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.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Dermatomyositis ; diagnosis ; Female ; Humans ; Male ; Middle Aged ; Otolaryngology ; Young Adult

Objective To investigate the effects of Peiyuan Shengjin Tongqiao Decoction, a Chinese herbal recipe with the actions of supplementing kidney to strengthen lung and dredging orifices , on traditional Chinese medicine (TCM) symptoms and lung function of childhood asthma complicated with allergic rhinitis. Methods Fifty-five childhood asthma complicated with allergic rhinitis were randomized into treatment group(N=28) and control group (N = 27). The two groups were treated with Budesonide and Formoterol Fumarate Powder for Inhalation, and the treatment group was given oral use of Peiyuan Shengjin Tongqiao Decoction additionally. After treatment, the clinical efficacy of the two groups was evaluated, and TCM symptom scores and lung function indexes [ the percentage of forced expiratory volume in the first second to the expected value (FEV1％) and the percentage of peak expiratory flow to the expected value (PEF％) ] were also observed before and after treatment. Results (1)After treatment for 3 months, the total effective rate of the treatment group was 92.86％, being superior to that of the control group (81.48％), and the difference was significant (P<0.01). (2) After treatment, the scores of cough plus asthma, rhinitis symptom scores and overall TCM symptom scores of the two groups were decreased (P < 0.01 compared with those before treatment) , and the rhinitis symptom scores and overall TCM symptom scores of the treatment group were lower than those of the control group (P < 0.01). (3) After treatment, PEF％ and FEV1％ were both improved in the two groups (P < 0.05 compared with those before treatment) , and the improvement in the treatment group was superior to that in the control group (P <0.05). Conclusion Peiyuan Shengjin Tongqiao Decoction is effective for the control of childhood asthmacomplicated with allergic rhinitis by improving rhinitis symptom scores, overall TCM symptom scores and lung function.

Objective To evaluate the interventional chemoembolization combined with proton radiotherapy in the treatment of hepatocellular carcinoma (HCC) accompanied with cancerous thrombus in the main portal vein. Methods Interventional chemoembolization combined with proton radiotherapy was performed in 46 patients of HCC accompanied with cancerous thrombus in the main portal vein. The proton radiotherapy was broke up into several fractions. The patients were treated with interventional chemoembolization and, alternatively, with proton radiotherapy. The short-term effectiveness and radiation reaction were evaluated. The survival rate was followed up. Results The effective rate was 91.3% . Disappearance of cancerous thrombus in the main portal vein was seen in 45.6% of patients. The liver functions were well restored, with a remarkable reduction in AFP. No acute or delayed radiation-induced hepatic damage or radiation hepatopathy occurred during the course of and after radiotherapy. The survival rate at 1, 6, 12 and 24 months was 100%, 89.1%, 52.2% and 21.4% respectively, with a median survival period of 17.6 months. Conclusion For the patients of HCC accompanied with cancerous thrombus in the main portal vein, interventional chemoembolization combined with proton radiotherapy is an effective, safe and newly-developed therapy.

AIM: To unveil the molecular mechanism of i sc hemic myocardium with displaying the differences on the protein expression in my ocardium. METHODS: Proteins of the ischemic myocardium induced by pituitri n were seperated by two dimentional electrophoresis (2-DE). The 2-DE image was a nalyzed by the software package PDQuest7.1.1. RESULTS: 10 proteins showed significant difference (P

Objective To detect NRAS gene mutations in patients with acral melanoma, and to analyze their relationship with the prognosis of acral melanoma. Methods Clinical and pathological data were collected from 55 patients with pathologically diagnosed acral melanoma. DNA was extracted from paraffin?embedded specimens from lesions of the 55 patients and 15 patients with nevus. PCR and direct DNA sequencing were performed to detect NRAS gene mutations. Univariate and multivariate analyses were performed using the Cox′s proportional hazards regression model. Results Of the 55 patients, 6(10.9%)carried the Q61R mutation in codon 61 of the NRAS gene. No mutations were found in exon 1 or 2 of the NRAS gene in any of these paraffin?embedded specimens, and none of the pigmented nevus specimens harbored NRAS gene mutations. Of the 6 patients carrying NRAS gene mutations, 4 had lymph node metastasis. Multivariate Cox regression analysis showed that independent factors of poor prognosis included advanced clinical stage(RR = 2.54, 95% CI: 1.062- 6.066, P < 0.05), not receiving surgical resection(RR = 2.98, 95% CI:1.316- 3.525, P < 0.05), and carrying NRAS gene mutations (RR = 2.73, 95% CI: 0.932- 3.257, P < 0.05). Conclusions NRAS gene mutations may be associated with lymph node metastasis in patients with acral melanoma. The prognosis of acral melanoma may be associated with clinical staging, treatment strategies and NRAS gene mutations. Additionally, NRAS gene mutations may serve as a new index for predicting prognosis of acral melanoma.

Objective To investigate the current knowledge and attitudes towards people living with HIV/AIDS (PWHAs) in Chinese registered nurses (RNs) and describe the relationships between the nurses' HIV/AIDS related knowledge and attitudes towards PWHAs. Methods A cohort of 1350 RNs from 51 comprehensive hospitals in Hunan, China were studied over a 4-month period. A 3-stage random sampling method was used. Results The total correct rate in AIDS Knowledge Scale was 63.2%. Most nurses were good at conceptions of routes of AIDS infection and some basic characteristics, with more than 80% of the correct responses rate of relevant items. Their weakness was in the knowledge of some activities which would not transfer AIDS, such as "eating in a restaurant where the cook has AIDS may infect HIV", with less than 50% of the correct response rate of relevant items. As for attitudes, 94% of the nurses sympathized with HIV patients. About 82.7% of the nurses showed little sympathy to patients getting HIV by sexual promiscuity. Among all the AIDS related knowledge, nurses' conception of non-infectious activities was significantly related to their attitudes to HIV/AIDS.Conclusion Chinese nurses waster well about HIV/AIDS basic characteristics and the routes of infection, and most nurses sympathize with PWHAs. Their weakness is in the knowledge of non-HIV-infectious activities and they hold different attitudes to those patients getting HIV/AIDS in different ways. There are some barriers for Chinese nurses to take care of all patients equally. Professional development programs are urgently needed to remedy this situation including clarifying the nurses' misconceptions on AIDS related knowledge, developing non-judgmental professional attitudes, and using universal prevention measures when they take care of all patients.

Objective To analyze the outcome of children with juvenile idiopathic arthritis (JIA) treated with recombinant human tumor necrosis factor receptor antibody fusion protein (rhTNFR:Fc) for 2 years,and to evaluate the long-term efficacy and safety as well as the related factors that affect the curative effect of rhTNFR:Fc.Methods Fifty-seven JIA patients treated with rhTNFR:Fc were followed up for 2 years.Clinical data were registered including age of onset,disease duration before rhTNFR:Fc treatment,disease activity assessment,medication before treatment,dosage regimen of infection or adverse reactions.Pearson Chi-Square statistical test and logistic regression model of binomial classification were used for statistical analysis.Results ①Twenty-two JIA cases completed 2-year therapy.Some were in the process of dosage tapering.Eight cases reached ACR Pedi 50,14 cases reached ACR Pedi 70.All of them were included in the clinical effectiveness analysis.Thirty-five cases withdrawal in 2 years because of disease remission or treatment failure or side effects or infection.Seven who withdrew and then maintained with DMARDs under the supervision of doctors were evaluated by assessment of ACR Pedi 70.They were stable at the end of 2 years,and were included for the clinical effectiveness analysis group.Nineteen cases were withdrew by the doctor because they failed to reach ACR Pedi 30 within 3 months.They were included in the treatment failure analysis.Seven cases were lost during the follow up.② The remission rate (ACR Pedi 50,70) of SO-J1A in 2 years was 33％.Oligoarthritis rate was 60％,while that of polyarthritis rate was 79％.The statistical analysis showed that different categories and RF level were significantly different in effectiveness and treatment failure (x2=31.6,P＜0.05; x2=5.488,P＜0.05).There was no significant difference in age,sex,duration before treatment,AKA,CCP,ANA between the two groups (P＞0.05).③ Logistic regression analysis showed that different categories of JIA and RF levels were correlated with therapy,P＜0.05.The relative risk (OR) value of different categories of JIA was 2.983 (P＜0.05).Negative RF might be the predictive factor for treatment response (OR =0.029,P＜0.05).④ Eight cases (2％) had recurrence and other adverse reations during treatment,the majority (7 cases) was SO-JIA.Conclusions ① The long-term therapeutic effect and safety for oligoarthritis and Polyarthritis by rhTNFR:Fc are better than SO-JIA.② Negative RF maybe the factor associated with favourable rhTNFR:Fc efficacy.③ The long-term safety of rhTNFR:Fc for SO-JIA is good.Physicians should be cautious to infection and other adverse reactions.

BACKGROUND: The soft tissues would shrink with nasal framework collapse following surgical trauma, which cause aseptic inflammation, lead to parts of cartilage resorption. Accordingly, long-term saddle nose deformity usually accompanied by short nasal columella. Complications such as skin perforation or ulceration would appear if corrected the deformity using medical silicone rubber with large tension.OBJECTIVE: To explore the effectiveness of repairing post-traumatic saddle nose deformity with autologous costal cartilage transplantation.METHODS: A total of 21 cases with post-traumatic saddle nose deformity accompanied by short nasal columella were selected, including 6 males and 15 females, aged 16 45 years. All of the cases had trauma history and agreed with the treatment. The costal cartilage was obtained from the seventh rib and formed to babylon weeping willow leaf shape and columella nasi stent to repair post-traumatic saddle nose deformity. The "V-Y" progradation suture was used in the philtrum introcession and the botton of nasal columella to extend the nasal columella. The recovery of saddle nose deformity after transplantation, discharge of transplanted cartilage, as well as the incision scar status was observed.RESULTS AND CONCLUSION: The results were satisfactory and there were no complications after transplantation. All the cases were followed up from 6 months to 2 years. No case suffered costal cartilage grafts discharge or chondral deformation. The scar was little at the bottom of nasal columella. It is an ideal method for repairing post-traumatic saddle nose deformity using transplantation of autologous costal cartilage with "V-Y" progradation suture.

Objective To study the relation between phlegm-damp retention type of metabolism syndrome and microcosmic indices in order to find out the objective evidence for TCM syndrome differentiation.Methods Totally 49 cases of metabolism syndrome were observed,25 of them were phlegm-damp retention type in differentiation and 24 were non-phlegm-damp retention type.The height, body weight,waistline and blood pressure of two groups were measured,the serum leptin,insulin and blood lipid were determined, and the insulin resistance index(IRI)and body mass index(BMI)were calculated.Results The leptin,BMI,systolic pressure,FINS and IRI of the phlegm-damp retention group were all higher than those of the non-phlegm-damp retention group.Conclusion BMI, leptin,insulin,and IRI may be taken as the the index of syndrome differentiation in metabolism syndrome.