Objective To analyze the clinicopathological characteris tics of systemic lupus erythematosus (SLE) with secondary antiphospholid syndrome (APS) . Methods Data of 11 cases of SLE with secondary APS (SLE with APS) admitted to Peking Union Medical College Hospital from January 2000 to March 2010 were retrospectively analyzed. Kidney biopsy was performed on all of these patients. Differences of clinicopathology and outcomes between SLE with and without APS were compared. Results Renal involvement was found in all the SLE with APS patients. The prominent clinical manifestations included hypertension (54.5%), nephrotic level of proteinuria (24 h proteinuria ≥3.5 g)(72.7%) and renal insufficiency (45.5%). Diastolic blood pressure, mean arterial pressure and glomerular filtration rate in SLE with APS were significantly higher than those in SLE without APS (all P＜0.05). In 8 out of 11 cases (72.7%), APS nephropathy (APSN) in kidney biopsy was found, characterized by small vessel vaso-occlusive lesions. These included thrombotic microangiopathy (TMA), fibrous intimal hyperplasia (FIH), focal cortical atrophy (FCA) and tubular thyroidization. Among those, 5 cases (45.5%) had chronic APSN and 4 (36.4%) had acute APSN (one case had acute and chronic APSN at the same time). The incidences of APSN and acute APSN in the SLE with APS group were significantly higher than those in SLE without APS group (P＜0.05). Conclusions The major renal manifestations of SLE with APS are hypertension, nephrotic level of proteinuria and renal insufficiency. Other than lupus nephritis, also a high incidence of APSN is found in SLE with APS patients.

OBJECTIVETo investigate the changes of the cardiac hemodynamics after acute high altitude exposure in healthy young males and the relationship with acute mountain sickness(AMS).

METHODSLeft ventricular function and oxyhemoglobin saturation (SaO2), heart rate (HR), blood pressure (BP) were measured in 218 healthy young males before and after high altitude exposure within 24 h respectively. According to the lake louise score criteria, the subjects were divided into two groups: acute mountain sickness group (AMS group) and non acute mountain sickness group (non-AMS group).

RESULTSHR, diastolic blood pressure (DBP), mean arterial pressure (MAP), left ventricular ejection fraction (LVEF), stroke volume (SV), stroke index (SI) cardiac output (CO), cardiac index (CI) were significantly increased upon acute high altitude exposure (P < 0.05). Whereas SaO2 and end-systolic volume (ESV) were significantly decreased (P < 0.05). In addition, HR, systolic blood pressure (SBP) and MAP in AMS group were significantly higher than those in non-AMS group (P < 0.05). But stroke index (SI) and end-diastolic volume (EDV) in AMS group were significantly lower than those in non-AMS group (P < 0.05).

CONCLUSIONCardiac function in healthy young males upon acute high altitude exposure was enhanced. EDV, HR and SI might become the indexes of predicting the acute mountain sickness in the future.

Acute Disease ; Adult ; Altitude ; Altitude Sickness ; physiopathology ; Humans ; Male ; Ventricular Function, Left ; physiology

BACKGROUND:Specific down-regulation of interleukin 1 beta (IL-1β) may al eviate the pain behaviors effectively after peripheral nervous injury. Compared with smal interference RNA (siRNA), short hairpin RNA (shRNA) could inhibit the expression of target gene more stably and efficiently. However, simple shRNA could not enter target cel s to down-regulate target gene efficiently. Adenovirus vectors have wide host range, high infection efficiency and stable expression in host cel s.
OBJECTIVE:To construct recombinant adenovirus vector expressing shRNA targeting IL-1βgene and detect its effect on the expression of target gene.
METHODS:Three siRNAs were designed on the basis of the nucleotide sequence of IL-1βobtained from NCBI and then three shRNAs (shRNA1, shRNA2 and shRNA3) were synthesized. The annealed shRNA product and adenovirus vector pHBAd/U6/GFP digested by BamH I and EcoR I were connected to construct the recombinant adenovirus vector shuttle plasmid expressing shRNA targeting IL-1β. After sequencing, HEK 293 cel s were co-transfected by the shuttle plasmid and skeleton vector, and three recombinant adenovirus vector expressing shRNA targeting IL-1β(rAd/shRNA1, rAd/shRNA2 and rAd/shRNA3) were packaged and amplified. Rats H9C2 cel s were infected by recombinant adenovirus vector expressing shRNA targeting IL-1βand fluorescence microscope was used to observe the infection efficiency. The effect of recombinant adenovirus vector expressing shRNA targeting IL-1βon the expression of target gene was detected by western blot assay.
RESULTS AND CONCLUSION:The sequencing results showed that the sequences of three shRNAs adenovirus vector shuttle plasmid were consistent with the sequences of three designed shRNAs. rAd/shRNA1, rAd/shRNA2 and rAd/shRNA3 were constructed successful y. rAd/shRNA1, rAd/shRNA2 and rAd/shRNA3 could down-regulate the expression of IL-1βin rat H9C2 cel s and the down-regulation effect of rAd/shRNA2 was the most significant.

Objective To evaluate the role of interleukin?1β( IL?1β) in activation of N?methyl?D?aspartate ( NMDA) receptors in spinal dorsal horns of rats with neuropathic pain. Methods One hundred twenty?eight pathogen?free healthy adult male Sprague?Dawley rats, weighing 200-250 g, were divided into 4 groups (n=32 each) using a random number table: control group (group C), recombinant adenovirus vector group ( group rAd) , recombinant adenovirus vector shRNA group ( group rAd∕shRNA) , and recom?binant adenovirus vector shRNA plus recombinant adenovirus vector IL?1β group ( group rAd∕shRNA+rAd∕IL?1β) , receiving intrathecally injected equal volume of 0.9% sodium chloride solution, recombinant ade?novirus vector, recombinant adenovirus vector shRNA, and recombinant adenovirus vector shRNA plus re?combinant adenovirus vector IL?1β5 μl, respectively. Chronic compression of dorsal root ganglia was per?formed on 8th day after intrathecal injection. The thermal paw withdrawal latency ( TWL) was measured at 1 day before intrathecal injection ( T0 ) and at 1, 2, 3 and 5 weeks after intrathecal injection ( T1-4 ) . After measurement of the pain threshold at each time point, 8 rats selected randomly were anesthetized and sacri?ficed, and the lumbar enlargement segments of the spinal cord were harvested for determination of the ex?pression of IL?1β and phosphorylated NMDA receptor NR1 subunits at serine 896 ( pNR1S896) in spinal dorsal horns on the injured side by immunohistochemistry and Western blot. Results Compared with group C, the TWL was significantly prolonged, and the expression of IL?1βand pNR1S896 in spinal dorsal horns was significantly down?regulated at T2-4 in group rAd∕shRNA (P<0.05), and no significant change was found in the parameters mentioned above at each time point in group rAd and group rAd∕shRNA+rAd∕IL?1β( P>0.05) . Compared with group rAd, the TWL was significantly prolonged, and the expression of IL?1βand pNR1S896 in spinal dorsal horns was significantly down?regulated at T2-4 in group rAd∕shRNA ( P<0.05) , and no significant change was found in the parameters mentioned above at each time point in group rAd∕shRNA+rAd∕IL?1β (P>0.05). Compared with group rAd∕shRNA, the TWL was significantly short?ened, and the expression of IL?1β and pNR1S896 in spinal dorsal horns was significantly up?regulated at T2-4 in group rAd∕shRNA+rAd∕IL?1β ( P<0.05) . Conclusion IL?1β is involved in the activation of NM?DA receptors in spinal dorsal horns of rats with reuropathic pain.

Objective To investigate functional role and clinical significance of the methylation in the promoter of TPAP gene in the development and progression of pancreatic cancer.Methods Surgically resected specimen from 68 patients who were pathologically diagnosed as pancreatic cancer in Changhai Hospital from July 2006 to August 2009 were collected.The methylation in the promoter of TPAP gene in tumor and nontumor adjacent tissue was detected by methylation specific PCR.Results The methylation rate of tumor and non-tumor adjacent tissue was (0.214 ± 0.057) ％ and (0.084 ± 0.096) ％,respectively,and pancreatic cancer tissue had significantly higher methylation rate than the adjacent tissue.Hypermethylation of TPAP gene was not correlated with age,gender,tumor differentiation,lymphatic metastasis,serum CEA and CA19-9,but was positively correlated with distant metastasis.Conclusions Hypermethylation in the promoter of TPAP gene may participate in the invasion and metastasis of pancreatic cancer and the hypermethylation of the promoter is closely associated with the tumorigenesis and development of pancreatic cancer.

Objective To study the relationship between environmental chemical elements,vires infection and dilated cardiomyopathy(DCM).Methods In 2008,233 patients with DCM(case group)and 150 patient with stable angina(control group)were chosen in Liaocheng People's Hospital and Yanggu People's Hospital,Shandong province.Population distribution and disease history were surveyed in the two groups.Human myocardial antibody IgG(AMA-IgG),Coxsackie B virus IgG(CBV-IgG),Adenofirus antibody IgG(ADV-IgG)were detected by ELISA in both the case group and the control group.Serum trace elements were detected in the two groups.The general chemical and toxicological indicators in drinking water of the high-and the low-incidence aireas of the disease were control group[60.00%(90/150),χ2=13.80,P<0.01)].Per capita annual income(Yuan,RMB)in the case group (3207.82±618.51)was lower than that of the control group[(5086.61±886.12),t=24.40,P<0.01].Personal alcohol consumption in the case group[(175.00±160.50)g/d]was higher than that of the control group[(110.22±100.03)g/d,t=4.40,P<0.01)].The rate of myocarditis in the case group[5.15%(12/233)]was higher than ADV-IgG in the cage group were 7.78%(7/90),6.67%(6/90)and 6.67%(6/90),respectively.Compared with those in the control group[3.33%(2/60),5.00%(3/60)and 5.00%(3/60),χ2=1.26,0.18,0.18,all P>0.05],no mg/L]in drinking water of the high-incidence areas were significantly higher than that of iron[(0.39±0.67)mg/L,t=2.11,P<0.05]and that of manganese[(0.15±0.14)mg/L,t=3.01,P<0.01]in the low-incidence arefas.The content of semm iron[(69.1±57.8)μmol/L]in the case group evidently exceeded the normal range(15.6-35.9 μmol/L)and obviously higher than that in the control group[(20.0±17.5)μmol/L,t=5.04,P<0.01].Conclusions Theso data do not support that DCM is related with persistent virus infection and autoimmunization.DCM is probably related with low incomes,high alcohol consumption,myocarditis,high iron and manganese contents in drinking water and high content of serum iron.

OBJECTIVETo further study the binding character of hepatitis B surface antigen (HBsAg) and beta 2-glycoprotein I (beta2GP I) and to explore whether beta2GP I plays an important role in the hepatotropism of hepatitis B virus.

METHODSUsing Western blot technique, we observed the binding character of the HBsAg with reduced and non-reduced beta2GP I.

RESULTSrHBsAgs with reduced and non-reduced beta2GP I showed identical binding activity.

CONCLUSIONSThe binding activity of HBsAg is dependent on tandem residues, but not on conformational structures of beta2GP I. There is a specific binding between HBV and beta2GP I, which may play an important role in HBV infection and is one of the reasons of hepatotropism of HBV.

Hepatitis B ; virology ; Hepatitis B Surface Antigens ; metabolism ; Hepatitis B virus ; pathogenicity ; Humans ; Viral Envelope Proteins ; blood ; beta 2-Glycoprotein I ; blood

Objective:To compare the efficacy of posterior atlas uniaxial and polyaxial screw instrumentation and fusion with bone graft for Gehweiler type IIIb atlas fracture.Methods:A retrospective cohort study was performed to analyze the clinical data of 36 patients with Gehweiler type IIIb atlas fracture admitted to Henan Provincial People′s Hospital from January 2015 to October 2020. There were 29 males and 7 females, with age range of 23-82 years [(48.8±15.5)years]. All patients were treated with posterior atlas screw-rod internal fixation and fusion with bone graft, of which 14 received atlas uniaxial screw internal fixation (uniaxial screw group) and 22 received atlas polyaxial screw internal fixation (polyaxial screw group). The operation time and intraoperative blood loss were compared between the two groups. The atlas fracture union rate and atlantoaxial posterior arch bone fusion rate were compared between the two groups at 3 months and 6 months after operation. The anterior atlantodental interval (ADI), basion-dens interval (BDI) and lateral mass displacement (LMD) were compared between the two groups to evaluate the reduction of fracture fragments before operation, at 1, 3, 6 months after operation and at the last follow-up. At the same time, the visual analogue scale (VAS) and neck dysfunction index (NDI) were compared between the two groups to evaluate neck pain and functional recovery. The postoperative complications were observed.Results:All patients were followed up for 12-44 months [(27.2±9.9)months]. There was no significant difference in operation time or intraoperative blood loss between the two groups (all P>0.05). The atlas fracture union rate and atlantoaxial posterior arch bone fusion rate were 85.7% (12/14) and 78.6% (11/14) in uniaxial screw group at 3 months after operation, insignificantly different from those in polyaxial screw group [72.7% (16/22) and 77.3% (17/22)] (all P>0.05). All patients in the two groups achieved bone union and fusion at 6 months after operation. There was no significant difference in ADI between the two groups before and after operation (all P>0.05). The BDI in the two groups did not differ significantly before operation ( P>0.05), but a significantly higher value was found in uniaxial screw group at 1, 3, and 6 months after operation and at the last follow-up [(5.9±1.3)mm, (5.8±1.3)mm, (5.9±1.2)mm and (5.8±1.2)mm] than in polyaxial screw group [(3.1±0.6)mm, (3.1±0.6)mm, (3.1±0.6)mm and (3.1±0.6)mm] (all P<0.01). The two groups did not differ significantly before operation ( P>0.05), but LMD at 1, 3, and 6 months after operation and at the last follow-up was (1.6±0.8)mm, (1.5±0.8)mm, (1.5±0.7)mm and (1.5±0.9)mm in uniaxial screw group, significantly lower than that in polyaxial screw group [(4.8±1.6)mm, (4.6±1.6)mm, (4.9±1.6)mm and (4.9±1.6)mm] (all P<0.01). There was no significant difference in VAS between the two groups before operation ( P>0.05). The VAS at 1, 3, and 6 months after operation and at the last follow-up was 3.0(3.0, 4.0)points, 2.0(1.0, 2.0)points, 1.0(0.8, 2.0)points and 1.0(0.0, 1.3)points in uniaxial screw group and was 3.5(3.0, 4.0)points, 2.0(2.0, 3.0)points, 2.0(1.0, 2.0)points and 2.0(1.0, 3.0)points in polyaxial screw group. In comparison, the VAS scored much lower in uniaxial screw group than in polyaxial screw group at 6 months after operation and at the last follow-up (all P<0.01). There was no significant difference in NDI between the two groups before operation ( P>0.05). The NDI at 1, 3, and 6 months after operation and at the last follow-up was 34.9±6.3, 23.4±6.2, 13.9±2.7 and 9.4±2.8 in uniaxial screw group and was 33.2±6.1, 24.4±6.3, 18.1±4.1 and 12.7±3.2 in polyaxial screw group, showing a significantly lower NDI in uniaxial screw group than in polyaxial screw group at 6 months after operation and at the last follow-up (all P<0.01). The complication rate was 21.4% (3/14) in uniaxial screw group when compared to 22.7% (5/22) in polyaxial screw group ( P>0.05). Conclusion:For Gehweiler type IIIb atlas fracture, both techniques can attain atlas fracture union and atlantoaxial posterior arch bone fusion, but the posterior atlas uniaxial screw instrumentation and fusion is superior in reduction of atlas fracture displacement and lateral mass separation, neck pain relief and functional improvement.

Objective:To observe the effect of insertion of in-out-in axis pedicle screws on the vertebral artery in the posterior occipitocervical surgery for atlantoaxial subluxation or instability.Methods:The data of 52 patients with atlantoaxial dislocation or instability were analyzed who had been treated by internal fixation with in-out-in pedicle screws in the posterior occipitocervical surgery from January 2015 to February 2021 at Department of Spine and Spinal Cord Surgery, Henan Provincial People's Hospital. There were 30 males and 22 females, aged from 17 to 65 years (mean, 41.2 years). There were 26 cases of unilateral vertebral artery high-riding, 3 cases of bilateral high-riding, 19 cases of unilateral narrow pedicle due to C2 and C3 fusion, and 4 cases of bilateral narrow pedicles. X-ray, CTA and MRI were performed before and 3 days after surgery. The patients' clinical symptoms were recorded. CTA was used to measure the diameter of the vertebral artery at the transverse foramina of C 2 and C 3 and to observe the effect of in-out-in screws on the morphology of the vertebral artery. X-ray and CT examinations were performed at 6 months after surgery to observe the bone fusion. Results:The surgery went on uneventfully in all the patients. In the 9 cases undergoing anterior and posterior surgery, the operation time averaged 271.2 min (from 213 to 352 min) and the bleeding volume 471.5 mL (from 230 to 830 mL). In the 43 cases undergoing posterior surgery, the operation time averaged 171.6 min (from 131 to 226 min) and the bleeding volume 395.9 mL (from 170 to 660 mL). There was no such complication as spinal or vascular injury. The CTA reexamination 3 days after surgery showed that the diameter of the vertebral artery was (2.92±0.55) mm and (3.04±0.54) mm, respectively at the cervical 2 and 3 transverse foramina, showing no significant change compared with the preoperative values [(2.91±0.68) mm and (3.11±0.50) mm] ( P>0.05) and that the vertebral artery was displaced externally and inferiorly in 21 cases. Follow-ups for all patients ranged from 7 to 24 months (mean, 11 months). At 6 months after surgery, bone fusion was observed by imaging and no breakage or displacement of the internal fixation was observed. Conclusion:The in-out-in pedicle screws in the posterior occipitocervical surgery may have little impact on the vertebral artery, leading to reliable clinical outcomes.

BACKGROUNDThe efficacy of montelukast (MONT), a cysteinyl leukotriene receptor antagonist, in nonasthmatic eosinophilic bronchitis (NAEB), especially its influence on cough associated life quality is still indefinite. We evaluated the efficacy of MONT combined with budesonide (BUD) as compared to BUD monotherapy in improving life quality, suppressing airway eosinophilia and cough remission in NAEB.

METHODSA prospective, open-labeled, multicenter, randomized controlled trial was conducted. Patients with NAEB (aged 18-75 years) were randomized to inhaled BUD (200 μg, bid) or BUD plus oral MONT (10 μg, qn) for 4 weeks. Leicester cough questionnaire (LCQ) life quality scores, cough visual analog scale (CVAS) scores, eosinophil differential ratio (Eos), and eosinophil cationic protein (ECP) in induced sputum were monitored and compared.

RESULTSThe control and MONT groups contained 33 and 32 patients, respectively, with similar baseline characteristics. Significant with-in group improvement in CVAS, LCQ scores, Eos, and ECP was observed in both groups during treatment. After 2-week treatment, add-on treatment of MONT was significantly more effective than BUD monotherapy for CVAS decrease and LCQ scores improvement (both P < 0.05). Similar results were seen at 4-week assessment (both P < 0.05). 4-week add-on therapy of MONT also resulted in a higher percentage of patients with normal sputum Eos (<2.5%) and greater decrease of ECP (both P < 0.05).

CONCLUSIONSMONT combined with BUD was demonstrated cooperative effects in improvement of life quality, suppression of eosinophilic inflammation, and cough remission in patients with NAEB.

Acetates ; therapeutic use ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bronchitis ; drug therapy ; immunology ; Budesonide ; therapeutic use ; Cough ; drug therapy ; Female ; Humans ; Inflammation ; drug therapy ; Male ; Middle Aged ; Quality of Life ; Quinolines ; therapeutic use ; Young Adult