Objective To investigate the changes of interleukin-21 (IL 21) and interleukin-21 receptor (IL 21R) expression level in Crohn's disease (CD) patients before and after accepted infliximab (IFX) treatment.Methods From June 2009 to July 2011,twenty-two CD patients met the research criteria were recruited at Tenth People's Hospital of Tongji University.Patients were treated with infliximab at weeks 0,2,6,and 16 healthy individuals were set as healthy control group at same time.Peripheral blood of healthy control group was taken at regular physical examination and blood of CD patients was taken before treatment and 10 weeks after treatment,intestinal mucosa biopsy samples were taken under colon endoscopy examination.The changes of Crohn's disease activity index (CDAI),erythrocyte sedimentation rate (ESR),C-reactive protein (CRP) in CD patients were observed.The change of IL-21R in peripheral blood CD4+ T lymphocytes was detected by flow cytometry.The change of IL-21 expression at mRNA level in intestinal mucosa was determined by realtime quantitative polymerase chain reaction (PCR).The data were analyzed by t test.Results Before treatment,the level of IL21R in peripheral blood CD4+ T lymphocytes of CD patients (12.25％±3.25％) and the expression of IL-21 at mRNA level in inflamed intestinal mucosa (1.38±0.32) were both significantly higher than those of healthy controls (4.25 ％ ± 1.41％,0.44±0.18),the differences were statistically significant (F=15.88,6.75 ; both P＜0.05).At 10th week,the level of IL-21R in peripheral blood CD4+ T lymphocytes of CD patients (8.12％ ± 2.05％) and the expression of IL-21 at mRNA level in intestinal mucosa (0.77 ± 0.24) were both significantly lower than those before treatment,the differences were statistically significant ( t=4.880,8.019; both P＜0.01).Before treatment,ESR,CRP and CDAI of CD patients was (46.8±11.4) mm/1 h,(52.4±11.5) mg/L and 319±74,which was (23.5±9.0) mm/1 h,(11.6±4.6) mg/L and 113±42 after treatment,the differences were statistically significant (t=9.485,16.458,11.100; all P＜0.05).Conclusion The IL-21 expression of active CD patients decreases after IFX treatment,which indicates that IL-21 may involve in IFX induced clinical remission of active CD.

Objective To investigate the changes of human epidermal stem cells after transfected with human telomerase reverse transcriptase(hTERT)gene.Methods The plasmid pIRES2-EGFP and plasmid pIRES2-EGFP-hTERT encoding hTERT were transfected into in vitro cultured human fetal epidermal stem cells by liposome-mediated transfection.Then,the positive cells were selected with G418.The mRNA and protein expressions of hTERT were detected by reserve transcriptase-polymerase chain reaction(RT-PCR)and Western blot.The telomerase activity and the proliferation and cycle of human epidermal stem cells were detected by telomeric repeat amplification protocol(TRAP)-ELISA and flow cytometry respectively.Results RT-PCR and Western blot techniques detected weak mRNA and protein expressions of hTERT gene in untransfected and vacant vector transfected cells but high level of mRNA and protein expressions of hTERT gene in pIRES2-EGFP-hTERT transfected cells.Compared with untransfected and vacant vector transfected cells,the pIRES2-EGFP-hTERT transfected cells had higher telomerase activity,with lower proportion of cells at G_0/G_1 phase,higher proportion of cells at S and G_2/M phases and enhanced proliferation ability.Conclusion Transfection with hTERT gene can markedly enhance mRNA and protein expressions,telomerase activity and proliferation ability of hTERT gene of human epidermal stem cells euhured in vitro.

Yiqi Huoxue Oral Liquid(YHOL) was a formula with Qi Reinforcing and bind-circulationactivating actions consisting of Radix Astragali seu Hedysari,Heada,Radix Ilicis Pubesceatis,etc,To study its Pharmacological mechanism, the effects of YHOL on cerebral edema and ultra- struture of cereblal ischemic rat model after reperfusion were observed. The results showed that YHOLdecreased the water content of ischemic barn to some extent, alleviated the neurological symptoms andreduced the damage of brain ultrastructure in the early stage of reperfusion. It is indicated that YHOLcan reduce cereblal edema by protecting the fumction of vascular endothelial cell and the integrity of basicmembranes and improving microcirculation, and exerts a protective effect on the delayed death of neuron.This will Provide an experimental evidence for the clinical application of YHOL.

Up to now, advantages and disadvantages in the treatment of hypertensive middle_ and large_amount cerebral hemorrhage (HMLCH) by western medicine or traditional Chinese medicine,or by medical treatment or surgical treatment still exist. Mortality and disablement rate remain high. Western medicine combined with Chinese herbal medicine shows better effect in treating HMLCH, but the related research is preliminary. Therefore, thoughts of establishing comprehensive therapeutic protocols for HMLCH are presented as follows. Western medicine combined with Chinese herbal medicine is the fundamental therapeutic principle. Proper surgical operation should be employed promptly to clear away hemotoma and relieve the symptoms first according to the situation of the patient, hospital and the surgeon. Clearing heat and calming the liver, removing blood stasis and phlegm, relaxing the bowels and restoring consciousness are the fundamental therapeutic methods for HMLCH with yang_excess syndrome, and reinforcing Qi and activating blood circulation, removing phlegm and dredging channels, relaxing the bowels and restoring consciousness for yin_excess syndrome. Routine treatment and symptomatic treatment also should be taken into account.

Objective To investigate the effects of sivelestat sodium on early inflammatory reaction in rats with smoke inhalation injury. Methods Forty SPF male SD rats were randomly divided into 5 groups:normal control group (A), injury group (B), smoke inhalation treated with 10 mg/kg sivelestat sodium group (C), smoke inhalation treated with 20 mg/kg sivelestat sodium group (D) and smoke inhalation treated with 30 mg/kg sivelestat sodium group (E), 8 rats for each group. After smoke inhalation injury model was established, the treatment groups were intraperitoneally injected sivelestat sodium 10 mg/kg, 20 mg/kg and 30 mg/kg separately. B group was treated with the same volume of physiological saline. After 24 hours,ELISA was used for detecting serum contents of neutrophil elastase (NE), myeloperoxidase (MPO), tumor necrosis factor-α(TNF-α) and interleukin-6 (IL-6) in five groups. Meanwhile the water content of lung tissue was measured, and the pathological changes were observed by HE staining. The thickness of alveolar septum was measured and compared between groups. Results Compared with control group, the serum levels of NE, MPO, IL-6, TNF-α, water content of the lung tissue and thickness of alveolar septum were significantly higher in other four groups (P<0.05). Compared with injury group, the serum levels of NE, MPO, IL-6, TNF-α, water content of the lung tissue and thickness of alveolar septum were significantly lower in treatment groups (P<0.05). Compared with 20 mg/kg treatment group and 30 mg/kg treatment group, the serum levels of NE, MPO, IL-6, TNF-α, water content of the lung tissue and thickness of alveolar septum were significantly lower in 10 mg/kg treatment group (P<0.05). Conclusion The result shows that sivelestat sodium can reduce the early inflammatory reaction of rats with smoke inhalation injury and attenuates the lung edema. In this experiment, the treatment effect of 10 mg/kg sivelestat sodium is better than other treatment doses.

To investigate the therapeutical effect of the chitosan (CS) nana-paritclessingle administration of Bla g 7 polypeptide - CS nanoparticles used as a BLa g7 polypeptide antigen in the sensitized mice and to explore its immune mechanism, the polypeptide Bla g 7 was enclosed into CS to develop the Bla g 7 polypeptide entrapped CS nano-particles. In the present experiment, 25 BALB/c mice were divided randomly into the Bla g 7 polypeptide treated group(group A , n= 5) , Bla g 7 polypeptide plus CS treated group(group B , n= 5) , CS=control group (group C , n= 5),model group (group D , n= 5) and negative control group (group E, n= 5), After sensitization by intraperitoneal route and challenged by intranasal instillation with crude extracts of German cockroach , the inflammatory changes in the mouse lung tissues were observed after the lung tissues were fixed and stained with haematoxylin and eosin(H&E). The total cell number and the cellular composition of bronchoalveolar lavage fluid (BALF) were detected; and the changes of the mouse airway hyper-reactivity were determined by the whole body plethysmograohy pre-and post-treatments. In these ways, the Bla g7 peptide CS nano-particel vaccine was successfully developed. It was found that the pathological changes in mouse lungs in group D were not so prominent in comparison with those of group A of mice sensitized with crude extract of German cockroach. in which the development of eosinophil infiltration in the airway of mice in D group could be demonstrated. The lung inflammatory reactions and the mucus secretion in lungs of D group were significantly alleviated than those of the B group. but there was no therapeutical effect for the mice fed with the isodoses of Bla g 7 polypeptide or CS. It was also shown that the airway hyper-reactivity of mice was depressed after treatment (P<0.05). It is evident that CS nano-particles show definite therapeutical effect and may serve as a powerful vehicle to improve the tolerance effect of the Bla g 7 polypeptide-CS nanoparticle vaccine, and a single administration of Bla g 7 polypeptide-CS nanoparticle vaccine may hold promise as a new strategy to desensitize the Bla g 7 sensitized disease.

Objective To analyze expression of interleukin (IL)-23p19 and IL-23 receptor (IL-23R) in inflammatory bowel disease (IBD),and the role in the induction of peripheral blood T cell activation and proinflammatory cytokine secretion.Methods Peripheral blood (PB) and intestinal mueosal biopsies were collected from 12 patients with Crohn's disease (CD),25 patients with ulcerative colitis (UC) and 20 healthy controls.Expression of IL-23p19 was determined by immunohistochemistry and RT-PCR.IL-23R expression in CD4+,CD8+ T and NK cells from peripheral blood and lamina propria was analyzed by flow eytometry.Peripheral blood mononuclear ceils (PBMC) were isolated and cultured under stimulation with IL-23 and anti-CD3,and the levels of tumor necrosis factor α (TNFα) interferon (IFN)γ and IL-2 were determined by enzyme-linked immunosorbent assay (ELISA).Results The expression of II.-23p19 was significantly increased in inflamed mucosa of CD at both the transcriptional and translational levels compared with that in UC and healthy controls.IL-23R was mainly expressed in PB- and lamina propria-CD4+,CD8+T cells and NK cells from IBD patients,and markedly increased compared with controls (P＜0.05).IL-23 strongly triggered PBMC from IBD patients to produce significantly higher levels of IFN-γ,TNF-α and IL-2(P＜0.05).Conclusions IL-23p19 and IL-23R are highly expressed in IBD,particularly in CD,and may play an important role in the induction of T cell activation and proinflammatory cytokine secretion,suggesting that targeted therapy directed against IL-23 may have a therapeutic role in IBD.

Objective To understand the level of urinary iodine of schoolchildren and salt iodine content of their families in a primary school and to analysis influence between salt iodine content and urinary iodine level in Haimen City,Jiangsu Province.Methods A cross-sectional study was conducted in a primary school of Haimen City in 2012.With the method of stratified cluster sampling,all students aged 9 ～ 12 were extracted in grades 3-5,urine samples and salt samples of their family were collected.Urinary iodine and salt iodine were determined according to Method for Determination of Iodine in Urine by As3+-Ce4+ Catalytic Spectrophotometry (WS/T 107-2006) and Direct Titration of Universal Test method in Salt Industry (GB/T 13025.7-1999).Results Totally,452 students from grades 3-5,including 233 boys and 219 girls were selected by cluster-stratified sampling.The median of children's urinary iodine was 231.90 μg/L,while the median of boys and girls was 235.40 and 222.60 μg/L,respectively.The median of urinary iodine of 9,10,11 and 12 year old students was 253.65,195.70,236.40 and 241.70 μg/L,respectively.The proportion of less than 100 μg/L and ≥300 μg/L was 7.7％ (35/452) and 27.7％ (125/452),respectively.There were no significant differences between different gender and age students.Among the 452 salt samples collected the median of salt iodine was 27.50 mg/kg.The coverage rate of iodized salt,the qualified rate of iodized salt and the intake rate of qualified iodized salt were 98.9％ (447/452),95.1％ (425/447) and 94.0％ (425/452),respectively.After consumptionn of non-iodized salt (＜ 5 mg/kg),unqualified iodized salt(5 ～ ＜ 20 mg/kg or ＞ 50 mg/kg) or qualified iodized salt [(35 ± 15)mg/kg],the median of urinary iodine of children was 177.30,211.95 and 232.90 μg/L,respectively.Correlation analysis showed that there was no relationship between iodine content of salt and urinary iodine level of schoolchildren (r =0.085,P ＞ 0.05).Conclusions Current nutritional level of schoolchildren in Haimen City is higher than the appropriate amount.Household salt iodine content of edible salt does not affect urinary iodine level of the children significantly.

OBJECTIVE: To explore the composition characteristics of traditional Chinese medicine (TCM) syndromes in patients with acute ischemic stroke of yin or yang syndrome by investigating the characteristics of TCM syndromes at different periods after onset. METHODS: One thousand two hundred and forty-six patients with acute ischemic stroke were admitted in twenty hospitals. According to the "diagnostic criteria of syndrome differentiation of stroke", the characteristics of syndromes in the patients were investigated at the periods of 1-3 days, 4-10 days and 11-30 days after they had ischemic stroke. General distribution of six basic syndromes was compared between the patients with yin syndrome and the patients with yang syndrome at the three periods. The six basic syndromes were wind syndrome, pathogenic fire syndrome, phlegm syndrome, blood stasis syndrome, qi deficiency syndrome, and syndrome of yin deficiency and yang hyperactivity. RESULTS: The percentages of wind, pathogenic fire, and phlegm syndromes in the patients were decreased at the period of 11-30 days as compared with the period of 1-3 days (87.1% vs 79.3%, 52.1% vs 38.7% and 67.1% vs 57.4% respectively, P<0.01). However, the percentages of the syndromes of blood stasis, qi deficiency, and yin deficiency and yang hyperactivity were similar at the three periods (P>0.05). There were no differences in the distribution of yin and yang syndromes among the three periods (P>0.05). The percentages of syndromes of wind, pathogenic fire, phlegm, and yin deficiency and yang hyperactivity were higher (P<0.01), and the percentages of syndromes of blood stasis and qi deficiency were lower (P<0.05, P<0.01) in patients with yang syndrome than in patients with yin syndrome. The complex of three syndromes was the most frequent composition pattern in the patients at the three periods. The percentages of complex syndromes of four or five syndromes were higher, and the percentages of single-syndromes and complex syndromes of two syndromes were lower in patients with yang syndrome than in patients with yin syndrome (P<0.05, P<0.01). The most frequent complex syndromes in patients with yin syndrome were complex syndrome of wind, phlegm, blood stasis and qi deficiency, and complex syndrome of wind, phlegm and qi deficiency; while the most frequent complex syndromes in patients with yang syndrome were complex syndrome of wind, pathogenic fire, phlegm and qi deficiency, and complex syndrome of wind, pathogenic fire and phlegm. CONCLUSION: The main discrimination between the yin and yang syndromes is that the yang syndrome is characterized by pathogenic fire. The syndromes of phlegm, qi deficiency, and blood stasis are not associated with the diagnosis of yin or yang syndrome.

Objective:To study the operation pattern and valuable experiences of the internationally renowned Proof-of-Concept Center(PoCC), and to improve the construction and management of PoCC in clinical medicine of our country.Methods:The data of basic structure, operation model, and performance in the health field of major PoCCs in the United States and Europe were compiled by literature review, policy combing, and official website search, and analyzed and summarized in combination with the basic national conditions and our practical experience.Results:The fundamental function of a PoCC consists of research and development support, science and technology evaluation, and communication services. The key points of building a PoCC include clear targets of service, widely opened resources, diversified operation patterns, and professional personnel.Conclusions:In China, PoCCs in the clinical medicine field could be built upon public hospitals with the full participation of physicians. Interdisciplinary cooperation, flexible mechanism, and versatile talents in technical management are also essential.