We reported a case of rheumatoid arthritis (RA) combined with pigmented villonodular synovitis (PVNS) from Peking University People's Hospital. The clinical data were introduced and the related literature was reviewed. The clinical features, treatment and prognosis of the disease were summarized to improve clinicians' understanding of this rare disease and avoid misdiagnosis and delayed diagnosis. A 45-year-old female, with 15 years of RA history and unregular treatment, was admitted to the hospital with the complaint of aggravating pain and swelling in the right knee for 3 months. The puncture of the right knee was performed and there was a large amount of bloody synovial fluid that could not be explained by her RA history. Moreover, the magnetic resonance imaging (MRI) of the right knee revealed hemosiderin deposition with low-intensity signals on both T1-weighted and T2-weighted images which suggested PVNS to us. Then, the patient underwent knee arthroscopy and biopsy to assist in diagnosis. The arthroscopic appearance and pathology were consistent with PVNS and the hyperplastic synovium was removed during arthroscopy. After the operation, she did active functional exercises and took disease-modifying antirheumatic drugs to control RA. She recovered well and remained asymptomatic after half a year of follow-up. Also, there was no recurrence of the right knee. As we all know, RA is a systemic autoimmune disease characterized by chronic synovitis and joint damage. And PVNS is characterized by synovial proliferation and infiltrative process. Both of them are synovial involvement and the clinical manifestations are quite similar. PVNS has occasionally been reported in association with RA. So it is difficult to make a clear diagnosis of RA combined with PVNS. Literature was searched with RA+PVNS in the WanFang Medical Network Database and China National Knowledge Infrastructure and there were no related Chinese cases. Then we searched literature from PubMed with RA+PVNS. The cases were still rare and eventually 2 related articles were yielded including 2 similar patients. It is necessary to fully understand the disease development, complicated MRI appearance and various pathological morpho-logy. They can contribute to making a correct diagnosis which is effective to guide the proper treatment.
Arthritis, Rheumatoid/diagnosis* ; Arthroscopy ; China ; Female ; Humans ; Knee Joint/diagnostic imaging* ; Magnetic Resonance Imaging ; Middle Aged ; Neoplasm Recurrence, Local ; Synovitis, Pigmented Villonodular/diagnosis*

BACKGROUND: p38 mitogen-activated protein kinase signal transduction pathway is a member of the mitogen-activated protein kinase family. It plays an important role in the development of osteoarthritis. OBJECTIVE: To review the progress of p38 mitogen-activated protein kinase signal transduction pathway in the pathological process of osteoarthritis. METHODS: An online search of CNKI and PubMed databases was performed for articles using keywords of “p38 mitogen-activated protein kinase signal transduction pathway, osteoarthritis, articular cartilage, chondrocyte” in Chinese and English, respectively. Relevant articles were summarized from three aspects of introduction of p38 signal transduction pathway, the role of p38 mitogen-activated protein kinase signal transduction pathway in osteoarthritis and the inhibitor of p38 in osteoarthritis. A total of 90 articles were included. According to inclusion criteria, a number of 46 articles were retained at last. RESULES AND CONCLUSION: p38 mitogen-activated protein kinase signal transduction pathway has a close relation with chondrocyte hypertrophy and calcification, chondrocyte apoptosis, synthesis of cartilage matrix metal oproteinase, production of proinflammatory cytokines, and exerts a significant effect on the development of osteoarthritis. p38 mitogen-activated protein kinase is involved in the formation and development of osteoarthritis through a variety of complex mechanisms and plays a very important role. Therefore, blocking p38 mitogen-activated protein kinase signaling pathway may be a new target in the treatment of osteoarthritis.

Objective To study the variation of serum IL-6,IL-8,TNF-α and CRP in perioperative patients with pancreatitis. Methods 39 caaes in perioperative patients with pancreatitis in our hospital from January 2008 to 2010 April were selected as observation group,and 39 healthy people were selected as control group,and the serum IL-6,IL-8,TNF-α and CRP of the observation group before the treatment and after the treatment at 4h,at the first day, at the second day and the seventh day and the control group were detected, and the results were analyzed and compared. Results The serum IL-6,IL-8 ,TNF-α and CRP of the observation group before the treatment were higher than those of the control group( all P ＜ 0. 01 ) there were significant differences, and the levels of the observation group at 4h,at the first day,and at the second day showed decreasing,the levels compared to those of the control group( all P ＜ 0. 05 ) there were significant differences, the levels of the observation group at seventh day were compared to those of the control group(all P＞0. 05) there were no significant differences. Conclusion It was regulation of the variation of serum IL-6, IL-8 ,TNF-α and CRP in perioperative patients with pancreatitis, and tit could provide evidence for the treatment.

Data quality issues of TCM structured data warehouse system is very important.This paper analyzed the data quality issues from the data repository to the data extraction,cleansing,transformation,loading (ETL) into the data warehouse process and established the principle of corresponding control,and researched improving data quality measures to ensure the success of data warehouse and right decision support.

Objective:To investigate the shaping and cleaning ability of Reciproc(RE),OneShape(OS)and ProTaper(PT)in oval-shaped root canal preparation.Methods:The canals of 57 distal roots of mandibular first molars were randomly divided into 3 groups and prepared by RE,OS and PT respectively.The preparation time was recorded.After instrumentation,all root canal walls were examined under SEMand evaluated by scores of debris and smear layer.The 3D data and images of the roots of pre-and post-preparation were con-structed by Micro-CT scanning.Results:Group RE and OS showed lower scores of debris and smear layer than those in group PT at the apical level(P <0.05),and less preparation time (P <0.05).Before and after preparation,the changes of root canal morphological pa-rameters (including volume,surface,area,major diameter and minor diameter)in OS group were less than those in group RE and PT(P<0.05).The changes of canal curvature in group PT was larger than that in group RE and OS (P <0.05).Conclusion:RE and OS are more effective than PT in debridement and faster in root canal preparation.RE and OS can maintain the centering of original canal better than PT in the apical part of the root canal.The shaping ability of OS is weaker than that of RE and PT.

Electrochemiluminescence was used to determine thyroid function and thyroid autoantibodies in 140 pregnant women,who were then divided into normal group (n =117) and subclinical hypothyroidism group (n =23) based on the thyroid function.The urine iodine level in the pregnant women was detected by arsenic cerium catalytic spectrophotometric method.The awareness of past history of thyroid disease among the subjects with thyroid dysfunctions were investigated.The results showed that the prevalences of iodine deficiency were 50％ and 57％ in the normal group and the subclinical hypothyroidism group,respectively.The state of iodine level was not related to thyroid function.The levels of serum thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody were markedly related to serum TSH(P＜0.01),so was the level of serum TPOAb related to serum FT4 (P＜0.05).Among the subclinical hypothyroidism women,70％ did not undergo thyroid function and thyroid autoantibodies screening before pregnancy,8.7％ denied past history of thyroid disease,and 21.7％ suffered from hypothyroidism before pregnancy.Therefore,we advocate the screening of urine iodine and thyroid autoantibodies before or during the first trimester of pregnancy,aiming to correct iodine deficiency,avoid supplementing too much iodine,improve the outcome of perinatal stage,and reduce all the negative effects on the offsprings.

Objective To study the association of MYH9 gene single nucleotide polymorphism (SNP) with clinical manifestation,pathology and prognosis of IgA nephropathy (IgAN) patients of Han nationality population in Inner Mongolia Autonomous Region.Method One hundred and forty-eight IgAN patients proven by biopsy were enrolled in the study.Fifty-six patients were followed up for 1-97 months.DNA was extracted from the peripheral blood of above patients.PCR restriction fragment length polymorphism (RFLP) assay was used to detect the single nucleotide polymorphisms of MYH9 gene Rs3752462,Rs4821480 sites.Association of different genotypes with clinical features,pathology and prognosis im patients with IgA nephropathy was examined.Result (1) Rs3752462 site was consistent with Hardy-Weinberg equilibrium,while Rs4821480 site did not meet the Hardy-Weinberg equilibrium.(2) IgAN patients with MYH9 gene Rs3752462 site TF genotype had lower systolic blood pressure as compared to those with CC +CT genotype (P＜0.05).There were significant differences in systolic blood pressure,diastolic blood pressure and age between patients with Rs4821480 site GG genotype and patients with TT or GT genotype (P＜0.05).There were no significant differences in Scr,Ccr,plasma albumin,hemoglobin,microscopic hematuria,proteinuria,pathological HASS classification,pathological lesion among Rs4821480 site GG,TT,GT genotypes.(3) Kaplan-Meier survival analysis revealed the time from renal biopsy to renal function decline was shorted in patients with Rs3752462 site CC genotype and Rs4821480 site TT genotype.Conclusions C allele of MYH9 gene Rs3752462 site is an independent risk factor of high blood pressure damage in IgAN patients.Polymorphism of 3 genotypes of MYH9 gene Rs4821480 site is associated to the prognosis of patients.Carrying Rs3752462 site C allele and Rs4821480 site T allele may affect the prognosis of patients.

Raman spectroscopy has generated many branches during the development for more than 90 years. Surface enhanced Raman spectroscopy (SERS) improves SNR by using the interaction between tested materials and the surface of rough metal, as to quickly get higher sensitivity and precision spectroscopy without sample pretreatment. This article describes the characteristic and classification of SERS, and updates the theory and clinical application of SERS. It also summarizes the present status and progress of SERS in various disciplines and illustrates the necessity and urgency of its research, which provides rationale for the application for SERS in microbiology.
Microbiology ; Spectrum Analysis, Raman

OBJECTIVETo investigate the role of autophagy in acute lung injury (ALI) caused by multiple trauma in rats via pretreat with 3-methyladenine (3-MA).

METHODSForty-five Sprague-Dawley male rats, with age of 4 months and body weight of 250-300 g,were randomly divided into three groups. In the sham group, the rats received sphenotresia only;in the control group, the rats were made model of femur shaft fracture combined with brain injury, and treated with physiological saline by abdominal cavity at 1 hour before making model; in the 3-MA group, the rats were made model of femur shaft fracture combined with brain injury,and treated with 3-MA of 10 mg/kg by abdominal cavity at 1 hour before making model. Histologic changes and the concentration of related inflammatory factors in the damaged lung tissue were examined at 48 h after opteration, at the same time, the effect of 3-MA on the expression of LC-3 II and Beclin-1 was examined through reverse transcriptase polymerase chain reaction technique (RT-PCR).

RESULTSCompared with sham group, LC-3 II and Beclin-1 level in control group at 48 h after operation were obviously increased (P < 0.01). Compared with control group, LC-3 II and Beclin-1 level in 3-MA group at 48 h after operation were obviously decreased (P < 0.01). Compared with sham group, the level of proinflammatory cytokines (TNF-α and IL-6) in control group obviously enhanced (P < 0.01). Compared with control group, above items in 3-MA group was obviously lower (P < 0.01). Compared with control group,the histopathological damage of lung in 3-MA group obviously reduced (P < 0.01).

CONCLUSIONAutophagy can aggravate the acute lung injury caused by fracture of shaft of femur combined with brain injuries,but 3-MA can reduce tissue damage by inhibiting the autophagy and inflammatory response.

Acute Lung Injury ; prevention & control ; Adenine ; analogs & derivatives ; therapeutic use ; Animals ; Apoptosis Regulatory Proteins ; analysis ; Beclin-1 ; Interleukin-6 ; analysis ; Lung ; chemistry ; immunology ; pathology ; Male ; Multiple Trauma ; complications ; Rats ; Rats, Sprague-Dawley ; Tumor Necrosis Factor-alpha ; analysis

From the perspective of humanistic care,the article explores the dilemmas and misunderstandings in the treatment of patients with terminal cancer,and states great significance to develop palliative treatment and hospice service.The importance to establish the center for pain prevention and hospice care hospital for patients with terminal cancer is also clarified so as to improve the quality of their life.The development of palliative care and hospitalpice service also plays an active role in the establishment of a harmonious society in Hunan province.It is also called for to include the education of proper values on death as a part of public education.