Objective To evaluate the clinical and image characteristics of rheumatoid arthritis (RA) patients accompanied with bronchiectasis (BR).Methods By retrospectively analyzing 67 patients admitted to our department,we divided RA patients into RA-BR group and non-BR group,according to the presence of BR or not.For those with interstitial lung disease (ILD),the ILD lesions were classified by inflammatory,fibrosis and mixed pattern.The clinical and image characteristics,as well as the correlation between BR patients with clinical/other lung changes were analyzed.Independent sample t test was used to compare the difference between the two groups if the data was normally distributed and those data that were not distributed normally were analyzed by Mann-Whitney U-test.Spearman correlation analysis was used for variables related analysis.Logistic regression analysis was used to identify independent risk factors for the presence of respiratory symptoms.Results Twenty-nine patients (43％) showed BR in CT scan.There was no statistically significant difference between BR and uon-BR group in age,gender,disease course of RA,smoking history and rheumatoid serology;respiratory symptom was presented in 6 pts in both groups;bronchiectasis involved unilaterallung in 10 patients (34％) and bilaterally in 19 (66％),26 patients (90％) were found to have bronchiectasis in their lower lobe.ILD was presented in 12 (41.4％) and 13 (34％) cases in BR and non-BR group,respectively (P＞0.05).BR in RA was not correlated with clinical parameters and presence of ILD.Logistic regression showed BR [OR:1.201,95％ CI.(1.023-1.411),P＜0.05] and ILD [OR:10.646,95％CI:(1.944-58.305),P＜0.01] were independent risk factors associated with respiratory symptoms in RA pts.Conclusion BR is a common lung lesion in pts with RA in China,and the dose was not correlated with ILD,the number of segment involved by BR is a risk factor for respiratory symptoms.

BACKGROUND:Stem cel transplantation has incomparable superiorities in the treatment of cardiovascular diseases. But stem cel s have a very low efficiency to differentiate into myocardial cel s spontaneously, and there are many factors influencing stem cel differentiation. OBJECTIVE:To clarify the pros and cons of different sources of stem cel s in the treatment of myocardial infarction, to investigate the methods for improving the differentiation efficiency of myocardial cel s, optimal differentiation conditions and mechanism underlying exercise-induced stem cel mobilization and endogenous myocardial cel regeneration. METHODS:A computer-based search of CNKI and PubMed databases was performed by the first author for articles related to stem cel therapy for myocardial infarction and stem cel differentiation into myocardial cel s, exercise effect on stem cel proliferation and myocardial cel regeneration published from 1985 to 2015. The key words were“stem cel s, myocardial infarction, myocardial regeneration, cardiac cel , exercise”in Chinese and English, respectively. Final y, 54 articles were included in result analysis. RESULTS AND CONCLUSION:In recent years, a variety of chemical inducers and biological components have been used in the myocardial differentiation of stem cel s. Simulation of myocardial microenvironment and vascular cel growth factors are the main methods of inducing myocardial differentiation. Aerobic exercise-induced stem cel mobilization can induce ischemic cardiac angiogenesis and upregulate a variety of vascular endothelial growth factors so as to promote myocardial proliferation and repair. However, in-depth exploration is stil needed in the harvesting of stem cel s, transplant rejection, and regulatory mechanisms underlying the directed differentiation of stem cel s into cardiomyocytes.

Objective To investigate whether there is any consistent evidence of linkage across multiple studies,and to identify novel AS susceptibility loci by using GSMA method.Methods Genome-search Meta-analysis(GSMA)method was applied to genome scans of AS and spondyloarthropathy(SpA)to assess evidence for linkage across studies.Results Four AS genome scans including 479 families with 1151 affected individuals were used.Suggesting these BINS most likely contain AS-linked loci;BINS 6p22.3-p21.1,6pter-p22.3,17pter-p12,2p12-q22.1 and 5q34-qter.Four AS genome scans and one SpA scan including 544 families with 1,331 affected individuals were used.The GSMA produced genome-wide evidence for linkage on bin 6p22.3-p21 and 16q23.1-qter.Conclusion This GSMA added the evidence of the HLA loci as the greatest susceptibility factor to AS and shows evidences of chromosome 6,17p,2,5q and 16q as non-HLA susceptibility loci.

Objective To investigate the therapeutic effect of 4-1BB monoclone antibodies on mice hepatitis induced by Coneanavalin A (ConA) and its influenes on CD4+CD25+T lymphoeytes during the course. Methods The miee model of hepatic injury was indueed by ConA and monitored by hepatic function tests and hepatic pathology. The expressions of 4-1BB were examined by flow eytometry. 4-1BB monoelone antibodies were intravenously injected to the mice. The therapeutic efficacy was then examined by hepatic function tests and hepatic pathology. The expressions of CD4+CD25+T lymphoeytes were also examined by flow eytometry. Results The group of immune hepatic injury induced by ConA showed damage and marked increase of ALT and AST which were (139±22) U/L and (130±16) U/L respectively. The expression level of 4-1BB was 8.1±2.6. Compared with the eontrol group, the difference was significant (P<0.05). The overall eondition of the miee was improved after being treated with 4-1BB monoelone antibodies. ALT and AST were lowed down to (98±14) U/L and (89±11) U/L respectively and the differenee was signifieant (P<0.01). The expression of 4-1BB of the control group was 3.0±0.8 and that of the treatment group was 8.3±3.0. The difference was significant (P<0.01). Conclusion 4-1BB eontributes to the immune-mediated hepatic injury induced by Con-A.

Objective To investigate the therapeutic effect of 4-1BB monoclonal antibodies (4-1BBmAb) and glucocorticosteroid and the affect of the expression of CD4+CD25+T lymphocytes on the mouse hepatitis induced by ConA.Methods Mouse model of hepatic injury was induced by the application of ConA and checked by hepatic function tests and hepatic pathology.Mter the animal models were constructed,the mice in the group of therapeutic alliance were treated with glucocorticosteroid and 4-1BBmAb.In contrast,mice in the control group were treated with 4-1BBmAb or glucocorticosteroid alone.The groups were then compared.After blood was collected respectively from the control group,the model group and the therapy group,flow cytometry was used to examine CD4+CD25+T lymphocytes.Chi-square test and t-test were used for statistical analysis.Results Compared with the control group,the conditions of the mice were improved after being disposed with 4-1BBmAb.The conditions became even better when 4-1BBmAb were used combined with glucocorticosteroid.ALT and AST of the control group were (140±22) U/L and (131±16) U/L respectively,that of 4-1BBmAb group were (98±14) U/L and (89±11) U/L respectively.The ALT and AST of the glucocorticosteroid treatment group were (76±11) U/L and (71±10) U/L respectively,ALT was (61±8) U/L and AST was (55±7) U/L in the combination treatment group.Differences among groups was statistically significant (P＜0.01).The expression of CD4+CD25+T lymphocytes was (3.0±0.8)％ in the control group,(8.5±2.9)％ in the gluco-corticosteroid treatment group,(8.4±3.5)％ in the 4-1BBmAb treatment group and was (11.2±3.5)％ in the combination treatment group.The difference was significant among the groups (P＜0.05).Conclusion 4-1BB-mAb have therapeutic effect for hepatic injury.The effectiveness will become even more evident when 4-1BB monoclonal antibodies are used together with glucocorticosteroid.During the course of treatment,4-1BBmAb and glucocorticosteroid can impact the expressions of CD4+CD25+T lymphocytes and this is the mechanism for the effectiveness in treating immune-mediated hepatic injury.

Objective:To find out the apoptosis mechanism of HT-29 colon cancer cell induced by NDGA,the lipoxygenase inhibitor in vitro.Methods:We applied respectively:RT-PCR to detect colon cancer cell’s expression of 5-LOX messenger ribonucleic acid(5-LOXmRNA) and that of messenger ribonucleic acid about human telomerase reverse transcriptase(hTERTmRNA)respectively,confocal laser scanning electron microscope to examine intracellular free calcium.Results:Colon cancer cell lines HT-29 showed positive expression of 5-LOXmRNA.This expression became weaker following the rise of cell’s apoptosis and so were hTERTmRNA.Intracellular Free calcium increased following the rise of cell’s apoptosis.Conclusion:The apoptosis of tumor cell is caused by a combination of factors,with 5-LOX,telomerase and free calcium all active in the course.

Objective To evaluate the efficacy objectively and systematically between endoscopic and microscopic surgery for transsphenoidal pituitary adenoma by a Meta-analysis.Methods A systematic literature search of Medline,the Cochrane Library,the Web of Science and the Google Scholar were performed to recruit studies between January,1990 and May,2015 that compared endoscopic and microscopic approaches in the treatment of pituitary adenomas.A Meta-analysis(R-3.1.3) was conducted to estimate the effect of different operative procedures.Results A total of 22 studies including 3 randomized or quasi-randomized controlled trails and 19 case-control studies met the inclusion criteria.Among 1421 patients studied,733 of them were treated with endoscopic and 688 were treated with microscopic surgery.The rate of gross tumor removal was higher in patients who underwent endoscopic surgery (71％) than those who underwent microscopic surgery (56％)(P ＜ 0.05).The rate of remission of hypersecretion was also higher in patients who underwent endoscopic surgery(60％) than those who underwent microscopic surgery(54％),but the difference was not significantly(P ＞ 0.05).Conclusion The present study indicates that the endoscopic transsphenoidal approach is more effective than microscopic surgery in the treatment of pituitary adenomas.

Objective:To investigate the frequency of metabolic syndrome (MS) in patients with psoriatic arthritis (PsA) and further analyze the correlation of MS and its components with clinical features of PsA.Methods:Data including demographics, clinical manifestations, laboratory tests, MS-associated features (height, weight, waist circumference, blood pressure, serum lipid spectrum, and so on) and history of complications (hypertension, diabetes mellitus, atherosclerosis, coronary heart disease, and cerebral vascular disease) were collected from PsA patients in our hospital from Jan 2017 to Sep 2019. The frequency of MS in PsA patients was calculated and the association between PsA clinical manifestations and MS as well as its components was investigated.Results:One hundred and sixty-two PsA patients who fulfilled the Classification Criteria for Psoriatic Arthritis (CASPAR) were recruited. Hypertension was identified in 36 (22.2%) patients, diabetes mellitus in 28(17.2%) patients, coronary heart disease in 11(6.7%) patients, and cerebral vascular disease in 7 (4.3%) patients. Based on the criteria of the International Diabetes Federation (IDF), 58(35.8%) patients were diagnosed as MS. Compared with MS-free patients, patients with MS, hypertension or diabetes mellitus were older [(54±10 vs 44±13; 56±11 vs 45±12; 54±11 vs 44±13, respectively, t=5.058 , 4.450, 5.150, P<0.01 for all], with higher disease activity [DAPSA scores 16.75(11.25, 26.7) vs 8.8(4.8, 16.4), 16.3(9.6, 27.8) vs 10.0 (5.1, 18.0), 14.4 (9, 25.7) vs 9.5 (5, 17.7), Z=4.539 , 3.046, 3.063, P<0.01]. There was a positive correlation between the sum of components of MS and DAPSA score ( r=0.27 , P<0.01), but multiple linear regression showed no correlation between each component with DAPSA score ( P>0.05) except for hypertension ( P<0.01, standard coefficient=0.334) and elevated fasting blood glucose ( P=0.023, standard coefficient=0.247). PsA patients with hypertension had higher ESR [16.5 (9.5, 34.25) mm/1 h vs 10 (5, 24.5) mm/1 h, Z=2.127, P=0.012]. CRP level was higher in patients with dyslipidemia [5.6(2.1, 17.8) mg/L vs 3.7(1.5, 6.5) mg/L, Z=2.543, P<0.01]. Prevalence of inflammatory back pain was also higher in dyslipidemia patients (41.3% vs 22.4%, χ2=5.901, P=0.016). DAPSA score was higher in dyslipidemia patients (14.1 vs9.9, P=0.031). Conclusion:MS and its components are not rare comorbidities in PsA patients. PsA patients with MS tend to be older with higher disease activity, which calls for more attention.

Objective: To investigate the epidemiological characteristics of other infectious diarrhea (OID) in Huzhou City, Zhejiang Province from 2013 to 2023, so as to provide the basis for formulating of prevention and control measures for OID. Methods: Data of OID in Huzhou City from 2013 to 2023 were collected from the Infectious Disease Reporting Information System of Chinese Disease Prevention and Control Information System. Epidemiological and etiological characteristics of OID cases were analyzed using a descriptive epidemiological method. Results: A total of 111 455 cases of OID were reported in Huzhou City from 2013 to 2023, with an average annual reported incidence of 331.82/105, showing a decreasing trend (P<0.05). The peak incidence of OID was reported from July to August and from November to February of the following year, primarily due to bacterial and viral pathogens, respectively. Changxing County had the highest reported incidence of OID (660.62/105), while Anji County had the lowest (188.92/105). Among the reported cases, 58 259 were male and 53 196 were female, with a male-to-female ratio of 1.10∶1. The highest incidence was observed in children aged under 1 year (4 545.70/105). The majority of cases were scattered children, with 36 933 cases (33.14%). There were 22 639 cases with clear pathogens, and rotavirus was the most common, with 16 953 cases (74.88%). Conclusions The overall incidence of OID in Huzhou City showed a decreasing trend from 2013 to 2023. OID peaked in summer and winter and was primarily observed in children aged 1 year below and scattered children. Rotavirus infection was the dominant etiology.

Objective To investigate the outcomes of patients with rheumatoid arthritis (RA) treated by different combination of synthetic disease modifying antirheumatic drugs (DMARDs) under the guidance of treat-to-target strategy.Methods Forty-two RA patients with high disease activity were enrolled into this randomized,open-label and prospective study.It was comprised of a maximal 36-week induction phase and then followed by a maintenance phase up to 84 weeks.Combination of synthetic DMARDs was initiated in the induction phase,with or without low dose glucocorticoids (GCs) during the first 12 weeks.Patients who achieved low disease activity (LDA) were randomized into two maintenance groups.An increase of DAS28 by 0.6 was defined as relapse.The patients achieved LDA in the induction phase,relapsed during maintenance phase and possible relevant risk factors were analyzed.Results Twenty-seven (64％) patients achieved LDA during the induction phase.More non-smoking patients achieved LDA than those smoked [85％ (11/13) vs 55％(16/29),P＜0.05].During the maintenance phase,14 (61％) out of 27 patients relapsed.Patients taking GCs during the first 12 weeks had a significantly higher relapse rate compared to those without GC (83％ vs 36％,P=0.021).Patients who entered maintenance phase at week 12 had a significantly higher tendency to relapse compared to those who entered the maintenance phase at week 24 [75％(9/12) vs 33％(3/9),P=0.026].Conclusion Smoking seems to be a risk factor for RA patients who fail to reach LDA.Low dose GCs as a bridge therapy may require a longer duration.High relapse rates in both the maintenance groups indicat that a longer tight induction phase may be appropriate before downstairs therapy.