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Juvenile idiopathic arthritis(JIA) is one of the most common chronic connective tissue diseases characterized by unknown etiologic arthritis with the onset before the age of 16 years and disease course for more than 6 weeks.JIA may be accompanied by impairment of multiple organ function.Recent studies have shown the important role of the Janus kinase (JAK)-signal transducer and activator of transcription (STAT) pathway in the pathogenesis of JIA.Tofacitinib is an oral Janus kinase(JAK) inhibitor approved by Food and Drug Administration (FDA) in 2012 for the effective treatment of rheumatoid arthritis.However, there is little clinical evidence for the use of Tofacitinib in pediatrics.This review aims to clarify the mechanisms, efficacy and safety of Tofacitinib on the treatment of JIA.
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There is no specific medicine for systemic lupus erythematosus (SLE). Compared with adult-onset SLE, childhood-onset SLE is characterized by severe condition, rapid changes, and poor prognosis.Glucocorticoids are the first-line drugs for SLE.However, some are still difficult to be controlled using the conventional drugs like glucocorticoids and immunosuppressive agents.Belimumab is the only biological agent approved for the use in both adults and childhood-onset SLE, although its application in children lacks clinical experiences.This study aims to review the application of Belimumab in childhood-onset SLE.
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Objective To study the serum levels of oxidative stress markers in the new type 2 diabetes mellitus (T2DM) patients with nonalcoholic fatty liver disease (NAFLD),and the effect of o-lipoic acid (A-LA) on oxidative stress markers.Methods From August 2016 to August 2017,80 new T2DM patients complicated with NAFLD (T2DM + NAFLD group) and 80 new T2DM patients without NAFLD (T2DM group) admitted to Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University were selected.The serum levels of Fasting blood glucose (FPG),body mass index (BMI),triglyceride (TG),total cholesterol (TC),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),insulin resistance index (HOMA-IR),serum superoxide dismutase (SOD),serum malondialdehyde (MDA),glutathione peroxidase (GSH-PX) were detected and compared between the two groups.And then,the T2DM patients with NAFLD were treated by A-LA for two weeks.The SOD,MDA,GSH-PX levels were compared before and after treatment.Results The FPG,BMI,TG,HOMA-IR of the T2DM + NAFLD group were (10.71 ± 3.63) mmol/L,(27.08 ± 3.87) kg/m2,(3.40 ± 1.85) mmol/L,(5.40 ± 2.98),respectively,which were significantly higher than those of the T2DM group[(9.50 ± 3.78)mmol/L,(23.58 ± 2.75) kg/m2,(1.79 ± 1.44) mmol/L,(2.41 ± 1.18)] (t =2.022,6.603,2.829,4.157,all P ＜ 0.05).The age and levels of HbA1c,TC,HDL-C,LDL-C between the two groups had no statistically significant differences (all P ＞ 0.05).The level of MDA in the T2DM + NAFLD group was (5.11 ± 0.25) μmol/L,which was significantly higher than (4.56 ±0.28) μmol/L in the T2DM group(t =2.106,P ＜0.05).The levels of SOD,GSH-PX,SOD/MDA in the T2DM + NAFLD group were (77.42 ± 10.31) U/mL,(69.62 ± 9.24) U,(15.39 ± 2.23),respectively,which were significantly lower than those in the T2DM group [(93.26 ± 11.21) U/mL,(87.54 ± 9.58) U,(20.33 ± 2.93)] (t =2.455,2.653,3.148,all P ＜ 0.05).After treatment with A-LA,the MDA level of the T2DM + NAFLD group was (4.81 ±0.26) μmol/L,which was significantly lower than that before treatment[(5.11 ±0.25) μmol/L,t=2.117,P ＜0.05],the levels of SOD,GSH-PX,SOD/MDA of the T2DM + NAFLD group were (87.15 ± 10.88) U/mL,(78.73 ± 9.57) U,(18.05 ± 2.51),respectively,which were significantly higher than those before treatment (t =2.117,2.207,2.228,3.148,all P ＜ 0.05).Conclusion A-LA might prove usefully in the treatment of patients with T2DM and NAFLD by change the oxidative stress.
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ObjectiveTo explore the effect of age on clinical outcomes of patients with massive infarction after decompressive craniectomy.MethodsClinical data of 103-sufferers,who have been operated by decompressive craniectomy in our hospital from January 1999 to January 2010 were summarized.Based on age,these data are divided into the research group( ≥60 years old,number =48) and the control group( ＜ 60 years old,number =55 ).Then two groups were studied and discussed by mortality,the ratio of postoperative complications and cases of preoperative comorbidities.ResultsComparing with the control group,it was evident that patients of the research group had higher mortality and ratio of postoperative complications,and moat of them suffered from preoperative manifold comorbidities ( x2 =11.097,24.915,14.404,all P ＜ 0.01 ).Besides,the percentage of patients with good prognosis was significantly lower( x2 =9.821,P ＜ 0.01 ).ConclusionPostoperative clinical outcomes of aged patients with the massive infarction were affected by preoperative manifold comorbidities and postoperative complications.However,younger patients could correspondingly achieve the preferable treatment effect after surgery.Hence,age should possess an imporrant impact for clinical outcomes of patients with massive cerebral infarction after decompressive craniectomy.
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Objective: To establish an efficient animal model for the study of explosive injury in maxillofacial region.Methods: The detonator, steel spheres as fragments simulants shot by smooth-bore barrel and a synchronizer were used to define the wound model in the maxillofacial region of 18 dogs. The whole system was triggered when shooting. Wounding parameters and the changes of targets after explosion were observed and recorded. Results: The overpressure of blast wave decreased exponentially according to the distance from explosive. After injury, the local damage of dogs was serious and extensive compounded with the damages in heart, lung and brain. The injury was aggravated with the increasing of over pressure and energy absorption. Conclusion: The new wound model can be used for the study of explosive injury in maxillofacial region that is characterized by serious tissue damage and multi-etiology.
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Objective: To study the difference between the facial nerve injury by gun-shot and that by blast. Methods: 40 adult dogs were divided into 2 groups, with 20 dogs in each. In the blast group, the impact wave was simulated by detonator blast in the distance of 10 cm over the dog's masseter. At the same time,a steel ball was projected to the dog's face by a rifle to imitate segments in blast. In the gun-shot group, only the steel ball was used. Then the facial nerve was taken at the time of immediateness, 6 hours, 1 day, 3 days and 7 days following the injury for HE or immunocytochemical staining. And the facial nerve conduction velocity was examined 6 hours, 3 days and 7 days after injury.Results: The facial nerve edema was found in both groups just after injury. There was scattering hemorrhage and little hematoma below the spineurium in the gun-shot wound, as well as the diffusing bleeding and larger hematoma in blast wound. In the blast group, the severe edema could be found by light microscope in the whole extracranial facial nerve. Axonal fragments, infiltrating imflammatory cells and few neurofilament protein NF positive axons were observed. In the gun-shot group, only scattering damage was found within 2 cm from the wound track.Conclusion: The facial nerve injury by gun-shot bacomes less severe with the increase of distance from the wound track, but the blast injury is wider and more severe.