Recommendations for diagnosis and treatment of systemic lupus erythematosus / 中华内科杂志

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with complicated pathogenesis and diverse clinical manifestations. The current recommendations of the Chinese Rheumatology Association are based on a comprehensive investigation of evidence based medicine, domestic and international guidelines for SLE, and experts' proposals, and aim to provide a more scientific and authoritative reference for the diagnosis and management of SLE. The recommendations focus on four aspects; clinical manifestations, laboratory evaluation, diagnosis and disease assessment, and disease treatment and monitoring. The goal of the recommendations is to standardize the diagnosis and treatment of SLE in China so as to improve the prognosis of SLE patients.

Analysis on survival time and influencing factors among reported HIV/AIDS in Yunnan Province, 1989-2021 / 中华流行病学杂志

Objective: To analyze the survival time of reported HIV/AIDS and influencing factors of Yunnan Province from 1989 to 2021. Methods: The data were extracted from the Chinese HIV/AIDS comprehensive response information management system. The retrospective cohort study was conducted. The life table method was applied to calculate the survival probability. Kaplan-Meier was used to draw survival curves in different situations. Furthermore, the Cox proportion hazard regression model was constructed to identify the factors related to survival time. Results: Of the 174 510 HIV/AIDS, the all-cause mortality density was 4.23 per 100 person-years, the median survival time was 20.00 (95%CI:19.52-20.48) years, and the cumulative survival rates in 1, 10, 20, and 30 years were 90.75%, 67.50%, 47.93% and 30.85%. Multivariate Cox proportional risk regression model results showed that the risk of death among 0-14 and 15-49 years old groups were 0.44 (95%CI: 0.34-0.56) times and 0.51 (95%CI:0.50-0.52) times of ≥50 years old groups. The risk for death among the first CD4+T lymphocytes counts (CD4) counts levels of 200-349 cells/μl, 350-500 cells/μl and ≥501 cells/μl groups were 0.52 (95%CI: 0.50-0.53) times, 0.41 (95%CI: 0.40-0.42) times and 0.35 (95%CI: 0.34-0.36) times of 0-199 cells/μl groups. The risk of death among the cases that have not received antiretroviral therapy (ART) was 11.56 (95%CI: 11.26-11.87) times. The risk for death among the cases losing to ART, stopping to ART, both losing and stopping ART was 1.66 (95%CI:1.61-1.72) times, 2.49 (95%CI:2.39-2.60) times, and 1.65 (95%CI:1.53-1.78) times of the cases on ART. Conclusions: The influencing factors for the survival time of HIV/AIDS cases were age at diagnosis in Yunnan province from 1989 to 2021. The first CD4 counts levels, antiretroviral therapy, and ART compliance. Early diagnosis, early antiretroviral therapy, and increasing ART compliance could extend the survival time of HIV/AIDS cases.

Recombinant Schistosoma japonicum egg ribonuclease SjCP1412 inhibits the activation of LX-2 hepatic stellate cells in vitro / 中国血吸虫病防治杂志

Objective To investigate the effect of recombinant Schistosoma japonicum egg ribonuclease SjCP1412 (rSjCP1412) on proliferation, cell cycle, apoptosis and activation of human hepatic stellate cells LX-2 in vitro, and explore the underlying mechanisms. Methods The rSjCP1412 protein was expressed in Escherichia coli BL21 by prokaryotic expression, and the highly purified soluble rSjCP1412 protein was prepared by Ni NTA affinity chromatography and urea gradient refolding dialysis. Yeast RNA was digested using 12.5, 25.0, 50.0 µg rSjCP1412 proteins at 37 °C for 2, 3, 4 h, and the enzymatic products were electrophoresed on 1.5% agarose gel to observe the RNAase activity of rSjCP1412 protein. The proliferation of LX-2 cells stimulated by different doses of rSjCP1412 protein for 48 hours was measured using CCK-8 assay, and the apoptosis of LX-2 cells stimulated by different doses of rSjCP1412 protein for 48 hours was detected using the Annexin V-FITC/PI double staining, while the percentage of LX-2 cells at G0/G1, S and G2/M phases of cell cycle following stimulation with different doses of rSjCP1412 protein for 48 h was detected by DAPI staining. The type I collagen, type III collagen and α-smooth muscle actin (α-SMA) mRNA expression was quantified using quantitative florescent real-time PCR (qPCR) assay and Western blotting at transcriptional and translational levels in LX-2 cells following stimulation with different doses of rSjCP1412 protein for 48 h, while soluble egg antigen (SEA) served a positive control and PBS without rSjCP1412 protein as a normal control in the above experiments. The expression of collagen I, α-SMA and Smad4 protein was determined using Western blotting in LX-2 cells following stimulation with rSjCP1412 protein, transforming growth factor-β1 (TGF-β1) alone or in combination, to examine the signaling for the effect of rSjCP1412 protein on LX-2 cells. Results The rSjCP1412 protein was successfully expressed and the highly purified soluble rSjCP1412 protein was prepared, which had a RNase activity. Compared with the normal group, the survival rates of LX-2 cells significantly decreased post-treatment with 12.5, 25.0, 50.0 µg/mL rSjCP1412 protein and SEA for 48 h (F = 22.417 and 20.448, both P values < 0.05). The apoptotic rates of LX-2 cells significantly increased post-treatment with 12.5, 25.0, 50.0 µg/mL rSjCP1412 protein for 48 h (F = 11.350, P < 0.05), and treatment with 12.5, 25.0, 50.0 µg/mL rSjCP1412 protein for 48 h resulted in arrest of LX-2 cells in G0/G1 phase (F = 20.710, P < 0.05). Treatment with 12.5, 25.0, 50.0 µg/mL rSjCP1412 protein for 48 h caused a significant reduction in relative expression levels of collagen I (F = 11.340, P < 0.05), collagen III (F = 456.600, P < 0.05) and α-SMA mRNA (F = 23.100, P < 0.05) in LX-2 cells, and both rSjCP1412 protein and SEA treatment caused a significant reduction in collagen I (F = 1 302.000, P < 0.05), α-SMA (F = 49.750, P < 0.05) and Smad4 protein expression (F = 52.420, P < 0.05) in LX-2 cells. In addition, rSjCP1412 protein treatment inhibited collagen I (F = 66.290, P < 0.05), α-SMA (F = 31.300, P < 0.05) and Smad4 protein expression (F = 27.010, P < 0.05) in LX-2 cells activated by TGF-β1. Conclusion rSjCP1412 protein may induce apoptosis of LX-2 cells and inhibit proliferation, cell cycle and activation of LX-2 cells through down-regulating Smad4 signaling molecules.

Retinal morphology and expression of Bcl-2, Bax and VEGF in early diabetic rats / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the expression and significance of B-cell lymphoma factor(Bcl-2), Bcl2-Associated X protein(BAX)and vascular endothelial growth factor(VEGF)in the retina of early diabetic rats. <p>METHODS: An early diabetic retinopathy model was made in rat by intraperitoneal injection of streptozotocin(60mg/kg). The model rats were sacrificed at 4,8,12wk after the establishment of the model, and the eyeballs were removed to make paraffin section and retina sheets were prepared. HE staining was used to detected the retinal morphology and vascularity. Immunohistochemistry(IHC)was employed to examine the expression of Bcl-2, Bax and VEGF in the retina. ADP enzyme staining were conducted to evaluate the retinal vascular morphologic change. Nikon-A1 laser confocal microscopy was used to detect the morphology, fluorescence intensity and distribution of Ca²⁺ in retinal cells. <p>RESULTS: In the diabetic group, the number of endothelial cells in the inner limiting membrane increased 12wk later. In diabetes mellitus group, there was no vascular area in the middle and peripheral retina, and no vascular area was significantly more than that in the blank control group(<i>P</i><0.05). There were significant differences in the values of VEGF, Bcl-2 and Bax between diabetic rats and control group(<i>P</i><0.05). Compared with diabetic rats at 4, 8, 12wk, the fluorescence concentration of calcium ions in RGCs increased gradually, and the ratio of fluorescence staining intensity increased significantly(<i>P</i><0.05). <p>CONCLUSION: The expressions of Bcl-2 and Bax were significantly increased, which upgraded the expression of VEGF in the retinas of early diabetic rats. Bcl-2, Bax and VEGF might play an important role in the neovascularization of the retinas in early diabetic rats.

Early predictors of necrotizing pneumonia in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the early predictors of necrotizing pneumonia in children.</p><p><b>METHODS</b>The clinical data of 43 children with necrotizing pneumonia and 83 children with lobar pneumonia were retrospectively analyzed. Sex, age, the number of days with fever, laboratory examination results, and bronchoscopic findings were compared between the two groups. The multiple logistic regression analysis was used to identify the early predictors of necrotizing pneumonia.</p><p><b>RESULTS</b>The necrotizing pneumonia group had a higher percentage of girls than the lobar pneumonia group (P<0.05). Compared with the lobar pneumonia group, the necrotizing pneumonia group had a larger number of days with fever, a higher peripheral blood white blood cell count (WBC), a higher percentage of neutrophils (NE%), and higher serum levels of high-sensitivity C-reactive protein (hs-CRP), albumin (Alb), and lactate dehydrogenase (LDH) (P<0.05). The necrotizing pneumonia group also had higher percentages of children with a large amount of sputum bolt under a bronchoscope which needed to be removed with biopsy forceps and children with rice-water-like bronchoalveolar lavage fluid (P<0.05). The multiple logistic regression analysis showed that being a female, the presence of sputum bolt under a bronchoscope which needed to be removed with biopsy forceps, the number of days with fever, WBC, hs-CRP, and LDH were independent predictors of necrotizing pneumonia. The receiver operating characteristic curve analysis showed that the cut-off values of the latter 4 predictors were 18.5 d, 15.1×10(9)/L, 121.5 mg/L, and 353.5 U/L, respectively.</p><p><b>CONCLUSIONS</b>Increased WBC (≥15.1×10(9)/L), increased hs-CRP (≥121.5 mg/L), increased serum LDH (≥353.5 U/L), and the presence of sputum bolt under a bronchoscope which needs to be removed with biopsy forceps and rice-water-like bronchoalveolar lavage fluid may be the early predictors of necrotizing pneumonia in children.</p>

Study of anti-aging effect and its mechanism of total saponins of Wu-He Dipsacus asper on skin of mouse-aging model / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To Study the effect of anti-aging and its mechanism of total saponins of Wu-He Dipsacus asper on skin of mice-aging model.</p><p><b>METHODS</b>Forty-eight mice were randomly divided into blank control group, model group, low-Dipsacus group, medium-Dipsacus group, high-Dipsacus group and positive control group( n = 8) . The mouse model of skin aging was established by nape subcutaneous injection of 5% D-galactose (0.025 mL/(g · d)), the mouse of low-Dipsacus group, medium-Dipsacus group, high-Dipsacus group were administered with total saponins of Wu-He Dipsacus asper (50 ml/(kg · d), 100 mL/(kg · d), 200 mL/(kg · d)), the mice of the positive control group were administered with vitamin E(50 mg/(kg · d)) for 42 d. The content of hydroxyproline (HYP) and lipofuscin (LF) were measured in skin of each group mice, the activity of catalase (CAT) glutathione peroxidase ( GSH-Px) superoxide dismutase (SOD) and the content of malondi- aldehyde (MDA) were determined in serum and skin of each group mice.</p><p><b>RESULTS</b>Compared with blank control group, the content of HYP decreased significantly and the content of LF increased significantly in skin, the activities of CAT, GSH-Px and SOD decreased significantly and the content of MDA increased significantly in serum and skin of model group; Compared with model group, the content of HYP increased significantly and the content of LF decreased significantly in skin, the activities of CAT, GSH-Px and SOD enhanced significantly and the con- tent of MDA decreased significantly in serum and skin of low-Dipsacus group, medium-Dipsacus group, high-Dipsacus group and positive control group; Compared with low-Dipsacus group, the content of HYP increased significantly and the content of LF decreased significantly in skin, the activities of CAT, GSH-Px and SOD enhanced significantly and the content of MDA decreased significantly in serum and skin of high-Dipsacus group and positive control group; The activity of SOD in serum and skin had a significant positive correlation with the content of HYP, and a significant negative correlation with LF in skin.</p><p><b>CONCLUSION</b>Total saponins of Wu-He Dipsacus asper have obvious effect of anti-agng on skin of mouse-aging model , its mechanism is closely related to oxidative damage.</p>

A comprehensive surveillance on HIV among 1237 men who have sex with men in thirteen cities of Yunnan / 中华流行病学杂志

Objective To understand the knowledge,risk behaviors and HIV prevalence in men who have sex with men (MSM) in thirteen cities.Methods Target samples were chosen using the snowball-rolling method,with transverse KABP and HIV-antibody testing developed for those MSM in thirteen cities of Yunnan.Results A total of 1237 valid questionnaires and 1129 blood samples were collected.Basic knowledge on HIV and the rate of the response was 93.2％.81.1％ of the respondents had anal sex with male parmers in the last six months,of them 49.7％ could persistently using condoms in each anal sex episode.29.0％ of the respondents had sex with female partners in the last six months.The HIV prevalence among the studied MSM was 8.2％ and the prevalence of syphilis among them was 3.9％.Most risky factors of those MSM infected by HIV would include:not persistently use condom when having sex and co-infection of syphilis.Conclusion Both rates of HIV infection associated risk behaviors and HIV prevalence were high in MSM under study that called for more work on HIV prevention and control MSM in Yunnan.

Protective effect of total alkaloids of Sophora alopecuroides on dextran sulfate sodium-induced chronic colitis / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the effect of total alkaloids of Sophora alopecuroides (TASA) on dextran sulfate sodium (DSS)-induced colitis in mice.</p><p><b>METHODS</b>Chronic experimental colitis was induced by administration of 4 cycles of 4% DSS. Fifty mice were randomly distributed into 4 groups (normal, DSS, DSS/high-dose TASA, and DSS/low-dose TASA groups) by a random number table with body weight stratification. Mice in the normal group (n=11) and DSS-induced colitis control group (n=15) received control treatment of 20 mL/kg distilled water; DSS plus TASA high- and low-dose groups (n=12 each) were treated with TASA solution (20 mL/kg) at the doses of 60 mg/kg and 30 mg/kg, respectively. The severity of colitis was assessed on the basis of clinical signs, colon length, and histology scores. Moreover, secretory immunoglobulin A (sIgA) and haptoglobin (HP) were analyzed by enzyme linked immunosorbent assay; intercellular adhesion molecule 1 (ICAM-1) and macrophage-migration inhibitory factor (MIF) gene expressions were analyzed by quantitative reverse transcriptase realtime polymerase chain reaction (qRT-PCR) using SYBA green I; and nuclear factor κ B (NF-κ B) expression and activation and p65 interaction with the promoter of ICAM-1 gene were assessed by Western blotting and chromatin immunoprecipitation assay.</p><p><b>RESULTS</b>TASA administration significantly attenuated the damage and substantially reduced HP elevation and maintained the level of cecum sIgA. TASA inhibited the ICAM-1 gene expression and had no effect on MIF gene expression. Also, TASA was able to reduce phospho-I κ B α (p-I κ B α) protein expression; however, it had no effect on the activation of I κ B kinase α (IKK α) and inhibitor of NF-κ B α (I κ B α). Moreover, TASA inhibited the p65 recruitment to the ICAM-1 gene promoter.</p><p><b>CONCLUSIONS</b>TASA had a protective effect on DSS-induced colitis. Such effect may be associated with its inhibition of NF-κ B activation and blockade of NF-κ B-regulated transcription activation of proinflammatory mediator gene.</p>

The clinical features and surgical treatment strategies of cervical kyphosis / 中华外科杂志

<p><b>OBJECTIVE</b>To analyze the clinical characteristics and the surgical treatment strategy of cervical kyphosis.</p><p><b>METHODS</b>From March 2006 to October 2009, 31 cases of cervical kyphosis were treated. According to the clinical features and imaging findings, different treatment methods were used. There were 9 patients in operation group, including 4 male and 5 female patients, aged from 17 to 72 years (average age of 35 years). Among them, 5 cases were idiopathic kyphosis and 4 cases were caused by laminectomy or other reasons. There were 22 patients in conservative treatment group, including 11 male and 11 female patients, aged from 14 to 40 years (average age of 29 years), who were all idiopathic cervical kyphosis. Before and 1 week after operation, clinical assessment were taken for the patients in operation group using Spinal Cord Injuries Classification Standard of American Spinal Injury Association (AISA). During the periodic review, the anteroposterior, normal sagittal films of cervical spine were taken. At 1 week and every 6 months after operation, MRI films were also taken. These films were studied to evaluate the effects of the operations. In the conservative group, assessment of treatment results by studying anteroposterior and normal lateral views of cervical spine were were taken every month. The clinical characteristics and the surgical treatment strategies of these patients were analyzed.</p><p><b>RESULTS</b>In operation group, 9 cases were followed up for 6 to 18 months, all patients did not failed in internal fixation and fusion. AISA neurological score and neurological function significantly improved. Three days after operation the average Cobb angle was -1.29 ° (preoperative 54.24 °). In conservative group, the average Cobb angle was -5.41 ° (before treatment 11.20 °) 4 months after the treatment. The symptoms of neck shoulder and back pain disappeared, and all patients were followed up for 3 to 24 months, with no recurrence of symptoms.</p><p><b>CONCLUSIONS</b>In the early period of cervical kyphosis, adopt postural therapy, plaster braces to correct an imbalance in cervical spine biomechanics can prevent deformity development. According to patients' clinical characteristics, choosing individual treatment programs can correct the severe cervical kyphosis and achieve good outcome.</p>

Incidence and risk factors on HIV infection among injection drug users in Dehong prefecture area of Yunnan province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To determine the incidence and risk factors on HIV infection among injection drug users (IDU) in Dehong prefecture area of Yunnan province.</p><p><b>METHODS</b>An epidemiological cohort of HIV-negative IDU had been developed and followed since October, 2004. HIV new infections and related behaviors had been investigated every six months.</p><p><b>RESULTS</b>By the end of 2008, 760 HIV-negative IDU had been recruited and followed for a total of 1153.6 person-years. 47 new HIV infections were identified, with an overall incidence of 4.07/100 person-years during the follow-up period. The HIV incidence was 4.45/100 person-years during 2004 - 2006, 4.50/100 person-years in 2007 and 2.54/100 person-years in 2008. Both the behavior of drug injection and the HIV incidence among the cohort had substantially decreased during the follow-up period. Multiple regression analysis using Cox proportional hazard model indicated that people with Jing-po ethnicity (Hazard ratio, HR = 2.56, 95%CI: 1.06 - 6.19) and other minorities except for Dai (HR = 3.26, 95%CI: 0.89 - 11.96) were at higher risk for HIV infection than the people with Han ethnicity. People injecting drugs with (HR = 2.27, 95%CI: 0.98 - 5.25) or without (HR = 5.27, 95%CI: 2.25 - 12.34) needle sharing were at higher risk for HIV infection than those reporting having no drug injection behavior during the follow-up period.</p><p><b>CONCLUSION</b>Both the behavior of drug injection and the HIV incidence among former IDU in Dehong prefecture area of Yunnan province had been decreasing during the four years. However, needle sharing remained the most important risk factor for HIV new infection among IDUs. IDUs with different ethnicities seemed to have different risks towards HIV infection.</p>

Effect of pectins of different degree of esterification on in-vitro sophoridine release of hydrophilic matrix tablets containing total alkaloids of Sophora alopecuroides / 中国中药杂志

<p><b>OBJECTIVE</b>To prepare colon-targetting tablets of total alkaloids of Sophora alopecuroides and evaluate the effect of pectins of different degree of esterification (DE) on sophoridine release profiles in-vitro.</p><p><b>METHOD</b>Wet granulation technique was employed to prepare petin-based matrix tablets, then tablets were coated the optimal formulation with Kollicoat MAE 30 DP based on the optimal formulation and analysed their release.</p><p><b>RESULT</b>Coated formulation E could target total alkaloids of S. alopecuroides to colon and various DE of pectin exerted different effects on sophoridine release. The release of low DE pectin-based matrix tablets coating with Kollicoat MAE 30 DP approximatedly fitted zere-order eqution, which was erosion depended.</p><p><b>CONCLUSION</b>Low DE pectin-based matrix tablet coating with Kollicoat MAE 30 DP can deliver sophoridine to colon, hence improve the effectiveness of sophoridine.</p>

Relationship between bleomycin-induced pulmonary fibrosis and vascular endothelial cell injury / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To explore the relationship between the injury of vascular endothelial cells and formation of lung fibrosis by bleomycin (BLM) in rats.</p><p><b>METHODS</b>The rats of experimental groups were treated with bleomycin intratracheally to induce pulmonary fibrosis. The expression of vascular endothelial growth factor (VEGF) in pulmonary tissues were analyzed qualitatively and quantitatively by immunohistochemistry and image analysis system.</p><p><b>RESULTS</b>(1) HISTOLOGY: Edema in rat alveoli and alveolar septum, inflammatory cells exudation, degeneration and necrosis of type I and type II alveolar epithelial cells (AETI and AETII), ruptured alveolar basement membrane, as well as swollen vascular endothelial cells and karyopyknosis were observed in 3 d and 7 d after treatment with BLM. AETII proliferation, with more fibroblasts in alveolar septum, and new capillary vessel formation in 7, 14 d, as well as thickened alveolar septum, damaged alveolar structure, and obvious pulmonary tissue fibrosis in 28 d after treatment with BLM were observed. (2) Immunohistochemistry: in normal control, VEGF expressed weakly in pulmonary tissue distributing mainly in AETII, bronchial epithelial cells, alveolar macrophages and leydig's cells. While in bleomycin treated groups, the expression of VEGF increased markedly. The expression in AETII, and pulmonary macrophage were significantly higher than that in control in 3 d to 28 d (P < 0.05, P < 0.01). The rat leydig's cells also had higher expression of VEGF in 7, 14, 28 d (P < 0.05, P < 0.01).</p><p><b>CONCLUSION</b>The high expression of VEGF is related to vascular endothelial cells injury which may be one of important factors in the formation of bleomycin-induced pulmonary fibrosis.</p>

Study Progress of Diagnosis and Treatment of Systemic Lupus Erythematosus in Children / 实用儿科临床杂志

Systemic lupus erythematosus(SLE) is an autoimmune connective-tissue disorder with a wide range of clinical features.Although the clinical symptoms and immunological findings of pediatric SLE are similar to those of adult SLE patients,the pediatric SLE has some special aspects.In the recent years,although there was no abrupt development in the diagnosis and treatment of SLE,there were some new findings,maybe not mature.On the basis of recent findings outsides,this study drew attention to the advances in the novel clinical manifestation,update treatment of pediatric SLE.