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.

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 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.

AIM: To investigate the effect of suberoylanilide hydroxamic acid (SAHA) on the apoptosis of hu-man small-cell lung cancer H446 cells and its possible mechanism.METHODS: H446 cells were incubated in the medi-um containing SAHA.CCK-8 assay was used to detect the anti-tumor effect of SAHA on the H446 cells, and IC50 values of SAHA were calculated.Flow cytometry was used to analyze the apoptosis.After Notch3 gene was silenced, the pro-apopto-tic effect of SAHA on the H446 cells was inhibited ( P <0.05).Eukaryotic expression plasmid containing N3ICD was transfected into the H446 cells, so that N3ICD was expressed in the H446 cells.The mRNA expression of Notch3 was measured by RT-PCR.The protein levels of Notch3, N3ICD, Puma and cleaved caspase-3 were determined by Western blot.RESULTS: SAHA remarkably reduced the cell viability in a dose-dependent manner (P <0.05), and the IC50 value of SAHA was 1.91 μmol/L.SAHA induced apoptosis in a dose-dependent manner (P <0.05).The expression of Notch3 gene was negative in the H446 cells, SAHA reactivated Notch3 gene and Notch3 pathway in a dose-dependent manner (P <0.05).Notch3 knockdown inhibited apoptosis induced by SAHA (P <0.05).Over-expression of N3ICD up-regula-ted the protein levels of Puma and cleaved caspase-3.CONCLUSION: SAHA induces apoptosis in human small-cell lung cancer H446 cells by activating Notch3 pathway and up-regulating the protein level of Puma.

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.

Objective To evaluate the neurotoxic effects of intrathecal (IT) chloroprocaine on the spinal cord in rats. Methods Forty male SD rats weighted 180 ～250g, which IT catheters were successfully placed, were randomly divided into 4 groups( n = 10 each). Group NS received normal saline 40 μl IT, group CP_1 received 2% chloroprocaine 40 μl IT, group CP_2 received 3% chloroprocaine 26.7 μl IT, and group CP_3 received 3% chloroprocaine 40 μl IT. The onset time of bilateral hindlimb paralysis were recorded. Degree of motor block was assessed and scored before (T_1, baseline) and at 10, 30, 60, 120, and 150 min (T_(1-6)) after IT injection. On the 3rd day after IT injection , specimens were obtained from lumbar spinal cord for mincroscopic examination. Results The onset time of bilateral hindlimb paralysis in group CP, and CP_3 was shorter than that in group CP_1. The onset time of bilateral hindlimb paralysis in group CP, was shorter than that in group CP_2. The motor block scores in group CP_1 and CP_2(T_(2-4))and group CP_3(T_(2_5)) were higher than that in group NS. The motor block scores in both group CP_1 and CP_2 at T_(4-5) was lower than group CP_3. The tissue damage in group CP_3 was severer, compared with group CP_1 and CP_2. Conclusion Large dose of 3% chloroprocaine may produce neurotoxicity to the spinal cord.

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.

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.