Objective Through the application of recombinant human Ⅱ tumor necrosis factor-Fc function protein (rhTNFR:Fc) in the treatment of juvenile idiopathic arthritis (JIA) with randomized control study,clinical characteristic and clinical effect were summarized.Methods According to the randomized controlled principle,124 patients with JIA were divided into control group and treatment group.The basic treatment in two groups were one antirheumatic slow-acting drug,nonsteroidal drug,adrenal cortical hormone.There were no significant differences between clinical type and basic treatment in two groups (P ＞ 0.05).Sixty-two patients of JIA treated with rhTNFR:Fc by subcutaneous injection.The doses was 0.8mg /kg per week.There were 17 cases of oligoarthritis,15 cases of polyarthritis,30 cases of systemic arthritis in the treatment group and control group respectively.The basic antirheumatic drugs,nonsteroidal anti-inflamatory drugs ( NSAIDs),adrenal cortex hormone were allowed to continued.Clinical evaluation index included ACR Pedi 30,ACR Pedi 50 and ACR Pedi 70.The adverse drug reactions were recorded.Results The remission rate of ACR Pedi 30,50,70 in 2 weeks,one month,three monthes and six monthes were different in types of JIA patients in the treatment group ( P ＜ 0.05 ).The remission rate of systemic arthritis was lower than the other two groups of arthritis ( P ＜ 0.05 ).Only 44％ ACR Pedi 50 remission was achieved after three monthes medication in systemic arthritis and 41.7％ ACR Pedi 50,29.2％ ACR Pedi 70 were achieved after six monthes.The remission rate in the types of oligoarthritis and polyarthritis at different time points (2 weeks,one month,three monthes,six monthes) of ACR Pedi 30,50,70 were similar.After six monthes,more than 80％ reached ACR Pedi 50 remission,more than half of patients reached ACR Pedi 70 remission.Three cases of macrophage activation syndrome in systemic arthritis group was effective treated with rhTNFR:Fc.In the treatment group,2 cases of systemic arthritis appeared ache and discomfort after one week treatment,3 cases appeared repeated mild upper respiratory tract infection and diarrhea during treatment,including one varicella infection.The incidence of adverse reactions in the treatment group of systemic arthritis were 16.7％,Other 2 types of patients did not show adverse reaction during rhTNFR:Fc treatment.Conclusion rhTNFR:Fc has good effect on oligoarthritis and polyarthritis of JIA.The adverse reactions of six monthes were rare.The cases of systemic arthritis could reach some clinical remission,but need to guard against infection and the occurrence of adverse reactions.To whom did not respond to conventional therapy in systemic arthritis or systemic arthritis combined with macrophage activation syndrome,it could be considered with rhTNFR:Fc.

Glucocorticoids have remained important anti-inflammatory agents in the treatment of chronic kidney disease (CKD).However,the use of glucocorticoids can invoke or enhance insulin resistance,which is closely associated with renal injury and serves as an independent risk of the occurrence and progression of CKD.On the other hand,CKD patients may have insulin resistance,which hampers the use of glucocorticoids in these patients.

BACKGROUND:Some researches demonstrate that bone mineral density of healthy males and females whose ages range from 20 to 40 years reaches the peak.With the age growing,bone mineral density decreases gradually so as to cause osteoporosis.OBJECTIVE:To analyze changes of bone mineral density and characteristics of osteoporosis in 289 healthy middle and old aged people in two communities,Dongcheng district,Beijing.DESIGN:Cross-sectional study.SETTING:Beijing Institute of Geriatrics,Beijing Hospital,Ministry of Health.PARTICIPANTS:A total of 289 healthy residents over 45 years old were randomly selected from two communities,Dongcheng district,Beijing from June to September 1998.There were 136 males and 153 females,and their ages ranged from 45 to 85 years.Exclusion criteria:① Hepatic and renal disfunction;② effects of various factors on bone metabolism (various acute and chronic diseases;histories of long-term administration of hormone and calcium preparation;19 kg/m2＞index of body mass＞28 kg/m2;long-term bed over three months;unusual occupation).All subjects provided the confirmed consent.METHODS:Dual-energy X-ray bone density meter (Lunar Company,USA) was used to measure bone mineral density of all subjects at proximal end of left femur (neck of femur,great troch,Ward's triangle) and antero-posterior position of lumbar spine (L2-4).Diagnostic criteria of osteoporosis set by WHO and peak bone value acquired from a tackle key program were used to determine diagnostic standards of osteoporosis at various sites.The diagnostic standards were detailed as follows:neck of femur:0.665 g/cm2 of males and 0.677 g/cm2 of females;great troch:0.598 g/cm2 of males and 0.506 g/cm2 of females;Ward's triangle:0.492 g/cm2 of males and 0.514 g/cm2 of females;L2-4:0.760 g/cm2 of males and 0.835 g/cm2 of females.Meanwhile,peak bone value acquired by Key Program During the Ninth Five-Year Plan Period was used to calculate bone mineral density losing rate and prevalent rate of osteoporosis.MAIN OUTCOME MEASURES:Bone mineral density,bone mineral density losing rate and prevalent rate of osteoporosis at various sites in patients with the two sexes.RESULTS:All 289 subjects were involved in the final analysis.① With the age growing,bone mineral density in the males was not increased obviously;however,decrease of bone mineral density and bone mineral density loss in the females were remarkable,especially over 55 years old.② Analysis of bone mineral density losing rate based on various sites:bone mineral density losing rate in both males and females ranged Ward's triangle＞neck of femur＞great troch＞L2-4.③ Prevalent rate of osteoporosis was increased gradually with the age growing;especially,that in the females was obviously higher than that in the males,and there was significant difference (P＜ 0.01).Osteoporosis highly occurred in femur,and then in Ward's triangle and L2-4.CONCLUSION:With the age growing of the females,osteoporosis easily onsets in neck of femur,Ward's triangle and L2-4;especially menopause is the main risk factor for osteoporosis.

Objective: To compare the extraction efficiency of imperialine extracted with different solvents. Methods: The content of imperialine in the extracts was determined by thin layer chromatography scanning. Results: Among the methods suitable for alkaloid extraction, the solvent ether chloroform 95% ethanol (25∶8∶2.5) is the best for imperialine extraction. Conclusion: The imperialine extraction efficiency is greatly affected by the extraction solvent.

Objective:To establish the high performance liquid chromatography (HPLC) combined with switching wavelength method to determinate chlorogenic acid, ferulic acid, Calycosin-7-glucoside in Shenqi-Yiqi oral liquid. Methods:The Shenqi-Yiqi oral liquid was separated on an Agilent HC-C18 column by gradient elution using acetonitrile (A) - 0.1% phosphate (B) as the mobile phase. The flow rate was 1.0 ml/min. The detection wavelengths were 260 nm (chlorogenic acid and Calycosin-7-glucoside), 316 nm (ferulic acid) by wavelength conversion method. Results:The linear ranges of chlorogenic acid, ferulic acid, Calycosin-7-glucoside were 70.40-704.00 μg ( r=0.999 8), 1.36-13.60 μg ( r=0.999 8), 1.28-12.80 μg ( r=0.999 7), the average recovery rate were 99.44% ( RSD=2.54%), 101.06% ( RSD=1.57%), and 98.00% ( RSD=2.09%). Conclusion:This method is convient, rapid and accurate for determinating chlorogenic acid, ferulic acid and Calycosin-7-glucoside in Shenqi-Yiqi oral liquid.

Since the polyjuice potion ingredient is complex, we need to develop an analysis method with well separation and high stability to perform qualitative analysis. After dividing chemical components of Mahuang Decoction into fat-soluble and water-soluble constituents by gradient extraction, GC-MS was used to analyze the chemical components of the ethyl acetate extraction. The results showed that forty compounds had been identified by NIST MS search 2.0 standard mass spectrometry Library and literatures. Next, UPLC-Q-TOF-MS was applied to idendify the chemical components of the water extraction. The results showed that thirty-nine compounds had been identified by MZmine-2.9.1, Isotope Pattern, fragmentation regularity of mass spectrometry and literatures. This experiment will provide evidences for elucidation of the effective substance in Mahuang decoction and can be used as a simple, shortcut method for analysis and identification for the polyjuice potion.
Chromatography, High Pressure Liquid ; methods ; Ephedra ; chemistry ; Ephedra sinica ; chemistry ; Gas Chromatography-Mass Spectrometry ; methods

OBJECTIVE: To investigate the features of adverse drug reaction(ADR) in our hospital and evaluate the quality of ADR report in order to promote rational clinical drug use and find out the existing problems in the report. METHODS: Microsoft Excel was designed to analyze statistically the sex and age of the patients,category of the used drugs and the clinical manifestations of ADR in 311 cases of ADR report collected between 2002 and 2005.RESULTS: The occurrence of ADR induced by antibacterials ranked the first.ADR affecting skin and its appendages counted for 50% of the total.The numbers of ADR reports were found to be less than expected.CONCLUSIONS: Professional staff training should be strengthened,the use of antibacterials should be rationalized to lessen and avoid the occurrence of ADR.

?Optic neuritis ( ON) is one of the most common causes of vision loss by neural eye diseases in youth and middle-aged. In the past, the diagnosis simply according to the risk position, which did not distinguish from the pathogenesis and clinical characteristics, can not meet the current clinical diagnosis and treatment needs. Combining with the etiology, clinical characteristics and prognosis, the latest classification of the current international diagnosis of ON are typical and atypical ON. Typical ON relates to multiple sclerosis ( MS ) or demyelinating disease of the central nervous system, it has a relatively good therapeutic effect and prognosis. Rather than, atypical ON has complex etiology, clinical manifestation, and the treatment and prognosis are also different. At present there are many international ON treatment guidelines with level I evidence-based medical evidence, but with different genetic background, geographical environment and ethnic groups, they are not been determined. China lacks of such a multicenter large sample, a wide range of research evidence. In this paper, we will summarize the progress of the diagnosis and treatment about ON, especially about the atypical ON, in order to provide some suggestions to further improve the standardization and individualization for clinical diagnosis and treatment on ON.

Objective To analyze the recurrence rate of intubation and increase of ventilator support rate within 24 hours after using fiberoptic bronchoscopy (FOB) in critically ill patients with hypoxemia complicated with respiratory failure, and to approach the feasibility of FOB in such patients.Methods A prospective study was conducted, including 200 critically ill patients with acute respiratory failure using FOB [oxygenation index (PaO2/FiO2) ≤ 300 mmHg (1 mmHg = 0.133 kPa)] admitted to the intensive care unit (ICU) of the First Affiliated Hospital of Xinxiang Medical College. The rates of intubation and increased ventilatory support and the reasons for bronchoscopy related complications after using FOB 24 hours were recorded, the main risk factors leading to these changes and complications were analyzed and screened by logistic regression analytic method.Results Within 24 hours after using FOB for 200 patients with respiratory failure, an increase in mechanical ventilatory support was required in 68 patients (34%) of that 28 (14%) led to endotracheal intubation. With the extension of time, the rates of intubation and ventilatory support showed a tendency of elevation, the rise in ventilatory support rate being faster. The reasons for bronchoscopy related complications after FOB consisted of cardiovascular disease (41%), coronary artery disease (17%), chronic obstructive pulmonary disease (COPD, 17%), chronic restrictive pulmonary disease (10%), immunity suppression (54%), malignant neoplastic hematologic disorder (20%), acquired immune deficiency syndrome (AIDS, 12%), solid organ transplantation (3%), solid tumor (10%), corticosteroid therapy (25%), immunosuppressive drug (16%), diabetes (15%), chronic renal failure (14%), swallowing nerve injury (37%), anticoagulant therapy (19%), antiplatelet therapy (13%). In the patients with occurrence of COPD or immunosuppression, the rate of invasive ventilation used was significantly higher than that without using invasive ventilation [COPD: 35% (10/28) vs. 14% (24/172),χ2 = 8.081,P = 0.004; immunosuppression: 75% (21/28) vs. 50% (86/172),χ2 = 6.051,P = 0.014]. The logistic regression analysis showed that the occurrence of COPD or immunosuppression was obviously related to whether the intubation being necessary or not [COPD: odds ratio (OR) = 5.200, 95% confidence interval (95%CI) = 1.500 - 17.700,P = 0.006; immunosuppression:OR = 5.300, 95%CI =1.600 - 17.100,P = 0.004].Conclusions In patients with hypoxemia using FOB, they often require addition of mechanical ventilatory support, but the intubation rate is not high. Under the ventilatory support, FOB has certain feasibility for treatment of critically ill patients with hypoxemia and acute respiratory failure.

Objective To investigate the correlation between augmentation index (AI) of the radial artery and diastolic heart function in patients with hypertension.Methods Echocardiographs were obtained for 305 patients with hypertension.AI,pulse wave velocity (PWV) of peripheral arteries and serum pro-brain natriuretic peptide (proBNP) levels were determined.Correlations and receiver operating characteristic (ROC) curves were drawn between AI values and impaired diastolic function.Results AI levels were significantly increased in patients with impaired diastolic function diagnosed by ultrasound.Assessment of diastolic heart function based on proBNP levels revealed that AI and aortic pulse wave velocity were significantly elevated in patients with impaired diastolic function.The operating curve indicated that AI may be a more accurate and efficient index for the evaluation of impaired diastolic function compared to pWV.Correlation analysis also showed that proBNP levels had altered in parallel with changes in AI and PWV.After adjusting for various factors including age,gender,blood pressure and blood lipid,a positive correlation was observed between proBNP and AI with a correlation coefficient of 0.3697 (P =0.003).However,no correlation between proBNP and aortic PWV was seen after adjustment.Conclusions Changes in radial AI levels may reflect parallel changes in diastolic cardiac function in patients with hypertension,suggesting that AI may be utilized as a non-invasive clinical indicator of diastolic heart function.