In recent decades a number of authors have argued that allergen exposure is the major primary cause of asthma and that the global increases in mites allergic asthma prevalence are associated with the increases of exposure to mites-allergens.The knowledge of the acaridan and the allergens is important for planning intervention of mites allergic asthma.The research progress in this field was reviewed in the present paper,including the epidemiology,the mechanism and immunotherapy of mites allergic asthma.

Objective To investigate the breeding situations of acaroid mites in some dwellings in Zhangjiagang city and the influence on the patients with mites allergic asthma.Methods Acaroid mites in the dust from five different positions of rooms of 40 patients with mites allergic asthma and 40 normal control were counted and identified by light microscope.Results The detection rate of acaroid mites in 400 samples was 52.25%(209/400).A total of 2 746 acaroid mites were detected,which belong to 15 species and 7 families.The highest breeding rate and relative abundance were 46.25%(185/209)and 54.26%(1 490/2 746)respectively,which comes from Pyroglyphidae family,the following families were Acaridae(34.5%;23.89%)and Glycyphagidae(19.25%;18.14%).About the breeding densities of acaroid mites,statistical difference between patients and normal control was found(P

Objective To investigate the mechanisms regarding protection of doxycycline from articular cartilage cataplasis in osteoarthritis,and provide experimental evidence for prevention and cure of degenerative osteoarthropathy and for treatment of osteoarthritis.Methods (Ⅰ) Models:Sixteen New Zealand rabbits underwent right anterior cruciate ligament riesction,and fed in each cage.The animals were injected with penicillin 400 thousands IU once a day for 3 days to prevent from infection.On the fourth day after operation,the animals were compelled to use their operated knee by driving 60 minutes per day for 4 weeks.(2) Animal groups:the animals were divided into two groups.The animals in experimental group were injected into the knees with 1.33％ doxycycline 0.3 ml (total 0.4 mg),once a day for 4 weeks.Rabbits in the control group were treated under the same condition using normal saline 0.3 ml.All rabbits were fed in their own cage and not drove.The total time was 4 weeks.(3)Example collection and data analysis:Rabbits were sacrificed by aeroembolism and their knee joints were examined by gross morphology.The mRNA expressions of MMP-3 and TIMP-1 in the cartilage and synovium were analyzed by a reverse transcription polymerase chain reaction ( RT - PCR).Results For the experimental group,condyles of femur cartilage inspection revealed that 6 cases were in Grade 0 and 2 cases were in Grade 1,and whirbone cartilage inspection showed that 5 cases were in Grade 0 and 3 cases were in Grade 1.For the control group,2 cases were in Grade 0 and 6 cases were in Grade 1.The extent of articular cartilage cataplasis was significantly different mRNA expression of MMP-3 ( 1.20 ± 0.32) (experimental) and ( 1.97 ± 0.54) (compared) ( t =3.47,P＜ 0.05).The expression of MMP-3 mRNA in cartilage and synovium was significantly decreased,respectively; while the expression of TIMP-1 mRNA was significantly increased in the experimental group(3.22 ±0.42) compared to the control group( 1.90 ±0.33) ( t =6.99,P ＜ 0.01 ).Conclusions Intra-articular injections of doxycycline inhibits the articular cartilage and synovial MMP-3 mRNA expression and increases TIMP-1 mRNA expression,thereby reducing the extent of degeneration of articular cartilage.

Objective To optimize the condition of converting murine naive CD4+ CD25-T cells ( effector T cells,Teffs) to CD4-CD8-double negative regulatory T cells ( DN Tregs) in vitro.Methods Naive Teffs from C57BL/6 mouse were isolated with magnetic activated cell sorting( MACS)and co-cultured with DBA/2 mature dendritic cells (mDCs) with different doses of recombinant murine interleukin-2 (IL-2).The percentage of converted DN Tregs was examined by flow cytometry after 6 days.Purified DN Tregs were co-cultured with CFSE labeled Teffs.The proliferation rate of Teffs were evaluated by flow cytometry.Results Without IL-2,the percentage of CD4-CD8-T cells was 6.21％ ± 2.03％.With IL-2,the percentage was 14.77％ ± 2.15％ ( 25 ng/ml),21.29％ ± 2.68％ (50 ng/ml),43.45％ ±4.45％ (75 ng/ml),and 28.59％ ±3.05％ ( 100 ng/ml) respectively.The IL-2 concentration of 75 ng/ml signilicantly enhanced the conversion of Teffs to DN Tregs ( separately t =10.700,8.288,6.158,3.932,all P ＜ 0.05).Highly purified DN Trega significantly suppress the proliferation of Teffs in vitro.Conclusions Teffs are converted to DN Trega in vitro with the LPS-activated allogeneic mDCs and that 75 ng/ml of IL-2 is the optimal concentration for the conversion of Teffs to DN Trogs in vitro.

ObjectiveTo investigate the expression levels of vascular endothelial growth factor (VEGF)in knee synovial membranes and synovial fluids whether it could be a marker for progressive osteoarthritis.MethodsKnee synovial membranes and synovial fluids of patients with osteoarthritis who were underwent total knee arthroplaaty or arthroscopy were collected. They were classified into four groups according to the radiographic grading[Kellegren-Lawrence(K-L) grade]. Appoint K-L-0-grade patients who suffered from menisci injuries only served as controls. The levels of VEGF in the synovial fluid were measured by enzymelinked immunosorbent assay(ELISA) and VEGF-secreting cells were identified by immunohistochemistry.ANOVA was used for statistical analysis. ResultsVarious degrees of inflammation could be found in all the samplesevaluated histologically on HE-stained sections. Synovial tissue inflammation presented as synovial lining thickening, and inflammatory cells infiltration. VEGF expressed in the synovium linings and surrounding blood vessels. The VEGF levels in the synovial fluids were increased accordingly with K-L grades, which reached the peak level in the late stage of osteoarthritis. The levels of VEGF in the synovial fluids were significantly higher in patients with osteoarthritis[from (1181±116), (1632±140) to (2252±216) pg/ml]than in those with menisci injury (P＜0.01); The percent ages positive cell in each groups were (5±4)％ , (9±4)％,(16±6)％ and (21±6)％ respectively, there were significantly differences too (P＜0.01). ConclusionVEGF originated from synovial tissue may play a role in the pathogenesis of osteoarthritis. High levels of VEGF in the synovial fluids can be regarded as the marker of active osteoarthritis.

BACKGROUND:Young patients with cruciate ligament injury and high activity levels are prone to grade III medial colateral ligament injury in knee joint. Conventional construction methods such as direct restoration of injured ligaments and muscle-tendon transposition may induce the loosening of medial colateral ligament complex. OBJECTIVE:To explore the clinical effect of autologous tendon transplantation for grade III medial colateral ligament injury of the knee joint. METHODS: Forty-seven patients with grade III medial colateral ligament rupture were treated by operative repair and reconstruction. After repairing the anatomical structure of medial colateral ligaments, we liberated organic semitendinous tendon, bone-patela tendon-bone, and hamstring tendon, to reconstruct superficial medial colateral ligament. RESULTS AND CONCLUSION:Thirty-seven patients were folowed up for 48 months. Preoperative Lysholm score, IKDC score, Tegner score at the final folow-up, and the widened medial joint space on valgus stress X-Ray films were significantly improved compared with before reconstruction (P < 0.05). According to clinical efficacy scores, 12 cases achieved excelent reconstruction, 18 cases achieved good reconstruction, 4 cases achieved moderate reconstruction, and 3 cases achieved poor reconstruction. The excelent and good rate was 82%. Medial colateral ligament reconstruction based on repairing the anatomical structure is effective and satisfactory. Autologous bone-patela tendon-bone or semitendinous tendon is a good choice for medial colateral ligament reconstruction.

ObjectiveTo study the effect on humoral immunity with combination of CsA and IL-2 fusion protein. MethodsForty C57/B6 mice were evenly divided into four groups,after receiving skin graft from DBA mouse.Mice in the experimental group was given CsA(30 mg/kg,ip) plus IL-2/Fc (1μg,ip) while the control group was only given CsA,each group was given HBV vaccine after skin graft surgery (2 μg,im),while blank group was only given vaccine after skin transplantation.The fourth group were left intact.Fourteen days later,the level of HBSAb,IL-4,IL-10,IFN-γ,IL-2 were measured with ELISA and IL-21and FoxP3 expression level and Tfh percentage of mixed lymphocytes detected. ResultsThe HBSAb level in experimental group is significantly higher than that in the control group and the survival time of skin graft is longer than that in the control group ( F =29.886,P =0.010 ; F =29.772,P =0.011).IL-2,IFN-γ are significantly higher than that in the control group( F =18.156,P =0.0020;F =90.042,P =0.003 ),but the Th2 cytokines such as IL-4,IL-10 are lower ( F =42.102,P =0.009 ; F =23.734,P =0.015 ).The expression level of both IL-21and FoxP3 are significantly higher than control group( F =9.784,P =0.048 ;F =27.883,P =0.012). ConclusionsCombination of CsA and IL-2 fusion protein can significantly enhance the immunogenicity of HBV vaccine and prolong graft survival time.It may be related to the higher expression level of IL-21and FoxP3.

Objective To investigate the clinical effects and related complications of surgical and endovascular treatments of paraclinoid aneurysms. Methods Seventy-two consecutive patients with paraclinoid aneurysm admitted to the Department of Neurosurgery, the First Affiliated Hospital of Soochow University were enrolled retrospectively. They were confirmed by head and neck CT angiography and DSA examination,including 45 females and 27 males. According to the different treatment modalities, 72 patients were divided into endovascular embolization group ( n=38,stent-assisted coil embolization) and microsurgery group (n=34,including aneurysm clipping or intracranial and extracranial vascular bypass plus trapping of aneurysms). The baseline data and aneurysm diameter of both groups were recorded and analyzed. Baseline data included age,sex,cranial nerve injury,Hunt-Hess grade,etc. The new cranial nerve injury,aneurysm recurrence and Glasgow outcome scale ( GOS) scores were compared between the two groups,and the size of recurrent and non-recurrent aneurysms were analyzed. The age, aneurysm diameter,and prognostic score were compared in patients with Hunt-Hess grade Ⅲ-Ⅳ in both groups. Results (1 ) The age of patients in the endovascular embolization group was older than that in the microsurgery group (60 ±10 years vs. 54 ± 10 years,t= -2. 490),the diameter of aneurysms was smaller than that of microsurgery group (5[4,8] mm vs. 9[5,16] mm,Z=3. 026). There were significant differences between the two groups ( all P <0. 05 ) . There were no significant differences in gender, incidence of visual impairment and Hunt-Hess grading between the two groups (all P >0. 05). (2) The patients of both groups were followed up for 6 months. There were no significant differences in GOS score, improvement of postoperative visual acuity,and immediate visual impairment after surgery ( all P>0. 05). The recurrence rate of aneurysms in the endovascular embolization group was higher than that in the microsurgery group. The difference was statistically significant between the two groups (18. 4%[7/38] vs. 2. 9%[1/34], χ2=4. 350,P<0. 05). (3) In the endovascular embolization group, the diameter of aneurysm in recurrent patients was larger than that in non-recurrent patients,and the difference was statistically significant between the two groups (10[8,15] mm vs. 5[3,7] mm,Z = -2. 356, P<0. 05). (4) For aneurysm patients with Hunt-Hess grade Ⅲ-Ⅳ, the GOS score of the endovascular embolization group was lower than that of the microsurgery group,and the difference was statistically significant (4[3,4] vs. 5[4,5],Z= -2. 282,P<0. 05]. Conclusion For paraclinoid aneurysms,the recurrence rate of aneurysms with microsurgical treatment is lower than that of endovascular embolization,and is beneficial to the prognosis of patients with Hunt-Hess grade Ⅲ-Ⅳ.

Objective: To investigate the imaging features and etiology of lymphatic trunk in primary facial lymphedema. Methods: 26 patients with primary facial lymphedema patients (F/M, 13/13, ages 21.8 ± 13.9 years old) were recruited from January 2015 to October 2017 in this study, with 32 sides facial lymphedema reported, including 6 right facial lymphedema, 14 left facial lymphedema, and 6 bilateral facial lymphedema. And all the patient data and imaging were retrospective analysis to summarize the MR imaging features of thoracic duct and right lymphatic duct, meanwhile compared with surgical results. Results: For all 26 patients, MR imaging result in thoracic duct manifests 32 lymphatic duct, including 20 thoracic duct and 12 right lymphatic duct. The imaging features demonstrate two typical findings: dilated(13 cases) and slim(7 cases) demonstrations. While for right lymphatic duct, the MR result included three types: dilated(6 cases), slim(4 cases) and no sign of manifestations(2 cases). In surgery, the thoracic duct in cervical segment demonstrated abnormal structures, including capsulated by fibrous tissues in peripheral area(30 sides), surrounded by internal jugular vein sheath(11 sides), external pressed by venae cervicalis transversa(5 sides) and lymphatic trunk dysplasia(2 sides). Conclusions MR thoracic duct and right lymphatic duct imaging can be used as an effective diagnostic imaging method for primary facial lymphedema, and the structural anomaly of the upper cervical catheter and the right lymphatic catheter may be one of the pathogenic factors of primary facial lymphedema.

Objective:To examine the clinical characteristics and abnormal reflux branches of primary isolated chylopericardium.Methods:Totally 43 patients with primary isolated chylopericardium at Department of Lymphatic Surgery, Affiliated Beijing Shijitan Hospital,Capital Medical University from June 2007 to January 2018 were recruited in this study. There were 21 males and 22 females, aging (23.0±15.9) years (range: 2 to 57 years). The levels of triglyceride, total cholesterol, total protein and albumin in pericardial effusion and blood were compared by paired- t test, and the characteristics of lymphatic system in direct lymphangiography and postoperative CT were analyzed. Results:Pericardial effusion was mainly milky white and monocytes, and 95.3%(41/43) were positive for Rivalta test. The level of triglyceride in pericardial effusion was significantly higher than that of blood ((9.67±5.11) mmol/L vs. (1.28±0.89) mmol/L, t=10.557, P<0.01), and the levels of total cholesterol ((2.19±0.52) mmol/L vs. (4.12±1.06) mmol/L, t=-3.732, P<0.01), total protein ((61.25±16.17) g/L vs. (68.26±8.30) g/L, t=-2.958, P=0.005) and albumin ((36.63±7.06) g/L vs. (42.32±4.73) g/L, t=-5.747, P<0.01) were significantly lower than that of blood. In the direct lymphangiography, the imaging of iliac and retroperitoneal lymphatics showed dilated or tortuous in 90.7% (39/43), the thoracoabdominal segment of thoracic duct showed dilation in 46.5% (20/43), and cervical thoracic duct imaging showed dilation in 44.2% (19/43) and stenosis in 55.8% (24/43). The image of lipiodol flowing into the vein showed obstruction at the venous angle. There were 60.5%(26/43) of the patients with lipiodol reflux through the bronchomediastinal trunk (type Ⅰ), 11.6%(5/43) with lipiodol diffusion to the pericardium through the abnormal pathway from the thoracic segment of the thoracic duct (type Ⅱ), while no communication pathway between the thoracic duct and the pericardial cavity (type Ⅲ) found in 27.9%(12/43). CT images obtained after the direct lymphangiography showed 34.9%(15/43) had abnormal distribution of lipiodol in pericardium, mediastinal lymph nodes and lung hilar lymph nodes, 46.5%(20/43) in mediastinal lymph nodes and lung hilar lymph nodes, 14.0%(6/43) only mediastinal lymph nodes, 4.6%(2/43) had no lipiodol in the above areas. Conclusions:Pericardial effusion compared with same period blood, has higher triglyceride, lower total cholesterol, total protein and albumin. The obstruction of the cervical segment of the thoracic duct and the formation of abnormal reflux branches would be corelative to primary isolated chylopericardium.