Inhalation of 2, 4-di-tert-butylphenol-Loaded micelles suppresses respiratory syncytial virus infection in mice.

Human respiratory syncytial virus (RSV) is a common cause of respiratory infections in infants, young children, and elderly people. However, there are no effective treatments or vaccines available in most countries. In this study, we explored the anti-RSV potential of 2, 4-Di-tert-butylphenol (2, 4-DTBP), a compound derived from Houttuynia cordata Thunb. To overcome the poor solubility of 2, 4-DTBP, we encapsulated it in polymeric micelles and delivered it by inhalation. We found that 2, 4-DTBP-loaded micelles inhibited RSV infection in vitro and improved survival, lung pathology, and viral clearance in RSV-infected mice. Our results suggested that 2, 4-DTBP-loaded micelle is a promising novel therapeutic agent for RSV infection.

Vibration comfort assessment of tractor drivers based on sEMG and vibration signals.

In order to comprehensively evaluate the driver's vibration comfort under different vibration conditions, eighteen subjects were required to drive a tractor at different speeds on field and asphalt roads respectively in the real vehicle experiment. The sEMG signals and vibration acceleration signals of the subjects were recorded. And the time-frequency domain analysis of sEMG signals and acceleration signals were used to determine the relationship among the characteristic indexes, tractor speed and road surfaces. The relevance analysis showed that there was a significant correlation between the integral electromyography (iEMG) and median frequency (MF) of the middle scalene muscle, erector spinae muscle and gastrocnemius muscle, the RMS of weighted acceleration (aw) of the neck, waist and legs, and the subjective comfort feelings. It was proven that the tractor speed had a significant impact on human body vibration based on the ANOVA result (p < 0.05). With the increase of running speed, the time domain indexes of sEMG signals including iEMG, RMS and the vibration acceleration signals of the testing body parts increased significantly, while the amplitudes of frequency domain indexes decreased. Therefore, a quantitative regression evaluation model for the comfort of the neck, waist and legs integrating the sEMG and vibration signals was established, and its relative errors were 5.05, 4.38 and 6.12% respectively. This proposed assessment model can combine characteristics of the partial and overall vibration response of human body effectively, predict the tractor driver's vibration comfort accurately, provide a theoretical basis for the evaluation of tractor cab vibration comfort.

Development of Inhalable Chitosan-Coated Oxymatrine Liposomes to Alleviate RSV-Infected Mice.

Human respiratory syncytial virus (RSV) infection is the most important cause of acute lower respiratory tract infection in infants, neonates, and young children, even leading to hyperinflation and atelectasis. Oxymatrine (OMT), originating from natural herbs, possessed potential antivirus activity against influenza A virus, Coxsackie B3 virus, and RSV, whereas the absence of an in vivo study indicated the difficulties in overcoming the physiological obstacles. Since RSV basically replicated in lung tissue, in this study, we fabricated and characterized a chitosan (CS)-coated liposome with OMT loaded for the treatment of lethal RSV infection via inhalation. The results uncovered that OMT, as a hydrophilic drug, was liable to diffuse in the mucus layer and penetrate through the gas-blood barrier to enter systemic circulation quickly, which might restrict its inhibitory effect on RSV replication. The CS-coated liposome enhanced the distribution and retention of OMT in lung tissue without restriction from mucus, which contributed to the improved alleviative effect of OMT on lethal RSV-infected mice. Overall, this study provides a novel inhalation therapy for RSV infection, and the CS-coated liposome might be a potential inhalable nanocarrier for hydrophilic drugs to prevent pulmonary infections.

Development and validation of a nomogram for predicting the risk of pressure injury in adult patients undergoing abdominal surgery.

Objectives: This study aimed to develop a nomogram for predicting the risk of pressure injury (PI) in adult patients undergoing abdominal surgery and validate its effectiveness among these patients. Methods: This study retrospectively included 11,247 adult patients, who underwent abdominal surgery and postoperative supervision in ICU, in a tertiary care hospital in western China between January 2017 and December 2020. All datasets were extracted from the patient's medical records and randomly divided into the training cohort (8,997) and the validation cohort (2,250) by 8:2. The univariable logistic regression was used to select potentially relevant features. Then, multivariable logistic regression was also conducted and utilized to establish the nomogram. The nomogram was compared with the Braden scale for predicting PI in the validation cohort through the area under the curve (AUC) of the receiver operator characteristic (ROC) curve, Hosmer-Lemeshow (H-L) test, and decision curve analysis (DCA). Results: 873 (7.8%) patients suffered PIs. Logistic regression analysis showed that time of operation, weight, type of operation, albumin, and Braden scale score were independent risk factors for PI. A nomogram integrating five selected characteristics was constructed. The AUC of the ROC curve for the nomogram was 0.831, with a specificity of 85.2% and sensitivity of 63.7%. The AUC of the ROC curve for the Braden scale was 0.567, with a specificity of only 33.0%. The P-values of the H-L test were 0.45 (nomogram) and 0.22 (Braden scale), both indicating good calibration. The DCA also displayed that the nomogram had better predictive validity. Conclusion: Compared with the Braden scale, the nomogram showed a better predictive performance. This nomogram is informative and has the potential to better guide caregivers for risk stratification and prevention of PI, although it requires further validation.

Evaluation of a Functional Single Nucleotide Polymorphism of the SARS-CoV-2 Receptor ACE2 That Is Potentially Involved in Long COVID.

Since the occurrence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in December 2019, SARS-CoV-2 has led to a global coronavirus disease 2019 (COVID-19) pandemic. A better understanding of the SARS-CoV-2 receptor ACE2 at the genetic level would help combat COVID-19, particularly for long COVID. We performed a genetic analysis of ACE2 and searched for its common potential single nucleotide polymorphisms (SNPs) with minor allele frequency >0.05 in both European and Chinese populations that would contribute to ACE2 gene expression variation. We thought that the variation of the ACE2 expression would be an important biological feature that would strongly affect COVID-19 symptoms, such as "brain fog", which is highlighted by the fact that ACE2 acts as a major cellular receptor for SARS-CoV-2 attachment and is highly expressed in brain tissues. Based on the human GTEx gene expression database, we found rs2106809 exhibited a significant correlation with the ACE2 expression among multiple brain and artery tissues. This expression correlation was replicated in an independent European brain eQTL database, Braineac. rs2106809*G also displays significantly higher frequency in Asian populations than in Europeans and displays a protective effect (p = 0.047) against COVID-19 hospitalization when comparing hospitalized COVID-19 cases with non-hospitalized COVID-19 or SARS-CoV-2 test-negative samples with European ancestry from the UK Biobank. Furthermore, we experimentally demonstrated that rs2106809*G could upregulate the transcriptional activity of ACE2. Therefore, integrative analysis and functional experiment strongly support that ACE2 SNP rs2106809 is a functional brain eQTL and its potential involvement in long COVID, which warrants further investigation.

Fine Mapping and Functional Research of Key Genes for Photoperiod Sensitivity in Maize.

Maize is native to the tropics and is very sensitive to photoperiod. Planting in temperate regions with increased hours of daylight always leads to late flowering, sterility, leggy plants, and increased numbers of maize leaves. This phenomenon severely affects the utilization of tropical maize germplasm resources. The sensitivity to photoperiod is mainly reflected in differences in plant height (PH), ear height (EH), total leaf number (LN), leaf number under ear (LE), silking stage (SS), and anthesis stage (AT) in the same variety under different photoperiod conditions. These differences are more pronounced for varieties that are more sensitive to photoperiod. In the current study, a high-density genetic map was constructed from a recombinant inbred line (RIL) population containing 209 lines to map the quantitative trait loci (QTL) for photoperiod sensitivity of PH, EH, LN, LE, SS, and AT. A total of 39 QTL were identified, including three consistent major QTL. We identified candidate genes in the consensus major QTL region by combined analysis of transcriptome data, and after enrichment by GO and KEGG, we identified a total of four genes (Zm00001d006212, Zm00001d017241, Zm00001d047761, and Zm00001d047632) enriched in the plant circadian rhythm pathway (KEGG:04712). We analyzed the expression levels of these four genes, and the analysis results showed that there were significant differences in response under different photoperiod conditions for three of them (Zm00001d047761, Zm00001d006212 and Zm00001d017241). The results of functional verification showed that the expression patterns of genes rhythmically oscillated, which can affect the length of the hypocotyl and the development of the shoot apical meristem. We also found that the phenotypes of the positive plants were significantly different from the control plants when they overexpressed the objective gene or when it was knocked out, and the expression period, phase, and amplitude of the target gene also shifted. The objective gene changed its own rhythmic oscillation period, phase, and amplitude with the change in the photoperiod, thereby regulating the photoperiod sensitivity of maize. These results deepen our understanding of the genetic structure of photoperiod sensitivity and lay a foundation for further exploration of the regulatory mechanism of photoperiod sensitivity.

Genetic screening for hypertension and COVID-19 reveals functional variation of SPEG potentially associated with severe COVID-19 in women.

The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to more than 6.4 million deaths worldwide. The prevalent comorbidity between hypertension and severe COVID-19 suggests common genetic factors may affect the outcome of both diseases. As both hypertension and severe COVID-19 demonstrate sex-biased prevalence, common genetic factors between the two diseases may display sex-biased differential associations. By evaluating COVID-19 association signals of 172-candidate hypertension single nucleotide polymorphisms (SNPs) derived from more than 1 million European individuals in two sex-stratified severe COVID-19 genome-wide association studies from UK BioBank with European ancestry, we revealed one functional cis expression quantitative trait locus of SPEG (rs12474050) showing sex-biased association with severe COVID-19 in women. The risk allele rs12474050*T associates with higher blood pressure. In our study, we found it is significantly correlated with lower SPEG expression in muscle-skeletal but with higher expression in both brain cerebellum and cerebellar hemisphere. Additionally, nominal significances were detected for the association between rs12474050*T and lower SPEG expression in both heart left ventricle and atrial appendage; among these tissues, the SPEG expression is nominally significantly higher in females than in males. Further analysis revealed SPEG is mainly expressed in cardiomyocytes in heart and is upregulated upon SARS-CoV-2 infection, with significantly higher upregulation of SPEG only observed in female but not in male COVID-19 patients compared to both normal female and male individuals, suggesting upregulation of SPEG is a female-specific protective mechanism against COVID-19 induced heart damage. Taken together, our analyses suggest the involvement of SPEG in both hypertension and severe COVID-19 in women, which provides new insights for sex-biased effect of severe COVID-19 in women.

Effects of high temperature and high humidity stress on the negative feedback regulation of hippocampus on HPA axis in rats.

OBJECTIVE: To investigate the negative feedback regulation from rat hippocampus on hypothalamic-pituitary-adrenal (HPA) axis under high temperature and high humidity stress. METHODS: Thirty (30) SD male rats were randomly divided into three groups: control group, high temperature and high humidity group, drug intervention group. The rats in control group were kept in the environment with temperature of 24 ± 1°C and humidity of 50 ± 5%, without any stimulation. The rats in the other groups were exposed to high temperature and high humidity environment for 4 h each day, with temperature of 35±1 °C and humidity of 85±5%. The rats in drug intervention group were intragastrically administered with the glucocorticoid receptor antagonist mifepristone. The administration was continued for 3 weeks. After 3 weeks, the serum levels of corticotropin releasing hormone (CRH), adrenocorticotropic hormone (ACTH) and corticosterone (CORT) were detected by ELISA.The protein and mRNA levels of corticosteroid receptors (MR), glucocorticoid receptors (GR) and inducible nitric oxide synthase (iNOS), transient receptor potential vanilloid 1 (TRPV1) and 11ß-hydroxysteroid dehydrogenase 1 (11ß-HSD1) in hippocampus were determined by immunohistochemistry and in situ hybridization, respectively. The apoptosis of hippocampal cells was examined with TUNEL apoptosis staining. RESULTS: After stimulation with high temperature and high humidity stress for 3 weeks, the serum levels of CRH, ACTH and CORT in the high temperature and high humidity group were significantly increased compared to that of control group; the levels of these indicators in drug intervention group were decreased compared to that of high temperature and high humidity group (P<0.05). In high temperature and high humidity group, the protein and mRNA levels of MR, GR, iNOS in hippocampus of rats were significantly increased compared with that of control group (p<0.05); and the levels of these indicators in drug intervention group were lower than that of high temperature and high humidity group (p<0.05). In addition, compared with the control group, the TRPV1 protein level in hippocampus of rats in high temperature and high humidity group was not significantly changed (p>0.05), while the TRPV1 mRNA level was significantly increased (p<0.05). Neither the protein nor mRNA levels of 11ß-HSD1 showed significant difference compared to control group (p>0.05). The apoptosis of hippocampus cells in the high temperature and high humidity group was significantly increased compared with that of control group (p<0.05); and it was lower in the drug intervention group than that of in high temperature and high humidity group while the result was not significant (p>0.05). CONCLUSION: High temperature and high humidity stress may up-regulate the local expression of iNOS in hippocampus and decrease the activity of glucocorticoids (GC) receptor, then the effective binding of GR-GC would be decreased and the negative feedback regulation of hippocampus on HPA axis would be inhibited. The glucocorticoid receptor antagonist can improve the negative feedback regulation of hippocampus on HPA axis in rat.

New states of matter with fine-tuned interactions: quantum droplets and dipolar supersolids.

Quantum fluctuations can stabilize Bose-Einstein condensates (BEC) against the mean-field collapse. Stabilization of the condensate has been observed in quantum degenerate Bose-Bose mixtures and dipolar BECs. The fine-tuning of the interatomic interactions can lead to the emergence of two new states of matter: liquid-like self-bound quantum droplets and supersolid crystals formed from these droplets. We review the properties of these exotic states of matter and summarize the experimental progress made using dipolar quantum gases and Bose-Bose mixtures. We conclude with an outline of important open questions that could be addressed in the future.

The low-energy Goldstone mode in a trapped dipolar supersolid.

A supersolid is a counter-intuitive state of matter that combines the frictionless flow of a superfluid with the crystal-like periodic density modulation of a solid1,2. Since the first prediction3 in the 1950s, experimental efforts to realize this state have focused mainly on helium, in which supersolidity remains unobserved4. Recently, supersolidity has also been studied in ultracold quantum gases, and some of its defining properties have been induced in spin-orbit-coupled Bose-Einstein condensates (BECs)5,6 and BECs coupled to two crossed optical cavities7,8. However, no propagating phonon modes have been observed in either system. Recently, two of the three hallmark properties of a supersolid-periodic density modulation and simultaneous global phase coherence-have been observed in arrays of dipolar quantum droplets9-11, where the crystallization happens in a self-organized manner owing to intrinsic interactions. Here we directly observe the low-energy Goldstone mode, revealing the phase rigidity of the system and thus proving that these droplet arrays are truly supersolid. The dynamics of this mode is reminiscent of the effect of second sound in other superfluid systems12,13 and features an out-of-phase oscillation of the crystal array and the superfluid density. This mode exists only as a result of the phase rigidity of the experimentally realized state, and therefore confirms the superfluidity of the supersolid.

Effect of hand-ear acupuncture on chronic low-back pain: a randomized controlled trial.

OBJECTIVE: To evaluate the effect of hand-ear acupuncture on chronic low-back pain (cLBP). METHODS: This was an open, randomized and controlled trial in The General Hospital of Western Theater Command, Sichuan Province. The trial was registered with ClinicalTrials.gov, NCT02260284. All the 152 participates with cLBP were randomly assigned to hand-ear acupuncture (n = 54), standard acupuncture (n = 50), or usual care groups (n = 48). Eighteen treatments were provided over 7 weeks. Back-related dysfunction and symptom severity were assessed by the Roland-Morris Disability Questionnaire (RMDQ) and the Visual Analogue Scale (VAS), which were collected at baseline, 2 months and 6 months post to the treatment. RESULTS: At 6 months, the RMDQ scores improved by 7.74 points of hand-ear acupuncture group. Significant improvement of VAS and RMDQ was observed in hand-ear acupuncture group (P < 0.001), but no significant changes of RMDQ were observed in both standard acupuncture group and usual care group. We also observed an overall efficacy rate of 88.89% in hand-ear acupuncture group, as evaluated by Diagnosis and Curative Effect Standard for Symptom pattern of Traditional Chinese Medicine, which was much higher than 45.84% in the usual care group (H = 16.000, P < 0.001). CONCLUSION: Both of the hand-ear acupuncture and standard acupuncture modes have beneficial and persistent effectiveness against cLBP compared with the usual care. Furthermore, hand-ear acupuncture is significantly more effective than the standardized acupuncture, especially in the long term.

Ferrocene-terminated dendrimer functionalized graphene oxide layered sensor toward highly sensitive evaluation of Di(2-ethylhexyl) phthalate in liquor samples.

We demonstrate the use of a dendrimer functionalized graphene oxide (GO) to fabricate a novel sensitive ferrocene-terminated poly(amine) ester dendrimer (Fc-AED)-GO modified glassy carbon electrodes (Fc-AED/GO/GCE) for direct quantification of Di(2-ethylhexyl) phthalate (DEHP) in liquor sample. GO sheets were grafted on the Fc-AED molecules by the esterification reaction between carboxylic end group in Fc-AED and hydroxyl group on GO sheets so as to form Fc-AED-GO composites. Construction of electrochemical sensors using the structure of nanosized dendrimer can provide compact matrix for the incorporation of GO to improve the adhesion of GO on electrode, which would be more possible for the design of sensor to improve the film forming performance and then increase the electrochemical activity of the electrode. Additionally, it can directly use the redox probe of ferrcene to sense the content variation of analyte. The GO also provides a larger surface area to facilitate deposition of Fc-AED redox probe resulting in the increased current response of the modified sensor. The modified sensor exhibites a wide linear response to DEHP and a low detection limit of 0.06 µM with higher sensitivity, good selectivity, and a better reproducibility promising to be a useful tool in the DEHP evaluation. The outstanding performance of the developed sensor could be attributed to the synergistic effect of Fc-AED and GO. Possible redox mechanism of DEHP on Fc-AED/GO/GCE are proposed based on experimental results.

The Effect of Puerarin on Carotid Intima-media Thickness in Patients With Active Rheumatoid Arthritis: ARandomized Controlled Trial.

PURPOSE: Cardiovascular and diabetic complications are the main causes of death in patients with rheumatoid arthritis (RA). Puerarin has potential protective effects against subclinical atherosclerosis and insulin resistance, but the clinical evidence is still not sufficient to draw definitive conclusions. Therefore, we performed the clinical trial to assess the effect of puerarin on carotid intima-media thickness (CIMT) in RA. METHODS: This is an open, controlled, randomized, and parallel-group comparison study of 119 patients with a definite diagnose of active RA. All 119 consecutive patients with RA receiving routine antirheumatic care were randomized to receive treatment with (n = 60; 16 males and 44 females; mean age, 52.97 years; 95% CI, 49.78-56.15 years) or without (n = 59; 17 males and 42 females; mean age, 54.05 years; 95% CI, 50.03-58.07 years) 400mg of puerarin. The effects of both interventions on CIMT, homeostasis model assessment of insulin resistance (HOMA-IR) value, and possible adverse events were assessed and compared at entry, 12 weeks, and 24 weeks. The collected data were processed and assessed using ANCOVA, paired t test, repeated-measure ANOVA, one-way ANOVA, Pearson's χ2 test, Fisher exact test, Kaplan-Meier survival analysis, Pearson correlation, and LOESS (locally weighted smoothing) regression analysis. FINDINGS: No significant adverse effects occurred concerning the use of puerarin, and both interventions were generally well tolerated in all the patients. A tiny but significant decrease of CIMT was observed in puerarin-treated patients at 24 weeks (-0.003 mm; 95% CI, -0.005 to -0.001vs 0.019 mm; 95% CI, -0.002 to 0.040; P < 0.001). At 24 weeks, insulin resistance was indicated with more pronounced improvement in the puerarin group versus the control group (homeostasis model assessment, -0.40; 95% CI, -0.47 to -0.33vs -0.05; 95% CI, -0.08 to -0.01; P < 0.001). Correlation analysis indicated an interaction between the parallel reductions in CIMT and insulin resistance in the puerarin group (r = 0.878, P < 0.001) but not in the control group. IMPLICATIONS: In the study, 24 weeks of treatment with 400mg of puerarin exerted a significant effect against CIMT progression in patients with active RA, which may be associated with the improvement of insulin resistance. Puerarin holds promise as a drug candidate for the prevention and treatment of cardiometabolic comorbidities in patients with active RA. However, more strictly designed trials, such as double-blind and placebo-controlled trials, are still required. ClinicalTrials.gov identifier: NCT02254655.

Collisions of ultracold 23Na87Rb molecules with controlled chemical reactivities.

The collision of molecules at ultracold temperatures is of great importance to understand the chemical interactions at the quantum regime. Although much theoretical work has been devoted to this, experimental data are only sparsely available, mainly because of the difficulty in producing ground-state molecules at ultracold temperatures. We report here the creation of optically trapped samples of ground-state bosonic sodium-rubidium molecules with precisely controlled internal states and, enabled by this, a detailed study on the inelastic loss with and without the NaRb + NaRb → Na2 + Rb2 chemical reaction. Contrary to intuitive expectations, we observed very similar loss and heating, regardless of the chemical reactivities. In addition, as evidenced by the reducing loss rate constants with increasing temperatures, we found that these collisions are already outside the Wigner region although the sample temperatures are sub-microkelvin. Our measurement agrees semiquantitatively with models based on long-range interactions but calls for a deeper understanding on the short-range physics for a more complete interpretation.

Effect of methotrexate combined with Sanhuang Yilong decoction on serum and synovial fluid aquaporin levels in rheumatoid arthritis dampness-heat blockage syndrome.

OBJECTIVE: To study the effect of methotrexate (MTX) combined with Sanhuang Yilong decoction (SYD) on aquaporin (AQP) expression, and to explore the role of AQPs in the pathogenesis of rheumatoid arthritis (RA). METHODS: A total of 118 dampness-heat blockage type RA patients who were hospitalized in the General Chengdu Military Hospital between January 2014 and December 2016 were selected as subjects in this study (30 patient of these patients with knee joint effusion were assigned to the RA synovial fluid group). For the pre-treatment control groups, 30 healthy volunteers were recruited as the healthy control group and 30 osteoarthritis (OA) patients with knee joint effusion were included as OA synovial fluid control group. The RA dampness- heat blockage syndrome treatment groups were divided into 45 cases in the combined group and 45 cases in the MTX group. The combined group received MTX combined with SYD treatment while the MTX group received MTX alone. AQP1, AQP2 and AQP3 expressions were detected in the serum and synovial fluid. RESULTS: AQP1 had the highest expression, followed by AQP3, and AQP2. The serum levels of AQP1, AQP2 and AQP3 were all significantly lower than those in the healthy volunteers (P < 0.05), while the synovial fluid AQP1, AQP2 and AQP3 expression in the RA group were comparable to these in the OA groups (P > 0.05). After treatment for 2 weeks, serum AQP1, AQP2 , AQP3 were significantly increased and erythrocyte sedimentation rate, C-reactive protein, disease activity score of 28 joints were decreased in the combined group (P < 0.05). CONCLUSION: Abnormal expression of AQPs inhibits water metabolism in RA dampness-heat blockage syndrome, so liquid is accumulated at the joint, which may play an important role in the pathogenesis of RA. MTX combined with SYD for the treatment of RA can effectively increase AQP expression.

Effect of Artemisia annua extract on treating active rheumatoid arthritis: A randomized controlled trial.

OBJECTIVE: To investigate the effect and safety of the complementary use of the extract of Artemisia annua L. (EAA) on treating active rheumatoid arthritis (RA). METHODS: A randomized controlled clinical trial was performed. All the 159 participates with active RA were randomly assigned to the control group (80 cases) and EAA group (79 cases) using concealed random allocation method. In the control group, patients were medicated with leflflunomide and methotrexate for 48 weeks; and patients in the EAA group were administrated with leflflunomide, methotrexate plus EAA (30 g/d). At the time points of 0, 12, 24 and 48 weeks, the clinical outcome measures, including objective pain score, tenderness score, number of painful joints, number of swollen joints, health assessment questionnaire (HAQ) score for quality of life, levels of serum rheumatoid factor (RF), anti-cyclic citrullinated protein antibodies (CCP-Ab), erythrocyte sedimentation rate (ESR), C reactive protein (CRP), visual analogue score for pain (VAS), and the overall effificacy were detected and recorded. RESULTS: The objective pain score, number of painful joints and ESR at 12 weeks, tenderness score and HAQ at 24 weeks, and the tenderness score, number of painfull joints, number of swollen joints, HAQ, CRP, RF and CCP-Ab at 48 weeks were signifificantly improved in the EAA group compared with the control group (P<0.01 or P<0.05). At 24 and 48 weeks, the overall effificacy of the EAA group was signifificantly higher than the control group (P<0.01). There were signifificantly higher withdrawal rate of corticosteroids within 12 weeks post-treatment and lower incidence rate of adverse effects in the EAA group compared with the control group (P<0.01 or P<0.05). CONCLUSION: EAA plus methotrexate and leflflunomide were more effective and safer than the routine use of methotrexate and leflflunomide in the treatment of active RA.

Creation of an Ultracold Gas of Ground-State Dipolar

We report the successful production of an ultracold sample of absolute ground-state ^{23}Na^{87}Rb molecules. Starting from weakly bound Feshbach molecules formed via magnetoassociation, the lowest rovibrational and hyperfine level of the electronic ground state is populated following a high-efficiency and high-resolution two-photon Raman process. The high-purity absolute ground-state samples have up to 8000 molecules and densities of over 10^{11} cm^{-3}. By measuring the Stark shifts induced by external electric fields, we determined the permanent electric dipole moment of the absolute ground-state ^{23}Na^{87}Rb and demonstrated the capability of inducing an effective dipole moment over 1 D. Bimolecular reaction between ground-state ^{23}Na^{87}Rb molecules is endothermic, but we still observed a rather fast decay of the molecular sample. Our results pave the way toward investigation of ultracold molecular collisions in a fully controlled manner and possibly to quantum gases of ultracold bosonic molecules with strong dipolar interactions.

Effect of Sanhuangyilong decoction plus methotrexate on tumor necrosis factor alpha and interferon gamma in serum and synovial fluid in rheumatoid arthritis patients with symptom pattern of damp heat obstruction.

OBJECTIVE: To investigate the effect of Sanhuangyilong decoction plus methotrexate (MTX) on Interferon gamma (IFN-γ) and tumor necrosis factor alpha (TNF-α) in the serum and synovial fluid of rheumatoid arthritis (RA) patients with damp-heat-obstruction symptom pattern, Sanhuangyilong decoction and the role of TNF-α and IFN-γ in the development of RA. METHODS: RA inpatients with damp-heat-obstruction symptom pattern (partly with knee joint effusion) were selected as the research subjects. Before the treatment, healthy subjects and osteoarthritis (OA) patients with knee joint effusion were assigned to the serum control group and the synovial fluid control group, respectively; during the treatment, RA patients with damp-heat-obstruction symptom pattern were divided into two groups: one is combined group that was administered Sanhuangyilong decoction plus MTX; the other group was MTX group that received MTX only. The expression levels of TNF-α and IFN-γ in the serum and synovial fluid were measured with enzyme-linked immunosorbent assay (ELISA) before and after the treatment, and the peripheral blood levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and disease activity score in 28 joints (DAS28) were determined. RESULTS: Before treatment, the serum levels of TNF-α and IFN-γ in the RA patients with dampheat- obstruction symptom pattern were higher than those in healthy control group (P < 0.05).The expression levels of TNF-α and IFN-γ in the synovial fluid of the RA patients were higher than those in the serum of the RA patients (P < 0.05). The expression levels of TNF-α and IFN-γ in the synovial fluid of the RA patients were higher than those of the synovial fluid of the osteoarthritis patients (P < 0.05). The expression of TNF-α and IFN-γ in the serum and synovial fluid of the RA patients had no correlation with the inflammatory activity index ESR, CRP, or DAS28 (P > 0.05). After 2 weeks of treatment, the expression level of TNF-α and IFN-γ in the combined group had increased, although the difference was not statistically significant (P > 0.05); in contrast, ESR, CRP, and DAS28 decreased, and the difference was statistically significant (P < 0.01). After 4 weeks of therapy, TNF-alpha and IFN-γ, ESR, CRP, and DAS28 in the combined group decreased compared with the before-treatment levels (P < 0.01). After 2 w of treatment, the differences in the TNF-α and IFN-γ expression levels in the combined group were not statistically significant (P > 0.05) compared with that in the MTX group, although there were statistically significant differences in the ESR, CRP, and DAS28 (P < 0.05). After 4 weeks of treatment, differences in TNF-α, IFN-γ, ESR, CRP, and DAS28 in the combined group compared with MTX group were statistically significant (P < 0.01). CONCLUSION: TNF-α and IFN-γ might be involved in the development of RA. The RA patients with damp-heat-obstruction symptom pattern show better benefits from the treatment of Sanhuangyilong decoction plus MTX, and the treatment is superior to that of using MTX only.