BACKGROUND:The etiological factor for rheumatoid arthritis remains unclear, but the effects of nuclear factor-κB on the onset of rheumatoid arthritis have been gradual y paid great attention by rheumatologists.
OBJECTIVE:By using the RNA interference (RNAi) technique to block the signal pathway of nuclear factor-κB
mRNA of human rheumatoid arthritis synovial cells, this study explored its application prospect in the treatment of rheumatoid arthritis.
METHODS:The synovial cells were isolated, digested, and cultured for further use. In accordance with the
design principle of smal interfering RNA (siRNA), target sequences of siRNA of nuclear factor-κB were identified, and siRNA expression vector of nuclear factor-κB was synthesized and constructed. The four pGenesil-1/nuclear factor-κB siRNA expression vectors were transfected into the first passage of synovial cells that wel grew. Blank and negative control groups were set. cells at 12, 24, 48, 72 hours, 5 and 7 days after transfection were col ected, and RNA was extracted. Intracellular nuclear factor-κB mRNA expression levels were measured, and siRNA plasmid vector that could effectively inhibit nuclear factor-κB mRNA expression was screened out.
RESULTS AND CONCLUSION:Nuclear factor-κB highly expressed in synovial cells after human rheumatoid arthritis. 3#pGenesil-1/nuclear factor-κB apparently suppressed nuclear factor-κB mRNA expression in synovial cells with human rheumatoid arthritis. RNAi technique blocked nuclear factor-κB mRNA expression. Therefore, the block of nuclear factor-κB signal pathway might be a good target for rheumatoid arthritis gene therapy.

Objective To study the roles of apoptosis and expression of the related genes in minor labial salivary gland of patients with primary Sjogren′s syndrome (pSS). Methods Biopsies of minor submucosal labial salivary gland (SG) were obtained from 30 patients with pSS and 10 control individuals. The in situ end labeling and immunohistochemical staining were used to detect the apoptotic cells and the expression of Fas, FasL and Bcl-2. Results The percentage of apoptotic acinar and ductal epithelial cells (AEC and DEC) in labial salivary glands of patients with pSS was significantly higher than that of control respectively, but the percentage of apoptotic infiltrating mononuclear cells (IMC) showed no significant difference compared with that of control, pSS AEC and DEC showed increased expression of Fas/FasL and decreased expression of Bcl-2, whereas pSS IMC showed increased expression of Fas, Fas/FasL and Bcl-2. There was significant positive correlation between the percentage of apoptotic cells and the cells expressing Fas and FasL in pSS AEC DEC and IMC, respectively, and there was significant negative correlation between the percentage of the apoptotic cells and that of cells expressing Bcl-2 in pSS DEC and IMC, but there wasn′t correlation between the percentage of the apoptotic cells and that of cells expressing Bcl-2 in pSS AEC. Conclusions The apoptotic cells increased in the epithelial cells and decreased in IMC of the labial salivary glands may be one of the mechanisms leading to the glandular destruction found in pSS. In pSS labial salivary glands, the expression of Fas and FasL may promote apoptosis, while the expression of Bcl-2 may inhibit apoptosis. The increased expression of Bcl-2 in pSS IMC indicates that IMC may be able to escape apoptosis, resulting in inflammatory cell foci.

Objective To examine the expression of CD8+CD28- T cells in the peripheral blood and explore their roles in the pathogenesis of AS. Methods The expression of CD8+CD28- T cells obtained from 50 AS patients and 21 healthy controls were assayed by flow cytometry. CRP was also measured. Results The percentage of peripheral blood CD8+CD28- T cells in patients with AS was significantly increased compared to normal individuals [(18±6)% vs (14±5)%, P=0.020], while the percentage of peripheral blood CD3+,CD8+ CD28+ T cells in patients with AS was significantly decreased[ (65±9)% vs (69±8)%, P=0.039]; [ (15±5)% vs(18±4)%, P=0.038]. No difference was found in CD8+ T cells between patients with AS and normal individuals(P＞0.05). Conclusion The percentage of peripheral blood CD8+CD28- T cells in patients with AS is significantly increased comparing to normal individuals. This suggests that CD8+CD28- T cells may play an important role in the pathogenesis of AS.

Implantable collamer lens (ICL) is widely used because of its good effect of myopia correction.The change of ICL position after surgery increases the risk of postoperative complications such as vision loss, complications, and glaucoma.This article summarizes the influencing factors and predictive parameters of ICL position change from two aspects of arch height and rotation according to ICL type, measurement parameters, the shape of the surrounding tissue of ICL, and the fixed position of ICL and found that type selection parameters, the parameter change of intraocular spatial tissue, the position of the lens foot loop, physiological adjustment and other factors can affect the arch height and axial position of ICL/toric ICL.Correct assessment of these factors can provide references for standardizing ICL operation, improving ICL stability, and reducing complications.It is also a trend to improve the accuracy and predictability of ICL surgery.

Objective:To explore the risk factors of hypotension in patients with hemodialysis-related superior vena cava diseases.Methods:This was a retrospective cohort study. The maintenance hemodialysis patients diagnosed as superior vena cava stenosis ≥50% or occlusion in West China Hospital of Sichuan University from January 1, 2019 to March 31, 2022 were selected. The patients were divided into hypotensive group and non-hypotensive group according to the occurrence of hypotension during non-dialysis period. The differences of general clinical data, cardiac ultrasound parameters and blood biochemical indexes between the two groups were compared. Multivariate logistic regression model was used to analyze the risk factors of hypotension in patients with hemodialysis-related superior vena cava lesions.Results:A total of 202 patients with hemodialysis-related superior vena cava lesions were included, of whom 84 patients (41.6%) developed hypotension during non-dialysis. Compared with the non-hypotensive group, patients in the hypotensive group had longer dialysis age ( Z=2.093, P=0.036), shorter left atrial diameter ( t=2.316, P=0.022), lower aortic valve orifice flow rate ( t=3.702, P=0.001) and serum calcium ( t=2.320, P=0.021), thicker left ventricular posterior wall ( t=3.042, P=0.003), lower proportions of hypertension history ( χ2=9.125, P=0.003), and higher proportion of residual superior vena cava ≤30% or occlusion ( χ2=8.940, P=0.003) and azygous vein opening ( χ2=11.067, P=0.001). Multivariate logistic regression analysis results showed that no history of hypertension ( OR=0.383, 95% CI 0.156-0.943, P=0.037), slow aortic valve orifice flow ( OR=0.207, 95% CI 0.062-0.695, P=0.011) and low blood calcium ( OR=0.236, 95% CI 0.066-0.841, P=0.026) were the independent influencing factors of hypotension in patients with hemodialysis-related superior vena cava diseases. Conclusions:Hemodialysis patients with severe stenosis or occlusion of the superior vena cava during non-dialysis have a higher risk of hypotension. No history of hypertension, slow aortic valve orifice flow, and low blood calcium are the independent risk factors of hypotension in patients with hemodialysis-related superior vena cava diseases.

Objective To analyze the clinical characteristics of IgG4-related disease (IgG4-RD),guide the selection of therapeutic drugs,and to explore the significance of potential tumor identification for IgG4-RD.Methods A total of 92 patients diagnosed with IgG4-RD and admitted to this hospital from January 1,2017 to December 31,2021were selected as the research subjects by using the Yidu Cloud system.The clinical data conducted the summary analysis. The clinical characteristics of IgG4-RD were summarized.Results The mean age of IgG4-RD was definitely diagnosed in the 92 patients was (58.1±11.3)years old,with 65 male ca-ses (70.7％) and 27 female cases (29.3％).The most commonly affected organ tissues were lymph nodes (37 cases,40.2％),pancreas (33 cases,35.9％) and salivary glands (31 cases,33.7％).In the patients woth the 92 patients,28 cases (30.4％) had involvement of a single organ tissue,while 32 cases (34.8％) had involvement of two or more organs.In the 92 patients,89 cases received steroid therapy,and 71 cases received immunosup-pressive therapy,in which 45 cases (63.4％) used cyclophosphamide.The initial treatment effective rate (72.7％ vs. 55.6％) and one-year non-recurrence rate (38.2％ vs. 20.0％) of the steroid combined immuno-suppressive therapy group were better than those of the single steroid group,but the differences were not sta-tistically significant (P>0.05).The proportion of the patients with tumor comorbidity and IgG4 level>40 g/L (18.2％) was significantly higher than that of the non-tumor comorbidity (1.2％),and the difference was statistically significant (P<0.05).However,there was no statistically significant difference in the proportion of patients with tumor comorbidity compared to the non-tumor comorbidity in other IgG4 level groups (P>0.05).Conclusion IgG4-RD is more common in middle-aged and elderly men,lymph nodes,pancreas and sal-ivary glands are commonly involved,and most patients have the double organs and multiple organs involve-ment. The combination use of hormone and immunosuppressant in treatment is recommended .The IgG4 lev-el>40 g/L in the patients with IgG4-RD may has the suggestive significance for complicating tumor.