Objective To compare the clinical features and treatment between elderly onset rheumatoid arthritis(EORA)and young onset rheumatoid arthritis(YORA).Methods The EORA patients (n=60)and the YORA patients (n =90)were compared regarding sex ratio,activity of pathogenetic condition,disease severity,extra-articular manifestations,complications,laboratory indexes,and therapeutic schedules.Results The female/male ratio was 36/24(1.50 ∶ 1.0)in group EORA,and 69/21(3.3 ∶ 1.0)in group YORA,with higher female/male ratio in in group YORA.The frequency of morning stiffness,proximal interphalangeal joint involvement and metacarpophalangeal joint involvement were lower in group EORA(53.3 ％,46.676％ and 61.67 ％) than in group YORA (72.2 ％,77.8 ％,81.11％) (x2 =5.521,15.385,6.960,P =0.018,0.000,0.008 respectively).Large joints involvement at onset of rheumatoid arthritis was higher in group EORA(38.33 ％)than in group YORA(18.89 ％)(x2=6.960,P=0.008).The joint swollen and tender counts were comparatively less (16.51 ± 7.34) and (15.92 ± 8.44) in group EORA than in group YORA(22.46 ± 7.58) and (23.8 ± 8.93) (t =5.080、5.740,all P =0.000) respectively.The accumulated disease activity score(DAS28)was higher in group EORA(5.86± 1.57)than in YORA(4.92± 1.64) (t=3.360,P =0.001).HAQ score was lower in group EORA(0.83 ± 0.85)than in group YORA (1.16±0.91) (t=2.43,P =0.02).Comorbid conditions such as osteoarthritis,osteoporosis,cardiovascular disease and chronic renal insufficiency were more frequent in group EORA (51.7 ％,31.7 ％,18.3 ％ and 15.00％)than in group YORA(27.8％,15.6％,5.6％ and 4.4％)(x2 =11.722,5.445,6.168,5.067,P=0.001,0.020,0.013,0.024).The positive rate of RF were more higher in YORA(70.00％)than in group EORA (48.33％)(x2 =7.126 P=0.008).The synthetic or biologic traditional DMARDs (disease modifying antirheumatic drugs)were widely used in group YORA(78.9％ and 31.1％)than in group EORA(40.0％ and 10.0％)(x2 =14.940,9.153,P =0.000,0.002).The more frequently used program with glucocorticoids hormonal therapy was received in group EORA(38.3 ％)than in group YORA(20.00 ％)(x2 =6.092 P=0.014) Conclusions EORA patients differs from YORA patients in many of ways,including a more balanced gender distribution,atypical presentation at onset of disease,more frequent involvement of large joints,seronegativity in a higher percentage,and less frequent positivity of anti CCP-antibody,which makes diagnosis more difficult in the earlier period.Therapy of EORA with DMARDs should be instituted based on disease activity,if there is no contraindication.

OBJECTIVE:To provide reference for clinical rational drug use.METHODS:Computer network system(CNS)of clinical rational drug use was constructed by using Hospital Information System(HIS),electronic medical records for both outpatients and inpatients and Prescription automatic screening system(PASS),which was then used for real time monitoring of clinical drug use.RESULTS & CONCLUSION:CNS has become an indispensable means for hospital management and clinical drug use in that it can provide support for the data analysis of clinical rational drug use,improve the level of clinical rational drug use,standardize the medical behavior and imrpove the treatment quality.

Objective To investigate the management of pseudomyxoma peritonei originated in the appendix.Methods The clinical data of 51 patients with pseudomyxoma peritonei originated in the appendix who were admitted to the Beijing Hospital from 1970 to 2010 were retrospectively analyzed.The results of operation,reoperation,adjuvant treatment and follow-up were analyzed.The time from pseudomyxoma peritonei recurrence to the reoperation between patients who did or did not receive chemotherapy was compared by two tailed t test.Results Of the 51 patients,48 received operation,and the operation time was (135 ± 72 )minutes.Tumor recurrence was observed in 34 patients,and 16 of them received cytoreduction procedure,and 33 cytoreduction procedures were performed in total.The median time of follow-up was 49.7 months (range,3-132 months).The disease-specific survival was observed in 25 patients and disease-free survival in 16 patients.Four patients died of tumor recurrence or progression.The results of postoperative pathological examination confirmed that 19 patients were with benign disseminated peritoneal adenomucinosis (DPAM),26 were with malignant peritoneal mucinous carcinomatosis (PMCA) and 6 were with intermediate subtype (PMCA-1).The 3-,5- and 10-year survival rates were 75％ (38/51),55％ (28/51) and 22％ ( 11/51 ),respectively.The survival time and reoperation time interval for patients who received postoperative chemotherapy were ( 21 ± 4) months and ( 10 ± 6 ) months,which were longer than (19 ±7 )months and (7 ±4)months of those who did not receive postoperative chemotherapy (t =1.027,0.361,P ＞ 0.05).The median survival time of patients with benign DPAM,PMCA-1 and malignant PMCA were 96,63,23 months,respectively.The tumor recurrence interval for patients with benign DPAM and those with malignant PMCA were ( 15 ± 5 ) months and (7 ± 4) months,with significant difference ( t =2.193,P ＜ 0.05 ).Conclusions An active cytoreduction surgery is feasible for patients with pseudomyxoma peritonei originated in the appendix in improving survival.Repeated cytoreduction is a treatment of strategy to prolong the recurrence time and improve the prognosis of selected patients.

Objective To investigate the biological characteristics of mouse erythrolenkemia cell FBL-3.Methods The morphological feature, growth characters, clone formation and immunochemistry of mouse erythroleukemia cell FBL-3 were examined by light microscope. The cell cycle distribution and expression of MHC were detected by flow cytometry. Drug sensitivity was measured by MTT assay. Tumorigenicity was evaluated after intravenous injection FBL-3 cells into C57BL/6 mice. Results FBL-3 cells were smaller,fusiform or polygon, adherence. Doubling time was 24.12 h. The clone formation rates were (35.23±1.44) %and (60.27±5.56) % at 14 th and 21 th day, respectively. The reactions for PAS and chloracetic acid were positive, while the POX, NAP and butanoic acid reactions were negative. The cell cycle distribution was as follow: G0/G1 phase (50.9±2.5) %, S phase (36.3±1.4) %, G2/M phase (13.8±0.8) %. The IC50 of FBL-3 cells to Ara-C, VDS, DDP, MMC and MTX were (0.49±0.04), (0.87±0. 09), (3.77±0.32), (1.66±0.16) μmol/L and (2.77±0.24) nmol/L, respectively. Chromosome number was at 34 to 41. MHC of FBL-3 cell was H-2b. Sexual gene Sry was positive. All C57BL/6 mice were morbidity with erythroblastic leukemia when FBL-3 cells had been intravenously inoculated. There was a linear relationship between the survival time and the number cell injected. The main targets for the leukemic FBL-3 cells were liver, spleen, kindey and lung. Conclusion FBL-3 cell has typical features of mouse leukemia cell, was easily cultured in vitro and tumorigenesised in C57BL/6 mice. FBL-3 cell could be as a satisfactory tool for the research of leukemia.

Objective To investigate the effect of pyrrolidine dithiocarbamate(PDTC) on monocyte chemotactic protein1 (MCP-1) in rejection of cardiac allograft and its mechanisms.Methods Heterotopic cervical heart transplantation was performed by cuff-technique.The SD rat recipients were randomly divided into 3 groups:AR group (Acute rejection,n =12),both the recipients and donors were without any treatment.CsA group(n =12),the recipients were treated with 10 mg/kg cyclosporine A after transplantation.PDTC group(n =12),the recipients were treated with 100 mg/kg PDTC after transplantation.All the cardiac allografts were harvested at different time post transplantation according to requirements.We studied allograft myocardial fibrosis wih the help of Masson stain,immuno-histo-chemistry and western blot also were used to detect the expression of MCP-1.Results The survival time of the cardiac allografts was significantly longer in PDTC group than in acute rejection group and CsA group(P ＜ 0.01),and myocardial fibrosis of cardiac allografts in PDTC group was significantly decreased (P ＜ 0.01).The IOD in PDTC group was markedly lower than in CsA group (P ＜ 0.01).Conclusion As the inhibitor of NF-κB,PDTC can significantly relieve rejection of cardiac allograft by inhibiting the expression of MCp-1.

Objective To investigate change of chemokine mRNA and protein in the patients with diabetes mellitus(DM)complicated infection.Methods Fourty-eight patients with DM complicated infection were studied.Expression of mRNA and protein of monocyte chemoattractant protein-1(MCP-1)and interleukin 8 (IL-8)were measured by FQ-PCR,RT-PCR and ELISA.The relationship between hs-CRP,PMNL,IL-8 and MCP-1 were analyzed.Results Expression of mRNA and protein of MCP-1 and IL-8 were increased in the DM patients complicated infection.MCP-1 mRNA(mesured by FQ-PCR)was positively correlated with the protein(IL-8 r = 0.33;MCP-1 r = 0.88;P

AIM: To explore the therapeutic effects of flunarizine combined with aspirin in the treatment of migrainous cerebral infaction. METHODS: 38 cases of patients diagnosed as migrainous cerebral infaction were respectively given flunarizine 10 mg combined with aspirin 100 mg every night for a month. The observed indices included the dysfunction scores of nervous system, the total classes of living ability, and the accumulating rate of platelet and viscosity of plasma before and after the treatment. RESULTS: Before the treatment the dysfunction scores of nervous system and the living ability of the patients were 13.51 ? 4.78 and 3.45 ? 1.13 , and after the treatment the values were 4.34 ? 1.85 and 1.79 ? 0.72 respectively (P

Objective: To acquire recombinant nematode anticoagulant peptide ( NAP) with high anticoagulant activity. Methods: Pichia pastoris GS115 strain was transformed with recombinant yeast expression vector pPICS. 5K-rNAP. Expression of rNAP was induced with methanol after the identification of positive strains. NAP expressed in the collected yeast culture supernatant was confirmed with SDS-PAGE and Western blot. The biological activity of the products was validated with PT (prothrombin time) , INR (international normalized ratio) and APTT (activated partial thromboplastin time) , respectively. Results: The yeast strains expressing NAP were identified. The rNAP was secreted into culture supernatant with a molecular weight of about 10 kDa due to glycosylation, which is a little bigger than that predicted (8.7kDa). The anticoagulant efficiency of rNAP was confirmed with the in vitro assays. Conclusion: The recombinant nematode anticoagulant peptide with high biological activity was successfully expressed in Pichia pastoris and can be used in the future development of novel anticoagulant agent.

Objective To investigate the effect of arginase (Arg) inhibitor N-ω-Hydroxy-L norArginine (nor-NOHA) on high glucose cultured rhesus macaque retinal vascular endothelial cell line (RF/6A) in vitro.Methods The RF/6A cells were divided into the following 4 groups:normal control group (5.0 mmol/L of glucose,group A),high glucose group (25.0 mmol/L,group B),high glucose with 125 mg/L nor-NOHA group (group C),and high glucose with 1％ DMSO group (group D).The proliferation,migration ability and angiogenic ability of RF/6A cells were measured by Methyl thiazolyl tetrazolium (MTT),transwell chamber and tube assay respectively.The express of Arg Ⅰ,eNOS,iNOS mRNA of RF/6A cells were measured by real-time polymerase chain reaction (RT-PCR),Enzyme-linked immuno sorbent assay (ELISA) was used to detect the expression of NO and interleukine (IL)-1b of RF/6A cells.Results The proliferation,migration,and tube formation ability of group A (t=2.367,5.633,7.045;P＜0.05) and group C (t=5.260,6.952,8.875;P＜0.05)were significantly higher than group B.RT-PCR results showed the Arg Ⅰ and iNOS expression in group B was higher than that in group A (t=6.836,3.342;P＜0.05) and group C (t=4.904,7.192;P＜0.05).The eNOS expression in group B was lower than that in group A and group C (t=4.165,6.594;P＜0.05).ELISA results showed NO expression in group B was lower than that in group A and group C (t=4.925,5.368;P＜0.05).IL-1b expression in group B was higher than that in group A and group C (t=5.032,7.792;P＜0.05).Conclusions Nor-NOHA has a protective effect on cultured RF/6A cells in vitro and can enhance its proliferation,migration and tube formation.The mechanism may be inhibiting the oxidative stress by balancing the expression of Arg/NOS.

Objective To investigate the effects of exosomes from cultured human retinal pigment epithelium (ARPE-19) cells affected by oxidative stress on the proliferation and expression of vascular endothelial growth factor-A (VEGF-A) and Akt of ARPE-19 cells. Methods Culture ARPE-19 cells. The concentration of 2.5μmol/L rotenone was selected to simulate oxidative stress and isolated ARPE-19-exosome. Exosomes were isolated by ExoQuick exosome precipitation solution. Transmission electron microscopy was used to identify the morphology of exosomes. Western blot was used to detect exosomes’ surface-specific maker protein CD63. ARPE-19 cells affected by oxidative stress were cultured with exosome as experimental group, normal ARPE-19 cells were cultured with exosome as control group. The cell proliferation was examined by methyl thiazolyl tetrazolium assay. Western blot and immunofluorescence assay were used to detect the expression levels of VEGF-A and Akt protein. Real-time quantitative polymerase chain reaction (RT-PCR) was used to detect the levels of VEGF-A mRNA and Akt mRNA. Results The diameter of normal ARPE-19-exosomes ranged from 50 to 150 nm. The isolated exosomes expressed CD63. AREP-19 cells were cultured with ARPE-19 (affected by rotenone)-exosome, the cell viability in experimental group was significantly reduced than in the control group. Green fluorescence was observed in the cytoplasm under fluorescence microscope. Compared with the control group, VEGF-A was up-regulated expressed and Akt was down-regulated expressed. Western blot results showed that, VEGF-A protein expression in the experimental group were higher than the control group. Akt protein expression in the experimental group were less than the control group. The difference was statically significant (t=3.822, 6.527;P<0.05). RT-PCR results showed that VEGF-A mRNA expression levels was higher in the experimental group than the control group. Akt mRNA expression levels was lower in the experimental group than the control group. The difference was statically significant (t=8.805,?7.823;P<0.05). Conclusions Exosomes from ARPE-19 cells affected by oxidative stress inhibit the proliferation of normal ARPE-19 cells, increase the expression of VEGF-A and reduce the expression of Akt.