AIM　The purpose is to study the anti-arrhythmic effects of extracts from cultured Cordyceps sinensis. METHODS　Aconitine and barium chloride were used to induce experimental arrhythmia models in rats. RESULTS　The results showed that PE was more potent than other ingredients. Pretreatment with PE by oral administration significantly antagonized arrhythmia induced by aconitine. PE significantly prolonged the onset of arrhythmia, decreased the duration and diminished the degree of severity. And in barium chloride-induced arrhythmia model, PE had some anti-arrhythmia effect，which could diminish the degree of severity effectively to some extent. CONCLUSION　PE is an active component to antagonize arrhythmia induced by aconitine and barium chloride.

Objective To study the prediction value of C-reactive protein (CRP) level to ankylosing spondylitis disease activity score (ASDAS),the most widely used activity score in ankylosing spondylitis (AS).Methods A total of 386 patients with AS were enrolled and divided into 2 groups by CRP≥3.5 mg/L (n =266) and CRP ＜ 3.5 mg/L(n =120).ASDAS-CRP was evaluated in patients with CRP below the normal range (3.5 mg/L) in different subgroups.Three methods were used to test the consistency between ASDAS-CRP and ASDAS-erythrocyte sedimentation rate (ESR).Results The ASDAS-CRP showed a good correlation with the ASDAS-ESR when CRP level was ≥ 3.5 mg/L (r =0.899,P =0.000).In the group of CRP ＜ 3.5 mg/L,ASDAS-ESR showed better consistency with ASDAS-CRP when CRP level was below 1.5 mg/L(intra-class correlation coefficient 0.902;kappa coefficient 0.70).By the evaluation of variant gradient matrix,CRP 1.5 mg/L coincided with disease activity states.Conclusion There is good consistency between ASDAS-CRP and ASDAS-ESR.When CRP level is below the normal range,1.5 mg/L could be a cut-off value to calculate the optimal ASDAS-CRP score.

Objective To analyze antimalarial assosiated retinopathy detected by different methods with of modern ocular fundus examination, and explore screening strategy and the diagnosis of hydroxych-loroquine assosiatedretinopathy according to clinical experience and international guidelines. Methods Full fundus examination was performed in two patients with antimalarial retinopathy. The related literature were reviewed. Results Two patients had bull's eyes maculopathy and abnormal visual fields. Conclusion Clin-icians' alertness to hydroxychloroquine related retinopathy may improve early diagnosis of hydroxychloroquine toxicity. New objective tests are more sensitive than visual fields examination. Visible bull's-eye maculopathy is a late change, and the goal of screening is to recognize toxicity at early stage.

BACKGROUND:Studies have shown that cytokine inhibitor pirfenidone can inhibit biological activity of fibroblasts by regulating a variety of cytokines. It has made good progress in the research and application of anti-fibrosis of internal organs, but the effect and mechanism for hypertrophic scars and skin fibroblasts are unclear. OBJECTIVE:To investigate the effect of pirfenidone on human hypertrophic scar fibroblasts. METHODS:Human hypertrophic scar fibroblasts were cultured using tissue culture method. Passages 3-6 cel s grew wel in the logarithmic growth phase were col ected. Cel s were divided into the control group (0 g/L pirfenidone), 0.15, 0.3 and 1 g/L pirfenidone groups according to different mass concentrations. Cel s were intervened for 12, 36 and 48 hours. RESULTS AND CONCLUSION:MTT, reverse transcription-polymerase chain reaction and enzyme-linked immunosorbent assay results demonstrated that compared with the control group, cel proliferation, transforming growth factorβ1 mRNA expression, types I and III col agen secretion were decreased in the 0.15, 0.3 and 1 g/L pirfenidone groups (P<0.05), and the decrease was most significant in the 1 g/L pirfenidone group (P<0.05). At 24, 48 and 72 hours after intervention, significant differences in inhibitory rate of cel proliferation and the secretion of types I and III col agen were detected among 0.15, 0.3 and 1 g/L pirfenidone groups (P<0.05). Results confirmed that pirfenidone apparently inhibited the secretion of col agen of hypertrophic scar fibroblasts cultured in vitro, transforming growth factorβ1 expression and cel proliferation and viability.

Purpose The diagnosis of adult onset Still's disease (AOSD) is usually difficult due to the lack of specific clinical manifestation.This paper summarizes the manifestations of 18F-FDG PET/CT in adult onset Still's disease and investigates the value of PET/CT in diagnosis and differential diagnosis of AOSD.Materials and Methods Fiftyfour patients who was diagnosed as AOSD were selected and underwent 1 8F-fluorodeoxyglueosepositron emission tomography/computed tomography (18F-FDG PET/CT).The clinical features,laboratory examination and the maximum standard uptake value (SUVmax) of liver,spleen,bone marrow,lymph node were collected.Then the main PET/CT manifestations of patients with AOSD,the influence factor of SUVmax and correlation between SUVmax and laboratory indexes were analyzed.Results FDG accumulation occurred mainly in bone marrow (88.89％;SUVmax:3.91 ± 1.16),spleen (79.63％,SUVmax:3.24±0.89) and lymph node (77.78％;SUVmax:3.83± 1.97).FDG accumulation can also occurred in joints,parotid gland,submandibular gland,pleural and other organs.Compared with the nonglucocorticoid group,SUVmax of the spleen,bone marrow and lymph node were significantly decreased in the glucocorticoid group with or without fever (P＜0.05),whereas the SUVmax of liver,spleen,bone marrow and lymph node between the two glucocorticoid groups were not statistically different (P＞0.05).The SUVmax of liver,spleen,bone marrow and lymph node between two groups with or without disease-modifying anti-rheumatic drugs were not statistically different (P＞0.05).Correlation analysis showed that spleen SUVmax and lactate dehydrogenase,bone marrow SUVmax and C reactive protein were weakly correlated (r=0.33 and 0.30,P＜0.05).Conclusion The main manifestations of 18F-FDG PET/CT of AOSD are FDG accumulation in spleen,bone marrow and lymph nodes.Glucocorticoid can reduce the SUVmax.18F-FDG PET/CT can help to rule out malignancy,guide biopsy and assist in definite diagnosis of AOSD.

[Absrtact] Objective To investigate the effect of anatomic quantitative target evaluation of class-room teaching on students' professional knowledge learning ability. Methods Twenty-five international students of 6-year program of grade 2013 were chosen as the experimental group, while twenty-seven Chinese students coming from the same class of grade 2013 and fifteen international students of 6-year program of grade 2012 were chosen as two control groups; quantitative and non-quantitative evaluation were imple-mented respectively by classroom questions and answers; teaching effects were evaluated by scales in the separation of teaching and examination, by records of answers for in-class questions and by questionnaire survey; SPSS 20.0 was used to make statistical analysis, one-way ANOVA and Kruskal Wallis test to com-pare the scores of three groups of students, P<0.05 indicates statistic significance. Results Compared with control groups, the accuracy of answers for class questions were improved greatly in the experimental group (2/3~3/4) vs. (1/2) and (2/3~3/4) vs. (1/2) and the average test scores (80.62±5.93) vs. (79.62±5.93) and (80.62 ±5.93) vs. (70.16 ±6.36) of the experimental group students were higher than control groups, the difference was statistically significant between the control group and the control group (P=0.045). Conclusions
Quantitative evaluation of teaching objectives in anatomy class can improve the learning attitude of foreign students and enhance their academic ability.

Abstract Depression severely affects the healthy development of adolescents and has become a major public health challenge in China. The outbreak and normalization of COVID-19 have posed a serious challenge to the prevention and treatment of depression in adolescents. Given the characteristics of adolescent physical and mental development and depression pathology, the prevention and control of depression in adolescents should be shifted to an earlier stage. "Screening and dynamic monitoring" should be an important way to shift the focus of prevention and control of depression in adolescents. "Population based prevention" should be an important guarantee for achieving the shift toward early prevention and control of depression in adolescents, which builds a solid barrier for the mental health protection and promotion among Chinese adolescents.

Objective To study the characteristics of work disability and its influencing factors in patients with ankylosing spondylitis (AS). Methods The demographic data, work conditons and disease related characteristics of 277 patients with AS were recorded, and randomly selected from the Department of Rheumatology, Chinese PLA General Hospital from November 2014 to January 2016. Work and productivity activity impair-ment questionnaire (WPAI) was used to survey the work disability and productivity loss, then explore its in-fluencing factors and the relationships between patient-reported outcomes and WPAI scores. Logistic regression was used to analyze the associated factors of work disability. Multivariate linear regression was used to analyze the predictive factors of lose of work productivity. Results The prevalence of work disability was 30.3%. Twenty patients were unemployed because of working disability. Two hudreds patients were employed, with average 36.5 (24.0, 50.0) hours workingtime in the past week. Average AS related absenteeism was 4.4 (0, 10) hour. Average workproductivity loss was 26.4%(2.5%, 40.0%). Logistic multiple regression analysis showed that Bath AS disease activity index (BASDAI), SF-36 physical component summary (PCS) scores might be the important influencing factors among those clinical measures ( OR=1.270, 0.959). Presenteeism and overall work impairment were moderately correlated with patients' global assessment of disease activity (VAS), BASDAI, bath AS functional index (BASFI), SF-36 physical Functioning (PF), SF-36 body pain (BP) and SF-36 Physical Component Summary (PCS) (|r|=0.539-0.648). Linear multivariate analyses indicated that work presente-eismand absenteeismwere significantly associated with BASDAI (P<0.01). Conclusion High prevalence of work disability in patients with AS is noted, which is closely related with disease activity and body function;High attention should be paid to AS patients with work disability.

The treatment of critically burned patients has benefited from the development of knowledge and technologies that we got in critical care medicine of our country in the past ten years. The close-ended management model of general intensive care unit (ICU) and the idea of general ICU doctors who treat the monitoring of organ function and alternative therapy of organs as their primary tasks would affect the treatments for special critical patients hospitalized in general ICU, especially for those patients who were severely burned. If the burn wounds of patients are not treated timely, properly or in effective manner, the final treatment outcome would be affected. Therefore, the establishment of burn ICU is necessary. The development and close-ended management of burn specialty ICU has significantly improved the success rates, reduced complications, shortened hospitalization time, and increased the quality of wound healing of severe burn patients in the past more than 10 years in our unit. With the reducing of burn, especially severe burn accidents, the construction of regional burn center and burn specialty ICU locating in burn center is necessary. It can not only reduce the waste of medical resource, but also ensure timely and professional treatments for the patients in sudden fire accidents. At present, there is no consensus on the establishment and management model of burn specialty ICU, and further discussion is needed in practice.

Objective In order to assess the structure damage of hip joint in ankylosing spondylitis (AS), a new radiograph-based scoring method was developed according to the radiological characteristics of hip involvement in AS, as well referring to prior existing scoring indexes. Methods A new scoring method consti-tuted of erosion, sclerosis and joint space narrowing was developed, pelvis anterior-posterior plain films acquired from patients with AS at baseline and follow-up were collected and assessed by two physicians who were trained in image reading by radiologists. All films were scored independently and blindly. Intra- and inter-reader reliability were assessed by intra-class correlation coefficient (ICC), the feasibility of this new scoring method was assessed by the mean time acquired to score a plain (two hips), its ability to detect the change of structure damage was assessed by the comparison of score differences between baseline and different follow-ups. The date were analyzed by paired-t test or nonparametric tests. Analysis of Variance (ANOVA) or nonparametric tests were utilized for the comparison of means of quantitative variables among the three groups, while Chi-square test for rates of categorical variables. Results No statistically significant differences existed in demographic data and suspected risk factors among the three groups at baseline (P>0.05). Intra-observer reliability was good (0.84 and 0.89), as well as the inter-observer reliability (0.72), the mean time needed to score was (33 ±10) seconds. Score changes were not statistically significant in the groups with follow-up duration of 1-2 and 3-4 years, but in the group of over 5 years, baseline/final scores assessed by the two observers were (6.0±2.7/7.5±3.7) and (5.6±2.1/7.1±3.6), respectively, both changes were statistically significant (t=2.86, Z=-2.99; P<0.01). Conclusion This new method is not only reproducible and easy to operate in clinic practice, but also can tell the changes of hip joint structure damage in the interval of over 5 years, further validation is requeired to demonstrate its discriminability in large populations.