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Objective:To investigate the expression of B lymphocyte induced maturation protein 1 (Blimp-1) in peripheral blood CD4 + T cells, CD19 + B cells and labial glands of patients with primary Sj?gren′s syndrome (pSS) and the correlation of Blimp-1 with clinical features. Methods:Expression of PRDM1 at mRNA level in CD4 + T cells, CD19 + B cells and labial gland tissues were detected by RT-PCR. Immunohistochemistry (IHC) was used to observe the distribution of Blimp-1. Correlation of PRDM1 expression at mRNA level with clinical indicators was analyzed. Results:PRDM1 expression at mRNA level in CD4 + T and CD19 + B cells were significantly higher in pSS group than in healthy control (HC) group ( P<0.01). Based on European League Against Rheumatism Sj?gren′s Syndrome Disease Activity Index (ESSDAI), the patients were classified into two groups: active group (ESSDAI≥5) and inactive group (ESSDAI<5). PRDM1 expression at mRNA level in CD4 + T and CD19 + B cells were also higher in the active group than in inactive group ( P<0.05). Blimp-1 protein accumulated around the acinus and duct of labial gland and in the germinal center in pSS patients. PRDM1 expression at mRNA level in labial gland tissues of pSS patients was positively correlated with lymphocyte infiltration ( r=0.781, P<0.001). Conclusions:pSS displayed high expression of Blimp-1. Blimp-1 might affect pSS disease activity and have clinical significance in pSS treatment.
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Objective:To investigate the therapeutic effects of leflunomide on salivary gland secretion hypofunction in NOD mice with Sjogren′s syndrome.Methods:NOD mice were randomly divided into four groups: prevention group, prevention control group, treatment group and treatment control group. Salivary flow rate was measured after pilocarpine stimulation. Changes in the average number and area of infiltrating lesions were compared after hematoxylin and eosin (HE) staining. The percentages of CD3 + T, CD4 + T, CD8 + T, CD44 + CD62L -CD4 + T, CD19 + B and CD138 + B cells in submandibular gland and spleen were detected by flow cytometry. The levels of TNF-α, IL-17A and IL-6 in serum were detected by CBA method. Results:The salivary flow rate ( t=-5.81, P<0.001; t=-3.61, P<0.05), the number of infiltrating lesions( t=3.95, P<0.01; t=4.94, P<0.001)and the average area of infiltrating lesions( t=3.18, P<0.05; t=2.35, P<0.05)were significantly ameliorated in the prevention and treatment groups. Moreover, CD3 + CD4 + T cells( t=2.39, P<0.05; t=3.82, P<0.01)and CD44 + CD62L -CD4 + T cells( t=3.53, P<0.05; t=3.36, P<0.05)in the submandibular gland were significantly decreased. CD3 + T( t=6.08, P<0.001; t=2.76, P<0.05), CD3 + CD4 + T ( t=3.73, P<0.05; t=2.39, P<0.05), CD19 + B ( t=5.88, P<0.001; t=4.23, P<0.01) and CD138 + B cells ( t=4.30, P<0.001; t=4.46, P<0.01) in the spleen were also significantly reduced. Serum IL-17A ( t=4.15, P<0.01; t=3.36, P<0.01) in the two groups and TNF-α ( t=4.56, P<0.001) in the prevention group were down-regulated, but no significant difference was observed in IL-6 level. Conclusions:This study suggested that leflunomide could prevent and improve salivary gland hypofunction and inhibit immune activation in NOD mice, providing reference for evaluating leflunomide in the treatment of Sjogren′s syndrome.
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Objective To investigate the change and significance of regulatory T cells (Tregs) in peripheral blood in patients with acute and chronic gout. Methods Flow cytometry was used to detect the ratio of Tregs in peripheral blood of healthy controls, patients with acute gout and patients with chronic gout. Enzyme linked immunosorbent assay (ELISA) was used to detect the levels of transforming growth factor (TGF)-βand interleukin (IL)-1βin plasma. Then, statistical analysis was conducted to analyze the changes and significance in different stages of gout, such as F test, Kruskal-Walls H test, q test and Pearson and Spearman correlation analysis. Results ① The percentage of CD4+CD25+Foxp+Treg/CD4+ T cells in peripheral blood was (1.22±0.27)％ in control group. While in patients with acute gout, it was (1.51±0.43)％, and (0.47±0.26)％in patients with chronic gout. There were statistical significant difference among the three groups ( F=101.39, P<0.05). The percentage of Tregs in acute gout group was significantly higher than that in control group and chronic gout group, while it was significantly lower in chronic gout group than in control group ( P<0.05). ②The concentration of TGF-β in plasma was (170 ±12) ng/L in control group, (214 ±77) ng/L in patients with acute gout and (179±21) ng/L in patients with chronic gout, the difference was statistically-significant (F=6.20, P<0.05). The concentration of TGF-β in plasma in acute gout group was significantly higher than the control group and chronic gout group, the difference was statistically significant (P<0.05), while the difference between chronic gout group and the control group was not statistically significant ( P>0.05). ③The con-centration of IL-1β in plasma in the control group was (4.8 ±1.3) ng/L, while that in patients with acute and chronic gout was (10.1±8.5) ng/L and (11.50±12.57) ng/L respectively, the difference between these three groupswas stati-sticallysignificant (P<0.05). The concentration of IL-1β in plasma in acute gout group and chronic gout group wassignificantly higher than that in the control group, the difference was statistical significant ( P<0.05). There was no significant difference between acute gout and chronic gout (P>0.05) patients. ④ The percentage of Tregs in peripheral blood of gout patients was negatively correlated with the duration of disease and the number of gout attacks within six months (duration of disease: r =-0.381, P <0.01 ; number of gout attacks: r=-0.518, P<0.01). But there wasno significant correlation to the concentration of TGF-β and IL-1β. Conclusion Tregsincreasesin acute gout and participate in the alleviation of gout inflammation, while the persistence of chronic gout may be related to the decrease of Tregs. Therefore, Tregs play an important regulatory role in the transformation of acute and chronic gout.
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Objective To design a new integrated portable biliary internal-external drainage catheter carrying125 I seeds used for the treatment of malignant biliary obstruction lesions so as to achieve the dual curative effects of biliary drainage and brachytherapy. Methods A total of 15 patients with malignant obstructive jaundice, who were admitted to the First Affiliated Hospital of Zhengzhou University, China, during the period from September 2016 to January 2018, were enrolled in this study. Biliary stent implantation was performed in all patients, which was followed by insertion of a new integrated portable biliary internal-external drainage catheter carrying125 I seeds. The technical success rate, clinical success rate, complications, stent patency time and patient survival rate were evaluated. Results The placement of the drainage tube was simple and smooth, and the technical procedure was successful in all patients. One month after treatment, the bilirubin level was decreased significantly when compared with preoperative one (P<0.01), while the blood indexes and immunological indicators showed no obvious changes (P>0.05) . After treatment, 2 patients (13.3％) developed cholangitis and 2 patients (13.3％) had small amount of biliary bleeding, which returned to normal after symptomatic treatment. No severe complications such as perforation of bile duct, massive bleeding, radiation enteritis and radioactive source leakage, etc., occurred. The patients were followed up for 55-402 days, 6 patients (40.0％) developed biliary re-obstruction. The median patency time of stent was 255 days, and 6-month stent patency rate was 64.5％. Five patients died and 10 patients survived, the 9-month survival rate was 64.3％, the median survival time was 368 days. Conclusion By using the new integrated portable biliary internal-external drainage catheter carrying125 I seeds, the effects of bile drainage and brachytherapy can be simultaneously achieved. Preliminary clinical practice indicates that this new drainage catheter is feasible, safe and effective, although its long-term efficacy needs to be clarified with further follow-up observations and controlled studies.
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Objective To investigate the relationship of skin-resident memory T cells (Trm cells) with the skin lesions in systemic lupus erythematosus (SLE) so as to deepen our understanding of the pathogenesis of skin lesions in SLE. Methods Peripheral blood and skin samples were collected from SLE patients and matched healthy volunteers. The percentages of effector memory T cells (Tem cells) and effcctor T cells (Teff cells) from peripheral blood were analyzed by flow cytometry. By using direct immunofluoresence, we detected the presence of immune complex,which deposited on the basement membrane of normal appearance skin from SLE patients or healthy individuals. Immunohistochemical staining was performed to detect the two characteristic surface markers of tissue-resident memory T lymphocytes,CD69 and CD103 and to analyze the expression of these T lymphocytes within skins from SLE patients or healthy volunteers. Data analysis was performed using t test. P<0.05 was considered statistically significant. Results As compared with control individuals,the proportions of CD4+Tem (12.6±3.4 vs 8.2±2.5,t=-3.15,P<0.05),CD4+Teff (2.5±1.5 vs 1.3± 0.8,t=-2.79,P<0.05)、CD8+Tem(15.3±3.6 vs 7.0±3.0,t=-6.22,P<0.05)and CD8+Teff cells(13.1±5.4 vs 3.7± 1.3,F=-7.36,P<0.05)in T cell subset were significantly increased. Also,the proportions of CD4+Tem(8.4±2.7 vs 5.8±2.0,t=-2.74,P<0.05),CD4+Teff (1.6±1.0 vs 0.8±0.5,t=-2.84,P<0.05),CD8+Tem (10.4±3.6 vs 5.3±2.4, t=-4.03, P<0.05) and CD8+Teff cells (8.2±4.1 vs 2.6±0.8, t=-6.15, P<0.05) in peripheral blood were increased as well. By direct immunofluorescence,we noticed the deposition of immunoglobulin IgA, IgM and complement C3 on the basement membrane zone of skins from SLE patients but not on heanlhy individuals. The amount of infiltrated lymphocytes in skin samples from SLE patients were significantly iecreased compared to that of healthy individuals,and the quantities of CD4, CD8 and CD103 positive T cells from SLE skin samples were all increased by various degrees than that of controls. Conclusion Skin-resident memory T cells may be involved in the pathogenesis of skin lesions in SLE.
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Objective To investigate the relationship between the level of circulating CD133+/KDR+ endothelial progenitor cells (EPCs) and outcome in patients with acute ischemic stroke.Methods Inpatients with first-ever ischemic stroke within 24 hfrom the onset and age-and sex-matched healthy subjects were enrolled in the study.The demographic and clinical data of the patients were collected.The level of CD133+/KDR+ EPCs was detected by flow cytometry.All patients were followed up at 90 d.The modified Rankin Scale was used to evaluate the clinical outcome,0-2 was defined as good outcome and >2 was defined as poor outcome.Results A total of 126 consecutive patients with first-ever ischemic stroke within 24 hfrom the onset and 60 age-and sex-matched healthy subjects were enrolled.In patients with ischemic stroke,33 (26.19%) were large artery atherosclerosis (LAA),74 (58.73%) were small artery occlusion (SAO),19 (15.08%) were cardioembolism (CE);82 (65.08%) had good outcomes and 44 (34.92%) had poor outcomes.The number of circulating EPCs at baseline in patients of the LAA subtype (0.071%±0.018%),CE subtype (0.068%±0.16%) and SAO subtype (0.118%±0.12%) was significantly lower than that in the control group (0.246%±0.052%;all P<0.05),and the CE subtype (P=0.028) and LAA subtype (P=0.037) were significantly lower than the SAO subtype;the CE subtype was lower than the LAA subtype,but the difference was not statistically significant (P=0.762).The proportions of patients with LAA subtype (40.91% vs.18.29%;χ2=7.577,P=0.006) and CE subtype (29.55% vs.7.32%;χ2=11.049,P=0.001) and atrial fibrillation (29.55% vs.10.98%;χ2=6.582,P=0.009),and age (69.64±9.62 years vs.61.12±7.31 years;t=5.570,P<0.001),and baseline NIHSS score (14.16±4.22 vs.6.96±2.04;t=12.919,P<0.001),baseline systolic blood pressure (176.06±13.42 mmHg vs.164.12±11.69 mmHg,1 mmHg=0.133 kPa;t=5.187,P<0.001),low-density lipoprotein cholesterol (2.92±0.52 mmol/L vs.2.49±0.36 mmol/L;t=5.447,P<0.001),fasting blood glucose (8.76±2.88 mmol/L vs.6.82±2.24 mmol/L;t=4.185,P<0.001),C-reactive protein (7.62±1.82 mg/L vs.4.57±1.58 mg/L;t=9.790,P<0.001),and D-dimer (1.14±0.08 mg/L vs.0.97±0.22 mg/L;t=4.946,P<0.001) levels in the poor outcome group were significantly higher than those in the good outcome group,while the proportion of the SAO subtype patients (29.55% vs.74.39%;χ2=23.759,P<0.001),high-density lipoprotein cholesterol (0.94±0.68 mmol/L vs.1.16±0.14 mmol/L;t=2.829,P=0.005),and baseline EPCs (0.069%±0.018% vs.0.098%±0.021%;t=7.755,P<0.001) were significantly lower than those in the good outcome group.Multivariate logistic regression analysis showed that the higher baseline NIHSS score (odds ratio 1.242,95% confidence interval 1.126-1.372;P<0.001),CE subtype (odds ratio 3.460,95% confidence interval 1.312-5.146;P=0.016),and the lower baseline EPCs (odds ratio 1.632,95% confidence interval 1.006-3.024;P<0.001) were the independent risk factors for poor outcome in patients.Conclusion s The level of circulating EPCs was decreased significantly in patients with acute ischemic stroke,and the lower level of baseline EPCs was an independent predictor of poor outcome in patients with ischemic stroke at 90 d.
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Acellular dermal matrix(ADM) is a special biological material that contains only collagen,elastin and other extracellular matrix.ADMs are made by special methods of separating skin epidermis and dermis,and removing Laugerhans cells,vascular endothelial cells,fibrohlasts cells and major histocompatibility complex (MHC)within the dermis.ADM causes no graft rejection,and provides a good scaffold for tissue reconstruction,angiogenesis and implantation of host cells.The preparation process of ADM includes the separation of epidermis and dermis,decellularization,perforation and freeze-drying.According to the classification method,ADMs can be classified into allogeneic and xenogeneic ADM,patch and injection type ADM,as well as cross-linked and non-crosslinked ADM,which can meet various clinical requirements.ADM is widely used in surgical field,such as treatment of deep burn wounds,breast reconstruction after masteetomy,oral mucosa repair,abdominal wall hernia repair,and treatment of vocal cord paralysis.Due to the characteristics ADM,its application prospect is considerable.The research progress of ADM in recent years was summarized.
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Objective To investigate the effect of long-term low dose prednisone administration on bone mineral density (BMD) in patients with inactive systemic lupus erythematosus (SLE).Methods A total of 118 inactive female SLE patients with long-term administration of low dose prednisone were recruited from the Department of Rheumatology and Immunology at An hui Provincial Hospital.All patients were given low dose prednisone for long-term (≤ 10 mg/d,more than half a year).According to prednisone doses,subjects were divided into two groups,namely group A (≤7.5 mg/d) and group B (7.5-10 mg/d).In addition,patients were also divided into four groups based on the duration of administration,including group Ⅰ ≤3 years,Ⅱ from 4-5 years,Ⅲ 6-10 years and Ⅳ ＞ 10 years.Twenty-nine healthy people were recruitedas normal controls.The BMD was measured by dual energy X-ray absorptiometry.The association of BMD with prednisone dose and duration was compared between different groups.Results The incidencc of osteopenia in all patients with SLE was 42.4％ (50/118),and the incidence of osteoporosis was 14.4％ (17/118).BMD of all bone sites in both group A and B were significantly lower than that in normal control group (P ＜ 0.05).Similarly,the BMD of all bone sites in group Ⅰ,Ⅱ,Ⅲ and Ⅳ were significantly decreased (P ＜ 0.05).What needed to be stressed was the BMD in group Ⅳ was lower than those in other three groups (P ＜ 0.05).Multiple logistic regression analysis showed that the cumulative prednisone dose was the risk factor for osteopenia,while taking calcium and alfacalcidol were protective factors.Conclusion Long-term use of low dose prednisone result in the decrease of BMD in patients with inactive SLE.The lumbar spine and femoral neck had more severe osteopenia.Long-term administration of prednisone,even less than 7.5 mg/d,can also cause osteopenia.Calcium and alfacalcidol were protective factors of BMD.
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Objective To investigate the relationship between the serum copeptin levels and the outcomes in patients with acute ischemic stroke.Methods Patients with first-ever ischemic stroke within 24 h were enrolled in the study.Enzyme-linked immunosorbent assay was used to detect the serum copeptin levels.The National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the severity of baseline stroke.The modified Rankin Scale (mRS) scores were used to evaluate the outcomes at day 90,and 0-2 was defined as good outcome.The age-and sex-matched healthy subjects were used as controls.Results A total of 86 consecutive patients with first-ever ischemic stroke within 24 h were enrolled and 50 age-and.sex-matched healthy subjects were used as controls.The serum copeptin levels of the patients with acute ischemic stroke at 24 h,day 7 and 14 were 7.81 ± 0.66 pmol/L,4.78 ± 1.76 pmol/L,and 2.82 ± 1.42 pmol/L,respectively.They were all significantly higher than those of the control group (1.67 ± 0.56 pmol/L;all P＜0.05).In 86 patients,74 (86.05％) had good outcome and 12 (13.95％) had poor outcome.The age (67.64 ± 9.62 years vs.61.12± 7.31 years;t=-3.420,P=0.020),NIHSS score (14.16±4.22 vs.6.96± 2.04;t=-8.263,P＜ 0.001),baseline systolic blood pressure (166.06± 13.42 mmHgvs.154.12± 11.69 mmHg;t=5.216,P=0.037;1 mmHg=0.133 kPa),fasting blood glucose (8.79 ±2.98 mmol/L vs.6.92 ±2.24 mmol/L;t =2.076,P =0.041),C-reactive protein (7.02 ± 1.72 mg/L vs.4.07 ± 1.58 mg/L;t =-1.724,P =0.019),copeptin level at 24 h (9.67 ±2.28 pmol/L vs.6.88 ±2.82 pmol/L;t =13.962,P ＜ 0.001),copeptin level at day 7 (8.22 ± 2.14 pmol/L vs.2.97 ± 2.04 pmol/L;t =20.564,P ＜ 0.001),copeptin level at day 14 (4.77 ± 1.86 pmol/L vs.2.02 ± 0.76 pmol/L;t =8.428,P =0.032),as well as the proportions of atrial fibrillation (33.33％ vs.8.11％;x2 =4.986,P=0.036),large artery atherosclerotic stroke (41.67％ vs.21.62％;x2 =6.729,P =0.038),cardioembolism (33.33％ vs.8.11％;x2 =4.986,P=0.036) in the poor outcome group were significantly higher than those in the good outcome group.The proportion of patients with small arterial occlusive stroke was significantly lower than that of the good outcome group (16.67％ vs.70.27％;x2 =16.972,P =0.041).Multivariate logistic regression analysis showed that the serum copeptin level at 24 h (odds ratio 2.424,95％ confidence interval 1.92 0-3.562;P ＜ 0.001) and day 7 (odds ratio 2.326,95％ confidence interval 1.768-3.482;P ＜ 0.001),and baseline NIHSS score (odds ratio 2.146,95％ confidence interval 1.616-3.268;P ＜ 0.001) were the independent risk factors for the poor outcomes.Conclusions The increased baseline serum copeptin level is an independent risk factor for poor outcomes at day 90 in patients with acute ischemic stroke.
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Objective To investigate the significance of ultrasonography in the examination of rheumatoid arthritis(RA). Methods The wrist joints of activated RA and wrist, metacarpophalangeal, proximal interphalangeal joints of remission of RA were determined, and the imaging features were analyzed. Results Patients with activated RA were divided into two groups. The bone erosion and sheath lesions were lower in the group of duration less than 1 year than those in the group of duration over 1 year (P < 0.01). The positive rate of ultrasound was higher than that of X-ray in bone erosion (P < 0.05). To patients with the remission of RA, the positive rate of ultrasound was higher than that of the physical examination in synovitis ( P < 0 . 05 ) . Conclusions For bone erosion, ultrasound is better than X-ray for patients with early RA. For synovitis, the sensitivity of ultrasonography is higher than the physical examination in remission for RA patients.
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Objective To detect the levels of peptidylarginine deiminase 4 (PAD4) mRNA and neutrophil extracellular traps (NETs) of the peripheral blood neutrophils in rheumatoid arthritis (RA) patients and to study the association between PAD4 and NETs in RA.The anti-cyclic citrullinated peptide (anti CCP) antibodies,disease activity score (DAS28) score,erythrocyte sedimentation rate (ESR) were recorded.Its value in the pathogenesis of RA was explored.T test,rank-sum test,Pearson and Spearman correlative analysis were used for statical analysis.Methods The serum double-stranded DNA (dsDNA)/NETs in 43 RA patients and 20 healthy controls were detected by PicoGreen dsDNA Quantitation Kits (Invitrogen).Real-time quantitative polymerase chain reaction (RT-PCR) was used to determine the expression of PAD4 mRNA in neutrophils,and the relationship between dsDNA/NETs and their clinical indexes were analyzed.Results ① The level of peripheral blood neutrophils PAD4 mRNA in RA was significantly higher than healthy controls [1.493(0.831,2.607)] vs [0.631(0.358,1.489)],(Z=-2.07,P=0.039).The levels of serum PAD4 mRNA in RA treated with disease-modifying antirheumatic drugs (DMARDs) were lower than untreated with DMARDs but no significant difference was found (Z=-1.19,P=0.234).② The levels of serum dsDNA/NETs in RA patients were significantly higher than in healthy controls (t=3.4,P=0.001).③ The levels of serum dsDNA/NETs in RA were positively correlated with DAS28 score,ESR,CRP and PAD4 mRNA (r=0.36,P=0.036;r=0.345,P=0.042;r=0.36,P=0.043;r=0.42,P=0.017) but not with anti-CCP antibodies (r=0.277,P=0.154).Conclusion ① PAD4 may play an important role in the pathogenesis of RA.② NETs maybe associated with disease activity and play an important role in RA pathogenesis,inhibit NETs generation or improve the ability to clear NETs,perhaps can treat RA.③ PAD4 probably play an important role in rheumatoid arthritis by influencing the formation of the NETs.
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Objective To analyze the association of miR-326 mRNA expression level on regulatory T cells between clinical manifestations of patients with systemic lupus erythematosus (SLE), in order to inves-tigate the role of miR-326 on Treg cells and pathogenesis as well as its association with disease activity of SLE. Methods Twenty milimeter anti-coagulated peripheral blood was obtained from 52 SLE patients and 20 healthy controls. Treg were purified by MACS from peripheral blood, in which the quantity of miR-326 and Ets-1 mRNA were assessed by real-time polymerase chain reaction (PCR). Data were analyzed by using Mann-Whitney U test and Spearman correlation analysis. Results Compared with healthy controls [0.921(0.345, 1.879)], the expression of miR-326 mRNA level was significantly higher in Treg from SLE patients [2.927 (0.518, 8.662) (Z=-3.756, P<0.05). The difference between new-onset SLE patients [8.878(5.922, 12.466)] and recurrence group [3.512(0.582, 11.223)] with healthy controls was significant (Z=-2.135, Z=-4.928, P<0.05). The expression level of miR-326 in new-onset SLE patients was higher than inactive SLE patients (Z=-4.928, P<0.05). Significant difference of the expression level of miR-326 mRNA was found between new-onset SLE patients with serous cavity effusion [7.606(0.656, 16.795)] and new-onset SLE patients without it [1.840(0.576, 13.025)](Z=4.263, P<0.05). Our analysis showed that significant positive correlation was found between the expression of miR-326 mRNA in Treg with CRP (rs=0.481, P<0.05) and anti-C1q antibody (rs=0.729, P<0.05) from new-onset SLE patients. Conclusion The expression level of miR-326 is upregulated in Treg from SLE patients and is associated with disease active index, which suggests that miR-326 in Treg may participate the pathological process and disease activity in SLE.
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Objective To explore the role of serum neutrophil extracellular traps (NETs) in rheumatoid arthritis (RA).Methods The serum circulating free DNA (cf-DNA) / NETs in 45 RA patients and 18 healthy controls were detected by Pico Green dsDNA Quantitation Kits,and the association between serum NETs and ESR,DAS28 score,anti-CCP antibodies was analyzed.T test,rank sum test,Pearson or Spearman correlation analysis were ued for statistical analysis.Results ① The levels of serum dsDNA/NETs in RA patients [0.523 0(0.282 0,1.637 0) μg/ml] were significantly higher than those in healthy controls [0.410 5 (0.140 0,0.966 0)μg/ml] (Z=-2.419,P=0.016).② The level of serum dsDNA/NETs in RA was positively correlated with ESR and DAS28 score (r=0.357,P=0.016; r=0.325,P=0.029),but not with anti-CCP antibodies(r=0.146,P=0.434).③ The levels of serum dsDNA/NETs in RA treated by DMARDs were lower than those of untreated with DMARDs[0.516 5(0.282 0,1.637 0) μg/ml,0.523 0 (0.369 0,1.485 0) μg/ml,Z=-1.215,P=0.225],but the difference was not significant.Conclusion NETs maybe associated with disease activity and play an important role in RA pathogenesis.
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Objective To assess the effect of stromal cell-derived factor 1 (SDF-1) on the migration of neural stem cells and recovery of lower limb function after spinal cord injury (SCI).Methods A modified version of Allen's method was used to establish a SCI model in each of 96 adult male Sprague-Dawley rats.They were then randomly divided into group A which received an injection of phosphate buffer solution,group B which received an injection of neural stem cells,group C which received a combination of SDF-1 and neural stem cells,and group D which received AMD3100 and neural stem cells 7 days after the modeling.The functioning of the hind limbs of all of the rats was assessed on the 7th,14th,21st and 28th day after the modeling.The rats were then sacrificed and frozen sections of their spinal cords were stained with hematoxylin-eosin (HE) and marked with CM-Dil under fluorescent light.Results An accumulation of fluorescing cells were observed in spine cords from both group B and C,with the counts of group B [(23.6 ±3.7),(18.9 ±5.6)and(15.2 ±4.3) respectively] at the day 14,21 and 28 after modeling significantly smaller than those of group C [(27.4 ± 4.7),(20.4 ± 5.2) and (18.3 ± 3.9) respectively].During the same period of time,the average BBB scores of groups B and C were significantly better than those of groups A and D.Moreover,the average score of group C was significantly higher than group B's at all time points.Conclusions Transplanted neural stem cells can migrate to the injured site,surviving and differentiating to promote the recovery of limb function in rats with spinal cord injury.SDF-1 can promote that migration and proliferation.Moreover,CXCR4 receptor's antagonist AMD3100 can significantly hinder neural stem cells' migration to the injured site on the spinal cord.
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Objective To explore the etiopathogenisis of fungal infections induced by systemic lupus erythematosus (SLE). Methods One hundred and forty-seven SLE patients with fungal infections during 2004-2013 were assigned as experimental group and the same number of SLE patients without infections were randomly selected as control group. Clinical and laboratory documents of these patients were comparatively analyzed. Results The fungal infections in SLE patients affected oral mucosa , lower respiratory tract and skin , and the pathogenic bacteria were mainly candida albicans. The wide application of glucocorticoid, immunosuppressants and antibiotics pushed the rise of incidence of fungal infections in SLE patients significantly. Conclusions The patients′ use of glucocorticoid , immunosuppressants and antibiotics attributes to a higher risk of fungal infections , especially infections by candida albicans. Fungus infection may raise the level of C4.
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Objective To investigate the clinical efficacy of a period of joint fusion and plate internal fixation for four parts calcaneal fractures.Methods The clinical data of 53 patients with four parts calcaneal fractures from January 2009 to January 2013 were analyzed retrospectively.Twenty-two patients were performed a period of joint fusion (joint fusion group),31 patients were performed plate internal fixation (plate internal fixation group).The Bohler angle and Gissane corner before and after operation,operation time and bleeding,the Maryland foot function score between two groups were compared.Results Compared with before operation,the Bohler angle and Gissane corner in plate internal fixation group and joint fusion group were improved significantly after operation (34.6° ± 4.2° vs.5.7° ± 2.4°,125.4° ± 8.2° vs.87.2° ± 6.8°,32.8° ± 3.9° vs.5.4° ± 2.7°,127.6° ± 7.8° vs.86.9° ± 6.7°),and there were significant differences (P ＜0.05),but the Bohler angle and Gissane corner before and after operation between two groups had no significant difference (P ＞ 0.05).The operation time and bleeding were (52.1 ± 5.1) min,(50.0 ± 10.2) ml in plate internal fixation group and (70.3 ± 5.2) min,(105.0 ± 20.5) ml in joint fusion group,and there were significant differences between two groups (P ＜ 0.05).The fineness rate of Maryland foot function at 6 months follow-up between two groups had no significant difference (P ＞ 0.05).Conclusions The plate internal fixation and joint fusion is therapeutic equivalence in treatment of four parts calcaneal fractures.Due to the small surgical trauma and less bleeding of plate internal fixation,it may be preferred in the treatment of four parts calcaneal fractures.
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Objective To explore the significance of aryl hydrocarbon receptor (AhR) in patients with rheumatoid arthritis (RA) through detecting the levels of AhR and its response gene cytochrome P4501 A1 (CYP1 A1) in peripheral blood mononuclear cells (PBMCs).Methods Peripheral blood samples were collected from 35 patients with RA and 20 healthy subjects.The expression of AhR and CYP1A1 at mRNA level were detected by real-time PCR.The percentages of AhR-positive cells in PBMCs were detected by flow cytometry (FCM).The effects of leflunomide (LEF) on the expression of AhR and CYP1A1 were analyzed.The detailed clinical data of RA patients were recorded.The disease activity score (DAS) was calculated.Correlation analysis between AhR/CYP1A1 level and clinical data was conducted.Results (1) Both the expression of AhR at mRNA level and the percentage of AhR-positive cells in PBMCs from RA patients without LEF treatment were significantly higher than those from healthy subjects [(3.61±1.65) vs.(2.00±1.27),P=0.002; (34.21±11.30)％ vs.(18.83±7.32)％,P＜0.01].There were no statistically significant differences in the expression of AhR at mRNA level and the percentages of AhR-positive cells between patients with or without LEF treatment [(3.83 ± 1.62) vs.(3.61 ± 1.65),P =0.670 ; (36.69±10.61)％ vs.(34.21±11.30)％,P=0.462].(2) Non-LEF treatment group showed a higher relative expression of CYP1 A1 at mRNA level than that from control group [1.33 (0.08,7.86) vs.(0.62 ±0.29),z=-3.922,P＜0.01],but there was no statistical difference between LEF treatment group and non-LEF treatment group [(2.62±2.08) vs.1.33(0.08,7.86) z=-0.133,P=0.894].(3) Neither the expression of AhR and CYP1A1 at mRNA level nor the percentages of AhR-positive cells showed significant correlations with clinical data.Conclusion AhR was highly expressed in PBMCs from patients with RA,which might participate in the progression of rheumatoid arthritis.But the high expression of AhR did not reflect disease activity.Moreover,the treatment of LEF showed no significant influences on the expression of AhR and CYP1A1 in PBMCs from patients with RA.
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Objective To investigate the plasma vitamin D3 level and its association with B cell subsets of patients with primary Sj(o)gren's syndrome (pSS).The role of vitamin D3 levels in the pathogenesis of pSS was explored.Methods The expression of plasma vitamin D3 levels of 55 patients with pSS and 32 controls were analyzed by ELISA.Frequencies of peripheral blood CD19+CD27-na(i)ve B cells,CD19+CD27+ memory B cells and CD19+CD27high plasma cells were analyzed by flow cytometry in 34 pSS patients without therapy and 22 controls.The relationship between the vitamin D3 levels and B cell subsets,SSDAI,tear flow rate,saliva flow rate,rheumatoid factor,immunoglobulin was analyzed in pSS patients.Non-parametric test,t test,one-way ANOVA,x2test,Pearman's and Spearman's correlation analysis were used for statistical analysis.Results ① There was significant difference in the levels of plasma 1,25 (OH)2D3 between the pSS patients group and normal control group,1,25 (OH)2D3 was significantly lower in pSS patients than that in the normal control group [24.17(22.20,28.41) pg/ml and 41.25(23.38,62.18) pg/ml,P＜0.05],and that was also obviously lower in the active group [22.64(20.74,24.90) pg/ml] than that in the normal control group (P＜0.05),and that was also obviously lower in the active disease group than that in the inactive disease group [25.39 (23.16,33.09) pg/ml,P＜0.05],but there was no difference between the inactive group and the normal control group (P＞0.05).② The percentage of peripheral blood of CD19+CD27high plasma cells and CD19+CD27+ memory B cells in CD19+ cells was reduced in patients in the pSS group compared with the control group [(0.89±0.30)％ and (1.72±0.43)％,(24±8)％ and (34±5)％; P＜0.05],and that was also significantly lower in the active group [(1.03±0.59) ％ ; (26± 10)％] and inactive group [(1.00±0.16)％,(26± 3)％] than that in the normal controls (P＜0.05).However,there was no difference between the active group and the inactive group (P＞0.05),but the frequency of peripheral blood of CD19+ CD27-naive B cells in CD19+ B cells was increased in patients with pSS compared with normal control group [(75.4±7.5)％ and (63.9±5.2)％,P＜0.05],and that was also significantly higher in the active group [(73.4±9.7)％] and inactive group [(73.3±2.9)％] than that in the normal control (P＜0.05),there was no difference between the active group and the inactive group.③ Significant negative correlation was observed between 1,25 (OH)2D3 and the percentage of peripheral blood CD19+CD27+ memory B cells in CD19+ cells as well as immunoglobulin G(r=-0.627,P=0.039; r=-0.657,P＜0.01) level.Conclusions These results demonstrate that abnormality of vitamin D levels may play an important role in the pathogenesis of pSS.
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Objective To observe the influence of transplanting neural stem cells (NSCs) on angiogenesis in rats with spinal cord injury (SCI).Methods The Allen's method was used to create SCI models in sixty adult Sprague-Dawley (SD) rats.They were then randomly classified into a control group which received injections of phosphate buffered solution (PBS) and an NSC group which received injections of NSCs via the tail vein,with 30 rats in each group.Another group of 30 similar rats without SCI received injections of NSCs via the tail vein as the normal group.Each rat was evaluated before transplantation and at days 7 and 14 post-transplantation using the Basso,Beattie and Bresnahan (BBB) scale for testing hindlimb function.After sacrifice,the distribution of yon Willebrand factor (vWF) in both groups was determined by immunofluorescence,and Western blotting was used to detect vascular endothelial growth factor (VEGF) protein.Results The average BBB score of the normal group was 21 at every time point.Before transplantation,the BBB scoresof the control and NSC groups were both 0,however they increased over time.At day 7 post-transplantation,the BBB scores showed no significant difference between the control group and the NSC group.At day 14 post-transplantation,the average BBB score of the NSC group was significantly higher than that in the control group.At days 7 and 14,the counts of vWF-positive cells in the normal group were significantly higher than in the control and NSC groups.VEGF protein expression in the normal group was significantly lower than in the NSC and control groups.Conclusions NSC transplantation may promote angiogenesis after spinal cord injury and improve motor function by inducing the expression of VEGF.
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Objective To study the pathophysiology of ankylosing spondylitis (AS)-related osteoporosis by investigating the relation between bone mineral density (BMD) and bone turnover markers.Methods Fortysix AS patients were included in this study,including 35 male and 11 female patients.Twenty-five gender and age matched healthy subjects were served as the healthy control group.Informed consents were obtained from all subjects.BMD of lumbar spine (L2-4),fermoral neck and radius were tested using dual-energy X-ray absorption method.Data about BASDAi,ESR,Ig was collected.Bone formation markers including procollagen type Ⅰ N-terminal peptide (PINP) and osteocalcin (OC) were included for analysis,the formal was measured by radioimmunoassay and the later was measured by immunoradiometric assay and bone resorption marker.β-Crosslaps was measured by electrochemiluminescence immunoassay.Independent-samples t test was used to compare normal distributed data between the two groups.Analysis of variance was used to compare the data between the three groups.For those data which were not normally distributed,Rank sum test was performed.Correlations were determined by Pearson or Spearman's ranking.Results ① 48％ of AS patients had bone loss,while the percentage in the healthy control group was 20％ (x2=5.32,P=0.021).BMD of lumbar spine,fermoral neck and radius of the AS patients were lower than the controls (t=-3.73,-3.68,-5.24; P＜0.05).② Bone density (BMD) of lumbar spine in patients at the late stage was higher than patients at early disease stage (t=2.26,P=0.034),however,the BMD in the femoral neck was not.③ The procollagen (PINP),OC and β-CrossLaps were not significantly different in patients at different stage of diseases (P＞0.05).④BMD of lumbar spine was negatively correlated with the β-CrossLaps and ESR(r=-0.325,P=0.047; r=-0.314,P=0.046),The BMD in fermoral neck was negatively correlated with β-CrossLaps and OC (r=-0.387,P=0.024; r=-0.371,P=0.034),but they were not correlated with disease duration and BADSAI.Conclusion Osteoporosis is common in AS.Bone turnover markers including bone formation and bone resorption are increased in AS.β-CrossLaps is likely to predict bone loss in AS.