Organizing Pneumonia in A Patient Double-Positive for ANCA and Anti-GBM Antibodies: A Case Report / 中国医学科学杂志(英文版)

Both anti-glomerular basement membrane (GBM) disease and the anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) are common causes of pulmonary-renal syndrome. Organizing pneumonia (OP), a special pattern of interstitial lung disease, is extremely rare either in AAV or anti-GBM disease. We report an old woman presented with OP on a background of co-presentation with both ANCA and anti-GBM antibodies.

Severe Pulmonary Embolism, Thrombosis of Lower Extremity, Unexpected Mild Renal Disorder in MPO-ANCA Associated Vasculitis: A Case Report / 中国医学科学杂志(英文版)

Myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA) associated vasculitis is an autoimmune disease usually with severe multiple dysfunction syndrome, especially prominent acute renal failure. A 65-year-old woman was admitted with progressive dyspnoea for six months and fever, sputum with blood, pain of the lower extremities and intermittent claudication for two days, indicating multiple organ involvement (respiratory system, blood vessels). The renal involvement was relatively mild, presenting with microscopic haematuria. The chest computed tomography demonstrated multiple pulmonary embolisms. Ultrasound and computed tomography angiography for the lower extremity vessels showed venous and arterial thrombosis. Exclusion of other diseases that can cause multiple organ damage and thrombosis, the positive perinuclear ANCA and MPO-ANCA strongly support the diagnosis of MPO-ANAC-associated vasculitis. The patient's physical condition has been greatly improved by treatment with corticosteroids and anticoagulation.

Comparison of multi-mode and single-mode intraoperative neurophysiological monitoring in the treatment of severe ossification of the cervical posterior longitudinal ligament with anterior cervical corpectomy with fusion / 中国骨伤

OBJECTIVE@#To compare the application of multi-mode and single-mode intraoperative neurophysiological monitoring in the treatment of severe ossification of posterior longitudinal ligament of cervical spine with anterior cervical corpectomy with fusion.@*METHODS@#From April 2015 to June 2018, 32 patients with severe ossification of the posterior longitudinal ligament were treated in the Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine. There were 21 males and 11 females, aged 45 to 73 years old, with a mean age of 59 years old. The duration of the disease ranged from 6 to 72 months, with a mean of 39 months. The main manifestations were numbness, numbness and weakness of limbs, cotton feeling of foot stepping on lower limbs, instability of standing and walking. With the gradual aggravation of symptoms, quadriplegia, dysfunction of urine and defecation may occur. Patients with ossification of posterior longitudinal ligament of cervical spine were monitored by somatosensory evoked potentials, motor evoked potentials and electromyogram patterns.@*RESULTS@#During the operation, 8 patients had abnormal amplitude of somatosensory evoked potential(SEP); 5 of them had bleeding during anterior cervical decompression procedure and were placed with too much hemostatic cotton, which caused compression of spinal cord and resulted in abnormal SEP waveform. After removal of the hemostatic cotton, SEP waveform returned ot normal; 3 patients had abnormal SEP waveform due to decreased systolic pressure, which was corrected by increased systolic pressure. Twelve patients had abnormal amplitude of motor evoked potential during monitoring, 9 of which were caused by intraoperative mis-contact with nerve root, and turned to normal after timely adjustment of position, 3 of which were caused by intraoperative inhalation of muscle relaxant during surgery. Among 11 patients with abnormal EMG waveform, 9 patients recovered to normal waveform after adjusting operation, 2 patients recovered to normal waveform after short observation, and all patients recovered to normal waveform of motor evoked potential after operation(<0.05). There were 2 cases of cerebrospinal fluid leakage after operation, which healed spontaneously 7 days after operation, and no complications of spinal cord and nerve occurred in all patients after operation.@*CONCLUSIONS@#In anterior cervical corpectomy with fusion operation for the treatment of severe cervical ossification of posterior longitudinal ligament, various modes of intraoperative neurophysiological monitoring can real-time understand spinal cord and nerve function status, significantly reduce the incidence of spinal cord and nerve injury during operation, and effectively improve the safety of operation.

Systemic disseminated Mycobacterium fortuitum infection:one case report and literature review / 中国感染控制杂志

Objective To explore the clinical characteristics of systemic disseminated infection caused by Mycobacterium fortuitum (M.fortuitum), and improve the diagnostic rate and understanding of the disease.Methods One case of systemic disseminated M.fortuituminfection was reported, and analyzed in combination with relevant literatures.Results Patient was with multiple systemic involvement (including lung, lymph node, skin, joint), lymph node tissue culture was positive for M.fortuitum, patient was given clarithromycin+levofloxacin+linezolid for treatment, disease was remitted.Conclusion Systemic disseminated M.fortuituminfection is rare, and patient with GATA2 deletion and IFN-γautoantibody may be a potential mechanism, diagnosis is mainly based on pathological morphology and microbiological detection, but positive rate is low, diagnosis is difficult.

Effects of Glucocorticoid-Induced Transcript 1 Gene Deficiency on Glucocorticoid Activation in Asthmatic Mice / 中华医学杂志(英文版)

Background@#Glucocorticoid (GC) is the first-line therapy for asthma, but some asthmatics are insensitive to it. Glucocorticoid-induced transcript 1 gene (GLCCI1) is reported to be associated with GCs efficiency in asthmatics, while its exact mechanism remains unknown.@*Methods@#A total of 30 asthmatic patients received fluticasone propionate for 12 weeks. Forced expiratory volume in 1 s (FEV) and GLCCI1 expression were detected. Asthma model was constructed in wild-type and GLCCI1 knockout (GLCCI1) mice. Glucocorticoid receptor (GR) and mitogen-activated protein kinase phosphatase 1 (MKP-1) expression were detected by polymerase chain reaction and Western blotting (WB). The phosphorylation of p38 mitogen-activated protein kinase (MAPK) was also detected by WB.@*Results@#In asthmatic patients, the change of FEV was well positively correlated with change of GLCCI1 expression (r = 0.430, P = 0.022). In animal experiment, GR and MKP-1 mRNA levels were significantly decreased in asthmatic mice than in control mice (wild-type: GR: 0.769 vs. 1.000, P = 0.022; MKP-1: 0.493 vs. 1.000, P < 0.001. GLCCI1: GR: 0.629 vs. 1.645, P < 0.001; MKP-1: 0.377 vs. 2.146, P < 0.001). Hydroprednisone treatment significantly increased GR and MKP-1 mRNA expression levels than in asthmatic groups; however, GLCCI1 asthmatic mice had less improvement (wild-type: GR: 1.517 vs. 0.769, P = 0.023; MKP-1: 1.036 vs. 0.493, P = 0.003. GLCCI1: GR: 0.846 vs. 0.629, P = 0.116; MKP-1: 0.475 vs. 0.377, P = 0.388). GLCCI1 asthmatic mice had more obvious phosphorylation of p38 MAPK than wild-type asthmatic mice (9.060 vs. 3.484, P < 0.001). It was still higher even though after hydroprednisone treatment (6.440 vs. 2.630, P < 0.001).@*Conclusions@#GLCCI1 deficiency in asthmatic mice inhibits the activation of GR and MKP-1 and leads to more obvious phosphorylation of p38 MAPK, leading to a decremental sensitivity to GCs.@*Trial Registration@#ChiCTR.org.cn, ChiCTR-RCC-13003634; http://www.chictr.org.cn/showproj.aspx?proj=5926.

Neural plasticity occurs in the adrenal medulla of asthmatic rats / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Airway symptoms in asthma are related to decrease of epinephrine secretion, which may be ascribed to elevated nerve growth factor (NGF) in the organism. The aim of this study was to monitor the neuroendocrine alteration in the adrenal medulla of asthmatic rats.</p><p><b>METHODS</b>Sixteen rats were randomly divided into two groups (n = 8), control group and asthma group, and the asthmatic rats were sensitized and challenged with ovalbumin (OVA). The levels of NGF, epinephrine and norepinephrine in serum were detected by enzyme linked immunosorbent assay (ELISA), the NGF expression in adrenal medulla was detected by immunohistochemistry, and the changes in the ultrastructure of the adrenal medulla was observed by electron microscopy.</p><p><b>RESULTS</b>The NGF expression was increased in asthmatic rats compared with control rats. Compared with control rats, the results indicated that the epinephrine level was decreased in asthmatic rats, but no significant difference was found in norepinephrine levels. We found more ganglion cells in the adrenal medulla of asthmatic rats than in control rats, with NGF immunostaining mainly located in these ganglion cells. Electron microscopic images showed the density of chromaffin granula decreased and there was shrunken nucleolemma in the adrenal medullary cells of asthmatic rats.</p><p><b>CONCLUSION</b>The innervation of the adrenal medulla is changed in asthmatic rats, and it may contribute to the epinephrine decrease in asthma.</p>

Regulation effect of nerve growth factor on Ras-MAPK signal transduction pathway in neurogenic inflammation of asthma / 中南大学学报(医学版)

OBJECTIVE@#To investigate the regulatory effect of nerve growth factor (NGF) on Ras-MAPK signal transduction pathway in neurogenic inflammation of asthma.@*METHODS@#Thirty-six Sprague-Dawley rats were randomly divided into 3 groups (control group, asthma group and anti-NGF group). The asthmatic model was established by ovalbumin inhalation and injection. The protein expressions of pan-Ras, pERK and c-fos in the dorsal root ganglion and lung of the asthma group and the control group were examined by immunohischemical method. Anti-NGF antibody was used to investigate how it affected the protein expression of pan-Ras, pERK and c-fos in the dorsal root ganglion and the lung of the asthma group. PD98059 (the inhibitor of MAPK) and PMA (the enhancer of PKC) were used to culture the NHBEC. Cell extracts were analyzed for pERK, total-ERK and c-fos by Western blot.@*RESULTS@#The protein expressions of pan-Ras, pERK and c-fos in the lung and dorsal root ganglion of the asthma group were significantly higher than those of the control group (P < 0.01). The protein expressions of pan-Ras, pERK and c-fos were decreased by the anti-NGF treatment (P < 0.01) . The expressions of epithelial pERK and c-fos in the NGF group were significantly higher than those in the control group, and PD98059 could inhibit NGF inducing NHBEC to produce pERK and c-fos. PMA could enhance the effects of NGF.@*CONCLUSION@#NGF may play a role in the pathogenesis of neurogenic inflammation in asthma through Ras-MAPK signal transduction pathway.

Synthesis and identification of antigenic conjugates of podophyllotoxin / 药学学报

<p><b>AIM</b>To synthesize and identify artificial antigen of podophyllotoxin for the production of podophyllotoxin polyclonal antibody.</p><p><b>METHODS</b>The hapten was synthesized by two different chemical approaches and characterized by TLC, IR, NMR, and MS. Mixed anhydride reaction (MAR) and active ester method (AEM) were used to couple the podophyllotoxin to carrier proteins (BSA and OVA). Characterization of artificial antigens was done by using spectroscopy and electrophoresis. The anti-podophyllotoxin polyclonal antibodies were obtained through immunizing rabbits.</p><p><b>RESULTS</b>The results from IR, NMR and MS showed that 4-O-succinoyl podophyllotoxin (hapten) was successfully synthesized. The coupling molar ratios of the hapten and carrier proteins were 88.6 for Hapten-BSA1, 40.3 for Hapten-BSA2, 17.8 for Hapten-OVA1, and 54.2 for Hapten-OVA2. Hapten conjugates coupled with BSA yielded two sets of the specific and affinitive polyclonal antibodies. One set of antibodies showed an IC50 value of 2.21 microg.mL(-1) with a detection limit of 0.12 microg.mL(-1).</p><p><b>CONCLUSION</b>Antigenic conjugates were artificially synthesized, and based on these artificial antigens, polyclonal antibodies against podophyllotoxin were raised from rabbits immunized with two different immunogens and characterized with an indirect ELISA format.</p>

Effect of xinglong pingchuan recipe on interleukin-5 and the inflammagen related to oxygen free radical in asthmatic mice / 中南大学学报(医学版)

OBJECTIVE@#To observe the effect of Xinglong Pingchuan recipe (XLPCR) on interleukin-5 (IL-5), superoxide dismutase (SOD), glutathione peroxidase (GPx), and malondialdehyde (MDA) in mouse asthma models, and to explore its mechanism in treating asthma.@*METHODS@#The mouse asthma models were established by sensitization and challenge with ovalbumin (OVA). The asthma model was treated with XLPCR. At last, the number of white blood cells and eosinophil was counted, and the concentrations of inflammation factors such as IL-5, SOD, GPx, and MDA in the serum or the lung tissue of each mouse were detected.@*RESULTS@#Compared with the asthmatic group, the number of eosinophil in the XLPCR group decreased significantly (P 0.05, respectively). On the other hand, the concentration of MDA in the XLPCR group was significantly lower than that of the asthmatic group (P < 0.05).@*CONCLUSION@#XLPCR might inhibit the airway inflammation by decreasing the IL-5 level and adjusting the balance of oxidants/antioxidants.