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ObjectiveTo review the classification of orthopedic insoles, common techniques of 3D printing orthopedic insoles, common materials and their application for flatfoot. MethodsLiteratures were retrieved from PubMed, Web of Science, CNKI and Wanfang Data from 2012 to 2022, and the relevant contents were summarized. ResultsA total of ten studies were finally included, from 5 countries, involving 290 participants, which published from 2019 to 2022. Orthotic insoles were classified as prefabricated, semi-custom, and custom, while custom ones were classified as traditional custom and 3D printed custom. 3D printed orthotic insoles were often made with selective laser sintering, fused deposition modeling (FDM) and PolyJet printing technologies, and commonly used materials included ethylene-vinyl acetate (EVA), polylactic acid, thermoplastic polyurethane, polyamide, and polypropylene. For flatfoot, 3D printed orthotic insoles could improve plantar pressure, relieve foot pain and the combined use of insole posting could control rearfoot valgus. Conclusion3D printed custom insoles can be made more efficiently and accurately than traditional custom insoles. The printing technologies and materials often chosen for 3D printed orthotic insoles are mainly FDM and EVA. 3D printed orthotic insoles is effective on plantar pressure, comfort and foot movement function of flatfoot.
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Stimulator of interferon genes (STING) is a cytosolic DNA sensor which is regarded as a potential target for antitumor immunotherapy. However, clinical trials of STING agonists display limited anti-tumor effects and dose-dependent side-effects like inflammatory damage and cell toxicity. Here, we showed that tetrahedral DNA nanostructures (TDNs) actively enter macrophages to promote STING activation and M1 polarization in a size-dependent manner, and synergized with Mn2+ to enhance the expressions of IFN-β and iNOS, as well as the co-stimulatory molecules for antigen presentation. Moreover, to reduce the cytotoxicity of Mn2+, we constructed a TDN-MnO2 complex and found that it displayed a much higher efficacy than TDN plus Mn2+ to initiate macrophage activation and anti-tumor response both in vitro and in vivo. Together, our studies explored a novel immune activation effect of TDN in cancer therapy and its synergistic therapeutic outcomes with MnO2. These findings provide new therapeutic opportunities for cancer therapy.
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DNA is a biological polymer that encodes and stores genetic information in all living organism. Particularly, the precise nucleobase pairing inside DNA is exploited for the self-assembling of nanostructures with defined size, shape and functionality. These DNA nanostructures are known as framework nucleic acids (FNAs) for their skeleton-like features. Recently, FNAs have been explored in various fields ranging from physics, chemistry to biology. In this review, we mainly focus on the recent progress of FNAs in a pharmaceutical perspective. We summarize the advantages and applications of FNAs for drug discovery, drug delivery and drug analysis. We further discuss the drawbacks of FNAs and provide an outlook on the pharmaceutical research direction of FNAs in the future.
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Objective:To investigate the clinical effect and safety of reduction and fixation for the anterior glenoid fracture through an axillary approach.Methods:Two autopsy specimens (a total of 4 shoulder joints) were used to simulate the surgery of open reduction and internal fixation to treat anterior glenoid fracture through an axillary approach. Specimens were placed in the lateral decubitus position. An incision was made in the posterior axillary line to expose the lateral side of the scapula through the interval ahead of the latissimus dorsi muscle. Attended to the separation and protection of the axillary nerve, posterior humerus artery, thoracic dorsal nerve, and scapular artery. The surgical area of the axillary approach was divided into the upper "quadrilateral area" and the lower "trilateral area", which exposed the anteroinferior glenoid, neck, and the full length of lateral border of the scapula. Thirteen cases (7 males and 6 females) were involved in this study, all patients were diagnosed with anterior glenoid fracture and treated by open reduction and internal fixation through the axillary approach between April 2018 and December 2020. Constant-Murley score and Disabilities of the Arm, Shoulder and Hand (DASH) were used to evaluate the clinical efficacy.Results:Thirteen patients were enrolled for final analysis, which included 12 right cases and 1 left case. The average age was 50.38±13.74 years (range 24-67 years). All 13 patients were classified as Ideberg type Ia fracture. Anatomical buttress plates were used in 5 cases, cannulated screws combined with metacarpal plates in 7 cases, and distal radius plate in 1 case. The average length of follow-up was 13.00±5.97 months (range 6-26 months). No delayed union or malunion in all cases at the last follow-up visits. The average of Constant-Murley score was 62.46±10.26 points (range 45-83) and the DASH score was 27.56±9.76 points (range 14.14-43.33) at the three months follow up visits. At 6 months postoperatively, the Constant-Murley score was 80.85±8.32 points (range 65 to 90) and the DASH score was 11.47±8.56 points (range 0 to 35.00). Constant-Murley score at the final patient's follow-up visit was 84.54±8.95 points (range 70-95), and the DASH score was 10.94±8.67 points (range 1.67 to 33.33 points). The joint function gradually recovered with time. The functional scores at 3 months, 6 months after surgery, and final follow-up visit had significant differences ( P<0.05). Conclusion:The axillary approach is a safe and feasible approach for the treatment of the anterior glenoid fracture. This approach exposes the anteroinferior glenoid and the lateral border of the scapula, which reduces rotator-cuff injury and achieves anatomic reduction and strong fixation of the fracture. The axillary approach surgery also allows early functional physiotherapy after surgery.
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Objective:To investigate the efficacy of the posterior axillary approach in the treatment of some scapular fractures.Methods:Retrospectively analyzed were the data of 41 patients with scapular fracture who had been treated through the posterior axillary approach at Department of Traumatology, The Second Hospital of Jilin University from April 2018 to July 2021. There were 32 males and 9 females, aged from 24 to 83 years (average, 52.4 years). Of them, 7 were complicated with multiple injuries, 16 with other fractures, and 4 with brachial plexus injury. Recorded were length of surgical incision, intraoperative blood loss, operation time, and range of shoulder motion, Disability of Arm Shoulder and Hand (DASH) score, Constant shoulder score and postoperative complications at the last follow-up.Results:In this cohort, length of incision ranged from 7 to 12 cm (average, 9.3 cm), intraoperative blood loss from 80 to 150 mL (average, 110.5 mL), exposure time of the posterior axillary approach from 5 to 10 min (average, 7.9 min), and fracture operation time from 85 to 140 min (average, 110.8 min). The 41 patients were followed up for 6 to 36 months (mean, 14.3 months) after surgery. At the last follow-up, the average ranges of shoulder motion were 177° (from 150° to 180°) in flexion, 175° (from 140° to 180°) in abduction and 47° (from 30° to 50°) in extension, the average DASH score was 36.4 points (from 34 to 46 points), and the average Constant score 96.0 points (from 84 to 100 points). There were no complications like loss of fracture reduction, loosening or breakage of plate or screw during follow-up. Incision healing was delayed in 2 patients and mild heterotopic ossification occurred in 2 patients.Conclusion:As a new surgical approach for some scapular fractures, the posterior axillary approach allows internal fixation of the fractures of the scapular glenoid, neck and body under direct vision, leading to good-looking postoperative wound and reliable curative effects.
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Adoptive cell therapy (ACT) is an emerging powerful cancer immunotherapy, which includes a complex process of genetic modification, stimulation and expansion. During these
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Objective:To investigate the current situation of doctor-patient communication ability and analyze the reasons and countermeasures, so as to provide a reference for the ability cultivation.Methods:We collected the data with survey sampling techniques from 366 graduates of clinical medicine in Grade 2016 at Hubei University of Medicine through a self-designed questionnaire and field interview. Similarly, a total of 266 patients and their family members were asked to evaluate the doctor-patient communication ability of the graduates. Kolmogorov-Smimov Z test was adopted for the enumeration data with skewed distribution, while chi-square test was applied for the enumeration data with normal distribution. The significance level was shown as α=0.05 in the analyses. Results:The doctor-patient communication ability of clinical graduates was far from perfect. The overall matching rate of non-verbal skills (including 4 items of personal appearance, body language, speech rate, voice volume and eye contact) reached 63.5% (930/1 464), while the number dropped below 50% regarding their verbal communication, listening and comprehension skills, professionalism and medical ethics. Graduates of different genders showed different communicative abilities. The self-assessments of graduates differed from the evaluations of patients and their family members.Conclusion:We suggest to lay stress on the cultivation of interpersonal communicative skills of undergraduates; reinforce the education on doctor-patient communication ability, especially on medical ethics and professionalism; enhance continuing education on communicative ability of young doctors.
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Objective To observe the effect and safety of intermittent epidural bolus without background infusion combined with patient-control epidural analgesia (PCEA) in transurethral resection of prostate. Methods Sixty patients with benign prostatic hyperplasia in Shengjing Hospital of China Medical University from January to August 2018 were selected, and the patients were treated with transurethral (plasma) resection of prostate. The patients were divided into test group and control group according to the random digits table method with 30 cases each. Postoperative epidural analgesia of 2 groups used the electronic analgesia pump. The analgesia mode of test group was intermittent epidural bolus without background infusion combined with PCEA, and the analgesia mode of control group was continuous infusion combined with PCEA. The visual analogue score (VAS), Ramsay sedation score, improved Bromage score, adverse reaction and satisfaction of patients end of surgery to 48 h after operation were compared between 2 groups. Results There were no statistical difference in VAS and Ramsay sedation score between 2 groups (P＞0.05). The improved Bromage score 6 h after operation in test group was significantly lower than that in control group: 0 (0, 0) score vs. 0.5 (0, 1.0) scores, there was statistical difference (P＜0.05). The dosage of electronic analgesic pump 48 h after operation in test group was significantly lower than that in control group: (159.73 ± 22.58) ml vs. 250 ml, there was statistical difference (P＜0.01). The patients in 2 groups were satisfied, and there was no obvious dissatisfaction. There was no statistical difference in incidence of adverse reaction between 2 groups (P＞0.05). Conclusions In the postoperative analgesia of transurethral (plasma) resection of prostate, intermittent epidural bolus without background infusion combined with PCEA can decrease the drug dosage without the decline of analgesia.
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Objective To explore the real experience during treatment of patients with multiple myeloma, so as to provide evidences for clinical nursing staff to implement targeted nursing measures and to carry out research on nursing staff of high evidence level. Methods Using phenomenological methods, nine cases of patients with multiple myeloma conducted semi-structured and in-depth interviews and then using Colaizzi 7-step for analysis. Results Three major topics were extracted: poor physiological experience (feeling abnormal, numbness, pain, urinary incontinence), positive response (family support, Increased medical standards, self-regulation), self-perceived burden (economic stress, short cycle of relapse, psychological burden). Conclusion Treatment of multiple myeloma have many adverse reactions, and patients bear too much psychological burden. Medical staff need to be evaluated in a timely manner, strengthen symptom management, provide comprehensive information support, analysis of patient self-perception burden causes, propose targeted interventions, and build continuation care system to improve patient treatment experience.
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There was preliminary understanding of the kidney-marrow correlation from the pre-Qin to Han dynasty.Until Wei-Jin and Sui-Tang dynasty,the close relationship between kidney-essence-marrow-bone-blood-brain was gradually realized in terms of the structure and physiological function.There was a new anatomical understanding of marrow in the Song,Jin and Yuan dynasty.The concept of spinal cord was put forward for the first time.There was also the etiology and pathogenesis on kidney marrow related diseases.In the Ming and Qing dynasty,there was in-depth understanding on the kidney-marrow correlation.However,the concept of kidney-marrow system was not clearly proposed.Modern scholars summarized traditional Chinese medicine (TCM) theories on kidney stores essence,essence generates marrow,marrow enriches brain,nourishes bone and transfers into blood. Then,the kidney-marrow systemhad begun to take form.It laid a theoretical foundation for the construction of kidney-marrow system..
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The kidney stores essence,essence generates marrow is one of the important contents in zaag-xiang theory of traditional Chinese medicine (TCM).The kidney-marrow-brain,kidney-marrow-bone and other biological axis put forward by modern scholars took kidney-marrow system as their cores.Derived from this basis as well as under the guidance of TCM holism concept,the construction of TCM kidney-marrow system has been continuously improved;and the kidney-marrow correlation theory has been enriched.To better grasp and apply the kidney-marrow correlation theory can solve clinical problems of major diseases.However,doctors in past dynasties did not clearly define kidney-marrow system. It has not formed a complete theoretical system.Marrow in the kidney-marrow system contained brain,spinal cord and bone marrow.Marrow can generate blood,which nourishes bone together with the bone marrow.The bone marrow connects with the brain and spinal cord,which are all related to blood.Hence,the function of marrow generates blood occupied an important position in the kidney-marrow system. In this paper,the structure and function of the kidney-marrow system were preliminarily explained and constructed;and the kidney-marrow system related theories were further enriched.
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Through reviewing and summarizing classical literatures of traditional Chinese medicine (TCM) and modern medical research results,TCM kidney-marrow system was presented and initially explained.The kidney marrow system is inseparable in structure,interdependent in physiology and mutually influential in pathology.The kidney-marrow system can be applied to the treatment of major diseases in TCM,which included metabolic bone diseases,brain and neurological disorders,haematological diseases and etc.,with significant clinical effects.The in-depth study on TCM kidney marrow system will improve the clinical curative effect of major TCM clinical diseases and achieve the precision treatment in traditional medicine.It displays unique advantages of TCM holism concept and achieves new breakthrough in TCM clinical diseases.
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Objective To assess the effects of two different managements of typeⅢsupracondyla humeral fractures in children: open reduction vs closed reduction and pinning. Methods Relevant articles were identified by using several database (Pubmed Medline, EMbase, cochranelibrary, CBM, CNKI, wanfang data). Control studies comparing closed reduction with percutaneous pinning and open reduction with pinning were analyzed.Results There was no significant difference in the carrying angle according to criteria of Flynn(OR=0.92,P=0.760).There was no significant difference in the functional results according to criteria of Flynn(OR=1.77, P=0.557).There was no significant difference in the ulnar nerve injury(OR=1.10,P=0.332).However, there was a obvious tendency to excellent and good results in the closed reduction group. Conclusions We recommend that closed reduction with percutaneous pinning should be performed first unless some special circumstances are present, for example:complex fractures and failed closed reduction.
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To study the effect of the Tangshenping containing serum on the proliferation of the high glucose-induced epithelial cells of renal tubules.To prepare durg-contained serum from rats to enter into in vitor reaction system,the cellscultured via 10％ FBS-RPMI 1640 were randomly divided into 7groups:the normal group,themodel group,the Y27632 group,theirbesartangroup,the small dose Tangshenping group,the medium dose Tangshenping group and the high dose Tangshenping group and The cells were cultured in 3000 cells/well and grown in 96-well plates.Each group had 8 wells,then detect the effects of all serum sections on the proliferation of high glucose-induced epithelial cells of kidney tubules by the MTT colorimetric method after cultured for 12 h,24 h,48 h,and 60 h.Based on the results above,cell protein were extracted from each group at 24 h,and the expression of RhoA,ROCK1,α-SMA and E-cadherin in each group were detected by Western blotting.After high glucose stimulation,the shape of cell was shuttle-like or irregular triangle,the way it grew was radial;after the intervention of the corresponding serum,the shape of the cell was fiat and irregular polygonal.Started with 12h,compared with the normal group,OD value of other groups increased;at the 24h、48hand 60h,compared with the normal group,OD value of high glucose groupincreased significantly (P＜0.01);compared with the high glucose group,OD value of treatment groups decreased (P＜0.05);and 48 h,compared with the Y27632group,irbesartan groupand Tangshenping high dose group,OD value of Tangshenping low and medium dose groups decreased (P＜0.05);60 h,compared with Y27632 group,OD value of Tangshenping medium dose groups decreased;compared with irbesartan group,OD value of o Tangshenpinggroupsdecreased (P＜0.05);compared with Tangshenping high dose group,OD value of Tangshenpinglow groupsdecreased (P＜0.05) Western blotting analysis showed that compared with normal group,the expression of E-Cadherin protein in high glucose group reduced,and the expression of RhoA,ROCK1 and α-SMA protein increased;compared with high glucose group,the expression of E-Cadherin protein in each treating group increased,and the Tangshenping large dose group wassignificantly different (P＜0.01);the expression of RhoA,ROCK1 and or-SMA protein reduced,Tangshenping,the large dose group was significantlydifferent (P＜0.01);Compared with the Y27632 group,the expression of E-cadherin,ROCK1 and α-SMA protein in Tangshenping large dose group had no significant difference,while the expression of RhoAproteinreduced (P ＜0.01).Compared with theirbesartan group,the expression of E-cadherin,RhoA,ROCK1 and α-SMA protein in Tangshenping large dose group had no significant difference (P＞0.05).The Tangshenping containing serum is abletoinhibit the proliferation of high glucose-induced epithelial cells of kidney tubules,and can reverse renal tubular-epithelial cell transdifferentiation via regulating RhoA/ROCK signaling pathway,and restrain renal interstitial fibrosis,thereby delaying the pathogenesis of diabetic kidney disease.
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Objective To explore the effects of using proton pump inhibitors (PPIs) on the outcomes of hip fracture.Methods Searches were conducted through Medline,Embase,Cochrane Library and Chinese Biomedical Literature Database to identify the studies of the association between PPIs exposure and hip fracture.Quality of studies was assessed using the Newcastle-Ottawa Quality Assessment Scale.Pooled odds ratios (ORs) and 95％ confidence interval (CIs) were calculated for the risk of hip fracture associated with current exposure of PPIs.And several subgroups were analyzed by dosing duration,dose,osteoporosis and corticosteroid usage to explore potential study heterogeneities.All statistical analyses were performed with STATA software.Results Among 11 publications included for final analysis,there were a total of 1 107 577 subjects with an average age of over 60 years.A positive relationship existed between PPIs exposure and hip fracture with an OR of 1.46 (95％ CI:1.26-1.70,P =0.000) as compared with nonPPI-users,especially those on concurrent corticosteroid and PPIs.A significantly increased risk of hip fracture was found in the group of a short-term duration for under 1 year (OR =1.18,95％ CI:1.01-1.38,P =0.041),medium-term for 1-3 years (OR =1.23,95％ CI:1.01-1.49,P =0.038) and longer duration for over 6 years (OR =1.38,95％ CI:1.27-1.50,P =0.000).Furthermore,concurrent use of PPIs was not associated with an increased risk of hip fracture in a definite dose-response manner.As compared with non-PPI-users,no significantly increased risk of hip fracture was found in PPI-users with osteoporosis (P ＞ 0.05).Publication bias was not present.Conclusions Use of PPIs may be somewhat associated with an increased risk of hip fracture.Considering potential adverse effects,clinicians should prescribe cautiously PPIs for high-risk patients,especially elders.
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Objective To study the combined effect of extremely low frequency electromagnetic fields ( ELF-EMF ) exposure (50 Hz and 3 mT) and high temperature exposure on hsp22 and hsp26 expression in Drosophila melanogaster. Methods Under the conditions of 50 Hz and 3 mT ELF-EMF,the male and female D.melanogaster was separately exposed for 2 h at 25℃, 27.5℃, 30℃, 32.5℃,and 35℃, respectively.The death rate, exercise capacity and the hsp22 and hsp26 expression levels of D.melanogaster were detected after exposure;or at 25℃and 35℃at 2 h, 4 h, 8 h, and 24 h, respectively.The hsp22 and hsp26 expression levels of D.melanogaster were tested after exposure .Results After exposure for 2 h at 25℃, 27.5℃, 30℃, 32.5℃, and 35℃, temperature had a significant effect (P0.05).After exposure for 2 h at 25℃, 27.5℃, 30℃, 32.5℃, and 35℃, the hsp22 and hsp26 expression levels of D.melanogaster were significantly impacted(P<0.01) by gender, temperature, ELF-EMF and exposure time, and tem-perature was the most important factor .Gender, temperature, ELF-EMF and exposure time had some interaction with the results.Conclusion ELF-EMF can influence the expression levels of hsp22 and hsp26.ELF-EMF exposure contributes to heat tolerance in D.melanogaster through accelerated expression of hsp22 and hsp26.
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BACKGROUND:Advancement in bioengineering based upon tissue engineering techniques may offer the possibility of repairing degenerative intervertebral disc. OBJECTIVE:To summarize the research progress in the scaffolds of tissue engineered intervertebral disc. METHODS:A computer-based retrieval was performed to search manuscripts describing tissue engineered intervertebral disc scaffolds published between January 1st, 1900 and December 31st, 2012 in PubMed database with the key words of“tissue engineering, intervertebral disc, scaffold”in English. RESULTS AND CONCLUSION:Scaffold is an important part of tissue-engineered research. There are three kinds of materials for intervertebral disc scaffolds:natural biomaterials, synthetic materials, and composite materials. A variety of scaffold materials have their own advantages and disadvantages. Up to now, none of these scaffold materials is accepted as the most suitable one. The selection of scaffold materials is stil to be further studied. The study and development of nanoscale biomaterials is an inevitable trend. Otherwise, with the help of bionics, improving scaffolds is also an inexorable trend in progress of simulating human intervertebral disc. Furthermore, injectable scaffold is also an research hot spot, and the selection range of injectable scaffold materials mainly focuses on chitosan, typeⅡcolagen,hyaluronic acid,fibrin,elastin,and alginate.C urrently, studies on chitosan as a scaffold material are relatively more.
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BACKGROUND: There are different methods to isolate and culture human nucleus pulposus cells, and the differences in digestive enzymes components and digestion time quite are significant. So how to rapidly and efficiently harvest human nucleus pulposus cells has become a research hotspot. OBJECTIVE: To optimize the digestive enzymes components and digestion methods for the preparation of human nucleus pulposus cells. METHODS: Nucleus pulposus tissue specimens were selected from three adult discs in the Department of Orthopedics, China-Japan Union Hospital of Jilin University. The acute traumatic disc tissues that outstanding to the spinal canal were taken under aseptic conditions, and then the peripheral white annulus and jel y-like nucleus pulposus in the center could be seen. According to different mixed enzyme concentration ratio, the samples were divided into two groups. The enzyme Ⅰ group was treated with 0.2% Ⅱ col agenase; and the mixed enzymeⅡ group was digested with 0.25% trypsin for 30 minutes, and then treated with 0.2% Ⅱ col agenase. According to digestion time, each group was divided into three subgroups: 2 hours group, 4 hours group, and overnight group. Final y, suspended cel volume was decided as 2 mL to count cells. Dulbecco’s modified Eagle’s medium containing fetal bovine serum was used for cel culture in vitro. Trypan blue staining was performed to count total cel number and ratio of living cells. Methylthiazolyldiphenyl-tetrazolium bromide assay was used to detect the growth curve of nucleus pulposus cells. RESULTS AND CONCLUSION: Based on the two digestion enzyme concentration, the number of digested cells in the enzyme Ⅰ group was larger than that in the enzyme Ⅱ group after digested for 2 and 4 hours, but the difference was not significant (P > 0.05). Overnight, cellsurvival rate was decreased in the enzyme Ⅰ group after digested for 2 and 4 hours when compared with the enzyme Ⅱ group, and the difference was significant (P < 0.05). After digested for 4 hours, tissue blocks disappeared, and the number of cells reached maximum. The results indicate that enzyme Ⅰgroup composite with Ⅱ col agenase is benefit for the separation of nucleus pulposus cells, and the digestion time is appropriate to 4 hours. This condition has the advantages of simple operation, high efficiency and low cost, and it considered that digestion of nucleus pulposus tissues with 0.2% Ⅱ col agenase for 4 hours is the best condition to obtain nucleus pulposus cells.
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ObjectiveInvestigate the value and feasibility of image registration with reverse rotation in lateral cerebral DSA.Methods ( 1 ) Experimental study:the target images were subtracted directly,and subtracted again after reverse rotation.Software of registration and subtraction with reverse rotation edited by the author utilizing Visual Basic.The function of the automatic angle detection by the software were evaluated to see whether it detected the angle of line.The subtraction function of DSA by the software was evaluated.(2) Clinical retrospective study:the untreated mask and target inages of 15 patients with motion along vertical axis during lateral cerebral DSA were uploaded to the software.The target images were processed with and without the software to get two sets of images.( 3 ) Evaluation:four experienced radiologists read and compared the two sets of the images,and graded their findings.Results ( 1 ) The automatic detection by the software suggested that the target images should be rotated counterclockwise 1.3°. The subtraction result of the software was satisfactory.(2)In the 15 sets of images,there were only three sets of images deemed optimal after traditional subtraction.After reverse rotation,artifacts were significantly reduced and the image sharper. There were ten cases with significant artifacts after traditional subtraction,and those images were sharper and showed more peripheral vessels after reverse rotation. The traditional subtraction images of two sets could not be interpreted,the reverse rotation registration images reached the diagnostic quality.(3)Subjective evaluation: there were more information and less noise and distortion in the registration images with reverse rotation than in the traditional subtraction. But the image resolution decreased slightly after reverse rotation registration.ConclusionThe registration of digital angiography with reverse rotation can improve the image quality in lateral cerebral DSA.
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Objective To investigate the change of adiponectin (AD),tumor necrosis factor-alpha (TNF-α) and S100 levels in serum elderly patients with rheumatoid arthritis and cerebral infarct in order to evaluate the therapeutic effect of dioscornin.Methods One hundred patients with rheumatoid arthritis and cerebral infarct were selected as our subjects,who were hospitalized in the Department of Neurology of Recovery Changzhi Municipal People's Hospital and the Department of Internal Medicine of the Affiliated Hospital of Shaoxing Medical College,between 2006 September and 2010 September.All subjects (male 55,female 45,average age of 57 years old) were randomly divided into regular and dioscomin groups,50 for per group.Patients in regular group were treated with routine therapy and patients in dioscornin groups were treated with dioscornin 80mg,three daily plus regular treatment drug.Meanwhile 40 middle patients with single rheumatoid arthritis subjects were severed as controls.The changes of BMI,fasting plasma glucose,lipid factors,insulin sensitivity index (ISI),serum adiponectin,TNF-α and serum S100B were determined at treatment before and 6 months after treatments.Results The level of TNF-α,serum S100 in ERA patients were significantly higher andAdiponectin significantly lower than that of the control group,(TNF-α:[(89.0 ± 25.3) ng/L,(88.0 ± 24.2)ng/L vs(74.0 ±21.0) ng/L,F =3.292,P ＜0.05],[S100B:(0.102 ±0.051) μg/L,(0.101 ±0.045) μg/L vs(0.092 ± 0.031) μg/L,F =2.792,P ＜ 0.05],and AD and BMI were lower [AD:(7.2 ± 1.4) μg/L,(7.3 ±1.4) μg/L vs (18.1 ± 3.5) μg/L,F =17.057,P ＜ 0.01],[BMI:(18.9 ± 2.4) kg/m2,(19.0 ± 1.9) kg/m2 vs (21.8 ± 1.8) kg/m2,F =6.147,P ＜ 0.01].There was a negative correlation between adiponect and TNF-α,S100B (r =-0.46,-0.52,P ＜ 0.01) and positive correlation between adiponect and BMI (r =0.44,P ＜0.01).The adiponectin level was significantly increased in patients for six months after dioscornin treatment than that of control group.[AD:(12.2±2.9) μg/L,(7.8 ±1.8) μg/L vs (18.0 ±4.3) μg/L,F=6.480,P＜0.01].The level of TNF-α and S100B significantly decreased than that of the control group,TNF-α:[(72.0 ±21.0) ng/L,(82.0±23.0)ng/L vs (68.0 ±20.0) ng/L,F =3.065,P ＜0.05],[S100B:(0.092 ±0.021)μg/L,(0.099 ±0.031) μg/L vs (0.091 ±0.029) μg/L,F=3.030,P＜0.05].Conclusion Dioscornin could ameliorate the prognosis through decreasing the levels of TNF-α and S100B,and increasing adiponectin level in patients with rheumatoid arthritis and cerebral infarct.