0.05).Additionally,Bax and Caspase-3 expression was increased in MCF-7 cells treated with casticin,whereas MMP-2 and MMP-9 were down-regulated.Conclusion Casticin may play a critical role in inhibiting breast tumor cell proliferation and invasion,reinforcing its potential in clinical application.

Objective To study the effect of continuous venovenous haemodiafiltration (CVVHDF) on the clearances of various solutes in multiple organ dysfunction syndrome (MODS)dogs.Methods Dogs were subjected to hemorrhagic shock plus resuscitation and endotoxemia to set up MODS model,then they were randomly divided into 2 groups: MODS group (M group)and MODS+CVVHDF group (M+C group).A PRISMA pre-dilution system with AN-69 filter was applied.Solute clearance of nitric oxide(NO),urea nitrogen(UN),creatinine (Cr),interleukin-6 (IL-6),interleukin-10 (IL-10),tumor necrosis factor-α (TNF-α) and endotoxin (LP) was determined with same dialysate and ultrafiltrate volume during CVVHDF.The clearance of various solutes (Kd) was calculated by the concentration of the cleared solutes in effluents (E) based on the formula Kd=(ExQE)/P.Results Clearances of NO,UN,Cr were greater than those of IL-6,IL-10,TNF-α,LP during the treatment of CVVHDF.Conclusion CVVHDF could effectively reduce the levels of various solutes in the development of MODS by convection and absorption.

The paper gives an account of the basic methods for assessing the intrinsic quality of patient nursing by nursing procedures. These include: ①monitoring the accuracy of nursing assessment via evaluating the integrity of patients health; ②evaluating the soundness of nursing diagnosis via analyzing and judging the individuality of patients; ③evaluating the rationality of nursing goals and the appropriateness and operability of nursing measures through patients changes in behavior, function, cognition and emotion; and ④evaluating the timeliness and cyclicity of nursing result assessment through the improvement of patients overall conditions. The paper also analyses the problems involved in employing nursing procedures and countermeasures, pointing out that timely transformation of the nursing management model can markedly enhance the intrinsic quality of nursing.

Objective To investigate the signal regulatory mechanism of expression of corticotropin releasing hormone (CRH) stimulated neurons of hypothalamic slices in rats in vitro . Methods Model of hypothalamic slices of rats was established. After CRH stimulatation of corticotropin releasing hormone type 1 receptor (CRH1R) of hypothalamic slices in rats in vitro , the changes of activity of protein kinase A (PKA) signal passway were observed by immunocytochemical method and Western blotting. The relationship between the changes and CRH mRNA expression was also observed. Results CRH could cause the remarkable increase in phosphorylated PKA, phosphorylated CREB, and CRH content in hypothalamic slices in rats. However, CPl54526 or H89 could have significant inhibitory effect on the synthesis of P PKA, P CREB, and CRH. Conclusion PKA signal passway can regulate the ultrashort positive feedback of CRH secretion in the rat hypothalamus in stress due to severe trauma.

Cooperation networks of nursing techniques were constructde by way of perspective practice so as to enhance the quality of nursing critical cases, the success rate of emergency treatments and patients' life quality. The measures included training in techniques for nmsing critical cases, making the rounds of wards and consultations, and enlarging the scope ofthe cooperation networks. Quantification methods were introduced into management, networks of critical case assessment were used in managing patients, and the system for assessing training in techniques for nursing critical cases was used in managing nursing personnel, thus improving the quality of the nursing pensonnel, ensuring the rational allocation of human resources and promoting the enhancement of the hospital's medical quality and its social and economic benefits. It is therefore not difficu1t to see that the cooperation networks are of application and dissemination value.

Objective To analyze the professional psychological pressure and coping style of male nursing students during different learning stage,and discuss effective ways to solve these problems in order to promote physical and mental health development of male nursing students.Methods Using coping style questionnaire and the professional psychological pressure of nursing students questionnaire to survey 102 undergraduate male nursing students from grade 2005 to 2008 of a nursing college of certain province.Results The professional psychological pressure of undergraduate male nursing students was moderate.Male nursing students of different grades had different professional pressure,in which male nursing students of secondyear had lower professional psychological pressure than other students.Manners they adopted to cope with pressure were mature,that is,the "problem-solving-help" approach,in which ways taken by second-year students were more than others.Conclusions Social bias to male nurses should be corrected.Professional psychological education should be carried out to relieve their mental pressure according to characteristics of students in different stage and direct them to realize role change.

Objective To investigate pharmacodynamics of propofol for smooth exchange of tracheal tube for u laryngeal mask airway after surgery in elderly patients. Methods Twenty elderly patients, ASA Ⅰ or Ⅱ, aged 65-70 yr, scheduled for elective laparoscopic cholecystectomy were enrolled in this study. Anesthesia was induced with propofol, atracurium and remifentanil. The patients were mechanically ventilated after the trachea was intubated. Anesthesia was maintained with propofol combined with remifentanil. After surgery, a predetermined propofol concentration was achieved and a steady state maintained for at least 5 min. The target plasma concentration of propofol at which the laryngeal mask airway following tracheal extubation was attempted was determined by Dixon's up-and-down method with 0.5 μg/ml as the step size, The probit model was used to calculate the EC_(50) and EC_(95) and 95% confidence interval (95% CI) of propofol for inhibiting patient's response induced by smooth excharge of tracheal tube. Results The EC50 of propofol to achieve laryngeal mask airway following tracheal extubation was 2.79 μg/ml (95% CI 2.44-3.04 μg/ml) and EC_(50) 3.61 μg/ml (95% CI 3.27-4.78 μg/ml). Conclusion The target plasma concentration of propofol for laryngeal mask airway following tracheal extubation in elderly patients is 3.61 μg/ml.