Ginsenoside Rb1 Protects Human Umbilical Vein Endothelial Cells against High Glucose-Induced Mitochondria-Related Apoptosis through Activating SIRT3 Signalling Pathway / 中国结合医学杂志

OBJECTIVE@#To investigate whether ginsenoside Rb1 (Rb1) can protect human umbilical vein endothelial cells (HUVECs) against high glucose-induced apoptosis and examine the underlying mechanism.@*METHODS@#HUVECs were divided into 5 groups: control group (5.5 mmol/L glucose), high glucose (HG, 40 mmol/L) treatment group, Rb1 (50 µ mol/L) treatment group, Rb1 plus HG treatment group, and Rb1 and 3-(@*RESULTS@#Rb1 ameliorated survival in cells in which apoptosis was induced by high glucose (P<0.05 or P<0.01). Upon the addition of Rb1, mitochondrial and intracellular reactive oxygen species generation and malondialdehyde levels were decreased (P<0.01), while the activities of antioxidant enzymes were increased (P<0.05 or P<0.01). Rb1 preserved the mitochondrial membrane potential and reduced the release of Cyt-c from the mitochondria into the cytosol (P<0.01). In addition, Rb1 upregulated mitochondrial biogenesis-associated proteins (P<0.01). Notably, the cytoprotective effects of Rb1 were correlated with SIRT3 signalling pathway activation (P<0.01). The effect of Rb1 against high glucose-induced mitochondria-related apoptosis was restrained by 3-TYP (P<0.05 or P<0.01).@*CONCLUSION@#Rb1 could protect HUVECs from high glucose-induced apoptosis by promoting mitochondrial function and suppressing oxidative stress through the SIRT3 signalling pathway.

Clinical manifestations and prognosis of SLE patients with positive anti-cardiolipin antibodies / 医学研究生学报

Objectives Anticardiolipin antibody (aCL) is an important component of antiphospholipid antibody (aPL) and a marker antibody of antiphospholipid syndrome (aPS). APL is positive in 20% to 40% of patients with systemic lupus erythematosus(SLE). This article investigated the clinical features and prognosis of SLE patients with aCL. Methods From January 1999 to December 2009, 495 cases of SLE patients detected aCL who were hospitalized for the first time in 26 hospitals in Jiangsu Province including Nanjing Drum Tower Hospital were divided into aCL-positive group and aCL-negative group according to the test results. The patients were followed up in survival status, and the demographic characteristics, affected organs, laboratory tests, treatment drugs, and prognosis were compared between two groups. Results 146 of the SLE patients in this group were positive for aCL. The proportion of women in aCL- positive group (96.6%) was significantly higher than that in aCL-negative group (90.8%), and the difference was statistically significant (P<0.05). The proportion of anemia (74.7% vs 61.3%), decreased C3(81.5% vs 71.1%), positive antinuclear antibody(97.2% vs 92.4%), and positive anti-dsDNA antibody (61.9% vs 49.6%) in aCL-positive group were significantly higher than those of aCL-negative group, and the difference was statistically significant (P<0.05). The aCL-positive group received a higher proportion of cyclophosphamide immunosuppressive therapy (39.5% vs 50.7%, P<0.05). At the end of follow-up, the mortality rate of aCL-positive group was 13.7%, and the mortality rate of aCL-negative group was 14.9% and there was no significant difference in mortality (P>0.05). Kaplan-Meier survival analysis showed that the 1-year, 5-year, and 10-year survival rates of aCL-positive group were 94.5%, 89.0%, and 82.9%, respectively, and there was no significant difference compared with aCL-negative group(P=0.776). The main causes of death in aCL-positive group were lupus encephalopathy (6 cases, 30.0%), renal failure (5 cases, 25.0%), heart failure (4 cases, 20.0%) and infection (3 cases, 15%). The main causes of death in aCL-negative group were infection (21 cases, 40.4%), lupus encephalopathy (11 cases, 21.2%) and heart failure (5 cases, 9.6%) and renal failure (4 cases, 7.7%). Conclusion SLE patients with aCL represent a high propotion in anemia, decreased C3, positive antinuclear antibody, positive anti-dsDNA antibody. There was no significant difference in disease activity and significant organ involvement between two groups. More SLE patients with aCL were treated with cyclophosphamide, and there was no significant difference in survival status between SLE patients with and without aCL during long-term follow-up.

Ginsenoside Rb1 Attenuates Human Umbilical Vein Endothelial Cells Senescence Induced by High Glucose through Sirt3/SOD2 Pathway / 中山大学学报(医学科学版)

@#Abstract】 【Objective】To investigate the effect and mechanism of ginsenoside Rb1 attenuating human umbilical vein endothelial cells(HUVEC) senescence induced by high glucose through Sirt3/SOD2 pathway.【Methods】The senescence of HUVEC induced by high glucose(40 mmol/L)was assessed by senescence-associated β-galactosidase(SA-β-Gal)staining,and the expression of plasminogen activator inhibitor 1(PAI-1)and P16. Annexin V-FITC/PI was performed to measure apoptotic effect. The expression of sirtuins 3(Sirt3)and superoxide dismutase 2(SOD2)was detected by western blot. Meanwhile,the level of intracellular malondialdehyde(MDA)and the activity of SOD2 were measured.【Results】Treatment of HUVEC with high glucose for 24 hours induced premature senescence instead of apoptosis,as indicated by a larger proportion of the cells stained with SA-β-Gal and the up-regulated expression of PAI-1 and P16. Pretreatment of HUVEC with ginsenoside Rb1(40 μmol/L)could reverse endothelial cell senescence,as indicated by the reduced SA-β-Gal positive cells and the down-regulated expression of PAI-1 and P16. Furthermore,ginsenoside Rb1 pretreatment upregulated the protein expression of Sirt3 and SOD2,and eventually increased the activity of SOD2 and decreased the level of MDA.【Conclusion】Ginsenoside Rb1 could antagonize high glucose-induced premature senescence of HUVEC via Sirt3/SOD2 signaling pathway.

Prognostic Value of Morphology and Hans Classification in Diffuse Large B Cell Lymphoma / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the prognostic value of morphology and Hans classification in diffuse large B cell lymphoma（DLBCL）.</p><p><b>METHODS</b>Clinical data of 249 patients diagnosed with DLBCL in our hospital and Hangzhou Xixi hospital during Jan 2006 to Dec 2016 were analyzed retrospectively. These patients were classified into 3 groups: immunoblastic variant（IB） group, centroblastic variant（CB） group and others group according to the cell morphology. And DLBCL was also divided into GCB（germinal center B-cell-like）or non-GCB（non-germinal center B-cell-like） group by analyzing the expression of CD10, BCL6 and MUM1 (GCB: CD10 ,BCL6,MUM1/CD10,BCL6,MUM1；non-GCB：CD10,BCL6,MUM1/CD10,BCL6,MUM1).</p><p><b>RESULTS</b>The univariate analysis displayed that the age，LDH level，IPI，IB，non-GCB，B-symptoms and rituximab all could influence the OS and EFS, the CR rate of CB subtype patients was significantly higher than that of the patients with IB subtype （68.3% vs 38.9%)(P=0.02）. IB subtype was the in dependent prognostic factor for both EFS and OS in the whole study. In multivariate analysis, IPI and IB were the independent prognostic factors for OS and EFS. IB subtype was also an independent prognostic factor in EFS and OS with or without rituximab. The expression of BCL2 and BCL6 was related with prognosis in R-CHOP, but not in CHOP treated patients. Other markers (CD5, CD10, IRF4/MUM1, HLA-DR and Ki-67 proliferation index) were not of the significant prognostic value for DLBCL. When accepted rituximab, the GCB and non-GCB were not different significantly for prognosis. However, the non-GCB group showed a poor prognosis without using rituximab （EFS P=0.020；OS P=0.020）. Multivariate Cox models showed that OS and EFS were not significantly different between GCB and non-GCB group, however, the IB subtype had a very significantly poor prognosis in OS and EFS (P=0.001, P=0.002). When the analysis was restricted to DLBCL with CB morphology only, no prognostic value was observed in Hans classification.</p><p><b>CONCLUSION</b>The subtype of immunoblast is a major risk factor in patients treated with CHOP or R-CHOP. There is a significant association between the Hans classification and the morphologic subclassification. Results of this study have supplemented the data for the prognostic factor of DLBCL and demonstrated that the cytomorphologic diagnosis can be reproducible.</p>

Determination of rutaecarpine in Fuzhengpingxiao capsule by HPLC method / 药学实践杂志

Objective To develop a new method to determine the contents of rutaecarpine in Fuzhengpingxiao capsule by HPLC method.Methods Samples were handled by ethanol and extraction with ethyl acetate.The separation was achieved on an Agilent TC-C18column using a mobile phase system of acetonitrile-water(2% Tetrahydrofuran and 0.2 % formic acid)at a flow rate of 1.0 ml/min.The temperature of column was 40 ℃ and the detection wavelength was 240 nm.Results The cali-bration curves of rutaecarpine showed good linearity in the ranges of 1.18-118 μg/ml,r=0.999 9.The results of intra-day and inter-day precisions were both within 2%,the average additional recovery rate was 94.20%.Conclusion The HPLC method was accurate,specific,sensitive and reproducible,which could be used for quality control of rutaecarpine in the preparation of Fuzhengpingxiao capsule.

Application of the "buddy-in-jail" technique during percutaneous coronary intervention:choice of wire and artery / 中国介入心脏病学杂志

Objective To evaluate the efficacy of the ' buddy-in-jail ' technique applied to complex coronary artery lesions during percutaneous coronary intervention.Methods A total of 12640 PCI cases from 4 different hospitals admitted between June 2014 to June 2017 were reviewed. Among them, the balloons or stents were unable to be delivered into the lesions in 25 cases. The "buddy-in-jail"technique was applied in 21 of these 25 cases. According to the guidewires used, the 21 cases were divided into the hydrophilic coated guidewire group(n=9) and non-hydrophilic coated guidewire group(n=21). The rates of procedural success and complications were compared between the 2 groups.Results 18 cases(18/21)were successfully treated with the "buddy-in-jail " technique. The success rates were similar between patients using the same artery(9/11) as the "buddy" vessel patients using other arteries(9/10) (P=0.593). Procedural success rates were also similar between patients using hydrophilic-coated guidewires (7/9) and non- hydrophilic coated guidewires(11/12)(P=0.386). All the wires were successfully taken out without complication.Conclusions "Buddy-in-jail" technique offers a potential alternative approach for patients with difflculty in delivering the balloon or stent to the target lesion.

Hydrogen sulfide attenuates human umbilical vein endothelial cell senes-cence via modulation of Sirt1/eNOS pathway / 中国病理生理杂志

AIM:To explore the role of Sirt1/eNOS signalling pathway in the protective effect of hydrogen sul-phide(H2S)against endothelial cell senescence induced by high glucose.METHODS:High glucose(33 mmol/L)was applied to induce senescence in primary human umbilical vein endothelial cells(HUVECs).The cell viability,the propor-tion of senescence-associated β-galactosidase(SA-β-Gal)positive cells and the plasminogen activator inhibitor 1(PAI-1) expression were detected to assess the senescence model.Mean while,Sirt1 siRNA was used to examine the effect of Sirt 1 on eNOS expression and the senescence-related parameters.RESULTS: Treatment of HUVECs with high glucose de-creased the cell viability slowly with a larger proportion of the cells stained with SA-β-Gal, and the protein expression of PAI-1 was dramatically increased.The increased cell viability,reduced SA-β-Gal positive cells and decreased protein ex-pression of PAI-1 were detected after sodium hydrosulfide(NaHS,100 μmol/L)treatment.Furthermore,NaHS treatment upregulated the protein expression of Sirt 1 and eNOS,and eventually increased the production of nitric oxide(NO).CON-CLUSION:Exogenous H2S modulates Sirt1/eNOS/NO pathway to prevent HUVECs against high glucose-induced senes-cence.

Expression of CD30 in Diffuse Large B Cell Lymphoma and Its Clinical Significance / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To evaluate the expression and clinical significance of tumor necrosis factor receptor (TNFR) superfamily protein CD30 in diffuse large B cell lymhoma (DLBCL).</p><p><b>METHODS</b>The CD30 expression, clinical characteristics and prognosis of 63 patients with DLBCL, NOS out of 149 patients with DLBCL admitted in our hospital between January 2008 and December 2012 were analyzed retrospectively.</p><p><b>RESULTS</b>no significant relationship existed between CD30 expression and clinical features, such as age, sex, B symptoms, staging, ECOG PS, LDH level, extranodal site involvement, IPI, GCB or non GCB type, bone marrow involvement. By univariate analysis, the clinical factors associated with general OS and EFS, included CD30, ECOG PS, B symptoms, extranodal site involvement, LDH level, IPI, bone marrow involvement and rituximab. Univariate analysis in GCB DLBCL indicated that CD30 had no significant effect on OS and EFS. However, univariate analysis in non-GCB DLBCL indicated CD30 was associated with longer OS (P=0.037) and showed a tendency of better EFS (P=0.067). In multivariate analysis, IPI and CD30 were independent prognostic factors for OS (IPI: P=0.000, 95%CI 0.042-0.374, CD30: P=0.044, 95%CI 1.055-60.613), and IPI also was independent prognostic factors for EFS (P=0.000, 95%CI 0.040-0.360). CD30+ and DLBCL have a tendency of better EFS (P=0.050, 95%CI 0.996-56.501).</p><p><b>CONCLUSION</b>CD30 expression level correlates with the prognosis of DLBCL and has a certain clinical value, which may be a new prognostic index of DLBCL.</p>

Lc-ms/ms for determination of seven steroid hormones in sera of primary hepatocellular carcinoma patients / 第二军医大学学报

Objective To establish a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for determination of seven steroid hormones in sera of patients with primary hepatocellular carcinoma. Methods The serum samples were extracted with ethyl acetate. and then derivatized with dansyl chloride. Chromatographic column was Agilent Poroshell 120 EC-Ci8 (2. 1 mmX150 mm, 2. 7 μm) column, mobile phase was acetonitrile and 0. 1% formic acid-water solution, flow rate was 0. 3 mL/min. the column temperature was 35°C. and the MSdetection was selected in dynamic MRM mode. Results Seven steroid hormones (estradiol. estriol. estrone. hydrocortisone. testosterone. androstenedione and progesterone) were baseline separated within 8 min. which possessed good linear relationship (r>0. 99) within the linear concentration range; the intra-day and inter-day precisions were less than 15%. the recoveries were ranged from80% to 119%. the matrix effect was 85%-112%. The detection results were stable when the samples were examined 6 h after collection. 24 h after treatment at room temperature. after three freezethaw cycles. and 30 dayswhen stored at —80°C. Conclusion The current LC-MS/MS method is simple. accurate. sensitive and reproducible. and it canbe applied to determine steroidhormones in the sera of patients with primary hepatocellular carcinoma.

HPLC-DAD for simultaneous determination of 20 colorants in hair dyes / 第二军医大学学报

Objective: To develop a high-performance liquid chromatography (HPLC)-diode array detector (DAD) method for determination of 20 colorants in hair dyes, so as to improve the method for determining oxidative hair dyes in Hygienic Standard for Cosmetics. Methods: After ultrasonic extraction with ethanol-water, samples were analyzed by HPLC. The separation was achieved on an Agilent Zorbax Bonus-RP column (4.6mm × 250mm, 5μm) using a gradient mobile phase system of A: acetonitrile and B: 4mmol/L PBS (pH = 6.0) containing 0.1 % 1-octanesulfonic acid sodium salt solution at a flow rate of 1 mL/min. The gradient elution program was as follows: 0-24 min, 10% A; 24-26 min, 10%-40% A; 26-45 min, 40% A; 45-47 min, 40%-80% A; 47-52 min, keep 80% A unchanged. The detection wavelength was set at 280 nm, the temperature of column was 15°C, and the injection volume was 5 μL. Results: All the components were separated at baseline within 50 min. Within the concentration range of 10.0-500.0 mg/L, the peak areas and concentrations of colorants had good linear relationship, with the linear correlation coefficients being higher than 0.999. The intra-day and inter-day precisions were within 4% and the average recoveries ranged from 81.90% to 119.88%. Conclusion: The present method is simple, rapid and accurate and is suitable for determination of colorants in oxidative hair dyes.

Research progress in steroid hormone analysis in vivo by chromatography-mass spectrometry / 药学实践杂志

Steroid hormones were chemical compounds of high efficiency , which played a significant role in various physiologi-cal activities.However, the concentrations of hormones in vivo were extremely low, so it was very important for their accurate quantifi-cation.Chromatography-mass spectrometry technology was widely employed because of advances in high efficient , rapid and sensitive. The application of steroid hormone analysis by chromatography-mass spectrometry was reviewed in this paper , which could provide ref-erence for furthuer clinical research .

Traditional Chinese medicine compound ShengJinRunZaoYangXue granules for treatment of primary Sjögren's syndrome: a randomized, double-blind, placebo-controlled clinical trial / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Traditional Chinese medical treatment of primary Sjögren's syndrome has advantages over Western medicine in terms of fewer side effects and improved patient conditions. This study was a multicenter, randomized, double-blind, placebo-controlled clinical trial of the efficacy and safety of ShengJinRunZaoYangXue granules for the treatment of primary Sjögren's syndrome, including the symptoms of dry mouth and dry eye.</p><p><b>METHODS</b>We undertook a 6-week, double-blind, randomized trial involving 240 patients with primary Sjögren's syndrome at five centers in East China. A computer-generated randomization schedule assigned patients at a 2:1 ratio to receive either ShengJinRunZaoYangXue granules or placebo once daily. Patients and investigators were blinded to treatment allocation. The primary endpoints were the salivary flow rate, Schirmer test results, and sugar test results. Intention-to-treat and per-protocol analyses were performed.</p><p><b>RESULTS</b>All 240 patients were randomly allocated to either the treatment group (n = 160, ShengJinRunZaoYangXue granules) or placebo group (n = 80) and were included in the intention-to-treat analysis. After program violation and loss to follow-up, a total of 199 patients were included in the per-protocol analysis. At six week, intention-to-treat and per-protocol analyses of the left-eye Schirmer I test results showed an improved difference of 1.36 mm/5 min (95% CI: 0.03 to 2.69 mm/5 min) and 1.35 mm/5 min (95% CI: 0.04 to 2.73 mm/5 min), respectively, and those of the right-eye Schirmer I test results showed an improved difference of 1.12 mm/5 min (95% CI: 0.02 to 2.22 mm/5 min) and 1.12 mm/5 min (95% CI: -0.02 to 2.27 mm/5 min), respectively. There was no significant difference between the two groups before treatment. After treatment, the between-group and within-group before-and-after paired comparison results were statistically significant (P < 0.05). Intention-to-treat and per-protocol analyses showed an improved salivary flow rate by 0.04 ml/15 min (95% CI: -0.49 to 0.58 ml/15 min) and 0.04 ml/15 min (95% CI: -0.52 to 0.60 ml/15 min), respectively, but the differences were not significant. Intention-to-treat and per-protocol analyses showed that the sugar test results were improved by 1.77 minutes (95% CI: 0.11 to 3.44 minutes) and 1.84 minutes (95% CI: 0.12 to 3.55 minutes), respectively, but the differences were not significant. For the secondary endpoint, intention-to-treat and per-protocol analyses showed significant improvement in the integrated evaluation of treated patients with dry eye and dry mouth after six weeks of treatment. The incidence of adverse events was 15.6% in the treatment group and 10.0% in the placebo group. Most (94%) adverse events were mild to moderate in the two groups, and only two cases of serious adverse events occurred in the treatment group; both were caused by autoimmune liver disease.</p><p><b>CONCLUSIONS</b>Six-week treatment with ShengJinRun ZaoYangXue granules for primary Sjögren's syndrome in this large-scale study improved the symptoms of dry mouth, dry eyes, and low tear flow rate with minimal adverse events.</p>

Research of mechanism jinxueyuan granules increased saliva secretion of xerostomia model rats / 中国中药杂志

To analyze the specific mechanism of Jinxueyuan granules, the relationship between the Jinxueyuan granules increased the saliva secretion of xerostomia model SD rats and excitement of receptors were studied in this experiment. In the study, three groups of xerostomia model rats were successfully established by using M-receptor blockers-4-diphenyl-acetoxy-N-methyl-piperidine (4-DAMP) and atropine, or adrenergic receptor blocker phentolamine; after the modeling, the medicine Jinxueyuan granules were gavaged. According to the clinical dose of Jinxueyuan granules and SD rats body surface area, the rats in atropine group were divided three dose groups respectively, namely low, medium and high dose of Jinxueyuan granules groups. The 4-DAMP group and phentolamine group were gavaged medium dose of Jinxueyuan granules. And the amount of salivary secretion for 150 minutes in all groups continuously were measured, and the effect of Jinxueyuan granules increased salivation and the relationship between characteristics and the receptors were observed; and submandibular gland tissue of the rats was isolated, then the effect of Jinxueyuan Granules for expression of the water channel protein aquaporin-5 (AQP5) in submandibular gland cells was analyzed by the Western blot technology. It was found that the saliva secretion of Jinxueyuan Granules groups was increased significantly, and compared with the saline control group, phentolamine group, 4-DAMP group and atropine group, difference was significant, P < 0.05. There was no significant difference between the low-dose of Jinxueyuan granules group and the saline group, but the medium dose of Jinxueyuan granules group had a significant difference, compared with the saline group (P < 0.05). In the time distribution of increasing saliva secretion, there was a significant difference between the saline and Jinxueyuan granules group in the saliva secretion (P < 0.05). After administration of Jinxueyuan granules, the expression of AQP5 protein in the submandibular gland cells expressing of treatment groups was increased, and compared with the blocker groups, there was a significant difference, P < 0.05. Except the atropine group, there was no significant difference in Jinxueyuan granules relieving the inhibition induced by blocks in phentolamine group and 4-DAMP group, compared with the saline group. Compared the AQP5 expression in three blockers groups, there was no significant difference in the efficacy of Jinxueyuan granules between phentolamine group and 4-DAMP group; but there was a significant difference between the atropine group and other groups (P < 0.05). Therefore, it was considered that the mechanism of Jinxueyuan granules increasing saliva secretion (effectiveness of nourishing Yin and generating body fluid ) possibly through the pathway mediated by muscarinic M receptor, especially M3 receptor, or adrenergic receptor, and increased expression of salivary gland AQP5 membrane, and then stimulate saliva production.

Combined subfascial endoscopic perforator surgery and endovenous laser treatment without impact on the great saphenous vein for management of lower-extremity varicose veins / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Conventional high ligation and stripping of the great saphenous vein (GSV) has a good curative effect but is highly traumatic with a considerable relapse rate. Subfascial endoscopic perforator surgery (SEPS) plus endovenous laser treatment (EVLT) could be applied as individual therapy. This study aimed to evaluate the feasibility of performing combined SEPS and EVLT without impacting GSV in the management of valvular insufficiency of the lower-limb venous perforators.</p><p><b>METHODS</b>Placement of lower-limb venous perforator insufficiency was marked by ascending phlebography in 83 affected limbs from September 2010 to June 2011. After randomization, SEPS was performed on 41 limbs to address the insufficiency of the venous perforators under the deep fascia, in combination with EVLT to close the superficial varicose veins without impacting the GSV. The remaining 42 limbs were treated using traditional GSV phlebectomy as controls.</p><p><b>RESULTS</b>Postoperatively, all varicose veins were resolved, with lightening of the pigmentation and healing of the ulcer. Within a follow-up period of 5 - 11 months, no symptoms had recurred. Compared with the control group, the operation time, the number of incisions sutured, and the in-hospital time decreased on average by 1.5 hours, 4.7, and 6.8 days, respectively (P < 0.01 in all cases).</p><p><b>CONCLUSION</b>Combined SEPS and EVLT for treatment of valvular insufficiency of the lower-limb venous perforators offer the advantages of microtrauma and rapid cure.</p>

Clinical and serological value of complement C3:a retrospective study of 1405 hospitalized patients with systemic lupus erythematosus / 中华风湿病学杂志

ObjectiveTo investigate the association of complement C3 with clinical and serological features of patients with systemic lupus erythematosus.MethodsData was collected by the same methods in the past ten years in fifteen hospitals in Jiangsu Province and then data weres summarized for retrospective analysis.Clinical and laboratory data were selected and then analyzed by Chi-square test,Wilcoxon rank sum test and Logistic regression.ResultsOne thousand four hundred and five patients were investigated.One thousand and forty two had low serum complement C3 level.In this case control study,hospitalization age,disease course,admission times,pleurisy,gastrointestinal involvement,general lymphadenopathy/hepatosplenomegaly,white blood cell count, haemoglobin level,platelet count, serum C-reactive protein level,serum albumin level,serum creatinine level,Urine protein quantification,anti-nuclear antibodies (ANA),anti-dsDNAantibodies, anti-SmantibodiesandSLEDAIscore were possible factors associatedwith complement C3 reduction(P＜0.05).Logistic regression analysis showed that CRP (OR=0.396,0.254-0.617,P=0.000),ANA (OR=2.907,1.267-6.670,P=0.012),urine protein level(OR=1.702,1.043-2.779,P=0.033) and SLEDAI score (OR-0.930, 0.886-0.975,P-0.003) were correlated with complement C3 reduction.Conclusion Complement C3 level is valuable for lupus flare assessment.The complement C3 reduction is a risk factor for renal impairment.

Action mechanism of lenalidomide in hematological malignancies - review / 中国实验血液学杂志

Immunomodulatory drug lenalidomide is a synthetic compound derived by modifying the chemical structure of thalidomide to improve its potency and reduce its side effects. Lenalidomide is a 4-amino-glutamyl analogue of thalidomide that has emerged as a drug with activity against various hematological and solid malignancies. It is approved by FDA in USA for clinical use in myelodysplastic syndromes with deletion of chromosome 5q and multiple myeloma. Studies have shown that lenalidomide exert anti-tumor activity probably by various mechanisms in hematologic malignancies, such as immunomodulation, anti-angiogenesis and effects on signal transduction. In this article, the progresses of study on these problems are reviewed.

Expression patterns of plasma von Willebrand factor and serum interleukin-8 in patients with early-stage severe pulmonary contusion / 世界急诊医学杂志（英文）

@#BACKGROUND: von Willebrand factor (vWF) is only released from endothelial cells and platelets and is an in vivo and in vitro marker of endothelial injury in septic patients with acute lung injury (ALI). Interleukin-8 (IL-8), as a proinflammatory mediator causing recruitment of inflammatory cells, induces an increase in oxidant stress mediators and makes it as a key parameter for localized inflammation. However, it has not been well established whether the level of serum IL-8 is associated with the severity of lung injury and whether it is a prognosis marker for severe lung contusion. This study was to investigate the expression of plasma vWF and IL-8 and their association with the severity and outcomes of severe pulmonary contusion. METHODS: A total of 63 patients were divided into a severe pulmonary contusion with acute respiratory distress syndrome (ARDS) group and a non-ARDS group, or a survivor group and a non-survivor group, or an injury severity score (ISS) <20 group and an ISS ≥20 group. Another 20 healthy volunteers served as controls. The levels of plasma vWF and serum IL-8 were measured by enzyme-linked immunosorbent assay (ELISA) at 1, 3, 5 and 7 days after injury. The expression patterns of the plasma vWF and serum IL-8 were compared between different groups. RESULTS: The concentrations of plasma vWF and serum IL-8 were significantly increased in all severe pulmonary contusion patients at all time points in comparison with the control group. The concentrations of plasma vWF in patients with ARDS increased during the whole study period, but vWF in patients with non-ARDS increased gradually until day 5 and then decreased at day 7. The concentration of serum IL-8 showed a similar expression pattern in both groups, but the expression increased more significantly in the ARDS group than in the non-ARDS group. Interestingly, both plasma vWF and serum IL-8 levels steadily increased in the non-survivor group. Furthermore, the level of plasma vWF was higher in the ISS≥20 group than in the ISS<20 group. The level of serum IL-8 in the ISS≥20 group was consistently high, while that in the ISS<20 group peaked at day 3 and decreased at day 5. In addition, the level of plasma vWF was positively correlated with platelet count, but negatively correlated with oxygen index. The level of serum IL-8 was positively correlated with white blood cell count and ISS score, and inversely correlated with oxygen index. CONCLUSION: The elevated levels of plasma vWF and serum IL-8 in severe pulmonary contusion patients reflect the severity of pulmonary injury and patients outcomes, suggesting that the plasma vWF and serum IL-8 are sensitive markers for clinical evaluation of the severity of pulmonary injury and predication of patient prognosis.

Clinical features and correlation research of fever in systemic lupus erythematosus patients / 中华风湿病学杂志

ObjectiveTo investigate the clinical features of systemic lupus erythematosus (SLE) patients with fever and find out the related factors.MethodsData was collected by the same methods in the past ten years in fifteen hospitals in Jiangsu province and then the data wereretrospectively analyzed.The potentially possible risk factors of fever in SLE were selected and then analyzed by chi-square test,Wilcoxon rank sum test and Logistic regression analysis.ResultsAll 1762 patients were investigated.Seven hundred and twenty-nine had active fever.Age at hospitalization,initially treated patients,photosensitivity,serositis,nervous system involvement,generalized lymphadenopathy/hepatosplenomegaly,white blood cell count (WBC),haemoglobin (HB),erythrocyte sedimentation rate (ESR),C-reaction protein (CRP),alanine aminotransferase(ALT),albumin(ALB),serum creatinine (Scr),complement C3,anti-dsDNA antibodies positive rate,anti-Sm antibodies positive rate,SLEDAI score and past therapies were factors associatedwith SLE fever.Logistic regression analysis showed that abnormal WBC count (OR=1.396,95％CI 1.114-1.711,P=0.004),CRP(OR=1.005,95％CI 1.002-1.009,P=0.002),ALT(OR=1.003,95％CI 1.001-1.005,P=0.005),Scr (OR=0.997,95％CI0.995-0.999,P=0.007),HB (OR=0.986,95％CI 0.981-0.992,P=0.000),age (OR =0.984,95％ CI 0.974-0.993,P=0.001 ) and past usage of cyclophosphamide (CTX) (OR =0.557,95％CI 0.382-0.813,P=0.002) were correlated with SLE fever.ConclusionFever is one of the most common clinical manifestations of SLE patients.Leucopenia,elevated CRP levels,liver function abnormalities,anemia,younger age are risk factors for SLE fever,while renal impairment and past usage of CTX are protective factors.

The relationship between impairment of hematological system and prognosis in systemic lupus erythematosus / 中华风湿病学杂志

Objective To explore the relationship between the impairment of hematological system and disease activity,immunological parameters,and the prognosis of systemic lupus erythematosus (SLE).Methods The clinical and laboratory data of in-patients with SLE in Jiangsu Province were investigated and all patients were hospitalized between 1999-2009.The impairment of hematological system was assessed and the relationship between hematological system damage and disease activity,immunological parameters,mortality rate of patients with SLE were analyzed.Statistic method used was X2 test.Results One thousand nine hundred and fifty eight cases of SLE were included in the study,in which,1836 were female and 122 were male.One thousand five hundred and forty nine (79.1%) patients complicated with hematological system damage,62.3% were anemia,45.5% with leucopenia and 29.4% with thrombocytopenia.There were significant differences in hematological system damage rate among patients with mild activity group,moderate activity group,severe activity group and almost no activity group,compared respectively with almost no activity group.The P values were P=0.01 and P＜0.01 respectively.The incidence of hematological system damage in elevated ESR,low complement C3 level,anti-dsDNA antibody group was higher than that in patients who had normal ESR,complement C3 level and anti-dsDNA group.(P＜0.01).During follow-up,166 patients died,of which the mortality rate(91.6%) in patients had hematological system damage,was obviously higher than those without hematological damage(8.4%)(P＜0.01 ).Among the 166 deceased patients,38.6% died of severe infection,22.9% died ofrenal failure,15.1% died ofnervous system damage,10.2% died of cadiovascular damage and 13.3% died from other causes.Conclusion Hematological system is one of the most commonly involved system in patients with SLE,of which anemia is the most common,and the incidence of leukopenia follows.The impairment of hematological system is closely related to lupus activity.Patients with abnormal immune parameters tend to have secondary hematological system damage.Severe infection is the main cause of death in patients with lupus,followed by nervous system damage and kidney damage.The mortality rate in patients with lupus that complicated hematological system damage is higher than patients who have no hematological system damage.

Retrospective study on the initial clinical manifestations of 1958 hospitalized patients with systemic lupus erythematosus / 中华风湿病学杂志

Objective To investigate the initial manifestation and disease onset feature of systemic lupus erythematosus(SLE) in the past ten years in fifteen hospitals in Jiangsu Province.Methods Data was collected by the same Methodsin all the participated hospitals and then it was summarized for retrospective analysis.Two groups were compared by chi-square test.Results ① One thousand nine hundred and fifty eight patients were investigated and the male-to-female ratio was 1∶15.0.② One thousand seven hundred and ninty eight patients had clear initial manifestations.The most common initial manifestations were skin and mucosal lesions(769 cases,42.8％ ) and arthritis (697 cases,38.8％ ).The main skin lesion was malar rash (706 cases).Arthritis was found to be more common in female than male.③ All hospitalized patients at their first admission showed multiple organ/system involvement:the most common involvement was skin and mucous membrane (82.3％),hematologic damage (74.0％),in which at least one series of blood cells were involved,arthritis (1156 cases,56.5％ ) much more than myositis (51 cases),proteinuria 1046 cases and hematuria in 385 cases.Renal biopsy pathology showed type Ⅳ glomerulonephritis.Conclusion ① SLE patients are mainly female and the male to female ratio is 1∶15.0.② The most common initial manifestations are skin and mucosal lesions.③ The most commonly involved organ/system are skin and mucous membrane,blood,joint and kidney.The most common pathological changes shown in renal biopsy is type Ⅳ glomerulonephritis.