OBJECTIVETo observe the expression of peripheral blood CD4+ T lymphocyte apoptosis gene in rheumatoid arthritis (RA) patients with cold dampness type (CDT), and to explore its correlation with clinical indicators of RA.

METHODSSixteen RA patients with CDT (as the RA group) and 16 healthy subjects (as the normal control group) were recruited. CD4 T cell apoptosis rate was detected in the RA group and the normal control group using FCM. mRNA expressions of fas, fasL, caspase-3, caspase-8, bcl-2, and bax were detected using RT-PCR. Correlations between the expression of apoptosis gene and clinical activity indicators of RA (ESR, CRP, RF, CCP, integrals for Chinese medial symptoms, morning stiffness time, joint tenderness number, joint swelling number, DAS28-3) were analyzed.

RESULTSThe apoptosis rate of CD4+ T was significantly lower in the RA group than in the control group [(2. 6 +/- 0.9) % vs. (7.7 +/- 1.3) %, P < 0.01]. mRNA expression levels of fas, fasL, caspase-8, caspase-3, and bax mRNA of CD4+ T significantly decreased, but bcl-2 mRNA expression increased in the RA group (P < 0.01). The apoptosis rate of CD4+ T was negatively correlated with ESR (P < 0.05). The mRNA expression of caspase-8 was negatively correlated with joint swelling number (P < 0.05). The mRNA expression of bcl-2 was negatively correlated with integrals for Chinese medial-symptoms and joint function classification (P < 0.01, P < 0.05).

CONCLUSIONApoptosis obstacle exists in peripheral blood CD4 +T lymphocyte of RA patients, and is closely related to disease activity.

Apoptosis ; Arthritis, Rheumatoid ; diagnosis ; metabolism ; pathology ; CD4-Positive T-Lymphocytes ; Caspase 3 ; metabolism ; Caspase 8 ; metabolism ; Fas Ligand Protein ; Humans ; RNA, Messenger

Objective To explore the methods and significance of section of multiple fibroadeno mas of breast with better incision.Methods From may 2005 to December 2014,21 cases were per formed by removing multiple fibroadenomas of breast with a new incision.Preoperatively,the diag nostic work-up included clinical examination,breast ultrasonography and/or mammography.A new approach,for removing of multiple fibroadenomas of the breast with the incision in periareolar site,was used in our hospital.All palpable breast lumps were excised with this approach through which the fibroadenomas were removed as a whole unit.Then,the breast cavity were irrigated with normal saline solution,and strict haemostasis of the bed was done by electrocautery.If the resulted cavity was larger,interrupted sutures should be performed with the absorbable stitches;otherwise,it was unnecessary.The skin wound was sutured to the deepithelialized area with Vicryl 5-0 (Ethicon).Results There were 21 cases,who underwent surgery using the described technique through which 95 lumps (0.5 cm× 0.5 cm-6.0 cm× 5.0 cm) were removed and included in the study.All patients' resected tumor specimens were pathologically confirmed as fibroadenoma.No major complications were encountered in any of the patients.The incision was well concealed by the dome of the nipple and the areolar pigmented and corrugated skin.Both doctors and patients were satisfied with postoperative aesthetic effect of the incision scar.Conclusions The incision in periareolar site for excision of multiple fibroadenomatas results in minimal scarring and a better appearance than that can be achieved with traditional methods.This technique,which can improve the aesthetic outcome of breast surgery,should be performed when feasible.

Objective To explore the complications of augmentation mammoplasty by polyacrylamide hydrogel (PAHG) injection and their management.Methods Preoperatively,174 patients underwent breast ultrasound image,and some patients received magnetic resonance imaging (MRI) to ascertain the distribution of injected PAHG.We used the periareolar incision and dissection extended to the subcutaneous tissue,mammary gland,and subgland space.We were able to suck most of the gel by the negative pressure machine and remove the abnormal breast tissue.The secondary breast deformity was repaired with subpectoral placement of silicone mammary implants (48 cases immediately,39 cases secondarily after 3-6 months) according to the individual situation.Results Following-up for 3 to 6 months,most of their symptoms were relieved after removal of the polyacrylamide hydrogel.In the patients who were performed with the implants augmentation mammoplasty,77 cases gained satisfactory results on the shape and texture of the breast (44.3％),and 10 cases were not satisfied with texture of the breast (5.7％).79 cases appeared breast atrophy or flat chest (45.4％).The severe breast deformities occurred in 8 cases (4.6％).Conclusions PAHG should be removed with surgical operation as soon as possible.The open operative technique via periareolar incisions may be a better method for the patients.The breast reconstruction is performed with implants prosthesis for those who are suitable and willing after removal of PAHG.

Objective To analyze the cause of delayed hemorrhage after minimally invasive percu- taneous nephrolithotomy(MPCNL),and to summarize the experience in the interventional treatment of severe bleeding after MPCNL by superselective arteriolar embolization.Methods The clinical data of 3812 cases of MPCNL from June 1998 to July 2004 were reviewed.Of them,12 patients(11 men and 1 woman;mean age,45 years)who developed severe hemorrhage after MPCNL were identified.The cause of hemorrhage and the treatment results were analyzed.Results The rate of delayed hemorrhage after MPCNL was 0.31% (12/3812).The mean time to onset of severe bleeding was 10 d after MPCNL.Renal arteriography was per- formed in all 12 patients,showing 5 arteriovenous fistulas and 7 false aneurysms.Superselective arteriolar em- bolization for hemostasis was performed in all 12 cases.All these vascular abnormalities were successfully treated by superselective embolization.Follow-up showed that the hematuria disappeared and renal function recovered well.Conclusions Severe hemorrhage following MPCNL is a rare complication,the incidence of which is significantly lower than that of conventional PCNL.The cause is mainly the arteriolar injury of re- nal puncture passage.Superselective embolization provides effective control of bleeding and currently consti- tutes the treatment of choice based on our experience.

Objective To determine the effect of individualized oral hygiene instruction (OHI) on volatile sulfur compounds (VSCs) level in mouth air of patients with chronic periodontitis.Methods The individualized oral hygiene instruction was provided for 31 patients with chronic periedontitis (Organoleptic score was over two points).The VSCs and plaque index (PLI) were evaluated pre-OHI and post-OHI.Results The score of PLI decreased from 3.09±0.44 to 2.63±0.46 significandy (P<0.05).The organoleptic score (OS) decreased from 2.68±0.70 to 2.35±0.75 significandy (P<0.05).While there was no significant difference on the VSCs level pre-OHI and post-OHI (P<0.05).Conclusions Individualized oral hygiene instruction is helpful to remove plaque and improve oral hygiene.But the effect of OHI on VSCs level in mouth air is limited.

China ; Health Knowledge, Attitudes, Practice ; Humans ; Occupational Diseases ; prevention & control ; Occupational Exposure ; prevention & control ; Occupational Health ; statistics & numerical data ; Rural Population ; statistics & numerical data

China ; Health Education ; Health Knowledge, Attitudes, Practice ; Humans ; Occupational Diseases ; prevention & control ; Occupational Health ; Rural Population ; Sampling Studies ; Transients and Migrants

Objective To evaluate the intraoperative advantage and postoperative outcomes of threedimensional laparoscopic common bile duct (CBD) choledochoscopic exploration by micro-incision made at the cystic duct-CBD junction (LCBDEM) for gall stones and choledocholithiasis.Methods From January 2014 to December 2015,31 patients were operated under 3D LCBDEM (study group) and 37 patients under 2D LCBDEM (control group).The outcomes of patients in two groups were compared,including total procedure time (TPT),modified procedure time(MPT),suturing time(ST) and the wrong grasping per 100grasps(WG)of the LCBDEM.8 surgeons experienced in 3D LCBDEM were asked to fill in a subjective questionnaire.Results In control group,the TPT,MPT,ST and WG were (148 ± 47) min,(108 ± 42)min,(20 ±3)min and (19 ±4)per 100 grasps,respectively.In study group,the TPT,MPT,ST and WG were (148 ± 46) min,(9 1 ± 25) min,(1 8 ± 3) min and (8 ± 2) per 100 grasps,respectively.There were significant differences in MPT (t =-2.026,P ＜ 0.05),ST (t =-2.239,P ＜ 0.05) and WG (Z=-7.062,P ＜ 0.001).In subjective questionnaire survey,3D laparoscopy has advantages over 2D laparoscopy in visual and operation experience.But 3D laparoscopy made eyes more easily tired and dizzy.31 aparoscopy was inferior to 2D laparoscopy in spinning the camera around to get optimal field of vision.Conclusions 3D LCBDEM shortens procedure time and suturing time,increases operating accuracy and safety by providing high definition stereovision.

Objective To compare the changes of retinal sensitivity of central 30? visual field after correction with spectacles with those before correction in juveniles and to provide data for the necessity of correction with spectacles in the measurement of juvenile central visual field. Methods The changes of the retinal sensitivity of central 30? visual field after correction with spectacles in 122 eyes of juveniles were measured using Humphrev 750 Ⅱ perimeter, and were compared with those before correction. Results All the myopic eyes of 122 juveniles passed the reliability of parameters. Among the detected eyes, 110 eyes showed degree dependent changes of the retinal sensitivity of central visual field. Conclusion Correction with spectacles should be used for the measurement of central visual field in juveniles. Otherwise, the results might be unreliable, especially in the cases with moderate and high myopia.

Objective To explore the effect of angiotensin-(1-7) [Ang-(1-7)] on proliferation and secretion in cultured rat's glo-merular mesangial cells(GMC) induced by transforming growth factor-β1 (TGF-β1). Methods GMC in logarithmic growth phase were in-cubated, and then were divided into 4 groups: control, Ang-(1-7), TGF-β1,and TGF-β1 + Ang-(1-7) group. Cell numbers of rat's GMC were detected by WST-1. Laminin(LN) and collagenlV (ColⅣ) mRNA expressions in GMC were analyzed by RT-PCR. The secretion of LN and ColⅣ in culture medium of rat's GMC was measured by radioimmunoassay. Results Ang-(1-7) significantly inhibited basal and TGF-β1-induced proliferation of cultured glomerular mesangial cells. Ang-(1-7) significantly down-regulated LN and Col Ⅳ mRNA expressions in glomerular mesangial cells and also inhibited the secretion of LN and ColⅣ induced by TGF-β1(P <0. 05). Conclusions Ang-(1-7) can inhibit basal and TGF-β1-induced proliferation, and inhibit ECM secretion of cultured rats glomerular mesangial cells.