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Synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome is a rare autoinflammatory disease characterized by dermatological disorders and osteoarticular inflammatory lesions. This article reviews the application of biologics and other treatments based on the therapeutic target and the size of molecules in SAPHO syndrome. We found that drugs, especially biologics, have different effects on bone, joint, and skin damage. This may relate to the different inflammatory pathways involved in the osteoarticular and cutaneous symptoms in SAPHO patients. In this study, we provide stratified medication recommendations for SAPHO syndrome. Patients with osteoarticular symptoms can consider tumor necrosis factor blockers, JAK inhibitor, interleukin (IL)-1 inhibitor, and IL-17 inhibitor. Patients with cutaneous symptoms should consider IL-17 and JAK inhibitors. Apremilast, Tripterygium wilfordii Hook F, and bisphosphonates are other effective treatments.

ObjectivesTo evaluate the extent to which marriage influences cancer-specific survival (CSS) by influencing the insurance status among patients with common solid cancers and the feasibility of reducing the survival gap caused by marriage by increasing private insurance coverage for unmarried patients.SettingA retrospective cohort study with patients retrieved from the Surveillance, Epidemiology and End Results programme.ParticipantsPatients with nine common solid cancers diagnosed between 2007 and 2016 were included. Patients were excluded if their marital status, insurance status, socioeconomical status, stage or cause of death was unavailable, if survival time was less than 1 month, or if they were younger than 18 years at the time of diagnosis.Primary and secondary outcome measuresThe primary outcome was CSS, which was compared between married and unmarried individuals. Mediation analyses were conducted to determine the contribution of insurance status to the association between marriage and CSS.ResultsMarried patients had better CSS than those unmarried (time ratio 1.778; 95% CI 1.758 to 1.797). Private health insurance was a key factor mediating the association between marital status and CSS (proportion mediated (PM), 17%; 95% CI 17% to 17.1%). The PM ranges from 10.7% in prostate cancer to 20% in kidney cancer. The contribution of private insurance to the association between marital status and CSS was greater among women than among men (PM 18.5% vs 16.7%). The mediating effect of private insurance was the greatest for the comparison between married and separated individuals (PM 25.6%; 95% CI 25.3% to 25.8%) and smallest for the comparison between married and widowed individuals (PM 11.0%; 95% CI 10.9% to 11.1%).Conclusions17% of the marital disparities in CSS are mediated by private insurance coverage. Increasing private insurance coverage for unmarried patients may reduce the survival gap related to marital status and sex. However, it is unclear whether better publicly funded insurance would have the same effect.

This work describes the application of an unexplored aromatic tetracarboxylate building block, 2,3′,4,4′-diphenyl ether tetracarboxylic acid (H4deta), for the synthesis of manganese(II) and cadmium(II) coordination polymers (CPs). Five new products, formulated as [Mn2(μ6-deta)(phen)2]n (1), [Cd2(μ6-deta)(phen)2]n (2), [Mn2(μ6-deta)(2,2′-bipy)2]n (3), [Cd2(μ5-deta)(4,4′-bipy)2(H2O)2]n·2nH2O (4), and [Cd2(μ6-deta)(py)(H2O)2]n (5), were assembled using a hydrothermal protocol from the respective metal(II) chlorides, H4deta, and different mediators of crystallization, namely 1,10-phenanthroline (phen), 2,2′-bipyridine (2,2′-bipy), 4,4′-bipyridine (4,4′-bipy), or pyridine (py). All the CPs 1–5 were obtained as stable crystalline products and characterized by conventional solid-state methods (elemental analysis, FTIR, UV-vis, TGA, and PXRD) and single-crystal X-ray diffraction. The structures of 1–3 feature decorated honeycomb-like 2D double layers of a 3,6L66 topological type. Compound 4 reveals a trinodal 4,4,5-connected 3D metal–organic framework (MOF) with a unique topology, while the 2D coordination polymer 5 discloses a binodal 4,6-connected layer with a 4,6L45 topology. The structural and topological traits, thermal stability, luminescence properties and photocatalytic activity toward methylene blue degradation were studied for the obtained compounds. In particular, MOF 4 acts as an active, stable, and recyclable photocatalyst for the UV-light-assisted discoloration of methylene blue in water under ambient conditions. By introducing a novel type of flexible tetracarboxylic acid linker, the present study discloses the first manganese and cadmium compounds derived from H4deta as an unexplored polycarboxylate building block, thus contributing to intensive research on functional metal–organic architectures.

Objective: Immune-mediated necrotizing myopathy (IMNM) with autoantibodies recognizing the signal recognition particle (SRP) patients tend to have prominent proximal weakness and infrequent extra-muscular involvement, especially interstitial lung disease (ILD). However, we reported a Chinese cohort of anti-SRP IMNM patients with relatively more frequent ILD.Methods: Anti-SRP IMNM patients from September 2016 to November 2019 were included according to the most recent European Neuromuscular Center criteria for IMNM. All sera for anti-SRP autoantibody and other myositis-related autoantibodies detection were obtained before the treatment initiation. Muscle strength, coexisting autoimmunity, complications including ILD, treatment and follow-up outcomes were also recorded. Univariate logistic regression was performed to determine variables predicting bad outcomes.Results: Of 271 patients with idiopathic inflammatory myopathy tested, we diagnosed 23 (8.5%) patients with anti-SRP IMNM. Muscle weakness was presented in 23 patients (100%) and generally worse in the lower limbs. ILD was observed in 50% anti-SRP IMNM patients. Predictor of bad outcomes identified by univariate logistic regression analysis was complicated ILD (odds ratio, 3.8).Conclusion: ILD tends to be more frequent in this Chinese anti-SRP IMNM cohort from Hunan province. Complicated ILD represents a risk factor for bad outcomes for anti-SRP IMNM.

The aim of this study was to evaluate the performance of passive muscle stiffness in diagnosing and assessing disease progression in Duchenne muscular dystrophy (DMD). Boys with DMD and age-matched controls were recruited. Shear wave elastography (SWE) videos were collected by performing dynamic stretching of the gastrocnemius medius (GM). At ankle angles from plantar flexion (PF) 30° to dorsiflexion (DF) 20°, the shear modulus of the GM was measured for each 10° of ankle movement. Shear modulus at each ankle angle was compared between the DMD and control group. Correlation between passive muscle stiffness and motor function grading was also analyzed. A total of 26 patients with DMD and 20 healthy boys were enrolled. At multiple stretch levels, passive muscle stiffness of the GM was significantly higher in patients with DMD than in those in the control group (all p values0.05). The shear modulus of GM at an ankle angle of DF 10° had the largest area under the receiver operating characteristic curve in differentiating DMD patients from normal subjects (AUC = 0.902, 95% confidence interval: 0.814-0.990). Motor function grading was a significant determinant of passive muscle stiffness at an ankle angle of DF 10° (B = 21.409, t = 3.372, p = 0.003). Passive muscle stiffness may potentially serve as a useful non-invasive tool to monitor disease progression in DMD patients.

To evaluate the effects of gastric coronary venous embolization with TH glue (developer-containing octyl-α-cyanoacrylate) in combination with splenectomy for the treatment of cirrhotic portal hypertension and gastroesophageal varices.

The study of the panic evacuation process is of great significance to emergency management. Panic not only causes negative emotions such as irritability and anxiety, but also affects the pedestrians decision-making process, thereby inducing the abnormal crowd behavior. Prompted by the epidemiological SIR model, an extended floor field cellular automaton model was proposed to investigate the pedestrian dynamics under the threat of hazard resulting from the panic contagion. In the model, the conception of panic transmission status (PTS) was put forward to describe pedestrians’ behavior who could transmit panic emotions to others. The model also indicated the pedestrian movement was governed by the static and hazard threat floor field. Then rules that panic could influence decision-making process were set up based on the floor field theory. The simulation results show that the stronger the pedestrian panic, the more sensitive pedestrians are to hazards, and the less able to rationally find safe exits. However, when the crowd density is high, the panic contagion has a less impact on the evacuation process of pedestrians. It is also found that when the hazard position is closer to the exit, the panic will propagate for a longer time and have a greater impact on the evacuation. The results also suggest that as the extent of pedestrian’s familiarity with the environment increases, pedestrians spend less time to escape from the room and are less sensitive to the hazard. In addition, it is essential to point out that, compared with the impact of panic contagion, the pedestrian’s familiarity with environment has a more significant influence on the evacuation.

Layer assignment, which is a part of global routing, aims to assign the flat nets to 3D distribution and decrease the via count without violating edge or via constraint. Negotiation-based method is used to obtain good result but bring too much time complexity, this work presents a net partition technology to reduce the problem complexity, and develops enhanced heuristic methods of effective layer shifting and rip-up procedure which could control the via count without multiple iteration process. Experimental results show that this method could bring inspiring improvement than LAVA.

Biphenyl-2,5,3′-tricarboxylic acid (H3L) was selected as an unexplored tricarboxylate building block and applied for the hydrothermal synthesis of three novel coordination compounds, namely a 0D tetramer [Co4(HL)2(μ3-HL)2(phen)6(H2O)2]·3H2O (1) and two 3D metal-organic frameworks (MOFs) [Cd3(μ5-L)(μ6-L)(py)(μ-H2O)2(H2O)]n·H2O (2) and [Zn3(μ4-L)2(2,2′-bpy)(μ-4,4′-bpy)]n·2H2O (3). These products were easily generated in aqueous medium from the corresponding metal(II) chlorides, H3L, and various N-donor ancillary ligands, selected from 1,10-phenanthroline (phen), pyridine (py), 2,2′-bipyridine (2,2′-bpy), and 4,4′-bipyridine (4,4′-bpy). Compounds 1–3 were isolated as stable crystalline solids and were fully characterized by IR and UV–vis spectroscopy, elemental, thermogravimetric (TGA), powder (PXRD) and single-crystal X-ray diffraction analyses. Compound 1 possesses a discrete tetracobalt(II) structure, which is extended into a 3D H-bonded network with the pcu topology. In contrast, MOF 2 discloses a very complex trinodal 4,5,12-connected net with an undocumented topology, while MOF 3 features the nce/I topological framework. The magnetic (for 1) and luminescence (for 2 and 3) properties were also studied and discussed. The present study thus widens a still very limited family of metal-organic and supramolecular frameworks driven by flexible biphenyl-2,5,3′-tricarboxylate building blocks.

To systematically evaluate the risks of cardiocerebral vascular events in patients with primary biliary cholangitis(PBC). Methods We carried out a Meta analysis by RevMan 5.3 software to investigate literatureon the risk of cardiocerebral vascular events in patients with PBC and controls. Results Compared with non-PBC controls,PBC patients had significantly higher risk of coronary events(

Background: To explore the risk factors and prevention methods of cervical mechanical anastomotic fistula and stenosis after the radical resection of esophageal cancer. Methods: From March 2018 to November 2018, 128 patients undergoing mechanical anastomosis of esophageal cancer were selected from the Department of Thoracic Surgery of The First Affiliated Hospital of Zhengzhou University. All the enrolled patients were operated on using the Mckeown method, and a retrospective study was conducted. Data for preoperative and postoperative test indices, intraoperative embedding materials, postoperative complications, and preoperative and postoperative treatment were collected, and the relationship between various factors and the incidence of cervical anastomotic fistula and stenosis was analysed. Univariate analysis was conducted using t tests or Fisher’s exact probability method, and multivariate analysis was conducted using logistic regression models. Results: All 128 patients successfully underwent surgery without dying. The enrolled patients were evaluated using the Stooler classification, with 28 patients having grade 0, 41 patients having grade 1, 34 patients having grade 2, 21 patients having grade 3, and 4 patients having grade 4 stenosis. Patients with stenosis of grade 3 or above had obvious choking sensation, which could only be relieved by balloon dilation. Symptoms in all patients with stenosis were relieved by balloon dilation. There were no significant differences between the two groups regarding embedding materials, preoperative choking history, history of alcohol consumption, history of hypertension, history of coronary heart disease, history of diabetes, postoperative calcium concentration, average albumin concentration, average platelet concentration, body mass index, anastomotic fistula, preoperative chemotherapy, postoperative chemotherapy, or postoperative cough (P>0.05). There were significant differences in postoperative reflux (χ 2 =11.338, P

4-(5-Carboxypyridin-2-yl)isophthalic acid (H3L) was applied as a flexible, multifunctional N,O-building block for the hydrothermal self-assembly synthesis of two novel coordination compounds, namely 2D [Zn(μ3-HL)(H2O)]n·nH2O (1) and 3D [Pb2(μ5-HL)(μ6-HL)]n (2) coordination polymers (CPs). These compounds were obtained in aqueous medium from a mixture containing zinc(II) or lead(II) nitrate, H3L, and sodium hydroxide. The products were isolated as stable crystalline solids and were characterized by IR spectroscopy, elemental, thermogravimetric (TGA), powder (PXRD) and single-crystal X-ray diffraction analyses. Compound 1 possesses a 2D metal-organic layer with the fes topology, which is further extended into a 3D supramolecular framework via hydrogen bonds. In contrast, compound 2 features a very complex network structure, which was topologically classified as a binodal 5,6-connected net with the unique topology defined by the point symbol of (47.63)(49.66). Compounds 1 and 2 disclose an intense blue or green luminescent emission at room temperature.

In this article, a new technique combining polymer dynamic processing and low temperature foaming was proposed to fabricate isotactic polypropylene (iPP) foams with nano-scale cellular structures. A self-developed loop oscillating push–pull molding (LOPPM) device was first used to fabricate the highly oriented iPP samples with shish-kebab crystalline structure. A temperature-quench batch foaming device was used to foam the shish-kebab structured iPP sample at 100 °C with supercritical carbon dioxide (sc-CO 2 ) as blowing agent. Nano pores with average size of 55.3 nm were generated during foaming, attributing to the hindrance and nucleation synergistic effects of the shish-kebab crystalline structure. The LOPPM-PP foam samples showed high ultimate tensile strength (100% higher than PP) and strain-at-break (186% higher than LOPPM-PP), and excellent impact strength (658% higher than PP).

For the problem of serial robot structure error, method of relative position correction was researched. An adaptive filtering correction method based on robot joint position feedback was proposed. The method built a robot joint adaptive filtering corrector (AFC) to correct robot joint feedback. The real spatial position of robot end-effector can be got through the forward kinematics computation with the corrected joint feedback. Thus, the robot structure error is corrected. Weights matrices of AFC were trained with relative positions between calibration points on the standard calibration module. The proposed method of relative positions correction provides a new way for serial robot structure error correction, which does not directly modify the robot kinematics design parameters, dose not need measuring equipment, and can be applied in field. The simulation results got with LabVIEW robot module show that the corrected trajectory of robot end-effector is more approaching to its true trajectory than before, which means the robot structure error is effectively corrected.Keywords: Correction; Relative position; Serial robot; Kinematics

Anti-tumor necrosis factor-α (TNF-α) biological agents, including soluble TNF-α receptors and anti-TNF-α monoclonal antibodies, bring new hope for treating rheumatic diseases such as rheumatoid arthritis, but also increase the risk of infection, especially tuberculosis (TB) infection. Recent findings have shown that the physiological TNF-mediated signaling was somehow impaired by TNF antagonists, leading to the exacerbation of chronic infection associated with aberrant granuloma formation and maintenance. Although both receptor and antibody agents appear to pose an equally high risk in causing development of new TB infections, monoclonal anti-TNF-α antibody seems more inclined to reactivate latent TB infection. This review is focused on the underlying mechanisms that cause the TB risk in the anti-TNF-α therapy and also the strategies to deal with it, with the aim of reducing the TB incidence during anti-TNF-α biological therapies.

This article reports a novel polymer processing method of loop oscillating push–pull molding (LOPPM), which was used to reinforce and toughen high impact polystyrene (HIPS) simultaneously via introducing a dynamic flow field with an oscillatory shear in HIPS molding process. It is found that the impact strength and tensile strength of the LOPPM-HIPS have been significantly increased by 467% and 70% compared with those of the conventional molding HIPS (CM-HIPS), respectively. The morphology of the HIPS samples was characterized by TEM and SEM to investigate the increases. The results revealed that the salami rubber particles in the LOPPM-HIPS turned into pebble-like shapes and formed a special orientation structure. Based on the relationship of structure and properties, the mechanism of the simultaneously reinforcing and toughening was proposed.

Treatment of nucleos(t)ide antiviral drugs for decompensated HBV-related cirrhosis can significantly improve the prognosis. But those patients with refractory ascites possibly deteriorate due to the complications of ascites before any benefit from anti-viral drugs could be observed. Therefore, it is important to find a way to help the patients with HBV-related cirrhosis and refractory ascites to receive the full benefits from antiviral therapy. Peritoneovenous shunt (PVS) using Denver tube enables ascites to continuously bypass into systemic circulation, thereby reducing ascites and albumin input and improving quality of life. We report herein 3 cases of decompensated HBV-related cirrhosis with refractory ascites, PVS using Denver tube was combined with lamivudine for antiviral treatment before and after. Then, ascites was alleviated significantly or disapeared and viral responsed well. All patients achieved a satisfactory long-term survival from 6.7 to 14.7 years. It was suggested that the Denver shunt could be used as an adjuvant method to antiviral drugs for decompensated HBV-related cirrhosis with refractory ascites to help the patients reap the full benefits and maximize efficacy of antiviral treatment.

Background and objective: Mounting studies have illustrated an important role of autophagy in various diseases, but few studies have reported its contribution to rheumatoid arthritis (RA) and the underlying mechanism was largely unknown. This study aimed to investigate whether autophagy inhibitors could regulate apoptosis and proliferation through PI3K/AKT pathway in RA. Methods: RA animal model was established by collagen induction. General observations and degree of joint swelling were observed. Inflammatory response, cell survival related factors and apoptosis were also detected in synovial fibroblasts. In addition, cultured rheumatoid arthritis fibroblast-like synoviocytes (RA-FLS) were subjected to TNF-α treatment in vitro, and TNF-α induced cell autophagy, synovial cell proliferation and apoptosis were detected. Moreover, cell cycle and cytokine secretion protein, along with the above parameters, were analyzed. Results: Results from the animal model showed that autophagy inhibitors attenuated inflammatory reaction and synovial hyperplasia, while promoted synovial fibroblasts apoptosis. Meanwhile, inhibition of autophagy promoted cell apoptosis and reversed cell proliferation in vitro, also blocked cell in the G2/M arrest and reduced the S phase cells. Furthermore, we observed that inhibition of PI3K/AKT pathway reversed TNF-α mediated autophagy and cytokine secretion. Conclusion: autophagy inhibitors could mitigate inflammation response, inhibiting RA-FLS cell proliferation while promoting cell apoptosis by the PI3K/AKT pathway.

At first this paper described the cavity pressure monitoring technology definition and work principle. Then showed that made use of monitoring the cavity pressure curve and study melt flow balance by specific example. The use of cavity pressure curve could be quickly and accurately get the best process parameters, so change the way of obtaining process parameters optimization from the "experience" basis to "scientific" basis. The article concluded it could understand deeply and grasp the relationship among the three proposals of the cavity pressure curve, process parameters and product quality.

To evaluate whether the multidrug resistance gene 1 (MDR1) exon 26 polymorphisms are associated with the refractory rheumatoid arthritis (RRA). The study was carried out on two hundred and twenty-three patients with RA treated and one hundred and three normal controls. The RA treated were divided into two groups according the response to disease-modifying antirheumatic drugs (DMARDs). There were 108 patients in the effective group and 115 patients in the ineffective group. Genotypes of the C3435T polymorphism were determined by polymerase chain reaction followed by restriction digestion (PCR-RFLP). There were significant differences in the genotype frequency and allele frequency among three groups. Compared to responders and controls, the nonresponders carried more CC genotype (χ(2) = 5.306, P = 0.021; χ(2) = 7.810, P = 0.005) and more C allele (χ(2) = 6.601, P = 0.010; χ(2) = 12.172, P = 0.000). But, there were no statistically significant differences in genotype nor allele frequency between RA and healthy controls. The results from our study suggest that the C3435T MDR1 gene polymorphism may not be related with the RA susceptibility, but may influence the efficacy of RA therapy with DMARDs, and the 3435CC genotype may be related with RRA.

There is a lack of appropriate classification criteria for the determination of atretic follicles in guinea pigs. In the present study, new criteria were established based on the latest morphologic criteria for cell death proposed by the Nomenclature Committee on Cell Death (NCCD) in 2009. Ovaries of guinea pigs were sampled on different stages of estrous cycle, and the morphologic observations of atretic follicles were investigated in serial sections. The results showed that the process of follicular atresia could be classified into four continuous stages: (1) the granulosa layer became loose, and some apoptotic bodies began to appear; (2) the granulosa cells were massively eliminated; (3) the theca interna cells differentiated; and (4) the residual follicular cells degenerated. In addition, the examination revealed that these morphologic criteria were accurate and feasible. In conclusion, this study provides new criteria for the classification of atretic follicles in guinea pigs, and this knowledge can inform future research in the area.

Takayasu arteritis (TA) is a type of systemic large-vessel vasculitis that usually affects the aorta and its major branches. It remains unrecognized owing to delayed diagnosis (Boltin et al. in Rheumatol Int 27(10):985-987, 2007) and non-characteristic clinical features. It has been described in association with many autoimmune diseases, such as inflammatory digestive tract diseases. However, report of TA associated with tumors, especially malignant tumors, are rare. We here presented a case diagnosed by both Takayasu arteritis and malignant fibrous histiocytoma, from which we learned not only clinical lessons, but also consensus of relationships between these two diseases.

Resveratrol (trans-3,4′-trihydroxystilbene), a natural phytoalexin, possesses anti-inflammatory, anti-proliferative, and immunomodulatory properties and has the potential for treating inflammatory disorders. The present study was designed to investigate the effects of resveratrol on TNF-α-induced inflammatory cytokines production of IL-1β and MMP3 in Rheumatoid arthritis (RA) Fibroblast-like synoviocytes (FLS) and further to explore the role of PI3K/Akt signaling pathway by which resveratrol modulates those cytokines production. The levels of IL-1β, MMP-3 in cultural supernatants among groups were measured by enzyme-linked immunosorbent assay. Messenger RNA expression of IL-1β and MMP-3 in RA FLS was analyzed using a reverse transcription-polymerase chain reaction. Western blot analysis was used to detect proteins expression in RA FLS intervened by resveratrol. Resveratrol inhibited both mRNA and proteins expressions of IL-1β and MMP-3 on RA FLS in a dose-dependent manner. Resveratrol also decreased significantly the expression of phosphorylated Akt dose dependently. Activation of PI3K/Akt signaling pathway exists in TNF-α-induced production of IL-1β and MMP3 on RA FLS, which is hampered by PI3K inhibitor LY294002. Immunofluorescence staining showed that TNF-α alone increased the production of P-Akt, whereas LY294002 and 50 μM resveratrol suppressed the TNF-α-stimulated expression of P-Akt. Resveratrol attenuates TNF-α-induced production of IL-1β and MMP-3 via inhibition of PI3K-Akt signaling pathway in RA FLS, suggesting that resveratrol plays an anti-inflammatory role and might have beneficial effects in preventing and treating RA.

The properties of microcellular polylactic acid (PLA)/organic modified montmorillonite (OMMT) clays and PLA/sericite powder (SP) nanocomposites were investigated and compared in terms of thermal property, rheological property, particles dispersability, and cell microstructure. The batch-foaming process uses carbon dioxide as the physical blowing agent. According to the transmission electron microscopy and X-ray diffraction characterization, fillers (i.e., OMMT and SP) have good dispersions in PLA matrices. The thermal and rheological properties of solid PLA composites are demonstrated by differential scanning calorimetry and capillary rheometer, respectively. The microcellular morphology of fractured cross-sectional surfaces is characterized by scanning electron microscope. The batch-foamed PLA composites have more uniform cells in comparison with foamed pure PLA parts due to the mineral particles.

At first this paper described the cavity pressure monitoring technology definition and work principle. Then showed that made use of monitoring the cavity pressure curve and study melt flow balance by specific example. The use of cavity pressure curve could be quickly and accurately get the best process parameters, so change the way of obtaining process parameters optimization from the "experience" basis to "scientific" basis. The article concluded it could understand deeply and grasp the relationship among the three proposals of the cavity pressure curve, process parameters and product quality.

Knowledge spillover is an exchange of ideas among individuals. In knowledge management economics, a knowledge spillover is a non-rival knowledge market externality that has a spillover effect of stimulating technological improvements in a neighbor through one's own innovation. This paper researches the efficiency of the modular organization from the perspective of knowledge spillovers. First of all, a production function model is proposed, which is build on the effect of knowledge spillovers among members of the modular organization. Additionally, some relevant factors are found that the efficiency of the modular organization is influenced by analyzing this model. Finally, this paper concluded that the efficiency of the modular organization and the knowledge spillovers among members of the organization which impacts each other, and two suggestions are proposed in the light of the conclusion.

OBJECTIVE To observe the effect of resveratrol (Res) on in vitro proliferation and apoptosis of TNF-alpha induced rheumatoid arthritis fibroblast-like synoviocytes (RA FLS), and further to investigate the PI3 K/Akt/BAD signal mechanism. METHOD The inhibition rate of RA FLS was examined by MTT assay. Cell cycle and the amount of apoptotic cells was measured by flow cytometry. PI3K/Akt/BAD signal transduction proteins expression was measured by western blot. RESULT The living cells measured by MTT dose and time-dependently reduced in Res groups. In Res groups, the fraction of living cells in the S-phase and G2/M-phase decreased respectively, while that in G1-phase increased, the difference was statistically significant compared with the TNF-alpha group (P < 0.05). Flow cytometry demonstrated that the apoptosis rate increased with increased Res concentration. Res inhibited TNF-alpha induced phosphorylation of Akt and BAD in RA FLS. CONCLUSION Res can inhibit RA FLS proliferation and induce apoptosis through inhibition of PI3K/Akt/BAD signalling pathway. Res may provide a new therapeutic approach in treatment of RA.

Psoriatic arthritis (PsA) is a rheumatoid factor (RF)-seronegative systemic inflammatory disorder associated with psoriasis. Current treatment for PsA in China is still focused on disease modifying anti-rheumatic drugs (DMARDs). In this paper, we report two Chinese patients with active longstanding PsA treated with infliximab, a human-mouse chimeric monoclonal antibody against tumor necrosis factor alpha (TNF-α). The results show that infliximab acted quickly and effectively in relieving peripheral and axial symptoms and refractory skin lesions, even in recombinant human TNF-α receptor (rhTNFR)-resistant case. The take-home message from our cases is that infliximab is a useful therapeutic option for refractory PsA, especially when a patient has a combination of psoriasis and psoriatic arthritis. Further local evidence and experience must be accumulated in order to make anti-TNF-α therapy more accessible to PsA patients in China.

To observe the effect of resveratol on cartilage, chondrocyte apoptosis, and nitric oxide in experimental osteoarthritis (OA) of rabbit and to study the mechanism of resveratol in the treatment of osteoarthritis. Thirty New Zealand rabbits were randomly divided into 5 groups: group A (normal control group), group B (model control group), group C (resveratrol intervention high-dosage group), group D (resveratrol intervention middle dosage group), and group E (resveratrol intervention low-dosage group). The model of OA of the knee was established using Hulth technique in groups B, C, D, and E. After 4 weeks, group A and group B rabbits were administered daily a knees injection of dimethylsulfoxide (DMSO), whereas groups C, D, and E were administered daily a knees injection of resveratrol in DMSO in different dosages for 2 weeks. Daily dosage for rabbits of groups C, D, and E was fixed at 50, 20, and 10 μmol/kg, respectively. Then, the rabbits were killed, and the lateral cartilage sections of right femoral medial condyle were evaluated using a histological scoring system (HE and safranin-O staining) and analyzed by TUNEL for apoptosis. Nitric oxide (NO) in synovial fluid was measured by nitrate reduction method. Histological evaluation of cartilage tissue revealed a significantly reduced cartilage destruction; the evaluation also revealed the loss of matrix proteoglycan content in cartilage in resveratrol intervention groups compared to the model control. Resveratrol reduced the apoptosis rate of chondrocyte and level of NO in the synovial fluid. In the above experiments of OA rabbits, the protective effects of resveratrol were enhanced with increased resveratrol dosage. Resveratrol controls the progression of experimental OA. One of the mechanism(s) responsible for this effect would include lowering of the apoptosis rate of chondrocyte and reducing the production of NO in experimental OA.

Anti-tumour necrosis factor-α (TNF-α) therapy brought new hopes for treating rheumatic diseases but also increased the risk of infection, including mycobacterium tuberculosis (MTb). Conventional screening tools, such as tuberculin skin test (TST), lack sensitivity or specificity. Recently, T-SPOT.TB has been introduced to detect tuberculosis infection. Reports have proved its superior performance in detecting tuberculosis infection in various patient populations than the TST. To compare the value of a T-cell-based enzyme-linked immunospot assay (ELISPOT) T-SPOT.TB and conventional (TST) in screening and monitoring tuberculosis in patients with rheumatic diseases during infliximab therapy in China. Fifty-eight patients with various rheumatic diseases who received infliximab therapy were enrolled in the trial. Freshly isolated peripheral blood mononuclear cells were stimulated with MTb-specific antigens (ESAT-6 and CFP10), and IFN-γ-producing cells were counted. TST was performed with 1 TU PPD injected intradermally into the volar aspect of forearm. A cutaneous induration with diameter ≥5 mm was considered as positive TST, and an increment ≥5 mm of cutaneous induration was considered as TST conversion. TST and T-SPOT.TB test were carried out at baseline and repeated 12 months after infliximab therapy (if no active TB occurs) or at times when TB occurred. Moreover, all patients were initially evaluated for latent tuberculosis infection (LTBI) with clinical examination and chest radiograph. The McNemar test was used for TST and T-SPOT.TB concordance analysis. Cohen’s kappa coefficient was used to assess strength of the agreement. Among the 58 patients evaluated, 25 (43.1%) had ankylosing spondylitis, 24 (41.4%) had rheumatoid arthritis, 4 (6.9%) had undifferentiated spondyloarthropathy, 3 (5.2%) had psoriatic arthritis and 2 (3.4%) had reactive arthritis. A total of 52 patients (89.7%) had previously received vaccination with Bacille Calmette-Guerin. All of the patients received either single or combination of disease modifying anti-rheumatic drug (DMARDs) therapy, and 16 (27.4%) had previously or presently received glucocorticoid therapy. Before infliximab therapy, 12 patients (20.7%) had positive and 46 (79.3%) had negative TST results, and only 1 (1.7%) had positive T-SPOT.TB. Among 51 patients completing the repeated TST and T-SPOT.TB assay, 7 patients (13.7%) had TST conversion and 4 (7.8%) had positive T-SPOT.TB results. Of 7 patients with TST conversion, 2 patients (28.6%) developed active TB and also had positive T-SPOT.TB results; of 44 patients with no TST conversion, 2 patients (4.5%) had positive T-SPOT.TB and 1 (2.3%) had active TB. If 5 mm was used as the cut-off value of TST, TST and T-SPOT.TB, had an agreement value of 68.6% with a kappa value of 0.166. If 10 mm was used as the cut-off value, the agreement between TST and T-SPOT.TB was 88.2% with a kappa value of 0.338. T-SPOT.TB was more specific than TST in detecting tuberculosis during infliximab therapy in China with high BCG vaccination and high prevalence of TB. It can be used as a reliable tool for TB monitoring during infliximab therapy in Chinese patients with rheumatic diseases. Finally, it is recommended to repeat the TST and T-SPOT.TB periodically during biological treatment.

To investigate the effects of carbachol (CAR) on pulmonary vascular permeability and pulmonary water content during oral fluid resuscitation of burn shock.Twelve male Beagle dogs with intubation of carotid artery and jugular vein for 24 hours were subjected to a 50% total body surface area (TBSA) full-thickness burn, then they were equally divided into oral resuscitation (OR) and OR plus CAR groups (OR+CAR). Dogs were given either a glucose-electrolyte solution (GES) in OR group or GES containing CAR (20 microg/kg) in OR+CAR group by gavage within 24 hours after burn. Dogs in each group were given intravenous fluid resuscitation after 24 post burn hour (PBH). The delivery rate and volume of GES was in accordance with that of Parkland formula. Respiratory rate (RR), arterial partial pressure of oxygen (PaO(2)), extravascular lung water index (ELWI) and pulmonary vascular permeability index (PVPI) were determined before burn (0 hour), and at 2, 4, 8, 24, 48 and 72 PBH. At 72 PBH or before death, dogs were sacrificed to collect lung tissue for evaluation of myeloperoxidase (MPO), malondialdehyde (MDA), and assessment of the tissue water content by dry to wet weight.Compared with those before burn, RR, ELWI and PVPI were greatly increased, and PaO(2) obviously decreased in two groups after burn (all P0.01). At 72 PBH, PaO(2) returned to pre-burn level, while RR, ELWI and PVPI were still higher than pre-burn levels. RR, ELWI and PVPI at 4, 8 and 24 PBH, and PaO(2) at 8, 24, 48 PBH in OR+CAR group were respectively lower or higher than those in OR group (P0.05 or P0.01), but those measurements showed no statistical differences between two groups at 72 PBH (all P0.05). MPO, MDA and lung water contents in OR+CAR group were significantly lower than those in OR group at 72 PBH [(2.64+/-0.38) U/mg vs.(4.12+/-0.46) U/mg, P0.01; (3.60+/-0.54) micromol/mg vs.(5.14+/-0.62) micromol/mg, P0.01; (77.40+/-0.56)% vs. (78.30+/-0.54)%, P0.01].The results indicate that CAR inhibits inflammatory response and oxidative damage in lung tissue, and alleviates pulmonary vascular permeability and lung edema during oral fluid resuscitation of burn shock.

To determine the molecular mechanism of reversing multi-drug resistance of K562/AO2 by puerarin.Effects of ADR and puerarin on NF-kappaB activity of K562,K562/AO2 were tested by immunofluorescence. The expression of survivin of K562,K562/AO2 was examined by immunocytochemistry. The p-gp expression was detected by flow cytometry.The NF-kappaB activity of K562 was significantly higher than that of K562/AO2. The NF-kappaB activity of K562 treated by ADR was significantly higher than untreated. The NF-kappaB activity of K562 which was pretreated by puerarin and then treated by ADR was much lower than that treated by ADR alone. The NF-kappaB activity of K562/AO2 intervened by puerarin was lower than that unintervened by puerarin.The p-gp and survivin expression of K562/AO2 was significantly higher than K562. The p-gp and survivin expression of K562 treated by ADR was higher than that untreated by ADR. But the p-gp and survivin expression of K562 which was pretreated by puerarin and then treated by ADR was much lower than that not pretreated by puerarin.The p-gp and survivin expression of K562/AO2 intervened by puerarin was lower than that unintervened by puerarin. The expression was negatively correlated to the duration of intervention. The inhibition effect demonstrated time dependence.The activation of NF-kappaB can increase the expression of p-gp and survivin, which may be part of the molecular mechanism of multi-drug resistance of K562. Puerarin can prevent and stop the multi-drug resistance in K562 and reverse the multi-drug resistance of K562/AO2 to ADR by inhibiting the activity of NF-kappaB and the expression of p-gp and survivin.