Abstract:Ebola virus disease (EVD)-related fear, stigma and discrimination are series of psychological barriers and behaviors during EVD epidemics, which are caused not only by the characters of EVD, such as high fatality rate, high transmission efficiency and clinical similarities to other infectious diseases, but also by the backward economy and educational levels, unsound hospital and health care system, traditional production mode and life style, and political unrest in West Africa countries. As members of the second batch of the Chinese People's Liberation Army (PLA) medical team to Liberia the authors noticed that not only EVD patients and the contacts, but also the medical workers had to face the fear, discrimination, and even the violence from other people, which decreased the effects of the EVD-prevention and control efforts. Prompt publicity and education about EVD in local communities, Ebola-prevention training programs to the local health workers, letting Ebola survivors to participate in the epidemic control mission, and providing more protective equipment should be employed to improve Ebola prevention and eliminate the Ebola-related fear, stigma and discrimination. It is suggested that strengthening the research on the specific vaccines and medicines against Ebola, all-around assistance from the international society and extensive publicity and education about Ebola can help to dismiss the psychological barriers of fear, stigma, and discrimination about EVD.

Abstract:Objective To summarize the design and implementation of standard work flow of sanitation and epidemic prevention work in the anti-Ebola mission in Liberia, so as to provide reference for treating infectious diseases in the future. Methods The working practice for sanitation and epidemic prevention in Chinese Ebola Treatment Unit in Liberia, including the organizational operation mode, work flow, quality control, and the improvement of the performance were reviewed. Then the importance of sanitation and epidemic prevention was analyzed and the experience and lessons were summarized. Results Deployed in Liberia for the mission of treating Ebola virus disease, the Medical Team of the Chinese People's Liberation Army (PLA) successfully achieved the goal of "win the war, zero infection", in which the sanitary and epidemic prevention work had played an important role. Conclusion The sound organization and management, excellent material preparation, reasonable arrangement of work flow, strict quality control and the continuous improvement of problems were the keys for successful sanitary and epidemic prevention work in the Chinese Ebola Treatment Unit in Liberia.

Abstract:Objective To summarize the characteristics of the training system for the Second Medical Team of Chinese People's Liberation Army (PLA) to Liberia for anti-Ebola mission and to give some suggestion. Methods Before going to Liberia, the Second Medical Team of Chinese PLA received pertinent training focusing on Ebola-related theories and practical protection skills. Training on working regulation and procedures, emergency protocol and foreign affair was also given. Theory learning was carried out by combining lectures and self-teaching; protection skills were strengthened by watching video, live demonstration and modular training. Finally, modular situation simulation and supervision assessment were used to integrate the theories, skills, working procedures and urgent drill, making each section coordinate and function well to achieve the designed training goals. Results The pertinent training was effective. We suggested that it is necessary to include general introduction of lemology, principles and rules of protection and control of communicable diseases in theory learning so as to guide the trainees to solve specific problems during their work. In addition, psychological counseling for the purpose of eliminating the members' fear and anxiety and other negative emotions, and learning self-grooming, are also helpful to facilitate the execution of mission in foreign areas. Conclusion The petinent training has laid a solid foundation for achieving the goal of "win the war, zero infection" during emergent medical situation. Modular scenario simulation training method is effective for emergent response training of medical team for communicable diseases, and it should be widely used.

Abstract:Objective To analyze and summarize the characteristics of multiple organ dysfunctions and the associated supportive therapies in patients with severe Ebola virus disease (EVD) through a systematic literature review. Methods Medline and EMbase were searched since 2014 for eligible studies on severe EVD patients in ICU. The data of clinical presentations, treatment procedures as well as prognosis of these patients were summarized and analyzed. Results Ten patients from 7 reports were finally enrolled in the present study. Internal environment disturbance, liver injury and thrombocytopenia occurred in almost all of the patients. Respiratory failure was found in 4 patients and 3 of them were also complicated with renal failure. All of the patients received aggressive supportive therapies, such as maintaining the stability of internal environment, transfusion of blood products, mechanical ventilation, renal replacement therapy, antiviral therapy, etc. Of the 10 patients, 9 recovered and 1 died. Conclusion Severe EVD patients are always complicated with multiple organ dysfunctions and effective supportive therapies can improve the organ dysfunctions and prognosis of these patients.

Abstract:Objective To investigate the resistance to deltamethrin and permethrin in Aedes albopictus in Haikou City, and to detect the knockdown resistance (kdr) mutants of A. albopictus, elucidating the association of resistant phenotype with kdr mutation. Methods The A. albopictus samples were collected from Xinfu Island, Longtang Town, Shishan Town, Baishamen Park, and the flower market in Haikou City. Their susceptibility to deltamethrin and permethrin was tested by larval bioassay. The resistance level was determined by the R/S ratio. The kdr gene was amplified and analyzed, and the relationship between the resistant phenotype and kdr mutation was determined by Chi-square test. Results The A. albopictus samples from the flower market and Baishamen Park showed resistance to deltamethrin and permethrin, of which the flower market population had an R/S ratio of up to 436.36, indicating a high level of resistance. The A. albopictus samples from Longtang Town and Shishan Town were sensitive to permethrin, but had low (R/S ratio, 9.09) and moderate (18.18) degrees of resistance to deltamethrin, respectively. The Xinfu Island population was sensitive to both deltamethrin and permethrin. The codon 1 534 kdr was detected point mutations among 317 A. albopictus samples, with two mutant alleles, TGC/C and TCC/S. The five genotypes were wild-type TTC/TTC (frequency, 62.15%), wild/mutant heterozygous TTC/TGC (0.63%) and TTC/TCC (16.09%), homozygous mutant TCC/TCC (20.82%), and mutant heterozygous TGC/TCC (0.32%). Chi-square test revealed significant differences in the frequency of kdr mutant genotype between A. albopictu sensitive to the insecticides (31.97%) and those resistant to the insecticides (42.94%), P <0.05. Conclusion Some A. albopictus populations in Haikou City have developed resistance to both deltamethrin and permethrin. The resistant phenotype and kdr mutant genotype are closely associated. This study has also discovered for the first time the novel TCC/S point mutation of kdr.

Abstract:Objective To investigate the effect of aldosterone on the activation of autophagy in mesangial cells. Methods Three classic techniques were used to detect the autophagy activity in mesangial cells with or without aldosterone treatment in this study. (1) Western blotting analysis was used to examine the expression of autophagy protein LC3, SQSTM1/P62 after human mesangial cell line (HMCL) was treated with different concentrations of aldosterone. (2) Confocal laser scanning microscope was used to observe the change of autophagy points after transforming eukaryotic expression vector GFP-LC3 into HMCL cells. (3) Transmission electron microscopy was used to observe the autophagic vacuoles of HMCL cells after treatment with aldosterone. Microscope and Western blotting analysis were used to observe the expression of apoptosis protein and poly(ADP-ribose) polymerase in mesangial cells under the conditions of oxidative stress (2.5×10^-6 mol/L H₂O₂ solution) and under the presence or absence of aldosterone. Results All the three methods confirmed that high physiological dose of aldosterone (10^-7 mol/L) could inhibit mesangial cell autophagy activation: (1) The autophagy marker LC3Ⅰ converting to LC3Ⅱ had a decrease of approximately 40% after 10^-7 mol/L aldosterone stimulation for 12 h. (2) The numbers of autophagy point of mesangial cells induced by Earle's balanced salt solution (EBSS) and rapamycin were also reduced by 60% and 47% upon aldosterone treatment, respectively. (3) Aldosterone treatment significantly reduced starvation and rapamycin-induced vacuole formation in mesangial cells examined by transmission electron microscopy. The mesangial cells treated by aldosterone had a significantly increased apoptosis rate than the control group under oxidative stress condition with hydrogen peroxide stimulation (2.5×10^-6 mol/L, P <0.05). Conclusion High physiological concentration of aldosterone shows an inhibition against the basic autophagy activation of mesangial cells and accelerates cell apoptosis under conditions of oxidative stress.

Abstract:Objective To investigate the effect of the placenta-derived three-dimensional (3-D) spheroid-cultured mesenchymal stem cells (MSCs) on the expression of tumor necrosis factor-α (TNF-α) and apoptosis-related proteins in rats with cerebral ischemia-reperfusion injury, so as to explore the neuroprotective effects and mechanism of 3-D spheroid-cultured MSCs. Methods The experimental animals were randomly divided into Sham group, Vehicle group and 3-D spheroid-cultured MSCs treated group (n=36). In the Sham group, the middle cerebral artery (MCA) was simply isolated but not ligated. In the MSC treated group, focal ischemia/reperfusion in rats was induced by intraluminal middle cerebral artery occlusion (MCAO) with a nylon monofilament suture and then MSCs transplantation was done. In the Vehicle group, the MCAO model was set up and an equal volume of vehicle was given. Neurological scores of animals were evaluated at different time points: the first day, the third day and the seventh day after surgery. Enzyme-linked immunosorbent assay (ELISA) and RT-PCR method were used to detect TNF-α expression in rat brain tissues. The SABC immunohistochemical staining method was used to detect the expression of Caspase-3 and Caspase-8 in rat brain tissues. Results The neuromotor function of rats in MSCs treated group was significantly decreased compared with those in the other two groups (P <0.05). Compared with the Sham group, the expressions of TNF-α, Caspase-3 and Caspase-8 in the brain tissue were significantly increased in the Vehicle group (P <0.01). Moreover, compared with the Vehicle group, expression of TNF-α, Caspase-3 and Caspase-8 in the brain tissue was significantly decreased in MSCs treated group (P <0.05, P <0.01). Conclusion 3-D spheroid-cultured MSCs transplantation may improve the neuromotor function in rats with cerebral ischemia/reperfusion injury via down-regulating inflammatory cytokine TNF-α and expression of Caspase-3 and Caspase-8 in the brain tissue.

Abstract:Objective To identify the risk factors of in-hospital adverse cardiovascular events in elderly patients with coronary artery disease (CAD) after percutaneous coronary intervention (PCI) and to establish a risk factor score for these CAD patients. Methods A total of 1 007 consecutive elderly patients with coronary heart disease, aged over 75 years old, who underwent PCI in our hospital from January 2005 to December 2010, were enrolled in this study. Univariate and multivariate logistic regression analysis were performed to determine the risk factors associated with adverse cardiovascular events, and then a risk score model was constructed according to the analysis results. The risk score model was then validated with 527 elderly CAD patients over 75 years old who underwent PCI in our hospital between January 2011 and December 2012. The area under the receiver operating characteristic (ROC) curve and the Hosmer-Lemeshow goodness of fit data were calculated to assess the performance and calibration of this risk score. Results Multivariate logistic regression analysis indicated 7 independent predictors with their associated risk weights as follows: urgent PCI (3 scores), renal insufficiency (2 scores), left main disease (2 scores), diabetes mellitus (1 score), acute myocardial infarction (1 score), type C lesion (1 score), and ≥3 stents placed (1 score). The validation results showed that the risk score model had a good performance in terms of discrimination and calibration, with the area under ROC curve being 0.89 and Hosmer-Lemeshow P value being 0.586. Conclusion Finally 7 risk factors are included for the risk score model, with the risk factor scores of each ranging 1-3 and the highest total score being 11. The constructed score model can accurately predict the adverse cardiovascular events in elderly CAD patients undergoing PCI.

Abstract:Objective To evaluate the preoperative value of the sleep respiration monitoring and upper airway obstruction positioning system ApneaGraph 200 (AG 200,JC Medical,America) in disease diagnosis (severity) and the location of upper airway obstruction plane in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods A total of 121 suspected patients with OSAHS were randomly selected. They were examined by Müller's maneuver in the upper airway obstruction site. Then they underwent one-night (7 h) sleeping monitor by polysomnography (PSG, D-22525, Weinmann GmbH, Germany) and AG 200 simultaneously. The data obtained by PSG and AG 200 were compared, including apnea-hypopnea index (AHI), mean arterial blood oxygen saturation (mean SaO₂, MSaO₂), lowest arterial oxygen saturation (lowest SaO₂, LSaO₂), percentage of the cumulative time of SaO₂≤90% to total monitoring time (CT90%) and diagnosis of the properties and the severity of upper airway obstruction. The constituent ratios of the different obstructive plane measured by AG 200 and the upper airway obstructive sites determined by Müller's maneuver were also compared. Results The AHI, MSaO₂, LSaO₂, CT90% and the properties and the severity of upper airway obstruction by the AG 200 and PSG were similar. The positive rates of the upper plane obstructive sites determined by the endoscopy with Müller's maneuver and AG 200 were the same. The positive rate of the down plane obstructive sites determined by AG 200 was significantly higher than that determined by the endoscopy with Müller's maneuver (P <0.05). Conclusion One-night PSG and AG 200 monitoring can simultaneously achieve accurate qualitative and primary positioning diagnosis of OSAHS. AG 200 can identify the level of upper airway obstruction more accurately when combined with the endoscopy with Müller's maneuver.

Abstract:Objective To explore the renal artery diameter immediately after the renal sympathetic denervation (RDN) in patients with resistant hypertension. Methods Patients with resistant hypertension were enrolled in this study, and all patients were measured and recorded for the renal artery diameter values using the quantitative coronary angiography (QCA) before and immediately after the RDN. All the ablation parameters including starting impedance, terminal impedance, ablation power, and ablation point were recorded. Ambulatory blood pressure (BP) measurement was performed at the baseline and 6 months after RDN. Results A total of 12 patients with resistant hypertension were finally enrolled in this study. The mean ambulatory BP of the patients was (185±15)/(99±9) mmHg (1 mmHg=0.133 kPa) at admission, which was decreased by 31/15 mmHg in 6 months after RDN, showing significant difference compared with before RDN (P <0.001). The dilation of renal artery diameter was observed in all patients immediately after the RDN, with the mean renal artery diameter increased by 0.6 mm, also showing significant difference compared with before RDN (P <0.001). It was found that the renal artery diameter was correlated with the decrease of ablation impedance (the correlation coefficient = 0.74, P=0.006). However, the degree of renal artery diameter dilation could not predict the changes of BP after RDN (P >0.05). No peripheral vascular complications occurred in these patients. Conclusion RDN can significantly reduce the ambulatory BP in patients with resistant hypertension, and expand the renal artery diameter immediately. The degree of renal artery diameter dilation is positively correlated with the ablation impedance decrease, but it can not predict the long-term BP in patients.

Abstract:Objective To explore the value of urine retinol-binding protein 4 (RBP4)detected by colloidal gold immunochromatography assay in evaluating the renal dysfunction state in kidney transplant patients. Methods A total of 141 kidney transplant patients followed-up by our urology center were included in this study. The RBP4 levels in the urine of the participants were measured by both enzyme-linked immunosorbent assay (ELISA) and colloidal gold immunochromatography assay. The consistency of the two methods was evaluated by kappa test. The patients were divided into three groups according to the results of colloidal gold immunochromatography assay, in which dark red, light red and colorless representing the low, medium and high levels of RBP4, respectively. The relationship between patient clinical manifestations and RBP4 results was analyzed. Results The two methods of ELISA and colloidal gold immunochromatography assay showed high consistency in detecting RBP4 concentration in the urine of kidney transplant patients (kappa=0.813, 95%CI: 0.763-0.933). According to the results of colloidal gold immunochromatography assay, the low, medium and high levels RBP4 groups had significantly different fasting glucose (P=0.028), serum creatinine (P=0.021), blood urea nitrogen (P=0.012), albumin (P=0.014), hemoglobin (P=0.026) and proteinuria (P=0.015). Conclusion Colloidal gold immunochromatography assay detecting urine retinol binding protein 4 can achieve semi-quantitative results via reaction color of the strip. It is reliable, sensitive and easy to perform, making it easy for the early diagnosis of renal tubular injury after kidney transplantation during follow-up.

Abstract:Objective To examine the reliability and validity of the mental disorder predictive scale for servicemen. Methods A test with the mental disorder predictive scale for servicemen was carried out in 1 477 soldiers and officers selected by random cluster sampling, and 120 of them were also tested by Chinese Military Mental Health Scale (CMMHS) at the same time. Statistical software was used to analyze the results and to assess the reliability and validity of the mental disorder predictive scale . Results The Cronbach's α coefficient of the total scale was 0.784, and those of the subscales were 0.705-0.854 (P <0.01). The half reliability of total scale was 0.914, and those of the subscales were 0.754-0.934(P <0.01). The correlation coefficients among factors were 0.512-0.948 (P <0.01), and the correlation coefficients of single factors with total scale score were 0.673-0.961 (P <0.01). Dimensional analysis proved that there were good distinctions between subscales. The exploratory factor analysis showed that the results of this study agreed with the collation of each entry factor of the original scale. There was a higher degree of fitting according to the results of confirmatory factor analysis. The validity of the present scale was effective. Conclusion The reliability and validity of the mental disorder predictive scale for servicemen are satisfactory and meet the standard psychometrics; it can be utilized as an effective tool for prediction of mental disorders among servicemen.

Abstract:Objective To evaluate the effect of apigenin on cell migration, invasion of human lung cancer cell line A549 and the underlying mechanisms. Methods A549 cells were cultured with different concentrations of apigenin (0, 5, 10, 20, 40, 80, and 160 μmol/L), and CCK8 assay was used to evaluate the cell inhibition rates. Cell migration and invasion capabilities were evaluated by means of transwell and transwell matrix penetration assays. Enzyme-linked immunosorbent assay (ELISA) and Western blotting analysis were used to study the activities and expressions of invasion-related proteins matrix-metallopeptidase 2 (MMP-2), MMP-9 and vascular endothelial growth factor (VEGF). Results CCK8 assay results showed that apigenin caused a concentration-dependent (40, 80, and 160 μmol/L) inhibition against proliferation of A549 cells (P <0.05). Compared with the control group, apigenin significantly inhibited the migration and invasion capabilities of A549 cells, accompanied by significantly decreased MMP-2 and VEGF expression (P <0.05). However, apigenin showed no effect on MMP-9 protein expression. Conclusion Apigenin can effectively inhibit migration and invasion of human lung cancer cell line A549, which is probably through suppressing the expressions of MMP-2 and VEGF.

Abstract:Objective To explore sex differences of salivary α-amylase activity (sAA), flow rate, pH value and correlation between sAA activity and flow rate. Methods Saliva samples were collected from 105 healthy volunteers before and after citric acid stimulation. Salivary sAA activity, flow rate and pH value were determined for each samples, and the correlation between sAA activity and flow rate was analyzed. The sex differences of the indices mentioned above were analyzed. Results Citric acid stimulation significantly increased salivary sAA activity, flow rate and pH value, with flow rate undergoing the greatest increase (P <0.01). No significant sex differences in sAA activity, flow rate or pH value were found at baseline, stimulation or acute responses (delta value) to citric acid stimulation. For female subjects, significant positive correlations were found between sAA activity and flow rate in unstimulated and stimulated saliva, between sAA activity delta value and flow rate delta value (P <0.05), and their coefficients kept relatively stable. For male subjects, significantly positive correlation was only found between stimulated sAA activity and flow rate (P <0.01). Conclusion Our study indicates that no sex difference in the sAA activity, flow rate or pH value at basal and acute responses to citric acid stimulation. However, certain sex difference is indicated in correlation between sAA activity and flow rate.

Abstract:The current therapies for treating prostate cancer, in many cases, also cause damage to normal tissues and organs at the same time when killing cancer cells. The recent development of targeted therapy to some extent, may be a good solution to this problem. As vectors in targeted therapy, viral vectors have strong immunogenicity, toxicity and other disadvantages, and non-viral vectors for targeted therapy of prostate cancer may overcome these drawbacks. This review summarized the recent application of cationic polymers, liposomes and polymeric chitosan as non-viral vectors of gene drug for targeted therapy of prostate cancer.

Abstract:Spinal fusion is the common procedure to restore the stability of spine. However, fusion failure and pseudoarthrosis are frequent. Previous studies have found that low-intensity pulsed ultrasound (LIPUS) can accelerate spinal fusion and reduce fusion failure, with endochondral ossification being the main pathological process. Further investigations have revealed that LIPUS can directly promote the migration, proliferation, osteogenesis, and chondrogenesis of mesenchymal cells. Moreover, LIPUS is indicated to accelerate angiogenesis and innervation coupling, finally promoting spinal fusion.

Abstract:Objective To observe the clinical efficacy of autologous dendritic cells (DCs) vaccine combined with cytokine-induced killer (CIK) cells for treatment of patients with biliary tract cancer. Methods Peripheral blood mononuclear cells (PBMCs) were collected from the patients with biliary tract cancer and were stimulated with multiple tumor-associated antigens (TAA) for amplification and culture. Mature DCs were harvested and made into vaccine for intradermal administration, and at the same time the patients were given autologous CIK cells via vein transfusion. The clinical efficacy, immune function, side effect, and overall survival of 85 patients with biliary tract cancer were observed before and after treatment. Results The clinical symptoms were improved significantly in the 85 patients after autologous DC-CIK therapy (P <0.05). The clinical efficacy was remarkable: with 2 cases (2.3%) having complete remission, 14 (16.5%) with partial remission, 54 (63.5%) with stable disease and 15 (17.6%) with progressive disease. The immune function was improved after combined treatment; CD3⁺, CD3⁺CD4⁺, CD3⁺CD8⁺, CD3⁺CD56⁺ and CD4⁺/CD8⁺ ratio were elevated in the lymhocyte subpopulation, but the regulatory T cells were reduced (P <0.05). At the end of the follow-up, 58 patients died, 2 patients were lost in follow-up, and 25 patients survived, with the median overall survival time being 16.5 months (95%CI: 12.1-20.9 months). Conclusion Autologous DC-CIK therapy is a safe and effective treatment for patients with biliary tract cancer, with less side effect, but the relevant conclusion still needs to be confirmed by larger sample randomized controlled studies.

Abstract:Objective To investigate the nuclear expression of CXC chemokine receptor 4 (CXCR4) in renal cancer, and analyze its relation with renal cancer metastasis and prognosis. Methods A total of 413 patients with renal cancer who were treated in our urologic center from Mar. 2011 to Nov. 2012 were included in the present study. The subcellular expression of CXCR4 was examined by immunofluorescence staining; the correlation between CXCR4 nuclear location and clinical features, prognosis was analyzed. Results We found that 170 of the 413 renal cancer patients were CXCR4 nuclear staining-positive (group A), and the rest 243 cases were CXCR4 nuclear staining-negative (group B); the two groups had matchable baseline data. Compared with group B, group A had significantly higher Robson stage (P <0.01), more frequent cancer embolus (P <0.01), more frequent lymphatic metastasis (P <0.01), and more frequent distant metastasis (P <0.01). The overall survival rate of group A (86.5%, 147/170) was significantly lower than that of group B (97.1%, 236/243; P <0.001). Conclusion Nuclear expression of CXCR4 in renal cancer tissues is associated with higher Robson stage, more frequent cancer embolus, more frequent lymphatic metastasis, more frequent distant metastasis and poor prognosis.

Abstract:Objective To study the choice of diagnostic and therapeutic strategy for young patients with acute myocardial infarction (AMI) according to the onset characteristics. Methods We retrospectively analyzed the clinical data of 36 young and 1 283 elderly patients with AMI, who were treated between Dec. 2006 and Jan. 2012 in our hospital. The risk factors, clinical characteristics and diagnosis/treatment strategies were analyzed. Results (1) The young patients accounted for 2.7% of all the AMI patients in our study, with most of them being male (97.2%). AMI with ST-segment elevation accounted for 94.4% (34/36) among the young AMI patients, often with risk factors like smoking and dyslipidemia, scarcely with hypertension or diabetes. In the young patients the incidence rates of cardiogenic shock, heart failure and arrhythmia were 5.6% (2/36), 16.7% (6/36), and 5.6% (2/36, respectively, and there was no death during treatment or follow-up. (2) Among the 33 young patients receiving coronary angiography, 21 (63.6%) had single vessel lesions, mostly involving the left anterior descending artery and resulting in anterior myocardial infarction. Among the 15 young AMI patients who received emergent coronary angiograpy, 6 (40%) had heavy thrombus burdern but had slighter coronary stenosis, and they did not receive stent treatment. Conclusion AMI should be considered when young male patients with smoking history, dyslipidemia and chest pain. Young AMI patients often have single vessel lesions and better prognosis, and they need timely revascularization.

Abstract:Objective To investigate the values of ASAS-endorsed disease activity score (ASDAS) and routine assessment of patient index data 3 (RAPID3) in assessing disease activity of patients with ankylosing spondylitis (AS) in China. Methods Questionnaires were used to obtain the general information and disease activity of 82 AS patients; and erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were measured in the venous blood samples. Correlation analysis and kappa consistency test were used to compare the value of traditional measures for assessing disease activity of AS including Bath ankylosing spondylitis disease activity index (BASDAI) with the new measures including ASDAS and RAPID3. Results ASDAS-CRP and RAPID3 had a good consistency in assessing AS activity (kappa value: 0.788), but both of them had poor consistency with BASDAI (kappa values: 0.342, 0.367). BASDAI, ASDAS and RAPID3 were well correlated with doctor global assessment (DOCGL) and patient global assessment (PATGL), and ASDAS and RAPID3 had stronger correlation with DOCGL and PATGL than BASDAI did (the r values of ASDAS-CRP, ASDAS-ESR, RAPID3, and BASDAI with DOCGL were 0.684, 0.720, 0.642 and 0.576; and those with PATGL were 0.822, 0.816, 0.851 and 0.725, respectively). Conclusion ASDAS is superior to BASDAI in assessing the disease activity of AS, making it a new promising index for evaluating disease activity and worth promoting. RAPID3 is convenient, simple, and independent to laboratory findings, and it has a good reliability and validity in evaluating disease activity of AS.

Abstract:Objective To explore the targeted distribution of flurbiprofen axetil (FA) in hysteromyoma and its influence on prostaglandin E₂ (PGE₂). Methods A total of 40 female patients undergoing myomectomy (ASAⅠ-Ⅱ) were enrolled in the present study. The patients were randomly divided into blank control group and FA groups of three different doses. The four groups were injected with normal saline, 0.5, 1, or 1.5 mg/kg of FA 15 min before the operation. Tumor tissues and normal tissues were collected by surgical operation and the sampling time was recorded. The concentration of flurbiprofen (FP), which was the active metabolite of FA, was detected in the tumor tissues and normal tissues by HPLC. The concentrations of PGE₂ were detected by ELISA in the two samples. Results FP was not detected in the tumor tissues or normal tissues of the blank group. With the increase of FA dose in the three groups, the concentration of FP had an increasing tendency in the tumor tissues, with significant differences found among the three groups (P <0.05), but not in the normal tissues (P >0.05).The concentrations of FP in the tumor tissues were significantly higher than those in the normal tissue in the three FA groups (P <0.01).With the increase of FA dose, the concentration of PGE₂ had a tendency to decrease in the tumor tissues; and there were significant differences between blank group and 1, 1.5 mg/kg FA groups (P <0.01), not between blank group and 0.5 mg/kg FA group. The concentrations of PGE₂ in the tumor tissues were significantly higher than those in the normal tissues in the four groups (P <0.01), and there were no significant differences in pairwise comparisons in the normal tissues among the four groups (P >0.05). Conclusion FA has a certain targeted distribution in hysteromyoma and can reduce the level of PGE₂.

Abstract:Objective To establish an HPLC method for simultaneous determination of five effective components (naringin, hesperidin, neohesperidin, acteoside and liquiritin) in the Jinlongshe oral solution. Methods SunFire^TM C₁₈ (4.6 mm×250 mm, 5 μm) column was used. The mobile phase was acetonitrile (B) and 0.2% formic acid (A), with gradient elution program as follow: 0-10 min, 10%-19% B; 10-32 min, 19% B. The flow rate was 1.0 mL/min, and the temperature was at 40℃. The injection volume was 10 μL, and the detection wavelength was set at 285 nm. Results There were good linearities for concentrations of naringin, hesperidin, neohesperidin, acteoside and liquiritin within the range of 2.00-60.00, 2.12-63.60, 1.68-50.40, 2.00-60.00 and 2.00-60.00 μg/mL (r≥0.999 9), respectively. RSD of the intra-day and inter-day precisions of the five components were less than 2.30% and 3.82%, respectively. RSD of the stability in 24 h was less than 4.47%. The average recoveries were 95.11%, 93.73%, 96.39%, 98.02% and 95.12%, with the RSD being 2.08%, 4.05%, 4.02%, 6.01% and 4.56%, respectively. Conclusion The present method has been proven to be convenient, accurate, sensitive and with good reproducibility, and can be applied for the quality control and assessment of Jinlongshe oral solution.

Abstract:Objective To investigate the relationship between metabolic syndrome (MS) and bone mineral density(BMD) in the aged. Methods 1002 cases were divided into MS group and non-MS(NMS)group according to with or without MS. Height, weight, waist circumference and blood pressure were measured, body mass index(BMI) were calculated, total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) ,fasting blood glucose (FBG)were tested. The calcaneal bone mineral density (BMD) was measured by the quantitative ultrasonography. To find the differences of BMD between subjects with or without MS by using the covariance analysis and to analyze the risk factors associated with BMD. Results Compared to NMS group, the values of BMI、waist circumference、TC、TG、FPG were significantly increased in MS group(P<0.05或P<0.01).Those with MS had higher BMD than those without after adjustment for age and BMI（P<0.01）. There was no significant difference in BMD among patients with different number of the components of the metabolic syndrome (P<0.05). However，the difference were significant after adjustment for age and BMI（P<0.05）.The multiple stepwise regression analysis demonstrated that BMD were correlated with age、waist circumference and HDL-C（P<0.05）.Conclusion .The BMD is higher in aged MS patients than that in non-MS subjects.

Abstract:Objective To investigate the feasibility and safety of Sandwich Balloon Dilation for totally ultrasound guided percutaneous nephrolithotomy (PCNL) . Methods An 18G needle with length marker was used to puncture the target calyx under the guidance of ultrasound and the depth of percutaneous tract was defined. Then the length of balloon similar to tract depth was marked by marker pen. Sandwich Balloon Dilation: Balloon was indwelled along the zebra guidewire until the marker, and inflated with 20atm for 5 minutes; 20.8F renoscope combined with EMS lithotripsy were used for fragmentation; finally before the end of surgery balloon was used again to tamponade the percutaneous tract. Results Between June 2014 and October 2014, a total of 56 patients (32 males and 21 females) with the average age of 53y underwent PCNL. The average stone size was 2.4±0.4cm; BMI23.1±2.8 and hospitalization 7 days. The average hemoglobin and hematocrit before and after operation was 14.1±2.1 vs 13.3±2.1g/dl and 40.7±5.3% vs 38.1±5.1%, respectively. No patient needed transfusion or embolization. No other severe complications happened. Conclusion Balloon dilation makes totally ultrasound PCNL easy and safe; while Sandwich Balloon Dilation further decreases haemorrhage complication.

Abstract:Objecive To evaluate the clinic value of 320 rows spiral CT in diagnosis of rib fractures. Methods Eighty-six patients with rib fractures were examined by 320 rows spiral CT. After the scanning, rib three-dimensional reconstructions were carried out. The number of ribs fractures was compared with that demonstrated by X-ray and common spiral CT. Results All patients were examined successfully in 3~5 seconds. The images quality of ribs reconstructed by the new method was excellent and exquisite. Many linear fractures and depressed fractures and costobrachial fractures which were not displayed in the images reconstructed by common spiral CT were displayed. The difference was significant statistically. Conclusion Compared with common spiral CT, 320 rows spiral is superior, with faster scanning speed, lower radiological dose and better image quality, improving the diagnostic accuracy of rib fractures to some extent. Therefore, it is an advanced and reliable diagnostic tool for rib fractures.