IgG plasma cells initiate changes in the protein C system in mouse ulcerative colitis through CD14+CD64+ macrophage activation.

BACKGROUND: Inhibition of the protein C system (PCS) might be one of the mechanisms of ulcerative colitis (UC). OBJECTIVES: The aim of the study was to explore the role of IgG plasma cells in changes in the PCS in UC. MATERIAL AND METHODS: Dextran sulfate sodium (DSS) was chosen to induce mouse UC. Inflammation was assessed using hematoxylin & eosin (H&E) staining and immunofluorescence. The profiling of colonic plasma cells and macrophages from colitis mice was analyzed with flow cytometry. After stimulation of macrophages with IgG type immune complex (IgG-IC), western blot was used to determine tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6) protein levels. After co-incubation of colonic mucosa microvascular endothelial cells (MVECs) with TNF-α or IL-6, mitogen-activated protein kinase (MAPK) expression was detected. RESULTS: The DSS-colitis mice showed higher inflammatory indexes (p < 0.05 or p < 0.01), accompanied by greater infiltration of CD38+IgG+ plasma cells (p < 0.01), CD14+CD64+ macrophages (p < 0.01) and IgG-IC than healthy mice. Enhancement of TNF-α and IL-6 protein expression was demonstrated in this subset of macrophages when stimulated by IgG-IC (p < 0.01). After MVECs were incubated with TNF-α or IL-6, the expression of ß-arrestin1, pP38 MAPK and pJNK MAPK exhibited an increase (p < 0.05 or p < 0.01), but downregulation of endothelial protein C receptor (EPCR) expression was observed (p < 0.05 or p < 0.01); this inhibition of EPCR expression was reversed by SB203580, SP600125 or U0126 (p < 0.05 or p < 0.01). In addition, changes in activated protein C (APC) presented results similar to those for EPCR expression (p < 0.05 or p < 0.01). CONCLUSIONS: These results reveal that the PCS is inhibited during UC processing. There is a possibility that the interaction between IgG plasma cells and CD14+CD64+ macrophages, as well as further secretion of cytokines from CD14+CD64+ macrophages by the formation and stimulation of IgG-IC, subsequently influence MVECs through the ß-arrestin-MAPK pathway. Enhancement of PCS activity may represent a novel approach for treating UC.

Perioperative Blood Loss During Total Hip Arthroplasty Among Patients With Ankylosing Spondylitis.

Intraoperative blood loss is frequently an overarching concern during total hip arthroplasty (THA) for patients who have ankylosing spondylitis with hip involvement. However, the factors that affect blood loss have not been identified. The goal of this study was to investigate these factors among patients with ankylosing spondylitis. Patients in the authors' department who had ankylosing spondylitis and underwent unilateral THA from 2011 to 2016 were studied retrospectively. Demographic characteristics, perioperative laboratory values, intraoperative data, transfusion rate, transfusion volume, and data on hemostatic use were collected and analyzed statistically. Multiple and univariate linear regression analyses were performed. As a result, 44 patients were eligible for inclusion in the study. Mean age was 31.7±10.6 years, and mean disease duration was 9.7±5.8 years. Mean body mass index was 21.30±3.01 kg/m2. Mean volume of blood loss during THA was 1735.19±756.04 mL. Multiple linear regression analysis showed that perioperative blood loss was positively associated with Ankylosing Spondylitis Disease Activity Score (ASDAS), fibrinogen concentration, and surgical time. Further evaluation with univariate linear regression analysis suggested that ASDAS, red blood cell transfusion, and change of hematocrit concentration from preoperatively to postoperatively were correlated with blood loss. Disease activity, allogeneic blood transfusion volume, and change of hematocrit concentration from preoperatively to postoperatively appeared to be positively associated with perioperative blood loss during THA for patients with ankylosing spondylitis. For these patients, disease activity and the potential for allogeneic transfusion should be considered carefully before surgery. [Orthopedics. 2017; 40(5):e904-e910.].

[Study on the application of laparoscopy-assisted radical gastrectomy for gastric cancer in the elderly].

OBJECTIVE: To evaluate the feasibility and efficacy of laparoscopy-assisted D2 radical gastrectomy for elderly patients with gastric cancer. METHODS: From October 2007 to October 2012, 233 gastric cancer patients over 65 years underwent D2 lymph node dissection. Among them, 109 patients underwent laparoscopy-assisted radical gastrectomy(LAG group), while 124 patients underwent conventional open gastrectomy(OG group). RESULTS: Compared to the OG group, LAG group was associated with less bleeding [(102.5±34.3) ml vs. (181.7±73.8) ml, P<0.05], quicker postoperative recovery of bowel function[(2.8±0.6) d vs. (4.0±1.2) d, P<0.05], shorter postoperative length of hospital stay[(10.7±7.5) d vs.(14.2±6.5) d, P<0.05], longer operative time [(231.2±51.4) min vs. (208.5±53.6) min, P<0.05]. The postoperative complication rate of LAG group and OG group was 10.1%(11/109) and 21.0%(26/124) respectively(P<0.05). Short-term quality of life of LAG group was better than that of OG group(P<0.05). The 5-year survival rates were 54.5% and 59.2% in LAG and OG groups respectively, and there was no significant difference(P>0.05). CONCLUSIONS: Efficacy of laparoscopy-assisted D2 radical gastrectomy is similar to open gastrectomy in elderly gastric cancer patients with less invasiveness.

[A meta-analysis for the efficacy and safety of tourniquet in total knee arthroplasty].

OBJECTIVE: To evaluate the efficacy and safety of tourniquet in total knee arthroplasty. METHOD: Studies on comparison between with and without tourniquet in total knee arthroplasty were identified from Medline, PubMed, EMASE, Cochrane Library, CBM, Highwire, CNKI, VIP, Articles Digital Periodicals.All the randomized controlled trials were included for meta-analysis with RevMan 4.2.2 software. RESULTS: Nineteen studies involving 15 in foreign languages, 4 in Chinese were identified. There were 1159 cases of knee replacement patients. The results of meta-analysis indicated that there were statistical difference between two groups on intraoperative blood loss (P = 0.000), the number of deep venous thrombosis (P = 0.020), thigh pain (P = 0.000), knee hematoma (P = 0.030), wound infection (P = 0.040), skin ecchymosis area (P = 0.000), and the increasing rate of knee circumference of 3 days after the operation (P = 0.000), while there were no statistical differences with respect to the total blood loss (P = 0.100), the number of blood transfusions (P = 0.150), operation time (P = 0.120), length of hospital stay (P = 0.350), the number of pulmonary embolism (P = 0.310), and skin blisters (P = 0.170). CONCLUSIONS: The tourniquet for total knee arthroplasty can reduce intraoperative blood loss, but can not reduce total blood loss and the number of blood transfusions transfusion, can not improve operative efficiency, can not shorten the hospitalization time and promote the knee joint functional recovery. Furthermore the tourniquet increases the probability of occurrence on deep vein thrombosis, wound infection, hematoma and ecchymosis knee, it also causes knee swelling and thigh pain. It suggests minimize to use tourniquet in total knee arthroplasty.

[Early clinical outcomes of fixed-bearing versus mobile-bearing total knee arthroplasty].

OBJECTIVE: To compare the early clinical outcomes of primary total knee arthroplasty by a fixed-bearing versus mobile-bearing prosthesis. METHODS: A total of 80 patients with osteoarthritis at our hospital from January 2008 to October 2008 were sequentially and randomly assigned into Group A (fixed-bearing prosthesis) (40 knees) and Group B (mobile-bearing prosthesis) (40 knees). And the data of the range of motion (ROM), Knee Society Score (KSS) and Western Ontario MacMaster (WOMAC) were collected at pre-operation and 6, 12 and 24 months post-operation respectively. RESULTS: The P values were as follows: KSS: 0.754, 0.802, 0.561, 0.764; HSS (Hospital for Special Surgery): 0.737, 0.361, 0.254, 0.330; WOMAC (Western Ontario and McMaster Universities) osteoarthritis index: 0.976, 0.557, 0.946, 0.818; ROM follow-up: 0.519, 0.646, 0.175, 0.276. No significant differences were found in clinical outcomes between two groups. CONCLUSION: The fixed-bearing and mobile-bearing prostheses show no difference in clinical outcomes.

10-Hydroxy-2-decenoic acid from Royal jelly: a potential medicine for RA.

AIM OF THE STUDY: Rheumatoid arthritis synovial fibroblasts (RASFs) are known to produce matrix metalloproteinases (MMPs) and cause joint destruction. The purpose of this study is to develop a potential medicine for rheumatoid arthritis (RA). MATERIALS AND METHODS: To this end, first, the MMPs inhibition factor was purified from an alkali-solubilized fraction of RJ (Apis mellifera) by C18 reverse-phase column chromatography and identified as 10-hydroxy-2-decenoic acid (10H2DA) by LTQ XL analysis. Next, Experimental test 10H2DA how to inhibited the activities of MMPs: with RASFs isolated from rheumatoid tissues by enzymatic digestion, cultures in monolayers were treated with 10H2DA (0.5mM, 1mM, and 2mM) or PBS for 2h followed by stimulation with TNF-alpha (10 ng/ml) for 2h, mRNA. Protein levels of MMP-1 and MMP-3 were measured by real-time PCR and enzyme-linked immunosorbent assay (ELISA), the DNA-binding activity of activator protein-1 (AP-1) and nuclear factor kappaB (NF-kappaB) by electrophoretic mobility shift assay (EMSA), and the protein kinase activity of p38, ERK and JNK by kinase assay. RESULTS: The molecular investigation revealed that the 10H2DA-mediated suppression was likely to occur through blocking p38 kinase and c-Jun N-terminal kinase-AP-1 signaling pathways. In contrast, 10H2DA had no effect on extracellular signal-regulated kinase activity, NF-kappaB DNA-binding activity and IkappaBalpha degradation. CONCLUSION: These results suggest that 10H2DA may be of potential therapeutic value in inhibiting joint destruction in RA.

Control of diesel soot and NOx emissions with a particulate trap and EGR.

The exhaust gas recirculation (EGR), coupled with a high-collection efficiency particulate trap to simultaneously control smoke and NOx emissions from diesel engines were studied. This ceramic trap developed previously provided the soot cleaning efficiency of 99%, the regeneration efficiency reaches 80% and the ratio of success reaches 97%, which make EGR used in diesel possible. At the presence of EGR, opening of the regeneration control valve of the trap was over again optimized to compensate for the decrease of the oxygen concentration in the exhaust gas resulted from EGR. The results indicated the cleaning efficiency and regeneration performance of the trap were maintained at the same level except that the back pressure increased faster. A new EGR system was developed, which is based on a wide range oxygen (UEGO) sensor. Experiments were carried out under steady state conditions while maintaining the engine speed at 1600 r/min, setting the engine loads at 0%, 25%, 50%, 75% and 100% respectively. Throughout each test the EGR rate was kept at nine different settings and data were taken with the gas analyzer and UEGO sensor. Then, the EGR rate and engine load maps, which showed the tendencies of NOx, CO and HC emissions from diesel engine, were made using the measured data. Using the maps, the author set up the EGR regulation, the relationship between the optimal amounts of EGR flow and the equivalence ratio, sigma, where sigma = 14.5/AFR.