Objective To analyze the clinical characteristics, laboratory results, treatment and prognosis of adult onset Still's disease (AOSD). Methods The clinical and laboratory data of 107 AOSD patients were retrospectively analyzed. SPSS 22.0 was used for statistical analysis. Categorical data were described as frequency and percentage, and numerical data were described using x±s deviation. Chi-square test was used to compare categorical data between groups and analysis of variance test was used to compare numerical data between groups. K-W test was used to compare skewed distributed data between groups and J-T test was compared in pairwise comparison. Logistic regression was applied to examine prognostic factors. Results The average age of 107 patients (12 male and 95 female) was(39±16) years and the average disease course was (1.4±2.7) years. The patients were classified into 3 types based on their disease course: monocyclic (38 cases, 35.5%), polycyclic (29 cases, 27.1%) and chronic arthritis (40 cases, 37.4%). The clinical characteristics were high fever (107 cases , 100%), rash (97 cases, 90.7%) and arthralgia/arthritis (86 cases, 80.4%). The most common involved joints were knee (24 cases, 23.3%), wrist (19 cases, 18.4%) and proximal interphalangeal joints (14, 13.7%). The laboratory results were elevated including white blood cells count (88/105, 83.8%) and elevated serum ferritin (107, 100%). Seventy-three out of 84 patients (86.9%) had negative rheumatic factor and 9 out of 91 (9.9%) had positive ANA, which were low titre in general. Eleven patients (10.3%) had joint erosions suggested by X-ray at diagnosis. Intergroup analysis revealed that patients with polycyclic type were less likely to have abnormal liver function tests at disease onset (χ2=9, P<0.05). Twenty-five patients (23.8%) in total had complications, which were mainly pulmonary interstitial fibrosis (9 cases ) and hemophagocytic syndrome (7 cases). Male patients (n=6, χ2=5.93, P=0.015) were more likely to have complications. One hundred and two (95.3%) patients were treated with glucocorticoid and among them, 86 (84.3%) were combined with immunosuppressive agents. After 4 weeks of treatment, 89 patients (89.2%) achieved complete remission. The number of patients with glucocorticoid dependence or treatment failure was less in monocyclic group, although the differences were not significant. The analysis of prognostic factors founded that patients with Tmax>39.5 ℃ (P=0.030) were mostly fell into the monocyclic group. Compared with monocyclic type, patients with polycyclic or chronic arthritis type were less likely to have thrombocytosis (P=0.019, P=0.004). However, when compared with chronic arthritis type, patients with monocyclic or poly - cyclic type were less likely to have arthralgia/arthritis (P=0.030, P=0.000), especially the involvement of large joints (P<0.05). Conclusion AOSD mainly presents as high fever, rash, arthralgia and elevated inflammatory markers. Joint erosion may occur during the course of disease. The treatment of glucocorticoid and immunosup - pressive agent combinations is effective and most patients could achieve remission during 4 weeks of treatment. Patients with thrombocytosis at disease onset might be monocyclic type, while patients with arthritis, especially involvement of large joints at disease onset might be chronic arthritis type.

The malignant phenotype of classical Hodgkin lymphoma ( cHL) is partly maintained by epige-netic aberrant ,of which consisted mainly abnormal histone methylation and deacetylation .Progress has been made in clinical trials related to the histone deacetylases inhibitors ( HDACis) in cHL.There is a close association noted between the epigenetic aberrants and the immune escape in cHL .DNA methyltransferase ( DNMT) inhibitors, HDACis and immune checkpoint blockade have shown synergistic effects .Further study to improve the cure rate in cHL by combination strategy is of significant importance .

Objective This paper aimed to evaluate the effect of preoperative embolization on the intraoperative blood loss of sacrum chordoma.Methods forty patients involved with the spinal chordoma were retrospectively analyzed in this study.The preoperative embolization group consisted of 16 sacrum chordoma patients were embolizationed by gelatin sponge particles (10 male and6 female)age from 35 to 71 years old,(mean 57.9 years) ; and the control group consisted of 4 sacrum chordoma patients (3 male and 1 female),age from 43 to 61 years old(mean 51.8 years).analyzed the predictive value of preoperative embolization in correlation with the intraoperative blood loss.Results The mean blood loss (2025.0 ±818.5)ml of sacrum chordoma in the preoperative embolization group was insignificantly than that (1950.0 ± 802.1) ml in the control group,(P ＞ 0.05).Conclusion The study shows that the preoperative feeding artery embolization of the spinal tumor has no significant effect on the intraoperative blood loss in the surgical excision of the sacrum chordoma.

To study the characteristics of pharmacological effects of property combinations of traditional Chinese medicines (TCMs) distributing in the stomach meridian based on medicinal property combination, in order to further define the association relationship between properties of TCMs and their pharmacological effects, and build a bridge for the interpenetration and combination between the medicinal property theory of TCMs and their pharmacological effects. On the basis of the studies on the medicinal property theory of TCMs distributing along the kidney meridian and their pharmacological effects, efforts were made to collect relevant data for medicinal properties and pharmacological effects and mine the characteristics of pharmacological effects that were corresponding to relevant medicinal property combination by processing materials related to medicinal properties and pharmacological effects with the association rules method. According to the analysis, TCMs distributing along the kidney meridian with different medicinal property combinations were significantly differentiated in the pharmacological effects, but shared identical pharmacological effects, such as immunological enhancement. In this study, TCMs distributing along the kidney meridian with different medicinal property combinations were taken as the carriers to closely integrate the traditional Chinese medicine theory with the modem study achievements, lay a solid foundation for further developing and enriching the traditional Chinese medical property theory, while providing a new perspective on the development of modem medicine.
Databases, Factual ; Drugs, Chinese Herbal ; chemistry ; therapeutic use ; Humans ; Kidney ; drug effects ; Kidney Diseases ; drug therapy ; Meridians

Objective To understand the impact of methicillin-resistant Staphylococcus aureus (MRSA)blood-stream infection on the length of hospital stay,hospital mortality,and poor prognosis of patients.Methods 357 patients with Staphylococcus aureus (S .aureus)bacteremia in a hospital between January 1 ,2009 and December 31 , 2013 were surveyed and analyzed retrospectively.Results Of 357 patients,91 were infected with MRSA and 266 with methicillin-susceptible S .aureus (MSSA).The length of hospital stay was statistically different between MR-SA and MSSA group(29 d vs 23 d,P <0.01);before infection,length of hospital stay of MRSA group was longer than MSSA group(P <0.01 );after infection,length of hospital stay was not statistically different between two groups(17 d vs 16.5 d,P = 0.92 ).Mortality of MRSA group and MSSA group was not statistically different (13.19% vs 9.02%,χ2 =1 .28,P =0.26).The incidence of poor prognosis of MRSA group was higher than MSSA group(29.67% vs 16.92%,χ2 =6.85,P =0.01 ).Multivariate analysis results showed that MRSA infection was independent risk factor for poor prognosis (P <0.01).Conclusion MRSA infection doesn’t contribute to the pro-longation of hospital stay,but MRSA bloodstream infection is a risk factor for poor prognosis of patients.

0.05).Conclusion:Modified osteotomy can not improve operative effect.

Primary liver adenosquamous carcinoma is a rare kind of liver malignant tumor with very poor prognosis. Clinical data of 5 cases were analyzed retrospectively, four male and one female, whose average age was 60.2 years (50-67 years) old. Adenosquamous carcinoma contains both adenocarcinoma and squamous carcinoma histologically, and squamous carcinoma cells are dominant (>80%). Four cases underwent surgical resection and one received liver transplantation. The postoperative follow-up period ranged from 6 to 35 months and the mean survival time of these cases was about 15 months. Three patients died during the follow-up period. The survival rates 1 and 2 years after operation were 60% and 20%, respectively.

CD40 and its receptor CD40L are a very important pair of co-stimulating molecule in immune response, which have extensive biological effects. After stimulating CD40 signal, it can exert corresponding function through MAPK (JNK, ERK, p38) pathway, PI3K cascade, as well as NF-κB and STAT. The CD40 signal is closely related to tumor immunity, this moleculer has already become targeted-molecule for cancer treatment. Recently, there have been many anti-CD40 monoclonal antibodies displaying good anti-cancer effect, among which CHIR-12.12, SGN-40 and CP-870, 893 developed rapidly and successively have entered clinical research stage. This review focuses the status of anti-CD40 monoclonal antibody, including distribution of CD40, physiological function of CD40, CD40 and tumor immunity, anti-CD40 monoclonal antibodies and so on.
Animals ; Antibodies, Monoclonal ; CD40 Antigens ; immunology ; Humans ; Neoplasms

OBJECTIVETo investigate the effects of chronic aluminum exposure on the learning and memory abilities and brain-derived nerve growth factor (BDNF) in Sprague-Dawley (SD) rats.

METHODSThirty-two male SD rats were randomly and equally divided into 4 groups: control group and high-, middle-, and low-dose exposure groups. The rats in high-, middle-, and low-dose exposure groups were fed with the feed mixed with AlCl(3) (120.0, 12.0, and 1.2 mg/kg, respectively), while the rats in control group were fed conventionally. After 6 months of feeding, brain aluminum levels were determined by inductively coupled plasma mass spectrometry; Morris water maze was employed to test the learning and memory abilities; the expression and content of BDNF in brain tissue were measured by Western blot and enzyme-linked immuno sorbent assay (ELISA).

RESULTSThe high- and middle-dose exposure groups had significantly higher brain aluminum levels than the control group (P<0.05). The Morris water maze test showed that the high- and middle-dose exposure groups had significantly prolonged escape latency (P<0.05), significantly prolonged time taken to first reach the target quadrant (P<0.01), and significantly decreased number of platform crossings and time spent in the target quadrant (P<0.05), as compared with the control group. The Western blot and ELISA showed that the expression and content of BDNF in brain tissue decreased as the dose of AlCl(3) increased, and they were significantly lower in the high- and middle-dose exposure groups than in the control group (P<0.05).

CONCLUSIONChronic aluminum exposure (12.0 and 120.0 mg/kg) can lead to cognitive dysfunction in rats, and the decreased expression of BDNF may be one of the mechanisms of learning and memory deficits induced by aluminum.

Aluminum ; toxicity ; Animals ; Brain ; metabolism ; Brain-Derived Neurotrophic Factor ; metabolism ; Male ; Maze Learning ; drug effects ; Rats ; Rats, Sprague-Dawley ; Toxicity Tests, Chronic

The design space of the high shear wet granulation process was established and validated within the framework of quality by design (QbD). The system of microcrystalline cellulose-de-ioned water was used in this study. The median granule size and bulk density of granules were identified as critical quality attributes. Plackeet-Burmann experimental design was used to screen these factors as follows: dry mixing time, the impeller and chopper speed of dry mixing, water amount, water addition time, wet massing time, the impeller and chopper speed of wet massing and drying time. And the optimization was implemented with the central composite experimental design based on screened critical process parameters. The design space of the high shear wet granulation process was established based on the quadratic polynomial regression model. Since the P-values of both models were less than 0.05 and values of lack of fit were more than 0.1, the relationship between critical quality attributes and critical process parameters could be well described by the two models. The reliability of design space, illustrated by overlay plot, was improved with the addition of 95% confidence interval. For those granules whose process parameters were in the design space, the granule size could be controlled within 250 to 355 μm, and the bulk density could be controlled within a range of 0.4 to 0.6 g x cm(-3). The robustness and flexibility of the high shear wet granulation process have been enhanced via the establishment of the design space based on the QbD concept.
Cellulose ; chemistry ; Reproducibility of Results ; Technology, Pharmaceutical ; methods ; Water