Objective To investigate the diagnostic value for rheumatoid arthritis(RA) by using combined detection of anti‐cy‐clic citrullinated peptide antibody (anti CCP ) ,anti keratin antibody (AKA ) and the antiperinuclear factor (APF ) in serum . Methods A total of 110 RA patients(RA group) ,50 patients with other autoimmune diseases(non RA group) and 110 healthy subjects (control group) were enrolled in the study .The concentrations of AKA ,APF were detected by using indirect immunofluo‐rescence assay and anti CCP by using ELISA .Results The positive rates of anti‐CCP ,AKA ,APF in RA group were higher than those in non RA group and control group(P<0 .05) .In the series detection of the three indicators ,the sensibility and specificity were 44 .55% and 99 .38% respectively ;in the parallel detection of the three indicators the sensibility and specificity were 93 .64%and 85 .63% respectively .Conclusion Anti CCP detection exhibits relatively higher sensitivity and specificity in the diagnosis of RA .Series detection of the 3 indicators can improve the specificity ,reduce the rate of misdiagnosis;parallel detection of the 3 indica‐tors can improve the sensitivity ,reduce the rate of misdiagnosis .The Combined detection of anti CCP ,AKA and APF has better di‐agnostic efficiency than single detection .

Objective To evaluate the diagnostic values of enzyme‐linked immunosorbent assay (ELISA ) and colloidal gold im‐munochromatographic assay in detecting serum anti‐cyclic citrullinated peptide(anti‐CCP) antibody .Methods Colloidal gold immu‐nochromatographic assay and ELISA were used to detect serum anti‐CCP antibody in 110 RA patients and 110 healthy cases . Results The data were analysed with the paired Chi‐Square Test (χ2 = 174 .354 ,P < 0 .01) ,the difference was significant .The K ap pa value was 0 .890(P< 0 .01) ,indicating that the coincidence between the two kinds of methods was good .The sensitivity , speciality of ELISA were 83 .64% and 92 .73% respectively .Conclusion In detecting serum anti‐CCP Antibody ,there was dife‐rence between colloidal gold immunochromatographic assay and ELISA according to statistics analysis .The sensitivity and speciality of ELISA were higher than those of colloidal gold immunochromatographic assay .

Heterotopic ossification is a common complication after acetabular fractures and fractures of the elbow.Heterotopic ossification often leads to severe joint movement disorder,which brings great pain to the patient.This paper reviewed the clinical research,including pathogenesis,clinical diagnosis,prevention,treatment and future directions of heterotopic ossification to investigate the effective method in prevention and treatment of heterotopic ossification.

Objective To provide a simple, convenient, and safe anesthesia method for the establishment of a M1 segment of middle cerebral artery occlusion model in rhesus monkey or other large laboratory animals.Method Twenty male rhesus monkeys weighing 7-11 kg (ages 7-9 years) from Academy of Military Medical Sciences were used in this study.Sumianxin injection combined with 0.1 mg/kg ketamine was given before endotracheal intubation (ID:4.5-5.5#).The animals were then transported to an interventional operation room, where the intravenous access was established and a urinary catheter was inserted into the urinary bladder.Mechanical ventilation was used during the surgery, propofol was continuously injected in a speed of 2-4 mg/kg/h, and Sumianxin-ketamine could be given if necessary to maintain adequate anesthesia depth.The dose was adjusted according to vital signs of the rhesus such as body movements, physiological parameters, and demand of surgery.Brain MRI examination was performed before and after thrombolysis.Anesthetic injection was suspended and the animals were allowed to have a spontaneous breathing every time before the MRI text.Heart rates, temperature, non-invasive blood pressure, and SpO2 were monitored during the whole surgery.Blood samples were taken from the radial artery for blood gas analysis after anesthesia induction and during operation.Results All the 20 animals underwent the operation successfully, no animal had restlessness, respiratory depression, arrhythmia and other serious complications.At the end of the study, animals awake soon.Fifteen of them survived longer than 24 hours, only 5 died from serious cerebral hemorrhage and larger cerebral infarction.Conclusions General endotracheal anesthesia is safe for rhesus monkeys during such interventional operation and MRI examination.

Objective Modified Decoction for Driving Out Blood Stasis in the Blood Mannsion on ascites tumor model of transplanted H22 anti-tumor effect and the impact of VEGF. Methods Adult male mice 100, inoculated with H22 hepatoma cells, the establishment of ascites H22 transplanted tumor model, then divided into 10 groups were given saline, capecitabine, flavored Modified Decoction for Driving Out Blood Stasis in the Blood Mannsion (high, medium and low dose) was administered orally for 10 days, 11 days of treatment, observation of suppression tumor rate, the rate of change in life extension; detected by immunohistochemistry the expression of VEGF in tumors, SPSS13.0 software for statistical analysis. Results Capecitabine, flavored Xuefuzhuyutang (high, medium and low dose) inhibited tumor growth rates were 60%, 49%, 41%, 35%, life extension rate of the three groups were 1.68% 157.98%, 70.58%, 49.57% higher. Conclusion Modified Decoction for Driving Out Blood Stasis in the Blood Mannsion can inhibit tumor cell proliferation in tumor-bearing mice, significantly prolonged the survival time of mice, reduce the tumor tissue and tumor tissue expression of VEGF.

OBJECTIVE: Embryonic stem cells (ES cells) is a special kind of cell population with totipotency and uninhibited self-renewal property. Researches on induced differentiation of ES cells were received and summed up to provide reasonable and constructive suggestions for clinical application of ES cells.DATA SOURCE: Papers published in Highwire press and Medline database were retrieved with keywords "Embryonic stem cell, differentiation, and induce" from 2000 to 2004. Additionally, papers published in Wanfang database were also retrieved with keywords "Embryonic stem cell" in Chinese from 2000 to 2004.STUDY SELECTION: Data were analyzed firstly in order to select papers related to induced differentiation. The inclusion criteria were selection of the original works, but the summaries and Meta analysis were excluded.DATA EXTRACTION: A total of 369 papers were chosen according to correlation with keywords; among them, 364 papers were in foreign language. After reading through summaries of these papers, 15 papers thoroughly discussing induced differentiation of ES cells were chosen for further intensive reading. Papers discussed various kinds of differential models, neural cells, cardiac muscle cells, epithelial cells and hematopoietic cells.DATA SYNTHESIS: The induced differential models of neural cells, cardiac muscle cells, epithelial cells and hematopoietic cells from ES cells were introduced comprehensively in the seven literatures. Based on these references mentioned above and other references which introduced cell model separately, all data were generally studied, sorted out and summed up.CONCLUSION: ES cells can be induced to be various kinds of cell models such as neural cells, epithelial cells, cardiac muscle cells and hematopoietic cells, which may be used to clarify the mechanism of cellular development and differentiation to provide good respects for clinical cellular therapy and screening of medicines.

Objective To investigate the relationship between the exon 4 gene polymorphism of TIM-1 and rheumatoid arthritis (RA) in Han population from Hubei province.Methods Polymerase chain reaction was used to detect the ins/del polymorphism of the exon 4 of TIM-1 from RA population and the normal con- trols.Rheumatoid factor (RF),anti-cyclic citrullinated peptide (CCP) antibody and anti-keratin antibody (AKA) were also detected.Results Two alleles,a wild type del and a variant allele ins were identified in the TIM-1 exon 4.The genotype frequencies of del/del,ins/del and ins/ins were 0.650,0.280 and 0.070 respec- tively in the normal controls and 0.616,0.302,0.082 respectively in RA population.There was a significant correlation between the positive ratio of AKA and the genotypes of the exon 4.Conclusion The polymorphism of the exon 4 of TIM-1 is not associated with rheumatoid arthritis in Han population from Hubei Province of China.The genotypes of the exon 4 may have an effect on the expression of AKA.

Objective:To investigate the effects of Daidzein on behavior of chronic stress depression rats and the expression of hippocampal brain-derived neurotrophic factor ( BDNF ) , neuropeptide Y ( NPY ) and non-specific immune regulation.Methods: 40 healthy adult male SD rats with body weight(210±19)g,clean grade,were chosen and fed with 1%sucrose solution for 4 d to change drinking habits.On the fifth day rats were subjected to water deprivation for 24 h without fasting.On the sixth day rats were fed with 1%surcrose solution.4 h later, preference of 1% surcrose solution was examined.According to the 1% sucrose solution preference and weight rats were randomly divided into 4 groups,normal control group(CG),model control group,(MG),fluoxetine group(FG,10.0 mg/kg),daidzein group(DG,80.0 mg/kg).At the same time of establishing model,rats were administered orally once a day for 32 d.The depression model was established by chronic unpredictable mild stress model and separation.The behavioral changes of the rats were observed, and expression of BNDF in hippocampus and NPY was measured by Western blot technology and immunohistochemistry.It was observed the proliferation function of lymphocytes,spleen index,the number of peripheral blood leukocytes and antibody-secreting cell function.Results: Compared with the normal control group(CG),the weight of rats with chronic stress protocol was lower, 1%sucrose consumption decreased,scores of rats in the open field test dropped significantly,the immobility time in the forced swimming test prolonged,the level of expression of BNDF and NPY decreased,all the differences above were statistically sig-nificant(P<0.01).Compared with model group,weight of rats in fluoxetine treatment group(FG) and daidzein treatment group(DG)in-creased,sugar consumption,scores in the open field test and the levels of expression of BNDF and NPY significantly increased,the differences were statistically significant( P<0.05 or P<0.01 ).The number of peripheral blood leukocytes and antibody-secreting cell function and proliferation of lymphocytes force in daidzein treatment group was significantly higher than the model group,daidzein dose spleen index was significantly higher than the model group(P<0.01).Conclusion: The daidzein can antagonize depressive symptoms in chronic stress mice,daidzein may increased content of BDNF in hippocampus and NPY protein, and enhanced the role of humoral immune response and lymphocyte proliferation in rats with chronic stress model.The mechanisms of antidepressant effects of daidzein might be related to the increase of content of BDNF in hippocampus and NPY protein and non -specific immune regulation.

[Abstract ] Objective To investigate the present situation and demand of nurses training in the different level hospitals of a suburb,so as to provide reference to the building of nursing team.Methods Stratified random sampling was taken in 764 nurses in 20 different level hospitals of a suburb of Beijing.Results In recent 3 years, 31.9% of nurses went out to short -term training and 15.58% of nurses went out to further study for a longer time. The continuous education scores came mainly from own hospital(88.22%),suburb training center(77.75%)and networks(42.54%).About training needs,over half of nurses chose training inside themselves areas,58.38% of nurses chose special short duration training,53.66% of nurses chose further study,48.04% of nurses chose WeChat network platform.About the training content,the first need of training for nursing administrators was nursing safety management (4.65 ±0.54)points,the first need of training for clinical nurses was emergency techniques training (4.41 ±0.69)points.89.14% of nurses would like to have two -way feedback.Conclusion The present situation of nurses training should be improved.Integrating resources and flexible and multiple training methods should be adopted to satisfy nurses training demand.

This study run through the process of developing behavioral medicine discipline in a general hospital with action research method,based on the balanced scorecard (BSC) framework.The four perspectives of the behavioral medicine BSC covered the main areas in hospital discipline development,including patients and community,healthy financial disciplines,clinical service process and efficiency,and research,innovation and growth.By the implementation of the discipline BSC,this hospital clarified its discipline development strategy,provided a communication platform,determined the objective and monitored the discipline effectively,and provided a mode which can integrate the discipline development and providing clinical services.The hospital set up the first neurology behavioral medicine clinic in Jinan Region though the exploration of the path and methods for developing behavioral medicine discipline,which had practical guiding significance for behavioral medicine development and services.