Objective To explore the early diagnostic significance of anti-cyclic citrullinated peptide(CCP) antibody and hidden rheumatoid factor immunoglobulin M(HRF-IgM) detected by ELISA in patients with juvenile rheumatoid arthritis(JRA). Methods The synthesized CCP was used as the antigen to detect anti-CCP antibody. Anti-CCP antibody and HRF-IgM were detected dynamically in 27 patients with early diagnosed JRA and their specificity and sensitivity were determined for early diagnosed JRA by calculating the positive predicting value (PPV) and negative predicting value (NPV). Results The total positive rate of anti-CCP antibody and HRF-IgM were 58.5 % and 65.0 % respectively in patients with JRA. The sensitivity of HRF-IgM was more predominant than that of anti-CCP antibody. There was a positive correlation between the positive rate of antibodies and the subtype of JRA. The specificity of anti-CCP antibody for predicting early JRA was superior to that of HRF-IgM. When using these two tests in combination, the PPV predicting rate of early JRA was 93.7 % . Conclusions Both anti-CCP antibody and HRF-IgM are elevated in patients with JRA, which show positive correlations with the subtype of the disease. The specificity of anti-CCP antibody testing is considerably higher for diagnosing early JRA, and when it was used together with HRF-IgM testing, the PPV for JRA can be raised further.

Objective To analyze the changes in the protein expression profile of peripheral blood mononuclear cells in systemic lupus erythematosus patients. Methods Peripheral blood was obtained from SLE patients and healthy controls, then mononuclear cells were isolated and the total protein was extracted by one-step method. Two-dimensional gel electrophoresis was performed and then stained with silver. Protein maps were analyzed and differentially expressed protein spots were detected using ImageMaster 2D Platinum 5.0 software. Results Match rates of (71±4)% and (72±4)% was obtained from gels from controls and pati-ents respectively. 791±17 spots were detected from control gels and 781±17 from patient gels. Eleven protein spots were up-regulated and 9 were down-regulated in SLE patients. Five proteins were identified by MS analysis, some of which had previously been shown to play a potential role in the pathogenesis of SLE. Conclusion There are significant changes in the protein expression of peripheral blood mononuclear cells in systemic lupus erythematosus patients. This study could be used as a preliminary work for better understanding of the pathogenesis and immune regulation pathways of SLE from an integrated lymphocyte protein profile perspective.

Objective To discuss the safety and advantages of prone-straddle position applied in transvaginal hysteromyomectomy of the posterior wall of the uterus. Methods The clinical data of patients who were admitted into our hospital from March 2013 to Janaury 2015 and received transvaginal hysteromyomectomy were retrospectively analyzed. They were divided into group A ( prone-straddle position, 30 cases) and group B (traditional lithotomy position,24 cases). The exposure of operative field, convenience of operation, time of the placement, time of operation, patient satisfaction, as well as patients’ heart rate, blood pressure, and oxyhemoglobin saturation were observed and ana-lyzed. Results Compared with the lithotomy position, there were significant differences in the time of the placement and the time of opera-tion in the patients treated by prone-straddle position. The patients with prone-straddle position cooperated well, and there was no obvious discomfort. Their vital signs were stable during the operation. The operative field during prone-straddle position exposed better and it was more convenient which make the operation became easier for both the operators and nurses. Conclusion Prone-straddle position applied in transvaginal hysteromyomectomy of the posterior wall of the uterus is safe and practicable, and it is valuable for clinical application.

Objective To study the expression and clinical significance of MMP-2 and MMP-9 protein and their relationships in human gastric carcinoma. Methods MMP-2 and MMP-9 protein expression were examined by two-step immunohistochemistry in 96 cases of human gastric carcinoma and paracancerous normal tissue. Results The expression rate of MMP-2 and MMP-9 in gastric carcinoma tissue was 72.9 %(70/96)and 66.7 %(64/96) respectively, which was significantly higher than those in the normal tissue (30.2 % and 31.3 % respectively, P<0.001). The expression of MMP-2 and MMP-9 was significantly correlated with site, depth invaded,TNM stage and lymph node metastasis of gastric carcinoma (P <0.05), and not with age, sex, size, histological differentiation of gastric carcinoma(all P>0.05). Conclusion There are close relationships between the expressions of MMP-2, MMP-9 in gastric carcinoma and pathological characteristics in clinic metastasis and prognosis. They may be used as important indexes to judge the biological behavior and prognosis of gastric carcinoma.

Objective To investigate whether ligustrazine can reduce endotoxemia and inhibit the increase of lipopolysaccharide (LPS)-induced vascular permeability by suppressing Rho/ROCK signaling pathway in guinea pigs. Methods Eighteen of white male healthy guinea pigs were divided into three groups randomly and pretreated with intravenous injection of ligustrazine(3 or 6 mg/kg) or saline. 30 min later, LPS (100, 300, 1 000 μg/0.1 mL/site) and saline (0.1 mL/site) were administered intracutaneously at the dorsum of guinea pigs. Vascular permeability was determined by leakage area and absorbance of 610 nm (OD610) of Evans Blue dye after intracutaneous injection of LPS (100-1 000 μg/site). Results Dye leakage in the skin began to increase at 5 min, and revealed significant increase 2 h after LPS injection. Significant differences in the dye leakage area(F = 5.77, P < 0.05) and the OD610 (F = 7.736, P < 0.05) induced by 100, 300 and 1,000 ug/site of LPS administration were demonstrated between the control and ligustrazine groups (3 or 6 mg/kg). Conclusion Ligustrazine has protective effect on the hypermeability of endothelial cells induced by lipopolysaccharide, and inhibition of Rho/ROCK signaling pathway is a possible mechanism.

This study examined effect of a new intervertebral cervical disc prosthesis in relieving the neurological symptoms and signs, improving the patients' ability to perform daily activities, reducing pain, and maintaining the stability and segmental motion. From December 2003 to October 2004, 12 patients, who had received 14 replacements of cervical artificial discs, were followed-up for 2 to 8 months (with a mean of 5.2 months). Of them 5 had cervical spondylotic myelopathy and 7 had cervical disc herniation. The patients included 7 males and 5 females, with their age ranging from 35 to 62 y and a mean of 50.3 y. Single-level replacements were performed in 10 cases and 2 cases received two-level replacement. Operation time of the single-level surgery averaged 130+/-50 min and the time of two-level surgery was 165+/-53 min on average (from skin incision to skin suturing). Neurological or vascular complications during or after surgery was not observed. Japanese Orthopedic Association scores (JOA scores) increased from 8.6 to 15.8 on average. There was no prothesis subsidence or excursion. Replaced segments were stable and the range of motion was partially restored, being 4.68 degrees (3.6 degrees -6.1 degrees ) in flexion and extension position and 3.51 degrees (2.5 degrees -4.6 degrees ), 3.42 degrees (2.6 degrees -4.3 degrees ) in left and right bending position. No obvious loss of physiological curvature was noted. CT or MRI follow-up showed that excursion was less than 1.5 mm) in 2 of 14 levels and between 1.5 mm and 3 mm) in 1 of 14 levels. No ossification in the replaced levels was observed. It is concluded that satisfactory short-term results were achieved in the 12 cases of artificial disc replacements. Different from anterior cervical discectomy and fusion, the replacement could achieve quick functional recovery and did not lead to the movement limitation of cervical vertebrae. At least a 5-years follow-up was needed to assess the long-term effect of the prosthesis on its neighboring segments.

OBJECTIVETo investigate effects of the variation of immune function in high humidity environment in different time, and lay a foundation for further study of the related mechanism.

METHODThirty SD rats were divided into 3 groups (n = 10): 20 day group, 40 day group in 90% relative humidity chamber and control group in normal relative humidity. Peripheral blood and spleens were collected to detect the levels of T lymphocyte subsets by Flow Cytometery.

RESULTSIn peripheral blood of the 20 day group rats, the CD3+ %, CD4+ %, CD8+ % and CD4+/CD8+ were 52.91 +/- 6.27, 37.80 +/- 4.11, 14.85 +/- 3.73 and 2.72 +/- 0.82 separately. Expect CD3+ %, they all had significant differences (P < 0.05). In addition, the data of the 40 day group rats showed no diversity in statistics. In spleen, CD8+ % of the 20 day group rats was 6.23 +/- 2.87 with significant differences (P < 0.05) and IgG, IgA and IgM did not change a lot in blood serum of the high humidity groups except C3 of the 20 days group (P < 0.05).

CONCLUSIONIn high humidity environment, the immune function of the rats increased in the initial stage. As time went on, the immune function gradually went to normal level through the self adjustment.

Acclimatization ; Animals ; Humidity ; Rats ; Rats, Sprague-Dawley ; Spleen ; immunology ; T-Lymphocyte Subsets ; immunology

OBJECTIVETo investigate etiologic factors,mechanisms and treatment of hyponatremia in patients with acute spinal cord injury.

METHODSFrom January 2005 to July 2010, 57 patients with hyponatremia after acute spinal cord injuries from severe trauma were treated. They included 46 males and 11 females who ranged in age from 26 to 69 years (mean 39.5 years). Of the 57 cases, 55 cases were complicated by cervical dislocation or fracture, and the remaining two cases were without dislocation or fracture. Among them, 28 patients had complete spinal cord injury, 29 had incomplete spinal cord injury. Nerve function was assessed according to the ASIA criteria, revealing type A in 28 cases, type B in 25 cases, and type C in 4 cases. Heart rate, blood pressure, 24-hour urine volume and serum sodium were measured daily, and fluid and sodium replacement was administered when the diagnosis of hyponatremia was confirmed. Urine sodium, serum osmotic pressure and urine osmotic pressure were measured every 3 days. The potential cause of the hyponatremia was supposed to be cerebral salt wasting syndrome (CSWS) or inappropriate antidiuretic hormone secretion (SIADH) according to the results and therapeutic reaction. Intravenous fluid infusion and salt replacement were required in patients with CSWS, while fluid restriction and intravenous salt replacement were administered for patients with SIADH. Parameters before and after treatment were analyzed with t-test.

RESULTSThere were 42 patients with SCWS,and 15 patients with SIADH. Heart rate, serum sodium and serum osmotic pressure were higher 3 weeks after admission in all patients (all P < 0.01), while blood pressure and urine osmotic pressure were higher and urine sodium was lower (all P < 0.05). There was no significant difference in 24-h urine volume (P > 0.05). Heart rate, serum osmotic pressure, urine osmotic pressure showed further improvement by the time of discharge, while 24-h urine volume decreased, urine sodium further decreased (all P < 0.05). There was no significant change in blood pressure (P > 0.05).

CONCLUSIONCSWS and SIADH are two potential causes of hyponatremia in patients with acute spinal cord injury. Distinguishing between these two disorders is of crucial importance because treatment of each condition is quite different, one needing vigorous salt replacement while the other needing fluid restriction.

Acute Disease ; Adult ; Aged ; Brain ; metabolism ; Female ; Humans ; Hyponatremia ; etiology ; physiopathology ; therapy ; Inappropriate ADH Syndrome ; complications ; Male ; Middle Aged ; Sodium ; metabolism ; Spinal Cord Injuries ; complications

Objective To investigate the infection status of HIV/AIDS patients complicated with pneumocystis Carinii Poneumonia(PCP),and the role of CD4+ T lymphocyte in PCP.Methods PC was detected by Giemsa's staining and CD4+ T lymphocyte was counted by flow cytometry.Meanwhile,this text calculated and compared a series of indexes about PC infection,such as the total positive rate,the average annual positive rate,the average monthly positive rate,the positive rate between female and male,the positive rate between sputum and BALF specimens,and the relationship between the positive rate and CD4+ T lymphocyte count.Results The total positive rate about PC infection of the 1 806 eases of sputum specimens was 46.8％,and the incidence mainly from April to July during a year,and the positive rates were 46.3％ and 50.2％ for males and females respectively.The results showed that there were no significant differences when compared with the average annual positive rate ( P ＞ 0.05 ),but there were significant differences when compared with the average monthly positive rate ( P ＜ 0.05 ),the positive rate between female and male(P＞0.05),and among 3 formerly defined ranges of CD4+count(P ＜0.05).Conclusion Giemsa's staining showed the total positive rate was 46.8％ of the HIV/AIDS patients infected by PC with sputum specimens,which represented a seasonal fluctuation tendency.The positive rate of BALF was higher than that in sputum,and it increased with CD4+ count decreasing.Giemsa's staining was an efficient,simple and feasible way for PC detection and easy for generalization.Meanwhile,it is strongly relied on the operator's experience and skill.

Objective Serum miRNA has been regarded as a potential biomarker for diagnosis, therapeutic evaluation and prognostic prediction in cancer patients. This study aims to explore the clinical significance of the expression level of metastasis- related microRNA (miR- 18b) in the serum in AFP- negative (≤ 20 ng/ml) hepatocellular carcinoma(HCC) patients receiving radiofrequency ablation (RFA). Methods A total of 131 HCC patients with negative serum AFP, who were encountered during the period from January 2007 to January 2011 at authors’ hospital, were enrolled in this study. Radiofrequency ablation (RFA) of the lesions was carried out in all patients. Serum samples were collected before RFA. Forty - three healthy individuals were selected for control. The expression level of serum miR - 18b was deternmined by using quantitative real- time PCR method in all the patients and the healthy individuals. The correlations of the expression level of serum miR - 18b with clinico - pathological factors, postoperative recurrence, overall cirrhosis (P = 0.035), tumor diameter (P < 0.01) and tumor differentiation (P = 0.020). During the follow-up period, 79 patients (60.3%) developed recurrent tumors, and the expression level of serum miR- 18b in them was dramatically higher than that in the patients showing no recurrence (3.26 ± 1.28 vs. 2.42 ± 0.86, P <0.01). The incidence of recurrence after RFA, especially distant intrahepatic metastasis, in patients with higher expression level of serum miR- 18b was strikingly higher than that in patients with lower expression level of serum miR- 18b (72.3% vs. 48.5%, P = 0.005). Kaplan- Meier survival analysis indicated that both overall survival rate and recurrence- free survival rate of patients with higher expression level of serum miR-18b were significantly lower than those of patients with lower expression level of serum miR- 18b. Conclusion The expression level of serum miR - 18b is significantly elevated in AFP - negative HCC patients. The expression level of serum miR- 18b might be used as an ideal biomarker for monitoring tumor recurrence as well as for predicting prognosis after RFA.