Search

Background Osteoarthritis is a common chronic disease in middle-aged and elderly people, which seriously affects their quality of life. Carrying out community-based management of osteoarthritis is conducive to the optimization of healthcare resource allocation and the improvement of the overall prevention and treatment level of osteoarthritis. However, current community-based management of osteoarthritis has many problems and is not effectively. Objective To perform a review and comparative analysis of the developments in foreign and domestic community-based management of osteoarthritis, and strategies addressing the existing problems, providing evidence for improving strategies regarding community-based management of osteoarthritis to improve the treatment and prognosis of osteoarthritis patients in China. Methods From October 2020 to January 2021, Studies related to osteoarthritis management in Chinese published from January 1, 2010 to January 1, 2020 were searched from databases of CNKI, Wanfang Data and CQVIP using "骨关节炎" plus "管理", "骨关节炎" plus "模式", "骨关节炎" plus "策略" as the search terms, and those in English published during the same period were searched from databases of PubMed, Web of Science, and the Cochrane Library using osteoarthritis and management, mode or strategy as the search terms. After excluding duplicates or those about self-management of osteoarthritis, the enrolled studies about community-based management of osteoarthritis were analyzed using systematic analysis. Results Altogether, 2 695 studies were retrieved, 2 642 of them were excluded, and the other 53 were included. Five studies were about surveys on the management of osteoarthritis in the community, all of which revealed the lack of coordination and purpose in community-based management of osteoarthritis at home and abroad, and the key treatments are relieving symptoms, delaying cartilage degradation, and reducing the possibility of developing deformities, but the efficacies of such treatments were unsatisfactory, and symptoms often recurred. Moreover, community-based management modes of osteoarthritis in China were undiversified, mostly were various types of health education. Six studies proposed that the management of osteoarthritis in the community may be influenced by insufficient understanding of osteoarthritis in patients and their families, insufficient understanding and undervaluing of osteoarthritis in some primary care physicians, and uncoordinated healthcare resources, and put forward that a variety of factors led to the lack of coordination and purpose in the management of osteoarthritis in the community. There were three articles referring the significance of community-based osteoarthritis management, which highlighted that community-based osteoarthritis management could relieve pain, delay disease progression, and improve the quality of life in patients, and improve patients' satisfaction with treatment and services by healthcare professionals, as well as optimize the use of healthcare resources. There were 39 studies related to the strategies for community-based osteoarthritis management, 22 of which involved systematic management strategies, including 18 studies of multi-disciplinary or integrated management models and four studies of hierarchical management. As a whole, China's successful experience of managing diabetes and hypertension in the community has provided new ideas for the prevention and treatment of osteoarthritis, but most of the strategies were in the developmental stage, and their applications in practice needed further research. The remaining 17 studies involved various non-systematic community-based management strategies of osteoarthritis, including eight centering on health education, three focusing on internet-based management approaches, two involving telephone-based management, two focusing on non-drug management, and two focusing on written guidance. Conclusion There are problems in the community-based management strategies of osteoarthritis, including uncoordinated management, unsound methods, and imperfect systems. The referential community-based management strategies for osteoarthritis include: multidisciplinary or comprehensive management, hierarchical management and other systematic management strategies; making full use of medical techniques and tools (such as e-health, remote management, and health manuals) ; optimizing resource allocation (such as adding osteoarthritis management as a national essential public health project, and increasing government policy support for osteoarthritis management) .

Background Osteoarthritis is a chronic disease commonly seen in community settings, and the management of which is associated with numerous inter-related factors. Due to lack of appropriate healthcare-seeking perceptions and behaviors in osteoarthritis patients, it is difficult to diagnose, treat and manage osteoarthritis. Objective To understand healthcare-seeking perceptions and behaviors in community-living osteoarthritis patients, providing evidence for improving the diagnosis and treatment of such patients in the community. Methods This was a mixed-methods study. From May to June 2019, interviews for understanding osteoarthritis patients' healthcare-seeking perceptions and behavior-related factors, as well as management were conducted with a purposive sample of five orthopedic physicians and five general practitioners (GPs) from a general hospital in a regional healthcare consortium in Shanghai's Yangpu District, and a convenience sample of 12 GPs and 12 osteoarthritis patients from six community health centers (CHCs) in the same consortium. Then from June 2019 to December 2020, 425 patients with osteoarthritis were chosen from three randomly selected CHCs of the above-mentioned six ones to attend a survey using a quantitative questionnaire developed based on the themes derived from the above-mentioned interviews (excluding some highly subjective and less quantifiable indicators) for understanding their socio-demographic information, disease status, healthcare-seeking perceptions and behaviors, self-management and utilization of the APP for chronic disease management. Binary Logistic regression was used to analyze the influencing factors of healthcare-seeking behaviors in patients with osteoarthritis. Results The following themes were extracted from the interviews: patients' insufficient awareness of osteoarthritis, lack of management of osteoarthritis and influencing factors of patients' healthcare-seeking behavior. Three hundred and ninety-seven of the 425 cases (93.4%) who effectively completed the questionnaire were included for quantitative analysis. One hundred and fifty-two (38.3%) respondents understood osteoarthritis, and 79 (52.0%) of them acquired relevant knowledge from the media, and other 50 (32.9%) from ward-mates. Two hundred (50.4%) respondents knew the treatments for osteoarthritis, including 91 (45.5%) knowing exercise and physical therapies, and 105 (52.5%) knowing treatment with painkillers. The healthcare-seeking behaviors in osteoarthritis patients varied significantly by sex, BMI, pain level, impact of pain on sleep quality, and previous healthcare-seeking experience (P

To investigate changes in vaginal microecology in women with high-risk human papillomavirus (HR-HPV) infection after focused ultrasound (FU) treatment. We collected vaginal secretions at the time of admission and 3 months after FU treatment from 169 women who received FU treatment for cervical HR-HPV infection between July 2020 and September 2022. Among them, there were 101 patients with cute vaginitis, we also collected their vaginal secretions after one week of drug treatment. These samples were evaluated for vaginal microecology and HPV-DNA examination. Of the 169 patients, 101 (59.7%) suffered from acute vaginitis at the time of admission. After one week of targeted antibiotics drug treatment, there were no pathogens or pus cells on the field of microscopic vision, but there was no significant difference(p > 0.05) in the diversity and density of vaginal flora, the proportion and function of Lactobacillus (H2O2 negative rate) between one week after treatment and at the time of admission. At the time of admission of the 169 patients, the normal flora rate was 40.3%, which increased to 93.5% three months after FU treatment. The differences in vaginal secretion parameters at the time of admission and 3 months after FU treatment were as follows: H2O2 negative rate (37.3% vs. 3.6%), leukocyte esterase positive rate (54.4% vs. 5.9%), sialidase positive rate (38.5% vs. 4.1%), bacterial vaginitis positive rate (55% vs. 4.7%), fungal vaginitis positive rate (44.4% vs. 5.9%), and trichomonal vaginitis positive rate (7.1% vs. 0). The difference was statistically significant (p < 0.01). The pH value and Nagent score at the time of admission were significantly higher than those three months after FU. Three months after FU, the positive rate of HPV was 5.8% in the group of patients with normal vaginal microecology at the time of admission and post-FU; it was 6.7% in the group of patients with abnormal vaginal microecology at the time of admission and normal vaginal microecology post-FU; and it was 100% in the group patients with abnormal vaginal microecology at the time of admission and post-FU. A significant difference was observed among the three groups (p < 0.01). FU is an effective treatment for patients with cervical HR-HPV infection. FU does not interfere with the vaginal microecology of HR-HPV positive patients with normal vaginal microecology.FU followed by antibiotic drug therapy for pathogens is beneficial to restore the function of Lactobacillus vaginalis in HR-HPV positive patients with acute vaginitis,so as to improve the vaginal microecology of HR-HPV positive patients with abnormal vaginal microecology. [ABSTRACT FROM AUTHOR]

Monoclonal antibodies (mAb) directed against CD20, either unmodified or in radiolabeled forms, have been successfully used in clinic as effective therapeutic agents in the management of non-Hodgkin''s B-cell lymphoma. Despite all clinical success the exact mechanisms of action of various anti-CD20 antibodies remains mostly unclear. Several mechanisms have been proposed to be responsible for the therapeutic activity of anti-CD20 antibodies, including antibody-dependent cell-mediated cytotoxicity, complement-mediated cytotoxicity, and direct inhibition of tumor growth via induction of apoptosis. We previously produced an anti-CD20 mAb, HI47, and showed that the antibody effectively blocked human B-cell proliferation in vitro and inhibited xenografted B-cell lymphoma in nude mice. In this study, we engineered the chimeric versions of both the Fab and F(ab)′2 fragments of HI47 and produced the fragments in E. coli. Both fragments competed efficiently with HI47 for binding to CD20+ B cells, and inhibited proliferation of B-lymphoma cells in a dose-dependent manner. Mechanistic studies revealed that both antibody fragments induced significant degree of B-cell apoptosis that is independent of any cross-linking agents. Further, both the F(ab)′2 and Fab fragments when administered in vivo significantly inhibited the growth of human B-cell lymphoma xenografts in nude mice. The bivalent F(ab)′2 fragment showed consistently better efficacy compared to its monovalent Fab counterpart in inducing apoptosis and inhibiting B-cell lymphoma growth both in vitro and in vivo. Taken together, these observations suggest that HI47 and its fragments most likely exert their antitumor activity through induction of cell apoptosis, and cross-linking/dimerization of CD20 molecules on B- cell surface is an important, but not essential, process for therapeutic efficacy of HI47 and its fragments. [Copyright &y& Elsevier]

Objective. This study characterized the activation of platelet integrin αIIbβ3 induced by two anti-human platelet tetraspanin monoclonal antibodies (mAbs), HI117 and SJ9A4. Method. Using [SUP125]I-labeled human fibrinogen(Fg), specific Fg binding to human platelets induced by HI117 and SJ9A4 was measured as indication of activation of platelet integrin αIIbβ3 by the two mAbs. Results. HI117 and SJ9A4 (10 μg/ml and 20 μg/ml) induced evident specific Fg binding to human platelets, suggesting that the two mAbs evoked activation of platelet integrin αIIbβ3. Further study indicated that HI117 and SJ9A4 induced integrin αIIbβ3 activation independent of platelet Fe-receptors, and that HI117 and SJ9A4-induced integrin αIIbβ3 activation was inhibited by sphingosing, aspirin, apyrase, and/or PGI2. Conclusion. The anti-platelet tetraspanin (CD9) mAbs, HI117 and SJ9A4, can induce platelet integrin αIIbβ3 activation independent of Fe-receptors. Three signaling pathways, i.e., thromboxane, secreted ADP, and cAMP pathways may be involved in the process, with protein kinase C activation presumably being the common step of the three pathways. [ABSTRACT FROM AUTHOR]

Interleukin 37b (IL-37b) plays a key role in suppressing immune responses, partially by modulating the function of dendritic cells (DCs). However, the precise mechanisms are still largely unknown. Here, we investigated the effects of IL-37b on DC maturation and T cell responses induced by DCs, and explored the involved signaling pathways. It was found that IL-37b down-regulated the expressions of co-stimulatory molecules CD80 and CD86 on DCs in vitro. At the same time, the expressions of pro-inflammatory cytokines, such as TNF-α and IL-6, were suppressed, while the expression of the T cell inhibitory cytokine TGF-β was increased in IL-37b-treated DCs. In addition, the activation effect of DCs on T cells was impaired by IL-37b. We further revealed that extracellular single-regulated kinase (ERK), nuclear factor-κB (NF-κB), and mTOR-S6K signaling pathways were involved in the inhibition of DCs induced by IL-37b. This was confirmed by the similarly suppressive effect of chemical inhibitors against NF-κB, ERK, and S6K on the expressions of IL-6 and TNF-α in DCs. In conclusion, these results demonstrated that IL-37b suppressed DC maturation and immunostimulatory capacity in T cell priming by involving in ERK, NF-κB, and S6K-based inhibitory signaling pathways., (© The Author 2015. Published by ABBS Editorial Office in association with Oxford University Press on behalf of the Institute of Biochemistry and Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences.)

Monoclonal antibodies (mAb) directed against CD20, either unmodified or in radiolabeled forms, have been successfully used in clinic as effective therapeutic agents in the management of non-Hodgkin's B-cell lymphoma. Despite all clinical success the exact mechanisms of action of various anti-CD20 antibodies remains mostly unclear. Several mechanisms have been proposed to be responsible for the therapeutic activity of anti-CD20 antibodies, including antibody-dependent cell-mediated cytotoxicity, complement-mediated cytotoxicity, and direct inhibition of tumor growth via induction of apoptosis. We previously produced an anti-CD20 mAb, HI47, and showed that the antibody effectively blocked human B-cell proliferation in vitro and inhibited xenografted B-cell lymphoma in nude mice. In this study, we engineered the chimeric versions of both the Fab and F(ab)'2 fragments of HI47 and produced the fragments in E. coli. Both fragments competed efficiently with HI47 for binding to CD20+ B cells, and inhibited proliferation of B-lymphoma cells in a dose-dependent manner. Mechanistic studies revealed that both antibody fragments induced significant degree of B-cell apoptosis that is independent of any cross-linking agents. Further, both the F(ab)'2 and Fab fragments when administered in vivo significantly inhibited the growth of human B-cell lymphoma xenografts in nude mice. The bivalent F(ab)'2 fragment showed consistently better efficacy compared to its monovalent Fab counterpart in inducing apoptosis and inhibiting B-cell lymphoma growth both in vitro and in vivo. Taken together, these observations suggest that HI47 and its fragments most likely exert their antitumor activity through induction of cell apoptosis, and cross-linking/dimerization of CD20 molecules on B- cell surface is an important, but not essential, process for therapeutic efficacy of HI47 and its fragments.

Bispecific antibodies have been exploited both as cancer immunodiagnostics and as cancer therapeutics, and have shown promise in several clinical trials in cancer imaging and therapy. A number of bispecific antibodies against B-cell markers have been shown to be effective in vitro in mediating tumor cell lysis and in vivo in inhibiting tumor growth in animal models. We have constructed a bispecific diabody from the variable genes encoding two hybridoma-derived monoclonal antibodies directed against human CD20 on B cells and CD3 on T cells. The anti-CD20 x anti-CD3 diabody was expressed in a single Escherichia coli host and purified by a one-step affinity chromatography. The bispecific diabody bound as efficiently to both CD20- and CD3-positive cells as the respective parental antibodies, and was capable of cross-linking CD20-positive tumor cells and human T lymphocytes as shown by cellular rosetting. The diabody effectively lysed human B-lymphoma cells in the presence of T-enriched human peripheral blood lymphocytes (PBL). Further, when combined with human PBL and interleukin-2, the diabody significantly prolonged the survival of nude mice inoculated with human B-lymphoma cells. Taken together, our results suggest that an anti-CD20 x anti-CD3 diabody may have significant clinical application in the treatment of human CD20-positive B-cell malignancies.