Thyroid-stimulating hormone receptor(TSHR)is an important autoantigen whose cleavage and shedding can induce autoimmunity.The TSHR is the main functional receptor of the thyroid.The shedding of the ? subunit plays an important role in the forming of TSAb and balancing between TSAb and TBAb.Research on the cleavage and shedding of the TSHR extracellualar domain helps to gain a deep insight into the structure and function of TSHR,illuminate the pathogenesis of autoimmune thyroid disease and find out a new therapy.The structure of TSHR,the mechanism and the significance of its cleavage and shedding are reviewed in this article.

Objective To explore the effects of oxidative stress in porcine iliac endothelial cells(PIECs) induced by high glucose. Methods After being intervened by high glucose for some time, dihydroethidium (DHE) or dihydrorhodamine 123 (DHR123) was used as a reactive oxygen species(ROS) capture. The mean fluorescent intensity(MFI) of above probes which were the products of intracellular oxidation was detected by fluorescent microscopy and flow cytometry, and the level of ROS was thus measured. With lucigenin as chemiluminescence agent, luminescence changes were detected by chemiluminescence analyzer after addition of NADPH to observe the effect of high glucose on activity of NADPH oxidase(NOX). Results Intracellular MFI was markedly elevated with the concentration of high glucose and time of exposure to high glucose. It was revealed by flow cytometry that the NOX activity was significantly activated compared with normal medium treated PIECs(P

Objective To investigate the clinical characteristics,pathogen distribution and outcome of lower respiratory tract fungal infection in patients with mechanical ventilation in emergency intensive care unit(EICU). Methods The clinical data of patients with lower respiratory tract fungal infection treated with mechanical ventilation in EICU were retrospectively analysed. Results Eighty(64.5%) of the 124 patients with mechanical ventilation experienced lower respiratory tract infection,among whom 21(26.2%) were complicated with fungal infection.The predominant pathogen was Candida(Candida albicans,n=11;Candida tropicalis,n=5;Candida smooth,n=3;Candida parapsilosis,n=2).Compared with patients with non-fungal infection(n=59),those with fungal infection(n=21) had higher APACHE II score,longer mechanical ventilation time and longer ICU stay duration(P

Objective To explore the effect of advanced glycation end products(AGEs) on the oxidative stress in porcine vascular endothelial cells(PIECs). Methods After being intervened by AGEs for some time,cell viability was detected by MTT.2′,7′-dichlorofluorescein diacetate(DCFH-DA) was used as a reactive oxygen species(ROS) capture agent.The fluorescent intensity of 2′,7′-dichlorofluorescein(DCF),which was the product of cellular oxidation of DCFH-DA,was detected by flow cytometry,and the level of ROS was thus measured. Results Viability of PIECs was inhibited by AGEs in a dose-and time-dependent fashion(P

Antimony ; adverse effects ; Dust ; Humans ; Lung ; pathology ; Male ; Middle Aged ; Occupational Exposure ; adverse effects ; Pneumoconiosis ; diagnosis ; pathology

Objective To explore the effects of high glucose on oxidative stress of human peritoneal mesothelial cells(HPMCs).Methods HPMCs were cultured in vitro and identified by immunohistochemistry, and cells of second generation were selected. After HPMCs were treated by glucose with different concentrations for some time, MTT method was employed to detect the cell viability. 2’,7’-dichlorofluorescein diacetate (DCFH-DA) was used as a reactive oxygen species (ROS) capture. The cell viability of HPMCs and ROS level were analysed after being intervened by glucose with different concentrations and for different time. Results Viability of HPMCs was significantly inhibited in a dose-and time-dependent manner by high glucose(P

Objective To compare the clinical efficacy and angiographic outcomes of balloon dilation angioplasty,balloon-expandable stent implantation and self-expanding stent implantation in the treatment of intracranial arterial stenosis.Methods The patients with intracranial arterial stenosis who met the indications of surgical intervention treated with balloon dilatation angioplasty and stent placement were selected from Nanjing Stroke Registry Program.According to the different interventional procedures,the patients were divided into the balloon expandable stenting goup,the self-expanding stents group and the balloon dilatation angioplasty group.The success rate of surgery,the perioperative complication rate and the significant residual stenosis rate were compared among the three groups.The clinical and angiographic assessments were performed through 1-,3-,6-,12- and 24-month regular outpatient or inpatient follow-up after procedure.The incidences of ischemic stroke and/or death and restenosis within 2 years were compared.Multivariate Cox proportional hazards analysis was used to analyze the risk factors for recurrent ischemic stroke and/or death and restenosis.Results A total of 183 patients with 192 stenoses performed balloon dilatation angioplasty or stenting,in which 92 were in the balloon expandable stenting goup,42 were in the self-expanding stents goup and 49 in the balloon dilatation angioplasty group.Their preoperative stenosis rates were 80.2 ±12.8％ 、76.3 ± 11.9％ and 89.7 ± 10.2％,respectively (F =15.863,P =0.000).There were no significant differences in other baseline data.The success rates of surgery in the balloon expandable stenting group,self-expanding stents group and balloon dilatation angioplasty group were 96.7％,95.2％ and 91.8％,respectively (x2 =1.646,P =0.439).The perioperative complication rates were 6.5％,14.3％ and 10.2％,respectively (Fisher exact test,P=0.334).The imaging follow-up showed that the restenosis rate in the balloon dilatation angioplasty group was 48.5％.Although it was high than 27.7％ in the balloon expandable stenting group and 34.8％ in the self-expanding stents group,there were no significant differences (x2 =4.176,P =0.124).Multivariate Cox proportional hazards analysis showed that balloon dilatation angioplasty was an independent risk factor for restenosis after procedure (hazard ratio 2.490,95％ confidence interval 1.247- 4.969,P=0.010).Conclusions Compared to the balloon expandable stenting,the balloon dilatation angioplasty is more likely to have restenosis,but it is not associated with the risks of postoperative recurrent ischemic stroke and/or death.

ObjectiveTo analyze the clinical characteristics and treatment of severe acute respiratory syndrome (SARS).MethodsDuring epidemic period of SARS,all suspected patients were isolated and treated at very early stage. Clinical symptoms, signs and changes of the chest film were observed carefully to make early diagnosis and begin early intervention. 14 SARS cases with definite diagnosis were treated by Western Medicine combined with Chinese Traditional Medicine.3 cases of them with severe type were treated by timely technical ventilation,which was nasotracheal intubition guided with fibronchoscope,with the principle of low tide volume and high PEEP to improve oxygen combination.ResultsAll patients were cured to discharge. Only two cases of mild pulmonary fibrosis were found after 2 months' follow-up. None of the medical workers taking part in rescuing and treating SARS patients and none of the family members of the patients were infected.ConclusionDuring SARS epidemic period,early isolation,early diagnosis,early combined treatment of Western Medicine and Chinese Traditional Medicine,and prompt technical ventilation intervention on severe cases are important factors to successfully rescue and treat SARS patients.

OBJECTIVETo observe the effects of long-term and low-dose hormone replacement therapy on bone mineral density (BMD), and the incidence of bone pain in postmenopausal women.

METHODSTotally 141 postmenopausal women were selected from the medical staff of the Peking Union Medical College Hospital. Of them, 63 women treated with low-dose sex hormone for over 5 (5-32) years were divided into hormone replacement therapy (HRT) group, and 78 never receiving HRT were divided into control group. The BMD was measured by dual energy X-ray absorptiometry (DEXA) at lumbar spine, Ward's triangle, femoral neck, trochanter, and total hip, and the incidence of bone pain was inquired.

RESULTSThe BMD in the HRT group was 9.1% higher than that in the control group (P < 0.05). The incidence of bone pain was significantly lower in the HRT group (71.4%) than that in the control group (89.7%).

CONCLUSIONLong-term and low-dose hormone replacement therapy can reduce bone loss and the incidence of bone pain.

Absorptiometry, Photon ; Bone Density ; Estrogens ; administration & dosage ; Female ; Hormone Replacement Therapy ; Humans ; Middle Aged ; Osteoporosis, Postmenopausal ; prevention & control ; Progesterone ; administration & dosage

OBJECTIVEAccording to the information obtained from the revision of total hip arthroplasty, the situations of the artificial femoral stem under physiological stress were analyzed preliminarily. In order to accumulate clinical experience, the discussions about how to enlongate the life of artifical joints were performed.

METHODSFifty-three patients required revision operations were selected, including 28 males and 25 females,with an average age of 74.66 years old (61 to 84 years old). The average life of artificial joints was 18.24 years (3 to 27 years). The initial weightbearing was started 11 days (5 to 16 days) after the first operation. The main reasons for the revision were the spontaneous loosening and trauma. Based on imaging and surgical findings, as well as the histological pathology, the situations of the stems in human bodies were determined.

RESULTSFemoral prosthesis would sink under physiological stress. The design of femoral stems, motion of patients', and bone growth determined the secondary stability. Straight stems were helpful for physiological subsidence of prosthesis, achieving the stability with close bone-implant contact by bone growth,which allowed the patient to do early landing exercise. The collared prosthesis and prosthesis combined with internal fixation limited the subsidence of femoral stems. Their stability depends on the time of initial placement and the bone growth for supporting. Delaying the inital weightbearing was suggested for patients with these protheses.

CONCLUSIONAccording to the actual situation of the patients, the appropriate chosen of femoral stems and time to perform the weightbearing can extend the life of the femoral prosthesis.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; adverse effects ; methods ; Female ; Hip Prosthesis ; Humans ; Male ; Middle Aged ; Prosthesis Design