RESUMEN
Objective:To construct a representative index system for evaluating pediatric orthopedic nursing quality, providing a basis for hospital pediatric orthopedic nursing quality assessment and monitoring.Methods:From April to July 2023, using the "structure-process-outcome" three-dimensional quality structure model as the theoretical framework, a literature review was conducted, and an item pool was formulated. Through two rounds of Delphi method expert consultations, the hierarchical analysis method was finally employed to determine the indicators and their weights at each level.Results:The effective recovery rates of the questionnaire of the two rounds of expert consultations were 100% (20/20), the authority coefficients of experts were 0.87 and 0.88, the coefficients of variation were 0.00 to 0.27 and 0.00 to 0.24. The Kendell harmony coefficients of the second and third indicators in the two rounds of inquiry were 0.140, 0.166 and 0.192, 0.161(all P<0.05). The final pediatric orthopedic nursing quality evaluation index system included 3 primary indicators, 21 secondary indicators and 83 tertiary indicators. Among the primary indicators, the weight of process quality was the highest at 0.493 4, followed by outcome quality at 0.310 8, and the lowest was structural quality at 0.195 8. In the secondary indicators, "assessment criteria of limb blood circulation" had the highest weight at 0.099 8. Conclusions:The constructed pediatric orthopedic nursing quality evaluation index system covers key aspects and is more operationally feasible. It provides better guidance for nursing interventions and quality control.
RESUMEN
Objective:To investigate the effects of oxidized low density lipoprotein (Ox-LDL) on cell proliferation and mRNA expression of inflammatory factors in fibroblast-like synoviocytes (FLS) from patients with rheumatoid arthritis (RA).Methods:Tissue culture was used to isolate and 4-6 generation cultured RA-FLS cells were used for subsequent experiments. RA-FLS were stimulated for 24 hours with different con-centr-ations of human Ox-LDL, then the MTS cell proliferation and toxicity test kit were used to detect the prolifer-ation of RA-FLS. Real time-polymerase chain reaction (RT-PCR) was used to test the expression of inflamm- atory factors like interleukin (IL)-6, transforming growth factor (TGF)-β, IL-8, tumor necrosis factor (TNF)-α and receptors like CD36 and scavenger receptor binds phosphatidylsed neoxidized lipoprotein (SR-PSOX) inRA-FLS. T test and F test were used in this study. Results:Ox-LDL (10, 25, 50 μg/ml) could obviously promote the proliferation of RA-FLS, and theabsorbance values (490 nm) were (1.04±0.15), (1.05±0.14), and (1.00±0.10), respectively, all higher than the control group (0.81±0.04) and the difference was statistically significant ( F=4.737, P<0.01). In addition, 50 μg/ml and 100 μg/ml Ox-LDL also promoted the expression of IL-6 mRNA ( F=14.709, P<0.01) and inhi-bited the expression of TGF-β mRNA ( F=299.074, P<0.01), but there was no obvious effect on the expression of IL-8 and TNF-α. Ox-LDL stimulation could obviously promote the expression of SR-PSOX receptor on RA-FLS ( F=68.636, P<0.01) and inhibit the expression of CD36( F=18.085, P<0.01). After the transfection of siRNA, SR-PSOX mRNA level was significantly inhibited and the mRNA expression of IL-6 was significantly decreased after Ox-LDL stimulation of RA-FLS ( t=3.875, P<0.01), while TGF-β mRNA expres-sion was not significantly changed( t=-0.193, P>0.05). Conclusion:Ox-LDL may play a role in promoting the activation of RA-FLS proliferation and the expression of IL-6 mRNA by increasing the SR-PSOX receptor of RA-FLS, suggesting that Ox-LDL is involved in the synovial inflammation of RA.
RESUMEN
Objective:The study was aimed to investigate the bone mineral density (BMD) status of newly diagnosed systemic lupus erythematous (SLE) patients.Methods:Newly diagnosed SLE patients and healthy controls in Peking University Third Hospital from 2014 to 2018 were enrolled into this cross-sectional study. Medical records including systemic lupus erythematosus disease activity index (SLEDAI)-2000 and BMD of the lumbar vertebrae and hips measured by dual-energy X-ray absorptiometry were collected. Patients were divided into normal and low BMD groups. Parameters were compared by Student- t test, Mann-Whitney U test and χ 2 test. Results:Eighty-nine patients and 20 healthy controls were included. Approximately 52.8% of the SLE patients had low BMD. Compared to the healthy control group, the BMD of lumbar spine and hip was obviously lower than in the newly diagnosed SLE group[(0.97±0.14) g/cm 2, (1.08±0.10) g/cm 2, t=3.548, P<0.01; (0.88±0.15) g/cm 2, (1.00±0.08) g/cm 2, t=3.878, P<0.01]. The BMD of lumbar spine and hip in the low BMD group was lower than that in the normal BMD group [(0.88±0.10) g/cm 2, (0.80±0.11) g/cm 2; (1.07±0.11) g/cm 2, (0.97±0.13) g/cm 2, respectively]. Compared with the normal BMD group, the body mass index (BMI) was significantly lower [(19.2±2.0) kg/m 2, (23.2±3.6) kg/m 2 respectively, t=3.678, P<0.01], the disease duration was longer [(45.7±7.7) weeks, (16.0±19.5) weeks, respectively, t=-3.306, P<0.01). Patients with low BMD tended to have lower 25-hydroxy-vitamin-D(25-OH-VD 3) level and higher bone metabolism marker levels (Degradation products of collagen B) [(9±5) nmol/L vs (12±7) nmol/L, t=1.385, P>0.05; 0.62(0.21, 1.61) ng/ml vs 0.43(0.19, 0.88) ng/ml, Z=0.624, P>0.05], although their differences didn't reach the statistical significant difference. Conclusion:Newly diagnosed SLE patients' BMD is lower than the healthy people. About 52.8% newly diagnosed untreated SLE patients have low BMD. Lower BMI and longer disease duration are their clinical characteristics. High bone metabolism marker levels, low 25-hydroxy-vitamin-D level might have clinical significance, although the current findings do not find statistically significant difference. Large sample size is required for subsequent research analysis.
RESUMEN
Objective To study a method for verifying the doses to PTV and OAR as well as the 2D dose distribution arising from IMRT through using radiochromic films and TLDs.Methods Totally 7 medical electronic linear accelerators from Varian,Siemens and Elekta were selected.The polystyrene phantom provided by IAEA was conducted with CT scan.After irradiation with 6 MV X-rays,the TLDs and films were returned to the secondary standard dosimetry laboratory of China CDC for measurement and estimation.Results According to the IAEA requirements,the relative deviations between TLD-measured and TPS-planned values for PTV and OAR doses were both within ±7.0%.For PTV,the measured relative deviations for 5 accelerators were in the range of-4.0% to 3.4%,consistent with the IAEA requirements,whereas the values for the other 2 accelerators were in the range of-7.0% to 10.6%,not consistent with the requirements.For OAR,the values for 4 accelerators were in the range of-5.6% to 3.3%,consistent with the IAEA requirements,whereas the values for the other 3 accelerators were in the range of-20.8% to 11.5%,not meeting the requirements.As required by the IAEA,the 2D dose distribution 3 mm/3% pass rate should be higher than 90%.The measured values for 5 accelerators were in the range of 91.8% to 98.5%,consistent with the requirements,whereas the values measured for the other 2 were 45.0% and 77.0% respectively,not meeting the requirements.Conclusions It is feasible for using TLDs and radiochromic films to verify the doses to PTV and OAR and the 2D dose distribution in IMRT.This method should be applied to not only quality verification but also hospital internal audit to the extent possible.
RESUMEN
Objective@#To study a method for verifying the doses to PTV and OAR as well as the 2D dose distribution arising from IMRT through using radiochromic films and TLDs.@*Methods@#Totally 7 medical electronic linear accelerators from Varian, Siemens and Elekta were selected. The polystyrene phantom provided by IAEA was conducted with CT scan. After irradiation with 6 MV X-rays, the TLDs and films were returned to the secondary standard dosimetry laboratory of China CDC for measurement and estimation.@*Results@#According to the IAEA requirements, the relative deviations between TLD-measured and TPS-planned values for PTV and OAR doses were both within ±7.0%. For PTV, the measured relative deviations for 5 accelerators were in the range of -4.0% to 3.4%, consistent with the IAEA requirements, whereas the values for the other 2 accelerators were in the range of -7.0% to 10.6%, not consistent with the requirements. For OAR, the values for 4 accelerators were in the range of -5.6% to 3.3%, consistent with the IAEA requirements, whereas the values for the other 3 accelerators were in the range of -20.8% to 11.5%, not meeting the requirements. As required by the IAEA, the 2D dose distribution 3 mm/3% pass rate should be higher than 90%. The measured values for 5 accelerators were in the range of 91.8% to 98.5%, consistent with the requirements, whereas the values measured for the other 2 were 45.0% and 77.0% respectively, not meeting the requirements.@*Conclusions@#It is feasible for using TLDs and radiochromic films to verify the doses to PTV and OAR and the 2D dose distribution in IMRT. This method should be applied to not only quality verification but also hospital internal audit to the extent possible.
RESUMEN
Objective To compare the clinical effects of G-arm X-ray machine and C-arm X-ray machine in percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fracture (OVCF) of thoracolumbar spine.Methods The clinical data of ninety-five patients with thoracolumbar OVCF treated with PKP from May 2016 to August 2017 in Yanan University Affiliated Hospital were retrospectively analyzed.They were divided into two groups according to the different guiding fluoroscopy methods used during the operation.Forty-six cases in G arm group completed PKP under the guidance of G arm X-ray machine,Forty-nine cases in C arm group completed PKP under the guidance of C arm X-ray machine.The operation time,fluoroscopy times,cement leakage cases,the height of injured vertebral leading edge,Cobb angle of kyphosis,visual analogue score and Oswestry dysfunction index were recorded before and after operation,and the related indexes were analyzed and compared.Results Two groups of patients were successfully completed surgery,no complications of vascular and nerve injury.The operation time and fluoroscopy times in G arm group were less than those in C arm group (operation time:(29.6±4.5) min vs.(42.5±5.3) min,and fluoroscopy times in G arm group:(9.1±2.0) vs.(16.9±3.2));the difference was statistically significant (t =-12.747,12.870,P< 0.01).Postoperative height of injured vertebral leading edge(G arm group (22.3±5.3) mm),C arm group (22.4±5.1) mm),kyphosis Cobb angle (G arm group (9.2±3.8)°,C arm group (9.3±3.7) o),visual analogue score (G arm group (2.1±0.7)points,C arm group (2.2±0.9) points),Oswestry dysfunction index (G arm group (21.3±8.5) points,C arm group(21.5 ± 8.3)points),compared with preoperative(the hight of injured vertebral leading edge of G arm group (18.2 ±5.3) mm,C arm group (18.4±5.2) mm,Cobb angle of injured vertebra G arm group (15.7±4.4) °,C arm group (15.9±4.3) °,visual analogue score of G arm group (7.8± 1.2) points,C arm group (7.7± 1.1) points,Oswestry dysfunction index score of G arm group(41.2±8.3)points,C arm group (41.5±8.2) points),the difference was statistically significant (t =-3.709,-3.844,-7.582,-8.144,27.827,27.088,11.360,11.999,P<0.01),but there was no significant difference between the two groups (P >0.05).Conclusion Using G-arm X-ray machine to assist PKP in the treatment of thoracolumbar spine OVCF can effectively shorten the operation time,reduce the intraoperative fluoroscopy time,and the clinical effect is satisfactory.
RESUMEN
Objective To introduce the method of using hollow pull screw insertion for the suprapubic fracture with 3D printing navigation template and to evaluate its clinical effect.Methods From March 2016 to August 2017,eighteen cases of suprapubic ramus fractures treated with hollow lag screw fixation in the Department of Orthopedics of Yanan University Affiliated Hospital were retrospectively collected was collected.Before operation,the thin slice CT scan of pelvis was used to get raw data,and the mimics17.0 software was used to reconstruction the model,to design and make the personalized navigation template assisting the suprapubic fractures surgery.The navigation template was printed out pre-operatively,and the nail was inserted via the assisted by the template intra-operatively.After the operation,the fracture reduction was evaluated by Matta imaging scores and the pelvis function was evaluated by Majeed scores.Results All the operations were successfully completed.The Matta scores were excellent in 11 cases,good in 6 cases,and fair in 1 case.The Majeed scores were excellent in 13 cases,good in 3 cases,and fair in 2 cases.Conclusion 3D Printing navigation template assisted the placement of the hollow screw on the suprapubic fracture could provide personalized treatment,reduce the difficulty of operation and satisfy the clinical effect.
RESUMEN
Objective To investigate the expression of miRNA-31 in peripheral blood mononuclear cells (PBMCs) of rheumatoid arthritis (RA) patients,and the relationship between miRNA-31 and disease activity of RA.Methods After obtaining the informed consent,peripheral blood samples of 56 RA patients,12 systemic lupus erythematosus (SLE) patients,6 Sj(o)gren's syndrome (SS) patients and 30 healthy controls were collected from the Department of Rheumatology,Peking University Third Hospital.RNA was extracted from the PBMCs which were separated by Ficoll-Paque PLUS.The expression of miRNA-31 in the PBMCs of RA patients,SLE patients,SS patients and healthy controls was detected by real-time Polymerase Chain Reaction (PCR).Furthermore,according to the RA disease activity score (DAS28),RA patients were divided into high,moderate and low disease activity groups and remission group,and miRNA-31 expression was compared between different groups.Data were analyzed using t test or Mann-Whitney U test.Results The expression of miRNA-31 in PBMCs of RA patients was 7.25 times (P=0.003 8) higher when compared with that of the control group.To be specific,the expression of miRNA-31 was 10.63 times in PBMCs of high activity RA group (P=0.01) and 8.95 times in moderate activity RA group (P=0.000 3) when compared with that of the control group,and there was no significant difference between low activity,remission groups and control groups in terms of miRNA-31 expression.Furthermore,the expression of miRNA-31 in PBMCs of SLE patients was not significantly different from the control and miRNA-31 expression in PBMCs of SS patients was 1.64 times (P=0.02) higher than that of the RA patients,but the average level of miRNA-31 was much less than that of RA patients.The increased miRNA-31 may serve as a diagnostic marker for disease activity of RA.
RESUMEN
Objective To investigate the expression level of oxidized low density lipoprotein (ox-LDL) and its scavenger receptor scavenger receptor that binds phosphatidylserine and oxidized lipoprotein (SRPSOX) in patients with rheumatoid arthritis (RA),and to explore the relationship between ox-LDL and disease activity.Methods The serum ox-LDL in RA patients and healthy control group were detected by enzymelinked immunosorbent assay (ELISA),as well as the fluidox-LDL in RA,osteoarthritis (OA) and inflammatory arthritis (IA).The expression of SR-PSOX in mixed cells of RA and IApatients was detected by western blot.The expression of serum ox-LDL between RA groupand the control group was analyzed by t-test and non-parametric test.The correlation of serum ox-LDL expression levels in RA patients with C-reactive protein (CRP),erythrocyte sedimentation rate (ESR) and other inflammatory factors and disease activitywas analyzed by Pearson linear regression.Results The expression of ox-LDL in the serum of RA patients was significantly higher than that of normal control group [(3 076±131) mU/ml,(2 334±84) mU/ml,t=4.242,P<0.01].The expression of ox-LDL in synovial fluid of RA patients was significantly higher than that of the OA group [(4 963±354) mU/ml],(3 956±347) mU/ml,t=2.372,P<0.05).The expression of SR-PSOX in synovial fluid mixed cells of RA patients was higher than that of the IA group [(4.92±0.18) vs (0.24±0.04),t=33.53,P<0.01].The expression of ox-LDL in serum of RA patients was negatively correlated with ESR,CRP and overall disease activity DAS28 (r=-9.42,P=0.009;r=-0.35,P=0.029 7;r=0.42,P=0.008 4).The expression of ox-LDL in the serum of RA patients with moderate disease activity was significantly higher than those patients with high disease activity [(3 302±138) mU/ml vs (2 464±228) mU/ml,t=3.335,P<0.01],however,those with low disease activity and disease remission had higher serum ox-LDL expression but without statistical significant differences.After treated with anti-rheumatic drugs (DMARDs),serum ox-LDL of RA patients had a trend of slight increasing butwithout sign-ificant difference.The ox-LDL/LDL-C or ox-LDL/HDL-C was negatively not correlated with disease activity score in 28 (DAS28),ESR,CRP.Conclusion In RA patients,the expression of ox-LDL in the serum and synovial fluid is high and the SR-PSOX expressionin synovial fluid is also high.The serum ox-LDL levels are negatively correlated with ESR,CRP and DAS28,which are related to disease activity of RA.These findings suggest that the ox-LDL and the receptor SR-PSOX may play a role in RA pathogenesis,but needs further study.
RESUMEN
BACKGROUND: Forest frog is a rare medicinal animal in China, but the skin of forest frog is waste after Oviductus Ranae production. The forest frog skin is rich of collagen, and is large in quantity without pollution and disease risk. So the forest frog skin has potential to be developed into collagen sponge; however, there is no research on collagen sponge preparation as yet.OBJECTIVE: To optimize the preparation of collagen sponge from forest frog skin, and to investigate the physical properties and in vitro cell compatibility.METHODS: Chitosan and glutaraldehyde were used to modify collagen sponge from forest frog skin. Chitosan/collagen (w/w) (1:1, 1:2, 1:4) and glutaraldehyde concentration (1%, 1.5% and 2%) were selected as the experimental factors.The significant water absorbency, mechanical properties and thermal denaturation temperature were chosen as the indexes. Using the orthogonal experimental design, we optimized collagen sponge preparation process. We also investigated the in vitro cell compatibility and surface morphology of the collagen sponge. The nine kinds of collagen sponges from forest frog skins were co-cultured with human foreskin fibroblasts to detect cell proliferation.RESULTS AND CONCLUSION: When the chitosan/collagen was 1:1 and the glutaraldehyde concentration was 1%, we could get the collagen sponge with ideal water absorbency (water absorption capacity=5.22), mechanical properties (elongation at break=10.96%) and thermal denaturation temperature (81.24 ℃). The aperture of the forest frog skin collagen sponge was 200-400 μm, and the pores were consistent in the size and arranged regularly. Except the chitosan/collagen of 1:4 and the glutaraldehyde concentration of 1% or 5%, all kinds of forest frog skin collagen sponges could promote the viability of human foreskin fibroblasts and exerted benefits to cell viability and growth. To conclude,the forest frog skin collagen sponge has good biocompatibility and apparent morphology, in aggreement with the requirements of biological materials.
RESUMEN
BACKGROUND: There are various kinds of design methods about preoperative osteotomy of ankylosing spondylitis with kyphosis, but each has their own errors and limitations. A convenient, precise and available method needs to bedeveloped.OBJECTIVE: To compare the clinical efficacy of two different preoperative osteotomy designs using paper-cut andphotoshop software for ankylosing spondylitis with kyphosis.METHODS: Thirty-nine patients suffering ankylosing spondylitis with kyphosis undergoing osteotomy in the Departmentof Spinal Surgery, Affiliated Hospital of Yan'an University between June 2009 and January 2015 were enrolled, andrandomly allotted to paper-cut (n=19) and photoshop (n=20) groups, followed by the preoperative osteotomy design,respectively. All patients were followed for 12-40 months to compare the postoperative osteotomy angle error andcorrection efficacy at the last follow-up between groups.RESULTS AND CONCLUSION: (1) The postoperative osteotomy angle error in the photoshop group was significantly smaller than that in the paper-cut group (P 0.05). (4) To conclude, compared with the osteotomy design usingtraditional paper-cut splice, the photoshop software can achieve a smaller osteotomy angle error and better postoperative balance of spinal sagittal plane, thus providing precise osteotomy for surgeons to obtain proper correction.
RESUMEN
Objective To evaluate the potential high risk factors of femoral head necrosis after femoral neck surgery in adult patients. Methods From January 2009 to October 2014,390 patients with femoral neck fractures in our hospital were treated with multiple hollow compression screws. All patients were followed up for 12 to 60 months. Then retrospectively analyzed the incidence rates of femoral head nec-rosis and the clinical data about age,gender,fracture side,Garden index,fracture shift condition,internal medicine complications,whether to do lower limb preoperative traction,restoration method,postoperative load time and whether take out hollow compression screw internal fixa-tion,so as to explore the higher risk factors for femoral head necrosis. Results Among the 390 cases,352 cases got followed up. There were 45 cases of them ended with nonunionand 49 cases ended with femoral head necrosis. The univariate regression analysis results showed that the age,fracture shift condition,internal medicine complications,postoperative load time and Garden index,whether take out internal fixation were risk factors for femoral head necrosis (P<0. 05). The multi-factor results showed that aged from 40 to 60 years old,transfered fracture, seriously complications,time of loading less than 3 mouths,Ⅲ and Ⅳ Garden index,take out internal fixation were the high risk factors for femoral head necrosis (P<0. 05). Conclusion Patients who aged from 40 to 60 years old and having transfered fracture,seriously complica-tion,early weight bearing,high Garden index and internal fixation take-out would increase the risk of femoral head necrosis.
RESUMEN
Objective To observe the preventive effect of different doses of diacerein on acute gout model rats and to explore its possible mechanism.Methods A total of 30 Wistar rats and were randomly assigned to the normal control group, the negative control (normal saline control group, and positive (colchicine) control group, diacerein low dose group, medium iddle dose group and high dose group.Except the normal control group that were given normal saline, other groups received colchicine (0.3 mg·kg-1 ·d-1), diacerein (10 mg·kg-1·d-1, 50 mg·kg-1·d-1 and 100 mg·kg-1·d-1) for 8 days respectively, and prepared acute gouty arthritis model on the 6th day, then observed rats joint swelling and gait at 2 h, 6 h, 8 h, 24 h and 48 h after the acute gouty arthritis model were established.After 48 h, the rats were killed, the serum and joint leachate of the rats were collected to test interleukin (IL)-1β and tumor necrosis factor (TNF)-α.One-way analysis of variance (ANOVA), LSD t test and Kruskal-Wallis rank sum test were used for statistical analysis.Results Compared with the normal group, joint swelling of the rats in the negative control group became significantly swollen at 2 h after the model was established,at and it reached the peak at 8 h reached the peak, then decreased gradually and remitted obviously at 48 h obviously remission.Joint swelling of the ccolchicine group and diacerein high dose group joint swelling [(0.106±0.081) cm, (0.112±0.030) cm] and ankle joint inflammation index score [(2.8±1.7), (3.16±0.75)] were significantly decreased compared with the negative control group [(0.208±0.078) cm, (4.7±1.6);P<0.05].In addition, compared with the negative control group, the gait of diacerein high dose group was significantly improved (F=7.552, F=1.859, P<0.05), colchieine group and diacerein high dose group, the serum and joint leaching liquid TNF-α and IL-1 levels also decreased significantly (P<0.05).Conclusion Diacerein in any In each dosage group of has a certain preventive and therapeutic effect on rats gouty arthritis rats, especially in high dose group, the anti-inflammatory mechanism may be down-regulating the expression of proinflammatory mediators such as IL-1 beta and TNF-α.
RESUMEN
Objective To evaluate the prevalence and clinical significance of IgG,IgA and IgM isotypes of anti-peptidylarginine deiminase 4 (anti-PAD4) antibodies in early rheumatoid arthritis (RA).Methods IgG,IgA and IgM isotypes of anti-PAD4 antibodies were measured in the sera of 88 RA patients with disease duration less than 2 years,62 patients with other rheumatic diseases and 57 healthy subjects.The diagnostic performance of IgG,IgA and IgM isotypes of anti-PAD4 antibodies and their relationship with disease duration,DAS28,ESR,CRP,anti-CCP antibodies and rheumatoid factor (RF) were evaluated.Data analysis were performed using t test,U test and Spearman's association analysis.Results ① The sensitivities of IgG,IgA,and IgM isotypes for early RA were 28.41%,36.36% and 9.09% respectively.The specificities of IgG,IgA and IgM isotypes were 94.12%,93.28% and 95.80% respectively.② IgA isotype was positively correlated with age (r=0.234,P=0.028),DAS28 (r=0.309,P=0.007),ESR (r=0.382,P=0.000) and CRP (r=0.291,P=0.008),while negatively correlated with disease duration (r=-0.295,P=0.006).③ IgA isotype was positively correlated with IgG isotype (r=0.451,P<0.01).In the IgG negative patients,the positivity of IgA isotype was 29%(18/63),which indicated that the IgA isotype might be helpful in diagnosing RA in IgG isotype negative patients.Conclusion Anti-PAD4 antibodies can be detected in early RA,primarily with IgA and IgG isotypes.IgA isotype has negative correlation with disease duration,indicating that IgA isotype of anti-PAD4 antibody may play a role in the very early stage RA.
RESUMEN
Objective To evaluate the prevalence and clinical values of anti-cyclic citrullinated peptide (anti-CCP) antibodies of IgG,IgA and IgM subtypes in individuals with early rheumatoid arthritis (RA).Methods IgG,IgA and IgM subtypes of anti-CCP antibodies were measured in the sera of 87 RA patients with disease duration shorter than 2 years,61 patients with other rheumatic diseases and 49 healthy subjects.We analyzed the diagnostic value of IgG,IgA and IgM subtypes of anti-CCP antibodies and their relationship with disease duration,DAS28,ESR,CRP,and rheumatoid factor (RF).Chi-square test,t test and Spearman's correlation analysis were used for statistical analysis.Results ① The diagnostic sensitivity of IgG,and IgA subtype for early RA was 75.9% and 67.8% respectively,which was higher than IgM subtype (14%,P<0.01 each).The specificity of IgG,IgA and IgM subtype was 96.4%,91.8% and 93.6% respectively.② IgG and IgA subtypes were correlated with CRP (r=0.278,P=0.01; r=0.217,P=0.047) and RF (r=0.430,P=0.000; r=0.271,P=0.012),while IgM subtype was positively correlated with disease duration (r=0.279,P=0.014).③ Patients who had IgG-and IgA subtype had a shorter disease course (3.3±2.3) than those patients who had IgA-and IgG+ (9.5±8.4) and who had IgG+ and IgA+ (8.2±7.0) (P<0.05).④ IgA subtype was positive in 19.0% of the IgG negative patients.When combining IgG,and antibodies of IgA subtypes together,the sensitivity and specificity was 63.2% and 100%,while the sensitivity and specificity was 80.5% and 85.2% when either one was positive.Conclusion Both the IgG,and IgA subtypes of anti-CCP antibodies have a good sensitivity for early RA.They are related to disease activity.Measuring IgA subtype of anti-CCP antibody in RA patients with negative IgG subtype may help to identify early RA.IgA subtype of anti-CCP antibody may play a role in very early RA.
RESUMEN
Objective To explore the relationship between collateral circulation and clinical manifestation after se-vere stenosis or occlusion of internal carotid artery. Methods According to the clinical manifestation, 78 cases of ICA ste-nosis or occlusion confirmed by digital subtraction angiography (DSA) were divided into two groups:asymptomatic group (n=31) and symptomatic group (n=47). Collateral circulation pathway in circle of Willis and the mean flow velocity of the middle cerebral arteries (MVMCA) were measured by Transcranial Doppler Ultrasonography (TCD). The correlation of the types of intracranial collateral circulation and clinical manifestation was analyzed. Results ① The collateral circulation opening rate of severe stenosis or occlusion of internal carotid artery in 78 cases of patients was 70.5%(55/78). The collat-eral patency rate (27/31, 87.1% of patients) was higher in asymptomatic group than in the symptomatic group (28/47, 59.6%of patients)(P<0.01).②Collateral patency of anterior communicating artery (ACoA)in asymptomatic group (24/31, 77.4%of patients) was higher than that in symptomatic group (20/47, 42.6%of patients) (P<0.01). Collateral patency of ophthalmic artery (OA) in symptomatic group (21/47, 44.7%of patients) was higher than that in asymptomatic group(6/31, 19.4%of patients)(P<0.05). The opening rate of ACoA was significantly higher than that of either the posterior commu-nicating artery (PCoA) or OA collateral circulation in asymptomatic group (P<0.05).③The mean flow velocity of the af- fected side middle cerebral arteries (MVMCA) in asymptomatic group (51.58±12.36cm/s) was significantly higher than that in symptomatic group (32.23±10.31cm/s) (P<0.01). Conclusion The clinical manifestation is closely related to arterial circle of Willis collateral circulation opening after severe stenosis or occlusion of internal carotid artery and collateral patency of anterior communicating artery is the major collateral supply vessel.
RESUMEN
Objective To investigate the pathogenesis of cerebral watershed infarction (CWI) through analyzing the appearance examined by Color duplex Imaging(CDI) and transcranial doppler (TCD).Methods One hundred and forty-two patients with CWI diagnosed by magnetic resonance imaging(MRI) were enrolled in the study group and 150 patients with acute cerebral infarction were enrolled in the control group.The results of CDI and TCD were retrospectively analyzed of the two groups.The vascular stenosis,plaque detection rate,plaque characteration,plaque scores,the cause of low blood volume,intracranial collateral circulation were compared between the two groups to investigate the pathogenesis of CWI.Results Among the 142 cases in the study group,there were 72 cases of severe stenosis and occlusion,21 cases of moderate stenosis,31 cases of mild stenosis and 18 cases without stenosis and there were 19 cases of severe stenosis and occlusion,41 cases of moderate stenosis,23 cases of mild stenosis and 67 cases without stenosis among the 150 cases in the control group.There were significant differences in the two groups (x2 =66.583,P =0.000).There were significant differences on the plaque detection rate between the two groups (80.99% (115/142) vs 49.33% (74/150),x2 =32.010,P =0.000).There were significant differences on the scores of plaque between the study group and the control group ((11.47 ± 3.78) points vs (6.57 ± 3.53) points,t =4.019,P =0.001).There were significant differences on the defined cause of low blood volume between the study group and the control group (54.93% (78/142) vs 11.33% (17/150),x2 =63.164,P =0.000).There were 50 patients had collateral circulation in the study group and 38 cases in the control group,there were no significant differences between the two groups (35.31% (50/142) vs 25.33% (38/150),x2 =3.381,P =0.066).Conclusion Angiostegnosis,microemboli from the unstable atherosclerosis plaque,lower perfusion on the basis of hypovolemia are all the pathogenesis of CWI.CDI combine with TCD can provide more information in vascular evaluation and treatment.
RESUMEN
ABCC8,KCNJ11,and GLUD1 gene mutations were investigated in a male patient with congenital hyperinsulinism and his parents were also investigated.A 1484 G>A mutation was found in the 10th exon of ABCC8 gene in the patient,which leads to amino acid substitution at the 495 residue of the sulphonylurea receptor SUR1 protein.The patient's father also carried the same heterozygous inactive mutation,while the genotype of the mother was normal,indicating that the gene mutation of the patient was paternally inherited.According to that mutation,it is deduced that the patient may suffer from the focal type of congenital hyperinsulinism.
RESUMEN
The current status of the application of data mining in Chinese medicine (TCM) safety research are analyzed in this paper, and the future development trend are discussed, which include: to establish ADR (adverse drug reaction) signal detection and automatic warning system based on traditional Chinese medicine (TCM) adverse reaction database, to explore the characteristics and influencing factors of TCM safety problems, to devise appropriate new algorithm, and to develop TCM adverse reaction literature mining.
Asunto(s)
Animales , Humanos , Minería de Datos , Bases de Datos Factuales , Medicamentos Herbarios Chinos , Estándares de Referencia , Medicina Tradicional China , Estándares de Referencia , Control de CalidadRESUMEN
Objective To investigate the possibility of immune tole rance induced by bone marrow-derived mesenchymal stem cells in allogeneic organ transplantation. Methods Allogeneic bone marrow-derived mesenchymal stem cells and syngeneic bone marrow cells were cotransplanted to lethally irradiated female C57BL/6 recipient mice. FACS was used to analyze the chimerism 150 days later. Mixed lymphocyte reaction and ConA induced proliferation test were performed to evaluate proliferative activity of mice spleen cells in cell-transplanted group. Skin transplantation test was done to observe immune response of cell-transplanted group mice against organ graft from donor mice. Results About 5 97% donor T cells were detected in splenocytes of cell-transplanted group mice. MLR showed that mean SI of cell-transplanted group mice was 1.79, and that of untreated group mice was 7 28. ConA induced proliferation test showed that mean SI of cell-transplanted group mice was 31 92; and that of untreated group mice was 34 99. Mean survival time of donor-derived skin graft in cell-transplanted group mice was more than 90 days; and that in untreated group mice was 8 days. Conclusion Our results showed for the first time that induction of stable mixed hematopoietic chimerism after allogeneic bone marrow derived mesenchymal stem cells transplantation lead to stable donor-specific tolerance in allogeneic host and skin graft survival from donor mice.