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Objective:To improve the clinical differential diagnosis ability of rheumatoid arthritis (RA) complicated with gout and septic arthritis (SA).Methods:The clinical characteristics, diagnosis, and treatment of one RA patient with hyperuricemia and recurrent swelling and pain in right shoulder were reported and discussed.Results:A patient, with a history of RA for 10 years, hyperuricemia for 8 years, recurrent swelling and pain in right shoulder for 1 year. RA, gout, and SA were diagnosed before, and the response was poor after symptomatic treatment. In recent 1 month, the symptom was aggravated with the formation of fistula on the right shoulder. The laboratory tests for tuberculosis T cell interferon release test (IGRA) and tuberculin (PPD) test were negative, and the CD4 + cell count decreased. The comprehensive analysis of the imaging with right shoulder showed MSU deposition on right shoulder, with bone erosion, bone destruction, bone marrow edema, joint effusion, and multiple sites of connective tissue involvement (synovial bursa, tendon sheath, tendon, and muscle) GeneXpert MTB/RIF (GeneXpert), metagenomic next-generation sequencing (mNGS) of puncture fluid and joint fluid culture prompted Mycobacterium tuberculosis complex group. He was finally diagnosed with RA, gout, and osteoarticular tuberculosis (OAT). Symptoms were relieved after symptomatic treatment. Conclusion:RA patients with hyperuricemia have recurrent single arthritis. In addition to considering for gout, the presence of OAT should also be considered. The immune functional status of the patient and drug used may interfere with the interpretation of immune function tests. It is necessary to integrate the clinical characteristics of patients, a variety of imaging examinations, and etiological detection to confirm the diagnosis and avoid misdiagnosis.
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Incision infection is one of the common complications in surgery. Infected incisions usually need to perform procedures including suture removal, debridement, drainage, sterilization and anti-inflammatory. Until, the wound edge was sutured again after the wound infection was controlled. This contributes to considerable physical and psychological suffering for patients. To this end, with Dalian Medical University as the main inventor and other several experts, a multi-assistance function incision and orifice closure buckle have been designed and obtained the national utility model patent (patent number: ZL 2019 2 1803918.4). The closure buckle with was composed of two blocks with an adhesive layer and one tensioning mechanism. The device is easy to operate, and could effectively play an analgesic, antibacterial and promote healing on the basis of perfecting its wound margins and orifice. It has certain clinical application value.
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There are a wide range of gap junction proteins and pannexins between brain cells. The neurovascular unit, which are composed of neurons, glial cells and vascular cells, integrate and process information through cell membrane channels composed of gap junction proteins and pannexins, so as to maintain the dynamic balance of the nervous system. After cerebral ischemia, cell membrane channels play an important role in ischemic brain injury by participating in excitatory toxicity, inflammatory response, blood-brain barrier injury and other pathological mechanisms. Therefore, maintaining the normal function of gap junction proteins and pannnexins is essential to protect neurons from ischemic brain injury.
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Invasive candidiasis (IC) is lack of specific clinical symptoms and signs. Conventional microbiological culture for IC diagnosis presents poor sensitivity and time-consuming. Non-culture-based methods include the detection of candida carbohydrates (1, 3-β-D-glucan, mannan/anti-mannan), candida protein and candida nucleic (PCR, T2Candida). Because they are sensitive and less time-consumming, the method have been widely used for IC diagnosis. This article describes the clinical application and limitations of these non-culture methods in the diagnosis of candida diseases, to provide reference for the clinical use.
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In recent years,studies have shown that inflammation is an important factor in secondaryischemic injury.The exploration of the related mechanisms of the occurrence of inflammation has become ahot spot in the field of cerebral ischemia.Toll-like receptor 4 (TLR4) signaling pathway is one of theclassical inflammatory pathways.Studies have shown that TLR4 is involved in the early inflammatoryresponse after cerebral ischemic injury and the late nerve repair.This article reviews the research progress ofthis signaling pathway in cerebral ischemia injury,so as to seek a therapeutic target against inflammatoryinjury caused by cerebral ischemia through the analysis of its potential research direction.
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The rapid spread and outbreak of Middle East respiratory syndrome coronavirus ( MERS-CoV) in the regions of Middle East in 2012 have been a great concern for researchers worldwide. Thus, efficient preventative and therapeutic countermeasures are urgently needed. Clinical studies have con-firmed that high titers of neutralizing antibodies ( Abs) against MERS-CoV in patients during convalescence have protective potency, which indicates that neutralizing Abs are safe and effective for the treatment of MERS-CoV infection. Spike ( S) protein is a key structural protein that mediates MERS-CoV infection and currently a critical protein for studying MERS-CoV neutralizing monoclonal antibodies. This review summari-zes recent advances in identifying neutralizing McAbs against MERS-CoV through describing the structural characteristics of MERS-CoV S protein, different kinds of MERS-CoV vaccines and methods for mAbs screening. Furthermore, we propose the prospects for future research on MERS-CoV neutralizing McAbs ac-cording to the current research progress.
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Intracerebral hemorrhage accounts for about 10%-30% of all stroke types.It is characterized by rapid onset, rapid progress, varied clinical symptoms, high morbidity and mortality, and poor prognosis.After the intracerebral hemorrhage, various inflammatory mediators result in white matter lesions and cognitive impairment.Thrombin acting on thrombin receptors at low concentration induces neuroprotection and at high concentration causes brain injury.This article reviews the role and mechanism of thrombin in white matter injury after intracerebral hemorrhage.
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Objective@#To develop the monoclonal antibody (mAb) against neuraminidase of H7N9 subtype influenza A virus and identify its biological function.@*Methods@#Female 8 week-old BALB/c mice were immunized and the splenocytes of the mice were fused with Sp2/0 myeloma cells. Indirect ELISA was used to screen hybridoma and the positive clones were subject to be subcloned. Positive clones were identified and the monoclonal antibodies(mAbs) were obtained by purifying the ascetic fluid of mice injected with the hybridoma. The NA-binding as well as neuraminidase-inhibition activity of these mAbs were determined.@*Results@#Three mAbs against neuraminidase of H7N9 subtype influenza A virus, 1G8, 3C4 and 4E8, were obtained. They demonstrated different epitop-recognizing. 3C4 and 4E8 exhibited neuraminidase inhibitory activity, with a IC50 of 1.45 μg/ml and 8.65 μg/ml, respectively.@*Conclusions@#The results suggested that mAbs specific to neuraminidase of H7N9 subtype influenza A virus were developed, providing an useful tool in control and preventing the novel H7N9 influenza A virus.
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Objective@#To generate monkeypox virus specific monoclonal antibodies for further establishing monkeypox virus immunofluorescence assay.@*Methods@#Monkeypox virus A29 protein, vaccinia ortholog A27 protein and cowpox ortholog 162 protein were expressed in E. coli BL21 to screen antibodies. Synthetic monkeypox virus A2917 ~ 49 polypeptide was used to immune BALB/c mice. Monkeypox virus monoclonal antibodies were generated through fusion, cloning and screening techniques. Indirect ELISA was performed to test antibodies specificity and subtype.@*Results@#A29, A27 and 162 proteins were highly expressed in E. coli and detected by Western blot. The three his-tagged proteins were purified using His-Bind affinity chromatography column. The purity of the proteins was all more than 90%. And 8 strains monkeypox virus specific monoclonal antibodies were screened by the three purified proteins. Two mAbs of 8 were IgG3 subtype and the rest were IgG1 subtype.@*Conclusions@#Eight strains of monkeypox virus specific monoclonal antibodies were generated, they can be used to further establish monkeypox virus immune immunofluorescence assay.
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The rapid spread and outbreak of Middle East respiratory syndrome coronavirus ( MERS-CoV) in the regions of Middle East in 2012 have been a great concern for researchers worldwide. Thus, efficient preventative and therapeutic countermeasures are urgently needed. Clinical studies have con-firmed that high titers of neutralizing antibodies ( Abs) against MERS-CoV in patients during convalescence have protective potency, which indicates that neutralizing Abs are safe and effective for the treatment of MERS-CoV infection. Spike ( S) protein is a key structural protein that mediates MERS-CoV infection and currently a critical protein for studying MERS-CoV neutralizing monoclonal antibodies. This review summari-zes recent advances in identifying neutralizing McAbs against MERS-CoV through describing the structural characteristics of MERS-CoV S protein, different kinds of MERS-CoV vaccines and methods for mAbs screening. Furthermore, we propose the prospects for future research on MERS-CoV neutralizing McAbs ac-cording to the current research progress.
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Stroke is the leading cause of death in Chinese Residents. Intracerebral hemorrhage accounts for 10-20% of all stroke, and the degree of nerve function damage is often more severe than that of ischemic stroke. The corticospinal tract injury is an important mechanism for motor function defect after stroke. Diffusion tensor imaging (DTI) is the only functional magnetic resonance imaging to noninvasively detect white matter tracts, which can objectively evaluate the degree of fiber bundle damage. This article reviews the role of DTI in predicting the outcome of motor function in patients with intracerebral hemorrhage.Stroke is the leading cause of death in Chinese Residents. Intracerebral hemorrhage accounts for 10-20% of all stroke, and the degree of nerve function damage is often more severe than that of ischemic stroke. The corticospinal tract injury is an important mechanism for motor function defect after stroke. Diffusion tensor imaging (DTI) is the only functional magnetic resonance imaging to noninvasively detect white matter tracts, which can objectively evaluate the degree of fiber bundle damage. This article reviews the role of DTI in predicting the outcome of motor function in patients with intracerebral hemorrhage.
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Objective To express the receptor binding domain (RBD) protein of the Middle East respiratory syndrome coronavirus (MERS-CoV) and to characterize the antigenicity of the purified recombi-nant protein. Methods The codon-optimized gene encoding the RBD protein of MERS-CoV was synthesized and then cloned into the pET30a ( +) vector to construct the recombinant expression plasmid. The trans-formed E. coli BL21 (DE3) strains carrying expression plasmid were induced by IPTG under different condi-tions. The expressed products were purified by using nickel affinity chromatography and further analyzed by SDS-PAGE and Western blot assay. Indirect ELISA was performed to analyze the antigenicity and specificity of RBD proteins expressed in prokaryotic expression systems in human serological test. Results The recom-binant RBD proteins were mainly expressed as conclusion body in an optimal induction condition of 37℃ and 0. 5 mmol/ L IPTG for 4 h. The high purified recombinant RBD proteins were obtained through denaturation and renaturation with a relative molecular mass of about 29×103 . Results of the Western blot assay showed that the recombinant RBD proteins could have specific reaction with the serum samples collected form mice with MERS-CoV infection. Indirect ELISA revealed that the RBD proteins expressed in the prokaryotic ex-pression system showed better sensitivity and specificity in the detection of antibodies against MERS-CoV in human serum samples. Conclusion This study reported the prokaryotic expression and purification of RBD protein of MERS-CoV for the first time, which might pave the way for further investigation on immunological detection of MERS-CoV and development of vaccines against MERS-CoV infection.
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The mortality and disability rates of stroke are very high.Stroke seriously threats to the human life and health.Hypertension is one of the most important risk factors for stroke.The management of blood pressure in acute stage is very important for stroke and is full of controversial.This article reviews advances in the management of blood pressure in acute stroke.
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Vascular endothelial growth factor (VEGF) is an endothelial cell-specific mitogen.Studies have shown that VEGF is closely associated with ischemic stroke,and this makes it possible to intervene in ischemic stroke from the level of VEGF and its receptor.This article reviews the biological effect of VEGF and its receptor,mechanism of action involving in various stages of ischemic stroke,and the therapeutic prospect in ischemic stroke.
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Early use of statins after onset of acute ischemic stroke can improve the functional prognosis of patients and reduce in-hospital mortality.This article reviews the preclinical and clinical trials of statins for the treatment of ischemic stroke.
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Objective To investigate the protective effect and its mechanism of DL-3-n-Butylphthalide on the brain damage in rats following whole brain irradiation.Methods A total of 120 male Sprague Dawley rats were randomly divided into sham-irradiation group,irradiatien group and DL-3-n-Butylphthalide group.The model of whole-brain irradiatien was established by exposuring rat brain to 4 MeV X-rays with a single-dose of 10 Gy.The rats were intraperitoneally injected with DL-3-n-Butylphthalide at the dosages of 0.3,1.0,and 3.0 mg/kg once a day.The contents of malondialdchyde and super oxide dismutase activity were measured,while the expressions of apoptosis-associated genes and the ultrastructural changes in hippocampus were examined by immunohistnchemisty staining and electron microscope,respectively.Results After irradiation,the content of malondialdehyde and the expression of apoptosis gene bax in rat brain tissue increased while the activity of super oxide dismutase(SOD) and the expression of anti-apoptosis gene bcl-2 decreased.Apoptosis was also observed in the neurons of hippocampus CA1.Compared with irradiation group,the content of malondialdehyde and the expression of bax gene in the DL-3-n-Butylphthalide group wen significantly reduced ( t =-3.89--1.96,2.72-3.48,P ＜ 0.05 ),while the activity of SOD and bcl-2 gene were significantly elevated ( t =2.94-3.76,-3.18--2.08,P ＜ 0.05),and the injury degree of neuron structure in the DL-3-n-Butylphthalide group was slighter than that in the irradiation group.Conclusions DL-3-n-Butylphthalide executes protective effects in a dose-dependent manner againest the radiation injury in rats brain by reducing the induction of malondialdehyde,raising the activity of SOD and inhibiting the generation of apoptosis.
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ObjectiveTo investigate the effects of 1-3-n-Butylphthalide on the blood-brain barrier (BBB) following whole brain irradiation in rats.Methods144 male Sprague Dawley rats were randomly divided into sham-irradiation group,irradiation group,1-3-n-Butylphthalide group,and irradiation plus 1-3-n-Butylphthalide group.Whole-brain irradiation was given as a single-dose of 10 Gy using 4 MV X-ray.The rats were injected intraperitoneally with 1-3-n-Butylphthalide at 0.3 mg/kg,1.0 mg/kg,3.0 mg/kg once per day.The changes of the BBB were assessed by Evans blue (EB) assay.The expression of vascular endothelial growth factor (VEGF) in the brain tissue was determined by immunohistochemistry. The circulating endothelial cells (CECs) isolated from right ventricular blood were counted.MRI was evaluated with the T1-weighted images,T2-weighted images and MRI enhancement images induced by Gd-DTPA.The data were compared among the groups through Student-Newman-Keuls test.ResultsCompared with the sham-irradiation group,the EB content,the expression of VEGF in the brain tissue and the CECs were significantly increased in the irradiation group (2.81∶ 7.82,P =0.002;5.83∶ 10.26,P=0.003;3.16∶6.14,P =0.002).The signal intensity of T1-weighted images was significantly decreased while T2-weighted images and the enhancement rate significantly increased in the irradiation group (P =0.004 -0.018 ).Compared with irradiation group,the EB content,the expression of VEGF and the CECs were decreased significantly in the irradiation plus 1-3-n-Butylphthalide group ( 7.80∶ 3.86,P =0.007 ; 10.83 ∶ 5.26,P =0.008 ;6.36∶ 3.64,P =0.009 ).However,the changes in the MRI were significantly attenuated ( P =0.008-0.026,and 0.006 -0.038,respectively).Conclusions Following whole brain irradiation,1-3-n-Butylphthalide can decrease the permeability of the BBB in rats via decreasing VEGF expression and decreasing the CECs.
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MicroRNAs (miRNAs) are a class of highly conserved non-coding small RNA molecules.They regulate gene expression by inhibiting transcription or translation.Ischemic stroke is one of the major diseases of resulting in death and disability worldwide.The final outcome of its pathological process is neuronal death.Neuronal apoptosis is mainly seen in ischemic penumbra,and saving the neurons in penumbra are the key to the treatment of ischemic stroke.This article reviews the roles of miRNAs in the neuronal apoptosis during cerebral ischemia.
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The activation of coagulation system,especially in the occurrence and development of cardiogenic cerebral embolism,plays an important role.As one of the major preventive measures in ischemic stroke,the anticoagulant therapy is getting more and more attention.At the same time,the studies of anticoagulant drugs aiming to the intervention of different links in coagulation pathway have also made significant progress.
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<p><b>OBJECTIVE</b>To investigate the changes of plasma fibrinogen level among acute ischemic stroke (ACI) subtypes according to Trial of Org10172 in Acute Stroke Treatment (TOAST) criteria and effects of Songling Xuemaikang.</p><p><b>METHOD</b>The 160 patients with acute ischemic stroke were divided into two groups randomly: treatment group 85 cases (Songling Xuemaikang + Shuxuetong + Aspirin enterie coated tablets), control group 75 cases (Shuxuetong + Aspirin enterie ccoated tablets). The plasma fibrinogen was detected before and after treatment.</p><p><b>RESULT</b>Compared with OC subtype, Fbg was higher in LAA, CE and SAO subtypes (P < 0.05). Compared with UE subtype, Fbg was higher in LAA, CE and SAO subtypes (P < 0.05). There was a significantly difference between LAA and SAO (P < 0.05). In LAA, SAO, CE of treatment group,the Fbg level were lowered significantly at the 15th day compared with pretherapy (P < 0.05). There was a significantly difference of Fbg between treatment group and control group In LAA, SAO and CE subtypes at the 15th day (P < 0.05).</p><p><b>CONCLUSION</b>Fbg produces a marked effect at the pathomechanism of LAA, SAO and CE subtypes. Songling Xuemaikang can depress the plasma fibrinogen level of ACI, and be an effective adjunctive therapy on ACI.</p>