Oxidized low-density lipoproteins impair the pro-atherosclerotic effect of granulocyte-macrophage-colony-stimulating factor-producing T helper cells on macrophages.

T cells contribute to the pathogenesis of atherosclerosis. However, the presence and function of granulocyte-macrophage-colony-stimulating factor (GM-CSF)-producing T helper (ThGM) cells in atherosclerosis development is unknown. This study aims to characterize the phenotype and function of ThGM cells in experimental atherosclerosis. Atherosclerosis was induced by feeding apolipoprotein E knockout (ApoE-/-) mice with a high-fat diet. Aortic ThGM cells were detected and sorted by flow cytometry. The effect of oxidized low-density lipoprotein (oxLDL) on ThGM cells and the impact of ThGM cells on macrophages were evaluated by flow cytometry, quantitative RT-PCR, oxLDL binding/uptake assay, immunoblotting and foam cell formation assay. We found that GM-CSF+IFN-γ- ThGM cells existed in atherosclerotic aortas. Live ThGM cells were enriched in aortic CD4+CCR6-CCR8-CXCR3-CCR10+ T cells. Aortic ThGM cells triggered the expression of interleukin-1ß (IL-1ß), tumour necrosis factor (TNF), interleukin-6 (IL-6) and C-C motif chemokine ligand 2 (CCL2) in macrophages. Besides, aortic ThGM cells expressed higher CD69 than other T cells and bound to oxLDL. oxLDL suppressed the cytokine expression in ThGM cells probably via inhibiting the signal transducer and activator of transcription 5 (STAT5) signalling. Furthermore, oxLDL alleviated the effect of ThGM cells on inducing macrophages to produce pro-inflammatory cytokines and generate foam cells. The nuclear receptor subfamily 4 group A (NR4A) members NR4A1 and NR4A2 were involved in the suppressive effect of oxLDL on ThGM cells. Collectively, oxLDL suppressed the supportive effect of ThGM cells on pro-atherosclerotic macrophages.

Identification of heterogeneous subsets of aortic interleukin-17A-expressing CD4+ T cells in atherosclerotic mice.

OBJECTIVES: T helper 17 (Th17) cells are involved in the inflammatory response of atherosclerosis. However, their heterogeneity in the atherosclerotic aorta remains elusive. This study was designed to identify aortic Th17 subsets. METHODS: The surface markers and transcription factors of aortic interleukin-17A (IL-17A)-expressing T cells were determined by flow cytometry in an ApoE-deficient mouse atherosclerotic model. Viable aortic IL-17A-expressing T cell subsets were isolated by flow cytometry on the basis of surface markers, followed by characterizing their transcription factors by either flow cytometry or real-time RT-PCR. The effect of aortic IL-17A-expressing T cell subsets on aortic endothelial cells was determined in vitro. RESULTS: C-X-C Motif Chemokine Receptor 3 (CXCR3), interleukin-17 receptor E (IL-17RE), CD200, and C-C Motif Chemokine Receptor 4 (CCR4) marked three subsets of aortic IL-17A-expressing T cells: CXCR3+IL-17RElowCD200+CCR4- T cells expressing T-box protein expressed in T cells (T-bet) and interferon-gamma (IFN-γ), CXCR3+IL-17RElowCD200+CCR4+ T cells expressing T-bet but fewer IFN-γ, and CXCR3-IL-17REhighCD200+CCR4+ T cells expressing very low T-bet and no IFN-γ. Based on these markers, viable aortic Th17 cells, Th17.1 cells, and transitional Th17.1 cells were identified. Both Th17.1 cells and transitional Th17.1 cells were more proliferative than Th17 cells. Compared with Th17 cells, Th17.1 cells plus transitional Th17.1 cells induced higher expression of C-X-C motif chemokine ligand 1 (CXCL1), C-C motif chemokine ligand 2 (CCL2), C-X-C motif chemokine 5 (CXCL5), and granulocyte-macrophage colony-stimulating factor (GM-CSF) in aortic endothelial cells. CONCLUSION: IL-17A-expressing CD4+ T cells were heterogeneous in atherosclerotic aortas.

Clavicle hook plate versus distal clavicle locking plate for Neer type II distal clavicle fractures.

BACKGROUND: The purpose of this meta-analysis was to compare clavicle hook plates versus distal clavicle locking plates for the treatment of Neer type II distal clavicle fractures. METHODS: PubMed (1996 to January 2019), Embase (1980 to January 2019), Web of Science (1990 to January 2019), the Cochrane Library (January 2019), and the China National Knowledge Infrastructure (January 2019) were systematically searched without language restrictions for literature retrieval. The Constant-Murley shoulder joint function score at 3 and 6 months after the operation and the postoperative complications after the operation (shoulder joint pain, abduction restriction, fracture delay healing, subacromial impingement) were the outcomes. Stata 12.0 was used for the meta-analysis. RESULTS: A total of 9 clinical trials involving 446 patients were finally included in this meta-analysis. The results showed that the improvement in the Constant-Murley shoulder joint function score in the distal locking plate group was better than that in the clavicle hook plate group at 3 and 6 months after the operation (P < 0.05). There were fewer cases of shoulder joint pain and restricted shoulder abduction range of motion in the distal locking plate group, and the difference was statistically significant (P < 0.05). There were no statistically significant differences in fracture delay healing and subacromial impingement between the two groups (P > 0.05). CONCLUSION: Compared with the clavicular hook plate, the distal clavicle locking plate for the treatment of Neer type II distal clavicle fractures is associated with better shoulder function recovery and fewer complications related to pain and abduction restriction.

Application of the triage and acuity scale in the emergency department of stomatological hospital / 口腔疾病防治

Objective@#This study aims to explore the effect of practice on the triage and acuity scale in the emergency department of Stomatological Hospital. @*Methods @#150 emergency patients admitted to the emergency department from April 2016 to July 2016 were randomly selected as the control group before the implementation of graded district diagnosis and treatment, and 150 emergency patients admitted from August 2016 to November 2016 were selected as the observation group after the implementation of graded diagnosis and treatment. The control group was treated with the traditional nursing treatment mode, and the observation group adopted the triage and acuity scale mode. The efficiency of treatment for the patients and the degree of satisfaction of the patients in terms of the nursing work was compared between the two groups (waiting time, checkup time, start treatment time). @*Results@#A comparison of the patients in the observation group and control group showed that the waiting time (min)(25.63 ± 8.75 vs. 35.57 ± 10.60, t = -8.52, P < 0.001), the time of accepting examination (min)(24.80 ± 7.90 vs. 39.23 ± 12.42, t = -12.01, P < 0.001) and the starting time of treatment （min）(28.67 ± 9.37 vs. 40.47 ± 10.86, t = -10.08, P < 0.001) were significantly lower in the observation group than the control group (P < 0.05). The degree of satisfaction with the nursing work for the patients in the observation group (96.67%) was higher than that of the control group (85.33%), and this difference was statistically significant (χ2=17.647, P=0.001). @*Conclusion@#The application of a triage and acuity scale in the diagnosis and treatment of stomatological emergency patients according to the severity and urgency of disease can ensure the priority of treatment in critically ill patients, the safe and efficient performance of emergency work, and improvements to the efficiency and quality of emergency medical services.

[Expression of MUC1 gene and MDR1 gene in non-M3 subtype acute leukemia and their correlations to clinical treatment efficacy].

BACKGROUND & OBJECTIVE: Mucin 1 (MUC1) gene is expressed in various tumors, and overexpressed in acute leukemia. This study was to evaluate the expression of MUC1 gene and multidrug-resistance protein-1 (MDR1) gene in non-M3 subtype acute leukemia and their correlations to clinical treatment efficacy. METHODS: The expression of MUC1 and MDR1 genes were measured in 34 patients with non-M3 subtype acute leukemia by reverse transcription-polymerase chain reaction (RT-PCR); their correlations to clinical treatment efficacy were observed. RESULTS: The positive rate of MUC1 gene in the 34 patients was 50.0%, and the positive rate of MDR1 gene was 29.4%. The positive rate of MDR1 was significantly higher in MUC1-positive patients than in MUC1-negative patients (52.9% vs. 5.9%, P=0.003). Complete remission (CR) rate was significantly higher in MUC1-negative patients than in MUC1-positive patients (94.1% vs. 52.9%, P<0.01). CR rate was significantly higher in MDR1-negative patients than in MDR1-positive patients (91.7% vs. 50.0%, P<0.05). In 9 patients with positive expression of both MUC1 and MDR1, the CR rate was 55.6%; while in 16 patients with negative expression of both MUC1 and MDR1, the CR rate was 100%. CONCLUSIONS: The non-M3 subtype acute leukemia patients with positive expression of MUC1 have high positive rate of MDR1. The patients with negative expression of both MUC1 and MDR1 have high CR. Co-detection of MUC1 gene and MDR1 gene can predict treatment efficacy on non-M3 subtype acute leukemia.