Complications and radiographic changes after implantation of interspinous process devices: average eight-year follow-up.

PURPOSE: This study aims to evaluate complications, clinical outcomes, and radiographic results following Coflex implantation. METHODS: We retrospectively studied 66 patients who had decompressive surgery combined with Coflex implantation to treat lumbar spinal stenosis. All imaging data were collected and examined for imaging changes. Clinical outcomes, included Oswestry Disability Index (ODI), back and leg visual analog scale (VAS) scores, were evaluated before surgery, six months after surgery and at the last follow-up. The number of complications occurring after five years of follow-up was counted. All reoperation cases were meticulously recorded. RESULTS: 66 patients were followed up for 5-14 years. The VAS and ODI scores were significantly improved compared with baseline. Heterotopic Ossification (HO) was detectable in 59 (89.4%). 26 (39.4%) patients had osteolysis at the contact site of Coflex with the spinous process. Coflex loosening was detected in 39 (60%) patients. Spinous process anastomosis was found in 34 (51.5%) patients. There was a statistically significant difference in the VAS score of back pain between patients with and without spinous process anastomosis. Nine cases of lumbar spinal restenosis were observed, and prosthesis fracture was observed in one case. CONCLUSION: Our study identified various imaging changes after Coflex implantation, and majority of them did not affect clinical outcomes. The majority of patients had HO, but osteolysis and Coflex loosening were relatively rare. The VAS score for back pain of these patients was higher if they have spinous process anastomosis. After five-year follow-up, we found lumbar spinal restenosis and prosthesis fracture cases.

Novel red light-emitting two-photon absorption compounds with large Stokes shifts for living cell imaging.

Three novel donor-π-acceptor two-photon absorption compounds (1PZPy, 2PZIm, 3CZPy) bearing the 10-butyl-10H-phenothiazine (9-butyl-9H-carbazole) donor, the pyridinium (benzimidazolium) acceptor, and the 2,5-divinylthiophene π-bridge were synthesized and fully characterized by 1H NMR, 13C NMR, FT-IR, and HRMS. The linear and nonlinear photophysical properties were systematically investigated. Their absorption properties show a strong solvent dependence, while the emission properties are nearly independent of solvent polarity. All of them possess large Stokes shifts (Δλ=149-190 nm in H2O). 1PZPy and 3CZPy exhibit red fluorescence emission centered at about 635 and 660 nm, respectively. The two-photon absorption cross-sections measured by the open aperture Z-scan technique are determined to be 486 (1PZPy), 601 (2PZIm), and 753 GM (3CZPy) in DMF. The density functional theory calculations were further carried out to reveal their electronic structures. All the target compounds are verified to have low cytotoxicity in the working solution and good capability for one- and two-photon excitation fluorescence imaging, suggesting their potential application in bioimaging. Moreover, they show the organelle targeting ability in living cells with the high Pearson's coefficients above 0.94 for the endoplasmic reticulum.

The amino acid variants in HLA II molecules explain the major association with adult-onset Still's disease in the Han Chinese population.

Adult-onset Still's disease (AOSD) is a rare autoinflammatory disease with systemic involvement, and its pathophysiology remains unclear. Genome-wide association studies (GWAS) in the Chinese population have revealed an association between AOSD and the major histocompatibility complex (MHC) locus; however, causal variants in the MHC remain undetermined. In the present study, we identified independent amino-acid polymorphisms in human leukocyte antigen (HLA) molecules that are associated with Han Chinese patients with AOSD by fine-mapping the MHC locus. Through conditional analyses, we identified position 34 in HLA-DQα1 (p = 1.44 × 10-14) and Asn in HLA-DRß1 position 37 (p = 5.12 × 10-11) as the major determinants for AOSD. Moreover, we identified the associations for three main HLA class II alleles: HLA-DQB1*06:02 (OR = 2.70, p = 3.02 × 10-14), HLA-DRB1*15:01 (OR = 2.44, p = 3.66 × 10-13), and HLA-DQA1*01:02 (OR = 1.97, p = 1.09 × 10-9). This study reveals the relationship between functional variations in the class II HLA region and AOSD, implicating the MHC locus in the pathogenesis of AOSD.

Clinical features and current treatments of adult-onset Still's disease: a multicentre survey of 517 patients in China.

OBJECTIVES: As a rare systemic autoinflammatory disease, adult-onset Still's disease (AOSD) has heterogeneous clinical manifestations, response to treatment and outcome. This study tried to assess the clinical characteristics, laboratory tests, and treatments of Chinese AOSD patients, and make a retrospective analysis. METHODS: We collected from 7 hospitals in China a total of 517 Chinese patients with AOSD who satisfied the Yamaguchi criteria. We retrospectively evaluated their clinical features, laboratory tests, treatments and compared them with published data from different studies. All the data in this study were from medical records and further statistic analyses. RESULTS: We evaluated a total of 517 AOSD patients, 72% female, average age of onset was 37.7; spiking fever, rash and arthralgia occurred in 472 (91.3%), 413 (79.9%), 378 (73.1%) cases, respectively. There were 439/513 (85.6%) cases with leukocytosis and 456/476 (95.8%) cases with raised serum ferritin. The highest frequently used medications and regimens for remission were glucocorticoids (498/517, 96.3%), methotrexate (273/517, 52.8%) and hydroxychloroquine (174/517, 33.7%). 84.4%. 357/423 of AOSD cases were able to achieve initial remission with different regimens, mostly including glucocorticoids, methotrexate or hydroxychloroquine. 47.2% of them (244/517) received 30

The role and clinical significance of programmed cell death- ligand 1 expressed on CD19+B-cells and subsets in systemic lupus erythematosus.

BACKGROUND: Programmed cell death-1 (PD-1) and programmed death-ligand 1 (PD-L1)-targeted therapies have enhanced T-cell response and demonstrated efficacy in the treatment of multiple cancers. However, the role and clinical significance of PD-L1 expression on CD19+ B-cells and their subsets, with particular reference to systemic lupus erythematosus (SLE), have not yet been studied in detail. OBJECTIVE: The present study aimed to investigate PD-L1 expression on CD19+ B-cells and their subsets, in addition to exploring its possible role in Tfh-cell activation and B-cell differentiation in SLE. METHODS: Frequencies of CD19+ B-cells, their subsets, PD-L1 and Tfh cells in the peripheral blood of SLE patients and healthy controls (HCs) were determined using cytometry. The clinical data of SLE patients were recorded in detail, and the correlation between their laboratory parameters, clinical parameters and disease activity indices was statistically analyzed. CD19+PD-L1+B-cells and CD19+PD-L1- B-cells were sorted and cultured with a stimulant, following which the supernatants were collected for immunoglobulin G and anti-double stranded DNA detection via enzyme-linked immunosorbent assay. RESULTS: In SLE patients, CD19+B-cells and partial subgroups were enriched in peripheral blood. Also, the observed increase in the frequency of CD19+PD-L1+B-cells was significantly associated with a higher disease activity index. An in vitro culture test demonstrated that the amounts of anti-dsDNA and immunoglobulin G secreted by the CD19+PD-L1+B-cells of SLE patients and HCs were vastly different. In addition, a strong correlation existed between the frequencies of CD19+PD-L1+B-cells and defined Tfh cells of SLE patients. CONCLUSION: This study demonstrated that the expression of CD19+PD-L1+B-cells in the peripheral blood of SLE patients was abnormal, and that disease-related laboratory parameters and clinical indicators were correlated. CD19+PD-L1+B-cells were enriched and played a critical role in activating the pathogenic T-cell and B-cell responses in patients with SLE.

[The Study of Protective Effect of Paeoniflorin on Lung Injury in MRL/lpr Mice].

OBJECTIVE: To investigate the protective effects of paeoniflorin on the lung injury in systemic lupus erythematosus with mouse model. METHODS: Ten wild type mice and 40 MRL/lpr mice were used in this study. MRL/lpr mice were randomly assigned to MRL/lpr group,MRL/lpr + dexamethasone (1.5 mg/kg) group,MRL/lpr + paeoniflorin (20 mg/kg) group,and MRL/lpr + paeoniflorin (40 mg/kg). The levels of malondialdehyde (MDA) , superoxide dismutase (SOD) ,catalase (CAT) ,glutathione peroxidase (GSH-Px) in serum were detected. The serum levesl of inflammatory cytokines were measured. Lung pathological changes were determined by HE staining. The protein level of phospho-phosphatidylinositol-3 kinase (P-PI3K),phospho-serine-threonine kinase B(P-Akt) ,phospho-nuclear factor kappa B (P-NF-κB),phospho-inhibitor of nuclear factor kappa Bα (P-IκBα) were detected by Western blot. RESULTS: Paeoniflorin decreased serum level of MDA and increased the levels of SOD,CAT,GSH-PX,and decreased the levels of inflammatory cytokines. Paeoniflorin improved lung pathological changes and inhibited the protein levels of P-PI3K,P-Akt,P-NF-κBp65,and P-IκBα in the lung tissue of MRL/lpr mice. CONCLUSION: Paeoniflorin may be beneficial for the prevention of lung injury in systemic lupus erythematosus.

Clinical and serological associations of anti-ribosomal P0 protein antibodies in systemic lupus erythematosus.

The purpose of this study is to investigate the clinical and serological associations of anti-ribosomal P0 protein antibodies (anti-Rib-P0) in patients with systemic lupus erythematosus (SLE). The sera of 470 patients with SLE and 124 patients with primary Sjogren's Syndrome (pSS) were collected. Line immunoassay (LIA) was used to detect anti-Rib-P0 and other related antibodies. A complete laboratory evaluation and clinical examination were also performed in each SLE patient. The prevalence of anti-Rib-P0 in SLE patients was significantly higher than that in pSS patients (35.74 vs 6.45%) (P < 0.001). There was a significantly lower prevalence of cardiac involvement in anti-Rib-P0-positive SLE patients compared to anti-Rib-P0-negative SLE patients (P = 0.019); no significant associations of anti-Rib-P0 antibodies with encephalopathy manifestations and other vital organs involvement were observed. Anti-nucleosomes, anti-dsDNA, anti-Histones, anti-SmD1, and anti-U1snRNP were significantly associated with serum anti-Rib-P0 antibodies positivity in SLE patients (all P < 0.05). The sensitivity and specificity of the anti-Rib-P0 antibodies to diagnose SLE were 35.74 and 93.55%, respectively. There is a higher prevalence of anti-Rib-P0 in SLE patients. Anti-Rib-P0 positivity may indicate lower cardiac involvement for SLE patients. It may serve as an important complementary parameter in SLE, in addition to anti-dsDNA, anti-SmD1, and anti-nucleosomes.

Plasma/Serum Leptin Levels in Patients with Ankylosing Spondylitis: A Systematic Review and Meta-analysis.

BACKGROUND AND AIMS: Leptin is an adipokine that has several effects on metabolism and immune system in patients with ankylosing spondylitis (AS). The present investigations of the relationship between plasma/serum leptin levels and AS are contradictory. To derive a more precise estimation on the plasma/serum leptin levels in AS patients and related factors, a meta-analysis was performed. METHODS: Published literature that compares plasma/serum leptin levels between AS group and control group from PubMed, Embase, Cochrane Library and other databases were searched. The study quality was assessed by the Newcastle-Ottawa scale. Pooled standardized mean difference (SMD) with its 95% confidence interval (CI) was calculated by fixed-effects or random-effect model analyses. Statistical heterogeneity within studies was examined by the Q statistic. RESULTS: A total of eight studies including 391 AS patients and 293 healthy controls were finally included in the meta-analysis. No significant differences in plasma/serum leptin levels was found between AS patients and healthy controls when all studies were pooled into the meta-analysis (pooled SMD = 0.384, 95% CI = -1.522 to 0.753). Meanwhile, subgroup analyses by gender also showed no significant differences in plasma/serum leptin levels between case group and controls. CONCLUSION: There is no significant difference in plasma/serum leptin levels between AS patients and controls.

Construction of a microrobot system using magnetotactic bacteria for the separation of Staphylococcus aureus.

Magnetotactic bacteria exhibit superiority over other bacteria in fabricating microrobots because of their high motility and convenient controllability. In this study, a microrobot system is constructed using magnetotactic bacteria MO-1 and applied in pathogenic separation. The feasibility of this approach is demonstrated using Staphylococcus aureus. The MO-1 magnetotactic bacterial microrobots are fabricated by binding magnetotactic bacteria MO-1 with their rabbit anti-MO-1 polyclonal antibodies. The efficient binding of MO-1 magnetotactic bacterial microrobots to Staphylococcus aureus is corroborated by phase contrast microscopic and transmission electron microscopic analyses. Further, a microfluidic chip is designed and produced, and the MO-1 microrobots are magnetically guided toward a sample pool in the chip. In the sample pool, Staphylococcus aureus samples are loaded on the microrobots and then carried away to a detection pool in the chip, suggesting the microrobots have successfully carried and separated pathogen. This study is the first to demonstrate bacterial microrobots carrying pathogens and more importantly, it reflects the great potential of using magnetotactic bacteria to develop magnetic-guided, auto-propelled microrobots for pathogen isolation.

[The expression and clinical significance of IL-17AR on peripheral blood B cells of patients with systemic lupus erythematosus].

AIM: To investigate the expressions of Interleukin-17A receptor (IL-17AR) on the peripheral blood B lymphocytes of SLE patients and to analyze the correlations between IL-17AR and clinical parameters. METHODS: Expression of IL-17AR on peripheral blood CD19(+);B lymphocytes were analyzed in 60 SLE patients and 33 healthy controls by flow cytometry. The difference of IL-17AR expression levels in two groups were compared. Furthermore, the correlation between IL-17AR expressions and clinical some measures, such as ESR, CRP, complement 3(C3), complement 4(C4), the amount of serum IgG, anti double strands DNA antibody, anti nuclear antibody, SLEDAI score and urine protein excretion were analyzed. RESULTS: Compared with healthy subjects, the proportions of B cells expressing IL-17AR were higher among SLE patients. In SLE patients, groups with mouth ulcer, serositis, renal lesions or immunologic abnormality were higher than the negative groups separately. The positive correlations were observed between IL-17AR expression levels and clinical measure of the SLEDAI, CRP and serum triglyceride level. The negative correlation was observed between IL-17AR expression levels and clinical measure of the serum indirect bilirubin level, serum albumin level. CONCLUSION: Interleukin-17A receptor expression increased on peripheral blood B cells of SLE patients, and correlate with clinical measures.

[Preparation and identification of the oligonucleotide chip for detecting the virulence-associated genotypes and drug resistance of Helicobacter pylori].

OBJECTIVE: To develop an oligonucleotide microarray-based method for the simultaneous detection of Helicobacter pylori (Hp) infection, virulence-associated genotypes, and drug resistance. METHODS: Hp was classified into cagA + and cagA- genotypes based on its virulence. Clarithromycin-resistance of Hp was identified by existence of point mutations in 23S rRNA. We constructed an oligonucleotide microarray chip to simultaneously diagnose Hp infection and detect its virulence-associated genotypes and mutations associated with clarithromycin-resistance. The diagnostic accuracy of the constructed microarray was tested with templates of wild type and mutated type. RESULTS: The oligonucleotide chip accurately detected cagA + and cagA- genotypes of Hp, as well as four common point mutations in 23S rRNA related to clarithromycin-resistance. CONCLUSION: Oligonucleotide microarray chip can be used to diagnose Hp infection and test its virulence-associated genotypes and drug resistance simultaneously.

Influence of dexamethasone on inflammatory mediators and NF-kappaB expression in multiple organs of rats with severe acute pancreatitis.

AIM: To observe the therapeutic effects of dexamethasone on rats with severe acute pancreatitis (SAP) and investigate the influences of dexamethasone on the inflammatory mediators and NF-kappaB expression in multiple organs of SAP rats as well as the mechanisms involved. METHODS: Ninety Sprague-Dawley (SD) rats with SAP were randomly divided into the model group (n = 45) and dexamethasone treatment group (n = 45), and another 45 rats were selected for the sham operation group. All groups were randomly subdivided into the 3 h, 6 h and 12 h groups, each group containing 15 rats. The survival of all groups and pathological changes of multiple organs (liver, kidney and lung) were observed at different time points after the operation. The pathological score of multiple organs was carried out, followed by the determination of amylase, endotoxin and TNF-alpha contents in blood. The tissue microarray was used to detect the expression levels of NF-kappaB p65 protein in multiple organs. RESULTS: There was no marked difference between the model group and treatment group in the survival rate. The amylase content of the treatment group was significantly lower compared to the model group at 12 h (P < 0.01, 7791.00 vs 9195.00). Moreover, the endotoxin and TNF-alpha levels of the treatment group were significantly lower than that of the model group at 6 h and 12 h (P < 0.01, 0.040 vs 0.055, 0.042 vs 0.059 and P < 0.05, 58.30 vs 77.54, 38.70 vs 67.30, respectively). Regarding the changes in liver NF-kappaB expression, the model group significantly exceeded the sham operation group at 3 h (P < 0.01, 1.00 vs 0.00), and the treatment group significantly exceeded the sham operation group at 12 h (P < 0.01, 1.00 vs 0.00), whereas no marked difference was observed between the model group and treatment group at all time points. The kidney NF-kappaB expression level in the treatment group significantly exceeded the model group (P < 0.05, 2.00 vs 0.00) and the sham operation group (P < 0.01, 2.00 vs 0.00) at 12 h. No NF-kappaB expression in the lung was found in any group. CONCLUSION: Dexamethasone can lower the amylase, endotoxin and TNF-alpha levels as well as mortality of SAP rats. NF-kappaB plays an important role in multiple organ injury. Further studies should be conducted to determine whether dexamethasone can ameliorate the pathological changes of multiple organs by reducing the NF-kappaB expression in the liver and kidney. The advantages of tissue microarrays in pancreatitis pathological examination include time- and energy- saving, and are highly efficient and representative. The restriction of tissue microarrays on the representation of tissues to various extents due to small diameter may lead to the deviation of analysis.

[Expression and purification of recombinant human interleukin 4 in Escherichia coli].

Human interleukin 4 (IL-4) cDNA was optimized and synthesized according to E. coli preferred codon. A recombinant expression plasmid pET-30a (+)/rhIL-4 was constructed with the target cDNA inserted between Nde I and EcoR I sites, which can translate the mature IL-4 protein with an extra methionine residue at N-terminal. The expression vector was transformed into E. coli BL21 (DE3). The rhIL-4 protein was expressed in the inclusion body. By using the optimized fermentation conditions, the high expression level was achieved with the expression level as high as 35% of total protein obtained. A purification strategy has been designed which includes Q-Sepharose and SP-Sepharose ion-exchange chromatography and dialysis renaturation. The rhIL-4 was purified with the purity more than 98% and the yield of 40 mg per liter fermentation culture achieved. Western blot proved that the purified protein is IL-4. Amino acid sequencing revealed that N-terminal 16 residue sequence is identical to the theoretical sequence. Biological activity assay on TF-1 cells demonstrated that the rhIL-4 is active with an activity of 2.5 x 10(6) AU/mg. This study promises large scale production of rhIL-4.

[Detection of P53 and K-ras gene mutations in lung cancer with oligonucleotide chip].

Different factors including hybridization solution components, hybridization temperature, and the concentration and proportion of the labelled primer, which affected the sensitivity and specificity of single mutation identification, were exploited. Asymmetric PCR increased the hybridization sensitivity, and the asymmetric multi-PCR did not affect the specificity, while the sensitivity was improved a little. Among 30 lung cancer samples detected with the oligonucleotide microarray, 12 was found P53 gene mutations and 5 had K-ras gene mutations. The P53 gene mutations identified by the oligonucleotide microarray was proved 80% same as the sequencing results. The obvious statistical relations of K-ras and P53 gene mutations with tumor type, tumor stage and smoking were not obtained because of less samples and mutation sites.