Objective To investigate whether expression quantity of HLA-B27 and its subtypes associated with incidence of AS,the gene expression of HLA-B27 and its subtypes were detected in patients with AS.Methods 120 cases patients sus-pected with AS and 50 healthy subjects were enrolled in the study.Main demographic and clinical characteristics of the sub-jects were collected.Meanwhile total RNA was isolated from peripheral blood and real time RT-PCR was used to measure the quantitative expression of HLA-B27 gene.Besides RT-PCR,sequence-based typing (SBT)method was used to confirm the HLA-B27 subtype.All experimental data were analyzed by SPSS17.0 software and P values <0.05 were considered to be significant.Results Firstly,there were 55 subjects were finally diagnosed as AS patients among the 120 patients suspec-ted with AS.There were 53 subjects whose HLA-B27 was positive (96.36%)in 55 patients with AS.It showed that there was a correlation between BASDAI and expression quantity of HLA-B27 gene (r=0.845,P =0.000).Five subtypes were found and which were HLA-B27∶04 subtype (29/53,54.72%),HLA-B27:05 subtype (20/53,37.74%),HLA-B27 ∶02 subtype (2/53,3.77%),HLA-B27∶03 subtype (1/53,1.89%)and HLA-B27∶07 subtype (1/53,1.89%),respectively. Among the 50 healthy subjects,there were only one kind of subtype (2/50,4%),which was HLA-B27∶04.There were no statistical difference in the age (t=0.711,P =0.480),sex (χ2 =0.880,P =0.348),family history (χ2 =0.011,P =0.916) and treatment (χ2 =0.113,P =0.736)between the HLA-B27∶04 and HLA-B27∶05 subtypes.Conclusion HLA-B27∶04 and HLA-B27∶05 were primary subtypes in AS patients which HLA-B27 positive.There was a correlation between gene expression quantity of HLA-B27 and AS disease activity index.

Objective To compare PCR-SBT to IMS-ELISA in the HLA-B27 detection in the ankylosing spondylitis (AS)pa-tients.Methods Simultaneously,PCR-SBT and IMS-ELISA were used to detect the HLA-B27 expression in peripheral blood samples which were suspected patients with AS from 120 cases.Chisquare test of paired design and the area under curve of receiver operating characteristics of SPSS17.0 software were used to evaluate the value of PCR-SBT and IMS-ELISA in HLA-B27 detection of AS patients.Results Among 120 cases of suspected patients with AS,the positive rates of HLA-B27 detected by PCR-SBT and IMS-ELISA were 45.83%(55/120)and 37.50% (45/120),respectively.There was statistical difference between the two methods in the HLA-B27 detection (χ2 =59.455,P =0.000).The sensibility and spe-cificity of PCR-SBT were 96.36% and 96.92%,respectively.While the sensibility and the specificity of IMS-ELISA were 69.09% and 89.23%,respectively.Area under the curve of two methods were 0.966 and 0.792,respectively.Conclusion In comparison with IMS-ELISA,the sensibility and the specificity of PCR-SBT in HLA-B27 detection were higher in AS diag-nosis,that is to say,PCR-SBT is better in HLA-B27 detection and AS diagnosis.

Objective To investigate the assciation between hypertriglyceridemia and insulin resistance in type 2 diabetes (T2DM).Methods One hundred and forty-nine T2DM patients were divided into hypertriglyceridemia (n =88) and normal-triglyceridemia (n =61) groups according to triglyceridemia levels,waist circumference (WC),waist to height ratio (WHtR),fasting blood-glucose (FPG),glycosylated hemoglobin (HbA1 c),uric acid (UA),total cholesterol (TC),fasting insulin (FINS) and homeostatic model assessment for insulin resistance (HOMA-IR) levels were measured and compared between the two groups.Results Compared with the normal-triglyceridemia group,The levels of WC,WHtR,UA,TC,FINS and HOMA-IR of patients in the thypertri-glyceridemia group were significantly higher (Hypertriglyceridemia group:WC(89.51 ±10.31) cm,WHtR 0.55 ±0.06,UA(316.95 ±88.50) μmol/L,TC(5.74 ± 1.72) mmol/L,FINS (8.63 ± 4.91) μU/L,HOMA-IR 4.48 ± 3.14 ; Normal-triglyceridemia group:WC (86.31 ± 7.98) cm,WHtR 0.53 ± 0.05,Uric(275.48 ± 88.36) μmol/L,TC (5.15 ± 1.13) mmol/L,FINS (6.20 ± 3.89) μU/L,HOMA-IR 3.38 ± 2.76; t value were 2.133,2.315,2.815,2.349,2.364,2.221 ; P ＜ 0.05) ; HOMA-IR correlated positively with WC (r =0.233,P ＜ 0.01),WHtR(r =0.268,P ＜ 0.01),BMI (r =0.161,P ＜ 0.05),FPG(r=0.442,P ＜0.01),AST(r=0.169,P ＜0.0S),UA (r =0.907,P ＜0.01),TG(r =0.220,P ＜0.01)and FINS(r =0.907,P ＜0.01).Conclusion T2DM with hypertriglyceridemia increased insulin resistance.

Objective To observe the correlation of histologicalactivity(HAI) of chronic hepatitis B (CHB) with CCL20 expression, and to investigate the impact of CCL20 expression in CHB infection. Methods On the basis of established competitive quantitative RT-PCR with an internal standard, the expression of the CCL20 in the hepatocytes in different infected patterns of HBV infected cells and liver biopsies were quantified and at the same time its correlation to HAI were explored. Results In the cell levels, the expression quantity of CCL20 in control cells (HepG2), persistent HBV infected hepatocytes( HepG2. 2. 15) are (2. 65 ± 0. 02) pg/106 cells, ( 1.22± 0. 04) pg/106 cells, respectively. There were significantly differences between them ( t = 39. 66, P < 0. 01 ). The expression of CCL20 was enhanced in hepatocytes stimulated by PMA but their expression pauern was not changed. Moreover, CCL20 expression in liver biopsies with CHB was (3.54 ± 0. 65 ) pg/20 mg and CCL20 expression in control groups was ( 8. 74±0. 56) pg/20 mg. The expression of CCL20 between two groups was different (t =30. 09,P <0. 01 ) and correlation lied in between HAI and CCL20 expression in liver biopsies of CHB patients ( r = 0. 675, P =0. 023 ). Conclusion CCL20 expression was down-regulated and it was correlated to HAI of liver biopsies in CHB patients.

Objective To investigate effects of hyperbaric oxygen (HBO) therapy on C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α) levels in patients with moderate or severe traumatic brain injury (TBI)and to analyze its therapeutic efficacy. Methods One hundred and eight patients with moderate or severe TBI were randomly divided into a control group (54 cases) and an HBO adjunctive therapy group (HBO group, 54 cases).Both groups received essential neurosurgical treatment and conventional drug treatment, and the HBO group was given one session of HBO therapy in addition. Serum CRP and TNF-α were detected, and the scores on the Glasgow coma scale (GCS) were measured before and after treatment. CRP was detected by turbidimetric immunoassay and TNF-α using ELISA. Glasgow outcome scale (GOS) scores were evaluated in a follow-up 6 months after injury. Results Average CRP, TNF-α and GCS measurements showed no statistically significant difference between the groups before treatment. After treatment, CRP and TNF-α were significantly lower and GCS scores significantly better in both groups, but patients in the HBO group were, on average, significantly better than the controls on all three measures.Six months later, GOS evaluation gave a significantly larger number of patients with a better prognosis in the HBO group compared with the controls. Conclusion HBO therapy can significantly decrease serum CRP and TNF-α after severe TBI, thus enhancing therapeutic efficacy.

Objective The concentration of NE and TNF-α was detected for elucidating the change of them in sera and bronchoalveolar lavage fluid (BALF) of rabbits with acute lung injury interposed by XueBiJing therapy in underwater explosion.Methods Underwater explosion decive was applied to cause acute lung injury of rabbits.The 20 rabbits were randomly divided into two groups which were injury group and XueBiJing therapy group,respectively.The concentration of NE and TNF-α in sera and BALF were detected by ELISA method in 24 hours after bursting.Results The concentration of TNF-α in sera (353.30±166.86 ng/L) of rabbits in therapy group were significantly lower than those in injury group (552.30± 169.64 ng/L;t=2.645,P =0.016).The concentration of NE in sera (63.40 ± 36.09 ng/ml) were lower than that of rabbits in injury group (97.60 ± 36.20 ng/ml;t=2.116,P=0.049).At the same time the concentration of NE in BALF (102.10± 9.50 ng/ml) of rabbits in therapy group were significantly lower than those in injury group (136.70± 13.60 ng/ml;t=6.593,P=0.000).Conclusion The expression of TNF-α in sera and NE in sera and BALF in rabbits with acute lung injury interposed by XueBiJing in underwater explosion were lower than those of injury group.

Objective The expression of TNF-α was detected in sera of rabbits treated by ulinastatin with acute lung injury in duced by underwater explosion.Methods Rabbits were randomly divided into two groups such as the injured group and ulinastatin therapy group.Established underwater explosion device was used to cause acute lung injury in rabbits.TNF-α in sera of the rabbits were measured by ELISA at 4,12 and 24 hours after the explosion.The SPSS17.0 software was used to analyze the data and P＜0.05 was considered to be significant.Results There was no significant difference between the concentrations of TNF-α in the sera of rabbits in the injure group (538.20±201.43 ng/L) and that of in the ulinastatin group (386.90± 109.22 ng/L,t=2.088,P=0.051) at 4 hours after burst.However,there was evidently decreased in the level of TNF-α in the ulinastatin group (400.60 ± 78.98 ng/L) compared with the injury group (573.80 ± 178.24 ng/L,t =2.809,P =0.012) at 12 hours after burst.Moreover and TNF-α in the ulinastatin group (356.10 ± 130.99 ng/L) was also decreased compared to the injure group (552.30± 169.64 ng/L,t=2.895,P=0.010) at 24 hours after burst.Conclusion The TNF-α expression in sera of the rabbits in ulinastatin group were dramatically decreased than thai of in injury group at 12 hours after burst,which may be benefit to rabbits with acute lung injury induced by underwater explosion.

Objective To investigate the level of urinary protein in type 2 diabetic patients with different glucose excursion and investigation the effect of the glucose excursion on early diabetic nephropathy.Methods Fifty-six type 2 diabetes patients were divided into two groups by the level of glycosylated hemoglobin(HbA1c),good glycemic.Patients in control group with HbA1c ＜ 7.0％ and patients in poor glycemic control group with HbA1c ＜ 7.0％.Microalbuminuria,urine transferring (UTRF),α1-microglobulin (α1-MG) and 32-microglobulin(32-MG) were measured.All the patients were monitored using the continuous glucose monitoring system (CGMS),and mean amplitude of glucose excursions (MAGE) were analyzed.Patients were divided into two groups by MAGE,one group's MAGE was lower than 3.9 mmol/L,and another group's MAGE was higher than 3.9 mmol/L.Urinary proteins were measured and analyzed in the two groups.Results In the poor glycemic control group,the levels of microalbuminuria,UTRF and albunin/ creatinine(A/C) rate were (81.28 ±44.13) mg/L,(4.54 ± 1.54) mg/L and (22.17 ± 14.52) mg/mmol significantly higher than that in the good glycemic control group((21.63 ± 10.16) mg/L,(2.48 ±0.29) mg/L and (2.05 ± 0.76) mg/mmol; t =4.758,5.360,4.805 ; P ＜ 0.05).Fasting C peptide in the poor glycemic control group was (1.01 ± 0.13) ng/ml,significant lower than that in the good glycemic control group ((1.51 ± 0.21) μg/L;t =4.826;P ＜0.05).The levels of A/C rate,α1-MG and β2-MG in the group with MAGE above 3.9 mmol/L significantly higher than those in the group with MAGE below 3.9 mmol/L(t =4.358,8.641,12.702;P ＜ 0.05).Conclusion Both persistent hyperglycemia and blood glucose variability could influent diabetic nephropathy.

Objective To investigate the effects of hyperbaric oxygen (HBO) therapy on interleukin-1 β( IL-1 β) and interleukin-6 ( IL-6 ) levels in patients with moderate or severe traumatic brain injury ( TBI ) and to analyze its therapeutic efficacy.MethodsOne hundred and fifty-six patients with moderate or severe TBI were randomly divided into a control group and an HBO adjunctive therapy group with 78 cases in each.The control group received essential neurosurgical treatment and conventional drug treatment,and the HBO group was given one HBO therapy session in addition.IL-1 β and IL-6 were quantitatively determined using sandwich ELISA,and the patients'scores on the Glasgow coma scale (GCS) were measured before and after treatment.The Glasgow outcome scale (GOS) was used to evaluate in a follow-up 6 months after injury.ResultsThe average IL-1 β and IL-6 levels of the two groups and their average GCS scores were not significantly different before treatment.After treatment,IL-1 βand IL-6 levels decreased significantly and GCS scores increased significantly in both groups,but there were significant inter-group differences in all three measures.Six months after injury the GOS evaluation indicated that significantly more patients had better outcomes in the HBO group than in the control group. Conclusion Conventional treatment combined with HBO therapy can promote neurofunction recovery in TBI patients.The mechanism may be related to down-regulation of serum IL-1 β and IL-6.

Objective:To search, evaluate and summarize the best evidence summary of perioperative accelerated rehabilitation nursing for patients undergoing hip and knee arthroplasty, so as to provide reference for clinical perioperative nursing.Methods:Evidence-based nursing methods were used to search for relevant databases such as BMJ Best Practice, UpToDate, PubMed, CINAHL, and CNKI, etc.. The search period was from December 2010 to December 2022. Four researchers independently evaluated the quality of the guidelines, and two researchers independently evaluated the quality of expert consensus and system evaluation. Finally, the included literature was summarized.Results:A total of 12 pieces of literature, 3 guidelines, 5 expert consensus and 4 systematic reviews were included. From 13 aspects of preoperative education, preoperative optimization, anesthesia management, perioperative blood management, perioperative pain management, perioperative fluid management, perioperative temperature protection, infection prevention, thrombus prevention, postoperative nausea and vomiting, postoperative drainage, functional exercise, and perioperative rehabilitation promotion, 35 pieces of the best evidence for hip and knee replacement patients to accelerate rehabilitation nursing in the perioperative period was summarized.Conclusions:This study summarizes the best evidence of accelerated rehabilitation nursing in the perioperative period of hip and knee arthroplasty, aiming to build and standardize the accelerated rehabilitation nursing scheme in the perioperative period of hip and knee arthroplasty, so as to provide reference for clinical perioperative nursing.