Objective To investigate the expression of adenosine receptor (ADOR) subtypes (A2A and A2B subtypes) in the mucosal dendritic cells (DCs) from patients with Crohn's disease and their pathogenic roles.Methods Mucosal DCs (mDCs) were isolated from resected intestine of patients with or without Crohn's disease.Some of the mDCs were cultured in vitro and others were used to extract RNA.The expression of ador-a2a and ador-a2b were detected by real-time qPCR.mDCs in culture were treated with selective ADOR-A2A and ADOR-A2B agonists (CGS 21680 and BAY 60-6583) and then the concentration of IL-1,IL-6 and IL-12 in the medium were measured by ELISA.The binding affinities of ADOR-A2A and ADOR-A2B to adenosine were determined by 3H-adenosine in combination with selective ADOR-A2A and A2B antagonists (SCH58261 and MRS1706).Na(i)ve CD4+ cells were collected from human umbilical cord blood and co-cultured with mDCs treated by different ADOR agonists to observe T cell responses.The production of cytokines in culture was measured by ELISA.The polarization of CD4+ cells was analyzed by intracellular cytokine staining and FACs analysis.Peripheral blood mononuclear cells (PBMCs) were treated with IL-4 and GMCSF to induce the expression of monocyte-derived DCs (Mo-DCs).Mo-DCs were treated with different toll-like receptor ligands to investigate their effects on the expression of ador-a2a and adora2b.Moreover,Mo-DCs were treated with LPS and BAY 60-6583 individually or in the combination to stimulate CD4+ cells.Then the production of cytokines and the polarization of CD4+ cells were evaluated.Results Compared with patients without Crohn's disease,patients with Crohn's disease showed no change in the expression of ador-a2a but a significantly increased expression of ador-a2b in mCDs (CD-mDCs),enabling to bind more adenosines.Activated ADOR-A2B signaling pathway induced CD-mDCs to secret more proinflammatory cytokines and to promote polarization of CD4+ cells toward Th1 and Th17 cells.Toll-like receptor ligands,pam3csk4 and LPS could intensively augment the expression of ador-a2b in Mo-DCs.The pathogenicity of Mo-DCs was strengthened upon a combined stimulation with BAY 60-6583 and LPS.Conclusion The significantly increased expression of ador-a2b in mDCs might be involved in the pathogenesis of Crohn's disease by promoting mDCs to secret more pro-inflammatory cytokines and enhancing the polarization of CD4+ cells.Moreover,the expression of ador-a2b in DCs could be regulated by certain toll like receptors.

The paper analyzed the experiences of clinical subjects development at hospitals of Capital Medical University.On this basis,the authors raised such development suggestions as further improvement of the management systems,progressive affiliation mechanism,information platform,and better performance appraisal mechanism,for the purposes of empowering the standard and strength of clinical subjects of the hospitals.

Objective To investigate the dosage and safety of insulin aspart in continuous subcutaneous insulin infusion plus oral antidiabetic drugs for the treatment of hyperglycemia in elderly hip fracture.Methods Patients with hip fracture and hyperglycemia who required insulin pump therapy were divided into 2 groups according to age:elderly group (patients aged over 65 years,n=42) and non-elderly group (patients aged under 65 years,n=43).All patients were treated with insulin aspart in continuous subcutaneous insulin infusion plus oral antidiabetic drugs combined with diet therapy.Dosages of aspart insulin and adverse effects were compared between the two groups.Results There were no significant differences in basic aspart dosage and additional premeal dosage between elderly and non-elderly groups [(0.29±0.09) IU/kg vs.(0.30±0.07) IU /kg,(0.27±0.09) IU/kg vs.(0.27±0.07) IU/kg,both P＞0.05].The incidences of hypoglycemia with and without symptoms in elderly versus non-elderly groups were 4.8％ vs.4.7％ and 14.3％ vs.18.6％,which had no significant differences between the two groups (P＞0.05).Hypoglycemia accompanied by consciousness disorders,allergy,nonhealing and slow healing wounds were not found in the two groups.The ratio of oral antidiabetic drugs including metformin,glimepiride,and glycosidase inhibitor had no differences between the two groups.Conclusions Aspart insulin in continuous subcutaneous insulin infusion is effective and safe in the treatment of acute severe hyperglycemia in elderly patients with hip fractures when combined with diet therapy and oral antidiabetic drugs.

Objective To observe the expressions of two inhibitors of apoptosis proteins (LAPs), survivin and livin, as well as their related factors, Bci-xl and Caspase-3 in mycosis fungoides (MF), along with the effects of NB-UVB irradiation on them. Methods Totally, 30 patients with MF (5 at erythema stage, 16 at plaque stage and 9 at tumor stage) collected from 1995 to 2007 were included into this study. Of the patients, 11 received the treatment with NB-UVB irradiation. Tissue samples were resected from 30 untreated patients, 11 irradiated patients and 10 normal human controls. SABC immunohistochemistry (IHC) stain was used to evaluate the protein expression of survivin, livin, Bel-xi and caspase-3 in these samples. Also, the mRNA expression of these four factors and cell apoptosis were detected by hybridization in situ (ISH) and terminal deoxynucleotidyl transferase (TdT)-mediated dUTP-fluorescence nick end labeling (TUNEL stain) respectively in the samples from 11 patients before and after NB-UVB irradiation. Results In samples of erythema-stage MF, plaque-stage MF and tumor-stage MF, the positivity rate was 40.00%, 75.00%, 77.78% for survivin respectively, 60.00%, 68.75%, 88.89% for Bcl-xl respectively, 40%, 25%, 44.44% for livin respectively, and 60.00%, 68.75%, 88.89% for caspase-3 respectively. No expression of survivin or Bcl-xl was observed in normal controls, while the expression of livin and caspase-3 was similar between MF and control samples. After NB-UVB irradiation, an increase was noticed in the count of apoptosis cells (t=6.49, P<0.001) and mRNA expression of caspase-3 (P<0.10), while a decrease in the mRNA expression of survivin and Bcl-xl in MF tissues, and no changes occurred to the mRNA expression of livin (P>0.10). Conehsions Survivin, Bcl-xl and caspase-3 may be associated with the pathogenesis of MF by regulating the cell apoptosis of T lymphocytes. NB-UVB could suppress the mRNA expression of survivin and Bcl-xl, lower the levels of LAP, enhance the transcription of caspase-3, and accelerate the apoptosis of tumor cells, which may partly explain the mechanism of therapeutic effect of NB-UVB in MF.

To investigate the chemical constituents of hemostatic extract of Pyrola calliantha H. Andres, the extract was subjected to chromatographic separation and purification. Along with some known compounds, a new naphthaquinone derivative was isolated and identified as 2-(1, 4-dihydro-2, 6-dimethyl-1, 4-dioxo-3-naphthalenyl)-3, 4, 5-trihydroxylbenzoic acid by physicochemical and spectroscopic analysis.

BACKGROUND: Defatting is to reduce the special cell surface antigens by clearing fat and lipoprotein, so as to decrease immunological rejection, improve the biocompatibility of allograft bone, and increase osteogenic potential. However, the effect of defatting on biomechanical performance of bone remains controversial.OBJECTIVE: To explore the influence of defatting on the biomechanics of bovine cortical bone samples.DESIGN, TIME AND SETTING: Randomized, self-controlled observation was performed in Futian People's Hospital of Guangdong Medical College between 2006 and 2008.MATERIALS: Eight pairs of healthy adult bovine femora were used. Bone blocks, 50 mm long and 10 mm wide, were selected from each pair of femora, and burnished into 24 pairs of 7 mm×7 mm×40 mm rectangular bovine cortical bone samples.METHODS: The 24 pairs of cortical bone samples were randomly divided into two groups (n=12). One of each pair was selected as test group sample, and the other as control group sample. The samples of test group were defatted In 500 mL chloroform and methanol mixture (1:1) for 24 hours, while control samples were immerged in deionized water for 24 hours. Six samples from each group were selected for axial compressive test and three-point bending test.MAIN OUTCOME MEASURES: Load and deflection of every sample.RESULTS: Axial compressive test showed that the maximum load and the maximum strain of defatted samples were significantly decreased compared with control group, but the fragility and elastic modulus were increased (P < 0.05). In three-point bending test, the maximum load and the maximum stress of defatted sampled were significantly decreased, the maximum deflection was decreased, and the elastic modulus was increased (P < 0.05).CONCLUSION: The mechanical strength of cortical bone decreased but the fragility increased after defatting.

Objective To compare the curative effect of laparoscopic and laparotomic operation for elderly Chinese women with cervical cancer. Methods The randomized controlled trials (RCT) and case controlled trials (CCT) were collected by searches of WanFang database, CNKI, VIP, China Biology Medicine (CBM) , PubMed. Data were extracted from these trials and data analysis was performed by RevMan 5.2.9. Results There were no RCTs, however, a total of 10 CCTs met the inclusion criteria and had data extracted for this review. The baseline characteristics of the laparoscopic group were similar to those of the laparotomic group. Comparing to laparotomic group, the laparoscopic group have longer operation time (MD =32.60, 95%CI: 5.65~59.55, P = 0.020), less amount of bleeding (MD = -94.01, 95%CI: -130.65 ~ -57.37, P = 0.000), smaller number of lymph node dissection(MD = 1.69, 95%CI: 0.67 ~ 2.72, P = 0.001), earlier anus exhaustion (MD=-17.09, 95%CI: -21.19 ~ -12.98, P = 0.000) and shorter hospital stays (MD = -4.30, 95%CI: -5.57 ~ -3.02, P = 0.000). There was significant difference between the two groups. But there was no statistical significance in postoperative indwelling catheter time (MD = -0.67, 95%CI: -1.92 ~ 0.58, P = 0.290) and surgical complications incidence (OR=0.62, 95%CI: 0.27 ~ 1.42, P = 0.260) between the two groups. Conclusion Laparoscopic management has the advantages of less traumatic and recovered quickly, and did not increase the incidence of complications. Laparoscopic operation is an ideal procedure for elderly Chinese women with cervical carcinoma.

Objective To analyze the application value of enhanced depth imaging optical coherence tomography (EDI-OCT) in measuring the lamina cribrosa thickness(LCT) in patients with branch retinal vein occlusion (BRVO).Methods The clinical data of 65 patients with unilateral BRVO treated in our hospital from September 2014 to March 2016 were selected as the observation group.The single healthy eyes of 40 healthy individuals who received physical examination in the hospital during the same period were selected as the control group.The changes of retinal nerve fiber layer (RNFL) thickness,LCT,central corneal thickness,axial length,transverse diameter of optic disc,vertical diameter of optic disc,diopter and extent of visual field defect in the two groups were determined by EDI-OCT.Results There was no significant difference in the central corneal thickness,axial length,transverse diameter of optic disc,vertical diameter of optic disc and diopter between the two groups (all P ＞ 0.05).LCT of different regions of optic disc in the observation group were lower than those in the control group (all P ＜ 0.05).The range of visual field defects in the observation group was larger than that in the control group,and the RNFL thickness was lower than that in the control group (P ＜ 0.05).LCT was positively correlated with the thickness of whole RNFL in patients with BRVO,and was negatively correlated with the visual field defects (P ＜ 0.05).Conclusion EDI-OCT is an effective means for measuring LCT.LCT of patients with glaucoma BRVO is thinner than that of normal healthy people,and LCT is positively correlated with RNFL.thickness,and negatively correlated with visual field defects.

Objective To study the clinical therapeutic effect of the combined antihistamine for the treatment of allergic pharyngitis.Methods In January 2015 to December 2016 during the hospital outpatient service received by irritating cough,50 patients with pharyngeal itching for the main symptoms as the object of study,summary and analysis on the clinical symptoms of all patients,in the conventional treatment on the basis of leukotriene receptor antagonist combined antihistamines treatment,close observation after 1 week,2 weeks after treatment in patients with symptoms improved after treatment.Results The clinical main characteristic of allergic pharyngitis is the irritating dry cough,and the first pharynx is a cough.After a week of treatment,the symptoms of the patient were significantly improved,and after two weeks of treatment,the symptoms of the patient continued to be improved and the results were significant.Conclusion In clinical patients with cough,is one of the most important causes of allergic pharyngitis,if the patient is not adopted in treatment of anti-allergic drugs,can lead to therapeutic effect,but the joint antihistamines leukotriene receptor antagonist treatment,can effectively eliminate the symptoms of allergic pharyngitis,obvious effect,effectively improve the patient's quality of life.

OBJECTIVE:To investigate the clinical efficacy of levodopa combined with comprehensive therapy for ametropic amblyopia children and teenagers and its effeets on pattern visual evoked potential(P-VEP)and visual function. METHODS:70 pa-tients(80 eyes)with ametropic amblyopia were randomly divided into observation group(35 cases,40 eyes)and control group(35 cases,38 eyes). Control group received comprehensive therapy as wearing correctional glasses,occlusion therapy and visual stimu-lation training;observation group additionally received levodopa 0.125(d1-3)-0.25 g/time,bid,on the basis of control group for 6 months. Therapeutic efficacy,P-VEP,Visual sensitivity and visual function were compared between two groups,and the occur-rence of ADR was recorded. RESULTS:The effective rate of observation group(92.50%)was significantly higher than that of con-trol group(76.32%),with statistical significance(P<0.05);the wave amplitude of P-VEP P100 in observation group were signifi-cantly greater than in control group,and the incubation period was significantly shorter than control group,with statistical signifi-cance(P<0.05);visual acuity under different spatial frequency contrast were significantly higher than control group,and correc-tion convergence range and correction separation range of observation group were significantly greater than those of control group, while corrected near stereo vision was significantly less than control group,with statistical significance (P<0.05). There was no statistical significance in ADR incidence between 2 groups (P>0.05). CONCLUSIONS:Levodopa combined with comprehensive therapy can improve the function of visual central neurons,and improve visual acuity and binocular stereo vision functions so as to improve therapy efficacy.