Objective We investigated interleukin (IL)-23 that might play a role in the pathogenesis of rheumatoid arthritis (RA) and whether it was correlated with disease activity and clinical manifestations in axial spondyloarthritis (SPA).In addition, the Spondyloarthritis Research Consortium of Canada (SPARCC) scores was used to examine whether recombinant human tumor necrosis factor-α receptor Ⅱ IgG Fc fusion protein for injection (rhTNFR:Fc) was effective for the reduction of magnetic resonance imaging (MRI)-proven sacroiliac joint (SIJ) inflammation.Methods The serum IL-23 levels of etanercept and conven-tional treatment groups were measured using enzyme-linked immunosorbent assay kits.At the same time, SIJ MRI SPARCC score levels were assessed by MRI, the change of clinical indicators of patients was observed.ANOVA, repeated measure data of ANOVA and Spearman's correlation analysis were used for statisical analysis.Results ① The basal serum IL-23 levels of the Etanercept group were (34.2±1.8) pg/ml and those of the conventional treatment group were (34.1 ±1.8) pg/ml (F=1 073.790, P=0.991), both were significantly higher than the healthy control group (18.1±0.8) pg/ml (P=0.005).After treatment, serum IL-23 levels of the rhTNFR: Fc treatment and conventional treatment group were (24.5 ±1.7) pg/ml and (25.2±1.7) pg/ml (F=232.488, P=0.242), (19.2±0.8) pg/ml and (21.6±1.3) pg/ml (F=114.135, P=0.025), (19.0±0.8) pg/ml and(19.4± 0.8) pg/ml (F=23.374, P=0.085) respectively.A significant decrease was observed in the two groups and the serum level of IL-23 of the rhTNFR:Fc group was lower than that of the conventional group at week 12.② SIJ MRI SPARCC scores of the rhTNFR:Fc group and the conventional drugs group were (20.1± 1.2) scores and(20.7±1.5) scores (F=2003.660, P=0.191), (12.5± 0.8) scores and (15.4±0.9) scores (F=1 680.430, P=0.004), (8.8±0.9) scores and (12.8± 0.9) scores (F=972.877, P=0.002), the scores of two group were significantly decreased after treatment.At week 12, 24 of the treatment, the rhTNFR:Fc group scores were lower than the conventional drugs group.③ The serum IL-23 levels, SLJ MRI SPARCC scores and clinical index (ESR, CRP, PGA, BASDAI, BASFI, BASMI and number of painful joints) were not correlated (P＞0.05), the SIJ MRI SPARCC scores and clinical indicators were not correlated (P＞0.05).Conclusion ① The serum IL-23 levels of the rhTNFR:Fc are higher than healthy controls.② rhTNFR:Fc treatment could significantly decrease IL-23 levels and improve the sacroiliac joint inflammation compared to conventional treatment.③ SIJ MRI is a good assessment method for the detection of SpA sacroiliac joint inflammation.

AIM:To explore the differences between unilateral recess-resection (R & R) and bilateral lateral rectus recession (BLR-rec) in the treatment of basic intermittent exotropia.METHODS: A retrospective analysis of treatment of basic intermittent exotropia in 89 patients,in which 49 cases underwent unilateral recess-resection,40 cases underwent bilateral lateral rectus recession of external rectus retroperitoneal surgery January 2013 to January 2015 in our hospital.The stereopsis and strabismus were observed in 1d,1,6mo,1 and 2a after operation.RESULTS: There was no significant difference in the success rate and oblique degree between the two groups after 1d,1,6mo,1 and 2a (all P>0.05),but the success rate of the operation was reducing as time passed.After 2d of the operation,the drift of the R & R group was 12.10±5.74PD and the drift of the BLR-rec group was 7.78±4.21PD,the difference was statistically significant (P=0.021).The R & R group was more likely to cause lateral slanting than BLR-rec group.Two groups of patients with nearly stereopsis were both significantly improved,there was no significant difference between the two groups in the two groups (x2=4.530,P=0.210).CONCLUSION: The long-term stability of BLR-rec is superior to R & R.

OBJECTIVETo explore the essence of Spleen-Kidney Deficiency in middle-aged patients.

METHODSInvestigation was carried out in 773 cases of 50-69 years old to assay 34 parameters in them, including blood lipid, oxidation and anti-oxidation related substance, sex hormone, liver and renal function, immune function, blood routine, blood pressure and lung vital capacity, etc.

RESULTSSpleen Deficiency Syndrome is closely related with lipid metabolism disorder; Kidney-Qi Deficiency Syndrome is closely related with hypoimmune function; Kidney-Yin Deficiency Syndrome is closely related with lipid metabolism disorder and hypertension, and Kidney Yang Deficiency is closely related with weakness of anti-oxidation capacity, hypoimmunity, the internal environment disorder of sex hormone and aging, manifested as multiple functions abating.

CONCLUSIONSpleen Deficiency, Kidney-Qi Deficiency and Kidney Yang Deficiency are different layers of a gradually developed and aggravated pathological process, but Kidney-Yin Deficiency could not be listed into this layer.

Aged ; Aging ; CD4-CD8 Ratio ; Cholesterol ; blood ; Diagnosis, Differential ; Female ; Humans ; Kidney Diseases ; blood ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Splenic Diseases ; blood ; Superoxide Dismutase ; blood ; Yang Deficiency ; blood ; Yin Deficiency ; blood

Total 149 strains of endophytic bacteria were isolated from different healthy organisms of Glycyrrhiza inflata Bat. from Xinjiang. The fermented liquids of these strains were screened by TLC and analysed by HPLC, and the glycyrrhizinic acid monoammonium salt was taken as standard control at the same time. Only one endophtytic bacterial stain of Bacillus subtilis could produce Glycyrrhizinic acid monoammonium salt analogue.

Objective To observe the effects of buccal acupuncture therapy and body acupuncture therapy on plasma metabolomites of rheumatoid arthritis rabbits model; To search for the metabolites related to the mechanism of buccal acupuncture and body acupuncture. Methods Sixteen rabbits were made into rheumatoid arthritis models by complete freund's adjuvant before the treatment. The buccal acupuncture group was treated by buccal acupuncture on the knee acupoint; 13 mm × 0.32 mm needle straight 0.2–0.5 mm, twist the main points of stimulation 15 s, once a day. The body acupuncture group was treated by body acupuncture on the Xiyan and Zusanli acupoints; with 13 mm × 0.32 mm needle straight 2–3 mm, every 5 min each time, twisting needle method, 100 times/min for 15 s, once a day. After the continuous treatment for 5 days, UPLC-QTOF/MS was applied to test metabolite from the plasma sample of all groups. Similarity analysis, hierarchical cluster analysis (HCA), principal component analysis (PCA), orthogonal partial least squares-discriminant analysis (OPLS-DA) were applied in this research; meanwhile load analysis method was used to identify the meaningful metabolites. Results The similarity analysis, HCA and PCA all showed the significant difference of endogenous metabolites in plasma samples among the buccal acupuncture group, the body acupuncture, the model group and the blank group. The 4 groups of different plasma sample metabolite were completely separated in three dimensions by OPLS-DA and all the samples were gathered respectively. The load analysis indicated that there were 19 kinds of endogenous metabolites which showed the significant differences between buccal acupuncture group and model group, and also happened between the body acupuncture group and the model group; N-cetyl-L-phenylalanine and 2-phenyl propionate in metabolism of phenylalanine and tyrosine decreased significantly in the buccal acupuncture group while significantly increased in the body acupuncture group. Conclusion There are relative similarity on the mechanism of treating rheumatoid arthritis between buccal acupuncture and body acupuncture. However, N-acetyl-L-phenylalanine and 2-phenyl propionate, as the main potential biomarkers of the difference, indicate that the dissimilarity can be significant.

Objective We aimed to construct the handbook of self-management for patients with permanent colostomy by using the Delphi method.Methods Based on htemture review,23 experts were consulted twice by using the Delphi method about the related problems of constructing the handbook of self-management for patients with permanent colostomy,and the consulting results were analyzed later.Results The valid response rates of two rounds of expert consultation were 91.3％ and 100.0％,respectively.The authority coefficient of the experts (Cr) was 0.879,and coordination coefficients of the experts' opinion (W) were 0.387 and 0.307,respectively.Finally,the handbook of self-management for patients with permanent colostomy was determined by two rounds of expert consultation.Conclusions The handbook of self-management for patients with permanent colostomy,consmucted by using the Delphi method,provides a practical and effective tool for the patients with permanent colostomy to manage themselves,so as to provide a guidance and supervision role on self-management,such as stoma management,role management and emotion management,fither more,it provides references for the clinical and community nursing of the patients with permanent colostomy.

Objective The survey aimed to investigate the self-efficacy of permanent colostomy patients at different stages,and explore its impact factors.Methods A total of 267 cases of permanent colostomy patients at different stages (postoperative hospital stay,postoperative chemotherapy and home rehabilitation),coming from many domestic top three hospitals were investigated using the general information questionnaire,C-COH,the Stoma Self-Efficacy Scale,and Perceived Social Support Scale (PSSS).Results The total score of self-efficacy of 267 colostomy patients was (75.97 ± 23.92),ranked in the middle level,and it showed a rising tendency at postoperative hospitalization,postoperative chemotherapy and home rehabilitation.The influencing factors of self-efficacy of the patients at postoperative hospitalization included psychological well-being,BMI and age the regression coefficients were 7.126,1.512 and-0.281.the influencing factors of self-efficacy of the patients at postoperative chemotherapy included psychological well-being,age,the proportion of medical insurance,living state and caregiver,the regression coefficients were 5.182,-0.726,0.238,7.993 and 6.083; the influencing factors of self-efficacy of the patients at home rehabilitation included spiritual well-being,social support,self-care degree,gender and the monthly cost of ostomy supplies,the regression coefficients were 7.215,-7.820,-9.616 and-4.762.Conclusions The influencing factors of self-efficacy of permanent colostomy patients at different stages was different,the medical staff should assess and screen the high-risk factors of self-efficacy positively,according to the individual circumstance and stage,to formulate the individualized intervention measures,so as to enhance the patients' self-confidence to deal with and manage the disease,thereby increasing the level of self-efficacy.

Objective In order to explore the safety , feasibility of early enteral nutrition for children of 1～36 months old undergoing nongastrointestinal postoperative received general anaesthesia. Methods 93 children of 1 ～ 36 months old received operation were divided into the experimental group (52 cases)and control group(41 cases), A kind of postopertion early enteral nutrion of diet method was conducted in the experimental group,while the traditional enteral nutrion of diet method was used in the control group. The time of drinking and eating, the postoperative discomfortable condition of children and patriarchal anxiety were compared between the groups. Results There were no significant differences about the postoperative vomiting and mis-inhalation between the two groups , the time of drinking and eating in experimental group [ (44.45 ± 27. 57 ),(57.75 ± 31.69 ) min ] was shorter than that of control group [ (218.12 ± 25.83), (225.00 ± 24.89) min ],the postoperative discomfortable condition of children and patriarchal anxiety in control group were significantlysevere than those in experiment group, P < 0. 01. Conclusions The early enteral nutrion of diet method forchildren is safty and feasibility , which can improve the comfort of children , but not increase the postoperativevomiting and mis-inhalation.

Objective To explore the better time for representing the true body temperature when measuring the axillary temperatures of the elderly patients with clinical thermometer. Methods The objects were divided into the test group(78 cases)with an average age of 79 years and the control group(52 cases)with an average age of 33.5 years. Three thermometers meeting the measurement requirement were selected and were placed in the armpit of the two groups. The thermometers were taken out when measuring for 5,10 and l5 minutes, respectively. The body temperatures were recorded and analyzed statistically. Results The temperatures at 5,10 and 15 minutes were(36.01±0.54),(36.30±0.41)and(36.45±0.37)℃ in the elderly patient group, and(36.11±0.37),(36.64±0.34)and(36.87±0.29)℃ in the control group(P

Objective To understand the characteristics of cervix diseases in female medical staff and provide basis for effective prevention and control.Methods The results of cervical cancer screening in 1 471 female medical staff in our hospitals in 2008 were compared with the 1 706 ones in 2010.Results Morbidity rates of various cervix diseases were 37.9％ (558/1 471) in 2008 and 50.6％ (864/1 706) in 2010,respectively.Most of them were diagnosed with chronic cervicitis (36.8％ in 2008 and 47.1％ in 2010).The difference of positive rate of screening test (TCT results ≥ASC-US) was significant between those in 2008( 1.1％,16/1 471 )and those in 2010(3.7％,63/1 706) ( x2 =12.65,P ＜ 0.01 ).The results also showed that the incidences of various cervix diseases were related to age,and that high rates of cervicitis and cervical cancer were observed in the middle-aged (35 -50 years old).Conclusions Positive rates of cervical cancer screening test tend to rise,and the health condition of the middle-aged women (35 -50 years old) should be paid particular attention.