Objective To analyze the 5-year survival rate,causes of death and prognostic indicators of systemic lupus erythematosus (SLE).Methods A retrospective analysis was performed on 243 newly diagnosed SLE patients who Were admitted into our hospital from 1998 to 2005.The clinical features and serologic data were studied.Survival rate of SLE patients over time was studied by the Kaplan-Meier method,and prognostic indicators of mortality were studied by Cox proportional hazards models.Results The 1-,3- and 5-yr survival rate was 96%,94% and 91%,respectively.Renal failure and infection were the main causes of death,followed by lupus encephalotmthy and pulmonary hypertension.Cox regression analysis revealed that lupus nephritis and lupus encephalopathy at the diagnosis were independent risk determinants for mortality.However,age,sex,low C3 level,positive anti-dsDNA antibody,hematological abnormalities,lupus lung involvement and heart damages at diagnosis and immunosuppressant treatment had no strong association with survival.Conclusion Early diagnosis,control of SLE organ damage and infection prevention are critical to improve survival of SLE patients.

Objective To explore the correlation between NF-κB signaling pathways activated by IL-18 in CD4+ T cells and the pathogenesis of PBC.Methods We detected the expression of IL-18 mRNA in PBMCs,IL-18 level in plasma,receptor IL-18R on surface of CD4+ T cell,proliferation rate of CD4+T cell and its NF-κB signaling pathway protein IκBα and NF-κB p65 by qRT-PCR,ELISA,flow cytometry,MACS and Western blot on 32 cases of patients with PBC (PBC group) and 32 healthy people (control group) in Guizhou provincial people′s hospital.Results The level of IL-18 in PBC group was significantly higher than that in control group (P<0.05).The relative expression of IL-18 mRNA in PBC group was significantly higher than that in control group (P<0.05).The percentage of CD4+T cells expressing IL-18Rα in PBC group was higher than that in control group (P<0.05).The proliferation rate of CD4+T cells stimulated by IL-18 in PBC group was significantly higher than that in healthy control group (P<0.01).The relative expression levels of NF-κB p65 protein were up-regulated in IL-18,and the expression of IκBα protein in each group was significantly increased,especially in PBC group (P<0.01).Conclusion IL-18 can activate NF-κB signal pathway in CD4+ T cells and participate in the pathogenesis of primary biliary cirrhosis.

Objective To evaluate the CT and MRI characteristics of Primary Central Nervous System Lymphoma(PCNSL)in immunocompetent patients,and enhance its diagnosis level.Methods CT and MRI data of 20 patients with PCNSL confirmed by histo-pathology were analyzed retrospectively.MRI scans were performed with and without Gadolinium contrast.Two of them had contrast-enhanced CT scan;six had CT scan without contrast administration;1 had CT scan with both non-contrast and contrast enhancement.Re- suits Totally,38 lesions were found in all patients:14 lesions of them were single and 24 lesions were found in 6 patients.Generally,the lesions were located in the surface and/or midline of the brain.The signal features and density were similar to meningioma,and strongly enhancing after contrast administration.Thirty-six of the 38 lesions had spicular sign peripheral to the lesion.Conclusion Although the manifestations of the PCNSL are variety,there are still many characteristics in the medical imaging,especially in the locations,the signal features,and spicular sign in the edge of the lesions after contrast material injection.

Objective To investigate the display status of ultrasonography imaging check in central nervous system (CNS) in infants of early pregnancy and the diagnostic value of CNS malformation in infants of early pregnancy.Methods Gestational weeks of 2 751 enrolled subjects were divided according to the ultrasonic measurement of the crown rump length (CRL):11-11 +6 weeks group,12-12+6 weeks group,and 13-13 + 6 weeks group,prenatal ultrasound were performed to examine fetal CNS anatomy in infants of early pregnancy,record the display status in each groups of infants and analyze the relationship between the display situation and gestational age.Results Fourteen cases of fetal CNS malformation (20 malformations) in total were found by prenatal ultrasound,and the incidence of CNS malformation was about 5.09％ (14/2 571).Wherein,12 cases of early pregnancy were diagnosed,and 2 cases of middle pregnancy were diagnosed.The sensitivity of ultrasound of early pregnancy in the diagnosis of fetal CNS malformation was 85.71％.In the group of research,the ultrasound display ratios of 11-11+6 weeks group,12-12+6 weeks group and 13-13+6 weeks group were 96.73％,97.94％,98.06％,respectively.There was no significant difference in early pregnancy fetal CNS display ratio among groups (x2 =1.56,v =2,x2＜ x0.05.2 =5.99,P ＞ 0.05).Conclusions The display rate of CNS structure in infants of early pregnancy (11-13+6 weeks)is higher,and is not affected by gestational weeks.Prenatal ultrasound can effectively diagnose CNS severe malformation in infants of early pregnancy.

Objective To identify interleukin (IL)-17-producing T cells and Foxp3 positive CD4 positive T ceils from patients with rheumatoid arthritis (RA), and investigate their cytokine levels as well as their correlations. Methods Flow cytometry was used to analyze the subsets of T cells in peripheral blood from 39 RA patients and 40 healthy donors. IL-17, IL-6, IL-23 and transforming growth factor (TGF)-beta levels in sera of these subjects were tested by ELISA. Results IL-17+CD4+ T cells increased significantly and IL-17, IL-6 and IL-23 elevated markedly in peripheral blood of RA patients compared to healthy donors (P< 0.01 ). However,Foxp3+CD4+T cells decreased evidently (P<0.01) and TGF-beta did not increase in RA pati-ents when compared to healthy donors (P>0.05). Conclusion This study suggests that Th17 cells predomin-ance coupled with relatively insufficient CD4+ regulatory T cells in RA is mainly caused by alterations of rela-ted cytokines.

Objective To investigate the clinical efficacy and safety of lamotrigine adjunctive therapy for vascular cognitive impairment.Methods Ninety -eight vascular cognitive impairment patients were divided into treatment group and control group, each group was 49 patients.In treatment group, every patients were received lamotrigine 50 mg· d-1 in the start dose, and increased to 100-200 mg· d-1 within four weeks.In control group, every patient was received lithium carbonate 500 mg· d-1 in the start dose, and increased to 1000-2000 mg· d-1 within four weeks.All patients were given eight weeks of treatment.Observed the efficacy, Bech -Rafaelsen mania rating scale (BRMS) and clinical global impression-severity of illness (CGI-SI) score changes, P300 and N400 latency changes and adverse reactions.Results The response rates in the treatment group and the control group were 95.92% and 81.63% respectively that the treatment group had significantly higher efficiency ( P<0.05 ).After treatment, the BRMS and CGI-SI scores were showing clear downward trend with a significant difference compared pre-treatment in the two groups( P<0.05 ) , and the the BRMS and CGI-SI scores in the treatment group were significantly lower than the control group after treatment ( P <0.05 ).After treatment, the P300 and N400 latencies were significantly shorter, while the volatility were increased significantly, with were significant differences compared pre-treatment ( P<0.05 ) , while the P300 and N400 latency and amplitude in the treatment group compared with the control group were statistical difference significance ( P<0.05 ).During the treatment, there were two patients were rash, one patient was dizziness and one patient was nausea in the treatment group; there were one patient was dizziness, one patient was nausea, one patient was lethargy.Conclusion Lamotrigine adjunctive therapy vascular cognitive impairment can effectively alleviate the condition and manic conditions, improve time-related potentials, thereby it is contributing to improve the overall clinical efficacy and safety.

OBJECTIVETo investigate the effects and regulatory mechanism of ILK on angiogenesis in hypertrophic scar.

METHODSThe human scar microvascular endothelial cells (HSMECs) were isolated from 6 patients' hypertrophic scar in vitro. The HSMECs with good condition in 2nd to 4th generation were selected as experimental objectives. (1) HSMECs were divided into the blank control group (treated with routine culture), negative control group (treated with only Lipofectamine 2000), LY294002 group (incubated with 50 nmol/L LY294002), ILK siRNA group (incubated with 20 nmol/L ILK siRNA). RT-PCR and Western Blot were used to detect the expression of ILK mRNA and its protein after transfecion for 48 h. (2) The digested HSMECs of four groups were resuspended with DMEM without serum and then seeded onto the upper compartment of transwell insert which contained complete medium in its lower compartment. The cell migration experiment was stopped in 10 h and then the migrated cells were counted to analyze the effects of different interventions on the migration ability of HSMECs. (3) The thawed ECMatrix was put into each well of pre-colled 48-well tissue culture plate, and then the plate was put into the incubator at 37 degrees C to make it to become gel. The HSMECs of four groups were seeded onto the surface of the ECMatrix gel and were put into incubator. Eight random view-fields per well should be valued by the sheet of pattern recognition about angiogenesis after 8 hours to evaluate the ability of angiogenesis in vitro between four groups.

RESULTS(1) The expression of ILK mRNA (ILK mRNA = 0.829 +/- 0.109, t = 13.151, P = 0.006) and protein (ILK protein = 0.096 +/- 0.049, t = 36.656, P = 0.000) were both inhibited obviously in ILK siRNA group compared with the blank control group (ILK mRNA = 0.829 +/- 0.109, ILK protein = 1). And, the expression of ILK in LY294002 group was slightly lower than that of black control group, but there was no statistical difference. (2) The number of migrated cells in ILK siRNA group (88.111 +/- 3.079) and LY294002 group (138. 667 +/- 2.404) were respectively lower than that in blank control group (322.333 +/- 3.712, P < 0. 05) in 10th hour. (3) Compared to blank control group (4.333 +/- 0.191), the ability of angiogenesis in vitro decreased significantly ILK siRNA group (2.625 +/- 0.125) and LY294002 group (3.125 +/- 0.250), in which, the vascular network structures were not formed perfectly in 8th hour (P < 0.05).

CONCLUSIONSThe ability of HSMECs' migration and angiogenesis in vitro are inhibited significantly when the expression of ILK is down-regulated. It reveals that ILK may play an role in the regulation of scar angiogenesis.

Cell Movement ; Cell Proliferation ; Chromones ; pharmacology ; Cicatrix, Hypertrophic ; enzymology ; pathology ; Endothelial Cells ; cytology ; drug effects ; Humans ; Lipids ; pharmacology ; Morpholines ; pharmacology ; Neovascularization, Pathologic ; etiology ; pathology ; Protein-Serine-Threonine Kinases ; genetics ; physiology ; RNA, Messenger ; analysis ; RNA, Small Interfering ; metabolism

OBJECTIVETo study the effect of dendritic cells (DC) stimulated with K562 cell lysate in inducing specific cytotoxic T lymphocytes (CTL) against K562 cells in vitro.

METHODSThe DCs were derived from healthy human peripheral blood monocytes in the presence of granulocyte-macrophage colony-stimulating factor, interleukin (IL)-4 and tumor necrosis factor (TNF) alpha. The T cells were stimulated by DCs loaded with freeze-thawed K562 cells and T-cell cytotoxicities were measured by lactate dehydrogenase (LDH) assay.

RESULTSThe DCs could be successfully obtained from peripheral blood monocyte after the culture. Mixed lymphocyte reactions induced by the antigen-loaded DC were much stronger than those induced by human peripheral blood monocytes (P<0.05). At the effector to target ratio of 10:1 and 20:1, cytotoxicities against K562 cells by CTL derived from culture with the antigen-loaded DCs were the strongest (P<0.05).

CONCLUSIONCTL derived from DCs pulsed with K562 cell lysate show effective and specific cytotoxicity against K562 cells.

Antigens ; immunology ; Cytotoxicity, Immunologic ; immunology ; Dendritic Cells ; drug effects ; immunology ; Granulocyte-Macrophage Colony-Stimulating Factor ; pharmacology ; Humans ; Interleukin-4 ; pharmacology ; K562 Cells ; L-Lactate Dehydrogenase ; metabolism ; Lymphocyte Activation ; immunology ; Lymphocyte Culture Test, Mixed ; T-Lymphocytes, Cytotoxic ; enzymology ; immunology ; Tumor Necrosis Factor-alpha ; pharmacology

ObjectiveTo evaluate the current practice of breast-conserving radiotherapy (BCR) in mainland China.MethodsA questionnaire on the details of treatment pattern of BCR for early breast cancer was mailed twice to all radiotherapy centers in mainland China in 2009.The responding data were collected and analyzed.ResultsOf the 952 surveyed centers,396 responded (41.6％) and 328 performed BCR.The median interval between surgery and radiotherapy was 9 weeks.Of the 328 centers with BCR,whole breast was the most common irradiation target (319 centers,97.3％ ),followed by supraclavicular region (273 centers,83.2％ ),axilla (138 centers,43.3％ ),and internal mammary chain (85 centers,26.8％ ).In 97.5％ of centers (310/319),whole breast was irradiated in all candidates.Supraclavicular region and axilla irradiation was performed for lymph-node positive patients in 41.8％ (114/273) and 26.8％(37/138) centers,and for ≥4 positive lymph-nodes in 31.5％ (86/273) and 29.0％ (/138)centers,respectively. Internal mammary chain was irradiated for tumors located in the center or inner quadrant in 72.9％ ( 56/85 ) centers.Conformal radiotherapy for the whole breast was used in 51.8％centers.The median total dose was 50 Gy,all using conventional fractionations.ConclusionsA consensus has been reached that radiotherapy is needed for patients receiving breast-conserving surgery and that irradiation to whole breast is necessary.However,establishment and widespread use of guidelines for BCR should be strengthened.

ObjectiveTo assess the current practice of postmastectomy radiotherapy (PMRT) in mainland China and to evaluate the improvement in the past six years.MethodsA questionnaire on the indications and techniques for PMRT for breast cancer was delivered to all radiotherapy centers of mainland China in 2010 survey,and the results were analyzed and compared with those in 2004 survey.The Fisher's exact test was used.ResultsCompared to 29.4％ (210/275) in 2004,396 of the 952 (41.6％) surveyed centers had performed PMRT.The median interval between surgery and PMRT was increased from 6 weeks to 12 weeks during the past 6 years.Adjuvant chemotherapy followed by PMRT was the most common combination in 73.5％ of the responding centers in 2010 other than Sandwich (71.7％) sequence of chemotherapy and PMRT in 2004.PMRT was only performed for T3 or Stage Ⅲ tumors and/or ≥ 4 positive lymph nodes (LN + ) in 7.1％ centers in 2004 and in 29.5％ centers in 2010 surveys,respectively.The use of PMRT for T1-2 N0 breast cancer,T1-2 N0 with tumors located in the center or inner quadrant,and stage T1-T2 and one to three LN + was decreased from 11.9％,63.8％,and 87.6％ in 2004 to 1.5％,19.7％,and 62.1％ in 2010,respectively (all P =0.000).The chest wall and the supraclavicular region were the most common radiation targets,which were used in 97.0％ and 97.0％ in 2010,similar to 97.1％and 96.2％ in 2004.Irradiation to the inner mammary area and axillary fossa decreased from 85.2％ and 74.8％ in 2004 to 39.1％ and 50.5％ in 2010.The boost to the chest wall was more based on the scar,increasingfrom9.0％ in004to75.0％ in 2010.Conclusions There are a high level of compliance of the practices with current guideline and continuing improvement of PMRT for breast cancer in mainland China.But it needs further improvement.