OBJECTIVETo explore the effect of Qiling Decoction (QD) combined highly active antiretroviral treatment (HAART) on expression levels of peripheral blood Th17 and Treg cells in HIV/AIDS patients.

METHODSTotally 55 HIV/AIDS patients were randomly assigned to the treatment group (28 cases) and the combination group (27 cases). Besides, 21 HIV negative patients were recruited as the healthy control group. Those in the treatment group received HARRT alone, while those in the combination group received HAART combined QD. The observation lasted for 24 weeks. Meanwhile, according to peripheral blood CD4+ T cell counts before treatment, HIV/AIDS patients were assigned to three subgroups. For patients in subgroup 1, 1 cells/microL < CD4+ T cell counts < or = 100 cells/microL; For patients in subgroup 2, 101 cells/microL < CD4+ T cell counts < or = 200 cells/lL; For patients in subgroup 3, 201 cells/microL < CD4+ T cell counts < or = 350 cells/microL. Expression of peripheral blood Th17 and Treg cells, and number of CD4+ T cell counts were detected using flow cytometry (FCM)in HIV/AIDS patients at the pre-treatment baseline, week 4, 12, and 24, as well as those in the healthy control group.

RESULTSCompared with the healthy control group, CD4+ T cell counts and the baseline expression level of Th17 cells in the peripheral blood of HIV/AIDS patients significantly decreased, the expression level of Treg cells significantly increased P < 0.01). Compared with before treatment in the same group, CD4+ T cell counts all increased at week 4, 12, and 24 in the two treatment groups, showing statistical difference (P < 0.05, P < 0.01). There was no statistical difference in the effective rate at various CD4+ T cell levels between the two groups (P > 0.05). There was no statistical difference in expression levels of Th17 and Treg cells between the combination group and the treatment group at any time point (all P >0.05). The Th17/Treg ration significantly increased in the combination group after 24 weeks of treatment, showing statistical difference when compared with the treatment group (U = 2.135, P = 0.038).

CONCLUSIONQD could improve the immune balance of Th17/Treg cells, which might be one of its mechanisms for improving HIV/AIDS patients' immunity.

Acquired Immunodeficiency Syndrome ; drug therapy ; immunology ; Adult ; Antiretroviral Therapy, Highly Active ; CD4 Lymphocyte Count ; Case-Control Studies ; Drugs, Chinese Herbal ; therapeutic use ; Female ; HIV Infections ; drug therapy ; immunology ; Humans ; Male ; Middle Aged ; Phytotherapy ; T-Lymphocytes, Regulatory ; cytology ; Th17 Cells ; cytology

AIM: To identify the novel nuclear export signal by analyzing the DNA sequences and detecting the cell localization of different adenovirus ElA - associated protein BS69 isoforms. METHODS:BS69 DNA sequences in Emsebl database were blasted and the sequence of amino acids was aligned with the typical nuclear export signal. Different BS69 isoform fragments were cloned into pcDNA3.1 vector and transfected into Cos7 cells. The BS69 localization was observed by immunostaining and the function was verified by Western blotting. RESULTS: A novel nuclear export signal was found in BS69 isoform 2 but not in isoform 1.The isoform 2 was localized in cytoplasm and isoform 1 in nucleus, which was also consistent with the DNA sequence. The isoform 2 was involved in LMP1 - activated JNK phosphorylation whereas the isoform 1 was not. CONCLUSION: Different BS69 isoforms have different cellular localization. BS69 isoform 2 is localized in cytoplasm, interacting with Epstein - Barr virus latent membrane protein 1 and may be involved in nasopharyngeal carcinoma development.However, the isoform 1 is localized in nucleus and plays important roles in transcription.

Objective To probe into the clinical curative effect of laparoscopic high ligation of spermatic vein in the treatment of critical varicocele.Methods The clinical data of the 26 eases of laparoscopic high ligation of apermatic vein in the treatment of critical varicocde were reviewed and analyzed in the last two years in this hospi- tal.Results All the 26 cases had been conducted smoothly with the operation time 25～50min,an average of(28?3)min.After 3～24 months being followed-up,all the symptoms and signs disappeared with no relapse and testicle a- trophy.Eight wives of the patients who had been operated on got pregnant.Conclusion With soon recovery and small wound,it was safe to adopt laparoscopic high ligation of spermatic vein in the treatment of critical varicocele, especially for critical two-sided varicocde.

Objective To investigate the effect of green light laser in complex posterior urethral stricture after surgical treatment of benign prostatic hyperplasia (BPH).Methods Green light laser was applied in treating 20 cases of complex iatrogenic posterior urethral stricture.Of these cases,12 had false passages,5 had more than 2 strictures and 5 had concurrently urethratresia.The scar tissues were transure- thrally vaporized and resected.The in-dwelling urethral catheter time was 1-2 months after operation. Results All the patients were initially cured without serious complications.The mean operative time was 39 rain (range,30-65 min).During the follow-up of 2-10 months,1 case had mild incontinence:another case (Q_(max)＜9ml/s 2 weeks after surgery) got satisfactory results(Q_(max)＞15ml/s)after the scheduled urethral dilatation.The other 18 cases were treated successfully and voided fluently with postoperative Q_(max)＞15ml/s in all.Conclusions It is suggested that transurethral green light laser procedure is not only safe and ef- fective,but also simple and minimally iuvasive for complex posterior urethral stricture following surgical treat- ment of BPH.

ObjectiveTo make a comparison between microsurgical lumbar discectomy(MSLD) and microendoscopic discectomy(MED) in terms of methods,feathers,and effectiveness for lumbar disc herniation (LDH).MethodsA prospective clinical review was conducted.From January 2006 to December 2009,900patients with single segment lumber disc herniation were randomly divided into the MSLD group and the MED group.There were 450 patients in each group.Comparison would be made in terms of the length of skin incision,the operative time,amount of bleeding,incidence of complication,duration of hospitalization,the time of recovery to ordinary work or life,pre- and post-operative assessment based on the criteria of visual analogue scales (VAS),and the Oswestry disability index(ODI).ResultsThe mean lengths of skin incision were (3.8±1.1) cm and (2.4±0.7) cm for MSLD and MED respectively; the operative time were (51.0±14.2) min and (62.0±16.3) min; and the blood loss were (60±35) ml and (106±43) ml,which showed a significant difference(P＜0.05).There was no significant differences in terms of the hospitalization time and the time of recovery to ordinary work or life between the two groups (P＞0.05).The results of VAS and ODI of two groups also showed no significant difference at final follow-up (P＞0.05).As for the complications,the incidence of dural tear,acute hematomas of sacrospinalis,nerve roots and cauda equina injury and recurrence in MSLD group were much lower than that of MED group (P＜0.01).There was no incidence of wrong segment,greater artery injury,or postoperative infection in each group.ConclusionThe clinical effects of both minimal invasive methods are satisfactory.However,MSLD has advantages of simpler maneuvering,shorter learning curve,and less complication than MED.

OBJECTIVETo explore operative clinical outcomes of proximal humeral fracture with rotator cuff tear in elderly patients.

METHODSFrom March 2010 to August 2014,54 elderly patients with proximal humeral fractures with rotator cuff tear were performed operation, including 30 males and 24 females aged from 68 to 83 years old with an average of 71.5 years old. Thirty patients were caused by falling down, 24 cases were caused by traffic accident. According to Neer classification, 3 cases were part I, 11 cases were part II, 21 cases were part III and 19 cases were part IV. All patients were operated with open reduction and plate internal fixation, 46 cases suffered from rotator cuff tear and carried out repair of rotator cuff; 8 cases were not suffered from rotator cuff tear. Postoperative Neer evaluation of shoulder's function were used to assess clinical results.

RESULTSForty-six patients with rotator cuff tear were followed up from 8 to 21 months with an average of 11 months. All fractures were obtained bone union. No incision infection, axillary nerve injury,loosening screw, plate breakage, shoulder joint dislocation and humeral head osteonecrosis were occurred. According to Neer evaluation of shoulder's function, total score was 88.60 ± 5.12, and 30 cases got excellent results, 7 cases good, 7 cases moderate and 2 cases poor.

CONCLUSIONFor osteoporotic proximal humeral fractures with rotator cuff tear in elderly patients' plate with rivet repair at stage I is an effective stable method, and provide advantages for earlier exercise of shoulder joint, then receive good clinical effects in further.

Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Rotator Cuff Injuries ; Shoulder Fractures ; diagnosis ; surgery

OBJECTIVETo evaluate the efficacy of percutaneous laser and O2-O3 mixture in treating chronic discogenic low back pain.

METHODSThere were 48 patients included 32 male and 16 female with the mean age of 43.5 years (range, from 21 to 66 years). The duration of symptoms was more than 6 months, all patients were treated with percutaneous laser and O2-O3 mixture under TV monitoring.

RESULTSForty-eight patients followed-up showed no severe complications. At 1 week follow up, 8 cases were evaluated as excellent, 28 as good, 8 as fair and 4 as poor by Macnab standard. The excellent and good rate reached 75%. At 3 months follow up, 17 cases were evaluated as excellent, 23 as good, 6 as fair and 2 as poor with the excellent and good rate of 83.3%. At 6 months follow up, 20 cases were evaluated as excellent, 22 as good, 4 as fair and 2 as poor with a total effective rate of 87.5%. At 12 months follow up, 21 cases were evaluated as excellent, 22 as good, 4 as fair and 1 as poor with a total effective rate of 89.6%.

CONCLUSIONCombined percutaneous laser and O3-O3 mixture is an effective and safe method in treating discogenic low back pain.

Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Laser Therapy ; Low Back Pain ; radiotherapy ; Male ; Middle Aged ; Ozone ; therapeutic use ; Treatment Outcome

Objective To investigate the effect of electroacupuncture on hypothalamic insulin receptor substrate 1 (IRS-1) in a rat model of type 2 diabetes mellitus (T2DM). Methods Sixty Wistar rats were randomized to a normal group (15 rats) and an observation group (45 rats). In the observation group, a rat model of T2DM was made by high-energy diet induction. After the model was successfully made 8 weeks later, the observation group was randomized to model making, treatment and blocker groups, 15 rats each. The treatment group received electroacupuncture and the blocker group, electroacupuncture plus intraventricular perfusion of phosphatidylinositol 3-hydroxyl kinase (PI3K) blocker. After 8 weeks of treatment, fasting plasma glucose (FPG) was measured using a glucometer, fasting insulin (Fins) was determined by ELISA, insulin resistance index (IRI) was calculated and IRS-1 expression was examined by SABC immunohistochemistry assay in every group of rats. Results FPG and Fins increased significantly (both P<0.01) and IRI and IRS-1 expression decreased significantly (P<0.01) in the model making group compared with the normal group. FPG and Fins decreased significantly (both P<0.01) and IRI and IRS-1 expression increased significantly (P<0.01) in the treatment group compared with the model making group. FPG and Fins decreased significantly (P<0.05, P<0.01) and IRI and IRS-1 expression increased significantly (P<0.01) in the treatment group compared with the blocker group. Conclusion Electroacupuncture can improve FPG, Fins and insulin sensitivity by regulating hypothalamic IRS-1 expression in T2DM rats.

Objective To detect the feasibility of magnetically labeled swine bone marrow mesenehymal stem cells(MSCs)with SHU 555A combined with poly-L-arginine(PLL),under MR imaging in vitro and in vivo.Methods Swine mesenehymal stem cells were isolated and culture-expanded 3 passages in vitro,then magnetically labeled by incubation with SHU 555A(25?g Fe/ml,Resovist,Schering)for 24 hours with 750 ng/mL poly-L-lysine(PLL;average MW_275 kDa)added 1 hour before incubation.Cellular iron incorporation and detention at 0 d,4 d,8 d,12 d,16 d,20 d after labeling was qualitatively assessed using Prussian blue and quantified at atomic absorption spectrometry.Cell viability was assessed by trypan-blue exclusion test.Cell suspensions underwent MR imaging with T_1-and T_2-weighted spin-echo and fast field-echo sequences on a clinical 1.5 T MR system.At last,1?10~6 SHU 555A labeled and unlabeled MSCs were transextracardially implanted into the infracted and normal myocardium approximately 2 week following the ligation of left anterior descending coronary artery in 1 swine respectively,and finally performed 1.5-T MRI within 1 week after infarction.Results①Intracytoplasmic particles stained with Prussian blue stain were detected for all cells with mean cellular iron content of(13.13?2.30)pg per cell.With division of stem cells, the stained particles decreased gradually with iron content(0.68?0.20)pg per cell.at 16 days after labeling, approximately to the prelabeled baseline values.(0.21?0.06)pg per cell(P＞0.05).The viability of the labeled cells at various time points were not significantly different with that of nonlabeled cells(P＞0.05).②MR images showed signal intensity changed most obviouly in T2*WI in vitro.The percentage change of signal intensity increased with increasing cell numbers,and decreased with the time.As few as 5?10~4-1?10~5 cells could be detected by using this approach.③Two injected sites containing MR-MSCs were detected in vivo,presentingas low signal intensity areas with the T_2*WI scanning sequence.Conclusion Swine bone marrow MSCs can be labeled with SHU555A-PLL and depicted with a standard 1.5-T MR imager in vitro and in vivo.(J lntervent Radiol,2007,16:115-121)