Objective To investigate the protective effect of adenosine A1 receptor agonist (2-chloro-N6-cyclopentyladenosine, CCPA) delayed preconditioning on myocardial ischemia reperfu-sion injury and the potential mechanism in rabbits. Methods Thirty New Zealand male white rabbits were randomly assigned to 3 groups:a control group, an I/R group, and a CCPA group. CCPA group was given CCPA 0.1 mg/kg before the myocardial ischemia. Twenty-four hours later I/R group and CCPA group underwent 40 min of coronary occlusion followed reperfusion for 2 h. At the end of the reperfusion, blood samples were taken from the arterial line for determining the plasma level of malondialdhyde and superoxide dismutase activity. The infarct size and area at risk were de-fined by Evans and TIC staining. The heart was harvested and levels of metallothionein (MT) were determined by Western blot, and ultrastructures were observed under the electron microscope. Results The MT level of CCPA group was significantly higher than that of the I/R group (P<0.05). CCPA significantly reduced the infarct size (22.1%±3.8% in the CCPA group) of the left yen-tricular area at risk as compared with the control (41.8%±4.3% in the I/R group,P<0.05). The injury of I/R group was worse than that of the CCPA group under the light microscope. CCPA group had higher superoxide dismutase and lower malondialdhyde than those of the I/R group. Con-clusion CCPA can increase the level of metallothionein during ischemia-reperfusion, which may be part of the molecular mechanism of CCPA delayed preconditioning on cardioprotection.

Objective To determine the prevalence of antibodies to cyclic citrullinated peptides (antiCCP) in patients with juvenile-onset systemic lupus erythematosus (JSLE) and its potential clinical significance. Methods Anti-CCP was measured in sera from patients with JSLE (n=47), juvenile idiopathic arthritis (JIA, n=54) and the sera from age-matched healthy children (n=40) using the third generation of anti-CCP ELISA commercial kit. The association of anti-CCP with other laboratory parameters and clinical features, especially arthritic symptoms in JSLE was also analyzed. T-test, Mann-Whitney U test, Chi-square and Fisher's exact test were used for statistical analysis. Results Out of the 47 JSLE patients, 6 (13%) were anti-CCP positive, which was significantly higher than that of the healthy controls( 13% vs 0, P＜0.05 ), but not different from that of the JIA group (26%, P=0.098). RF was more prevalent in JSLE patients with anti-CCP than patients without (83% vs 15%, P＜0.01 ), but there was no difference in other laboratory parameters and the clinical features ineluding the occurrence of arthritis (67% vs 51%, P＞0.05). As one of the initial symptoms, arthritis was observed in 25 of 47 JSLE patients and no one had developed deforming arthropathy.There was no statistical difference in anti-CCP positivity between JSLE patients with and without articular involvement ( 16% vs 9%, P＞0.05 ). Anti-CCP was not detected in any of the 3 patients with JSLE who had experienced joint pain and limited activity during 3 years follow-up. Conclusion Anti-CCP could be detected in patients with JSLE. It is noteworthy when differentiate from juvenile idiopathic arthritis, but the presence of anti-CCP does not relate with the occurrence of arthritis at presentation and persistence of arthritis in JSLE.

Objective To study the potency of transdifferentiated renal tubular epithelial cells for acquiring the tissue stem cells during renal fibrosis.Methods The in vitro cellular model of renal tubular epithelial cells(NRK-52E)transdifferentiation under the inflammatory environment of the local renin-angiotensin (AngⅡ)system was established.The expression and change situation of the embryonic kidney developmental gene Pax2 and the tissue stem cell surface marker CD133 were observed.Results Local high concentration of AngⅡcould stimulate the NRK-52E cells to express Pax2 and CD133 molecule,its effect demonstrated the dose-and time-dependent relation.Conclusion The inflammatory damage leads to the transdifferentiated renal tubular epithelial cells po-tency to acquire the tissue stem cell.

Background Behcet's disease is a refractory panuveitis with high blindness rate.Multifocal electroretinography (mfERG) is a useful tool for the evaluation of the function of the posterior retina.ObjectiveThe aim of this study is to assess the characteristics of Behcet's disease using the mfERG.Methods mfERG was recorded in 68 eyes of 39 cases with active stage of Behcet's disease.All of the patients were diagnosed based on the Standard of International Study Group for Behcet's Disease and assigned to the cystoid macular edema (CME) group and the diffuse macular edema (DME) group after assessment by fundus fluorescein angiography (FFA).Seventeen normal subjects were used as controls.Oral informed consent was obtained from all of the subjects prior to this trial.mfERG recording followed the ISCEV Guidelines for Clinical Multifocal Electroretinography (2007 edition).The response density and latency of P1 and N1 waves in 6 rings were analyzed and compared.Results The amplitudes of N_1 waves from rings 1 through 6 and N1 wave from rings 1 through 5 were significantly declined in patients with Behcet's disease compared with normal control (P＜0.01).All of the latencies of P_1 waves from rings 1 through 6 were insignificantly shortened in patients with Behcet's disease compared with normal control (P＞0.05).The amplitudes of P_1 and N_1 waves from rings 1 through 6 in diffuse macular edema group were considerably lower than those in the cystoid macular edema group (P＜0.05,P＜0.01).A test of visual acuity showed a negative correlation to the amplitude and latency of N_1 wave (r=-0.36,-0.37,P＜0.05 ) and a positive correlation with the amplitude of N1 wave (r=0.43,P＜0.05) in the DME group.In the CME group,a test of visual acuity presented a negative correlation to the amplitude and latency of N1 wave and latency of P1 (r=-0.41,-0.35,-0.40,P＜0.05 ) and a positive correlation with the amplitude of P1 wave (r=0.48,P＜0.05).Conclusion mfEGR demonstrates that retinal electro-activity is abnormal in eyes with Behcet's disease.The distinct functional disorder is situated around the fovea.

Objective: To explore the clinical effects of split-thickness scalp and allogenic acellular dermal matrix (ADM) in repairing deep wounds of hands in patients with extremely extensive burns. Methods: Six patients with extremely extensive burns complicated by deep burn in hands were admitted to our department from December 2014 to December 2017, including 4 males and 2 females, aged 21 to 58 years. Their total burn areas were from 85% to 95% total body surface area (TBSA), and the sum of deep-partial thickness and full-thickness wounds was larger than 50% TBSA. Under general anesthesia, deep wounds of 10 dorsal hands were repaired by combined transplantation of split-thickness scalp and allogenic ADM in 4 to 6 weeks after injury. The skin grafting range was beyond the metacarpophalangeal joint, including partial dorsal digital deep wounds. Survival of skin grafts on dorsal hands, follow-up of hand shape and functional recovery were observed and recorded. Results: Six patients were successfully treated. There was no infection on the dorsal deep wounds of 10 hands after surgery, and the grafts survived well. During follow-up of 1 to 2 years after operation, there were no recurrent tension blisters or dorsal extension deformity of the metacarpophalangeal joints in 10 hands, the shape and function of hands recovered well, and hand Carroll scores were from 90 to 99 points, with functional levels of Ⅴ and Ⅵ. Conclusions The combined transplantation of split-thickness scalp and allogenic ADM is a good method for repairing deep hand wounds in patients with extremely extensive burns, which can alleviate the cicatrix hyperplasia and contracture of healed hand wounds, and improve the shape and function of hands.