Objective To investigate the effect of total flavonoids from astragalus complanatus (FAC) on attenuating lung injury resulted from paraquat (PQ) poisoning by inhibiting excessive endoplasmic reticulum stress (ERS) and c-Jun N-terminal kinase (JNK) pathway in rat.Methods Forty-eight Sprague-Dawley (SD) rats were randomly divided into six groups (n=8 in each group),including control group,model group,dimethyl sulfoxide (DMSO) vehicle control group,and FAC in low,medium,and high dosage groups.The model was reproduced by giving PQ 80 mg/kg orally to induce lung injury.The rats in control group were treated with saline by gavage.The rats in DMSO group were given 10％ DMSO 20 mL/kg by gavage 2 hours before intraperitoneal injection of PQ,and those in FAC low,medium and high dosage groups received 40,80,160 mg·kg-1· d-1 of FAC solution intraperitoneally after the PQ administration.The rats were sacrificed 72 hours after giving PQ,and the left lung tissue was harvested 72 hours after the reproduction of experimental model.The ratio of wet/dry weight (W/D) and total lung water content (TLW) were determined.The pathohistological changes of the left lung was observed under light microscope,and scored with alveolar damage index of quantitative assessment (IQA).The mRNA expressions of JNK and glucose regulated protein 78 (GRP78) were determined by reverse transcription-polymerase chain reaction (RT-PCR),and the protein expression of JNK,phosphorylation-JNK (p-JNK),and GRP78 were determined by Western Blot.Results Compared with control group,the W/D ratio,TLW and IQA were increased significantly in model group and DMSO group,and the mRNA expressions of JNK and GRP78 and the protein expressions of JNK,p-JNK and GRP78 were markedly increased.Compared with the model group,the W/D ratio,TLW and IQA,and the expressions of JNK mRNA and p-JNK protein were significantly decreased in the FAC groups,especially in FAC high dosage group [W/D ratio:3.0 ± 0.3 vs.5.5 ± 0.5,TLW:2.2 ± 0.3 vs.4.7 ± 0.4,IQA:(15.4 ± 3.0)％ vs.(40.0 ± 5.7)％,JNK mRNA:0.21 ± 0.08 vs.0.82 ±0.27,p-JNK protein:0.31 ±0.09 vs.0.78 ±0.25,all P＜0.O1].The mRNA expression of GRP78 and the protein expressions of JNK and GRP78 were highly expressed in FAC low,medium and high dosage groups,and there was no significant difference compared with those in model group (GRP78 mRNA:0.54 ± 0.18 vs.0.74 ± 0.20,JNK protein:0.76 ± 0.27 vs.0.80 ± 0.28,GRP78 protein:0.51 ± 0.18 vs.0.69 ± 0.21,all P＞0.05).Conclusions PQ induces excessive ERS in the lung tissue resulting in lung injury.FAC has a protective effect on lung against PQ injury,and it may be related with inhibition JNK pathway in ERS.

OBJECTIVE:To systematically review the effects of long-term oral low-dose of azithromycin on pulmonary func-tion and clinical signs of patients with stable COPD. METHODS:Retrieved from PubMed,Medline,CJFD,VIP and Wanfang da-tabase,randomized controlled trials(RCTs)about long-term oral low-doses of azithromycin for stable COPD were collected. After quality evaluation according to modified Jadad scale,Meta-analysis was conducted by Rev Man 5.2 statistical software. RESULTS:A total of 13 RCTs were included,involving 1207 patients. Meta-analysis showed that,long-term oral low-doses of azithromycin could significantly improve FEV1[SMD=0.78,95%CI(0.62,0.93),P<0.001],FEV1%[SMD=0.81,95%CI(0.61,1.00),P<0.001],FEV1/FVC [SMD=3.91,95%CI(2.58,5.24),P<0.001] and 6MWD[SMD=23.74,95%CI(21.20,26.18),P<0.001] in sta-ble COPD patients,meanwhile significantly reduce dyspnea score [SMD=-1.15,95%CI(-1.60,-0.71),P<0.001],quality of life score [SMD=-1.82,95%CI(-2.74,-0.90),P<0.001] and 24 h sputum volume[SMD=-18.68,95%CI(-24.79,-12.56), P<0.001],with statistical significance. CONCLUSIONS:Long-term oral low-doses of azithromycin can improve pulmonary func-tion,dyspnea,activity tolerance and quality of life in acute exacerbation of COPD patients.

Background Inflammation is one of the most popular aspects in the studies of diabetic retinopathy (DR) mechanisms.Researches showed that S100A8/A9 participate in the inflammatory procedure of many diseases,however,the relationship between S100A8/A9 complex and retinal inflammation of DR needs to be researched.Objective This study was to detect the serum S100A8/A9 level of diabetes mellitus (DM) and DR patients,and explore its role in DM an DR development.Methods A cases-controlled study was carried out.The DR patients,type 2 DM patients without retinal change and heathy controls were enrolled in Shanghai Xuhui Central Hospital from January to June 2014,and 30 patients for each group.The DR patients were subgrouped to non-proliferative DR (NPDR) group and proliferative DR (PDR) group.The periphery blood was collected to isolate the serum,and serum S100A8/A9 complex level was detected by ELISA.Serum high-sensitivity C-reactive protein (hsCRP) and glycosylated hemoglobin A1C (HbAlc) level was assayed by immunity turbidimetry and immune agglutination respectively.Results Serum S100A8/A9 complex levels in the DR group,DM group and normal control group were (9.74±0.59),(11.41 ±0.64) and (6.46 ±0.62) μg/L,respectively,and the serum S100A8/A9 complex level in the DM group and DR group was significantly higher than that in the normal control group,and the serum S100A8/A9 complex level in the DM group raised in compared with the DR group (all at P＜0.01).Serum hsCRP levels in the DR group,DM group and normal control group were (1.40±0.34),(1.27±0.13) and (1.11 ± 0.12)mg/L,respectively,with the highest value in the DR group and the lowest value in the normal control group (all at P=0.00).The serum HbAlc levels were higher in the DR group and DM group than those in the normal control group (both at P =0.00),while no significant difference was found in the serum HbAlc level between DR group and DM group (P =0.12).There was no significant differece in the serum S100A8/A9,hsCRP and HbAlc levels between NPDR group and PDR group (t=-0.10,P =0.92;t =-0.17,P =0.87;t =0.66,P =0.51).A weak positive correlation was seen between serum S100A8/A9 level and serum hsCRP level (r =0.36,P =0.00).Conclusions As an inflammatory marker,S100A8/A9 complex might play an important role in the pathogenesis and development of DR.Intensive control of glycemia can alleviate retinal inflammation in DM patients.

Objective To study the expression of cellular FLICE inhibitory proteins(c-FLIP)in peripheral blood B lymphocytes in patients with systemic lupus erythematosus (SLE)and its correlation with clinical features.Methods Blood samples were obtained from 53 patients with SLE and 30 normal human controls.Flow cytometry and ELISA were performed to measure the expression of c-FLIP in pefipheral blood B lymphocytes and serum levels of IL-4 and IL-10,respectively.Relevant laboratory examinations were carried out for these patients.SLE disease activity index(SLEDAI)score was calculated for patients.Results The positivity rate of c-FLIP in B lymphocytes was 3.11%±0.70%in 18 patients with active SLE.significantly higher than that in 35 patients with inactive SLE (0.78%±0.28%)and normaI controls(0.68%±0.12%),while no statistical difierence was found between inactive patients and controls(t=1.56,P＞0.05).In SLE patients,the expression of c-FLIP showed a positive correlation with SLEDAl score(r=0.96.P＜0.05),erythrocyte sedimentation rate(r=0.96,P＜0.01),serum level of C reactive protein(r=0.92.P＜0.01)and the titer of antinuclear antibodies(r=0.86,P＜0.01),whereas in 36 patients with leucopenia.a negative correlation was noticed between white blood cell count and the expression level of c-FLIP(r=-0.94,P＜0.0 1).The 23 patients with lupus nephritis had a higher level of c-FLIP than those without lupus nephritis(3.04%±1.09%vs 1.76%±1.09%,t=4.23,P＜0.05).Additionally.the expression of c-FLIP positively correlated with the serum level of IL-4 and IL-10(r=0.80,0.89.respectively,both P＜0.01).Conclusions In patients with active SLE,the expression of c-FLIP is upregulated in peripheral blood B lymphocytes,and positively correlated with the severity of SLE as well as the serum level of IL-4 and IL-10.The upregulation of c-FLIP in B cells might play a certain role in deficient apoptosis or clearance of activated B cells in SLE.

During past 50 years,has achieved a great progress and derived some profound lessons worthy of learning and studying for our country.This article introduces the deinstitutionalization processes of mental health institutions,reinstitutionalization and the inspiration for Chinese mental health reform.Introduced the paper are the reform of deinstitutionalization of mental health institutions in USA and some other countries,and the concept of such a reform,pointing out inspirations of such a reform for mental health reform in China.

Summary: In order to study the expression of IL-1β and TNF-α in the myocardium of MCMV myocarditis and their role in the myocardial damages, 60 BALB/C mice of 4 weeks were randomly divided into two groups: 36 were injected intraperitoneally with MCMV and 24 served as control group. Immunohistochemistry was used to detect IL-1β and TNF-α expression in the myocardium, and myocardial lesions were observed histopathologically. Histopathological study on the myocardium from infected mice revealed focal or diffuse lesions characterized by inflammatory cells and degeneration or necrosis of myocytes. The myocardial lesion score showed the degree of inflammatory cell infiltration was slight in MCMV myocarditis.The positive staining signals for IL-1β and TNF-α proteins which mainly located in the infiltrating inflammatory cells and degenerative or necrotic myocytes were markedly detectable whereas there were no positive findings in the myocardium of control mice. IL-1β and TNF-α was expressed in the myocardium of viral myocarditis murine model induced by MCMV. IL-1β and TNF-α may play an important role in the pathogenesis of viral myocarditis.

OBJECTIVETo assess the significance of the method of percutaneous radiofrequency ablation (PRFA) combined with transcatheter arterial chemoembolization for hepatocellular carcinoma.

METHODSThirty patients with hepatocellular carcinoma were divided into PRFA group and TACE + PRFA group between January 2000 and July 2001. All patients were followed up to examine the value of AFP, MRI or CT. Kaplan-Meier estimation was used for the analysis of disease-free survival and the cumulative survival rate.

RESULTSThe complete necrosis rates were 86.7% (13/15) and 26.7% (4/15) in the TACE + PRFA group and group PRFA group respectively. The rates of AFP positive down to negative were 66.7% (6/9) for the former and 20% (2/10) for of the latter, and the six-month disease-free survival rates were 100% (13/13) and 75% (3/4) in the two groups. The 1-, 1.5- and 2-year survival rates of the group TACE + PRFA were 100%, 100% and 66.7% respectively. The survival rates of 1 and 1.5 years of the group PRFA only were 80% and 40%.

CONCLUSIONSFor those hepatocellular carcinomas over 3 cm in size, located in the porta hepatis, or with indistinct boundary or the presence of foci, TACE can be performed first and then followed by PRFA in suitable time. This method can enlarge the necrosis range and increase the rate of complete necrosis of tumors, thereby decrease the recurrence and improve the disease-free survival and total survival of patients.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Hepatocellular ; mortality ; therapy ; Chemoembolization, Therapeutic ; Combined Modality Therapy ; Female ; Humans ; Liver Neoplasms ; mortality ; therapy ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Survival Rate

Objective:To observe the therapeutic effect of quercetin (QUE) on triggering receptor expressed on myeloid cells (TREM-1) activated macrophage inflammation and lipopolysaccharide (LPS) induced acute lung injury (ALI) in mice, and explore its possible mechanism.Methods:In vitro cell experiment: The primary peritoneal macrophages of mice were collected by intraperitoneal injection of 3% calcium mercaptan acetate. The collected cells were divided into blank control group, dimethylsulfoxide (DMSO) vehicle group, TREM-1 agonist group (10 μg/ml), QUE group (10 μmol/L) and TREM-1 agonist + QUE group (cells were pretreated with 10 μmol/L QUE for 30 min before adding agonist). Enzyme linked immunosorbent assay (ELISA) was used to detect the secretion of interleukin (IL)-1β, tumor necrosis factor (TNF)-α and IL-6 in the culture supernatant of primary macrophages; To observe the effect of QUE on LPS-induced TREM-1 protein levels, macrophages were divided into: normal control group, LPS group (100 ng/ml) and LPS+ QUE treatment group [macrophages were pretreated with 10 μmol/L QUE for 2 hours, and then incubated with LPS (100 ng/ml) for 16 hours]. Western blot was used to detect the expression of TREM-1 protein. In animal experiments: 80 male C57BL/6 mice were randomly divided into 4 groups (20 in each group): normal control group, ALI model group, QUE group and QUE treatment group (LPS+ QUE). In the ALI model group, the ALI model was established by intratracheal injection of 5 mg/kg LPS; The mouse ALI model was established by intratracheal injection of LPS 5 mg/kg in the QUE treatment group, and then intraperitoneal injection of 15 mg/kg QUE. The control group was given the same amount of normal saline intratracheal followed by intraperitoneal injection of DMSO, and the QUE group was given the same amount of normal saline intratracheal followed by intraperitoneal injection of 15 mg/kg QUE. Hematoxylin-eosin (HE) staining was used to observe the pathological changes of lung tissue in each group; Inflammatory cells including IL-1β, TNF- α and IL-6 in bronchoalveolar lavage fluid (BLAF) of mice in each group were counted ; The expression of TREM-1 mRNA and protein in lung tissue of mice in each group was detected by real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) and Western blot. Results:In vitro cell experiment: the secretion of IL-1β, TNF-α and IL-6 in the supernatant of primary macrophages in TREM-1 agonist group was higher than those in DMSO vehicle group, while the secretion of IL-1β, TNF-αand IL-6 in the supernatant of primary macrophages in TREM-1 agonist + QUE group were lower than that of TREM-1 agonist group (all P<0.001). The expression of TREM-1 protein in LPS group was higher than that in control group ( P<0.05), while the expression of TREM-1 protein in LPS + QUE group was lower than that in LPS group ( P<0.05). Animal experiments showed that compared with the control group, the ALI model group had higher lung pathological injury score, more total cells, macrophages and neutrophils in BALF and increased TNF-α, IL-6, IL-1β content (all P<0.001). The above indexes in QUE group were lower than those in ALI model group (all P<0.001). The results of qRT-PCR and Western blot showed that compared with the control group, the expression of TREM-1 mRNA and protein in the lung tissue of ALI model group was increased, while the expression of TREM-1 mRNA and protein in the lung tissue of QUE group was lower than that of ALI model group (all P<0.05). Conclusions:Quercetin can inhibit TREM-1 activation, reduce macrophage inflammatory response and LPS induced acute lung injury in mice.

Objective:To compare the clinical features of patients with acute Vogt-Koyanagi-Harada syndrome (VKH syndrome) of optic disc swelling (ODS) and serous retinal detachment (RD).Methods:A retrospective clinical study. From January 2013 to November 2019, 212 patients with acute VKH syndrome diagnosed in the Department of Ophthalmology of Shanghai Xuhui District Central Hospital were included in the study. Among them, there were 105 males (210 eyes) and 107 females (214 eyes). The average age was 40.84±13.90 years. All affected eyes were examined by BCVA, FFA, and OCT. The standard logarithmic visual acuity chart was used for BCVA examination, which was converted into logMAR visual acuity in statistics. According to the changes in the fundus, the patients were divided into the ODS group and the RD group, 36 patients with 72 eyes (16.98%) and 176 patients with 352 eyes (83.02%), respectively. The independent sample t test was performed to compare the age of onset, visit time and BCVA of the two groups of patients, the χ2 test was performed to compare the count data. Results:Among the 72 eyes of 36 patients in the ODS group, there were 16 males with 32 eyes (44.44%), 20 females with 40 eyes (55.56%). The average age was 40.56±16.57 years, the average visit time was 22.47±19.98 days, the average logMAR BCVA was 0.68±0.53. Among the 352 eyes of 176 patients in the RD group, there were 89 male patients with 178 eyes (50.56%), and 87 female patients with 174 eyes (49.43%). The average age was 40.90±13.34 years, the average visit time was 17.25±24.40 days, the average logMAR BCVA was 0.80±0.56. The average age ( t=-0.116), gender composition ratio ( χ2=0.448), average visit time ( t=1.204), average logMAR BCVA ( t=-1.661) comparisons between the two groups showed no statistically significant differences ( P>0.05). There was no statistically significant difference in the average logMAR BCVA between the RD group and the ODS group of different eyes ( t=0.227, 0.810; P>0.05). There were 50 (69.44%, 50/72) and 272 (77.27%, 272/352) eyes in the ODS group and RD group with inflammation of the anterior segment. There were anterior segment reactions between the two groups. There was no statistically significant difference in the number of eyes ( χ2=1.003, P>0.05). There were 34 (19.32%, 34/176) and 2 (5.56%, 2/36) patients with headache and hearing loss, respectively. The comparison of the number of patients with headache and hearing loss between the two groups showed statistically significant differences ( χ2=4.015, P<0.05). Conclusion:Compared the patients with ODS acute VKH syndrome, the patients with serous RD acute VKH syndrome are more likely to have extraocular symptoms such as headache and hearing loss.

Objective:To analyze the hepatic tissue inflammatory activity and influencing factors in HBeAg-positive patients during normal alanine aminotransferase (ALT) and indeterminate phases so as to provide a basis for evaluating the disease condition.Methods:Patients with HBeAg-positive with normal ALT and HBV DNA levels below 2 × 10 7 IU/ml from January 2017 to December 2021 were selected as the study subjects. A histopathologic liver test was performed on these patients. Age, gender, time of HBV infection, liver function, HBsAg level, HBV DNA load, genotype, portal vein inner diameter, splenic vein inner diameter, splenic thickness, and others of the patients were collected. Significant influencing factors of inflammation were analyzed in patients using logistic regression analysis, and its effectiveness was evaluated using receiver operating characteristic (ROC) curves. Results:Of the 178 cases, there were 0 cases of inflammation in G0, 52 cases in G1, 101 cases in G2, 24 cases in G3, and one case in G4. 126 cases (70.8%) had inflammatory activity ≥ G2. Infection time ( Z=-7.138, P<0.001), γ-glutamyltransferase ( t ?=-2.940, P=0.004), aspartate aminotransferase ( t ?=-2.749, P=0.007), ALT ( t ?=-2.153, P=0.033), HBV DNA level ( t ?=-4.771, P=0.010) and portal vein inner diameter ( t ?=-4.771, P<0.001) between the ≥G2 group and < G2 group were statistically significantly different. A logistic regression analysis showed that significant inflammation in liver tissue was independently correlated with infection time [odds ratio (OR)=1.437, 95% confidence interval ( CI): 1.267-1.630; P<0.001)] and portal vein inner diameter ( OR=2.738, 95% CI: 1.641, 4.570; P<0.001). The area under the curve (AUROC), specificity, and sensitivity for infection time and portal vein inner diameter were 0.84, 0.71, 0.87, 0.72, 0.40, and 0.95, respectively. Conclusion:A considerable proportion of HBeAg-positive patients have inflammation grade ≥G2 during normal ALT and indeterminate phases, pointing to the need for antiviral therapy. Additionally, inflammatory activity has a close association with the time of infection and portal vein inner diameter.