Objective To identify the correlation between vitamin D prescription and recurrence in rheumatoid arthritis (RA).Methods A randomized controlled trial study was performed in 170 RA patients who were in remission during the past 2 months.According to the level of vitamin D,170 RA patients were divided into normal vitamin D group (84 patients) and deficiency vitamin D group (86 patients).Deficiency vitamin D group were randomly allocated to receive vitamin D treatment(vitamin D treatment group) or without vitamin D treatment (control group).In the 6-month follow-up period,the recurrence status was observed and compared.Results In the 6-month follow-up period,the recurrence rate of RA in normal vitamin D group was 16.7％(14/84),in vitamin D treatment group was 19.0％(8/42) and in control group was 29.5％(13/44),and there was no significant difference (P ＞ 0.05).In vitamin D treatment group,no hypercalcemia and hyperphosphatemia occured.The age,course of disease and remission time in recurrence patients of three groups were no significant difference (P ＞ 0.05).The level of vitamin D in recurrence patients of vitamin D treatment group was higher than that in recurrence patients of control group:(25.5 ± 8.9) ng/L vs.(20.9 ± 8.6)ng/L,and there was significant difference(P＜ 0.05).Conclusion Vitamin D deficiency is not identified to be a risk factor for RA recurrence.Vitamin D does not reduce the recurrence of RA.

AIM: It is tested that the suppressive effects of (-)-Epigallocatechin-3-gallate (EGCG ) on the migration, invasion and RhoA expression of human lung carcinoma 95-D cells and B16BL6 melanoma cells invasion in vivo,which will possibly help to understand the molecular mechanisms by which EGCG inhibits the invasion of tumor cells. METHODS: The inhibitory effect of EGCG on the migration of 95-D cells was tested by cell migration assay. Cell invasion was analyzed by the matrigel invasion assay. Assay of tumor metastasis in an animal model, RT-PCR and Western blot analysis of expression of RhoA was also performed. RESULTS:EGCG was effective in inhibiting the migration of 95-D cells in a dose-dependent manner. EGCG dose-dependently inhibited 95-D cells invasion in vitro and 40 μmol·L-1 EGCG exhibited 79.9% inhibition and EGCG 50 mg·kg-1·d-1 for 3 weeks inhibited B16BL6 melanoma cells invasion by 71.7% in vivo. EGCG could down-regulate the expression of RhoA. CONCLUSION: EGCG strongly inhibits metastasis of 95-D cells, and the mechanism of EGCG is possible associated with the inhibition of RhoA expression.

BACKGROUND:Active components of Astragalus have an antioxidant effect, which is considered to result in the neuron-like differentiation of bone marrow mesenchymal stem cels. OBJECTIVE:To investigate the effect of astragalus polysaccharides combined with basic fibroblast growth factor to induce the differentiation of bone marrow mesenchymal stem cels into nerve cels. METHODS:After 24 hours of pretreatment with basic fibroblast growth factor, passage 3 human bone marrow mesenchymal stem cels were cultured with astragalus polysaccharides for 1-3 days (combined group). Blank control group and basic fibroblast growth factor group were set up. Expression of neuron-specific enolase and nestin was detected using western blot or immunocytochemical staining. RESULTS AND CONCLUSION:The expression of neuron-specific enolase was higher in the combined group than the basic fibroblast growth factor group (P < 0.05). Expression of nestin was found in both basic fibroblast growth factor group and combined group, but the gray value was higher in the combined group than the basic fibroblast growth factor group (P < 0.05). These findings indicate that astragalus polysaccharides combined with basic fibroblast growth factor is better to induce the neuronal differentiation of bone marrow mesenchymal stem cels.

Objective To investigate the clinical features of rheumatoid arthritis combined with femur head necrosis. Methods The clinical data of 22 patients with rheumatoid arthritis combined with femur head necrosi were retrospectively analyzed. Results Among the 22 patients with rheumatoid arthritis combined with femur head necrosi, male was in 5 cases, female was in 17 cases, age was 28-69 (56.3 ± 1.9) years, and the disease duration of rheumatoid arthritis was 4-30 (14.1 ± 1.2) years. All patients had ≥ 2 grade femur head necrosis, with bilateral femur head necrosis in 9 cases, right femur head necrosis in 9 cases and left femur head necrosis in 4 cases. Only 2 cases did not take glucocorticosteroid, and the other 20 cases used glucocorticosteroid in the long-term. The treatment was no standardized. The multiple fracture was found in 4 cases by X-ray examination (the patients had no history of trauma); 4 cases examined bone density, and the results showed they all were osteoporosis. Conclusions Rheumatoid arthritis combined with femur head necrosis is not uncommon. The majority of patients receive long-term glucocorticosteroid treatment. Treatment is not standardized, and some patients are combined with osteoporosis.

Occupational therapy provides protective and corrective non-surgical measures for carpal tunnel syndrome. The information gained from the assessment process can help the occupational therapists determine the targets and treatment options, including the nerve-gliding exercises, tendon-gliding exercises, production or select splints, modification of tasks resulting in patients with exacerbations, modification of equipment and environment, transformation of daily necessities. The education would cover the pathophysiology of carpal tunnel syndrome, treatment options (conservative management and surgery), posture and activity modification principles. This information can also be provided in the form of an education booklet which participants will be encouraged to review at home.

Objective To explore the effects of prenatal taurine supplementation on the expression of protein kinase A(PKA) and c-fos,Ca2+/calmodulin-dependent protein kinase Ⅱ (GaMK Ⅱ) in fetal rat brains with intrauterine growth restriction and its significance.Methods Fifteen pregnant Sprague-Dawley rats were randomly divided into 3 groups:the control group,the intrauterine growth restriction (IUGR) group and the IUGR with prenatal taurine supplementation group(the taurine group),with 5 fetal rats in each group.All the fifteen fetal rat brains were detected as following:the expression of PKA,c-fos,CaMK Ⅱ mRNA in fetal rat brains was detected by way of real-time polymerase chain reaction(real-time PCR),while the expression changes of PKA,CaMK Ⅱ,and c-fos protein in fetal rat brains were detected by using Western blot,and the number of PKA,CaMK Ⅱ,c-fos positive cells in fetal rat brains was detected by using immunohistochemistry.Results The control group,the IUGR group and the taurine group:Comparison of the expression of PKA,CaMK Ⅱ,c-fos mRNA among 3 groups were of significant differences(F =7.934,P =0.021 ; F =5.568,P =0.043 ;F =7.332,P =0.024).Comparison of the expression of PKA,CaMK Ⅱ,c-fos protein among the 3 groups were of significant differences(F =57.743,P =0.000 ; F =163.405,P =0.000 ; F =160.136,P =0.000).Comparison of the number of PKA,CaMK Ⅱ,c-fos positive cells among the 3 groups were of significant differences (F =42.903,P =0.000 ;F =329.123,P =0.000 ; F =43.674,P =0.000).Compared with the control group,the expression of mRNA,protein,positive cells of three indicators in IUGR group was less,and the difference was statistically significant (P ＜ 0.05).The expression of mRNA,protein,positive cells of three indicators in fetal rat brains of the taurine group were not different from the control group.The expression of mRNA,protein,positive cells of three indicators in fetal rat brains of the taurine group were significantly more than the IUGR group(P ＜ 0.05).Conclusions Prenatal taurine supplementation can improve PKA-CaMK Ⅱ,c-fos mRNA and protein levels in fetal rat brain tissue with IUGR,and increase its number of positive cells and may enhance the regenerative capacity of the central nervous system,so as to reduce the IUGR brain injury and promote its role in brain development.

Objective To analyze retrospectively the relationship between protein nutrition index (PNI) and survival conditions in patients with peritoneal dialysis (PD).Methods Various clinical and laboratory indexes of patients with chronic kidney disease from January 2004 to January 2014 were analyzed retrospectively.PNI score was determined by serum albumin (ALB),normalized protein nitrogen presentation rate (nPNA),lean body mass (LBM).According to PNI score,PD patients were divided into four groups:good nutrition status,nutrition status in general,poor nutrition,PEW status.Linear regression analysis was used to analyze determine factors of PNI;analysis of Kaplan-Meier was applied to examine relationship between the protein nutrition status and survival rate;COX regression analysis was used to analyze the risk factors for survival in patients with PD.Results All the indexes,age,complications index,serum Cr,K-Kt/V,T-Kt/V had a linear relationship with PNI.5-year survival rate in the four groups were respectively 95％,92％,65％,23％.Age,complications,PNI index were the survival risk factors of PD patients.Conclusions According to PNI score,evaluation of protein nutritional status of patients with PD could predict survival conditions of PD patients,the higher PNI score,the higher survival rate.

Objective To explore the relationship between gastric juice pH and hospital-acquired pneumonia ( HAP) , the gastric bacterial colonization and etiology of HAP in neurologic intensive care unit patients by monitoring gastric juice pH value.Methods From October 2014 to May 2015, consecutive seventy-two tube feeding patients admitted in the Department of Neurology Intensive Care Unit in Xijing Hospital were enrolled in this research.The type and concentration of pathogens from gastric contents were collected, while samples from upper respiratory tract and pharynx were detected dynamically at the same time.Results (1)The group with new onset HAP was higher in gastric juice pH (6.4(5.4,6.4) vs 5.4 (2.5, 6.4), Z=-2.37, P=0.01); (2) The isolation rate of colonized bacteria in gastric cavity was associated with the pH of gastric juice , achieving 60.8% ( 42/69 ) in HAP group; ( 3 ) When the gastric juice pH was >4, the isolation rate of Gram-negative bacilli in gastric cavity obviously increased (63.6%(28/44) vs 35.7%(10/28),χ2 =5.323, P=0.021); (4)The same pathogens were found in stomach-pharynx-upper respiratory tract in 7 cases ( 17.5%) of the total 40 HAP patients.Conclusion Increased gastric juice pH was associated with gastric colonization , especially Gram-negative bacilli , and may lead to a higher incidence of new onset HAP in patients on enteral feeding.

Objective To investigate the energy intake and complications of continuous and intermittent pump feeding in acute stroke patients and provide a theoretical evidence to support for clinical treatment.Methods From April 2012 to June 2016,69 acute srtoke patients on the nasogastric tube feeding and admitted in the Department of Neurology intensive care unit in Xijing Hospital were enrolled and randomly assigned to have continuous or intermittent pump feeding.The primary endpoint was the efficacy in supplying the desired amount of nutrients by the fifth day and complications(hospital-acquired pneumonia,diarrhea,gastric retention,gastrointestinal bleeding)during the first week.The secondary endpoint was nutritional assessments(albumin,prealbumin,transferrin,hypersensitive c-reactive protein)in the first week.Results Both groups were comparable in acute physiology and chronic health evaluation Ⅱ(13.3±4.7 vs.12.9±4.5),Glasgow coma scale[10(7.2,14)vs.9.5(7.7,12)],National Institute of Health stroke scale[17(15,19)vs.16(13,20)],and Barthel scores[5(0,12.5)vs.10(5,15)](all P>0.05).It was no significantly different in the achievement percentage of the energy determined in the fifth day [93.9％(77.9％,99.8％)in continuous group and 84.8％(75.7％,93.9％)in intermittent group(U=0.144,P>0.05).Intermittent pump feeding significantly reduced the rate of hospital-acquired pneumonia in the first week when compared with continuous pump feeding(58.3％vs.33.3％,X2=4.327,P=0.038),and both groups displayed a moderate number of digestive complications without significant differences,including diarrhea(30.6％vs.27.3％,X2=0.09,P=0.764),gastric retention(2.78％vs.3.03％,X2=0.001,P=1.000),and gastrointestinal bleeding(5.56％vs.9.10％,X2=0.010,P=0.920).No difference could be demonstrated in serum protein markers between two groups in the first week,including prealbumin[0.17(0.13,0.20)g/L vs.0.18(0.15,0.24)g/L,P=0.195),transferrin[1.90(1.52,2.20)g/L vs.1.94(1.65,2.06)g/L,P=0.747),and hypersensitive C-reactive protein[22.5(8.3,50.1)mg/L vs.14.6(6.5,30.5)mg/L,P=0.205].Conclusions Both continuous and intermittent pump feeding can reach the target predictive nutrition(100％of calculated caloric requirements)without statistical differences in the incidences of gastrointestinal complications,and the rate of HAP is lower in intermittent group.Intermittent enteral nutrition can be used as an appropriate method of enteral nutrition support to improve the nutritional status in critically acute stroke patients.

Ras-associated domain family 1A (RASSF1A) genes are members of the RASSF family, which bind to Ras in a guanosine triphosphate(GTP)-dependent manner and then induce Ras-mediated apoptosis. The protein encoded by the RASSF1A gene is similar to the Ras effector protein, which can interact with DNA repair protein XPA, and can also inhibit the accumulation of cyclin D1, thereby inducing cell cycle arrest. The deletion or abnormal expression of RASSF1A gene is related to the pathogenesis of various malignant tumors, indicating that it has tumor suppressor function. RASSF1A gene methylation has been found in at least 37 tumors, and RASSF1A gene may be the most frequently described methylated gene in human cancers. In this paper, the abnormal methylation of RASSF1A gene in different malignant tumors was introduced, and the research progress of its related effects and mechanisms in malignant tumors of the respiratory system, digestive system, genitourinary system, and nervous system in recent years was reviewed, with a view to malignant tumors early diagnosis, individual molecular targeted therapy and prognostic evaluation provide important guidance.