Objective To investigate the influence of Hui medicine flatiron moxibustion therapy and nursing intervention on pain and serum IL-2,TNF-α in rheumatoid arthritis (RA) patients before and after treatment and care interventions.Methods 89 cases RA hospitalized patients from Traditional Chinese Orthopedics and Traumatology department of General Hospital of Ningxia Medical University were collected and were randomly divided into the control group (43 cases) and the treatment group (46 cases) from May 2011 to September 2013.Two groups used a combination method of overall and portion acupoints.The control group used warm acupuncture,30 min every time,1 time per day,routine care was given.The treatment group was given with Hui medicine flatiron moxibustion instrument by the professional Chinese medicine nurses,direct moxibustion acupoints site to portion skin slight degree redness,30 min every time,1 time per day,and with routine care,focused on the reasons things out the enlighten,emotion,suggested transferring,calm the nerves of the traditional Chinese medicine psychological care guidance.10 times as a course,to rest for 3～5 days on treatment interval,for efficacy evaluation after three courses.Meanwhile,before and after the application,to test the pain degree with NPRS; to assess the psychological and emotional status with SCL-90,serum IL-2 and TNF-α levels were tested with radioimmunoassay.Results The total effective rate was 89.13％ on the treatment group,the control group was 74.42％.After treatment,the NPRS,SCL-90 scores were significantly improved than those before treatment; the NPRS,SCL-90 scores of the treatment group were better than those of the control group.After treatment,serum IL-2 and TNF-α levels were significantly improved compared with those before treatment; after treatment,IL-2 and TNF-α levels of the treatment group were better than those of the control group.All the above comparison had statistical significance.Conclusions Hui medicine flatiron moxibustion therapy and nursing intervention may effectively improve pain in RA patients,ease the psychological anxiety,increase serum IL-2,TNF-α levels,enhance the quality of life for patients,and promote disease recovery.

Objective:To investigate frailty status of the elderly patients with leukoaraiosis (LA) and to analyze the correlation between white matter hyperintensities and their frailty status.Methods:From June 2019 to September 2020, a total of 162 patients with leukoaraiosis over 65 years old were screened by cranial MRI.The Fried frailty phenotype was used to evaluate their frailty status.The Fazekas scale scoring method was used to independently assess the periventricular white matter hyperintense (PVH) and deep white matter hyperintense (DWMH) by the cranial MRI images.SPSS 22.0 software was used for statistical analysis.ANOVA test was used to compare normal distribution data between groups, and Kruskal-Wallis H test was used to compare non-normal distribution data between groups.Spearman rank correlation analysis was used to analyze the correlation between PVH and DWMH scores and Fried frailty phenotype score. Results:Among 162 elderly patients with leukoaraiosis, 46 patients (28.40%) were non-frailty, 76 patients (46.91%)were pre-frailty and 40 patients (24.69%) were frailty.There were statistically significant differences in age( F=9.382, P<0.01), number of chronic diseases( H=10.736, P<0.01), number of medication ( H=15.927, P<0.01) and mini-nutritional assessment short form (MNA-SF) scores( F=5.263, P<0.01) among older LA patients with different frailty phenotype.There was statistical difference in PVH scores in elderly LA patients with different frailty phenotype (χ 2=108.537, P<0.01), but no significant difference in DWMH scores (χ 2=4.239, P>0.05). Spearman correlation analysis showed significant positive correlation between PVH score and frailty phenotype score in elderly LA patients ( r=0.718, P<0.001). Conclusion:Elderly LA patients have a high incidence of frailty, which may be related to aging, multi-disease coexistence, multiple medication, nutritional risk and other factors.The occurrence of weakness in elderly LA patients is related to periventricular white matter lesions, and the more serious the white matter damage, the more obvious the degree of frailty.

Objective To investigate the distribution of femoro-popliteal artery chronic totally occlusions (CTO) and to analyze the influence of different risk factors on the distribution of lesions. Methods A total of 47 patients with CTA and DSA proved femoro-popliteal artery CTO, who were admitted to the Affiliated Beijing Shijitan Hospital of Capital Medical University during the period from January 2013 and May 2015, were enrolled in this study. In order to make a clear description about the distribution characteristics of the lesions, the superficial femoral artery was averagely divided into three segments (F1-F3), and the popliteal artery was also divided into three segments (P1-P3) according to the bony landmarks. Based on the CTA images (including 3D reconstruction images) and DSA images, the distribution of CTO lesions was determined. The factors that might influence the distribution of CTO lesions were collected, and the results were analyzed using multivariable logistic regression analysis. Results A total of 59 femoro-popliteal artery CTO lesions detected in 47 patients were included in this study. The average length of lesion segment was (12.91 ± 10.13) cm. According to the 6-section division method of femoro-popliteal artery, the lesions involved F1 (n=23), F2(n=34), F3(n=48), P1(n=18), P2(n=6) as well as P3(n=5) segments. Multivariable logistic regression analysis reveals that F1 segment was most prone to be affected by CTO lesions in patients with hypertension (RR=3.21) and in patients who had cigarette smoking habit (RR=1.76). In male patients, P1segment was more easil y involved by CTO lesions (RR=1.98). In patients with diabetes mellitus, the RR value was gradually increased from the proximal to the distal end of the blood vessel, indicating that the lesion was more likely to involve distal vessels. Conclusion The distributions of femoro-popliteal artery CTO lesions have certain characteristics, which are closely associated with femoro-popliteal artery hemodynamics and atherosclerosis risk factors.

Objective To assess the clinical application of iterative reconstruction (IR)in the head and neck CT angiography (CTA).Methods 100 patients who underwent the head and neck CTA examination were divided into Group A and Group B at ran-dom.Each group included 50 patients.Group A was performed the conventional-dose scan method (tube voltage 120 kV,tube cur-rent 300 mAs),and images were reconstructed with filtered back projection (FBP);Group B was performed the low-dose scan method [tube voltage 100 kV,dynamic tube current (1 99-399 mAs)],and images were reconstructed with IR.Two experienced radiology physicians reviewed the results of image quality using double blind method,and compared CT dose index volume (CTDIvol)and dose-length product (DLP).Results There were significant differences between radiation dose and image quality of the two groups (P <0.001).Radiation dose of Group B was significantly lower than that of Group A,while image quality of Group B was significantly better than that of Group A.Conclusion In the head and neck CTA applications,compared with FBP,IR recon-struction can reduce radiation dose and improve image quality.

Objective:To analyze the gait and balance disorder and fall risk in patients with leukoaraiosis (LA) in different degrees and locations.Methods:Seventy-eight patients with LA (LA group) and thirty healthy controls (NC group) were selected.According to Fazekas grading scale, the LA group were subgroups of different degrees(LA1, LA2, LA3)and evaluated independent scores for periventricular white matter hypersignal (PVH) and deep white matter hypersignal (DWMH). All subjects were tested by Tinetti scale, and the gait test, balance test and fall risk assessment were carried out, and the correlation between gait test results and balance test results and PVH and DWMH scores were analyzed.Results:There were significant differences in gait test((11.47±0.51), (10.18±1.29)), balance test((15.63±0.49), (13.96±1.58)) and fall risk((27.10±0.76), (24.15±2.73)) between LA group and NC group ( t=5.310, 5.667, 5.799, all P< 0.01). There were no significant differences in gait test, balance test and fall risk between NC group and LA1 group (all P>0.05). There were significant differences in gait test, balance test and fall risk between NC group and LA2 group and LA3 group ( t=1.110, 1.562, 1.336; 2.592, 3.342, 2.985; all P<0.01). There were significant differences in gait test, balance test and fall risk between LA1 group((11.19±0.85), (15.38±0.75), (26.58±1.47)) and LA2 group((10.36±0.82), (14.07±1.09), (24.43±1.64)) and LA3 group((8.88±0.99), (12.23±1.08), (21.21±1.93)) ( t=0.835, 1.313, 1.039; 2.317, 3.093, 2.756; all P<0.01). There were significant differences in gait test, balance test and fall risk between LA2 group and LA3 group ( t=1.482, 1.780, 1.639, all P<0.01). The analysis showed that the gait test was negatively correlated with the PVH and DWMH scores ( r=-0.810, P<0.01; r=-0.452, P<0.01). The balance test was negatively correlated with the PVH and DWMH scores ( r=-0.502, P<0.01; r=-0.836, P<0.01). Conclusions:There are gait disorder and balance disorder in patients with moderate and severe LA.With the increase of the degree of LA , the damage of gait and balance function is significantly increased, and the risk of fall is also significantly increased.The gait disorder and the balance disorder of LA patients has different correlation with the high-signal score of the white matter in different parts.The correlation between gait disorder and PVH score is more obvious, and the correlation between balance disorder and DWMH score is more obvious.

Objective To investigate the significance of interleukin-6 IL-6),interleukin-8 (IL-8) and metal matrix protease-9 (MMP-9) in lung injury caused by intrauterine infection in ueonatal rats.Method Eighteen 18-day-old SD pregnant rats were selected and randomly assigned into 0.6,0.7,0.8,0.9,1.0 mg/kg lipopolysaccharide (LPS) groups and control group.Rats of LPS group were injected intraperitoneally with LPS 0.6.0.7,0.8,0.9,1.0 mg/kg,those of control group was injected with equal volume of sterile saline.After 24 hours of injection,one pregnant rat from each group underwent cesarean seetion and placentae were collected for pathological evaluation.The other pregnant rats delivered spontaneously.When the neonatal rats came to 1,3,and 7 days of age,8 rats were randomly selected from each group.The respiratory frequency,body weight,lung weight,and blood samples for detecting inflammatory factors using enzyme-linked immunosorbent assay were measured among 3-day-old neonatal rats.Lung tissue for hematoxylin-eosin staining and lung pathology score were taken in the 1,3 and 7-day-old neonatal rats.Result (1) The mortality rate of neonatal rats increased gradually with the increasing dose of LPS injection.The mortality rate of neonatal rats in the LPS 1.0 mg/kg group was 20％.The placental pathology score and the frequency of 3-day-old neonatal rats in LPS 0.8,0.9,and 1.0 mg/kg groups were higher than control group and other LPS groups (P ＜ 0.05).(2) The histopathological scores of the neonatal rats in the control group and LPS 0.6,0.7,0.8,0.9,1.0 mg/kg groups on the first day after birth were (0.08±0.08),(0.17±0.11),(1.33±0.19),(1.75±0.33),(1.92±0.36),(2.67±0.14),respectively,and that of the third day after birth were (0.00 ± 0.00),(0.50 ± 0.15),(0.67 ±0.19),(1.33 ±0.36),(2.17 ±0.21),(2.92 ±0.08),respectively.LPS 1.0 mg/kg group on the 1st and 3rd day after birth were significantly different from the other groups (P ＜0.05),LPS 0.8 mg/kg group on the 1st and 3rd day after birth were significantly different from the control group and LPS 0.6 mg/kg group (P ＜ 0.05),and there was significant difference among the LPS 0.9 mg/kg group and the other groups on the 3rd day after birth (P ＜ 0.05).When the concentration of LPS was less than 0.8 mg/kg,there was no significant difference in the pathological scores of the lung tissues between each group (P ＞0.05).(3) The concentrations of IL-6,IL-8,and MMP-9 in the neonatal rats of LPS 0.7,0.8,0.9,and 1.0 mg/kg groups were significantly higher than those in the control group at 3 days of age,and the difference among LPS groups were statistically significant (P ＜ 0.05).Conclusion The intraperitoneal injection of LPS in rats 18 days after gestation can lead to lung injury,pulmonary edema,and increasing level of blood IL-6,IL-8,and MMP-9 in the neonatal rats,and this damage lasts until 7 days after birth which suggests the important meaning for lung diseases caused by intrauterine infection.

Objective: To report the clinical and pathological features of primary proximal epithelioid sarcoma (PES) in skull base. Methods: The clinical and pathological features of four cases of PES in skull base from Sanbo Brain Institute of Capital Medical University and Kunming Sanbo Brain Institute were analysed retrospectively. Results: Three cases was female, and one male, the age ranged from 46 to 52 years.All cases occurred in skull base, and sellar region was the main site of involvement.Under the microscope, the tumor cells characterized by epithelioid cell changes, with or without rhabdoid tumor cells.Mitotic figure was active.Immunohistochemical staining showed that AE1/AE3, EMA and CD34 were variously expression in tumor cells.INI-1 protein was lost in all cases.Three cases were detected by FISH, and INI1 (22q11.2) gene locus was absent in them.Three patients died less than 3 months after surgery, and case 4 was under treatment after five months of surgery. Conclusions Primary PES in skull base mostly occurs in sellar region and its clinical prognosis is poor.It features with epithelioid/rhabdoid tumor cells with lack granuloma structure as distal ES.It has epithelial and mesenchymal differentiation characteristics.CD34 is always positive.INI1 gene deletion and protein loss expression are characteristic molecular alteration of PES.