Objective To explore drug abuse prevention measures by surveying the changes before and after methadone maintenance treatment(MMT). Methods The baseline survey data were obtained from patients who participated in the MTT program for the first time at Wuhan First Health Clinic of Mental Health Center Affiliated to Tongji Medical College between March 2006 and December 2013,and the general conditions of these patients were analyzed. Results There were 1 186 drug abusers, with a male and low education(junior high school and below)dominance. After the initiation of the MMT program,the number of addicted people was highest in 2008,and then gradually decreased after 2009.MMT program achieved obvious social benefits.The proportion of injectable drug use alone was decreased and the rates of oral drug use and snorting were increased over time.Fixed salary and temporary salary were obviously increased in drug abusers after 2009. Daily drug cost was decreased over time. The proportion of community/ media propaganda through which people got to know MMT remained low. Conclusion The community support and educational propaganda should be strengthened at the same time when MMT is carried out.

Objective To study the role of OIf-1/EBF associated zinc finger protein (OAZ),a transcription factor encoded by a positional systemic lupus erythematosus (SLE) candidate gene,in the function of mesenchymal stem cells (MSC) of SLE patients by silencing this gene.Methods OAZ mRNA levels of bone marrow MSC obtained from 5 SLE patients and 5 healthy controls were detected by real-time PCR.Bone marrow MSC obtained from 6 SLE patients were incubated with specific siRNAs for 3 days,then cells were harvested for OAZ measurement,Idl-3 and CCL2 mRNA levels were tested by real-time PCR,and levels of CCL2 were detected in culture supernatants using ELISA.Differences between groups were analyzed using t-test or MannWhitney test.Results ① OAZ mRNA levels of bone marrow MSC were significantly elevated in SLE patients (0.013±0.016) compared to healthy controls (0.001±0.000,P=0.009).② After OAZ silencing,the expression levels of OAZ,Id1,Id2 and ld3 mRNA were significantly decreased (△Ct 10.3±0.7,15.2±1.6,8.1±1.4,10.5±0.6 vs 8.7±0.7,14.1±1.2,7.1±1.5,9.8±0.6) (P all ＜0.05).③ Both the expression levels of CCL2 mRNA (△Ct 2.2±1.1 vs 3.0±1.1 ) and the levels of CCL2 protein in culture supernatants [(341±29) pg/ml vs (304±19) pg/ml] were significantly increased in OAZ silencing group comparing to those in the control group (P all ＜0.05).Conclusion OAZ gene expression is significantly elevated in bone marrow MSC of SLE patients.OAZ may affect autoantibody production in SLE patients by regulating CCL2 expression.

objective To study the role of anti-EBV antibody in the development of systemic lupus erythematosus(SLE).Methods Peripheral blood was obtained from 55 SLE patients and 29 normal controls,and anti-EBV-VCA IgG,IgA,IgM antibody was detected by enzyme-linked immunosorbent assay[ELISA).Totat RNA was extracted from peripheral blood of 33 SLE patients and 26 normal controls and then reverse transcribed into complementary DNA.Real-time PCR technique was used to determine gene expressions at the transcription level.Comparison of anti-EBV antibody level and interferon inducible gene expression was made between SLE Datients and normal controls by t-test.The associations between anti-EBV antibody level,lupus activitv and IFN inducible gene expression were analyzed by Spearman's correlation analysis.Results (1)The levels of anti-EBV antibodies in SLE patients were significantly increased as compared to those in the normal controls[IgG(41±6)vs(19±6)U/ml,IgA(15.4±1.8)vs(8.3±2.1)U/ml,IgM(7.8±1.0)vs(3.7±1.2)U/ml]cantly elevated in SLE Datients as compared to normal controls[IFN scores 11±13 vs 0±3](all P<0.05),but not correlated with the levels of anti-EBV antibody in patients(all P>0.05).Conclusion Anti-EBV antibody is overproduced in SLE patients but not associated with disease activity as well as the expression level of several major types of I IFN inducible genes,suggesting that EBV infection may not be a major factor mediating the activation of IFN pathway and consequently the exacerbation of SLE.

Objective To explore the role of OAZ gene in the pathogenesis of systemic lupus erythe-matosus (SLE) by using RNA interfering technique. Methods Peripheral blood mononuclear cells (PBMC) from SLE patients were collected. Each sample was equally divided into four groups for cell culture in 96 well plates. Specific siRNA for OAZ and GAPDH were concordantly added to the experimental group and the positive control group, while nonspecific siRNA was added to the negative control group and only culture medium was added to the Mock control group. Cells and supernatants were harvested after culturing for 72 hours, then RNA was extracted and reverse transcripted to cDNA. OAZ, Id1, Id2, Id3, Id4 mRNA expression levels were analyzed by using real-time PCR. Levels of IFN-γ, IL-4, IL-10, IL-12, IL-21, CCL2, ANA in the supernatant were tested by ELISA. Relationships between the expression levels of OAZ mRNA with levels of cytokines and ANA were analyzed. Results OAZ, Id1, Id2, Id3 gene mRNA expression levels (△Ct: 12.5±1.4, 8.9±1.5, 4.3±0.8, 8.04±1.1) in the experimental group were significantly decreased comparing to those in the negative control group (△Ct: 10.2±1.1, 6.5±1.2, 2.4±1.3, 6.2±1.2 respectively, P<0.05). Levels of IFN-γ, IL-10, IL-12, IL-21 and ANA in the experimental group were significantly lower than those in the negative control group (P< 0.05), but level of CCL2 was higher than the negative control group (P<0.05). Difference of OAZ mRNA expression levels (△△Ct) between the experimental group and the negative control group was negatively correlated with changes of ANA, IL-21 levels, but positively correlated with changes of Th1/Th2, CCL2. Conclusion OAZ siRNA can effectively reduce the expression of genes involved in the OAZ signaling pathway in SLE. OAZ may lead to abnormal production of ANA via regulating Id genes and cytokines.

Objective To explore the expression levels of interferon-inducible genes in patients with systemic lupus erythematosus ( SLE) , and to validate these gene expressions as potential biomarkers for the differentiation of disease flare and infection.Methods Peripheral blood was obtained from 48 SLE, 16 rheumatoid arthritis ( RA) patients and 26 normal controls, and total RNA was extracted and reverse transcribed into complementary DNA.Real-time PCR technique was used to determine the gene expressions of MX1, OASL,OAS1, ISG15 and LY6E at transcription level.Univariate logistic regression analysis and multivariate conditional logistic regression model were applied to analyze 5 related factors for infection or activity.Results ( 1 ) The expression levels of MX1, OASL, 0AS1, ISG15, and LY6E mRNA in SLE patients were significantly increased as compared with normal controls ( P all < 0.01 ) , while the expression levels of OASL,OAS1 ,ISG15 and LY6E mRNA in SLE patients were also higher than those in RA patients (P all <0.05 ).(2)There were no significant difference between male and female patients of the 5 gene expression in SLE patients.(3) By logistic regression analysis, ISG15 and LY6E were independent risk factors for active SLE patients (P <0.01) , OASL expression was an independent risk factor for SLE patients with infection ( P = 0.003 ).Conclusion All the 5 interferon inducible genes are highly expressed in SLE patients, in which ISG15 and LY6E are independently associated with disease flare, while OASL may be helpful for the evaluation of infection in SLE patients.

Objective To investigate the effects of intrathecal (IT) dexmedetomidine on analgesia and neurotoxicity produced by ropivacaine spinal block .Methods Male SD rats weighing 250-300 g were used in this study. The animals were anesthetized with intraperitoneal 10% chloral hydrate 300 mg/kg. IT catheter was placed according to the technique described by Yaksh and Rudy. The tip of the IT catheter was positioned at lumbar region. Thirty-six SD rats in which IT catheter was successfully placed without complication were randomly allocated into 6 groups (n = 6 each): group Ⅰ received normal saline IT (group C); group Ⅱ received 0.5% ropivacaine 20 μl IT (group R); group Ⅲ received dexmedetomidine 3 μg/kg IT (group D ); group Ⅳ, Ⅴ , Ⅵ received 0.5% ropivacaine 20 μl + dexmedetomidine 1, 2 and 3 μg/kg IT respectively (group DR1, DR2, DR3). Tail-flick test, paw withdrawal threshold to yon frey stimuli and incline plate test were performed at 5, 30, 60, 120 and 240 min after IT drug administration. Two weeks later, the animals were sacrificed and the lumbar segment of the spinal cord was removed for microscopic examination. Results The duration of spinal block was significantly longer and the effect stronger in group DR1, DR2 and DR3 than in group R. Electron microscope showed that the injury to the myelin sheath of axon was the most severe in group DR3. Little or no damage to the axon was found in the other 5 groups (pathological score = 0). Conclusion Dexmedetomidine IT can enhance spinal block produced by 0.5 % ropivacaine, and there is celling effect.

Objective To investigate the in vivo effects of allogeneic mesenchymal stem cells transplantation (MSCT) on OAZ signaling pathway in patients with systemic lupus erythematosus (SLE).Methods Isolated and expand human MSCs from bone marrow cells or umbilical cord of healthy donors were infused into SLE patients. Peripheral blood cells were collected from 10 pre-MSCT patients as well as 1 week and 4 week post-MSCT, and RNA was extracted and reverse transcripted to cDNA. mRNA expression levels of OAZ and Id1-3 were measured by using real-time PCR. Serum levels of IL-10, IL-12, IL-21, CCL2 and ANA were tested by ELISA. Relationships of the gene expression levels with levels of cytokines and ANA were analyzed. Results mRNA expression levels of OAZ, Id1 and Id3 gene in patients with SLE were significantly decreased at week 1(△C:12.4±1.1, 9.7±1.9, 9.7±1.9, 2.1±1.0) and at week 4 (△Ct:13.3±1.2, 10.4±1.5,10.8±1.2, 2.1±1.2) after MSCT when compared to those of the pre-MSCT (△Ct:11.0±0.9, 7.4±2.1, 7.8±2.1, 0.1±1.5 respectively, P all＜0.05). Levels of IL-10, IL-21 and ANA were significantly lower 4 week after MSCT than those before (P＜0.05); while level of CCL2 was higher than pre-MSCT (P＜0.05). Cytokines and ANA levels 1 week after MSCT were not differentially changed comparing to those of the pre-MSCT. Alteration of OAZ mRNA expression levels pre- and post-MSCT were negatively correlated with changes of ANA, IL-21levels and positively correlated with changes of IL-12/IL-10 and CCL2 levels. Conclusions The expression of genes involving in the OAZ signaling pathway is effectively reduced along with the alteration of several cytokines and ANA after allogeneic MSCT in SLE patients. OAZ signaling pathway may play an important role in MSCT treatment for SLE.

Objective:To explore the efficacy of group cognitive-behavioral therapy (GCBT) to generalized anxiety disorder (GAD).Methods:In this randomized controlled trial,the control group (n =23) and the intervention group (n =33) were included,all of the participants received duloxetine (30-120 mg/d) as pharmacotherapy.The intervention group received 8 group cognitive-behavioral therapy sessions weekly,90 minutes for each time.Assessments were conducted with the Hamilton Anxiety Scale (HAMA),Hamilton Depression Scale (HMAD) and Clinical Global Impression (CGI) at baseline,mid-treatmentand post-treatment.CGI included three factors,the severity of illness (SI),the globalimprovement (GI) and the efficacy index (EI).Results:The repeated measures analysis of variance of HAMA showed that,there were statistical significance on the HAMA for interaction between measure time and group processing (F =4.35,P ＜ 0.05).Compared with the control group,the intervention group got higher decreased scores of HAMA at the 4th week and 8th week,and higher prevalence of being cured and efficient at the 4th week.At the 8th week,the decreased scores of HMAD were higher in the intervention group than in the control group,and the scores of CGI-SI and the CGI-IE were lower in the intervention group.Conclusion:It suggests that group cognitive-behavioral therapy combined with pharmacotherapy could be earlier to be effective,and the symptoms of anxiety,depression and the state of illness could be improved more significantly compared with pharmacotherapy alone.

Objective To study the role of the expression levels of 5 type Ⅰ interferon (IFN)-inducible genes (LY6E, OAS1, OASL, MX1, and ISG15) in the diagnosis and disease activity evaluation of systemic lupus erythematosus (SLE). Methods Peripheral blood was obtained from 68 SLE patients, 50 patients with other connective tissue diseases and 26 normal controls, and total RNA was extracted and reverse transcribed into complementary DNA. Real-time PCR technique was used to determine gene expressions at transcription level. An IFN score for each individual was calculated according to the expression of 5 1FN genes. Comparisons of gene expression and IFN score were made among groups. The genes expression levels in patients with SLE were analyzed using receiver operative characteristic curve. The association between IFN scores and disease activity, as assessed by the SLEDAI scores and 24 h proteinuria, was analyzed using Spearman correlation analyses. Results ① The expression levels of MX1, OASL, OAS1, ISG15 and LY6E mRNA in SLE patients were significantly increased as compared with normal controls and disease controls (P all＜0.01 ).② IFN scores in SLE patients (17.9±29.1) were significantly increased as compared with normal controls (0±3.3)and disease controls (3.0±8.1) (P all＜0.01 ). ③ IFN scores area under the ROC curve (AUCROC) was 0.846. When The IFN scores reached 2.56, its sensitivity and specificity for the diagnosis of SLE were 93.1%and 78.3%, respectively. ④ Levels of IFN score was positively correlated with SLEDAI scores (r=0.256,P＜0.05) and 24 h proteinuria (r=0.337, P＜0.05). Conclusion The 5 IFN-inducible genes are highly expressed in SLE patients. IFN score level is valuable for the diagnosis of SLE and a high IFN score is usually associated with an elevated disease activity.

Objective To further investigate clinical manifestations and management for thallium poisoning. Methods Clinical data of 6 patients who were hospitalized in Union Hospital of Tongji Medical College in May 2008 with diagnosis of acute or chronic thallium poisoning,were retrospectively analyzed.Results Six patients (4 male and 2 female) ,aged from 12 to 50,came from one family (two sisters with their husbands and sons). Five of them (3 acute and 2 chronic,for the second time in half a year,thallium poisoning) initiated with peripheral neuritis,represented with severe burning pain,numbness,paresthesia in the lower limbs,accompanied with or without gastrointestinal symptoms. A 12 year-old boy with obviously elevated urinary thallium concentration was asymptomatic. Blood and urinary thallium concentrations of the patients were determined by atomic absorption spectrophotometry and were all significantly elevated.Treatment was initiated using potassium supplementation,diuresis,oral laxatives,Prussian blue and intramuscular injection of dimercaptopropansulfonate sodium.Meanwhile two of them were treated with hemoperfusion. Finally,two of them recovered,another two were transferred to a specialized hospital for continuous treatment,and the rest two deteriorated rapidly with occurrence of unconsciousness and died of multiple organ failure. Conclusions The main clinical manifestations of thallium poisoning are multiple peripheral neuritis,gastrointestinal symptoms and dermatological changes. In order to avoid missed diagnosis and misdiagnosis,a high suspicion should be arose for thallium poisoning when a patient suffering from the above symptoms.Prussian blue was considered traditionally as an effective therapeutic strategy for the condition,and hemoperfusion may be a more effective treatment for acute thallium poisoning.