Objective To explore the differential expression of Toll-like receptor 4(TLR4)mRNA in peripheral blood mononuclear cells(PBMCs)between the patients with ankylosing spondylitis(AS),rheumatoid arthritis(RA)and the healthy individuals as well as its clinical significance.Methods The expression level of TLR4 mRNA in PBMCs was determined from 60 AS patients,30 RA patients and 30 healthy controls by real-time fluorescence quantitative RT-PCR.Erythrocyte sedimentation rate(ESR)and plasma C-reactive protein(CRP)were detected automatically respectively by ESR automatic analyzer and specific protein electrophoresis analyzer.Results The expression level of TLR4 mRNA in PBMC was significantly higher in patients with AS or RA than in the controls,while no significant difference was observed between the two disease groups.Furthermore,both HLA-B27-positive and -negative AS patients showed higher TLR4 mRNA level than healthy controls,and HLA-B27-positive AS patients higher than RA patients.However,there was no significant difference between HLA-B27-positive,-negative AS and RA patients.In HLA-B27-positive AS patients,close correlations between TLR4 mRNA and ESR or CRP were observed,but no correlation observed in HLA-B27 negative patients.In RA patients,the level of TLR4 mRNA correlated with CRP.Conclusion The expression level of TLR4 mRNA is elevated in PBMC from either AS or RA patients.Although the upregulation of TLR4 mRNA is not associated with whether HLA-B27 is positive or not in AS patients,it is more significant in HLA-B27-positive AS than in RA.Furthermore,the correlations between the expression of TLR4 mRNA and ESR or CRP are influenced by HLA-B27 antigen in AS patients.In conclusion,the present results indicate that the abnormal expression of TLR4 might play a role in the development and progression of AS and RA.

Objective:To explore the mediating effect of rumination between social anxiety and mobile phone addiction tendency among college students.Methods:The social avoidance and distress scale (SAD), mobile phone addiction tendency scale (MPATS) and ruminative response scale (RRS) were used to measure 682 college students.SPSS 25.0 and Mplus 7.0 were used for data analysis.Pearson correlation analysis was used to explore the correlation among social anxiety, mobile phone addiction tendency and rumination.Bootstrap method was used to test the mediating effect of rumination between social anxiety and mobile phone addiction tendency among college students.Results:The total score of social anxiety was (13.36±6.02), the total score of rumination was (51.04±11.56), and the total score of mobile phone addiction tendency was (40.46±11.74). The detection rate of mobile phone addiction tendency was 23.90%, and the detection rate of social anxiety was 49.85%.The total score of social anxiety was positively correlated with the total score of rumination ( r=0.31, P<0.01) and the total score of mobile phone addiction tendency ( r=0.25, P<0.01). The total score of rumination was positively correlated with the total score of mobile phone addiction tendency ( r=0.46, P<0.01). The structural equation model showed that rumination played a complete mediating role between high social anxiety and mobile phone addiction tendency, and the effect value was 0.18.There was no mediating effect between low social anxiety and mobile phone addiction tendency, and the direct effect value was 0.33. Conclusion:Low social anxiety directly affects college students' tendency of mobile phone addiction, while high social anxiety indirectly affects college students' tendency of mobile phone addiction through rumination.

Objective To study the causes of emergency department (ED) overcrowding and access block in Beijing.Methods This was a multi-center cross sectional study.The studied cohort of patients included all ED visiting patients from 18 municipal teaching hospital EDs in Beijing from 2012 to 2013.Patient' s characteristics and medical care settings were analyzed.Results The urgent care cases accounted for only 4.6 ％ (71 224/1 554 387) of the emergency annual visits in 2012 and 5.5 ％ (88 190/1 615 571) in 2013.The total number of observation patients in EDs was 185 277 and 211 900 in 2012 and 2013 respectively,with an increase of 14.4 ％ (P ＜ 0.01).The total ED-admission inpatients only accounted for 2.97％ and 2.89 ％ of total annual visits in 2012 and 2013 respectively.The average time of ED-admission took 37.1 hours and 36.2 hours in 2012 and 2013 respectively.The average time of ED stay for observation was 4.9 days and 5.4 days in 2012 and 2013 respectively.Upper respiratory tract infection was the leading illness in annual visits.The leading cause of ED stay for observation was bedridden with pneumonia.Conclusions The ED settings in Beijing are different from other countries.The EDs actually assume the task of the clinic and ED service for 24 hours thereby made EDs terribly overcrowded.The main causes are large number of non-emergency patients visiting the ED and patients in the ED are difficulty to be hospitalized.Patients with end-stage disease and multiple organ failure stayed in the ED due to nursing home shortage.

[ABSTRACT]OBJECTIVETo investigate the relationship between food allergen specific IgE, IgG and allergic rhinitis, and to explore the significance of food allergen in the diagnosis and prevention of allergic rhinitis.METHODSTen kinds of food specific IgE were detected by Western blot and 14 kinds of food specific IgG were detected by ELISA in 2860 allergic rhinitis patients. The positive results of specific IgE and specific IgG were retrospectively analyzed.RESULTSThere was no difference in positive rate of allergen in patients with different gender. Total positive rate of food specific IgE was 68.5%. The specific IgE positive rate of crab was 31.5%, shrimp 27.6%, milk 21.3%, fish assemblages 19.2%, freshwater fish assemblages 18.3% and soybean 17.2%. With the growth of age, the specific IgE positive rate of peanut increased, but eggs decreased. The total positive rate of food allergen specific IgG was 81.5%. The specific IgG positive rate of egg was 59.4%, milk 38.2%, codfish 32.6%, soybean 22.8%, rice 19% and shrimp 12.7%. With the growth of age, the specific IgG positive rate of crab increased. Specific IgE and IgG of soybean, milk, crab, shrimp and fish were correlated well.CONCLUSIONThe detection of specific food allergen antibodies is helpful for the diagnosis of allergic rhinitis.

Objective: To observe the effect of needling Hegu (LI 4) on functions of the prefrontal cortex using the functional near infrared spectroscopy (fNIRS). Methods: A total of 12 healthy volunteers were randomly assigned to an acupuncture group (n=6) and a control group (n=6). The control group received no intervention. The acupuncture group received needling Hegu (LI 4) on the right side. The real-time concentration changes of oxygenated hemoglobin (HbO2), deoxygenated hemoglobin (d-Hb) and total hemoglobin (t-Hb) in the prefrontal cortex were recorded using the fNIRS, allowing for effect analysis of needling Hegu (LI 4) on the functions of the prefrontal cortex. Results: Compared with the control group, the HbO2 and t-Hb concentrations were increased in the acupuncture group and there were between-group statistical significances (bothP<0.05). There was no between-group statistical significance in d-Hb concentration (P>0.05). Conclusion: Needling Hegu (LI 4) can extensively activate the prefrontal cortex and therefore has significant effect on the functions of the brain's prefrontal cortex.

Public hospitals reform is a key roadblock for the ongoing health reform.By means of such experiments as Three openings and three mechanisms,Beijing is practicing a separation of hospital regulation and management and separation of clinic and pharmacy,while building the mechanism of financial subscription for pricing,that of medical insurance adjustment,and that of hospital corporate governance.These measures aim at building a new management structure,operation mechanism and medical service model focusing on quality of care,efficiency and satisfaction.Separation of clinic and pharmacy has lowered drug proportion,average outpatient expense and out of-pocket payment of patients,as well as producing higher patient satisfaction,quality of care and hospital income.Other benefits include better management efficiency indirectly caused by separation of clinic and pharmacy,higher acceptance of the corporate governance,and service model innovation to better serve the people.

Objective To investigate the difference of niacin skin flush response between patients with major depressive disorder (MDD) and healthy controls (HCs), and its sensitivity and specificity for the diagnosis of MDD. Methods Twenty-one untreated patients with MDD and 28 age- and gender-matched HCs were enrolled in this study. The severity of depressive symptoms was assessed mainly by using the 17-item Hamilton Depression Rating Scale (HDRS-17). Methyl Nicotinate (MN) solution at 8 different concentrations (10-5 mol/L, 10-4 mol/L, 10-3.5 mol/L, 10-3 mol/L, 10-2.5 mol/L, 10-2 mol/L, 10-1.5 mol/L, 10-1 mol/L) were applied on subjects' forearms. Signals of blood flow were collected using the Doppler Laser Flowmetry to detect the skin flushing of the test. Results Under the concentrations of 10-2.5 mol/L, 10-2 mol/L, 10-1.5 mol/L and 10-1 mol/L MN solution, the blood flow was significantly higher in depressive patients than in HCs (P<0.01). The MN sensitivity (logEC50) was inversely correlated to the severity of depressive symptoms (r=-0.57, P<0.05). ROC curve analysis implied that the maximum blood flow (MBF) caused by the niacin skin flush response, could efficiently discriminate MDD from HCs (AUC=0.90, P<0.01). Conclusion The presence of enhanced niacin skin flush response may be helpful in the diagnosis of MDD.

Objective To investigate the effect of Kuanxiong Lifei decoction on inflammatory factors in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and turbid phlegm obstructing lung syndrome. Methods Two hundred patients with AECOPD and turbid phlegm obstructing lung syndrome diagnosed by traditional Chinese medicine (TCM) differentiation visiting four hospitals of Longhua Hospital Affiliated to Shanghai University of TCM, Shanghai Seventh People's Hospital, Punan Hospital of Shanghai Pudong New Area, Gongli Hospital of Shanghai Pudong New Area were selected from May 2017 to March 2018, and they were divided into a test group and a control group by a random number table, 100 cases per group. The patients in the two groups were treated with routine western medicine according to the guidelines, and in the test group, additionally Kuanxiong Lifei decoction (components: pinellia ternate 15 g, allium macrostemon 12 g, ephedra 9 g, trichosanthes 30 g, poria cocos 15 g, almond 12 g, lumbricus 12 g, citrus peels 12 g, peach kernel 12 g , roasted licorice 6 g) was used for 10 days, the decoction was uniformly made by Chinese Medicine Pharmacy of Longhua Hospital, 1 dose daily, 2 times a day orally taken, warm 200 mL each time, 0.5 hours before or after meal. The efficacy was evaluated after treatment for 10 days. The level changes of white blood cell count (WBC), neutrophils (N), C-reactive protein (CRP), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α) before and after treatment and the improvement of TCM syndrome scores and clinical efficacy were observed in two groups. Results After treatment, the levels of WBC, N, CRP, IL-8, TNF-α, TCM syndrome score of the patients in the two group were significantly decreased compared with those before treatment in the two groups (P < 0.05), and the above indexes in the test group were all significantly lower than those in the control group after treatment [WBC (×109/L): 6.58±1.41 vs.7.44±1.85, N: 0.58±0.08 vs. 0.64±0.08, CRP (mg/L): 7.3±1.8 vs. 9.6±1.7, IL-8 (ng/L): 23.5±6.2 vs. 27.8±9.8, TNF-α (ng/L): 9.45±2.18 vs. 10.25±1.67, TCM syndrome total score: 4.0 (3.0, 8.0) vs. 8.0 (5.0, 10.0), all P < 0.05]. The total effective rate of the test group was significantly higher than that of the control group [88% (88/100) vs. 84% (84/100), P < 0.05]. Conclusion Kuanxiong Lifei decoction can significantly reduce lung inflammatory factors, ameliorate overall symptoms and improve the prognosis of AECOPD patients with turbid phlegm obstructing lung syndrome.

The concept of theranostics, where individual patient-level biological information is used to choose the optimal therapy for that individual, has become more popular in the modern era of ‘personalised’ medicine. With the growth of theranostics, nuclear medicine as a specialty is uniquely poised to grow along with the ever-increasing number of concepts combining imaging and therapy. This special report summarises the status and growth of Theranostic Nuclear Medicine in Singapore.We will cover our experience with the use of radioiodine, radioiodinated metaiodobenzylguanidine, peptide receptor radionuclide therapy, prostate specific membrane antigen radioligand therapy, radium-223 and yttrium-90 selective internal radiation therapy.We also include a section on our radiopharmacy laboratory, crucial to our implementation of theranostic principles. Radionuclide theranostics has seen tremendous growth and we hope to be able to grow alongside to continue to serve the patients in Singapore and in the region.
Hope ; Humans ; Lutetium ; Membranes ; Nuclear Medicine ; Prostate ; Radium ; Receptors, Peptide ; Singapore ; Theranostic Nanomedicine ; Yttrium

The concept of theranostics, where individual patient-level biological information is used to choose the optimal therapy for that individual, has become more popular in the modern era of ‘personalised’ medicine. With the growth of theranostics, nuclear medicine as a specialty is uniquely poised to grow along with the ever-increasing number of concepts combining imaging and therapy. This special report summarises the status and growth of Theranostic Nuclear Medicine in Singapore.We will cover our experience with the use of radioiodine, radioiodinated metaiodobenzylguanidine, peptide receptor radionuclide therapy, prostate specific membrane antigen radioligand therapy, radium-223 and yttrium-90 selective internal radiation therapy.We also include a section on our radiopharmacy laboratory, crucial to our implementation of theranostic principles. Radionuclide theranostics has seen tremendous growth and we hope to be able to grow alongside to continue to serve the patients in Singapore and in the region.