Objective:To observe the clinical features of primary Sjgren syndrome(pSS) in young people(≤34 years).Methods: The data of 232 patients with pSS who were in hospital from 2004 to 2008 were analysed in a prospective study.Results: A total of 23.7%(55/232)patients' symptoms came on in youth(≤34 years),who were all females,mean age was(27.6?6.2) years.The other 177 patients' symptoms came on when they were more than 34 years old.In young group,32.73%(18/55) patients' first symptoms were xerostomia and/or keratoconjunctivitis sicca,the other 67.27%(37/55)came on without xerostomia and keratoconjunctivitis sicca,while in the middle-aged and aged group,59.32%(105/177)patients' first symptoms were xerostomia and/or keratoconjunctivitis sicca,40.67%(72/177)without xerostomia and keratoconjunctivitis sicca.There was significant difference(P=0.001).The duration from first symptom to first diagnosis of pSS in the young group was(93?107) months,which was significantly longer than those of the middle-aged and aged group [(45?59) months,P=0.001].The systemic damage of the young group was 61.8%(34/55),which was significantly greater than 41.24%(73/177)in the middle-aged and aged group(P=0.026).Conclusion: Primary Sjgren syndrome in young people is not rare,and about 2/3 of them come on without xerostomia and/or keratoconjunctivitis sicca.Not only the duration from first symptom to first diagnosis of pSS in the young group is longer,but also the systemic damage of the young group is greater than those of the middle-aged and aged group.These findings should alert the clinician to make the possible diagnosis of pSS in young patients.

Objective To investigate clinical characteristic of primary Sjogren's syndrome(pSS) with initial manifestations in the extra-gland organs. Methods Clinical data, including symptoms, laboratory parameters and complications of 85 pSS patients with initial manifestations of extra-gland organs hospitalized at the People's Hospital of Peking University during 2003 to 2006 were collected and analyzed retrospectively, as compared to those of pSS with xerophthalmia or xerostomia as initial ones. Results Mean time interval from onset to diagnosis in these patients with initial manifestations involved in the extra-gland organs was 94.5 months, higher than that in those with xerophthalmia or xerostomia as initial ones. Arthritis was manifested initially in 38 of the 85 patients (44.7 percent), peripheral leukopenia in 16 (18.8 percent), thrombocytopenia in nine (10.6 percent) and abnormal liver function in 13 (15.3 percent), respectively. Percentage of serum positive autoantibedies was higher in the patients with initial manifestation of the extra-gland organs than that in those with xerophthalmia or xerostomia as initial ones. Conclusions Initial manifestation of primary Sjogren's syndrome varies, and some patients can be initially involved in their extra-gland organs, with more proportion of arthritis than of other symptoms, and xerophthalmia or xerestomia could appear in them during the course of disease. And, xerophthalmia or xerostomia would not appear even as pSS was diagnosed in some other pSS patients. More attention should be paid to these clinical characteristics mentioned above in practice to avoid misdiagnosis.

Objective To analyse the clinical features and risk factors of interstitial lung disease in primary SjSgren's syndrome (pSS).Methods A retrospective study was employed.All 130 pSS patients who were hospitalized during 2004 to 2006 were enrolled into this study.Thirty-seven clinical and laboratory variables were used as the research factors and interstitial lung involvement as the related factor.The data were analyzed with the Logistic regression model.Results of 130 patients,22(16.9%) had interstitial lung involvement.Twelve patients were asymptomic when pulmonary involvement was detected.Variables in the univariate analysis which were significantly associated with lung fibrosis were age,exocrine glands(including parotid,sublingual gland and submandibular gland) swelling,oral ulceration and fever.Positive rate of antiU1RNP antibody in group of lung damage was significantly higher than non-lung damage group [5/22(22.7%)vs 6/108 (5.6%),P=0.021].In the Logistic regression model.variables which were significantly associated with pulmonary involvement were exocrine glands swelling (OR=3.739,95%CI 1.069～16.079,P＜0.05).oral ulceration (OR=3.739,95%CI 1.069～16.079,P＜0.05)and fever (OR=3.067,95%CI 1.198～20.067,P＜0.05).Conclusions This study indicates that some of the pulmonary damages of pSS are subclinical.Exocrine glands swelling,oral ulceration and fever are the risk factors for interstitial pulmonary involvements in pSS.

Objective To examine the dissimulation in memory test by event-related potentials (ERP).Methods Recording the ERP of 20 students in the choosing tasks according to Binomial Forced-Choice Digit Memory Test (BFMDT) in three situations including reality,dissimulation and forced wrong choose. Results The reaction time was lengthened gradually by the situation of reality ( 681 ± 21 ) ms, dissimulation ( 741 ± 25 ) ms and forced wrong choose( 946 ± 31 ) ms (F= 115.73, P = 0.000). The main components in ERP waveforms, N2 ( 180 ～184 ms) and P2 ( 214 ～ 243 ms) had higher amplitudes in situations of dissimulation and forced wrong choose than that of reality. The amplitude of N2 showed significant difference in three groups(F=6. 896, P＜0.01 ). The amplitudes were increased gradually by the situation with reality( -0.376 ± 0.58 )μV, dissimulation( 0. 86 ± 0.71 )μV and forced wrong choose( 1.77 ±0.82)μV. Conclusion ERP may be an electrophysiological index of the intention of dissimulation in memory test.

Epilepsy is one of the most common diseases of the central nervous system, affecting tens of millions of people around the world. Most of clinically used antiepileptic drugs are based on ion mechanism to antagonize epileptic seizures, targeted to various ion channels or ion channel receptors. However, with the in-depth research on the pathogenesis of epilepsy, the non-ionic antiepileptic mechanism has increasingly become the key to the control of various intractable epilepsy, and the relevant drugs have gradually achieved clinical transformation. In this paper, non-ionic antiepileptic mechanisms are classified to clinical and preclinical types according to whether clinical transformation has been achieved. The application of non-ionic antiepileptic drugs in refractory epilepsy was mainly introduced, including everolimus, cannabidiol, fenfluramine, padsevonil, medium chain triglyceride modified ketogenic diet, and anakinra. Additionally, some preclinical non-ionic antiepileptic mechanisms such as prostaglandin, adenosine, metabolic glutamate receptor and mitochondrial mechanism are briefly introduced. The authors believe that the current stage of ionic antiepileptic drugs research has reached the bottleneck of transformation and it is difficult to achieve a major breakthrough in the mechanism, but there are broader research prospects in non-ionic antiepileptic mechanisms because a large number of them have not yet been clinically transformed. From a deeper perspective, some non-ionic antiepileptic mechanisms may have been involved in the fundamental mechanism of epileptogenesis, and they may be the prospect for the future treatment of refractory epilepsy.

Objective To explore the effects of different doses of 5,2′,4′-trihydroxy-6,7,5′-trimethoxyflavone nanoparticles (TTF1-NP)on the apoptosis of human hepatoma cells and human normal hepatocytes,and to explore their mechanisms through endoplasmic reticulum stress (ERS)-meditated apoptosis pathway. Methods The human hepatoma cell lines (HepG2,Hep3B and PLC/PRF/5)and human hepatocytes (Chang Liver)were used as cell model, and divided into vehicle, 5-Fu and TTF1-NP treated groups with the concentrations of 50, 100 and 200 μmol·L-1 respectively. The inhibitory effects of TTF1-NP on the cell growth were assessed using MTT assay and the best inhibitory one (HepG-2)was selected as the main research cell lines.Flow cytometry was used to detect the TTF1-NP-induced apoptosis;Western blotting and immunocytochemistry were used to determine the expressions of ERS key proteins.Finally,the expressions of key proteins were detected by Western blotting after using the ERS inhibitor 4-PBA.Results Compared with vehicle group,the inhibitory rates of growth of 4 kinds of human hepatoma cells in different concentrations of TTF1-NP groups were increased (P <0.05 or P <0.01);moreover,the inhibitory effects of TTF1-NP were in a time-and dose-dependent manner.Compared with vehicle group,the apoptotic rates of the cells in TTF1-NP groups were increased in a dose-dependent manner (P <0.05 or P < 0.01 );the expression levels of ERS key proteins GRP78 and caspase-4 were increased with the increasing of the concentration of TTF1-NP (P < 0.05 or P < 0.01).The expression levels of ERS key proteins GRP78 and caspase-4 induced by TTF1-NP were inhibited by ERS inhibitor 4-PBA (P < 0.05 or P < 0.01 ). Conclusion TTF1-NP can induce the apoptosis of HepG2 cells;ERS pathway plays a central role in TTF1-NP-induced apoptosis of HepG-2 cells.

To study the effect of Sorbaria Sorbifolia extract on anti-oxidative activities in rats with precancerosis induced by diethylnitrosamine.

OBJECTIVE: To study the effect of Boschniakia rossica extract on free radicals in the brain of D-galactose induced senile rats. METHODS: Sixty Wistar rats were randomly divided into normal group, model group (48 mg.kg(-1).d(-1) D-galactose, SC), Boschniakia rossica group (100, 150, 200 mg/kg ig and 48 mg.kg(-1).d(-1) D-galactose, SC). After 40 days, the activities of SOD, MAO and the content of MDA were measured with colorimetric method, and the histological changes were synchronously observed by electronic microscope. RESULTS: Boschniakia rossica extract significantly increased the SOD activity, decreased the MDA content, and inhibited the MAO activity in the brain tissue. It was observed under microscope that Boschniakia rossica extract could retrieve the degeneration of mitochondrion. CONCLUSION: Boschniakia rossica extract can clear the free radicals for D-galactose induced senile rats.

Disorders of sex development (DSD) is a complex disease that involves multiple traditional professional disciplines.Multidisciplinary team(MDT) mode is a particularly advantageous treatment mode that has been developed in recent years for the diagnosis and treatment of complex diseases.This article is based on the analysis of research progress at home and abroad about DSD and MDT,and the latest advances application of MDT treatment try for DSD,probe into how to establish a DSD-MDT treatment mode in theory preliminarily.

Objective To evaluate the efficacy of double filtration plasmapheresis (DFPP) combined with immunosuppressive agents (leflunomide plus methotrexate) on synovitis in magnetic resonance imaging (MRI) in patients with high active rheumatoid arthritis (RA). Methods Fifty eight patients with RA (disease duration 6 months to 12 years) were randomly divided. Thirty-one were randomized to the treatment group and 27 were randomized to the control group. All patients received leflunomide 10 mg, two times daily; plus methotrexate 15 mg orally once weekly. DFPP was performed in the treatment group once 1-2 weeks for 3-4 sessions. Control patients did not receive DFPP. All patients underwent contrast-enhanced MRI of the right wrist at the baseline and 6 months, 1 month in the treatment group. The signs including synovitis pannus, bone marrow edema and effusion were observed on MRI. The scoring of synovial hypertrophy, pannus, bone marrow edema were measured according to the outcome measures in RA MRI scoring system. Comparisons between groups were performed with paired-samples t test and independent-sample t test. Results The MRI synovitis score, MRI pannus score and MRI bone marrow edema in the treatment group was (1.4±1.6), (0.13± 0.35) and (5±4) respectively,so was significantly lower than that of the control group [respectively for (7.9± 1.3), (2.76±0.43), (16±12),P<0.01]. 53% of the treatment group satisfied both the disease activity score 28-joint assessment and MRI synovitis assessment (no enhancement of synovium or pannus, no effusion), but none in the control group (P<0.01). Significant changes at 1 month was observed in DAS28 and HAQ scores (P<0.01), but not in the MRI synovitis score, MRI pannus score, MRI bone marrow edema score and effusion in the treatment group (P>0.05). Conclusion DFPP combined with immunosuppressive agents can significantly improve synovitis in MRI in patients with high active RA. Improvement of the signs of MRI is later than that in the clinic. So imaging assessment may be necessary for accurate evaluation of disease status and selection of therapy.