Objective:To investigate the effects of dexmedetomidine(DEX)on T cell subsets in rats with rheumatoid arthritis(RA)by regulating interleukin-10(IL-10)/signal transduction factor and transcriptional activator 3(STAT3)signaling pathways.Methods:SD rats were grouped into control group(NC group),Model group,DEX low-dose group(DEX-L group,5 μg/kg),DEX medium-dose group(DEX-M group,10 μg/kg),DEX high-dose group(DEX-H group,20 μg/kg),methotrexate group(MTX group,0.33 mg/kg),AS101 group(IL-10 inhibitor,1.5 mg/kg)and DEX-H+AS101 group(20 μg/kg+1.5 mg/kg),with 18 rats in each group.Except NC group,RA models were established in rats of other groups.The administration was started 24 hours after the second immunization,once a day for 3 weeks.The changes of foot swelling rate and joint index were measured;HE staining was applied to detect the pathological changes of spleen tissue;the levels of TNF-α and IL-1β in rat spleen were detected by ELISA;the percentages of CD3+CD4+T cells,CD3+CD8+T cells and the proportions of helper T cell 17(Th17)and regulatory T cell(Treg)in rat spleen were measured by flow cytometry;and Western blot was applied to detect the expressions of IL-10 and p-STAT3 protein in rat spleen.Results:Compared with NC group,the pathological damage of spleen tissue in Model group was serious,the feet swelling rate,joint index,the levels of TNF-α and IL-1β,the percentage of CD3+CD4+T cells,Th17 cells,Th17/Treg were increased,the percentage of CD3+CD8+T cells,Treg,and expression of IL-10 and p-STAT3 protein were decreased(P<0.05);compared with Model group,the pathological damage of spleen tissue in DEX-L group,DEX-M group,DEX-H group and MTX group were reduced,the feet swelling rate,joint index,the levels of TNF-α and IL-1β,the percentage of CD3+CD4+T cells,Th17 cells,Th17/Treg decreased,the percent-age of CD3+CD8+T cells,Treg,and expressions of IL-10 and p-STAT3 protein were increased(P<0.05);compared with Model group,the pathological damage of spleen tissue in AS101 group was aggravated,the feet swelling rate,joint index,the levels of TNF-α and IL-1β,the percentage of CD3+CD4+Tcells,Th17 cells,Th17/Treg were increased,the percentage of CD3+CD8+T cells,Treg cells,and expression of IL-10 and p-STAT3 protein were decreased(P<0.05);AS101 attenuated the promoting effect of high dose DEX on the proportion balance of T cell subsets in RA rats.Conclusion:DEX may promote the balance of T cell subsets in RA rats by activating IL-10/STAT3 pathway.

Objective:To investigate the effects of dexmedetomidine(DEX)on T cell subsets in rats with rheumatoid arthritis(RA)by regulating interleukin-10(IL-10)/signal transduction factor and transcriptional activator 3(STAT3)signaling pathways.Methods:SD rats were grouped into control group(NC group),Model group,DEX low-dose group(DEX-L group,5 μg/kg),DEX medium-dose group(DEX-M group,10 μg/kg),DEX high-dose group(DEX-H group,20 μg/kg),methotrexate group(MTX group,0.33 mg/kg),AS101 group(IL-10 inhibitor,1.5 mg/kg)and DEX-H+AS101 group(20 μg/kg+1.5 mg/kg),with 18 rats in each group.Except NC group,RA models were established in rats of other groups.The administration was started 24 hours after the second immunization,once a day for 3 weeks.The changes of foot swelling rate and joint index were measured;HE staining was applied to detect the pathological changes of spleen tissue;the levels of TNF-α and IL-1β in rat spleen were detected by ELISA;the percentages of CD3+CD4+T cells,CD3+CD8+T cells and the proportions of helper T cell 17(Th17)and regulatory T cell(Treg)in rat spleen were measured by flow cytometry;and Western blot was applied to detect the expressions of IL-10 and p-STAT3 protein in rat spleen.Results:Compared with NC group,the pathological damage of spleen tissue in Model group was serious,the feet swelling rate,joint index,the levels of TNF-α and IL-1β,the percentage of CD3+CD4+T cells,Th17 cells,Th17/Treg were increased,the percentage of CD3+CD8+T cells,Treg,and expression of IL-10 and p-STAT3 protein were decreased(P<0.05);compared with Model group,the pathological damage of spleen tissue in DEX-L group,DEX-M group,DEX-H group and MTX group were reduced,the feet swelling rate,joint index,the levels of TNF-α and IL-1β,the percentage of CD3+CD4+T cells,Th17 cells,Th17/Treg decreased,the percent-age of CD3+CD8+T cells,Treg,and expressions of IL-10 and p-STAT3 protein were increased(P<0.05);compared with Model group,the pathological damage of spleen tissue in AS101 group was aggravated,the feet swelling rate,joint index,the levels of TNF-α and IL-1β,the percentage of CD3+CD4+Tcells,Th17 cells,Th17/Treg were increased,the percentage of CD3+CD8+T cells,Treg cells,and expression of IL-10 and p-STAT3 protein were decreased(P<0.05);AS101 attenuated the promoting effect of high dose DEX on the proportion balance of T cell subsets in RA rats.Conclusion:DEX may promote the balance of T cell subsets in RA rats by activating IL-10/STAT3 pathway.

Objective:To investigate the role of microRNA (miR)-155 in hydrogen peroxide (H 2O 2)-induced oxidative stress injury in lens epithelial cells (LECs) and its mechanism regulating silent information regulator factor related enzymes 1 (SIRT1). Methods:The HLE-B3 at the logarithmic growth phase was taken and cultured for 24 hours under different concentrations of H 2O 2 (0, 50, 100, 200, 400, 800 μmol/L), and the cell viability was detected by MTT assay to determine the optimal concentration of H 2O 2 for establishing an oxidative stress injury model.HLE-B3 cells were divided into 6 groups, untreated blank control group, model control group cultured with 100 μmol/L H 2O 2, miR-155 mimics group transfected with miR-155 mimics, miR-155 mimics negative control group transfected with miR-155 mimics negative control, miR-155 inhibitor group transfected with miR-155 inhibitor, and miR-155 inhibitor negative control group transfected with miR-155 inhibitor negative control.Transfected cells were cultured with 100 μmol/L H 2O 2.Cells in various groups were cultured for 24 hours, and cell morphology was observed under an inverted microscope.The relative expression of miR-155 and SIRT1 mRNA in cells was assayed by fluorescent quantitative PCR.Cell apoptosis rates were detected by flow cytometry.Reactive oxygen species (ROS) content was identified by 2', 7'-dichlorofluorescein diacetate (DCFH-DA) fluorescent probe method.Superoxide dismutase (SOD) activity and malondialdehyde (MDA) concentration were measured by ELISA method.The targeting of SIRT1 by miR-155 was tested by dual luciferase reporter gene system.Expressions of SIRT1, B-cell lymphoma/leukemia-2 gene (bcl-2), bcl-2 associated X protein (bax), cleaved-cysteine aspartase 3 (cleaved-Caspase-3) proteins were determined by Western blot. Results:With the increase of H 2O 2 concentration, the cell viability gradually decreased, and the differences in cell viability among different concentrations were statistically significant (all at P<0.05), and 100 μmol/L was selected as the experimental concentration.Cells in blank control group grew well adherently.The number of cells in model control group decreased, and the morphology of some surviving cells changed, and their boundaries were blurred.There were fewer cells in miR-155 mimics group than model control group, and the cell morphology changed.There were more cells in miR-155 inhibitor group than model control group, and the cells grew well.Compared with model control group, the relative expression level of miR-155, the apoptosis rate, ROS content, MDA concentration, as well as the relative expression levels of bax and cleaved-Caspase-3 proteins were increased, and the relative expression level of SIRT1 mRNA, the SOD activity, the relative expression of SIRT1 and bcl-2 proteins, as well as bcl-2/bax were decreased in miR-155 mimics group, and the differences were statistically significant (all at P<0.05). Compared with model control group, the relative expression of miR-155, the apoptosis rate, ROS content, MDA concentration, as well as the relative expression levels of bax and cleaved-Caspase-3 proteins were decreased, and the relative expression level of SIRT1 mRNA, SOD activity, the relative expression levels of SIRT1 and bcl-2 protein, as well as bcl-2/bax were significantly increased in miR-155 inhibitor group, and the differences were statistically significant (all at P<0.05). The relative luciferase activity of wild-type SIRT1 in cells transfected with miR-155 mimics was 0.41±0.07, which was significantly weaker than 1.00±0.11 in cells transfected with miR-155 mimics negative control, and the relative luciferase activity of wild-type SIRT1 in cells transfected with miR-155 inhibitor was 1.98±0.17, which was significantly higher than 1.00±0.12 in cells transfected with miR-155 inhibitor negative control, showing statistically significant differences ( t=7.838, 8.157; both at P<0.05). No obvious effect on the relative luciferase activity of mutant SIRT1 was found in transfected cells. Conclusions:miR-155 is involved in H 2O 2-induced oxidative damage of LECs, and its overexpression can target the expression of SIRT1 and play a role in cell injury.

Objective:To analyze and summarize the characteristics of ultrasonographic images of non-lactating mastitis, improve the diagnostic accuracy, and guide the clinical treatment.Methods:The ultrasonic images of 46 patients with non lactation mastitis diagnosed by pathology in People′s Hospital of Heyuan from January 2017 to November 2020 were retrospectively analyzed. The ultrasonic images were compared with the pathological results, and the ultrasonic characteristics of non lactation mastitis were analyzed.Results:Among the 46 cases of non lactation mastitis, there were 24 cases of chronic mastitis, 15 cases of granulomatous lobular mastitis, 5 cases of plasma cell mastitis and 2 cases of lymphocytic lobulitis. The ultrasonographic features of non lactation mastitis were patchy hypoechoic mixed with anechoic areas with poor sound transmission. Granulomatous lobular mastitis was easy to be misdiagnosed as malignant lesions because of its disordered echo.Conclusions:Mastering the ultrasound characteristics of non-lactation mastitis can help to improve the accuracy of diagnosis of non-lactation mastitis.

Objective:To analyze the sensitivity and specificity of SARS-CoV-2 nucleic acid testing in 20 348 close contacts of COVID-19 cases in different prevention and control stages in Guangzhou and to provide scientific evidence for optimizing epidemic response strategies.Methods:A total of 20 348 close contacts of COVID-19 cases in Guangzhou were traced between February 21 and September 22,2020. All the close contacts were tested for the nucleic acid of SARS-CoV-2. The sensitivity and specificity of nucleic acid testing and diagnosis in the different prevention and control stages were compared.Results:In 20 348 close contacts, 12 462 were males (61.24%), the median ( P 25, P 75) of age of them was 31.0 years (23.0,43.0), the median number ( P 25, P 75) of nucleic acid testing for them was 2.0 (1.0,3.0), and the median ( P 25, P 75) of their quarantine days was 12.0 (8.0,13.0) days, respectively. A total of 256 COVID-19 cases were confirmed in the close contacts after seven nucleic acid tests. In the 1 st, 2 nd, 3 rd and 7 th nucleic acid testing, the sensitivity and specificity were 69.14% and 99.99% (177 cases confirmed), 89.84% and 99.99% (230 cases confirmed), 97.27% and 99.99% (249 cases confirmed), and 100.00% and 99.98%, respectively. In the three stages of COVID-19 prevention and control in China: domestic case stage, imported case stage, and imported case associated local epidemic stage, the sensitivity of the 1 st nucleic acid testing was 70.68%, 68.00% and 67.35%, and the specificity was 99.98%, 100.00% and 100.00%, respectively. Conclusions:The sensitivity of nucleic acid testing in the close contacts at the different stages were consistent with slight decrease, which might be related to the increased proportion of asymptomatic infections in the late stage of epidemic prevention and control with COVID-19 in Guangzhou. It is suggested to give three nucleic acid tests to improve the sensitivity and reduce false negative risk.

Objective:To explore the value of shear wave elastography imaging(SWE) in the diagnosis of renal allograft fibrosis and analyze its advantages and limitations.Methods:The renal allograft of 61 patients who underwent renal allograft biopsy from June 2019 to April 2020 in the First Affiliated Hospital of Sun Yat-sen University were included in this study. According to the Banff classification, there were 51 patients with mild-degree fibration(interstitial fibrosis/tubular atrophy, IFTA 0-Ⅰ), and 29 patients with moderate or severe-degree fibration(IFTA Ⅱ-Ⅲ). Two-dimensional ultrasound, color Doppler flow imaging, SWE and kidney function test performed. All the results were compared between the two groups. Diagnostic performance was evaluated by receiver operating characteristic (ROC) curve using pathology as gold standard. The sensitivity, specificity, positive predictive value and negative predictive value were calculated for the diagnosis of moderate or severe-degree fibration.Results:Compared to mild-degree fibration group, creatinine( P<0.001), glomerular filtration rate( P<0.001), RI of arcuate arteries( P=0.022) and SWE value( P<0.001) significantly increased in the moderate or severe-degree fibration group. There were significant correlations between IFTA and creatinine ( r s=0.488, P<0.001), glomerular filtration rate ( r s=-0.452, P<0.001), RI of arcuate arteries( r s=0.228, P=0.042), SWE value( r s=0.584, P<0.001). Taking the cutoff value of SWE value deduced by ROC curve as 21.7 kPa, the area under ROC curve was 0.827. The sensitivity, specificity, positive predictive value and negative predictive value were 86.2%, 74.5%, 61.0% and 89.7%, respectively. Conclusions:There is a good correlation between the SWE value and the degree of fibrosis in the transplanted kidney. SWE can be used to distinguish mild from moderate or severe fibrosis of renal allograft, providing a potential noninvasive method for the assessment of kidney allograft fibration.

Adrenal rest tumor (ART) is a well-known complication in congenital adrenal hyperplasia (CAH), which may occur in all age groups, especially in adolescence and adulthood. Tumors that occur in the testicular known as testicularadrenal rest tumor (TART), in the ovarian and parovarian tissue known as ovarian adrenal rest tumor (OART). ART is one of the major causes of reproductive dysfunction in adult with CAH. Early prevention and treatment is the key to avoid irreversible damage to gonadal function. In the past, we paid more attention to TART in children, while ignored TART and OART in adults. This article will review the origin of tumor cells, pathogenesis, epidemiology, diagnosis, treatment and prognosis of CAH associated with ART, which aims to guide clinical work through the profound understanding of CAH with ART.

OBJECTIVE： To study the chemical constituents of ethanol extract from Yao medicine Cissampelopsis spelaeicola. METHODS： The petroleum ether， ethyl acetate and n-butanol fraction from 75％ ethanol extract of C. spelaeicola were isolated and purified by silica gel， SephadexLH-20 gel column and AB-8 macroporous resin column， etc. The structures of the compounds were analyzed and identified by physicochemical properties and spectral data （mass spectrometry， hydrogen spectrum， carbon spectrum）. RESULTS & CONCLUSIONS： Twelve compounds were isolated and identified from 75％ ethanol extract of C. spelaeicola. β-sitosterol（Ⅰ） and Stigmasterol（Ⅱ） were isolated from petroleum ether fraction； p-hydroxybenzoic acid（Ⅲ）， β-daucossterol（Ⅳ）， protocatechuic acid（Ⅴ）， 6β-hydroxyeremophi-7（11）-en-12，8β-olide（Ⅵ）， 10β-hydroxyeremophil-7（11）-en-8，12-olide（Ⅶ）， 10β-hydroxyeremophi-7（11），8（9）-dien-8，12-olide（Ⅷ）， Quercetin（Ⅸ）， Hyperin（Ⅹ） and 4α-hydroxy- eudesman-11-ene（Ⅺ） were isolated from ethyl acetate fraction； quercetin-3-O-robinobioside（Ⅻ） was isolated from n-butanol fraction. Compounds Ⅰ-Ⅻ are isolated from C. spelaeicola for the first time. The study can lay material foundation for activity stady of C. spelaeicola.

Objective To explore the diagnostic value of contrast-enhanced ultrasound combined with tumor markers in benign and malignant ovarian tumors.Methods The clinical data of 100 patients with ovarian tumors treated in our hospital from May 2016 to May 2017 were analyzed retrospectively.The parameters of contrast-enhanced ultrasonography (CEUS) for benign and malignant ovarian tumors were analyzed.The levels of tumor markers were measured and the ultrasound imaging was analyzed.Analysis of the detection rate of benign and malignant ovarian tumors by contrast-enhanced ultrasound alone or in combination with tumor markers.Results Compared with benign ovarian tumors,ovarian malignant tumors have the characteristics of uneven enhancement,early onset and peak time of contrast enhancement,and higher rate of enhancement (P ＜ 0.05);compared with benign ovarian tumors,serum CA125 and CA199 levels in patients with ovarian malignant tumors were higher,with significant difference (P ＜ 0.05).The detection rates of contrast-enhanced ultrasound combined with tumor markers were higher than those of ultrasound or tumor markers alone,and were in accordance with pathological criteria.Conclusions The application of combined contrast-enhanced ultrasound and tumor markers in the diagnosis of ovarian benign and malignant tumors has a high detection rate,can significantly improve the accuracy of clinical detection,and provide a strong basis for treatment.

Objective:To determine clinical curative effects of ozone therapy for pemphigus vulgaris.Methods:Ozone hydrotherapy was used as an aid treatment for 32 patients with pemphigus vulgaris.The hydropathic compression of potassium permanganate solution for 34 patients with pemphigus vulgaris served as a control.The main treatment for both groups were glucocorticoids and immune inhibitors.The lesions of patients,bacterial infection,usage of antibiotics,patient's satisfaction,and clinical curative effect were evaluated in the 2 groups.Results:There was no significant difference in the curative effect and the average length of staying at hospital between the 2 groups (P＞0.05).But rate for the usage of antibiotics was significantly reduced in the group of ozone hydrotherapy (P=0.039).The patients were more satisfied in using ozone hydrotherapy than the potassium permanganate solution after 7-day therapy (P＞0.05).Conclusion:Ozone hydrotherapy is a safe and effective aid method for pemphigus vulgaris.It can reduce the usage of antibiotics.