10.3969/j.issn.1000-3606.2013.06.023

Rheumatoid arthitis is a chronic idiopathic immunodeficient diease and its cause is uncertainty,it is hard to cure radically.Rescently years,the treatment of rheumatoid arthitis with supplementing and boosting the liver and kidney had got great successes.The authors will discuss the following aspects:compound formulas(including classical formula and present formula),traditional Chinese external treatment,treatment of combined traditional Chinese and Western medicine in order to lay a foundation in scientific research in the future.

Objective To observe the effect of catgut implantation at acupoint on treating cerebrovascular epilepsy and discuss the therapeutic mechanism. Methods 58 patients were divided into an observation group and a control group. The control group was treated with sodium valproate, and the observation group was treated with catgut implantation at acupoint on the basis of the control group.Epilepsy scoring, sodium valproate adverse reactions, the change of blood concentrations of sodium valproate and curative effect evaluation and so on were observed before and after the treatment. Results The basic control and excellent rate in the observation group were 16.7%and 73.3%, better than the control group of 10.7%and 53.6% respectively. The epilepsy scoring and sodium valproate adverse reactions after treatment in the observation group were superior to the control group [observation group is(5.05±1.5),(5.09±1.53),control group is(6.40±1.74),(10.85±1.91),P<0.05]. The number of patients with blood concentrations of sodium valproate in range 50-100 mg/L after treatment was increased in the observation group(Z=2.07, P=0.038). Conclusion Catgut implantation at acupoint combined sodium valproate was more effective than sodium valproate in treating cerebrovascular epilepsy, which can obviously alleviate the adverse reaction of drugs and increase blood concentrations of sodium valproate.

Objective To study the esophageal motor function in patients with reflux esophagitis (RE) and Barrett esophagus ( BE). Methods Patients with reflux esophagitis and Barrett esophagus which were diagnosed by endoscopy were recruited for symptomatic investigation, Twenty-seven patients with RE, 18 patients with BE and 12 non-reflux patients as controls were recruited prospectively for stationary esophageal manometry and 24-hour ambulatory esophageal pH monitoring. Results Besides dysphagia, the symptom scores of heartburn, acid regurgitation and retrosternal pain in BE groups were lower than those in RE groups (P 0. 05). DeMeester score of 24-hour ambulatory esophageal pH monitoring, total times of pH

Objective To investigate the value of partial hepatectomy in the treatment of hilar cholangiocarcinama( HCC). Methods In this report, 42 patients with hilar cholangiocacinoma treated surgically were analyzed retrospectively. Results Of the 42 patients, 34 cases (81%) underwent surgical resection. In these 34 cases, 15 cases were treated by local resection, 8 cases by a combination of right lobectomy, 3 cases by left lobectomy, 4 cases by left lobectomy and caudate lobectomy, 1 case by left lateral lobectomy and caudate lobectomy, 3 cases by quadrate lobectomy. Curative resection was performed in 25 patients. The median survival rate in patients with curative resection was 28 months, while that with palliative operation was 14 months. The 1-, 2-, and 4-year survival rates of curative resection were 90% , 73% , and 28% , respectively. The 1-, and 2-year survival rates of palliative operation were 57% , and 27%. Conclusion Survival rates in patients with curative resection were better than that of palliative operation. Radical resection in many cases demands a combined liver resection.

256 mg/L) are resistant to metronidazole by two tests. The level of transcripts of rdxA genes significantly reduced the total RNA in Helicobacter pylori grown with metronidazole compared to that without metronidazole. And the expression of the galE gene used as the control was unchanged. Conclusion The low expression of the rdxA gene may play a role in the development of metronidazole high resistant Helicobacter pylori isolates.

8 mg/L). The rdxA gene fragment (886 bp) of H. pylori was amplified by PCR and then sequenced. Finally polymorphism analysis was performed in the rdxA gene sequence from those strains resistant or susceptible to Mtz and standard strains H.pylori 26695. Results A total of 47 H.pylori strains were isolated from 51 patients positive for rapid urease test. Mtz resistance rate was 34% by E-test method and 31.9% by breakpoint susceptibility testing. Among them 15 strains were resistant to Mtz by the two tests. The rdxA genes of both 15 strains resistant to Mtz and 8 strains susceptible to Mtz were sequenced. Compared with that of strain H.pylori 26695, the sequence of rdxA gene nucleotide in 15 H.pyloristrains resistant to Mtz showed similarity ranging from 90% to 95% and being 92.5% on average, and the sequence of rdxA gene nucleotide in susceptible strains showed similarity ranging from 94% to 95% and being 94.5% on average. In most resistant strains, the rdxA genes occurred point mutation, single nucleotide insertion or deletion, however, the insertion or deletion of large nucleotide fragment were rare, and mutational site were variable. Conclusions The rdxA gene mutation in H.pylori strains resistant to Mtz may result from point mutations in several bases or insertional mutations or deletional mutations in one base, without insertion or deletion of large neuclectide fragment, and mutational position being variable.

Objective To explore the effect of panaxadiols saponin (PDS) on the oxidative damage in lung tissue in hemorrhage-lipopolysaccharides (LPS) two hits rats. Methods Forty Wistar rats were divided randomly into 4 groups: sham operational group(S group); two hits groups with hemorrhage-LPS(HL group);dexamethasone preventive therapy group (HLD group) ;panaxadiol saponins preventive therapy group(HLP group). The rats were made first-hit by hemorrhagic shock,LPS were administered intraperitoneally to make endotoxic shock and induce two hits in rats,then the model of acute lung injury (ALI) induced by two hits had been built up successfully. NO-2/NO-3,MDA content and NOS,iNOS,SOD activities were measured by 722S spectrophotometer. Results The results of pathological observation showed that there was obvious inflammatory reaction in lung tissues after two-hits,and the structure was destroied.Compared with HL group,the inflammatory reaction was reduced in HLD group and HLD group.NOS,iNOS activities and NO-2/NO-3,MDA contents were increased significantly,and SOD activity was significantly lower in HL group compared with S group(P

Objective To investigate the value of conventional ultrasound combined with contrast‐enhanced ultrasound in qualitative diagnosis of benign and malignant cervical lymph nodes (LNs) .Methods Totally 129 enlarged LNs in 112 cases were performed the 2‐dimensional ,color Doppler ultrasound ,and grey‐scale contrast‐enhanced ultrasound(CEUS)examinations .LNs were divided into the benign group and malignant group according to pathologic results .The aspect ratio ,eccentric medulla or medulla de‐fect ,echo type ,blood supply distribution ,contrast‐enhancement pattern and distribution equilibriuym of contrast agent were com‐pared between the two groups .Results The most of aspect ratio in the benign LNs group were ≥ 2 ,the cortex and medulla were uniform with symmetric increase and without microcalcification ,the blood supple was mainly the non‐blood flow type or hilar type , in contrast‐enhanced ultrasound ,the majority were the early hilar and medullar enhancement ,showing the centrifugally full filling ;the most of aspect ratio in the malignant LNs group were <2 ,medulla was eccentric or loss ,partial of LNs showed the increased parenchymal echo accompanied with cystic lesion and microcalcification ,the blood supply was mainly the peripheral and mixed types ,and the non‐hilar and medulla started enhancement pattern .The ultrasonographic parameters mentioned above were statisti‐cally different between the two groups ,in which the non‐hilar and medulla started enhancement patterns had the highest sensitivity and accuracy for diagnosing malignant LNs ,the positive predictive values of these parameters were higher ,whereas the negative predictive values were lower .Conclusion The conventional ultrasound combined with contrast‐enhanced ultrasonography has a higher practical value in qualitative diagnosis of cervical LNs ;the comprehensive judgment of multiple indicators can increase the differentiating ability for benign from malignant LNs .

Objective:To summarize the development of the HIV/AIDS designated hospital system, analyze the main issues and explore solutions for this system. Methods:184 leaders/experts of three levels of healthcare facilities ( provinces, cities and counties) from 30 provinces engaged in AIDS prevention and control for over five years, and 2,432 people living with HIV/AIDS(PLWHA) from seven provinces were investigated through two different question-naires. Results:According to the staff responses, the issues of surgery and hospitalization are difficult and outstand-ing for PLWHA due to the current designated hospital system with scores of 6. 49 in severity. Of the ten largest prob-lems, ranked third is the need for improved AIDS prevention and control. 2 367 (97. 3%) PLWHAs had an aware-ness of the designated hospitals, 1,376 received treatment in the designated hospitals, and 85. 5% believed that the illness was effectively treated, while 9. 0% thought that the medical technology of the designated hospital was limited;18 . 7% of hospitalized HIV/AIDS patients or those who received surgery experienced prevarication by the non-des-ignated hospitals. Policy analysis shows that China’s designated hospital system for PLWHA has developed gradually with the characteristics of periodic and temporary changes. Conclusion:The designated hospital system for PLWHA in China has played an important role, but there are still several problems. The government should improve the existing system by strengthening the comprehensive medical service capacity of designated hospitals, improving the mechanism of consultation and referrals, coordinating the non-designated hospitals to provide technical support, reducing dis-crimination and fear from medical staff against HIV/AIDS, decreasing the risk of occupational exposure, and enhan-cing the communication among hospitals, CDCs and patients.