Necroptosis, a form of programmed cell death, initiates a series of biological responses and further culminates in necroinflammatory processes, consequently limiting the efficacy of cytokine antagonists in treating inflammatory diseases. To address this issue, DNAzyme R3-Dz specifically targeting receptor-interacting protein kinase 3 (RIP3) mRNA, a necrosome component, has been successfully developed and studied to elucidate the mechanism in cleaving its target mRNA. Then a polyamidoamine (PAMAM) derivative was constructed through the modification of nucleobase analog (termed AP) to achieve the R3-Dz delivery to macrophages. The AP/R3-Dz nanoparticles effectively downregulated the RIP3 expression, leading to subsequent decrease in the levels of reactive oxygen species (ROS) and damage-associated molecular patterns (DAMPs), ultimately inhibiting the necroinflammatory processes mediated by the NOD-like receptor family pyrin domain-containing 3 (NLRP3). Finally, AP/R3-Dz nanoparticles and their combination with the NLRP3 inhibitor MCC950 suppressed the necrotic phenotype and ameliorated the disease progression in diverse models, including gouty arthritis, autoimmune hepatitis and rheumatoid arthritis. In summary, the AP/R3-Dz nanoparticles in combination with MCC950 have been demonstrated to achieve the intervention in necroptosis and inflammation by dual disruption of the intricate feedback loop of necroinflammation and thus have promising potential in the treatment of inflammatory diseases.

Objective To explore the clinical features, diagnosis and treatment of chronic diarrhea with primary systemic amyloidosis (AL). Methods The clinical experience of an AL patient with chronic diarrhea who was admitted to chinese PLA General Hospital in November 2017 was presented, and the related literature was reviewed. Results The patient was definitely diagnosed as AL with chronic diarrhea onset;after treatment with VCD regimen, the condition was improved obviously and achieved complete remission. Conclusion AL patient with chronic diarrhea onset needs to undergo various detections to make a clear diagnosis and differential diagnosis, and the bortezomib-based treatment scheme can achieve good curative effect.

Objective To investigate the indications,techniques and effects in surgical treatment of stale acetabular comminuted fractures.Methods A retrospective review was made on 24 cases (24 hips) of obsolete acetabular fractures undergone delayed reconstruction due to the combined injuries in other organs from October 2003 to June 2010.There were 18 males and 6 females,at 22-68 years of age [mean (42.2 ± 10.5) years].Mean time from injury to operation was (4.6 ± 1.3) weeks (range,3-6 weeks).According to Letournel classification,there were 11 simple fractures including six posterior wall fractures,one anterior wall fracture,one posterior column fracture,one anterior wall fracture and two transverse fractures and 13 compound fractures including six posterior column with posterior wall fractures,two transverse with posterior wall fractures,one T-shape fracture,two posterior semitransverse fractures and two both-column fractures.Surgery was performed via ilioinguinal approach in two cases,posterior acetabular approach in 13 and the combined approaches in nine.Results All 24 cases were available to average (15.6 ± 10.5) months of follow-up (range,10-36 months).Quality of reduction based on Matta standard was anatomic in 21 cases,unsatisfactory in two and poor in one.Clinical results evaluated using modified d' Aubigne-Postel score were excellent in 21 cases,good in two and poor in one.There were one femoral head necrosis,11 heterotopic ossification and six sciatic nerve transient palsy after operation.Conclusion Delayed open reduction and internal fixation is effective in treatment of obsolete acetabular comminuted fractures.

Objective To retrospectively evaluate the incidence and treatment of fungous infection compli-cations after hematopoietic stem cell transplantation. Methods The incidence, pathogenic microorganism, prophy-laxis,treatments of infectious complications in 150 patients, who accepted hematopoietic stem cell transplantation from September 1990 to Martch 2000 in our hospital were analyzed. Results The incidence of infectious complica-tions was 89.3% (134/150) in all 150 cases. Three patients (2%) died of the fungal infection. The incidence of the fungal infections was 32.5% (26/80) in patients who accepted treatment with impenem or/and ceftazidine, and 15.7% (11/70) in other patients without the above treatment (P<0.05). 12 fungal infection cases were treated with small-dosage of amphotericin B(10 mg/d) ,with the healing rate was 100%. Conclusion The strong antibac-terial prophylaxis can't reduce the incidence of infection ,but may increase the risk of fungal infection;small-dosage of amphotericin B is a new effective way to treat fungal infection.

Objective To compare the effects of bipolar femor al head replacement (BFHR) and total hip replacement (THR) in the treatment of femoral neck fractures (FNF) in the elderly. Methods Between August 1993 and December 2001, BFHR or THR were performed in 48 old patients (at age of 60-85 years, mean 70.8 years) with subcapital and transcervical types of FNF. Of all, 18 cases were tre ated with BFHR (Group BFHR) and 30 with THR (Group THR). Results OF all, two patients died (not related to operation), one received no f ollow up and 45 were followed up for average 5 years and 2 months with no wound infection or hip dislocation. Occurrence rate of hip and thigh pains in the Grou p THR was 3% (1/29), lower than that in the Group BFHR (4/16). Conclus ions BFHR is only fit for senile cases with poor physical con dition. However, THR can be used for most old patients with FNF.

OBJECTIVE To evaluate retrospectively the incidence and treatment of infectious complications within the first 60 days after hematopoietic stem cell transplantation,and to find more efficient anti-infective regimens. METHODS To study the incidence,pathogenic microorganism,prophylaxis,treatments of infectious complications in 150 patients accepted hematopoietic stem cell transplantation from April 1984 to March 1998 in our hospital.The results were analyzed statistically.RESULTS Incidence of infectious complications was 89.3% in all 150 cases.Three patients(2%) died of the fungal infection.The incidence of the infections was 32.5% in patients accepted treatment with imipenem or／and ceftazidine,and 15.7% in other patients without the treatment with imipenem or／and ceftazidine(P＜0.02).CONCLUSIONS The strong antibacterial prophylaxis can′t reduce the incidence of infection,and may increase the chance of fungal infection.