Objective To evaluate the recognition and uptake of transglutaminase 3 (TG3) by dendritic cell-specific intercellular adhesion molecule 3-grabbing nonintegrin (DC-SIGN) receptors on the membrane surface of DC-SIGN-transfected human embryonic kidney (HEK) 293T cells and monocytederived dendritic cells (MDDCs).Methods The eukaryotic expression vector pGCMV-enhanced green fluorescent protein (EGFP) containing DC-SIGN gene fragments was transfected into HEK293T cells to prepare DC-SIGN-EGFP-HEK293T cells by using liposome transfection method.CD14+ monocytes were isolated from peripheral blood samples by magnetic bead-based negative selection,and then were induced by granulocyte-macrophage colony stimulating factor (GM-CSF) and interleukin-4 (IL-4) to prepare MDDCs.Laser confocal microscopy and flow cytometry were performed to evaluate the recognition and uptake of TG3 protein by DC-SIGN receptors on the surface of HEK293T cells and MDDCs.MDDCs treated without Alexa Fluor 647 dye-tagged TG3 served as blank control group,and those treated with Alexa Fluor 647 dye alone served as negative control group.Results After co-culture with TG3 for 3 hours,laser confocal microscopy and flow cytometry both showed that TG3 could be recognized by and uptaken through DC-SIGN receptors into HEK293T cells and MDDCs.Flow cytometry also revealed that the binding of TG3 to MDDCs could be partially blocked by DC-SIGN blocking antibodies.Neither the negative control group nor the blank control group showed the recognition and binding of TG3 to HEK293T cells and MDDCs.Conclusion TG3 can serve as a kind of autoantigen to be recognized and bound by DC-SIGN receptors,followed by uptake by dendritic cells.

Objective To compare the therapeutic efficacy of combined biliary stent and 125I seed intracavity irradiation with palliative surgery in the treatment of extrahepatic ductal cholangiocarcinoma.Methods A prospective analysis was conducted on 142 patients with cholangiocarcinoma who were treated in The First Affiliated Hospital of Bengbu Medical College from January 2012 to December 2015.There were 80 patients who underwent percutaneous biliary metal stenting combined with 125I particles implantation (the stenting-particle group) and 62 patients who were treated by palliative biliary drainage (the surgical group).The surgical group included R1 resection in 17 patients,R2 resection in 26 patients and biliary enteric drainage in 19 patients).The levels of jaundice,liver function,survival time,hospitalization time and hospitalization cost before and after therapy were analyzed.Results Jaundice was effectively alleviated in the two groups after a short period.The liver function in the 2 groups improved significantly at 1,3 and 6 months when compared with that before operation,(P ＜ 0.05).The average hospitalization time of the stenting-particle group and the surgery group were (16.5 ± 5.0) days and (25.5 ± 10.5) days,respectively,(P ＜ 0.01).The average hospitalization cost of the stenting-particle group and the surgery group were (39 622.0 ± 7 666.4) yuan and (59 562.0 ± 24 218.2) yuan,respectively,(P ＜ 0.05).The average survival time of the stenting-particle group and the surgery group were (12.2 ± 5.1) months and (12.69 ± 7.46) months,respectively,and the difference was not significantly different (P ＞ 0.05).Conclusions For patients with extrahepatic ductal cholangiocarcinoma who were not suitable for radical surgery,percutaneous biliary stenting combined with 125I seed brachytherapy effectively reduced jaundice,improved liver function,shortened average length of hospital stay and reduced average cost of hospitalization.When compared with palliative surgery,it was a minimally invasive,easy,safe and efficacious treatment,especially for elderly patients with poor physical conditions.

Objective To detect the serum level of transglutaminase 2 (TG2)-specific IgE (slgE) in patients with atopic dermatitis (AD),and to analyze its correlation with the disease condition.Methods A total of 77 patients with AD were enrolled into this study,including 44 patients aged ≥ 12 years and 33 patients aged ＜ 12 years.Of the 77 patients,20 were diagnosed with intrinsic AD,which was characterized by the absence of sIgE and total serum IgE values ＜ 150 kU/L,and 49 with extrinsic AD characterized by positive (++) or even strongly positive slgE for more than 1 kind of exogenous allergens,or total serum lgE values ≥ 150 kU/L.[mmunocapture-biotinylated detector enzyme immunoassay was performed to detect the serum level of TG2-sIgE in 77 patients with AD,40 adult patients with psoriasis vulgaris (PV) and 30 healthy adult controls.Clinical data on the AD patients were recorded,including age,disease duration,SCORAD score,blood eosinophil count,levels of total IgE and TG2-sIgE.Results The serum levels of TG2-sIgE in AD patients aged ≥ 12 years,AD patients aged ＜ 12 years,PV patients and healthy controls were 1.02 ± 0.2,1.04 ± 0.044,0.93 ± 0.25 and 0.71 ± 0.13,respectively.Additionally,the serum level of TG2-sIgE significantly differed among AD patients aged ≥ 12 years,PV patients and healthy controls (x2 =37.407,P ＜ 0.001),and was significantly higher in both AD patients aged ≥ 12 years and PV patients than in the healthy controls (t =7.38,4.83,respectively,both P ＜ 0.001).Moreover,the intrinsic AD group showed significantly higher TG2-sIgE levels compared with the extrinsic AD group (1.16 ± 0.03 vs.1.02 ± 0.20,t =2.27,P =0.02).The TG2-sIgE level was uncorrelated with the patients' age,disease duration,SCORAD score,blood eosinophil count or serum total IgE levels in AD patients (r =0.03,0.14,-0.04,-0.08,0.06,respectively,all P ＞ 0.05).Conclusion The serum level of TG2-sIgE obviously increases in AD patients,so TG2 may be one kind of autoantigen in AD patients,but there is no significant correlation between the TG2-sIgE level and AD severity.

A 59-year-old male patient presented with recurrent erythema and wheals all over the body for 6 years,complicated by irregular fever (the highest body temperature ＜ 39 ℃)and arthralgia for 2 months.He experienced a weight loss of 5 kg during two years prior to the presentation.Physical examination showed anemic comlexion,and there was no palpable enlargement of superficial lymph nodes,liver and spleen.Generalized erythema and wheals occurred all over the body,involving about 50％ of the body surface area.Histopathological examination of skin lesions showed infiltration of multiple neutrophilic granulocytes around blood vessels in the superficial dermis,and no vasculopathy was observed.Laboratory examinations revealed increased white blood cell (WBC) counts(13.97 × 109/L),erythrocyte sedimentation rate (ESR,136 mm/1 h) and C-reactive protein (CRP) level (75 mg/L),decreased hemoglobin level (96 g/L),and high serum levels of IgE (1 596 kU/L),IgG(20.4 g/L)and IgM(6 310 mg/L).Serum immunoelectrophoresis demonstrated that the IgM was a κ-type monoclonal immunoglobulin.Bone marrow examination showed active bone marrow hyperplasia.DNA sequencing analysis of 10 pairs of exons of the NLRP3 gene revealed 3 synonymous mutations,including c.663:C ＞ T:p.T221,c.732:G ＞ A:p.A244A and c.786:A ＞ G:p.R262R.Finally,the patient was diagnosed with Schnitzler's syndrome.There was no improvement of symptoms after the treatment with multiple oral antihistamines at increased dose levels.Then,the treatment protocol was adjusted to oral ciclosporin at a dosage of 200 mg/d for consecutive 18 days,but the patient still showed no response.After the treatment with oral prednisone (30 mg/d) and Tripterygium wilfordii tablets (66 μg thrice a day) for 2 weeks,the skin rashes subsided gradually,and arthralgia was relieved.Moreover,the WBC count,ESR and CRP level were decreased to 9.01 × 109/L,50 mm/1 h and 6 mg/L respectively,while the hemoglobin level was increased to 109.7 g/L.After 1-year follow-up,the dosage of glucocorticoids was gradually decreased to 8 mg/d.In addition,his condition was controlled well with no skin lesions and fever,except for occasional arthralgia in the knees and hip.

There are various kinds of antihypertensive agents with complex chemical structures. Common antihypertensive agents are divided into 5 classes, including diuretics, calcium antagonists, angiotensin-converting enzyme inhibitors, angiotensin Ⅱ receptor blockers and β-blockers, and can cause various types of drug eruptions. This review summarizes clinical characteristics, possible pathogenesis, treatment and consequences of antihypertensive agent-induced drug eruptions, including angioedema, and lupus erythematosus-like, psoriasis-like, eczematoid, herpetiform or lichen planus-like drug eruptions, in hope to facilitate their early detection, diagnosis and treatment, and to provide information and ideas for clinical and basic researches into them.

Objective To analyze γ?secretase gene mutations in a pedigree with acne inversa. Methods Clinical data were collected from a pedigree with acne inversa, which contained 30 members spanning 4 generations. Of these members, 12 were affected by acne inversa, and 9 of the affected members were alive. Peripheral blood DNA was obtained from the proband, his seven relatives (including 4 affected and 3 unaffected members), and 100 unrelatedhealthy human controls. PCR was performed to amplify all the coding exons and their flanking sequences of the NCSTN, PSEN1, PSENEN, Aph1 genes followed by DNA sequencing. Results A heterozygous insertion mutation (c.229_230insCACC)of the PSENEN gene, which led to translational frameshifting and resulted in dysfunciton of the PSENEN protein, was detected in all the 5 patients, but not in unaffected members or healthy controls. Conclusion There is a novel heterozygous insertion mutation c.229_230insCACC in the PSENEN gene, which may be the molecular basis of acne inversa in this family.

Skin microbiome maintain homeostasis with the host, and affect skin barrier and immune function. The components of skin microbiome are diverse and specific, and are affected by multiple factors. The predominance of Staphylococcus aureus and decrease in diversity of skin microbiome are a characteristic of atopic dermatitis. The overgrowth of S. aureus can aggravate inflammatory reactions in AD. S. epidermidis, although another predominant bacterium in AD, exerts an immunoprotective role by regulating skin barrier?associated immunoreactions through the dendritic cells, interleukin (IL)?17A?producing Th17 cells/IL?17 pathway, and by suppressing the overgrowth of S. aureus. Malassezia can induce and aggravate inflammatory reactions in AD through colonization, sensitization, cross reactions, and other mechanisms. Studies on skin probiotics may provide new directions for the treatment of AD.

Objective To evaluate the clinical application of the treatment on malignant obstructive jaundice by combination of percutaneous biliary stent placement and 125 I particles intraluminal implanation.Methods As a prospective study , 32 patients with malignant obstructive jaundice who either have no opportunity for radical operations or unwilling to be surgically treated were enrolled to be treated with percutaneous biliary stent placement and 125 I particles intraluminal implanation.Biochemical routine tests , blood routine tests , tumor markers , coagulation function , color ultrasound , CT and magnetic resonance cholangiopancreatography were conducted prior to the operation to obtain general information of the clinical status of the patients and the tumor and the site of obstruction.Percutaneous transhepatic cholangial drainage was performed first under the B -type ultrasound system.After one week , biliary stents were placed under DSA.According to the stent expansion presented by real-time DSA imaging , 125 I particles were implanted simultaneously or afterwards.Routine biochemical tests and cholangiopancreatography under DSA were conducted in one week , one month and three months after the implantation.Variance analysis was performed with repeated measurements to compare the difference of liver function indexes pre -and post-operation.Meanwhile, 125I particle displacement, falling off and stent patency were observed.After three months, the tumor size was measured by CT.Student t-test was used to compare the tumor sizes of pre-and post-operation.Results The symptoms of jaundice resolved and the general physical conditions improved in 32 patients substantially.The total bilirubin level decreased from preoperative level of (302 ±169)μmol/l to the level of (108 ±50)μmol/l at one week following the surgery , and the indirect bilirubin level decreased from preoperative level of ( 250 ±160 )μmol/l to the level of ( 85 ±43 )μmol/l at one week following the surgery(F=76.32,58.23,P<0.01).The maximal diameters of the tumors decreased from preoperative size of (3.78 ±1.14)cm to the size of (3.14 ±1.28)cm at three months following the surgery, and the minimal diameters of the tumors decreased from preoperative size of ( 2.80 ±0.88 ) cm to the size of ( 1.93 ± 1.00)cm at three months following the surgery, and the differences were statistically significant (t=5.11, 6.73,P<0.05).By using Kaplan-Meier survival curve, the average survival periods were ( 9.9 ± 0.7) months.Conclusions Percutaneous biliary stent placement and 125 I particles intraluminal implanation have definite short-term effects in prolonging survival time , stent patency time and improving the living standard of the patients.The technique is safe and simple.It only needs small incision , has no absolute contraindications and can be applied repeatedly .

OBJECTIVE ToevaluatetheeffectandmechanismofPaecilomyceshepialimycelium
(PHM)onexhaustedfatigueinmice.METHODS Micewereforcedtorun30minadayforconsecutive 18 d using the wheel running fatigue apparatus, and the speed was gradually increased from 10.2 m·min -1 to 12.6 m·min -1 .On d19,these animals were forced to run 60 min to establish an exhausted fatigue model.Every day,40 min before the run training,the animals were ig administered with PHM (140,280,560 mg·kg -1 )and modafinil (13 mg·kg -1 ).The number of electric shocks was recorded on d5,d9,d1 3,d1 7 and d1 9,respectively,and the body mass of each mouse was recorded daily.The levels of muscle glycogen (MG),liver glycogen (LG),serum urea nitrogen (SUN),serum lactic acid (SLA)and serum creatine kinase (CK)were detected by commercially available kits. RESULTS Duringthelastexhaustedrunningond19,thenumberofelectricshocksofthemodelgroup was markedly larger than that of the drug administration groups.When compared to the normal control group,the model group showed a significant decrease in the level of either MG or LG,but a significant increase in the level of either SUN or CK.The nu mber of electric shocks of the PHM in the moderate and high dose groups was 133 ±55 and 1 15 ±41 times,respectively,which was significantly smaller than that of the model group 240 ±89 (P<0.01 ).The levels of MG and LG of the PHM560 mg·kg -1 group were (1 .28 ±0.24)mg·g -1 and (40.9 ±1 0.2)mg·g -1 ,respectively,which were significantly higher than those of the model group〔MG:(0.91 ±0.26)mg·g -1 ,LG:(22.2 ±2.9)mg·g -1;P<0.01〕,and the levels of SUN,SLA and CK of this PHM group were (5.8 ±1 .3)mmol·L-1 ,(5.7 ±1 .7)mmol·L-1 and (0.6 ±0.2)kU·L-1 ,respectively,which were significantly lower than those of the model group 〔SUN:(7.5 ±2.1 )mmol·L-1 ,SLA:(7.1 ±1 .8)mmol·L-1 ,CK:(0.8 ±0.3)kU·L-1;P<0.05〕.The number of electric shocks of the modafinil group was also significantly smaller than that of the model group (P<0.01 ),but there were not any significant differences between the modafinil group and the model groupinthelevelsofMG,LG,SUN,SLAorCK.CONCLUSION ThisstudyshowsthatPHMcanhelp relieve fatigue,which might be associated with its abilities to increase the storeage of energy sources,to enhance the aerobic metabolis m,and to decrease the accu mulation of metabolic products.

Objective To explore renal clear cell carcinoma ( CCRCC) expression and significance of CD146 mR-NA in tumor tissue of patients with. Methods ELISA method for quantitative detection was used for CD146 protein and real-time PCR technique for the detection of CCRCC in 102 ( CCRCC) expression in tumor tissue of patients with CD146 mRNA, and 51 cases of renal patients with non tumor tissues as control. Results Found metastasis in patients with CCRCC, the CD146 protein concentration was statistically significant compared with the control group (F=52.1, P<0.01),the average expression of CD146 mRNA value (0.043 8±0.002 4) was significantly high-er than that of in situ CCRCC patients (0.038 2±0.001 1, P= 0.018) and control group (0.034 4±0.001 0, P=0.001 ) . Conclusion Pathological grading and lymph node up regulation of CD146 mRNA expression in renal cell carcinoma and metastasis, is expected to become a new index, evaluation of malignant degree of CCRCC me-tastasis and prognosis, and provide a reliable basis for the intervention of clinical treatment.