OBJECTIVE:To optimize the formulation of Methotrexate thermosensitive hydrogels,and to study the in vitro re-lease property of it. METHODS:Taking PLGA-PEG-PLGA as matrix and mannitol as viscosity modifiers,Methotrexate thermosen-sitive hydrogels were prepared. Using the absolute value of the deviation of gelation temperature between 35 ℃,its formulation was optimized by orthogonal test using the concentrations of PLGA-PEG-PLGA,methotrexate and mannitol as factors. The dialysis bag method was used to investigate accumulative release rate of Methotrexate thermosensitive hydrogels and methotrexate solution within 336 h in vitro. RESULTS:The optimal formulation was as PLGA-PEG-PLGA of 20%,methotrexate of 0.10% and mannitol of 0.10%;gelation temperature were 35.1,35.0,35.0℃. The average drug-loading rate was more than 90%. 12 d accumulative re-lease rate was more than 90%(r=3). Methotrexate solution has been substantially completely relased within 240 h. CONCLU-SIONS:Methotrexate thermosensitive hydrogels with sustained-release are prepared successfully,and the preparation technology is simple and practical.

Objective:To investigate the radiosensitizing effect of three flavonoids on ovarian cancer SKOV3 cells under hypoxia. Methods:The SKOV3 cells were divided into normoxic group and hypoxic group. The hypoxic SKOV3 cellular model in vitro was es-tablished and tested by measuring the expression profile of HIF-1αprotein in SKOV3 cells. Colony-forming assay was used to detect the radiosensitivity of normoxic and hypoxic SKOV3 cells. The cytotoxicity and radiosensitizing effects of flavonoids were evaluated on the basis of cell death and MTT assay. Results:The Western blot results showed that the gray intensity ratio of HIF-1α/β-Actin in hypoxia group was significantly higher than that in normoxia group (1. 068>0. 117). Radiosensitivity of hypoxic SKOV3 cells in hypoxia group was significantly lower than that in normoxia group. The survival rate of SKOV3 cells was decreased with the increase of concentration. When the concentration was increased, D0 and Dqin chrysin group and quercetin group were significantly decreased (P<0. 01), and SER was increased (P<0. 05). SER showed no significant difference in breviscapine group (P>0. 05). The overall radiobiological parameters of hypoxia group were higher than those of normoxia group. Conclusion: Hypoxia can induce the expression of HIF-1α in SKOV3 cells, which results in the decrease of radiosensitivity. Chrysin and quercetin can enhance the radiosensitivity of SKOV3 cells, and the enhancement is significant under hypoxia, while breviscapine is without such effect. The radiosensitizing effect may be achieved by the level decrease of HIF-1α in SKOV3 cells and inhibition of DNA damage repair.

Objective To prepare triamcinolone acetonide acetate(TAA)thermosensitive hydrogel for intra-articular injection,and to investigate its release in vitro. Methods TAA suspending thermosensitive hydrogel was prepared by using poly lactic-co-glycolic acid(PLGA)-polyethylene glycol(PEG)-PLGA as gel matrices,xanthan gum as suspending agent and NaCl as flocculant. It was evaluated preliminarily by determining its contents and its in vitro release. Results The best compositions for preparation of TAA suspending thermosensitive hydrogel were 25% PLGA-PEG-PLGA,0.05% xanthan gum, 0.9% NaCl and 4 mg·mL-1 TAA.The gelation temperature was 35.3 ℃ .The average recovery was(98.98±0.31)%. By the method of membraneless dissolution,the accumulative drug release was up to 83. 31% at 16 days. The drug release followed Ritger-Peppas methematical model. Conclusion The TAA thermosensitive hydrogel with obviously sustained release is expected to become a new drug delivery system for intra-articular injection.

Objective:To investigate the clinical manifestations, serological and cerebrospinal fluid test results for syphilis, imaging features, and prognoses of cerebral syphilitic gumma.Methods:The clinical data of 1 patient with cerebral syphilitic gumma admitted to Department of Neurology, Second Affiliated Hospital of Soochow University in March 2023 were retrospectively analyzed. Papers about cerebral syphilitic gumma were searched from journals in Journal Citation Reports Q1 from 2000 to 2019, journals from 2020 to 2024 in PubMed, WOS, Embase, and Scopus databases, and journals from 2000 to 2024 in Wanfang Database, CNKI, and VIP database; the clinical data of 54 patients with cerebral syphilitic gumma reported in above databases and 1 patient in our hospital were collected for pooled analysis.Results:The main clinical manifestations of 55 cerebral syphilitic gumma patients included headache (32, 58.2%), lateral limb/facial weakness (25, 45.5%), nausea and vomiting (14, 25.5%), dizziness (11, 20.0%), sensory disturbances (10, 18.2%), blurred vision (7, 12.7%), seizure (5, 9.1%)), hearing loss (5, 9.1%), tinnitus (5, 9.1%), memory loss (3, 5.5%), aphasia (3, 5.5%), dysarthria (2, 3.6%), drop attack (2, 3.6%), weakness in opening eyes (2, 3.6%), unresponsiveness (1, 1.8%), Argyll-Robertson pupil (1, 1.8%), tabes dorsalis gait (1, 1.8%), and fever (1, 1.8%). In 51 patients who reported complete serologic test results, 45 patients (88.2%) were positive for non-specific antibodies to syphilis, and all patients were positive for specific antibodies to syphilis. In 34 patients underwent cerebrospinal fluid examination, 25 (73.5%) were positive for non-specific antibodies to syphilis, and 32 (94.1%) were positive for specific antibodies to syphilis. Isolated intracranial lesion (43, 78.2%) was mostly common in imaging test, and the frequently involved cranial sites were, orderly, the frontal lobe (14, 25.5%), parietal lobe (14, 25.5%), temporal lobe (5, 9.1%), frontotemporal lobe (3, 5.5%), frontoparietal lobe (2, 3.6%), parieto-occipital lobe (2, 3.6%), nucleus pulposus (1, 1.8%), clivus (1/55, 1.8%), and cerebral peduncle of the midbrain (1, 1.8%). Thirty patients (54.5%) were misdiagnosed as having other intracranial space-occupied diseases, orderly, glioma (11, 36.7%), metastatic tumors (5, 16.7%), meningiomas (4, 13.3%), other unexplained intracranial space-occupying (4, 13.3%), brain abscess (3, 10.0%), cavernous hemangioma (1, 3.3%), intracranial lymphoma (1, 3.3%), auditory nerve and pituitary tumors (1, 3.3%). Of the 42 patients who reported prognosis after anti-syphilitic treatments, 41 had varying degrees of improvement, and one died of brain herniation.Conclusion:Because of atypical clinical manifestations and lack of clear diagnostic criteria, cerebral syphilitic gumma is often misdiagnosed as intracranial tumors; cerebral syphilitic gumma should be considered in patients with positive non-specific antibodies to syphilis/specific antibodies to syphilis in serum and cerebrospinal fluid having neurological symptoms and intracranial space-occupied foci; timely diagnosed and treated patients can prognosed well.

OBJECTIVETo investigate the value of serum IgA/C3 ratio in the diagnosis of IgA nephropathy and explore its relationship with the clinicopathological features of the patients.

METHODSSixty-six patients with IgA nephropathy, 111 with other glomerular diseases, and 40 healthy control subjects without kidney disease were tested for serum IgA and C3 levels using CRM470 adjusted standardized immune turbidimetric method, and the IgA/C3 ratio was calculated. According to Oxford and Lee's classification criteria, we analyzed the pathological grades of the renal biopsy samples from patients with IgA nephropathy. The ROC curve was used to assess the value of serum IgA and IgA/C3 ratio in predicting IgA nephropathy.

RESULTSPatients with IgA nephropathy had an elevated serum IgA/C3 ratio than those with other glomerular diseases and the control subjects, with an area under the ROC curve of 0.776. An elevated serum IgA/C3 ratio was not found to significantly correlate with the pathological grade of renal biopsy samples in patients with IgA nephropathy.

CONCLUSIONIn the absence of renal biopsy findings, serum IgA/C3 ratio can help in the diagnosis of IgA nephropathy.

Biopsy ; Case-Control Studies ; Complement C3 ; analysis ; Glomerulonephritis, IGA ; blood ; diagnosis ; Humans ; Immunoglobulin A ; blood ; Kidney ; pathology

Objective To investigate the value of serum IgA/C3 ratio in the diagnosis of IgA nephropathy and explore its relationship with the clinicopathological features of the patients. Methods Sixty-six patients with IgA nephropathy, 111 with other glomerular diseases, and 40 healthy control subjects without kidney disease were tested for serum IgA and C3 levels using CRM470 adjusted standardized immune turbidimetric method, and the IgA/C3 ratio was calculated. According to Oxford and Lee's classification criteria, we analyzed the pathological grades of the renal biopsy samples from patients with IgA nephropathy. The ROC curve was used to assess the value of serum IgA and IgA/C3 ratio in predicting IgA nephropathy. Results Patients with IgA nephropathy had an elevated serum IgA/C3 ratio than those with other glomerular diseases and the control subjects, with an area under the ROC curve of 0.776. An elevated serum IgA/C3 ratio was not found to significantly correlate with the pathological grade of renal biopsy samples in patients with IgA nephropathy. Conclusion In the absence of renal biopsy findings, serum IgA/C3 ratio can help in the diagnosis of IgA nephropathy.

Objective To investigate the value of serum IgA/C3 ratio in the diagnosis of IgA nephropathy and explore its relationship with the clinicopathological features of the patients. Methods Sixty-six patients with IgA nephropathy, 111 with other glomerular diseases, and 40 healthy control subjects without kidney disease were tested for serum IgA and C3 levels using CRM470 adjusted standardized immune turbidimetric method, and the IgA/C3 ratio was calculated. According to Oxford and Lee's classification criteria, we analyzed the pathological grades of the renal biopsy samples from patients with IgA nephropathy. The ROC curve was used to assess the value of serum IgA and IgA/C3 ratio in predicting IgA nephropathy. Results Patients with IgA nephropathy had an elevated serum IgA/C3 ratio than those with other glomerular diseases and the control subjects, with an area under the ROC curve of 0.776. An elevated serum IgA/C3 ratio was not found to significantly correlate with the pathological grade of renal biopsy samples in patients with IgA nephropathy. Conclusion In the absence of renal biopsy findings, serum IgA/C3 ratio can help in the diagnosis of IgA nephropathy.

Objective To analyze HIV-1 drug resistance gene mutations in AIDS patients who failed first-line antiviral therapy in Hubei Province from 2017 to 2018, and to provide references for clinical treatment. Methods Plasma samples of HIV patients who had received first-line antiviral treatment for more than 12 months and had a viral load greater than 103 copies / ml were collected in Hubei Province, and drug resistance genotypes were detected. The prevalence and characteristics of drug resistance were analyzed. Results A total of 198 patients were selected, and 182 target gene sequences were successfully detected. The gene subtypes were mainly CRF01_{_}AE, with a total drug resistance rate of 69.23%. The proportion of NRTIs, NNRTIs and PIs resistance mutations was 46.15%, 65.38% and 0.55%, respectively. The occurrence of cross resistance mutations of NRTIs and NNRTIs reached 40.66%. The mutation sites related to NRTIs were mainly M184V and K65R, while the mutation sites related to NNRTIs were mainly V179D, K103N and Y181C. There was only one case of PIs related mutation at the site of M46I. Conclusion HIV-1 genotyping demonstrated a high proportion of drug resistance in the HAART failure population in Hubei Province, and multi-drug resistance occurred frequently. It is necessary to strengthen the monitoring of drug resistance, implement timely adjustments to antiviral treatment programs, and reduce the occurrence and spread of drug-resistant strains.

Objective To investigate the prevalence of primary drug resistance among HIV-1 patients in Hubei Province from 2020 to 2022, and to provide corresponding basis and data support for HIV antiviral therapy (ART) in Hubei Province. Methods During 2020-2022, plasma samples of HIV-1 infected patients before ART were collected., Patients’ demographic data and baseline laboratory test data were also collected. HIV-1 pol region was amplified by in-house method for sub-type typing and drug-resistant mutation site analysis. Results The pol gene sequence was successfully amplified in 242 of 285 cases, with a success rate of 84.9%. CRF07_BC was the predominant HIV-1 sub-type, accounting for 47.11% (114/242), followed by CRF01_AE, accounting for 25.21% (61/242), sub-type B, accounting for 14.16% (35/242), and CRF55_01B, accounting for 4.13% (10/242). The primary resistance rate was 6.20% (15/242). The mutation site of nucleoside reverse transcriptase inhibitors (NRTIs) was mainly M184V, and the mutation sites of non-nucleoside reverse transcriptase inhibitors (NNRTIs) were mainly E138A/G/EG and V179E. These different mutation sites led to different degrees of drug resistance to 12 drugs. The incidence of drug resistance mutation of CRF55_01B sub-type was significantly higher than that of other sub-types. Conclusion The primary drug resistance rate of HIV-1 infected patients is at a slightly high level in Hubei Province, and close monitoring of primary drug resistance and mutation sites should be strengthened before ART, especially for CRF55_01B sub-type.