A 54-year-old man was admitted to the Department of Rheumatology in Peking Union Medic.al College Hospital due to polyarthritis.back pain and multiple subcutaneous masses.He had symmetrical polyarthritis at onset.which was diagnosed as theumatoid arthritis.His follow-up and treatment were irregular.Back pain and multiple subcutaneous masses developed 2 year ago.Erythrocyte sedimentation rate and C-reac.tive protein were elevated.Rheumatoid fac.tor and Anti-cylic citrullinated peptide antibody were positive.No evidence of infection or malignancy was detected.Chest CT suggested pulmonary fibrosis and osteolytic lesions of stemum.Spinal MRI showed paravertebral soft tissue.Biopsy of the soft tissue suggested the pathologic.al finding of a theumatoid nodule.The patient was diagnosed as theumatoid arthritis complic.ated with multiple theumatoid bursal cysts.Combination therapy of methylprednisolone (40mg/d) and cyclophosphamide (0.4g/w) lead to a rapid improvement of clinical symptoms and laboratory parameters.The patient was still in remission at 6-month follow-up.

Objective To explore the application of Oxybuprocaine Hydrochloride Gel in colonoscopy examination. Methods 1000 patients received colonoscopy examination were randomly divided into experimental group and control group, 500 cases in each. Oxybuprocaine Hydrochloride Gel was applied on anal region in the experimental group before endoscopy for perianal anesthesia and lubrication. Paraffin oil was used in the control group to lubricate perianal and enteroscopy. The success rate of primary insertion, visual analogue pain score (VAS) score, examination time and postoperative complications were compared between the two groups. Results In the experimental group, the success rate of primary insertion (95%) was higher than that of the control group (76%), and the pain score was lower than that of the control group.The examination time was shortened, and the difference was statistically significant (P < 0.05). Conclusions Oxybuprocaine Hydrochloride Gel applied to colonoscopy can effectively reduce the patient's pain and discomfort, improve the success rate of primary insertion, shorten the examination time. And the method is worthy of clinical popularization and application.

Objective:To evaluate the effect of tropisetron on pyroptosis in cardiomyocytes subjected to hypoxia-reoxygenation (H/R) and the relationship with α7 nicotinic acetylcholine receptor (α7nAChR).Methods:Routinely cultured H9C2 cardiomyocytes were divided into 4 groups ( n=6 each) using a random number table method: control group (C group), H/R group, tropisetron plus H/R group (Tro+ H/R group), and α7nAchR antagonist MLA plus tropisetron plus H/R group (MLA+ Tro+ H/R group). H/R was produced by 12 h exposure of cells to hypoxia followed by 6 h reoxygenation in the other three groups except group C. Tropisetron at the final concentration of 10 nmol/L was added at 1 h before hypoxia in group Tro+ H/R.In group MLA+ Tro+ H/R, MLA was added at 2 h before hypoxia, and then 1 h later tropisetron at the final concentration of 10 nmol/L was given.At 6 h of reoxygenation, the pyroptosis rate of cardiomyocytes was determined by fluorescence immunostaining of caspase-1-AlexaFluor 488/DAPI, the concentrations of interleukin-1beta (IL-1β) and IL-18 in the supernatant were determined by enzyme-linked immunosorbent assay, the activity of LDH in the supernatant was measured by 2, 4 dinitrophenylhydra-zine colorimetric method, and the expression of α7nAchR, NLRP3 and caspase-1 in cardiomyocytes was detected by Western blot. Results:Compared with group C, the pyroptosis rate, activity of LDH and concentrations of IL-1β and IL-18 in the supernatant were significantly increased, the expression of NLRP3 and caspase-1 was up-regulated, and the expression of α7nAchR was down-regulated in group H/R ( P<0.05). Compared with group H/R, the pyroptosis rate, activity of LDH and concentrations of IL-1β and IL-18 in the supernatant were significantly decreased, the expression of NLRP3 and caspase-1 was down-regulated, and the expression of α7nAchR was up-regulated in group Tro+ H/R ( P<0.05). Compared with group Tro+ H/R, the pyroptosis rate, activity of LDH and concentrations of IL-1β and IL-18 in the supernatant were significantly increased, the expression of NLRP3 and caspase-1 was up-regulated, and the expression of α7nAchR was down-regulated in group MLA+ Tro+ H/R ( P<0.05). Conclusion:α7nAchR is involved in the process of tropisetron inhibiting pyroptosis in cardiomyocytes subjected to H/R.

Objective To observe the effect of electric acupuncture on the infarct volume and amount of cerebral cortex and spinal neuron at different times of cerebral ischemia/reperfusion(I/R)in stroke prone renovascular hypertensive rats(RHRSP)with middle cerebral artery occlusion(MCAO),and investigate the possible mechanisms of electric acupuncture on remote damage in ischemic stroke. Methods 480 male SPF Sprague-Dawley(SD)rats were duplicated to form the RHRSP models by clamping both kidneys. 370 successful ones were selected by taking the tail artery blood pressure,and divided into hypertension group and sham operation group(each n=60)by random number table method. The MCAO models were created by stringing middle cerebral artery in the remaining RHRSP. The nerve function defect score(NDS)was graded by Longa 5 point method after the rats waked up from anesthesia,then the ones scored 1-3 were enrolled. Totally,there were 190 rats with MCAO successfully created from which 10 were randomly selected to determine the infarct size by 2,3,5-triphenyl four azole nitrogen chloride(TTC)staining. The remaining 180 MCAO rats were randomly divided into model group,electric acupuncture group and fake acupuncture group(each n=60). The sham operated group only received surgical trauma;the electrical acupunctures atBaihuiandDazhuiacupoints on Du channel were performed on the day of model establishment in electric acupuncture group,once a day for 28 days;in fake acupuncture group,sticked the acupuncture needles at the skin ofBaihuiandDazhuipoints,then gived the same electrical acupuncture treatment. On 1,7,14 and 28 days after treatment,the rats of each group were respectively sacrificed,and the brains were collected,then the infarct volume and spinal neuron number were calculated by Nissl staining. Results ①Cerebral infarction volume:No infarcts were found in hypertension group and sham operated group. On 1 day and 7 days after MCAO,the infarct volumes were increased gradually in model group,electric acupuncture group and fake acupuncture group〔infarct volumes on 1 day were(12.36±0.11)%, (12.19±0.15)%,(12.24±0.16)%,and on 7 days were(20.01±0.24)%,(19.54±0.61)%and(19.77±0.25)%, respectively〕,and on 14 days and 28 days after MCAO,the infarct volumes were decreased gradually〔infarct volumes on 14 days were(17.18±0.23)%,(16.96±0.11)%,(17.08±0.62)%,and on 28 days were(14.38±0.21)%, (13.95±0.46)% and(14.29±0.37)%,respectively〕,but the differences among three groups had no statistical significance(all P>0.05). ② Cortex area:On 1 day after MCAO,the differences in the cortical neuron numbers among all groups were not statistically significant(all P>0.05). On 7,14,28 days after MCAO,the cortical neuron number of sham operated group was more than that of hypertension group,but the difference had no statistical significance(all P>0.05). Compared with sham operated group,the cortical neuron number in model group began to increase significantly after 7 days;compared with model group,the cortical neuron number in electric acupuncture group was increased obviously(cell/HP,7 days:75.48±2.41 vs. 68.78±1.42,14 days:61.32±2.60 vs. 48.78±1.41,28 days:53.65±1.46 vs. 28.78±1.21,all P<0.05),while the cortex neuron number of fake acupuncture group was markedly reduced(7 days:67.75±1.43,14 days:47.50±1.25,28 days:27.50±1.25), but the differences had no statistical significance(all P>0.05).③Spinal cord area:On 1,7,14 days after MCAO, the differences of the spinal cord neuron numbers among all groups were not statistically significant(all P>0.05). On 28 days,compared with hypertension group,the cord neuron number of sham operated group was increased,but the difference had no statistical significance(P>0.05). Compared with model group,the cord neuron number in electric acupuncture and fake acupuncture groups was inecreased(cell/HP:21.32±1.60,16.17±1.05 vs. 15.02±1.18),the difference being statistical significant in electric acupuncture group(P<0.05)but no statistical significance in fake acupuncture group(P>0.05). Conclusions Generally,the secondary spinal(cervical part)neuron death occurs after cerebral infarction in rats. The therapeutic action of electric acupuncture may reduce the secondary spinal neuron damage at remote site after cerebral infarction,that is possibly the mechanism of electric acupuncture for the protection of brain in hypertensive rats from I/R injury.

Objective To develop a method of detecting dry blood spot (DBS) samples collected in the filter paper by using Surface Enhanced Raman Spectroscopy (SERSp,also known as Raman molecular fingerprint spectrum) technology.The possibility and reliability of applying the technology to the newborn screening of congenital hypothyroidism (CH) was investigated.Methods The case-control study was used.The results of CH-hTSH screening test based on the DBS samples collected in the filter paper,and the clinical diagnosis were all provided by neonatal screening center of Shanghai Children's Hospital.The results of SERSp analysis were provided by Dalian University of Technology.Six positive and six negative samples,which were confirmed respectively by CH-hTSH screening using time resolved fluoroimmunoassay (TRFIA) were chosen.With the spectrum lines of 725 cm-1 as internal standard,the SERSp from the aqueous solution of these samples were analyzed.The specific spectrum line analysis,the principal component analysis (PCA) and the scatter diagram of PCA were used to compare the results of TSH test.Results With the spectrum lines of 725 cm-1 as internal standard,the CH specific spectrum lines of 1373 cm-1 and 1400 cm-1 were discovered.They showed the most significant difference of the peak height between the positive and negative samples of CH,while TSH specific spectrum lines of 785 cm-1,827 cm-1 and 853 cm-1 failed to distinguish positive from negative samples with distinct peak height.The consistency between the results of CH-Raman Screening and CH-hTSH Screening was 91.7％ (11/12),which was proven by PCA,the scatter diagram of PCA and the specific spectrum line analysis.The sensitivity of CH-Raman Screening was 100％ and the specificity was 83.3％.Conclusion There is a new CH-Raman Screening method using the SERSp analysis,which was proven to be a promising technology in the newborn screening of congenital hypothyroidism with the DBS in the filter paper.

Objective To evaluate the effect of exogenous hydrogen sulfide (H2S) on mitochondrion-dependent apoptosis in lung tissues of rats with endotoxemia.Methods Forty healthy male SpragueDawley rats,aged 2-3 months,weighing 250-310 g,were divided into 5 groups (n=8 each) using a random number table:control group (group C),lipopolysaccharide (LPS) group,low dose sodium hydrosulphide (NaHS) group (group L-NaHS),moderate dose NaHS group (group M-NaHS) and high dose NaHS group (group H-NaHS).Endotoxemia was induced by Ⅳ LPS 5 mg/kg in chloral hydrate-anesthetized rats.The equal volume of 0.9％ sodium chloride solution was intravenously injected in group C.NaHS (an exogenous donor of H2S) 0.78,1.56 and 3.12 mg/kg were intraperitoneally injected at 3 h after LPS injection in L-NaHS,M-NaHS and H-NaHS groups,respectively.The rats were sacrificed at 6 h after injection of LPS or 0.9％ sodium chloride solution,and lungs were removed for examination of the mitochondrial ultrastructure of lung tissues and for determination of apoptosis in lung cells (by flow cytometry) and expression of caspase-3,caspase-9,Bcl-2 and Bax protein and mRNA in lung tissues (by Western blot or real-timne polymerase chain reaction).The apoptosis rate and ratio of Bcl-2 expression to Bax expression (Bcl-2/Bax ratio) were calculated.The expression of cytochrome c (Cyt c) in cytoplasm and mitochondria of lung tissues was detected by Western blot.Results The apoptosis rate was significantly increased,the expression of caspase-3,caspase-9,Bcl-2 and Bax protein and mRNA was up-regulated,Bcl-2/Bax ratio was decreased,the expression of Cyt c in cytoplasm was up-regulated,and the expression of Cyt c in mitochondria was down-regulated in group LPS (P ＜0.05 or 0.01).Compared with group LPS,the apoptosis rate was significantly decreased,the expression of caspase-3 and Bax protein and mRNA was down-regulated,the expression of Bcl-2 protein and mRNA was up-regulated,Bcl-2/Bax ratio was increased,the expression of Cyt c in cytoplasm was down-regulated,and the expression of Cyt c in mitochondria was up-regulated in L-NaHS,M-NaHS and H-NaHS groups,the expression of caspase-9 protein and mRNA was significantly down-regulated in M-NaHS and H-NaHS groups,and the expression of caspase-9 was significantly down-regulated (P ＜0.05 or 0.01),and no significant change was found in caspase-9 mRNA expression in group L-NaHS (P＞0.05),and the damage to mitochondrial ultrastructure was significantly mitigated in MNaHS and H-NaHS groups.Conclusion The mechanism by which exogenous H2S inhibits cell apoptosis in lung tissues may be related to inhibition of mitochondrion-dependent apoptosis in rats with endotoxemia.

Objective To investigate the biological effects of Wnt gene in kidney cancer Caki?2 cells. Methods The Wnt gene was silenced in kidney cancer Caki?2 cells by lentivirus vector. The cell proliferate ability of cells in each group were assayed by CCK?8 kit at different time points. The apoptosis of Caki?2 cells was observed after silencing Wnt gene by transmission electron microscope. The invasion ability of each group cells was tested using Transwell chambers. The genes expression changes of Wnt/β?catenin signaling pathway and apoptosis related gene were determined by realtime PCR. Results Compared with the other two groups,the cell proliferate ability of the cells after silencing Wntgene was suppressed,and the difference was statistically significant(P<0.05). Apoptosis increased significantly in shRNA+Caki?2+Wnt group cells with silencing of Wntgene, and apoptotic body appeared in these cells. In invasive experiment,the number of emigrated cells in shRNA+Caki?2+Wnt group were significantly lower than other groups(P<0.05). The expression of Wnt mRNA,β?catenin mRNA and Bcl?2 mRNA in shRNA+Caki?2+Wnt group cells was lower than other groups(P<0.05). Conclusion Silencing of Wnt gene of kidney cancer Caki?2 cells can affect the proliferation rate of the cells, promote the cell apoptosis,and inhibit the invasion ability,which provide certain theoretical basis for the research and development of new drugs and new therapeutic targets.

AIM: To observe the effect of cornus of ficinalis glycosides(COG) ophthalmic solution on the corneal allograft rejection by topical instillation. METHODS: The corneal transplantation model on the closed colony rats was established. The rejection time of all animals was recorded and compared by slit-lamp microscope. The pathologic changes were measured by immunohistochemistry and scanning electron microscope.RESULTS: The histopathological and immunohistochemistry findings showed that the lymphocytes, neovascularity and the expression of ICAM-1 in COG-treated group were significantly fewer than that in control group at 15 d after operation.CONCLUSION: COG ophthalmic solution prevents and suppresses the corneal allograft rejection.

Objective To evaluate the efficacy of multimodal-antiemetic therapy on postoperative dizziness,headache,nausea and vomiting (PONV) in patients undergoing thyroidectomy.Methods One hundred patients (39 males and 61 females,ASA physical status Ⅰ or Ⅱ) scheduled for thyroidectomy were randomly divided into two groups according to random number table: control group (group C) and multimodal-antiemetic therapy group (group M).Two groups received total intravenous anesthesia (TIVA) with propofol and remifentanil.Prophylactic dexamethasone 10 mg were given after anesthesia induction and palonosetron hydrochloride 0.25 mg was used 30 min before the end of surgery in both groups.Mannitol 2 ml/kg in group M and the same amount of normal saline in group C were given 30 min before the end of surgery.The incidence of dizziness,headache and PONV were observed for 24 h in two groups.Results The incidence of headache was 5 cases (10%)and PONV was 5 cases (10%) in group M,which were respectively significantly lower than that of group C of 15 cases (30%) and 12 cases (24%) in 24 h after surgery (P<0.05).The additional antiemetic therapy for 24 h after surgery in group M of 2 cases (4%) was significantly lower than that of group C of 9 cases (18%) (P<0.05).Conclusion The multimodal-antiemetic therapy: prophylactic dexamethasone,palonosetron hydrochloride and mannitol were used 30 min before the end of surgery could significantly reduce the incidence of dizziness,headache and PONV after thyroidectomy.

Objective:To explore the clinical efficacy of sinew-regulating and bone-setting manipulation combined with functional exercise to treat mild to moderate rotator cuff injury (RCI).Methods:Forty patients with mild to moderate RCI were randomly divided into a treatment group and a control group,with 20 cases in each group.The treatment group was given sinew-regulating and bone-setting manipulation combined with functional exercise,and the control group was given the same manipulation as the treatment group.The therapeutic effect on the functional improvement was assessed after treatment according to pain threshold,shoulder range of motion (ROM) including flexion,abduction,internal rotation and external rotation,and the University of California at Los Angeles (UCLA) shoulder rating score.Results:Compared with the same group before treatment,the pain threshold,shoulder flexion,abduction,internal and external rotations increased after the treatment in the two groups (all P＜0.05).The UCLA shoulder rating score increased (both P＜0.05).The improvement in the treatment group is significantly better than that in the control group with a statistical significance (P＜0.05).The total effective rate was 95.0％ in the treatment group,was higher than 65.0％ in the control group (P＜0.05).Conclusion:The sinew-regulating and bone-setting manipulation combined with functional exercise relieve the pain of patients with mild to moderate RCI,increase the motion of shoulder joints,and improve the quality of life of patients.The curative effect is better than the treatment of simple sinew-regulating and bone-setting manipulation.