[Clinicopathological analysis of 98 cases of benign lymphoidenosis of oral mucosa]

Objective: To investigate the clinical manifestations and pathological changes of benign lymphoadenosis of oral mucosa. Methods: The clinical data of 98 cases of benign lymphoadenosis of oral mucosa were analyzed. Results: The clinical manifestations of benign lymphoadenosis of oral mucosa included erosive ulcer (64%) and nodule (9%) and the rate of misdiagnosis was 98%. Neutrophil infiltration occurred in the epithelium of 51% cases and the lymphocyte was diffusely infiltrated in lamina propria of 83% cases. Conclusions: When the mucous membrane of the lamina propria is characterized by complex cell components, diffuse infiltrating lymphocytes and infiltration of neutrophils in mucosal epithelium without erosion and ulceration, it is necessary to highly suspect benign lymphoadenosis of oral mucosa. Finding the focal aggregation of lymphoid follicles or lymphocytes is helpful for the correct diagnosis.

Identification of serum metabolites associated with obesity and traditional risk factors for metabolic disease in Chinese adults

BACKGROUND AND AIMS

Obesity is a major worldwide health problem and is often associated with many metabolic diseases. Levels of several serum-specific metabolites may be altered in patients with these metabolic diseases. We aimed to investigate the associations of serum metabolite levels with obesity and traditional risk factors for metabolic disease in Chinese individuals.

METHODS AND RESULTS

Six-hundred Chinese individuals undergoing annual physical exams were recruited and categorized into overweight/obese and control groups (1:1 ratio). We simultaneously quantified the serum lysophosphatidylcholine (LPC), branched-chain amino acids (BCAA), aromatic amino acids (AAA), 25-hydroxyvitamin D, glutamine (Gln), glutamic acid (Glu), and Gln/Glu ratio levels using our previously established targeted serum metabolomic method. The overweight/obesity group had significantly higher levels of BCAA, AAA, and Glu, as well as lower levels of unsaturated LPC, Gln, and Gln/Glu, than the control group. Correlation analyses revealed significant and positive relationships of saturated LPC, BCAA, AAA, and Glu with blood pressure, glucose, triglycerides, apolipoprotein B, and high-sensitivity C-reactive protein, while unsaturated LPC, Gln, Gln/Glu, and 25-hydroxyvitamin D exhibited an opposite trend. In the multifactor logistic regression model, low unsaturated LPC and Gln/Glu, as well as high BCAA and AAA levels, were found to be independent risk factors for obesity; the odds ratios (95% confidence interval) of the highest quartile compared to the lowest quartile were 0.241 (0.139-0.417), 0.436 (0.252-0.755), 3.944 (2.094-7.430), and 2.357 (1.274-4.361) (P < 0.01), respectively.

CONCLUSION

LPC, BCAA, AAA, and Gln/Glu are significantly related to obesity development and risk factors of some metabolic diseases.

[Effect of HIF-2α on the biological characteristics of breast cancer stem cells]

Objective: To explore the effect of hypoxia inducible factor (HIF)-2α on biological characteristics of breast cancer stem cells (BCSCs). Methods: Stem cells were isolated and purified from MCF-7 cells by using the immunomagnetic microbeads. HIF-2α ORF/shRNA lentiviral vectors were transduced into MCF-7 stem cells respectively, and then the stable stem cell lines were detected and gained. Using the method of Cell Counting Kit-8 (CCK-8) and flow cytometry, the effect of HIF-2α on cell vitality and apoptosis of MCF-7 cancer stem cells (CSCs) were tested. Serum-free suspension culture was used on MCF-7 cells to get breast CSCs microspheres. The expression of CD44(+) in different groups were detected by flow cytometry. Tumor-bearing nude mice model was established to compare tumor growth rate and pulmonary metastasis probability of MCF-7 CSC HIF-2α knock up/down in vivo. Results: Compared with MCF-7 CSC group, the apoptosis rate of MCF-7 CSCs HIF-2α knockup group decreased obviously and cell proliferation activity increased significantly (all P<0.05). However, the MCF-7 CSCs HIF-2α knock down group had the opposite trend. Results of flow cytometry showed that the proportion of CD44(+) cells in HIF-2α knock up group(93.0%)was much higher than MCF-7 group(83.8%)and MCF-7 HIF-2α knock down group(51.6%). The tumor growth rate, quality and lung metastasis rate of MCF-7 CSC HIF-2α knock up group were significantly higher than those in MCF-7 CSCs group and MCF-7 CSCs HIF-2α knock down group (P<0.01). Conclusions: In hypoxic microenvironment, up-regulation of HIF-2αpromoted the formation of MCF-7 CSCs. Over-expression of HIF-2α can promote proliferation and inhibit apoptosis of MCF-7 CSCs, and thus increase the risk of tumorigenic ablility and pulmonary metastasis.

[Co-morbidity of vasovagal syncope and postural tachycardia syndrome with allergic diseases in children]

OBJECTIVE

To explore the clinical characteristics of the co-morbidity of vasovagal syncope (VVS) and postural tachycardia syndrome (POTS) with allergic diseases in children.

METHODS

A re-trospective analysis was launched to summarize the clinical data of children with VVS and POTS. They were divided into allergic group and non-allergic group according to the history of allergic diseases. The participants' clinical characteristics were compared between allergic group and non-allergic group using independent sample t test or rank sum test; composition comparisons were completed by Chi-square test. Bi-variate correlation analysis was used to explore the association between eosinophil percentage/count and symptom scores/frequency of syncope episodes. A P value <0.05 was defined as statistically significant.

RESULTS

Sixty-seven children complaining of orthostatic intolerance (43 patients diagnosed as VVS and 24 cases diagnosed as POTS) were enrolled. Totally 21 cases (31%) had allergic diseases, including allergic rhinitis, atopic eczema, asthma, as well as food allergy. And allergic rhinitis is the most common co-morbidity. There were no significant differences between the two groups in age, gender ratio, height, body weight and basement blood pressure. Compared with the non-allergic group, the allergic group showed later onset age (year) (11±2 vs. 9±3, P<0.05) of orthostatic intolerance and shorter course of the diseases (month) [8.0 (0.1, 0.1) vs. 24.0 (0.1, 144.0), P<0.05]. The frequency of syncope episodes in the allergic group among VVS children (times per month) [2.50 (0.08, 30.00) vs. 0.25 (0.03, 5.00), P<0.05] was much higher than that in the non-allergic group. Additionally, the eosinophil percentage (%) [3.50 (0.70, 0.59) vs. 1.65 (0.30, 6.20), P<0.001] and eosinophil count (×10⁹) [0.18 (0.05, 0.71) vs. 0.10 (0.02, 0.38), P<0.001] were increased in the allergic group. However, there were no remarkable differences in the results of head-up tilt test in children with VVS or in the maximum change of heart rate during standing test in children with POTS were involved.

CONCLUSION

Allergic diseases are common co-morbidities in children with both VVS and POTS. Allergic rhinitis is the most common co-morbidity. Children with co-morbidity of VVS/POTS and allergic diseases had a later onset of symptoms of orthostatic intolerance, and were more likely to be hospitalized for intensive attacks of symptoms during a short period when compared with those without allergic diseases. Children diagnosed as VVS combined with allergic diseases had more frequent episodes of syncope.

[Value of mDIXON-Quant sequence, diffusion-weighted imaging in quantitatively diagnosing the sacroiliitis stages]

Objective: To evaluate the value of mDIXON-Quant sequence, diffusion-weighted imaging (DWI) in quantitative diagnosing of the sacroiliitis stages in patients with ankylosing spondylitis (AS). Methods: Based on the Bath Ankylosing Spondylitis Activity Index (BASDAI) and laboratory parameters, a total of 51 patients were diagnosed with AS. They were divided into two groups as early active group (n=20) and chronic active group (n=31), and at the same time, 25 healthy people from Tianjin were included as control group. The regular MRI sequences and mDIXON-Quant sequence, DWI were obtained. The apparent diffusion coefficient (ADC) and fat-signal fraction (FF) value of bone marrow with edema of the sacroiliac joints in early active group and chronic active group and of subchondral bone marrow of sacroiliac joint in control group all were measured by ADC maps and FF maps. Mean (FF, ADC) values were compared between groups. Results: The ADC value of the early active group, chronic active group and the control group is (1.07±0.20)×10(-3)mm(2)/s, (1.00±0.22)×10(-3)mm(2)/s, (0.25±0.07)×10(-3)mm(2)/s, respectively, and the differences of ADC value between early active group and control group, chronic active group and control group were significant (P<0.01), but the difference of the ADC value between early active group and chronic active group was not significant (P=0.394). That is to say, the ADC value can't distinguish the early active group and chronic active group. The differences of FF value between groups was significant (P<0.01), and the FF value of bone marrow with edema in chronic active group were higher than that in early active group. Conclusions: The mDIXON-Quant sequence can quantitatively diagnose early active group and chronic active group, and the diagnostic value is better than DWI. Thus, it can provide guidance for clinical treatment and prognosis.

[Nested case-control study on associated factors for anemia during pregnancy]

Objective: To explore the related factors of anemia during pregnancy and provide scientific evidence for the primary prevention of anemia during pregnancy. Methods: The pregnant women (≤12 pregnant weeks) who received the first pregnancy care in a local medical institution in Hunan province from June 2013 to November 2014 were included in this cohort study, and for them anemia had been excluded by physical examination. Baseline survey and follow up till childbirth were conducted for them. A queue-based nested case-control study (1 ∶ 2) was conducted (380 pregnant women with anemia detected in this study as case group, 760 pregnant women without anemia randomly selected and matched by age, habitual residence during pregnancy as control group. And t test, χ(2) test and logistic regression analysis were conducted to identify related factors of anemia during pregnancy. Results: Multivariate logistic regression analysis indicated that low family annual income level (net income) (OR=2.08, 95%CI: 1.22-3.59), low educational level (OR=2.09, 95%CI: 1.22-3.59), pre-pregnancy perm/hair dye (OR=2.23, 95%CI: 1.63-3.05), early pregnancy vomiting (OR=2.51, 95%CI: 1.56-4.03) were the risk factors for anemia during pregnancy. Intake of vitamin and trace element supplements (OR=0.69, 95%CI: 0.50-0.94), frequent meat, fish, shrimp, egg intakes (OR=0.68, 95%CI: 0.49-0.92), frequent soy milk, milk intakes (OR=0.51, 95%CI: 0.27-0.95) were the protective factors for anemia during pregnancy. Conclusion: A number of factors, such as family annual income level, education level, poisonous and harmful material contact, pregnancy reaction, nutrition, are related to the incidence of anemia during pregnancy, it is necessary to take preventive measures to reduce the incidence of anemia during pregnancy.

[Relationship between blood routine test parameters and syncopal recurrence of vasovagal syncope in children]

Objective: To explore the relationship between venous blood routine test parameters and syncopal recurrence of children with vasovagal syncope (VVS). Method: Sixty-three children (male 32, female 31) diagnosed as VVS in Department of Pediatrics, Peking University First Hospital from November 2010 to October 2015 were included in a case observational study.Their mean age was (11.2±2.7) years and basic treatment such as predisposing causes avoiding, standing training, autonomic nervous function exercise and oral rehydration salts were advised to them.The clinical data were obtained by out-patient visit and over telephone from December 2015 to January 2016, with a median follow-up period of 10 (4, 26) months. The effects of baseline venous blood routine test parameters, gender, age, and body mass index (BMI) on syncopal recurrence were studied via univariate and multivariate Cox regression analysis.Kaplan-Meier curve was used to evaluate the long-term prognosis. Result: Among the 63 VVS children in this study, 31 cases were diagnosed as VVS vasodepressor type, 4 cases as VVS cardioinhibitory type and 28 cases as VVS mixed type, 16 cases (25%) had experienced recurrence of syncope while 47 cases (75%) had not.The result of univariate analysis of Cox regression showed that baseline platelet count (PLT) (HR=1.012, 95%CI: 1.003-1.022) had a marked impact on the survival rate.And the result of multivariate analysis of Cox regression showed that baseline hemoglobin concentration (HGB) (HR=1.055, 95%CI: 1.007-1.105), mean corpuscular hemoglobin (MCH) (HR=0.612, 95%CI: 0.423-0.884) and PLT(HR=1.015, 95%CI: 1.006-1.024) had significant effects on survival rate of VVS children.In this study, the one-year, two-year, and three-year survival rate were 83% (52/63), 79% (50/63) and 75% (47/63), respectively. Conclusion: The baseline venous blood routine test parameters HGB, MCH and PLT might be the influencing factors of the syncopal recurrence of VVS children.

[Full Sibling Identification by IBS Scoring Method and Establishment of the Query Table of Its Critical Value]

OBJECTIVES

To establish a query table of IBS critical value and identification power for the detection systems with different numbers of STR loci under different false judgment standards.

METHODS

Samples of 267 pairs of full siblings and 360 pairs of unrelated individuals were collected and 19 autosomal STR loci were genotyped by Goldeneye™ 20A system. The full siblings were determined using IBS scoring method according to the 'Regulation for biological full sibling testing'. The critical values and identification power for the detection systems with different numbers of STR loci under different false judgment standards were calculated by theoretical methods.

RESULTS

According to the formal IBS scoring criteria, the identification power of full siblings and unrelated individuals was 0.764 0 and the rate of false judgment was 0. The results of theoretical calculation were consistent with that of sample observation. The query table of IBS critical value for identification of full sibling detection systems with different numbers of STR loci was successfully established.

CONCLUSIONS

The IBS scoring method defined by the regulation has high detection efficiency and low false judgment rate, which provides a relatively conservative result. The query table of IBS critical value for identification of full sibling detection systems with different numbers of STR loci provides an important reference data for the result judgment of full sibling testing and owns a considerable practical value.

[Association of peripheral and central systolic blood pressure with urinary albumin-to-creatinine ratio in a community-based population in Beijing]

Objective: The aim of this study was to investigate the association of both peripheral and central systolic blood pressure (pSBP and cSBP) with urinary albumin-to-creatinine ratio (UACR) in a community-based population in Beijing. Methods: A total of 3 479 Chinese subjects with questionnaire, UACR, pSBP, and cSBP data available were included from an atherosclerosis cohort of Peking University First Hospital in Shijingshan District, Beijing followed up from April to July in 2014. Multivariate linear regression analyses were used to examine the effect of pSBP and cSBP on lnUACR, and further tests for interactions were performed according to associated covariates. Results: Subjects were (59.0±8.6) years old, 36.2% (n=1 260) were male, 46.0% (n=1 595) had hypertension, and 20.2% (n=700) had diabetes. The pSBP and cSBP was (126.9 ± 16.4) mmHg (1 mmHg=0.133 kPa), and (136.3 ± 16.7) mmHg, respectively. P(50) (P(25)-P(75)) of UACR was 6.2 (4.2-11.1) mg/g. Both pSBP and cSBP were linearly associated with lnUACR adjusted for age, sex, body mass index, smoking status, drinking status, triglyceride, HDL-C, LDL-C, fasting glucose, creatinine, history of cardiovascular disease, antihypertensive and hypoglycemic agents (every 10 mmHg increase for pSBP: β=0.12, 95%CI: 0.10-0.15, P<0.001; for cSBP: β=0.11, 95%CI: 0.09-0.14, P< 0.001). The relationships were remained in subgroups such as non-hypertension group, non-diabetes group, normal UACR group, and 3-combination group (every 10 mmHg increase for pSBP: β=0.09, 95%CI: 0.05-0.13; β=0.12, 95%CI: 0.10-0.15; β=0.07, 95%CI: 0.06-0.09; β=0.08, 95%CI: 0.05-0.12. for cSBP: β=0.07, 95%CI: 0.04-0.11; β=0.11, 95%CI: 0.08-0.13; β=0.07, 95%CI: 0.05-0.08; β=0.06, 95%CI: 0.03-0.09, all P<0.001). Furthermore, analyses for interaction found that both pSBP and cSBP were more strongly associated with lnUACR in males, current smokers and subjects with high serum creatinine level (≥87 µmol/L) when compared with females, non-current smokers and subjects with low serum creatinine level (<87 µmol/L), respectively (all P for interaction<0.05). Conclusion: The results showed that both pSBP and cSBP were independently associated with UACR in this Chinese community-based population even in low risk population suggesting well-controlled both peripheral and central blood pressure may reduce urinary albumin. Males, current smokers and subjects with higher serum creatinine should pay more attention to the impacts of pSBP and cSBP on UACR.

[Causal analysis and management strategies of 30-day unplanned revision surgery following single-stage posterior vertebral column resection for severe spinal deformity]

Objective: To investigate the causes of 30-day unplanned revision surgery following one-stage posterior vertebral column resection (PVCR) for severe spinal deformity and the methods of prevention and management. Methods: A total of 112 severe deformity patients underwent one-stage PVCR for surgical treatment in the 306(th) Hospital of People's Liberation Army from May 2010 to December 2015 were retrospectively reviewed. Six patients required reoperation within 30 days after PVCR, including 2 males and 4 females with average age of 21 years (ranging from 12 to 38 years). Four cases were congenital kyphoscoliosis, 1 was post-laminectomy kyphoscoliosis and 1 was post-tuberculous angular kyphosis. Three cases associated with preoperative neurologic deficit (Frankel C in 1 patient and D in 2 patients). The causes, management and outcomes of unplanned revision surgery within 30 days after PVCR were recorded. Results: The total incidence of unplanned revision surgery within 30 days following PVCR was 5.4% (6/112). There was 1 case due to cerebrospinal fluid leak, 5 cases with varying degrees of new neurologic deficits, the causes were as followed: dural buckling in 1 case, residual bone compression in 1 case, epidural hematoma compression in 2 cases, spinal subdural hematoma in 1 case. All the 6 cases underwent surgical exploration again, including further dural repair, decompression and hematoma clearance. After unplanned reoperation, 6 cases recovered completely. The average follow-up time after surgery was 30.8 months (ranging from 10 to 60 months). The major curve at coronal plane was improved from preoperative 87.7° to 34.2°, with a mean correction of 61.0% at final follow-up; the sagittal kyphosis curve was improved from preoperative 119.5° to 45.5°, with a mean correction of 61.9% at final follow-up. Two patients' neurological status improved from Frankel D to Frankel E, one patient's neurological status improved from Frankel C to Frankel E. Conclusions: One-stage PVCR could be an effective method for treatment of severe spinal deformity. The causes of 30-day unplanned reoperation after PVCR are as followed: cerebrospinal fluid leak, dural buckling, residual bone compression and hematoma compression. Timely surgical exploration can gain good clinical outcomes.

[Predictive value of upright blood pressure change for long-term prognosis of children with postural tachycardia syndrome treated with midodrine hydrochloride]

OBJECTIVE

To explore the predictive value of upright blood pressure change for long-term prognosis of children with postural tachycardia syndrome (POTS) treated with midodrine hydrochloride.

METHOD

A total of 90 children (male 41, female 49) were enrolled in this study. Their mean age was (11.8±2.7) years. They were diagnosed as POTS in Peking University First Hospital from 2005 to 2011. According to the upright change of blood pressure at the first visit, they were divided into two groups, effective group (n=55) and ineffective group(n=35). The follow-up time was 53-130 months. The orthostatic intolerance symptom score and symptom free survival rate were compared between the two groups.

RESULT

The change of systolic blood pressure and of diastolic blood pressure was lower in effective group than those in ineffective group (0(-6, 0) mmHg (1 mmHg=0.133 kPa) vs. 9(6, 11) mmHg, Z=-8.303, P<0.01; 0(0, 5) mmHg vs. 11(10, 16) mmHg, Z=-7.058, P<0.01). Two groups had no significant difference in symptom scores before treatment((4.8±0.9) points vs. (5.0±0.8) points, t=-0.53, P=0.595), while symptom scores were lower in effective group than that in ineffective group((1.3±0.9) points vs. (4.7±0.9) points, t=-15.60, P<0.01 ). The symptom free survival rate was higher in effective group than that in ineffective group (48/55(87.3%) vs. 23/35(65.7%), χ(2)=5.969, P<0.01).

CONCLUSION

The upright change of blood pressure has a good predictive value on the long-term survival of POTS children treated with midodrine hydrochloride.

[CD8 and FOXP3 expression in stromal tumor-infiltrating lymphocytes of triple-negative breast carcinomas: a clinicopathologic study]

OBJECTIVE

To investigate the relationship between stromal tumor-infiltrating lymphocytes (TIL) and CD8 or FOXP3 positive lymphocytes in triple-negative breast carcinoma.

METHODS

A total of 160 triple-negative breast carcinomas were collected from the First Affiliated Hospital of Nanjing Medical University during 2012 to 2014. All were surgical excision or biopsy specimens from patients without prior chemotherapy and radiotherapy. Histopathologic analysis of stromal TIL was performed on hematoxylin and eosin-stained sections, and MaxVision immunohistochemical method was used for detection of CD8 and FOXP3 protein expression.

RESULTS

Stromal TILs were positively correlated with Ki-67 labeling index (P=0.002). The density of CD8(+) cytotoxic T-lymphocyte (CTL) was negatively correlated with tumor size (P=0.009), and positively correlated with Ki-67 index (P=0.021). The density of FOXP3(+) regulatory T-lymphocyte (Treg) was inversely correlated with the patient age (P=0.030), and positively correlated with histological grade (P=0.026). Stromal TILs were positively correlated with the density of CD8(+) CTL (P=0.014).

CONCLUSIONS

The percentage of stromal TILs and density of CD8(+) CTL are associated with tumor cell proliferation of triple-negative breast cancers. The density of FOXP3(+) Treg is significantly associated with poor prognosis. Stromal TIL is positively correlated with the density of CD8(+) CTL. Stromal TIL may provide a potential marker for pathological diagnosis and a target for guiding adjuvant therapy in patients with triple-negative breast cancers.

[Predictive value of dynamic enhanced MR synovial wash in rate in progression to rheumatoid arthritis in patients with undifferentiated arthritis]

Objective: To investigate the predictive value of dynamic enhanced MR synovial wash in rate (WASHIN) in progression to rheumatoid arthritis (RA) in patients with undifferentiated arthritis (UA). Methods: The data of dynamic enhanced MR synovial WASHIN and C- reactive protein (CRP) of 33 patients with UA were analyzed between October 2014 and January 2016 from Tianjin First Center Hospital, so as to evaluate the correlation between the two indicators. According to the value of CRP, the patients were divided into two groups, the CRP>8 mg/L for CRP positive group (18 cases), CRP≤8 mg/L for CRP negative group (15 cases). Ranked sum test was used to compare the difference of WASHIN between two groups. The ROC curve analysis was carried out to test the diagnostic power of WASHIN. Results: In 33 patients with UA, the correlation between WASHIN and CRP was positive, r=0.767, P<0.01; as for the WASHIN, there was significant difference between CRP positive group(49.51±19.79)/s and CRP negative group(19.90±14.51)/s (P<0.01). 9 cases were clinically diagnosed with RA during follow-up, of which 8 cases for CRP positive group and 1 case for CRP negative group. The biggest area under the ROC curve of synovial WASHIN was 0.944, the biggest Youden index was 0.85, sensitivity was 100.0%, specificity was 87.5%. 2 cases were clinically diagnosed with osteoarthrosis during follow-up, synovial WASHIN respectively of 18.42 and 21.48 /s. Conclusion: Synovial WASHIN can improve the sensitivity and specificity to predict the prognosis from UA to RA, and can provide certain guiding significance for clinical work.

Relation between therapy options for Graves' disease and the course of Graves' ophthalmopathy: a systematic review and meta-analysis

BACKGROUND

The relation between therapy options for Graves' disease (GD) and the course of Graves' ophthalmopathy (GO) are still controversial. Our aim was to compare the occurrence of development or worsening of GO in patients who were treated with antithyroid drugs (ATDs) or radioactive iodine (RAI) or thyroidectomy (TX).

METHODS

We conducted a comprehensive search of the Embase and PubMed database. Odds ratio (OR) was used as a measure of the effect of therapy options for GD on the risk of development or worsening of GO. The analysis was further stratified by factors that could affect the treatment effects.

RESULTS

Nine trials involving 1773 patients were included. RAI therapy showed a significant effect on the risk of development or worsening GO compared with ATD (OR 2.25; 95 % CI 1.61-3.14; P < 0.00001). Glucocorticoid prophylaxis was effective in preventing GO development or worsening (0.40; 0.23-0.68; P = 0.002); especially for patients with preexisting GO (0.41; 0.23-0.73; P = 0.002). At 3 months, showed GO to be improved in 17 TX and 21 total thyroid ablation (TTA) patients, with no significant difference between the two groups; between 6 and 12 months, TTA did show significant beneficial effect on the improvement of GO (6.02; 2.80-12.96; P < 0.00001); GO was found to be inactive in a significantly higher percentage of patients in the TTA (2.17; 1.04-4.52; P = 0.04).

CONCLUSION

Radioiodine therapy is a significant risk factor for development or worsening of GO in GD. But GO progression can be prevented by prophylactic glucocorticoids in patients with preexisting GO. Compared with TX alone, TTA induces an earlier and steadier GO improvement in patients with mild to moderate-severe and active GO. Whether this is sufficient to offer TTA to patients needs further investigation.

[Effect of heme oxygenase-1 transduced by cell penetrating peptide PEP-1 on renal injury in rats with acute paraquat poisoning]

Objective: To study the effects of heme oxygenase-1 transduced by cell penetrating peptide PEP-1 on renal injury in acute paraquat-induced rats. Methods: The fusion protein PEP-1/HO-1 was manufactured by genetic engineering methods. One hundred and twenty-six healthy adult Sprague-Dawley (SD) rats (63 male, 63 female) were randomly divided into three groups: (1) Control group: 42 rats, (2) Poisoned group: 42 rats, (3) PEP-1/HO-1 intervention group: 42 rats. The rats in Poisoned group and intervention group were treated intraperitoneally with paraquat (25 mg/kg) deliquated with normal saline. Control group rats were treated with the same way of normal saline as the others. Intervention group rats were injected 1 mg of the fusion protein PEP-1/HO-1 into the left iliac vein at 30 minutes before the administration of the paraquat. After abdominal dissection with ether anaesthesia, six rats respectively from each of three groups were taken tissue samples from kidney at 1 st、6 th、12 th、24 th、36 th、48 th、and 72 nd hour respectively. Tissue Superoxide Dismutase (SOD) activity and Malondialdehyde (MDA) content were measured, and renal tissue was quickly remained to observe the expression of Heme Oxygenase-1 (HO-1) by the method of immunohistochemistry. Blood samples were collected from the abdominal aorta for determination of Blood Urea Nitrogen (BUN) and Creatinine (Cr) concentrations in plasma. Results: To prepare high purity fusion protein PEP-1/HO-1 Successfully. The levels of the plasma Bun and Cr in Poisoned and intervention group were significantly higher than that in Control group in the six to seventy-two hours (P<0.01) ; Whereas the increases of Bun and Cr were markedly intibited in PEP-1/HO-1 intervention group, in which, the levels of Bun and Cr in the six to seventy-two hours were significantly lower than Poisoned group (P<0.05). Compared with control group, the levels of MDA in poisoned groups were increased in the one to forty-eight hours and the levels of it in groups PEP-1/HO-1 in the one to thirty-six (P<0.01 or P<0.05). The T-SOD activity of the poisoned group was decreased in the one to thirty-six hours than that of the control group (P<0.05). Compared with poisoned group, the T-SOD activity at various points in time was increased in group PEP-1/HO-1 (P<0.01). In control group, there was only very weak expressions of HO-1 in the normal renal tissue. In poisoned and intervention group, the expressions of HO-1 were significantly higher than that in control group in all time (P<0.01). The HO-1 expressions of PEP-1/HO-1 group in all time was significantly higher than that in poisoned group (P<0.01 or P<0.05). Conclusion: The HO-1 protein Can be successfully transduced into renal tissue by cell penetrating peptide PEP-1 and the transduced HO-1 protein reduces renal injury of the acute paraquat-induced rats by inhibiting lipid peroxidation response.

[Feasibility study of transplantation of penile corpus cavernosum and major pelvic ganglion in renal subserous region]

OBJECTIVE

To study the feasibility of transplantation of normal rat penile corpus cavernosum and major pelvic ganglion (MPG) into the renal subserous region of a Nu/Nu mouse based on allograft technology.

METHODS

Penile corpus cavernosum and MPG, harvested from Sprague-Dawley (SD) rats under sterile condition, were transplanted underneath the kidney capsule of Nu/Nu mice through the microsurgery instruments and surgery microscope. The histopathologic changes and cellular proliferation in the transplanted penile corpus cavernosum and MPG were then analyzed at the end of 1week and 4 weeks after transplantation. Histological staining and immunohistochemical staining were used to evaluate the main outcome measures.

RESULTS

After 1 week, the tissue morphology of the transplanted corpus cavernosum underneath the kidney capsule of Nu/Nu mice was consistent with normal penile corpus cavernosum, and blood could be observed in the penis cavernous sinus of the graft; after 4 weeks, the mophorlogy of the tranplanted corpus cavernosum near the kidney was consistent with normal penile corpus cavernosum, while fibrosis was noteworthy in the graft away from the kidney, but blood could still be seen in the penis cavernous sinus. After 1 week, the tissue morphology of the transplanted MPG was consistent with normal MPG, multiple islet-like cell clusters could be seen in the transplanted MPG in the renal subserous region, and angiogenesis could be observed near the kidney; after 4 weeks, a network of blood vessels was clearly visible away from the kidney, and islet-like cell clusters were still clearly observed in the transplanted MPG. In addition, ki67 positive cells were observed in the transplanted penile corpus cavernosum and MPG after 4 weeks of transplantation, which indicated that there was still cell proliferation activity in the grafts.

CONCLUSION

The transplanted corpus cavernosum and MPG underneath the kidney capsule of Nu/Nu mice could survive at least 4 weeks. Moreover, the inner structure of the transplanted corpus cavernosum and MPG was close to the normal tissue. The underlining mechanism may be related to the local microenvironment underneath the kidney capsule of Nu/Nu mice and the neovascularization in the transplanted grafts.

[Outcomes after singleversus bilateral lung transplantation for idiopathic pulmonary fibrosis]

OBJECTIVE

To compare outcomes after single and bilateral lung transplantation in patients with idiopathic pulmonary fibrosis (IPF).

METHODS

104 patients with IPF who underwent lung transplantation at Wuxi People's Hospital from January 2008 to February 2015 were evaluated. Recipients were divided into single lung transplantation (STL)group(41cases)and bilateral lung transplantation(BLT) group (63 cases). Preoperative characteristics, postoperative outcomes, postoperative complications, functional outcomes, survival and causes of death between the two groups were analyzed retrospectively. The patients were followed up by letter, call and outpatient visit.

RESULTS

Preoperative characteristics: The SLT group were significantly older (P<0.05), and had significantly higher systolic (P<0.05) pulmonary artery pressures than the BLT group. Postoperative outcomes: The intraoperative blood loss of SLT group as significantly less than BLT group (P<0.05). The cold ischemic time of SLT group as significantly shorter than BLT group (P<0.05). The BLT group was significantly more frequently required extracorporeal membrane oxygenation (ECMO) support than SLT group (P<0.05). There was no statistically significant difference inventilator support, reoperation, reintubation, length of ICU stay and death between the SLT and the BLT group (P>0.05). Postoperative complications: The BLT group had a higher incidence of primary graft dysfunction than the SLT group (P<0.05). There was no statistically significant difference in chest complications, acute rejection, airway complications, pulmonary infection between the SLT and the BLT group (P>0.05). Functional outcomes: FVC%, FEV1%, DLCO and 6-MWD, were significantly higher in the BLT group than the SLT group (P<0.05).

SURVIVAL

The overall survival rates at 1, 2 and 3 years were not different between the SLT and the BLT group (75.3%, 61.6% and 46.2% vs 79.1%, 68.6% and 53.4%, P>0.05).

CONCLUSIONS

The lung transplantationis an effective treatment for idiopathic pulmonary fibrosis, BLT could significantly improve the postoperative lung functionin comparison with STL, BLT may be a preferable operation for younger patients, especially if significant pulmonary hypertension is present.The short-term survival of BLT was similar to SLT, but long-term survivalstill needs further follow-up. Considering the quality of life, BLT is better than SLT.

Rapamycin enhances IFN-γ and IL-4 production in co-culture of gδ T and dendritic cells from mice with lipopolysaccharide-induced acute lung injury

This study aimed to study the role of rapamycin (RAPA) in modulating the interaction between gδ T cells and dendritic cells (DCs) in a lipopolysaccharide (LPS)-induced acute lung injury mouse model. Mice were injected with LPS to establish the acute lung injury model or LPS + RAPA to assess the role of RAPA in modulating cell interactions. Mice were injected with PBS or RAPA alone as controls. gδ T cells and DCs were isolated from all mice and assessed by flow cytometry and fluorescence microscopy. The isolated gδ T cells and DCs were cultured independently or co-cultured to study their interactions. Enzyme-linked immunosorbent assay was performed to assess the expression of the cytokines, namely, interferon (IFN)-γ, interleukin (IL)-4, tumor necrosis factor (TNF)-α and IL-12 in the individually cultured or co-cultured gδ T cells and DCs, and reverse transcription-polymerase chain reaction (RT-PCR) was employed to investigate the levels of relevant mRNAs. Our study found that co-culture of gδ T cells and DCs from mice treated with LPS + RAPA have reduced expression of IFN-γ and IL-4 (but not TNF-α and IL-12) compared to mice treated with LPS only. These results were confirmed by RT-PCR, where the levels of IFN-γ and IL-4 mRNA were also reduced. This study may provide useful information in understanding the interaction between gδ T cells and DCs in the LPS-induced lung injury model in mice.

Molecular characterization of the gene checkpoint homolog 1 in Daphnia carinata during different reproductive phases

Full-length cDNA of the gene checkpoint homolog 1 (Chk1) was cloned from Daphnia carinata and designated DcarChk1. DcarChk1 cDNA was 1817 bp in length and encoded a 497-amino acid polypeptide. Phylogenetic analyses revealed that DcarChk1 was most closely related to Chk1 of Daphnia pulex, followed by homologous genes of insects. Expression of DcarChk1 was higher in adult Daphnia than in larvae, and significantly higher in males than females, as determined by real-time polymerase chain reaction analysis. Using whole-mount in situ hybridization techniques, DcarChk1 in parthenogenetic females was found to be expressed mainly on the head surface, capillus, and carapace valve edge. In contrast, in sexual females, DcarChk1 was expressed mainly in the joint of the second antenna, and in the thoracic limbs and capillus. These results suggest that DcarChk1 plays a significant role in both the growth and development, as well as in regulating reproductive plasticity, in D. carinata.

[Study on the expression of T, B lymphocyte antigen and platelet antibodies in patients with platelet transfusion refractoriness]

目的

探讨T、B淋巴细胞，血小板膜糖蛋白和血小板抗体在血小板输注无效中作用。

方法

选择41例临床确诊血小板输注无效患者为研究对象，以27例血小板输注有效患者为对照组，采用流式细胞术检测两组患者外周血细胞毒性T淋巴细胞（CD3 ⁺CD4⁻CD8⁺）、辅助性T淋巴细胞（CD3 ⁺ CD4⁺CD8⁻）、B淋巴细胞（CD19⁺）比例和血小板膜糖蛋白CD41а、CD61的表达，采用固相凝集法检测两组患者血清中的血小板抗体。

结果

与对照组比较，血小板输注无效组患者：①辅助性T细胞比例明显下降（36.60%对48.53%），细胞毒性T细胞比例显著增高（53.26%对44.02%），二者比值下降（0.85对1.31），差异均有统计学意义（P值均<0.05）；②B淋巴细胞比例差异无统计学意义（3.02%对2.85%，P=0.901）；③CD41а阳性细胞率[（88.10±12.75）%对（51.69±24.45）%，P=0.001]和CD61阳性细胞率[（88.36±12.31）%对（51.83±24.48）%，P<0.001]均显著升高；④血小板抗体阳性率显著增高（85.37%对14.82%，P<0.05）。

结论

细胞毒性T淋巴细胞的激活、辅助性T细胞的抑制、血小板膜糖蛋白CD41а和CD61的表达以及血小板抗体的产生均在血小板输注无效的发生过程中发挥重要作用。

[Feasibility study of transplantation of penile corpus cavernosum and major pelvic ganglion in renal subserous region]

OBJECTIVE

To study the feasibility of transplantation of normal rat penile corpus cavernosum and major pelvic ganglion (MPG) into the renal subserous region of a Nu/Nu mouse based on allograft technology.

METHODS

Penile corpus cavernosum and MPG, harvested from Sprague-Dawley (SD) rats under sterile condition, were transplanted underneath the kidney capsule of Nu/Nu mice through the microsurgery instruments and surgery microscope. The histopathologic changes and cellular proliferation in the transplanted penile corpus cavernosum and MPG were then analyzed at the end of 1week and 4 weeks after transplantation. Histological staining and immunohistochemical staining were used to evaluate the main outcome measures.

RESULTS

After 1 week, the tissue morphology of the transplanted corpus cavernosum underneath the kidney capsule of Nu/Nu mice was consistent with normal penile corpus cavernosum, and blood could be observed in the penis cavernous sinus of the graft; after 4 weeks, the mophorlogy of the tranplanted corpus cavernosum near the kidney was consistent with normal penile corpus cavernosum, while fibrosis was noteworthy in the graft away from the kidney, but blood could still be seen in the penis cavernous sinus. After 1 week, the tissue morphology of the transplanted MPG was consistent with normal MPG, multiple islet-like cell clusters could be seen in the transplanted MPG in the renal subserous region, and angiogenesis could be observed near the kidney; after 4 weeks, a network of blood vessels was clearly visible away from the kidney, and islet-like cell clusters were still clearly observed in the transplanted MPG. In addition, ki67 positive cells were observed in the transplanted penile corpus cavernosum and MPG after 4 weeks of transplantation, which indicated that there was still cell proliferation activity in the grafts.

CONCLUSION

The transplanted corpus cavernosum and MPG underneath the kidney capsule of Nu/Nu mice could survive at least 4 weeks. Moreover, the inner structure of the transplanted corpus cavernosum and MPG was close to the normal tissue. The underlining mechanism may be related to the local microenvironment underneath the kidney capsule of Nu/Nu mice and the neovascularization in the transplanted grafts.

[Telescopic technique associated with mucosectomy in pancreaticoduodenectomy]

OBJECTIVE

To explore the feasibility of the telescopic technique associated with mucosectomy in preventing pancreatic fistula after pancreaticoduodenectomy (PD).

METHODS

The data of 39 patients who received PD in the Affiliated Hospital of Nantong University was retrospecively analyzed. We developed a safe and simple method of pancreaticojejunostomy in 39 patients, in whom approximately 3 cm of jejunal mucosa was cut to improve the adhesion between the loop and pancreatic parenchyma after end-to-end invagination.

RESULTS

This procedure was proved to be much more expeditious, and only 2 of 39(5.1%)patients had pancreatic leakages, who were treated with drainage only. No hemorrhage or cholangitis was observed. No postoperative mortality was observed.

CONCLUSION

The telescopic technique associated with mucosectomy is an acceptable and safe surgery for pancreaticojejunal anastomosis.