Objective To explore the mechanism of combined treatment with methotrexate (MTX) and Ga-Al-As laser irradiation for rheumatoid arthritis (RA) and to assess the effectiveness of Ga-Al-As laser therapy for RA. Methods Twenty-two patients with RA were randomly and evenly divided into two groups: the treatment group treated with Ga-Al-As laser irradiation combined with MTX and the control group treated with MTX only. Ten age-matched normal subjects were observed as normal controls. The amount of CD4 + CD25 + regulatory T cells in peripheral blood (PB) of the normal controls and that in the PB and synovial fluid (SF) of the 22 patients before and after therapy were counted by flow cytometry. Meanwhile, the amount of prostaglandin E2 (PGE2) in synovial fluid of the patients was measured before and after treatment by enzyme-linked immunosorbent assay(ELISA). Results After combined treatment the clinical symptoms of the patients were improved significantly, and the amount of PGE2in SF decreased significantly. The count of CD4 + CD25 + regulatory T cells in PB of RA patients was ( 3.84 ±3.20) % , compared to ( 10.05 ± 7.04) % in healthy individuals. The count of CD4 + CD25 + regulatory T cells in SF of RA patients was ( 14.89 ± 12.30) % , much higher than that in PB. The count of CD4 + CD25 + regulatory T cells in SF decreased significantly in treatment group compared to control group (P ＜0.05). Conclusion Ga-Al-As laser irradiation eombined with MTX can effectively improve the clinical symptoms of RA patients. It may be related to the decrease of amount of PGE2 and count of CD4 + CD25 + regulatory T cell in PB and SF.

25 year).The patients were analyzed for the clinical characteristics.Autoantibodies to glutamic acid decarboxylase 65(GAD65-Ab),insulin(I-Ab)and autoantobodies to protein tyrosine phosphatase-like proteins(IA2-Ab)were assayed.HLA-DRB1,DQA1,DQB1 alleles(HLA-DRB1*03,*04,*09,*15,DQB1*0201,*0302,*0601,DQA1*0301,*0501)were typing by PCR-sequence specific primer(PCR-SSP).Results A little higher proportion of males,a longer duration of disease; a higher BMI and WHR characterized the adult-onset patients.The adults have a higher level of triglycerides and 120 min C-peptides than adolescent.The frequency and level of IA2-Ab of the adolescents were higher than adults(47.1% vs 15.1% and 0.46 U?mL~ -1 vs 0.07 U?mL~ -1 ,respectively,P

Objective To observe the effect of ritodrine hydrochloride on peripheral blood and tocolysis rate of patients with threatened premature labor.Methods89 cases of patients with threatened premature labor were selected from October 2015 to September 2016 and randomly divided into two groups, research group with 45 cases treated with ritodrine hydrochloride and control group with 44 cases treated with epsom salt.The peripheral blood, extinction time of uterine contraction, extended days of pregnancy, postpartum hemorrhage, neonatal birth weight and tocolysis rate were compared between two groups.ResultsAfter treatment, CRH, NO, PGE2 and IL-8 of control group were obviously higher than research group, the difference was statistically significant (t=10.826,3.839,7.534,8.075,P<0.05).The extinction time of uterine contraction in control group was obviously longer than research group, while extended days of pregnancy and neonatal birth days in research group were obviously longer than control group, the difference was statistically significant (t=4.566,7.855,3.237,P<0.05).There was no significant difference in postpartum hemorrhage between two groups (t=0.889,P>0.05).The overall efficacy of tocolysis in control group was 70.5%, while that in research group was 86.7%, which was obviously higher than the control group, the difference was statistically significant (χ2=7.801,P<0.05).ConclusionRitodrine hydrochloride can effectively control uterine contraction factor in peripheral blood and extend gestational days of patients with threatened premature labor, so as to improve tocolysis rate and birth quality.

Objective To investigate the effect of Propess on cervical collagen remodeling and cervical ripening in full-term pregnancy.Methods 94 cases of mid-term pregnant women enrolled in obstetrics and gynecology of our department from January 2016 to January 2017 were divided into two groupaccording to the random number table method.47 cases of the control group, taking oxytocin intravenous infusion;observation group of 47 cases, taking propess suppository vaginal medication.Labor time, medication to labor time, cervical Bishop score, mode of delivery, postpartum hemorrhage and neonatal situation of two groups were compared.Results Compared with the control group, the Bishop score of the cervix was increased, the total effective rate of cervical ripening was improved, the labor was shortened, the time of medication was shortened, and the delivery rate of vaginal delivery was improved(P<0.05), while the two groups were bleeding, neonatal Apgar score and the incidence of fetal distress were not statistically significant.Conclusion It can promote cervical collagen remodeling, promote cervical ripening, thereby reducing the rate of cesarean sectionwith taking propess in the vaginal.

Objective: To construct a prediction model for sleep disorders in shift workers of a chemical fiber enterprise, so as to provide the basis for early identification and prevention of sleep disorders in shift workers. Methods: Shift workers were sampled from a chemical fiber enterprise in Tongxiang City, Zhejiang Province using a cluster sampling method from August 2022 to July 2024. Demographic information, length of service and average weekly working hours were collected through questionnaire surveys. Depressive symptoms, anxiety symptoms and sleep disorders were evaluated using the Pittsburgh Sleep Quality Index, Patient Health Questionnaire and Generalized Anxiety Disorder Questionnaire, respectively. The shift workers were randomly divided into a training set and a validation set at a ratio of 7∶3. Predictive factors were selected using a multivariable logistic regression model based on the training set, and a nomograph model for prediction of sleep disorders in shift workers was established. The predictive values of the model were evaluated using the receiver operating characteristic (ROC) curve and calibration curve based on the training set and validation set. Results: Totally 673 shift workers were included, with a median age of 32 (interquartile range, 12) years. There were 493 males, accounting for 73.25%. There were 471 (69.99%) workers in the training set and 202 (30.01%) workers in the validation set. There were 274 workers with sleep disorders, accounting for 40.71%. The equation for the prediction model was ln[p/(1-p)]=-8.391+1.906×average weekly working hours+1.822×depressive symptoms+1.667×anxiety symptoms. The area under the ROC curve was 0.769 (95%CI: 0.661-0.835) for the training set and 0.655 (95%CI: 0.593-0.737) for the validation set, and Hosmer-Lemeshow test showed a good fitting effect (both P>0.05). Conclusion The nomograph model constructed by average weekly working hours, depressive symptoms and anxiety symptoms can be used to predict the risk of sleep disorders in shift workers of a chemical fiber enterprise.

Objective: To analyze the trends of development and equity of health institutions in China during the period from 2002 to 2013 , and put forward references to optimize the decision-making on health resources alloca-tion. Methods:Statistical map, Gini coefficient and other methods were used to analyze the distribution and equity of health institutions in China for 12 years, during the period from 2002 to 2013. Results:(1) The overall development of health institutions is on the rise in China, and the distribution density of health resources with the population ad-justment is opposite to the adjustment of both population and geographic area at the same time. (2) In the past 12 years, the number of tertiary hospitals showed an increasing trend, and growth in the eastern region was the most sig-nificant. (3) From 2002 to 2013, the Gini coefficient of the number of health institutions and beds per 1,000 per-sons per square kilometer was maintained at 0. 40, and decreased from 0. 70 to 0. 60 in the eastern region of China, respectively. This same number was maintained at 0. 40 and 0. 20 in the central and western region. Conclusion: In China, the fairness trend of health resources allocation has improved during the period from 2002 to 2013, but the imbalance is more serious in the eastern region than in the central and western regions. It should be paid more atten-tion to optimizing the health resources allocation according to the local conditions of different regions, especially the influence of geographical distribution.

Objective To investigate the role of interleukin-18(IL-18) and interleukin-15(IL-15) in the mechanism of acute pancreatitis.Methods The serum levels of IL-18 and IL-15 were detected by enzyme-linked immunosorbent assay(ELISA) in SAP group(n=7) and MAP group(n=19).The relationship between IL-18 and IL-15 were analyzed.Results SAP group was compared with the MAP group:IL-18 (78.32?15.45)ng/L vs (28.21?13.18)ng/L,P

Objective By combining the traditional Chinese medicine(TCM) health care service and the current community puerperal women's health management, to explore the feasibility of TCM health management in the grass-roots community on puerperal women’s breast-feeding. Methods 440 patients meeting the inclusion criteria of puerperal women according to the neighborhood of residence were recruited into a non TCM intervention group of 225 people, and a TCM intervention group of 215 people. The non TCM intervention group was given health guidance on puerperal women. On such basis, the TCM intervention group was further cooperated with appropriate technical guidance of TCM. Puerperal women breastfeeding before and after the intervention was studied. Results After the intervention, the milk shortage of puerperal women breastfeeding rate of TCM intervention group was higher than the non TCM intervention group, 76.9% (60/78) vs. 56.9% (41/72), and mixed feeding rate was lower 21.8% (17/78) vs. 40.3%(29/72), the difference was statistically significant (χ2=5.916, 5.178; P < 0.05). The rate of breast feeding and mixed feeding rate were also statistically different between the TCM intervention group and the non TCM intervention group 78.1%(168/215) and 17.2% (37/215) vs. 62.7% (141/225) and 33.3% (75/225), (χ2=11.860, 14.226; P<0.01). Conclusion TCM health management guidance on puerperal women in the community can effectively improve the hypogalactia puerperal women's breastfeeding rate.

Aim To study the regulatory of Jiaweisini-san on expression of hippocampal BDNF, NR1 and dental gyrus ( DG ) neurogenesis in rats with chronic stressed-depression and its possible mechamisms. Methods Chronic unpredictable mild stress was used to establish the rat model of stressed depression. The expression of BrdU, NeuN, brain -derived neurotro-phic factor ( BDNF ) and N-methyl-D-aspartate recep-tor1 ( NR1 ) in hippocampal dental gyrus were detected by fluorescently labeled immunohistochemical method. In addition, BDNFmRNA was detected by in situ hy-bridization. Results Chronic stress could inhibit the proliferation of neural precursors in hippocampal DG ( P<0. 01 );the expression of BDNF decreased signifi-cantly in DG in model rats ( P <0. 01 ) , while the ex-pression of NR1 increased significantly ( P <0. 01 ) . JWSNS and Fluoxetine hydrochloride significantly en-hanced the amount of new proliferating cells and the number of neurons in unit area of DG ( P<0. 01 ) , in-creased the expression of BDNF ( P <0. 01 ) and de-creased the expression of NR1 in DG(P<0. 01). Con-clusion JWSNS could promote the neuronal prolifera-tion in hippocampal DG of rat with chronic stressed-de-pression,and may exert an effect of promoting the pro-liferation of neurons in hippocampal DG by enhancing the expression of BDNF and decreasing the expression of NR1 .

Objective To study the utility of acute gastrointestinal injury (AGI) grading system in the strategy of diagnosis and treatment of severe acute pancreatitis (SAP) in patients for the guidance of nutritional support.Methods Forty-five patients with SAP admitted to the ICU from January 2012 to December 2013 were enrolled for study.The diagnosis of SAP was made as per the 2013 Chinese guideline of dliagnosis and treatment of acute pancreatitis.The patients with aged ＜ 18 years,length of hospital stay ＜72 h,and those included in other experimental study were excluded.The patients were divided into two groups:AGI group (n =24) and control group (n =21).There were no statistically significant differences in age,gender,APACHE Ⅱ between two groups (P ＞ 0.05).The length of hospital stay,in-hospital mortality,the incidence of complications such as infection,the time of starting enteral nutrition (EN) and reaching caloric goal were compared between the two groups.The t test or Mann-Whitney U test was used for continuous variables and x2 test or Fisher exact test was used for categorical variables,and P ＜ 0.05 was considered statistically significant.Results (1) Between two groups,there were statistically significant differences in the time of starting EN (2.0 d vs.5.7 d,Z =-4.149,P ＜0.01) and reaching caloric goal (5.5 d vs.10.4 d,Z =-3.392,P =0.001).(2) Between two groups,there were statistically significant differences in the incidence of pneumonia (25％ vs.57.14％,P =0.028 1) and catheterrelated infection (0％ vs.23.81％,P =0.039 4).(3) Between two groups,there was no statistically significant difference in in-hospital mortality (16.67％ vs.33.33％,P =0.194 3).In addition,there was significant difference in length of hospital stay between two groups (23.13 ± 10.58) d vs.(31.10 ± 15.33) d,P =0.046.Conclusions The diagnosis and treatment strategy based on AGI grading system is associated with earlier initiation of EN and reaching caloric goal,and partly reduces the incidence of infections and shortens the length of hospital stay,in the meantime,provides guidance for the rationale of nutritional support in the patients with SAP.