ABSTRACT
Rheumatoid arthritis （RA） is a common autoimmune disease. Excessive hyperplasia of synovial tissues and osteoclastic bone absorption are two main causes of bone and joint destruction in RA. Synovial fibroblasts in RA （RA-FLS） are important cells in the synovial tissues of RA. The changes in their growth characteristics and inhibition of apoptosis lead to the proliferation of synovial tissues， stimulate inflammatory reactions， damage joint structure， and result in joint dysfunction. Therefore， regulating abnormal proliferation and promoting apoptosis of RA-FLS can interfere with the pathogenesis of RA. At present， there are many studies on the effect of Chinese medicine and its monomer components on the excessive proliferation and apoptosis of RA-FLS. The present study reviewed the effect of RA-FLS in RA and the intervention of Chinese medicinal monomers and compounds by regulating RA-FLS. The results showed that monomer components mainly included terpenoids， flavonoids， alkaloids， and anthraquinones. Despite different types， they can effectively intervene in RA through different approaches. For instance， they can prevent bone and cartilage injury by inhibiting the secretion of inflammatory cytokines and inhibiting the generation of chondrocytes and osteoclasts. They can achieve apoptosis by up-regulating the pro-apoptotic genes B-cell lymphoma 2 （Bcl-2）， Bcl-2-associated X protein （Bax）， and cysteinyl aspartate-specific protease （Caspase） in the Fas/FasL， nuclear factor-κB （NF-κB）， Janus kinase （JAK）/signal transducer and activator of transcription protein （STAT）， and p38 mitogen-activated protein kinase （p38 MAPK） signaling pathways， and down-regulating the anti-apoptotic genes Bcl-xl and Bcl-2. They can also inhibit the proliferation of RA-FLS by inhibiting the protein expression of microtubule-associated protein 1 light chain 3Ⅱ（LC3Ⅱ）/LC3Ⅰ and Beclin-1. Although their molecular mechanisms of action and targets are different， they all exert corresponding roles. The above research results provide a scientific basis for elucidating the multi-component and multi-target characteristics of Chinese medicine in the treatment of RA.
ABSTRACT
Objective:To investigate the molecular characteristics, drug resistance rate and virulence genes harboring status of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) associated with skin and soft tissue infections (SSTIs), and provide epidemiological basis for clinical antibiotic usage and infection prevention and control. Methods:The Staphylococcus aureus associated with SSTIs in Quzhou People′s Hospital from 2014 to 2018 were retrospectively analyzed. A total of 72 CA-MRSA isolates were screened, and molecular typing was performed by multilocus sequence typing (MLST). K-B method and micro broth dilution method were used to analyze the antibiotic susceptibilities of those strains. The virulence genes screened including fibronectin binding protein genes (fnbA, fnbB),hemolysin genes (hla, hlb), enterotoxin genes (sec, seh) and leukocidin gene (PVL) were detected by polymerase chain reaction (PCR).Statistical analysis of differences between drug resistance rates and virulence genes carrier rates between ST59 and non-ST59 groups used were Chi-square test or Fisher exact test. Results:ST59 type was the main epidemic clone in skin and soft tissue infection CA-MRSA in Quzhou area with account for 55.56% (40/72). All isolates had higher resistance rates to erythromycin (90.28%, 65/72), clindamycin (68.06%, 49/72) and tetracycline (41.67%, 30/72). The nitrofurantoin, daptomycin and linezolid were all sensitive. The resistance rate to clindamycin of sequence type 59 (ST59) was (85.00%, 34/40). The resistance rate of ST59 to clindamycin was significantly higher than that of other clone types (χ 2=11.886, P<0.01). There was no significant difference in the resistance rates of other antibiotics. All 72 isolates exhibited carriage of virulence genes as follows, hla (97.22%, 70/72) , hlb (33.33%, 24/72) , fnbA (50.00%, 36/72) , fnbB (48.61%, 35/72) , PVL (63.89%, 46/72) , sec (4.17%, 3/72) , seh (4.17%, 3/72) . The carrier rate of PVL gene in ST59 type was (77.50%, 31/40). ST59 showed higher rates of PVL genes compared with other clone types (χ 2=7.227, P<0.01). Conclusions:The main clone of CA-MRSA associated with SSTIs in Quzhou was ST59, which was similar to other parts of the Country. The carrying rate of PVL gene of ST59 isolate was significantly higher than that of other isolates. CA-MRSA associated with SSTIs has a high resistance rate to erythromycin and clindamycin, which should not be used as the first choice in treatment.
ABSTRACT
Objective The aim of this study was to evaluate the value of pleural effusion heparin-binding protein ( HBP) in differential diagnosis of parapneumonic effusion .Methods Case-control study. The pleural effusion of 189 patients with pleural effusion admitted to Quzhou People's Hospital from February to July 2018, including parapneumonic effusion (n=72), tuberculous pleural effusion (n=24), cases of malignant pleural effusion ( n=46 ) and transudative pleural effusion ( n=47 ) were collected.Routine analysis,lactate dehydrogenase(LDH),adenosine deaminase (ADA) and total protein(TP)examination of all pleural effusions were performed .The levels of heparin-binding protein in the patients'pleural fluid were measured by ELISA.The difference in the overall level of each group was determined by One-way ANOVA or LSD test followed by Kruskal-Wallis H test dependence on the homogeneity of variances .The categorical data was analyzed by chi-square test.Receiver operating characteristic ( ROC) curve was plotted to evaluate the diagnostic value of heparin-binding protein for parapneumonic effusion . Results The concentration of heparin-binding protein was low in malignant pleural effusion [15.2(8.4, 33.3) ng/ml] and transudative effusion[14.1(6.5, 23.0)ng/ml], but high in parapneumonic effusion[316.1(99.5,399.8)ng/ml]and tuberculous pleurisy [64.7 (18.6, 96.8) ng/ml] .The heparin-binding protein level in parapneumonic effusion was significantly different from the other three groups (H=120.3,P<0.05).The receiver operating characteristic curve analysis for an optimal discrimination between parapneumonic effusion from non -parapneumonic effusion could be performed at a cut-off point of 64.2 ng/ml with area under the curve of 0.953[sensitivity:88.9％(64/72), specificity:89.7％(105/117),positive predictive value:84.2％(64/76), negative predictive value:92.9％(105/113)].Conclusions Heparin-binding proteinin pleural fluid is effective to be used to classify parapneumonic effusion samples .The detection of heparin-binding protein in pleural effusion has good sensitivity and specificity .It could be a biomarker for differential diagnosis of parapneumonic effusion .