Objective To study the characteristic and management method of steroidogenic diabetes in patients with rheumatic disease. Methods The follow-up data of steroidogenic diabetes in 38 patients with rheumatic disease were analyzed retrospectively. Results The nosogenesis of steroidogenic diabetes and fast blood sugar level was related with steroid dosage, using time, age, obesity and hypertipoidemia. The blood-fasting sugar level was not so obviously increased. Blood sugar at bedtime was (24.40±5.92)mmol/L,before breakfast was (9.52±3.64)mmol/L, after breakfast was (20.38±7.19)mmol/L, before lunch was(10.69±3.23)mmol/L, after lunch was (21.81±6.92) mmol/L, before dinner was (12.17±3.63)mmol/L. There was significant difference between blood sugar at bedtime and that in others (P<0.01 or<0.05). Most patients needed insulin to control blood sugar. Decreasing the daily dosage of steroid might be beneficial to the reduction of corticosteroid induced diabetes. Most patients could stop insulin injection when the daily dosage of steroid decreased to a certain level. Conclusions The prescription of corticesteroid in rheumatic diseases can cause temporal increase of blood sugar. Intensive follow-up aad blood sugar monitor is important for the diagnosis of steroidogenic diabetes. Promptly administration of insulin is required for blood sugar control.

Objective To investigate the affect of rhTNFR:Fc on the postoperative recovery of patients with inflammatory arthritis after arthroplasty. Methods Patients with inflammatory arthritis undergoing arthroplasty were included and divided into rhTNFR:Fc group (rhTNFR:Fc only or combined with conven-tional DMARDs) and conventional DMARDs group (monotherapy with or combination of conventional DMARDs). We retrospectively analyzed the incidence of postoperative infection, wound healing time, the febrile period (body temperature ≥37.5 ℃) and the duration of antibiotics treatment after arthroplasty. x2 test and t test were used for statistical analysis. Results Sixty-seven patients were included, 18 in the rhTNFR: Fc group and 49 in the conventional DMARDs group. One postoperative infection occurred in rhTNFR :Fc group but none in the DMARDs group. There was no significant difference by Fisher's exact test (P＞0.05). The febrile duration was (4±3) days in the rhTNFR :Fc group and (3±3) days in the conventional DMARDs group, the difference was not statistically significant (P＞0.05). The wound healing time was (14.0±3.1) days in the rhTNFR :Fc group and (14.7±2.9) days in the conventional DMARDs group, which was not statistically different(P＞0.05). The duration of antibiotics treatment after operation was (14.8±9.3) days in the rhTNFR: Fc group and (10.3±2.7) days in the conventional DMARDs group, the difference was statistically significant (P＜0.05). Conclusion Using rhTNFR:Fc during perioperative period in patients with inflammatory arthritis does not increase the risk of infectious complications or extending wound healing time and the febrile duration.

Aim DPF2 has been reported to be involved in pathogenesis of leukaemia and oncogenic activity.However,the role of DPF2 in oncogenesis and pathogenesis of pancreatic cancer remains unclear.Therefore,the present research aims to investigate the effects of DPF2-RNAi on proliferation,apoptosis and cell cycle regulation of a pancreatic cell line,PANC-1 cells.Methods The lentivirus-mediated DPF2-RNAi was employed to knockdown DPF2 expression in PANC-1 cells,and the role of DPF2-RNAi in proliferation,apoptosis and cell cycle regulation of the PANC-1 cells was examined through MTT assay,colony formation assay and flowcytometry assay.Results The lentivirus-mediated DPF2-RNAi middle and high doses(2 μL and 4 μL)significantly decreased the expression of DPF2 in the PANC-1 cells.DPF2-RNAi decreased cell viability and colony formation,and increased apoptosis of the PANC-1 cells.Besides,DPF2-RNAi induced the S-phase arrest and decreased G2/M phase population of the PANC-1 cells.Conclusions DPF2 may play a crucial role in proliferation,apoptosis and cell cycle regulation of PANC-1 cells.Knockdown of DPF2 through lentivirus-mediated DPF2-RNAi may provide experimental basis for finding a new method for therapy of pancreatic cancer.

Objective:To study clinical features of rheumatoid arthritis (RA) patients with peripheral neuropathy (PN).Methods:The clinical data of 46 RA patients with PN in the First Affiliated Hospital of Zhengzhou University from August 2012 to August 2019 were retrospectively analyzed, including clinical manifestations, laboratory and imaging results, previous treatment, treatment and clinical outcome. The other 92 RA patients without PN at the same period were selected as controls.Results:In RA patients with PN, the male to female ratio was 1∶2.1 with an average age (59.1±11.8) years. The course of RA and PN was 102.0 (19.0-156.0) months and 4.2 (0.7-5.5) months respectively. Numbness (84.8%, 39/46) and muscle weakness (21.7%, 10/46) were the most common symptoms. According to results of electromyography, polyneuropathy (60.0%, 27/46) was the predominant manifestation, followed by mononeuritis multiplex (31.1%, 14/46). Compared to RA patients, rheumatoid factor (RF) ( P<0.001) and the percentage of cutaneous vasculitis ( P=0.042) were higher in RA patients with PN. Logistic regression analysis revealed significant correlation between RF>178.4 IU/ml ( OR＝5.626, 95% CI 2.509-12.618, P<0.001) and development of PN. Paresthesia in 27 patients (58.7%, 27/46) were relieved after treatment of high dose glucocorticoid and immunoglobulins (IVIG). Twelve patients were followed up regularly and the mean duration of follow-up was 17.0(4.8-52.8)months. Paresthesia in 10 (10/12) patients were relieved compared to that at discharge, 1 (1/12) patient achieved complete remission. Conclusion:Numbness and muscle weakness are the common symptoms in RA patients with PN and polyneuropathy is the main type. RF>178.4 IU/ml is correlated with the development of PN in RA patients. Intensive treatment such as high dose glucocorticoid and IVIG are effective.

Objective To elucidate the etiology feature of viral infection in hospitalized children with acute lower respiratory infection. Methods A total of 5 480 children with acute lower respiratory tract infection, hospitalized from September 2007 to September 2009, were studied. Nasopharyngeal aspirates were screened for 8 types of viruses by direct immunofluorescence (DIF) assay. Results At least one type of viral pathogen was detected in 2 710 out of 5 480 patients and the overall positive rate was 49.5%. The most common virus was RSV (51.1%), followed by hMPV (18.9%), PIVⅢ (12.5%), ADV (7.1%), IFA (4.7%), IFB (2.9%), PIV Ⅰ (1.5%) and PIV Ⅱ (1.2%). The positive rate was highest in children under 6 months (43.5%). The seasonal change of RSV, hMPV was more obvious. The peak of RSV, hMPV appeared in the winter and the spring. The prevalence of viral infection in children with pneumonia, bronchitis, asthmatic bronchitis, non asthmatic bronchitis and asthma were 47.4%、63.6%、 50.5%、 30.1% and 43.5% respectively. Conclusions Viruses are the main cause of lower respiratory tract infections in children, especially in infants and young children. RSV and hMPV were the most common viruses in these years.

Objective To evaluate the clinical efficacy and safety of methotrexate(MTX) plus low dose glucocorticoid in the treatment of rheumatoid arthritis (RA) from thetarget control point of view.Methods Patients diagnosed as RA according to American College of Rheumatology(ACR)/European League against Rheumatism (EULAR) 2010 classification criteria were enrolled.All of the patients were prescribed with 15 mg/week MTX,5 mg/week folic acid and prednisone (not exceeding 10 mg/day) orally.At week 0,4,12,disease activity and clinical efficacy were recorded.Co-primary assessment criterion was disease activityscore (DAS28)-based on C-reactive protein (CRP).Secondary assessment criteria included EULAR response criteria,ACR response criteria,simplified disease activity index(SDAI),clinical disease activity index(CDAI).The tolerability and toxicity of MTX was recorded at week 4,12.All patients were evaluated for the occurrence of adverse drug reactions associated with prednisone at week 12.Results A total of 76 patients were enrolled in the study.At week 4 and 12,68 and 65 patients completed regular follow-up respectively.At week 12,there were 30(46.2％),9(13.8％),26(40.0％) patients who met DAS28-CRP remission,low disease activity,middle and high disease activity criterion respectively.Three of nine patients who grouped in low disease activity after therapy were early or intermediate patients and didn't reach the target.Thus 36 (55.4％) patients met the standard of target control.The percentage of patients who met the criteria of EULAR good response,the ACR criteria for 20％ improvement (ACR20),the ACR criteria for 50％ improvement (ACR50),the ACR criteria for 70％ improvement (ACR70) were 29.2％,75.4％,69.2％,64.6％,respectively.The proportion of patients meeting the standard of treat to target using SDAI and CDAI were 76.9％,58.5％ respectively.The rate of liver injury,abdominal pain,abdominal distention and acid reflux,nausea were 11.8％,4.4％,4.4％,2.9％ respectively at week 4.At week 12,4.6％ of patients reported abdominal distention.There was only one patient (1.5％) each who complained of abdominal pain,nausea,loss of hair,varicella zoster virus infection and pulmonary infection at week 12.No serious adverse event was observed during the study.Conclusions Based on the view of target control,drug efficacy and safety,MTX plus low dose prednisone is still a useful therapeutic regimen for RA at present.

Objective To investigate natural killer(NK) and NKT cells in acute pancreatitis(AP).Methods Changes of NK and NKT cells in peripheral blood of 86 AP cases were detected using muhiparameter flow cytometry.Results Compared with control group,the NKT cells decreased in AP patients (t =5.23,P =0.00),but NK cells didn't (t =-1.15,P =0.25).NKT cells in severe SAP and mnoderate MAP were lower than that in the control group (t =-3.92,P =0.00;t =4.84,P =0.00).There was no statistically significant difference of NK cells between MAP and the controls (t =-0.54,P =0.59),but NK cells in SAP group was obviously higher than that in control group (t =3.12,P =0.00).After one week treatment,NK cells significantly decreased (t =8.43,P =0.00).NKT cells were higher than control group (t =-4.44,P =0.00).Dynamic monitoring in AP patients found continuous declination in NK cells,and NKT cells experienced an increase before a falling.Conclusion Monitoring of NK and NKT cells can be used as an important index for the severity and response to treatment in acute pancreatitis.

Objective To investigate the involvement of sympathetic nerve system in the transmission of nociceptive information related to vascular headache. Methods Fos expression in the midbrain periaqueductal grey (PAG) induced by electrical stimulation of dural matter near the superior sagittal sinus (SSS) of the rat was determined before and after the extirpation of the superior cervical ganglion (SCG) using standard avidin-biotin immunohistochemistry. Results Fos immunoreactive positive neurons were detected in the ventrolateral PAG, and were bilateral symmetry. Fos expression was (133.3±12.5) in SCG extirpated group, and higher than that in sham-operated group (76.0±11.3). Conclusion The sympathetic system may be involved in the transmission of nociceptive information through PAG, associated with vascular headache such as migraine.

Objective To observe the effect of recombinant human tumor necrosis factor receptor-Fc fusion protein (rhTNFR-Fc, etanercept) on the expression of transforming growth factor-β1 (TGF-β1) in bleomycin induced interstitial lung disease of rats. Methods Forty-five male Sprague-Dawley (SD) rats were randomly divided into three groups (control group, model group and rhTNFR-Fc treatment group, 15 rats in each), on the 7th, 14th and 28th days, five rats of each group were killed. The lungs were incised to make pathological sections which were stained with HE and Masson, and the expression of TGF-β1 was detected by immunohistochemical technique. Results There was no collagen deposition, alveolitis and fibrosis changes in the control group. The alveolitis and fibrosis of the treatment group was less severe than that in the model group (P<0.01). The expression of TGF-β1 in the model group was significantly higher than that in the control group (P<0.01). In the 7th and 14th days, the expression of TGF-β1 in the treatment group was signific-antly higher than that in the control group (P<0.01). Although that in the 28th day was a slightly higher but no statistical significance (P>0.05) could be detected. In the treatment group, the expression of TGF-β1 was lower in the 7th day (P>0.05) and was significantly lower in the 14th and 28th days than that in the model group (P<0.01). Conclusion Recombinant human tumor necrosis factor receptor-Fc fusion protein can alleviate the severity of alveolitis and pulmonary fibrosis induced by Bleomycin-A5 in rats, which may be due to the inhibition of TGF-β1 overexpression.

Objecfive To investigate the clinical characteristics,treatment and prognosis of autoimmune diseases associated and non-autoimmune diseases associated hemophagocytic syndrome.Methotis Clinical records of 15 cases witll secondary hemophagocytic syndrome'were collected and the relations with treatment and prognosis was analyze.The similarities and differences between autoimmune disease associated bemophagocytic syndrome (group A)and non-autoimmune disease associated hemophagocytic syndrome (group B)were compared.Fisher exact test,t test and Willcoxen test were used for statistical analysis.Results Both groups had fever,bleeding,jaundice,hepatosplenomegaly,and arthralgia,skin rash and positive of autoantibodies in group A were discovered specifically.But in group B,the patients with icterus were mo common(38% vs 100%,p=0.018).There was no significant difference in their laboratory data and prognosis when compared between the two groups(P>0.05).The patients who received corticosteroids and IVIG and/or immunosuppressive agents had better prognosis(P<0.05).Conclusion Except for icterus there is no significant difference in clinical features and laboratory data among autoimmune disease associated hemophagocytic syndrome and other secondary hemophagocytic syndrome.And the therapy with corticosteroids combined with IVIG and/or immunosupprcssive agents is effective.