OBJECTIVE:To systematically review the effectiveness and safety of methotrexate(MTX)in the treatment of rheuma-toid arthritis,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from Medline,EMBase,Cochrane Library,PubMed,CJFD,CBM,VIP and Wanfang Database,randomized controlled trials(RCT)about MTX in the treatment of rheu-matoid arthritis were collected,Meta-analysis was performed after data extraction and quality evaluation. RESULTS & CONCLU-SIONS:33 effectiveness evaluation were included,involving 8 253 patients,and 53 safety evaluation were included,involving 4 803 patients. Results of analysis show,the efficacy of MTX was not higher than leflunomide in the treatment of rheumatoid arthritis,superi-or to cyclosporine A,and similar to sulfasalazine. In addition,MTX shows similar efficacy with etanercept(7.5-20 mg per week),goli-mumab,adalimumab or rituximab,but less effective than trastuzumab. The incidence of adverse reactions of MTX is high,but mainly mild or moderate,and the most common adverse reactions are gastrointestinal symptoms. Oral administration of MTX is more secure than intramuscular injection and subcutaneous injection.

Objective To analyze the species of the antibody and immune responsibility in pneumonic plague patients in order to pave the way to screen the new sub-unit of the vaccine to provide the experimental basis. Methods Using the virulence-related protein microarray containing 149 proteins of Yersinia pestis (Y.pestis), the species of the antibody and immune responsibility were analyzed in serum of two pneumonic plague patients in six months after onset. Results Eighty-eight gene coded proteins were detected out the related antibodies except YPMT1.23c, YPMT1.86, YPO0406 and YPO1071 in patient 1. Forty-three antibodies from gene coded protein were analyzed, other forty-nine had not been identified in patient 2. Thirty-nine antibodies were detected in both patients. The proteins YPMT1.81c, YPMT1.84, YPCD1.31c, rw10, YPCD1.28, YPCD1.58, YPMT1.62c, YPO3247-related antibodies increased significantly by 109.96,176.4 ;20.64,17.73 ;16.50,7.16 ;23.51,7.65 ;46.00,25.61 ;4.50,8.24 ;5.98,5.08 ;23.98,4.76 folds, respectively. Conclusions The study on the antibody in pneumonic plague patients helps us to select the potential vaccine candidates, which reveals that eight proteins are the immunity diagnosis targets and the research key of sub-unit vaccine.

Objective To research the effect and the mechanism of cinnamon oil on experimental rat prostatic hyperplasia.Methods SD rats were randomly divided into normal group,model group,control group and cinnamon oil-H,-M,-L groups,with 10 rats in each group.The prostatic hyperplasia model was induced by injected subcutaneously with 5 mg·kg-1·d-1 testosterone propionate for 30 d.Normal group and model group were given 1 mL·kg-1 0.9％NaCl;control group were given 1 mg·kg-1 finasteride;cinnamon oil-H,-M,-L groups were given 1,0.5,0.25 mg·kg-1 cinnamon oil by intragastric administration,respectively,once a day for 30 d.The wet weight and index of prostate gland in rats were compared to explore the therapeutic effect of cinnamon oil,and the inhibitory effect of cinnamon oil on 5α-reductase and NADPH oxidase was studied to explore its mechanism.Results The prostate wet weight in normal group,model group,control group and cinnamon oil-H,-M,-L groups were(0.51±0.09),(1.02±0.17),(0.65±0.15),(0.64±0.17),(0.79±0.09)and(0.81±0.15)mg;the prostate index were(2.25±0.33),(4.70±0.48),(3.03±0.82),(3.02±0.60),(3.53±0.46)and(3.68±0.66)mg·kg-1;the fluorescence intensity of NADPH oxidase were(1.26±0.18),(5.21±0.80),(2.21±0.56),(2.51±0.56),(4.13±0.64)and(4.90±0.88)RLU,respectively.Compared with model group,the fluorescence intensity of NADPH oxidase in normal group,control group and cinnamon oil-H,-M groups all had significantly differences(all P＜0.01).The average inhibition rates of 5α-reductase in positive control group(20 μmol·L-1),cinnamon oil group(10,20 μmol·L-1)were 49.36％,45.62％and 63.45％,respectively.The average inhibition rate of 5α-reductase in cinnamon oil group(20 μmol·L-1)was higher than that in positive control group(20 μmol·L-1),the difference was statistically significant(P＜0.05).Conclusion Cinnamon oil may inhibit prostate hyperplasia by inhibiting 5α-reductase and NADPH oxidase.

Objective To compare the difference of biochemical characteristics and virulent Pst Ⅰ of Yersinia pestis strains in traditional focuses of plague in Yunna Province and in the new focuses of plague in Yulong County. Methods The identification data of biochemical characteristics(Rhamnose, Glycerol, Maltose, L-Arabina and Melibiose fermentation) and virulence factor(Pst Ⅰ) from different focuses of plague in Yunna Province were Retrospectively collected by tube test followed by the analysis using statistics software SAS 8.0 by Fisher exact probability of disordered two-way R × C table χ2 test. Results Among 48 strains of Yersinia pestis from hantaan type plague focus, 1 strain fermented L-maltose, 48 strains fermented Glycerol. Among 165 strains of Yersinia pestis from the Soul type plague focus, 1 strain did not ferment L-maltose, only one of them fermented Glycerol. 1 strain from the Soul type plague focus was confirmed to have mutation, for the test of nitrate reduction reaction was negative. All 5 strains of Yersinia pestis from the new focuses of plague in Yulong County fermented L-maltose and Glycerol. The statistical result showed that the differences in L-maltose and Glycerol fermentation of Yersinia pestis from different natural focuses of plague in Yunnan Province were statistically siguificant (P < 0.01). The differences of other biochemical characteristics and Pst Ⅰ were not statistically significant (P > 0.01). Conclusions Biochemical characteristics of Yersinia pestis from the hantaan type plague focus and the Soul type plague focus in Yunnan province are overlapping. Biochemical characteristics of Yersinia pestis from the new focuses of plague in Yulong County are different from those tradition focuses of plague in Yunna Province but share similarities to those from Unquiculatus focuses in North Tibet.

Objective To observe the influence of human umbilical cord mesenchymal stem cells (hUCMSC) transplanted into the tail vein of diabetic rats on apoptosis of retinal neurons and the retinal expression level of glial fibrillary acidic protein (GFAP).Methods Seventy clean male Sprague-Dawley rats were randomly divided into the normal control group (group A),diabetes mellitus (DM) only group (group B),DM + balanced salt solution (BSS) group (group C),DM + hUCMSC group (group D),with 10 rats in each group.DM rats were induced by intraperitoneal injection of streptozotocin.Apoptosis of retinal cells was assayed by dUTP nick end labeling.Immunohistochemistry and Western blot was performed to detect the retinal expressions of GFAP in rats.Results Compared with group A,large numbers of apoptotic cells could be found in the retinal ganglion cell layer (GCL) and inner nuclear layer (INL) of group B and group C,however the apoptotic cells in group D were significantly reduced than group B and C.The expression of GFAP was mainly located in the retinal GCL and retinal nerve fibre layer (RNFL) in group A,throughout the inner plexiform layer (IPL) in group B and C,only distributed in RNFL and GCL in group D.It was obvious that the expression of GFAP in group B and C was higher than group A.Compared with group B and C,the expression of GFAP in group D was significantly reduced.The difference of GFAP expression among the 4 groups was significant (F=79.635,P＜0.05).Conclusion hUCMSC could inhibit the apoptosis of retinal cells and activation of glial cells in early DM rats.

Objective:To observe the efficacy and safety of albumin-bound paclitaxel in the treatment of metastatic breast cancer.Methods:Multi-center data of patients who accepted single-drug albumin-bound paclitaxel or combination regimens from 2013 to 2019 were collected and the efficacy and safety were evaluated. Kaplan-Meier method was used for survival analysis, while Log-rank test was used to compare the survival rates.Results:A total of 203 advanced breast cancer cases were enrolled. The median progression-free survival time (PFS) lasted for 4 months, the median overall survival(OS)was 14 months, objective response rate (ORR) was 36.0% while the disease control rate (DCR) was 81.3%. The ORRs of Luminal, human epidermal growth factor receptor 2 (HER2) overexpression and triple-negative breast cancer patients underwent albumin-bound paclitaxel treatment were 37.3%, 45.5% and 31.0%, respectively, the DCRs were 85.5%, 68.2% and 78.9%, respectively. The OS of patients with relapse or metastasis who accepted less than two and more than two chemotherapy regimens were 22 months and 11 months ( P<0.000 1), the ORRs were 44.9% vs 30.4%, DCRs were 87.2% vs 77.6% ( P=0.018). The ORR and DCR of patients who accepted traditional paclitaxel treatment before the albumin-bound paclitaxel treatment were 35.8% and 82.1%, respectively. The common adverse reaction of these patients was numbness of limbs, which incidence rate was 64.5% (131/203), and 61.1% (124/203) were degree 1 to 2. Other adverse reactions including decreased white blood cells, which incidence rate was 56.1% (114/203); nausea and vomit, which incidence rate was 36.9% (75/203); anemia, which incidence rate was 21.2% (43/203); decreased platelet, which incidence rate was 18.7% (38/203); hepatic dysfunction, which incidence rate was 18.2% (37/203). Conclusions:Albumin-bound paclitaxel single or combination regimen is still significant efficient for various molecular subtypes of breast cancer patients or patients with traditional paclitaxel resistance or multi-line chemotherapy failure. Early usage has better prognosis, controllable adverse reaction and prominent clinical application value.

Objective:To observe the efficacy and safety of albumin-bound paclitaxel in the treatment of metastatic breast cancer.Methods:Multi-center data of patients who accepted single-drug albumin-bound paclitaxel or combination regimens from 2013 to 2019 were collected and the efficacy and safety were evaluated. Kaplan-Meier method was used for survival analysis, while Log-rank test was used to compare the survival rates.Results:A total of 203 advanced breast cancer cases were enrolled. The median progression-free survival time (PFS) lasted for 4 months, the median overall survival(OS)was 14 months, objective response rate (ORR) was 36.0% while the disease control rate (DCR) was 81.3%. The ORRs of Luminal, human epidermal growth factor receptor 2 (HER2) overexpression and triple-negative breast cancer patients underwent albumin-bound paclitaxel treatment were 37.3%, 45.5% and 31.0%, respectively, the DCRs were 85.5%, 68.2% and 78.9%, respectively. The OS of patients with relapse or metastasis who accepted less than two and more than two chemotherapy regimens were 22 months and 11 months ( P<0.000 1), the ORRs were 44.9% vs 30.4%, DCRs were 87.2% vs 77.6% ( P=0.018). The ORR and DCR of patients who accepted traditional paclitaxel treatment before the albumin-bound paclitaxel treatment were 35.8% and 82.1%, respectively. The common adverse reaction of these patients was numbness of limbs, which incidence rate was 64.5% (131/203), and 61.1% (124/203) were degree 1 to 2. Other adverse reactions including decreased white blood cells, which incidence rate was 56.1% (114/203); nausea and vomit, which incidence rate was 36.9% (75/203); anemia, which incidence rate was 21.2% (43/203); decreased platelet, which incidence rate was 18.7% (38/203); hepatic dysfunction, which incidence rate was 18.2% (37/203). Conclusions:Albumin-bound paclitaxel single or combination regimen is still significant efficient for various molecular subtypes of breast cancer patients or patients with traditional paclitaxel resistance or multi-line chemotherapy failure. Early usage has better prognosis, controllable adverse reaction and prominent clinical application value.

Veno-arterial extracorporeal membrane oxygenation is an effective method to reduce perioperative adverse events such as cardiogenic shock in patients undergoing complex high-risk indicated percutaneous coronary intervention.Femoral artery and femoral vein are the main routes for conventional veno-arterial extracorporeal membrane oxygenation in China,while the cases of extracorporeal membrane oxygenation insertion via axillary artery are relatively rare.However,the axillary artery intubation veno-arterial extracorporeal membrane oxygenation assisted mode has been regarded as one of the routine clinical paths for the treatment of critically ill patients in foreign countries.This paper reports a case of an elderly male patient who underwent high risk and complex percutaneous coronary interventional therapy by right axillary artery implantation with extracorporeal membrane oxygenation assisted circulation due to the difficulty of femoral artery approach.In order to provide reference for the selection of clinical extracorporeal membrane oxygenation technique route.

This study investigated the effect of guarana on plasma lipid metabolites in obese rats and analyzed its mechanism in the treatment of dyslipidemia in obesity. High-fat diet was used to establish obese rat models, and the therapeutic effect of guarana on obese rats was evaluated by measuring body weight, white fat, liver weight, and lipid content, as well as observing liver histomorphology. Lipid metabolites in plasma of rats in each group were detected by UHPLC-Q-TOF-MS lipidomics. The protein expressions of fatty acid synthase, acetyl-CoA carboxylase 1, triglyceride synthesis enzyme, carnitine palmitoyltransferase Ⅰ, and acetyl-coenzyme A acyltransferase 2 in rat liver were detected using Western blot. The results revealed that guarana significantly reduced body weight, white fat, and liver weight of obese rats due to high-fat diet, and alleviated dyslipidemia and liver steatosis. Lipidomics showed that some triglycerides and phospholipids were significantly elevated in the high-fat model group, and part of them was reduced after guarana treatment. Western blot found that guarana inhibited the expression of hepatic fatty acid and triglyceride synthesis-related proteins and increased the expression of fatty acid β-oxidation-related proteins. Abnormalities in triglyceride and phospholipid metabolism are the main characteristics of plasma lipid metabolism in obese rats induced by high-fat diet. Guarana may regulate partial triglyceride and phospholipid metabolism by inhibiting hepatic fatty acid and triglyceride synthesis and increasing fatty acid β-oxidation, thereby improving rat obesity and dyslipidemia.

OBJECTIVE: To investigate the therapeutic effects of total saponins from Panax notognseng (PNS) combined with cyclophosphamide (CTX) in mice bearing hepatocellular carcinoma H₂₂ cell xenograft. METHODS: We examined the effects of treatment with different concentrations of PNS on H₂₂ cell proliferation for 24 to 72 h in vitro using CCK8 colorimetric assay. Annexin V/PI double fluorescence staining was used to detect the effect of PNS on apoptosis of H₂₂ cells. Mouse models bearing H₂₂ cell xenograft were established and treated with CTX (25 mg/kg), PNS (120, 240 or 480 mg/kg), alone or in combinations. After treatments for consecutive 10 days, the mice were euthanized for examinations of carbon clearance ability of the monocytes and macrophages, splenic lymphocyte proliferation, tumor necrosis factor (TNF-α), interleukin-2 (IL-2), serum hemolysin antibody level, blood indicators, and the tumor inhibition rate. RESULTS: Treatment with PNS concentration-dependently inhibited the proliferation and significantly promoted apoptosis of cultured H₂₂ cells (P < 0.01). In the tumor-bearing mouse models, PNS alone and its combination with CTX both resulted in obvious enhancement of phagocytosis of the monocyte-macrophages, stimulated the proliferation of splenic lymphocytes, promoted the release of TNF-α and IL-2 and the production of serum hemolysin antibody, and increased the number of white blood cells, red blood cells and lymphocytes in the peripheral blood. Treatment with 480 mg/kg PNS combined with CTX resulted in a tumor inhibition rate of 83.28% (P < 0.01) and a life prolonging rate of 131.25% in the mouse models (P < 0.05). CONCLUSION PNS alone or in combination with CTX can improve the immunity and tumor inhibition rate and prolong the survival time of H₂₂ tumor-bearing mice.
Animals ; Carcinoma, Hepatocellular/pathology* ; Cyclophosphamide/therapeutic use* ; Hemolysin Proteins ; Heterografts ; Humans ; Interleukin-2 ; Liver Neoplasms/pathology* ; Mice ; Panax notoginseng ; Saponins/therapeutic use* ; Tumor Necrosis Factor-alpha