Objective To evaluate the role of anti-cyclic citrullinated peptide antibody(ACCP) and rheumatoid factor(RF) in patients with rheumatoid arthritis.Methods ACCP antibody and RF were detected in serum samples of 90 RA patients,30 other diseases patients and 35 healthy blood donors.The sensitivity,specificity,positive predictive value,negative predictive value,agreement rate and Youden`s index of these parsmeters for the diangnosis of RA were analyzed.We maped the receiver operative characteristic curve(ROC) and calculated area under the ROC curve.Results The positive rates of ACCP and RF were higher than those of patients with other diseases or healthy controls(P0.5).Conclusion ACCP is a valuable index for RA diagnosis.It is useful in improving the diagnostic accuracy of RA.

Rheumatoid arthritis(RA) is very common in immune rheumatism, with high disease incidence and long course, hard to cure. The medicines and bio-preparation used in treating RA in modern medicine are difficult to spread and for long application owing to their unsatisfactory effect or much toxic or side effects. However, the acupuncture has definite effect without side effects. As the unique therapy in acupuncture field—abdominal acupuncture, can it bear the task of treating RA The article makes analysis and discussion on its availability.

Objective To investigate the status of community type 2 diabetic patients with peripheral arterial disease,analyze the influencing factors and put forward nursing countermeasures.Methods 210 type 2 diabetic patients living in a community in Shanghai were enrolled in the investigation.ABI and arterial peak velocity were measured using Doppler blood flow detector,symptoms and signs of foot were assessed and related laboratory examinations,including HbA1c,HDL-C,LDL-C were tested.Results There were 49 cases of ABI ＜ 0.9.The proportion of abnormal color of foot skin,edema,abnormal pulsation of dorsal artery of foot and sense of coldness in group of ABI ＜ 0.9 were larger than group of ABI≥0.9.There was no statistical significance between the two groups in the pain at rest and intermittent claudication.Logistic stepwise regression analysis showed that age and LDL-C not up to the standard were risk factors of PAD and the peak of foot dorsal artery flow was a protective factor of PAD.Conclusions It's important to early screen for PAD and to adopt corresponding nursing measures on the basis of treatment.We hope to further prevent the development of PAD and effectively prevent diabetic foot.

Objective To study the clinical significance of detection of infectivity index in patients before transfusion. Methods A total of 12 863 patients in hospital were examined for hepatitis B virus surface antigen(HBsAg),anti-hepatitis C virus(anti-HCV),anti-AIDS virus(anti-HIV)and treponemiasis test(TRUST)before operation and transfusion. Results The positive rates of HBsAg,anti-HCV,anti-HIV and TRUST were 12.59%,1.90%,0.02%and 0.80%respectively.Conclusion The detection of infectivity index before transfusion has a very,important role in the prevention of blood transmissible disease and reduction or medical treatment dispute caused by infection after transfusion.

Objective To investigate the relationship between serum nesfatin-1 and gestational diabetes mellitus (GDM). Methods The serum nesfatin-1 concentrations were measured in 45 GDM patients and 44 NGT pregnant women , as well as 47 non-pregnant healthy women served as control. Serum nesfatin-1 were measured by sandwich enzyme linked immunosorbent assay (ELISA). Meanwhile FPG、 lipoid、 FFA、 FINS、 C-tide were also measured. Result Serum nesfatin-1 level in GDM were significantly higher in GDM patients than in NGT and control (P < 0.01), while serum nesfatin-1 in NGT was significantly lower than in control (P < 0.01). Correlation analysis showed that serum nesfatin-1 was positively correlated with FINS , C-tide , HOMA-IR , triglycerides FBG and OGTT 1 hour glucose, HbA1c (P < 0.05). Conclusion Serum nesfatin-1 level in pregnant women significantly decreas, while in GDM patients significantly increase. Serum nesfatin-1 level in pregnant women is positively correlated with Insulin resistance (IR) and triglycerides level.

Objective To evaluate the effects of transtheoretical model and motivational interviewing on medication?compliance in patients with percutaneous coronary intervention (PCI) post-operation. Methods One hundred patients with PCI post-operation were randomized into the observation group (n = 50) and the control group (n = 50). The medication compliance, 6-min walk test and major adverse cardiovascular events (MACE) were compared between two groups. Results At 1 month, 3 months and 6 months post-intervention, the medication compliance in the observation group was significantly increased (P < 0.05, respectively). The 6-min walk test in the observation group was significantly increased compared with the control group. The MACE rate in the observation group and the control group was 10.0% and 36.0%, respectively, with significant difference (P< 0.05). Conclusion The transtheoretical model and motivational interviewing can effectively increase the medication compliance, improve the postoperative rehabilitation, and decrease the MACE rate.

OBJECTIVE: To discuss the protective effect of captopril on the nicotine-induced impairment of endothelium-dependent relaxation(EDR) in rat mesenteric arteries and explore the possible mechanisms underlying the observed protective effects of captopril.METHODS: A total of 30 rats were randomly divided into 3 groups: normal control group,nicotine group(2 mg?kg-1),captopril group(nicotine 2 mg?kg-1+captopril 3 mg?kg-1).After treatment for 4 weeks,vasodilatation rate of mesenteric arteries,the content of NO and NOS,and the SOD activities in serum were measured.RESULTS: Nicotine significantly decreased the vasodilatation rate of mesenteric arteries and decreased the content of NO and NOS,SOD activities in serum(P

Objective To investigate the status of risk population of diabetic foot in community and analyze the influencing factors.Methods 210 diabetes patients living in a community in Shanghai were enrolled,acoording to Gavin's weighted integral method with risk factors of diabetic foot,Doppler blood flow detector,Semmes Weistein 5.07 (10 g) nylon monofilament and 128Hz tuning fork were used to screen for the risk population of diabetic foot.Results Risk population of diabetic foot were 174 patients (82.9％),wherein the low risk group were 112 patients (53.4％),in the middle and high risk group were 62 people (29.5％).In addition to the Gavin's diabetic foot risk factors,different ages,cultural degrees,the values of FBG,PBG and HbAlc would also affect the risk level of diabetic foot.While the values of FBG,PBG and HbAlc of diabetes patients in the moderate and high risk group were significantly higher than those in the normal group.Conclusions We should make early screening for risk factors of diabetic foot and strengthen health education and management in order to effectively prevent diabetic foot.

Objective:To investigate and analyze the effect of ubiquitin-editing protein A20 on monocytes activity in patients with ventilator-associated pneumonia (VAP).Methods:Twenty-four VAP patients (VAP group) and twelve healthy controls (control group) were included from the First Affiliated Hospital of Zhengzhou University between February 2019 and September 2019. Peripheral blood mononuclear cells (PBMCs) and bronchial alveolar lavage fluid (BALF) (both infection site and non-infection site) were collected from VAP patients, while PBMCs were collected from healthy controls. A20 level in CD14 + monocytes were measured. CD14 + monocytes and CD4 + T cells were purified from VAP patients. CD14 + monocytes were transfected by A20 siRNA. Transfected CD14 + monocytes were directly/indirectly co-cultured with autologous CD4 + T cells. The secretion of interferon-γ (IFN-γ) and interleukin-17 (IL-17) by CD4 + T cells was investigated. Transfected CD14 + monocytes were directly/indirectly co-cultured with NCI-H889 cells. Cytotoxicity, and cytokines/granzyme B level, and tumor necrosis factor-related apoptosis inducing ligand (TRAIL)/Fas ligand (FasL) level was assessed. Student t test or SNK-q test was used for comparison. Results:VAP group had elevated percentage of circulating CD14 +A20 + cells than control group [(66.14±19.62)% vs. (52.52±13.71)%, P<0.05], and also had increased A20 mean fluorescence intensity (MFI) than control group [(268.0±72.56) vs. (197.4±60.01), P<0.05]. The percentage of CD14 +A20 + cells in BALF from infection site was higher than from non-infection site in VAP group [(66.14±19.62)% vs. (52.52±13.71)%, P<0.05], while A20 MFI in infection site was also up-regulated compared with non-infection site [(268.0±72.56) vs. (197.4±60.01), P<0.05]. In direct contact co-culture, A20 siRNA transfected CD14 + monocytes, which were purified from peripheral blood and BALF of VAP patients, induced elevated percentage of IFN-γ and IL-17 secreting CD4 + T cells than un-transfection or control siRNA transfection ( P<0.05). However, there were no significant differences of CD4 +IFN-γ + or CD4 +IL-17 + percentages among un-transfection, control siRNA transfection, and A20 siRNA transfection ( P>0.05). A20 siRNA transfected CD14 + monocytes, which were purified from peripheral blood and BALF of VAP patients, induced increased target cell death in both direct and indirect contact co-culture than un-transfection or control siRNA transfection ( P<0.05). Tumor necrosis factor-α, IL-6, granzyme B level and TRAIL MFI was also up-regulated ( P<0.05). There was no remarkable difference of target cell death between direct and indirect contact co-culture ( P>0.05). Conclusions:A20 was increasingly expressed in monocytes of VAP patients, and might dampen the activity of monocytes.

Objective To compare the effectiveness and safety of different intracranial stents assisted coil embolization of intracranial aneurysms and to discuss the selection of different stent assisted embolization of intracranial aneurysm.Methods From 2007 April to 2012 April,118 cases (a total of 128 wide-neck aneurysms) with intracranial aneurysms were analyzed retrospectively.This included the use of 70 neuroform,38 Enterprise,and 20 Solitaire AB stents forthe treatment of intracranial aneurysms.The successful use,aneurysm occlusion at the immediate post-operation,and early period of peri-operative complications were recorded from those clinical data in order to assess the effectiveness and safety of the different intracranial stents,which assisted coil embolization of intracranial aneurysms.Rank sum test and x2 test were used for statistics.Results Three aneurysms assisted with Neuroform stent were planted unsuccessfully,and the Enterprise and Solitaire stents were placed successfully.The embolism results of three stents after immediate postoperative angiography aneurysm: Neuroform stent occlusion rate was 40.0％ (28/ 70),the tumor residual rate was 38.6 ％ (27/70),and the partial embolization rate was 21.4 ％ (15/70) ; The Enterprise stent occlusion rate was 42.1％ (16/38),the tumor residual rate was 36.8 ％ (14/38),and the partial embolization rate was 21.1％ (8/38).The Solitaire AB stent occlusion rate was 40.0 ％ (8/20),the tumor residual rate was 35.0 ％ (7/20),and the partial embolization rate was 25.0 ％ (5/20).There were not significant differences in aneurismal occlusion (H =0.12,P ＞ 0.05).Early peri-operative complications results were: Neuroform stent occurred in 7,Enterprise frame in 4,and Solitaire AB stent occurred in 2.There were no significant differences in the incidence of complications in the early period after coiling (x2 =0,P ＞ 0.05).Conclusions Three kinds of intracranial stents assisted embolization of intracranial aneurysms are applied safely and effectively.The stent may be chosen according to morphology of parent artery and stent biological character.