Objective To study the the overall effect of methotrexate combined with multi-glycosides of tripterygium wilfordii on the clinical intervention of rheumatoid arthritis.Methods In Changxing county people's hospital,96 cases with rheumatoid arthritis were selected as the research object,which were randomly divided into the the control group and the study group,48 cases in each group.On the basis of the basic treatment in the two groups,the control group were given methotrexate,the experimental group were given methotrexate combined with multi-glycosides of tripterygium wilfordii.3 months after treatment,the clinical symptoms,the laboratory index and assessment of disease activity by physicians and patients were evaluated.The drug safety was observed.Results Before treatment,The clinical symptoms,laboratory index and physician and assessment of disease activity by physicians and patients showed no significant differences between the two groups.All the indexes in the two groups after treatment were improved(P<0.05).Compared with the control group,all the indexes in the study group were better(P<0.05).There were 4 cases(8.3％)gastrointestinal adverse reaction in the control group and 6(12.5％)in the study group.There was no significant difference about adverse reaction between the two groups.Conclusion It can obtain satisfactory overall effect that methotrexate combined with multi-glycosides of tripterygium wilfordii on the clinical intervention of rheumatoid arthritis which is safty.The joint pain,swelling and other symptoms and inflammatory index were significantly improved.It is worthy of clinical application.

Objectives To evaluate the influence of cardio-pulmonary bypass (CPB) to the endothelial function and lipid oxidative status of the Coronary Artery Bypass Grafting (CABG) patients. Methods Thirty-five coronary patients (female 5 cases, male 30 cases, mean age 59.5±8. 6 years) who needed CABG operation therapy were included. The control group consisted of 20 health volunteers (female 5 cases, male 15 cases, mean age 49. 5 ± 7.3 years).Blood samples were taken at preoperative, 3 and 7 days postoperative. Serum von Willebrand factor (vWF) level, one of the endothelial dysfunction markers,and oxidized low density lipid (OxLDL) level, one of the lipid oxidization status markers were detected with ELISA kits. Results The levels of vWF and OxLDL in CABG patients' serum were elevated significantly compared with those of control group ( 139.60% ± 34. 39% vs 82. 79% ±13. 89% and 63. 7 ±18. 9U/ml vs 25.4± 15.2U/ml respectively). Three and 7 days after CABG significant increases in the vWF level (194. 30% ±37. 74%; 181.07% ±31.05%vs 139.60% ±34.39% at baseline, P＜0. 0001, respectively) and OxLDL level (79. 3±26. 7U/ml; 72.4±23.1U/ml vs 63.7±18. 9U/ml at baseline, P＜0. 01, respectively) were detected. Conclusion Compared with normal people, the endothelial system of CABG patients is impaired, and their lipids are in a more oxidative status. CABG procedure with CPB can further deteriorate the conditions, which may imply that the patients are predisposed to acute coronary accident shortly are the procedure.

Objective To primarily study the possible biological significance of yon Willebrand factor (vWF) expression at the fracture site in the mechanism of fracture healing. Methods A total of 28 male SD rats were selected to set up femoral fracture models. Then, tissue samples from fracture site were randomly taken at days 2, 3, 5, 7, 10, 14 and 21 after establishment of the models, with 4 rats at each time point, vWF expression at fracture site and the relationship of vWF expression with osteoblasts and chondroblasts were observed by using computer image analysis system. The biological significance of vWF expression at fracture site in mechanism of fracture healing were analysed based on the results of vWF expression of in vitro cultured rat osteoblasts. Results The expression of vWF at every time point was positive and distributed disproportionally irregular at bone trabecula and soft tissue of the fracture site. vWF expressed positively in the extracellular matrix around the chondroblasts. Conclusions During the course of fracture healing, there may be vWF-platelet activation pathway that can regulate differentiation and proliferation of local osteoblasts and chondrocytes and activate platelets secreting growth factors such as PDGF, IGF-1, EGF and TGF-a, as creates a sound microenvironment for fracture healing.

Objective To determine the real time radiation dose rate displayed on DSA equipment in interventional management for patients with coronary heart disease in order to provide medical staff with useful basis to reasonably control the radiation dose. Methods A total of 30 patients with coronary heart disease, who received interventional treatment at authors’ hospital in September 2014 with a GE DSA unit, were randomly selected. Intraoperative radiation dose rates when fluoroscopy was converted to movies , which were displayed on DSA at respective sequence, were determined, and the results were analyzed and compared. Results The fluoroscopy radiation dose rate ranged from 18.5 to 212.0 mGy/min, the mean value was (114.7±42.1) mGy/min;while the radiation dose rate of movies varied from 216 to 1 691 mGy/min, with a mean value of(970.1±298.4) mGy/min. The overall mean fluoroscopy-to-movies radiation dose ratio was 1 ∶8.5. The larger the digital flat panel detector area was , the bigger the mean radiation dose rate would be and the more obvious increase in the mean radiation dose rate of movies than that of the fluoroscopy would be observed; the mean radiation dose rate of fluoroscopy was lower than that of movies , and the difference was significantly. Conclusion During the performance of coronary intervention , the medical staff should make reasonable choice of the equipment and closely observe the dynamic real-time display of the radiation dose rate, promptly adjust the inspection mode and the controllable parameters when it is needed , make immediate evaluation of dose level that might cause radiation injury to the patient , and reasonably control the radiation dose to reduce the effects of ionizing radiation on human health.

Objective:To establish a method for simultaneous determination of 7 elemental impurities(V,Co,Ni,As,Cd,Hg Pb)in amlodipine besylate tablets based on inductively coupled plasma mass spectrometry(ICP-MS).Methods:After the samples were treated by microwave digestion,the solution was analyzed by ICP-MS.Ge,In,Bi were selected as the internal standards.The established method was validated.The contents of 7 elemental impurities in amlodipine besylate tablets from 54 enterprises were determined by this method.Results:The content of(V,Co,Ni,As,Cd,Hg,Pb had good linear relationship in the ranges of 1-100,1-100,1-100,1-100,1-100,0.5-4,1-100 ng·mL-1,respectively.The correlation coefficients(r)all above 0.999 4.The detec-tion limits and quantification limits were in the range of 0.000 4-0.018 4 ng·mL-1 and 0.001 4-0.061 2 ng·mL-1.The RSD of precision was less then 1.8％.The RSD of repeatability was less then 6.1％.The average re-coveries(n=9)were between 85.4％-106.5％,while their RSD was less then 4.7％.The content of 7 elemental impurities in 54 sample batches were in accordance with the limit value.Conclusion:The method is simple,rapid,accurate,reliable and highly sensitive,and can be used for the quality control of elemental impurities in amlodipine besylate tablets.

OBJECTIVETo evaluate the efficacy and safety of glucosamine hydrochloride for the treatment of osteoarthritis.

METHODSA multi-central, randomized, controlled clinical trial of glucosamine hydrochloride comparing glucosamine sulfate for the treatment of osteoarthritis was performed. One hundred and forty-three patients suffering from knee or hip osteoarthritis were randomized into study (glucosamine hydrochloride) or control (glucosamine sulfate) group. Patients in study group orally took glucosamine hydrochloride 2 times daily for 6 weeks, each time 1 capsule, and those in control group took glucosamine sulfate 3 times daily for 6 weeks also, each time 2 capsules.

RESULTSThe symptomatic improvement of joint pain at walking, at rest and stiffness after 6 week treatment with glucosamine hydrochloride was better than those with glucosamine sulfate. The results had significant difference (P < 0.05). Total effective rates of patients with glucosamine hydrochloride was 75.4% and 60.6% with glucosamine sulfate, but no statistical difference. The results suggested both glucosamine had the considerable efficacy in the treatment of osteoarthritis. Three cases in study group and 2 in control group reported mild adverse events. No severe adverse events (SAE) was observed.

CONCLUSIONGlucosamine hydrochloride is as effective and safe as glucosamine sulfate for the treatment of osteoarthritis.

Double-Blind Method ; Female ; Glucosamine ; therapeutic use ; Humans ; Male ; Osteoarthritis, Hip ; drug therapy ; Osteoarthritis, Knee ; drug therapy ; Treatment Outcome

Objective To investigate the clinical manifestations, laboratory and imaging features, treatments and prognosis of anti GABA-B receptor encephalitis. Methods We performed a retrospective analysis of the clinical data of five cases with anti GABA-B receptor encephalitis diagnosed by cerebrospinal fluid immunological examination. Results Five cases had acute onset. The initial clinical symptom was epileptic seizure. After epileptic attack, patients developed different degrees of cognition dysfunction, mental and behavioral disorders. Neuroimaging showed that the lesions mainly involved medial temporal lobe and hippocampus. The lesions ware equal or low density shadows in CT scan and long T 1 and T2 signals, T2 high signals on Flair, equal or high signals on DWI in MRI scan. Cranial MRI enhancement showed lesions with no enhancement in two tested cases. One case took PET-CT and data showed a low density shadow of temporal lobe and hippocampus with increased metabolism. CSF and blood immunological examinations showed CSF GABAB-R-AB positive (+), blood GABAB-R-AB positive (+). Five cases were associated with increased NSE. EEG was nonspecific and related to the conscious state of the patient. Lung CT showed enlarged mediastinal lymph nodes in 5 tested cases. Central lung cancers were found in five cases including three cases at onset and two cases during three month follow-up. Bronchoscopic biopsy identified small cell lung cancer in two examined cases. Conclusion Epileptic seizure is the most frequent initial symptoms of anti GABA-B encephalitis. Inflammatory response signals in the medial temporal lobe and hippocampus are image features of anti GABA-B encephalitis. The disease is closely related to lung cancer (Especially c small cell lung cancer, SCLC). Immunological examination of cerebrospinal fluid and the above characteristics are helpful for diagnosis.

OBJECTIVE To systematically evaluate the safety of paroxetine in the treatment of pregnant patients with depression in the second and third trimesters of pregnancy， and provide reference for rational clinical use of it. METHODS Retrieved from Cochrane Library， PubMed， Embase， VIP， CNKI， Wanfang database and SinoMed database， by manual search， randomized controlled studies or observational studies were collected on depression patients who were given paroxetine vs. selective serotonin reuptake inhibitor （SSRI） in the second and third trimesters of pregnancy during the inception to Aug. 2022. Methodological qualities of the included studies were assessed by Cochrane Handbook 5.1.0 or Newcastle-Ottawa Scale （NOS）. Meta-analysis was performed with RevMan 5.4.1 software. RESULTS Finally， 9 observational studies were included， and all included studies were of high quality in NOS scale. Meta-analysis was performed on 8 cohort studies. Meta-analysis showed that the total incidence of adverse pregnancy outcomes of mothers and infants [RR＝0.99， 95%CI（0.89，1.10），P＝0.87]， total incidence of maternal adverse pregnancy outcomes [RR＝0.98， 95%CI （0.87，1.10）， P＝0.69] and premature birth [RR＝0.89， 95%CI （0.43， 1.83）， P＝0.75] in the second and third trimesters of pregnancy were lower than that with other SSRI， without statistical significance. The incidence of neonatal complications with paroxetine in the second and third trimesters of pregnancy was higher than that with other SSRI， but the difference was not statistically significant [RR＝1.02， 95%CI （0.82，1.29）， P＝0.84]. One study reported that the incidence of neonatal pulmonary hypertension in paroxetine group was higher than that in other SSRI group （0.4% vs. 0.3%）. CONCLUSIONS The safety of peroxetine in the second and third trimesters of pregnancy is comparable with that of other SSRI， but it is necessary to be alert to the occurrence of neonatal pulmonary hypertension.

The vagina contains at least a billion microbial cells,dominated by lactobacilli.Here we perform metagenomic shotgun sequencing on cervical and fecal samples from a cohort of 516 Chinese women of reproductive age,as well as cervical,fecal,and salivary samples from a second cohort of 632 women.Factors such as pregnancy history,delivery history,cesarean section,and breastfeeding were all more important than menstrual cycle in shaping the microbiome,and such information would be necessary before trying to interpret differences between vagino-cervical micro-biome data.Greater proportion of Bifidobacterium breve was seen with older age at sexual debut.The relative abundance of lactobacilli especially Lactobacillus crispatus was negatively associated with pregnancy history.Potential markers for lack of menstrual regularity,heavy flow,dysmenor-rhea,and contraceptives were also identified.Lactobacilli were rare during breastfeeding or post-menopause.Other features such as mood fluctuations and facial speckles could potentially be predicted from the vagino-cervical microbiome.Gut and salivary microbiomes,plasma vitamins,metals,amino acids,and hormones showed associations with the vagino-cervical microbiome.Our results offer an unprecedented glimpse into the microbiota of the female reproductive tract and call for international collaborations to better understand its long-term health impact other than in the settings of infection or pre-term birth.

Abdomen/diagnostic imaging* ; Artificial Intelligence ; Body Composition ; Magnetic Resonance Imaging ; Practice Guidelines as Topic