1. To Study The Correlation Between Expression Of Jagged-1/Jagged-2 In Human Placenta And CD56~+NK In The Decidua During Pregnancy 2. Efficacy And Safety Of Etanercept For Patients With Ankylosing Spondylities: A Systematic Review

Objective:To study the expression and distribution of Jagged-1/Jagged-2 in human villus, placenta and CD56+Natural killer(NK) cells in the decidua during pregnancy. Moreover, this study was also to explore whether there were any correlations in the level of expression of CD56+ on the uterine decidual Natural Killer (dNK) cells and Jagged-1/Jagged-2 in placenta during pregnancy.Method:A total of 37 samples,15 decidua and 11 chorionic villous samples from induced abortion,2 samples from spontaneous abortion,10 fullterm placentae from normal placenta.Immunohistochemical technique were used. An immunohistochemical study was performed with a Dako REALTM En VisionTM kit. Formalin-fixed and paraffin-embedded tissues were stained using mouse monoclonal antibody raised against human and Rabbit polyclonal antibody raised against human. We evaluated the quantity of positive of them using Image Pro-Plus (IPP) Software.Results:A level of expression of Jagged-1 in villus from the first trimester to the third trimester in pregnancy increase, but the level of expression of Jagged-2 decrease during pregnancy. Jagged-1/Jagged-2 mianly expressed on glandular epithelium cells. The expression level of Jagged-1/Jagged-2 and CD56+NK cells in decidua of induced abortion women were significantly higher than that of spontaneous abortion. We also showed a significant correlation the expression level of between CD56+NK cells and Jagged-1/Jagged-2 in placenta during early pregnancy.Conclusion:Notch-Jagged signaling pathway in trophoblast cells may be involved in the regulation of CD56+decidual NK cells. Jagged-1/Jagged-2 and CD56+NK may be of significance in to build mother-fetal immunotolerance for successful pregnancy. Objectives:To assess the efficacy and safety of ankylosing spondylitis(AS) treated with different dosages of etanercept and etanercept compared with placebo in treatment of ankylosing spondylitis.Methods:In this meta-analysis study, We searched EMBASE (1974 to September 2008), MEDLINE (1966 to September 2008),The Cochrane Library (Issue 4.2008), China Academic Journal Full-text Database (CNKI,1994 to 2008), China Biomedical Literature Database (CBM, 1978 to 2008), Chinese Scientific Journals Database(VIP,1989 to 2008), and Wanfang Database (1999 to 2008). The quality of included studies was evaluated. Data analyses of included studies were performed with the Cochrane Collaboration's RevMan 5.0 software.Results:Seven randomized controlled trials(RCTs) with a total of 949 patients met the included criteria. The meta- analysis showed the effective rate of ASAS 50 or ASAS 20 receiving Etanercept was significantly higher than in patients receiving placebo, while no significant differences were noted when receiving Etanercept compared with patients receiving placebo in other indices. There was no statistical significance between the 50mg etanercept group and 25mg etanercept group. Patient Injection-site reaction rate for Etanercept was higher than Injection-site reaction rate for placebo. In other adverse effects, no significant differences were observed.Conclusion:Etanercept is safe and effective in the treatment of patients with Ankylosing spondylitis. However, some trials were included in the review were of poor quality, so we needed the multi-center, large-scale, higher quality of randomized controlled trials and the longer course of treatment to confirm this result.