ObjectiveTo observe the effect of mycophenolate mofetil(MMF) on systolic pulmonary arterial pressure (SPAP), right ventricle index (RVI), cytokines, receptors of pulmonary artery hypertension (PAH) rat models. MethodsThe rat models of monocrotaline (MCT)-PAH were developed. Thinty-two Sprague-Dawley male rats were divided randomly into four groups: the control group, the MCT, the MCT +low-dose MMF (20 mg·kg-1·d-1, MMF 20) and the MCT + high-dose MMF(40 mg·kg-1·d-1, MMF 40).There were eight rats in each group. SPAP, RVI, cytokines and receptor in the serum and lung tissue were measured in all rats. Comparisons between multiple groups were performed with q test and rank sum test.Results① Low-dose and high-dose MMF group were compared with the MCT group, SPAP[(40±13),(53±10) vs (68±10) mm Hg]and RVI(0.36±0.06, 0.38±0.03 vs 0.44±0.05) were reduced and showed statistically significant difference respectively(P＜0.05). (②) Compared with the MCT group, basic fibroblast growth factor(bFGF) of serum in both low-dose and high-dose MMF group were reduced and showed statistical difference respectively[(2.3±1.9), (2.7:t±1.3) vs (6.9±5.4) pg/ml, P＜0.05]. ③ Low-dose and high-dose MMF group were compared with the MCT group and showed that MA was decreased and the musculization of arterial wall was improved. ConclusionMMF can reduce SASP, RVI, number of MA. The inhibitory effect of MMF in PAH is possibly by inhibiting cytokines and receptors.

Objective The aim of this study was to detect the serum 25-hydroxyvitamin D (25-OH-D)and anti-vitamin D levels in new cases of systemic lupus erythematosus (SLE),and to investigate their clinical significance.Methods Fifty patients who fulfilled the ACR criteria for the classification of SLE and 36 healthy donors were included.Enzyme-linked immunosorbent assay was performed for serum 25 [OH] D and anti-vitamin D level measurement.Statistical methods used were t-test and Pearson's correalation analysis.Results The serum 25-OH-D level in SLE was (13±6) ng/ml,and the level in healthy donors wase (17±8)ng/ml,P =0.007); the difference was statistically significant.A significant negative correlation was demonstrated between the serum level of vitamin D and the 24 h urinary protein excretion (r=-0.314,P＜0.01),and the level of serum creatinine (r=-0.322,P＜0.01).Anti-vitamin D antibody was detected in 6 of 50 patients with SLE,in 10 of 36 sera from healthy donors.There was no difference of 25-OH-D level between the anti-vitamin D antibody positive group and anti-vitamin D antibodu negative group [(13±6) and (14±6) ng/ml in the SLE group; (17±6) and (18±9) ng/ml in the healthy control group].Conclusion The serum 25-OH-D level in SLE is low; however,it is not correlated with Anti-vitamin D antibody,but is correlated with renal lesions.So the serum 25-OH-D level may be important in the pathogenesis of SLE.

Objective To study the content of urokinase-type plasminogen activator receptor(uPAR)in the peripheral blood to investigate its value for the invasion metastasis and prognosis in cervical cancer.Methods The plasma level of suPAR in 30 normal women.94 patients with cervieal cancer was measured by using enzyme linked immunosorbent assay(ELISA).Results The mean level of suPAR was(0.5023±0.1724)ng/ml in plasma of 30 normal women,while that in plasma of 94 cervical cancer patients was (1.0433±0.2736)ng/ml.The plasma suPAR level of cervical cancer patients was increased in comparision with that of normal women (P＜0.01).The suPAR level in the cervieal cancer patients did not show a significant correlation with histological classification,histological grade,style of growth and tumor size(P＞0.05),but was related to clinical stage.lymphnode metastasis and depth of invasion (P＜0.05).Conclusion Plasma suPAR would be a more reliable and convenient indicator in monitoring uPA system,and could be widely used as a new tumor marker in clinic.

Objective The objective of this study is to describe the clinical features and outcomes of connective tissue disease (CTD) patients with mycophenolate mofetil (MMF) and with Pneumocystis jirovecii pneumonia (PJP).Methods We retrospectively reviewed the characteristics,clinical features,treatment and outcomes of PJP in patients with CTD.The clinical variables were compared between groups using t-test.Results ① A total of 17 cases were reviewed.② Sixteen patients were treated with glucocorticoids(GCs) plus immunosuppressive drugs.Only one patient had GCs without immunosuppressive drugs.Sixteen patients were with PJP,10 (63％) patients had MMF.③ Ten MMF patients and 7 non-MMF patients had absolute lymphocyte counts with the average being (557±170)/` and (926±162)/μl,respectively (t=-4.481,P＜0.05).④ Six of 17 patients died during the hospitalization.Five patients of 10 patients with MMF died 1 of 7 patients without MMF died.Fifteen of 17 patients were treated by trimethoprim-sulfamethoxazole (TMP-SMX).Conclusion MMF may be risk factors of PJP in CTD.

Objective To investigate the relationship between nucleo-tide-binding domain leucinerich-containing family pyrin domain-containing-3 (NLRP3) and the pathogenesis of arthritis.Methods The collagen-induced arthritis (CIA) mouse were divided into two groups:the model group (CIA,n=16) and the control group (n=8).The arthritis score and imaging evaluation (X-rays,Micro-CT) were performed;Synovial tissue NLRP3 expression were analyzed by immunohistochemical staining.Joint clinical score,radiographic score and joint NLRP3 expression were analyzed suing Pearson correlation analysis.Results The arthritis score (6.0±2.5),imaging score (4.6±0.9) and synovial tissue NLRP3 expression (4.0±2.0) were significantly increased in the CIA mice.The expression of synovial NLRP3 was positively correlated with arthritis clinical and radiographic scores (r=0.792,P＜0.05;r=0.669,P=0.005,respectively).Conclusion Synovial NLRP3 expression level is correlated with the clinical arthritis severity and extent of radiological destructions,suggesting that NLRP3 is involved in the pathogenesis of CIA.

Objective We investigated the effect of VX-765 on collagen induced arthritis (CIA).Methods Twenty-four mice were divided into three groups:the VX-765 prophylaxis group (VX-765),the CIA model group (CIA) and the wild-type control group (Normal).Each group has 8 mice.Mice with CIA were in-tra-peritoneally injected with VX-765 (100 mg/kg,twice a day),mice with CIA and controls were treated with 0.9％ saline.At the end of the study,clinical scores,radiographic scores and histological scores of joints were calculated.Serum cytokine levels including interleukin (IL)-1β,IL-18,IL-33 were assessed by enzyme linked immunosorbent assay (ELISA).The serum cytokines levels between the CIA group and the VX-765 groups were compared using F test.The clinical scores,radiographic scores and pathological scores between the CIA group and the VX-765 group were compared using the Mann-Whitney test.Results The clinical scores of arthritis and the radiographic scores were significantly lower in the VX-765 group (1,1) than the CIA group (6.5,3.5;Q=4.5,2.75,P＜0.05).Compared with the CIA group,the histological analysis (1,5.5;Q=4.75,P=0.000),serum cytokine levels [IL-1β (2.0±1.0) vs (6.9±2.4) pg/ml,IL-18 (75±42) vs (129±48) pg/ml,IL-33 (145.46 vs 287.22) pg/ml] were significantly lower in the VX-765 group (F=27.98,F=17.27,Q=89.72,P＜0.01).Conclusion These findings suggest that caspase-1 is a potential therapeutic target for rheumatoid arthritis.

Objective To detect the quantity of Th17 cells and expressions of related cytokines including interleukin (IL)-17 and IL-22, in peripheral blood and skin lesions of patients with psoriasis vulgaris, and to analyze their correlation with disease severity and clinical course. Methods Peripheral blood was obtained from 44 patients with progressive psoriasis vulgaris and 28 normal human controls. Three-color flow cytometry was carried out to detect the quantity of Th17 cells, and ELISA to examine the levels of serum IL-17 and -22.Skin samples were obtained from 20 patients with psoriasis vulgaris and 8 normal human controls, and a quantum dot-based double labled immumofluorescence method was used to determine the quantity of Th17 cells.Results The percentage of peripheral blood Th17 cells was higher in patients with psoriasis vulgaris than in normal human controls (4.71% ± 2.55% vs. 0.55% ± 0.39%, P ＜ 0.01 ). Elevated expressions of IL-17 and IL-22 were noted in the patients compared with the normal human controls (24.02 ± 12.31 ng/L vs. 7.16 ±4.04 ng/L, P ＜ 0.05; 18.32 ± 8.14 ng/L vs. 6.52 ± 4.15 ng/L, P ＜ 0.01 ). The percentage of peripheral blood Th17 cells and serum levels of IL-17 and IL-22 were positively correlated with psoriasis area and severity index (r= 0.53, 0.47, 0.53, respectively, all P ＜ 0.01 ), but unrelated to the clinical course of psoriasis (r = 0.09,0.03, 0.19, respectively, all P ＞ 0.05). There was an infiltrate of Th17 cells in psoriatic lesions, which was mainly distributed around the blood vessels in superficial dermis, whereas there were only a small number of CD4+ T cells in the normal control skin with the absence of Th17 cells. Conclusions Th17 cells are involved in the development of psoriasis, and Th17 cell-secreted cytokines, such as IL-17 and IL-22, may serve as a new therapeutic target for psoriasis.

Objective To evaluate the significance of suPAR,SCC-Ag in plasma and HPV16,18 in cervical secretion for monitoring pathogenetic condition and prognosis in patients with cervical cancer.Methods 206 cervical cancer patients blood and cervical secretion were collected.Plasma level of suPAR and SCC-Ag were measured by enzyme linked immunosorbent assay (ELISA) in health women and patients with cervical cancer.The expression of HPV16,18 of cervical secretion in control group and patients with cervical cancer were detected by fluorescence quantitative PCR.The correlations of the three indexes were analyzed.Results The plasma level of suPAR and SCC-Ag,the expression of HPV16,18 of cervical secretion in cervical cancer patients were obviously higher than those in health controls with statistical significance ((1.072 5±0.305 2) ng/ml vs (0.501 7±0.179 3) ng/ml,(0.980 6±0.162 7) μg/ml vs (0.261 4± 0.006 3) μg/ml and 53.89 ％ (90/167),46.15 ％ (18/39) vs 6.67 ％ (4/60),P ＜ 0.05).There was a positive correlation between plasma suPAR level and SCC-Ag level in invasive carcinoma of cervix patients (r =0.564,P ＜ 0.05).The plasma level of suPAR between in HPV16,18 positive group and in HPV16,18 negative group did not show difference (P ＞ 0.05).Conclusions In invasive carcinoma of cervix patients,there is a positive correlation between plasma suPAR level and SCC-Ag level.But it's not yet to conclude that plasma suPAR level of cervix invasive carcinoma patients is related to infection of HPV16,18.

Objective To explore the wound healing of semi-toe nail flap donor site after transplantation. Methods To repair small wounds,on 13 toes the first metatarsal dorsal flaps were applied,and on 7 toes the second toe digital flaps were applied.While,to repair large wounds,free flaps were applied,including foot inside flaps on 3 toes,peroneal artery perforator flaps on 5 toes,tarsal lateral artery flaps on 2 toes,and phil bowel artery inside branch flaps on 3 toes.Wounds remaining on semi-toe nail flaps of 7 toes were all covered with fibular island flaps of the first toes. Results Twenty cases were followed up,and the rang between 6 months to 5 years.The nail margin was exposed out of the lateral flaps in 2 cases.The first toes and the second toes appeared nearly normal in the other 18 cases.The flaps appeared smooth,flexible appearance with nice color and no ulceration.Seven cases applied with free flaps recovered protective sensibility with no complaint. Conclusion To cover wounds on semi-toe nail flaps of the first toes and the second toes with flaps is an ideal treatment method.The method of free flap transplantation is superior to vascular pedicle flap graft.

Objective To investigate the effect of vascularized fibula with fibular flap to repair limb bones and soft tissue defects.Methods Transpositional fibulas were used to repair tibiae defects in 4 cases.Free fibular transplantation was used in 6 cases,including folded fibular transplantation in 3 cases distal femur repair in 2 cases,calcaneus repair in I case.Hole fibular transplantation was used in 11 cases to repair tibia radius and metatarsal bones.Semi-fibular transplantation was used to repair metacarpal bone defects in 2 cases.All transplanted bones were together with the flap to repair bones and soft tissue defects.Results Twenty cases were all survived,with bone healing time of 6 to 10 weeks,and weight bearing time of 3 to 6 months,fifteen cases were followed up for 6 months to 4 years,and the results showed that their transplanted bones became thicker,their lower limbs recovered to normal walking,hand grip function recovered,the transplanted flaps were elastic.Conclusion Vascularized fibula and fibular flaps transplantation was an effective way to repair limb bones and soft tissue defects.