Value of serum YKL-40 in the diagnosis of anti-MDA5-positive patients with dermatomyositis complicated with severe pulmonary injury / 北京大学学报(医学版)

OBJECTIVE@#To investigate the value of serum and bronchoalveolar lavage fluid (BALF) chitinase-3-like-1 protein (YKL-40) in the diagnosis of anti-melanoma differentiation-associated gene 5 (MDA5)-positive dermatomyositis (DM) patients complicated with serious pulmonary injury, including rapidly progressive interstitial lung disease (RP-ILD) and pulmonary infection.@*METHODS@#Anti-MDA5 antibodies positive patients with DM who were hospitalized in the Department of Rheumatology of China-Japan Friendship Hospital from 2013 to 2018 were involved in this study. Demographic information, clinical, laboratory and imaging data were retrospectively collected. ELISA was used to detect the serum and BALF levels of YKL-40. The receiver operating characteristic (ROC) curve was drawn, and the area under ROC curve (AUC) was used to evaluate the diagnostic value of serum YKL-40 for pulmonary injury.Interstitial lung disease (ILD) was confirmed by chest high-resolution CT (HRCT). RP-ILD was defined as progressive respiratory symptoms such as dyspnea and hypoxemia within 3 months, and/or deterioration of interstitial changes or appearace of new pulmonary interstitial lesions on chest HRCT. Pulmonary infection was considered as positive pathogens detected in qualified sputum, blood, bronchoalveolar lavage fluid or lung biopsy specimens.@*RESULTS@#A total of 168 anti-MDA5-positive DM patients including 108 females and 60 males were enrolled in the study. Of these patients, 154 had ILD, and 66(39.3%) of them presented RP-ILD. Seventy patients with pulmonary infection were confirmed by etiology. In the patients with RP-ILD, 39 (59.1%) of them were complicated with pulmonary infection. While only 31 cases(30.4%) had pulmonary infection in the non-RP-ILD patients. The incidence of pulmonary infection in the patients with RP-ILD was significantly higher than that of those with non-RP-ILD (P < 0.001). The serum YKL-40 levels in the RP-ILD patients with pulmonary infection were the highest compared with RP-ILD without pulmonary infection, non-RP-ILD with pulmonary infection and non-RP-ILD without pulmonary infection groups among all the patients [83 (42-142) vs. 42 (21-91) vs. 43 (24-79) vs. 38 (22-69), P < 0.01].The sensitivity, specificity and AUC of serum YKL-40 in the diagnosis of RP-ILD complicated with pulmonary infection were 75%, 67%, and 0.72, respectively. The AUC of diagnosed of anti-MDA5 positive DM patients complicated with RP-ILD and pulmonary infection was higher than that of patients complicated with only RP-ILD and only pulmonary infection (0.72 vs. 0.54 and 0.55, Z=2.10 and 2.11, P < 0.05).@*CONCLUSION@#The prognosis of anti-MDA5-positive DM patients with RP-ILD and pulmonary infection were poor. Serum YKL-40 level can be used as a helpful tool for the diagnosis of coexistence of these conditions in the patients.

Research advances in pathomechanism and treatment of joint contracture / 中国骨伤

Joint contracture is one of the common musculoskeletal disorders. It has seriously disturbed patients' activities of daily living in various aspects. The pathogenesis of it is eager to explore to distinct degree. Nowadays the thickeness and fibrosis of joint capsular is redarded as the major reason to joint contracture. It is reported that excessive fibroblasts and myofibroblasts activity, collagen hyperplasia, and extracellular matrix (ECM) deposition in these fibrotic condtions lead to the contracture. In addition, upregulators of myofibroblast and collagen synthesis, transforming growth factor-beta 1 (TGF-β1), and connective tissue growth factor (CTGF) were shown to be increased. Altered levels of cytokines were also thought to play a role in this process as elevated levelsof tumor necrosis factor-α(TNF-α), matrix metalloproteinases(MMPs) and abnormal distribution tissue inhibitors of MMPs(TIMPs) were demonstrated in contracted capsules. At present, the methods for clinical treatment of joint contracture mainly include two major categories:stretching therapy, physical factor therapy, exercise therapy, botulinum toxin injection and other non-surgical treatments, arthroscopic lysis, open lysis, and other surgical treatments. Surgical treatment is performed when non-surgical treatment is difficult to achieve further improvement. It has a good effect on mild to moderate joint contracture, but it is difficult to completely restore joint activity for serious joint contracture. Although clinical treatment methods are diverse, the clinical effects are staggered and the effectiveness of their treatment is controversial. Joint contracture is an important challenge faced by orthopedics and rehabilitation physicians, therapists and patients. The review summarized the pathogenesisand treatment of joint contracture and provided a theoretical basis for clinical diagnosis and treatment.

Successful micro-resection of lacrimal punctum neoplasm using XL -radiofrequency ablation skin apparatus under a microscope / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To study the therapeutic method of XL -radiofrequency ablation skin apparatus (invented by Rehabilitation medicine, PLA General Hospital) in micro-resecting the lacrimal punctum neoplasm and to observe its clinical effects. ·METHODS:XL-radiofrequency ablation skin apparatus was performed on 7 cases (7 eye lesions) of lacrimal punctum neoplasm including 3 intradermal nevus, 1 boundary nevus, 1 mixed nevus with inflammatory granuloma,1 inflammatory granuloma,and 1 squamous papillary cell tumor by separating layer, point and flake removing methods. The clinical effect was investigated 2-6mo postoperatively and leftover was removed by twice. The postoperative follow- up durations ranged from 6 to 60mo. ·RESULTS: Totally 6 cases (6 eye lesions) were cured successfully by once but 1 case by twice. They were all without recurrence, cicatrix, palpebral margin deformity, obstruction of lacrimal punctum, stenosis of lacrimal punctum or epiphora. Micro - resecting the lacrimal punctum neoplasm using the XL-radiofrequency ablation skin apparatus had several advantages, such as high accuracy,no cicatrix,no bleeding,no epiphora,no damage to the structure of lacrimal canaliculus, short operation time, little pain during the procedure, without hospitalization, slight inflammation reaction after procedure. ·CONCLUSION: The efficacy of XL - radiofrequency ablation skin apparatus is significantly more evident and highly accurate in micro - resecting lacrimal punctum neoplasm.

The Effect of Serum Cytokine Levels prior Transplantation on the Outcome of Severe Aplastic Anemia Patients Received Allogeneic Hematopoietic Stem Cell Transplantation / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To identify the role of serum cytokine levels prior allogeneic hematopoietic stem cell trans-plantation (allo-HSCT) in the outcome of severe aplastic anemia (SAA) patients received allo-HSCT treatment.</p><p><b>METHODS</b>The clinical data of 117 SAA patients received allo-HSCT were enrolled in this study. The overall survival (OS), graft versus host disease (GVHD) incidence and relationship of serum cytokines with OS and major transplantation complications were retrospectively analyzed.</p><p><b>RESULTS</b>The patients enrolled in this study included 78(66.7%) cases received HSCT matched sibling donors (MSD), 12(10.2%) HSCT of unrelated donors (MUD) and 27 cases received HSCT of haploidentical donors (HID). The 5-years OS was 76.0%(95% CI: 64.4-87.5%); aGVHD cumulative incidence was 49.6%(95% CI: 40.4%-58.8%) and cumulative incidence cGVHD was 31.6%(95% CI:23.1%-40.2%). MSD allo-HSCT had a significantly higher 5-years OS as compared with the other donors(82.3%±6.6% vs 61.3%±11.7%, P<0.05). HLA matching, donor's age, cytomegalovirus/ Epstein-Barr virus (CMV/EBV) infection were important factors of affecting occurence of aGVHD. The patients with higher serum IL-6 had reduced platelet recovery time after transplantation (14.6±1.8 vs 18.3±2.6 d)(P=0.050) and higher serum TNF-α level accompanied by a lower incidence of CMV/EBV infection (37.8%±11.1% vs 58.8±16.8%)(P<0.05).</p><p><b>CONCLUSION</b>MSD allo-HSCT is the effective treatment for SAA patients. Donor's type remains the strong predictor of survival. The serum levels IL-6 and TNF-α before transplantation associate with platelet recovery and CMV/EBV infection.</p>

Influence of MicroRNA-382 on Biological Properties of Human Umbilical Cord-Derived Mesenchymal Stem Cells / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the effect of microRNA-382 (miR-382) on the biological properties of human umbilical cord-derived mesenchymal stem cells (hUC-MSC).</p><p><b>METHODS</b>The mimics and inhibitor of miR-382 were transfected into hUC-MSC with lipo2000. Inverted microscopy was used to observe the morphology change of hUC-MSC. The proliferation of hUC-MSC was detected by CCK-8. Oil red O and alizarin red staining were applied to assess the adipogenic and osteogenic differentiation of hUC-MSC. Cetylpyridinium chloride was used to the quantitative analysis of osteogenic differentiation. The expression of Runx2 and some cytokines were detected by RT-PCR.</p><p><b>RESULTS</b>miR-382 did not influence the morphology, proliferation and adipogenic differentiation of hUC-MSC miR-382 inhibited the expression of Runx2, thus could inhibit the osteogenesis of hUC-MSC, being confirmed by alizarin red stain; miR-382 could influence the expression of key cytokines secreted from hUC-MSC, such as IL-6, IDO1, G-CSF, M-CSF, GM-CSF.</p><p><b>CONCLUSION</b>miR-382 decreases the expression of Runx2 and inhibites the osteogenesis of hUC-MSC. In addition, it also affects the expression of some key cytokines secreted from hUC-MSC.</p>

Anchors and peroneous brevis tendon augmentation and plantaris muscle tendon covering for the reconstruction of achilles tendon rupture caused by corticosteroids injection / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the clinical therapeutic effects of anchors, peroneus brevis tendon augmentation and plantaris muscle tendon covering on the reconstruction of achilles tendon rupture caused by corticosteroids injection.</p><p><b>METHODS</b>From March 2005 to April 2010, the clinical data of 10 patients with acute achilles tendon rupture repaired with suture anchors, peroneus brevis tendon augmentation and plantaris muscle tendon covering were retrospectively analyzed. The achilles tendon rupture was caused by corticosteroids injection. There were 8 males and 2 females with a mean age of (46.80 +/- 2.83) years old(ranged from 21 to 68 years). Postoperative complications, the range of movement of affected foot, number of consecutive heel raises and single leg jumpings were recorded. Functional recovery of achilles tendon were assessed according to ankle and hindfoot scores of the American Orthopedic Foot Ankle Society (AOFAS).</p><p><b>RESULTS</b>All patients were followed up for 12 to 18 months with an average of 13.5 months. No wound infection, re-rupture and rejection reaction were found. At the last follow-up, there was no significant difference in the range of movement between affected foot (54.5 +/- 6.3) degrees and unaffected foot (56.8 +/- 3.8) degrees (t = 0.989, P = 0.336). The affected foot could raise heel and do single-leg hops for 10 times continuosly. There was significant difference in AOFAS between preoperative score (67.3 +/- 7.6) and postoperative score (95.5 +/- 7.6) (t = 8.297, P = 0.000);and there was no significant difference between affected foot scores (95.5 +/- 7.6)and unaffected foot scores (98.5 +/- 6.3) (t = 0.961, P = 0.349). Function recovery of achilles tendon: 9 cases were good, 1 case was fine.</p><p><b>CONCLUSION</b>Anchors, peroneus brevis tendon augmentation and plantaris muscle tendon covering for the reconstruction of achilles tendon rupture caused by corticosteroids injection is a reliable and effective method, with advantage of simple operation, dependable fixation and less complications.</p>

Effect of Sciatic Nerve Compression with Different Pressures and Sites on Neural Blood Flow in Rats / 中国康复理论与实践

@#Objective To observe the changes of neural blood flow when oppressed with different pressures and at different sites in rat's sciatic nerve.MethodsThe sciatic nerve compression model of rat with pressure and time controlled simultaneously was established.The changes of neural blood flow were observed by oppressing the sciatic nerve with five grades pressures using Gasbag.The rats were randomly divided into the distal compression group and proximal compression group,and the changes of neural blood flow were observed in each group.ResultsThe neural blood flow changed significantly(P<0.05) when the sciatic nerve was oppressed with different pressures and it had the decreasing tendency with the pressures increasing.The neural blood flow of each group decreased obviously(P<0.01).The effect of oppressing distal nerve on neural blood flow was more obvious than that of oppressing proximal nerve(P<0.01).ConclusionMechanical compression can influence the neural blood flow obviously.The distal vessels of sciatic nerve are the major sources of nerve blood supply.

Changes of regulatory T cell number in hepatocellular carcinoma-bearing mice and its relationship with tumor growth / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the relationship between the change of regulatory T cell number in CD4+ T subset and the growth of tumor in H22 hepatocellular carcinoma-bearing mice.</p><p><b>METHODS</b>Tumor-bearing mice were established by subcutaneous inoculation of H22 hepatocelluler carcinoma cells. Flow cytometry was used to detect the expression of CD4 and CD25 molecules of the T cells which came from the tumor-bearing mice. The Foxp3 gene expression was detected by RT-PCR and flow cytometry. CD4+ CD25+ T cells and CD4+ CD25- T cells were separated and purified by immuno-magnetic beads. The proliferation and suppressive function of the CD4+ CD25+ T cells coming from tumor-bearing mice was measured by [3H]-thymidines incorporation experiment in vitro, and then effect of CD4+ CD25+ T cells originated from hepatocellular carcinoma-bearing mice on tumor growth was observed in vivo.</p><p><b>RESULTS</b>(1) Compared with mice of the control group, the percentage of CD4+ CD25+ T cells of CD4+ T cells in tumor-bearing mice is not only higher in draining lymph nodes (18.80% < or = 0.06%) vs. (9.50% +/- 0.03%), (P < 0.01), but also higher in non-draining lymph nodes (LN) and spleen (SP), LN: (16.28% +/- 0.02%) vs. (9.50% +/- 0.03%), P < 0.01; SP: (17.28% +/- 0.06%) vs. (11.08% +/- 0.04%), (P < 0.05). The expression of regulatory T cell specific marker Foxp3 gene was also increased. In the same tumor-bearing mice, the number of CD4+ CD25+ T cells in draining lymph node was relatively higher than the contralateral nondraining lymph node, but the difference was statistically not significant (18.8% +/- 0.06%) vs. (16.28% +/- 0.02%), (P > 0.05). (2) The CD4+ CD25+ T cells purified from tumor-bearing mice--like naturally occurring regulatory T cells--were anergic to anti-CD3 monoclonal antibody stimulation in vitro, but it could suppress CD4+ CD25- T cells proliferation. (3) The percentage of CD4+ CD25+ T cells was positively related to tumor size. It could also suppress the anti-tumor effect of CD4+ CD25- T cells in vivo. Conclusion The growth of hepatocellular carcinoma in mice can boost the amount of regulatory T cells. The amount of regulatory T cells is positively related to tumor size, indicating that attack on regulatory T cells could be used as one of modalities in cancer treatment in the future.</p>

Application of Electrical Stimulation in Regeneration of Peripheral Nerve(review) / 中国康复理论与实践

@#Injury of peripheral nerve is a so common complication in trauma, that it is important to improve regeneration to recover the function of peripheral nerve. This paper has reviewed the pathology after injury of peripheral nerve, condition of successful regeneration of peripheral nerve, experiment and clinical study of electrical stimulation promoting regeneration of peripheral nerve and the possible mechanism. The effect of electrical stimulation on promoting regeneration of peripheral nerve has been gradually accredited. However, further study is still needed to discover the many unknown field.

Application of Electrical Stimulation in Regeneration of Peripheral Nerve(review) / 中国康复理论与实践

@#Injury of peripheral nerve is a so common complication in trauma, that it is important to improve regeneration to recover the function of peripheral nerve. This paper has reviewed the pathology after injury of peripheral nerve, condition of successful regeneration of peripheral nerve, experiment and clinical study of electrical stimulation promoting regeneration of peripheral nerve and the possible mechanism. The effect of electrical stimulation on promoting regeneration of peripheral nerve has been gradually accredited. However, further study is still needed to discover the many unknown field.

Soluble tumor necrosis factor related apoptosis inducing ligand (sTRAIL) and clinical outcome of HBV infection in human / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To explore the role of sTRAIL in the pathogenesis of HBV infection in human being.</p><p><b>METHODS</b>sTRAIL in 153 patients' sera was examined with ELISA. Correlations between sTRAIL and liver functional parameters were analysed.</p><p><b>RESULTS</b>The levels of sTRAIL in patients with various clinical types of hepatitis B as well as primary hepatocellular carcinoma were all higher than that in normal persons and became almost normal in recovering stage cases. In acute and chronic HBV infection, sTRAIL level was negatively correlated with ALT, AST and total bilirubin levels, and positively correlated with serum albumin.</p><p><b>CONCLUSION</b>The results indicated that higher level of sTRAIL expression is correlated with liver damage, and apoptosis induced by sTRAIL is one of the mechanisms of liver damage in HBV infection.</p>

Inhibition of HBV DNA replication and expression in 2.2.15 hepatoma cells infected with AFP-mediated HBX antisense RNA / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To study the specific expression of the antisense RNA against hepatitis B virus X (HBX) gene in hepatoblastoma cell line and its anti -HBV activity.</p><p><b>METHODS</b>HBX gene (nt.1370-1827) was amplified by PCR, then cloned into EB virus vector pEBAF which contained human alpha-fetoprotein promoter and enhancer. After transfected into 2.2.15 hepatoma cells and ECV304 human endothelial cells by lipofectin, northern blot, ELISA and real-time qualitative PCR were carried out to assay the expression of HBX mRNA, HBV antigens and HBV DNA level, respectively.</p><p><b>RESULTS</b>The HBX antisense RNA expression vector pEBAF-as-HBX which could be expressed specifically in 2.2.15 hepatoblastoma cells was successfully constructed. Both HBV DNA level and the expressions of hepatitis B virus surface antigen (HBsAg) and e antigen (HBeAg) in 2.2.15 hepatoblastoma cells were inhibited by pEBAF-as-HBX. Compared with those in sense control (pEBAF-s-HBX), the inhibitory rates of HBsAg, HBeAg, and HBV DNA were 37.9%, 36.8%, and 25%, respectively.</p><p><b>CONCLUSIONS</b>The pEBAF-as-HBX expression vector may lead to targeted-expression of HBX antisense RNA in hepatoma cells and shows great inhibition effect on HBV.</p>