Objective To explore the changes of serum C-reactive protein(CRP)and pneumonia severity index(PSI)of community-acquired pneumonia(CAP)and further assess the effect of CRP on the severity and prognosis of CAP.Methods One hundred and six cases of patients with CAP hospitalized from January 2009 to May 2011 were retrospectively analyzed.Patients were classified according to different assessment criteria and age(≥65 years old)and serum CRP was detected in all patients.Results CRP was correlated positively with PSI(r =0.453,P ＜ 0.001).CRP and PSI had no correlation in elderly hospitalized patients with CAP,but CRP([81.70 ± 75.63]mg/L)correlated positively with PSI(78.30 ± 42.63)in non-elderly patients(r =0.489,P ＜ 0.001).There was significant difference on PSI(89.24 ± 36.44 vs 53.59 ± 35.41),CRP ([106.93 ±74.76]mg/L vs[31.34 ±33.68]mg/L)between PSI severity group and PSI non-severity group (t =-4.289,-5.934,respectively,P ＜ 0.001).Conclusion Both CRP and PSI can be used to evaluate the severity of community-acquired pneumonia,and CRP can be used as a supplement to PSI scoring system,especially in the assessment of non-elderly patients.

A total of 96 patients with Graves'disease(GD)were followed for one and half years to observe the effect of antithyroid drugs(ATD)treatment.Serum TRAb,total iodine concentration and CD80 mRNA expression of peripheral blood monouclear ceils were measured.Logistics regression analysis was conducted with the combination of above parameters.Those GD patients with high level of TRAb,positive family history of GD, increased expression of CD80 and early age of onset were more inclined to relapse after ATD treatment.

Objective To investigate the effect of small interference RNA (siRNA) targeting at 11β-hydroxysteroid dehydrogenase type 1 on the glucose-stimulated insulin secretion (GSIS) in pancreatic β cell line NIT-1 cell.Methods siRNA plasmid vectors specifically targeting at 11β-HSD1 gene were constructed,named as olig886,oligo866 and scrabble control for oligo886,then tansfected into NIT-1 cells.The expression of 11β-HSD1 was detected by RT-PCR and Western blot.O1igo886 vector was transfected into the NIT-1 cells in 25 mmol/L glucose concentrations medium.The insulin secretion level was measured in GSIS test.Results After treatment with 11β-HSD1 siRNA,the mRNA level of 11β-HSD1 in NIT-1 cell was decreased by 78.1%±2.9% and 51.7% ±2.7% inolig886 and oligo866 group respectively.The protein of 11β-HSD1 were decreased by 82.2% ±2.1% and 56.5%±2.0 % respectively.After transfected by olig 8 8 6 vector,the insulin secretion increased in NIT -1 cell.Conclusion 11β-HSD1 gene silencing may improve GSIS in NIT-1 cell 11β-HSD1 regulate local glucocorticoid metabolism in pan-creatic islet and affect the function of insulin secretion.

Objective To investigate the relationship and mechanism of the serum vitamin D levels with insulin sensitivity and adipokines APN,RBP4,visfatin and TNF-α in patients with gestational diabetes mellitus(GDM). Methods A total of 101 patients with gestational diabetes( GDM group) and 50 pregnant women with normal blood sugar( control group) were recruited to detect the serum levels of correlative biochemical indexes,APN,RBP4,visfatin,TNF-α and 25OHD3 using an HPLC method. Twenty-four patients in the GDM group diagnosed with vitamin D deficiency(<25 nmol·L-1 ) were randomized to receive either 1,25(OH) 2D3(0. 25 μg·d-1) orally or no treatment. Serum levels of correlative biochemical indexes were detected after 1 month. Results GDM patients had 25OHD3 levels significantly lower than the control group(P<0. 05),APN levels lower than the control group,and RBP4,visfatin,TNF-α levels significantly higher than the control group(all P<0. 05). After 1 month of 1,25(OH) 2D3 treatment,HOMA-IR increased,while HOMA-β decreased. APN levels was positively correlated(r= 0. 526) with 25OHD3;RBP4,visfatin,TNF-α decreased and were negatively correlated with 25OHD3( r values were -0. 272,-0. 153,-0. 072). Conclusion Vitamin D can reduce the adipokines RBP4,visfatin,TNF-α,increase APN,and thus play a protective role for gestational diabetes.

Objective To explore the effects of immunoglobulin G on tumor necrosis factor (TNF-α) secretion of human peripheral blood mononuclear cells(PBMCs) in type 2 diabetes mellitus complicated with Alzheimer's disease(AD). Methods A total of 20 cases were chosen in each group from patients with type 2 diabetes mellitus complicated with Alzheimer' s disease and patients with type 2 diabetes mellitusm.PBMCs were isolated using density gradient centrifugation method and incu-bated with phytohemagglutinin (PHA) as well as immunoglobulin G extracted from blood serum of the patients with type 2 diabe-tes mellitus.TNF-α concentration in supernatant was measured by enzyme linked immunosorbent assay (ELISA). Results TNF-α concentration in supernatant of PBMCs was significantly increased in type 2 diabetes mellitus complicated with AD com-pared with that in type 2 diabetes mellitus (P<0.01).IgG further increased TNF-α concentration in type 2 diabetes mellitus and type 2 diabetes mellitus complicated with AD(P<0.01). Conclusion IgG extracted from the serum of type 2 diabetes mellitus patients can promote TNF-α secretion in PBMCs of type 2 diabetes mellitus complicated with AD.Immunity injury could play a role in the development of type 2 diabetes mellitus complicated with AD by promoting inflammatory reaction.

In order to explore the expression of erythropoietin receptor (EPOR) in pancreatic cell ine NIT-1 and its effect on cell apoptosis after binding with erythropoietin (EPO), NIT-1 cells were cultured and expanded. The expression of EPOR was detected using electrophoresis. NIT-1 apoptosis was induced by cytokines and their effects on cell apoptosis and cell insulin secretion were assayed after binding of EPO to EPOR. The results showed that EPOR was expressed in NIT-1 cells. Recom- binant human EPO (rHuEPO) had no effect on cell apoptosis but significantly inhibited apoptosis in- duced by cytokines, rHuEPO had no effect on cell insulin secretion but significantly improved insulin secretion inhibited by cytokines. From these findings, it was concluded that EPOR was expressed in NIT-1 cells and EPO could protect N1T-1 cells from apoptosis induced by cytokines.

Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis. At present, the situation of tuberculosis control in China and even the world is severe. Bacillus Calmette-Guerin (BCG) vaccine is the only approved vaccine for tuberculosis, but its protective effect is limited. Hence, it is imperative to develop more effective tuberculosis vaccines. Currently, many new tuberculosis vaccine candidates are in clinical or preclinical trials. In this paper, to provide reference for the development of tuberculosis vaccines in China, the status of the research on vaccine candidates were reviewed and the progress in new tuberculosis vaccine strategies were summarized.

OBJECTIVETo investigate the role of glycogen synthase kinase 3β (GSK-3β) in the maturation and function of murine bone marrow-derived dendritic cells (BMDCs).

METHODSMature DCs (mDCs) induced by LPS were examined for GSK-3β phosphorylation level with Western blotting before and after LPS exposure. To explore the role of GSK-3β in maturation and function of DCs, we added SB216763, a selective inhibitor of GSK-3β, in the cell culture of immature DCs (iDCs), and examined CD40 and CD86 expressions in the cells by flow cytometry and the expression of IL-6, IL-12 and IL-10 mRNA by real-time PCR; the changes of the immunogenicity of the cells was evaluated by mixed lymphocyte reaction. The expression of GSK-3β and RelB was examined by Western blotting in DC2.4 cells transfected with a lentiviral vector over-expressing murine GSK-3β gene.

RESULTSLPS exposure significantly lowered GSK-3β activity in iDCs as demonstrated by increased Ser9 phosphorylation and reduced Tyr216 phosphorylation. GSK-3β inhibition induced DC maturation by increasing the expression of surface costimulatory molecules CD40 and CD86, lowered the expressions of IL-6 and IL-12 while enhanced the expression of IL-10 in iDCs, and impaired mixed lymphocyte reaction of the cells. In DC2.4 cells, lentivirus-mediated over-expression of GSK-3β obviously down-regulated the expression of RelB.

CONCLUSIONSGSK-3β is a crucial enzyme involved in the differentiation and maintenance of an immature phenotype of DCs. GSK-3β is constitutively active in iDCs to inhibit their spontaneous maturation. DCs become phenotypically mature after inhibition of GSK-3β, which also executes a proinflammatory task in DC activation. The reduction of RelB protein levels as a result of GSK-3β overexpression supports GSK-3β as a new target for inducing tolerogenic DCs.

Animals ; B7-2 Antigen ; metabolism ; CD40 Antigens ; metabolism ; Cell Differentiation ; Cells, Cultured ; Culture Media ; chemistry ; Dendritic Cells ; enzymology ; Glycogen Synthase Kinase 3 ; metabolism ; Glycogen Synthase Kinase 3 beta ; Indoles ; chemistry ; Interleukin-10 ; metabolism ; Interleukin-12 ; metabolism ; Interleukin-6 ; metabolism ; Lentivirus ; Lymphocyte Culture Test, Mixed ; Maleimides ; chemistry ; Mice ; Myeloid Cells ; enzymology ; Phosphorylation ; RNA, Messenger ; Real-Time Polymerase Chain Reaction ; Signal Transduction

Objective:To explore the application value of artificial intelligence-assisted diagnosis model based on convolutional neural network (CNN) in the differential diagnosis of benign and malignant breast masses.Methods:A total of 10 490 images of 2 098 patients with breast lumps (including 1 132 cases of benign tumor, 779 cases of malignant tumor, 32 cases of inflammation, 155 cases of adenosis) were collected from January 2016 to January 2018 in Beijing Tiantan Hospital Affiliated to the Capital University of Medical Sciences. They were divided into training set and test set and the auxiliary artificial intelligence diagnosis model was used for training and testing. Two sets of data training models were compared by two-dimensional imaging (2D) and two-dimensional and color Doppler flow imaging (2D-CDFI). The ROC curves of benign breast tumors, malignant tumors, inflammation and adenopathy were analyzed, and the area under the ROC curve (AUC) were calculated.Results:The accuracies of 2D-CDFI ultrasonic model for training group and testing group were significantly improved. ①For benign tumors, the result from training set with 2D image was: sensitivity 92%, specificity 95%, AUC 0.93; the result from training set with 2D-CDFI images was: sensitivity 93%, specificity 95%, AUC 0.93; the result for test set with 2D images was: sensitivity 91%, specificity 96%, AUC 0.94; the result for test set with 2D-CDFI images was: sensitivity 93%, specificity: 94%, AUC 0.94. ② For malignancies, the result for training set with 2D images was: sensitivity 93%, specificity 97%, AUC 0.94; the result for training set with 2D-CDFI images was: sensitivity 93%, specificity 96%, AUC 0.94; the result for test set with 2D images was: sensitivity 93%, specificity 96%, AUC 0.94; the result for test set with 2D-CDFI images was: sensitivity 93%, specificity 96%, AUC 0.94. ③For inflammation, the result for training set with 2D images was: sensitivity 81%, specificity 99%, AUC 0.91; the result for training set with 2D-CDFI images was: sensitivity 86%, specificity 99%, AUC 0.89; the result for test set with 2D images was: sensitivity 100%, specificity 98%, AUC 0.98; the result for test set with 2D-CDFI images was: sensitivity 100%, specificity 99%, AUC 0.96. ④For adenopathy, the result for training set with 2D images was: sensitivity 88%, specificity 97%, AUC 0.94; the result for training set with 2D-CDFI images was: sensitivity 93%, specificity 98%, AUC 0.94; the result for test set with 2D images was: sensitivity 94%, specificity 98%, AUC 0.93; the result for test set with 2D-CDFI images was: sensitivity 88%, specificity 99%, AUC 0.90. Its diastolic accuracy was not affected even if the maximum diameter of the tumor was less than 1 cm.Conclusions:Through the deep learning of artificial intelligence based on CNN for breast masses, it can be more finely classified and the diagnosis rate can be improved. It has potential guiding value for the treatment of breast cancer patients.

Objective To investigate the optimal HbA1Cthreshold to be used for the diagnosis of diabetes mellitus in Chongming rural area,and further to evaluate the optimal HbA1Ccutoff values in different age stratifications and body mass index classifications.Methods Data from 9,981 individuals aged greater than 40 years who participated in a population-based cross-sectional survey in Shanghai,China,were analyzed.A 2 h 75 g oral glucose tolerance test(OGTT)value was used to diagnose diabetes.The performance of HbA1Cwas evaluated against the results of the OGTTs by using receiver operating characteristic(ROC)curve analysis.Results At the optimal HbA1C cutoff point of 6.15%for newly diagnosed diabetes, sensitivity was 69.73%, and specificity was 89.71%.The optimal HbA1Ccutoff points for diabetes were 6.05%in subject with age less than 60 years(sensitivity was 72.88%, and specificity was 90.25%),and 6.25%in subjects with age≥60 years(sensitivity was 70.89%,and specificity was 92.34%).The optimal HbA1Ccutoff points for diabetes were 6.05% in normal-weight(with sensitivity 70.94%,and specificity 89.93%),6.25%in overweight(with sensitivity 70.21%,and specificity 90.32%), and 6.35% in obese population(with sensitivity 72.33%, and specificity 92.75%).Conclusion An HbA1C threshold of 6.15%was highly specific for detecting undiagnosed diabetes.The HbA1Cdiagnosis cutoff point can be affected by age and overweight/obesity status.