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Objective:To systematically evaluate the role of air pollutants in the development and exacerbation of autoimmune rheumatic diseases.Methods:We followed PRISMA guidelines and searched EMBASE, Scopus, PubMed, and Cochrane Library databases using keywords and MeSH terms from inception to July 2019. Observational studies reporting the relationship between autoimmune rheumatic diseases and exposure to certain air pollutants were included. Screening of literature according to established inclusion and exclusion criteria. No meta-analysis but the qualitative analysis was conducted due to the high methodological heterogeneity.Results:A total of 24 studies were included. Rheumatoid arthritis (RA) ( n=6), anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) ( n=1), ankylosing spondylitis (AS) ( n=1), systemic lupus erythematosus (SLE) ( n=3), childhood-onset systemic lupus erythematosus (cSLE) ( n=3), juvenile idiopathic arthritis (JIA) ( n=2), Kawasaki disease (KD) ( n=4), systemic autoimmune rheumatic diseases (SARD) ( n=4). The results of the study suggested that short-term elevation in particulate matter (PM)2.5 concentration was possibly associated with an increased risk of SLE and cSLE flare-ups, disease activity of AS, JIA and SARDs exacerbation. Studies demonstrated an increased risk of RA with cumulative exposure to carbon monoxide (CO), nitrogen dioxide (NO 2), ozone (O 3), and sulfur dioxide (SO 2). Only one study demonstrated an increased risk of KD admission with elevated O 3 levels. No association was found between AAV and ambient air pollution. Conclusion:Air pollution is likely to be involved in the development and exacerbation of certain autoimmune diseases. At the same time, the mechanism of autoimmune diseases of ambient air pollutants should be actively studied, so as to promote the early prevention of cardiovascular diseases.
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Objective:To systematically evaluate the effectiveness and safety of intra-articular in-jection of mesenchymal stem cells (MSCs) and hyaluronic acid (HA) in the treatment of knee osteoarthritis.Methods:The relevant literatures published in both English and Chinese were systematically searched in PubMed, Embase, Wanfang database, China Knowledge Network (CNKI), SinoMed database and other data-bases from inception to May 2020. Two researchers independently extracted data and evaluated the included literature. Risk assessment of literature bias was carried out. RevMan 5.3 software was used for Meta analysis, and the combined sensitivity were calculated.Results:Finally, 13 references were included, including a total of 726 patients with knee osteoarthritis. Meta-analysis results showed that compared with the HA group, the Western Ontario and McMaster University Osteopathic Index Total Score (WOMAC) [ MD=-10.92, 95% CI (-16.87, -4.96), P<0.01], the visual analogue scale (VAS) score [ MD=-1.70, 95% CI(-2.44, -0.95), P<0.01], and the knee joint Lequesne index score of MSCs group all decreased significantly [ MD=-13.78, 95% CI (-15.03,-12.52), P<0.01]. Furthermore, there was no significant difference in the incidence of adverse events (AEs) between the two groups [ RR=1.11, 95% CI(0.90, 1.37), P=0.33]. However, American Knee Association Score (AKS score) [ MD=-10.15, 95% CI(-22.33, 2.03), P=0.10] and whole-organ magnetic resonance imaging score (WORMS) [ MD=-3.93, 95% CI(-11.60, 3.75), P=0.32] were not statistically significant ( P>0.05). Conclusion:Compared with intra-articular injection of HA, intra-articular injection of MSCs can significantly improve the symptoms and dysfunction, and has favorable clinical tolerability and safety, suggesting that MSCs is expected to bea new treatment for knee osteoarthritis.
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OBJECTIVE@#To investigate the antitumor activity of decoction and study its liver and kidney toxicity and its effect on the immune system in a tumor-bearing mouse model.@*METHODS@#Hepatoma H22 tumor-bearing mouse models were randomized into model group, cyclophosphamide (CTX) group, and low-, moderate-, and high-dose decoction groups (JW-L, JW-M, and JW-H groups, respectively). The antitumor activity of decoction was assessed by calculating the tumor inhibition rate and pathological observation of the tumor tissues. Immunohistochemistry was used to detect the expressions of Bax, Bcl-2, Bax/Bcl-2 and caspase-3 in the tumors. The liver and kidney toxicity of decoction was analyzed by evaluating the biochemical indicators of liver and kidney functions. The immune function of the tumor-bearing mice were assessed by calculating the immune organ index, testing peripheral blood routines, and detection of serum IL-2 and TNF-α levels using enzyme-linked immunosorbent assay.@*RESULTS@#Compared with that in the model group, the tumor mass in CTX, JW-M and JW-H groups were all significantly reduced ( < 0.05) with cell rupture and necrosis in the tumors. Immunohistochemistry revealed obviously up-regulated expressions of Bax and caspase-3 and down- regulated expression of Bcl-2 protein with an increased Bax/Bcl-2 ratio in CTX, JW-M and JW-H groups. Treatment with decoction significantly reduced Cr, BUN, AST and ALT levels, improved the immune organ index, increased peripheral blood leukocytes, erythrocytes and hemoglobin levels, and up-regulated the levels of TNF-α and IL-2 in the tumor-bearing mice. These changes were especially significant in JW-H group when compared with the parameters in the model group ( < 0.01).@*CONCLUSIONS@# decoction has a strong anti-tumor activity and can improve the liver and kidney functions of tumor-bearing mice. Its anti-tumor effect may be attributed to the up-regulation of Bax, caspase-3, TNF-α and IL-2 levels and the down-regulation of Bcl-2 expression as well as the enhancement of the non-specific immune function.
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Animals , Mice , Antineoplastic Agents, Phytogenic , Pharmacology , Carcinoma, Hepatocellular , Drug Therapy , Allergy and Immunology , Metabolism , Pathology , Drugs, Chinese Herbal , Pharmacology , Kidney , Liver , Pathology , Liver Neoplasms , Drug Therapy , Allergy and Immunology , Metabolism , Pathology , Necrosis , Neoplasm Proteins , Metabolism , Random Allocation , Up-RegulationABSTRACT
Objective· To investigate the clinical features of macrophage activation syndrome (MAS) associated with adult-onset Still's disease (AOSD),and provide the basis for clinical diagnosis and treatment of the disease.Methods· The clinical data of 42 patients with AOSD,including 14 patients with AOSD-induced MAS (the MAS group) and 28 AOSD patients paired by age and sex (the non-MAS group),diagnosed in Department of Rheumatology,Renji Hospital,Shanghai Jiao Tong University School of Medicine from October 2013 to June 2016 were collected and then retrospectively analyzed.Results· There was no significant difference in age,sex and duration of AOSD between two groups.The mortality rate of patients in MAS group was significantly higher than that of patients in non-MAS group,as well as the rates of rash,splenomegaly and hemophagocytosis.The levels of ALT and serum ferritin in MAS group were higher than those in non-MAS group,while the level of FDP is lower.Glucocorticoids were used in all 42 patients,and the dosage of glucocorticoids was significantly higher in MAS group than non-MAS group.Only 1 patient with AOSD-induced MAS received MTX,the percentage of patients receiving MTX was significantly lower in MAS group than non-MAS group.Five patients with AOSD-induced MAS received IVIG,the percentage of patients receiving IVIG was significantly higher in MAS group than non-MAS group.Two patients with AOSD-induced MAS received VP-16.Conclusion · The mortality rate of patients in MAS group was significantly higher than that of patients in non-MAS group,as well as the rates of rash,splenomegaly and hemophagocytosis.The levels of ALT and serum ferritin in patients with AOSD-induced MAS were higher than patients without MAS,while the level of FDP was lower.Early diagnosis and active treatment is the key point to improve clinical outcome.
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Objective:To study relationship between B10 cells and the incidence of autoimmune diabetes in nonobese diabetic mice. Methods:20 NOD/LT female mice of 6 week old were cultured in normal culture to 30 weeks,and the mice were divided into two groups according the mice’s blood glucose,serum creatinine and body weight detected at their 30 weeks old. IL-10 levels in spleen tissues of the two groups were detected by enzyme-linked immunosorbent assay. We used flow cytometry to detect the proportion of B10 cells in the spleen of mice in the two groups. NOD/LT mice were randomly divided into control group and B10 group. The B10 cells were inoculated in B10 groups,their blood glucose were detected when they were 10,15,20,25 and 30 weeks old. Results: The blood glucose and serum creatinine levels were significantly higher in the group than that in the autoimmune diabetes group (P< 0. 05),and the body weight was significantly lower than that in the autoimmune diabetes group (P<0. 05). The level of IL-10 in the spleen tissues of the autoimmune diabetes mice was significantly higher than that in the non autoimmune diabetes group. The content of B10 cells in the spleen of the mice with autoimmune diabetes mellitus was significantly higher than that in the non autoimmune diabetes group. When mice at the age of 10,15 weeks,the incidence of autoimmune diabetes in B10 group was significantly lower than that in the control group,but the incidence of autoimmune diabetes in B10 group was significantly higher than that in control group at 20,25 and 30 weeks. Conclusion:The over accumulation of B10 cells may be one of the reasons for the further development of autoimmune diabetes in NOD mice.
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OBJECTIVE:To observe therapeutic efficacy of adjuvant treatment of Xuebijing injection for severe acute pancreati-tis. METHODS:80 cases of severe acute pancreatitis were randomly divided into control group and observation group with 40 cas-es in each group. Control group was given symptomatic and supportive treatment,and observation group was additionally given in-travenous injection of Xuebijing injection 100 ml,twice a day,on the basis of control group. The levels of TNF-α,IL-6 and hs-CRP,organ failure were compared between 2 groups before and after treatment. RESULTS:There was no statistical significance in the levels of TNF-α,IL-6 and hs-CRP in 2 groups before treatment(P>0.05);after treatment,the levels of TNF-α,IL-6 and hs-CRP in observation group was significantly lower than control group and before treatment,with statistical significance (P<0.05). The proportion of renal function,respiration function and circulating failure in observation group were significantly lower than in control group,with statistical significance (P<0.05). CONCLUSIONS:Adjuvant treatment of Xuebijing injection for se-vere acute pancreatitis can significantly reduce the level of inflammation in the body and reduce organ damage.
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Objective To explore the association between serum neutrophil‐to‐lymphocyte ratio (NLR) and DR in T2DM patients . Methods A total of 128 T2DM patients were recruited and divided into three groups :PDR group (n=22) ,NPDR group(n= 44) ,and simple T2DM group(n=62) .The levels of FPG ,HbA1 c ,TC ,TG and NLR were measured in each group . Results Spearman correlation analysis revealed that DR was positively correlated with T 2DM duration ,SBP ,DBP ,FPG ,HbA1 c ,TC , TG ,LDL‐C ,NLR ,CKD (r= 0.524 ,0.277 ,0.279 ,0.194 ,0.271 ,0.208 ,0.223 ,0.358 ,0.621 , 0.362 ,P<0 .05 or P<0 .01) .Logistic multiple regression analysis showed that ,T2DM duration ,NLR and CKD were independent risk factors for DR . Conclusion NLR level is associated with DR .
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Objective Objective To analysis the clinical curative effect on elderly patients with choledocholithiasis by endoscopic retro-grade cholangiopancreatography ( ERCP) and endoscopic sphincterotomy ( EST) and discuss its clinical significance. Methods 256 patients with choledocholithiasis were collected for diagnosis and treatment by ERCP. The stone characteristics was mastered by ERCP and the pa-tients were treated with EST. Results Patients with choledocholithiasis were successful in 249 cases (97. 27%) for ERCP intubation and 239 cases (93. 36%) for stone remove. After EST,the stones were removed successfully at one time in 199 cases (83. 26%),2 times in 40 cases (16. 74%). 7 patients (2. 73%) with multiple diverticulum and papillary position poor by intubation failure were changed over to op-eration treatment. After ERCP,patients were performed endoscopic nasobiliary drainage (ENBD) 64. 44% (154/239). Pull out the drain-age tube of 90. 91% (140/154) of the patients after stones disappeared which was proved by angiography for 3~5 days. 14 cases (9. 09%) were performed second times to remove the stones due to the presence of residual stones. Postoperative complications occured in 15 cases (6. 02%) including 9 cases of acute pancreatitis and 6 cases of infection of biliary tract, and they were cured after 1 week of corresponding treatment. Transient increase of serum amylase occurred in 39 cases, and all of them recoveried after 3 days without special treatment. Con-clusion The results showed that ERCP ( or EST) were well tolerated by elderly patients with choledocholithiasis,and they were of obvious curative effect and quick recovery,which is worthy of promotion and application.
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Objective To investigate the preventive effect of Indomethacin for post-ERCP pancreatitis and hyperamylasemia.Methods A total of 600 patients,who were undergoing ERCP,were randomly divided into 3 groups to receive anal Indomethacin (n=200),intravenous octreotide (n=200) or no special medication (n=200) before ERCP.The level of serum amylase before and 24h after ERCP were measured,and the rate of acute pancreatitis and hyperamylasemia after ERCP were assessed.Results Serum amylase levels before ERCP of all groups were normal.The mean serum amylase level of Indomethacin group (101.3±77.7 U/L) after ERCP was significantly lower than those of octreotide group ( 176.6±138.3 U/L,P =0.040 ]and control group (227.2±264.9 U/L,P=0.048),while there was no difference between octreotide group and control group ( P＞0.05 ).The incidence of post-ERCP pancreatitis in Indomethacin group (2.5％) was significantly lower than that of control group (9.5％,P=0.003),while there was no difference between octreotide group (4.5％) and control group ( P=0.05 ).The incidence of hyperamylasemia after ERCP in Indomethacin group (5.5％) was significantly lower than that of control group ( 13.5％,P=0.006 ),while there was no difference between octreotide group (10.0％) and control group ( P＞0.05 ).Conctusion Anal administration of Indomethacin before ERCP can effectively reduce the incidence of acute pancreatitis and hyperamylasemia after ERCP.
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Objective To investigate the role of macrophage migration inhibitory factor (MIF) gene polymorphisms in adult onset Still's disease(AOSD).Methods Plasma MIF levels were measured by enzymelinked immunosorbent assay (ELISA).Genomic DNAs were collected from patients and controls.The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay and short tandem repeat genotyping were used to detect the polymorphisms of MIF gene promoter.The -173 G/C SNP and -794 CATT repeat genotype and allele frequencies between patients and controls were capared using pearson's Chi-square test.The non-parmetric Mann-Whithey U test was conducted to compare MIF expressin between cases and controls.Results Plasma MIF levels were significantly higher in AOSD (119±113) ng/ml than those in controls (55±29) ng/ml (P＜0.01).Individuals with -173 * C allele (OR=1.776; 95％CI 1.101-2.864; P=0.017) or -794 *5-CATT allele (OR=1.81;95％CI 1.27-2.58; P=0.001) were at increased risk for AOSD.Conclusion The MIF gene polymorphisms are associated with AOSD.
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<p><b>OBJECTIVE</b>To develop a method for the determination of harpagide and harpagoside in Scrophulariae Radix (Xuanshen) by HPLC-UV under double wavelength, and to study the changes of these two constituents during processing, and to set the limitation of harpagide and harpagoside contents in crude drug and sliced pieces of Xuanshen.</p><p><b>METHOD</b>The analyses were performed on an Agilent Technologies ZORBAX SB-C18 (4.6 mm x 250 mm, 5 microm) eluted with acetonitrile-water (containing 0.03% phosphoric acid) in gradient model. The flow rate was 1.0 mL x min(-1) . The column temperature was 25 degrees C. The UV detector wavelength was set at 210 nm before 13 min and then changed to 280 nm.</p><p><b>RESULT</b>Harpagide and harpagoside were separated well. The linear calibration curves were obtained over of 0.0549 - 1.46 microg for harpagide (r = 0.9999, n =7) ,0.0225 - 0.900 microg for harpagoside (r = 0.9998, n = 9). The recoveries ( +/- RSD)% were 98.1 (+/- 2.4)% for harpagide and 98.8 (+/- 4.3)% for harpagoside. The contents of harpagide were 0. 277% - 0.620%, harpagoside were 0.078% - 0.362% in Xuanshen, and harpagide were 0.276% - 1.059%, harpagoside were 0. 059% - 0.183% in sliced Xuanshen, respectively. After the processing of Scrophulariae Radix, the content of harpagide increases 13.7% - 96.0%, while harpagoside decreases 11.0%-73.9%.</p><p><b>CONCLUSION</b>This method is simple, accurate, and can be used for the quality control of Scrophulariae Radix. We propose that the total content of harpagide and harpagoside in either crude drug or sliced pieces of Scrophulariae Radix should not be less than 0.45%.</p>