This study performed to observe the effect of Yiqi Jianpi Shengjin recipe on Tfr/Tfh cell balance and autophagy expression in primary Sj?gren's syndrome(pSS)patients,and to explore the intervention mechanism of Yiqi Jianpi Shengjin recipe in treating pSS.We collected 60 cases of pSS with deficiency of both qi and yin from the Department of Rheumatology and Immunology of Anhui Provincial Hospital of TCM and randomly grouped them into experimental group and control group,with each group consisting of 30 cases.The control group was given a dose of hydroxychloroquine sulphate 0.2 g bid,the experimental group received an additional oral dose of Yiqi Jianpi Shengjin formula on top of the control group's treatment,and both continued to take it for 12 weeks.IL-10,IL-21 and IL-6 levels were measured by enzyme-linked immunosorbent assay,Tfh and Tfr cells ratios were measured by Flow cytometry,Western blot was used to detect the protein expression of Atg5,Beclin1 and LC3-Ⅱ/Ⅰ,and qPCR was used to detect the RNA expression of Atg5,Beclin1 and LC3.The indexes of inflammation,dryness,ESSPRI,ESSDAI and TCM syndrome integral before and after treatment were statistically analyzed.Data showed that the scores of corneal fluorescence stainin g in the experimental group were significantly lower and the static saliva flow rate was significantly higher compared with the control group.The experimental group showed a marked reduction in TCM,ESSPRI and ESSDAI score after treatment compared to control group.The expression of IL-21,IL-10 and IgG in the experimental group was markedly lower compa red with the control group.Tfr cells were significantly lower in the experimental group as compared to the control group.T he expression and ratio of autophagy protein and mRNA in the experimental group were significantly lower compared with t he control group.In conclusion,Yiqi Jianpi Shengjin recipe can effectively reestablish the balance of Tfr/Tfh cells,regulate cytokines,inhibit autophagy and activity,relieve clinical symptoms,delay disease activity,and improve the secretion of lacrimal gland and salivary gland.

The aim of this study is to investigate the mechanism by which triptolide(TP)ameliorates inflammation in adjuvant arthritis(AA)rats by inhibiting pyroptosis through the lncRNA GAS5/miR-21/TLR4 signaling axis.Rats were divided into 4 groups:normal control group(NC),model control group(MC),triptolide group(TP)and methotrexate group(MTX),with 6 rats in each group.The AA rat model was established,and the general state,right foot-plantar swelling and arthritis index were observed;HE staining was used to detect the histopathological morphology of synovial joints of rats in each group;ELISA was used to detect the levels of inflammatory factors IL-1β,IL-6,IL-18 and TNF-α;fluorescence quantitative PCR was used to detect the mRNA expression levels of Caspase-1,IL-1β,NLRP3,GSDMD,GAS5,TLR4,NF-κB and miR-21;and Western blot was used to detect the expression levels of Caspase-1,NLRP3,GSDMD,NF-κB,Caspase-4 and TLR4 proteins.Compared with the NC group,rats in the MC group showed significantly higher levels of swelling,arthritis index(P<0.05)and inflammatory cell infiltration;compared with the MC group,the levels of IL-1β,IL-6,IL-18 and TNF-α were decreased in the TP and MTX groups(P<0.05),and the levels of Caspase-1,IL-1β,NLRP3,GSDMD,TLR4,NF-κB,miR-21 mRNA expression decreased,GAS5 mRNA expression increased(P<0.05),and the protein levels of Caspase-1,NLRP3,GSDMD,NF-κB,Caspase-4 and TLR4 decreased(P<0.05);compared with the MTX group,the TP group showed lower levels of IL-1β,IL-6,IL-18,TNF-α(P<0.05),and lower expression levels of Caspase-1,IL-1β,NLRP3,GSDMD,TLR4,NF-κB and miR-21 mRNA(P<0.05).In conclusion,triptolide may inhibit the production of pro-inflammatory factors and inhibit pyroptosis through the lncRNA GAS5/miR-21/TLR4 signaling axis,thus ameliorate inflammation in AA rats.

Objective To improve the performance of auto-segmentation of prostate target area and organs-at-risk in online magnetic resonance image and enhance the efficiency of magnetic resonance imaging-guided adaptive radiotherapy(MRIgART)for prostate cancer.Methods A retrospective study was conducted on 40 patients who underwent MRIgART for prostate cancer,including 25 in the training set,5 in the validation set,and 10 in the test set.The planning CT images and corresponding contours,along with online MR images,were registered and input into a deep learning network for online MR image auto-segmentation.The proposed method was compared with deformable image registration(DIR)method and single-MR-input deep learning(SIDL)method.Results The overall accuracy of the proposed method for auto-segmentation was superior to those of DIR and SIDL methods,with average Dice similarity coefficients of 0.896 for clinical target volume,0.941 for bladder,0.840 for rectum,0.943 for left femoral head and 0.940 for right femoral head,respectively.Conclusion The proposed method can effectively improve the accuracy and efficiency of auto-segmentation in MRIgART for prostate cancer.

Objective To explore the mechanism underlying the protective effect of α2-macroglobulin (A2M) against glucocorticoid-induced femoral head necrosis. Methods In a human umbilical vein endothelial cell (HUVEC) model with injuries induced by gradient concentrations of dexamethasone (DEX;10-8-10-5 mol/L), the protective effects of A2M at 0.05 and 0.1 mg/mL were assessed by examining the changes in cell viability, migration, and capacity of angiogenesis using CCK-8 assay, Transwell and scratch healing assays and angiogenesis assay. The expressions of CD31 and VEGF-A proteins in the treated cells were detected using Western blotting. In BALB/c mouse models of avascular necrosis of the femoral head induced by intramuscular injections of methylprednisolone, the effects of intervention with A2M on femoral trabecular structure, histopathological characteristics, and CD31 expression were examined with Micro-CT, HE staining and immunohistochemical staining. Results In cultured HUVECs, DEX treatment significantly reduced cell viability, migration and angiogenic ability in a concentration- and time-dependent manner (P<0.05), and these changes were obviously reversed by treatment with A2M in positive correlation with A2M concentration (P<0.05). DEX significantly reduced the expression of CD31 and VEGF-A proteins in HUVECs, while treatment with A2M restored CD31 and VEGF-A expressions in the cells (P<0.05). The mouse models of femoral head necrosis showed obvious trabecular damages in the femoral head, where a large number of empty lacunae and hypertrophic fat cells could be seen and CD31 expression was significantly decreased (P<0.05). A2M treatment of the mouse models significantly improved trabecular damages, maintained normal bone tissue structures, and increased CD31 expression in the femoral head (P<0.05). Conclusion A2M promotes proliferation, migration, and angiogenesis of DEX-treated HUVECs and alleviates methylprednisolone-induced femoral head necrosis by improving microcirculation damages and maintaining microcirculation stability in the femoral head.

Objective:To evaluate the feasibility of using MRI-only simulation images for dose calculation of both photon and proton radiotherapy for nasopharyngeal carcinoma cases.Methods:T 1-weighted MRI images and CT images of 100 patients with nasopharyngeal carcinoma treated with radiotherapy in Cancer Hospital of Chinese Academy of Medical Sciences from January 2020 to December 2021 were retrospectively analyzed. MRI images were converted to generate pseudo-CT images by using deep learning network models. The training set, validation set and test set included 70 cases, 10 cases and 20 cases, respectively. Convolutional neural network (CNN) and cycle-consistent generative adversarial neural network (CycleGAN) were exploited. Quantitative assessment of image quality was conducted by using mean absolute error (MAE) and structural similarity (SSIM), etc. Dose assessment was performed by using 3D-gamma pass rate and dose-volume histogram (DVH). The quality of pseudo-CT images generated was statistically analyzed by Wilcoxon signed-rank test. Results:The MAE of the CNN and CycleGAN was (91.99±19.98) HU and (108.30±20.54) HU, and the SSIM was 0.97±0.01 and 0.96±0.01, respectively. In terms of dosimetry, the accuracy of pseudo-CT for photon dose calculation was higher than that of the proton plan. For CNN, the gamma pass rate (3 mm/3%) of the photon radiotherapy plan was 99.90%±0.13%. For CycleGAN, the value was 99.87%±0.34%. The gamma pass rates of proton radiotherapy plans were 98.65%±0.64% (CNN, 3 mm/3%) and 97.69%±0.86% (CycleGAN, 3 mm/3%). For DVH, the dose calculation accuracy in the photon plan of pseudo-CT was better than that of the proton plan.Conclusions:The deep learning-based model generated accurate pseudo-CT images from MR images. Most dosimetric differences were within clinically acceptable criteria for photon and proton radiotherapy, demonstrating the feasibility of an MRI-only workflow for radiotherapy of nasopharyngeal cancer. However, compared with the raw CT images, the error of the CT value in the nasal cavity of the pseudo-CT images was relatively large and special attention should be paid during clinical application.

Objective To explore the mechanism underlying the protective effect of α2-macroglobulin (A2M) against glucocorticoid-induced femoral head necrosis. Methods In a human umbilical vein endothelial cell (HUVEC) model with injuries induced by gradient concentrations of dexamethasone (DEX;10-8-10-5 mol/L), the protective effects of A2M at 0.05 and 0.1 mg/mL were assessed by examining the changes in cell viability, migration, and capacity of angiogenesis using CCK-8 assay, Transwell and scratch healing assays and angiogenesis assay. The expressions of CD31 and VEGF-A proteins in the treated cells were detected using Western blotting. In BALB/c mouse models of avascular necrosis of the femoral head induced by intramuscular injections of methylprednisolone, the effects of intervention with A2M on femoral trabecular structure, histopathological characteristics, and CD31 expression were examined with Micro-CT, HE staining and immunohistochemical staining. Results In cultured HUVECs, DEX treatment significantly reduced cell viability, migration and angiogenic ability in a concentration- and time-dependent manner (P<0.05), and these changes were obviously reversed by treatment with A2M in positive correlation with A2M concentration (P<0.05). DEX significantly reduced the expression of CD31 and VEGF-A proteins in HUVECs, while treatment with A2M restored CD31 and VEGF-A expressions in the cells (P<0.05). The mouse models of femoral head necrosis showed obvious trabecular damages in the femoral head, where a large number of empty lacunae and hypertrophic fat cells could be seen and CD31 expression was significantly decreased (P<0.05). A2M treatment of the mouse models significantly improved trabecular damages, maintained normal bone tissue structures, and increased CD31 expression in the femoral head (P<0.05). Conclusion A2M promotes proliferation, migration, and angiogenesis of DEX-treated HUVECs and alleviates methylprednisolone-induced femoral head necrosis by improving microcirculation damages and maintaining microcirculation stability in the femoral head.

The paper introduces Professor XU Yunxiang's experience in treatment of tic disorder with Xu's manual flying needling therapy by both hands. This therapy is characterized by the integration of yinyang regulation and the painless technique of manual flying needling. It is especially applicable to pediatric encephalopathy. Professor XU Yunxiang believes that tic disorder is related to the liver hyperactivity and spleen weakness, and the imbalance in the sea of marrow in pathogenesis. The treatment should focus on inhibiting the wood, supporting the earth, eliminating the wind and regulating the mind. The acupoints are specially selected on the head and from the back-shu points, the front-mu points and the affected meridians. The needling technique is featured by "flying for calming down the mind, manipulating with both hands simultaneously, combining the back-shu points and the front-mu points, inducing the sensation transmission, obtaining the reinforcing and reducing with both hands and removing the needles for tranquilizing the mind". This therapy is aimed at regulating the mind, qi and body movement. It increases the efficiency of acupuncture, reduces needling pain, strengthens needling sensation and improves children's compliance.
Humans ; Acupuncture Points ; Acupuncture Therapy ; Tic Disorders/physiopathology*

【Objective】 To develop a novel screening reagent for -D- phenotype preliminary screening based on the difference in RhD antigen expression level of -D- phenotype and normal RhD phenotype. 【Methods】 RhD antigen expression of -D-phenotype and Rh D-- gene carrier were detected by flow cytometry. By adjusting the concentration of polybrene in the screening system, the red blood cells with high RhD antigen expression level agglutinated, and the preliminary screening of the -D-phenotype and its gene carriers was realized. 【Results】 According to the quantitative results of immunofluorescence intensity (MFI) analysis by flow cytometry, the expression level of RhD antigen in -D- phenotype cells (284 360±16 698, n=3) was about 3 times normal RhD positive cells (98 642±35 908, n=9)(P<0.01), while RhD antigen expression level of RhD-- gene carrier (181 109±39 455, n=4) was about 2 times normal RhD positive cells(P<0.01). RhD antigen expression (144 538±227 445, n=7) of the positive cells screened by 15 μL 3% fresh red blood cell suspension and screening system 35 μL (1 μL IgG anti-D, 29 μL polybrene polybrene, and 5 μL low ionic strength solution) was about 1.5 times normal RhD positive cells. 【Conclusion】 The polybrene preliminary screening system, which can be used for high-throughput screening of -D- phenotype, is a reliable technical method for frequency study of this phenotype.

Objective To observe the curative effect of continuous gastrointestinal decompression after gastric lavage with edible oil on saving patients with oral aluminum phosphide poisoning.Methods Seventy-eight patients with oral aluminum phosphide admitted to the Department of Internal Emergency of the Second People's Hospital of Yunnan Province from October 2009 to October 2016 were divided into a mild poisoning group (39 cases), a moderate poisoning group (26 cases) and a severe poisoning group (13 cases) according to clinical manifestations and laboratory examinations, all the patients were treated with continuous gastrointestinal decompression after early gastric lavage with edible oil, including scavenging toxicant, correcting intracellular oxygen intake and metabolic disturbance, and inhibiting and eliminating inflammatory mediators. The difference of remission times of clinical symptoms, recovery times of abnormal indexes and hospitalization times were compared among patients with different disease severities. Results With the aggravation of disease, the remission times of clinical symptoms (hours: from mild to severe were 24±12, 54±18, 84±12), recovery times of abnormal indexes (hours: from mild to severe were 18±6, 72±0, 108±12) and hospitalization times (hours: from mild to severe 48±24, 120±24, 144±24) were all gradually extended. Of the 13 patients with severe poisoning, 2 patients died of multiple organ functional failure (MOF) after 28 hours of treatment because they were incapable of cooperating with continuous gastrointestinal decompression. There were 76 patients were clinically cured, the cure rate being 97.4%. In the follow-ups at 1 month and 6 months after the treatment, no abnormalities were seen.Conclusion Continuous gastrointestinal decompression after early gastric lavage with edible oil for saving patients with oral aluminum phosphide poisoning is an effective therapy worthwhile to be popularized.

Objective To investigate expression of histone deacetylase 5 (HDAC5) in normal and colorectal cancer (CRC) tissues and its mechanism.Methods Immunohistochemistry was used to detect the expression of HDAC5 in CRC tissues.The relationship between HDAC5 expression content and survival prognosis was analyzed.Proliferation,immigration and apoptosis changes were observed after knockdown of HDAC5.Results Positive expression of HDAC5 in tumor tissue was related with poor prognosis of CRC patients,and HDAC5 could inhibit the LS174T cell proliferation by regulating the SIX1 expression.Conclusion Our results reveal that HDAC5 expression is variant in CRC tissues,and it is correlated with prognosis of colorectal cancer,and can affect cell proliferation by regulating the SIX1 expression.