Treatment of severe active systemic lupus erythematosus by PMC therapy combined langchuang fuzheng jiedu capsule: a clinical observation / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of PMC therapy (Prednisone, Methotrexate, Chloroquine) combined Langchuang Fuzheng Jiedu Capsule (LFJC), thus choosing a better therapy of integrative medicine for SLE in the period of glucocorticoid use.</p><p><b>METHODS</b>Sixty active SLE patients were randomly assigned to two groups, the control group and the treatment group. Those in the control group received PMC therapy (As for Prednisone, it was given at the daily dose of 1 mg/kg till 2 weeks after the condition being stable or after 8 weeks of treatment. Then the dose was reduced by 10% every two weeks. When the dose was reduced to 0.5 mg/kg daily, it was reduced by 2.5 mg per two weeks. When the dose was reduced to 15 mg daily, the dose was reduced to 2.5 mg per four weeks. As for Methotrexate, 10 mg each time, once a week. As for Chloroquine, 100 mg each time, twice daily), while those in the treatment group received PMC therapy (the same way as that for the control group) combined with LFJC (consisting of Astragalus membranaceus 50 g, Angelica sinensis 20 g, Ligusticum Chuanxiong 20 g, prepared Rehmannia Rhizome 30 g, Herba Serissae 30 g, Centella 30 g, centipede 4 g, scorpions 10 g, nidus versace 12 g, et al., 0.5 g per pill, containing 5.7 g crude drug. When the hormone was given at a large dose, LFJC was administered at 12 pills each time, three times daily). When the hormone was given at a middle dose, LFJC was administered at 8 pills each time, three times daily. When the hormone was given at a small dose, LFJC was administered at 6 pills each time, three times daily. The treatment course was six months. The improvement of symptoms and signs between before and after treatment, SLE disease activity index (SLEDAI), efficacy of Chinese medical syndrome, UPro quantitation, erythrocyte sedimentation rate (ESR), complement 3 (C3), C-reactive protein (CRP), the reduction and withdrawal of hormones, and infection of the respiratory tract were observed.</p><p><b>RESULTS</b>The difference in post-SLEDAI was obviously larger in the treatment group than in the control group (P < 0.05). The fatigue severity scale (FSS) was less after treatment than before treatment in the treatment group, showing statistical difference when compared with that of the control group (P < 0.05). The total effective rate was 93.33% in the treatment group, showing statistical difference when compared with that of the control group (86.66%; chi2 = 6.736, P < 0.05). The ESR decreased after treatment in the treatment group, showing statistical difference when compared with that of the control group (P < 0.01). C3 increased after treatment in the treatment group, showing statistical difference when compared with that of the control group (P < 0.05). The hormone was reduced to (13.70 +/- 5.42) mg/d by the end of the therapeutic course in the treatment group, obviously less than that of the control group [(17.63 +/- 7.80) mg/d, P < 0.05). Seven patients suffered from secondary infection of the respiratory tract infection in the treatment group (5 from upper respiratory tract infection and 2 from lower respiratory tract infection), obviously less than those of the control group (25 from upper respiratory tract infection and 10 from lower respiratory tract infection) (P < 0.05).</p><p><b>CONCLUSIONS</b>PMC combined LFJC was a better treatment program for severe active SLE (SLEDAI > or = 15). It was more safe and effective when compared with using Western medicine alone. It could enhance the efficacy of hormones and help reduction/withdrawal of hormones.</p>

Antibiotic-PMMA beads combined with external fixator for treating the infected fracture nonunion / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the effects of antibiotic-PMMA (polymethyl-methacrylate) beads combined with external fixator in treatment of infected fracture nonunion.</p><p><b>METHODS</b>Twenty-two cases of infected fracture-nonunions were reviewed involving 20 male and 2 female with an average age of 34.68 years (ranging 21 to 74 years). The data consisted of 9 cases of tibial fractures, 2 distal fractures of the femur, 6 femoral shaft fractures, 3 intertrochanteric fracture of the femur and 2 humeral shaft fractures. The procedure included thorough debridement to wipe out dead bone and granulation tissue, then antibiotic-PMMA bead chains imbedded into the dead space. One week later, secondary debridement was performed, antibiotic-PMMA bead chains were changed according to result of bacterial culture and susceptibility test, and fractures were stabilized with external fixator. Three months after debridement, antibiotic-PMMA bead chains were taken out and bone graft with autogenous iliac cancellous bone chips was performed.</p><p><b>RESULTS</b>The mean follow-up period was 19.98 months (ranging 15 to 28 months). Infection was controlled in 20 cases. One tibial fracture and 1 intertrochanteric fracture of the femur needed repeated debridement 2 and 3 months after bone grafting respectively,because of infection recurrence and sinus formation. All 22 cases achieved bony union averaged 15.09 weeks after bone grafting with a range of 8 to 24 weeks.</p><p><b>CONCLUSION</b>Thorough debridement, imbedding antibiotic-PMMA bead chains combined with external fixator and staged bone grafting has proven to be effective and simple for treatment of infected fracture nonunion. The antibiotic bead delivers high tissue levels,obliterates dead space, aids bone repair.</p>

Expression of a novel human retroviral NP9 gene and potential roles of its protein in systemic lupus erythematosus patients / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the expression of a novel retroviral (NP9) gene transcripts and the possible role of its protein in systemic lupus erythematosus (SLE) patients.</p><p><b>METHODS</b>The retroviral NP9 gene in SLE patients was isolated and cloned using RT-PCR and TA cloning techniques, and it was analyzed by sequencing. The expression of the NP9 genes in 40 patients with SLE and 48 normal controls using RT-PCR was detected. NCBI BLAST and DNASIS 3.1 software were used to analyze the features of protein of NP9 gene.</p><p><b>RESULTS</b>The positive ratio (77.5%) of the mRNA expression of the retroviral NP9 gene in SLE patients is significantly higher than that (8.3%) in normal subjects (P<0.01). The recombinant NP9 protein comprises 74 AA with pI 9.59. Amino acid sequence analysis indicates that the retroviral NP9 protein shares higher homologies with several human proteins with important biological functions.</p><p><b>CONCLUSION</b>SLE patients possess specific novel retroviral NP9 transcripts. The expression of the retroviral NP9 gene may involve in the genesis or development of SLE.</p>

Molecular cloning of a novel retroviral NP9 gene of human endogenous retrovirus and its viral protein expression / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the relationship between retroviruses and autoimmune diseases, to clone the novel retroviral NP9 gene from human endogenous retrovirus (HERV), and to construct its expression vector.</p><p><b>METHODS</b>The viral NP9 gene was amplified and cloned by RT-PCR and T-A clone techniques, and its sequence was determined with Perkin-Elmer 377 DNA Sequencer. The amplified viral NP9 gene was subcloned into the prokaryotic express vector pQE30. The recombinant plasmids were identified by restriction endonuclease digestion and sequencing. The recombinant pQE30-NP9 protein was expressed in M15 host cells under the IPTG induction and showed with SDS-PAGE,and the corresponding NP9 viral protein was identified with Western blot analysis.</p><p><b>RESULT</b>A specific band of 250 bp was amplified using RT-PCR from total RNA of peripheral blood mononuclear cells (PBMCs) from patients with systemic lupus erythematosus (SLE) and confirmed as the NP9 gene via T-A clone and DNA sequencing analyses. SDS-PAGE profile showed a clear protein band with a relative molecular weight 9 kD in the IPTG-induced samples, which was confirmed as viral NP9 protein by Western blot analysis.</p><p><b>CONCLUSION</b>The NP9 gene has been successfully isolated and cloned from PBMCs of SLE patients and the corresponding NP9 viral protein expressed in prokaryotic expression vector.</p>