Clinical Observation on Modified Huqianwan in Treatment of Rheumatoid Arthritis Liver-kidney Yin Deficiency Syndrome / 中国实验方剂学杂志

Objective: To explore the clinical efficacy and safety of modified Huqianwan in treatment of rheumatoid arthritis (RA) liver-kidney Yin deficiency syndrome, and investigate its possible mechanism. Method: A total of 184 patients with RA liver-kidney Yin deficiency syndrome were randomly divided into Chinese medicine group (62 cases), western medicine group (57 cases) and integrated Chinese and western medicine group (65 cases) according to the digital table method. The patients in Chinese medicine group were treated with Huqianwan; the patients in western medicine group were treated with methotrexate tablets and leflunomide tablets; and the patients in integrated Chinese and western medicine group received Huqianwan+methotrexate tablets and leflunomide tablets,with a treatment course of 12 weeks in all groups. The pain visual analog scale (VAS), swelling and tenderness scores of 28 joints (DAS28), average hands grip strength, morning stiffness time and liver-kidney Yin deficiency syndrome differentiation of traditional Chinese medicine (TCM) syndrome score were compared between groups before and after treatment. The changes of erythrocyte sedimentation rate (ESR), C reactive protein (CRP), immunoglobulin (Ig) G, tumor necrosis factor-alpha (TNF-α) and rheumatoid factor (RF) were detected in all groups after treatment. Clinical efficacy, and incidence of adverse reactions such as gastrointestinal response, liver injury, leukopenia, serum glutamate oxaloacetic aminotransferase (GOT) and platelet (PLT) level changes were compared between the groups, so as to investigate the efficiency and safety of the different medicines. Result: After 12 weeks of treatment, the total clinical effective rate was 79.0%, 80.7%, and 92.3% respectively in Chinese medicine group, western medicine group, and integrated Chinese and western medicine group; the integrated Chinese and western medicine group was significantly better than the Chinese medicine group and western medicine group (PPPPConclusion: The efficacy in treating RA liver and kidney Yin deficiency syndrome shows no significant difference between modified Huqianwan and methotrexate tablets+leflunomide tablets. In the treatment of RA liver and kidney Yin deficiency syndrome, Huqianwan has fewer adverse reactions. Huqianwan combined with methotrexate tablets+leflunomide tablets is superior to that in methotrexate tablets+leflunomide tablets in treatment of RA liver-kidney Yin deficiency syndrome.

Acupuncture combined with western medicine on rheumatoid arthritis and effects on blood stasis / 中国针灸

<p><b>OBJECTIVE</b>To observe the clinical efficacy of acupuncture combined with western medicine in the treatment of rheumatoid arthritis (RA) and its effect on blood stasis, and to explore ways to improve the clinical curative effect.</p><p><b>METHODS</b>A total of 56 patients of RA were randomly divided into an observation group and a control group, 28 cases in each one. ① ibuprofen sustained-release tablets, 2 times a day, each time 0.3 g; ② methotrexate tablets (MTX), once a week, each time 10 mg ③ folic acid tablets, once a week, each time 5 mg were given in the control group, 30 days as one course, a total of 3 courses were required. In the observation group, acupuncture was adopted on the basis of the treatment as the control group. The main acupoints were Ganshu (BL 18), Pishu (BL 20), Shenshu (BL 23), Hegu (LI 4), Quchi (LI 11), Zusanli (ST 36) combined with local points. The treatment was given once every day for continuous 6 days a week, the treatment for 30 days as one course, a total of 3 courses were required. The serological indexs were evaluated before and after treatment, including the rheumatoid factor (RF), hypersensitive C-reactive protein (hs-CRP), erythrocyte sedirnentation rate (ESR), platelet (PLT), fibrinogen (FBG) and D-dimer (D-D), the changes of disease activity score (DAS-28), symptom grade quantitative score, blood stasis syndrome symptom (the joint tingling, lip color, tongue, pulse, subcutaneous ecchymosis, squamous and dry skin) score were observed.</p><p><b>RESULTS</b>① The scores of RF, hs-CRP, ESR, PLT, D-D, FBG, DAS-28 and symptom grade quantitative were significantly improved in the two groups compared with those before treatment (all <0.05), and the scores of hs-CRP, ESR, DAS-28 and symptom grading in the observation group were more better than those in the control group (all <0.05). ② The total score of joint tingling, lip color, tongue, pulse, subcutaneous ecchymosis, squamous and dry skin and blood stasis syndrome in both groups were decreased after treatment (all <0.05), the joint tingling, tongue, lip color and subcutaneous ecchymosis were improved obviously in the observation group than those in the control group (all <0.05). ③ The total effective rate in the observation group was 85.7% (24/28), which was better than 75.0% (21/28) in the control group (<0.05).</p><p><b>CONCLUSION</b>Acupuncture combined with western medicine can not only improve the clinical efficacy of RA patients but also improve the blood stasis.</p>

Evaluation of fully automated erythrocyte sedimentation rate analyser Monitor-100 for determining erythrocyte sedimentation rate / 国际检验医学杂志

Objective To evaluate the reliability and accuracy of the fully automated erythrocyte sedimentation rate (ESR) analy‐ser Monitor‐100 for determining ESR .Methods 146 outpatients and inpatinets were selected and detected ESR by the fully automa‐ted ESR analyser 1 h ,30 min and the Westergren method .Then these three kinds of method were compared and the repeatability test was performed .Results (1)The ESR values determined by the analyser 1 h ,analyser 30 min and Westergren method were 37 . 8 ± 34 .1 ,38 .1 ± 33 .7 ,36 .4 ± 32 .9 respectively ,there were no statistical significance between any two methods (P>0 .05) .(2)The detection rates of the positive results by the analyser 1 h ,analyser 30 min and Westergren method were 43 .2% ,44 .5% and 45 .2%respectively ,no statistical difference between them was found (P>0 .05) .(3)The Kapper values between the analyser 30 min with the analyser1h ,between the analyser 30 min with the Westergren method and between the analyzer 1h with the Westergren method were 0 .944 ,0 .875 and 0 .903 .4 respectively .(4)The CV values in the repeatability test were very lower and within the acceptable limits .Conclusion Compared with the Westergren method ,the fully automated ESR analyser Monitor‐100 has lower false positive rate and lower false negative rate ,moreover its consistency and repeatability are excellent ,it is convenient ,fast ,safe and should be largely promoted in clinic .

Velocidade de hemossedimentação: comparação entre o método Microtest X (microssedimentação) e o método de referência Westergren: [carta ao editor] / Erythrocyte sedimentation rate: comparison between the Microtest X technique (micro-sedimentation) and the Westergren reference method: [letter to editor]

The erythrocyte sedimentation rate (ESR) is an easy and common routine laboratory technique. Over the last few decades, new methods have been proposed to reduce biological sample manipulation, to measure rates using an automated system, to optimize the workflow and to reduce blood volume from venipuncture. The aim of this study was to compare the efficacy of the Microtest X technique with the original Westergren method. EDTA blood samples of 25 subjects were submitted to both methodologies. A positive correlation (p<0.0001; R2=0.809) was found as was agreement with Bland-Altman analysis. In conclusion, the Microtest X technique allows precise and accurate measurements of ESR and can be used to replace the Westergren method. The benefits of Microtest X are the use of very small volumes of EDTA samples, it reduces sample manipulation avoiding occupational hazards and markedly reduces the analytical time.

Alteration in the erythrocyte sedimentation rate in dengue patients: analysis of 1, 398 cases

A study of the erythrocyte sedimentation rate during the first hour (ESR) in dengue patients would help determine how this parameter is affected by this disease, as well as whether it can be used for diagnosis. One thousand, three hundred and ninety-eight cases of dengue attended at the Dengue Treatment Center, Campos dos Goytacazes Rio de Janeiro, Brazil, were included. The ESR values were classified as normal or elevated and compared by gender and clinical form of the disease. Among the 1,398 cases ESR was normal in 81.25 percent (n = 1,136), while in 18.75 percent (n=262) it was elevated. In 83.92 percent (n=514) of the male dengue patients ESR was normal, while in 16.08 percent (n=98) it was elevated. Among female dengue patients, 79.17 percent (n=622) had normal ESR, and in 20.83 percent (n=164) ESR was elevated (p=0.05). Among patients with classic dengue, 77.28 percent (n=961) had normal ESR, while in 22.72 percent (n=282), it was elevated. Also in 85.81 percent (n=133) of patients with hemorrhagic dengue, ESR was normal, while in 14.19 percent (n=22) ESR was elevated (p=0.026). We concluded that ESR was within normal ranges in most dengue cases, independent of gender or clinical presentation. Given the high frequency of normality and the ease of determination of this parameter, ESR data can help in the differential diagnosis of dengue.

The changes of serum c-reactive protein in the head and neck infection

The purpose of this study is to determine the value of serum concentration of C-reactive protein(CRP) in comparison with ESR and leukocyte as the tools for diagnosis and follow-up study of infection. For this study, thirty-one patients with head and neck infection and thirty-two patients performed the orthognathic surgery were selected for experimental and control groups each other. we analyzed the blood sample daily to measure CRP, ESR and leukocytosis. The results of this study are as the following : 1. Serum C-Reactive Protein levels in the experimental group were higher than control group and the pattern of CRP changes contin-ued to decline in both groups(P<0.001). 2. ESR changes in both groups were scattered without any special pattern. 3. Correlation between CRP and Leukocyte was higher than others(r=0.664, P<0.01). 4. In the Receiver Operating Characteristic(ROC) Curve of experimental group, rapid increase of CRP curve and Area under the curve(AUC) value, 0.774, indicate the high accuracy of estimation. 5. In experimental group, sensitivity of CRP, ESR, and Leukocytosis on recovery day were 83%, 17% and 71%. Based on the results of this study, we could conclude that determination of CRP is more useful method to diagnosis and follow-up study of infection than other commonly used variables in oral and maxillofacial region.

Early Sacroiliitis in Ankylosing Spondylitis:MRI Correlated to Clinical and Laboratory Findings / 实用放射学杂志

Objective To analyze the correlation between the early sacroiliitis in ankylosing spondylitis(AS) and clinical and laboratory parameters.Methods 39 patients with AS corresponding to the modified New York criteria for AS(0-Ⅲ)were included.According to pain score(BASDAI),the patients were divided into three groups,that were static group,suspicious active group and active group.The patients were examined by MRI and laboratory including erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP).The severity of activity of sacroiliac joint(SIJ) inflammation was evaluated using spondyloarthritis research consortium of Canada(SPARCC)score,comparative analysis was done among these three groups.Results There was significant differences among these three groups in SPARCC score(P0.05).The spearman correlation coefficient between SPARCC score and BASDAI score was rs=0.503,P0.05.Conclusion In early sacroiliitis of AS,the SPARCC score of SIJ lesions is positively correlated with the severity of BASDAI,but there is no correlation between the SPARCC score and ESR,CRP.