Objective To explore the nuclear factor-kappa-B activator 1 (Act1) expression in salivary gland and peripheral blood lymphocytes in patients with Sj(o)gren's syndrome (SS),and to explore its possible regulatory mechanisms.Methods The Act1 expression in salivary gland tissue from 10 patients with SS was analyzed by immunohistochemical staining,and immunolluorescence double staining was used to detect Act1-expressing cells.Peripheral blood mononuclear cells were obtained from 28 SS patients and 22 healthy controls (HC).The Act1 expression in different lymphocyte subpopulations was determined by flow cytometry and Act1-mRNA expression was detected by reverse transcription polymerase chain reaction (RT-PCR),and the data was analyzed by Wilcoxon test and Mann-Whitney U test and Pearson correlation analysis.Results Remarkable expression of Actl in the salivary glands from SS patients was observed,especially in T lymphocytes,in contrast to the few expression in B lymphocytes.The expression of Act1 in the peripheral CD4+ T cells,CD8+ T cells,CD20+ B cells was higher in SS patients than HC.There was no significant difference of Act 1-mRNA levels in peripheral blood mononuclear cells in healthy controls and SS patients.However,a tendency of up-regulation of Act1 expression was noticed in SS patients than healthy controls (0.84±0.35 vs 0.79±0.21,U=274.5,P＞0.05),and the up-regulation of Act1 was also found in those SS patients with hypergammaglobulinemia (0.88±0.39 vs 0.75±0.27,U=73.0,P＞0.05) or with internal organ involvement(0.92±0.38 vs 0.77±0.33,U=75.0,P＞0.05),but the differences were not statistically significant.Conclusion Our data suggest that Act1 may be involved in the pathogenesis of SS by negative feedback mechanism in B cell-mediated humoral immune pathway,and positive feedback mechanism in IL-17 mediated T-cell immune pathways.Act1 may be associated with disease activity and severity in SS.

Objective To analyze the nuclear factor-kappa-B activator 1 (Act1) expression in synovial tissues and peripheral blood lymphocytes in patients with rheumatoid arthritis (RA),and explore its possible regulatory mechanisms.Methods The Act1 expression of synovial tissue from 10 RA patients and 5 osteoarthritis patients were analyzed by immunohistochemical staining,and double immunofluorescence staining was used to identify the Act1-expressing cells.The peripheral blood of 47 RA patients and 22 healthy controls (HC) were obtained.The Act1 expression in different lymphocyte subpopulation from peripheral blood was determined by flow cytometry and Act1-mRNA expression was detected by real-time quantitative polymerase chain reaction (RT-PCR).The data was analyzed by Mann-Whitney U test,two independent sample t test and Pearson correlation analysis.Results Remarkable infiltration of inflammatory cells and expression of Act1 in synovium from RA patients was observed.The Act1 was expressed in T lymphocytes,in contrast to the few expression in B lymphocytes.Compared to HC,the expression of Act1-mRNA was lower in peripheral CD4+ T cells and CD8+ T cells [CD4+ T cells:133 (69,380) vs 158 (117,246),U=36,P＞0.05; CD8+ T cells:127(63,363) vs 129(81,222),U=35,P＞0.05],however,higher in CD20+ B cells in RA patients [62(34,81) vs 52(33,105),U =36,P ＞0.05].There was no significant difference of Act1-mRNA levels in peripheral blood mononuclear cells between HC and RA patients (0.71 ±0.32 vs 0.79±0.21,t=1.717,P=0.091).However,a tendency of down-regulation of Act1 expression was noticed in RA patients than HC.No significant correlation was found between Act1-mRNA level and RA disease activity index.Conclusion Our data suggest that Act1 may be involved in the pathogenesis of RA,however,we could not yet found its association with RA disease activity.

Objective:To investigate the efficacy and safety of less invasive surfactant administration(LISA) of neonatal respiratory distress syndrome(NRDS).Methods:From July 2017 to December 2018, 50 premature infants with birth weight ≤1 500 g and/or gestational age≤32 weeks diagnosed as NRDS at the Fifth Medical Center of PLA General Hospital were randomly divided into LISA group( n=25)and INSURE group( n=25). The patients in LISA group was inserted fine duct into the trachea through direct laryngoscope under nasal continuous positive airway pressure (nCPAP) and pulmonary surfactant was injected.The INSURE group adopts endotracheal intubation-pulmonary surfactant-nCPAP was performed after unplugging.The changes of vital signs, blood gas indexes, adverse reactions and the incidence of complications were compared between two groups at different time points. Results:There was no significant difference in respiration, heart rate, systolic blood pressure, diastolic blood pressure and PaO 2, PaCO 2, BE, SpO 2 between two groups at different administration time points.Although the pH value of LISA group was lower than that of INSURE group, it was within the normal range.There was no significant difference in bronchopulmonary dysplasia, intraventricular hemorrhage, periventricular leucomalacia and other complications between two groups, and there was no death, air leakage, retinopathy of prematurity and pulmonary hemorrhage in both two groups.In addition, there was no significant difference in hospitalization days, total medical expenses, oxygen use time between the two groups(all P>0.05). Conclusion:Compared with INSURE technology, LISA technology has its feasibility for premature infants with NRDS, but the effectiveness and safety in the practical application need to be further confirmed.

Medicine, Chinese Traditional ; Mind-Body Relations, Metaphysical

Objective To evaluate the health status ,dyspnea and exercise endurance in the patients with chronic obstructive pul-monary disease(COPD) by the CAT scale ,modified medical research council(mMRC) dyspnea scale and 6-min walk test(6MWT) and to analyze the correlation between their evaluation results with the percentage (FEV1% pred) of the forced expiratory volume at 1 second(FEV1) in the predict value and whether complicating pulmonary hypertension (PH) .Methods 70 patients with COPD were performed the examinations of the lung function ,CAT scale ,mMRC score and 6MWT .The correlation among the various e-valuation systems and between each evaluation system with the severity of the pulmonary function airway limitation were compre -hensively evaluated .The CAT scores ,mMRC scores and 6 min walking distance(6MWD) were compared between the COPD com-plicating PH group and the simple COPD group .Results The CAT scale was negatively correlated with 6MWD(r= -0 .623 ,P<0 .01) and had no correlation with FEV1% pred(P=0 .159) .The CAT scale was positively correlated with mMRC (r=0 .492 ,P=0 .000) .mMRC was negatively correlated with 6MWD(r= -0 .514 ,P= 0 .000) and had no correlation with FEV1% pred(P>0 .05) .The CAT scores had statistical difference between the COPD complicating PH group and the simple COPD group (P<0 .01) .6MWD had the highest accuracy for screening COPD whether complicating PH ,followed by CAT .The diagnostic cut-off point by adopting CAT for judging the risk of COPD complicating PH was 21 .Conclusion The CAT scale has good correlation with 6MWD and no correlation with FEV1% pred .The CAT scale is more suitable for the overall assessment of the total severity of COPD .Patients with the high CAT scores have higher risk of suffering from PH .

Objective To explore the effect of TBL based on evidence-based medicine PICOS model in practice teaching of neurology. Methods Totally 47 medical undergraduates in our department were chosen and randomly divided into 2 groups during March 2016 to April 2016. 24 students in the trial group were taught with TBL based on PICOS, while other 23 students in the control group were only taught with conventional TBL method. After three times clinical practices, the test referring to disease pathogenesis, clinical manifestations, auxiliary examinations, diagnosis and treatments of related diseases was performed, and meanwhile, questionnaires were distributed to students in order to survey their satisfaction degree of teaching methods. All the evaluation results and scores of two groups were compared. Statistical data were analyzed by using t-test or Chi-square test with SPSS 17.0 software. Results The score of the theoretical test of trial group was significantly superior to the control group [(89.08±3.60) vs. (79.09±7.75), t=5.707, P=0.03 ]. Survey showed that in the experimental group , the number of students in the trial group who thought teaching method could help understand clinical thinking of neurology and could help integrate the theory into clinical practicewas significantly higher than that in the control group (P<0.05). Conclusion In the clinical teaching of neurology, the TBL based on PICOS model is more effective than conventional TBL method for medical undergraduates.

Objective To establish the cancer vaccine (EC109-DC) prepared by fusions of esophageal carcinoma cell line with dendritic cell derived from cord blood and study the biological characteristics and antitumor immunity.Methods CD 34 + hematopoietic stem cells were isolated from cord blood using CD 34 + Progenitor Cell Isolation Kit by magnetic cell sorting system (MACS);expended the cells as DC,and then fused with EC109 by PEG-3600;selected the fusion cells by MACS;observed the phenotypes and proliferation by flow cytometry and technique of cell culture in vitro. Lymphocytes proliferation reaction and the CTL cytotoxicity were examined with MTT.Results EC109-DC could proliferate slowly in vitro and highly expressed CD80,CD83 and CD86.Lymphocytes proliferation reaction and the specific cytotoxicity against EC109 induced by EC109-DC cells were significantly higher than the control groups (P

ObjectiveTo investigate the corelation between fibrinogen in pleural effusion and pleural adhesion in tuberculosis exudative pleurisy.Methods234 cases of primary tuberculosis pleurisy were divided into 3 groups (A、B、C) according to their level of fibrinogen in pleural effusion from low to high. The incidence rates of pleural adhesion were assessed during the course of treatment and after treatment.ResultsThe incidence rate of pleural adhesion in the course of treatment were as those: group A 10.5%, group B 32.3%, group C 54.5%. After treatment, it was as those: group A 10.5%, group B 16.9%, group C 42.4%. Whenever, there was significant difference between group C and group A or B (P<0.05).ConclusionThe level of fibrinogen in pleural effusion may be associated with pleural adhesion, which hinder the recovery of patients.

This study plans to prepare lipid bilayer-coated mesoporous silica nanoparticles (LMSNs) which are pH sensitive with core-shell structure to improve the tumor cell lethality of antitumor drug. The lipid coated mesoporous silica nanoparticles loaded with irinotecan (CPT-11) (CPT-11-LMSNs) were prepared by hot water-film hydration method, and the characterized its morphology, particle size and release in vitro. Meanwhile, the intracellular uptake and cell toxicity of CPT-11-LMSNs and intracellular accumulation of CPT-11 were evaluated on human breast carcinoma cell line (MCF-7). The results indicated that the mean diameter of the spherical LMSNs was (120.27 +/- 5.91) nm. The slow release in simulated normal physiological conditions and a rapid release under simulated intracellular condition demonstrated the pH sensitivity of CPT-11-MSNs in vitro. Moreover, the CPT-11-LMSN could improve the intracellular CPT-11 cumulant 2.1 times and reduce half maximal inhibitory concentration (IC50) values of CPT-11 1.4 times compared with CPT-11-MSNs, demonstrating a stronger cell lethality.

A total of 52 endophytic fungi were isolated from roots and stems of Tibetan medicinal plant Phlomis younghusbandii Mukerjee. These fungal isolates were molecularly identified based on ITS sequnces and 28S sequences distributed to 12 genera, including Phoma, Chaetosphaeronema, Fusarium and Leptosphaeria, etc. Among them, the dominant genus was Phoma. Extracts of all strains were evaluated for anti-HIV-1 integrase activity by using soluable integrase expressed in E. coli BL21 (DE3). The results showed that seven samples from five fungal endophytes PHY-24, PHY-38, PHY-40, PHY-51, PHY-53, which belonged to genus Chaetosphaeronema, inhibited strand transfer reaction catalyzed by HIV-1 integrase with IC50 values, of 6.60, 5.20, 2.86, 7.86, 4.47, 4.56 and 3.23 microg x mL(-1) respectively. In conclusion, the endophytic fungi of Phlomis younghusbandii Mukerjee are valuable for further screening anti-HIV-1 integrase agents.