The study aimed to analyze the efficacy and safety of rituximab in the treatment of 23 cases of lupus nephritis and explore the prospect of half-dose rituximab in lupus nephritis treatment. Twenty-three patients with lupus nephritis hospitalized in the Department of Rheumatology and Immunology at the First Medical Center of the PLA General Hospital from May 2013 to December 2021 were selected. Eighteen patients received rituximab 375 mg/m 2 on the first and 14th days, 5 patients received 500 mg of rituximab on the first and 14th days, and rituximab was used as needed 6 months later. Methylprednisolone (80-120 mg) was given together with rituximab. Afterward, 1 mg/kg prednisone was used for 4 weeks, which was progressively tapered to maintenance doses or discontinued. B lymphocyte level, renal function, 24-h urine protein level, and systemic lupus erythematosus (SLE) disease activity index 2000 (SLEDAI2K) score before and after treatment were recorded. The efficacy and adverse reactions were analyzed. The results showed that 11 patients suffered from renal insufficiency [creatinine (162.7±58.6) μmol/L ] at baseline, while the creatinine level of 9 patients returned to normal 12 months after the treatment [ (66.3±10.1)μmol/L ]. Normal renal function of the other 12 patients was maintained during treatment. After 12 months, the 24-h urine protein level decreased from 4.00 (2.00,6.80) g in the baseline period to 0.10 (0.08,0.40) g. SLEDAI2K score decreased from 22 (18,26) in the baseline period to 3 (0,6) 12 months after the treatment. The B lymphocyte level reached 0.00 (0.00,0.01)% at 3 months. Of 23 patients, 13 patients achieved complete remission, and 7 patients achieved partial remission after 6 months of rituximab treatment. Five patients experienced adverse reactions related to rituximab, including 1 case of transfusion reaction, 1 case of perioral herpes with pulmonary infection, and 3 cases of decreased IgG levels. Therefore, rituximab regimen used in this study can be an effective treatment strategy for lupus nephritis.

Objective:To evaluate the efficacy of combining modified manipulative reduction with functional training for the treatment of acute anterior disc displacement without reduction.Methods:Sixty anterior disc displacement patients aged from 19 to 55 years were randomly divided into an experimental group and a control group, each of 30. The experimental group was given modified manipulative reduction, while the control group was provided with traditional manipulative reduction. After the manipulative reduction, both groups received 3 months of functional training. Visual analog scale (VAS) ratings, maximum active mouth opening, a mandibular movement index and magnetic resonance imaging (MRI) were employed before and immediately after the reduction and after the functional training to evaluate their effectiveness. An oral health-related quality of life scale was also used. The number of attempts needed to achieve successful reduction and the overall success rate were compared between the two groups.Results:There was significant improvement in the average VAS ratings, maximum active mouth opening, mandibular movement index and oral health-related life quality of both groups after the experiment. Immediately after reduction, the maximum active mouth opening and mandible movement in the experimental group were significantly higher than in the control group, on average. Further improvement was observed after the treatment such that there was no significant difference between the two groups. After the functional training, however, the experimental group′s average VAS and oral health-related life quality scores were significantly better than the control group′s averages. According to MRI right after reduction, the success rate of the experimental group (96.7%) was significantly better than among the control group (80%). After the functional training the corresponding values were 86.7% and 73.3%. That difference was no longer significant. There was also no significant difference in the number of attempts needed to achieve successful reduction.Conclusion:The modified manipulative reduction not only has a higher success rate, but also can immediately improve mouth opening and mandible mobility. Combined with functional training, it can effectively reduce pain and improve life quality.

Objective To set up a living mice colonoscopy platform to establish an orthotopic model of colorectal cancer in mice under direct vision,and to observe its biological behavior such as metastasis.Methods Eighteen-week-old male C57/BL mice were anesthetized,and the intestinal lumen of the mice was examined by a self-developed living mice colonoscopy and Olympus URF-P5 ureteroscopy,respectively.The imaging effects of the two methods were compared.Human colon cancer HT-29 cells were injected into the colonic mucosa of BALB/c-nu mice under direct vision.The colonoscopy was performed on the 3rd,7th and 15th day after the injection to observe the tumor formation in the intestinal lumen.The mice were sacrificed when the body weight decreased significantly or cachexia appeared,and then the abdominal cavity was examined including the tumor formation and metastasis.Results The self-developed living mice colonoscopy platform can provide clear vision of enteric cavity,and no mice died in the colonoscopy examination.In vivo subcutaneous injection of HT-29 cells in mice was performed with a perforation rate of 15％,a mortality rate of 33.3％,a tumor formation rate of 62.5％,an abdominal metastasis rate of 60％,a liver metastasis rate of 25％,and an abdominal wall transfer rate of 25％.Conclusion The self-developed mice colonoscopy platform can be used for the study of colorectum in living mice.The imaging effect is no less than that of Olympus URF-P5 ureteroscopy.In addition,an orthotopic colorectal cancer model can be established by this platform combing with submucosal injection technology.

Objective To explore the impact of telomerase regulation factor PinX1 to the proliferation and invasion ability of hepatoma cells. Methods Hepatoma cells PinX1-7721 (experimental group) with stable expression of PinX1 as well as control cell VECTOR-7721 (control group) were constructed. The expression of PinX1 mRNA was detected by RT-PCR. The proliferation ability and clonality of hepatoma cells were detected by CCK-8 method and plate clonality assay, and the invasion ability of hepatoma cells by Transwell assay. Comparison of the experiment data was conducted by t test. Results Expression level of PinX1 mRNA in experiment group was (13.9±2.0)×10-3, which was significantly higher than (1.1±0.2)×10-3in control group (t=10.98, P<0.05). A450of the cells on 1-7 d in experiment group was respectively 0.260±0.004, 0.340±0.008, 0.450±0.040, 0.500±0.020, 0.730±0.030, 1.350±0.040 and 1.640±0.050, which were significantly lower than 0.280±0.009, 0.410±0.007, 0.680±0.044, 0.730±0.029, 0.850±0.070, 1.700±0.020 and 2.080±0.280 in control group (t=-5.82, -12.99, -6.36, -5.96, -28.42,-18.98, -5.08; P<0.05). The plate clonality assay results showed that the clone formation quantity of cells in experiment group was 143±32, which was significantly lower than 305±25 in control group (t=-6.91, P<0.05).Transwell assay results showed that the quantity of trans-membrane cell in experiment group was 230±16, which was significantly lower than 650±30 in control group (t=-21.40, P<0.05). Conclusion PinX1 could inhibit the proliferation and invasion ability of hepatoma cells.

Objective To investigate expression of plasmalemmal vesicle-associated protein (PLVAP) in hepatocellular carcinoma (HCC) tissues and its relationship with clinicopathological features.Methods Tissue specimens were collected from 108 patients with HCC in the Third Affiliated Hospital of Sun Yat-sen University from January 2013 to December 2015.92 patients were male and 16 female,aged (48±5) years on average.The informed consents of all patients were obtained and the local ethical committee approval was received.The expression level of PLVAP was analyzed based on the data of HCC in public databases.The expression level of PLVAP mRNA in HCC and paracarcinoma tissues was detected by RT-PCR,and the relationship between the expression of PLVAP and clinicopathological characteristics of HCC was analyzed.The relationship between PLVAP and prognosis of HCC patients was investigated with the data from cancer genome atlas (TCGA) database.The expression levels of PLVAP mRNA between HCC tissues and para-carcinoma tissues were compared by Kruskal-Wallis rank-sum test.Correlation analysis was performed by Chi-square test.Survival analysis was conducted by Kaplan-Meier survival curve and Log-rank test.Results According to Human Protein Atlas and Oncomine databases,the expression level of PLVAP in HCC tissues was significantly higher than that in normal liver tissues.RT-PCR showed that the median expression level of PLVAP mRNA in HCC tissues was 0.172(0.004-0.607),significantly higher compared with 0.091(0.002-0.513) in para-carcinoma tissues (Z=6.839,P＜0.05).The expression level of PLVAP in HCC patients was significantly correlated with TB,tumor size and microvascular invasion (x2=4.183,3.924,6.075;P＜0.05).In PLVAP high expression group,the overall survival and tumor-free survival were 58.8(0.5-107.0) and 42.2(0.1-67.2) months,where no significant difference from 55.7(0.2-120.7) and 20.9(0.1-109.4) months in PLVAP low expression group (x2=0.054,0.065;P＞0.05).Conclusions The expression level of PLVAP is significantly correlated with the development and progression of HCC,whereas it is probably not associated with the prognosis of HCC patients.

Objective To investigate the effect and mechanism of long noncoding RNA (lncRNA) PTEN pseudogene 1 (PTENP1) on the proliferation and migration of hepatocellular carcinoma (HCC) cells. Methods Lentiviral vectors expressing PTENP1 were constructed. HCC cells BEL-7404 were infected with LV003-GFP-PTENP1 and control vectors LV003-GFP. BEL-7404 cells stably expressing PTENP1 were constructed and the experimental and control groups were established. The proliferation and clone formation abilities of HCC cells in two groups were detected by CCK-8 assay and clonogenic assay. The migration ability of HCC cells was detected by wound healing assay. The expression of p44/42 mitogen-activated protein kinase (MAPK) and p38 MAPK proteins were detected by Western blot. Results The absorbance values A450 of the cells at 48 and 72 h in the experimental group were 1.4±0.3 and 2.3±1.1, signiifcantly lower compared with 3.2±1.7 and 3.4±1.1 in the control group (t=-5.78,-4.23;P<0.05). The number of cell clone formation in the experimental group was 55±12, signiifcantly less than 154±45 in the control group (t=-3.98, P<0.05). The percentage of cell migration in the experimental group was (21.7±2.6)%, signiifcantly lower than (57.7±4.9)%in the control group (t=-8.34, P<0.05). Western blot revealed that the expression of p44/42 MAPK and p38 MAPK proteins in the experimental group was significantly down-regulated compared with those in the control group. Conclusion lncRNA PTENP1 can inhibit the proliferation and migration of HCC cells probably through regulating MAPK signaling pathway.

ObjectiveTo investigate the clinical characteristics of primary liver cancer (PLC) complicated with non-Hodgkin’s lymphoma.MethodsClinical data of 2 patients with PLC complicated with non-Hodgkin's lymphoma admitted and treated in the Third Afifliated Hospital of Sun Yat-sen University between January 2006 and July 2015 as well as 18 patients reported by the literature were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. The incidence, diagnosis and treatment process, therapeutic regimen, curative effect and prognosis were observed. Relevant literature in PubMed database from January 1994 to December 2015 was searched for literature review.ResultsAmong the patients, 17 were males and 3 were females with the onset age ranging from 35 to 80 years old and the median of 64 years old. Nineteen cases were with hepatocellular carcinoma and 1 with mixed type liver cancer. Hepatitis virus infection was found in 90%(18/20) of the patients with 8 cases of hepatitis B virus (HBV) infection and 10 of hepatitis C virus (HCV) infection. All patients were complicated with B-cell non-Hodgkin's lymphoma. The main type was diffuse large B-cell lymphoma, accounting for 60%(12/20). And the other types were follicular lymphoma (n=5), mucosa-associated lymphoid tissue (MALT) lymphoma (n=1), marginal zone lymphoma (n=1) and unspeciifed lymphoma (n=1). The main lesions of non-Hodgkin's lymphoma respectively located in the liver (n=9), spleen (n=3), lymph node (n=3), stomach (n=3), vertebral body (n=1), other non-tissue and visceral organ (n=1). The therapeutic regimens were operation + chemotherapy (n=9), radiofrequency ablation or transcatheter arterial chemoembolization (TACE) + chemotherapy (n=6), liver transplantation (n=1) and palliative treatment (n=4). The median postoperative survival time of the patients was 48(5-105) months, while the survival time of the patients receiving palliative treatment was less than 1 month.ConclusionsMost PLC patients complicated with non-Hodgkin's lymphoma are male, and the pathological type of all the non-Hodgkin's lymphoma is B-cell type. The morbidity is closely associated with HBV infection. There are no speciifc clinical manifestations, and the conifrmed diagnosis depends on the pathological examination. Radical resection is the ifrst choice for treatment.

BACKGROUND:Previous studies have confirmed that bone marrow mesenchymal stem cells in vitro can promote hepatic stel ate cellapoptosis and inhibit its activity, in which the mechanism of action remains unknown. OBJECTIVE:To screen out apoptosis-related genes during hepatic stel ate cellapoptosis regulated by bone marrow mesenchymal stem cells using gene chip technology. METHODS:Purified human bone marrow mesenchymal stem cells were seeded in 6-wel Transwel plate and cocultured with hepatic stel ate cells. Cultured human bone marrow mesenchymal stem cells alone served as control group, and cultured for 72 hours. The alterations in apoptosis-related genes were analyzed between culture alone group and coculture group using gene chip technology. The genes strongly associated with regulation of hepatic stel ate cells were selected. RESULTS AND CONCLUSION:By the functional classification of second-generation SABiosciences Gene chips, apoptotic gene screening found that after coculture, significantly upregulated genes in bone marrow mesenchymal stem cells contained:AKT1, PIK3R2, DAPK1, DHCR24, NOTCH2 and BDNF. Combined with previous findings, we hypothesized that NOTCH may play a key role in the regulation of hepatic stel ate cells by bone marrow mesenchymal stem cells.

Objective To review the diagnosis and treatment of severe complications after transcatheter arterial chemoembolization (TACE) of hepatocellular carcinoma (HCC). Methods Clinical data of 15 patients with severe complications after TACE of HCC in Department of General Surgery, Lingnan Hospital, the Third Afifliated Hospital of Sun Yat-sen University from June 2011 to May 2013 were analyzed retrospectively. The informed consents of all patients were obtained and the ethics committee approval was received. There were 12 males and 3 females with age ranging from 40 to 78 years old and the median age of 55 years old. Results Manifestations of cholangitis such as abdominal pain, fever, rising white blood cell etc. were observed in all the patients. According to the clinical manifestations, history of receiving TACE and imaging examinations, 10 cases were diagnosed with biloma after TACE of HCC, 4 cases with liver abscess and 1 case with ischemic cholangitis. All the patients received basic treatments of anti-infection, cholagogue and liver protection. Ten cases with biloma were cured after receiving ultrasound-guided percutaneous transcatheter drainage of biloma, percutaneous transhepatic cholangial drainage (PTCD) and endoscopic nasobiliary drainage (ENBD). Four cases with liver abscess were cured after receiving ultrasound-guided percutaneous transcatheter drainage of liver abscess, local douche with antibiotics. One case with ischemic cholangitis received drainage of 3 catheters of PTCD and the serum bilirubin went down from 500μmol/L to 300μmol/L, but gave up treatment ifnally because of complicating severe biliary infection and gastrointestinal hemorrhage. Conclusions The diagnosis of severe complications after TACE of HCC is mainly based on the clinical manifestations, history of receiving TACE and imaging examinations. The therapies include basic treatments of anti-infection, cholagogue and liver protection etc., and symptomatic treatments of ultrasound-guided percutaneous drainage, PTCD, ENBD, etc.

Objective To understand the features of immunoglobulin G4-related diseases and to improve its diagnosis and treatment.Methods The clinical data of 20 cases discharged from our hospital were analyzed retrospectively.Results Twenty cases with IgG4 related diseases were reviewed retrospectively.IgG4-related diseasesis more prevalent in male than in female (14∶6),and the mean age was 58 years.Pancreas and bile ducts were the most commonly affected organs,2 and more than 2 organs were involved in 17 patients.All patients had significantly elevated serum immunoglobulin G4.Histopathological findings included diffuse tissue fibrosis with extensive lymphoplasmacytes infiltration.On immunohistochemical staining,the ratio of IgG4-positive plasma cells to IgG-positive plasma cells was higher than 40％.One patient deceased and one patient was left untreated,other patients responded well to the treatment.Conclusion There is no characteristic clinical symptoms for IgG4-related diseases,and serum immunoglobulin G4 is the essential diagnostic method in suspected cases.IgG4-related diseases can be well controlled with prompt use of glucocorticosteroid.