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.

The pharmacokinetics of a long-circulating PEGylated Radix Ophiopogonis polysaccharide (ROP) was investigated in rats following i.v. or s.c. administration at three dose levels (9, 20, 50 mg x kg(-1)). A moderate coupling reaction between the hydroxyl-activated ROP and the amino-terminated mPEG was chosen to produce PEGylate ROP. The grafting degree of the prepared conjugate was 1.03, and the molecular mass of mPEG used was 20 kDa. High-performance gel permeation chromatorgraphy with fluorescein isothiocyanate prelabeling was established to determine levels of the conjugate in plasma. The results showed that the elimination half-life of the conjugate following s.c. administration was basically identical to that after iv administration. An accurate linear correlation was observed between administration doses and areas under the curve of plasma conjugate level vs. time profile, regardless of the administration route. The absolute bioavailability of the conjugate following sc administration was approximately 56%, and the mean in vivo residence time was 52.1 h, increased 2.4 times compared to those of iv administration. In general, linear pharmacokinetics was observed for the conjugate within the dose range studied, and sc should be a promising administration route for the conjugate.

Objective To assess the role of Matrix Metalloproteinase-9 (MMP-9)in rheumatoid arthritis (RA).Methods Peripheral blood from 45 RA patients and 28 healthy individuals (HV)were collected to detect RF and hs-CRP by immuno-turbidimetry,ESR by westergren method and MMP-9 by ELISA.The correlation was analysed between MMP-9 and RF, ESR or hs-CRP,respectively,by pearson correlation analysis.Results Levels of RF,ESR,hs-CRP and MMP-9 were signifi-cantly higher in RA patients than HV group (t=3.93~5.96,P<0.001),respectively.RF high titer patients or patients with a high inflammation response showed a higher MMP-9 levels than the RF low titer or slight inflammation patients (P<0.05).MMP-9 was positively correlated to RF,ESR and hs-CRP in RA patients(P<0.05),respectively.Conclusion MMP-9 maybe a sensitive tool in the diagnosis and management of RA patients.

ObjectiveTo observe right ventricle (RV) structure and function of New Zealand rabbits with chronic intermittent hypoxia (CIH) for short-term (0-8 weeks) by echocardiography. MethodsTwenty-four healthy male New Zealand rabbits were set up CIH animal model for 8 weeks. RV structure?s systolic and diastolic function were measured by conventional and tissue Doppler echocardiography at 0, 1, 2, 4, 6 and 8 week and one rabbit was sacriifced randomly for RV myocytes and pulmonary tissue pathology examination. RV structure and function parameters at 0, 1, 2, 4, 6 and 8 week were analyzed by mixed effects model analysis.ResultsRV structure variables: RV, RA at 8 week increased compared with those at 0 week, but had no signiifcant difference (P>0.05); RV systolic function variables:RVFAC at 8 week increased compared with those at 0 week (F=3.45, P<0.05), TAPSE at 4, 6, 8 week increased compared with that at 0 week (F=3.11, 3.41 and 3.86, all P<0.05), RVMPI at 4 week decreased compared with that at 0 week (F=3.46, P<0.05), recovered to baseline at 6, 8 week. Isovolumetric relaxation time (IRTc) corrected by heart rate at 1, 2, 4 week decreased compared with that at 0 week (F=3.15, 3.31 and 3.17, all P<0.05), recovered to baseline at 8 week, ET of PA at 1, 2 week decreased compared with that at 0 week (F=3.01 and 3.15, both P<0.05), recovered to baseline at 4, 6, 8 week, AT of PA at 1, 2, 4 week decreased compared with that at 0 week (F=3.13, 3.15 and 3.32, all P<0.05), recovered to baseline at 6, 8 week. RV diastolic function variables: isovolumetric contraction time (ICTc) corrected by heart rate at 2, 4 week decreased compared with that at 0 week (F=3.13 and 3.33,both P<0.05), E/E? at 1, 2 week decreased compared with that at 0 week (F=3.13 and 3.44,bothP<0.05), recovered to baseline at 4, 6, 8 week, E/A at 4, 6, 8 week increased compared with that at 0 week (F=4.01, 3.82 and 3.37, all P<0.05), E?/A? at 8 week increased compared with that at 0 week (F=3.81, P<0.05). The myocardial pathology showed that RV myocardial cell structure was normal at 4 week. Nuclei enlarged, stain darkened and some cytoplasms loosed when exposed to CIH for 8 weeks. The structure of lung tissues was normal when exposed to CIH for 4 weeks. Inflammatory cell inifltrated, capillary engorged as well as the wall of pulmonary arterioles thickened slightly at 8 week.ConclusionsRV diastolic and systolic function showed compensatory and structure was normal in early CIH (0-8 week). RV diastolic function compensated earlier than systolic function. IRT and ICT were sensitive indicators of RV systolic and diastolic function compensation.

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 explore the change regulation of periodical needs of main caregivers during transition period from being admitted to hospital to home among patients with initial stroke in 9 hospitals in Shanghai Pudong New Area and to analyze the reasons. Methods? From May 2017 to January 2018, we selected 1 200 initial stroke patients and 1 200 main caregivers of them in 9 hospitals of Shanghai Pudong New Area as subjects by convenience sampling. The Family Needs Questionnaire (FNQ) was used to investigate the change of needs of them on admission, at discharge and two weeks after discharge. A total of 1 200 questionnaires were sent out and 1 089 valid questionnaires were collected. Results? Among 1 089 main caregivers of initial stroke patients, the scores of importance of total demand on admission, at discharge and two weeks after discharge were (3.44±0.77),(3.24±0.82) and (3.01±0.71) respectively with statistical differences (P＜ 0.05). At different stages, the need for health information and need for professional support were two dimensions with the high importance of care need of main caregivers among initial stroke patients; the stage with the highest satisfaction with the total demand was at discharge; the items with high rates of no satisfaction with needs included "to be shown that my opinions are used in planning the treatment" "to have enough resource for myself" and "to be shown what to do when the patient is upset" on admission, at discharge and two weeks after discharge. Conclusions? The importance of total demand of main caregivers of initial stroke patients decreases with the increasing of disease course on admission, at discharge and two weeks after discharge. The need satisfaction is high at the stage of discharge and is low after discharge. Medical staff should strengthen the family follow-up.

This study elaborates on the content of caregiving preparation, the related theory model, the relevant evaluation tools and the intervention effect of caregiving preparation for stroke caregivers, in order to provide reference for health education, discharge guidance and nursing intervention research of stroke caregivers.

Objective:To understand the epidemiological characteristics of public health emergency events (PHEE) of varicella in China from 2006 to 2021 and related response performances.Methods:The data of varicella PHEE in 31 provinces of China from 2006 to 2021 were collected through the Public Health Emergency Management Information System, Microsoft Excel 2019 software and SPSS 26.0 statistical software were used to conduct descriptive epidemiological, statistical analysis on the time, area, location distribution, scale and epidemic management.Results:A total of 11 443 PHEE involving 341 048 related cases were reported from 2006 to 2021, with an annual attack rate of 1.78%-3.80% and a total attack rate of 2.33% (341 048/14 624 042). The number of PHEE and related cases of varicella decreased from 1 107 (35 349) in 2007 to 262 (6 884) in 2012 ( Z=-2.40, P<0.001), then increased year by year to 1 318 (42 649) in 2019 ( Z=2.58, P<0.001), with a significant decline since 2020. The varicella PHEE in China presents the seasonal characteristics,the peak is from April to June and from October to December, respectively. The sub-peak of varicella PHEE in eastern China generally appears 1-2 months earlier than in central and western China. Varicella PHEE reports are mainly distributed in eastern China, the attack rate is relatively high in western China, school-reported varicella PHEE was 88.26% of the total reports (10 099/11 443). The epidemic scale of varrcella PHEE typically range from 10 to 29 cases per year among the given outbreaks. The M ( Q1, Q3) of average number of cases, average duration, and average reporting interval of PHEE were 23 (16,35), 20 (14, 26) days, and 9 (5,19) days, respectively, and the reporting interval was positively correlated with the duration ( r=0.854, P<0.001). Conclusions:The varicella PHEE in China from 2006 to 2021 has not been effectively controlled. Schools are the key places to prevent and control varicella PHEE. Improving the sensitivity of varicella PHEE monitoring, strengthening the timely disposal of varicella epidemic, and promoting varicella vaccination are effective measures to prevent and control varicella PHEE.

Objective:To analyze the risk factors of multidrug-resistant organism（MDRO）infection among patients in neurosurgery intensive care unit（NSICU）and to construct a risk prediction nomogram.Methods:A total of 434 patients admitted in the NSICU of the First Affiliated Hospital of Kangda College of Nanjing Medical University from August 2021 to October 2022 were enrolled in the study. Patients were divided into modeling group（ n=217）and validation group（ n=217）. Multivariate Logistic regression was used to analyze the risk factors of MDRO infection in patients，and R software was used to construct a risk prediction nomogram.The prediction power of the nomogram was evaluated with receiver operating characteristic（ROC）curve，the calibration of the model was assessed with Hosmer-Lemeshow（H-L）goodness-of-fit method. Results:Multivariate Logistic regression analysis showed that the underlying disease≥3（ OR=2.580，95% CI 1.322-5.035），the combination of antimicrobial drugs >10 days（ OR=2.336，95% CI 1.182-4.615），hypoproteinemia（ OR=1.962，95% CI 1.031-3.735），invasive operation time（10-20 d： OR=2.358，95% CI 1.048-5.306；>20 d： OR=3.486，95% CI 1.643-7.395）and GCS≤8 points（ OR=2.961，95% CI 1.470-5.963）were independent risk factors of MDRO infection among patients in NSICU. The area under the curve（AUC）of the nomogram in predicting the risk of MDRO infection for patients in modeling group was 0.787（95% CI 0.725-0.849）with a sensitivity of 73.3% and a specificity of 72.5%，the H-L test results were χ2=7.482， P=0.486，the calibration curve was close to the ideal curve，and the mean absolute error was 0.022. The AUC of the nomogram in predicting MDRO infection for patients in verification group was 0.800（95% CI 0.739-0.861）with a sensitivity of 74.7% and a specificity of 73.9%，the H-L test results were χ2=9.824， P=0.278，the calibration curve was close to the ideal curve，and the average absolute error was 0.015. Conclusion:The nomogram constructed based on the risk factors can effectively predict the risk of MDRO infection for patients in neurosurgical ICU，which may be used in clinic pratcice.

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.