Objective:To assess the efficacy of a minimally invasive technique for repairing tibial plateau bicondylar fractures utilizing the double reverse traction repositor.Methods:A retrospective analysis was performed of the data of 31 patients (Schatzker V 17 cases, Schatzker VI 14 cases) who had been admitted to trauma center of Shandong provincial hospital affiliated to Shandong first medical university for tibial plateau bicondylar fractures from January 2017 to January 2022. There were 21 males and 10 females, aged from 18 to 67 years (average, 32.4±6.5 years). The intervention strategy comprised the use of a double reverse traction repositor and was augmented by precise screw fixation. A comprehensive set of parameters were measured, including time interval between injury and operation, operation time, blood loss, hospital stay, fracture healing time, incision complications. Postoperative assessments were made immediately and at the 12-month mark, including the evaluation of articular step-off height, medial tibial plateau angle, and posterior tibial slope angle. The evaluation also included thTime interval between injury and operation ranged from 5 to 11 days, with an average of 6.1±1.3 days. The surgical procedures varied in length from 70 to 160 minutes, averaging at 109.2±15.6 minutes. The volume of blood loss was noted to be between 90 to 380 ml, averaging at 176.5±20.8 ml. Hospitalization spanned from 10 to 15 days, with an average stay of 12.2 ±0.8 days. Over a follow-up duration of 12 to 20 months, averaging at 13.5±1.1 months, all patients achieved fracture union within a period of 11 to 20 weeks, with an average time of 14.6±1.5 weeks. The postoperative articular step-off was recorded at 0.45±0.13 mm immediately after surgery and 0.58±0.21 mm at the one-year follow-up. Similarly, the medial tibial plateau angle and posterior tibial slope angle showed marginal changes from the immediate postoperative period to the 12-month evaluation. Knee joint mobility at the one-year mark ranged impressively from 0° to 135°, with an average of 125.6°±2.1°. Functional outcomes as reflected by Rasmussen scores ranged from 18 to 28 points, with an average of 25.4±1.7 points. Pain, as assessed by the VAS, had a low score range of 0 to 2 points, averaging at 0.7±0.2 points. Notably, there were no postoperative complications associated with the incisions, such as fat liquefaction, infection, skin necrosis, or exposure of internal fixations. Additionally, no cases of delayed union or fixation failure were observed. Six patients had traumatic arthritis 1 year after operation.Conclusion:The minimally invasive double reverse traction repositor technique for tibial plateau bicondylar fracture repair is effective, warranting its broader application in orthopedic surgery.

Objective To investigate the secretory capacity and apoptosis of interleukin ( IL)-21 induced normal B cells by co-culture with serum from patients with systemic lupus erythematosus (SLE). Methods Serum from twenty new-onset SLE patients and 20 healthy donors were collected .CD1+9 B cells from the normal controls were co-cultured with serum from SLE patients in the presence or absence of IL-21-R-FC(4 μg/ml).Supernatant IgG and IgM concentration were measured by immunoturbidimetric assay on day 5.Supernatant anti-dsDNA level was determined by ELISA .The percentage of apoptotic cells was detected by flow cytometer.Results IgG,IgM and anti-dsDNA levels in normal B cells with SLE serum were significantly higher than those in the serum of SLE patients alone [ ( 5.84 ±1.79 ) g/L vs ( 4.25 ± 1.48)g/L,P=0.000;(0.46 ±0.21)g/L vs (0.43 ±0.21)g/L,P=0.003;(127.76 ±70.24)IU/ml vs (115.15 ±63.88) IU/ml,P=0.014 respectively].However, no significant differences were found in the group of normal B cells with non-homologous serum from normal controls (P>0.05).Supernatant IgG, IgM and anti-dsDNA levels in normal B cells with SLE serum significantly decreased while IL-21R-fusion protein was added [(5.26 ±1.62)g/L vs (5.84 ±1.79)g/L, P=0.006;(0.42 ±0.20)g/L vs (0.46 ±0.21)g/L, P=0.002;( 118.00 ±69.62 ) IU/ml vs ( 127.76 ±70.24 ) IU/ml, P =0.012 respectively ] .The apoptotic rate of B cells with SLE serum was significantly higher than that with normal serum [ ( 47.88 ± 12.65)%vs (38.86 ±10.32)%,P =0.004].But adding IL-21R-fusion conversed the apoptotic rates [(42.08 ±12.52)%vs (47.88 ±12.65)%,P=0.001].Conclusions SLE serum could induce normal B cells to form immunoglobulin secreting cells and producing autoantibodies , or apoptosis in pathological conditions.IL-21 might be considered as a potential therapeutic target of SLE .

MicroRNA (miRNA) are small non-coding molecules of ribonucleic acid. They are about 22 nucleotides in length, single-stranded, and mediate post-translational regulation by the repression or degradation of messenger RNA(mRNA). miRNA play a key part in the proliferation, differentiation and death of cells. Viral infection is one of the most common causes of human disease. Some studies have found that miRNA has a very close relationship with viral infection, which has an effect on viral replication, the immune response and antiviral immunity. Use of miRNA may become the cornerstone of new methods for the diagnosis and treatment of viral infection. This article summarizes the progress of research into miRNA and viral infection.
Animals ; Humans ; MicroRNAs ; genetics ; metabolism ; Virus Diseases ; genetics ; metabolism ; virology ; Virus Physiological Phenomena ; Virus Replication ; Viruses ; genetics

Objective To assess the efficacy of combined vitamin D with calcium and vitamin D or cal-cium alone in rickets of vitamin D deficiency by meta-analysis method. Methods Searches were made in Cochrance Library , Pubmed, Web of science, Scirus, CNKI, Chinese Biological Medical Literature Database, (CBM),Wangfang from the establishment of the data base till March 2013. All randomized controlled trials about combined with vitamin D and calcium in rickets of vitamin D deficiency were eligible. Serum 25-( OH) ritamin D,phosphate ,ALP,calcium,PTH,phosphate,albumin ,radiographic score were chosen as evaluation in-dex to evaluate the weighted mean diffreence ( WMD) and 95% confidence interval ( CI) for continuous data. RevMan 5. 0. 2 software was used to make meta-analysis. Results 437 literatures were reviewed. Three eligible trials were used for meta-analysis. Meta-analysis showed that:(1)the increase of Serum 25-(OH)vitamin D:Combined therapy group and vitamin D group (MD= -7. 88,95%CI:-12. 24~ -3. 52);Combined therapy group and calcium group (MD= -18. 32,95%CI:-22. 61~ -14. 04). (2)the increase of serum phosphate:Combined therapy group and vitamin D group ( MD= -0. 64 ( 95%CI:-0. 86 ~ -0. 42 );Combined therapy group and calcium group MD= -0. 16 ( 95%CI:-0. 84 ~0. 51 ) . ( 3 ) the decrease of Serum ALP:Combined therapy group and vitamin D group (MD= 109. 99,95%CI:20. 40 ~199. 58);Combined therapy group and calcium group (MD=59. 89,95%CI:10. 09~109. 59 ). (4)the increase of serum calcium :Combined therapy group and vitamin D group (MD= -0. 71,95%CI:-0. 91,-0. 52);the decrease of Radiographic score:Com-bined therapy group and vitamin D group( MD=0. 68,95%CI:0. 42~ 0. 95). Except that the increase of serum phosphate between combined therapy group and calcium group had no significant difference,the rest had signifi-cant difference. Conclusion The long term efficacy in combined therapy group is much effective than vitamin D group or calcium group.

Objective To investigate that p53 expression in fibroblast-like synoviocytes (FLS) and its effects on CD4+ T lymphocytes from active rheumatoid arthritis (RA) patients. Methods Human FLS was transfected with p53siRNA and cocultured with CD4+ T lymphocytes from active RA patients. The expression of osteoprotegerin and IL-6 secretion was detected in the transfected FLS. In addition, the expressions of IFN-γ, IL-17, IL-4 and CD25 as well as mRNA levels of IFN-γ RORγt, IL-17 and Foxp3 in cocuhured CD4+ T lymphocytes were also measured. Results IL-6 secretion decreased in p53-inhibited FLS while osteopro-tegerin expression was not altered, p53-inhibited FLS could significantly increase IL-17 and IFN-γ expres-sions. It also upregulated Foxp3 expression though had no effect on CD4+CD25high T lymphocytes. Conclusion p53 expression in FLS regulates Th1 and Th17 cells of RA patients, and therefore participate in the pathogenesis of RA.

Objective To compare the phenotypes of abnormal CD4+CD25-Foxp3+ T cells with traditional regulatory T cells (CD4+CD25+Foxp3+) in patients with untreated new-onset lupus (UNoL) and investigate their clinical relevance. Methods The expressions of surface markers (CD25, CD127, CCR4, GITR, CTLA-4) and intracellular marker(Foxp3) on the peripheral blood mononuclear cells from twenty-two UNoL patients were analyzed by flow cytometry analysis, and their clinical relevance were assessed. Results There were no significant differences between CD4+CD25-Foxp3+ and CD4+CD25+Foxp3- T cells in the expressions of GITR, CTLA--4 and CCR4 (P>0.05), but they were significantly lower than those of CD4+CD25+ Foxp3+ T cells in UNoL patients (P<0.01). The percentages of CD127low- in CD4+Foxp3+CD25high,CD4+Foxp3+ CD25low and CD4+Foxp3+CD25+ T cells were (93.8±3.5 )%, (93.7±2.3)% and (92.0±2.1)% respectively (P> 0.05), whereas the expressions of Foxp3 on CD4+CD127low- T subpopulations showed significant differences in CD4+CDI27low-CD25high (91.4±2.6)%, CD4+CD127low-CD25low (71.9±3.3)% and CD4+CD127low-CD25- (9.0± 2.2)% T cells(P<0.01 ). The frequency of CD+CCR4+CD25high T cells correlated negatively with SLEDAI (r=-0.695,P<0.001).and it was significantly lower in lupus nephritis patients(1.10±0.17)%compared with SLE patients without nephritis [(1.61±0.23)%,P<0.01]and healthy controls [(1.75±0.10)%,P<0.01], furthermore,the frequency of CD4+CCR4+CD25low-T cells in lupus nephritis was significantly higher than that in healthy controls[(11.5±2.3)%vs (8.0±1.0)%,P<0.01].Conclusion The increased CD4+CD25-Foxp3+ T cells in the Untreated Newonset Lupus(UNoL)patients mimic activated T effector cells.CD4+CD25high-CD127low-T cells can be used to isolate live CD4+CD25highFoxp3+regulatory T cells.CCR4+regulatory T cells may be involved in the pathogenesis of lupus nephritis.

Objective To study the clinical, laboratory, radiological and pathological findings of patients with hypertrophic cranial pachymeningitis (HCP) in Wegner's granulomatosis (WG) to improve the recognition of the disease, even when it occurs in limited form. Methods Three patients were described and English literatures of biopsy-proven pachymeningitis in WG were reviewed. Results The features of WG-associated pachymeningitis included: ① Frequently occurred early in the course of active limited WG; ② Commonly presented with sever headache and cranial neuropathies in the absence of other meningeal irritative signs; ③ Variable cerebrospinal fluid findings with mild predominantly lymphocytic pleocytosis and elevated protein concentration were major laboratorg findings; ④Elevated ESR and positive serum anti-neutrophilic cytoplasmic antibody (ANCA) could be found in most patients; ⑤ Gadolinium-enhanced brain MRI is very senitive in the detection of pachymeningitis; ⑥A dural biopsy showed granulomatous necrotizing inflammation, giant cell, and evidence of vasculitis;⑦ A favorable response to standard treatment with corticosteroid, cyclophosphamide or other cytotoxic drugs could be observed. Conclusion HCP may be the initial or cardinal manifestation of the limited form of WG. Early diagnosis by ANCA, MRI and dural biopsy may facilitate diagnosis Corticosteroid and immunosupressant are the choices of treatment.

Objective To study the changes of clonality of T cell receptor (TCR) and complementarity determinative region 3(CDR3) before and after autologous peripheral blood CD34+ stem cell transplantation(auto-PBSCT) for severe/refractory connective tissue disease(CTD). Methods Thirteen patients with severe/refractory CTD were enrolled for auto-PBSCT in Peking Union Medical College Hospital, including systemic lupus erythematosus (8 cases), rheumatoid arthritis(4 cases), and primary Sjogren’s Syndrome(1 case). Blood samples were collected before/after mobilization, 2 weeks, 1, 3, 6, 12 and 18 months post-transplantation. Diversity of TCRBV and CDR3 were showed by reverse transcription-polymerase chain reaction(RT-PCR) and genescan. Results The TCR BV usage and CDR3 spectral pattern of pre-auto-PBSCT CTD patients were revealed skewed pattern and oligoclonality, Which developed severe oligoclonality within 1 months after auto-PBSCT. However, they showed diversity andpoly-clonality 3～6 months after auto-PBSCT. Conclusion Skewed pattern and oligoclonality of TCRBV and CDR3 which implied auto-reactive were depressed after auto-PBSCT, and inclined to change to normal pattern.

BAFF is an essential ligand essential for survival and differentiation of peripheral B cells. By interacting with three receptors, BAFF can promote B cell maturation and class switching, enhance humoral immunity and T cell co-stimulation. Over-expression of BAFF leads to autoimmune diseases such as systemic lupus erythematosus (SLE) in mouse model. Treating the mice model with BAFF antagonists can slow-down disease progression and enhance survival rate. Moreover, in some SLE patients serum level of BAFF is elevated and correlated with serum anti-dsDNA titer. The preliminary clinical trial of anti-BAFF monoclonal antibody has shown to be safe and effective. BAFF antagonists are promising therapeutic drugs for SLE.

Objective To investigate the prevalence,their autoantigen and the clinical significants of antiendothelial cell antibodies(AECAs) in systemic vasculitis.Methods Western blotting was performed to detect specific AECA in serum of systemic vasculitis,SLE,RA,SS and healthy donors.Then to analyze the relationships of AECA with the disease manifestation.Results(1)The prevalence of AECA was 77.7% in systemic vasculitis,87.5% in SLE,66.7% in SS,7.14% in RA and 10% in normal group respectively.(2)AECA reacted with a heterogeneous series of endothelial proteins which ranged in molecular size from 16 to 120 ku Furthermore,AECA against a 47 ku endothelial cell antigen were more frequently found in a variety of systemic vasculitis and SLE.(3)Compared with those in AECA-negative patients,the mean levels of ESR in AECA-positive patients with TA and the mean levels of BVAS in patients with WG,MPA and CSS were both significantly higher in AECA-positive patients.Patients with BD who have AECA against 47 ku endothelial cell proteins were more frequently found to have neuropathy than those 47 ku-AECA-negative patients,and the prevalence of inhanced CRP are also more frequent.Conclusion AECA showed to be correlated with the disease manifestation,and the same molecular sizeantigen could be found in a variety of systemic vasculitis and SLE.