Aim To study the effect of Tongxinluo on the polarization of macrophages to type M2 and M1, and on Notch signaling pathway.Methods THP-1 was respectively induced by PMA and IL-4 or LPS to M2 and M1 type polarized macrophages, and treated by Tongxinluo.The expressions of marker molecules IL-10, TNF-α, IL-6 and protein of Notch signaling pathway were detected.Results The level of IL-10 increased in M2 group and there was no statistical difference on the level of IL-6 and TNF-α;the level of IL-10 decreased and IL-6, TNF-α increased in M1 group;the level of IL-10 increased and IL-6,TNF-α decreased in TXL group.There was no statistical difference in the expression of active Notch-1, DLL4 and Hes-1 between control group and M2 group;the expression of active Notch-1, DLL4 and HES-1 increased significantly in M1 group;the expression of active Notch-1, DLL4 and HES-1 decreased significantly in TXL group;there was no significant difference in the expression of Notch-1 protein in each group.Conclusion The polarization of macrophages to M1 type can be inhibited by Tongxinluo, and its mechanism may be related to the inhibition of activation of Notch-1 signaling pathway.

Objective To evaluate the efficacy and safety of recombinant human endostatin (rh-endostatin) combined with cis-platinum for patients with malignant pleural effusions.Methods A computer-based online search was performed through Elsevier, PubMed, Medline, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese BioMedical Literature Database and Wanfang Database.According to the inclusion and exclusion criteria, the randomized controlled trials about short-term therapeutic effect of rh-endostatin combined with cis-platinum on malignant pleural effusions published until December 2015 were selected.Quality of the studies was assessed using modified Jadad scale.After data extraction, a Meta-analysis was performed by RevMan 5.3 software.Relative risk (RR) and its 95% confidence interval (CI) were calculated.The Egger test was performed by Stata 12.0 software.Results Fourteen eligible randomized controlled trials were included in this Meta-analysis involving 1 330 patients,665 in cis-platinum alone group(control group), and 665 in rh-endostatin combined with cis-platinum group(treatment group).The results showed that there were significant improvements in overall response rate (ORR) [73.53% vs 45.41%,RR=1.62,95%CI(1.47,1.78),P<0.000 01] and the rate of quality of life improvement [71.65% vs 46.94%,RR=1.52,95%CI(1.38,1.68),P<0.000 01] in the treatment group, as compared with those of the control group.Meanwhile, there were no statistically significant differences in the rate of cardio toxicity [10.38% vs 5.77%,RR=1.73,95%CI(0.99,3.03),P=0.06].Conclusion This Meta-analysis indicated that in comparison with cis-platinum alone, rh-endostatin combined with cis-platinum has a better therapeutic effect on malignant pleural effusions.

Objective To evaluate the efficacy of etanercept in active ankylosing spondylitis (AS) pa-tient for 48 weeks by tapering the dosage of etanercept every 12 weeks. Methods 52 patients with active AS were enrolled in this study , and 47 patients finished 48 Weeks of observation. 50 mg etanercept was applied subcutaneously once a week for 12 weeks , and was tapered to 50 mg every two weeks for another 12 weeks , and then 25 mg every two weeks for another 24 weeks. BASDAI, BASFI, BASMI, ASDAS, as well as Serum levels of CRP and ESR were doaunented at week 0, 12, 24 and 48, respectively. Result Among the 47 active AS patients, 40 (85.1%) were male, with mean disease duration of 4.1 ± 3.8 years. After 12 -week treatment with 50 mg etanercept weekly, the scores of BASDAI, BASFI, BASMI, ASDAS, as well as levels of ESR and CRP, declined significantly compared to the baseline (P < 0.05, respectively). Despite of tapering the dosage of etan-ercept gradually, most of the patients (87.2%, 41/47) kept in ASAS 40 response during the following 36 weeks. No severe adverse events were observed during the treatment period. Conclusion This study demonstrat-ed the clinical efficacy of etanercept in patients with active AS. A dosage reduction strategy could maintain the clinical efficacy of etanercept during 48 weeks , which indicates that gradually tapering etanercept might be a po-tential effective, economic and safe way for active AS patients.

Objective To analyze the influence of anticoagulants on platelet count .Methods A total of 5 patients with decreased platelet level ,detected by using haemocyte analyzer and samples anticoagulated by ethylene diamine tetraacetic acid dipotassium (EDTA‐K2 ) ,were enrolled ,and EDTA‐K2 ,sodium citrate ,heparin lithium ,sodium fluoride anticoagulated venous blood samples and fingers peripheral blood samples were collected and detected for platelet by using haemocyte analyzer and microscopic detection . Wright‐Giemsa′s stained cell smears were prepared and observed by using microscope .Results Platelet levels of anticoagulated samples ,detected by haemocyte analyzer and microscopic detection were obviously decreased ,and with large platelet aggregation ob‐served under microscope .Platelet levels of finger peripheral blood samples detected by haemocyte analyzer and microscopic detection were normal ,and without platelet aggregation observed under microscope .Conclusion Various anticoagulants could cause pseudo‐thrombocytopenia ,and fingers peripheral blood samples ,without anticoagulants ,should be used for platelet count to obtain accurate results .

Objective To investigate the genotype and allele frequencies of osteopontin gene single nucleotide polymorphisms (SNP) rs11728697and rs9138 in Zhuang populations in Guangxi ,and to compare the distribution of osteopontin polymorphisms a‐mong different races .Methods The osteopontin gene rs11728697 and rs9138 polymorphisms were detected by SNaPshot SNP gen‐otyping technique in 150 Zhuang populations in Guangxi ,the genotype and allele frequencies of osteopontin gene rs 11728697 and rs9138 polymorphisms were analyzed in Zhuang populations compared with the other four populations (HapMap‐CEU ,HapMap‐YRI ,HapMap‐JPT ,HapMap‐HCB) from HapMap database .Results The most common genotype and allele of osteopontin gene rs11728697 polymorphism in Zhuang populations in Guangxi were CC(42 .7% ) and C(62 .7% ) ,and the most common genotype and allele of osteopontin gene rs9138 polymorphism were CA (51 .3% ) and C(63 .0% ) .There were no significant differences in the gen‐otype and allele frequencies of osteopontin gene rs11728697 and rs9138 polymorphisms between male and female groups ( P >0 .05) .The genotype and allele frequencies of osteopontin gene rs11728697 polymorphism were significantly differenct compared with HapMap‐CEU ,HapMap‐JPT and HapMap‐YRI(P< 0 .05) ,but were not significantly different compared with HapMap‐HCB (P> 0 .05) .The genotype and allele frequencies of osteopontin gene rs9138 polymorphism were significantly differenct compared with HapMap‐CEU and HapMap‐YRI(P < 0 .05) ,but had no significantly different compared with HapMap‐JPT and HapMap‐HCB(P> 0 .05) .Conclusion There are significant differences in the genotype and allele frequencies of osteopontin gene rs 11728697 and rs9138 polymorphisms between Zhuang populations and other ethnic populations ,and this variation might contribute for a varie‐ty of clinical manifestation and morbidity of some osteopontin related diseases .

Objective To investigate non-invasive and safe methods for positioning and assessing the functional areas of epilepsy patients secondary to cerebral hemisphere atrophy to reduce postoperative dysfunction.Methods Eight epilepsy patients with cerebral hemisphere atrophy,admitted to our hospital from March 2006 to April 2009,were chosen in our study; magnetoencephalography (MEG) and magnetic resonance diffusion tensor imaging (DTI) were combined to locate the functional areas and assess the functional compensation of these patients.Different surgical methods were adopted according to different results of the patients.All patients were followed up for 12-46 months,averaged 21.6 months.Results MEG could clearly position the cortical sensory,motor,language and visual functional areas of 5 patients,and the other 3 could only be conformed functional areas without clear boundary resulting from their bad cooperation.DTI successfully showed the shape of functional area cortical fibers,which helped the surgery in deciding the extent of resection.Modified hemispherectomy was performed in two patients,multi-lobe resection in five,and temporal lobe resection and hemisphere incision in one; muscles in the contralateral limb of surgery appeared short-term myodynamia weakness and recovery was achieved after rehabilitation exercise.No epileptic seizure was noted in all the patients,enjoying Engle Ⅰ grading.Conclusion Combination of MEG and DTI is a safe,noninvasive method for locating functional areas,could provide security protection for surgical treatment of patients with epilepsy secondary to cerebral hemisphere atrophy.

Objective To explore the relationship between Adult-onset Still's disease (AOSD) and macrophage activation syndrome (MAS). Methods A total of 78 patients with AOSD who had completed medical information were included in this study. Eleven patients who were diagnosed as rheumatic disease associated hemophagocytic syndrome among 26 patients who had hemophagocytic syndrome with histological evidence consisted of the MAS group. Clinical and laboratory data were analyzed in 78 patients with AOSD and 11 patients with MAS. Results Among 78 cases of AOSD, 9 patients (12%) could be diagnosed as MAS but didn't have hemophagocytic histological evidence. In the 11 MAS cases with hemophagocytic phenomenon, 6 patients fulfilled the diagnostic criteria of AOSD, 2 cases with panniculitis, 1 case with SLE, 1 case of dermatomyositis and 1 case of systemic vasculitis. Logistic analysis showed that splenomegaly (OR =2.13, 95%CI=1.11-3.42), leukopenia (OR=3.57, 95%CI=2.30～4.86), anaemia (OR=0.85, 95%CI=1.03～2.76), thrombocytopenia (OR=2.98, 95%CI=1.17-4.30) and hypertriglyceridemia (OR=1.66, 95%CI=1.02～2.74) were associated with development of MAS in AOSD. Conclusion The development of MAS in AOSD patient is frequent and hemophagocytic histological evidence could be found in severe cases. When splenomegaly and hypocytomsis present in AOSD patients, bone marrow examination should be done and the level of triglyceride and fibrinogen and activity of NK cells should be measured for early diagnosis.

Objective To explore the efficacy of tumor necrosis factor inhibitor in hip joint lesion of ankylosing spondylids (AS). Methods Eight-six patients with hip joint lesion of ankylosing spondylitis were Enrolled in this study. The treatment protocol was: ①Etanercept 25 mg was suncutaneously injected twice a week in the first two months and once a week in the following two months. Then it was injected once every oth-er two weeks in the last two months of the study period.②Methotrexate 15 mg was administered orally or in-travenously once a week.③NSAIDs and prednisone were stopped when symptoms sunsides. Results Twenty-eight cases (33%) stopped NSAIDs because of the disappearance of symptoms in 2 weeks after starting of the study. Forty-three (50%) stopped NSAIDs with in 8 weeks and 36 cases (42%) in them stopped NSAIDs and prednisone. During the 9th and 16th week, etanercept was used once a week and 49 cases (60%) stopped NSAIDs and prednisone. During the 17th and 24th week, etanercept was used once every two weeks, and 38 cases (44%) stopped NSAIDs and prednisone and their disease was stable. Hip Functional Scores of patients were elevated significantly at 2, 4 and 6 months after the treatment (p<0.05) BASDAI and BASFI decreased, and the difference was significant when compared to those before the treatment (P<0.05). For the 19 cases with hip joint synovitis and hydrarthrosis in MRI image but without obvious change in pelvic plain films, syn-ovitis of 11 cases disappeared and 4 cases improved significantly. In 84 hip joints with grade Ⅱ or Ⅲ changes, 13 joints improved for one grade, 16 joints had improvement but less than one grade, and 49 joints had no radiological changes. Conclusion Etanercept, when combined with methotrexate, is effective in treat-ing hip joint lesion of ankylosing spondylitis. The dosage of etanercept can be tapered after the disease is un-der control.

AIM: To determine the expression of membrane-bound B lymphocyte stimulator((BLyS)) and its mRNA in peripheral blood mononuclear cells(PBMCs) from individuals with systemic lupus erythematosus(SLE),and to investigate the effect of dexamethasone on(BLyS) expression.METHODS: PBMCs were obtained from 25 individuals with SLE(mean age of 31.40?14.23) and 20 female healthy volunteers(mean age of 28.20?10.36).They were randomized into dexamethasone((1 ?mol/L)) group and media group.PBMCs were gathered at 0,6,12 and 24 h for(BLyS) mRNA assessment using reverse transcription-PCR(RT-PCR).PBMCs were also collected at 72 h for membrane-bound(BLyS) protein detection using flow cytometry(FACS) and direct immunofluorescence.RESULTS:(1) The expression of(BLyS) mRNA and membrane-bound protein were significantly higher in PBMCs from individuals with SLE than that in PBMCs from healthy controls(0.40?0.18 vs 0.27?0.20,P