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.

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.

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.

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.

Objective:Cholangioduodenal reflux is still an unresolved problem in interposed jejunal choledochoduodenostomy (IJC) yet.To settle this problem,we designed IJC with distal suspending (IJCDS).Methods:IJCDS is to insert and suspend the distal end of the 25 cm-ling interposed jejunum to the duodenal cavity,which is about 2.5 cm long.The pressure of the biliary tract and the biochemical composition or the bile were measured during and after the operation and the results were compared.Barium meal and cholangiography through T tube were performed after the operation.Follow-up surveys were also done.Results:The pressure or the biliary tract decreased distinctively after the operation.Barium meals found no cholangioduodenal reflux although the patients had changed many postures.Cholangiography through T tube showed parisaltic or the interposed jejunum and the contrast medium was continuously pushed into the duodenum.Noreflux cholangitis and stone recurrence were found in the follow-up survey in 14 patients.Conclusion:IJCDS has the powerful function on preventing cholangioduodenal reflux.On the other hand,it avods the shortcomings of other reflux-preventing operative pattern.So it had the good prospect to extend its clinical usage.

Objective:To study the sTRAIL levels in chronic hepatitis B(CHB) patients upon nucleoside analogues therapy.Methods:Serial sera of 60 CHB patients before and after nucleoside analogues therapy were collected,among which there were 20 complete responding cases,20 partial responding cases,20 non-responding cases,and 10 healthy people.The level of sTRAIL,IFN-γ and ALT were detected.Results:The level of sTRAIL,IFN-γ and ALT of CHB patients were higher than that of normal group.The sTRAIL level of complete responding group at 4 weeks and partial responding group at 12 weeks were lower than those before therapy,while serum TRAIL of complete responding group were lower than those of partial responding group at 4 weeks.The IFN-γ level of complete responding group at 4 weeks and partial responding group at 12 weeks were higher than those before therapy.ALT levels of all groups in the course of therapy declined gradually and significant difference was observed at different time point.Conclusion:Serum TRAIL level can be used as an early marker for efficacy of nucleoside analogues therapy efficacy in CHB patients.sTRAIL may play a role in restoring immune injury of early anti-viral response in patients with hepatitis B.

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.