Objective To investigate the correlation of the serum prolactin level and the secret mode of Th1/Th2 eytokines with clinical activity in patients with systemic lupus erythematosus. Methods The serum level of The levels of PRL[ (21.58 ± 4.29 ) ng/ml vs ( 11.87 ± 2.57 ) ng/ml, P < 0.01 ), IL-4 [ ( 26.79 ± 5.08 ) ng/L vs (10.71 ± 1.35)ng/L,P <0.01 ] in SLE patients were significantly higher than the healthy controls,but IFN-γ [ (11.47±3.36)ng/L vs (18.36 ±2.61)ng/L,P <0.01 ], IFN-γ/IL-4(0.76γ±0.29 vs 2.30±0. 15,P <0.01) [ (38.52 ± 8.44) ng/L vs ( 14.15 ± 1.63 ) ng/L, P < 0.01 ] in the active SLE patients were significantly higher than that in the nonactive patients, whereas, the levels of IFN-γ [ (6.98 ± 2.72) ng/L vs ( 16.24 ± 2.57 ) ng/L, P < 0.01 ] and IFN-γ/IL-4 (0.35 ± 0.14 vs 1.24 ± 0.29, P < 0.01 ) were lower in the active group compared with the nonac-[ (45.12±10.44) ng/L vs ( 17.53 ± 5.42) ng/L, P < 0.01 ] declined while IFN-γ [ (6.31 ± 2.59) ng/L vs (16.89 ±4.43)ng/L,P<0.01 ] and IFN-γ/IL-4 (0.16 ±0. 11 vs 1.16 ±0. 27,P<0.01) increased when SLE patients in remission. Conclusions Hyperprolactinemia and imbalance of Th cytokines production which exhibited Th2 dominant are found in SLE patients. Prolactin and the degree of imbalance of Th cytokines production varies with the remission or exacerbation of the disease.

BACKGROUND: Wuhuang oil has a bacteriostatic action to treat burn wound and promote traumatic healing, but the action on inhibition of scars formation remains poorly understood.OBJECTIVE: To investigate the effects of modified Wuhuang oil at different concentrations and administration times on the growth and proliferation of human fibroblasts in vitro.DESIGN, TIME AND SETTING: Comparison observation regarding cytology in vitro was performed at the Burns Institute in the First Affiliated Hospital of Nanchang University between April 2006 and January 2007.MATERIALS: Prepuce specimens were harvested from patients who underwent circumcision in Department of urinary surgery, at First Affiliated Hospital of Nanchang University and Jiangxi Provincial Children Hospital. All patients aged 2-12 years old, and informed consents were obtained from their relatives. Wuhuang oil and modified Wuhuang oil (water-solubility) were offered by Department of Pharmaceutical Preparation in the First Affiliated Hospital of Nanchang University, China. METHODS: Human fibroblasts cultured in vitro were divided into 2 groups at random, experiment and control. Experiment group was treated with 300 g/L Wuhuang oil, while control group with 300 g/L modified Wuhuang oil. Serum-free culture fluid was used to prepare 6 concentrations of oil solution: 0 (blank control), 100, 150, 200, 250, 300 g/L.MAIN OUTCOME MEASURES: MTT assay was used to determine the growth and proliferation of human fibroblasts at 2, 3, 4, 5,6 days; inhibition rate of cell growth was observed at 2, 4, 6, 8, 10 days.RESULTS: Modified Wuhuang oil (0-300 g/L) concentration positively correlated with inhibition of human fibroblast proliferation;the inhibition was not related to culture time. Modified Wuhuang oil (300 g/L) had the greatest inhibition rate of human fibroblasts at 8-10 days, there were significant differences between experiment group and control group (P < 0.01).CONCLUSION: Modified Wuhuang oil has an effective inhibition on the proliferation of human fibroblasts in vitro, and shows a dose-dependent tendency. Compared with Wuhuang oil, 300 g/L modified Wuhuang oil is superior to suppress the growth of human fibroblasts.

OBJECTIVE To optimize the parameters of passive cutaneous anaphylaxis(PCA)in rats immunized by ovalbumin(OVA). METHODS 1-2 month-old Sprague-Dawley rats were immu?nized by ip injection of OVA(0.2,1.0 and 5.0 mg per rat)mixed with complete Freund′s adjuvant once every other day 3 times. Serum was collected on the 12th-16th days after final immunization. Then the rats were intracutaneously injected with sensitized serum and then stimulated by iv injection of the same dose of OVA mixed with Evans blue after a latent period of 0.5,1.5,3,6,12,24,36,48 and 60 h. Finally,the diameters of blue spots in the skin were measured at stimulation. RESULTS Serum total-IgE(T-IgE)and OVA-specific IgE(sIgE)levels increased significantly and reached the peak on the 3rd-7th days and 12th-16th days after final immunization,respectively. There was no correlation between the serum T-IgE level and OVA-sIgE level when the rats were immunized with OVA at OVA 0.2-5.0 mg per rat. The rats experienced PCA after injection of OVA 1.0 and 5.0 mg per rat. Diameters of blue spots in the skin reached the maximum value after rats were sensitized for 0.5-3 h. Moreover,the shape,color and size of blue spots were better 30-60 min after stimulation. CONCLUSION Optimized PCA is as follows:1-2 month-old rats are immunized on the 1st,3rd and 5th days by ip injection of OVA 1.0-5.0 mg. The immunizing serum is collected at 12-16 d after final immunization. The rats are stimulated by OVA and Evans blue after a latent period of 0.5-3 h. Diameters of blue spots in rats′ skin are then measured 30-60 min after stimulation.

Objective:To compare the effect of age and gender on mastication efficiency between healthy volunteers and dysphagic stroke survivors and to document any correlation of mastication efficiency with mandible movements.Methods:Thirty-two stroke survivors with dysphagia and 84 healthy volunteers were asked to chew two-color gum. Their chewing efficiency was indicated by the degree of color mixing after chewing (SDHue). The SDHue value was evaluated using ViewGum software. The healthy volunteers were further divided into an age 20-40 years group, a 41-60 years group and an over-60 group. The SDHue values were compared among the 3 groups. The SDHue values were correlated with clinical mandibule movement scores.Results:Among the healthy volunteers, those older than 60 years had significantly higher SDHue values on average than those between 20 and 40 years. However, no significant gender difference was observed. The dysphagic stroke survivors had, on average, significantly higher SDHue results than the healthy volunteers, and those results were positively correlated with their mandible movement scores.Conclusions:Mastication efficiency tends to be age-related but not gender-related. Among those with post-stroke dysphagia mandible movement is positively correlated with mastication efficiency.

Objective To investigate the role of epigenetic regulations of peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α) in the development of diabetic retinopathy and the metabolic memory phenomenon after hyperglycemia was terminated.Methods Diabetic rat model was established by intraperitoneal injection of streptozotocin (STZ).Sixty diabetic rats were randomly divided into 3 groups,poor glycemic control group rats were maintained in poor glycemic control for 4 months;semi glycemic control group rats were maintained in poor glycemic control for 2 months,followed by good glycemic control for 2 additional months;good glycemic control group rats were maintained in good glycemic control for 4 months.Twenty normal rats served as control group.The mRNA expression of PGC-1α and superoxide dismutase 2 (SOD2) of retina were measured by real-time PCR;the expression of PGC-1α and manganese superoxide dismutase (MnSOD) protein were measured by Western blot;the situation of DNA methylation in the promotor region of PPARGC1A was measured by bisulfite sequencing.Results The body-weight in the control group was significantly higher than that in the poor glycemic control group,semi glycemic control group and good glycemic control group (all at P =0.000).The blood glucose value in the poor glycemic control group was significantly higher than that in the control group (P =0.000).The expression levels of PGC-1 α mRNA were significantly lower and the expression levels of SOD2 mRNA were significantly higher in the good glycemic control group,semi glycemic control group and poor glycemic control group than those in the control group (all at P＜0.05).The expression levels of PGC-1α and SOD2 mRNA were significantly different between the good glycemic control group and poor glycemic control group (both at P＜0.05).Compared with the control group,the expression levels of PGC-1α and MnSOD protein were decreased in the diabetic model groups,with significant differences between them (all at P＜0.05).The expression level of PGC-1 α protein was significantly higher in the good glycemic control group than that in the poor glycemic control group (P＜0.05).Diabetes increased DNA methylation in the promotor region of PPARGC1A gene of retina.The DNA methylation level was significantly higher in the poor glycemic control group and semi glycemic control group than that in the control group (P =0.008,0.031).No statistical difference was found between the poor glycemic control group and semi glycemic control group (P ＞ 0.05).Conclusions The expressions of PGC-1o mRNA and protein and MnSOD protein in the retina of STZ induced diabetic rats are decreased,the expression of SOD2 mRNA is increased,the expression changes have metabolic memory characteristics.Increased DNA methylation in the promotor region of PPARGC1A when exposed to high glucose may have a role in the regulation of PGC-1 α expression and metabolic memory.

Objective:To investigate the imaging features and surgical strategies of late-onset spinal deformity after myelomeningocele (MMC) repair.Methods:A total of 23 patients with late-onset spinal deformity after MMC repair from January 2006 to December 2019 were retrospectively analyzed, including 16 males and 7 females, aged 15.4±5.9 years (range, 6-28 years). All patients underwent MMC resection and repair in infancy (0-4 years). The complications of MMC, imaging characteristics of spinal deformity (Cobb angle of scoliosis, coronal balance, regional kyphosis), surgical methods, clinical outcomes and incidence of complications were analyzed. The Scoliosis Research Society-22 (SRS-22) score and Oswestry disability index (ODI) were used to evaluate the quality of life.Results:All patients were followed up for 2.4±0.8 years (range, 1-4 years). Among 23 patients, MMC occurred in the upper thoracic segment in 3 cases, thoracic segment in 1 case, thoracolumbar segment in 13 cases, and lumbosacral segment in 6 cases. 16 patients had scoliosis or kyphosis with the apex of the spine in the same segment as the MMC lesion. Among 13 patients with MMC located in thoracolumbar segment, 12 patients had scoliosis and 9 patients had kyphosis. Among 6 patients with MMC located in lumbosacral segment, 3 patients had pelvic tilt. Vertebral deformities included widening of pedicle space in 21 cases, enlargement of spinal canal in 19 cases, absence of spinous process in 17 cases, malsegmentation in 17 cases, and hemivertebra deformity in 9 cases. Intramedullary lesions included split cord in 6 cases and tethered cord in 9 cases. The overall implant density was 57.2%±17% (range, 16.6%-100%). At the last follow-up, the Cobb angle of scoliosis was 40.9°±19.1°, which was significantly smaller than 71.5°±28.2° before operation ( P<0.001). The local kyphosis angle was 26.7°±12.9°, which was significantly lower than that before operation (40.4°±21.5°), the difference was statistically significant ( P<0.001).The coronal balance was 16.1±13.6 mm, which was smaller than that before operation 28.5± 23.7 mm, the difference was statistically significant ( P<0.001). The total score of SRS-22 was 18.7±0.7, which was higher than that before operation 17.7±0.9, and the difference was statistically significant ( t=-9.74, P<0.001); ODI was 25.5%±6.2% after operation, which was significantly lower than that before operation (44.8%±10.1%), the difference was statistically significant ( t=13.66, P<0.001). Dural rupture occurred in 4 patients, including postoperative cerebrospinal fluid leakage in 2 cases; postoperative pleural effusion in 1 patient; and screw malposition in 2 patients. Three patients had broken rods and one had deep infection at final follow-up. Conclusion:About 70% of MMC patients who underwent resection and repair in early childhood developed late-onset spinal deformity in adulthood with the lesion at the parietal vertebrae. Posterior correction can obtain satisfactory clinical results. If the posterior element of the apical vertebral body is hypoplastic, the implant density can be increased by anterior vertebral screw, lamina hook fixation, and S 2 sacroiliac screw.

Objective:To investigate the clinical outcomes and complication of posterior surgery for Scheuermann kyphosis fusing to different distal fusion levels.Methods:From January 2012 to December 2017, a consecutive cohort of 34 patients who were treated with posterior spinal instrumented correction and satisfied the inclusion criteria were retrospectively reviewed, including 29 males and 5 females, aged 17.1±4.3 years (range, 12-30 years). All of the patients had a minimum follow-up of 2 years. According to the distal fusion level, patients were divided into 2 groups. Group sagittal stable vertebra (SSV) (22 cases) included patients whose lowest instrumented vertebra (LIV) was SSV; Group SSV-1 (12 cases) included patients who had a LIV one level above the SSV. Radiographic parameters including global kyphosis (GK), lumbar lordosis (LL), sagittal vertical axis (SVA), pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS) were measured in the standing radiographs before and after operation and at the latest follow up. Intraoperative and postoperative complications were recorded. The Scoliosis Research Society-22 questionnaire (SRS-22) were conducted at pre-operation and the final follow up to evaluate the clinical outcomes. The sagittal radiographic parameters and the incidence of distal junctional kyphosis (DJK) were compared between the two groups.Results:There were no significant differences in terms of age, sex, radiographic measurements and scores of SRS-22 between two groups preoperatively ( P>0.05). The correction rates of GK in the SSV group and the SSV-1 group were 42.8%±7.6% and 43.2%±8.4% ( t=0.151, P=0.881) respectively. While the correction rates loss were 1.2%±5.2% and 3.9%±7.2% ( t=0.767, P=0.449) at the latest follow up. No significant difference was observed in terms of other radiographic parameters ( P>0.05). During the postoperative follow up period, 3 patients (16.7%) in SSV group and 2 patients (13.6%) in SSV-1 group developed DJK. The incidence of DJK did not show any significant difference between two groups ( χ2=0.057, P=0.812). At the final follow-up, the function scores of SRS-22 in SSV-1 group (4.1±0.6) was significantly higher than SSV group (3.7±0.5) ( t=2.300, P=0.028) and there was no significant difference in the rest of the domain ( P>0.05). Conclusion:Compared with stopping at SSV, fusion to SSV-1 could achieve comparable curve correction with the preservation of more lumbar motility. Moreover, it would not increase the risk of DJK. As a result, we recommend selecting SSV-1 as the ideal LIV for SK patients.

Objective:To explore the effect of high-flow airway humidification on aspiration and residues in cases of dysphagia after a tracheotomy.Methods:Seventeen persons with dysphagia after a tracheotomy were asked to swallow 5ml of a thick liquid when their tracheal cannula was either connected to a high-flow airway humidification system or blocked, or the cuff was empty or full. Endoscopic evaluation was then used to grade the residue and aspiration in the different conditions.Results:There were significant differences in the residuals grading and aspiration among the four conditions. The average penetration-aspiration scale grade was significantly lower when the subject was connected to high-flow airway humidification than in the other three conditions. The grade of residuals was also significantly lower.Conclusion:High-flow airway humidification can effectively improve the swallowing of persons with dysphagia after a tracheotomy.

Objective:To explore the value of flexible endoscopic evaluation of swallowing (FEES) in guiding the decannulation of neurological disease patients with dysphagia after a tracheotomy.Methods:The FEES results of 188 neurological disease patients with dysphagia who had undergone a tracheotomy were analyzed retrospectively. The utility of FEES evaluation indexes (including glottis activity, the classification of pharyngeal secretions and residues as well as penetration-aspiration grade) for predicting the success of decannulation was explored.Results:One hundred and nine of the patients (the success group) were decannulated successfully and 79 (the failure group) were not, a success rate of 57%. The abnormal glottis activity rate among the failure group was 55%, significantly higher than among the success group (21%). The pharyngeal secretion classifications and penetration-aspiration grades among the success group were also significantly lower than among the failure group, on average. The average course of recovery from the tracheotomy was 184 days in the success group, significantly shorter than that of the failure group (292 days). No significant differences in residues were observed.Conclusion:The glottis activity, secretions and intake aspiration evaluated using FEES are of great value for guiding the decannulation of neurological disease patients with dysphagia after a tracheotomy.

Objective:To investigate how pelvic incidence (PI) would change during the follow-up in degenerative scoliosis (DS) patients who underwent second sacralalar-iliac (S 2AI) fixation and identify the possible factors associated with the changes in PI. Methods:The DS patients who underwent long fusion to pelvis with S 2AI fixation with a minimum follow-up of two years between November 2014 to January 2017 were retrospectively reviewed in this study. The following sagittal radiographic parameters were measured, including pelvic incidence (PI), lumbar lordosis (LL), pelvic tilt (PT), PI minus LL (PI-LL), and sagittal vertical axis (SVA) at pre-operation, post-operation and 2-year follow-up. Patients were divided into two groups at immediate post-operation: PI decreased less than 5° or increased (Group PI stabilization); PI decreased larger than 5° (Group PI activity). Descriptive statistics were calculated for all patients in the form of mean value and standard deviation (SD). Comparisons of means between variables were performed using an unpaired Student's t test. Pearson correlation coefficienttest was performed to determine the correlations between all radiographic variables. Inter- and intra-observer reliability was assessed using intraclass correlation coefficient (ICC). The internal consistency of the measurements was characterized as excellent ( ICC≥0.9), good (0.7≤ ICC<0.9), acceptable (0.6< ICC≤0.7), poor (0.5≤ ICC<0.6), or unpredictable ( ICC<0.5). Results:There were no significant differences in terms of age, sex, radiographic measurements and scores of SRS-22 between twogroups preoperatively ( P>0.05). 80 DS patients with a mean age of 55.3±16.2 years were enrolled in this study with a mean follow-up period of 34.6±8.7 months. At post-operation, 39 patients (38.8%) were in group PI stabilization whose PI decreased from 45.7°±11.4° to 45.3°±11.2° with no significant difference; while the other 41 (61.2%) were in group PI activity whose PI significantly decreased from 51.6°±14.5° to 40.9°±14.0°. At the last follow-up, 24 patients (49%) in group PI activity had PI returned with an increase of larger than 5°; while the other 25 (51%) showed no increase with a mean ΔPI change of -4.2°. Subgroup comparison revealed that ΔPI, post-operation PI, post-operation PT and age were significantly different between the two subgroups. Pre-operation PI, post-operation PI, post-operation PT, post-operation PI-LL were significantly correlated with ΔPI at the last follow-up. Logistic regression analysis showed that post-operation PI was the associated factor ( OR=0.87, P=0.024). Conclusion:PI decreased in more than half of DS patients after spinal surgery using S 2AI screws, while returned among 48% of them during 2-year follow-up. Lower pre-operation PI, post-operation PI and PT were strongly associated with the return of PI.