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Objective:To analyze the relationship and clinical value between serum matrix metalloproteinases-3 (MMP-3) and rheumatoid arthritis (RA).Methods:By using retrospective study to collect 123 patients with RA diagnosed in our hospital from January 2019 to January 2020 as the RA group. Among the patients, there are 25 males and 98 females, the median age is 60 years old. During the same term, 53 healthy people were selected as the control group, with 12 males and 41 females, the median age is 55 years old. MMP-3, erythrocyte sedimentation rate (ESR), high sensitivity C-reactive protein (hs-CRP), rheumatoid facotrs (RF), anti-cyclocitrulline factor (ACCP) in peripheral blood of all subjects were detected. Disease activity score of 28 joints (DAS28) were collected. This research used T test, Spearman correlation analysis and receiver operating characteristic curve (ROC curve) to analyze the relationship between MMP-3 and other clinical biochemical indices, and the efficacy of MMP-3 in the diagnosis of RA.Results:Compared with the control group (26.30±14.83)ng/ml, the levels of serum MMP-3 in the RA group (79.71±123.54) ng/ml had significantly increased ( t=-4.95, P<0.001). The serum concentration of MMP-3 in RA patients was significantly correlated with ESR, hs-CRP and DAS28 ( r value were 0.521, 0.372, 0.405 respectively, P<0.001). The area under the curve (AUC) of MMP-3 to diagnose RA was 0.765, and the sensitivity was 64.44%, and the specificity was 75.76%, cut-off of MMP-3 were 32.50 ng/ml. Conclusions:The levels of serum MMP-3 in the RA group had significantly increased. MMP-3 and the disease activity were highly correlated. MMP-3 can be used as an indicator of RA disease activity, also can significantly improve the diagnostic efficacy, treatment and warning of early RA.
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Objective:To investigate the effect and application feasibility of low tube voltage, low concentration of contrast agent volume to CTA in the diagnosis of coronary artery stenosis and its effect.Methods: Seventy two cases of suspected patients with coronary atherosclerosis selected as the object Using random number table method, all patients were divided into group A and group B 36 cases in each group, two groups of patients underwent 320 slice CTA examination, in group A the tube voltage is 120kV, the contrast agent was 350mgI/mL iodixanol group, B tube voltage is set to 100kV, the contrast agent was 270mgI/mL iodixanol. According to the examination results of group A, group B and catheter coronary angiography (CCA), evaluated group A, group B of acquiring the image quality and radiation dose of patients, and analyzed the sensitivity of A, B and CCA examination of the extent of coronary artery stenosis degree and deliberately.Results: The quartering method showed no significant difference between the group A and the group B of image quality. There was significant difference between the two groups of patients with the image noise and enhance the effect (t=-4.736, 11.927;P<0.05); Group B of coronary artery stenoses (more than 50%) and severe stenosis (more than 75%) sensitivity, specially degree and coincidence rate compared with the results of CCA showed no significant difference. Kappa consistency analysis showed that the two consistency is good(kappa=1.320,P<0.001).Conclusion: In the premise of ensuring the image quality with low tube voltage, low concentration of contrast agent volume coronary CTA examination had safety and reliability of inspection.
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Objective:To investigate the 256 slice spiral CT pulmonary angiography (CTPA) application value by using multiple stage double mixed injection velocity tracking method in the diagnosis of pulmonary embolism.Methods: Fifty patients with pulmonary embolism from 2014 January to 2015 January were treated in our hospital patients as the research object. Using a random number table method, all patients were randomly divided into observation group and control group, 25 cases each group of patients, two groups of patients in our hospital by imaging with 256 slice spiral CT pulmonary artery (CTPA), the control group were treated by routine pre injection time density curve method, was used in the observation group than in mixed injection agent tracking method by two physicians, CT, using the double-blind assessment of two groups of patients with image quality and quantification of pulmonary artery trunk.Results: in the control group, 25 patients were satisfied with the time - density curve, the results of 5 conventional image quality scores showed no significant difference between the two imaging methods, was not statistically significant; two groups of patients with pulmonary artery trunk, branch clear imaging score and endovascular CT value had no significant difference(t=1.892,t=1.952,t=1.832;P>0.05), but the observation group patients with CTPA were examined by contrast agent dose was significantly lower than the control group, the patient''s heart rate, blood pressure was significantly lower than the control group(t=2.315,t=1.958,t=2.982;P<0.05), with statistical significance. Conclusion: CTPA with multi period mixed double flow injection method can guarantee the tracking based on image quality and diagnostic value can effectively reduce the contrast agent dosage and application effects of cardiac function, and the examination is relatively simple, safe, has clinical value of application and popularization.
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Objective To investigate the relationship between wound suture and incision complications in acute gastrointesti -nal tract incision .Methods Patients with abdominal surgery ( acute digestive tract perforation , and acute intestinal obstruction ) were divided into two groups .The differences between two suture methods were compared with the indicators such as operative time , incision complications, and hospital stay, etc.Results There were no significant differences between two groups (12.5%vs 20%) in incision complications ( P >0.05 );while there were differences in the postoperative hospital stay between two groups .The hospital stay of the intradermalsubcutaneoussuturegroup(13.54±7.32)dweresignificantlyshorterthanthatoftraditionalgroup(18.11±11.67)d(P<0.05 ) .Conclusions Wound intradermal subcutaneous suture was superior to traditional suture in acute gastrointestinal tract inci -sion.No significant difference was found between two groups in incision complications , but wound intradermal subcutaneous suture had significantly shorter postoperative hospital stay .
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Objective To explore the role of health management in the treatment of rheumatoid arthritis combined with osteoporosis.Methods A total of 140 women with postmenopausal osteoporosis and rheumatoid arthritis were enrolled in this 12-month randomized controlled study and randomly assigned to receive drug therapy ( group A,n =70 ) or drug therapy + health management ( group B,n =70 ).Bone mineral density (BMD) of the forearm,lumbar spine and hip was measured by using dual-X-ray absorptiometry at baseline and 12 months after the intervention.The rates of fractures were calculated at 12months.Results BMD of the forearm,lumbar spine and hip of both groups were significantly increased at 12 months (group A:0.50 ± 0.13,0.78 ± 0.15 and 0.68 ± 0.14,respectively,all P ＜ 0.05; group B:0.54± 0.14,0.80 ± 0.12 and 0.73 ± 0.15,respectively,all P ＜ 0.05 ).The elevation of BMD and therapy compliance of group B were significantly higher than those of group A ( P ＜ 0.05 ),while the rate of fracture was relatively lower.Conclusions Health management can significantly improve patient compliance and medication efficacy.
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Blood samples were collected from 90 patients with confirmed rheumatoid arthritis (RA), 73 patients with other rheumatic diseases and 50 normal controls. Serum glucose-6-phosphate isomerase (GPI) and anti-cyclic citrullinated peptide (CCP) were detected with ELISA method, rheumatoid factor IgM( RF IgM)was measured with turbidimetric immunoassay and antikeratin antibody (AKA) was determined with indirect immunofluorescence assay. The serum GPI levels of RA group[1.73 (0. 43 -4. 40)mg/L]were significantly higher than those of rheumatic disease[0. 14 (0. 10 -0. 18 )mg/L]and normal controls[0. 12 (0. 09 - 0. 15 ) mg/L], ( H = 18. 13, P ＜ 0. 01 ). The sensitivities of GPI, anti-CCP,RF-IgM, AKA, GPI + CCP, GPI + RF-IgM were 80% (72/90), 57% (51/90), 68% (61/90), 29% (26/90) ,92% (83/90) and 96% (86/90), respectively; the specificities were 97% (119/123) ,95% ( 117/123 ) ,77% (95/123) ,95% ( 117/123 ), 93% ( 115/123 ) and 76% ( 93/123 ), respectively. GP1 level was significantly correlated with CCP and RF-IgM ( r = 0. 674 and 0. 533, P ＜ 0. 01 ), but not correlated with AKA ( r = 0. 12, P ＞ 0. 05 ). The results suggest that serum glucose-6-phosphate isomerase level is a valuable indicator for early diagnosis of rheumatoid arthritis.