Objective:To study the relationship between the levels of serum insulin,C-reactive protein(CRP),Tumor Necrosis Factor(TNF-?),insulin resistance index,blood fat,and phlegm-stagnation stasis syndrome of metabolic syndrome(MS),so as to discuss the signifi cance of phlegm-stagnation stasis syndrome in treatment based on syndrome differentiation of MS,in order to fi nd the objective evidence of differentiation of symptoms and signs of TCM of MS.Methods: In this study,54 cases with MS were divided into groups of phlegm-stagnation stasis syndrome and non-phlegm-stagnation stasis syndrome according to the clinical symptoms,tongue demonstration and pulse tracings.There were 25 cases in phlegm-stagnation stasis group,29 cases in non-phlegm-stagnation stasis group.The levels of serum insulin,CRP,TNF-?,blood fat were checked,the insulin resistance index was calculated.Results:The levels of serum insulin,CRP,TNF-? of the two groups of metabolic syndrome were signifi cantly higher than those of the healthy persons(P

ObjectiveTo investigate the clinical value of color Doppler ultrasound examination in the diagonosis of acute and chronic artery occlusion of the extremities.MethodsA review was made on 129 extremetiy artery occlusion patients at Anzhen Hospital during 2006 -2010. 85 cases were male, and 44 cases were female. Age was from 17 to 94 years (average: 62 ±9 years). We analyzed two-dimensional and color Doppler flow imagings of 39 acute occlusion arteries and 97 chronic occlusion arteries. We compared factors including the echoes of artery lumens, the vessel wall structures, hemodynamic parameters of inlet and outlet at the occlusion, and collaterals between groups.ResultsThe factors of depths of vessel wall,internal diameters of ccclusion arteries, proximal resistant index and collaterals were significantly different between groups ( P ＜ 0. 05 ). The internal diameters of acute occlusion arteries were wider than chronic occlusion arteries. The depths of vessel wall, proximal resistant index and collaterals were thinner, smaller,and less than chronic occlusion arteries. The total accurate rate of differential diagnosis for acute and chronic artery occlusion by color Doppler ultrasound was 95.6％.ConclusionsColor Doppler ultrasound is an effective method for the differential diagnosis of acute and chronic artery occlusion of the extremities.

Objective:To investigate the currentstatus of the diagnosis of fibromyalgia syndrome (FMS), and analyze the related factors in order to improve the diagnostic level of the disease.Methods:A survey was carried out, A "FMS diagnosis table" was developed. The demographic data and past medical experience of patients were recorded. The rates of misdiagnosis and missed diagnosis were calculated. The specific misdiagnosed cases were recorded and analyzed. According to the previous diagnosis history, patients were divided into misdiagnosed group, missed diagnosis group and correct diagnosis group. The demographic characteristics, medical history and disease severity in the misdiagnosis group and missed diagnosis group were statistically analyzed, and compared with the correct diagnosis group. The reasons for missed diagnosis or misdiagnosis were explored.Results:A total of 277 patients were included in the survey. Only 19.1%(53 cases) of patients were correctly diagnosed, 22.7%(63 cases) of patients were misdiagnosed, 58.1% of patients were missed. The mean time from first symptom to disease diagnosis was (51.0±81.2) months. They were often misdiagnosed as osteoarthritis ( n=21, 33.3%), rheumatoid arthritis ( n=13, 20.6%), lumbar disease ( n=12, 19.0%), and anxiety and depression ( n=11, 17.4%). Patients' social and economic status such as age, income, educational level and the diagnosis level of pain related clinicians in medical institutions at all levels were factors that might influence misdiagnosis and missed diagnosis rate. In terms of demographic characteristics, the correctly diagnosed group had a lower average age of (44±13) years ( t=8.64/9.20, P<0.05), a higher proportion of employees, a higher monthly income ( χ2=7.10/6.87, P<0.05), and a higher education level ( χ2=7.12, P<0.05). In terms of visits, the rate of visits to other medical institutions (private hospitals) in the missed diagnosis group was higher, and the number of doctors visited was also lower. In terms of illness, the diffuse pain index (WPI) score and FMS symptom severity (SSS) score were lower in the missed diagnosis group. Conclusion:The current situation of the diagnosis of FMS in China is not optimistic, and the diagnosis should be differentiated from osteoarthritis, rheumatoid arthritis, cervical and lumbar diseases, and cardiac diseases. In order to reduce the misdiagnosis and missed diagnosis of this disease, it is necessary to strengthen the public education, improve the understanding of this disease in primary care doctors, and physicians in orthopedics, acupuncture and pain departments.

Objective:To investigate the precipitating and aggravating factors in patients with fibromyalgia (FMS) compared to patients with rheumatoid arthritis (RA).Methods:This study was conducted from January 2015 to November 2021, using a cross-sectional survey research method, based on references to develop a patient-reported "onset and exacerbation triggers questionnaire", and surveyed patients with FMS and RA at the same time, and counted the types and proportions of onset and exacerbation triggers in the two groups of patients and used the chi-square test to make comparisons between the groups.Results:A total of 415 patients with FMS and 200 patients with RA participated the survey. 146 patients with FMS (35.2%) and 38 patients with RA (19.0%) reported morbidity triggers. Experiencing physical injury (71, 17.1%), wind-cold/cold-dampness (30 patients, 7.2%), mental stress (26, 6.2%), and exercise fatigue (10 patients, 2.4%) were the common morbidity triggers for FMS. More FMS patients reported to have experienced physical injuries and mental stress before the onset of the disease compared to RA patients [8.2%(17/200), χ2=5.41, P=0.020; 1.5%(3/200), χ2=6.82, P=0.009]. Exacerbation triggers were reported by 319 patients with FMS (76.9%) and 137 patients with RA (68.5%), in the order of weather changes (219 patients, 52.7%), physical labor (192 patients, 46.2%), mood swings (147 patients, 35.4%), sleep deprivation (145 patients, 34.9%), and mental stress (130 patients, 31.3%). The proportion of FMS patients with symptom exacerbation due to physical labor [46.2%(192/415)], mood swings[35.4%(147/415)], sleep deprivation[34.9%(145/415)], mental stress[31.3%(130/415)], and infection [9.3%(39/415)] was significantly higher than that of RA patients [35.0%(70/200), χ2=7.00, P=0.008; 19.5%(39/200), χ2=16.22, P<0.001; 13.5%(27/200), χ2=30.79, P<0.001; 17.5%(35/200), χ2=13.14, P<0.001; 3.0%(6/200), χ2=8.15, P=0.004). Conclusion:More than a third of FMS patients reported precipitating factors, and nearly four fifths FMS patients reported at least one aggravating trigger. FMS patients are likely to be more sensitive to environmental changes and perceived stress than RA patients.

Objective To overcome the limitations of existing human respiratory syncytial virus(hRSV)animal models,such as semi-permissiveness and short duration of infection,this study established an IL2rg gene knockout(IL2rg-/-)rat model using TALEN gene editing technology.Methods The animal model was infected with hRSV intranasally.Clinical characteristics,body weight,and temperature changes were observed over the infection period(0～35 days).The total viral loads in respiratory organs,such as the nasal tissue,trachea,and lungs,were measured at various time points(4,11,20,and 35 days post-infection).Pathological analysis was conducted on target organs at the endpoint of observation(35 days post-infection).Changes in peripheral blood T,B,NK,and NKT cells and various cytokines were assessed at various time points(4,20,and 35 days post-infection).Results(1)IL2rg/-knockout rats sustained high viral loads in the nasal cavity upon intranasal inoculation with hRSV.The average peak titer rapidly reached 1 × 1010 copies/g in nasal tissue and 1 × 107 copies/g up to 5 weeks post-infection.(2)However,no significant pathological changes were noted in nasal,tracheal,or lung tissues.(3)An increase was observed in the content of peripheral blood B cells in hRSV-infected IL2rg--rats.(4)IL-6 and MCP-1 were increased in the early stage of infection and then decreased at the end of the observation period.Conclusions This study established a new IL2rg-/-rat model using TALEN technology and found that this model effectively supported high-level replication and long-term infection of hRSV,providing a good basis for antiviral drug screening and in vivo efficacy evaluation of anti-hRSV antibodies.