The Expert Consensus on the Diagnosis and Therapy of myelodysplastic syndrome (MDS) (2014) will be interpreted in this paper focusing on whether it is scientific and reasonable.Some advises and views will be put forward,hoping that it will be useful to improve the diagnostic and therapeutic ability on MDS for clinicians in our country.

The human cytomegalovirus (HCMV) is a widespread herpesvirus. Virus reactivation from latency can lead to stillbirth, miscarriage, fetal anomalies, and intrauterine growth retardation. During latent infection with the HCMV, the virus can be cleared by the immune response or apoptosis of host cells. However, the HCMV has developed several strategies to manipulate expression of its genes and the microenvironment of host cells. Recent studies have shown that latent infection with the HCMV is associated with viral: regulation of early expression of genes; evasion of cell death; evasion of the immune response; regulatin of non-coding RNAs. This review summarizes recent research progress on the mechanisms underpinning latent infection with the HCMV.
Animals ; Cytomegalovirus ; genetics ; physiology ; Cytomegalovirus Infections ; immunology ; virology ; Humans ; Viral Proteins ; genetics ; metabolism ; Virus Latency

Objective To investigate the efficacy and safety of tocilizumab inpatients with refractory systemic'onset juvenile idiopathic arthritis (SoJIA),and to provide a new option for the treatment of this severe disease.Methods We retrospectively studied 25 cases of hospitalized patients with refractory SoJIA treated withtocilizumab,of whom 22 had data that fit for analysis,from May 2005 to February 2016.Data of 22 cases were collected retrospectively from physicians in charge of the patients.Children with SoJIA were treated with nonsteroidal antiinflammatory drugs (NSAIDs),Glucocorticoid (GC),methotrexate,cyclosporin A,etanerceptetc before,but still in high disease activity due to inadequate response were involved.Weretrospective analyzedthe laboratory test results like C'reactive protein (CRP),Erythrocyte sedimentation rate (ESR),Ferritin and other inflammatory index.Improvement of pain,fever,rash,hepatosplenomegaly and lymphadenectasis of active SoJIA (disease course ≥6 months,and inadequate response to NSAIDs and GC) after tocilizumab treatment (Body weight ≥30 kg,8 mg/kg;Body weight＜30 kg,12 mg/kg,per 4 weeks) were analyzed.Safety data of 22 cases were collected throughout the treatment period including neutropenia,infections,anaphylaxis and elevated liver enzymes etc.We also retrospectively analyzedthe dose change of GC and the long'term effect.Dichtomous paramenters were compared teween groups using thex2 test.Continuous parameters were compared using the analysis of uariance.Results In comparison to the indices before the treatment,the level of CRP [(8.7±2.2) mg/L vs (111.6±74.4) mg/L,F=5.192,P=0.002],ESR [(6.4±6.3) mm/1 h) vs (65.6±24.3) mm/1 h,F=50.393,P=0.000],white blood cell (WBC) [(8.4±2.5)×109/L vs (17.6±8.6)×109/L,F=9.321,P=0.000],Neutrophil count [(4.9±2.4)×109/L vs.(14.4±8.7)×109/L,F=10.541,P=0.000],blood platelet (PLT) [(269.5±79.2)×109/L vs (405.4± 145.3)×109/L,F=5.704,P=0.000] and globulin [(19.2±4.1) g/L vs (30.1±3.8) g/L,F=22.896,P=0.000] decreased rapidly and hemoglobin [(118.3±9.0) g/L vs (108.5±9.8) g/L,F=4.693,P=0.002] increased significantly at 24 weeks after Tocilizumab (TCZ) treatment.Clinical manifestationssuch as fever,rash,hepatosplenomegaly,joint swelling and pain were significantly improved.GC dose [(1.25±3.8) mg·kg-1·d-1 vs (16.2±12.8) mg·kg-1·d-1,F=8.21,P=0.000] were significantly reduced after TCZ treatment (P＜0.05);American College of Rheumatology (ACR) Pedi 30/50/70/90 was improved after TCZ treatment.Adverse events occurred in 3 cases of 25 children,who were not included in the statistical analysis group.Conclusion This retrospective case series has demonstrated the efficacy of tocilizumab in SoJIA,low incidence of adverse reactions.Further studies are needed to be developed because this case series haslimited sample size.

Objective To explore the protective role of lipoxin A4 (LXA4) during early process of atherosclerosis formation in rats with juvenile metabolic syndrome (MS).Methods Rat models of juvenile MS were established with 3-week Sprague-Dawley (SD) rats fed on high-carbonhydrates and high-fat diet for 6 weeks.The other qualified ones were randomly grouped into model group,LXA4 low-dose group,LXA4 middle-dose group,and LXA4high dose group,and a control group fed with normal forage.The low,middle,high-dose groups were injected different doses of LXA4 daily,while the model group and control group were injected with the same dose of isotonic NaCl solution for 2 consecutive weeks.After 2-week medication,the visceral adipose tissue were isolated by laparotomy and heart blood collected by thoracotomy under anesthesia,followed the fixation of thoracic and abdominal aortas in the immobilized rats.The mRNA expression level of inflammation cytokines interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α),C-reactive protein (CRP) in the adipose tissue were determined by semi-quantitative reverse transcription PCR (RT-PCR),respectively.Secretions of IL-6,and TNF-α in serum were determined by enzyme linked immunosorbent assay (ELISA).Immunocytochemistry was used to label endomembrane and middle-membrane of thoracic aorta,and endothelial cell layer in each group and the ratios of thickness of endomembrane and middle-membrane were compared.Results Compared with the control group,weight,body length and abdominal circumference of juvenile MS rats increased significantly (all P ＜ 0.05),and levels of fasting plasma glucose (FPG),triglyceride (TG),high density lipoprotein cholesterol (HDL-C) and insulin in models increased significantly (P ＜ 0.05).RT-PCR showed that the mRNA expressions of inflammatory cytokines IL-6,TNF-α and CRP in adipose tissue in model rats were upexpressed (all P ＜ 0.05).Compared with model rats,mRNA of IL-6,TNF-oα,and CRP in mid,high-dose rats were downexpressed (all P ＜ 0.05),mRNA of TNF-α in low-dose rat downexpressed (all P ＜ 0.05),and there were no significant differences between mRNA expressions of IL-6,CRP in low-dose and model rats according to statistics (all P ＞0.05).Compared with control group,inflammatory cytokines IL-6,TNF-α secreted in serum of model rats were increased significantly (all P ＜ 0.05),and inflammatory cytokines secreted in serum of intervention rats were decreased significantly compared with model rats (P ＜ 0.05).Pathological changes were as follows:HE staining:compared to model group,aortic tunica intima of model rats were remarkably thickened and endothelial cell layer was fragmented and incomplete,which was attenuated in each intervention group.The ratios of endomembrane and middle-membrane in rats:at the end of consecutive medication for 2 weeks,the ratios of endomembrane and middle-membrane in model rats were significantly greater than those of control group (P ＜ O.05),and the ratios of endomembrane and middle-membrane in high-dose intervention rats were significantly smaller than those of the model group (P ＜ 0.05),but still greater than control group,while there were no statistical differences between the ratios in low,middle-dose intervention rats and model rats (P ＞ 0.05).Conclusions The increasing inflammatory cytokines are involved in early process of atherosclerosis formation in rats with juvenile MS.LXA4 by reducing the expression of inflammatory factor level in adipose tissue,thereby reducing the inflammatory cytokines in serum,alleviate the damage of arterial wall.

This study aims to investigate the effect of total flavones of Fructus Chorspondiatis (TFFC) on the mRNA and protein expression of collagen type I and III of rat cardiac fibroblasts (CFs) induced by angiotensin II (Ang II), and explore its anti-myocardial fibrosis molecular mechanism. Neonatal rat CFs were prepared from Sprague-Dawley rats (1-3 d after birth). The expression of collagen type I and III mRNA and protein were measured by RT-PCR and Western blotting, respectively. The study showed that stimulation of neonatal rat CFs with 100 nmol.L-1 of Ang II for 72 h resulted in a significant increase of the expression of collagen type I and III mRNA and protein. The changes on the expression level were blocked by TFFC. The results demonstrated that TFFC can inhibit myocardial fibrosis induced by Ang II in rats, which is probably associated with the collagen type I and III mRNA and protein levels up-regulated by Ang II, and TFFC was shown to decrease the expression levels of collagen type I and III mRNA and protein.

Objective To explore the biological basis of TCM syndromes from a biomolecules network perspective with qi deficiency syndrome as the breakthrough point. Methods A data dictionary of neuro-endocrine-immune (NEI) related genes and qi deficiency syndrome characterization terminology thesaurus were established. Literature about qi deficiency syndrome characterization was retrieved by using Genclip, to excavate the characteristic NEI gene, thereby to explore different bioactive substances of syndromes. Results The analysis of the genetic data, showed qi deficiency related cluster with the relevance of endocrine, signal transduction, hematopoietic cell and immune deficiencies etc. It is confirmed that the intrinsic biological features of TCM syndrome can effectively identify in the NEI level. Conclusion Literature mining method as a new way to discover syndromes biological indicators has certain feasibility, and it is recommended to be further expanded into other studies on syndromes to validate the universality and reliability of this method.

Objective To explore the reaction time and attention bias characteristics of patients with first-episode depressive disorder.MethodsTotally 32 patients with first-episode depressive disorder (MD group) and 24 non-depression control participants(NC group) matched with MD group on age,gender and education level were enrolled in the study.The clinical symptoms were assessed by Beck Depression Inventory(BDI).All participants completed a dot-probe task to assess attentional preference for facial stimuli with varying valence (happy,sad and neutral facial expressions).ResultsThe reaction times(RTs) of MD group was longer than that of NC group in the dot-probe task ((468.6±87.7)ms,(451.7±82.5)ms,P<0.01).The four-way ANOVA revealed a significant main effect of prime duration,indicating overall shorter RTs on primes with longer duration ((476.9±88.4)ms vs (456.2±82.7)ms vs (447.7±83.9)ms,P<0.01).Compared with NC group,the scores of attention bias for sad faces were decreased in MD group ((7.43±26.4)ms vs (-4.97±19.5)ms,P<0.05).With the longer duration of presentation,the score of attention maintenance of emotional facies for MD group were increased (happy faces: (-11.0±4.8)ms,(2.2±6.9)ms,(6.1±8.5)ms;angry faces:(-1.6±7.5)ms,(6.5±8.6)ms,(14.9±6.7)ms).The adherence score of attention to happy faces were decreased ((1.8±5.6)ms,(-8.2±6.7)ms,(-8.7±7.1)ms),while the score of adherence score towards sad faces were increased ((-7.6±7.2)ms,(-2.6±8.5)ms,(1.5±6.2)ms) with increasing prime duration.ConclusionPatients with first-episode depressive disorder have slower response to emotional faces and associated with attentional bias for sad faces.With the increasing prime duration,it is more and more obvious to attentional bias in the two aspects of allocation and adherence.

ObjectiveTo research the intestinal absorption characteristics in rats of multiple constituents,when Wuwei-Jiangya recipe was used in rats and showed reducing blood pressure effects.Methods ① After extracting Wuwei-Jiangya recipe,we fed it to rats once daily,until the blood pressure reduced; ②Establish Wuwei-Jiangya recipe and intestinal absorption of multiple constituents fingerprint by using reverted gut sac method and RP-HPLC fmgerprint.ResultsAfter one week's administration,there was the hypotensive effects and multiple constituents can be absorbed by intestine.ConclusionWhen the drug works,reverted gut sac method for studying intestinal absorption constituents can be used for locking the exposure constituents.

The case is the cornerstone of case teaching. The construction of case database can support case teaching and its orderly development. The clinical cases of gynecology of Chinese medicine were collected, sorted and processed in combination with the teaching syllabus and teaching objective. Operating platform was based on the Excelltable. The column was divided into overview, menstrual disorders, leukorrhoeal diseases, pregnancy disease, postpartum disease and miscellaneous diseases of gynecology with hierarchical set of 15 modules per column, including basic information, complaints, history, symptoms, physical examination, diagnosis, application purpose and context and so on. And the corresponding search term was also selected. Cases can be divided into introduction cases and improvement ones according to their easiness and difficulty , into typical cases and atypical ones according to their feature types. Case database content also needs to be constantly revised by teaching activities to make it more suitable for clinical teaching.

Objective To investigate the expression of glucagon-like peptide-1 receptor (GLP-1R) of skeletal muscle cells and the changes of skeletal muscle microstructure of diabetic rats, and to explore the relationship between the expressions of GLP-1R and insulin resistance in skeletal muscle. Methods Male Wistar rats were divided into two groups, normal glucose tolerance ( NT, n =25 ) , diabetes group ( DM group, n=30), the methods of creating diabetes model were used high-sugar high-fat diet and low-dose in-traperitoneal injection of streptozotocin. Immunohistochemical methods was used to detect the expression of GLP-1R in the muscle cells. The number of GLP-1R positive cells in the muscle of two groups was observed and compared. The relationship was analyzed between the homeostasis model assessment insulin resistance (HOMA-IR) and the number of GLP-1R positive cells. Results ⑴Compared to the NT group, the num-ber of GLP-1R positive cells in muscle of DM group was decreased (P<0. 05); ⑵ Compared to the NT group, HOMA-IR was increased in DM group (P<0. 05);⑶ Pearson correlation analysis showed that the percentage of GLP-1R positive cells expressed in rat skeletal muscle was negatively correlated with HOMA-IR (r= -0. 538, P<0. 01). Conclusions The expression of GLP-1R positive cells was decreased in the skeletal muscle of diabetic rats, insulin resistance increased. Therefore, the expression of GLP-1R on skele-tal muscle cells may promote the development of insulin resistance and diabetes mellitus.