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Objective:To summarize and analyze the clinical status of tumor necrosis factor-α (TNF-α) antagonists.Methods: The clinical trials of TNF-α antagonists registered before August 2,2016 were searched on the National Institutes of Health (NIH) Clinical Trials Register,and SPSS17.0 software was used for statistical analysis of the data.Results: A total of 306 TNF clinical trials were conducted in the world,19 of them were in China.The main research diseases for bone and joint disease,autoimmune diseases,infections,blood tumors.There were 241 items in intervention study,and 56,7,55,60 items in 178 cases,accounting for 73.9% in Ⅱ,Ⅱ/Ⅲ,Ⅲ,Ⅳ,respectively.The interventional study of TNF-α antagonist clinical trials mainly focused on intervention research,The main purpose of the practical application of the process after the listing of further validation and evaluation of drug efficacy and safety.Conclusion: There are many kinds of TNF-α antagonists,and clinical indications are wide.The design of clinical trials is diversified and mature.
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Objective:By observing the effects of curcumin on synovial pathology, synovial osteoprotegerin and receptor activator of nuclear factor κB ligand expression factor of adjuvant arthritis rat models, we try to explore the possible mechanism of prevention and treatment of rheumatoid arthritis.Methods: There were three groups, the normal group, the model group and the curcumin group.We made adjuvant arthritis rat models with Freund′s complete adjuvant,and they were divided into the model group and the curcumin group.On d 28 after modeling,all rats were killed.All synovial membranes were sent for routine histological evaluation with HE staining.And synovial RANKL and OPG protein expression were measured by Western blot.Results: Curcumin could influence synovium pathology change of adjuvant arthritis rats,the pathological picture showed that infiltration of joint synovial cell,pro-liferation of synovial fibroblasts in model group rats were significantly increased,compared with normal group( P<0.01).Pathology of rats synovial tissue in rats of curcumin group were significantly improved, compared with that in rats of model group.Expression of RANKL,OPG protein in synovial tissue of curcumin group,based on pairwise comparison between with model group,the results were statistically significant( P<0.01 ).Synovial RANKL/OPG ratio were significantly lower than model group ( P<0.01 ).Conclusion:Curcumin can improve synovial pathology damage of adjuvant arthritis rats,curcumin may exert a protective effect on arthritis rats by regulating OPG/RANKL signaling pathway.
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BACKGROUND:Bone densitometry using dual energy X-ray absorptiometry(DXA)is the "gold standard" for osteoporosis diagnosis.However,it has limited in clinical examination for it only supply area bone mineral density(BMD).OBJECTIVE:To form BMD coefficient by correcting area BMD based on body mass index(BMI),in addition,to predict whole body BMD via multivariate linear regression equation.DESIGN,TIME AND SETTING:A prospective study was performed at the Nanjing General Hospital of Nanjing Military Area Command of Chinese PLA between October 2004 and June 2008.PARTICIPANTS:Twenty subjects,who received DXA examination at the Nanjing General Hospital,Nanjing Military Area Command of Chinese PLA were selected.No relative operation which would affect BMD performed before examination.METHODS:The BMD of waist,hip as bone mineral content(BMC)of whole body was measured.Height,body weight of subjects was measured and calculates BMI,which called BMD coefficient after correction.It was obtained by BMD/BMI?10.BMC coefficient was obtained by BMC/body weight ?10.MAIN OUTCOME MEASURES:The BMD of waist,hip,as well as BMC of whole body.Independent variable BMC and dependent variable BMD were made respectively,and to do linear correlation analysis.RESULTS:There was a correlation between BMC and BMD(P=0.000),which was more significant after correction(P=0.000).The multivariate linear regression equation between BMC and BMD was:BMC=(0.065+0.415?G1+0.270?G2)?T/10.In this formula,G1 was corrected value of right hip BMD,G2 was the corrected value of waist BMD,and T was body weight.The predictive BMC was basically tallies with actual value.CONCLUSION:BMD of whole body can be predicted based on BMD of waist and hip,and the BMD coefficient may be the potential index for BMD evaluation.
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BACKGROUND: Congestive heart failure (CHF) is the clinical syndrome of all kinds of heart disease on the serious or final stage. About half of patients with organic heart disease will have heart failure that has a high incidence rate and mortality. The survival of heart failure was inferior to that of malignant tumor.OBJECTIVE: To confirm the clinical effect of Lujiao prescription on CHF and elucidate its possible mechanism.DESIGN: A control observation on CHF patients.SETTING: Department of Cardiovasology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.PARTICIPANTS: A total of 60 patients with CHF were selected from the department of cardiovasology in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 1996 to December 1998. There were 31 male and 29 female. Included criteria: ①All of patients were consistent with Framinham diagnostic criteria. ② Above Ⅲ degree by New York Heart Association(NYHA). ③ Three months case history. ④Accept quantity sufficient diuretic and vasodilating agent (exclude angiotensin converting enzyme inhibitor ). ⑤ Left ventricle hypertrophy was proved by echocardiogram or chest X-ray. ⑥ Differentiation of symptoms and signs of Traditional Chinese Medicine refers to asthenia syndrome of differentiation of symptoms and signs of Traditional Chinese Medicine (1986, Researching Association of Chinese integrated medicine) General state of health and basic disease of the patients in the two groups were not significant deviation.METHODS: 60 patient s of CHF were randomly divided into Lujiao prescription group(n=40) and Digoxin group (n=20) at the rate of 2:1. Lujiao prescription group: Orally liquid decoction of Lujiao Prescription 35 mL (1 mL contain crude drug 1.6 g) Bid. po. Course of treatment: 4 weeks. Digoxin group: Digoxin tablet, 0.125-0.25 mg, qd. po. course of treatment: 4 weeks.After 4-week treatment, the patients' clinical effect, integrals of the symptoms of renal deficiency, classification of function capacity of the NYHA,Lee's heart failure score, heart rate(HR), myocardium oxygen consumption (MOC), proportion of heart to chest, echocardiogram, measurement of plasma angitention Ⅱ (Ang Ⅱ ) and plasma atrial natriuretic factor (ANF) were observed.MAIN OUTCOME MEASURES: ① The total clinic effective rate. ②Integrals of the symptoms of renal deficiency. ③ Classification of function capacity of the NYHA. ④ Lee's heart failure score. ⑤HR and MOC. ⑥The proportion of heart to chest. ⑦ Ejection fraction(EF), cardic output (CO), interventricular septal thickness (IVST), posterior wall thickness (PWT) and left ventricular mass index (LVMI) through echocardiogram. ⑧The measurement of plasma Ang Ⅱ and plasma ANF.RESULTS:Totauy 60 patients entered the final analysis. ① The total clinical effective rate of the Lujiao prescription group was 90 %, which showed no significant difference from the Digoxin group (90 %, P ＞ 0.05).② Improvement was significantly observed in the integrals of the symptom of renal deficiency of the patients in the Lujiao prescription group after treatment (P ＜ 0.01), but which was not significant in the Digoxin group(P＞ 0.05). ③ It was found that classification of functional capacity of NYHA between Lujiao prescription group and Digoxin group after treatment was obviously decreased (P ＜ 0.01). ④ Lee's heart failure score of patients in Lujiao prescription group and Digoxin group after treatment was decreased (P ＜ 0.01). ⑤Myocardium oxygen consumption and HR of the patients in the Lujiao prescription group and Digoxin group after treatment was decreased (P ＜ 0.01). ⑥ The proportion of heart to chest between Lujiao prescription group and Digoxin group after treatment was decreased (P ＜ 0.01).⑦ EF and CO were increased by Lujiao prescription and by Digoxin (P＜ 0.01,vs pretreatment, respectively). IVST, PWT, LVMI of Lujiao prescription group after treatment were obviously decreased (P ＜ 0.01), while those of the Digoxin group were not obviously decreased (P ＞ 0.05). ⑧ Thlevel of plasma Ang Ⅱ of the patients in the Lujiao prescription group after treatment were obviously decreased (P ＜ 0.01), while that of the Digoxin group were not obviously decreased (P ＞ 0.05). The level of plasma ANF was decreased by Lujiao prescription and by digoxin(P ＜ 0.01, vs pretreatment, respectively).CONCLUSION: There is increasing cardiac constriction power and regressing left ventricular hypertrophy of patients with CHF by Lujiao prescription. The therapeutical effect of Lujiao prescription for CHF is better than that of Digoxin. The effect may be related to the regulation of circular or local endocrine(plasma Ang Ⅱ and ANF) disorder.
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BACKGROUND: Left ventricular hypertrophy (LVH) is an important ring-joint of congestive heart failure (CHF). It is also considered to be independent risk factor of cardiovascular disease, so how to reverse or relieve LVH is valuable to cure CHF.OBJECTIVE: To observe the effect of Lujiao prescription on degree of LVH in patients with CHF.DESIGN: A random-control observation on CHF patients.SETTING: Department of Cardiovasology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.PARTICIPANTS: A total of 20 patients with CHF were selected from the Special Clinic and Department of Cardiovasology in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 1996 to December 1998. All of them were consistent with the Framirham diagnostic criteria and following standardizations: ①above Ⅲ degree of cardiac functional grading by New York Heart Association (NYHA);②over 3 months case history;③accepted basic treatment of quantity sufficient diuretic and vasodilating agent excluding angiotensin converting enzyme inhibitor (ACEI);LVH was proved by echocardiogram or chest X-ray. They were informed of treatment items and consented.METHODS: According to random lot, the patients were divided into Lujiao prescription group and Digoxin group, each containing 10 patients.①Oral administrations of Lujiao prescription (35 mL, two times per day, produced by Shanghai Shuguang Hospital) and Digoxin (0.125-0.25 mg per tablet, batch number: 970757, once daily) were given in the corresponding groups, and the treatment duration was 3 months. After treatment, all the patients were detected in①NYHA cardiac functional grading; ②interventricular septal thickness (IVST) and posterior wall thickness (PWT) in diastolic phase through echocardiogram, myocardium weight of left ventricular by Devereux formula, left ventricular mass index (LVMI) corrected by bodysurface area, and degree of LVH;③the level of plasma angiotensin Ⅱ (Ang Ⅱ ) by radioactive immunoassay.MAIN OUTCOME MEASURES: NYHA cardiac functional grading, e-chocardiogram (IVST, PWT, LVMI, degree of LVH), the level of plasma Ang Ⅱ.RFSULTS: All 20 adopted patients entered the result analysis.①The classification of NYHA cardiac functional grading ( Ⅰ , Ⅱ ,Ⅲ,Ⅳ) were respectively 2, 5, 3, 0 case in Lujiao prescription group and 2, 4, 4, 0 case in Digoxin group after treatment, and difference was significant compared with those before treatment (0, 0, 7, 3, P ＜ 0.05).②IVST, PWT and LVMI of Lujiao prescription group were obviously decreased after treatment [(11.20±0.42), (12.10±0.32) mm, P ＜ 0.01; (10.60±0.84), (11.40±1.10) mm,P ＜ 0.01; (139.4±12.4), (155.3±15.4) g/m2, P ＜ 0.01], while those of the Digoxin group were untouched (P ＞ 0.05). The degree of LVH of Lujiao prescription group after treatment was obviously decreased [normal, mild,moderate, sever: 2, 6, 2, 0; 0, 3, 4, 3, P ＜ 0.01], while that of the Digoxin group was not obviously decreased (P ＞ 0.05).③)The level of plasma Ang Ⅱin the Lujiao prescription group was obviously decreased [(97.7±19.5),(144.0±18.5) ng/L, P ＜ 0.01], while that of the Digoxin group was not obviously increased (P ＞ 0.05).CONCLUSION: Lujiao prescription can reverse or relieve the degree of LVH in patients with CHF.
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BACKGROUND: Pressure overload can lead to the activation of reninangiotensin-aldosterone system, and then left ventricular remodeling occurs.Captopril can reverse this progress.OBJECTIVE: To observe the effect of captopril in reversing left ventricular remodeling in rats with pressure overload and to elucidate its possible mechanism.DESIGN: A randomized controlled trial.SETTING: Department of Integrated Traditional Chinese Medicine and Western Medicine, Nanjing General Hospital () Nanjing Military Area Command of Chinese PLA; Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine; Postdoctor Institute of Hebei Medical University.MATERIALS: The experiment was conducted in the Laboratory of Shanghai University of Traditional Chinese Medicine between January 1998 and October 1998. Totally 153 male Wistar rats were recruited.There were 5 experiments, 36 rats in each experiment except 9 rats in the fourth one.METHODS: A total of 36 Wistar male rats selected for each experiment were randomly divided into sham operation group, model group and captopril group. Rats in model group received modeling for 4 weeks, then gastric perfusion with 15 mL/kg of distilled water once per day for 4 consecutive weeks. Abdominal aorta of the rats in sham-operation group were separated without closure by sliver clip, then 4 weeks later the procedure was the same as that in model group. In captopril group, 4 weeks after modeling, the rats were performed gastric perfusion with diluted captopril of 100 mg/kg, once a day for 4 consecutive weeks.MAIN OUTCOME MEASURES: The effect of captopril on left ventricular mass index (LVMI), mRNA expression of collagen type Ⅰ and Ⅲ, content of plasma angiotensin Ⅱ (Ang Ⅱ ) and left ventricular tissue Ang Ⅱ,plasma atrial natriuretic factor (ANF), and serum aldosterone (ALD) level.RESULTS: Totally 153 rats entered the result analysis. During the test for detecting the absorbance (A) of collagen type Ⅰ, 3 rats in sham operation group and 3 in captopril group died, and 1 rat died in model group; finally 29 rats were involved. During the test for detecting the absorbance (A) of collagen type Ⅲ, 3 rats died in sham operation group, 4 rats diedin model group, and 2 rats died in captopril group; finally 27 rats were involved. All in sham operation group and captopril group was lower than that in model group [(2.24±0.12)/1 000, (2.67±0.40)/1 000, (3.15±0.47)/1 000, t=2.649,cantly lower in sham operation group and captopril group than in model group [(0.57±0.19, 0.86±0.25, 2.79±2.00), t=3.661, 3.170, P ＜ 0.01, 0.05].operation group and captopril group than in model group [(0.48±0.10,sion of mRNA of collagen type Ⅰ: It was significantly lower in sham operation group and captopril group than in model group [(79.1 ±18.6)%,plasma Ang Ⅱ content: It was significantly lower in sham-operation group and captopril group than in model group [(130.2±30.2),(137.6±39.5),was significantly lower in sham operation group and captopril group than in model group [(170.6±51.6), (202.5±64.2), (339.3±115.4) μg/L, t=4.623,P ＜ 0.01].type Ⅲ and mRNA expression in rats with pressure overload, suggesting its captopril on left ventricular remodeling might be related to decreasing circulating or local Ang Ⅱ level, plasma ANF and serum aldosterone as well as affecting the expression of collagen type Ⅰ and type Ⅲ mRNA.
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Objective: To explore the potential influencing factors of the quality guidelines for medical treatment by factor analysis.Method: We analyzed with the SPSS package 9 quality guidelines for medical treatment in the department of integrated TCM and Western medicine of a hospital,including the out-patient person-time,the number of discharges,the average days of hospitalization,the rate of bed utilization,the frequency of bed rotation,the rate of cure and improvement,the case fatality rate,the coincidence rate of diagnoses at admission and discharge,and the success rate of emergency treatment.Results: Four common factors were extracted,namely,the quantifiable factor,determined by the out-patient person-time,the number of discharges,the average days of hospitalization and the frequency of bed rotation;the treatment factor,determined by the cure and improvement rate and case fatality rate;the diagnostic factor,determined mainly by the rate of bed utilization and the coincidence rate of diagnoses at admission and discharge;and the emergency treatment factor,determined by the success rate of emergency treatment.The cumulative contribution rate of the 4 factors was 85.1%.Conclusion: The amount of medical work,the techniques of treatment,the ability of diagnosis and the efficiency of emergency rescue are the main influencing factors of quality guidelines for medical treatment.
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Objective:To investigate the influential factors correlated to bone mineral density(BMD) in the lumbar vertebra of postmenopausal females,and to find out the influence of body mass and menostasis time on BMD. Methods: BMD in the frontal and lateral lumbar vertebrae of postmenopausal females were measured by dual-energy X-ray absorptiometry(DXA).The correlations of BMD to age,body height,body mass,body mass index(BMI),menopausal age,and/or menopausal years were analyzed using multiple linear regression with SPSS10.0. Results:The change of BMD in the frontal lumbar vertebra was positive to body mass but negatively with postmenopausal years,and that in the lateral lumbar vertebra was closely correlated to BMI. Conclusion: Bone mineral density decreases with increase of menostasis time.Females with a high body mass numerical value have higher bone mineral density.
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Objective:To investigate the consistency of two methods in the measurement of bone mineral density in the lateral lumbar vertebra.Methods:The bone mineral densities of the 2nd,3rd and 4th lumbar vertebras in 18 female patients,at a preset side lying position,were measured respectively by two methods(lateral spine analysis,LS and lateral vertebral analysis,LVA) provided by the dual-energy(X-ray) absorptiometry(GE Lunar,Prodigy).The results were recorded and analyzed by SPSS(Version(10.0).) The values of bone mineral density were displayed by boxplot,paired and analyzed by(Wilcoxon's) signed rank test and(Pearson's) correlation analysis.Statistical significance was considered when P(0.05),) and were clearly correlated(P
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Objective: Recent studies have suggested that congestive heart failure(CHF) is related to neuroendocrine system and cytokines,and its activation contributes to myocardial remodeling and leads to the development and progression of CHF.Tumour necrosis factor-?(TNF-?) is one of the most important factors.This study intends to establish the animal model of isoproterenol(ISO)-induced CHF in rats and to study the changes of serum TNF-?.Methods:Male SD rats were randomly allocated to the ISO-induced CHF group(n=50) receiving two subcutaneous injections of 170mg ISO per kilogram of body and the healthy control group(n=10) receiving two subcutaneous injections of 0.25ml normal saline.At 18th week,the hemodynamic parameters including HR,LVSP,LVEDP and ?dp/dtmax were assessed.TNF-? in plasma were all detected.Results:Compared with the control group,the LVSP、?dp/dtmax significantly decreased and the HR,LVEDP enlarged notably in CHF group(P
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Objective: Recent years has witnessed new progress in the molecular genetic study of the relationship between the myosin heavy chain and myocardial hypertrophy.This study aimed to observe the expressions of myocardial ?-myosin heavy chain(?-MHC) and ?-myosin heavy chain(?-MHC) mRNA in rats with pressure overload,and to investigate the mechanism by which abdominal aorta constriction induces left ventricular hypertrophy.Methods: Male SD rats were randomly divided into a sham operation and model group.The models were made by clamping the suprarenal abdominal aorta with a silver chip.Eight weeks later,changes in the left ventricular mass index(LVMI) and the ultra microstructure of the left ventricular myocyte were observed,and the expressions of ?-MHC and ?-MHC in the myocardial tissue were detected by RT-PCR.Results: Compared with the sham operation group,the model rats showed markedly increased LVMI(P
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Objectives: Observe the effects of acupuncture on obese SD rats fed by self-prescribed high calorie diet. Methods: The model group were male SD rats fed by self-prescribed high calorie diet, while the control group were male SD rats fed by common roughage. After acupuncture, the changes of some indexes were observed such as eating and drinking amount,body weight,length, Lee index,fattiness in groin and circumrenal areas, TG,TC,BG levels in blood etc. Results: The obesity was defined as the average body weight of the model group was 20% heavier than the average body weight in the control group. And the obesity ratio was 56%. The indexes were changed in different degrees with statistic significance after one period of treatment. Conclusions: Over-nutrition is one of the causes of obesity. Our high calorie feed for obese rat is reasonable. Acupuncture has obvious therapeutic effects for simple obesity.
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[Objective] To observe the effect of Wumei Wan on histological features of colic mucosa of rats with uleera-tive colitis. [ Methods ] Forty rats were randomly allocated to normal control group ( Group A), model group ( Group B), salicylazosulfapyridine group (Group C) and Wumei Wan group (Group D). Ulcerative colitis models were established by immune method combined with local stimulation. After gastric infusion treatment, the histological features of colic mucosa of rats were observed under light microscope and transmission electron microscope. [Results] The results of pathological slices showed histological feature of colic mucosa in Wumei Wan group was much improved as compared with Group C. [Conclusion] Wumei Wan has a certain effect in treating ulcerative colitis.