Interleukin-33 is regarded as the orphan receptor ST2 that belongs to the cytokine family of interleukin-1 in 2005. IL-33 is found to play a potentially pathogenic roles in the autoimmune disease, allergic disease, vascular disease, inflammatory disease and it might be a useful sera marker for the diagnosis and prognosis in related diseases. Here we make a review on the relationship between IL-33 and autoimmune disease in recent years.

Objective To investigate the effect of hypoxia-inducible factor (HIF)-1α and vascular en-dothelial growth factor (VEGF) on the angioge-nesis of rheumatoid arthritis (RA). Methods The collagen-induced arthritis (CIA) model was set up in male Wistar rats. The pathological angiogenesis and expression of HIF-1α and VEGF in the synovia different time points were observed by H&E and immunohistochemistry staining. Results The expressions of HIF-1α and VEGF on CIA synovium were significantly elevated and their expression increased gradually with the prolonged disease course. Both synovial HIF-1α expression and VEGF expression were correlated significantly with the pathological angiogenesis score. Synovial lining and sublining HIF-1α expression were correlated significantly with VEGF expression respectively. Conclusion H1F-1α may play an important role in the pathogenesis of RA by upregulating the expression of VEGF and then promoting angiogenesis.

Objective To study the expression and distribution of protein STAT3 in the retina after optic nerve transection. Methods Immunocytochemistry, Western blot and computer image analysis techniques were used. Results After optic nerve transection, STAT3 levels in the retina was highly up-regulated, the peak of which appeared at day 1 postaxotomy, then decreased gradually to the normal level 5 days later. More translocations of STAT3 to the nucleus were seen.Conclusion JAK-STAT signal transduction pathway was involved in the pathological processes in the retinal after transection of the optic nerve.

Objective:To develop a framework for a national system of elderly health standards in response to population aging in China and to meet the need for health service standards for elderly care, thus providing a roadmap for the development of elderly health standards.Methods:Preliminary indicators for a framework of a Chinese elderly health standards system were established by literature review and expert consultations.Using the Delphi method, we invited 23 experts to form a consultation panel.After two rounds of expert consultations, the preliminary framework was updated and the weight of each indicator was calculated by using the analytic hierarchy process.Results:A framework of the Chinese elderly health standards system was established after two rounds of expert consultations.The expert authority coefficient was 0.847.The framework proposed four primary indicators, including basic health standards, medical service standards, public health standards and social support standards, for the elderly, with a weight of 0.204, 0.346, 0.260 and 0.189 for each indicator.There were 22 secondary indicators, including standardized terminologies, medical services, health education, geriatrics personnel training, etc., for elderly care.Conclusions:Our research has generated a preliminary framework of an elderly health standards system that incorporates China's specific issues, takes into consideration of the needs of various parties and covers many relevant aspects.It will provide the basis for decision-making in the elderly health standardization process in China and safeguard the implementation of the Healthy China strategy.

BACKGROUND:Thrombospondin-1 is an important endogenous activator of transforming growth factor beta 1 in this experimental inflammatory kidney disease model. Transforming growth factor beta 1 is considered the major cytokine that causes tissue fibrosis in many different inflammatory disease processes, in particular in renal disease.
OBJECTIVE:To investigate the expression of thrombospondin-1 on renal fibrosis in rats.
METHODS:Healthy male Sprague-Dawley rats were randomly divided into sham surgery group and model group. In themodel group, right ureters of rats were ligated to construct models of renal fibrosis. 3 weeks after surgery, blood and urine were obtained weekly. Enzyme linked immunosorbent assay and Bradford method were used to detect the contents of serum creatinine,blood urea nitrogen and urinary protein. After rats were sacrificed, kidneys were fixed. Western blot assay was utilized to identify the expression of vascular endothelial growth factor, transforming growth factor beta 1 and thrombospondin-1 protein. Hematoxylin-eosin staining was applied to detect the changes in pathological structure of the kidney after surgery.
RESULTS AND CONCLUSION:(1) One week after model induction, urinary protein, serum creatinine and urea nitrogen levels were significantly higher in the model group than in the sham surgery group (P< 0.05). Three weeks later, the difference in each index was significant (P< 0.01), which showed that the injury of the kidney was aggravated. (2) Transforming growth factor beta 1 protein and thrombospondin-1 expression was significantly higher in the model group than in the sham surgery group, but vascular endothelial growth factor protein expression was significantly lower in the model group than in the sham surgery group. (3) Hematoxylin-eosin staining results demonstrated that severe pathological changes of renal tissue in rats were detected after ligation of renal tubule. (4) These results confirmed that thrombospondin-1 expression increased in renal tissue, and its expression was strongly associated with vascular endothelial growth factor protein and transforming growth factor beta 1, which may play an important role in the renal fibrosis.

BACKGROUND:Common strategies for preventing diabetic nephropathy include effective control of blood sugar and blood pressure, inhibition of the rennin-angiotensin system and lipid-lowering therapy, but it is often difficult to get the desired results. OBJECTIVE:To investigate the effect of transplantation of bone marrow mesenchymal stem cels on levels of blood glucose and urinary total protein in diabetic nephropathy rats. METHODS: Forty-five Sprague-Dawley rats were randomly divided into three groups (n=15 per group): normal control group, diabetic nephropathy group and stem cel transplantation group. Rats in the diabetic nephropathy and stem cel transplantation groups were given single use of 60 mg/kg streptozotocin to make diabetic nephropathy models. The same dose of citric acid-sodium citrate buffer was injected in the normal control group. After modeling, 200μL of bone marrow mesenchymal stem cel solution (2×106) was injected into the left ventricle of rats in the stem cel transplantation group, and then at 7 days after the first transplantation, the cel transplantation was conducted again. The same dose of serum-free L-DMEM was injected intracardialy into the rats in the normal control and diabetic nephropathy groups. Levels of urinary total protein and blood glucose were detected. RESULTS AND CONCLUSION:At 1, 4, 8 weeks after treatment, the urinary total protein and blood glucose levels were significantly higher in the stem cel transplantation group and diabetic nephropathy group than the normal control group (P < 0.05). At 1 week after treatment, the urinary total protein and blood glucose levels were significantly lower in the stem cel transplantation group than the diabetic nephropathy group (P < 0.05). At 4 and 8 weeks after treatment, the total urinary protein and blood glucose levels were slightly higher in the diabetic nephropathy group than the stem cel transplantation group, but there was no significant difference (P > 0.05). These findings indicate that bone marrow mesenchymal stem cel transplantation in diabetic nephropathy rats can get good results in a short period, significantly improve the blood glucose and urinary total protein levels, but the long-term treatment effect is poor.

Objective To explore the feasibility of team-based learning (TBL) for practice teaching of internal medicine.Methods TBL was carried out in 40 interns from clinical medical students of eight-year program.Every team included 4 ～ 5 members.The course of rheumatoid arthritis was chosen according to the course syllabus.Results The students discussed enthusiastically in the team test and in-class application exercises.More than 80％ of the students expressed that TBL was helpful to understand the course content better,to learn the disease better,to elevate personal study ability and to know others' thought processes.76％ of the students supported to carrry out TBL again.Conclusions TBL is helpful for senior medical students to elevate their ability of applying course concepts to solve practical problems through a series of team activities.Improvement of teaching idea and skill is the key to perform TBL successfully.

ObjectiveTo investigate the effect of rosiglitazone (RSG), a high-affinity synthetic agonist for PPAR-γ, on the expression of receptor activator of NF-κB ligand (RANKL) and osteoprotegerin (OPG)in rheumatoid arthritis fibroblast-like synoviocyte (RA-FLS) and the underlying mechanisms. MethodsRAFLS were incubated with different concentrations of RSG(0, 5, 10, 15, and 20 μmol/L) for 3 days, RAFLS proliferation was detected by Cell Counting Kit-8 assay, and then the expression of RANKL and OPG was examined by real-time PCR and Western blot. The expression of phosphorylated ERK, p38 and JNK was also detected after RA-FLS was incubated with RSG(0, 15, and 20 μmol/L) for 3 days. One-way ANOVA and Bonferroni were used for statistical analysis. ResultsRSG (5, 10, 15, and 20 μmol/L) had significantly inhibited the expression of RANKL mRNA(0.503±0.005, 0.438±0.031, 0.161±0.042, 0.050±0.018) and protein (1.72±0.09, 1.58x±0.05, 1.46±0.11, 1.22x±0.14) in RA-FLS (F=200.820, F=13.602, P＜0.01 ), while the expression of OPG mRNA (2.8 ±0.5, 7.0 ±3.2, 8.4 ±2.3, 25.7 ±5.1 ) and protein ( 1.21 ±0.11, 1.52 ±0.16, 1.63±0.11, 1.91 ±0.03) increased significantly (F=26.531, F=24.872, P＜0.01), both in a dose dependent manner. The ratio of RANKL/OPG mRNA and protein significantly reduced (F=453.425, P＜0.01 ;F=4.173, P＜0.05 ). RSG (15, 20 μ mol/L) significantly inhibited the expression of p-ERK-1/2 protein (0.55±0.06, 0.45±0.06, F=6.991, P＜0.05). ConclusionRSG can inhibit RANKL expression in RA-FLS through p-ERK pathway.

ObjectivesTo examine the validity of high-frequency Doppler ultrasound in identifying knees synovitis in patients with rheumatoid arthritis(RA).MethodsNinety-five consecutive patients with active RA were examined withhigh-frequency Doppler ultrasound to examine synovitis signals in knees.Synovial tissue samples of 51 patients were obtained by closed needle biopsy from knees after ultrasound examination.Serial synovial tissue sections were stained with H&E and immunohistochemical staining,and the histopathological synovitis scores were evaluated.The relationship among clinical, histopathological and ultrasound synovitis indexes was analyzed by Spearman's rank order correlation test and receiver operating characteristic curve analysis.ResultsAmong 95 RA patients,the median thickness of synovial membrane in ultrasound was 2.8 mm,the median depth of effusion was 2.7 mm; Doppler signals of synovial blood flow were detected in 82％(78/95 ) of patients and the median semiquantitive grading of synovial blood flow was 1.0.The thickness of synovial membrane and synovial blood flow at Doppler ultrasound correlated positively with histological synovitis score,hyperplasia of the lining layer,and inflammatory infiltration in sublining area (the thickness of synovial membrane:r=0.438,0.424,0.368,respectively; synovial blood flow:r=0.357,0.377,0.347,respectively; all P＜0.05).Although there was no significant difference in clinical synovitis indexes between patients with histologically low-grade and high-grade synovitis,the thickness of synovial membrane and synovial blood flow in ultrasound in patients with histologically high-grade synovitis was significantly higher than those with low-grade synovitis(P=0.001,0.036,respectively).When the thickness of synovial membrane in ultrasound was ≥ 3.9 mm,the specificity of diagnosing the high-grade synovitis was 96.7％ and the sensitivity was 61.9％.ConclusionSynovitis signals at high-frequency Doppler ultrasound correlate with histopathological synovitis,and it might be helpful in evaluating the severity of histopathological synovitis.

Objective To detect the expression and function of cysteinyl leukotriene receptors (CysLTRs)in keratinocytes.Methods Human keratinocytes were isolated from the tissue of foreskin by digestion with dispase Ⅱ and trypsin,and subjected to primary culture.By using confocal laser scanning microscopy and reverse transcriptase PCR,the localization and expression of CysLTRs were studied in kemtinocytes.respectively.Some primarily cultured keratinocytes were pretreated with leukotriene D4 (30 nmoi/L),MK571(300 nmol/L),and BAYu9773 for 5 minutes followed by the detection of intmcellular calcium level using the Ca2+ indicator dye Fura-2/AM as well as cell proliferation bv MTT assay.Results The expressions of CysLTR1 and CysLTR2 were observed in cultured keratinocytes,and they were mainly located on cell membrane,partly in cytoplasm and nuclei.Compared with non.stimulated cells,a significant increase Was noted in the expression of CysLTRs,especially in the nuclei of keratinocytes stimulated by LTD4(P＜0.05),together with an elevation in intracellular calcium level(42.27±3.00 mmol/L,P＜0.01)and acceleration in cell proliferation (P＜0.01).However,both MK571 and BAYu9773 could completely block the effect of LTD4 on intmcellular calcium level and cell proliferation.and there was no significant difference in the blocking effect between MK571 and BAYu9773.Conclusions Functional CysLTRs are expressed in human keratinocytes.and they carl increase the intracellular calcium level in,and cell proliferation of,keratinocytes.