Objective:To summarize and analyze the clinical characteristics of systemic lupus erythematosus (SLE) combined with ischaemic stroke and the factors associated with poor prognosis.Methods:A total of 50 patients with SLE combined with ischaemic stroke in the First Affiliated Hospital of Xi′an Jiaotong University from January 2014 to June 2024 were included in the study, the clinical data of the patients were retrospectively collected and summarized, the Shapiro-Wilk test was used to assess the normality of data, and the factors related to poor prognosis were analyzed by logistic regression analyses.Results:Fifty patients with SLE combined with ischaemic stroke had a mean age of (47.1±15.5)years, 80.0%(40/50) were female, the duration of SLE was (5.6±6.3)years, the mean SLEDAI-2K score was (14.3±4.1), the rate of anticardiolipin antibody positivity was 30.0%(15/50), and the rate of β 2-glycoprotein Ⅰ antibody positivity was 28.0%(14/50). The most common clinical manifestations of stroke were impaired limb movement (34.0%) (17/50), cerebral infarction mainly in the cerebral hemisphere (82.0%)(41/50), combined with cerebral haemorrhage in 6.0%(3/50), cerebral leukoencephalopathy in 26.0%(13/50), and cerebral atrophy in 24.0%(12/50). In terms of treatment, the most used immunosuppressant was cyclophosphamide (34.0%, 17/50), 64.0%(32/50) of patients received aspirin, 32.0%(16/50) received clopidogrel and 14.0%(7/50) received anticoagulation. Four deaths and 12 cases of severe disability were found in 50 patients at follow-up, and SLEDAI-2000 scores were positively correlated with the above poor prognosis using univariate [ OR(95% CI)=1.407(1.123,1.764), P=0.003] and multivariate [ OR(95% CI)=1.388(1.097, 1.756), P=0.006] regression analyses. Conclusion:Patients with SLE combined with ischaemic stroke had high disease activity in SLE, and SLEDAI-2000 scores were positively associated with poor prognosis of death and severe disability.

Objective:To summarize and analyze the clinical characteristics of systemic lupus erythematosus (SLE) combined with ischaemic stroke and the factors associated with poor prognosis.Methods:A total of 50 patients with SLE combined with ischaemic stroke in the First Affiliated Hospital of Xi′an Jiaotong University from January 2014 to June 2024 were included in the study, the clinical data of the patients were retrospectively collected and summarized, the Shapiro-Wilk test was used to assess the normality of data, and the factors related to poor prognosis were analyzed by logistic regression analyses.Results:Fifty patients with SLE combined with ischaemic stroke had a mean age of (47.1±15.5)years, 80.0%(40/50) were female, the duration of SLE was (5.6±6.3)years, the mean SLEDAI-2K score was (14.3±4.1), the rate of anticardiolipin antibody positivity was 30.0%(15/50), and the rate of β 2-glycoprotein Ⅰ antibody positivity was 28.0%(14/50). The most common clinical manifestations of stroke were impaired limb movement (34.0%) (17/50), cerebral infarction mainly in the cerebral hemisphere (82.0%)(41/50), combined with cerebral haemorrhage in 6.0%(3/50), cerebral leukoencephalopathy in 26.0%(13/50), and cerebral atrophy in 24.0%(12/50). In terms of treatment, the most used immunosuppressant was cyclophosphamide (34.0%, 17/50), 64.0%(32/50) of patients received aspirin, 32.0%(16/50) received clopidogrel and 14.0%(7/50) received anticoagulation. Four deaths and 12 cases of severe disability were found in 50 patients at follow-up, and SLEDAI-2000 scores were positively correlated with the above poor prognosis using univariate [ OR(95% CI)=1.407(1.123,1.764), P=0.003] and multivariate [ OR(95% CI)=1.388(1.097, 1.756), P=0.006] regression analyses. Conclusion:Patients with SLE combined with ischaemic stroke had high disease activity in SLE, and SLEDAI-2000 scores were positively associated with poor prognosis of death and severe disability.

Objective To establish an evaluation system of Guangdong health high-quality development index,conduct a comprehensive assessment of the regional health high-quality development with the Guangdong Health High-quality Developmen Index(HDI),and provide data reference for decision-making by health administrative departments.Methods An expert team was organized,methods such as literature research,expert consultations,soliciting opinions,and evaluation arguments were used.After multiple rounds of screening,discussions,and continuous refinement,the evaluation system was constructed.Results The evaluation system of Guangdong health high-quality development index was constructed,including 5 primary indicators,18 secondary indicators,and 32 tertiary indicators.The results showed that HDI was 86.6,and Guangzhou,Shenzhen,Zhuhai,Foshan,and Zhongshan were the top 5 cities.Conclusion The evaluation system of Guangdong health high-quality development index is scientifical and reasonable,the evaluation results can provide effective reference for government decision-making.

Objective: To investigate the role of piperine on the transformation of endothelial cells into fibroblasts. Methods: Cultured human umbilical vein endothelial cells (HUVECs, 4-6 passage) were used for the main experiments. The transformation models of endothelial cells into fibroblasts were induced by transforming growth factor β (TGF-β) stimulation. HUVECs were divided into 6 groups: control group, TGF-β group and 4 groups treated with various concentrations of piperine (1, 5, 10, 20 μmol/L). CKK-8 was used to detect cell proliferation. The CD31/α-smooth muscle actin (α-SMA) expression level was detected by fluorescent staining. The vascular endothelial cadherin (VE-cadherin)/vimentin expression was detected by immunofluorescence staining. RT-PCR was used detect the mRNA expressions of transformation markers. Western blot was used to detect the protein expression of snail and twist. Results: TGF-β increased HUVECs proliferation (P<0.05), which could be significantly inhibited by 10 and 20 μmol/L of piperine, but not by 1 and 5 μmol/L of piperine. Immunofluorescence results demonstrated that TGF-β increased HUVECs transformation to fibroblasts as shown by downregulated expression of endothelial markers CD31, VE-cadherin, and upregulated expression of α-SMA and vimentin, again, these effects could be attenuated by 10 and 20 μmol/L piperine. The expression levels of collagen type Ⅰ and type Ⅲ were significantly higher in TGF-β group than in control group (P<0.05), significantly lower in TGF-β+10 μmol/L piperine group and TGF-β+20 μmol/L piperine group than in TGF-β group (P<0.05).In addition, RT-PCR results showed that TGF-β increased mRNA expression of transformation markers (snail1, snail2, twist1, twist2), while 10 and 20 μmol/L of piperine could significantly downregulated the mRNA expressions of these markers. The protein expression levels of snail and twist were significantly higher in TGF-β group than in control group (both P<0.05), which was significantly lower in TGF-β+20 μmol/L piperine group than in TGF-β group (both P<0.05). Conclusions Piperine can inhibit the transformation of endothelial cells into fibroblasts. This effect might be viewed as one of the potential mechanisms of reduced myocardial fibrosis post piperine treatment.

Objective To study the clinical and immunologic features of 67 cases of patients with scrub typhus.Methods Epidemiological data,clinical manifestations,laboratory and image examination results and treatment of 67 cases of patients with scrub typhus hospitalized from January 2010 to December 2013 at the First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed.Results Autumn-winter type scrub typhus was predominant in the 67 patents.The main clinical manifestations included hyperpyrexia (100％,67/ 67),eschar or ulcer (91.0％,61/67),rash (52.2％,35/67),lymphadenopathy (46.3％,31/67) and other non-specific symptoms.Laboratory test results:①80.6％ (54/67) of the patients had normal or decreased white blood cell count,62.7％ (42/67) of them with elevated lymphocytes (＞ 40％),thrombocytopenia was detected in 34.3％ (23/67) of the patients,the lowest platelets count was 14 × 109/L.②14 of 17 cases (82.4％) had normal percentage of CD3+ T lymphocytes,CD8+ T lymphocytes increased in 16 of 17 cases (94.1％),while the percentage of CD4+ T lymphocytes (14 of 17,82.4％) and B lymphocytes (15 of 17,88.2％) decreased in most of the patients.③C reactive protein (CRP),ferritin and erythrocyte sedimentation rate (ESR) were elevated in 95.2％ (59/62),93.8％ (45/48) and 89.1％ (49/55) of the patients,respectively.④Elevated alanine aminotransferase (77.6％,52/67) and aspartate aminotransferase (80.6％,54/67) were frequent findings.⑤94.6％ (35/37) of the patients had increased adenosine deaminase.⑥ Antinuclear antibody was positive in 31.0％ (13/42) patients.⑦Epstein-barr virus DNA was detected in 15.6％ (7/ 45) cases,77.6％ (38/49) was accompanied with chest radiographic abnormalities.Two cases had tuberculosis.All the patients recovered after therapy with doxycycline,levofloxacin or moxifloxacin.Conclusion Autumn-winter scrub typhus has typical clinical manifestations in the 67 patients,and it can cause patients' immune disorders.