Objective To understand the clinical characteristics of systemic lupus erythematosus with Antiphospholipid syndrome (SLE-APS).Methods The clinical data of 39 cases of SLE-APS were collected and analyzed retrospectively. Results Thirty-one patients had 48 thrombosis episodes in total, among which the most common presenting manifestations were deep venous thrombosis and stroke. 12 of 26 married women had fetal morbidity. The prevalence of anticardio lipin antibody (aCL) and lupus anticoagulant ( LA) was 72% and 41% , respectively. 24 patients had SLE at first,on an average of 9. 5 years later they had the characteristics of APS, 12 patients had thrombosis episodes or fetal morbidities ,4. 8 years later they developed into SLE,and 3 patients had the characteristics of SLE and APS from the onset The SLEDAI was less than 5 in five cases when they had thrombosis episodes or fetal morbidities.Conclusions The incidence of thrombosis episodes or fetal morbidities increased in SLE-APS patients. APS occurred before, after or at the same time with SLE. SLE patients might have the clinical features of APS during the steady stage. It's very important to ask the medical history in detail and measure aCL in lupus patients to find the risk factor of APS and prevent the APS' occurrence.

To explore the clinical manifestations, diagnosis and treatment of pulmonary thromboembolism associated with protein C (PC)/protein S (PS) deifciency. Two male patients 29 and 26 years old diagnosed with PC deifciency and/or PS deifciency were retrospectively analyzed and related literatures were reviewed. The most common symptoms were pain in the lower limbs with chest pain or decreased vision. Color dopper lfow imaging (CDFI) showed lower deep venous phlebothrombosis. Multislice CT angiography (CTA) revealed pulmonary embolism. The level of serum homocysteine (HCY) increased and the level of plasma PC/PS content decreased to PC 57.4%, and PS 28.9%in patient 1, while PS 33.4%in patient 2. Poor routine anticoagulant response was observed. After the diagnosis of PC/PS deficiency, vitiamin B6 and B12 anticoagulant therapy was added, and the symptoms in the patients improved significantly. Congenital thrombophilia should be taken into consideration for young patients with lower deep venous thrombosis and pulmonary embolism which occur recurrently without obvious predisposing causes before 40. Plasma PC/PS concentrations or activity help a lot in the diagnosis and treatment.

0.05).)Conclusion The extra-pedicular technique is feasible in biomechanics.

BACKGROUND:Some studies have showed that the accuracy and surgery outcome of the percutaneous pedicle screw implantation was superior to open surgery, but the relationship between the angle of pedicle screws and screw stability is stil unclear in previous studies. OBJECTIVE:To investigate the effect of different angles of implanted screws on the stability of pedicle screw. METHODS:A total of 30 vertebral specimens of adult pigs were selected and screws were implanted respectively according to different coronal and sagittal angles. The maximum pul-out strength of screws from each specimen was tested by machine. Load-displacement curves were drew and statistical y analyzed. RESULTS AND CONCLUSION:The maximum pul-out strength and maximum energy of screw with 10° and 15° coronal and sagittal angles implantation were significantly better than those of 0° angle group (P<0.05). When the stress exceeded the maximum pul-out strength, the pul-out strength of screw decreased gradual y. The curves in coronal and sagittal 10° and 15° angle groups was similar, and the slope was better than 0° angle group (P<0.05). These results confirm that the angle of the implanted screw provides effective assistance to the stability of percutaneous pedicle screw. After the looseness of the screws, the pul out strength shows a steady downward trend.

Background and purpose: High expression of telomerase and telomere stability are two common features in tumor cell. hTERT is a catalytic subunit of telomerase, TRF2 is extremely important to maintain the length and stability of telomerase. This study was to construct the recombinant adenovirus mediated shRNA to hTERT and TRF2, and to investigate the inhibitory effects of the vector by solo-inhibiting and connect-inhibiting in the MCF-7 cells, in order to present a new approach to the gene therapy for breast cancer. Methods: rAd-hTERT and rAd-TRF2 were constructed and the expression of hTERT mRNA and TRF2 mRNA were tested by FQ-PCR 48 hours after transfecting in MCF-7 cells. Apoptosis was observed by flow cytometry 1 to 6 days after transfection. Results: ①At 48 hours after transfection, the results of FQ-PCR showed that compared to PBS group, the expression of hTERT in rAd-hTERT group was obviously decreased and the inhibition ratio was about 86%, but TRF2 had not been obviously inhibited (P>0.05);the expression of TRF2 in rAd-TRF2 group was obviously decreased and the inhibition ratio was about 80%, but hTERT had not been obviously inhibited (P>0.05);in rAd-hTERT/rAd-TRF2 group, the inhibition ratio of hTERT and TRF2 were about 88% and 85%. Comparing rAd-hTERT/rAd-TRF2 group with rAd-hTERT group and rAd-TRF2 group, there were no significant differences of inhibition ratio between hTERT gene and TRF2 gene(P>0.05). Otherwise, comparing rAd-HK group, rAd-blank group with PBS group, there were no significant differences of inhibition ratio between hTERT gene and TRF2 gene(P>0.05). ②The result of flow cytometry showed that apoptosis was induced at the first day after transfecting in rAd-hTERT group and rAd-TRF2 group, the most obvious apoptosis was in the 3rd to 5th days,at the peak in the 5th day, and decreased in the 6th day after transfection. The apoptosis ratio of rAd-hTERT group was 46.2%, rAd-TRF2 group was 43.5%. The apoptosis ratio of rAd-hTERT/rAd-TRF2 group was 46.2% at first day, 68.5% at the second day, the most obvious apoptosis was in the 3rd to 6th days and was 77.6% in the 6th days in rAd-hTERT/rAd-TRF2 group. There were significant differences in apoptosis ratio in solo-inhibiting and connect-inhibiting(P<0.05). In addition, comparing rAd-HK group, rAd-blank group with PBS group, there were no significant differences in apoptosis ratio(P>0.05). Conclusion: ①Target sequence of RNAi which aimed at hTERT gene and TRF2 gene was designed efficiently, and the RNAi expression vectors were seen in vivo study efficiently and specifically inhibited the correspond gene expression and promoted cell apoptosis in MCF-7 cells. ②rAd-hTERT vector and rAd-TRF2 vector have no synergistical effect and antagoinstical effect on inhibiting hTERT gene and TRF2 gene mRNA expressing in MCF-7, but there was synergistical effect in terms of the induction of apoptosis. So association-RNAi-technique targeting to the genes of telomere length and stability can effectively promote tumor cell into apoptosis and inhibit breast cancer cell growth. RNAi technique of connecting correlation genes is a more effective gene therapy strategy.

Objective To observe the change of peripheral blood Th17 cells and relationship between the severity and Th17 cells in patients with acute asthma.Methods We recruited patients with mild acute asthma(n=10) and severe acute asthma(n=10), and healthy volunteers(n=10). T-lymphocytes were collected from the peripheral blood mononuclear cells (PBMC). Flow cytometer (FCM) was used to detect the expression of peripheral blood Th17 cells. IL-17 levels in the peripheral blood were measured by enzyme-linked immunosorbentassay (ELISA).Results The rate of positive Th17 cells of peripheral blood in the severe acute asthma group was higher than that in the mild acute asthma group(P＜0.05) and the rate of positive Th17 cells of peripheral blood in healthy volunteer group were the lowest among all groups (P＜0.05, respectively). The level of IL-17 in the peripheral blood of patients with severe acute asthma increased significantly compared with that in patients with mild acute asthma and healthy volunteers (P＜0.05). The positive Th17 cells of peripheral blood in patients with acute asthma were positively correlated with the severity of acute asthma(r=0.869, P＜0.05).Conclusion The positive rate of Th17 cells in the peripheral blood increases in patients with acute asthma and has positive correlation with the severity of acute asthma.

Objective To identify the effect of morphology of adult upper and middle thoracic pedicle on security of screw implantation.Methods Five fresh adult cadaveric thoracic spine from T1 to T8 were harvested.Pedicle transverse diameters were measured and compared with the smallest diameter(4.5 mm) of screw used in clinic.The screws were inserted and implant effect was observed.Results The mean transverse diameter of adult thoracic(T1-T8) were T1:4.74(3.85-5.25)mm,T2:4.51(3.45-5.25)mm,T3:4.15(3.60-4.65)mm,T4:3.75(3.10-4.50)mm,T5:4.25(3.70-4.65)mm,T6: 4.53(4.40-4.70)mm,T7:5.38(5.25-5.60)mm,T8:5.55(5.50-5.80)mm.Of all specimens,there were 9 specmen(22.5%) whose tranverse diameters were smaller than 4.5 mm.After implantation,two screws broke through pedicle lateral wall.Conclusion Adult pedicle transverse diameters in T3-T4 are smallest,transpedicular screw placement is difficult in some of these vertebrae,but in most of thoracic vertebrae,pedicle tranverse diameter could permit screw implanting in security.

Objective To evaluate the value of high-frequency color Doppler ultrasound in the examination of pathological changes in the peripheral joints of patients with early rheumatoid arthritis (RA).Methods Peripheral joints of 30 consecutive patients with early rheumatoid arthritis (disease duration ＜1year) and 15 healthy volunteers were assessed with ultrasound searching for joint effusion,synovial hypertrophy,tendon lesion and bone erosions.The joints examined including bilateral elbows,wrists,knees,ankles,metacarpophalangeal joints (MCP),proximal interphalangeal joints (PIP) and metatar-sophalangeal joints (MTP).Data were analyzed with t-test and kappa test.Results Joint effusion and/or synovial hypertrophy were found in 471 joints (41.3％).Four hundred and four (35.4％) joints had joint effusion,359(31.5％) had synovial hypertrophy.Power Doppler signals were found in 128 (35.7％) joints with synovial hypertrophy.Periarticular tendon lesions were found in 90(25％) joints of all wrists,ankles and the 2nd to 5th metacarpophalangeal joints.Bone erosions were detected in 27 (2.4％) joints.The most likely involved joint in all peripheral jints was wrist which had the highest positive rate of effusion,synovial hypertrophy,bone erosion and power Doppler signals in the synovial membrane.Other joints which were easily involved with synovitis were knee,ankle,elbow,MTP,MCP and PIP.The positive rate of synovitis was highest in the MTP of all small joints exception the wrist.Synovitis present most frequently in the 2nd MCP of all MCPs,the 3rd PIP of all PIPs and the 2nd MTP of all MTPs.The kappa coefficient between clinical examination and ultrasound in the detection of peripheral joints synovitis was 0.21,showing very poor agreement.Conclusion High-frequency color Doppler ultrasound exa.mination is an effective method in assessing the pathological changes of peripheral joints of patients with early rheumatoid arthritis.It may improve the early diagnosis of RA and useful in assessing disease activity comprehensively.

Ganglioneuroma (GN) is a rare benign tumor of neural crest origin usually found in the abdomen, but may occasionally present at uncommon sites including the cervical, lumbar, or sacral spine. However, GNs of thoracic spine are extremely rare. In this report, we describe a 12-year-old girl with giant GN in the thoracic spine, who underwent successful resection (T1–4 level) of the tumor. Histopathological examination confirmed the diagnosis. GN should be considered in the differential diagnosis of any paraspinal mass. A high index of suspicion and correlation of clinico-radiological findings is necessary in differentiating a large benign tumor from a malignant growth. Complete surgical excision is the treatment of choice; however tumor size and location need to be considered for the surgical approach (one-step or multiple surgeries). Close follow-up after surgery is mandatory.
Abdomen ; Child ; Diagnosis ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Ganglioneuroma* ; Humans ; Neural Crest ; Spine*

Objective To investigate the role of the p38 MAPK pathway in the formation of cytoplasmic vacuoles .Methods Af-ter treated with Anisomycin ,SB203580 or SP600125 ,images of HepG2 ,LM3 ,QBC939 ,Hela and A549 cells were recorded by light microscopy and taken at a magnification of 400 × .The effects of anisomycin ,SB203580 and SP600125 on the activity of p38 and JNK were measured by Western blot .LM3 and A549 cells were stained with the ER-tracker red and the lyso-tracker red and subjec-ted to confocal microscopy analysis .Results (1)Anisomycin could abolish cytoplasmic vacuolization of HepG2 cells .(2)p38 MAPK activation was responsible for anisomycin-induced cytoplasmic vacuolization abolishment .(3)p38 MAPK blocking initiated cytoplas-mic vacuoles formation in various cancer cell lines .(4)p38 MAPK blocking-induced cytoplasmic vacuoles disrupted the integrity of endoplasmic reticulum .(5)p38 MAPK blocking reversibly induced cytoplasmic vacuoles formation .Conclusion These observations provide direct evidence for a role of p38 MAPK signaling in regulating the formation of cytoplasmic vacuoles .