Objective To discuss the role of p38MAPK signal pathway in the process of TWEAK inducing rheumatoid arthritis(RA) fibroblast-like synoviocyte(FLS) to synthesize MMP-9 and look for a new target for RA treatment. Methods RA FLS were primarily cultured and stimulated with TWEAK. Western blot was used to detect the expression of p-p38MAPK and p65 in RA FLS. FLS were pretreated by SB203580 or not. ELISA was used to detect the concentration of MMP-9 in cell-cultured fluid. The mRNA expression of MMP-9 was measured by RT-PCR. Results TWEAK( 100 ng/ml) can make p38MAPK phosphorylated and increased the expression of p65 protein in the cell nucleus. SB203580 can partially inhibit the expression of MMP-9 and MMP-9 mRNA produced by RA FLS which is induced by TWEAK. Conclusion TWEAK induced RA FLS to synthesize MMP-9, in that process, the p38MAPK signal trausduction pathway was in active state, and induced the expression of NF-κB.

Objective To evaluate the values of the combined eGFR and qualitative determination of urine albumine on in both during and 3 years after hospitalization prognosis of after PCI.Methods One thousand and five PCI patients were divided into 4 groups by level of eGFR and qualitative determination of urine albumine.A group:eGFR ＜ 60 ml/min,urine albumine negative ( n =34 ) ; B group:eGFR ＜ 60 ml/min,urine albumine positive ( n =34) ; C group:eGFR ≥60 ml/min,urine albumine negative ( n =797 ) ; D group:eGFR ≥60 ml/min,urine albumine positive (n =140).The levels of serum creatinine and urine albumine of PCI patient were measured,and then compare body mass index,smoking,hypertension,hyperlipaemia,diabetes mellitus,previous MI,perioporative PCI and etc.All patients were followed up from 30 d to 3 years.The prognostic facters of PCI patients were analyzed by COX proportional hazards models.Kaplan-Meier survival analysis was used to compare survival curves between the four groups stratified by level of eGFR.The log rank statistic was used to test for differences between groups.Results By multivariate COX regression adjustment for body mass index,smoking,hypertension,hyperlipaemia,diabetes mellitus,previous MI,perioperative PCI,the relative risk (RR) of albuminuria for cardiac events was 2.006 ( 95％ CI:1.020 - 3.947,P ＜ 0.05 ),perioperative PCI 3.375 ( 95％ CI:2.106 - 5.410,P ＜0.05 ).The cardiac events rate of B group with PCI after 1,2 and 3 year was 20.59％,2.94％,2.94％respectively,have statistical significant(x2 =8.774,P ＜ 0.05 ).The cardiac events rate of the first year in A,B,C,D groups was 5.89％,20.59％,4.01％,2.86％ respectively.The different cardiac events rate among four groups had statistical significant(x2 =22.050,P ＜0.01 ).B group cardiac events rate of the first year was significant higher than C,D group,which had statistical significant (x2 =20.020,14.520,P ＜0.01 ).The survival rate of 3 year follow-up after PCI was 91.2％,73.5％,91.6％,93.6％ respectively in four group,the different survival rate among four groups have statistical significant(x2 =16.750,P ＜0.01 ).Conclusion For the identification and treatment of high incidence of cardiac events in patients undergoing PCI,eGFR and qualitative determination of urine albumine are simple and effect tools.

Objective To investigate the levels of transformation growth factor-β1 (TGF-β1),vascular endothelial growth factor (VEGF) and insulin growth factor-Ⅰ (IGF-Ⅰ) role in the pathogenesis of serum of patients with combined pulmonary fibrosis and emphysema (CPFE).Methods Recruited 20 patients with CPFE,40 cases with idiopathic pulmonary interstitial fibrosis (IPF) and 40 cases with emphysema who were admitted to our hospital during July 2011 to February 2012.Serum levels of TGF-β1,VEGF and IGF-Ⅰ were detected by ABC-ELISA.Results Serum levels of TGF-β1 and IGF-Ⅰ were significantly higher in patients with CPFE and IPF than these in patients with emphysema (TGF-β1:(160.73 ± 40.62) ng/L vs.(167.35 ± 42.82) ng/L vs.(128.75 ±35.77) ng/L; IGF-Ⅰ:(179.65 ±60.73) ng/L vs.(192.32 ±58.75) ng/L vs.(148.73 ±49.67) ng/L,P ＜ 0.05 or P ＜ 0.01).The IPF group had significantly higher serum level of VEGF than the emphysema group ((506.12 ±82.37) ng/L vs.(437.31 ±62.58) ng/L,P ＜0.01).Serum levels of TGF-β1 and IGF-Ⅰ in CPFE and emphysema groups were positively correlated (r =0.885,0.918 respectively,P ＜ 0.01).Smokers in the CPFE group had significandy lower level of serum VEGF than those who did no smoke ((406.19 ± 66.94) ng/L vs.(482.88 ± 79.91) ng/L,t =-2.287,P =0.035).Conclusion Serum level of VEGF increased significantly in the IPF group,suggesting the participation of VEGF in pulmonary interstitial fibrosis.IGF-Ⅰ involved in the pathogenesis of pulmonary interstitial fibrosis.TGF-β1 and IGF-Ⅰ have a positive linear regressive relationship,which indicates that they may work synergistically in the process of the fibrosis.

Objective To analyze the clinical features of pure red cell aplasia (PRCA),and to improve the recognition of its pathogenesis and treatment.Methods Among 35 PRCA patients from 1990-01 to 2003-04 in our hospital,17 patients(group Ⅰ) had immunologic abnormality,and the other 18 patients (group Ⅱ)were normal at every immunologic index.Removed the primary affection,all patients were given the combine treatment with drugs:androgen,immunosuppressive agent or/ and glucocorticoid.Results Nine patients in group Ⅰ appeared T subgroup ratio inversion in peripheral blood,eleven patients had higher level than normal with TNF?,and six patients' IL-2 level was higher.The response was 70.6%.Some patients shifted to normal in immunologic index.The response was 86.7% in group Ⅱ.But 11 cases relapsed of the 25 cured and remission patients.They responded again to the initial therapy.Conclusion Dysimmunity is the most important pathogenesis in PRCA patients.Most patients respond to immunosuppression therapy.The relapse patients also respond to initial therapy.

Objective To establish a method for content determination of harpagide and harpagoside in Mailuoning injection by HPLC. Methods The experimental condition of HPLC method was as follows: SunfireTM C18 column (4.6 mm ×150 mm, 5 μm), with gradient elution using acetonitrile and 0.03% phosphoric acid; the detected wavelength was 210 nm, and the flow rate was 1.0mL/min.ResuIts Harpagide and harpagoside demonstrated good linear relationship in the range 0.1424~0.8544 μg/mL(r=0.9998) and 0.0732~0.4392μg/mL (r=0.9997) respectively.The average recovery rate were 98.22% and 99.27% with RSD of 1.46% and 1.42%(n=6)respectively.ConcIusion The method is simple, reliable, accurate, reproducible and stable, and it could be used in the determination of harpagide and harpagoside in Mailuoning injection.

Objective To study the effect of acupuncture on the ratio of CD4+ CD25+ regulatory T cells and expression of transcription factor Foxp3 in patients with septic shock.Methods Sixty-four patients with septic shock were randomly divided into two groups by using the random number table method.Acupuncture group (34 cases) was treated with both western medicine and acupuncture,and control group(30 cases) was treated with western medicine.The period of treatment was 7 days.After treatment,the ratio of CD4+ CD25+ T cells in peripheral blood was determined by flow cytometry.And the expression of Foxp3 mRNA in peripheral blood was detected by quantitative real time PCR.Results After treating for 7 days,the ratios of CD4+ CD25+ Treg cells and CD4+ CD25+ Foxp3 + Treg cells were (20.23 ± 1.12) ％ and (78.70 ± 7.65) ％ respectively in peripheral blood of the control group,which in the acupuncture groupwere (17.32 ± 0.78) ％ and (68.53 ± 8.01) ％,the differences were statistically significant between the two groups(t =2.587,2.749,all P ＜ 0.05).The levels of Foxp3 mRNA in peripheral blood were (1.21 ±0.02) and (1.02 ± 0.04) in the control group and acupuncture group,the difference was statistically significant(t =2.119,P ＜ 0.05).Conclusion Acupuncture can adjust immune status of patients with septic shock by reducing the ratio of CD4+ CD25+ Treg cells and down-regulating the expression of Foxp3 mRNA.

Objective To apply fluorescence-activated cell sorting (FACS) and magnetic activated cell sorting (MACS) in sorting natural killer (NK) cells from human peripheral blood. The efficiency of these two methods were compared so that the basic conditions for the further study on the lower proportion of peripheral blood cells could be created. Methods Twenty cases of normal peripheral blood and 3 cases of post-hematopoietic stem cell transplantation (post-HSCT) were collected and NK cell were sorted by FACS and MACS. Results Before sorting the normal peripheral blood, the proportion of the NK cell in the leukocyte was (12.86±3.62) %, the purity of NK cell was up to (96.15±2.03) % and the recovery was (95.08±2.16) %after sorting by FACS, the purity was up to (93.35±3.61) % and the recovery was (94.11±3.01) % by MACS.And before sorting the post-HSCT peripheral blood, the proportion of the NK cell in the leukocyte was (11.01±2.08) %, the purity of NK cell was up to (96.22±2.16) % and the recovery was (95.27±1.18) % after sorting by FACS. The purity was up to (90.98±1.94) % and the recovery was (94.54±3.52) % by MACS. Thereis difference in purity of NK cell (t = 5.925, P ＜0.05), while no difference in rate of recovery between 2methods (t = 0.789, P ＞0.05). Conclusion FACS is more efficient, rapidly and easily than MACS in sorting NK cell, especially for post-HSCT cases.

OBJECTIVE:To observe the clinical efficacy and safety of caspofungin acetate in the treatment of invasive pulmo-nary fungal infection(IPFI). METHODS:70 patients with IPFI were selected and randomly divided into observation group(40 cas-es) and control group (30 cases). Control group was given Itraconazole injection with initial dose of 250 mg,bid,decreasing to 200 mg,qd,2 days later;observation group was given Caspofungin acetate injection 70 mg on the first day,decreasing to 50 mg, ivgtt,qd,within 1 h. Clinical efficacy,the rate of nacterial smear negative conversion and ADR were observed in 2 groups. RE-SULTS:The total effective rate of observation group was 92.50%,which was significantly higher than that of control group (76.67%);the rate of nacterial smear negative conversion was 72.00% in observation group,which was significantly higher than that of control group(42.10%);the incidence of ADR was 7.50%in observation group,which was significantly lower than that of control group (13.33%),with statistical significance (P<0.05). CONCLUSIONS:Caspofungin acetate is effective for IPFI with low incidence of ADR.

Objective To explore the indications, superiority and surgical technique of periareolar approach in the management of benign breast diseases. Methods 132 patients with benign breast disease (91 cases of Fibroadenoma, 12 cases of limited gland hyperplasia, 8 cases of cyst, 2 cases of benign phyllodes tumor and 6 cases of male gynecomastia) underwent operation through areolar incision. Results All patients were followed up for 1-10 months. 107 cases were satisfied with their treatment,19 cases were not quite satisfied with the relatively long incision, and 6 cases were not satisfied with the front incision. The one-month-later reexamination showed that 117 cases feel good and 15 cases had partial numbness of the nipple (15/132, 11.36%). All but two patients wound healing delayed because of local hematoma (2/132, 1.52%). Neither necrosis nor infection was found. Conclusions With the advantages of fewer complications and cosmetic effect, periareolar approach can be applied in management of various benign breast diseases. Factors such as indications, anatomical layer, postoperative molding, appropriate drainage, pressure dressing should be taken into consideration for the success of operation.

ObjectiveTo study the correlation of personality dysfunction with resilience in secondary vocational students.MethodsBy adopting the questionnaire of Personality Dysfunction Inventory for Middle School Students (MPDI) and Healthy Kids Resilience Assessment scale (HKRA) to assess 358 secondary vocational students.ResultsThe secondary vocational student's scored lower on relationship dysfunction (4.15 ±2.67) than ordinary high school students'( 5.18 ± 3.37 ),and higher on behavioral deviation (6.07 ± 3.20) than ordinary high school students (5.18 ± 3.37 ).There existed great capable difference of total and every fact of personality dysfunction according to grade (P ＜ 0.05,P ＜ 0.01 ),and the quo of personality dysfunction on second year in high vocational school students was better than high and senior high vocational school students.Both parents of secondary vocational student's scored lower on relationship dysfunction( 3.96 ± 2.36),emotional deviation (3.96 ± 2.36 )and personality dysfunction( 15.50 ± 6.27 ) than Single-parent family of secondary vocational students ( 5.73 ±4.12,6.51 ± 3.72,19.78 ± 10.44).There existed great capable difference of total and every fact of personality dysfunction according to relationship with parents (P ＜ 0.05,P ＜ 0.01 ),and the more harmonious in parental relationship,the better in personality.There also existed great capable difference of total and every fact of personality dysfunction according to educational background of parents (P ＜ 0.05,P ＜ 0.01 ),and the higher degree,the better in personality.Personality dysfunction of Students of secondary vocational was negatives correlated with their resilience (Pearson correlation coefficient was between -0.064 and -0.345 for each pair).The linear regression showed thatthepeerrelationshippredictedpersonalitydysfunctionofsecondaryvocationalstudents.ConclusionThe personality dysfunction of secondary vocational students is affected by their parental relationships,educational background of parents,grade and resilience.