ObjectiveTo compare the clinical disease activity index (CDAI) and simplified disease activity index(SDAI) as well as disease activity score 28(DAS28) by assessing the activity of rheumatoid arthritis (RA) and to explore which one is better.MethodsTwo hundred RA patients were enrolled.Swelling joint counts (SJC),tenderness joint counts(TJC ),patient's and doctor's global assessment of disease activity based on visual analogue scale(PGA,PhGA),health assessment questionnaire(HAQ) were recorded and the erythrocyte sedimentation rate(ESR),C reaction protein (CRP) of each patient were tested.DAS28,CDAI,SDAI of all patients were calculated for all patients.Statistical analysiswas carried out by Pearson correlation for the association between DAS28 and the above parameters,as well as CDAI,and SDAI.We created 4 patient groups based on DAS28,CDAI and SDAI ranks and used kappa statistics to assess the level of overall agreement of different disease activity categories between any of the two indices above for individual patients.We assessed the discriminating validity using receiver operating characteristic(ROC) curve analysis to compare the ability of the CDAI and SDAI to discriminate betwecn patients with remission, low and moderate,high disease activity.ResultsOf all the patients,CDAI(17.2±11.1) and SDA[(19.1±11.6) were correlated with DAS28 (4.3±1.5),the correlation coefficients were 0.876,0.861 (P＜0.05) respectively.CDAI and SDAI were correlated with HAQ (0.6±0.7),as well as DAS28.The correlation coefficients were 0.522,0.523,and 0.482(P＜0.05).The Kappa of CDAI and SDAI was 0.777.The Kappa of CDAI and DAS28,SDAI and DAS28 were 0.482,0.394.The areas under ROC of CDAI and SDAI were 0.906,0.888 if DAS28 was used as the gold standard.ConclusionCDAI and SDAI as well as DAS28 can be used to assess the activity of RA and both are better correlated with HAQ than DAS28.Though there is no CRP in CDAI when compared with SDAI,CDAI has very goodoverall agreement with SDAI and the overall agreement of CDAI and DAS28 is better than SDAI and DAS28.In addition, CDAI is better in discriminating between patients with remission/low and moderate/high disease activity.So,CDAI is a simple,convenient,accurate,quick assessment tool and is suitable for daily application.

AIM: To explore the mechanism of immune tolerance to experimental autoimmune myasthenia gravis (EAMG) in nasally tolerized rats and Wistar rats. METHOD: [ 3H] thymidine incorporation and solid-phase ELISPOT assay were used. RESULTS: The stimulative index of lymphocyte proliferation responses to acetylcholine receptor (AChR) in popliteal and inguinal lymph nodes (PILN) of EAMG rats was higher than that of nasally tolerized rats on week 3, 5 and 7 post immunization (PI) with AChR plus complete Freund′s adjuvant (CFA), and was higher than that of Wistar rats on week 7 PI ( P

Objective: To assess the clinical effects of acupuncture treatment for primary dysmenorrhea. Methods: 80 cases of the patients were randomly divided into two groups by single blind to 40 cases in the acupuncture group were treated with acupuncture plus ginger-partitioned moxibustion. 40 cases in the medication group were treated with oral administration of Ibuprofen sustained release capsules. The therapeutic effects were observed after continuous treatment for 3 months. Results: The total effective rate was 85.0% in the acupuncture group and 70.0% in the medication group, with statistical significance in comparison of differences between the two groups (P<0.05) Conclusion: Acupuncture plus ginger-partitioned moxibustion is better than Ibuprofen sustained release capsules in treating dysmenorrhea.

Rheumatoid diseases (RD) are a group of diseases affecting bones,joints,and the surrounding soft tissues,such as muscle,synovial membrane,tendons,fascia,nervus.The etiology and pathogenesis are complicated.Since most RD are systemic diseases,traditional imaging techniques have limited value for the diagnosis and treatment monitoring of RD.18F-FDG PET/CT can display morphologic and metabolic information simultaneously,and is considered as a potential tool for the diagnosis of RD.This review summarizes the application of 18F-FDG PET/CT in RD,such as systemic vasculitis,relapsing polychondritis and rheumatoid arthritis.

Objective:To assess the effectiveness and safety of radiotherapy combined with surgery for gastric cancer compared with single surgery. Methods:We retrieved relevant randomized controlled trails in Cochrane Library (Issue 2, 2009), PubMed (Jan 1966-Jun 2009), EMBASE (Jan 1974-Jun 2009), Chinese Biomedical Literature Database (Jan 1978-Jun 2009), Chinese Science and Technology Periodicals Database (Jan 1989-Jun 2009) ,China National Knowledge Infrastructure (Jan 1994 to Jun 2009) and Wanfang database (Jan 1997-Jun 2009). Two researchers assessed the quality of included randomized controlled trials (RCT) and extracted data independently. The RevMan 5.0 software was used for Meta-analysis. Results:Nine RCTs including 1 548 patients were selected for Meta analysis. Five RCTs were related with comparison of preoperative radiotherapy plus surgery with single surgery. Two RCTs were about the comparison of surgery plus perioperative radiotherapy with single surgery. Two RCTs were the comparative studies between surgery plus postoperative radiotherapy and single surgery. The Meta analysis results showed that: (1)compared with surgery alone, preoperative radiotherapy combined with surgery can increase 3 years [OR = 1.78, 95% confidence interal (CI):1.14-2.78], 5 years (OR = 1.67, 95%CI :1.22-2.29),and 10 years (OR = 1.64, 95%CI 1.03-2.60) survival rate,and reduce the tumor recurrent rate(OR = 0.59, 95%CI :0.37-0.92) and metastasis rate (OR= 0.44, 95%CI :0.27-0.73); (2) The tumor recurrent rates (OR = 0.19,95%CI :0.03-1.14 )and tumor metastasis rates (OR = 0.09, 95%CI :0.00-1.77)had no difference between single surgery group and peri-operative radiotherapy plus surgery group;(3) Postoperative radiotherapy compared with surgery had no significant effects on 1 year (OR = 0.83, 95%CI :0.60-1.15) and 3 years (OR = 0.75, 95%CI :0.51-1.11) survival rate compared with single surgery, but the 5 years (OR = 0.57,95%CI :0.34-0.95) survival rate of the patients who received surgery alone was higher than those who received combined therapy. No difference of the tumor recurrence rate(OR=0.59,95%CI :0.33-1.05) and tumor metastasis rate (OR=0.90,95%CI:0.51-1.59) were observed between the two groups. Conclusion:Preoperative radiotherapy combined with surgery is more rational and effective than surgery alone in the treatment of gastric cancer. However in terms of the clinical effects of perioperative or postoperative radiotherapy combined with surgery, more RCTs with larger samples and higher quality need to be carried out to make further verification.

Objective To explore the mechanism of IL-6 in EAE. Methods 25 female Wistar rats were randomly divided into 2 groups, EAE group( n=15 ) and normal control group( n=10). The expression of IL-6, TNF-αtand TGF-β of the two groups rots were ob-served by immunohistochemistry staining, and then correlation analysis of the expression of IL-6, TNF-αtandTGF-β was made. Results There was negative correlation between gray scale of IL-6 and symptom scores( r=-0.953, P＞0.05). IL-6 and TGF-β had no statistical-ly significant correlation ( r=-0.492, P＞0.05). There was negative correlation between gray scale of TNF-α and symptom scores( r=-0.978, P＜0.05), and both of the correlation between TNF-α and TGF-β ( r=-0.502, P＞0.05), TGF-β and scores( r=0.470,P＞0.05 ) were not statistically significant. Conclusions IL-6 may participate in EAE as a inflammatory factor.

Objective This study evaluates the effectiveness for using acute plateletpheresis (APP) as a blood conservation method to reduce the need of blood transfusion and increase coagulation function in aortic arch surgery with deep hypothermic circulatory arrest (DHCA ). Methods Thirty-six type-A aortic dissections patients (male 31,female 5,age 23-65 years,ASA physical status II-IV)undergoing frozen elephant trunk with total arch replacement (Bentall plus Sun's surgery)were enrolled in the prospective randomized trial.The patients were randomized into two groups:regular blood conservation group (group control,n = 18)and group APP (n = 18).Blood sample was collected respectively after anesthesia induction (T1 ),before heparinization (T2 ),by the end of surgery (T3 )and 24 hours after surgery (T4 ).Data was collected and reviewed in terms of perioperative transfusion needs,normal laboratory examination,clinical outcomes including blood routine analysis (Hb,Plt,MPV,P-LCR)and thrombelastography (TEG-R,TEG-K,TEG-α,TEG-A,TEG-MA,TEG-EPL).Kaolin and heparinase detections were performed for TEG.Results Com-pared with T1 ,TEG-R,TEG-K,TEG-A,TEG-MA,TEG-EPL and Plt were significantly decreased while TEG-CI,MPV,P-LCR significantly increased in T4 in group APP (P <0.05 ).TEG-A,TEG-MA and Plt were significantly greater(P <0.05)in group APP than in group control at T2 ,and TEG-K,TEG-ELP and HBG were significantly less (P <0.05)in group APP than in group control at T3 . Conclusion The utilization of APP technique was associated with the improved coagulation function in aortic arch surgery with DHCA.

Objective To observe the clinical efficacy of glucocorticoidcombined with the eradication of helicobactepylori (HP) in the treatmenof idiopathithrombocytopenipurpura(ITP) and itinfluence on platelecounand cell subset.MethodNinety-foucaseof ITP were randomly divided into two group.The control group(47 cases) wagiven prednisone treatmen, while the observation group(47 cases) wagiven prednisone combined with HP eradication treatmen.The clinical effecand recur-rence rate within 1 yeawere observed ,and the changeof platelecounand cell subsetwere tested .ResultThe total effective rate of the observation group wa89 .36% ,which wasignificantly highethan 70 .21% in the control group ;the 1-yearecurrence rate in the observation group wa36 .17% ,which wasignificantly lowethan 72 .34% in the control group ,the differencebetween the two grouphad statistical significance (P＜0 .05) .The platelecounaftetreatmenin the two groupwere significantly in-creased ,platelet-associated antibody(PAIgG) level wasignificantly decreased ,buthe improvemenin the observation group wamore significant(P＜0 .05) .The percentage of CD3+CD4+ % increased significantly ,the percentage of CD3+CD8+ % wadecreased significantly ,buthe improvemenin the observation group wamore obviou(P＜0 .05) .Conclusion Glucocorticoidcombined with HP eradication treatmenin treating ITP hadefinitely clinical efficacy ,can increase the platelecoun,improve cell subsetimbalance ,and iworthy to be clinically promoted .

Objective To isolate and culture bone marrow mesenchymal stem cells (BMSCs) from patients with rheumatoid arthritis (RA) and examine their biological characteristics. Methods MSCs were isolated from bone marrow of RA patients and purified by density gradient centrifugation and cultured in vitro. The morphology, immunophenotype, and proliferative; property of BMSC and colony forming unit-fibroblast (CFU-F) were measured and analyzed. Results The culture expanded cells from RA patients presented a typical fibroblast-like morphology. Ceils were positive for SH2 (CD105), CD71, and CD44, but negative for CD45. Their proliferative capacity and CFU-F number were similar to those of BMSCs from healthy donors. Conclusion In respect to morphology, immuno-phenotype, proliferative property and colony forming unit-fibroblast (CFU-F), MSCs from bone marrow of RA patients are not different from those of MSCs isolated from bone marrow of normal donors. MSCs from the bone marrow of RA patients have the potential for clinical application.

BACKGROUND: The animals commonly used to induce experimental allergic encephalomyelitis (EAE) in oversea laboratory are rodentia animals such as Lewis rats. But in China we are short of Lewis rats. The un-susceptive animal Wistar rats are inexpensive and plentiful. The adding of pertussis toxin may induce EAE successfully in EAE un-susceptive Wistar rats.OBJECTIVE: To investigate the influence of pertussis toxin injected atdifferent sites in inducing EAE model in un-susceptive Wistar rats.DESIGN: A randomized control animal experiment.SETTING: Institute of Brain Science, Shanxi Datong University.MATERIALS: The study was performed in the Institute of Brain Science of Shanxi Datong University from March to October in 2003. Fifty-eight und adjuvant (CFA) group (n=10).METHODS: Besides routine immunization, each rat in the foot dorsum EAE group and intraperitoneal EAE group was administrated with 005 mL pertussis toxin (containing 5.0×1010 thalli), which were given intraperitoneally and subcutaneously on one hind foot respectively, and the antigen in the CFA group was replaced by CFA.cidence rate and tine of atta ck: In the foot dorsum EAE group, the incidence of EAE was 87.5% (21/24), and the time of attack was at (10.25 ±1.67) days after immunization, which were significantly different from those in the intraperitoneal EAE group [35.7% (9/24), (14.8±l.79) days, P sum EAE group, the change of body mass was (-16.00±7.30) g and the symptomscpre was 3.4±0.7, and those in the intraperitoneal EAE group Therewere no or little infiltration of inflammatory cells in the encephalon and spinal cord of CFA rats. In the EAE rats, there were inflammatory cells infiltrated in the boundary of white matter and gray matter of lumbar intumescence, spinal pia mater, spinal parenehyma, and the boundary of cerebral cortex and medulla, even deep medulla, meninges and around lateral ventricle. There were also mild inflammations in the cerebellum,brainstem and optic chiasma, which were concordant with the observed asynchronism, tic, etc. Hematoxylin and eosin (HE) staining displayed that the infiltrated mononuclear cells assembled in perivascular spaces, which were identified by morphological criteria as lymphocyte and macrophages.Forming typical muff-like changes, the inflammation was less severe in intraperitoneal EAE group than in subcutaneous foot dorsum EAE group.CONCLUSION: The EAE model induced in Wistar rats by Pertussis toxin administered subcutaneously on foot dorsum has the representative course of diseases, pathology change and clinical manifestation and the incidence of diseases is high and the cost is low. So it is a more ideal EAE model inducing method.