BACKGROUND:Rheumatoid arthritis is a complex autoimmune disease characterized by joint swelling,pain,and progressive damage.The basic pathological changes include synovitis and pannus formation,with T lymphocyte infiltration being the key to its pathogenesis.In recent years,the application of traditional Chinese medicine(TCM)monomers in the treatment of rheumatoid arthritis has attracted increasing attention.They have shown long-lasting effcacy and fewer side effects by regulating the T helper cell 17(Th17)/regulatory T cells(Treg)balance in the treatment of rheumatoid arthritis.OBJECTIVE:To discuss the mechanisms by which TCM monomers regulate the Th17/Treg balance to treat rheumatoid arthritis,based on the latest basic research,providing a solid theoretical basis for future applications of TCM in the treatment of rheumatoid arthritis.METHODS:Using keywords such as"rheumatoid arthritis,Th17/Treg,traditional Chinese medicine,Chinese herbal monomer,"and their Chinese equivalents,literature searches were conducted in PubMed,Web of Science,Embase,Cochrane,VIP,CBM,CNKI,and WanFang databases for relevant studies from their inception to August 2024.Inclusion and exclusion criteria were established,and the articles were screened by reading the titles,abstracts,and full texts.Finally,57 relevant articles were included.RESULTS AND CONCLUSION:(1)TCM monomers have immunoregulatory effects in the treatment of rheumatoid arthritis.They exert therapeutic effects by maintaining the Th17/Treg balance through the regulation of transcription factors,cytokines,signaling pathways,and miRNAs.(2)There may be synergistic effects among some TCM monomers,but the specific mechanisms and enhancement effects in regulating the Th17/Treg balance require further exploration.(3)Regulating the Th17/Treg balance using TCM monomers may become a key clinical therapy for the treatment of rheumatoid arthritis.

BACKGROUND:Rheumatoid arthritis is a complex autoimmune disease characterized by joint swelling,pain,and progressive damage.The basic pathological changes include synovitis and pannus formation,with T lymphocyte infiltration being the key to its pathogenesis.In recent years,the application of traditional Chinese medicine(TCM)monomers in the treatment of rheumatoid arthritis has attracted increasing attention.They have shown long-lasting effcacy and fewer side effects by regulating the T helper cell 17(Th17)/regulatory T cells(Treg)balance in the treatment of rheumatoid arthritis.OBJECTIVE:To discuss the mechanisms by which TCM monomers regulate the Th17/Treg balance to treat rheumatoid arthritis,based on the latest basic research,providing a solid theoretical basis for future applications of TCM in the treatment of rheumatoid arthritis.METHODS:Using keywords such as"rheumatoid arthritis,Th17/Treg,traditional Chinese medicine,Chinese herbal monomer,"and their Chinese equivalents,literature searches were conducted in PubMed,Web of Science,Embase,Cochrane,VIP,CBM,CNKI,and WanFang databases for relevant studies from their inception to August 2024.Inclusion and exclusion criteria were established,and the articles were screened by reading the titles,abstracts,and full texts.Finally,57 relevant articles were included.RESULTS AND CONCLUSION:(1)TCM monomers have immunoregulatory effects in the treatment of rheumatoid arthritis.They exert therapeutic effects by maintaining the Th17/Treg balance through the regulation of transcription factors,cytokines,signaling pathways,and miRNAs.(2)There may be synergistic effects among some TCM monomers,but the specific mechanisms and enhancement effects in regulating the Th17/Treg balance require further exploration.(3)Regulating the Th17/Treg balance using TCM monomers may become a key clinical therapy for the treatment of rheumatoid arthritis.

Objective To explore the diagnostic value of the quantitative detection of plasma miRNA-125b and miRNA-133b in children with asthma.Methods Thirty asthmatic patients were enrolled in this study and collected the blood specimens during acute phase and stable phase respectively (AP group and SP group).Thirty allergic rhinitis children (AR group) and thirty healthy children were recruited to the control group (NC group).The levels of miRNA in different groups were detected by qRT-PCR.The performance of miRNA-125b and miRNA-133b were evaluated by receiver operating characteristic curves (ROC) and the area under the curve (AUC) (95％CI).Results The relative expression of miRNA-125b in AP group and SP group were significantly higher than A R group (t=3.913,3.120,P＜0.01),miRNA-133b.In AP group and AR group the expression of miRNA-133b were significantly higher than control group (t=4.426,4.720,P＜0.01).The detection of miRNA-125b yielded an area under the curve of ROC of 0.7989,(95 ％ CI:0.7111～ 0.8864) in discriminating asthmatic patients from healthy group.And the miRNA-133b was 0.7274 (95％CI:0.586 5～0.863 0) in discriminating asthmatic patients during the acute phase from healthy group.Conclusion The relative expression of miRNA-125b in children with asthma was significantly higher than that in AR group and NC group,miRNA-125b may prove to be a non-invasive biomarker for the auxiliary diagnosis of asthma especially when the relative expression up to 1.998.

Objective To analyze the morbidity rate and clinical etiology distribution of secondary thrombocytosis(ST ) in chil‐dren in order to guide the clinical treatment .Methods The clinical data of 170 children patients with ST in hospitals were retro‐spectively analyzed for investigating its etiology distribution ,total morbidity and onset situation in different age periods . Results The primary etiologies of ST mainly included the infectious diseases(especially respiratory tract) ,anemia ,immune disea‐ses ,drugs ,surgical disease ,etc .Thrombocytosis caused by neonatal diseases also were common .The total morbidity rates of ST in children was about 3 .37% and which in newborns ,infants and children aged over 3 years were 2 .48% ,3 .78% and 1 .99% respec‐tively ,the difference was statistically significant(P<0 .5) .Conclusion ST is one of the common complications in children ,especial‐ly in children aged under 3 years old .The etiology of ST is various ,which are dominated by respiratory and digestive tract infec‐tions .Children aged under 3 years old ,especially infants and young children with respiratory tract infection are easier to suffer from complicating thrombocytosis .

Objective To explore the diagnostic value of the quantitative detection of miRNA-145 and miRNA-143 in the ser-um of children with Kawasaki disease (KD).Methods In this study,45 KD cases were enrolled and were divided into 19 ca-ses with coronary artery lesions (CAL group)and 26 cases without coronary artery lesions (NCAL group).Thirty healthy children were recruited as the control group (NC group).qRT-PCR was conducted to detect the expression of miRNA-145 and miRNA-143 in serum of each group.The diagnostic value of miRNA-145 and miRNA-143 were evaluated by receiver op-erating characteristic curves (ROC)and the area under the curve (AUC)(95%CI).Results The relative expressions of miRNA-145 and miRNA-143 in the serum of the CAL group in acute phase were 2.33±1.26 and 1.64±0.50,which were respectively higher than the control group,with statistically significant difference (t=5.108,5.072,P<0.01).The relative expression of miRNA-145 during the recovery phase of CAL group was 1.55±0.49,which was statistically significant high-er than NC group (t=3.837,P<0.01).While the relative expression of miRNA-143 during the recovery phase of CAL group was 1.17±0.33 and had no difference with NC group (t=1.033,P>0.05).During the acute phase of NCAL group, the relative expressions of miRNA-145 and miRNA-143 were 2.02±1.00 and 1.63±0.50 respectively.They were signifi-cantly higher than the control group (t=4.746,5.261,P<0.01).However,when comes to the recovery phase,the relative expression of miRNA-145 and miRNA-143 were 1.07±0.18 and 1.12±0.16,which had no difference with NC group (t=0.264 9,0.584 9,P>0.05).The critical value of miRNA-145 for diagnosis of KD was 1.697 with sensitivity of 64.44% and specificity of 90% and yielded an area under the curve of ROC of 0.7733 (95%CI:0.667 0~0.879 7).Also,the critical val-ue of miRNA-143 was 1.361 with sensitivity of 64.44% and specificity of 86.67% and yielded an area under the curve of ROC of 0.8163 (95%CI:0.722 5~0.910 0)in discriminating KD from healthy group.Conclusion miRNA-145 and miR-NA-143 may prove to be a non-invasive biomarker for the auxiliary diagnosis of KD.

Objective To explore the clinical application value of the detection of sIgE and sIgG4 in children with allergic asthma and allergic rhinitis .Methods The levels of sIgE and sIgG4 of allergic asthma group (n=85) ,allergic rhinitis group (n=72) and control group (n=60) were respectively detected by ELISA .The diagnostic efficiency of sIgE and sIgG4 were analyzed by using ROC curve .Results Before treatment ,the serum levels of sIgE and sIgG4 of allergic asthma group and allergic rhinitis group were remarkably higher than those of control group (P< 0 .01) .After 6 -month treatment ,the serum sIgE levels of allergic asthma group and allergic rhinitis group significantly decreased ,and the serum sIgG4 levels significantly increased (P< 0 .01) .For the combined detection of sIgE and sIgG4 ,the diagnostic sensitivities of allergic asthma and allergic rhinitis were 90 .6% (77/85) and 84 .7% (61/72) respectively ,and the diagnostic specificities of allergic asthma and allergic rhinitis were 81 .2% (69/85) and 76 .4%(55/72) respectively .Conclusion The serum sIgE and sIgG4 are good indicators for the diagnosis of allergic diseases .

Objective To explore the role of chemokine CCL18 in the occurrence and development of children allergic diseases. Methods The serum levels of CCL18 in 87 children cases of allergic asthma,64 cases of allergic rhinitis,46 cases of allergic con-junctivitis and contemporaneous 50 health students with physical examination as the control group were measured by ELISA and re-measured after 6-month treatment.The detection results were statistically analyzed with combining the clinical related detection data by adopting SPSS18.0 statistical software and t-test.Results The serum levels of CCL18 in the children allergic asthma,allergic rhinitis and allergic conjunctivitis groups were remarkably higher than those in the control group with statistical differences(P <0.05);the levels of CCL18 in the severe groups were remarkably higher than those in the mild and moderate groups with statistical difference(P <0.05);the levels of CCL18 after 6-month treatment in 3 groups were significantly decreased compared with before treatment with statistical difference(P <0.05).Conclusion The serum level of CCL18 is significantly associated with the severity of illness and significantly decreased after treatment,which indicating that the CCL18 detection has the important value in the diag-nosis,severity evaluation and treatment effect monitoring of children allergic diseases.