Objective To observe the effect of combination therapy with methotrexate,sulfasalazine and hydroxychloroquine on serum lipids in elderly patients with rheumatoid arthritis (RA).Methods 136 patients with RA were randomly divided into group A and group B (n=68,each).Patients in group A were treated with methotrexate,sulfasalazine and hydroxychloroquine sulfate plus life style intervention.Patients in group B were treated with the therapy as same as that of group A and received xuezhikang additionally.The levels of cholesterol (TC),low density lipoprotein cholesterol (LDL-C),triglyceride (TG),high density lipoprotein cholesterol (HDL-C),C-reactive protein (CRP),erythrocyte sedimentation rate (ESR) were determined before and 6 months after treatment.Disease activity was assessed by DAS28,swelling index,joint pain index,duration of morning stiffness.Results The levels of TC,TG and LDL-C were lower and HDL-C level was higher in the two groups after 6 months of the treatment than before treatment (all P＜ 0.05).DAS28,ESR,CRP,joint tenderness,joint swelling and duration of morning stiffness were significantly reduced in two groups after 6 months of the treatment as compared with pretreatment (all P＜0.05).There was no significant difference in levels of TC,TG,LDL-C,HDL-C,DAS28,ESR,CRP,joint tenderness,joint swelling and duration of morning stiffness between the two groups after treatment.There were no obvious differences in liver and kidney function between the two groups before and after treatment.Conclusions Blood lipids levels are abnormal in RA patients.The slow acting antirheumatic drugs have certain effect on blood lipids when alleviating disease symptoms.

Objective To understand the clinical characteristics of lower respiratory tract infection,pathogenic distribution and drug resistance in intensive care unit to provide a basis for reasonable use of antibiotics. Methods From January 2008 to August 2010,the clinical data from our hospital ICU impatients of lower respiratory tract infection were retrospectively analyzed. The isolated strains were identified, the antibiotic susceptibility test was performed by K-B methods and the results were read according to CLSI 2007. Results There were 509 patients, 147 cases of lower respiratory tract infection were found. Lower respiratory tract infection rate was 28.9% (147/509); 283 strains of pathogens had been isolated by culture and most of which were Gram negative bacilli(86. 9%), the other pathogens included Gram positive cocci(7.4%) and fungi(5.7%). The most common pathogens were Acinetobacter spp, Pseudomonas aeruginosa, Klebsiella pneumoniae,Stenotrophomonas oligotrophic aeromons, Fungi, Escherichia coli, Staphylococcus aureus, Burkholderia cepacia,etc,accounting for 24. 7% ,20. 5% ,12. 7% ,6. 4% ,5.7% ,5. 3% ,5.3% and 4. 6% ;The main pathogens were highly resistant to the most antibiotics. Conclusion ICU had a higher lower respiratory tract infection rate, Gram negative bacilli are the main pathogen, and showed the multi-drug resistance features to the antibiotics.

Objective To discuss incidence and related risk factors of vascular cognitive impairment (VCI) after acute subcortical infarction (SI).Methods One hundred and eighty-two patients with acute SI were divided into two groups:VCI group (81 cases) and no-VCI group ( 101 cases) according to VCI diagnostic standard.Sex proportion,age,culture degree between two groups were compared,and correlation was analyzed between the quantity of risk factors and the incidence of VCI.Results The incidence of VCI after acute SI was 44.5％(81/182).According to age stratification,the incidence of VCI in the patients of 56-65 years was 35.4％ (23/65),in the patients of 66-75 years was 45.3％ (48/106),and in the patients of 76-85 years was 90.9％ (10/11 ).The age in VCI group was significantly higher than that in no-VCI group [(69.93 ±6.91) years vs. (67.62 ±5.56) years,P =0.014],and culture degree was significantly lower than that in no-VCI group (P =0.028).The sex proportion between two groups had no significant difference (P =0.876).The more accompanying risk factors,the higher incidence of VCI.Conclusions Along with the increase of age,the incidence of VCI after acute SI is higher.The more accompanying risk factors,the higher incidence of VCI.

BACKGROUND:Numerous studies have demonstrated that mild hypothermia has a better protective effect on neurons after cerebral infarction.
OBJECTIVE:To investigate theeffect of mild hypothermia on nerve regeneration microenvironment of infarcted area in rat models of cerebral infarction and analyze its possible effects on neural functional recovery after cerebral infarction.
METHODS:Twenty out of 65 adult femaleSprague-Dawleyrats were randomly selected as the sham group. The remaining 45 rats were subjected to carotid artery ligation to establish rat models of cerebral infarction. Five rats were rejected because of modeling failureor death, the remaining 40 rats were randomly and evenly divided into cerebralinfarction and mild hypothermia groups. The head temperature of rats in the cerebral infarction group was downregulated to (37±1)℃ using a semiconductor refrigeration instrument. The rats were transferred to the room with the temperature of 25℃ after the operation. Brain hypothermia was also induced in rats from the mild hypothermia group. At 13.0-14.0 minutes after establishing rat models of cerebral ischemia, the head on the side of cerebral ischemia was tightly connected with the probe of the semiconductor refrigeration instrument. The refrigerator temperature was adjusted to 6-8℃, so as to make the temperature of brain tissue on the lesion side at 32.0-33.0℃ for 4 hours.
RESULTS AND CONCLUSION:Compared with the cerebral infarction group, the BBB scores of rats inthe mild hypothermia group were distinctly increased, and the volume of infarcted area decreased. At 1 day after modeling, the expression level of growth associated protein 43 mRNA in brain tissue of rats in the mild hypothermia group was close to that in the cerebral infarction group. At 2 weeks after modeling, the expression level of growthassociated protein 43 mRNAin brain tissue of rats in the mild hypothermia group was significantly increased compared with that in the cerebral infarction group. These results suggest that mild hypothermia therapy can protect nerve cels against injury caused by cerebral infarction and promote the recovery of neurological function. Its underlying mechanism may be related to the up-regulation of the expression of growth associated protein 43 in ischemic penumbra .

The incidence of open-angle glaucoma has been rising year after year in China, which has caught much at-tention from ophthalmologists.There are various methods to evaluate the disease progression of an open-angle glaucoma pa-tient.These methods can be divided into two classes:functional assessment and structural assessment.We survey these two classes of methods in this paper.

An improved method for the purification of 1,25-(OH)2D3-26,23-lactone was established by using one step of highperformance liquid chromatography (HPLC). The analytic column was Shim-pack NH2 (straight-phase type). The mobile phase was Methanol: Dichloromethane: Hexane = 4:26:70 and the flow rate was 2ml/min. An ultraviolet detector with 254nm was used. The retention time of 1,25-(OH)2D3, l,25-(OH)2D3-26,23-lactone and 1, 24, 25-(OH)3D3 werel2.10, 17.06 and 22,00 minutes respectively. This method can separate 1,25-(OH)2D3, l,25-(OH)2D3-26,23-lactone and 1,24,25-(OH)3D3 only by one step of HPLC and it is better than the old one which need two steps of HPLC for the separation of these substances.

OBJECTIVE: To compare the in vitro dissolution of carvedilol tablets from four different pharmaceutical factories for references of clinical application of carvedilol tablets. METHODS: The dissolution test was carried out with basket-rotating method. The content of carvedilol was determined by UV spectrophotometry. The accumulative dissolution percentage was calculated. The Weibull’s equation was used to fit the dissolution parameters including T50,Td,T80,and m. Then an ANOVA was performed on these parameters. RESULTS: The dissolution of carvedilol from four manufactories conformed to the requirements of Chinese Pharmacopoeia(2005 edition). But significant differences were found among carvedilol preparations from different factories in dissolution parameters including m,T50,Td and T80(P

Bursa of Fabricius is a very important organ for B-eell development. We sot bursa extracts from 2-3 months old Peking Duck. A partially purified PFC-stimulating active factor has been seperated from the extracts by twice molecular sieve chromatography, Sephadex G-15 and Moselect G-10. The M. W. of the active factor is below 750 dal. The results of HPLC analysis of the factor show that its polarity is relatively strong, and it has more positive charges.The works of purifying and looking for a new assay are still going on.

Bursa of Fabricius is the central organ of B-cell development in birds. There are some active factors in Bursa that are involved in the maturation of B lymphocytes. Bursa extracts from 2-3 month-old peking Duck, with a M. W. of 10,000 dal, can obviously increase the number of plaque-forming cells (PFCs) in normal or cyclophosphamidetreated mouse spleen. Cyclophosphamide (CP) is a kind of B-cell inhibitor. The extracts can also increase the life expectation of mouse treated with deathal dose of CP. These results show that Bursa extracts contain a factor (or some factors) which can promote the development or function of B cells. The factor is named as Bursatin. Because the PFCs-stimulating activity of the factor is susceptible to high temperature and pronase E, Bursatin is infered to be a peptide. The effect of Bursa extracts on elevating the cAMP level of mouse spleen cells suggests that Bursatin may function via cAMP. Besides, it is interesting that we have found that the extracts can also increase the rumber of E-rosett forming cells in pig thymocytes. The result shows that there are several active factors or certain factor poesses different activities in Bursa extracts.

Objective To observe the clinical effect of point-to-point acupuncture with electric stimulation of direct current induction for facial nerve paralysis. Methods A total of 65 patients with facial nerve paralysis were randomly divided into the observation group (n=33) and the control group (n=32). The control group received routine treatment, and observation group was received Dicang (ST4)-to-Jiache (ST6) and Yangbai (GB14)-to-Taiyang (EX-HN5) by acupuncture with electric stimulation of direct current induction combined with conventional western medicine. The treatment of both groups last 3 weeks. The House-Brackmann Scale and the BR indexe at baseline and after 3 weeks treatment were observed. Results After treatment, The clinical effect of observation group was 66.7%, which was significantly higher than control group 43.8% (U=2.175, P=0.013). After treatment, House-Brackmann facial nerve scale (Ⅰ level=15 cases, Ⅱ level=4 cases, Ⅲ level=3 cases) in the observation group was significantly better than that in the control group (Ⅰ level=5 cases, Ⅱ level=7 cases, Ⅲ level=2 cases; U=2.069, P=0.018). After treatment, R1 latency (12.28 ± 2.55 ms vs. 13.84 ± 3.07 ms, t=2.227) and R2 latency (32.28 ± 7.08 ms vs. 35.95 ± 5.11 ms, t=2.396) in the observation group were significantly shorter than those in the control group (P=0.030, P=0.020). Conclusions The point-to-point acupuncture with electric stimulation of direct current induction could reduce latency of R1 and R2 for facial nerve paralysis, and improve the clinical effect.