OBJECTIVE: To investigate the biological activity and antitumor effect of pegylated recombinant human interleukin 2 (PEG-rhIL-2) obtained by site-specific conjugation of polyethylene glycol (PEG) with non-natural amino acids, and to explore its antitumor mechanism. METHODS: The binding activities of PEG-rhIL-2 at three different sites (T41, Y45, and V91) to human interleukin 2 receptors α (IL-2R_α) and β (IL-2R_β) and were detected by surface plasmon resonance (SPR) technology. Western blot was used to detect the levels of the Janus kinase-signal transducer and activator of transcription 5 (JAK-STAT5) signaling pathway activated by different doses of rhIL-2 and PEG-rhIL-2 in CTTL-2 and YT cells. Blood was collected after a single administration in mice to detect the drug concentration at different time points and evaluate the pharmacokinetic parameters of Y45-PEG-rhIL-2. Mouse hepatoma cell line Hepa1-6, pancreatic cancer cell line Pan-02, and colon cancer cell line MC-38 were selected. Tumor models were constructed in C57BL/6 mice. Different doses of Y45-PEG-rhIL-2 and excipient control were administrated respectively to evaluate the tumor suppression effect of the drug. In the MC-38 colon cancer model, the tumor suppression effect of Y45-PEG-rhIL-2 combined with anti-programmed death-1 (PD-1) monoclonal antibody was evaluated. Hepa1-6 mouse tumor models were constructed and rhIL-2, Y45-rhIL-2 and Y45-PEG-rhIL-2 were administrated respectively. The proportion of tumor-infiltrating lymphocytes was analyzed by flow cytometry. RESULTS: The SPR detection results showed that the binding activities of PEG-rhIL-2 to IL-2R_α/IL-2R_β were both reduced. The affinity of Y45-PEG-rhIL-2 to IL-2R_α was reduced to approximately 1/250, and its affinity to IL-2R_β was reduced to 1/3. Western blot results showed that the activity of Y45-PEG-rhIL-2 in stimulating JAK-STAT5 signaling in CTLL-2 cells expressing heterotrimeric IL-2 receptor complex IL-2R_αβγwas reduced to approximately 1/300, while its activity in YT cells expressing heterodimeric IL-2 receptor complex IL-2R_βγwas reduced to approximately 1/3. The pharmacokinetic evaluation after a single dose in the mice showed that the elimination half-life of Y45-PEG-rhIL-2 was 17.7 h. Y45-PEG-rhIL-2 has pharmacokinetic characteristics superior to those of rhIL-2. Y45-PEG-rhIL-2 showed dose-dependent tumor suppression activity, and the combination of Y45-PEG-rhIL-2 and anti-PD-1 antibody had a better tumor-inhibiting effect than the single use of Y45-PEG-rhIL-2 or anti-PD-1 antibody. Flow cytometry analysis demonstrated that 72 h after the administration of Y45-PEG-rhIL-2, the proportion of tumor-infiltrating cytotoxic T lymphocytes (CD8⁺T cells) increased by 86.84%. At 120 h after administration, the ratio of CD8⁺T cells to regulatory T cells (Treg) increased by 75.10%. CONCLUSION Y45-PEG-rhIL-2 obtained by site-specific conjugation via non-natural amino acids changed its receptor binding activity and inhibited tumor growth in dose-dependent manner in multiple tumor models by regulating CD8⁺T cells.
Interleukin-2/pharmacokinetics* ; Animals ; Mice ; Humans ; Recombinant Proteins/pharmacology* ; Polyethylene Glycols/chemistry* ; Cell Line, Tumor ; Antineoplastic Agents/pharmacokinetics* ; Signal Transduction/drug effects* ; STAT5 Transcription Factor/metabolism* ; Interleukin-2 Receptor alpha Subunit/metabolism* ; Interleukin-2 Receptor beta Subunit/metabolism*

Objective:To analyze the clinical characteristics of nail involvement in patients with pemphigus and the correlation between nail damage and the severity of pemphigus.Methods:The clinical data of 23 patients with pemphigus combined with nail damage admitted to the People′s Hospital of Xinjiang Uygur Autonomous Region from January 2011 to August 2019 were retrospectively analyzed, the manifestations of pemphigus combined with nail damage were summarized. The nail damage number of patients with pemphigus complicated with nail damage of different genders were analyzed, as well as the distribution of nail damage in nail and toenail. The titer of anti-desmocoglycoprotein(dsg) antibody was detected in all patients. The relationship between nail damage and disease severity and course in pemphigus patients was analyzed.Results:A total of 132 damage nails were found in 23 patients (14 males and 9 females) with pemphigus, including 66 nails in male, 66 nails in female, 82 nails and 50 toenails. There were 10 forms of nail damage, of which chronic paronychia was the most common. The number of damage nails between different genders in pemphigus patients was statistically significant (χ 2=9.183, P<0.001). The distribution of nail and toenail damage in pemphigus patients was statistically significant (χ 2=10.880, P<0.001). Of the 23 patients, only 3 were positive for dsg1 and 1 was positive for dsg3. There were 19 patients with both positive for dsg1 and dsg3. The titers of dsg1 and dsg3 were compared in 14 patients before and after nail damage. The results showed that the titers of anti-dsg antibody in pemphigus patients after nail damage were significantly higher than before. Thirteen of the 23 patients had nail damage at the time of the initial onset of pemphigus. The nail damage occurred from 6 weeks before the onset to 4 weeks after the onset. The nail damage occurred in 10 patients when the disease recurred. The nail damage occurred within 4 weeks before or at the same time with the blister. Conclusions:The number of damage nails per capita in female patients with pemphigus and nail damage was significantly higher than that in male patients, and nail damage was more common. The titers of anti-dsg antibody will be at a high level when pemphigus patients with nail damage, and the condition gets worse. Nail involvement is positive to the severity of the disease, and it can prolong the time of disease.

【Objective】 To summarize a rapid and effective method to eliminate autoantibodies interference with blood group identification and evaluate its treatment effect. 【Methods】 Blood samples with suspicious results in initial blood group identification were collected, and those caused by autoantibodies were chosen, and their red blood cells were washed, dispersed or treated with sulfhydryl reagent. After allogeneic or autologous absorption of plasma, blood groups of those patients were re-detected to evaluate the effectiveness of the above method. 【Results】 Among 39 patients presenting suspicious ABO blood group, 9 were interfered by autoantibodies. After appropriate treatment, the ABO/RhD blood group of those patients could be identified. 【Conclusion】 Autoantibodies could interfere the identification of ABO/RhD blood group, and the efficiency and accuracy of blood group identification could be improved by analyzing the test results and selecting appropriate treatment methods.

Cell-Free Nucleic Acids ; blood ; Female ; Humans ; Mosaicism ; Placenta ; Pregnancy

Literature regarding the pathogenesis of non-alcoholic fatty liver disease (NAFLD) and the mechanisms of acupuncture for NAFLD published between January of 2006 to December of 2016 was searched in CBM database, Wanfang database, CNKI database and PubMed. After analysis, the possible mechanisms of acupuncture for NAFLD were summarized from 5 following aspects: acupuncture regulating lipid metabolism and participating lipid metabolism-related signaling pathways, acupuncture improving insulin resistance, acupuncture increasing the antioxidant levels of liver tissue to improve lipid peroxidation, acupuncture inhabiting the expression of inflammatory cytokines, and acupuncture improving the morphology and structure of hepatocyte. Based on the characteristics of acupuncture, the suggestions and prospects of future research were proposed from the 4 following aspects: the specificity and compatibility of acupoint, the treatment timing of acupuncture, the stimulus parameter of acupuncture, and the intervention of acupuncture combined with dietary control.

In the guidance of preventive treatment, taking "consolidation and non-obstruction" as the core, emphasizing the importance of the antipathogenic in the treatment, the method of " acupoint combination" was proposed in acupuncture therapy. In the paper, the theoretic basis and the connotation of " acupoint combination", the application of the key acupoint combination and the study on cardiovascular system, digestive system and immune system were introduced and it was anticipated to provide the theoretic evidences for the acupoint selection and enrich the contents of acupoint combination in acupuncture.
Acupuncture Points ; Acupuncture Therapy ; Cardiovascular System ; Digestive System ; Humans ; Immune System

Objective To investigate the effectiveness of three different anesthetic techniques in intraventricular catheterization and its effect on the survival rate of rats. Methods Thirty Wistar rats were equally allocated into 3 groups:chloral hydrate group,pentobarbital sodium group and isoflurane group. Intraventricular catheterization was performed in the rats after anesthesia with i. p. injection of chloral hydrate and pentobarbital sodium, and isoflurane inhalation, respectively. Levels of blood glucose were detected before and at 15 and 30 minutes and 1, 3, 7, 14, 28 days after anesthesia. Body mass and 24-hour food intake were recorded before and at 1, 3, 7 days after anesthesia. The onset time and effective time of anesthesia, operation time and the survival rates on 30 days of the rats were compared and analyzed. Results The onset time and effective time of anesthesia, and the operation time in the isoflurane group were shorter than that in the chloral hydrate group, while these parameters in this group were shorter than that in the pentobarbital sodium group. Blood glucose in the chloral hydrate group was apparently increased during the surgical operation, while the body mass, 24-hour food intake and blood glucose were decreasing since one day after operation, and all the rats in this group died during the 30-day observation, mainly, due to enteroplegia. Blood glucose in the pentobarbital sodium group was mildly increased after anesthesia, while the body mass, 24-hour food intake and blood glucose were mildly decreased at one day after operation and recovered within one week. In this group, 3 rats died of respiratory distress due to overdose anesthesia and one rat died during the 30 day-observation. The blood glucose in the isoflurane group was mildly increased after operation, while the 24-hour food intake and blood glucose did not markedly changed, the body mass was stably increased, and no rat died during the 30-day-observation. Conclusions Intraperitoneal injection of chloral hydrate is not suitable for intraventricular catheterization in rats. Intraperitoneal injection of pentobarbital sodium can be only carefully applied for intraventricular catheterization under poorly-limited conditions. Isoflurane inhalation anesthesia is recommended for intraventricular catheterization in rats.

OBJECTIVETo observe the improvement of acupuncture and moxibustion on symptoms of-deficiency syndrome as well as their differences on the parameters of heart rate variability (HRV).

METHODSThirty patients with-deficiency syndrome and 15 healthy volunteers were recruited. Thirty patients with-deficiency syndrome were randomly assigned into an acupuncture group and a moxibustion group, 15 cases in each one. Fifteen healthy volunteers were allocated as a healthy control group. Patients in the acupuncture group and healthy control group were treated with acupuncture while patients in the moxibustion group were treated with moxibustion. Guanyuan (CV 4) and Zusanli (ST 36) were chosen for treatment, once every other day, for totally 10 times. All the patients were evaluated with-deficiency assessment scale (QDAS) and HRV parameters before treatment, after 4th treatment and after all treatment. The correlation was analyzed between QDAS and HRV parameters, and HRV parameters were compared among the three groups before treatment, after 4th treatment and after all treatment.

RESULTSCompared before treatment, the scores of QDAS were decreased in the acupuncture group and the moxibustion group after 4th treatment and after all treatment (all<0.05); after all treatment the score of QDAS in the moxibustion group was lower than that in the acupuncture group (<0.05). The HRV parameters of-deficiency syndrome were significantly lower than those of healthy volunteers with higher correlation with QDAS. Compared before treatment, the mean heart rate was decreased after treatment (<0.05), while total HRV and low frequency were increased in the moxibustion group (both<0.05). The mean heart rate in the healthy control group was increased after treatment (<0.05). The differences of HRV parameters before and after treatment were not significant in the acupuncture group (all>0.05).

CONCLUSIONSTotal HRV can reflect the severity of-deficiency syndrome. Both acupuncture and moxibustion can improve symptoms of-deficiency patients, which is superior in moxibustion. The possible mechanism is likely to be related with improved sustainable activation of autonomic nervous system.

Grading of Recommendations Assessment,Development,and Evaluation (GRADE) offers a worldwide approach to guideline development for clinical practice.For the clinical practice of acupuncture therapy,18 evidence-based guidelines have been developed in China using GRADE.In this study,we review the advantages and limitations of the GRADE approach in the guideline development for acupuncture and moxibustion and propose some solutions to these limitations.Scientific advantages of rating the quality of evidence,outcome-centric direction,overall progression to develop recommendations,and strength of recommendations providing specific clinical guidance are the advantages of GRADE.The limitations of GRADE in the development of guidelines for acupuncture and moxibustion include rating the quality of evidence for ancient literature and literature on famous traditional Chinese medicine experts' experiences and specific guidelines for formulating recommendations from evidence.In the guideline development for clinical practice with acupuncture and moxibustion,we suggest that a specific method should be explored based on the GRADE approach and the characteristics of acupuncture therapy.

OBJECTIVETo compare the clinical effects between ginger-partition moxibustion combined with glucocorticoid and simple oral glucocorticoid for thyreoitis at subacute stage.

METHODSEighty-one patients were randomly divided into an observation group (41 cases) and a control group (40 cases). In the observation group, ginger-partition moxibustion and hormone were applied. Moxa cones were used at local ashi points, Zusanli (ST 36), Guanyuan (CV 4) and Qihai (CV 6), six cones every point, once every other day and three times a week. Besides, 24 mg methylprednisolone tablets were adopted orally every day, and in two weeks the dose was 16 mg/d, in four weeks 8 mg/d, in six weeks 4 mg/d; all the patients were observed for 8 week. In the control group, simple methylprednisolone was prescribed orally, and the dose, the usage and treatment time were the same as those in the observation group. Erythrocyte sedimentation rate (ESR), triiodothyronine (T3), thyroxin (T4) and ultra-sensitive thyroid stimulating hormone (TSH) before and after treatment were observed in the two groups, as well as fever, the pain of thyroid gland, the regression time of swelling and adverse reaction.

RESULTSThe time of thyroid gland pain relieved of the observation group was earlier than that of the control group [(3.07 ± 0.78) days vs (3.62 ± 0.92) days, P < 0.05]. After treatment, T3, T4 and ESR were declined apparently (all P < 0.01), and TSH was obviously increased in the two groups (both P < 0.01). After 2-week treatment, ESR in the observation group was lower than that in the control group (P < 0.05). After 4-week treatment, T3, T4, TSH and ESR in the observation group were better than those in the control group (all P < 0.05). After 8 weeks, all indices in the observation group were superior to those in the control group, without statistical significance between the two groups (all P > 0.05). The effects of the observation group in 2 weeks, 4 weeks and 8 weeks were better than those in the control group (all P < 0.05). The cured course was shorter in the observation group than that in the control group (P < 0.05). The adverse reaction rate in the observation group was lower than that in the control group [4.9% (2/41) vs 22.5% (9/40), P < 0.05]. Three months later after treatment, the cured patients were followed. There was no recrudescence in the observation group and three patients caught the disease again in the control group, but there was no statistical significance between the two groups (P > 0.05).

CONCLUSIONGinger-partition moxibustion combined with glucocorticoid achieves better effect than simple oral glucocorticoid for thyreoitis at subacute stage, and the adverse reaction is less, which presents the clinical advantages of the integration of Chinese and western medicine.

Adult ; Female ; Ginger ; chemistry ; Glucocorticoids ; administration & dosage ; Humans ; Male ; Middle Aged ; Moxibustion ; Thyroid Gland ; drug effects ; metabolism ; Thyroid Hormones ; metabolism ; Thyroiditis ; drug therapy ; pathology ; therapy ; Thyrotropin ; metabolism ; Young Adult