Objective To investigate the expression and role of costimulatory molecule 4-1BB on T cells of patients with rheumatoid arthritis(RA).Metheds The expression of 4-1BB on T lymphocytes from 30 RA patients and 20 healthy controls were detected by flow cytometry.Results The expression of 4-1BB on CD4~+T and CD8~+T lymphocytes from RA patients was significantly higher than that of normal control(18.56?4.08,10.33?2.13 vs 1.24?0.12,0.87?0.09,P＜0.01).There was more expression of 4-1BB on CD4~+T and CD8~+ T lymphocytes stimulated by anti-CD3 antibody from RA patients(33?4 vs 21?8,P＜0.01).In addition,the ra- tio of CD4~+T/CD8+T in RA patients was higher than that of normal controls and was positively correlated with 4-1BB~+CD4~+T cell.The expression of 4-1BB on CD4~+T in RA patients was positively correlated with the level of ESR and IgA(r=0.476,P＜0.05;r=0.659,P＜0.05).Conclusion The costimulatory molecule 4-1BB is ab- normally expressed in T lymphocytes from patients with rheumatoid arthritis.The abnormal expression of 4-1BB on T lymphocytes may play an important role in the development of RA.The expression of 4-1BB on CD4~+T cell may take part in the inflammation of RA.

Objective To investigate the effect of T lymphocyte proliferation,Th1 and Th2 cytokines on T cells from systemic lupus erythematosus (SLE)patients by blocking 4-1BB/4-1BBL.Methods The proliferation of T cells from 30 SLE patients and 20 normal controls was detected by MTT and the levels of patients stimulated with anti-CD3 McAb were significantly higher than those of T cells without stimulation(P＜IFN-γand IL-4 in SLE were significantly higher than those of normal controls(P＜0.01).There were more ex-pression of IFN-γ and IL-4 in supernatant of T cells from SLE after stimulated with anti-CD3 McAb(P＜0.01).However,the production of IFN-γ and IL-4 was inhibited by anti-4-1BB McAb(P＜O.05),and especially the level of IL-4 was markedly decreased.Conclusion Blocking 4-1BB/4-IBBL can significantlv inhibit the abnormal activation of T cells and the secretion of Thl and Th2 cytokines of SLE.

Objective To investigate the effect of costimulatory molecules 4-1BB/4-1BBL on T cell activation with systemic lupus erythematosus(SLE)patients.Methods The expression of NF-kB mRNA and p38 MAPK mRNA of T cells with 20 SLE patients and 20 normal controls before activation,after activation and blocked bv 4-1BB/4-1BBL were detected bv RT-PCR.The protein levels of p-p38 MAPK and NF-kB were detected by Western blot.Results The expression of NF-kB mRNA and p38 MAPK mRNA and the protein expression of NF-kB and p-p38 MAPK of T cell with SLE patients were higher than that of normal controls(P＜0.01).There were more expression of NF-kB mRNA,p38 MAPK mRNA,NF-kB protein and p-p38 MAPK protein of T cell with SLE patients stimulated by anti-CD3 monoantibody(P＜0.01).In anti-4-1BB monoantibody blockage group,there were decreased expression of p38 MAPK mRNA and p-p38 MAPK protein(P＜0.01).but not the decreased NF-kB mRNA and protein expression.Conclusion Costimulatory molecule 4-1BB plays a critical role in T cell activation of SLE by p38 MAPK signal pathway.

Objective To study the application value of direct digital X‐ray radiography system in the degenerative lumbar insta‐bility .Methods 100 patients with degenerative lumbar instability disease were collected in our hospital ,in which there were L4 ,L5 (80 cases) and L5 ,S1 (20 cases) with degenerative lumbar instability disease .Carestream DRX‐Evolution system was used ,which included conventional horizontal lumbar function photography (control group) and physiological load of lumbar function photography (observation group) .Changes of the displacement or the angle of the lumbar segment on two groups were measured ,and the statisti‐cal software was used to carry on the comparative analysis .Results In 100 patients ,the position and the physiological load position were showed on the sagittal position which were as following :For the lumbar segment of L4 and L5 ,flexion [position (4 .50 ± 0 .25) mm , load position (4 .78 ± 0 .30) mm] ,extension [position (4 .87 ± 0 .22) mm ,load position (5 .18 ± 0 .30) mm] ,and for the lumbar segment of L5 and S1 ,flexion [position (4 .64 ± 0 .24) mm ,load position (4 .91 ± 0 .24) mm] ,extension [position (4 .95 ± 0 .30) mm , load position (5 .30 ± 0 .29) mm];For the intervertebral angle degree of L4 and L5 ,flexion (position 10 .64° ± 0 .29° ,load position 12 .12°± 0 .57°) ,extension (position 11 .57°± 0 .24° ,load position 12 .61°± 0 .28°);For the intervertebral angle degree of L5 and S1 , flexion (position 11 .63° ± 0 .26° ,load position 12 .72° ± 0 .27°) ,extension (position 13 .55° ± 0 .30° ,load position 14 .58° ± 0 .33°) , respectively .The difference between two groups was statistically significant (P< 0 .05) .Conclusion Compared with traditional method ,DR lumbar physiological weight‐bearing functional can more accurately understand the lumbar instability degree ,grading and lumbar positive rate ,which provides the basis for clinical diagnosis and treatment plan .

OBJECTIVETo analyze the clinical effect and related risk factors of Gartland type II-III supracondylar fractures of humerus in children in the emergency closed reduction and percutaneous Kirschner wire fixation.

METHODSFrom January 2008 to June 2013,112 children of Gartland type II to III supracondylar humeral fractures were treated in children in emergency closed reduction and percutaneous K-wire fixation, including 72 males and 40 females with an average age of 6.2 years old ranging from 2 to 11 years old. Among them,74 cases were in Gartland type II fractures,38 cases were in type III; The duration from injury to surgery time was 2.5 to 8 hours (averaged 4.6 hours). Elbow cast was applied after operation with the elbow extended of 100 degrees for 4 to 6 weeks, then the gypsum and Kirschner wires were removed.

RESULTSAll patients were follow-up from 6 to 60 months (averaged 12 months). All fractures reached clinical healing. The final follow-up was assessed by Flynn criteria, the result was excellent in 86 cases, good in 23 cases, general in 3 cases, excellent and good rate was 97.3%. Three patients had mild cubitus varus deformity without orthopedic treatment. No pin tract infections, iatrogenic ulnar nerve injury, compartment syndrome, and complications such as Volkmann ischemic contracture occurred.

CONCLUSIONClosed reduction and percutaneous Kirschner wire fixation had advantages of exact reduction, firm fixation, fewer complications ,less pain in children undergoing emergency surgery, and.high success rate, so it is a safe and efficient treatment for humeral supracondylar fracture in children.

Bone Wires ; Child ; Child, Preschool ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Humeral Fractures ; surgery ; Male ; Reconstructive Surgical Procedures

Objective To determine the role of human serum albumin therapy in the post-operative management of patients with hepatocellular carcinoma (HCC) associated with cirrhosis.Methods Between January 2011 and December 2012,we treated 171 consecutive cirrhotic patients with HCC.88 patients were treated with 5％ human serum albumin for 48 hours followed by 20％ human serum albumin in the post-operative period (the observer group) ; 81 patients were only treated with 20％ human serum albumin during the same time duration (the control group).The prognosis,complications,average amount of human serum albumin and plasma used as well as the in-hospital stay were observed.Results There were no deaths or major complications in either of these 2 groups.After treatment,the observer group was lower than the control group in the amount of intravenous fluid infused,the volume of peritoneal drainage,the amount of human serum albumin and plasma used as well as the mean post-operative hospitalization days (P ＜ 0.05).At the same time,the daily urine output,the central venous pressure and the mean arterial pressure within 48 hours after surgery were higher in the observer group than the control group.Furthermore the observer group had a smoother post-operative recovery in liver function,and the difference was significant between the two groups (P ＜ 0.05).Conclusion Not only did treatment with 5 ％ and 20％ human serum albumin gave the advantages of a more stable blood circulation,better organ perfusion and improved liver function recovery but it also reduced the amount of consumption of human serum albumin and plasma and shortened the hospital stay.

Objective To systematically review the effectiveness and safety of statins for chronic obstructive pulmonary diseases (COPD) combining with pulmonary hypertension (PH).Methods The electronic searches in databases of PubMed,EMbase,the Cochrane Library,Web of Science,CBM,CNKI,VIP and Wanfang Data were conducted from the date of their establishment to January 2016 and the references of the include studies were also retrieved for collecting randomized controlled trials (RCTs) or quasi-RCTs on statins treating COPD combining with PH.Two researchers independenlty screened the literature according to the inclusion and exclusion criteria,extracted the data,assessed the quality of the included studies by adopting the Cochrane collaboration' s tool for assessing risk of bias,and performed Meta-analysis by using RevMan 5.3 software.Results A total of 24 studies involving 1 587 cases were included.The results of Meta-analysis showed that:compared with the control group,simvastatin significantly improved FEV1 [MD =0.23,95％ CI:0.16-0.31,P ＜ 0.000 01],FEV1 ％ [MD =6.73,95％ CI:1.34-12.12,P =0.01],FVC [MD =0.39,95％ CI:0.34-0.45,P ＜ 0.000 01],6 minutes walk distance (6MWD)· [MD=59.09,95％CI:54.24-63.93,P ＜0.000 01] and decreased mPAP [MD=6.73,95％ CI:1.34-12.12,P =0.01],SPAP [MD =-4.53,95 ％ CI =-8.87--0.19,P =0.04].Atorvastatin significantly improved FEV1 [MD =6.22,95 ％ CI:2.51-9.93,P =0.001] and 6 MWD [MD =24.10,95 ％ CI:12.98-35.23,P ＜ 0.000 1] and decreased sPAP [MD =-6.44,95％CI:-7.95--4.93,P＜0.00001] andmPAP [MD=-3.51,95％CI:-5.81--1.22,P=0.003].But no significant difference was found in the improvement of FEV1,FVC or FEV1/FVC.Fluvastatin significantly decreased sPAP [MD=-5.89,95％ CI:-6.99--4.79,P ＜0.000 01].There was a significant decrease in the Borg dyspnoea score in statins group [MD =-3.37,95％ CI:-4.61--2.14,P ＜ 0.000 01] as compared with the controls.In addition,the incidence of adverse drug reactions (ADRs) was similar between statins and the control group.Conclusion Current evidence suggests that statins may decrease pulmonary hypertension in patients with COPD combining with PH.However,high-quality clinical trials with large sample size are needed to verify whether the improvement of pulmonary function,6MWD and Borg dyspnoea score are the class effect or the incidence of ADRs is disparate among different statins.

Objective To establish real-time PCR with SYBR Green Ⅰ for quantification the gene of survivin.Methods The components and conditions of PCR system were optimally determined by fluorescence intensity,cycle threshold(Ct),melting curve,coefficiency and slope of the standard curve.The means to eliminate the contaminating fluorescence of primer-dimers and the mode for Ct value determination were also optimized.Using the developed PCR system,we quantificated the survivin gene in 43 patients with gastric carcinoma.Results The optimized condition for PCR amplification of survivin were 2 mmol/L of MgCl_2,2.5 U/100 ?l of Taq DNA polymerase,0.2 ?mol/L of primers,and the optimized annealing temperatures for PCR were 58℃.The influence of primer dimmer can be eliminated by setting the fluorescence collecting temperature below the Tm of the specific amplicon by 2℃.The second derivative maximum mode,instead of fit point mode,was a feasible method to determine the Ct value for quantification.The sensitivity of this method was 10 copies/?l,and a good linearity was found from 10~1 to 10~4 copies/?l(r = 0.999 7).The inter-experimental coefficient of variation was 1.13%-1.91%,whereas the coefficient of variation between runs was 3.31%-4.50%.Using the optimized PCR system,we quantificated the gene of survivin,the result indicated that survivin gene was amplified in 13.9% of gastric carcinomas.Conclusions The optimal real-time PCR with SYBR Green Ⅰ,as a cost-effective and feasible DNA quantitative method,is fit for quantification of the survivin with satisfactory repeatability and high sensitivity.

Objective To study the influence of electro-acupuncture(EA)at Zusanli points(足三里穴) on the apoptosis of thymocytes in rats with abdominal infection and its mechanism.Methods A total of 40 Sprague-Dawley(SD)rats were randomly divided into four groups,including normal control group,model group,non-acupoint group and Zusanli group.The abdominal infection model of rat was made by cecal ligation and puncture(CLP).After abdominal cavity infection for 36 hours,the apoptosis of thymocytes was observed under electron microscope and light microscope,and the apoptosis ratio of thymocytes was determined by Annexin V-PI method with flow cytometry technique.The content of Bcl-2 protein of thymocytes and concentration of corticosterone in plasma were determined.Results Abdominal infection resulted from CLP could significantly increase the apoptosis of thymocytes and lead to the typical histopathological changes of apoptosis of thymocytes under electron microscope and light microscope.Apoptosis ratios of thyrnocytes in model group[(44.7?3.3)%],non-acupoint group[(42.7?3.0)%]and Zusanli group[(32.6?3.3)%] were significantly higher than the ratio in the control group[(21.2?2.3)%,all P0.05).Abdominal infection resulted from CLP also could reduce the content of Bcl-2 protein of thymocytes.The content of Bcl-2 protein of thymocytes in model group(71.2?5.6),non-acupoint group(73.5?5.9)and Zusanli group(82.4?6.8) were significantly lower than normal control group(95.3?6.3,all P

Objective To observe the efficacy and adverse reaction of Durogesic (thansdermal fenfanul) for analgesia in patients with malignant tumors, who occur moderate or severe pain from mucosal response during radiochemotherapy. Methods 50 patients were divided into two groups randomly. The treatment group received Durogesic and normal therapy, the contrast group received normal therapy. The analgesic effects, the quality of life and the side effects after medicine were observed. Results The pain remission rates of treatment group and control group were 100 % (25/25) and 52 % (13/25), respectively (χ2 =15.78, P ＜ 0.01)[(9.66±0.35), (10.01±0.34) min]and[(18.12±0.46), (14.68±0.19) min].The quality of life in treatment group was improved significantly (t = 8.11, P ＜0.01).The main adverse reactions of Durogesic included constipation, itch of skin, drowsiness, nausea, vomiting and so on. All of adverse reactions were tolerable. Conclusion Durogesic for analgesia have high curative effect and slight adverse effects in pain of oral cavity and laryngeal pharynx in patients with malignant tumors during radiochemotherapy which make patients complete radiochemotherapy successfully.