Objective To explore the clinical and pathological characteristics of neurological lesions in systemic lupus erythematosus (SLE).Methods The clinical and pathological data of 6 SLE patients with neurological lesions were analyzed retrospectively.Results Clinically, the central nervous system was involved in four patients with presentation of epilepsy in one case, cerebral infarction in two cases and leukoencephalopathy in one case. Mononeuropathy was involved in three cases. Pathologically, sural nerve biopsies disclosed typical vasculitis in one of three cases. There were loss of myelinated fibers, segmented and dark-stained axons and myelin, and myelin bead formation in the sural nerves. Muscular biopsy of one case showed mild degeneration and necrosis. Three skin biopsies demonstrated degeneration of fibrinogen, perivenous infiltration of inflammatory cells.Conclusions SLE may lead different damage of nervous system. Therefore, the changes of its clinical and pathological manifestations are complicated.

Background Recent studies have confirmed that sulforaphane (SFN) can activate multiple pathways,and promote the expression of the antioxidants in cells.Thioredoxin (Trx) plays an important role in maintaining the intracellular redox in the steady state.Objective This study was to investigate the effect and mechanism of SFN on Trx expression in bovine trabecular meshwork cells (BTMCs) cultured in vitro.Methods BTMCs were cultured in vitro and identified by morphological evaluation.The third generation of BTMCs were cultured in the medium with 0,10,20 and 30 μmol/L SFN for 30 minutes.Real-time PCR was applied to measure the expression of Trx mRNA in BTMCs.The BTMCs were randomly divided into normal control group,LY294002 group,U0126 group,SFN group,LY294002 +SFN group and U0126+SFN group.The expressions of Nrf2 protein and Trx protein in each group were measured by Western blot.Results The BTMCs was successfully cultured in vitro.The expressions of Trx mRNA were significantly different among the different concentrationss of SFN treatment (F=88.090,P＜0.01).The expressions of Trx protein and Nrf2 protein in the LY294002 +SFN group,U0126 +SFN group and SFN group were significantly higher than those in the normal control group (all at P ＜ 0.01).The expressions of Trx protein and Nrf2 protein in the LY294002+SFN group and U0126+SFN group were significantly higher than those in the SFN group (all at P＜0.01).Conelusions SFN can activate Nrf2 by phosphatidylinositol-3-kinase (PI3K)/protein kinase B (Akt) and mitogen-activated protein kinase (MAPK)/extracellular regulated protein kinases 1/2 (ERK1/2) signaling pathways,which can increase the expression level of Trx in BTMCs cultured in vitro.

Objective To investigate the clinical and pathological features of lymphomatoid granulomatosis(LG).Methods The data of clinic and the results of pathological study of brain biopsy which stained by immunohistochemical method were reviewed in one case with LG.Results The patient was presented with headache,dizzy,slurred speech and myasthenia of limbs.MRI showed abnormal signals on bilateral cerebral white matter,pons,cerebellum and cervical-thoracic spinal cord.Gd-enhanced imaging showed punctiform enhancement.The protein and IgG in cerebrospinal fluid elevated slightly.Brain biopsy showed angiocentric,angiodestructive granuloma formation combined with infiltration of multiple cells.The infiltrated cells confirmed immunohistochemically were lymphocytes and mononuclear phagocytes.In situ hybridization technique showed EBV positive.The status of this patient improved after radiotherapy and glucocorticosteroid treatment.Conclusion LG lacks characteristic features in clinic,laboratory and radiological examinations,so the pathological examination is important for diagnosis of this disease.

AIM: To observe the clinical effect of Huangqi Injection combined with Shuxuetong Injection therapy on aged acute cerebral infarction and to observe the effect on patients' nerve injury extent and hemorheology parameters. METHODS: 83 patients with acute cerebral infarction were divided randomly into two groups Huangqi combined with Shuxuetong group(therapy group) and low molecule dextrose combined with weinaolutong group(control group).The two groups were both tested hemorheology parameters before and after therapy.And clinical effect was estimated according to the extent of patients nerve function injury. RESULTS: The effective rate and curative rate of therapy group were obviously different form control group(P

Diabetic retinopathy (DR) is one of the most common and serious diabetic complications, which is the main cause of vision loss in adults. The specific vascular and neuropathology mechanism of DR is not clear. It has been demonstrated that Inflammatory reaction might be take effects in the development and progression of DR. Monocyte chemoattractant protein-1 (MCP-1), as an important chemokine in the inflammatory response process, promotes chemotactic and activating factors, destroys the blood-retinal barrier, causes retinal vascular disease, and activates microglia, which is related to the severity of the disease. With further research on MCP-1, it is possible to use chemokines and their receptors as target cells to control or slow down the progression of DR by reducing or inhibiting the production of MCP-1 in diabetic patients in the early stages of the disease. This study can provide new ideas and new methods about preventing and treating DR.

Objective To apply fluorescence-activated cell sorting (FACS) and magnetic activated cell sorting (MACS) in sorting natural killer (NK) cells from human peripheral blood. The efficiency of these two methods were compared so that the basic conditions for the further study on the lower proportion of peripheral blood cells could be created. Methods Twenty cases of normal peripheral blood and 3 cases of post-hematopoietic stem cell transplantation (post-HSCT) were collected and NK cell were sorted by FACS and MACS. Results Before sorting the normal peripheral blood, the proportion of the NK cell in the leukocyte was (12.86±3.62) %, the purity of NK cell was up to (96.15±2.03) % and the recovery was (95.08±2.16) %after sorting by FACS, the purity was up to (93.35±3.61) % and the recovery was (94.11±3.01) % by MACS.And before sorting the post-HSCT peripheral blood, the proportion of the NK cell in the leukocyte was (11.01±2.08) %, the purity of NK cell was up to (96.22±2.16) % and the recovery was (95.27±1.18) % after sorting by FACS. The purity was up to (90.98±1.94) % and the recovery was (94.54±3.52) % by MACS. Thereis difference in purity of NK cell (t = 5.925, P ＜0.05), while no difference in rate of recovery between 2methods (t = 0.789, P ＞0.05). Conclusion FACS is more efficient, rapidly and easily than MACS in sorting NK cell, especially for post-HSCT cases.

Objective To study the killing effects of the killer cell immunoglobulin-like receptors (KIR) KIR2DS1-positive natural killer (NK) cells against leukemia cells.Methods High-purified NK cells separated by RosetteSep NK cell enrichment kit from healthy donor peripheral blood were taken as effector cells,and the freshly isolated bone marrow mononuclear cells from newly diagnosed acute myelogeneous leukemia (AML) patients were taken as target cells.The cytotoxic activity of NK cells were detected by CCK8 kit assay.HLA-Cw,KIR gene of the healthy donors and patients were detected by polymerase chain reaction and sequence specific primer (PCR-SSP) genotyping techniques,respectively.NK cells were divided into KIR2DS1-positive group and KIR2DS1-negevitive group,and then anti-KIR2DS1 mononuclear antibody was used to block KIR2DS1 of NK cells.Meanwhile based on HLA-Cw,KIR2DS1-positive NK cells and target cells were divided into C1 homozygote group(expressing HLA-Cw 01,03,07,08,12,14,16 alleles),C2 homozygote group (expressing HLA-Cw 02,04,05,06,15,17,18 alleles) and the C1/C2 heterozygote group (co-expressing the alleles in C1 group and C2 group).Results The purity of NK cells was (91.2±5.94) ％ through flow cytometry analysis.At the same effector-target ratio,cytotoxicity of KIR2DS1-positive NK cells against target cells was higher than that of KIR2DS1-negetive NK cells.While the E:T =10:1,cytotoxicity of KIR2DS1-positive NK cells against target cells [(2.82±6.81) ％] was significant higher than that of KIR2DS1-negetive NK cells [(28.61±5.14) ％] against target cells.The killing effects of KIR2DS1-positive NK cells was significantly weakened after KIR2DS1 blockaded with specific antibody (t =-3.00,P =0.05).When focusing on the C1 group NK cells,KIR2DS1-positive NK cells against C2 group [(4.39±3.46) ％] target cells was significantly higher than than against C1 group [(41.22±3.68) ％] (t =8.33,P ＜ 0.05) and C1/C2 group [(41.32±5.09) ％] (t =6.37,P ＜ 0.05) target cells.Conclusions The killing effects of KIR2DS1-positive NK cells are significantly higher than that of KIR2DS1-negetive NK cells.The HLA-C1 group KIR2DS1-positive NK cells could recognize HLA-C2 loci and then kill the target cells.

Unclear cultivating aim and training plan as well as tutors' lacking of experience are the main problems of the postgraduate education for clinical medicine professional degree,which will cause the quality of clinical postgraduate training to fall greatly.Through the analysis,the author proposes increasing management authority of rotating disciplines for graduates,establishing tutor groups in rotating disciplines,making clear training plan,increasing the clinical simulation skill training courses,training and optimizing the professional master's tutors,which is to fit the needs of the postgraduate education for clinical medicine professional degree and to provide related references.

Objective To explore the value of dynamic monitoring of the neutrophils/lymphocyte ratio ( NLR ) in peripheral blood for the prognosis of patients with bloodstream infection ( BSI ). Methods A retrospective study was conducted. 205 patients who were≥18 years old, their length of hospital stay>24 hours, and they were treated in the China-Japanese Friendship Hospital from January 2013 to October 2014 were enrolled. According to the 28-day survival, the patients were divided into survival group ( n=160 ) and death group ( n=45 ). The white blood cell ( WBC ), neutrophils count ( NEU ), neutrophils ratio ( Neut%), lymphocyte count ( LYM ), lymphocyte ratio ( Lym%), and NLR in peripheral blood were recorded at 1, 3, 7 days after admission. Receiver-operating characteristic curve ( ROC ) was plotted for evaluating the value of these factors on the 28-day prognosis, and logistic regression analysis was used to evaluate the risk factors for predicting the outcome. Results ①On the 1st day, WBC, NEU, Neut%, NLR, and procalcitonin ( PCT ) in the death group were significantly higher than those in the survival group [ WBC (×109/L ):15.28±8.23 vs. 11.58±6.55, NEU (×109/L ):13.34±7.53 vs. 10.03±5.31, Neut%:0.886±0.076 vs. 0.845±0.102, NLR:21.20 ( 13.10, 28.80 ) vs. 12.08 ( 6.81, 20.47 ), PCT (μg/L ):3.13 ( 0.85, 10.12 ) vs. 1.34 ( 0.36, 5.81 ), P<0.05 or P<0.01 ], while hemoglobin ( Hb ), platelet count ( PLT ), albumin ( ALB ) content were significantly lower than those of the survival group [ Hb ( g/L ):86.09±19.83 vs. 107.89±22.82, PLT (×109/L ):157.51±117.81 vs. 195.44±97.28, ALB ( g/L ):24.11±6.94 vs. 31.99±6.89, P<0.05 or P<0.01 ]. On the 3rd day and 7th day, WBC, NEU and NLR in the death group were significantly higher than those of the survival group [ WBC (×109/L ):16.61±10.25 vs. 8.91±4.93, 16.05±9.46 vs. 8.79±4.45; NEU (×109/L ): 14.15±9.98 vs. 6.97±4.64, 14.36±9.03 vs. 6.59±4.07; NLR: 24.13 ( 8.49, 38.26 ) vs. 5.52 ( 3.58, 8.87 ), 17.74 ( 10.74, 32.85 ) vs. 4.35 ( 2.78, 7.27 ), all P<0.01 ], and the LYM and Lym%were significantly lower than those in the survival group [ LYM (×109/L ):0.61 ( 0.38, 1.04 ) vs. 1.05 ( 0.78, 1.43 ), 0.69 ( 0.35, 0.92 ) vs. 1.37 ( 0.93, 1.76 );Lym%:0.039 ( 0.024, 0.101 ) vs. 0.135 ( 0.094, 0.186 ), 0.056 ( 0.033, 0.082 ) vs. 0.170 ( 0.108, 0.237 ), all P<0.01 ].②It was shown by ROC curve that the maximum area under the ROC curve ( AUC ) of WBC, NEU, Neut%, LYM, Lym%, and NLR about prognosis of BSI were observed on 7 days ( 0.777, 0.819, 0.905, 0.755, 0.880, 0.887 ). Based on Neut%>0.855 on the 7th day as a predictor of cut-off value of death in 28 days, the sensitivity was 78.8%, specificity 89.1%, respectively. When Lym%<0.088 on the 7th day as a predictor of cut-off value of death on 28 days, the sensitivity was 89.5%, and specificity was 83.9%. When NLR>10.34 on the 7th day as a predictor of cut-off value of death in 28 days, the sensitivity was 81.8%, and specificity was 91.0%.③Survival analysis showed that the 28-day survival rate in the patients with 7-day NLR<10.34 was significantly higher than that in those with 7-day NLR>10.34 ( 95.0%vs. 34.1%,χ2=82.650, P=0.000 ).④It was shown by multi-factor logistic regression analysis that the levels of 1-day Hb and 7-day NLR were the independent prognostic predictors of 28-day mortality [ Hb: odds ratio ( OR ) = 0.946, 95% confidence interval ( 95%CI ) = 0.913-0.981, P = 0.003; 7-day NLR:OR=34.941, 95%CI=8.728-139.884, P=0.000 ]. Conclusions The trend of changes in NEU, LYM and NLR as shown by repeated routine blood examinations contributes to prediction of the outcome of patients with BSI. The levels of 1-day Hb and 7-day NLR are the independent prognostic predictors for 28-day mortality.

Percutaneous coronary intervention (PCI) is becoming a common practice in the treatment of patients with coronary heart disease (CHD) of all age.Depression is considered to be a risk factor for the development of CHD and deteriorates the outcome after cardiac rehabilitation efforts.The aim of our study was to evaluate the presence of clinically relevant anxiety and depression in patients before and after PCI.Additionally we evaluated their relationship to age because of the increasing number of elderly patients undergoing PCI.Methods One hundred and twelve consecutive patients in three Sanatoria for Retired Cadres in Beijing who underwent PCI were asked to fill in the Hospital Anxiety and Depression Scale (HADS) to measure depression and anxiety scores two days before and ten days after PCI.Differences between these pre- and post-surgical scores were then calculated as means for changes,and the amount of elevated scores was appraised,in order to investigate the relationship between age and anxiety and depression,respectively,Spearman correlations between age and the difference scores were calculated.In addition,ANOVA procedures with the factor age group and McNemar tests were calculated.Results 25.8% of the patients were clinically depressed before and 17.5% after PCI;34.0% of the patients were clinically anxious before and 24.7% after PCI.This overall change is not significant.We found a significant negative correlation between age and the difference between the two time points for anxiety (Spearman rho = -.218,P = 0.03),but not for depression (Spearman rho = -.128,P = 0.21).ANOVA and McNemar tests revealed that anxiety scores and the number of patients high in anxiety declined statistically meaningful only in the youngest patient group.Such a relationship could not be found for depression.Conclusions Our data show a relationship between age and anxiety.Younger patients are more anxious before PCI than older ones and show a decline in symptoms while elderly patients show hardly any change.(J Geriatr Cardiol 2008;5:203-206)