Objective To investigate the expression of peripheral programmed death (PD)-1hiCXCR5-CD4+T cells and its clinical significance in systemic lupus erythematosus (SLE). Methods Peripheral blood PD-1hiCXCR5-CD4+ T cells from 21 SLE patients and 16 healthy controls were examined by flow cytometry. The levels of serum anti-double-stranded deoxyribonucleic acid (dsDNA) antibodies were determined using immunoradiometric as-say. Data were analyzed with t test and Pearson's correlation test. Results The per-centages of PD-1hiCXCR5- cells within CD4+ T cell were significantly higher in SLE patients [(2.1 ±2.0)％] compared to normal controls [(0.3±0.3)％] (t=2.959, P<0.01). The percentages of PD-1hiCXCR5-cells within CD4+T cells in moderate to severe active SLE patients (3.0 ±2.0)％ was significantly increased compared to patients with mild or inactive (1.0±1.4)％(t=2.574, P<0.05) and normal controls (0.3±0.3)％ (t=5.149, P<0.01). The percentages of PD-1hiCXCR5- cells within CD4+ T cells from SLE patients were positively related with systemic lupus erythematosus disease activity index (SLEDAI) (r=0.475, P=0.0297). SLE patients in serum anti-dsDNA antibodies positive group (2.7±2.1)％displayed a higher percentage of PD-1hiCXCR5-cells within CD4+T cells than patients in serum anti-dsDNA antibodies negative group (0.6 ±0.5)％ (t=2.303, P<0.05). The percentages of PD-1hiCXCR5-cells within CD4+T cells from SLE patients were positively correlated with anti-dsDNA antibody titers. Conclusion The percentages of PD-1hiCXCR5- cells within CD4+ T cells from SLE patients are increased and are positively correlated with SLEDAI and anti-dsDNA antibody levels. Increased percentage of PD-1hiCXCR5-cells within CD4+T cells might play an important role in the pathogenesis of SLE.

Objective To recapitulate the clinical traits of conjunctiva-corneal carcinoma in situ with microinvasion,and explore the early diagnosis and precise therapeutic methods.Methods The clinical features,diagnosis,surgical methods and follow-up results of a hospitalized patient with keratoconjunctival in situ carcinoma with microinvasion were retrospectively analyzed and related literature was consulted.Results Surgical resection of the tumor and 2 mm marginal tissue outside the edge of the tumor was performed.Fresh corneal lamellar grafts were used to treat the disease.After 2 years of follow-up,the operation was effective and no recurrence was found.Conclusion Early diagnosis plays an important role in improving the prognosis of keratoconjunctival carcinoma in situ with microinvasion and preventing recurrence.For patients with keratoconjunctival carcinoma in situ acompanied with microinvasion,we have to expand the surgical resection of the tumor (≥2 mm at the edge of the tumor),and follow-up at regular intervals,if necessary,supplemented with chemotherapy or anti-metabolic treatment.

Objective To study the clinical value and the safety of endoscopic retrograde cholangio-pancreatography(ERCP)for chronic pancreatitis in the pediatric population.Methods Clinical data,endo-scopic reports,and radiography of chronic pancreatic patients aged from 2 to 17 years old who underwent ERCP between Jan.1,2008 and Apr.30,2014 at Endoscopy Center of Ruijin Hospital were reviewed.These patients were divided into 3 groups,patients aged from 2 to 6 years old as children group(n =27),patients aged from 7 to 12 years old as juvenile group(n =35)and patients aged from 13 to 17 as adolescent group(n =25). Their clinical data and complications were analyzed by groups.Results A total of 170 ERCP procedures were performed in 87 patients,with the success rate of 99.4%(169 /170).All patients were diagnosed as having chronic pancreatitis by ERCP.Success rates of children group,juvenile group and adolescent group were 97.6%(40 /41),100.0%(72 /72)and 100.0%(57 /57)respectively.There was no statistically significance among the three groups(P =0.207).No serious complications like bleeding or perforation occurred.No proce-dure-related mortality occurred in this study either.The rate of post-ERCP adverse events in children group, juvenile group and adolescent group were 41.5%(17 /41),25.0%(18 /72)and 24.6%(14/57),respective-ly.Children group had more adverse events than the juvenile group(P =0.039)and adolescent group(P =0.045).Conclusion Pediatric ERCP is highly effective in the pediatric population with chronic pancreatitis. The incidence of post ERCP adverse events is higher among the youngest children.

PURPOSE: Several studies have compared the effects of coronary stenting and coronary-artery bypass grafting (CABG) on left main coronary artery (LMCA) disease. However, there are limited data on the long-term outcomes of these two interventions in diabetic patients. MATERIALS AND METHODS: We evaluated 56 patients with LMCA stenosis who underwent drug-eluting stent (DES) implantation and 116 patients who underwent CABG in a single hospital in China between January 2004 and December 2006. We compared long-term major adverse cardiac events (death; a "serious outcome" composite of death, myocardial infarction, or stroke; and target-vessel revascularization). RESULTS: In-hospital (30-day) mortality was 0% for the DES group and 3.4% for the CABG group (p=0.31). There was no difference between the two groups in terms of risk of death [hazard ratio for stenting group, 0.49; 95% confidence interval (CI), 0.13-1.63; p=0.55] or risk of serious outcome (hazard ratio for DES group, 1.11; 95% CI, 0.39-1.45; p=0.47). The target-vessel revascularization rate was higher in the DES group than in the CABG group (hazard ratio, 3.67; 95% CI, 1.24-11.06; p=0.018). CONCLUSION: In this cohort of diabetic patients with LMCA stenosis, there was no difference in composite endpoints between patients receiving DESs and those undergoing CABG. However, stenting was associated with higher rates of target-vessel revascularization than CABG. DES implantation in diabetic patients with LMCA disease was found to be at least as safe as CABG.
Angioplasty, Balloon, Coronary/*methods ; Coronary Stenosis/*therapy ; Diabetes Mellitus ; *Drug-Eluting Stents ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome

Objective To observe the clinical outcome of repair of the tissue defects of the tendon and skin with thigh anterolateral free flap with iliotibial tract. Methods The data was reviewed from June 2006 to June 2010, which the thigh anterolateral free flap with iliotibial tract were used to repair the defects of the tendon and skin of back of hand in 12 patients. The skin flap was 7 cm´10 cm~8 cm´12 cm in area. The iliotibial tract was 7~13 cm in length and 8~10 cm in width. Institute of Hand Surgery of Chinese Medical Association was to assess the effect. The fellow-up of the 12 patients was 6 months~4 years. Results All the flaps survived after the operation. The result showed excellent in 3 patients, good in 6 and fair in 3. Conclusion It is an effective surgical method to repair the tissue defects of the tendon and skin with thigh anterolateral free flap with iliotibial tract.

ObjectiveTo study the effect of tetramethylpyrazine cooperated with autogenous periosteum graft on fibrous scar formation in the epidural space after laminectomy. Methods48 SD rats were divided randomly into 4 groups. Laminectomy was performed in lumbar 2 segment, and the exposed duras were covered with saline solution (group A), tetramethylpyrazine (group B), autogenous periosteum (group C), and tetramethylpyrazine and autogenous periosteum (group D) respectively. 12 weeks postoperatively, they were evaluated with the gross and histopathological observation, biochemistry examination. ResultsThe assessment of Rydell-Balazs and Nussbaum's Criterion of group B, C, D were obviously better than that of group A (P<0.01), and that of group D was superior to group B and C (P<0.05), no significant difference between group B and C (P>0.05). ConclusionTetramethylpyrazine cooperated with autogenous periosteum graft has a better effect on prevention peridural adhesion after laminectomy.

OBJECTIVE:To observe the outcomes of umbilical cord blood mesenchymal stem call transplantation for treating neural function of multiple system atrophy (MSA) patients.METHODS:A total of 20 MSA patients were selected at the Beijing Wu Stem Cells Medical Center from January to October 2008.All patients received treatment of vessel distention,anti-free radical,trophic nerve and call membrane stabilization,as well as umbilical cord blood mesenchymal stem call transplantation via intrathecal injection.Patients at left-lateral position,and body bent at hips,knees and necks.Acupuncture was conducted at the space of lumbar vertebra 3 and 4.Following local anesthesia,No.9 needle was directly pricked into the subarachnoid cavity.2 mg dexamethasone was slowly infused,and 5 mL (5×106 stem cells) umbilical cord blood mesenchymal stern call injection was obtained and slowly infused into the subarachnoid cavity within 10 minutes,once per week,four times as a course,totally one course.We adopted Unified Multiple System Atrophy Rating Scale (UMSARS) to evaluate those MSA patients.The higher score represented a severe pathogenetic condition.RESULTS:Compared with pretransplantation,the UMSARS score was significantly decreased in 20 patients 4 weeks follwing transplantation (P ＜ 0.01).After the treatment,patient's clinical symptoms such as slow movement,balance disturbance,orthostatic hypotension,urinary and bowel disorders had full obvious improvement.Graft versus host disease was not found.CONCLUSION:It is indicated that mesenchymal stem call transplantation is effective,can partly improve MSA patients' clinical symptoms,and improve patients' life quality.

Objective To search for the genetic and molecular immunity basis of CXCR-1 associated pathogenesis in ankylosing spondylitis (AS) patients. Methods Sequencing analysis was used to detect mutation in the exonic, junctional and promoter sequences of CXCR-1 which might be related with ankylosing spondylitis; the hydrophobicity, conservation and evolutionary distance of the mutated amino acids were also analyzed. Results Six affected individuals in the family were detected with a novel mutation Arg192Gly. The glycine at 192 codon was highly conserved in different species. Arginine and glycine had quite distinct hydrophobicity and BLOSUM score. Conclusion The mutation CXCR-1 (Arg192Gly) detected in these patients might be involved in genetic and molecular immunity mechnisms of ankylosing spondylitis.

BACKGROUND:Qingre Huoxue Xiaozhong composition Ⅰ and Ⅱ made by ourselves are effective in treating bone fracture complicated by soft tissue injury.However,its mechanism is still unclear.OBJECTIVE:To observe the effect of Qingre Huoxue Xiaozhong composition on the levels of intedeukin 1β(IL-1β) and interleukin 6(IL-6) in serum of patients with closed bone injury-induced soft tissue injury.DESIGN:Randomized controlled observation.SETTING:Wards of the Department of Traditional Chinese Medicine,the 401 Hospital of Chinese PLA.PARTICIPANTS: Eighty-eight inpatients with bone fracture at early and moderate stages accompanied by soft tissue injury were chosen as volunteers to be studied in the Department of Traditional Chinese Medicine,the 401 Hospital of Chinese PLA between February 2000 and February 2002.The involved inpatients were assigned into 2 groups according to the table of random digit:Oingre Huoxue Xiaozhong composition Ⅰ + Ⅱ group (n=45) and Qingre Huoxue Xiaozhong composition Ⅱ group (n=43).Oingre Huoxue Xiaozhong composition Ⅰ was for internal administration,and Qingre Huoxue Xiaozhong composition Ⅱ was for external fumigation.METHODS:①Treatment of bone injury:Both caltrate D pellets and pills for strengthening bone joints were used in two groups.②Treatment of soft tissue injury: In the Qingre Huoxue Xiaozhong composition Ⅰ+ Ⅱ group,Qingre Huoxue Xiaozhong composition Ⅰ was decocted.Each decoction was 450 mL,and was packed into 3 pouches, 150 mL/pouch,three times a day;Qingre Huoxue Xiaozhong composition Ⅱ was decocted.Each decoction was 600 mL,and was packedinto 4 Douches,150 mL/pouch.Four pouches of Qingre Huoxue Xiaozhong composition Ⅱ was diluted by 2 000 mL water,then heated and used for fume-washing, twice a day, 20 to 30 minutes once. Four pouches could be used for fume-washing for 2 days successively. In the Oingre Huoxue Xiaozhong compositionⅡgroup, only Oingre Huoxue Xiaozhong composition Ⅱ was used to fume-wash the lesioned region.The concrete method was the same as that in the Qingre Huoxue Xiaozhong composition Ⅰ+Ⅱ group.In each group, ten days were set as one course of treatment,and totally, there are 2 courses of treatment.IL-1β and IL-6 levels in serum of patients were detected by with ELISA kit before.one and two courses after treatment, and compared separately.MAIN OUTCOME MEASURES: Levels of IL-1β and IL-6 in serum of patients in two groups before, one and two courses after treatment.RESULTS: In the eingre Huoxue Xiaozhong composition Ⅰ+Ⅱ group,the level of IL-1β and IL-6 was respectively significantly lower after 2 courses of treatment as compared with the previous one and one course after treatment (P＜0.05-0.01), also at the same time point in compared with the Qingre Huoxue Xiaozhong composition Ⅱ group (P＜0.05).In addition, in the Oingre Huoxue Xiaozhong composition Ⅰ+Ⅱ group,the level of IL-1β and IL-6 was respectively significantly decreased after one course of treatment as compared with before treatment (P＜0.05). In the Oingre Huoxue Xiaozhong composition Ⅱ group,after 2 courses of treatment,the level of IL-1β was significantly decreased as compared with before treatment, and the level of IL-β was also significantly decreased as compared with before treatment and after one course of treatment (P＜0.05).CONCLUSION: Qingre Huoxue Xiaozhong composition Ⅰ+Ⅱ can be used to treat bone fracture accompanied by soft tissue injury by inhibiting the levels of IL-1β and IL-6. The effect of the combination of Oingre Huoxue Xiaozhong composition Ⅰ and Ⅱ is superior to that of each alone.

BACKGROUND: Human leukocyte antigen (HLA)-B27 is closely connected to the occurrence of some rheumatic diseases such as ankylosing spondylitis and can be used as an important factor for evaluating the diagnosis of ankylosing spondylitis. Immunomagnetic separation and enzymelinked immunosorbent assay (IMS-ELISA) has been applied to the detection of HLA-B27.OBJECTIVE: To explore the accuracy, sensitivity and specificity of IMSELISA for detecting HLA-B27 and its value in the auxiliary diagnosis of ankylosing spondylitis.DESIGN: A clinical trial in comparison with the gold standard.SETTING: Departments of Rheumatology and Clinical Laboratory, Third Affiliated Hospital of Sun Yat-sen University.PARTICIPANTS: Eighty-six patients suffering from low back pain and/or arthritis who were treated for the first time in Department of Rheumatology from December 2002 to April 2003. Inclusion criteria: ① Presence of manifestations of low back pain and/or arthritis; ② Thorough documentation of clinical and other examinations; ③ Informed consent to HLA-B27 examination; ④ Treatment for the first time in the Third Affiliated Hospital of Sun Yet-sen University. Those with other serious diseases or with incomplete record of clinical and/or accessory examinations were excluded. The 86 patients included 56 male and 30 female patients aged from 12 to 65 years.METHODS: Blood sample was detected for HLA-B27 by both IMS-ELISA and microlymphocytotoxicity test, and the latter was selected as the gold standard. The coincidence rate of the results detected by the two methods as well as the sensitivity, specificity, positive and negative predictive values of IMS-ELISA were calculated.MAIN OUTCOME MEASURES: ① The coincidence rate of the results of the two methods. ② The sensitivity and specificity of IMS-ELISA for detecting HLA-B27.RESULTS: None of the patients was lost. For the 33 patients with ankylosing spondylitis, the positivity rate of IMS-ELISA (90.9％) was higher than that of microlymphocytotoxicity test (87.9％), but the difference was not statistically significant (P＞0.05). The total coincidence rate of the two methods was 93.0％ in all the 86 patients. The sensitivity, specificity, positive and negative predictive values of IMS-ELISA were 90.0％, 95.7％,94.7％ and 91.7％ respectively.CONCLUSION: Both IMS-ELISA and microlymphocytotoxicity test are capable of reliable examination of HLA-B27 with high sensitivity and specificity.