The Janus kinase (JAK) /signal transducer and activator of transcription (STAT) signaling pathway plays an important role in the occurrence of dermatomyositis. JAK inhibitors can block signal transduction dependent on JAK/STAT pathway-related factors, and inhibit immune cell activation and T cell-mediated inflammatory responses. So far, the US Food and Drug Administration (FDA) has only approved rheumatic arthritis and myelofibrosis as the indications of JAK inhibitors, but there have been many reports on JAK inhibitors for the treatment of refractory dermatomyositis. This review summarizes the role of JAK/STAT pathway in the pathogenesis of dermatomyositis, the mechanism of action and clinical application of JAK inhibitors in the treatment of dermatomyositis.

OBJECTIVE: To investigate whether the proteasome inhibitor, gliotoxin, combined with the endoplasmic reticulum stress inducer, tunicamycin, could enhance the apoptotic death of tumor cells. METHODS: MTT assay was used to detect the cytotoxicity. The combined drug index (CDI) was used to evaluate the synergistic effect. Flow cytometry was used to analyze the apoptosis rate. The protein expression level was detected by Western blot. RESULTS: The IC50 of gliotoxin and tunicamycin is (1.44±0.23) and (26.14±6.14) μmol·L-1, respectively. In the effective concentration, gliotoxin combined with tunicamycin could significantly inhibit cell proliferation and induce typical apoptotic morphological changes. The combination was synergistic according to the result of MTT assay. As measured by flow cytometry, the combination remarkably increased the apoptosis rates of HT-1080 cells, especially for 0.2 μmol·L-1 gliotoxin combined with tunicamycin, the apoptosis rate was up to 66.6% and CDI was 0.649. The expression changes of apoptosis-related proteins such as caspase-8, caspase-3, PARP and NF-kB were detected when treated with the combination. CONCLUSION: Gliotoxin can improve the chemosensitivity of fibrosarcoma HT-1080 cells to tunicamycin and enhance the apoptosis of tumor cells induced by tunicamycin. Thus, our study may provide a new drug combination to antitumor therapy.

ObjectiveTo evaluate the accuracy of the vascular ultrasound testing technique on detecting large arterial lesions in neck. MethodsVascular ultrasound testing and digital substraction angiography(DSA) were performed on 75 arteries in 53 consecutive patients with chronic cerebral ischemia, transient ischemic attack(TIA) or cerebral infarction.The sensitivity, specificity, and accuracy of vascular ultrasound testing on moderate stenosis(50%—69%), severe stenosis(70%—99%),or occlusion of arterial lesions in neck were analysed by means of cross tabulation, using DSA as the standard of reference. ResultsThe sensitivity, specificity and accuracy of vascular ultrasound testing on arterial lesions of moderate stenosis, severe stenosis and occlusion were 85.7%,78.9%,84.0%;90.2%,88.2%,89.3%;93.3%,95.0%,94.6%,respectively.The complete corresponding rate between the two type of tests was 73.3%. ConclusionThe vascular ultrasound testing technique shows high accuracy on detecting large arterial lesions, especially on severe stenosis or occlusion in neck. It can be applied extensively in prevention and treatment of cerebrovascular diseases.

Background Fungal keratitis has a high incidence in China and its clinical treatment is very difficult,and its etiology diagnosis and appraisal is the premise to improve the prognosis of disease.With the changes of regional environment and climate in recent years,whether the spectrum of fungal keratitis change in South China is remarkable.Objective The purpose of this study was to investigate recent pathogenic distribution of fungal keratitis in South China area.Methods The consecutive fungal culture resuhs of 3 350 purulent keratitis at Zhongshan Ophthalmic Center from January 2009 to December 2014 were retrospectively reviewed.The positive rate of fungal culture,genus or species distribution,seasonal distribution and different term distribution were analyzed.Results The culture-positive rate was 31.34％ in this study (1 050/3 350),and the average culture-positive number was 175 strains per year.In the positive fungus,the highest positive rate was Fusarium SP (32.10％,337/1 050),and followed by Aspergillus SP (25.71％,270/1 050),Heminthosporium SP (14.29 ％,150/1 050) and Mucor SP (9.14％,96/1 050).The fungal culture-positive rate was 36.05％ (367/1 018) in 2009 to 2010,32.45％ (324/1 014) in 2011 to 2012,and 26.86％ (354/1 318) in 2013 to 2014,respectively,with a significant difference among the three periods (x2 =22.37,P＜0.01),showing a decreasing tendency of incidence.Two hundreds and sixtyone strains were isolated from January to March (31.15 ％,261/838),182 strains from April to June (25.53 ％,182/713),237 strains from July to September (30.00％,237/790),370 strains from October to December (36.67％,370/1 009),showing a statistically significant difference among them (x2 =25.19,P ＜ 0.01).The number of infectious strains was most during October to December and fewest during April to June.Conclusions The leading pathogenic fungi of fungal keratitis is Fusarium SP and followed by Aspergillus SP,Helminthosporium SP,Mucor SP in turn.Fungal keratitis is usually prevalent from October to December,and its incidence is still rising in Chinese mainland recently.However,the increasing tendency in South China has been prevented in recent six years.

Objective To induce directional differentiation from spinal cord-derived neural stem cells(SNSCs)into neurocytes in the simulated microenvironment of development of embryonic spinal cord of rat after isolation and culture of SNSCs and to investigate the proliferation and differentiation of SNSCs in vitro.Methods SNSCs were isolated mechanically from rat embryonic(E10 to 11d)spinal cord under microscope.SNSCs were cultured and maintained in serum-free medium.Directional differentiation from SNSCs to neurocytes was induced by adding N4 supplement.The morphologic features of the differentiated cells were noted.Cultured and differentiated cells were identified by immunochemistry stain and t he mean differentiating percentages of the positive cells were calculated.Resul ts SNSCs isolated by the mechanical method under microscope were vigorous and pr oliferative,and could differentiate into neurons,astrocytes and oligodendrocyt es.Conclusion The mechanical method under microscope of isolating SNSCs is simp le and efficient to obtain a high percentage of neurons.N4 supplement can induc e SNSCs to differentiate into neurocytes.

Objective To diagnose the intrauterine occupational disease by vaginal ultrasonography or hysteroscopy, and to evaluate the diagnostic values of these two methods. Methods One hundred and fifty patients were detected by vaginal ultrasonography and hysteroscopy from Jan 2004 to Dec 2004, and a total of 71 cases were confirmed intrauterine occupational disease. Tissue hysteroscopy or bioposy were performed during the hysterosocopy in order to analyse the tissue pathology. Results In these 71 patients, 47 were no less than 46 years old. Most of them had abnormal uterine bleeding.Thirty-three cases (46.48%) were suggested by vaginal ultrasonography, and 49 (69.01%) by hysteroscopy. Thirty-eight cases (53.52%) were in line with the pathological result.There were significant differences between vaginal ulterasonography and hysteroscopy in diagnosing the intrauterine occupational disease (P

Objective To evaluate the application of MSCT 3D reconstruction technology without contrast on pulmonary arterio-venous malformation(PAVM).Methods The clinical and imaging data of 12 cases with PAVM confirmed by DSA were analyzed ret-rospectively.The plain scan with 16 slice spiral CT scanner performed pulmonary 3D reconstruction at post-processing work station by methods of MPR,MIP and VR.Results All cases could be diagnosed accurately,and images could clearly show the spatial struc-tures and its relations of the feeding arteries,draining vein and aneurysmal sac.Conclusion MSCT post-processing technique of PAVM without contrast is able to make a precise diagnosis,and to show the configuration of PAVM,which does not need contrast medium and acquirelow radiation dose.

To provide suggestions for perfecting essential drug centralized bidding and purchasing system. Methods:Using literature method to analyze comparatively essential drug bidding purchasing implement plans of 30 provinces in China. Results:Bidding mode in most provinces was double envelope system. Most evaluation methods did not distinguish the quality level, while there were great differences among provincial evaluation standard and scores of economic, technical and business bidding. Conclusion: To explore scientific and reasonable evaluation standard, it needs to establish an authoritative evaluation system for reference, choose the objective index as far as possible and properly increase the amount of bidding manufacturer.

Objective To summarize the clinical experience of laparoscopic cholecystectomy (LC) in the treatment of acute cholecystitis. Methods A total of 93 cases of acute cholecystitis treated by LC from May 2003 to May 2005 was retrospectively reviewed, including 15 cases of preoperative endoscopic retrograde cholangiopancreatography (ERCP) combined with endoscopic sphincterotomy (EST) for common bile duct stones and 6 cases of intraoperative cholangiography. The LC was performed within 48 hours after admission. Results The LC was successfully completed in 91 cases (97.8%), whereas a conversion to open surgery was required in 2 cases (2.2%). The operation time was 35~160 min (mean, 65 min). Postoperatively, biliary leakage occurred in 3 cases (3.2%) and residual stones in the common bile duct were found in 3 cases (3.2%), which were all cured by open surgery combined with ERCP, EST, and endoscopic nasobiliary drainage (ENBD). No iatrogenic injuries happened. Conclusions With proper selection of ERCP and EST, LC for the treatment of acute cholecystitis is feasible and safe. But the incidence of conversions and complications may be high.

Objective To study the treatment of deep vein thrombosis (DVT) of lower limbs. Methods A series of 82 patients with DVT treated in this hospital from July 1995 to July 2002 were retrospectively analyzed. Sixty-two patients underwent conservative therapy while 20 patients underwent thrombectomy. Results Oedema on diseased limbs subsided in varying degrees in all the patients. However, complete re-perfusion was achieved in only 15 patients, and partial re-perfusion in 9 patients. In the rest of 58 patients, thrombosis was unimproved or recurred, leaving behind the post-thrombotic syndrome. Conclusions Early treatment for acute DVT, conservative therapy or surgical intervention, is effective. Surgery is advisable in most early central type or mixed type patients, whereas conservative therapy in late central type or peripheral type patients. The intravenous interventional therapy is a relatively novel and favorable vascular technique.