Objective To analyze the level of Th17 and Treg cells in the peripheral blood of patients with rheumatoid arthritis(RA),and to investigate its role in the pathogenesis of RA and the clinical significance.Methods Flow cytometry(FCM)was used to analyze the ratio of interleukin(IL)-17+CD4+T (Thl7)cells and Foxp3+CD25+CD4+T(Treg)cells in CD4+T cells from the peripheral blood of 57 RA patients and 32 normal controls.T-test and Chi-square test were used for inter-group comparison and Pearson's linear analysis was used for correlation analysis.Resuits Compared with normal controls.the level of both IL-17+CD4+T cells and the ratio of Th17/Treg in RA patients increased significantly.while the level of Foxp3+CD4+CD25+T cells decreased markedly[(4.2±2.2)%vs(2.3±1.4)%,P=0.000;1.15±0.62 I)5 0.34±0.17,P=0.000;(3.9±1.6)%vs(7.0±2.2)%,P=0.000].Compared with early RA(persistent for 2 years or less)patients,the levels of Th17,Treg and the ratio of Th17/Treg in chronic RA(duration for more than 2 years)patients didn't markedly changed(P>0.05).The level of Th17 cells and the ratio of Th17/Treg was directlycorrelated with disease activity parameter (including tender ioint counts,visual analog seale of patients,disease activitv score in 28 joints,etc).Regression analysis discovered that risk factors of bone erosion were the level of Th17 cells,the ratio of Th17/Treg,disease activity score in 28 joints and disease duration.Antirheumatic drugs could decreascthe ratio of Th 17/Treg.Conclusions Treg cells is decreased in RA patients while Th7 cells is increased in patients with RA.Th17/Treg ratio goes up significantly as well.Change of T celt subsets,especially Th17 and Treg cells are important for the pathogenesis of RA.Th17 and Treg cells could aggrevate disease activity and bone destruction throughout the whole disease process.Anti-rheumatic medications is effective by regulating Th17/Treg subset balance.

Objective To investigate the echocardiographic features of complete transposition of the great arteries (TGA)in fetuses.Methods Prenatal echocardiographic data of 9 fetuses diagnosed as TGA by autopsy or postnatal echocardiography during January 2010 to January 2017 were retrospectively analyzed.Results All of 9 fetuses showed normal cardiac axis and atrioventricular connection on four-chamber view.Eight of them showed the baby bird's beak sign on left ventricular outflow tract view.On left and right ventricular outflow tracts view,the two great arteries were parallel in 8 fetuses.Totally 6 fetuses showed just 2 vessels on three vessels and tracheal (3VT) view.On aortic arch view,the radian of aortic arch had increased in different degrees in 7 fetuses.There were 4 fetuses with ventricular septal defect observed by both of four-chamber and left ventricular outflow tract views.Conclusion The echocardiographic features of fetuses with TGA are characteristic in left ventricular outflow tract,left and right ventricular outflow tracts,3VT and aortic arch views,including baby bird's beak sign,2 great arteries' parallel relations,only 2 vessels on 3VT view,and increased radian of aortic arch.Of these features,baby bird's beak sign is the most common.

Objective To explore the value of systematic continuous sequence approach combined with two- and three-dimensional ultrasonography in screening of fetal hand deformity. Methods Systematic continuous sequence approach was performed with two- and three-dimensional u1trasonography in 28 541 cases to detect the fetal hand from January 2011 to December 2014 in the 105th Hospital of PLA. Prenatal ultrasonic diagnosis was compared with clinical delivery follow-up and pathology results of induced labour, then prenatal ultrasound features of various fetal hand deformities and the causes of missed diagnosis were analyzed. Results Thirty-four cases of fetal hand deformity were diagnosed out of 28 541 fetuses by prenatal ultrasonography (43 hands). In the 34 cases, there were 5 cases of cleft hand, 13 cases of ectrodactyly with fingers abnormal morphology, 3 cases of forearm and hand dysplasia, 7 cases of wrist or finger abnormal posture and 6 cases of hand absence of abnormal. Three missed cases included 1 case of polydacty, 1 case of middle phalanx and distal phalanx of the little thumb absence and 1 case of middle phalanx of little thumb absence. Hand deformity rate was 0.13%(37/28 541). The detection rate ofprenatal ultrasonography was 91.89%(34/37). The rate of hand deformity complicated deformity with one or more other organ was 52.94%(18/34). The rate of chromosome abnormalities was 13.51%(5/37). Cleft hand showed that fetal hand from the central longitudinal split into two halves. Ectrodactyly with fingers abnormal morphology showed that one or multiple fingers were absent combined with residual finger abnormal morphology. Forearm and hand dysplasia showed that the forearm was abnormally developed, the ulna and radius were short and the structure of the wrist disappeared. Wrist or finger abnormal posture showed that a hook-shaped wrist or half fist shaped hand, thumb adduction flexion, the index finger bending baroclinic on the dorsal of the middle finger and small finger bending baroclinic on the dorsal of the ring finger dorsal. Hand absence showed that no fetal hands. Conclusions Application of systematic continuous sequence approach combined with real time three-dimensional ultrasonography in the diagnosis of fetal hand deformity, such as ectrodactyly with fingers abnormal morphology and wrist or finger abnormal posture, can make up for the shortage of two-dimensional ultrasonography and obtain more diagnostic information.

Objective To observe the response of left ventricular (LV)function and structure to chronic intermittent hypoxia (CIH)early stage in New Zealand white rabbits by echocardiography.Methods The New Zealand white rabbits were placed in the CIH chamber and exposed to hypoxia for 8 weeks (6 hours/day,6 days/week).The flow of nitrogen and oxygen were regulated into the customized chambers by the gas control delivery system.The fraction of inspired oxygen was changed from 21 % to 8% for 25 s of every 1 70 s.LV structure and function was assessed by echocardiography at CIH 0,1 ,2,4,6,8 weeks and histopathology was done by HE staining simultaneously.Results ①LV structural variables:compared with 0 week,LV posterior wall and interventricular septum thickness thickened at 6 week.LV end diastolic increased at 8 week (P < 0.05 ).② LV systolic function variables:compared with 0 week,LV ejection fraction increased at 2 week and 4 week,decreased at 6 week and 8 week,but it was higher than 0 week (P < 0.05).Isovolumic contraction time (IVCT)decreased at 1 week,2 week,4 week (P <0.05 ).③LV diastolic function variables:compared with 0 week,Peak velocity of early diastolic period increased at 2 week and 4 week,decreased at 6 week and 8 week with E/A>1 .Isovolumic relaxation time (IVRT)decreased at 1 week and 2 week,but increased at 8 week (P < 0.05 ).④ The myocardial pathology showed that myocardial fibers disordered slightly,cardiomyocytes swelled,nuclei increased and intracellular edema when exposed to CIH for 2 week and 4 week.Vacuolar degeneration,edema and congestion were found in intercellular substance at 6 week and 8 week.Conclusions ① LV systolic and diastolic function compensation started at CIH early stage then LV structure abnormality advent later.②IVCT and IVRT are sensitive indicators of LV systolic and diastolic function compensation.

Objective To study the application of combined detection of serum eosinophil cationic protein (ECP) ,C reactive protein (CRP ) and fractional exhaled nitric oxide (FeNO ) in the bronchial asthma . Methods 50 patients of bronchial asthma who received therapy from October 2014 to October 2016 in Tangs-han city union hospital were selected as research objects ,and selected 50 healthy people who received physical examination at the same time in the hospital as control group .The expression of serum ECP and CRP was de-tected by enzyme-linked immunosorbent assay ,and the FeNO concentration was detected using FeNO detec-tor .The expressions of serum ECP ,CRP and FeNO between the bronchial asthma group and the control group were compared ,and the expressions of serum ECP ,CRP and FeNO in patients with different severity of bron-chial asthma were compared ;the bronchial asthma group received 3 months of symptomatic treatment ,The ex-pression of serum ECP ,CRP and FeNO in patients with different therapeutic effects were compared .Results The serum ECP ,CRP and FeNO in the bronchial asthma group [(15 .86 ± 1 .47)ng/L ,(4 .87 ± 0 .52)mg/L , (61 .23 ± 11 .52)ppb]were significantly higher than those in the control group [(6 .62 ± 0 .63)ng/L ,(1 .04 ± 0 .23)mg/L ,(23 .58 ± 3 .40)ppb] ,the difference was statistically significant (P＜0 .05) ;The serum ECP ,CRP and FeNO in the acute attack of bronchial asthma[(18 .56 ± 1 .85)ng/L ,(5 .74 ± 0 .70)mg/L ,(66 .93 ± 10 .62) ppb] were higher than those in the remission stage[(12 .34 ± 1 .47)ng/L ,(3 .69 ± 0 .37)mg/L ,(54 .54 ± 8 .02) ppb] ,the difference was statistically significant (P＜0 .05) ;The patients with bronchial asthma were treated 3 months later ,clinical control in 28 cases ,partial control in 18 cases ,uncontrolled in 4 cases ,the serum ECP , CRP and FeNO in the clinical control group were significantly lower than those in the partial control group and the uncontrolled group ,the difference was statistically significant (P＜0 .05) .Conclusion The combined detection of serum ECP ,CRP and FeNO expression in patients with bronchial asthma is helpful to understand the severity of the disease ,it′s of positive significance in the early diagnosis and treatment of diseases .

AIM: To observe the effect ofacacia honey (AH) on serum uric acid level and renal function in potassium oxonate modelrats after drinking AH aqueous solution. METHODS: Sixty male SD rats were selected and randomly divided into control group (CON group), potassium oxonate model group (OA model group), 10% fructose group (10% F group) and different concentration honey groups (25%, 12.5% and 6.25% AH groups). All rats were fed with normal diet.The rats in CON group were subcutaneously injected with 5% sodium carboxymethyl cellulose (CMC-Na) solution and drunk sterile water every day, while rats in other groups were injected with 100 mg / kg OA solution suspended with 5% CMC-Na subcutaneouslyand drunksterile water orfructose solution or AH solution of different concentrations every day. Before and during the 4-week test, rats were weighed and blood was taken once a week. At the end of test, urine and feces specimens or kidney tissues were collected and blood was taken from the abdominal aorta. The uric acid content in blood, urine, and feces and the levels of serum creatinine (Cre) and blood urea nitrogen (BUN) or inflammatory factors in kidney tissues were measured. Renal function and histology were evaluated. RESULTS: Compared with CON group, AH could significantly reduce the body weight of rats (P<0.05), increase the kidney organ coefficient, the levels of serum uric acid, and uric acid in urine or feces, and reduce the level of fecal uric acid (FUA) in rats. AH can down regulate the level of tumor necrosis factor alpha (TNF-a) (P< 0.05) and up regulate the expression of monocyte chemoattractant protein 1 (MCP-1) and transforming growth factor β - 1 (TGF - β1) in rats kidneys; AH can cause slight to mild dilatation of renal tubules and mild to moderate basophilic lesions of renal rubules in rat kidney in a dose dependent manner. CONCLUSION: In the doses rang of present study, AH can cause hyperuricemia, renal tubular dilatation and basophilic lesions, and lead to renal function damage in rats.

ObjectiveTo analyze the quality changes of Platycladi Semen before and after the deterioration of moth-eaten and rancidity during storage. MethodFour types samples of Platycladi Semen， including normal， moth-eaten， oxidative rancidity and hydrolytic rancidity， were determined for volatile components， odor， and taste based on headspace solid phase microextraction/gas chromatography-mass spectrometry （HS-SPME/GC-MS） and electronic sensory techniques such as electronic nose and electronic tongue. Volatile components were identified by searching the database and manual comparison， the odor and taste were determined by the response values of the electronic nose and electronic tongue sensors， and the difference between samples before and after deterioration was studied by multivariate statistical analysis. ResultA total of 85 compounds were identified in Platycladi Semen samples. Compared with the normal samples， the number of volatile compounds in samples after hydrolytic rancidity decreased by 5， the number of volatile compounds in samples after moth-eaten and oxidative rancidity increased by 1 and 21， respectively. Aldehydes and acids accounted for majority of types. Among them， the contents of N-hexanoic acid， hexanal and propionic acid in the samples of oxidative rancidity reached 11.49%， 10.21% and 7.52%， which became the key indicators of rancidity. There was significant variance among the odor components corresponding to W1W， W2W and W1S sensors by electronic nose analysis. It was indicated that the value of sourness in deteriorated samples generally increased by mean of electronic tongue analysis. Compared with normal samples， the moth-eaten samples had changed slightly and rancidity samples had changed significantly especially oxidative rancidity samples of volatile components， odor and taste by multivariate statistical analysis. ConclusionIn terms of Platycladi Semen， the oxidative rancidity caused by nature storage for 12 months has the greatest impact on the quality. Therefore， it should be mainly to prevent oxidative rancidity to ensure the quality of Platycladi Semen.

OBJECTIVE：To know about the research status of health utility value obtained by mapping method in pharmacoeconomic evaluation ，and to provide reference for bibliometric study in pharmacoeconomic evaluation . METHODS ： Using“Mapping method ”“Health utility value ”“Cost-utility”“Utility point system ”as Chinese and English keywords ，retrieved from CNKI ，Wanfang database ，PubMed，Medline，Ebsco，Ovid and Wiley database ，empirical journal documents published from the inception to Dec. 31st，2018 about using mapping method to obtain health utility value were collected. The bibliometrics was used to statistically analyze basic information of included literature ，the construction and test of the model ，the type of the best model and so on. RESULTS ：The 124 included documents were all published in English journal. In the construction and testing of the mapping model ，the most frequently used econometric methods ，performance evaluation indicators and model testing methods were ordinary least squares （OLS），mean absolute error （MAE）and residual normality test ，application frequency of which were 97 times（31.60％），89 times（24.93％）and 62 times（21.09％）. There are 117 articles that define the best mapping model ，of which 101 articles（86.32％）have the best direct mapping effect. Most of the non-utility measurement scales adopted specific scales （92 articles，77.97％），and a few literatures adopted the universal scale （26 articles，22.03％）. The most utility measurement scales were 3-level European 5-dimensional health scale （79 articles，66.95％）. CONCLUSIONS ：The domestic empirical researches that use the mapping method to obtain health utility values need to be developed yet. A series of mapping models successfully developed by foreign scholars not only provide the feasibility of using non-utility measurement scales for cost-utility analysis ，but also provide more ideas for China to choose the corresponding econometric methods ，evaluation indicators and mapping methods in the empirical research of the mapping method in the future.

A new definition of metabolic dysfunction-associated fatty liver disease (MAFLD) has recently been proposed. We aim to examine the associations of MAFLD, particularly its discordance from non-alcoholic fatty liver disease (NAFLD), with the progression of elevated brachial-ankle pulse wave velocity (baPWV) and albuminuria in a community-based study sample in Shanghai, China. After 4.3 years of follow-up, 778 participants developed elevated baPWV and 499 developed albuminuria. In comparison with the non-MAFLD group, the multivariable adjusted odds ratio (OR) of MAFLD group for new-onset elevated baPWV was 1.25 (95% confidence interval (CI) 1.01-1.55) and 1.35 (95% CI 1.07-1.70) for albuminuria. Participants without NAFLD but diagnosed according to MAFLD definition were associated with higher risk of incident albuminuria (OR 1.77; 95% CI 1.07-2.94). Patients with MAFLD with high value of hepamet fibrosis score or poor-controlled diabetes had higher risk of elevated baPWV or albuminuria. In conclusion, MAFLD was associated with new-onset elevated baPWV and albuminuria independently of body mass index, waist circumference, and hip circumference. Individuals without NAFLD but diagnosed as MAFLD had high risk of albuminuria, supporting that MAFLD criteria would be practical for the evaluation of long-term risk of subclinical atherosclerosis among fatty liver patients.
Humans ; Pulse Wave Analysis ; Albuminuria ; Ankle Brachial Index ; Non-alcoholic Fatty Liver Disease/diagnosis* ; Vascular Stiffness ; Prospective Studies ; Risk Factors ; China/epidemiology*