The American College of Rheumatology (ACR) published treatment recommendations for juvenile idiopathic arthritis (JIA) in 2011.The recommendations meant as a guide to health care providers caring for JIA children with dividing JIA into 5 distinct subtypes.The ACR updated the 2011 recommendations in 2013 and focused on the treatment of systemic-onset juvenile idiopathic arthritis (SOJIA).According to the clinical feature of the SOJIA,the subtybe is developed to 3 phenotypes.And the conception was firstly addressed that systemic JIA with features concerning for macrophage activation syndrome(MAS).Different treatment options was applied for clinical manifestations score,and these recommendations offered guidance for providers caring for children with the most common phenotypes associated with systemic JIA,rather than exceptional cases with unusual disease manifestations or refractory disease.

BACKGROUND:The mesh size used for herniorrhaphy mainly depends on clinicians' experience, which is less reliable. OBJECTIVE:To obtain the mesh size by measuring the posterior wall of inguinal hernia in Chinese adult men undergoing Rutkow surgery, and to assess the postoperative effect. METHODS:The posterior wall size of inguinal hernia in 180 Chinese adult male patients undergoing tension-free hernioplasty was measured, and then the optical mesh size was calculated. All patients were equivalently randomized into two groups, followed by subjected to Rutkow surgery according the calculated mesh size (experimental group) or subjective size (control group). Clinical indexes, the incidence of complications and recurrence rate were compared between groups. RESULTS AND CONCLUSION:The distance of pubic tubercle to internal oblique inguinal ligament starting point was (6.03±0.58) cm;the vertical distance of the highest point on the edge of the arcuate to inguinal ligament was (3.02±0.32) cm;therefore, the length of mesh should be larger than (13.04±0.74) cm, and width larger than (5.88±0.52) cm. The time of off-bed, dieting and hospitalization in the experimental group were significantly less than those in the control group (P<0.05);the time of operation and recovery of normal activities showed no significant difference between groups (P>0.05). The rates of postoperative complication and recurrence in the experimental group were significantly lower than those in the control group (P<0.01). These results suggest that after measuring the posterior wall size of inguinal hernia, the Rutkow used for inguinal hernia repair, obtains desired treatment outcomes with low incidence of complications and recurrence.

The American College of Rheumatology (ACR) updated the 2011 recommendations for juvenile idiopathic arthritis (JIA) in 2013 and focused on the treatment of systemic-onset juvenile idiopathic arthritis (SOJIA).According to the clinical feature of the SOJIA,the subtype is developed to 3 phenotypes:(1) phenotype of systemic JIA with active systemic features and yarying degrees of synovitis; (2) phenotype of systemic JIA without active systemic features and with varying degrees of active synovitis ; (3) phenotype of systemic JIA with features concerning for macrophage activation syndrome (MAS).The treatment recommendation was made according each phenotype,including initial therapeutic options and therapeutic options for continued disease activity.And uncertain or inappropriate options for continued disease were listed alphabetically.Development of treatment recommendations for children with SOJIA and features of MAS is particularly challenging.However,it is anticipated that in the near future,with research of the disease process,the better recommendation may be made.

This paper reports the technique to develop a disposable screen-printing base carbon electrode for the utilization in the study of enzyme electrode. The silk fibroin was applied to immobilize the mushroom extracted protein, which contained abundant polyphenol oxidase, on the surface of base electrode when it was chemically moldified by ferrocene. The voltammetric current of this enzyme electrode responded to the concentration of substrate such as catechol or dopamine. The linear range is from 2.0× 10-8 mol/L to 2.0× 10-2 mol/L, it reaches to a 95%steady value of current within less than 30 seconds, and the RSD equals to 2.7%. The service life of this enzyme electrode is at least 10 days and it will be preserved for a longer period at a humid and cool condition. All of these performances of the enzyme electrode make clear that its commercial development would be very possible.

Objective To investigate the mechanism of extremely low frequency electromagnetic field (ELF-EMF) and X-ray irradiation on liver carcinoma cell lines BEL-7402. Methods Liver carcinoma cell lines BEL-7402 had been incubated with ELF-EMF (100 Hz, 0.7 mT, 30 min, 3 days) after X-ray irradiation at different doses (0, 2, 4, 6, 8,10 Gy). The cells were observed on morphologic changes with scanning electron microscope. Flow cytometry and gene microarray were used to investigate the mechanism of cell apeptosis. Results ELF-EMF plus X-ray induced apoptosis on BEL-7402 was observed under scanning electron microscope.When X-irradiation was 2, 4, 6, 8 and 10 Gy, the apoptosis ratios of combined group and only X-irradiation group were 10.0%, 14.5%, 4.3%, 5.1%, 7.1% and 0.1%, 8.1%, 0.1%, 0.4%, 2.2% (P < 0.05) on flow cytometry. The result of microarray indicated that 1465 genes were up-regulated and 1108 down*regulated in the ELF-EMF plus X-ray group in comparison with the control group. The change rates of 110 apoptosis related genes were above 2 times, which including 71 up-regulated and 39 down-regulated. Gene microarray showed that ELF-EMF and X-ray irradiation had a mainly effect on different gene of apoptosis paths (CDC25 and CHKI, ATM, p38, PTEN, p53, G1/S, Fas, G2/M, Cell Cycle, Apoptosis and Caspase). The same genes of ELF-EMF plus X-ray group were showed 13 in ELF-EMF group and 42 in X-ray group. Conclusions Apoptosis paths were significantly different between ELF-EMF and X-irradiation. ELF-EMF cooperates with X-irradiation on inducing BEL-7402 cell apoptosis.

Objective: To analyze the bioactive components of Acnoitum Kusnezoffii Reichb..Methods: To detect the water extraction of Aconitum kusnezoffii Reichb.by the method of ESI-MSn.Results: Three kinds of alkaloids were detected in the water extraction of Aconitum kusnezoffii Reichb.:monoester alkaloids,diester-diterpenoid aconitines and lipo-alkaloids.Conclusion: The effect components of processed and unprocessed Acnoitum Kusnezoffii Reichb.can be analyze rapidly by ESI-MSn,and only needs few sample.

AIM:To study the bioactive components effect of every kind of herbal in Naru Sanwei Pill (Fructus litseae, Fructus chebulae) on Radix Aconiti kusnezoffii. METHODS: Analysising the Naru Sanwei Pill, adding the extraction of Radix Aconiti kusnezoffii to Fructus chebulae and Fructus litseae and was analyzed by ESI-MS~n. RESULTS: The quantity of mesaconitin was low in the extraction of Aconitum kusnezoffii Reichb,and Fructus chebulae.Long Pepper did not have much effect on alkaloids of Aconiti kusnezoffii Reichb. CONCLUSION: Fructus chebulae reduced toxicity in the process of Radix aconiti kusnezoffii,through lowering the dissolving-out of aconitine.

Objectives To explore the changes of T helper (Th) lymphocyte and its related factors in children with syste-mic-onset juvenile idiopathic arthritis (SoJIA). Methods A total of 36 SoJIA inpatients, hospitalized from January 2012 to June 2013, were divided into active phase group and remission group. In addition, 20 healthy children were selected as normal con-trols. Th1, Th2 and Th17 cell ratios in peripheral blood mononuclear cells were detected and compared between each group by flow cytometry. Serum interferon-γ(INF-γ), interleukin-4 (IL-4), interleukin-17 (IL-17) levels were measured by enzyme-linked immunosorbent assay. Results The proportions of Th17 cells over CD3+CD8-cell were (3.30±2.15)%, (1.78±1.14)%and (1.22± 1.14)%in active phase group, remission group and control group. The difference among three groups was significant (H=14.437, P=0.001), and the active phase group had higher proportion of Th17 than the other two groups (P<0.05). The ratio of Th1 and Th2 over CD3+CD8-cell between each group was not significantly different (P>0.05). The serum IL-17 levels were (125.82 ± 45.87) pg/ml, (57.79±25.84)pg/ml and(50.02±18.37)pg/ml in active phase group, remission group and control group with signifi-cant difference among three groups (F=31.82, P=0.000), and the active phase group had higher level of IL-17 than the other two groups (P<0.05). But serum INF-γ and IL-4 were not significantly different between each group (P>0.05). Conclusions Acquired cellular immunity is involved in pathogenesis of SoJIA, the increased proportion of Th1 and Th17 cell and the changes of related cytokines seem to correlate with active phage of SoJIA.

Objective To know the stability of 3 kinds of traditional Chinese drug injection with different solvent under different temperature and different storage time,and then reference to safty of clinical durgs. Methods Use particle analyzer,UV SpectropHotometer,pH Determination of three traditional Chinese medicine injection,at different temperatures and different times,the nuanber of particles,pH value,the value of UV absorbance Observe changes. Results The records of experimental data by repeated measures analysis of statistics: Ciwujia Injection,Aidi injection combined with normal saline solution after the particles of ≥ 10μm excess pharmacopoeia standards; ≥ 2μm number of particles is considerable,in the 32～35℃,Ciwujia at T=O min Aidi at T=I80 min ,the number of particles are smaller and with statistical significance,its pH value of the standard range. Xuesaitong injection with glucose injection ≥ 10μm particulate mixture at a higher temperature in excess of pH annacopoeia standards,number of ≥ 2 μm particles in the 4～8℃ and 20～23℃,T=30 min and 60 min time less with statistical significance,and its range of pH value less than pHarmacopoeia. Three kinds of Chinese medicine in the Department's largest UV absorbance peak value and appearance almost unchanged. Conclusions Different drugs in their relative Suggestions of temperature,time and place under intravenous drug use,or better terminal filter,in order to improve the safety of clinical medication.

Children Takayasu arteritis(c-TA)is a potentially life-threatening macrovasculitis that occurs during childhood.The early clinical manifestations are nonspecific, and the damage often leads to ischemic dysfunction of the organ.Non-invasive techniques such as magnetic resonance angiography has been included in the diagnosis and follow-up of children.At present, the conventional treatment plan is the combination of glucocorticoid and immunosuppressant.In the cases of refractory venereal diseases, biological agents should be considered as soon as possible to prevent the damage of ischemia to the terminal organs.When artery stenosis is severe, intravascular(stent or balloon)or bypass intervention is needed to reconstruct the blood vessels of the affected organs.Early diagnosis and timely and correct management are of vital importance in reducing the incidence rate and risk of injury.