Research Advances of Circulating Tumor Cells in Lung Cancer / 肿瘤防治研究

Metastasis is the main factor leading to the death of patients with lung cancer, and active prevention is the key to improve the efficacy of treatment. Circulating tumor cells (CTCs) play an important role in initiating metastasis. They trigger a series of metastatic cascade reactions at the moment of shedding from the primary focus, and finally colonize and proliferate in the distant target organs. In recent years, the detection technology of lung cancer CTCs has been continuously optimized. It can not only count CTCs, but also identify different subsets. CTCs detection of lung cancer can be used for early screening, the prediction of prognosis after surgery and chemoradiotherapy and the evaluation of curative effect of targeted immunotherapy. Dynamic monitoring of tumor heterogeneity is helpful to adjust personalized treatment plan and achieve the accurate treatment of cancer. Tian Jianhui's research group established the world's first circulating tumor cell line of human lung adenocarcinoma, integrated it into the theory of "positive deficiency and toxin" in the subclinical core pathogenesis of lung cancer, and actively promoted the construction of a specific research platform for lung cancer, in order to improve the research, prevention and control efficiency of lung cancer metastasis.

The impact of informal care on quality of life in the elderly: mediating effects based on frailty and depression / 中国实用护理杂志

Objective@#To investigate the impact of informal care satisfaction on quality of life on the elderly by establishing a structural equation model between them and introducing two mediating variables of frailty and depressive factors.@*Methods@#A total of 210 elderly over 60 years old from 6 communities of 2 urban areas in Qingdao were surveyed by general information questionnaire, the informal care satisfaction scale, frailty phenotype, depression scale and the SF-36 brief health scale.@*Results@#There was a direct effect on quality of life of daily life care dimension in informal nursing satisfaction (β=0.160, P<0.01) and an indirect effect of debilitating as intermediary (β=0.055, P<0.01). There was a direct effect on quality of life (β=0.130, P<0.01) and an indirect effect mediated by depression (β=0.132, P<0.01). There was a direct effect on quality of life (β=0.150, P<0.01) and an indirect effect mediated by debilitating and depression (β=0.147, P<0.01).@*Conclusions@#We should pay more attention to the impact of informal care on the quality of life on the elderly. Taking corresponding measures to promote the use of informal nursing and improving the quality of informal care is of great significance to improve the quality of life of the elderly and promote healthy aging.

Clinical study on Duhuo-Xuduan decoction combined with massage in the treatment of lumbar intervertebral disc herniation with yin deficiency of liver and kidney type / 国际中医中药杂志

Objective@#To explore the Duhuo-Xuduan decoction combined with massage in the treatment of lumbar intervertebral disc herniation with yin deficiency of liver and kidney type.@*Methods@#According to the random number table method, 67 patients were divided into the control group (n=33) and the study group (n=34). The patients in the control group were treated with traditional massage, while the patients in the study group were treated with Duhuo-Xuduan decoction on the basis of the control group. The groups were treated continuously for 4 weeks. After treatment, the total clinical effective rate of the two groups was counted. The Visual analogue scale (VAS) and Oswestry dysfunction index were measured before and after treatment. At the same time, the level of serum Aggrecan, bone morphogenetic protein 7 (BMP-7), P substance (SP), 5-hydroxytryptamine (5-HT), dopamine (DA) were detected respectively before and after treatment. In addition, the adverse reaction of the two groups were observed.@*Results@#The total clinical effective rate of the study group was 97.06% (33/34), significantly higher than 81.82% (27/33) of the control group, and the difference was statistically significant (χ2=4.157, P=0.041). After treatment, the VAS score, Oswestry dysfunction index and serum SP, 5-HT, DA of study group was significantly lower than those of the control group (t=13.175, 12.524, 14.481, 15.729, 14.391, all Ps<0.01), while the level of serum Aggrecan, and BMP-7 of study group was significantly higher than that of the control group (t=18.697, 16.222, all Ps<0.01). There were no serious adverse reactions during treatment in both groups.@*Conclusions@#The Duhuo-Xuduan decoction combined with massage can alleviate pain, improve dysfunction of the patients with lumbar intervertebral disc herniation with yin deficiency of liver and kidney type. It is speculated that its mechanism may be related to analgesia and promoting cartilage regeneration of injured lumbar intervertebral disc.

The impact of informal care on quality of life in the elderly: mediating effects based on frailty and depression / 中国实用护理杂志

Objective To investigate the impact of informal care satisfaction on quality of life on the elderly by establishing a structural equation model between them and introducing two mediating variables of frailty and depressive factors. Methods A total of 210 elderly over 60 years old from 6 communities of 2 urban areas in Qingdao were surveyed by general information questionnaire, the informal care satisfaction scale, frailty phenotype, depression scale and the SF-36 brief health scale. Results There was a direct effect on quality of life of daily life care dimension in informal nursing satisfaction (β=0.160, P＜0.01) and an indirect effect of debilitating as intermediary (β=0.055, P＜0.01). There was a direct effect on quality of life (β=0.130, P＜0.01) and an indirect effect mediated by depression (β=0.132, P＜0.01). There was a direct effect on quality of life (β=0.150, P＜0.01) and an indirect effect mediated by debilitating and depression (β=0.147, P＜0.01). Conclusions We should pay more attention to the impact of informal care on the quality of life on the elderly. Taking corresponding measures to promote the use of informal nursing and improving the quality of informal care is of great significance to improve the quality of life of the elderly and promote healthy aging.

Clinical study on Duhuo-Xuduan decoction combined with massage in the treatment of lumbar intervertebral disc herniation with yin deficiency of liver and kidney type / 国际中医中药杂志

Objective To explore the Duhuo-Xuduan decoction combined with massage in the treatment of lumbar intervertebral disc herniation with yin deficiency of liver and kidney type. Methods According to the random number table method, 67 patients were divided into the control group (n=33) and the study group (n=34). The patients in the control group were treated with traditional massage, while the patients in the study group were treated with Duhuo-Xuduan decoction on the basis of the control group. The groups were treated continuously for 4 weeks. After treatment, the total clinical effective rate of the two groups was counted. The Visual analogue scale (VAS) and Oswestry dysfunction index were measured before and after treatment. At the same time, the level of serum Aggrecan, bone morphogenetic protein 7 (BMP-7), P substance (SP), 5-hydroxytryptamine (5-HT), dopamine (DA) were detected respectively before and after treatment. In addition, the adverse reaction of the two groups were observed. Results The total clinical effective rate of the study group was 97.06% (33/34), significantly higher than 81.82% (27/33) of the control group, and the difference was statistically significant (χ2=4.157, P=0.041). After treatment, the VAS score, Oswestry dysfunction index and serum SP, 5-HT, DA of study group was significantly lower than those of the control group (t=13.175, 12.524, 14.481, 15.729, 14.391, all Ps<0.01), while the level of serum Aggrecan, and BMP-7 of study group was significantly higher than that of the control group (t=18.697, 16.222, all Ps<0.01). There were no serious adverse reactions during treatment in both groups. Conclusions The Duhuo-Xuduan decoction combined with massage can alleviate pain, improve dysfunction of the patients with lumbar intervertebral disc herniation with yin deficiency of liver and kidney type. It is speculated that its mechanism may be related to analgesia and promoting cartilage regeneration of injured lumbar intervertebral disc.

Detection of promoter and 3′ UTR mutation in A20 gene of a case with T cell lymphoma cell leukemia / 中华血液学杂志

Objective@#To clarify the characteristics of the A20 regulatory changes by analyzing mutations in the non-coding region of the A20 gene in patients with T-cell lymphoma leukemia (T-LCL) .@*Methods@#PCR and nucleotide sequence analysis were used to detect mutations in the non-coding region of the A20 gene, and DNA samples from PBMCs of 52 cases of T-LCL and 99 healthy controls.@*Results@#A missense mutation (c.-672T>G) was detected in the A20 gene promoter from one T-LCL patient, which has been registered as a SNP (rs139054966) in gene bank. Meanwhile, a new mutation was detected in the 3′ UTR mRNA (3916 (C>G) ) . These two mutations were absent in other T-LCL samples and controls.@*Conclusion@#The rs139054966 (c.-672T>G) and 3916 (C>G) mutations in the A20 gene were detected in T-LCL patients for the first time. There was also rs139054966 located on the binding region of the transcription factor P53, and its significance remained to be further clarified.

Mechanisms of vascular endothelial growth factor receptor 2 expression regulation by erythropoietin in a premature rat model of periventricular white matter damage / 中华围产医学杂志

Objective@#To explore the mechanisms of vascular endothelial growth factor receptor 2 (VEGFR2) expression regulated by recombinant human erythropoietin (rh-EPO) in a premature rat model of periventricular white matter damage. @*Methods@#Sprague-Dawley rats aged three days were randomly divided into five groups: sham group without hypoxia-ischemia (HI), HI group (HI with saline administration), HI+erythropoietin (EPO) group, HI+erythropoietin receptor (EPOR) antagonist group and HI+EPO+EPOR antagonist group. Rat pups were either subjected to permanent ligation of the right common carotid artery and 6% O2+94% N2 for two hours (HI) or sham operated and exposed to normal air (sham). After the operation, rats in the HI+EPOR antagonist and HI+EPO+EPOR antagonist groups received a single intraventricular injection of EPOR antagonist (5 μl). Four hours after the operation, rats in the HI+EPO and HI+EPO+EPOR antagonist groups received a single intraperitoneal injection of rh-EPO (5 U/g). Western-blot was performed to detect EPOR, phosphorylated EPOR (p-EPOR), extracellular regulated protein kinases (ERK) and phosphorylated ERK (p-ERK) at 60 and 90 minutes after the models were established successfully, and also used to analyze the expression of VECFR2 on day 2 and 4. Analysis of variance and SNK test were used as statistical methods. @*Results@#At 60 and 90 minutes after model establishment, the expression of EPOR protein in rat brain tissues was increased in HI (1.717±0.206 and 1.416±0.242), HI+EPO (2.557±0.222 and 2.111±0.159) and HI+EPO+EPOR antagonist (1.547±0.170 and 1.452±0.250) groups as compared with that in sham group (1.095±0.182 and 0.751±0.136), that in HI+EPO group was higher than that in HI and HI+EPO+EPOR antagonist groups, and that in HI+EPOR antagonist group (1.088±0.160 and 1.020±0.174) was lower than that in HI group. All differences were statistically significant (F=30.154 and 20.265, both P<0.05). The expressions of p-EPOR, p-ERK and VEGFR2 in the five groups were consistent with the expression of EPOR, and the differences were also statistically significant (all P<0.05). In addition, the expression of VEGFR2 in HI+EPO+EPOR antagonist group was lower than that in HI group on day 4 (1.053±0.118 vs 1.439±0.074, F=54.248, P<0.05). No statistically significant difference in ERK expression was found among all groups at 60 or 90 minutes after modeling (F=1.117 and 0.734, both P>0.05). @*Conclusions@#ERK signaling pathways will be affected by EPO binding to EPOR. As a result, VEGFR2 expression was increased leading to enhanced angiogenesis in a premature rat model of periventricular white matter damage.

Study on extraction and clathration process of volatile oil in Tianma-Shouwu tablet / 国际中医中药杂志

Objective To optimize the extraction and β-cyclodextrin clathration process of volatile oil in Tianma-Shouwu tablet.Methods The extraction of volatile oil was optimized through the orthogonal design L9(34) with the volatile oil extraction amount as assessment index. The saturated aqueous solution preparation of clathrate form was used. The volume of β-cyclodextrin and volatile oil, clathration temperature, clathration time was investigated by central composite design-response surface methodology, with the score of volatile oil inclusion ratio and utilization ratio as the index. The results were fitted by second-order polynomial equation, and then the best clathration process was determined. Results The optimization extraction process of volatile oil in Tianma-Shouwu tablet was as follows:to add 8 times water,immerse 30 minutes,steam distill 6 hours;and the best clathration process was as follows: the ratio of β-cyclodextrin and volatile oil was 9.50:1, clathration temperature 43 ℃, and clathration time 4.2 hours. Conclusions The optimized extraction and clathration process were reasonable, stabled and repeatable.

Mechanisms of vascular endothelial growth factor receptor 2 expression regulation by erythropoietin in a premature rat model of periventricular white matter damage / 中华围产医学杂志

Objective To explore the mechanisms of vascular endothelial growth factor receptor 2 (VEGFR2) expression regulated by recombinant human erythropoietin (rh-EPO) in a premature rat model of periventricular white matter damage.Methods Sprague-Dawley rats aged three days were randomly divided into five groups:sham group without hypoxia-ischemia (HI),HI group (HI with saline administration),HI+erythropoietin (EPO) group,HI+erythropoietin receptor (EPOR) antagonist group and HI+EPO+EPOR antagonist group.Rat pups were either subjected to permanent ligation of the right common carotid artery and 6％ O2+94％ N2 for two hours (HI) or sham operated and exposed to normal air (sham).After the operation,rats in the HI+EPOR antagonist and HI+EPO+EPOR antagonist groups received a single intraventricular injection of EPOR antagonist (5 μ l).Four hours after the operation,rats in the HI+EPO and HI+EPO+EPOR antagonist groups received a single intraperitoneal injection of rh-EPO (5 U/g).Western-blot was performed to detect EPOR,phosphorylated EPOR (p-EPOR),extracellular regulated protein kinases (ERK) and phosphorylated ERK (p-ERK) at 60 and 90 minutes after the models were established successfully,and also used to analyze the expression of VECFR2 on day 2 and 4.Analysis of variance and SNK test were used as statistical methods.Results At 60 and 90 minutes after model establishment,the expression of EPOR protein in rat brain tissues was increased in HI (1.717±0.206 and 1.416±0.242),HI+EPO (2.557±0.222 and 2.111±0.159) and HI+EPO+EPOR antagonist (1.547±0.170 and 1.452±0.250) groups as compared with that in sham group (1.095±0.182 and 0.751 ±0.136),that in HI+EPO group was higher than that in HI and HI+EPO+EPOR antagonist groups,and that in HI+EPOR antagonist group (1.088±0.160 and 1.020±0.174) was lower than that in HI group.All differences were statistically significant (F=30.154 and 20.265,both P＜0.05).The expressions of p-EPOR,p-ERK and VEGFR2 in the five groups were consistent with the expression of EPOR,and the differences were also statistically significant (all P＜0.05).In addition,the expression of VEGFR2 in HI+EPO+EPOR antagonist group was lower than that in HI group on day 4 (1.053 ± 0.118 vs 1.439± 0.074,F=54.248,P＜0.05).No statistically significant difference in ERK expression was found among all groups at 60 or 90 minutes after modeling (F=1.117 and 0.734,both P＞0.05).Conclusions ERK signaling pathways will be affected by EPO binding to EPOR.As a result,VEGFR2 expression was increased leading to enhanced angiogenesis in a premature rat model of periventricular white matter damage.

Curative effect of L-carnitine combined with trimetazidine in the treatment of chronic heart failure / 中国基层医药

Objective To observe the clinical efficacy of L-carnitine combined with trimetazidine in the treatment of chronic heart failure.Methods The clinical data of 700 patients with chronic heart failure were retrospectively analyzed.According to different treatment methods,they were divided into four groups:A,B,C,D.181 cases of A group used L-camitine combined with trimetazidine treatment on the basis of routine treatment.177 cases of B group received L-carnitine treatment on the basis of routine treatment.175 cases of C group received trimetazidine treatment on the basis of routine treatment.167 cases of D group received conventional treatment.Then,the clinical efficacy of the four groups was compared.Results The total effective rates of A,B,C,D groups were 83.43％,76.84％,73.71％,62.28％,respectively.The total effective rate of A group was obviously higher than the other groups,the difference was statistically significant(x2 =22.40,P ＜0.05).There was no significant difference in total effective rate between B group and C group (x2 =0.46,P ＞ 0.05),but both B and C groups were obviously better than group D (x2=4.37,5.13,all P ＜ 0.05).The data before and after treatment in four groups were significantly improved,such as 6MWT,NT-proBNP,LVEF and FS(A group:t =33.856,37.474,17.722,31.250,B group:t =27.328,31.559,6.863,25.581,C group:t =23.430,32.640,9.524,16.923,D group:t =15.863,9.602,3.061,10.169,all P ＜ 0.01).In the above four indicators,those in A group were obviously better than B group,C group and D group (F =5.884,38.621,4.357,13.770,all P ＜ 0.01).Conclusion L-carnitine combined with trimetazidine can improve the abnormal metabolism of myocardium,optimize the energy metabolism pathway of myocardium,improve the short-term cardiac function of patients markedly.L-carnitine combined with trimetazidine is worthy of promoting joint use.

Cost-effectiveness Analysis of 2 Kinds of Moderate Intensity Statins Plan in the Treatment of Hyperlipid-emia / 中国药房

OBJECTIVE:To investigate the effectiveness and economics of 10 mg/d rosuvastatin and 20 mg/d atorvastatin in the treatment of hyperlipidemia (HLP). METHODS:The information of 180 HLP patients selected from Tianmen Municipal First People's Hospital during Mar. 2015-Feb. 2016 were divided into group A and B according to medication regimen,with 90 cases in each group. Group A was given Atorvastatin calcium tablet 20 mg,qd;group B was given Rosuvastatin calcium tablet 10 mg,qd. Treatment course of 2 groups lasted for 8 weeks. Blood lipid indexes before and after treatment,lipid-lowering efficacy,the rate of qualified blood lipid and the occurrence of ADR after treatment were compared between 2 groups. Cost-effectiveness analysis was adopted for economic evaluation. RESULTS:Before treatment,there was no statistical significance in the levels of blood lipid in-dexes between 2 groups (P>0.05). After treatment,TC and LDL-C levels of 2 groups were significantly lower than before treat-ment,and those of group B were significantly lower than those of group A,with statistical significance(P0.05). The costs of group A and B were 488.32,436.24 yuan,and cost-effectiveness ratios were 5.63,4.46;incremental cost-effectiveness ratio was -4.69. The plan of group B had cost-effective-ness advantage. The results of cost-effectiveness analysis were supported by sensitivity analysis. CONCLUSIONS:In the view of short-term efficacy,10 mg/d rosuvastatin plan is better than 20 mg/d atorvastatin plan in lowering lipid and has cost-effectiveness advantage,and both have similar safety.

Therapeutic Observation of Umbilicus Application withDa Huang (Rheum Officinale) during 5-7 a.m. for Senile Constipation after Hip Fracture / 上海针灸杂志

Objective To observe the clinical efficacy of umbilicus application withDa Huang (Rheum Officinale) during 5-7 a.m. in treating senile constipation after hip fracture.Method Fifty-nine elderly patients with constipation after hip fracture were randomized into a treatment group of 30 cases and a control group of 29 cases. The treatment group was intervened by umbilicus application withDa Huang (Rheum Officinale) during 5-7 a.m, while the control group was by umbilicus application withDa Huang (Rheum Officinale) at any time but avoiding 5-7 a.m. period. After a treatment course, the therapeutic efficacy was evaluated based on bowel movement frequency and shape of stool, and the two groups were compared with each other.Result The total effective rate and markedly-effective rate were respectively 93.3% and 70.0% in the treatment group versus 82.8% and 37.9% in the control group. The between-group difference in the total effective rate was statistically insignificant (P>0.05); there was a significant difference in comparing the markedly-effective rate between the two groups (P<0.01).Conclusion Umbilicus application withDa Huang (Rheum Officinale) during 5-7 a.m. is an effective method in treating senile constipation after hip fracture.

Application value of atorvastatin combined with anticoagulation drugs in elderly patients with steroid-induced avascular necrosis of the femoral head / 中国生化药物杂志

Objective To study the application value of atorvastatin combined with anticoagulation drugs in the treatment of steroid-induced necrosis of the femoral head in the elderly.Methods From February 2013 to January 2016, 112 cases elderly patients accepted treatment of steroid-induced necrosis of the femoral head in our hospital were selected.They were divided into observation group and control group with 56 cases in each group randomly.The two groups were treated with anticoagulant therapy, the observation group received atorvastatin on the basis of control group.The efficacy and indicators between two groups after treatment were compared.Results The excellent and good rate was in observation group was 92.86%, which was higher than 66.07% in control group ( P <0.05 ) .The pain degree, walking ability and total joint mobility score of the observation group were significantly higher than those in the control group(P<0.05).After treatment, plasma viscosity and hematocrit of the observation group were significantly lower than the control group(P<0.05).The time of collapse of the femoral head and the index of necrosis of the observation group were significantly lower than the control group(P <0.05).Conclusion Atorvastatin combined with anticoagulant drugs in the treatment of elderly patients with steroid-induced femoral head necrosis has significant effect, could effectively improve the quality of life of patients with good safety, high application value.

Effects of bone marrow mesenchymal stem cells transplantation on tumor necrosis factor-α and interleukin-1β in preterm rats with hypoxic-ischemic brain damage / 中华围产医学杂志

ObjectiveTo determine the changes in tumor necrosis factor-α (TNF-α) and interleukin-lβ (IL-1β)expression after bone marrow mesenchymal stem cells (BMSCs) transplantation in a rat pup model of hypoxic-ischemic brain damage (HIBD) and discuss the anti-inflammatory mechanism of BMSCs transplantation in the repair of HIBD.MethodsThree-day-old Sprague-Dawley rat pups were randomly divided into three groups: the transplantation group, in which a model of HIBD was established by ligation of left common carotid artery and hypoxia for two hours followed by the injection of 2μl BMSCs (2×105 cells) into the lateral ventricle; the HIBD model group, in which HIBD model was established and 2μl phosphate saline buffer was injected into the lateral ventricle; and the sham-operation group, in which no intervention was given. Histological changes in the brain were detected by HE staining and the number of cells positive for ectodermal dysplasia-1 (ED-1) staining, which is a specific marker for activated microglia, was detected by immunohistochemistry. The protein and mRNA levels of TNF-α and IL-1β were determined by enzyme-linked immunosorbent assay and reverse transcription-polymerase chain reaction. One-way analysis of variance and LSD test were applied for statistical analysis.ResultsHE staining showed that cellular edema and necrocytosis was not observed in cerebral white matter on the 7th post-transplantation day in the transplantation group, but observed in the HIBD model group. In the sham-operation group, cerebral white matter was normal. The number of ED-1 positive cells in the transplantation group (26.3±2.5) was significantly lower than that in the HIBD model group (33.0±4.0), but higher than that in the sham-operation group (2.3±0.6) (LSD test, allP<0.05). The contents of TNF-α and IL-1β both in the transplantation group and the HIBD model group increased and peaked 24 h after transplantation, then gradually decreased, but did not reach normal levels (sham-operation group) on the 7th day. The contents of TNF-α and IL-1β in brain tissue in the HIBD model group [TNF-α: (3.03±0.10), (5.57±0.19), (7.78±0.19), (4.39±0.20), (2.70±019)μg/L; IL-1β:(293.1±7.9), (369.8±17.5), (303.6±23.9), (226.7±21.6), (183.9±33.4) ng/L] were significantly higher than those in the transplantation group [TNF-α: (2.84±0.20), (3.80±0.14), (4.63±0.17), (3.56±0.03), (1.99± 0.17)μg/L; IL-1β: (267.6±14.5), (323.5±26.9), (211.2±24.9), (140.8±7.4), (100.2±8.3) ng/L] at 6, 12, 24, 48 h and 7 days after BMSCs transplantation, respectively. The contents of TNF-α and IL-1β in the sham-operation group [TNF-α:(1.03±0.02), (1.13±0.03), (1.05±0.02), (1.09±0.02), (1.07±0.02)μg/L; IL-1β:(63.6±13.0), (64.0±11.3), (60.8±10.0), (67.9±13.5), (66.2±11.7) ng/L] were significantly lower than those in the transplantation group and HIBD model group (LSD test, allP<0.05). TNF-α and IL-1β mRNA at 24 h after transplantation in the HIBD model group (TNF-α: 2.69±0.43; IL-1β: 3.07±0.38) were significantly higher than those in the transplantation group (TNF-α: 1.61±0.29; IL-1β: 1.08±0.11) and those in the sham-operation group (TNF-α: 0.94±0.16; IL-1β: 1.08±0.11) (LSD test, allP<0.05).ConclusionsBMSCs may play an important role in the recovery of preterm HIBD and the mechanism may involve the inhibition of microglia activation and down-regulation of the expression of inflammatory factors.

Correlations of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and red blood cell distribution width with disease activity of rheumatoid athritis / 中华风湿病学杂志

Objective To investigate the clinical value of neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio and red blood cell distribution width in discriminating disease activity of rheumatoid athritis.Methods Eighty-nine rheumatoid arthritis out-patients of the Affiliated Hospital of Jiangsu University from Jan.2012 to Mar.2013 were recruited into this study.The disease activity index,such as swollen joint count and tender joint count were made by rheumatologists,and laboratory parameters（blood cell analysis,erythrocyte sedimentation rate and C-reactive protein) were measured as well.The enrolled patients were divided into the active RA group and remission RA group based on the DAS28 definition.Differences of NLR,PLR and RDW among groups were analyzed by t test and relations between variables were assessed by Spearman correlation analysis.The t test,non-parametric test and Spearman analysis were used for statistical analysis.Results The levels of NLR (3.2±2.0,2.4±0.9,respectively) and PLR (167±70,133±43,respectively) in active RA group were higher than that of the RA remission group (t=2.28 and 2.50,P=0.02 and 0.01).The level of RDW [(13.9±2.5)％,(13.9±2.4)％,respectively] was not significantly different between the active RA group and the RA remission group (t=0.14,P=0.89).However,compared with healthy controls,the level of RDW [(13.9±2.5)％,(13.2±0.2)％,respectively] was significantly increased in RA patients (t=2.74,P=0.006 9).NLR and PLR were positively correlated with DAS28 (r=0.23,P=0.03;r=0.26,P=0.04,respectively),ESR (r=0.28,P=0.03;r=0.43,P＜0.01,respectively) and CRP (r=0.33,P=0.006;r=0.41,P＜0.01,respectively).However,there was no association between RDW and DAS28 (r=0.01,P=0.93),ESR (r=0.20,P=0.15) and CRP (r=0.05,P=0.71).Areas under curve of receiver operating characteristic (ROC) for assessing disease activity of rheumatoid athritis by NLR and PLR were 0.802 and 0.753 respectively.The cut-off values for discriminating active/remission RA were 2.86 and 143.05,with the sensitivity as 0.66 and 0.63,specificity as 0.72 and 0.65.Conclusion NLR and PLR are significantly associated with the disease activity of RA and can be useful to understand the activity state of the illness.

Epidemiological investigation of macrosomia-related knowledge awareness among pregnant women in Zhejiang province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the awareness rate of macrosomia related knowledge and influencing factors among pregnant women in Zhejiang province and provide evidence for the improvement of pre-gestational and prenatal care.</p><p><b>METHODS</b>A face to face questionnaire survey was conducted among 1 512 pregnant women selected through multistage cluster random sampling from 20 counties (district) in Zhejiang. Macrosomia-related awareness and related factors were analyzed.</p><p><b>RESULTS</b>A total of 1 494 valid questionnaires were analyzed, the awareness rate was 40.7% for macrosomia diagnostic criteria (95% CI: 38.2%-43.2%), 55.0% for the cause of macrosomia (95% CI: 52.4%-57.6%) and 62.4% for prevention related knowledge (95% CI: 59.9%-64.9%) and the awareness rate of both the cause and the prevention related knowledge was 49.0% (95% CI: 46.4%-51.6%). Multivariate logistic regression analysis showed that the third trimester of pregnancy (OR = 1.906, 95% CI: 1.128-3.221), urban residence (OR = 1.335, 95% CI: 1.014-1.756), educational level of junior college (OR = 2.474, 95% CI: 1.635-3.744) and educational level of regular college or above (OR = 2.072, 95% CI: 1.338-3.209), receiving health education about health pregnancy (OR = 1.936, 95% CI: 1.509-2.484) and self-learning about the knowledge of health pregnancy (OR = 2.065, 95%CI: 1.338-3.189) were the influencing factors to the awareness rate of macrosomia diagnostic criteria and prevention related knowledge of macrosomia among pregnant women. The awareness rate of the cause and prevention related knowledge of macrosomia was higher in older age group (OR = 2.103, 95% CI: 1.330-3.323).</p><p><b>CONCLUSION</b>Among the pregnant women in Zhejiang, the awareness rate of macrosomia diagnostic criteria was less than 50%. Therefore, it was necessary to strengthen the health education during pre-gestational and gestational periods among reproductive women, especially the education about pregnancy health in rural area.</p>

Value of dual-energy computed tomography in the diagnosis of gouty arthritis / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the value of dual-energy computed tomography (DECT) in the diagnosis of gouty arthritis.</p><p><b>METHODS</b>Sixty-one patients with gout, 30 with ankylosing spondylitis and 30 with rheumatoid arthritis were included in the study. DECT scans of the hands, wrists, elbows, feet, ankles, knees, lumbar, pelvis and sacroiliac joint were performed. For post-processing, a color-coding gout software protocol was used. The demographic data and blood uric acid levels were recorded. For 3 gout patients, the findings of puncture biopsy and DECT were compared. Ten gout patients with urate crystal deposition upon recruitment underwent DECT scans again after a 6-month urate-lowering therapy.</p><p><b>RESULTS</b>The positivity rates of DECT scan differed significantly among the patients with gout, ankylosing spondylitis and rheumatoid arthritis [98.4% (60/61), 13.3% (4/30), and 6.7% (2/30), respectively; χ² =95.522, P<0.05). Of the 21 patients with acute gouty arthritis, 20 (95.2%) showed positive DECT finding, and all the 40 patients with chronic gouty arthritis showed positive findings. In the patients with patients with gout, ankylosing spondylitis and rheumatoid arthritis, the positivity rates of hyperuricemia were 97.3% (36/37), 44.4% (4/9), and 28.6% (2/7), respectively (χ² =24.197, P<0.05). A total of 344 urate deposition sites were detected in the gout patients, involving most commonly the first metatarsophalangeal joint (22.1%), the middle and distal end of the first phalanges of the toes (19.8%), the calcaneus (17.4%), and the inferior extremity of the tibia (13.4%). Seventeen and 5 urate deposition sites were found in ankylosing spondylitis patients and rheumatoid arthritis patients, respecitvely. The 10 gout patients receiving a 6-month urate-lowering therapy showed decreased urate deposition on DECT scan.</p><p><b>CONCLUSIONS</b>DECT scan can detect urate deposition to allow differentiation diagnosis and follow-up in gout patients.</p>

Multivariate analysis of prognostic makers in patients with nasopharyngeal carcinoma intreatment of radiotherapy combined with induction chemotherapy / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To observe the therapeutic effect of radiotherapy combined with TPF in patients with nasopharyngeal carcinoma (NPC) and to explore the influencing factors on prognosis of NPC.@*METHOD@#A retrospective analysis of 144 patients with nasopharyngeal carcinoma receiving radiotherapy combined with chemotherapy, from January 2006 to December 2011, was conducted. The survival analysis in patients with nasopharyngeal carcinoma were performed. The impact of age, sex, clinical stage, alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), lactate dehydrogenase (LDH), homocysteine (Hcy), uric acid, NK cell proportion, T cell proportion, Carbohydrate antigen on survival time was observed with univariate and multivariate methods.@*RESULT@#By the last follow-up, 9 cases were lost . The follow-up rate was 93.75 percent and the average follow-up time were 54.67 ±17.17 (37-88) months. The age, clinical stage, LDH, proportion of T cells and NK cells were independent factor in patients with NPC with univariate analysis (P < 0.01). COX regression multivariate analysis revealed that age, clinical stage and LDH were strong risk factor affecting prognosis (P < 0.01) and the proportion of NK cells and T cells were protective factors (P < 0.01).@*CONCLUSION@#Radiotherapy combined with TPF is more effective than radiotherapy alone in patients with nasopharyngeal carcinoma . Age, clinical stage and LDH may adversely influence the disease prognosis, and NK cells and T cell proportion may act as protective factors.

Preparation and clinical application of esophagus cancer vaccine / 中国综合临床

Objective To explore the anticancer mechanism of esophageal cancer vaccines and clinical effect.Methods Esophagus cancer cells (Eca109) were cultured and the soluble antigen were extracted from the cells.Esophagus cancer vaccine was constructed with the antigen and superantigen SEC.Lymphocytes were isolated from peripheral blood and then stimulated with the vaccine in vitro.Phenotypes of the cells were checked by FCM and killing activity was tested with cytotoxic assays.One hundred and six early esophageal cancer patients were selected after surgery,who were divided into the observation group of 53 cases with esophageal cancer vaccine therapy and 53 cases in the control group with conventional treatment.Then clinical effect was observated and 3 year follow-up survival rate was observed of the of two groups of patients.Results Proliferation of vaccine stimulated lymphocyte group was the strongest,and high peaked at 72 h (A =0.22),and raise CD8+ T cell populations of CTLs.The killing activity of lymphocyte group stimulated by the vaccine against target cells was significantly higher than that of lymphocyte group ((97.36±2.11) ％) vs.(79.27±5.57) ％,F =38.62,P＜0.01).Three years follow up shows that the survival rates of experiment group were 48.27％ (male) and 45.83％ (female) respectively,and control group were 21.43％ (male) and 24.00％ (female),and the difference was significant (x2 =5.06,6.28,P ＜ 0.05).Conclusion The tumor vaccine constructed with esophagus cancer antigen and superantigen SEC can induce PBMC to activate and proliferate into CD8+ CTL with specific cytotoxicity against the cells which the antigen comes from.The vaccine may raise the survival rate of the patients with Esophagus cancer.

The clinical efficacy and influence of atorvastatin and urinary kallidinogenase on endothelin and inflammato-ry mediators in the treatment of elderly patients with acute cerebral infarction / 中国基层医药

Objective To observe the clinical efficacy and influence of atorvastatin and Urinary Kallidinoge-nase on rheology,endothelin and inflammatory mediators in the treatment of elderly patients with acute cerebral infarc-tion,and to guide clinical treatment.Methods 86 patients with acute cerebral infarction were randomly divided into 43 cases of the observation group and 43 cases of the control group.Both groups were given conventional therapy,then the control group were given atorvastatin(20mg/d,qd),the observation group were given atorvastatin(20mg/d,qd) and Urinary Kallidinogenase(0.15PNA /time).2 weeks were set for a course of treatment,NIHSS score and ADL score were calculated before and after treatment.Then endothelin,CRP,IL -1 and hemorheology were measured by phlebotomized when limosis to evaluated the efficacy.Results The high shear whole blood viscosity,erythrocyte ag-gregation index,hematocrit,fibrinogen,erythrocyte sedimentation rate,endothelin,CRP,IL -1 and NHISS of the ob-servation group and control group after treatment were respectively (3.45 ±0.21)mpa/s vs.(4.89 ±0.31)mpa/s, (4.05 ±0.56)vs.(6.43 ±0.63),(33.4 ±3.4)% vs.(39.8 ±3.7)%,(2.43 ±0.72)g/mL vs.(3.18 ±0.64)g/mL,(20.5 ±7.5)mm/h vs.(27.3 ±7.3)mm/h,(58.8 ±5.7)pg/L vs.(70.7 ±7.5)pg/L,(6.68 ±2.96)mg/L vs.(16.78 ±8.97)mg/L,(3.64 ±1.56)ng/L vs.(6.53 ±2.64)ng/L,(8.2 ±3.3)point vs.(15.5 ±6.3)point. Data of both groups were significantly lower than before treatment,(t =5.234 vs.4.267,4.627 vs.3.532,4.872vs.3.726,5.021 vs.3.429,6.046 vs.3.848,10.477 vs.6.818,11.557 vs.6.686,9.267 vs.6.421,12.712 vs. 5.044,all P <0.05).The ADL score were (28.7 ±11.2)point vs.(22.5 ±10.1)point,and the data of both groups were significantly higher than before treatment (t =8.396 vs.5.336,all P <0.05).The high shear whole blood vis-cosity,erythrocyte aggregation index,hematocrit,fibrinogen,erythrocyte sedimentation rate,endothelin,CRP,IL -1 and NHISS of the observation group were significantly lower than the control group(t =3.207,3.388,3.667,3.761, 3.959,3.929,3.884,3.304,3.778,all P <0.05).The ADL score of the observation group were significantly higher than the control group(t =3,447,P <0.05);The total effective rate of the observation group and control group were 95.35% (41 /43 )vs 69.77% (30 /43 ),the difference was statistically significant (χ2 =10.904,P <0.05 ). Conclusion The method contained atorvastatin and urinary kallidinogenase have exact clinical efficacy,can improve neurological deficit assessment and the ability of daily life.Its mechanism may be that it can reduce endothelin levels of inflammatory mediators and improve blood circulation,which is worthy of clinical use.