Objective To analyze the variation of peripheral blood Th17 cells and Foxp3+CD4+CD25+regulatory T (Treg)cells in patients with ankylosing spondylitis (AS),and to interpret the role of the ratio imbalance of peripheral blood Th17/Treg cells in the pathogenesis of AS.Methods The percentage of peripheral blood Th17 cells and Foxp3 +CD4+CD25+ Treg cells in AS patients and healthy subjects were determined by flow cytometry (FCM).The concentrations of IL-2,IL-10,TGF-β,IL-6,IL-17 and IL-23 in the serum were measured by enzyme linked immunosorbent assay.The correlation between these cytokines and traditional parameters was analyzed.T test,ANOVA,SNK-q and Speannan's analysis were used for statistical analysis.Results Compared with healthy controls,the percentage of Th17 cells in AS patients increased significantly (P＜0.05); Compared with the inactive AS patients,the percentage of Th17 cells in active AS patients increased significantly [(2.10±0.82)％,(2.89±1.77)％,P＜0.05)]; the percentage of Foxp3+CD4+CD25+ Treg cells in active AS patients was markedly lower than healthy controls (P＜0.05).Compared with healthy controls and inactive AS patients,the specific value of Th17/Treg in active AS patients increased significantly(P＜0.05).The concentrations of IL-17 and IL-23 was found significantly higher in patients with AS than that in healthy controls (t=2.203,P=0.032 and t=2.088,P=0.041).The concentrations of IL-17 and IL-23 was found significantly higher in patients with active AS than that in inactive AS (t=2.808,P=0.008 and t=2.242,P=0.020).The correlation analysis revealed that these cytokines and traditional parameters was not relevant except IL-17/BASDAI (r=0.32,P=0.044).Conclusion The increased ratio of Th17 cells and decreased ratio of Foxp3+CD4+CD25+ Treg cells may play a critical role in AS progression.Manipulating the balance of Th17/Treg would provide a new approach for the treatment of AS.

Objective To evaluate the maternal and fetal outcomes of pregnant women with lupus nephritis (LN) and the risk factors.Methods Ninety-three patients with 97 pregnancies from January 1st,1990 to December 31st,2012 in Peking Union Medical College Hospital were evaluated retrospectively.Objects of study were divided into three groups:stable lupus before pregnancy (stable group,52 cases),active lupus before pregnancy (active group,26 cases),and newly diagnosed LN during pregnancy (19 cases).Adverse maternal outcomes included exacerbated disease during pregnancy,preeclampsia,increased proteinuria and impaired renal function during pregnancy or postpartum,maternal death,thrombocytopenia and hypocomplementemia.Adverse fetal or neonatal outcomes included therapeutically termination of pregnancy,fetal loss,neonatal death,preterm labor,small gestational age and asphyxia.Statistical analysis was performed by Chi-square test or Fisher's exact test.A binary logistic regression model was used to evaluate the risk factors for adverse maternal and fetal outcomes.Results (1) Adverse maternal outcomes:There was no significant difference between exacerbated cases during pregnancies in stable group and that in active group [53.8 ％ (28/52) vs 61.5 ％ (16/26),x2 =0.417,P＞0.05].After deleting abortions before 20 weeks of gestation (5 cases in stable group and 4 cases in active group),there was no significant difference between preeclampsia incidence in stable group and that in active group [36.2％ (17/47) vs 59.1％ (13/22),x2 =3.204,P＞0.05].In nineteen newly diagnosed LN women,eighteen cases were over 20 weeks of gestation,during which preeclampsia incidence was 6/18.(2) Adverse fetal or neonatal outcomes:Therapeutically termination of pregnancy rate was higher in active group than that in stable group[42.3％(10/26) vs 7.7％(4/52),Fisher's exact test,P＜0.01].After deleting patients who required termination of pregnancy (three cases in stable group) and therapeutically termination of pregnancy (four cases in stable group and ten cases in active group),the rate of fetal loss and neonatal death was higher in active group than that in stable group [5/16 vs 6.7％(3/45),Fisher's exact test,P＜0.05].The rate of adverse fetal or neonatal outcomes was higher in active group than that in stable group [92.3％(24/26) vs50％(26/52),x2=13.483,P＜0.001].Among the nineteen newly diagnosed LN cases during pregnancy,the numbers of therapeutically termination of pregnancy and fetal loss were five and three cases respectively; among eleven live birth cases,two newborns died from severe asphyxia,and nine cases were preterm birth.(3) Binary logistic regression analysis showed that the independent risk factors for exacerbated lupus during pregnancy were hypocomplementemia (OR =0.300,95％ CI:0.104-0.863) and thrombocytopenia (OR =0.054,95％CI∶0.007-0.439).The independent risk factors for preeclampsia in LN pregnant women were thrombocytopenia (OR=0.151,95％CI:0.046-0.499) and LN recurrence or first diagnosed during pregnancy (OR=0.135,95％CI:0.027-0.679).The independent risk factors for adverse fetal or neonatal outcomes were preeclampsia (OR=0.134,95％CI:0.028-0.637) and lupus active during pregnancy (OR =0.026,95 ％ CI:0.005-0.138).Conclusions Active lupus before pregnancy is associated with poor maternal and fetal outcomes in lupus nephritis pregnancy.All pregnancies with LN should be planned,preferably after more than six months of quiescent disease.Blood pressure,renal function,proteinuria and level of platelet and serum complements should be closely monitored.

Objective To set up the quality standard of Wanbile Wan. Method s Fructus Psoraleae, Radix Puerariae, Radix paeoniae Alba and Radix Glycyrrhiza e Preparatae in Wanbile Wan were identified by TLC .Isopsoralen was determined b y TLC scanning. The chromatographic conditions were: high performance silica gel G plate as lamellated plate, n- hexane - ethyl acetate (8 ∶ 2)being the exp ander, serrated scanning with single- wavelength reflection, beam stricture of 0.4? 0.4 mm, linear parameter SX=3 and scanning wavelength at 300 nm. Results The TLC spots were highly specific, clear and concentrated without interferen ce of the presence of negative controls. Isopsoralen showed a good linearity wit hin the range of 0.064～ 1.536 ? g, r=0.9980, average recovery rate was 100.7 % , and RSD was 2.0% .Conclusion This method can be used for the quality co ntrol of Wanbile Wan.

Objective To investigate the PCR-based evaluation of prednisolone-induced relapse of asymptomatic Toxoplasma gondii infection and the therapeutic efficacy of azithromycin.Methods A total of 36 of female ICR mice,about 20 g,were randomly divided into 6 groups:contrast group (C),prednisolone group (P),infection group(I),infection plus prednisolone group (IP),infection plus azithromycin group(IA),infection plus prednisolone and azithromycin group (IPA).The infection group (I),infection plus prednisolone group(IP),infection plus azithromycin group(IA),infection plus prednisolone and azithromycin group (IPA)were challenged at week 0 with 10 cysts of Toxoplasma gondii Prugniaud strain per injection intraperitoneally.The prcdnisolone group (P),infection plus prednisolone group (IP) infection plus prednisolone and azithromycin group (IPA)were injectied with prednisolone 1 mg into hind medial subcutaneous every day from the 6th week to 7th week.The infection plus azithromycin group(IA),infection plus prednisolone and azithromycin group (IPA) were injectied with azithromycin 250 mg/kg intraperitoneally every day from the 6th week to 7th week.The serum samples were collected and DNAs extracted at week 0,1,2,3,4,5,6 and 7 for amplification of Toxoplasma gondii of specific B1 gene by PCR.All the mice were sacrificed 7 weeks after the challenge to calculate the number of cysts in brain tissues.Results Compared with the primer of AF146527 gene,the primer of B1 gene was more sensitive and specific.The method of PCR could amplify the productions of specific B1 gene Toxoplasma gondii 5 weeks before the challenge,while it could not amplified 5 weeks after the challenge.All the mice of the IP group were dead 2 weeks after the injection of prednisolone (week 7),and the only two mice of the IPA group were dead at the same time (P <0.05),respectively.Compared with the I group,IA group and IPZ group,the number of cysts in brain tissues of the IP group significantly increased (P <0.01).Conclusions B1 as target gene is more suitable for diagnosis of Toxoplasma gondii infection by PCR.Prednisolone could induce the relapse of asymptomatic Toxoplasma gondii infection of mice and the mice are finally dead.Azithromycin is effective but it can not completely cure the Toxoplasma gondii infection.

Objective To evaluate the predictors of maternal and fetal outcome of pregnancy for systemic lupus erythematosus(SLE)patients.MethodsNinety-four patients with 96 pregnancies which were evaluated retrospectively from Jan 1990 to Jan 2008 in Peking Union Medicai College Hospital were divided into two groups:disease stable during pregnancy(group A)and lupus flares during pregnancy (group B).Statistical analysis was performed by X2 or Fisher exact test and Student's t-test.A binary logistic regression model was used to evaluate the predictors of matemal and fetal outcome.Results There were 36 pregnancies with stable lupus disease(group A)and 60 pregnancies with lupus flares(group B).of the 96 pregnancies.18 resulted in therapeutic abortion and 7 in fetal loss,71 resulted in a live birth,3 in neonatal death.The rates of preterm delivery,small gestational age(SGA)and neonatal asphyxia in group B were higher than those in group A(P＜0.05).By binary logistic regression analysis,preeclampsia/eclampsia low serum platelet count and SLE flares were associated with poor fetal outcome(β=2.463,2.228.2.769 respectively.P＜0.05).,rhere were 56 pregnancies with stable lupus disease at the conception with 22(39.3%)occurred lupus flares during pregnancies.Twenty-four preeclampsia and 2 eclampsia were seen in all the pregnancies.Fifty-two pregnancies were complicated with lupus nephritis,and 25 pregnancies(48.1%,25/52)of which were disease stable at the conception,and among 22 pregnancies with disease stable over one year.twelve of which occurred lupus nephritis flares.Three pregnancies which have disease activity within one year before pregnancy all occurred lupus nephritis flares.There were four maternal death which all occurred at the postpartum.By binary logistic regression analysis,lupus nephritis flares were associated with preeclampsia/eclampsia(B=2.658,P＜0.05),and proteinuria at the conception before dilivery were significantly associated with SLE flares(13=3.263,P＜0.05).Conclusion An increase of fetal loss,preterm delivery,SGA and neonatal asphyxia was seen in patients with lupus flares during pregnancy compared with those with stable disease.About 1/3 lupus activity may increase after pregnancy.Preeclampsia and eclampsia were increased when there were lupus nephritis flares.

In this paper, we develop a method to build FEA model, boundary conditions and to analyse static strength and rigidity of the object based on the CT patient table. Especially to introduce the examples of how to simplify the actual models to ideal models which can easily add some loads. In the end of the paper, we compare the results analysis of FEA with the results of experiment and we confirm the high accuracy of FEA, so we summarize that FEA technology is very important for the development of medical equipment.
Equipment Design ; Finite Element Analysis ; Models, Theoretical ; Tomography, X-Ray Computed ; instrumentation

Objective To investigate the effect of carbon dioxide ( CO2 ) pneumoperitoneum on the neuromuscular block of cisatracurium in patients undergoing laparoscopic operation.Methods Sixty ASA Ⅰ or Ⅱ patients,aged 35-60 yr,with body mass index of 18-24 kg/m2,scheduled for elective hysterectomy,were randomly divided into 2 groups ( n =30 each ):pneumoperitoneum group ( group P) and control group ( group C ).Each group was further divided into 2 subgroups according to the use of the antagonist of neuromuscular block ( n =15 each):no neostigmine group ( group P0 or C0 ) and neostigmine group (group P1 or C1 ).Anesthesia was induced with fentanyl,propofol and cisatracurium and maintained with target-controlled infusion of propofol and remifentanil.Tracheal intubation was performed and the patients were mechanically ventilated.Neuromuscular function was monitored by TOF-Watch SX accelerography (Organon Co.,Organon).A train of four (TOF) stimulation of the ulnar nerve was used.When T,returned to 5％ of control height after CO2 pneumoperitoneum was established,cisatracurium 0.05 mg/kg was injected intravenously in group P.When T1 returned to 25％ of control height after the end of operation,neostigmine was injected intravenously in groups P1 andC1.The clinical duration and recovery index were recorded after CO2 pneumoperitoneum was established.Arterial blood samples were obtained immediately before induction,at 30 and 60 min of pneumoperitoneum,and at the end of operation for blood gas analysis.Results The clinical duration and recovery index were significantly longer in group P0 than in group C0,and in group P1 than in group C1 ( P ＜ 0.05).Compared with group C0,the pH value was significantly decreased and PaCO2 was significantly increased at 30 and 60 min of pneumoperitoneum,and at the end of operation in group P0 ( P ＜ 0.05).Compared with group C1,the pH value was significantly decreased and PaCO2 was significantly increased at 30 and 60 min of pneumoperitoneum,and at the end of operation in group P1 ( P ＜ 0.05).Conclusion CO2 pneumoperitoneum can strengthen the neuromuscular block induced by cisatracurium and prolong the recovery time following antangonism by neostigmine administration in patients undergoing laparoscopic operation.

Chemotherapy as a routine method for clinical treatment of cancer has disadvantages such as significant toxicity and strong resistance. In order to improve the efficacy of the drugs and reduce the by-effects, we tried to combine static magnetic field (SMF) with cisplatin or adriamycin. The growth of Hepa1-6 cells treated with the static magnetic field (SMF) combined with cisplatin or adriamycin was significantly inhibited, as detected with MTT (3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide) test. Combined treatment group cells underwent significant morphological changes as observed by HE (Hematoxylin and eosin) staining under optical microscope. Cell cycle analysis indicated that SMF increased the ratio of cells arrested in G2/M phase caused by cisplatin, and when treated with SMF combined with adriamycin, cells were almost arrested in G1 and G2/M phase. SCGE test showed that SMF can enhance the ability of cisplatin or adriamycin to promote cell DNA damage. Atomic force microscope observation found that the combination of antitumor drugs and magnetic field treatment induced larger and deeper holes on the cell membrane, and surface structure damage is serious. The combination of antitumor drugs and magnetic field technology effectively inhibits the growth of tumor cells, and reduces drug doses. The results implicate this method as potential cancer therapy.
Antineoplastic Agents ; pharmacology ; Cell Cycle ; Cell Line, Tumor ; drug effects ; Cisplatin ; pharmacology ; DNA Damage ; Doxorubicin ; pharmacology ; Humans ; Magnetic Fields

Objective To study the auditory perception and speech ability outcomes after cochlear implantation in prelingually deaf children with extremely severe neurosensory hearing loss and comorbid leukoencephalopathy.Methods Our study included 14 prelingually deaf children with leukoencephalopathy (confirmed by preoperative MRI scanning) who were treated with cochlear implantation in the Department of Otorhinolaryngology Head and Neck Surgery of Hainan Provincial People''s Hospital, including 8 males and 6 females of 1~6 yr with a mean age of 3.8 yr.Sixteen synchronous prelingually deaf children without central nervous system (CNS) diseases were also included as the control group, including 11 males and 5 females of 1~6 yr with a mean age of 4.4 yr.All the patients underwent pre-surgical assessments of audiology, radiology, speech ability and intelligence before cochlear implantation via transmastoid facial nerve recess approach was done, after which rehabilitation was provided at the Hainan Rehabilitation Center for Deaf Children.Categories of auditory performance (CAP) and speech intelligibility rate (SIR) were employed as the assessment criteria for the outcome of surgery, the scores of which at different timepoints after surgery were statistically compared through paired t-test between the two groups.Results All the patients gained post-surgical hearing and speech abilities to different degrees, whereas CAP and SIR scores both chronologically improved in the both groups.No statistical difference was revealed either in CAP or in SIR scores between the two groups at 6, 12 and 24 months after surgery (P>0.05).Conclusion Children with extremely severe neurosensory hearing loss can be reated with cochlear implantation even if they have comorbid leukoencephalopathy.The effects of auditory and speech rehabilitation for the same age patients with leukoencephalopathy are similar to those without leukoencephalopathy in 2 years after surgery.

Objective To study the effects of different types of exercise training on learning and memory, as well as on the expression of synaptophysin (SYP) and on postsynaptic density protein 95 (PSD-95) in rats in which a model of vascular dementia had been created.Methods Forty male Wistar rats were divided randomly into a voluntary exercise group (V-EX) , a forced exercise group (F-EX) , an involuntary exercise group (I-EX) , a vascular dementia group (VD) and a sham-operation group (Sham) , with 8 rats in each group.Two-vessel occlusion (2-VO) of the arteria carotis communis was used to create a model of vascular dementia in all of the rats except those in the sham-operation group.Beginning one week after the surgery, the V-Ex rats were free to run in a running wheel.The F-EX rats were forced to run 270 m a day in an electric wheel.The I-EX rats were stimulated to imitate the gait pattern of their forelimbs running at 9 m/min three times a day for l0 minutes each time.No special training was given to the rats in the other 2 groups.Three weeks after the surgery, their learning and memory were tested using a novel object recognition test.Immediately after the test, their prefrontal cortex was sampled and the expression of SYP and PSD-95 was detected using western blotting.Results The average novel object recognition indices of the rats in the V-EX, F-EX and I-EX groups were all significantly higher than that of the VD group.Average PSD-95 expression was also significandy higher than in the VD group.Conclusion Exercise, whether voluntary, forced or induced by functional electrical stimulation can improve learning and memory in vascular dementia, at least in rats.The mechanism is possibly that the training can increase the expression of PSD-95 in the prefrontal cortex, though not SYP.