Objective To explore the effects of psychological intervention on negative emotions and quality of life in patients with rheumatoid arthritis (RA).Methods A total of 112 patients with rheumatoid arthritis were divided into two groups:the intervention group and the control group.All patients were given drugs for treatment of RA.Additionally,patients in the intervcntion group were received psychological intervention.Zung's self-rating depression scale (SDS),Zung's self-rating anxiety scale (SAS),RA disease activity score (DAS28),visual analog scale (VAS),disability index of health assessment questionnaire (HAQ-DI) were assessed,and the related laboratory parameters such as erythrocyte sedimentation rate (ESR),C reactive protein (CRP),rheumatoid factor (RF)were determined.Results 6 months after the treatment,there were significant differences in SDS and SAS between the treatment group and the control group [SDS:(31.7±4.7)scores vs.(29.6±4.4)scores; SAS:(34.7±5.3)scoresvs.(32.6±5.1)scores; t=2.441,-2.119,both P＜0.05].The patients with tender joints,joint swelling and morning stiffness time were less in the treatment group than in control group [(5±3) vs.(7±4),(4±3) vs.(5±3),(36±16) min vs.(42±19)min.respectively,t=2.054,2.393,1.995,all P＜0.05].The scores of HAQ-DI,VAS and DAS28were lower in the treatment group than in control group [(0.89±0.73) vs.(1.20±0.77),(6.1±1.6) vs.(6.8±1.8),(3.2±1.7) vs.(3.9±1.9),respectively,t=2.136,2.406,2.135,all P＜0.05].There was a significant difference in CRP between the treatment group and the control group [(34±14) mg/L vs.(37± 17)mg/L,t=2.406,P＜0.05].Conclusions Psychological intervention can improve the negative emotions and quality of life in patients with rheumatoid arthritis.

Objective To observe the effect of combination therapies with methotrexate, sulfasalazine and hydroxychloroquine on hyperlipemia of rheumatoid arthritis.Method From 2009 November to 2010 November, 68 RA inpatients and outpatients in the department of rheumatism of our hospital were randomly divided into two groups: A group and B group, 34 cases in each group. The patients in A group were given combination of methotrexate, sulfasalazine, hydroxychloroquine sulfate for the treatment of RA,patients in B group, based on A group's treatment, were treated by xuezhikang. Some indexes were observed in two group before treatment and 6 months after treatment, including cholesterolTC,low density lipoprotein cholesterol LDL-C , triglyceride TG , high density lipoprotein cholesterol HDL-C , swelling index, joint pain index, time of morning stiffness, C-reactive protein CRP , erythrocyte sedimentation rate ESR and DAS28. Results After 6 months’ treatment, the serum levels of TC, TG,, LDL-C, both in two groups of patients, were lower than those before treatment, and HDL-C was higher than that before treatment, there were significant differences (P<0.05 or P<0.01) . After 6 months of treatment,DAS28,ESR,CRP,joint tenderness,joint swelling and morning stiffness time, both in two groups RA patients, significantly reduced compared with before treatment, there were a very significant difference (P<0.05 or P<0.01) .After treatment, the above indexes had no statistically significant difference between two groups (P>0.05) . Conclusion RA patients have abnormal blood lipid levels, disease-modifying anti-rheumatic drugs have effect on blood lipid during remission joint disease in RA patients.

Gastrointestinal stromal tumours(GISTs)are the most common primary mesenchymal tumours of the gastrointestinal tract and the disease is occasional and asymptomatic. Though the high rate of recur- rence after surgery, operation remains the firstline treatment of the GIST without metabasis. With the consid- eration the molecular biology of tumor, the treatment including surgery and molecular targeted therapy can im- prove the prognosis of GISTs.

Objective To investigate the association between diabetes and pancreatic cancer to provide the basis for the early di‐agnosis and prevention of pancreatic cancer .Methods By formulating the retrieval stategy ,the databases of PubMed ,EMbase ,Ov‐id 、EBSCO ,CNKI and CBMdisc ,VIP ,Wanfang/database etc .were retrieve by computer from their establishment to July of 2013 .At the same time ,the relevant literature references were also retrieved .All case‐control studies(CCS) on the association between diabe‐tes and pancreatic cancer were included and their quality was assessed .The meta analysis was conducted by using Review Manager 5 .0 software .Results A total of 21 CSC were included ,finally 18 case‐control studies met the inclusion criteria for conducting meta analysis ,including 6 184 cases in the pancreatic cancer group and 10 296 cases in the control group .The meta analysis on the pan‐creatic cancer group and the control group showed that the result of heterogeneity test from all research data was I2 = 74% ,χ2 =65 .38 ,P< 0 .01 ,the random effects model was adopted ,the pooled odds ratio(OR) was 3 .60 and 95% confidence interval(95% CI) was 3 .28 - 3 .94 ,the difference showed the statistic significance(P< 0 .05) ,which indicating that the risk suffering diabetes in the patients with pancreatic cancer was 3 .6 times of the normal population .Conclusion Diabetes is associated with pancreatic cancer and diabetes may be an early clinical manifestation of pancreatic cancer .

Malignant bowel obstruction (MBO) is common in patients with bowel or gynaecological canc-er. Although surgery is the primary treatment for most patients with MBO, it should not be undertaken rou-finely in patients with poor prognosis. Nasogastric drainage is only a temporary measure. Serf-expanding me-tallic stents are optimistic in malignant obstruction of the gastric outlet and proximal small bowel.

Objective To explore the effects of low-dose CT scan on diagnostic quality of images and the radiation dose to the lens.Methods 60 cases were scanned in axial orientation at different mA.Lens radiation dose was measured and image quality was evaluated.Results Image quality score of group A was(11.2 ± 0.7)points,higher than the group C(4.9 ± 1.8)points(t =12.634,P ＜0.05),and score difference of group B(10.6 ± 1.1)was significantly different(P ＞ 0.05).CTDIvol of group A,group B and group C were 18.32mGy,7.63mGy and 4.58mGy,group B,group C and group A difference was statistically significant(t =15.625 and 14.037,P ＜ 0.05).Group B and C groups difference was not statistically significant(P ＞ 0.05).Conclusion Low dose CT scanning(50mA)in orbit not only could assure the image quality,but also decrease the radiation dose.

Hazards of noise-induced hearing loss (NIHL) to crowd who are long-term exposured and work in the noisy environment is increasingly prominent. But just part of the individuals who are exposed to the same noisy environment have hearing loss, and the severity of hearing loss are different, which indicates genetic predisposition might be associated with NIHL. In recent years, many experts and scholars at home and abroad have done a lot of research in this field, this article summarizes all available studies.
Genetic Predisposition to Disease ; Hearing Loss, Noise-Induced ; genetics ; Humans ; Noise, Occupational ; adverse effects

To study the significance of the pathological changes of axon and myelin sheath in injured brainstem.The neurofilament and myelin basic protein was demonstrated immunohistochemically,and the pathological changes of axons and myelin sheathes in human brainstem following trauma were observed.In the injured brainstem,irregular swelling and disconnecting axons could be found as early as 0 5h after injury, while pathological changes in myelin sheaths such as tortuous change,partial peeling off from axon and intermittent disappearance could be observed at 19～22h after injury.However,in the normal brainstem,there were no evident changes in axons and myelin sheaths.Pathological changes of axon and myelin sheath in brainstem would occur after trauma,which could be used for postmortem diagnosis of brainstem injury.

Objective To compare the efficiency and safety of clopidogrel of different loading-dose in acute coronary syndromes(ACS) patients with percutaneous coronary intervention(PCI) therapy, and, give an assessment of security about higher loading dose of clopidogrel. Methods 120 patients from January 2008 to January 2009 in our hospital were included.They were randomly divided into 3 groups(na=nb=nc=40)and were given 600 mg,450 mg and 300 mg clopidogrel on the 6 hour before PCI. There was no significant difference between the three groups' basic clinical information(p>0.05),such as age, sex and so on. Four points were selected to observe: the platelet aggregation induced by ADP with 5umol/L before and two hours、four hours, six hours after taking medicine; Primary endpoint events, which include shock during hospitalization, death, target revascularization, myocardial infarction, recurrent angina, stroke in 30 days,and Postoperative Bleeding events and adverse Reactions after Surgery in 30 days. Results compared to the standard dose of 300 mg clopidogrel, 600 mg doses clopidogrel can give a greater degree of inhibition on platelet activating than 450 mg doses in the pre-6 h after administration. Increase Clopidogrel loading dose can reduce the occurrence of major cardiovascular events rate. Bleeding events and the occurrence of adverse events was no significant difference among three groups. Conclusions compared to the standard dose of 300 mg clopidogrel, a higher loading dose of clopidogrel can produce much more faster, greater platelet inhibition, and similar security.

BACKGROUND: Generally, repairing the injuries of sketetal muxcle is to suture the epimysial and exterior muscular nerve. OBJECTIVE: To determine the intramuscular nerve effects on the recovery of lacerated musculus rectus femoris. DESIGN, TIME AND SETTING: The randomized control animal experiment was performed at the Animal Experimental Center, Chongqing Medical University from September 2006 to August 2007. MATERIALS: Twenty New Zealand rabbits weighing 2.0-2.5 kg were used to establish models of right skeletal muscle injury; left side was used as controls. METHODS: Twenty rabbits were randomly divided into two groups. Rabbits in the intact intramuscular nerve group underwent complete muscle laceration with intramuscular nerve intact. Musculus rectus femoris was traversed at 4.0-5.0 mm from nerve entry point. Rabbits in the intramuscular neurotmesis group underwent complete muscle laceration, but intramuscular nerve was cut concomitantly at the same place as above. MAIN OUTCOME MEASURES: 28 weeks after surgery, wet weight and isometric contraction of musculus rectus femoris were detected. Morphological change of musculus rectus femoris was observed by Hematoxylin & Eosin Staining. Fibrous degree was measured by Masson trichrism staining. Myofibrillar type was examined by myosin ATPase staining and tetrazolium staining method of reduced coenzyme Ⅰ to calculate cross-sectional area of muscle fiber. RESULTS: Compared with the controls, wet weight and isometric contraction of musculus rectus femoris reduced in the intramuscular neurotmesis group (P