The interaction between T cell and osteoclasts is important in osteoimmunology.T-helper cells,which produce interleukin-17,induce the expression of receptor activator of nuclear factor κB ligand in synovial cells.Companied by with inflammatory cytokines,they stimulate the differentiation and activation of osteoclasts.Osteoimmunology helps us understand how antirheumatic drugs work,as well as developing new therapeutic strategies for rheumatic diseases.

In the process of the introduction of classical problem based learning,the combination of PBL teaching method and current teaching method was found to be abstract and difficult to operate. PBL gradual teaching was brought forward through qestionnaires and analysis. Improved PBL teaching is more suitable for clinical teaching of hepatobiliary surgery in China and helping the interns to get good learning habits. Thus ,it is an effective PBL teahcing method of hepatobiliary surgery.

Objective To study the effect of Jade -Screen Powder (JSP)on regulating expression of 5 microRNAs associated with helper T cells in asthmatic mouse model.Methods Forty Balb /c mice were randomly di-vided into 4 groups,1 0 mice for each group,namely normal control,asthma model,JSP treatment and Dexamethasone treatment.The mouse models of allergic inflammation on both upper and lower airways were established by ovalbumin sensitization and challenge.Interleukin(IL)-1 3 and IL -1 7 expressions were detected from lung homogenates by ELISA.Hematoxylin and eosin staining was also performed to observe the pathological changes in the lung tissue.The expressions of miR -1 46a,miR -1 46b,miR -21 0,miR -1 26 and miR -21 a were detected by quantitative real time PCR from splenocytes.Results The lower levels of IL -1 3 [(6.382 ±1 .690)μg/L]and IL -1 7 [(24.21 2 ± 1 .250)μg/L]were found in JSP treatment group compared with those in the asthma model group [(20.1 54 ±7.960)μg/L;(50.31 2 ±5.770)μg/L,rseparately],there was significant difference in IL -1 3 between JSP group and the asthma model group,as well as IL -1 7 (t =3.785,P =0.005;t =9.891 ,P =0.000).Same findings were found in Dexamethasone treated group as well [IL -1 3:(9.366 ±3.460)μg/L,IL -1 7:(29.1 32 ±4.960)μg/L;t =2.779, P =0.024;t =6.225,P =0.000].However,upregulation of miR -21 0 was observed in JSP treatment group (2.052 ± 0.871 )compared with that in the asthma model group (4.034 ±1 .379)(3.95 folds,t =2.71 8,P =0.026).Mean-time,the expression of miR -1 26 in JSP group (4.920 ±0.924)and Dexamethasone group (3.862 ±1 .51 0)in-creased compared with asthma model group (6.024 ±0.447)(2.1 5 folds,t =2.405,P =0.043,and 4.48 folds,t =-3.069,P =0.01 5).Conclusions Th2 and Th1 7 T cells participate in the pathogenesis of asthma and the asthmatic process can be inhibited by JSP.JSP may affect the helper T cells by regulating miR -21 0 and miR -1 26.

Objective To investigate the efficacy of pancreaticoduodenectomy (PD) combined with vascular resection and reconstruction.Methods The clinical data of 56 patients who received PD combined with vascular resection and reconstruction at the Southwest Hospital of Third Military Medical University from January 2007 to May 2011 were retrospectively analyzed.The incidence of perioperative complications,mortality and postoperative conditions were also analyzed.Results The mean operation time and intraoperative blood transfusion were 473 minutes (range,234-853 minutes) and 781 ml (range,0-900 ml),respectively.Seven patients did not receive blood transfusion.The median period of hospital stay was 25.9 days (range,17-100 days).A total of 43 patients underwent PD combined with vascular reconstruction.The incidence of perioperative complications and mortality rate were 34％ (19/56) and 7％ (4/56),respectively.There were 42 patients with pancreatic ductal adenocarcinoma,5 with ampullary carcinoma,3 with distal bile duct carcinoma,4 with papillary carcinoma of duodenum,1 with pancreatic neuroendocrine carcinoma and 1 with pancreatic serous cystadenoma.All patients were followed up till August 2011,and the 1-year survival rate was 57％ (32/56).The mean survival time was 13.5 months.The weight of 32 surviving patients increased and no abdominal pain occurred.Within 3 months after the operation,5 patients had slight diarrhea and were administered antidiarrheal; thrombosis in the artificial blood vessels and peritoneal effusion were found in 1 patient,while 6 months later,collateral circulation was formed and the peritoneal effusion was diminished.Conclusion PD combined with vascular resection and reconstruction can improve the quality of life for patients with pancreatic cancer and with blood vessels involvement.

Objective To investigate subacute exposure of airborne particulate matter (PM) on pregnancy and fetal development in female mice. Methods Forty female and forty male ICR adult mice group (A), small (B) , middle (C) , large (D) or overdose (E) PM challenge groups (n = 8 - 11), and were administered with 30 μl of phosphate buffered solution (A) or resuspended standard PM SRM 1649a at 0.09 (B), 0.52 (C), 1.85 (D) or 69.2 (E) μg/μl, once per trid from d 0 till d 19 of pregnancy via instillation onto the base of the tongue. Fetal mice were harvested by cesarean section at the time when spontaneous delivery occurred. Body weight of the pregnant mice, gestational days, intrauterine survival and growth, hepatic and pneumonic histopathological changes of the fetal mice were investigated. Lung/body and liver/body weight ratios were calculated. Expressions of mRNA and protein of CYP1A1 in the fetal lung and CYP1 A2 in the fetal liver were assayed. Results (1) All of the pregnant mice survived pregnancy throughout the entire experiment. Body weight of the pregnant mice was not significantly different among all the groups at gestational d 1 and 7 (P ＞ 0.05), but significantly lower in group E [(41.8 ± 5.8) and (48.9 ± 8.9) g] than in group A [(45.9 ± 1.8) and (56.2 ± 4.9) g] at gestational d 14 and 18 (P ＜0.05). The gestational days were significantly decreased in group E [(19.3 ± 1.3) d] when compared with group A [(20.5 ± 0.7) d; P ＜ 0.05] and were not significantly different among groups A, B, C and D (P ＞ 0.05). Lung/body and liver/body weight ratios of the fetal mice were significantly increased in group E [(1.21 ±0.18) and (4.68 ±0.21)%] as compared with groups A, B, C and D (P＜0.05). (2)Mortality rates of the fetuses were significantly higher in group E (23.0%) than in groups A (0.8%), B (0.9%), C (1.7%) and D (3.7%) (P ＜ 0.05), but were not significantly different among groups A,B, C and D (P ＞ 0.05) despite of an increasing tendency. (3) Pathological changes in the liver and lung of the fetuses were conspicuous in group E. The fetal liver injury was histopathologically evidenced by deranged tissue structure, degenerated parenchyma of hepatic cells, and mildly stained cytoplasm. Adipose degeneration was represented by clear-boundary intracytoplasmic vacuoles in most of the liver cells, and cell pyknosis with heavily stained cytoplasm was observed in some of the liver cells. Inflammatory cell infiltration and focal necrosis were occasionally found in the hepatic tissue. The fetal lung exhibited bronchiole with narrow lumina, vascular engorgement in the submucosal layer, interstitial and alveolar edema, thickened alveolar septum, granulocyte and lymphocyte infiltrations within the pulmonary alveoli and around the bronchioles. The above pathological changes were lesser in groups C and D, and were not or least found in groups A and B. (4) Protein expressions of CYP1A1 in the fetal lung and CYP1A2 in the fetal liver were significantly increased in group E (1.20 ± 0.40 and 2.55 ± 0.89) when compared with group A (0.77 ±0.36 and 2.08 ±0.31) (P ＜ 0.05). mRNA expressions of CYP1A1 in the fetal lung were significantly increased in groups C (0.36 ±0.12), D (0.41 ±0.08) and E (0.43 ±0.11) compared with group A (0.21 ±0.10), and significantly increased in groups D and E compared with group B (0.28 ±0.10,P＜0.05). mRNA expressions of CYP1 A2 in the fetal liver were significantly increased in groups C (0.37 ±0.13), D (0.36 ±0.14) and E (0.43 ±0.16) compared with group A (0.21 ±0.03), and significantly increased in group E compared with group B (0.24± 0.11, P ＜ 0.05). Conclusions PM elicited embryotoxigenicity and resulted in adverse pregnancy outcomes in mice by intrauterine exposure of overdose PM. The expressions of cancer-related genes CYP1A1 and CYP1A2 were up-regulated in organs after the middle- and large-dose subacute exposure of PM, which may have a potential role on the future development.

AIM: To study the effect of Yupingfeng Powder(YPFP) on rat's allergic rhinitis induced by stimulating ovalbumin.and reveal the influence on Th1,Th2 and Th1/Th2 proportion. METHODS: 8-week-old BALB/c mice were sensitized by means of intranasal and systemic intraperitoneal injection application of OVA,6 subjects were administered including 2,500 mg/kg extracts of YPFP for 7 days in early stage(interference group);6 mice were administered YPFP in after challenge(therapy group);the placebo group were given saline.After 7 days,Th1 and Th2 in splenocyte were detected by flow cytometry(FCM) and nasobuccal mucosa pathology were observed. RESULTS: When compared with Th2 of animal model group(9.86?1.40),there was a significant decrease expressing Th2 after PFP treatment(3.41?0.72,P

Congenital abnormalities of the neonatal lung structure can easily cause childhood lung diseases and increase the susceptibility to chronic lung diseases in adulthood.Fibroblast growth factor 10(FGF10) regulates structu-ral morphology, cellular differentiation, and damage response at multiple stages of lung development.FGF10 deficiency in the formation stage of bronchial branches will lead to neonatal lung disease.In other words, congenital airway abnorma-lities caused by gene mutations in the fgf10 cause increase the risk of developing chronic lung diseases in adulthood.FGF10 also maintains lung precursor cell lines and promotes proliferation and differentiation of alveolar typeⅡ cells after lung injury.In this article, the cellular and molecular mechanisms of FGF10 associated with various lung diseases were reviewed, including bronchopulmonary dysplasia in extremely premature infants, cystic lung fibrosis in children, and chronic lung diseases in adults, so as to offer help for the development of new therapeutic strategies for respiratory diseases.

With the understanding of the biological characteristics of breast cancer and the improvement of systemic treatment, the treatment concept of breast cancer has changed, and the treatment strategy of axillary lymph nodes has also been constantly changing. With the change of these concepts, a large number of relevant clinical trials have been gradually carried out. The NSABP B04 study took the lead in exploring the transformation of axillary treatment strategies in the classic breast cancer treatment. Although this study did not change the clinical practice of axillary treatment at the time, it provided a preliminary data basis for a subsequent series of clinical studies on axillary preservation. In these changes, sentinel lymph node biopsy, as a milestone in the surgical treatment of breast cancer, has become the standard staging procedure for axillary negative patients. Since then, a series of related clinical studies have also been carried out, among which the results of studies on patients with low-load axillary metastasis have confirmed the feasibility of axillary preservation in some patients, which has influenced and changed clinical practice. In addition, the results of the study make it possible for some patients to preserve the axilla after neoadjuvant therapy reduce postoperative upper extremity edema effectively. Whether axillary surgery can be completely eliminated, and whether axillary dissection can be waived for patients with positive axilla after neoadjuvant therapy under the premise of equal survival benefit have also received extensive attention.

Objective:To improve the Rapid Arterial Occlusion Evaluation (RACE) scale and to investigate its value in identifying large vessel occlusion (LVO) in patients with acute anterior circulation ischemic stroke (AIS).Methods:Consecutive patients with AIS treated in Liangxiang Hospital of Fangshan District, Beijing through stroke easy access from January 1, 2016 to December 31, 2018 were enrolled prospectively. The clinical data and multimodal CT examinations required to determine LVO were collected. The existing problems in the RACE score were modified. The patients were evaluated by the modified RACE score, RACE score, and National Institute of Health Stroke Scale (NIHSS). The receiver operator characteristic (ROC) curve was used to evaluate the predictive ability of the modified RACE score for LVO, and it was compared with the RACE score and NIHSS score. The ROC curves of LVO predicted by modified RACE score and NIHSS score in patients with left and right hemispheric lesions were compared.Results:A total of 184 patients were included, of which 66 (35.9%) had LVO. The age (64.8±11.7 vs. 60.5±10.8 years; t=2.483, P=0.014), baseline NIHSS score (13 [6.75-17] vs. 5 [2-9]; Z=-6.361, P<0.001) and the proportion of patients with gaze (37.9% vs. 17.4%; χ2=4.696, P=0.030) in the LVO group were significantly higher than those in the non-LVO group. ROC curve showed that the modified RACE score was more effective in identifying LVO than RACE score (area under the curve: 0.812 vs. 0.770; Z=4.654, P<0.001). The best cutoff value of the modified RACE score in predicting LVO was 5, and its predictive sensitivity and specificity were 75.8% and 75.4%, respectively, and the positive and negative predictive values were 63.3% and 84.8%, respectively. A comparison of patients with left hemispheric lesion and those with right hemispheric lesion showed that the ability of the modified RACE score in predicting LVO was more balanced (area under the curve: 0.826 vs. 0.796; Z=0.454, P=0.650), while there was a significant difference in NIHSS score (area under the curve: 0.856 vs. 0.703; Z=2.149, P=0.031). Conclusions:The modified RACE score is better than the original RACE score in the predictive value of LVO in patients with AIS, and its predictive power of LVO in patients with left and right hemisphere stroke is more balanced than the NIHSS score, which may help clinical discrimination and screening for patients suitable endovascular treatment.

Objective:To assess the changes in profiles of microRNAs (miRNAs) in peripheral blood of neonatal Sprague-Dawley (SD) rats with hypoxia-ischemia(HI) injury with self-resuscitation.Methods:Neonatal rats of 3 pregnant rats were divided into 3 groups according to their nests, in which group A was the blank control group, group B was the HI group, and group C was the alternative group.The expression profiles of miRNAs in periphe-ral blood of neonatal rats in group A and B by high-throughput sequencing was compared.Bioinformatics analysis was applied to investigate these differentially expressed miRNAs.Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were performed to screen out enriched signaling pathways and functions.Target genes of miRNAs and those correlated with hypoxia-ischemia brain damage were predicted using miRBaseData (miRBD) software.HE staining was performed to observe the pathological changes of rat brain tissues.Results:A total of 1 049 mature reliable miRNAs in peripheral blood of neonatal rats were identified, including 525 miRNAs in group A, and 524 in group B. There were 27 differentially expressed miRNAs between group A and B, and their types were highly correlated.A total of 38 dysregulated miRNAs were screened out in group B, involving 21 upregulated miRNAs and 17 downregulated ones.GO and KEGG analyses showed that the identified differentially expressed miRNAs were mainly enriched in the glutamatergic synapse pathway, myelin lipid metabolism, neural activity ligand-receptor interaction and the vascular epithelial growth factor (VEGF) signaling pathway, all of them were significantly correlated with HIBD and over-activated.Cortex and subcallosal white matter lesions, enlarged ventricles, disordered arrangement of gray matter neurons, and obvious apoptosis in rat brain tissues of group A and B were not observed in HE staining.Conclusions:Differential expression of miRNAs in peripheral blood of HI self-resuscitated rats suggests that miRNAs has a positive response to hypoxia and ischemia.Differentially expressed miRNAs, including miR-200, miR-471, miR-429, miR-216 and miR-871 families, in peripheral blood of neonatal rat with HI showed their active response after HIBD.They are related to the molecular mechanisms of the nervous system damage, and are expected to become novel diagnostic markers for HIBD or HI.Differentially expressed miRNAs are conductive to the development of therapeutic targets of HI.