AIM:To discuss the changes of IL-17, IL-21 in glucocorticoid therapy of active thyroid associated ophthalmopathy (TAO) and analyze the relation with results.METHODS:The 67 patients (134 eyes) of TAO in our hospital, were divided into activity group(32 patients 64 eyes) and atypical activity group(35 patients 70 eyes) according clinical activity score (CAS) grading standard, and 30 cases of healthy as control group at the same time.The activity group were treated by glucocorticoid therapy treatment, and proceed the CAS scores before and after treatment, measured the degree of exophthalmus and width of palpebral fissure.At the same time, compared the expression level of IL-17 and IL-21 in all groups, and analyzed the correlation between the IL-17 and IL-21 and CAS score.RESULTS:Compared with control group, expressions of IL-17 and IL-21 in TAO patients were significantly higher (P<0.05).The expressions of IL-17 and IL-21 in active period TAO patients were higher than atypical activity (P<0.05).After glucocorticoid treatment, the expressions of IL-17 in active period TAO patients decreased significantly(P<0.05), and it was significantly positive correlation with CAS score (before treatment:r=0.8847,P=0.042;after treatment:r=0.8886,P=0.0439) the expression of IL-21 in active period TAO patients was significantly positive correlation with CAS score (before treatment:r=0.8893, P=0.0435;after treatment:r=0.8876,P=0.045).CONCLUSION:IL-17 and IL-21 is closely related to the TAO disease activity, and glucocorticoids impact treatment by reducing IL-17 and IL-21 in activity TAO, IL-17 and IL-21 can be used as one of indexes of predicted curative effect and condition in patients with TAO.

Objective To detect the changes in DNA loads of human papillomavirus (HPV) type 6/11 in lesions of patients with condyloma accuminatum (CA) before and after 5-aminolevulinic acid photodynamic therapy (ALA-PDT).Methods After removal of warts by electrocautery,HPV6/11-positive patients with CA were divided into two groups:treatment group (32 cases) receiving two sessions of ALA-PDT with intervals of 7-10 days,and control group (29 cases) remaining untreated.Exfoliated cells were collected from the lesional sites of these patients before and 3 months after the first session of ALA-PDT,and fluorescence-based quantitative PCR was conducted to estimate the DNA loads of HPV 6/11 in these cells.Results Three months after the first session of ALA-PDT,89.7％ (26/29) of the patients in the treatment group and 68.4％ (13/19) in the control group became HPV DNA negative,with significant differences between the treatment group and control group in the DNA loads of HPV ((1.70 ± 7.86) × 105 vs.(1.27 ± 2.21) × 106 copies/ml,P ＜ 0.05).Conclusion ALA-PDT can reduce HPV DNA loads in lesions of CA in patients.

Objective To evaluate the value of revised Geneva score, Daniel ECG score and age-adjusted D-dimer for predicting pulmonary embolism(PE).Methods A total of 91 cases suspected as pulmonary embolism were collected, and 52 cases were diagnosed as pulmonary embolism by computed tomographic pulmonary angiography(CTPA) results.Receiver operating characteristic(ROC) curves and diagnostic test evaluation indexes were used to evaluate the probability of PE predicted by the revised Geneva score,Daniel ECG score, age-adjusted D-dimer and combination of these two clinical scores and age-adjusted D-dimer.Results The confirmed PE was 21.4% with a low probability(revised Geneva score 0~3 points),55.4% in intermediate probability(4~10 points),85.7% in high probability(score≥11 points).The prevalence of PE was 33.3% with a low clinical probability (Daniel ECG score<2 points)and 70.7% with a high clinical probability(Daniel ECG score≥2 points).The sensitivity and specificity of age-adjusted D-dimer in predicting pulmonary embolism were 92.3%,69.2%.The area under curve of the ROC curve(AUC)in the revised Geneva score and Daniel ECG score has no significant difference(Z=0.979).The negative predictive value of the revised Geneva score, Daniel ECG score combined with D-dimer in pulmonary embolism were 100.0% and 87.5%.Conclusion All of revised Geneva score, Daniel ECG score and age-adjusted D-dimer have certain predictive value on pulmonary embolism , and the revised Geneva score combined with age-adjusted D-dimer can be more safely exclude pulmonary embolism.

China ; Foundations ; Integrative Medicine ; Natural Science Disciplines

Humans ; Integrative Medicine ; Medicine ; Medicine, Chinese Traditional

Objective To study the significance of plasma homocysteine(Hcy),high sensitivity C-reactive protein(hs-CRP)and cardiac treponin T(cTnT)changes in the patients with coronary heart diseases(CHD).Methods From August 2012 to November 2013,240 patients with CHD in our hospital were collected as the CHD group and 250 individuals of healthy physical examination served as the control group.Serum Hcy,hs-CRP and cTnT were detected by using the enzymatic cycle assay,immune scatter turbi-dimetry and electrochemiluminescence assay respectively.The data were statistically analyzed by the SPSS software.Results The serum levels of Hcy,hs-CRP and cTnT in the CHD group were (24.89±17.78)μmol/L,(17.43±35.89)mg/L and (0.76±2.36) ng/mL respectively,which were significantly higher than those in the control group(P <0.001).Moreover,the positive rate of Hcy in the CHD group was the highest (81 .25%),followed by hs-CRP(64.58%)and cTnT (58.75%).Conclusion Hcy,hs-CRP and cTnT played important roles in the development and progression of CHD,so reducing Hcy level may be an important pathway for preventing and treating CHD.

This paper discussed the different ways on the pharmacology of traditional Chinese medicine teaching to cultivate students' autonomous learning ability, promoting independent learning through PBL teaching, enhancing students' ability to think independently and practical operation using heuristic teaching.Survey results showed this student-centered, teacher-led, student-teacher interaction style pharmacology teaching model could improve the quality of teaching of Pharmacology.

Objetives: To evaluate the microtensile bond strengths o f four dentin adhesives (Single Bond, Bond-1, Prime&Bond NT and One-Step) i n vivo.Methods: Before extraction the superficial occlu sal dentin of 19 molars (because of severe periodontitis) in 17 volunteers was exposed by diamond bur of a high-speed hand-piece copious air-water spray under local anesthesia, the crown was bonded with one of the above adhesives a ccording to the manufacturers' instructions. The teeth were then extracted and kept in normal saline for 24 h under 37 ℃,sectioned to obtain two or three bar -shaped specimens, which were then shaped to an hour-glass form. The specimens were stressed until rupture of the bond. The mean bond strength of the adhesive s was measured and compared using student test. Rusults: M ean microtensile bond strength (MPa) of Single Bond,Bond-1,One-Step and Prime & Bond NT to the tooth surface was 26.18?3.67,30.08?3.15,29.91?3.51,29.70?3 .03 respectively (P

Twenty six uncontrolled patients with Graves′ disease were treated with thyroid artery embolism. Twenty two cases were followed for 24 60 months. The long term effect was observed after thyroid artery embolism. The results showed that the long term cure rate is 81.4% (18/22).

Objective To evaluate the nighttime blood pressure(BP) control status of hypertensive Chinese chronic kidney disease (CKD) patients and related risk factors.Methods This cross-sectional study enrolled 337 hypertensive CKD in-patients.The clinical and ambulatory BP monitoring (ABPM) data were retrieved from the electronic database of the hospital.High ambulatory BP were defined as ＞130/80 mmHg (average 24-hour BP) and ＞135/85 mmHg (daytime)/＞120/70 mmHg (nighttime),respectively.Multivariable analysis was used to evaluate the risk factors for lack of nighttime BP control and circadian rhythm.Results There were 38.6％ of the whole population had average 24-hour BP controlled.But only 22.8％ of them achieved nighttime BP control,which was far less than the 50.7％ of daytime BP control (P ＜ 0.01).Even among those patients who achieved average 24-hour BP control shown by ABPM,there were still 44.6％ of them with uncontrolled nighttime BP.Multiple analyses showed urinary protein excretion (OR:1.151,95％CI:1.035-1.279) was independent risk factor for lack of nighttime BP control.About 80％ of patients presented with nondipping BP pattern,among whom 37.3％ were presented with reverse-dipper pattern.Lack of nighttime BP control was independent risk factor for lack of normal circadian rhythm (both P＜0.001).Conclusions Lack of nighttime BP control was common in hypertensive CKD patients and contributed to the abnormal circadian rhythm.ABPM should be performed more commonly in clinical practice to help nighttime BP control in the future.