Uveitis is the most common extra-articular manifestation of juvenile idiopathic arthritis, typically as chronic anterior uveitis with insidious onset. Delayed and inadequate treatment may result in loss of patients' vision and even blindness. For refractory or severe uveitis related to juvenile idiopathic arthritis, systemic immunosuppressive agents should be used as early as possible. With the advantage of controlling ocular inflammation, avoiding ocular complications and reducing the use of traditional immunosuppressant drugs and glucocorticoid, tumor necrosis factor-α inhibitors have been new therapeutic options for uveitis associated with juvenile idiopathic arthritis, although methotrexate is known as the first-line approach. However, there are no internationally unified guidelines for clinical issues regarding the timing of application, reduction and withdrawal of tumor necrosis factor-α inhibitors, and no agreement on the application of tumor necrosis factor-α inhibitors in the management of ocular complications either. An in-depth understanding of the application status and progress of tumor necrosis factor alpha inhibitors in the treatment of juvenile idiopathic arthritis-associated uveitis has important clinical significance.

Objective: To investigate the application of conventional ultrasound and 16-slice CT examination in clinical diagnosis of hepatocellular carcinoma (HCC) and hepatic focal nodular hyperplasia. Methods: To choose 94 cases patients were receiving treatment in our hospital who were diagnosed as hepatic focal lesion through percutaneous biopsy of hepatocyte or histopathological examination of postoperation, and then take conventional ultrasound and 16-slice CT, respectively, to detect them. To compare and analyze the two methods in series of indicator, such as accuracy, the number of lesion size and the imageology character. Results: Conventional ultrasound diagnosis of benign tumor lesions was consistent with spiral CT results, and the difference was not statistical significance (x2=0.5556, P>0.05). The accuracy of spiral CT for hepatic carcinoma was higher than that of conventional ultrasound, and the difference was significant (x2=8.1987, P<0.05). The consistent rate of the spiral CT group with real result for micro-miniature carcinoma (the diameter less than 1 cm) was higher than that of conventional ultrasound group, and their difference was significant (x2=14.4028, P<0.05). The disappear and persist time of hepatic carcinoma patients were longer than that of non-hepatic carcinoma patients, and the difference between them was significant (t=9.7531, P<0.05). Conclusion: It is higher accuracy that 16-spiral CT can diagnose malignancy lesions in earlier stage.

Objective To investigate the effect of nimesulide,a selective cyclooxygenase (COX)-2 inhibitor,on the chemoprevention of N-ethyl-N-nitro-N-nitrosoguanidine (ENNG)-induced gastric cancer in rat model. Methods Ninety-six male Wistar rats were randomized to drink the solution of ENNG (group M), ENNG/low dose nimesulide (group MN_L), ENNG/ high dose nimesulide (group MN_H), low dose nimesulide (group N_L), high dose nimesulide (group N_H) or water (group P). Eighty-nine(92.7%) rats completed the study and were sacrificed at (28?2) weeks. The animals were assessed for the presence of gastric cancer, COX-2 expression and precancerous changes in gastric mucosa. Results The incidence of gastric carcinoma in group M was 56.3% (9 /16), significantly higher than 7.4%(1/14)in MN_L group and 6.3%(1/16)in MN_H group( P

Objective To investigate the inhibitory effects of combined treatment of nimesulide, a selective cyclooxygenase-2 inhibitor, with 5-fluorouracil (5-FU) on gastric cancer cell lines and its pos-sible mechanisms. Methods The human gastric cancer cell lines MKN45 and MKN28 were used in the study. After 48 hours treatment with nimesulide or 5-FU alone or in combination, the cells growth was determined by MTT assay. Flow cytometry and FITC-Annexin-V/PI kit were used to determine the effect of drugs on the cell cycle and the apoptosis of gastric cancer cells. The expression of COX-2 mRNA was detected by RT-PCR. The expressions of apoptosis-associated protein Bax and Bcl-2 were detected by Western blotting. Results Different level of COX-2 mRNA expression was observed in MKN45 and MKN28 cell lines. Treatment of the two cell lines with nimesulide in combination with 5-FU can significantly reduce the expression of COX-2 mRNA. Nimesulide could inhibit the growth and induce apoptosis of gastric cells. Combined treatment of nimesulide with 5-FU resulted in a synergistic effect of inhibiting growth and inducing apoptosis. The synergistic inhibiting effect on cell growth was irrespective of treatment sequence, but the highest cytotoxity was obtained when the cell lines were treated with two drugs simultaneously. Treatment with 5-FU enhanced expression of the pro-apoptotic gene Bax, while nimesulide reduced expression of the anti-apoptotic gene Bcl-2, resulting in a significantly higher ratio of Bax-to-Bcl-2. Conclusions The combined treatment of nimesulide with 5-FU results in synergistic inhibiting effect on growth of gastric cancer cell lines, and inducing apoptosis by enhanced Bax-to-Bcl-2 ratio and suppression of COX-2 mRNA expression may be the mechanisms.

Objective To investigate the effects of H. pylori infection on cyclooxygenase 2 (COX 2) expression in gastric antral mucosa. Methods Antral biopsies were taken from 46 patients with chronic gastritis and H. pylori infection before and after anti H. pylori treatment. COX 2 protein was stained by immunohistochemical method. Gastritis and H. pylori infection status were graded according to the updated. Sydney system. Results Cytoplasmic staining of COX 2 protein could be detected in epithelial cell both before and after eradication of H. pylori . The mean percentage of the cells staining with COX 2 was significantly higher in H. pylori infected mucosa, compared with the mucosa after successful H. pylori eradication [(20.1?13.1)% vs (13.8?5.9)%, P

3 d) was only 1 in each. Conclusions In prevention or treatment of NRDS with PS,prophylactive indome-(thacin) reduces the rate of PDA,pulmonary hemorrhage and early death in preterm infants.

Objective To explore the value of neopterin (Np) in early diagnosis and risk stratification of sepsis.Methods A total of 82 patients admitted to the emergency department from April 2013 to February 2014 were enrolled in the study.They were divided into two groups:sepsis-free group (n =8) and sepsis group (n =74).Patients' APACHE Ⅱ scores were calculated within 24 hours after admission,and then their plasma levels of Np and procalcitonin (PCT) were detected and analysis was carried out to find the correlation between plasma levels of Np,PCT and acute physiology and chronic health evaluation Ⅱ score (APACHE Ⅱ score) in two groups.And 74 patients in sepsis group were further divided into three subgroups according to their APACHE Ⅱ score:Ⅰ subgroup (score ＜ 15,n =27),Ⅱ subgroup (score 15 to 24,n =32),and Ⅲ subgroup (score ＞ 25 or more,n =15).The differences in plasma Np and PCT levels were compared among three subgroups and correlation analysis of Np levels with PCT levels and APACHE Ⅱ scores was carried out.Results The plasma levels of Np,PCT and APACHE Ⅱ scores in sepsis group were higher than those in sepsis-free group (P ＜ 0.05).In sepsis group,the plasma levels of Np and PCT were gradually increased with the increasing severity of sepsis (P ＜ 0.05);In sepsis group,the plasma levels of Np,PCT and APACHE Ⅱ scores were positively correlated (P ＜0.01).The area under receiver operating characteristic curve (ROC) of Np was O.79 and the area under ROC of PCT was 0.75,both of which had high diagnostic accuracy.Conclusions Neopterin has greatly useful value in early diagnosis and risk stratification of sepsis.

Objective To study the characteristics of bone mineral density and bone metabolism in elderly men.Methods 220 male elderly hospitalized patients were selected and divided into three groups according to age:65-74 years group,75-84 years group and 85-94 years group.Bone mineral density and bone metabolic biochemical makers including serum parathyroid hormone (PTH),bone gla-protein (BGP) and 25-dihydroxy vitamin D (25-OH VD) were detected.Results The prevalence of osteoporosis was increased along with ageing in three groups (6.8％,12.0％ vs.22.9％,respectively,F=4.986,P＜0.05).The characteristics of bone metabolism showed that serum PTH level was increased and serum levels of BGP,25-OH VD were decreased along with ageing (F =4.986,3.245,5.997,all P＜0.05),and the levels of BGP,25-OH VD were generally decreased in elderly men.Conclusions The prevalence of osteoporosis is high in elderly men.Bone metabolism can be used as the auxiliary index for osteoporosis risk assessment,which is helpful for the early diagnosis of primary osteoporosis.

AIM To study the effects of Scutellarin on glutathione peroxidase and thioredoxin reductase gene expression and activities in liver, kidney and testis tissues of rats supplemented with upper limit intake (UL) of Se. METHODS RT PCR and enzyme activities were used to determine GSH Px and TR mRNA levels and activities. RESULTS GSH Px and TR mRNA levels and activities were remarkably decreased in livers of rats supplemented with UL Se. Scutellarin significantly increased GSH Px and TR mRNA levels and activities in livers of rats supplemented with UL Se. No significant effects were found in rats treated with only Scutellarin as compared with the control. There were also no significant effects of UL Se on GSH Px and TR mRNA levels and activities in rat kidney and testis. CONCLUSION Scutellarin effectively antagonized the decrease of GSH Px and TR mRNA levels and activities in rat livers due to supplementation with UL. The effect of UL on GSH Px and TR mRNA levels shows tissue specificity.

ObjectiveTo explore the early diagnostic value of pro-adrenomedullin (pro-ADM) in sepsis. Methods A prospective study was conducted. Eighty-two patients with acute infection admitted to Department of Emergency of Shanxi Medical University Second Hospital from April 2013 to March 2014 were enrolled. According to the diagnostic criteria of sepsis, the patients with acute infection were divided into ordinary infection group [infection without systemic inflammatory response syndrome (SIRS),n = 25] and sepsis group (infection combined with SIRS, n = 57). According to degree of severity of sepsis, the latter group was subdivided into three subgroups: sepsis group (n = 22), severe sepsis group (n = 27) and septic shock group (n = 8). Twenty-four healthy persons were included to serve as healthy control group. The venous blood from all the research objects in hospital was collected within 24 hours. The levels of pro-ADM and procalcitonin ( PCT ) were determined by enzyme linked immunosorbent assay (ELISA), and acute physiology and chronic health evaluationⅡ (APACHEⅡ) score was recorded. The relationship between pro-ADM and PCT and also APACHEⅡ score was analyzed with Pearson correlation analysis. The receiver-operating characteristic curve (ROC) of pro-ADM and PCT were used to evaluate the diagnostic acuity of sepsis.Results The plasma levels of pro-ADM, PCT and APACHEⅡ score in sepsis group were significantly higher than those in ordinary infection group and healthy control group [pro-ADM (ng/L): 66.69±1.73 vs. 53.43±2.70, 45.87±1.43; PCT (ng/L):1 336.49±40.26 vs. 1 083.09±47.99, 959.04±37.53; APACHEⅡ score: 14.60±0.81 vs. 8.10±1.14, 3.00±1.15,allP< 0.01]. With the aggravation of sepsis, the levels of pro-ADM, PCT and APACHEⅡ score were gradually increased, and there were significant differences among sepsis, severe sepsis, and septic shock groups [pro-ADM (ng/L): 64.91±2.50, 73.56±2.80, 84.67±4.52; PCT (ng/L): 1 152.65±48.62, 1 233.93±63.06, 1 475.71±109.93;APACHEⅡ score: 12.91±1.15, 14.55±1.14, 19.37±2.40,P< 0.05 orP< 0.01]. Pearson correlation analysis results showed that the level of pro-ADM was positively related with PCT (r = 0.473,P = 0.006), and it was also positively correlated with APACHEⅡ score (r = 0.707,P = 0.008). ROC curve analysis showed that area under the ROC curve (AUC) of pro-ADM for diagnosis of sepsis was 0.823 (P = 0.003). When the cutoff value was 59.40 ng/L, the sensitivity was 80.7%, the specificity was 68.0%, the positive predictive value was 85.2%, and the negative predictive value was 60.7%. AUC of the PCT for diagnosis of sepsis was 0.653 (P = 0.043). When the cutoff value was 1 194.67 ng/L, the sensitivity was 68.4%, the specificity was 64.0%, the positive predictive value was 81.8%, and the negative predictive value was 44.7%. It was proved that the pro-ADM had a higher diagnostic value for sepsis than PCT.Conclusion The plasma levels of pro-ADM can be used as an early indicator in diagnosis and severity evaluation and prognosis in patients with sepsis .