A unicenter real-world study of the correlation factors for complete clinical response in idiopathic inflammatory myopathies / 北京大学学报(医学版)

Objective:To investigate the correlation factors of complete clinical response in idiopathic inflammatory myopathies(IIMs)patients receiving conventional treatment.Methods:Patients diagnosed with IIMs hospitalized in Peking University People's Hospital from January 2000 to June 2023 were in-cluded.The correlation factors of complete clinical response to conventional treatment were identified by analyzing the clinical characteristics,laboratory features,peripheral blood lymphocytes,immunological indicators,and therapeutic drugs.Results:Among the 635 patients included,518 patients finished the follow-up,with an average time of 36.8 months.The total complete clinical response rate of IIMs was 50.0％(259/518).The complete clinical response rate of dermatomyositis(DM),anti-synthetase syn-drome(ASS)and immune-mediated necrotizing myopathy(IMNM)were 53.5％,48.9％and 39.0％,respectively.Fever(P=0.002)and rapid progressive interstitial lung disease(RP-ILD)(P=0.014)were observed much more frequently in non-complete clinical response group than in complete clinical re-sponse group.The aspartate transaminase(AST),lactate dehydrogenase(LDH),D-dimer,erythrocyte sedimentation rate(ESR),C-reaction protein(CRP)and serum ferritin were significantly higher in non-complete clinical response group as compared with complete clinical response group.As for the treat-ment,the percentage of glucocorticoid received and intravenous immunoglobin(IVIG)were significantly higher in non-complete clinical response group than in complete clinical response group.Risk factor analysis showed that IMNM subtype(P=0.007),interstitial lung disease(ILD)(P=0.001),eleva-ted AST(P=0.012),elevated serum ferritin(P=0.016)and decreased count of CD4+T cells in peripheral blood(P=0.004)might be the risk factors for IIMs non-complete clinical response.Conclu-sion:The total complete clinical response rate of IIMs is low,especially for IMNM subtype.More effec-tive intervention should be administered to patients with ILD,elevated AST,elevated serum ferritin or decreased count of CD4+T cells at disease onset.

Study on the extensibility of platelet donor gene database in Shaanxi / 中国输血杂志

【Objective】 To analyze the commonality and characteristics between voluntary blood donors and hematopoietic stem cell donors in this region, and explore the potential for integration and development between China Marrow Donors Program (CMDP) and voluntary blood donors, especially platelet donor databases, so as to improve recruitment success rate and inventory rate. 【Methods】 The database modeling and comparison methods were used to screen and stratify the matching and integration degree between the voluntary blood donors in recent 10 years and the marrow donors in the Shaanxi Branch of CMDP. The frequencies of HLA-A,-B alleles, HPA alleles and haplotypes were calculated with Arlequin 3. 5. 2. 2 software, and the matching probability of different platelet donor reserve pools was conducted according to the phenotypic frequencies. 【Results】 Among the voluntary donors with known HLA genotypes in this region, according to their blood donation behavior,the active blood donors excavated were divided into the first, second, third and fourth echelons of platelet donor reserve pools, with 696, 2 752, 9 092 and 12 028 donors, respectively. The first echelon had the highest proportion of 10-50 times of platelet donations and 10-20 times of whole blood donations, with 13.65% and 26.01%, respectively. The second echelon had 10-20 times of whole blood donations and 10-50 times of platelet donations, accounted for 15.04% and 1.38%, respectively, which were significantly different from other echelons' blood donation characteristics (P<0.05). With a database size of the existing platelet donor bank adding the first and second echelons (n=4 955), there was a 69.02% probability of matching at least one donor with matching HLA-A-B phenotype. When considering the matching ABO and HPA phenotypes, the probability of finding at least one donor with fully matching HLA, HPA and ABO isotype (type B as an example) was 48. 73%. 【Conclusion】 The three groups of whole blood donation, apheresis platelet donation and marrow donation in Xi'an area have a large cross-distribution. Compared with expanding the storage capacity from scratch, the active blood donors in CMDP database are the largest back-up force of platelet donors. While expanding the effective storage capacity, it can minimize the cost of building platelet donor bank and the demand for resources.

Berberine inhibits autophagy and promotes apoptosis of fibroblast-like synovial cells from rheumatoid arthritis patients through the ROS/mTOR signaling pathway / 南方医科大学学报

OBJECTIVE@#To evaluate the regulatory effect of berberine on autophagy and apoptosis balance of fibroblast-like synoviocytes (FLSs) from patients with in rheumatoid arthritis (RA) and explore the mechanism.@*METHODS@#The inhibitory effect of 10, 20, 30, 40, 50, 60, 70, and 80 μmol/L berberine on RA-FLS proliferation was assessed using CCK-8 method. Annexin V/PI and JC-1 immunofluorescence staining was used to analyze the effect of berberine (30 μmol/L) on apoptosis of 25 ng/mL TNF-α- induced RA-FLSs, and Western blotting was performed to detect the changes in the expression levels of autophagy- and apoptosis-related proteins. The cells were further treated with the autophagy inducer RAPA and the autophagy inhibitor chloroquine to observe the changes in autophagic flow by laser confocal detection of mCherry-EGFP-LC3B. RA-FLSs were treated with the reactive oxygen species (ROS) mimic H2O2 or the ROS inhibitor NAC, and the effects of berberine on ROS, mTOR and p-mTOR levels were observed.@*RESULTS@#The results of CCK-8 assay showed that berberine significantly inhibited the proliferation of RA-FLSs in a time- and concentration-dependent manner. Flow cytometry and JC-1 staining showed that berberine (30 μmol/L) significantly increased apoptosis rate (P < 0.01) and reduced the mitochondrial membrane potential of RA-FLSs (P < 0.05). Berberine treatment obviously decreased the ratios of Bcl-2/Bax (P < 0.05) and LC3B-II/I (P < 0.01) and increased the expression of p62 protein in the cells (P < 0.05). Detection of mCherry-EGFP-LC3B autophagy flow revealed obvious autophagy flow block in berberine-treated RA-FLSs. Berberine significantly reduced the level of ROS in TNF-α-induced RA-FLSs and upregulated the expression level of autophagy-related protein p-mTOR (P < 0.01); this effect was regulated by ROS level, and the combined use of RAPA significantly reduced the pro-apoptotic effect of berberine in RA-FLSs (P < 0.01).@*CONCLUSION@#Berberine can inhibit autophagy and promote apoptosis of RA-FLSs by regulating the ROS-mTOR pathway.

Clinical characteristics of psoriatic arthritis and the concomitant diseases / 中华风湿病学杂志

Objective:To explore the differences on clinical characteristics, concomitant diseases and treatment status between psoriasis and psoriatic arthritis (PsA), and provide clues for the early diagnosis and treatment of PsA.Methods:Data were collected by in-person interview of 225 patients with psoriasis and 299 patients with PSA who visited the department of rheumatology and Immunology and Department of Dermatology in People′s Hospital of Peking University from November 2020 to May 2021. After informed consent, the questionnaire was completed on site. The differences of clinical characteristics, concomitant diseases, mental health evaluation and treatment status between patients with arthritis (PsA) and patients with psoriasiswere analyzed and compared. Enumeration data were described by frequency. Chi square test was used to compare categorical variables. Multivariate Logistic regression analysis was used to determine the independent risk factors. P value of less than 0.05 was considered statistically significant. Results:Dactylitis [ OR(95% CI)=8.439(4.677,15.226), P<0.001], hip pain [ OR(95% CI)=3.442(1.829,6.480), P<0.001], heel pain [ OR(95% CI)=2.621(1.652,4.157), P<0.001] and low back pain [ OR(95% CI)=1.924(1.156,3.203), P=0.012] may be closely related to the progression of PsA ( P<0.05). The three most common concomitant diseases of patients with PsA and psoriasis both were overweight [43.1%(129/299)、29.3%(66/225)], fatty liver [(28.4%(85/299)、23.1%(52/225)]and hypertension[24.1%(72/299、13.3%(30/225)]. The proportion of osteoporosis in PsA group at the age of 30-39 and 40-49 years old was significantly higher than those in psoriasis group (30-39 years old:12.5%(10/80) vs 1.5%(1/65), χ2=6.14, P=0.013; 40~49 years old: 19.2%(15/78) vs 2.0%(1/51), χ2=8.46, P=0.004]. The proportion of hypertension in PsA group was also higher than that in psoriasis group at the age of 40~49 years old[7.0% (21/78) vs 2.7%(6/51), χ2=4.99, P=0.026)]. And the proportion of fatty liver in PsA group was also higher than that in psoriasis group at the age ≥60 years old [(46.0%(23/50) vs 29.1(7/24), χ2=4.99, P=0.025)]. Among 299 PsA patients, 47.1%(141/299) had anxiety tendency, 45.2%(135/299) had sleep disorder and 41.8%(125/299) had depression tendency. Among 225 psoriasis patients, 44.4%(100/225) had anxiety tendency, 40%(90/225) had sleep disorder and 36.9%(83/225) had depression tendency, there was no significant difference in above-mentioned situations between the PsA and psoriasis patients ( P>0.05). Conclusion:More attention should be paid to the management of concomitant diseases and psychological intervention in patients with PsA. When psoriasis patients occur with heel pain, dactylitis, low back pain and hip pain, the risk of development into PsA should be considered.

Correlation of serum FABP4 and PPAR γ levels with nonalcoholic fatty liver disease and type 2 diabetes mellitus / 中华内分泌外科杂志

Objective:To explore the correlation between serum adipocyte fatty acid binding protein 4 (FABP4) and peroxisome proliferator activated receptor gamma (PPAR gamma) levels and metabolism related fatty liver disease (MAFLD) and type 2 diabetes mellitus (T2DM) .Methods:230 patients with T2DM and MAFLD in Zhangjiakou First Hospital from Feb. 2019 to Feb. 2021 were selected. According to their disease conditions, 80 patients with T2DM and without MAFLD were set as simple T2DM group, 78 patients with MAFLD and normal glucose tolerance were set as simple MAFLD group, 72 patients with T2DM and MAFLD were set as T2DM and MAFLD group, and 100 healthy volunteers in the same period were selected as the control group.Results:The levels of HOMA-IR and FABP4 in T2DM patients were significantly higher than those in the control group ( P<0.05) , while the levels of HDL-C, crea and PPAR γ in T2DM grou were significantly lower than those in the control group ( P<0.05) . The levels of BMI, AST, alt, GGT, TG, HOMA-IR and FABP4 in MAFLD group were significantly higher than those in control group ( P<0.05) , while the level of PPAR γ in MAFLD group was significantly lower than that in control group ( P<0.05) . BMI, AST, alt, GGT, TG, HOMA-IR and FABP4 of T2DM patients with MAFLD were significantly higher than those of T2DM patients without MAFLD and control group ( P<0.05) , while HDL-C and PPAR γ were significantly lower than those of T2DM patients without MAFLD and control group ( P<0.05) . HOMA-IR and FABP4 in T2DM patients with MAFLD were significantly higher than those in MAFLD group ( P<0.05) , while HDL-C, crea and PPAR γ were significantly lower than those in MAFLD group ( P<0.05) . FABP4 was positively correlated with HOMA-IR and CREA (all P<0.05) , and negatively correlated with HDL-Cand PPAR γ (all P<0.05) . PPAR γ was positively correlated with TG and ALT (all P<0.05) , and negatively correlated with HOMA-IR ( P<0.05) . Alt, TG, HOMA-IR, FABP4 and PPAR γ were independent risk factors for MAFLD in T2DM patients ( P<0.05) . Conclusion:FABP4 is positively correlated with the occurrence of T2DM and MAFLD, PPAR γ is negatively correlated with the occurrence of T2DM and MAFLD, the negative feedback loop regulation of FABP4 and PPAR γ can cause the occurrence of insulin resistance, so as to improve the risk of T2DM combined with MAFLD, and provide clinical basis for clinical disease prevention and treatment.

Effect of perioperative transcutaneous electrical acupoint stimulation on postoperative cellular immune function in patients undergoing posterior spinal internal fixation / 中华麻醉学杂志

Objective:To evaluate the effect of perioperative transcutaneous electrical acupoint stimulation (TEAS) on postoperative cellular immune function in the patients undergoing posterior spinal internal fixation.Methods:Ninety patients, aged 40-70 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, undergoing elective posterior spinal internal fixation in our hospital, were divided into 2 groups ( n=45 each) using a computer-generated table of random numbers: routine group and experiment group.Total intravenous anesthesia was used in routine group, while total intravenous anesthesia combined with TEAS was applied in experiment group.In experiment group, bilateral Zusanli and Sanyinjiao acupoints were stimulated with 2/15 Hz disperse-dense waves at the intensity that could be tolerated by patients at 30 min before induction of anesthesia, maintaining with 2/100 Hz disperse-dense waves from the end of induction until the end of operation at the same stimulation intensity before induction.Bilateral Neiguan and Taichong acupoints were stimulated for 30 min each time with 2/15Hz disperse-dense waves once a day at 1st-4th days after operation.In routine group, the electrodes were connected at the same time period, but no stimulation was given.Venous blood samples were collected before induction of anesthesia, at 1 h after surgery, and on 1st, 3rd, and 5th days after surgery, and the percentage of CD3 + , CD4 + , CD8 + T lymphocytes, CD4 + /CD8 + ratio, WBC count and percentage of neutrophils (NE%) were determined by flow cytometry, and the consumption of intraoperative anesthetics, use of postoperative analgesics, nausea and vomiting, dizziness, infection and length of hospital stay were recorded. Results:Compared with routine group, the total consumption and consumption index of remifentanil were significantly decreased, the percentage of CD3 + T lymphocytes was increased on 3rd and 5th postoperative days, the NE% was decreased on 1st postoperative day, and the incidence of dizziness was decreased ( P<0.05), and no significant change was found in the other indicators in experiment group ( P>0.05). Conclusions:Perioperative TEAS can improve postoperative cellular immune function and has a certain potential value in preventing postoperative infection in the patients undergoing posterior spinal internal fixation.

The capacity evaluation and utilization strategy of the platelet donor database with known HLA/HPA genotype in Shaanxi / 中国输血杂志

【Objective】 To evaluate the appropriate optimal capacity and matching probability of the platelet donor database with known HLA/HPA genotype in Shaanxi aera, and provide data support for subsequent construction, maintenance and application of the local platelet donor database. 【Methods】 A total of 11 755 individuals from the Shaanxi Branch of China Marrow Donor Program, 401 and 249 unrelated random platelet donors in Shaanxi aera were enrolled to the population study of HLA-A, -B polymorphisms, HPA genotyping and CD36 antigen expression, respectively. The frequencies of HLA-A, -B alleles, HPA alleles and haplotypes were calculated with Arlequin 3. 5. 2. 2 software; matching probability and capacity evaluation of platelet donor database was conducted according to the phenotypic frequencies. 【Results】 The population genetic and phenotypic polymorphisms data of HLA-A, -B and HPA1-6, 10, 15, 21 in Shaanxi aera were obtained. The frequency of CD36 type Ⅰ or Ⅱ deficiency was 0.40%(1/249). According to the subsequent calculating and deriving, with a database size of 194 donors, the patient having approximate 95% probability could achieve matching of HPA1-6, 10, 15, 21 genotype. With a database size of 1500 donors, there is a 95% probability of matching at least one donor with HLA-A-B phenotype frequency >0.002 or haplotype frequency >0.001; meanwhile, the probability of matching a cross-reactive group donor should be 44.95%-97.57%. Based on database size of 8 856 and 15 033, the probabilities of matching HLA-A, -B phenotype were about 80% and 90%, respectively. 【Conclusion】 The differences in the distribution of HLA/HPA polymorphism in different regions make the establishment mode and optimal capacity of platelet donor database different. It is necessary to apply a variety of platelet matching transfusion strategies to expand the range of donor selection, thereby effectively reducing the database construction cost and resource requirements.

Evaluation on the effects of multidisciplinary cooperative nutrition management model in acute stroke patients with dysphagia / 中华临床营养杂志

Objective:To analyze the effects of multidisciplinary cooperative nutrition management model in acute stroke patients with dysphagia.Methods:From February 2019 to February 2020, 69 acute stroke patients with dysphagia were enrolled in this study. After exclusion of those unable to complete the trial, patients were randomized into control group ( n=30) and experimental group ( n=30). Patients in the control group were given routine nutrition management, while patients in the experimental group were treated under multidisciplinary cooperative nutrition management model. Nutritional indicators were compared between the two groups on Day 1, 7 and 14 after admission, including levels of albumin (ALB), pre-albumin (PALB), hemoglobin (HB), triceps skin-fold (TSF) thickness on the uninjured side, upper arm muscle circumference etc. Incidence of gastrointestinal complications and infectious complications was also recorded. Results:There was no difference between two groups in the levels of HB, TSF thickness and upper arm muscle circumference on the uninjured side (all P>0.05). However, the serum levels of ALB and PALB on Day 7 and 14 in the experimental group were higher than that in the control group(all P<0.05), The incidence of gastrointestinal complications ( P=0.015)and infectious complications ( P=0.016) in the experimental group was lower than that in the control group. Conclusion:Multidisciplinary collaborative nutrition management improved nutritional indicators, reduced the incidence of gastrointestinal complications and infectious complications in acute stroke patients with dysphagia, making multidisciplinary collaborative nutrition management model worthy of clinical promotion and application.

Emerging infectious diseases in voluntary blood donors in parts of China: Based on metagenomics analysis / 中国输血杂志

【Objective】 To analyze the metagenomics and microbiology of voluntary blood donors in China, so as to assess the potential threats of emerging infectious diseases to the safety of blood transfusion. 【Methods】 12 300 plasma samples (10 mL each) collected by central blood stations in Chongqing, Liuzhou, Urumqi, Mianyang, Wuhan, Nanjing, Mudanjiang, and Dehong Prefecture area from 2012 to 2018 were subjected to total DNA extraction after ultracentrifugation (32 000 rpm/min, centrifugal radius 91.9 mm) in minipools of 160 donations. The metagenomic library was constructed, and deep sequencing was conducted by Illumina Hiseq 4 500. By comparing with reference sequences of bacteria, fungi, parasites and viruses, metagenomic data were analyzed, classification of microbes were identified, and potentially harmful pathogens were evaluated. 【Results】 A total of 632 GB clean data were obtained by deep sequencing, and the top three pathogens were Pseudomonas(0.561 1%), Burkholderia(0.468 7%) and Serratia(4.242 0%). Pathogens with potential threat which could be transmitted by blood transfusion or blood products were found, such as human parvovirus B19(0.126 6%), Leishmania spp(1.348 5%) and Toxoplasma gondii(0.615 8%). 【Conclusion】 Our study analyzed metagenomics of voluntary blood donors in parts of China and revealed pathogens that may cause potential harm to blood safety, which were helpful for targeted prevention and control of emerging infectious diseases.

Mental health status in close contacts of COVID-19 infections undergoing centralized quarantine and observation / 四川精神卫生

ObjectiveTo explore the prevalence rate and related risk factors of anxiety， depression and insomnia symptoms in close contacts of COVID-19 patients undergoing centralized quarantine and observation， so as to provide references for follow-up targeted psychological crisis intervention. MethodsFrom February 6 to 8， 2020， a total of 136 close contacts at designated quarantine sites in four districts and counties of Ya'an city were enrolled， and assessed using the general information questionnaire， Hospital Anxiety and Depression Scale （HAD） and Insomnia Severity Index （ISI）. ResultsA total of 26 quarantined individuals （19.12%） had various degrees of anxiety， depression or insomnia， including 16 cases （11.76%） with anxiety， 9 cases （6.62%） with depression and 16 cases （11.76%） with insomnia. Correlation analysis showed that HAD （A） score was positively correlated with HAD （D） score （r=0.642， P<0.01）. HAD （A） score was positively correlated with ISI score （r=0.590， P<0.01）. HAD （D） score was positively correlated with ISI score （r=0.329， P<0.01）. Multivariate Logistic regression analysis showed that the risk factor of anxiety was the first week of isolation （OR=3.290， P<0.05）， meantime， the risk factors of insomnia included the old age （OR=7.990， P<0.05） and the first week of isolation （OR=4.659， P<0.05）. ConclusionThe close contacts of COVID-19 infections undergoing centralized quarantine and observation in Ya’an have high prevalence rate of anxiety and insomnia， and the symptoms are most severe during the first week of quarantine.

Trigeminal neuropathy as a complication of systemic sclerosis: case reports and literature review / 中华风湿病学杂志

Objective:Our study aimed to investigate clinical and immunological features, and prognosis of systemic sclerosis (SSc) complicated with trigeminal neuropathy (TN).Methods:Data of SSc-associated TN were collected from clinical records in Peking University People's Hospital between January 2009 and July 2019.Results:Five cases collected from our cohort and 8 cases from literature. Out of 13 cases, 11 were females, with the average age of (50±9) years. TN occurred before, concurrent, or after SSc. Raynaud's phenomenon (100%, 13/13), lung involvement (75%, 9/12) and esophageal dysfunction (60%, 6/10) were key clinical features of SSc-associated TN patients. Twelve cases received blink reflex tests and 10 of them had positive results. In SSc-associated TN patients, ANA was detected in 92% (11/12) of cases, anti-Scl-70 antibody was detected in 40% (4/10) of cases, and anti-RNP antibody was detected in 36% (4/11) of patients. Elevated ESR and immunoglobulin were found in 43% (3/7) of patients, and 57% (4/7) of patients, respectively. Symptoms of nervous system gradually improved after treated with glucocorticoid and immuno-suppressants.Conclusion:TN is identified as a complication of SSc. SSc patients with Raynaud's pheno-menon, lung involvement, esophageal dysfunction, positive ANA, anti-Scl-70 antibody and anti-RNP antibody are prone to develop TN and should receive more effective intervention. Blink reflex test is useful for patients with SSc-associated trigeminal sensory neuropathy.

Study on HPLC Fingerprints of Zhuang and Yao Medicine Lespedeza formosa Based on Cluster Analysis and Principal Component Analysis / 中国药房

OBJECTIVE： To establish HPLC fingerprint of Zhuang and Yao medicine Lespedeza formosa， and to provide reference for quality control of L. formosa from different producing areas. METHODS： Totally 10 batches of samples were collected from 5 producing areas as Guangxi Nanning， Guilin， Wuzhou and so on. HPLC fingerprints was established and similarity analysis was carried out by using “Similarity evaluation system of TCM chromatographic fingerprint” （2012 edition） software. The determination was performed on Inertsil ODS-3 column with mobile phase consisted of acetonitrile-0.2％ phosphoric acid solution （gradient elution） at the flow rate of 0.8 mL/min. The detection wavelength was set at 350 nm， and the column temperature was 35 ℃. The sample size was 10 μL. Common peaks were identified by comparing substance control. Cluster analysis and principal compoent analysis were performed by using IBM SPSS 21.0 statistical software. RESULTS： HPLC fingerprint was established， and 12 common peaks were calibrated. 3 common peaks were identified （common peak 8， 10， 11 were chafotalin， vitexin and isovitexin）. The similarity of 10 batches of samples were all higher than 0.9. Through cluster analysis， 10 batches of medicinal materials could be clutered into 2 groups. According to the principal component analysis， the cumulative variance contribution rate of the two principal component factors was 86.108％ （contribution rates of first principal components and second principal components were 66.891％ and 19.217％）. CONCLUSIONS： HPLC fingerprint of L. formosa is established successfully. The method is simple and easy to use， provides a reliable evalution method for quality control of L. formosa.

Effect of acupuncture on TGF-β1/Smads pathway in mice with airway remodeling mic / 南方医科大学学报

OBJECTIVE@#To investigate the effect of acupuncture on TGF-β1/Smads signaling pathway in the lung tissue of mice with airway remodeling.@*METHODS@#Thirty specific pathogen-free mice were randomly divided into blank group, model group and acupuncture group (=10). Mouse models of asthma were established in the model group and the acupuncture group, and the mice in the latter group received 7 acupuncture therapies (at bilateral Fei Shu, Da Zhui and Zu Sanli, 20 min each time) every other day, starting on the 10th day after the modeling. At 24 h after the last acupuncture, the mice were subjected to inhalation of 1% OVA for 3 days, and 24 h after the last challenge, the mice were given methacholine chloride (Mch) inhalation at different concentrations for measurement of lung resistance using a noninvasive stroke volume meter. HE staining was used to observe the pathological changes in the lung tissues, and TGF-β1 levels in the the bronchoalveolar lavage fluid (BALF) and serum were detected using ELISA; Western blotting was used to detect the differential protein expressions in the airway smooth muscles between the two groups. The airway smooth muscle cells were isolated from the mice in the acupuncture group and treated with a TGF- β1 inhibitor (LY2157299), and the relative expressions of type-Ⅰ and Smads proteins were detected using Western blotting.@*RESULTS@#The mice in the model showed obvious tracheal fistula with airway pathologies including lumen narrowing, bronchial mucosa thickening, dissociation of the epithelial cells, and thickening of the alveolar septum and airway smooth muscles. These pathological changes were obviously milder in the acupuncture group. The asthmatic mice exhibited significantly increased lung resistance in positive correlation with Mch concentration. Serum TGF-β1 level was significantly elevated in asthmatic mice ( < 0.05); TGF-β1 levels in the serum and BALF were significantly lower in the acupuncture group than in the model group ( < 0.05). In the model group, the expressions of -SMA, TGF-β1 and Smads in the airway smooth muscles were significantly higher than those in the other two groups (both < 0.05). In cultured airway smooth muscle cells, the expressions of type-Ⅰ and Smads were significantly higher in cells treated with LY2157299 than in the control cells (>0.05).@*CONCLUSIONS@#Acupuncture can inhibit airway remodeling by inhibiting the expression of airway TGF-β1 and down-regulating the expression of Smads and -SMA to reduce airway inflammatory response. Airway expressions of type-Ⅰ and Smads proteins remain high after inhibiting TGF-β1. Acupuncture may control asthma progression through the TGF-β1/Smads pathway.

Lymphoma mimicking Beh?et's disease:case report and literature review / 中华风湿病学杂志

Objective To study the clinical char acteristics and outcome of two lymphoma patients mimicking Beh?et's disease. Methods Lymphoma was diagnosed in two patients mimicking Beh?et's disease referred to our Department in 2015. A search on published similar cases in Chinese database and the Pubmed was also performed and then analyzed. Results Eight patients were indentified in this pooled analysis, six of which were non-Hodgkin lymphoma (NHL). All of the eight cases presented with cutaneous lesion, seven cases with fever, seven cases with oral ulceration and six cases with orogenital ulceration, respectively. Ocular involvement was present in four of the eight cases, two were with a positive pathergy test. Among feverish patients, six were moderate or high fever, four were high fever, one was low-grade fever. Neutropenia was found in four patients, and lymphocytoponia in four of five patients with detailed data. All patients fulfilled the 2014 International Criteria for Beh?et's Disease (ICBD) with an average score of (5.8 ±1.5), ranging from 4 to 8. Survival period ranged from one month to 36 months, with an average of 8 months. Conclusion For patients diagnosed as Beh?et's disease are finally diagnosed as lymphoma. For patients with Beh?et's disease present-ation but also present with mediate to high fever, atypical deepseated ulcer, neutropenia or lymphocytoponia, malignancy especially lymphoma should be investigated.

Anti-aging Effect Study of Ethyl Acetate Extract from Folygonum multiflora on Caenorhabditis Elegans / 中国药房

OBJECTIVE:To study the lifespan effect of ethyl acetate extract from Polygonum multiflora(EPM)on caenorhab-ditis elegans,and to investigate its anti-aging effect. METHODS:EPM low-concentration,medium-concentration and high- concen-tration groups(25,37.5,50 mg/L,calculated by crude drug)and blank group(0 mg/L)were established to investigate the effects of EPM on the lifespan of caenorhabditis elegans. EPM group(37.5 mg/L)and blank group(0 mg/L)were established to perform re-productive test,acute heat stress test and acute oxidative stress test of caenorhabditis elegans. The effects of EPM on reproductive capacity and pressure stress of caenorhabditis elegans were investigated. RESULTS:The lifespan test,average lifespan of cae-norhabditis elegans in EPM low-concentration,medium-concentration and high-concentration groups were prolonged significantly, compared to blank group(P<0.05 or P<0.01),especially in EPM medium-concentration group. In reproductive test,the number of offspring of caenorhabditis elegans in EPM group on the second and third day were increased significantly,compared to blank group (P<0.05). In acute heat stress test and acute oxidative stress test,average survival time of caenorhabditis elegans in EPM group was prolonged significantly(P<0.05). CONCLUSIONS:37.5 mg/L EPM can retard the aging process of caenorhabditis ele-gans and doesn’t damage the reproductive capacity.

The clinical and immunological feat ures of idiopathic inflammatory myopathy patients with rapid progressive interstitial lung disease / 中华风湿病学杂志

Objective To investigate the clinical and immunological features of rapid progressive interstitial lung disease (ILD) in patients with idiopathic inflammatory myopathy (ⅡM).Methods The medical records of 146 adult ⅡM patients associated with ILD in Peking University People's Hospital from February 1996 to February 2015 were retrospectively analyzed.They were divided into three subgroups:the classic DM,PM and the clinical amyopathic dermatomyositis (CADM),and were further stratified based on with or without rapid progressive ILD (RP-ILD).Chi-squared test was used for group comparisons of categorical data and independent-sample t test for numerical data.Results ① Among 146 patients,62 (42.5％) developed RP-ILD.The prevalence of RP-ILD in CADM was signifcantly higher than dermatomyositis (DM) and polymyositis (PM).② ILD occurred after or at the same time with ⅡM in more than 90％ of patients.ILD arising before or simultaneously with DM (named early-onset ILD) tended to progress rapidly.③ For the DM group,mechanic's hands,fever,lymphopenia,hypoxemia,hypoalbuminemia,and the elevation of globulin α1 were associated with RP-ILD.CADM-ILD with weakness of swallow muscles,increasing C-reactive protein (CRP) and globulin α2,decreased vital capacity and the relatively high level of segmented granulocytes in bronchoalveolar lavage fluid tended to undergo a rapid progressive clinical course.Additionally,the decreased free triiodothyronine (FT3) and the elevation of tumor markers including carcino-embryonic antigen (CEA),neuron specific enolase (NSE),cytokerantin-19-fragment (CYFRA211) and ferritin were significantly more frequent both in DM and CADM with RP-ILD (P＜0.05) patients.④ According to multivariate analysis,mechanic's hands [HR =31.747,95％CI (2.367,425.817),P=0.009] and the elevation of CEA [HR =57.047,95％CI (1.140,2 854.885),P=0.043] and CRP [HR=31.568,95％CI (1.818,548.093),P=0.018] were potential predictive factors for RP-ILD in DM and CADM patients,respectively.Conclusion The prevalence of RP-ILD in CADM is higher than DM and PM.ILD usually occurs after or simultaneously with ⅡM,early-onset ILD in DM patients tends to progressive rapidly.Increased tumor markers and decreased FT3 indicate the deterioration of disease.Mechanic's hands and the elevation of CEA and CRP are potential predictive factors for RP-ILD in DM and CADM patients,respectively.

Ultrasound molecular imaging of endothelial vascular endothelial growth factor recptor-2 expression during hind-limb ischemia-mediated angiogensis / 中华超声影像学杂志

Objective To explore the feasibility of evaluation of mice hind limb ischemia-mediated angiogenesis with ultrasound molecular imaging using molecular probes targeted to angiogenesis endothelial marker VEGFR-2.Methods A mice model of unilateral hind-limb ischemia was induced by femoral artery excision in 12 experimental mice.Ultrasound molecular imaging of the ischemia and contralateral non-ischemia hind-limbs was performed in all mice on day 7 after surgery at 8 minutes after intravenous injection of either VEGFR-2 targeting microbubbles or isotype control microbubbles in random with 30 min interval,and the video intensity (VI) was measured.Following ultrasound imaging,the hind-limb was harvested for immunohistochemical analysis.Results As expected,VI in the ischemia hind-limb was significantly higher (P ＜0.05) for MBvEGFR-2 [(25.6 ± 4.3)U] as compared with MBIso[(6.7 ± 1.6)U].However,the ultrasound signal in the non-ischemia hind-limb was low for both MBvEGFR-2 [4.4 ± 1.5)U] and MBIso [(4.6 ± 1.6)U].A marked endothelial VEGFR-2 expression in ischemia hind-limb was confirmed by immunohistochemistry.Conclusions Ultrasound molecular imaging using molecular probes targeted to angiogenesis endothelial VEGFR-2 can effectively evaluate ischemia-mediated angiogenesis.

Effects of early enteral nutrition support on the nutritional status and outcomes of patients with post-stroke dysphagia / 中华临床营养杂志

Objective To evaluate the effect of enteral nutrition support on the nutritional status and clinical outcomes of patiems with dysphagia after stroke.Methods 148 patients with acute stroke and associated dysphagia were enrolled from August 2013 to July 2014 in the Fifth Affiliated Hospital of Zhengzhou University,and randomly divided into 2 groups by drawing lots within 48 hours after admission:enteral nutrition group (n =75,early enteral nutrition support) and control group (n =73,routine diet).The nutritional status (triceps skinfold thickness,levels of serum total protein,albumin and hemoglobin),incidence of lung infection,mortality,and neurological function were compared between the two groups on day 1 and day 21 after admission.Results On day 1 after admission,the triceps skinfold thickness,levels of serum total protein,albumin,and hemoglobin in the enteral nutrition group were not significantly different from those in the control group [(15.4 ±4.1) mm vs.(15.1 ± 3.7) mm,t=1.36,P=0.392; (75.7±2.6) g/Lvs.(76.6±3.1) g/L,t=1.12,P=0.254; (39.2± 1.8) g/Lvs.(38.7±2.1) g/L,t=1.24,P=0.200; (137.4±14.5) g/Lvs.(135.1±15.3) g/L,t=1.01,P =0.461].On day 21 after admission,all the 4 nutrition indicators were significantly higher in the enteral nutrition group than in the control group [(13.5 ±3.9) mmvs.(11.2±4.6) mm,t=2.08,P=0.019; (63.3±4.1) g/Lvs.(57.1±4.7) g/L,t=4.01,P=0.001; (35.7±1.6) g/Lvs.(34.1± 2.0) g/L,t=2.31,P=0.022; (125.7 ±17.9) g/Lvs.(120.3 ±16.7) g/L,t=2.39,P=0.027].The enteral nutrition group showed lower incidence of lung infection,mortality,and reduced scores of American National Institutes of Health Stroke Scale compared with the control group (41.3％ vs.63.2％,x2 =9.69,P =0.002; 15.3％ vs.21.2％,x2=3.27,P=0.014; 11.1 ±4.1 vs.14.7 ±3.9,t=2.98,P=0.007).Conclusions Early enteral nutrition support can improve the nutritional status and outcomes of stroke patients with dysphagia.In addition,early enteral nutrition support may also be helpful for the improvement of the neurological function.

Multiple myeloma presented as polyart hritis: case reports and literature review / 中华风湿病学杂志

Objective We reported 5 unusual cases of multiple myeloma (MM) initially presented as polyarthritis.Special attention should be paid to this very unusual scenario.Methods Five cases who presented initially as polyarthritis and finally diagnosed as MM were administered to Peking University People's Hospital and 11 cases from literature were reported.The clinical symptoms and laboratory parameters were analyzed respectively.Results The primarily affected joints were small joints,such as metacarpophalangeal joints,proximal interphalangeal joint,metatarsophalangeal and temporomandibular joints,but large joints such as wrists,elbows,shoulders,knees,ankle joints could be involved,too.Fourteen of 16 patients were misdiagnosed as rheumatoid arthritis (RA).Renal dysfunction presenting as high level of serum creatinine or proteinuria was detected in 14 cases.Laboratory tests showed elevated erythrocyte sedimentation rate or C reactive protein level in 13 cases.Anemia was detected in 9 cases.Hypercalcemia was detected in half of the patients.Hyperglobu-linemia was detected in 6 cases.The serum level of free M-protein was markedly elevated in 14 cases.Auto-antibodies were negative,except that rheumatoid factor was positive in 1 case.Conclusion It is important to pay attention to the clinical pictures presented as polyarthritis with negative autoantibodies,and associated with renal dysfunction,anemia and hypergammaglobulinemia.MM is important in the differential diagnosis.

Research progress of neoadjuvant therapy for stage Ⅲ non-small-cell lung cancer / 肿瘤研究与临床

Neoadjuvant therapy aiming at improving the resection rate and prognosis for patients with lung cancer is a hot spot in the study field of lung cancer in today and future.This paper reviews the safety and clinical significance of neoadjuvant therapy for stage Ⅲ non-small-cell lung cancer.