Juvenile idiopathic arthritis(JIA)is the most common rheumatology disease in childhood period with poor prognosis.The biological agents are newly developed drugs with features of clear therapeutic targets and fast effects.But its use in JIA is still limited,so this article focuses on the clinical use experience,timming and sideffects of the biological agents on JIA.

Arthritis, Juvenile ; blood ; Child ; Humans ; Interleukin-15 ; blood

OBJECTIVETo observe the effect of Pingchuan Mixture (PCM) on plasma eosinophil cation protein (ECP), interleukin-5 in bronchial alveolar lavage fluid (BALF) and inflammatory cell count in experimental guinea pigs with asthma.

METHODSThe eosinophil, neutrophil, lymphocyte count were conducted by conventional method, IL-5 was detected by ELISA and ECP determined by RIA.

RESULTSLevels of eosinophil, neutrophil, lymphocyte, ECP and IL-5 after treatment were significantly lower than those before treatment, the difference between groups treated respectively by PCM, aminophylline, dexamethasone and Dingchuan Zhike Tablet was insignificant.

CONCLUSIONPCM could treat asthma by reducing the inflammatory cell count, ECP and IL-5.

Animals ; Asthma ; chemically induced ; metabolism ; Blood Proteins ; metabolism ; Bronchoalveolar Lavage Fluid ; chemistry ; Drugs, Chinese Herbal ; pharmacology ; Eosinophil Granule Proteins ; Eosinophils ; metabolism ; Guinea Pigs ; Interleukin-5 ; metabolism ; Ovalbumin ; Ribonucleases ; metabolism

Objective To analyse the distribution characteristics of major allergens initiating allergic diseases in children from rural Shanghai. Methods Eight hundred children with allergic diseases from rural Shanghai (rural ease group), 450 children with allergic diseases from urban Shanghai (urban ease group) and 100 healthy children from rural Shanghai (rural normal control group) underwent skin prick tests (SPT), and children of rural case group were subdivided into infant group, preschool age group and school age group according to age. The positive rates of allergens and SPT were compared among groups. Results The positive rate of SPT of rural case group was significantly higher than that of rural normal control group (73.38% vs 26.00%, P<0.05), and was significantly lower than that of urban ease group (73.38% vs 80.22%, P<0.05). Dermatophagoidesfarinae and Dermatophagoides pteronyssinus were the major allergens in rural ease group, with the positive rates of 57.88% and 59.13%, respectively. Except weed and rubber, there were significant differences in positive rates of the other allergens between rural ease group and the other two groups(P<0.05). There were significant differences in positive rates of SPT among different age groups of rural children with allergic diseases (P<0.05). Conclusion Dermatophagoides farinae and Dermatophagoides pteronyssinus are the major allergens in children with allergic diseases from rural Shanghai, whose positive rates of SPT are lower than those of children with allergic diseases from urban Shanghai. The positive rate of SPT is related to age to some extent.

Background Diabetic complication is associated with lipid peroxidation.Aldehyde dehydrogenases (ALDH) catalyze the irreversible oxidation of a variety of biological aldehydes,including lipid-derived aldehydes (LDAs),and thus protect organs and tissues from toxic LDAs.Understanding the activity of ALDH in different ocular tissues in diabetic subjects is very important for prevention and treatment of diabetic ocular complications.Objective This research aimed to investigate the activity and expression of ALDH in different ocular tissues in diabetic rats and to explore the mechanism of ALDH in diabetes-induced eye disease.Methods Twenty-eight healthy SPF male Sprague-Dawley(SD) rats weighted 170-180 g were randomly divided into the normal control group and diabetic group.The diabetic animal model was established by intraperitonial injection of 4％ streptozotocin at 65 mg/kg.Isometric citric acid buffer was injected in the rats of the normal control group.The rats were sacrificed in each group 2 and 4 months after the establishment of the diabetic models,and eyeballs were obtained for the preparation of corneal,lens and retinal homogenates.ALDH activity was detected using a multifunctional microplate reader SpectraMax M5,and ALDH content was measured by ELISA at the wavelength of 450 nm with the SpectraMax M5 ELISA reader.Results The blood glucose level in diabetic rats was significantly elevated at various time points compared with the normal control group(P=0.000),and body weights were evidently lower in the diabetic group than in the normal group (P =0.000).The activities of ALDH (A340) in corneal,lens and retinal tissues in the diabetic group were increased in comparison with the normal control group (F =396.601,P=0.000),and showed an enhancement with the lapsing of time (F =53.139,P =0.000).In addition,the highest level of ALDH was found in the cornea and the lowest level in the lens(F =6973.000,P=0.000).The expression level of ALDH in the corneal,lens and retinal homogenates was significantly higher in the diabetic group compared with the normal control group (F=312.985,P =0.000) and showed a considerable increase over the course (F =19.203,P=0.000).The highest expression level was seen in the cornea and the lowest was in the lens,with a significant difference among these three kinds of tissues (F =3243.000,P =0.000).Conclusions ALDH can protect ocular tissue from the damage of lipid peroxidation.Thess results suggest that ALDH plays a role in preventing diabetes-related ocular complications.

Continuing medical education refers to the completion of basic medical education for inservice education,which is to guarantee the sustainable development of physicians in clinical and scientific research ability,and is the essential means to safeguard and improve the level of medical treatment.Traditional continuing medical education is given priority to the form of regularly organize workshops,so it has some limitations to oral and maxillofacial surgery.MOOC teaching is a kind of large-scale open new online teaching mode.This study provides an overview of the MOOC development,characteristics and development situation in the medical teaching.The necessity and feasibility of MOOC based teaching protocol in oral and maxillofacial surgery continuing medical education has been discussed.And curriculum transformation,construction of education model and possible challenges have also been analyzed and discussed in this paper.

To explore the relationship between maternal insulin levels and fetal insulin resistance.Maternal blood and venous cord blood samples were collected in gestational diabetes mellitus (GDM) mothers and control subjects.The glucose and insulin levels were measured and insulin resistance levels estimated.Maternal levels of insulin and homeostasis model of assessment for insulin resistance index (HOMAIR) were significantly higher in the GDM group than those in the control group (P ＜ 0.05) ; fetal levels of insulin and HOMA-IR were significantly higher in the GDM group than in the control group (P ＜ 0.05).Maternal insulin level positively correlated with fetal insulin (r =0.326,P ＜ 0.05) and HOMA-IR levels (r =0.378,P ＜0.05).In this study,a higher level of fetal insulin resistance was reported in the GDM group.And maternal hyperinsulinemia might affect fetal insulin resistance in pregnant women with GDM.

Objective To investigate the influence of pregnancy and delivery on maternal graft and newborns after renal transplantatior.Method Two cases of successful pregnancy and delivery after renal transplantation were retrospectively analyzed and the literatures were reviewed.Result The first recipient received the immunosuppressive treatment,which was based on the mycophenolate after renal transplantation.Three years after transplantation,the recipient had the requirement of pregnancy,but there was no pregnancy without contraception for over one year.On the next month after the myocphenolate-based immunosuppressive regimen changed to the purine-based,B ultrasound revealed follicular growth,ovulation and pregnancy.Caesarean section was performed at 37 gestational weeks and a body was delivered.The weight of the boy was 2 750 g,and the Apgar scores of the newborn were 10.The second recipient received triple immunosuppressive therapy (cyclosporin A + azathioprine + methylprednisolone),and got natural pregnancy 4 years after renal transplantation.The recipient was hospitalized due to the increased blood pressure and reduced fetal heart rate at 33 W+2 gestational weeks,and discharged after treatment.Caesarean section was performed at 38 W+1 gestational weeks,the weight of the boy was 3 000 g,and the Apgar scores of the newborn was 10.After follow-up for 8 years old,there was on abnormity of the function of the transplanted kidney and the growth of the newborns.Conclusion Successful pregnancy and delivery are possible in renal transplant recipients with normal renal function.Regulating the immunosuppressive regimen appropriately,and treating the complications of pregnancy effectively can obtained the satisfactory outcome of pregnancy.

Objective To evaluate the CT findings and classification of the Le Fort fracture. Methods Sixty-two cases with Le Fort fractures were studied with thin-slice high-resolution CT scanning and analyzed with three-dimensional(3D)imaging reconstruction.Results Of the 62 patients,10 had Le Fort type Ⅰ fracture,9 had Le Fort type Ⅱ fracture,8 had Le Fort type Ⅲ fracture,and 35 had various combinations of the three types of Le Fort fractures,including 18 Le Fort Ⅰ+Ⅱ fracture,7 Le Fort Ⅰ+ Ⅱ+Ⅲ fracture and 10 Le Fort Ⅱ+Ⅲ fracture.Fifty-five cases had associated multiple fractures in the maxillofacial region.On 2D CT images,Le Fort fracture manifested as multiple and complex fractures. Though 2D image was better than 3D image in accurately defining tiny fractures and fractures of deep structures,the diagnosis of Le Fort fracture could not be correctly made solely on 2D image.3D CT clearly and stereoscopically demonstrated the entire shape and orientation of Le Fort fracture,thus facilitating the correct classification of Le Fort fracture.Conclusion 3D CT image is important in providing information about the space relationship of Le Fort fracture,thus very valuable for the preoperative planning.

Objective To investigate clinical characteristics of refractory systemic juvenile idiopathic arthritis(JIA)and the efficiency of glucocorticoid in therapy on this kind of disease.Methods Thirty-nine children with systemic JIA were divided into low dose group 0.5-1.0 mg/(kg?d)and high dose group 1.0-1.5 mg/(kg?d).And the efficiency was observed by change of active index after 10 and 20 days.Results The effective power was 58.8% and 72.7% after 10 days,respectively.After 20 days,the power was 76.5% and 90.9%,respectively.The power in high dose group was significantly higher than that in low dose group.It had no difference in statistical analysis for efficiency of 2 kind of glucocorticoid dosage to control fever,but it had obvious difference to control arthralgia,arthrocele,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP).Conclusion Glucocorticoid therapy is very effective to control the activity of disease in patients with systemic JIA.