Systemic lupus erythematosus (SLE) is a kind of complex autoimmune connective tissue disease involving multi-organ and multiple systems.And the cardiovascular complication is a major cause of mortality in SLE patients.The diagnosis and evaluation depend on imaging.As a non-invasive,simplicity and repeatability method,echocardiography plays a vital role in evaluating heart structure and function.The application of echocardiography in the SLE with cardiovascular complications were reviewed in this article.

AIM:To prepare O/W microemulsion formulation containing sinomenine and investigate the effect of different penetration enhancers on transermal delivery character of microemulsion in vitro. METHODS: The microemulsions were prepared and characterized using Zetasize potential/particle size analysis instrument.The stability tests were performed to evaluate the sinomenine microemulsions.Franz diffusion cell was adopted as the apparatus for in vitro transdermal test.Excised Wistar-rat abdomen skin was pretreated with penetration enhancers,such as menthol,borneol and isopropyl myristate. RESULTS: The average droplet size of the microemulsion was about(31.3 nm.)A high permeation rate of(32.238?1.13)?g/cm~(2)?h was showed in vitro.Ail the enhancers showed significant enhancement effect on the transdermal behavior of sinomenine microemulsion.2% borneol had the strongest effect in all. CONCLUSION: These results indicate that the studied microemulsion system with high permeation rate may be a promising vehicle for the transdermal delivery of sinomenine.Menthol,borneol and isopropyl myristate were found to be the proper penetration enhancers in the transdermal preparation.

BACKGROUND: The pathogenesis of alcoholic avascular necrosis remains unclear. OBJECTIVE: To introduce the physiological structure and pathologic changes induced by alcohol of the microenvironment of femoral head, and to review the research status of the influence of alcohol on the microenvironment of femoral head. METHODS: A computer-based online research of PubMed database for clinical and basic studyies concerning the effect alcohol on the microenvironment of femoral head published from 1990 to 2016. The pathological changes of alcoholic osteonecrosis of the femoral head were overviewed. RESULTS AND CONCLUSION: There are various theories about the pathogenesis of alcoholic osteonecrosis of thefemoral head, but the essence is the disturbance of blood circulation in femoral head, and long-term decrease in the nutrients and oxygen supplying of bone leading to bone degeneration and necrosis. Large-dose intake of alcohol will induce the imbalance of oxidation and anti-oxidation system, which dose harm to the microenvironment of femoral head. The change of oxygen supplying accelerates the necrosis of femoral head, the weakened differentiation of bone marrow mesenchymal stem cells into osteoblasts and the disturbance of bone resorption-formation imbalance finally result in the necrosis and collapse of femoral head. It is expected to provide a new therapeutic strategy for delaying or preventing the early femoral head necrosis by controlling the microenvironment of femoral head.

OBJECTIVE:To evaluate the cost-effectiveness of 3 therapeutic schemes in the treatment of Parkinson's disease (PD). METHODS:A total of 94 PD cases were randomly assigned into 3 groups:Group A (Benserazide tablets +carbidopa and Levodopa controlled release tablets),Group B (Benserazide tablets+Carbidopa and Levodopa controlled release tablets+Selegiline tablets) and Group C (Benserazide tablets+Carbidopa and Levodopa controlled release tablets+Entacapone tablets). After treatment for 8 weeks,the cost-effectiveness analysis were conducted for all the 3 groups. RESULTS:For Group A,B and C,the costs were 448.78,803.89,1 559.89 yuan,respectively; the total effective rates were 56.67%,83.33% and 85.71%,respectively; the cost-effectiveness ratios were 791.92,964.71,1 819.96,respectively. The incremental cost-effectiveness ratios of Group B and C were 1 332.00 and 3 826.14,respectively as against Group A. CONCLUSION:Group B is preferable for PD among the 3 groups.

Objective To assess the effect of resident training in clinical skills on SARS prevention and treatment. Methods A survey was conducted by means of questionnaires on 101 residents of the authors' hospital who were at the forefront of the fight against SARS. Results Training in clinical skills assisted the residents to various degrees in SARS prevention and treatment. 100% of the residents surveyed held that the training was helpful, beneficial and assisted them in solving problems. Conclusion Training in clinical skills, which rendered the residents proficient in basic skills and more capable of clinical application of the skills, also enhanced their ability to handle emergent events in SARS prevention and treatment.

ObjectiveTo investigate osteopontin (OPN) level in pulmonary tuberculosis and its clinical significance.MethodsThe level of serum OPN was determined in 80 pulmonary tuberculosis patients before anti-tuberculosis treatment[patients group,simple pulmonary tuberculosis with 60 cases (simple pulmonary tuberculosis group),pulmonary tuberculosis combined with tuberculous pleurisy with 20cases (pulmonary tuberculosis combined with tuberculous pleurisy group)],and compared with that of 30healthy persons (healthy control group) and 20 patients having received effective anti-tuberculosis treatment and followed-up for 6 months (followed-up group).At the same time,the clinical significance of OPN was studied by other commonly used clinical indicators of tuberculosis.ResultsThe level of serum OPN in patients group [(843.49 ±569.23) ng/L] was significantly higher than that in healthy control group [(352.50 ± 185.02) ng/L,P ＜0.05].The level of serum OPN after treatment in followed-up group were significantly decreased compared with those before treatment [(494.11 ±352.40) ng/L vs.(1106.60 ± 628.39) ng/L,P＜ 0.05 ] and there was no significant difference compared with those in healthy control group (P ＞ 0.05 ).The level of serum OPN in pulmonary tuberculosis combined with tuberculous pleurisy group [(1179.80 ±606.33) ng/L] was significantly higher than those in simple pulmonary tuberculosis group [(727.53 ±511.66) ng/L,P ＜0.05],and they were both higher than those in healthy control group [ ( 352.50 ± 185.02 ) ng/L,P ＜ 0.05 ].Therefore,for further additional subgroup analysis in simple pulmonary tuberculosis group,the level of serum OPN in patients with cavity[ ( 836.51 ± 549.80) ng/L ] was significantly higher than that without cavity [ (535.52 ± 375.95 ) ng/L,P ＜ 0.05 ],while the levels of serum OPN had no statistical difference between pulmonary lesion involved ＜ 3 leaf patients and ≥ 3 leaf patients,sputum mycobacterium tuberculosis positive patients and negative patients,mycoDot test results positive patients and negative patients,erythrocyte sedimentation rate elevated patients and normal patients,PPD strongly positive patients and non-strongly positive patients (P＞0.05).ConclusionsOPN activity is closely related with pulmonary tuberculosis.OPN can serve as a judge of pulmonary tuberculosis and the clinical indicators of disease outcome.The level of serum OPN and the severity of pulmonary tuberculosis have some correlations.

Epigenetics is defined as heritable changes in genc expression that are,unlike mutations,not attributable to alterations in the sequence of DNA.The predominant epigenetic mechanisms are DNA methylation,histone modification and microRNA.Exploring the precise roles of epigenetic factors on autoimmunity has become an active research area.Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disorder with a prevalence of approximately 0.5％ to 1.0％ worldwide.The mechanisms underlying the initiation and progression of RA are still not completely understood.In recent years,the epigenetics of RA have been widely investigated.Alterations in the modification of histones and DNA methylation are the two major epigenetic mechanisms that may potentially cause a breakdown of immune tolerance and the perpetuation of RA.These epigenetic changes may be ideal targets for new personalized treatments.

This article studies the application value of disposable umbilical cord clamp and amputator during gravida childbirth.The umbilicalis is clamped and sheared with disposable umbilical cord clamp and amputator in the area of 3~5mm far from the neonatal abdomen.The operation is simple and consumedly shortens the time and reduces the procedure compared to the traditional method.It is safe and convenient,which is worth spreading.

Objective The regulation on glucose transporters(GLUT1~GLUT5)by sodium butyrate was observed,and the regulation on bax and bcl-x/l by sodium butyrate and glucose was studied.This helped to learn about the possible mechanism of apoptosis of cancer cells induced by sodium butyrate.Methods The expression of GLUT1~GLUT5 mRNA was detected by RT-PCR.The expression of bax and bcl-x/l was detected by immuocytochemistry.Cell apoptosis was detected by TUNEL assay.Results In HT-29 cell line,sodium butyrate downregulated the expression of GLUT1 mRNA and the expression of bcl-x/l and induced cancer cell apoptosis,but did not regulate the expression of GLUT2,GLUT3,GLUT5 and bax.GLUT4 was not detected in HT-29 cell line.And when treated with sodium butyrate,the increase of concentration of glucose could increase the expression of bcl-x/l and reduce the effect of apoptosis induced by sodium butyrate.Without treatment with sodium butyrate,the change of glucose concentration only had a feeble regulation on apoptosis.Conclusion Sodium butyrate can obviously downregulate the expression of GLUT1 and downregulation of the expression of GLUT1 is associated with the apoptosis induced by sodium butyrate in HT-29 cell line.

Professor LI Guo-heng is one of famous TCM old doctors in our country.He is the main outstanding inheritor of Wei Shi Traumatology.He is skill in internal and external use of Chinese herb,manipulation and body guidance technique.He is good at treating injury congestion syndrome,Jin Chu Cao,Gu Cuo Feng with Wei Shi Traumatology.Combining differentiation syndrome with differentiation diseases,and using Chinese herb and manipulation,which has a good clinical efficacy.