Objective:To investigate the effect of Cyr61 on the proliferation of Fibroblast-like Synoviocytes (FLS) in rheumatoid arthritis (RA).Methods:Cyr61 expression in synovial tissues (ST) and FLS was examined using Real-time PCR,Western blot and immunohistochemistry simultaneously.FLS were isolated from synovial tissue of RA patients and cultured in vitro.The proliferation of FLS stimulated with synovial fluid (SF) was determined by 3 H-TdR incorporation.Cyr61 protein level in RA SF was detected by ELISA.Results:Cyr61 was over expressed in ST,FLS of RA patients while hardly examined in normal individuals and osterarthritis (OA) patients.Meanwhile,Cyr61 protein level was elevated in SF,which promoted the proliferation of RA FLS.This proliferation was abrogated by knockdown the Cyr61 gene of FLS or neutralizing monoclonal antibody against human Cyr61.Moreover,inflammatory factor IFN-γ and TNF-α up-regulated the expression of Cyr61.Conclusion:These results indicate that the elevated level of IFN-γ and TNF-α in RA SF can promote the proliferation of the FLS derived from RA patients by increasing expression of Cyr61,suggesting that Cyr61 may play an important role in the development of RA.

Objective To determine if using a soft-tipped guidewire to cannulate the common bile duct may ameliorate development of PEP(post-ERCP pancreatitis)and facilitate cannulation of the CBD(common bile duct).Methods A total of 78 patients treated treateed in our hospital underwent ERCP through conventional direct cannulation(52 diagnostic ERCPs,26 therapeutics ERCPs)from 1998 to 2001 were randomly selected as group A while 112 patients underwent ERCP through guide wire-directed cannulation(21 diagnostic ERCPs,91 therapeutics ERCPs)from 2007 to 2008 as group B.Then we retrospectively studied and compared the following parameters between the two groups:1)Success rate of biliary access;2)visualization rate of pancreatic duct;3)the level of serum amylase,severity of abdominal pain and the rate of PEP.Meanwhile,the correlation between grading of pancreatic duct visualization and PEP was analyzed.Results The success rate of biliary access of the guidewire group(106/112 cases)was significantly greater than the conventional group(33/78 cases)(94.64%vs.42.30%,P<0.01).In group A,about61.53%(16/26)of the 26 cases could not continue the next therapeutics ERCP because of unsucceasful carmulation. The visualization rate of pancreatic duct of group A and B were 58.97%(46/78 cases)and 8.04%(9/112 cases)(P<0.01) respectively.On occurrence rate of PEP,group A(17/78 cases)was significantly higher than group B(4/112 cases)(21.79% vs.3.57%,P<0.01),and severe pancreatitis occurred in 3 patients in conventional group.However,there was no severe pancreatitis in the guide wire group.There were no significant differences (P>0.05) in terms of the rate of hyperamylasemia between the two groups.The significant correlation was found between the grading of pancreatic duct visualization and the occurrence of PEP.Condusion Guidewire-directed selective access to the bile duct lowers likdihood of PEP by facilitating cannulation and lowering the visualization rate of pancreatic duct.The occurrence of PEP could be predicted by the grading of pancreatic duct visualization,which is a very important but not the unique factor leading to PEP.

Objective To investigate the short- and long-term complications after endoscopic Oddi's sphincterotomy (EST) upon endoscopic retrograde cholangiopancreatography (ERCP) procedure and determine whether the size of EST correlates to the occurrence of EST complications.Methods 95 cases receiving EST in the process of ERCP in our hospital were studied and followed up. The patients were divided into large, moderate and small incision groups according to the size of EST and the states of short-term and long-term EST complications were statistically analyzed.Results The incidence of short-term complications of EST was 18. 94% (18/95). They included bleeding in the process of ERCP in 11 cases, delayed bleeding in 3, acute pancreatitis in 1, acute cholangitis in 2 and duodenal perforation in 1. All these patients but 1 with duodenal perforation were discharged after undergoing symptomatic treatments. Eleven out of the 95 patients had long-term complications (11.57 % ). These included biliary system infection in 5 cases, recurrent calculus of bile duct in 3, papilla stricture in 1 and chronic relapsing pancreatitis in 2. All 11 patients recovered after therapeutic ERCP again or symptomatic drug treatments. There was no significant difference in incidence of short-term (χ2 =2.433, P=0.296) or long-term complications (χ2 = 1.151, P=0.562) among the 3 groups. Furthermore, there was no statistical correlation between the incision size of Oddi and complications including operative bleeding (P=0.109), short-term complications (P=0.124) and longterm complications(P=0.402). Conclusion There are many short-term and long-term complications after EST, but there is no correlation between the complications and the incision size of Oddi. The occurring rate of complications might be reduced through accurate direction of papilla incision, avoidance from injury of blood vessel, keeping bile drainage unobstructed and protection of the function of Oddi sphincter as far as possible in the process of ERCP.

OBJECTIVETo review the major progress in primary angle closure glaucoma (PACG).

METHODSContents of this article were selected from the original papers or reviews related to primary angle closure glaucoma published in Chinese and foreign journals. A total of 76 articles were selected from several hundred original articles or reviews. The content of selected articles is in accordance with our purpose and the authors are authorized scientists in the study of glaucoma.

RESULTSPrimary angle closure glaucoma is the most common type of glaucoma in the Sino-Mongoloid population. PACG in Chinese can be classified into three types depending on the mechanism of angle closure: 1. Multimechanism: 54.8% of Chinese PACG is caused by co-existing factors. The pattern of angle closure appears to mainly be creeping closure. After iridectomy, almost 40% of the cases still manifest a positive response to the darkroom provocative test and progressive synechial closure or recurrent angle closure may occur. Several mechanisms are involved in this form of PACG such as pupillary blocking component, iris crowding component and anterior positioned ciliary body. These factors can coexist in the follow patterns: pupillary blocking and iris crowding coexist; pupillary blocking and anterior positioned ciliary body coexist or three of them co-exist. 2. Pupillary block: (38.1% of Chinese PACG) is caused by iris bombe due to pupillary block with acute or subacute attack. It responds well to iridectomy or laser iridotomy. 3. Non-pupillary blocking: (7.8% of Chinese PACG). They usually have a deeper anterior chamber, and tend to be younger (below 40 years of age). Angle closure in this form of PACG is caused by: iris crowding mechanism or/and anteriorly positioned ciliary body against iris root to angle. It is critical to distinguish multi-mechanism PACG from other types. The initial treatment for this type of PACG is also iridectomy, but after the pupillary block component is eliminated by iridectomy, the residual non-pupillary blocking components should be highlighted by a diagnostic treatment procedure or by a ultrasound biomicroscopy (UBM) provocative test. Finally, the role of UBM in the observation and evaluation of the mechanism of angle closure is discussed and future research directions on PACG in Asians are proposed.

CONCLUSIONChinese eyes have been recognized to be prone to the development of creeping angle closure. There is some direct evidence that creeping angle closure is caused by multiple mechanisms. Further study on this topic is needed.

Asian Continental Ancestry Group ; China ; Glaucoma, Angle-Closure ; diagnosis ; ethnology ; etiology ; Humans

Surface molecularly imprinted polymers (SMIPs) for selective adsorption of ampicillin sodium were synthesized using surface molecular imprinting technique with silica gel as a support. The physical and morphological characteristics of the polymers were investigated by scanning electron microscope (SEM), Fourier transform infrared spectroscopy (FT-IR), thermogravimetric analysis (TGA), elemental analysis and nitrogen adsorption–desorption test. The obtained results showed that the SMIPs displayed great adsorption capacity (13.5μg/mg), high recognition ability (the imprinted factor is 3.2) and good binding kinetics for ampicillin sodium. Finally, as solid phase extraction adsorbents, the SMIPs coupled with HPLC method were validated and applied for the enrichment, purification and determination of ampicillin sodium in real milk and blood samples. The averages of spiked accuracy ranged from 92.1%to 107.6%. The relative standard deviations of intra-and inter-day precisions were less than 4.6%. This study provides a new and promising method for enriching, extracting and determining ampicillin sodium in complex biological samples.

Objective To explore the mechanism of down-regulation of regulatory T cells (Treg) by immunization with attenuated activated autologous T cells. Methods Aulologous T cells were activated with ConA in vitro. Mice were immunized subcutaneously and inlraperitoneally every 5 days for 3 times (5 ×10~6 per time for each mouse), and the number and function of Treg were examined. PBS was subcutaneously injected for control group. Serum level of anti-mouse CD25 antibody was measured by ELISA. The number and function of Treg was detected by serum adoptive transfer and proliferation and inhibition assays. Results Compared with control group, there were less CD4~+ CD25~+ Foxp3~+ Treg in the mice after immunization (P < 0. 01), the immunosuppression ability decreased (P<0. 01), and the level of anti-CD25 antibody increased (P <0.01). Adoptive transfer of serum from immunized mice to naive mice led to a significant decrease in Treg population and function in recipient mice (P<0. 01). Conclusion Immunization with attenuated activated autologous T cells induces more anti-CD25 antibody, which may further down-regulate CD4~+CD25~+Foxp3~+ Treg expansion and function in vivo.

Humans ; Diagnosis, Differential ; Constriction, Pathologic/diagnosis* ; Bile Duct Neoplasms/diagnosis* ; Endoscopy, Digestive System

OBJECTIVETo investigate in vivo survival of retinal ganglion cells (RGCs) after partial blockage of optic nerve (ON) axoplasmic flow by sub-retinal space or vitreous cavity injection of brain-derived neural factor (BDNF) produced by genetically modified neural progenitor cells (NPCs).

METHODSAdult Sprague-Dawley (SD) rat RGCs were labeled with granular blue (GB) applied to their main targets in the brain. Seven days later, the left ON was intra-obitally crushed with a 40 g power forceps to partially block ON axoplasmic flow. Animals were randomized to three groups. The left eye of each rat received a sham injection, NPCs injection or an injection of genetically modified neural progenitors producing BDNF (BDNF-NPCs). Seven, 15 and 30 days after ON crush, retinas were examined under a fluorescence microscope. By calculating and comparing the average RGCs densities and RGC apoptosis density, RGC survival was estimated and the neuro-protective effect of transplanted cells was evaluated.

RESULTSSeven, 15 and 30 days after crush, in the intra-vitreous injection group, mean RGC densities had decreased to 1885 +/- 68, 1562 +/- 20, 1380 +/- 7 and 1837 +/- 46, 1561 +/- 58, 1370 +/- 16, respectively with sham injection or neural progenitors injection. However, RGCs density in the groups treated with intra-vitreous injection of BDNF-NPC was 2101 +/- 15, 1809 +/- 19 and 1625 +/- 34. Similar results were found in groups after sub-retinal injection. Higher densities were observed in groups treated with BDNF-NPCs. There were statistically significant differences among groups through nonparametric tests followed by the Mann-Whitely test. RGC apoptosis density in BDNF-NPC at each follow-up time was less than in other groups.

CONCLUSIONSA continuous supply of neurotrophic factors by the injection of genetically modified neural progenitors presents a highly effective approach to counteract optic neuropathy and RGC degeneration after partial ON axoplasmic flow blockage.

Animals ; Apoptosis ; Axonal Transport ; Brain-Derived Neurotrophic Factor ; genetics ; Cell Survival ; Gene Transfer Techniques ; Genetic Therapy ; Glaucoma ; therapy ; Male ; Rats ; Rats, Sprague-Dawley ; Retinal Ganglion Cells ; cytology ; Stem Cells ; physiology ; Vitreous Body ; metabolism

OBJECTIVETo study the expression of tumorigenesis-related stem cell markers Lgr5 and CD44 in different pathological types of intestinal polyps and their clinical significance in predicting tumorigenesis.

METHODSA total of 145 cases of colorectal polyps, adenomas and cancer tissues were obtained by colonoscopy biopsy. Immunohistochemistry was employed to detect the expression of Lgr5 and CD44 to analyze their relationship with the occurrence and prognosis of colon and rectal cancer.

RESULTSThe expression of CD44 in colon cancer tissue was 95.65%, significantly higher than that in normal mucosa (5%), inflammatory hyperplastic polyps (22.58%), tubular adenomatous polyps (55.26%) and villous polyps (75.76%) (P<0.05). The expression of Lgr5 in colorectal cancer was up to 95.65% while negative in normal colorectal tissue and was 16.12% in inflammatory hyperplastic tissues (P<0.05). The expression rate of Lgr5 was 86.84% in tubular adenoma and 93.94% in villous polyps, both comparable with that in colon cancer (P>0.05). Correlation analysis indicated that the expression of CD44 and Lgr5 were positively correlated with the progression of intestinal polyp tumorigenesis (rs=0.69377, P<0.0001; rs=0.81637, P<0.0001).

CONCLUSIONLgr5 and CD44 are highly expressed in colorectal cancer tissues in close correlation with the clinical and pathological features. The expression profiles of Lgr5 and CD44 represent a distinct feature to differentiate colorectal cancer from normal intestinal mucosa. Lgr5 is more closely correlated with tumor progression of polyps than CD44. This means detecting of the expression of Lgr 5 together with CD44 is important and necessary in clinical diagnosis of patients with early stage colorectal diseases such as polyps and their canceration.

Adult ; Aged ; Colorectal Neoplasms ; metabolism ; pathology ; Female ; Humans ; Hyaluronan Receptors ; metabolism ; Intestinal Polyps ; metabolism ; pathology ; Male ; Middle Aged ; Prognosis ; Receptors, G-Protein-Coupled ; metabolism ; Young Adult

Objective:To explore the therapeutic effect of peroral endoscopic myotomy (POEM) for primary achalasia (AC) in patients aged over 60 years.Methods:Data of 146 patients aged ≥60 years (the elderly group) and 146 patients aged 18-59 years (the adult group) who received POEM from November 2010 to September 2019 at the Digestive Endoscopy Center of PLA General Hospital were retrospectively analyzed. Baseline data, surgery data, surgery-related complications and surgery-related efficacy were compared.Results:There was no significant difference in gender, Ling classification, HRM classification or previous treatment between the two groups ( P>0.05). All 292 patients successfully underwent POEM surgery. The clinical success (Eckardt score ≤3) rates in the elderly group and the adult group were 96.33% (105/109) and 96.77% (90/93), respectively with no significant difference between the two groups ( χ2=0.030， P>0.05). There was no significant difference in the length of myotomy between the two groups (7.09±2.49 cm VS 7.12±2.24 cm， t=0.472， P>0.05). Complications occurred in 26 cases (17.81%) in the elderly group and 21 cases (14.38%) in the adult group with no significant difference between the two groups ( χ2=0.634， P>0.05). There was no significant difference in the postoperative hospital stay (12.61±9.69 days VS 11.00±4.43 days, t=1.825, P>0.05) or the incidence of gastroesophageal reflux [43.33% (13/30) VS 51.52% (17/33), χ2=0.422, P>0.05] between the elderly group and the adult group. Conclusion:The efficacy of POEM for AC patients over 60 years old is equivalent to that of adult patients, and the incidence of complications is similar. POEM is safe and effective for AC patients over 60 years old.