Objective:To study the clinical features and prognostic risk factors of gastrointestinal (GI) involvement in systemic lupus erythematosus (SLE), and improve clinicians' understanding of GI involvement in SLE.Methods:The clinical data of SLE patients admitted to the First Affiliated Hospital of Guangxi Medical University from September 1, 2012 to September 1, 2019 were retrospectively analyzed. Two hundred and forty-three patients with GI system involvement were the GI system affected group, and 486 patients with-out GI system involvement at the same period were randomly selected as the control group. The clinical mani-festations, laboratory tests and treatment effects of the two groups were compared by t test, Wilcoxon signed-rank test and χ2 test and Logistic regression was used to analyze the prognostic risk of SLE with GI system involvement. Results:① There were 243 SLE patients with GI involvement, with the proportion of GI involvement in SLE patients of 6.4%(243/3 820), and as the first manifestation with GI system symptoms accounted for 20.2%(49/243). The common causes were lupus hepatitis accounted for 52.3%(127/243), lupus mesenteric vasculitis (LMV) for 35.0%(85/243), pseudo Intestinal obstruction (IPO) for 9.9%(24/243), lupus-related pancreatitis for 8.6%(21/243), and protein-losing enteropathy (PLE) as 7.0%(17/243). ② Compared with the control group, the group with GI involvement had a lower average age [(38±14) year vs(32±15) year, t=-2.47, P=0.014], a shorter median duration of illness [12.0(3.0, 72.0) months vs 5.0(1.1, 24.8) months, Z=-5.67 , P<0.001], a higher median systemic lupus erythematosus disease activity index (SLEDAI) score [10(6,28) vs 16(9, 37), Z=2.24 , P<0.001], the occurrence of skin rash (38.7% vs 53.5%, χ2=14.46), arthritis (36.4% vs 46.7%, χ2=7.12 , P=0.008), myositis (43.0% vs 56.4%, χ2=11.53 , P=0.001), pericarditis [(216±111)×10 9/L vs (175±114)×10 9/L, t=-4.69 , P<0.001], thrombocytopenia, and hydroureterosis (1.0% vs 12.8%, χ2=47.47 , P<0.001) were high, but the incidence of pulmonary arterial hypertension (PAH) (31.2% vs 10.7%, χ2=36.99 , P<0.001) was low; Serum alanine aminotransferase (ALT) [17(10, 29) U/L vs 59(16, 127) U/L, Z=9.65 , P<0.001], aspartate aminotransferase (AST) [25.0 (18.0, 37.0) U/L vs 82.5(25.0, 289.0) U/L, Z=10.57 , P<0.001], alkaline phosphatase (ALP) [58(46, 76) U/L vs 82(56, 187)U/L, Z=8.42 , P<0.001], Creatine kinase (CK) [44.0(28.0, 83.0) U/L vs 58.5(34.0, 176.0) U/L, Z=4.46 , P<0.001], lactate dehydrogenase (LDH) [(309±206) U/L vs (443±332) U/L, t=5.64 , P<0.001], fasting blood glucose (FBS) [(5.0±1.5) mmol/L vs (5.3±1.7) mmol/L, t=2.16 , P=0.031], triglyceride (TG) [(2.0±1.3) mmol/L vs (2.7±2.2) mmol/L, t=4.55 , P<0.001] increased, albumin (ALB) [(30±7) g/L vs (27±7) g/L, t=5.87 , P<0.001)] and high-density lipoprotein (HDL) [(1.1±0.8) mmol/L vs (0.9±0.5) mmol/L, t=-4.20 , P<0.001] decrease, and anti SSB antibody positive rate (16.0% vs 9.5%, χ2=5.60 , P=0.018) decreased.③ After 3 months' follow-up, 203 patients with SLE GI involvement were relieved, 30 patients (12.3%) died, and 9 patients (1.8%) died in the control group. Ninety-five (46.8%) patients in the remission group had a significantly higher rate of cyclophosphamide treatment when compared with 5(12.5%) in the non-remission group ( χ2=16.23, P<0.001) . Logistic regression analysis showed that no increase of PAH, elevated erythrocyte sedimentation rate (ESR), ALT, glutamyl transpeptidase (GGT), indirect bilirubin (IBIL) and high SLEDAI scores, hydroureteral dilatation, decreased ALB and HDL were independent related factors for SLE GI involvement, while ascites and elevated FBS were SLE GI involvement factors of poor prognosis. Conclusion:SLE patients with GI involvement have a high mortality rate, and lupus hepatitis and LMV are common. Hydroureterosis, high SLEDAI score, abnormal liver function are risk factors for GI involvement. Jaundice and elevated FBS are the risk factors for poor prognosis, and treatment with cyclophosphamide is the protective factor.

Thimerosal has been widely used as a preservative in drug and vaccine products for decades.Due to the strong propensity to modify thiols in proteins,conformational changes could occur due to covalent bond formation between ethylmercury(a degradant of thimerosal)and thiols.Such a conformational change could lead to partial or even complete loss of desirable protein function.This study aims to investigate the effects of thimerosal on the capsid stability and antigenicity of recombinant human papillomavirus(HPV)18 virus-like particles(VLPs).Dramatic destabilization of the recombinant viral capsid upon thimerosal treatment was observed.Such a negative effect on the thermal stability of VLPs preserved with thimerosal was shown to be dependent on the thimerosal concentration.Two highly neutralizing antibodies,13H12 and 3C3,were found to be the most sensitive to thimerosal treatment.The kinetics of antigenicity loss,when monitored with 13H12 or 3C3 as probes,yielded two distinctly different sets of kinetic parameters,while the data from both monoclonal antibodies(mAbs)followed a biphasic expo-nential decay model.The potential effect of thimerosal on protein function,particularly for thiol-containing proteinaceous active components,needs to be comprehensively characterized during formulation development when a preservative is necessary.

Transjugular intrahepatic portosystemic shunt (TIPS) can effectively reduce the portal venous pressure and relieve the clinical complications related to portal hypertension. However, hepatic encephalopathy (HE) is still the main complication post TIPS. Studies have shown that patients over 65 years old with liver function reserve in Child-Pugh grade C are the high-HE-risk group post TIPS, and early TIPS treatment can benefit the survival of these high-risk patients. In this study, TIPS was used to treat 60 cases aged > 65 years old and liver function reserve in Child-Pugh grade C (decompensated liver cirrhosis) with esophagogastric variceal bleeding. The clinical results of 1-year was observed and the porto systemic gradient (PSG) was evaluated. The relationship between the incidence of HE and the PSG of patients with and without HE were compared to evaluate the effect of PSG on the incidence of HE.

Objective To explore the clinical value of a new scoring system for gastric cancer screening in hospital visits.Methods A new scoring system for gastric cancer screening was used to retrospectively analyze data of patients who visited Wenzhou Central Hospital for various digestive symptoms from April 2017 to August 2018 and met the screening requirements.All patients were divided into three groups according to the grading results of the new scoring system:low-risk group (0-11 points),medium-risk group (12-16 points) and high-risk group (17-23 points).A comparative analysis was performed on the detection of gastric cancer and gastric precancerous conditions among the three groups.Results A total of 2 674 patients were included in this study,1 694(63.35％) in the low-risk group,833(31.15％) in the medium-risk group,and 147(5.50％) in the high-risk group.The total detection rate of gastric cancer was 2.73％ (73/2 674).The detection rates were 1.06％ (18/1 694),4.32％ (36/833) and 12.93％ (19/147) in the three groups,respectively.There were significant differences in the detection rate of gastric cancer between any two of the three groups (all P ＜ 0.05).The detection rates of early gastric cancer in medium-risk group [2.04％ (17/833)] and high-risk group [4.08 ％ (6/147)] were significantly higher than that in the low-risk group[0.35％(6/1 694),all P＜0.05].Conclusion The new gastric cancer screening scoring system can not only significantly improve the detection rate of gastric cancer in hospital visits,but also improve the diagnostic rate of early gastric cancer.

[Objective]To investigate the micro-structural alterations within whole brain white matter(WM) in cough syrup abuse addiction patients containing codeine,and to explore the correlation between aberrant WH and abuse time of cough medicine abuse patients.[Methods]Thirty cough syrup abuse addiction patients containing codeine and 30 controls participated in the study. Structural changes in FA and(mean diffusivity)MD were examined in cough syrup abuse addiction patients containing codeine which derived from DTI tractography. Pearson correlation analysis was performed to compare the mean FA value and duration of cough syrup abuse addiction in patients.[Results]Cough syrup abuse addiction patients containing codeine had lower FA value in bilateral anterior limb of internal capsule(ALIC)and higher MD in the bilateral hippocampus and insula,right anterior cingulate cortex(ACC)and superior temporal gyrus,compared to the controls. Cough syrup abuse addiction group also had positive correlation between mean FAvalues and duration of cough syrup abuse addiction in patients.[Conclusion]Micro-structural alterations within whole brain white matter(WM)are found in cough syrup abuse addiction patients containing codeine. This disturbance progresses as duration increases of cough syrup abuse addiction in patients.

BACKGROUND:Shengjiyuhong ointment has been reported to inhibit hypertrophic scarring. OBJECTIVE:To verify the effects of Shengjiyuhong ointment on hypertrophic scarring of in a rabbit ear model. METHODS:Each ear of thirty-six Japanese rabbits was used to make four 1-cm-diameter circular ful-thickness skin wounds with the entire perichondrium removed. Final y, 288 wounds were made and randomly divided into 6 groups:model, negative control (no drugs were administered), low-, moderate-, high-crude herbal dose drugs (Shengjiyuhong ointment was administered topical y at concentrations of 8.39%, 25.18%, and 75.54%), and positive control (recombinant bovine basic fibroblast growth factor was administered topical y). Shengjiyuhong ointment was administered twice daily til wound healing. The wounds were evaluated by the Vancouver scar scale (VSS). Scar elevation index (SEI) of scar specimens was calculated under a microscope at 40× magnification. mRNA expression levels of type I and III col agen, connective tissue growth factor, fibronectin, andα-smooth muscle actin (α-SMA) were determined by fluorescent quantitative PCR. Protein expression levels of type I and III col agen andα-SMA were detected by western blot assay.α-SMA immunoreactivity was determined by immunofluorescent staining. RESULTS AND CONCLUSION:VSS scores and SEI were significantly increased in each group at 30 days (P<0.05). VSS scores and SEI were significantly decreased in the moderate-and high-crude herbal dose drug groups and positive control groups compared with the model, negative control, and low-crude herbal dose drug groups (P<0.05 or P<0.01). mRNA expression levels of type I and III col agen, connective tissue growth factor and fibronectin, and protein expression levels of type I and III col agen andα-SMA were significantly inhibited after moderate-crude herbal dose Shengjiyuhong ointment and positive drug treatment (P<0.01). These findings suggest that Shengjiyuhong ointment can reduce hypertrophic scars by inhibiting fibroblast proliferation and col agen deposition.

Objective To explore the effects of Shengjiyuhong cream(SJYHC) on proliferation,transdifferentiation,collagen production and TGF-β1/Smads signaling of normal human dermal fibroblasts (NHDFs).Methods Primary cultured NHDFs between 3-6 passages derived from 6 hypertrophic scar samples were all treated with TGF-β1 (0,2,5,10 ng/ml)stimulation added 5 μg/ml SJYHC or not.After culturing 72 h,CCK-8 solution was added to record absorbance at 450 nm to test proliferation of NHDFs.Fluorescence quantitative PCR was used for testing mRNA expression of α-SMA and type Ⅰ and Ⅲ collagen.Digestion method was to test the hydroxyproline content in the supernatant liquor.Western Blot was used for testing protein expression of α-SMA,type Ⅰ and Ⅲ collagen and Smad2,Smad3,P-Smad2 and P-Smad3.One-way analysis of variance were uesd to analyze differences among more than two groups,while LSD-t test as post hoc test were uesd to make paired-comparisons among the groups.P ＜ 0.05 indicated significant difference.Results With the stimulation of 2,5,10 ng/ml TGF-β1,the absorbance values(A values),mRNA and protein expression of α-SMA and type Ⅰ and Ⅲ collagen,hydroxyproline content,and protein expression of Smad2,Smad3,P-Smad2 and P-Smad3 were all elevated contrasted with the control group (P ＜ 0.05,P ＜ 0.01).Without TGF-β1 stimulation,SJYHC only increased the absorbance values(A values) from 1.645 ±0.052 to 1.796 ±0.060(P ＜0.05),while mRNA and protein expression of α-SMA and type Ⅰ and Ⅲ collagen,hydroxyproline content,and protein expression of Smad2,Smad3,P-Smad2 and P-Smad3 were infinitely variable(P ＞ 0.05).With stimulation of 2,5 ng/ml TGF-β1,SJYHC elevated the the absorbance values (A values) from 1.814 ± 0.052,1.970 ± 0.045 to 1.981 ± 0.061,2.133 ± 0.059 (P ＜ 0.05).While stimulated with 10 ng/ml TGF-β1,SJYHC declined the absorbance values(A values) from 2.130 ± 0.050 to 1.958 ± 0.045 (P ＜ 0.05).With stimulation of 2,5,10 ng/ml TGF-β1,mRNA expression of α-SMA were declined by SJYHC from 1.04 ±0.06,2.42 ±0.07,7.17±0.11 to 0.28 ±0.06,0.36 ±0.06,1.89 ±0.08 respectively,protein expression from 0.48± 0.05,1.17 ±0.09,2.04 ±0.09 to 0.18 ±0.03,0.21 ±0.08,0.91 ±0.11 respectively (P＜0.01),mRNA expression of Col Ⅰ from 0.73 ± 0.08,1.52 ± 0.08,3.05 ± 0.11 to 0.45 ± 0.07 0.46 ± 0.05,1.28±0.09 respectively,protein expression from 0.36 ±0.11,0.94 ±0.10,2.13 ±0.13 to 0.21 ± 0.13,0.24 ±0.08,0.87 ±0.09 respectively (P ＜0.01),mRNA expression of Col Ⅲ from 1.51 ±0.09,3.28 ±0.09,6.96 ±0.14 to 0.66 ±0.08,0.69 ±0.08,2.23 ±0.10 respectively,protein expression from 0.26 ± 0.08,0.96 ±0.09,1.96 ±0.15 to 0.08 ±0.02,0.12 ±0.02,0.43 ±0.06 respectively (P ＜0.01),hydroxyproline content from (7.219 ±0.590) μg/ml,(8.745 ±0.514) μg/ml,(10.969 ± 0.489) μg/ml to (6.242 ±0.225) μg/ml,(6.603±0.336) μg/ml,(7.516±0.511) μg/ml (P＜ 0.05).Under stimulation of 5 ng/ml TGF-β1,SJYHC had no significant effect on protein expression of Smad2 and Smad3 (P ＞ 0.05),while protein expression of P-Smad2,P-Smad3 were all declined from 0.56±0.08,0.87 ±0.13 to 0.31 ±0.07,0.46 ± 0.05 (P ＜0.01).Conclusions SJYHC may accelerate wound healing and prevent HS by promoting proliferation,inhibiting transdifferation and collagen production and secretion of NHDFs.

Objective To explore the effects of Shengjiyuhong cream(SJYHC) on proliferation,transdifferentiation,collagen production and TGF-β1/Smads signaling of normal human dermal fibroblasts (NHDFs).Methods Primary cultured NHDFs between 3-6 passages derived from 6 hypertrophic scar samples were all treated with TGF-β1 (0,2,5,10 ng/ml)stimulation added 5 μg/ml SJYHC or not.After culturing 72 h,CCK-8 solution was added to record absorbance at 450 nm to test proliferation of NHDFs.Fluorescence quantitative PCR was used for testing mRNA expression of α-SMA and type Ⅰ and Ⅲ collagen.Digestion method was to test the hydroxyproline content in the supernatant liquor.Western Blot was used for testing protein expression of α-SMA,type Ⅰ and Ⅲ collagen and Smad2,Smad3,P-Smad2 and P-Smad3.One-way analysis of variance were uesd to analyze differences among more than two groups,while LSD-t test as post hoc test were uesd to make paired-comparisons among the groups.P ＜ 0.05 indicated significant difference.Results With the stimulation of 2,5,10 ng/ml TGF-β1,the absorbance values(A values),mRNA and protein expression of α-SMA and type Ⅰ and Ⅲ collagen,hydroxyproline content,and protein expression of Smad2,Smad3,P-Smad2 and P-Smad3 were all elevated contrasted with the control group (P ＜ 0.05,P ＜ 0.01).Without TGF-β1 stimulation,SJYHC only increased the absorbance values(A values) from 1.645 ±0.052 to 1.796 ±0.060(P ＜0.05),while mRNA and protein expression of α-SMA and type Ⅰ and Ⅲ collagen,hydroxyproline content,and protein expression of Smad2,Smad3,P-Smad2 and P-Smad3 were infinitely variable(P ＞ 0.05).With stimulation of 2,5 ng/ml TGF-β1,SJYHC elevated the the absorbance values (A values) from 1.814 ± 0.052,1.970 ± 0.045 to 1.981 ± 0.061,2.133 ± 0.059 (P ＜ 0.05).While stimulated with 10 ng/ml TGF-β1,SJYHC declined the absorbance values(A values) from 2.130 ± 0.050 to 1.958 ± 0.045 (P ＜ 0.05).With stimulation of 2,5,10 ng/ml TGF-β1,mRNA expression of α-SMA were declined by SJYHC from 1.04 ±0.06,2.42 ±0.07,7.17±0.11 to 0.28 ±0.06,0.36 ±0.06,1.89 ±0.08 respectively,protein expression from 0.48± 0.05,1.17 ±0.09,2.04 ±0.09 to 0.18 ±0.03,0.21 ±0.08,0.91 ±0.11 respectively (P＜0.01),mRNA expression of Col Ⅰ from 0.73 ± 0.08,1.52 ± 0.08,3.05 ± 0.11 to 0.45 ± 0.07 0.46 ± 0.05,1.28±0.09 respectively,protein expression from 0.36 ±0.11,0.94 ±0.10,2.13 ±0.13 to 0.21 ± 0.13,0.24 ±0.08,0.87 ±0.09 respectively (P ＜0.01),mRNA expression of Col Ⅲ from 1.51 ±0.09,3.28 ±0.09,6.96 ±0.14 to 0.66 ±0.08,0.69 ±0.08,2.23 ±0.10 respectively,protein expression from 0.26 ± 0.08,0.96 ±0.09,1.96 ±0.15 to 0.08 ±0.02,0.12 ±0.02,0.43 ±0.06 respectively (P ＜0.01),hydroxyproline content from (7.219 ±0.590) μg/ml,(8.745 ±0.514) μg/ml,(10.969 ± 0.489) μg/ml to (6.242 ±0.225) μg/ml,(6.603±0.336) μg/ml,(7.516±0.511) μg/ml (P＜ 0.05).Under stimulation of 5 ng/ml TGF-β1,SJYHC had no significant effect on protein expression of Smad2 and Smad3 (P ＞ 0.05),while protein expression of P-Smad2,P-Smad3 were all declined from 0.56±0.08,0.87 ±0.13 to 0.31 ±0.07,0.46 ± 0.05 (P ＜0.01).Conclusions SJYHC may accelerate wound healing and prevent HS by promoting proliferation,inhibiting transdifferation and collagen production and secretion of NHDFs.

Objective To observe the usage of antiasthmatic drugs and seek problems of following the guidelines of asthma and COPD prevention & treatment in community hospitals.Methods The prescribed quantity in 2013 of antiasthmatic drugs was recorded for 5 community hospitals in a district of Shanghai.Basing on the defined daily dose (DDD),the dosing frequency of drugs (DDDs) and the percentages of each category of drugs were calculated.Then comparisons were made with the data of a grade Ⅱ hospital and a grade Ⅲ hospital in the same district.Results Among three level hospitals,no significant difference existed in the percentages of oral antiasthmatic drugs.But the major category of oral drugs at grades Ⅱ-Ⅲ hospitals was leukotriene receptor antagonist whereas only oral theophylline and oral β2-receptor agonists were available at community hospitals.Among inhaled drugs,inhaled corticosteroids (ICS) dominated at grades Ⅱ-Ⅲ hospitals.But at community hospitals,inhaled short-acting beta-agonists (SABA) predominated.Among inhalants,dry powder inhaler (DPI) dominated at grades Ⅱ-Ⅲ hospitals and metered dose inhaler (MDI) at community hospitals.Conclusions The usage of antiasthmatics at community hospitals is not consistent with the guidelines.Optimizing drug purchasing at hospitals,strengthening continued medical education,modifying the medication concept of patients and boosting the production of domestic inhalants should be urgently undertaken.

ObjectiveTo investigate the etiology and prognosis of asymptomatic hematuria in children.MethodsThe etiological factors, clinical features and prognosis of asymptomatic hematuria were analyzed retrospectively in 431 children from Jan. 2001 to Dec . 2014. ResultsIn 431 children (197 males and 234 females) with asymptomatic hematuria, the mean age of ifrst visit was 5.52±2.77 years (8 months-17 years). Four hundred and twenty-ifve cases had persistent microscopic hematuria and 6 cases had gross hematuria. Three hundred and iffteen cases (73.1%) were glomerular hematuria, among which 286 cases were isolated hematuria, 5 cases were acute glomerulonephritis, 13 cases were minimal change glomerulopathy, 4 cases were IgA nephropathy, 4 cases were mesangial proliferation glomerulonephritis and 3 cases were thin basement membrane nephropathy. One hundred and thirty-six cases (31.5%) were non-glomerular hematuria, among whom 113 cases were left renal vein entrap-ment syndrome, 17 cases were idiopathic hypercalciuria, 4 cases were kidney stone, 1 case was urinary tract infection and 1 case was left kidney absence. The mean follow-up period was 3.05±2.69 years (0.5-13.5 years). One hundred and forty-ifve patients showed the resolution of microscopic hematuria, among whom 110 cases (75.8%) had the resolution in 3 years after the ifrst visit. In 24 cases with family history of hematuria, only 6 cases showed the resolution. At the end of the follow-up, renal function remained stable in all children.ConclusionsThe onset age of asymptomatic hematuria in children varies widely, and most of them are glomerular hematuria. Most children with isolated hematuria show resolution within three years after the ifrst visit. The children with familial hematuria may last longer. The isolated hematuria has good prognosis but needs to be followed up.