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Objective:To summarize the perinatal management and prognosis of congenital chylous ascites (CCA).Methods:Clinical data of 20 infants diagnosed with CCA and treated in Guangdong Women and Children Hospital from June 2015 to November 2020 were retrospectively analyzed and described.Results:There were ten patients with isolated CCA and ten with non-isolated CCA. In isolated CCA cases, seven were cured after conservative treatment and three after postoperative conservative treatment following an ineffective surgery. Non-isolated CCA cases were complicated by intrauterine cytomegalovirus infection ( n=1), malrotation of intestine ( n=4) or bilateral chylothorax ( n=5). In addition to conservative treatment for CCA, non-isolated CCA patients also received antiviral therapy, Ladd's procedure or intrauterine/extrauterine closed thoracic drainage. Of eight patients who were firstly diagnosed with ascites before 30 gestational weeks, including four isolated and four non-isolated cases, only one underwent surgical intervention. During hospitalization, serious infections occurred in three infants with isolated CCA and two with non-isolated CCA, and were all controlled by anti-infection treatment. During a follow-up to median age of 29 months (15-82 months), none of the patients had any abnormalities except for the one with intrauterine cytomegalovirus infection who was deaf at the age of two. Conclusions:Conservative management is effective and the prognosis is generally good for most cases with isolated CCA. Treatment and prognosis of non-isolated CCA depend on its comorbidities. Gestational age at diagnosis may not be a prognostic predictor.
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Objective:To explore the prognosis and treatment experience of fetal/neonatal ovarian cyst.Methods:Clinical data of 35 cases of fetal/neonatal ovarian cyst (38 ovarian cysts) admitted to Guangdong Women and Children Hospital from June 2014 to December 2019 were retrospectively collected, including the cyst size before and after birth, ultrasonic features, intraoperative conditions, and pathology. According to the ultrasonic features at the first prenatal detection, the ovarian cysts were divided into two groups: simple cyst group (25 cysts) and complex cyst group (13 cysts). Two independent samples t-test and Fisher exact test were used to compare the characteristics of cysts between the two groups. The outcomes and treatment experience were summarized. Results:(1) The ratio of intraoperative torsion in the complex cysts group was higher than that in the simple cysts group [10/13 vs 32% (8/25), Fisher exact test, P<0.05]. (2) Twenty-five simple cysts were found on the first prenatal ultrasound scan, and 32% (8/25) of them eventually transformed into complex cysts. Among these eight cysts, the maximum diameter of five cysts was >4 cm before the transformation. (3) Postnatal ultrasound found one cyst regressed spontaneously and among the remaining 37 cysts, simple and complex type cysts were accounted for 16 and 21, respectively. Among the complex type cysts, 90% (19/21) were consistent with prenatal ultrasound. (4) Out of the 21 complicated cysts, 19 were surgically removed; the remaining two cysts (maximum diameter <3 cm) were observed conservatively and disappeared spontaneously within one year. During the operation, 81% (17/21) of the complicated cysts were found with torsion and 24% (5/21) with ovarian loss. Conclusions:Simple cysts can transform into complex cysts, especially the biggest diameter >4 cm. Complex fetal/neonatal ovarian cysts indicated by ultrasonography were more prone to torsion, which required postnatal operation.
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Beh?et′s syndrome (BS) is classified among variable vessel vasculitis with unknown etiology and extensively heterogeneous clinical features. It is easily missed or misdiagnosed due to the lack of a specific laboratory diagnosis index. Based on the evidence and guidelines from China and other countries, the Chinese Rheumatology Association developed the standardization of diagnosis and treatment of BS. The purposes are: (1) To standardize the detection and interpretation of key indicators for BS; (2) To standardize rational management for BS patients with topical and systemic organ involvement to reduce complications and improve outcomes.
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Objective To explore the effect of group painting art therapy on social function rehabili-tation and quality of life of chronic schizophrenia patients. Methods Totally 104 inpatients with schizophre-nia were assigned to study group with 53 cases and control group with 51 cases by random number table method. Patients in study group received group painting art therapy intervention,medication and other reha-bilitation activities. While the patients in control group were only given medication and other rehabilitation activities. All patients in both groups received positive and negative symptoms scale(PANSS),schizophrenia quality of life scale(SQLS) and scale of social-skills for psychiatric inpatients(SSPI) before and after the in-tervention. The results were analyzed by independent sample t test. Results Before treatment,there were no significant differences of the total scores and the dimensional subscores of PANSS,SQLS and SSPI between the study group and control group( all P>0. 05). Compared with control group,the difference score between pre-test and post-test of PANSS ((12. 26±6. 87) vs (5. 11±3. 11),t=13. 11,P<0. 01) and negative symp-tom ((-7. 96±5. 44) vs (-2. 82±3. 47),t=-12. 30,P<0. 01),score of SQLS ((27. 45±12. 22) vs (2. 41 ±10. 68),t=-11. 11,P<0. 01) and score of SSPI((-20. 40±8. 10) vs (-0. 94±8. 01),t=12. 31,P<0. 01) in study group changed statistically(all P<0. 01). Conclusion These results suggest that group painting art therapy intervention can improve the negative symptoms,the quality of life and the recovery of social function in patients with chronic schizophrenia.
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OBJECTIVE@#To investigate the effect of vitamin D3 on polarization of monocyte macrophages induced by serum from patients with ankylosing spondylitis (AS).@*METHODS@#Twenty AS naïve patients and 20 healthy controls from Wenzhou People's Hospital during January 2016 and December 2017 were enrolled. The macrophages were differentiated from THP1 cells induced by phorbol 12-myristate 13-acetate (PMA), and then co-cultured with the serum from healthy subjects (control group) or AS patients. Vitamin D3 was added in the medium mixed with serum from AS patients. Flow cytometry was used to analyze the ratio of CD68 and CD206 positive cells, and RT-PCR was performed to detect the mRNA expression of inducible nitric oxide synthase(iNOS) and arginase-1(Arg-1).@*RESULTS@#THP1 cells could be polarized into mononuclear-macrophages with the induction of PMA. The proportion of CD206 positive cells in AS-serum group was lower than that in the control group (=9.434, <0.05), while the proportion of CD68 positive cells was higher than that in the control group (=43.920, <0.05). The proportion of CD206 positive cells in vitamin D3 group was higher than that in AS-serum group (=8.895, <0.05), while the proportion of CD68 positive cells was lower than that in AS-serum group (=9.089, <0.05). mRNA expression of Arg-1 in AS-serum group was lower than that in the control group (=8.899, <0.05), while mRNA expression of iNOS was higher than that in the control group (=3.656, <0.05). mRNA expression of Arg-1 in vitamin D3 group was higher than that in AS-serum group (=6.219, <0.05), while mRNA expression of iNOS was lower than that in AS-serum group (=5.876, <0.05).@*CONCLUSIONS@#Vitamin D3 can regulate the polarization of mononuclear macrophages for immunoregulation in patients with AS.
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Humans , Adjuvants, Immunologic , Pharmacology , Cell Differentiation , Cholecalciferol , Pharmacology , Monocytes , Spondylitis, Ankylosing , BloodABSTRACT
Objective To explore the correlation between B lymphocyte activation and CD154 expression and lupus anticoagulants (LAC) in patients with systemic lupus erythematosus (SLE). Methods Sixty newly diagnosed SLE patients (SLE group) and 32 healthy controls (control group) were involved. The expressions of CD27 and CD154 in peripheral blood were determined by flow cytometry, and the positive expression rates were computed. The LAC was determined by activated partial thromboplastin time, and the LAC ratio > 1.20 was positive. Results The positive rate of CD27, expression intensity of CD27, positive rate of CD154 and expression intensity of CD154 in SLE group were significantly higher than those in control group: 0.047 ± 0.021 vs. 0.035 ± 0.014, 0.387 ± 0.185 vs. 0.214 ± 0.091, 0.191 ± 0.108 vs. 0.101 ± 0.081 and 0.049 ± 0.018 vs. 0.022 ± 0.012, and there were statistical difference (P<0.05 or <0.01). Among patients with SLE, the LAC positive was in 28 cases, and the LAC negative was in 32 cases. The positive rate of CD27, expression intensity of CD27, positive rate of CD154 and expression intensity of CD154 in SLE patients with LAC positive were significantly higher than those in SLE patients with LAC negative: 0.055 ± 0.023 vs. 0.037 ± 0.014, 0.444 ± 0.179 vs. 0.329 ± 0.123, 0.218 ± 0.101 vs. 0.158 ± 0.044 and 0.058 ± 0.035 vs. 0.020 ± 0.009, and there were statistical differences (P<0.05). Conclusions The B lymphocyte activation and CD154 abnormal expression correlates with generation of LAC in patients with SLE. It provides a basis for the further study on intervening the generation of LAC and reducing the risk of thromboembolism.
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Objective To investigate the effects of tripterygium glycosides combined with methotrexate in treatment of rheumatoid arthritis (RA) curative effect and peripheral blood of patients with IL-6, effects of IL-10 and TNF- alpha. Methods 80 patients with RA from February 2014 to August 2016 in our hospital were retrospectively analyzed. According to the different treatment methods by for the observation group, the control group (40 cases). To compare and analyze the curative effect before and after short-term treatment and treatment of patients in the 2 groups were the main clinical symptoms and signs of change and ESR, RF, CRP, IL-6, TNF- alpha, IL-10 index. Results The total effective rate of observation group (92.50％) was significantly higher than the control group (77.50％), the difference was statistically significant (P<0.05), 2 groups of patients before treatment of main clinical symptoms and signs, there was no significant difference, after treatment, clinical symptoms and signs of 2 groups of patients were compared with those before treatment was statistically significant to alleviate the differences (P<0.05), and the observation group of main clinical symptoms and signs were lower than the control group and the remission (down), the difference was statistically significant (P<0.05).Before ESR, the treatment of 2 patients with RF, CRP, TNF- IL-6, alpha, IL-10 index level, no statistical significance, the 2 groups after treatment in patients with ESR, RF, CRP, IL-6, TNF- alpha, IL-10 index level than before treatment with significant difference (P<0.05), and the observation group ESR, RF, CRP, TNF- alpha, IL-6 average index of water compared with the control group decreased significantly, IL-10 index increased significantly than the control group. The difference was statistically significant (P<0.05). Conclusion Tripterygium glycosides combined with methotrexate in treatment of rheumatoid arthritis And it can effectively inhibit the expression of peripheral serum L-6 and TNF- alpha, promote the expression of IL-10 and alleviate the inflammatory reaction
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OBJECTIVE To investigate the effect of asiaticoside (AS) on endothelial-to-mesenchymal transition (EndoMT) in hypoxia pulmonary hypertension (HPH). METHODS Male Sprague-Dawley (SD) rats were divided into normoxia control group, hypoxia model group, and AS 25 and 50 mg · kg-1 group. Hypoxia model group and AS group were subjected to intermittent hypoxia exposure. Control group and model group received 1-1.5 mL saline daily, and AS groups were ig administrated with AS 25 and 50 mg·kg-1 for 4 weeks. Human pulmonary artery endothelial cells (HPAECs) were divided into normoxia control group and hypoxia AS groups. Hypoxia groups were cultured with AS 0, 25, 50, 100 and 200 mg·L-1 for 72 h under hypoxic (5%O2, 5%CO2) conditions. Anti-proliferation effect of AS was investigated by CCK-8 assay. Then, HPAECs were divided into normoxia control group, normoxia AS 100 mg · L-1 group, hypoxia model group, and hypoxia AS 100 mg · L-1 group. After five days of culture, migration ability of cells was detected by Transwell test. Expression of CD31 andα-SMA was detected by immunofluorescence and Western blotting in both in vivo and in vitro experiments. RESULTS In both in vivo and in vitro experiments, compared with normoxia control group, expression of CD31 was reduced (P<0.01) andα-smooth muscle actin (α-SMA) was increased (P<0.01) in hypoxia model group in both immunofluorescent analysis and Western blotting. Compared with hypoxia model group, expression of CD31 was increased andα-SMA was decreased (P<0.05, P<0.01) in AS treatment groups. Compared with normoxia control group, proliferation and migration ability of HPAEC were elevated in hypoxia model group (P<0.05). Compared with hypoxia group, AS 100 mg · L-1 depressed proliferation and migration of HPAEC under hypoxia exposure up to 72 h (P<0.05). CONCLUSION EndoMT might be involved in HPH and could be partly inhibited by AS.
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Objective To explore the efficacy and safety of glucocorticoids+cyclophosphamide+tacrolimus capsules (GC+CTX+FK506) in the treatment of patients with type Ⅲ+V and Ⅳ+Vlupus nephritis. Methods The 31 cases with first diagnosis as systemic lupus erythematosus (SLE) with type Ⅲ+V and Ⅳ+Vlupus nephritis (LN) were selected, then divided into group A (CTX+GC) with 16 cases and group B (FK506+CTX+GC) with 15 cases. The group A received CTX+GC during treatment, group B received GC+CTX+FK506 for the first three months, and received FK506+GC for the last three months. The patients were followed up once monthly to observe the efficacy and safety,the efficacy was analysed after 6 months. Results After treatment, the total efficacy in group B was significantly higher than group A (86.7%vs.50.0%, P<0.05). The 24 h urine protein of group B was lower than group A(P<0.05). The plasma albumin of group B was higher than group A (P<0.05). After treatment, the systemic lupus erythematosus disease activity index (SLEDAI) in two groups were lower and C3 level was higher than those pre-treatment(P<0.05), but there was no significant difference in above indicators between two groups. There was one case menelipsis in group A, and one case with transient increasing of creatinine. Conclusion The FK506+CTX+GC could reduce urine protein sifnificantly compared with CTX+GC without serious adverse reaction.
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Objective To study effect of etoricoxib on IL-1βand TNF-αin patients with gouty arthritis.Methods 86 patients with gouty arthritis from July 2014 to July 2016 in our hospital were selected, all patients were divided into study group and control group according to the treatment method with 43 cases in each group.The patients in the control group were treated with diclofenac sodium, the patients in the study group were treated with etoricoxib.The clinical symptoms, clinical treatment effects, VAS score, serum IL-1β, TNF-αlevels and adverse reactions were observed and compared between the two groups.Results The VAS score, the joint swelling score and the mobility limitation score of the study group were decreased than before treatment and significantly lower than those of the control group, the difference was statistically significant (P<0.05).The effective rate of the study group (95.35%) was significantly higher than that of the control group (79.07%), the difference was statistically significant(P<0.05).The levels of IL-1βand TNF-αin the two groups were significantly lower than before treatment and the levels of IL-1βand TNF-αin the study groups were significantly lower than those in the control group,the difference was statistically significant(P<0.05).The incidence of adverse reactions in the study group was lower than that in the control group, the difference was statistically significant(P<0.05).Conclusion The clinical efficacy of etoricoxib in treating patients with gouty arthritis is significant, which can effectively relieve the clinical symptoms, inhibit the expression of IL-1βand TNF-α, and the adverse reactions less.
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Objective To study the clinical efficacy and safety of leflunomide combined with irbesartan in the treatment of lupus nephritis . Methods 80 cases of patients with lupus nephritis in Yueqing Hospital Affiliated to Wenzhou Medical University from May 2014 to May 2016 were selected and randomly divided into leflunomide group ( leflunomide combined with irbesartan group ) and cyclophosphamide group ( cyclophosphamide combined with irbesartan group),40 cases in each group.The urine indexes and blood indexes levels,clinical curative effect,adverse reaction of the two groups were statistically analyzed.Results The 24h urine protein,urine beta 2-MG,urine red blood cell count,blood beta beta2-MG,ESR,Cr levels of the leflunomide group were significantly lower (P<0.05),the serum albumin,C3 levels were significantly higher (P<0.05),the total treatment efficiency 97.5%was significantly higher than the cyclophosphamide group 82.5%(P<0.05),the incidence of adverse reactions 5.0%was significantly lower than the cyclophosphamide group 22.5%(P<0.05).Conclusion Leflunomide combined with irbesartan is safe and effective in the treatment of lupus nephritis.
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Objective To investigate the effect of before and after combination therapy of thalidomide and methotrexate (T+M) on regulatory T cells and IL-6 expression profile,and to reveal the mechanism of therapeutic effect of T+M on rheumatoid arthritis.Methods A total of 58 patients with rheumatoid arthritis from August 2014 to August 2016 in the Third Affiliated Hospital of Wenzhou Medical University.The flow cytometry assay and enzyme-linked immunosorbent assay (ELISA) were used to estimate the ratio of peripheral blood regulatory T cells and expression profile of IL-6 in peripheral blood lymphocyte before and after combination therapy of thalidomide and methotrexate .Results After combination therapy of T+M,the ratio of peripheral blood CD25 +Foxp3/CD4 +T cells had a marked increase compared with before combination of therapy of T +M;but the expression of IL-6 had a significant decrease in the group of after combination therapy of T +M compared with before combination therapy.Conclusion The effect of combination therapy of T+M on rheumatoid arthritis is associated with increasing the ratio of regulatory T cells and decreasing the secretion of IL-6 that could regulate T cells to homeostasis.
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OBJECTIVE To study the therapeutic effect and the underlying mechanism of asiatico?side on bleomycin-induced rat interstitial pulmonary fibrosis(IPF). METHODS Male Sprague-Dawley (SD)rats were divided into normal control group,bleomycin 5 mg·kg-1 model group and asiaticoside 50 mg · kg-1 group. The model and asiaticoside group were administrated with bleomycin 5 mg · kg-1 to induce IPF,while the asiaticoside group was administrated with asiaticoside 50 mg·kg-1 by gastric perfusion. Hematein eosin(HE)and Masson staining were carried out to analyze the histopathological changes in the lung. Lung homogenates were used to examine hydroxyproline(HYP) content,and serum samples were used to measure the concentration of interferon-γ(IFN-γ),interleukin-4(IL-4) and tumor necrosis factor-α(TNF-α). In addition,immunohistochemical methods were used to locate lung transforming growth factor-β1(TGF-β1)and adenosine 2A receptor(A2AR)expression,and Western blotting was used to examine the expression levels of TGF-β1 and A2AR. RESULTS On the 7th,14th and 28th days,the scores of pulmonary inflammation were higher in model group than in control group (P<0.01),and the asiaticoside group showed mitigated alveolitis(P<0.01,P<0.05) compared with model group. Compared with control group,the scores of pulmonary fibrosis in model group were elevated(P<0.01),and the asiaticoside group showed reduced pulmonary fibrosis(P<0.05). On the 14th and 28th days,HYP content in the model group〔1.85±0.10,(2.48±0.18)mg·g-1〕was higher than in the control group〔0.79 ± 0.07,(0.84 ± 0.08)mg · g-1〕(P<0.01),but HYP content in the asiaticoside group〔1.32±0.131,(1.71±0.13)mg·g-1〕was lower than in the model group(P<0.05). IL-4 and TNF-αin the asiaticoside group were lower than in model group(P<0.05),but were higher in the model group than in the control group(P<0.01,P<0.05). The expression level of TGF-β1 protein in the asiaticoside group was lower than in the model group(P<0.05),but was higher in the model group than in the control group(P<0.05). The expression level of A2AR protein in the asiaticoside group was higher than in the model group(P<0.05),but was lower in the model group than in the control group(P<0.05). CONCLUSION Asiaticoside can mitigate bleomycin-induced IPF by inhibiting the expression of IL-4, TNF-αand TGF-β1,and raising the level of A2AR.
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Objective To study the Val247Leu and Trp316Ser polymorphisms of β2-glycoprotein Ⅰ(β2GPⅠ) in systemic lupus erythematosus (SLE) patients and their associations with antiphospholipid antibodies and thrombotic complications.Methods We used DNA sequencing to detect the polymorphisms of Val247Leu and Trp316Ser in 378 SLE patients and 240 normal controls.Anti-β2GP Ⅰ antibodies and anticardiolipin (ACA) were tested by enzyme linked immunosorbent assay (ELISA).Lupus-type anticoagulants(LAC) was performed by diluted Russell's Viper Venom Test.Then the patient group was further analyzed according to APLs (Anti-β2GP Ⅰ antibody,LAC and ACA),thrombosis and obstetrical complications using Logistic regression analysis to confirm whether there are associations between β2GPⅠpolymorphism and those factors.Results For Va1247Leu,the predominant genotype was LL in healthy controls which accounted for 57.08％,while it was VL in SLE patients which accounted for 59.5％ (x2=45.01,P=0.000).Frequency of VV genotype was significantly higher in patients with thrombosis,anti-β2GP Ⅰ,ACA and obstetrical complications (OR=6.79,3.75,2.12 and 3.85,respectively;P=0.000,0.001,0.044 and 0.017,respectively).Those patients with VL genotype tended to have positive anti-β2GPI,LAC,ACA,thrombosis and also obstetrical complications (OR=2.95,1.88,2.47,2.97 and 2.74,respectively;P=0.000,0.007,0.000,0.001 and 0.016,respectively) than those negative ones.The predominant genotype of Trp316Ser was TT,then TS.No correlations could be found between Trp316Ser polymorphism and APLs,neither relation to thrombosis complications.Conclusion The polymorphism of Val247Leu is significantly associated with the presence of APLs,thrombosis and obstetrical complications.Both VV and VL genotype are risk factors for the generation of APLs,occurrence of thrombosis and obstetrical complications.The VV genotype is a high risk factor for thrombosis.Trp316Ser polymorphism does not contribute to the APLs production and also have no correlations with thrombotic complication.
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<p><b>OBJECTIVE</b>To investigate the operation timing of newborns with rectosigmoid Hirschsprung's disease (HD).</p><p><b>METHODS</b>From March 2013 to September 2015, 35 newborns diagnosed as rectosigmoid HD in our department were prospectively and randomly divided into 2 groups: less than 3 months treatment group (18 cases) and more than 3 months treatment group (17 cases, conservative treatment for 3 months). They all underwent laparoscopic-assisted transanal endorectal pull-through (LATEP) (modified Soave) procedure. Clinical data, perioperative conditions, postoperative complication, postoperative anal function evaluated by Wingspread score and barium enema were compared between two groups.</p><p><b>RESULTS</b>The baseline data of two groups were comparable (all P>0.05). All the cases completed single-stage LATEP procedure successfully without conversion to open operation. Compared with more than 3 months treatment group, preoperative bowel preparation time and operation time were significantly shorter [(6.2±3.3) vs. (9.3±4.1) days, P=0.042; (95±15) vs.(121±23) minutes, P=0.029, respectively], intra-operative blood loss was significantly less [(13±3) ml vs. (22±5) ml, P=0.036], length of resected bowel was significantly shorter [(16±5) cm vs.(23±8) cm, P=0.033], and bowel movement recovery time, parenteral nutrition time, hospital stay were also significantly shorter [(2.3±0.5) vs. (2.9±0.6) days, P=0.046; (5.1±2.1) vs. (5.9±2.3) days, P=0.048; (12.9±3.3) vs. (15.8±4.3) days, P=0.049, respectively] in less than 3 months treatment group. No short-term complications, such as anastomotic leak, interlayer infection and abdominal infection occurred in both groups. The follow-up period ranged from 2 months to 24 months. Only the incidence of perianal excoriation was significantly higher in less than 3 months treatment group compared with more than 3 months treatment group [50.0%(9/18) vs. 23.5%(4/17), P=0.045]. Wingspread score results at 6 and 12 months after operation showed excellent rate of postoperative anal function, which was not significantly different between two groups[ <3 months group : 81.3%(13/16) and 92.9%(13/14); >3 months group: 85.7%(12/14) and 92.3%(12/13), all P>0.05]. Postoperative barium enema results at 6 and 12 months after operation all showed normal shape of colon without residue of barium.</p><p><b>CONCLUSIONS</b>For newborns with rectosigmoid HD, single-stage definitive operation performed at the age less than 3 months has the advantages of shorter preoperative preparation time, less operating injury, shorter resected bowel, and faster postoperative recovery as compared to the age more than 3 months. If rectosigmoid HD is definitively diagnosed, early operation is suggested to perform at the age less than 3 months.</p>
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Female , Humans , Infant , Infant, Newborn , Male , Anastomotic Leak , Barium Enema , Blood Loss, Surgical , Defecation , Digestive System Surgical Procedures , Hirschsprung Disease , General Surgery , Intraabdominal Infections , Laparoscopy , Length of Stay , Operative Time , Parenteral Nutrition , Parenteral Nutrition, Total , Postoperative Complications , Postoperative Period , Treatment OutcomeABSTRACT
Objective To study the correlation between fractional excretion of uric acid (FEUA) and blood uric acid,body mass index (BMI),blood pressure,blood glucose,blood lipid and other metabolic factors in patients with primary gout.Methods Sixty-two patients with primary gout (gout group) and 32 healthy people (control group) were selected in this study.Gout group was divided into uric acid excretion decreasing group (FEUA ＜ 7％,29 cases),mixed group (7％ ≤FEUA ≤ 12％,25 cases) and uric acid production increasing group (FEUA ＞ 12％,8 cases) according to the level of FEUA.The fasting blood glucose (FPG),2-hour postprandial blood glucose (2 h PBG),blood lipid,serum creatinine,blood uric acid,glycosylated hemoglobin were tested.24 hours urine was collected and urinary uric acid and urinary creatinine was measured,FEUA was calculated and analyzed.Results BMI,mean arterial pressure,blood uric acid,glycosylated hemoglobin,total cholesterol,2 h PBG in gout group was higher than that in control group,and high density lipoprotein cholesterol,FEUA was lower than that in control group,and there was significant difference (P ＜ 0.05).There was no significant difference in age,FPG,low density lipoprotein cholesterol,triacylglycerol between two groups (P＞ 0.05).There was no significant difference in age,blood uric acid,FPG,2 h PBG,glycosylated hemoglobin,total cholesterol,low density lipoprotein cholesterol,high density hpoprotein cholesterol among uric acid excretion decreasing group,mixed group and uric acid production increasing group (P ＞ 0.05),and there was significant difference in BMI,mean arterial pressure,triacylglycerol,FEUA among three groups(P＜ 0.05).FEUA was negatively correlated with blood uric acid in control group and gout group (r =-3.900,-0.476,P ＜0.05).FEUA was positively correlated with 24 h urinary uric acid in gout group (r =0.465,P =0.001),and nagatively correlated with triacylglycerol (r =-0.304,P ＜ 0.05).Pearson analysis showed that FEUA was negatively correlated with blood uric acid in uric acid excretion decreasing group (FEUA ＜ 7％) (r =-0.392,P ＜ 0.05),FEUA was positively correlated with blood uric acid in non uric acid excretion decreasing group (FEUA ≥7％)(r =0.437,P ＜ 0.05),but 24 h urinary uric acid was not correlated with blood uric acid(P ＞ 0.05).Multi-stepwise regression analysis showed that blood uric acid,glycosylated hemoglobin,FEUA was significantly correlated with the onset of the gout (P ＜ 0.05).Conclusions Besides blood uric acid level,there are significant changes in primary gout in blood pressure,serum glucose and lipid levels.FEUA could be used to estimate the ability of renal excrete the uric acid.Mean arterial pressure,glycosylated hemoglobin and FEUA are the risk factors for gout.
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Objective To detect the prevalence of human cytomegalovirus (HCMV) in peripheral blood of patients with systemic lupus erthematosus (SLE) and explore its role in the pathogenesis of SLE.Methods HCMV DNA was isolated from the peripheral blood leucocytes (PBLs) of 60 patients with SLE and 111 healthy controls.Nested polymerase chain reaction (nPCR) technology was used to investigate the gene of HCMV glycoprotein gB (UL55) in these specimens.HCMV infections in the PBLs of SLE patients were confirmed by HCMV-UL55 detection.Two-sample t test,nonparametric test,Chi-square test and Fisher probabilities were used to analyze.Results Agarose gel electrophoresis and sequencing analysis showed that established nPCR could specifically detect HCMV-UL55 gene,the HCMV infection rate was significantly higher in patients with SLE than in the healthy controls (P＜0.01).Positive rates of HCMV infection in SLE group and controls were 41.7％ (25/60) and 1.8％ (2/111),respectively.Compared to the SLE patients with HCMV-negative PBLs,the positive rate of Rib-P [26％(9/35) vs 56％(14/25),x2=5.659,P=0.017],the positive rate of direct Coomb's test [37％(13/35) vs 72％(18/25),x2=7.096,P=0.008] and the level of antiβ2GP1 [21.3 (9.9,51.8) U/ml vs 13.6 (5.9,23.1) U/ml,U=2.017,P=0.044] were significantly higher than those in the SLE patients with HCMV-positive PBLs.Compared to the SLE patients with HCMV-negative PBLs,the number of red blood cells [(3.65±0.10)×1012/L vs (3.17±0.17)×1012/L,t=2.574,P=0.013] and lymphocytes [(1.37±0.14)×1012/L vs (0.90±0.13)×1012/L,t=2.456,P=0.017] in peripheral blood and the hemoglobin levels [(110±19) g/L vs (98±5)g/L,t=2.034,P=0.048] of the SLE patients with HCMV-positive decreased significantly.At the same time,the positive rate of hematuria [40％(14/35) vs 72％(18/25),x2=6.000,P=0.014] and 24 h proteinuria [0.80 (0.53,2.37)g vs 0.48 (0.13,1.21)g,U=2.140,P=0.032],which indicated kidney damage were also significantly increased in SLE patients with HCMV-positive PBLs.Conclusion The infection of HCMV in peripheral blood cells may take part in the development of SLE.
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To observe the influence of human leucocyte antigen B27 [HLA-B27] status and gender on sacroiliitis on computed tomography [CT] in ankylosingspondylitis [AS]. We reviewed the archived medical records of the AS inpatients admitted in the Rheumatology Department of the First Affiliated Hospital of Wenzhou Medical University during the period from January 2007 through January 2013 and finally 386 patients were included in the study. The severity of sacroiliitis on CT was evaluated according to the grading used in the modified New York criteria for AS. Two-way classification analysis of variance [ANOVA] was employed to examine the effect of HLA-B27 status and gender on age at disease onset. The impact of HLA-B27 and gender on sacroiliitis on CT was tested by univariate and multivariate logistic regression analyses. There were 350 HLA-B27 positive patients [90.7%] and 36 HLA-B27 negative patients [9.3%]. The ANOVA test indicated that HLA-B27 positive patients and male patients respectively had an earlier age at disease onset than HLA-B27 negative patients and female patients. The logistic regression analysis indicated that positive HLA-B27 status [OR 2.601, p=0.004] and male gender [OR 1.923, p=0.004] were significant predictors of worse sacroiliitis. In addition, elevated ESR [OR 2.181, p=0.013] and longer disease duration [OR 1.100, p < 0.001] contributed to worse sacroiliitis likewise. Positive HLA-B27 status and male gender are associated with worse sacroiliitis on CT, acting as predictors of sacroiliitis. Elevated ESR and longer disease duration also contribute to worse sacroiliitis. Meanwhile, positive HLA-B27 status and male gender are associated with earlier age at disease onset
ABSTRACT
Objective To study the relationship between the valine/leucine247 (817G/T) polymorphism in exon 7 of apolipoprotein H (apoH) gene and the generation of antiphospholipid (APL)antibodies in patients of Han nationality with systemic lupus erythematosus (SLE) in Wenzhou region.Methods This study included 165 patients with SLE and 160 healthy controls of Han nationality in Wenzhou region.Venous blood samples were obtained from all of the subjects followed by the isolation of blood plasma,sera and white blood cells.PCR and DNA sequencing were carried out to assess the Leu/Va1247 polymorphism in apoH gene.Lupus anticoagulant (LAC) was detected by Russell viper venom time (RVVT) assay.Enzyme-linked immunosorbent assay (ELISA) was carried out to quantify the serum levels of anti-β2-glycoprotein Ⅰ (GPI) antibodies and anticardiolipin antibodies (ACA).Chi-square test was carried out to compare the 817G/T polymorphism between the patients and controls,and Logistic regression analysis to evaluate the correlation between the 817G/T polymorphism and production of antiphospholipid antibodies.Results There were significant differences between the patients and controls in the genotype distribution and allele frequency at position 817 of apoH gene (both P ＜ 0.01).The TT,GT genotypes and T allele were more frequent,while GG genotype and G allele were less frequent,in the patients than in the controls.The GT genotype at position 817 was a risk factor for the production of LAC (P＜ 0.05,OR =2.33,95％CI =1.18-4.59),anti-β2GPl antibodies(P＜ 0.01,OR =5.92,95％CI =2.61-13.46) and ACA(P＜ 0.05,OR =2.52,95％CI =1.22-5.24),and the TT genotype was associated with an increased frequency of anti-β2GPI antibodies (P ＜ 0.01,OR =5.84,95％CI =1.69-20.20).Conclusions The 817G/T(Leu/Va1247) polymorphism in exon 7 of apoH gene is associated with the generation of APL antibodies in patients of Han nationality with SLE in Wenzhou region.The TT and GT genotypes at position 817 of apoH gene appear to be a risk factor for the production of APL antibodies.
ABSTRACT
ObjectiveTo investigate the effect of arsenic trioxide (ATO) on anti-dsDNA antibody and the expression of DNA methyltransferase 1-mRNA and CD11a-mRNA in lupus MRL/lpr mice.Methods MRL/lpr mice were divided into three groups:the ATO group,the sodium chloride(NS) group,and the cyclophosphamide(CTX) group.The control group consisted of 20 syngeneic normal C57/BL mice,which were subdivided into the ATO group and the NS group.After two-month treatment,all mice were sacrificed.Blood routine test was conducted by SYSMEX KX21.The anti-dsDNA antibody in the serum were detected by ELISA.The expression of DNMT1 and CD11a was determined by RT-PCR.ANOVA and paired t test were used for statistical analysis.Results① The serum level of anti-dsDNA antibody(0.89±0.07) and the gray scale value of CD11a-mRNA(0.43±0.25) in the ATO group were much lower than those in the NS group of MRL/lpr mice(1.77±0.28,P＜0.01; 0.99±0.31,P＜0.05),while the gray scale value of DNMTI-mRNA (0.32±0.30) was significantly higher than that in the NS group(0.16±0.26,P＜0.05 ).② The serum levels of anti-dsDNA antibody was low in both the ATO group and the CTX group (0.90±0.07,0.66±0.22),and it was higher in the ATO group than that in the CTX group (P＜0.05).The gray scale value of DNMT1 mRNA in the ATO group (0.32±0.30) was higher than that in the CTX group (0.16±0.18,P＜0.05) in MRL/lpr mice,and the gray scale value of CD11a mRNA in the ATO group(0.43±0.25) was lower than that in the CTX group (0.86±0.31,P＜0.05) in MRL/lpr mice.③ There was no difference in above parameters between the ATO-group and NS group in C57/BL mice(P＞0.05).ConclusionArsenic trioxide can reduce the serum level of auto-antibody and reverse low methylation.But it has no effect on normal mice.