Systemic lupus erythematosus (SLE) is an autoimmune disease that mainly affects young and middle-aged women. It can involve multiple organ systems, with complex and diverse clinical manifestations. The research on the etiology, diagnosis and treatment of SLE has always been a hot spot in this field. In 2019, a lot of new progress was made in the pathogenesis, diagnosis and evaluation, and treatment of SLE in China and other countries, and this review summarizes main representative advances.

Objective To explore the characteristics of heart rate variability (HRV) and its impact factors in patients with cerebral infarction and provide evidence for treatment of cerebral infarction. Methods The clinical data of 190 patients with cerebral infarction were analyzed. These patients admitted to our hospital from May 2007 to June 2009 and CT or MRI confirmed their diagnoses. Fifty healthy subjects in the same period were chosen as control group. The 24 h HRV analysis technology was employed to compare the activity impairment of their cardiac autonomic nervous. According to age, gender, type of infarction, infarct location, severity and prognosis, patients with cerebral infarction were divided into several subgroups; the impact of these factors on patients with HRV was analyzed. Results HRV indexes in patients with cerebral infarction were lower than those in the control group (P<0.05). Patients that were older than or equal to 60-year-old showed lower HRV indexes as compared with the patients that were younger than 60-year-old (P<0.05). Except for the temporal frequency, the other HRV indexes satisfied the following conditions: lower HRV indexes in female were showed as compared with those in male (P<0.05); the HRV indexes in patients with lacunar infarction were significantly higher than those in patients with atherosclerotic cerebral infarction or cerebral embolism (P<0.05); patients with right insula infarction showed significantly lower time domain HRV indexes than patients with other position infarction (P<0.05); HRV indexes were low in patients with low GCS scores. The lowest HRV indexes were noted in patients with the incidence of death, followed by patients with improvement and cured patients. Conclusion Autonomic nervous system in patients with cerebral infarction is overbalanced. Early dynamic monitoring of HRV can determine the extent of brain injury and the evolution of the disease, contributing to early identification of high risk patients and guiding the clinical treatment.

OBJECTIVEIschemic postconditioning effectively minimizes the ischemic/reperfusion injury, and the large series of case reports on its protective effects in cardiac surgery are limited. A randomized trial was conducted to investigate the effect of ischemic postconditioning on cardiopulmonary protection in children undergoing cardiac surgery for tetralogy of Fallot.

METHODSOne hundred and five-children with tetralogy of Fallot undergoing surgery were randomly assigned to control (n=58) and ischemic postconditioning groups (n=47). Ischemic postconditioning was performed by intermittent aortic clamping after reperfusion. After surgery, the duration of intensive care unit (ICU) stay, capacity of blood transfusion, hemodynamics, inotropic scores, respiratory function, and release of blood lactate were assayed.

RESULTSThere was a significant decrease in the ICU stay in the postconditioned group compared with the control group (37+/-21 hrs vs 54+/-26 hrs; P<0.05 ). The capacity of blood transfusion (308+/-230 mL vs 526+/-515 mL; P<0.05) and the inotropic scores (5.9+/-5.0 vs 10.3+/-7.7; P<0.05) in the postconditioned group were significantly reduced compared with those in the control group. Blood lactate contents in the postconditioned group was significantly lower that those in the control group 1, 3, 6, 9, 12 and 20 hrs after surgery. The postconditioned group showed more improved hemodynamics and respiratory function than the control group.

CONCLUSIONSIschemic postconditioning may provide clinical benefits with respects to myocardial and pulmonary protections in children undergoing repair for tetralogy of Fallot.

Adolescent ; Cardiac Surgical Procedures ; methods ; Cardiopulmonary Bypass ; Child ; Child, Preschool ; Female ; Hemodynamics ; Humans ; Infant ; Lactic Acid ; metabolism ; Male ; Myocardial Reperfusion Injury ; prevention & control ; Postoperative Complications ; prevention & control ; Respiration ; Tetralogy of Fallot ; physiopathology ; surgery

The gene of mutated TNF-?D4 gene was amplified by overlap PCR and cloned into the prokaryotic expressive vector pBV220.TNF-?D4 contains two changes:substitutions of Pro8Arg,Ser9Lys,Asp10Arg,Ile157Phe,Leu29Ser,Arg31Val and a deletion of the N terminal four amino acids.The recombinant vector pBV220-TNF-?D4 was transformated into E.coli strain DH5?,and the high expression strain was obtained by screening monoclones.The level of expression was about 45% of total cell protein.After purification,the purity of fusion protein was above 90% by HPLC and relative ability was 8 ?107.TNF-?D4 was modificated by mPEG-ButyrALD。After purification,the purity of mPEG-TNF-?D4 was above 85% and relative ability was 8.6?107.The in vivo systemic toxicity of mPEG-TNF-?D4,which is indicated by LD50,is lower than that of rhTNF-?.These results strongly supported for the further study and exploitation of TNF-antitumor drug.

Acute Kidney Injury ; therapy ; Cardiac Surgical Procedures ; adverse effects ; Female ; Humans ; Infant, Newborn ; Male ; Peritoneal Dialysis

OBJECTIVETo assess the therapeutic effect, timing of administration, complication prevention and management of the double filtration plasmapheresis (DFP) in the treatment of refractory myasthenia gravis (MG).

METHODSThirty-one patients with refractory MG were treated with KM 8800 membrane plasmapheresis monitor. DFP was performed every 3 days and the exchanging liquid was composed of 50 ml of 20% albumen and 1000 ml plasma substitute. Physical examination for absolute clinical score and blood sample was collected for AchR-Ab determination early in the morning on days 0, 3, 7, 14 of DFP.

RESULTSWith a total effective rate of 91.9%, complete recovery, basic recovery, improvement, and response was achieved in 2, 4, 11, and 17 patients, respectively, whereas the other 3 failed to respond. Hypotension occurred twice in 2 cases and was corrected after symptomatic treatment.

CONCLUSIONDFP may effectively lower blood AchR-Ab level of with minimal complications, and can be valuable for treatment of refractory MG.

Adolescent ; Adult ; Autoantibodies ; blood ; Child ; Female ; Filtration ; Humans ; Male ; Middle Aged ; Myasthenia Gravis ; blood ; therapy ; Plasma Exchange ; methods ; Receptors, Cholinergic ; immunology ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo establish and assess the Caco-2 cell in vitro absorption model.

METHODSCaco-2 cells were cultured on the millipore filters fixed in Snapwell transport chamber. The cell morphology, transepithelial electrical resistance, mannitol efflux rate and alkaline phosphatase activities were monitored during culture.

RESULTSAfter 21 days of in vitro culture, formation of tight junction was observed between the cells. The transepithelial electrical resistance reach a relatively stable value of 620-/+47 Omega.cm(2), the mannitol efflux rate was lower than 0.3%.h(-1).cm(-2), and the alkaline phosphatase activity in the apical side was significantly higher than that in the basolateral side.

CONCLUSIONThe established Caco-2 cell model shows similar morphology to intestinal epithelial cells with formation of polarity, and can be used as an in vitro model for absorption studies.

Caco-2 Cells ; Cell Culture Techniques ; methods ; Epithelial Cells ; cytology ; metabolism ; Humans ; Intestinal Absorption ; Intestines ; cytology

OBJECTIVETo study the feasibility of close and three-dimensional reconstruction of maxillary defects combination with pedicled buccal fat pad graft, temporalis myofascial flap and titanium mesh.

METHODSAmong 11 patients with maxillary tumors, 9 were malignant and 2 were benign. 8 cases underwent subtotal maxillectomy and 3 cases underwent total maxillectomy. Maxillary defects were closely reconstructed combination with pedicled buccal fat pad graft (BFP), temporalis myofascial flap (TMF) and titanium mesh to restore the profile of maxilla.

RESULTSAll flaps were alive with satisfactory function and aesthetic appearance. The uncovered BFP and the facial muscle surface of TMF epithelialized within 4-6 weeks. Their degree of mouth opening ranged from 2.5 to 4.0 cm and without nasal foods return. All patients had a good voice quality.

CONCLUSIONMaking use of BFP, TMF and titanium mesh can restore the good contour and function of maxillary. It is an effective method of reconstruction of maxillary defects, and is easy to manipulate. It is worthy to popularization.

Adipose Tissue ; Female ; Humans ; Male ; Maxilla ; Maxillary Neoplasms ; Middle Aged ; Prostheses and Implants ; Reconstructive Surgical Procedures ; Surgical Flaps ; Titanium

Systemic lupus erythematosus (SLE) is a complex autoimmune disease mainly involving young and middle-aged women, with various clinical manifestations and complicated pathogenesis. SLE has always been a hot spot in the field of autoimmune diseases. This review summarizes new achievements and advances in genomics and clinical studies in SLE in 2018.

Objective To compare the effect of cutaneous buckle and conventional suture on the suturing time and the artistic appear -ance of postoperative incision with patients who underwent anterior cervical spinal surgery .Methods The patients were randomly divided in-to cutaneous buckle group(50 patients) and conventional suture group(50 patients),the suturing time and artistic appearance of postopera-tive incision of two groups were observed .Results Buckle group and conventional suture group both got good wound healing ,the same heal-ing rate of two groups(100％) showed that there was no statistical difference in healing rate (P>0.05).The mean time of buckle group and conventional group were 7.3 minutes and 13.5 minutes,respectively,the suturing time of cutaneous buckle group was much shorter than con-ventional suture group (P<0.05).The satisfactory degree for artistic appearance of the former was higher than the latter (9.1 vs.6.8 points),the difference was significant(P<0.05).Conclusion Compared with conventional suture ,cutaneous buckle has the advantages of shorter suturing time ,better artistic appearance of incision and higher satisfactory degree in the anterior cervical spinal surgery .