OBJECTIVE: To observe the effect of high-dose Astragalus injection and cyclophosphamide (CTX) on infection, urine protein and immune function of the patients with lupus nephritis. METHODS: Forty-three patients diagnosed as systemic lupus erythematosus (SLE) complicated by kidney damage and qi-deficiency syndrome were randomly divided into trial group (n=23) and control group (n=20). Patients in both groups were treated for 3 months. Intravenous drip infusion of 0.8 g CTX was administered to all patients once a month, while intravenous drip infusion of 20 ml Astragalus injection was only administered to patients in the trial group every day for 12 days in each month. RESULTS: The decrease of active clinical symptom score after the treatment in the trial group was greater than that in the control group (P<0.05). The infection rates of the trial group and the control group were 4.35% and 25% respectively. The decrease of 24-hour urine protein and CD8, and the increase of red blood cell count and serum albumin in the trial group were greater than those in the control group, and there were significant differences between the two groups (P<0.05). White blood cell count in the trial group was decreased less than that in the control group after the treatment (P<0.05). CONCLUSION: High-dose Astragalus injection used together with CTX is more effective than CTX alone in decreasing infection rate and urine protein and improving immune function for patients with lupus nephritis.

Energy expenditure of five young adults worked in the hot desert environment were measured by the methods of indirect calorimetry in the Wuwei Gansou in July 1989.The results indicated that the basal metabolism rate, the resting metabolism rate and the energy cost of young adults marching in the desert and Gobi (15kg load, at rate of 3.5km/h) were 2.782,3.059,14. 188, 10.305 kJ? m-2?min-1 respectively. It was shown that under the similar conditions energy expenditure marching in the desert was 38% more than in the Gobi.Ambient temperature had a greater effect on energy expenditure but the effect was various at different activities. When at 24.5-38.4℃ during marchi-ng(15kg load),1℃increase in ambient temperature was associated with anincrease of about 0.86% energy consumption. While at 25-33℃ during quiet rest the energy consumption tended to decrease with an increase of ambient temperature. But at 33-40℃ it increased with ambient temperature again. It is suggested that the energy metabolism may be more easily influenced by ambient temperature when the metabolic heat production of human body is increased.The present study recommended the estimation of energy requirement for the adult with a moderate activity in hot desert environment should be approximate 15.062MJ/d

Objective To explore the curative effect of acyclovir combined with pidotimod in treatment of adult varicella.Methods 80 adult patients with varicella in our hospital were randomly divided into two groups.40 cases in group A were intravenously injected acyclovir.40 cases in group B were intravenously injected acyclovir combined with oral pidotimod.The time of herpes blisters drying and completely crusted were observed in two groups.Results The time of herpes blisters drying and completely crusted of B group was shorter than A group.And the differences were statistically significant(P ＜0.01).Conclusion Acyclovir combined with pidotimod in treatment of adult varicella can significantly shorten the healing time,and show better curative effect than single use of acyclovir.

Objective To expound the mechanism and the clinical features of Tong-Du-Huo-Luo exercise in treating ankylosing spondylitis.Methods Besides taking SASP per os,the patients in treatment group did Tong-Du-Huo-Luo exercise twice daily. Patients in control group took SASP only.The patients in both groups had accepted the treatments for 6 months.Results Compared with western medicine treatment,the Tong-Du-Huo-Luo exercise can bring better effects on ability of expanding chest,finger-floor distance,pulvinar-wall distance,and improving the results of Schober test and blood sedimentation test.Conclusions Tong-Du-Huo-Luo exercise is an effective method in treating ankylosing spondylitis patients.

BACKGROUND:Knee osteoarthritis is characterized by inreversible pathological changes, belonging to arthragia syndrome. The goal of the treatment is to release or relieve symptoms and delay joint degeneration. Jianxi Qianggu Pil is an empirical formula developed by the Third People’s Hospital of Jingzhou, School of Basic Medical Science, Wuhan University, China. This prescription can nourish liver and kidney, eliminate wind and disperse cold, expel wet and dredge the col aterals, consolidate bone and reinforce knee.
OBJECTIVE:To observe the protective effect of Jianxi Qianggu Pil on joint cartilage and expression of bone morphogenetic protein 7 in rabbits with knee osteoarthritis.
METHODS:A total of 36 New Zealand rabbits were randomly divided into three groups, with 12 ones in each. The involved rabbits were applied to establish the model of knee osteoarthritis by using the modified Hulth’s method. At 6 weeks after modeling, the drug group was given 0.1 g/kg Jianxi Qianggu Pil via intragastric administration, while model group and normal control group received equal volume of saline. At 4 weeks after drug administration, rabbit articular cartilage was evaluated with Mankin’s scoring method. The cartilage morphology was observed under electron microscopy, and bone morphogenetic protein 7 expression was detected using immunohistochemistry.
RESULTS AND CONCLUSION:The pathological degeneration degree of articular cartilage in the drug group was significantly lighter, and bone morphogenetic protein 7 expression was significantly higher than the other two groups (P<0.05). Experimental findings indicate that, Jianxi Qianggu Pil can promote the expression of bone morphogenetic protein 7 in articular cartilage of knee osteoarthritis rabbits, thereby promoting articular cartilage regeneration and reducing cartilage deformation or necrosis for the treatment of arthritis.

Objective To Investigate the expression of IL-21 and Blimp1 mRNA in Rheumatoid arthritis ( RA) patients and the influence on the expression of Blimp 1 in peripheral blood mononuclear cells (PBMCs) of RA patients after IL-21 stimulated; To further explore the mechanism of IL-21 and blimp1 in the pathogenesis of RA.Methods Case control study.The samples of peripheral venous blood from 50 RA patients of department of rheumatology of The First Affiliated Hospital of Zhengzhou University and 50 healthy people were collected respectively , then the plasma and PBMCs was separated.IL-21 in plasma was measured by ELISA; the correlation between patients clinical index DAS 28, anti-CCP antibody and IL-21 was analyzed.Blimp1 mRNA of patients′PBMCs was detected by qPCR; PMBCs were isolated from RA patient and then cultured in vitro.Blimp1 mRNA level was measured by qPCR and the ratio of CD 20 positive B cell and the ratio of CD138 positive cells in all groups were detected by flow cytometry after 72 h stimulated by IL-21 and CD40L.Results IL-21 content in RA patient blood plasma (130.51 ±11.35)ng/L was significantly higher than that in healthy control (25.46 ±6.05)ng/L, t=5.39,P<0.05.Besides, IL-21 level also had a close relativity with patients DAS28(r=0.658) and anti-CCP antibody (r=0.674, P=0.039 and 0.035).In addition, the expression level of Blimp1 mRNA in RA patient PMBCs (1.321 ± 0.11)was higher than that in healthy control group (1.000 ±0.000), Z=-2.48, P<0.05.While after IL-21 and/or CD40L stimulation, Blimp1 mRNA of IL-21 group and CD40L+IL-21 group(1.084 ±0.029, 1.157 ±0.028)were higher than those of control (1.000 ±0.000)(P=0.002,P=0.001), moreover the expressive level of Blimp1mRNA of CD40L+IL-21 group was higher than that of control group (t=4.862, P=0.02).Compared to negative control group , the ratio of CD20 positive B cells [2.42 ±0.35, 2.63 ± 0.33, 6.35(4.85,6.57),F=278.363,P<0.001] and the ratio of CD138 positive cells(0.474 ±0.110, 0.668 ±0.120, 0.955 ±0.170,F=49.01, P<0.001) in CD40L group, IL-21 group and CD40L+IL-21 group were much higher and the differences among CD 40L+IL-21 group with CD40L group and IL-21 group were statistically significant.Conclusion IL-21 could promote the level of Blimp 1 mRNA in peripheral blood mononuclear cells in RA patient; IL-21 and CD40L could co-promote B cell maturation though regulating Blimp1 mRNA expression and eventually participate in RA pathogenesis.

Objective To investigate the effects of a chitosan product on scarring and adhesion after never injury in laminectomy in rats. Methods 48 male Sprague-Dawley rats were divided into group A and group B, and carried laminectomy of L4-5, and injured the right spinal nerve roots. The normal saline was smeared on the operation field in the group A, while the chitosan product was smeared in the group B. The adhesion was assessed with Rydell score 1 (groups A1/B1), 2 (groups A2/B2) and 4 (groups A3/B3) weeks after operation, while the spinal nerves were observed with HE staining and Masson staining, and the adhesion was assessed with Nussbaum score. The complete blood count and the series of blood chemistries and enzymes for liver and kidney functioning were measured. Results The Rydell scores of adhesion was I grade in group A1, II grade in A2 and III grade in A3, while was 0 grade in B1, 0 grade in B2 and II grade in B3. The scar and adhesion contact more loosely in the group B than in the group A, and the Nussbaum score was less in the group B than in the group A at the same time (P<0.05). The complete blood count and the series of blood chemistries and enzymes for liver and kidney functioning were in normal. Conclusion This chitosan product can prevent the formation of epidural scar and adhesion around the spinal and the nerve roots after laminectomy, with little toxicity and side effects.

Objective To investigate the changes of regulatory T cells (Treg) in patients with hepatocellular carcinoma (HCC) after ultrasound- guided percutaneous cool- tip radiofrequency ablation (RFA), and to discuss its influence on the prognosis. Methods A total of 30 patients with HCC were enrolled in this study. The percentage of Treg in peripheral blood was estimated with flow cytometry before RFA and one, 4, 7 and 12 months after RFA. During the follow-up period, the therapeutic effects were evaluated by contrast enhanced sonography or contrast enhanced CT scanning. By using the methods of receiver operating characteristic (ROC) curve and Kaplan-Meier survival function, the correlation of Treg dynamic changes with the progression-free survival time was analyzed. Results One month after RTA, the tumor response (TR) rate in the 30 patients was 93.3% (28/30), the tumor progression (TP) rate was 6.67%(2/30). The percentage of Treg before RFA was (9.42 ± 1.16)%, which decreased to (6.55 ± 0.97)% one month after RFA, the difference was statistically significant (t = 15.325, P <0.001). Twelve months after RFA, TR rate became 33.3%(10/30), and TP rate became 66.7%(20/30). The preoperative percentage of Treg of TR group was (8.75 ± 0.72)%, which was significantly lower than that of TP group (9.76 ± 1.20)%, the difference was statistically significant (t=-2.448, P=0.021). ROC curves indicated that the optimal cut-off value of Treg nadir was 4.82%, the sensitivity was 90.0% and the specificity was 60.0%. The optimal cut-off time to reach Treg nadir was 5.5 months, the sensitivity was 70.0% and the specificity was 85.0%. Kaplan-Meier curve analysis showed that after RFA the progression-free survival rate (PFS) of patients with Treg nadir ≤ 4.82% was significantly higher than that of patients with Treg nadir>4.82%. PFS of patients with reaching Treg nadir≥5.5 months was significantly higher than that of patients with reaching Treg nadir<5.5 months. Log-rank test results were字2=5.207, P=0.023; 字2=22.079, P < 0.001, respectively. Conclusion Percutaneous cool-tip radiofrequency ablation can decrease the percentage of Treg cells. Besides, Treg nadir and the time reaching Treg nadir can reflect the prognosis of HCC patients after RFA to a certain extent.

Objective To understand the use of mycobacterial and fungal blood culture bottle and the prevalence of Mycobacterium and fungus in the bloodstream infections in AIDS patients.Methods Blood samples were collected from hospitalized AIDS patients for culture of Mycobacterium and fungus.Results Of the 3 012 blood samples submitted for culture,425 (14.1％) were positive,including195 strains of fungal pathogens,mostly Talaromyces mnarneffei (129) and Cryptococcus (62),172 strains of Mycobacterium spp,and 58 strains of other pathogens.Conclusions The mycobacterial and fungal blood culture bottle is useful for detection of bloodstream infection in AIDS patients.The prevalence of fungal bloodstream infection is 6.5％ (195/3 012) and the prevalence of mycobacterial bloodstream infection is 5.7％ (172/3 012).The top three pathogens are Mycobacterium spp,Talaromyces marneffei and Cryptococcus neoformans.Our finding is inconsistent with the reports of other authors.