Objective To evaluate the efficacy of Yishen-Tongdu decoction combined with sulfasalazine and meloxicamin for ankylosing spondylitis(AS).Methods A total of 86 AS patients were recruited and randomized into an observation group and a control group,43 in each group.The control group was treated by sulphasalazine and meloxicam,while the observation group was treated by Yishen-Tongdu decoction combined with sulfasalazine and meloxicam.The physical function and the disease activity were measured with the Bath Ankylosing Spondylitis Functional Index (BASFI) and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI),respectively.The erythrocyte sedimentation rate (ESR) and serum C-reactive protein (CRP) were determined.Results The BASFI (3.25 ± 1.18 vs.4.18 ± 0.96;t=4.544,P＜0.01) and BASDAI (2.33 ± 1.46 vs.3.26 ± 1.43;t=5.245,P＜0.01) after treatment in the observation group were significantly decreased than those in the control group.Serum CRP level (8.62 ± 14.71 mg/L vs.12.57 ± 16.32 mg/L;t=3.143,P＜0.05) and ESR (14.93 ± 17.15 mm/h vs.18.61 ± 20.98 mm/h;t=3.615,P＜0.05) in the observation group were significantly lower than those in the control group.The occiput-wall distance (2.07 ± 0.59 vs.2.68 ±0.69 cm;t=5.332,P＜0.01),finger-floor distance (12.88 ± 1.92 vs.13.26 ± 1.71 cm;t=3.593,P＜0.05),and jaw-sternum distance (1.58 ± 0.63 vs.2.43 ± 0.64 cm;t=4.671,P＜0.01) in the observation group were significantly decreased than those in the control group,while the chest expansion (4.99 ± 0.73 cm vs.4.26 ± 0.68 cm;t=4.226,P＜0.01),and Schober test (6.57 ± 0.91 vs.6.13 ± 0.87em;t=3.733,P＜0.01) in the observation group were significantly increased than those in the control group.Conclusion Yishen-Tongdu decoction combined with sulfasalazine and meloxicam can improve the physical function and the disease activity and tts effect is superior to sulfasalazine and meloxicam in patients with AS.

Objective To summarize the experience in the treatment of cardiac and thoracic aortic injury.Methods 30 patients with cardiac and thoracic aortic injury from 1996 to 2007 are retrospectively studied,including the diagnosis,preoperative preparation,main points of the operation and cardiopulmonary resuscitation.Results 24 patients were completely cured,having no residual in the follow-up periods.4 patients with multiple wound died of complication.2 patients with thoracic aortic injury died in the operation.Conclusion Prompt diagnosis after injury,fast preoperative preparation,precise operative approach and technique,effective cardiopulmonary resuscitation and refraining from omitting associated injury are the key points to the salvage of cardiac and thoracic aortic injury.

Objective To investigate the effects of insulin resistance (IR)on hypoxia/reoxygenation (H/R)inj ury in PC1 2 cells and the protective effects of N-actyl-L-cystine (NAC)against H/R inj ury. Methods PC12 cells were treated with 100 nmol/L insulin to induce IR. The H/R injury model was established by Na2 S2 O4. CCK-8 assay was used to detect the cell viability. Glucose consumption was detected by glucose oxidase method. Activity of superoxide dismutase (SOD)was detected by xanthine oxidase method. The levels of malonaldehyde (MDA)were measured by thiobarbituric acid method. Flow cytometry was used to determine the apoptosis and mitochondrial membrane potential (MMP). Results High-insulin inhibited insulin-induced glucose uptake in PC12 cells without affecting the cell viability (P<0. 05). PC12 cells with IR exhibited lower SOD activity and higher levels of MDA (P<0. 05 ),and enhanced apoptosis and depolarization of MMP induced by H/R(P<0. 05). NAC neutralized these effects induced by IR(P<0. 05). Conclusion IR aggravates H/R injury in PC12 cells by enhancing oxidative stress and NAC reduces the H/R injury in PC12 cells with IR via inhibiting oxidative stress and stabilizing MMP.

Objective To discuss the anatomical and radiographic characteristics of acetabular fossa,and evaluate their value as a reference for achieving the anticipated inclination of the acetabular cup.Methods Sixteen adult normal pelvic specimens were studied.Central axis of acetabular fossa and its intersection with fossa edge and acetabular rim were marked.The radiographic appearance of the two intersections was evaluated.With radiographic templating,the relationship between the top of acetabular fossa and the central axis of acetabular cup at anticipated inclination was identified.Implantation of cementless acetabular cup was performed bilaterally on the pelvic specimens.The acetabular fossa was used as a reference for implantation on one side,and the acetabular positioning device was used on the other side.The discrepancy of acetabular inclination was recorded before and after operation in the two groups.Results Intersection of central axis of acetabular fossa with fossa top edge and acetabular rim corresponded to the most medial and lateral aspect of acetabular sourcil respectively on standard anteroposterior pelvic radiograph.There was close correlation between most medial aspect of acetabular sourcil and central axis of the acetabular cup at anticipated inclination of 40°±5°.For the group of using acetabular fossa as reference,the mean difference of inclination was 0.19°±3.14°(-6°-5°)before and after operation,and the discrepancy was 2.75°±2.89°(-2°-8°)for the control group.The difference between the two groups was statistically significant(t=-2.453,P=0.027).Conclusion In primary total hip replacement,if normal anatomy of acetabulum was found,the anticipated inclination of acetabular cup can be accurately obtained,based on the relationship between the top of acetabular fossa and anticipated inclination of acetabular cup on preoperative templating.

Objective To investigate the expression of membrane type 1 matrix metalloproteinase(MT1-MMP) in the esophageal carcinoma tissues and in normal periearcinomatous tissues and its clinical significance. Methods Immunohistochemistry was used to study the expression of MT1-MMP in esophageal carcinoma tissues and normal tissues in distance for 5-7 em from tumor. Results Among 54esophageal carcinoma specimens, the positive expression rate of MT1-MMP was 87.0%, while all of themwere expressed a small quantity in normal esophageal epithelial tissues, the expression in the esophageal carcinoma tissues was significantly higher than those in normal esophageal epithelial tissues (P ＜ 0.01 ).The degree of MT1-MMP expressions was associated with the depth of tumor invasion (P ＜ 0.01 ), the invasion of the lymph nodes(P ＜ 0.01 ) and the relapse and/or metastasis of the tumors for three years after surgery(P ＜0.01 ), and was also related to differentiation of tumor cells (P ＜ 0.01 ). Conclusions The expression of MT1-MMP in the esophageal carcinoma tissues is well associated with the depth of tumor invasion, the invasion of the lymph nodes, the differentiation of tumor cells and relapse and/or metastasis of the tumors for three years after surgery. MT1-MMP plays an important rote in the invasion and metastasis in the patients with esophageal carcinoma.

Objective To summarize the experience of clinical diagnosis and treatment for recurrence and progress of relieved myastbenia gravis after thymectomy. Methods 22 recurrent and progressive after relieved pa-tients with myasthenia gravis who underwent thymectomy were retrospectively analyzed. The remission therapy was conducted with combined glucocorticoid and anticholinesterase and its effectiveness was estimated. Results It was 1,17,4 as better Osserman scale Ⅰ , Ⅱ , Ⅲ respectively before operation but 15,6,1 as better Osserman scale Ⅱ , Ⅲ, Ⅳ respectively in recurrence and progress of relieved myasthenia gravis after thymectomy besides 6 with myas-thenic crisis. Complete remission and partial remission were gained in 9 patients and 12 patients respectively. There was 1 hospital-death. Conclusions Recurrence and progress can occur in any patient of relieved myasthenia gravis after thymectomy. Bulbar myasthenia gravis is usually presented as dysphagia. Reasonable administration of glucocor-tieoid could improve majority of recurrence and progress of relieved myasthenia gravis after thymectomy but responses poorly to the anticholinesterases.

The connotation and extension of the acupuncture changes along with the development of science and technology. Working out the principle on the connotation and extension of acupuncture at present will contribute to better inherit and development of acupuncture. In this paper, through literature analysis, the study on the process of formation and development of acupuncture, we believe connotation of acupuncture and moxibustion mainly include the basic theory of TCM, meridians theory, diagnosis, techniques, clinics, and literatures of acupuncture and moxibustion;and its extension include basic integrated medicine of acupuncture and moxibustion, physiology, pathology, and theories, techniques and clinics derived from modern science.

Objective To research the location in cerebral circulations of recurrent stroke.Methods We included patients with acute cerebral infarction from the Department of Neurology of People's Hospital of Peking University within three years.We followed up the patients by telephone and electronic medical record to determine whether they belong to recurrent group or not.We recorded the clinical and image variables of recurrent group.We classified the recurrent group by whether the loci of recurrent stroke is in the same circulation.We determined the independent risk factors of the same circulation loci by Cox regression.Results There are 106 cases of recurrent stroke.Within 5 years,46.2％ of the cases had recurrent loci in the same circulation as first stroke loci.53.8％ of the cases had recurrent loci in the different circulation from first stroke loci.According to logistic regression,whether the recurrent loci was in the same circulation was not related to age,sex,hypertension,diabetes mellitus,smoking,but related to the survival time.The shorter the survival time was the more ratio of same circulation loci happened.The longer the survival time was the more ratio of different circulation loci happened.37％ of cases with recurrent strokes happened in the first year occupied the most cases in the 5 years.Conclusions With the long time study of the location of recurrent stroke,we get the conclusion that the longer the survival time is the more ratio of different circulation stroke happen.So we emphasize the importance of medicine for the stroke in long time.At the same time we conclude the rationality of endovascular treatments within 1 year from first stroke because recurrent loci is more often in the same circulation in 1 year.

Background Allergic conjunctivitis is common in clinical practice.But some patients,especially pediatric patients,are not diagnosed and treated correctly because of different classifications and other associated symptoms.A comprehensive understanding of the clinical characteristics of allergic conjunctivitis helps to correct diagnosis and management.Objective This study tried to analyze the clinical characteristics of allergic conjunctivitis.Methods A descriptive study was carried out.The clinical data of 745 cases of various classifications of allergic conjunctivitis who received treatment in Beijing Tongren Eye Center from April 2011 to March 2015 were retrospectively analyzed.The general status,disease history,family medical history,personal allergy history,medication history,disease course,attacked duration,affecting factors of symptoms,other non-ocular allergic diseases,other associated eye disease,the findings of the anterior ocular segment,treating outcomes were summarized and the correlation of age with symptoms was evaluated.Results In the 745 cases,75.44％ cases (562/745 were seasonal allergic conjunctivitis (SAC) and perennial allergic conjunctivitis (PAC),21.88％ cases (163/745 were vernal keratoconjunctivitis (VKC),2.42％ cases (18/745) were giant papillary conjunctivitis (GPC),and 0.27％ cases (2/745) were atopic keratoconjunctivitis (AKC).The number of patients was most in July (180,24.16％) and least in December (26,3.49％).The itching was found in 53.02％ patients,redness in 36.64％ patients,blinking in 21.88％ patients.In the patients,58.26％ patients were ≤ 14 years,34.09％ patients were 15-39 years and 7.65％ patients were ≥40 years,and a significant difference in gender was found in various age groups (x2 =89.431,P =0.000).The co-morbidities appeared to be allergic rhinitis,eczema,urticaria,allergic purpura and asthma,and the ocular coexisting conditions included dry eye,refractive error,blepharitis and meibomian gland dysfunction,corneal epithelial disorders,triehiasis and anterior uveitis.Logistic regression analysis revealed that blinking patients were more and dry eye,foreign body sensation and pain were less in ≤ 14 years patients than those in the ＞14 patiens (3=-2.039,P =0.000;3 =1.585,P=0.001;3=1.174,P=0.003;3=1.218,P =0.037).The symptoms of allergic conjunctivitis were relieved by the administration of dual-acting antiallergic agent/antihistamine drug,glucocorticoid or immunosuppressor agents.Conclusions SAC and PAC are more common classifications of allergic conjunctivitis,followed by VKC.July is a high-occurrence duration and clinical symptoms are diverse and often accompanied by other allergic diseases.The administration of dual-acting antiallergic agent/antihistamine drug,glucocorticoid or immunosuppressor agents is an effective approach to the management of allergic conjunctivitis.

OBJECTIVETo explore the rhythm regulatory mechanism of interleukin-6 (IL-6) in the process of moxibustion for rheumatoid arthritis (RA).

METHODSA total of 144 Sprague-Dawley (SD) rats were randomly divided into a blank group, a model group, a moxibustion group, a sham operation group, an operation group, an operation+moxibustion group, 24 rats in each one. Each group was divided into 4 time points (0:00 am, 6:00' am, 12:00 am, 6:00 pm), 6 rats in each time point. The Light-Dark 12 : 12 was given in all rats for light-dark cycle. Except the blank group, rats in the remaining groups were treated with intracutaneous injection of freund's complete adjuvant at right-side foot to establish the model of RA. After the model establishment, bilateral adrenal, glands were removed in the operation group and operation + moxibustion group, while those in the sham operation group were not removed with identical operation procedure. Rats in the moxibustion group and operation + moxibustion group were treated with grain-sized moxibustion from 7:00 am to 9:00 am at "Shenshu" (BL 23) and "Zusanli" (ST 36) once everyday, 6 times were taken as one session and 3 sessions were required tatclly, while rats in the remaining groups received identical fixation without moxibustion. The general health state and foot volume of rats were measured before model establishment, after establishment and after treatment. After treatment, rats were sacrificed at each time point to collect the blood sample and measure the content of IL-6 by using enzymne-immunoassay method.

RESULTSCompared with the blank group, the foot swelling in the model group was obviously increased (P<0. 05); the IL-6 maintained circadian rhythm (P<0. 05), but the peak phase had a backward trend, famplitude had an increased trend and the median was significantly lifted (P<0. 05). Compared with model group, !the foot swelling in the moxibustion group was obviously decreased (P<0. 05); the IL-6 maintained circadian. rhythm (P<0. 05), and the peak phase had a forward trend, amplitude had a decreased trend and the median was significantly reduced (P<0. 05). Compared with the moxibustion group, the foot swelling in the operation--moxibustion group was obviously increased (P < 0.05); the IL-6 maintained circadian rhythm (P < 0.5), but the peak phase moved forwrd, and the median was significantly elevated (P < 0.05).

CONCLUSIONThe IL-6 in plasma maintains significant pathological circadian rhythm in RA rats; with the complete hypothalamic-pituitary-adrenal axis, moxibustion is likely to regulate the circadian rhythm of IL-6 to play an important role of anti-inflammatory effect in RA rats.

Acupuncture Points ; Animals ; Arthritis, Rheumatoid ; metabolism ; physiopathology ; therapy ; Circadian Rhythm ; Disease Models, Animal ; Female ; Humans ; Hypothalamus ; metabolism ; Interleukin-6 ; metabolism ; Male ; Moxibustion ; Pituitary-Adrenal System ; metabolism ; Rats ; Rats, Sprague-Dawley ; Time Factors