Recombinant erythropoietin protective and related effects on brain injury in premature infants

OBJECTIVE

The aim of this study was to investigate the protective effect of recombinant erythropoietin at different doses on brain injury in premature infants and the related effects on blood routine, liver function, intellectual development, mental development index (MDI), psychomotor development index (PDI), etc. PATIENTS AND METHODS: A total of 120 premature infants were divided into four groups, including experimental group A (n=30), experimental group B (n=30), experimental group C (n=30) and control group (n=30). The experimental group was treated with different doses of recombinant erythropoietin for brain injury protection of premature infants, while the control group with conventional methods.

RESULTS

There was no statistical significance in all test indicators of the four groups of patients before the intervention. After the intervention experiment, the S-100B index was p<0.05, and the erythropoietin (EPO) index was p<0.05. In the comparison of IL-6 indicators, the indicators of the experimental group were reduced after the comparison experiment, and there were significant differences, p<0.05. In neonatal behavior evaluation, there was a statistical difference between groups A and B and the control group (p<0.05), and no statistical significance was shown between group C and the control group (p>0.05). In the intelligence test comparison, the F value of the experimental group was 3.113 three months after treatment. After six months, the F value was 3.654. After nine months, the F value was 3.392 with p<0.05. In the comparison of blood routine indicators, the p-values of four indicators between groups were more than 0.05. In the comparison of liver function indexes, the indexes of groups A, B, and C were significantly changed before and after treatment, and the data after treatment were significantly different from those before treatment, p<0.05. In the comparison of development, there were no significant differences observed in the p-values of the two indicators of vigorous exercise and language in the experimental group.

CONCLUSIONS

Recombinant erythropoietin has a protective effect on infants with brain injury and can improve the intellectual development of premature infants, but has no significant effect on blood routine indicators. It can effectively improve the MDI, PDI, and related cytokines of premature infants, and has certain significance for the treatment of brain injury.

Haploidentical haematopoietic stem cell transplantation for the treatment of severe aplastic anaemia patients with high-risk factors who lack an HLA-matched sibling donor

This study aimed to analyse the efficacy of haploidentical donor (HID) haematopoietic stem cell transplantation as a first-line treatment for severe aplastic anaemia (SAA) with high-risk factors (infection or very severe aplastic anaemia,VSAA) in patients who lack an HLA-matched sibling donor (MSD). The patients with infection were treated with anti-infection therapy, and allogeneic haematopoietic stem cell transplantation (HSCT) was carried out after the infection being effectively controlled was in accordance with the stable infection (SI) standard. A total of 44 SAA patients receiving MSD transplantation (n=19) and HID transplantation (n=25) were included in this study. There was no significant difference in neutrophil engraftment between the two groups [MSD vs. HID, 19 (11-38) vs. 22 (15-47).P=0.241], and the difference in platelet engraftment was statistically significant [MSD vs. HID, 11(7-33) vs. 20 (12-69), P=0.034]. The HID group exhibited a higher incidence of grade II-IV acute graft-versus-host disease (aGVHD) (HID vs. MSD, 48.0% vs10.5%, P=0.034)and a higher incidence of chronic GVHD (cGVHD) than the MSD group (64.0% vs. 21.1%, P=0.026). There was no significant difference between overall survival (OS) following HID and MSD transplantation (84.0% vs. 89.5%, P=0.664) and failure-free survival (FFS)(80.0% vs. 84.2%, P=0.965). The interval from diagnosis to transplantation (>50d) and ECOG (>2) were independent factors associated with OS and FFS. HID HSCT may be an effective and safe option for SAA patients with high-risk factors who lack an MSD.

[Impact of systolic blood pressure on outcome of patients with nonvalvular atrial fibrillation]

Objective: To investigate the impact of different levels of systolic blood pressure on all-cause, cardiovascular and cerebrovascular mortality in patients with nonvalvular atrial fibrillation (AF). Methods: This is a prospective cohort study. Patients with AF or atrial flutter diagnosed by 12 lead electrocardiogram during physical examination of Kailuan Group employees from July 2006 to December 2017 or previously diagnosed with AF in an inpatient setting at a level 2A hospital or above were eligible for the study. Baseline clinical characteristics including age, gender, systolic blood pressure were collected. According to the level of systolic blood pressure, patients were divided into systolic blood pressure<120 mmHg (1 mmHg=0.133 kPa)group, 120 mmHg ≤ systolic blood pressure<140 mmHg group, and systolic blood pressure ≥140 mmHg group. The time of first diagnosis with AF was defined as the start of follow-up and the final follow-up ended at December 2018. Primary endpoint was all-cause death. Related information was obtained through the social security system or inpatient medical records. The cause of death was defined according to the International Classification of Diseases disease (ICD-10) codes by professional medical stuffs. Multifactorial Cox proportional risk model was used to analyze the relative risk ratios for the occurrence of death in different systolic blood pressure level groups. The relationship between systolic blood pressure levels and mortality in the patients with AF was analyzed by using natural spline function curves. Results: A total of 1 721 patients with AF were enrolled (average age=(67.0±9.0) years), patients were followed up for (6.3±3.8) years. 544 out of 1 721 patients with AF died during the follow-up period (31.61%). The cumulative incidence rate of all-cause mortality, cardiovascular and cerebrovascular death was 26.13%, 25.59%, 36.96% and 14.86%, 11.87%, 19.76% respectively in the systolic blood pressure<120 mmHg, 120 mmHg ≤ systolic blood pressure<140 mmHg and systolic blood pressure ≥140 mmHg groups. The cumulative incidence rate of all-cause, cardiovascular and cerebrovascular death was significantly higher in the group with systolic blood pressure ≥140 mmHg than in 120 mmHg ≤ systolic blood pressure<140 mmHg group (P<0.05). Compared with 120 mmHg ≤ systolic blood pressure<140 mmHg group, multivariable Cox proportional hazards regression models showed that the HRs (95%CI) for all-cause, cardiovascular and cerebrovascular death were 1.47 (1.20 to 1.79) and 1.69 (1.27 to 2.26) for the group with systolic blood pressure ≥ 140 mmHg (P<0.05). In contrast, the HRs (95%CI) for all-cause, cardiovascular and cerebrovascular death in the systolic blood pressure<120 mmHg group were 0.99 (0.73-1.35) and 1.24 (0.82-1.89), respectively, with no statistically significant differences between the two groups (P>0.05). The natural spline curve showed that there was a "U" relationship between systolic blood pressure levels and all cause death and cardiovascular and cerebrovascular death in this patient cohort. Systolic blood pressure greater than or less than 123 mmHg was associated with increased risk of death of AF patients in this cohort. Conclusion: Compared with systolic blood pressure<120 mmHg and systolic blood pressure≥140 mmHg group, the risk of all-cause and cardiovascular and cerebrovascular death is the lowest in AF patients with 120 mmHg ≤ systolic blood pressure<140 mmHg in this cohort.

Circ-0104631 promotes cell proliferation and invasion in colorectal cancer and predicts poor prognosis

OBJECTIVE

The aim of this study was to elucidate the effect of Circ-0104631 on the progression of colorectal cancer (CRC) and to demonstrate the underlying mechanism. Our research might provide new biological markers and molecular therapeutic targets for the diagnosis and therapy of CRC.

PATIENTS AND METHODS

Quantitative real-time polymerase chain reaction (qRT-PCR) was applied to detect Circ-0104631 expression in human colorectal cancer tissues and normal control tissues. To further explore the effect of Circ-0104631 on CRC in vitro, we first knocked down Circ-0104631 in colorectal cancer cells (SW480 and LoVo) by shRNA transfection. Subsequently, we detected its effect on cell proliferation and invasion by cell counting kit-8 (CCK-8) assay, colony formation assay and cell invasion assay, respectively. The regulation of Circ-0104631 on the expressions of phosphate and tension homology deleted on chromosome ten (PTEN)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) signaling pathway-related proteins was detected by Western blot. Besides, the regulatory mechanism of Circ-0104631 on the progression and metastasis of CRC was further verified by recovery experiments.

RESULTS

QRT-PCR results showed that Circ-0104631 was highly expressed in tissues of patients with CRC when compared with that of normal control tissues. At the same time, we also found that the expression of Circ-010463 was significantly up-regulated in CRC tissues with high topography lymph node metastasis (TNM) stage and distant metastasis. Survival curve analysis indicated that high expression of Circ-010463 predicted poor prognosis of CRC patients. In vitro experiment demonstrated that inhibition of Circ-0104631 in SW480 and LoVo cells could markedly decrease cell growth and metastasis abilities. Meanwhile, Western blot results indicated that the protein expression of PTEN increased significantly, while p-Akt and p-mTOR decreased remarkably after knock-down of Circ-0104631 in CRC cells. Furthermore, recovery experiments illustrated that knockdown of PTEN in SW480 and LoVo cells partially attenuated the inhibitory effect of shRNA-Circ-0104631 on cell growth and metastasis.

CONCLUSIONS

Circ-0104631 was highly expressed in CRC tissues. Furthermore, knockdown of Circ-0104631 could inhibit the growth and metastasis of CRC cells by regulating PTEN/Akt/mTOR signaling pathway.

[Giant trichilemmal carcinoma of the retroauricular: a case report]

The trichilemmal carcinoma is a rare tumor that usually occurs on sun-exposed skin, especially on the face, scalp, neck and back of hands, mainly in elderly subjects but commonly between the 4th and 9th decades of life. We report a case of giant trichilemmal carcinoma. A 65-year-old man presented with a 5-year history of a slowly developing mass arising from his right retroauricular region, with local destruction of the auricle. The lesion appeared as a 8.0 cm×6.5 cm×2.0 cm sized, with surface ulceration and erosion, subcutaneous nodule, and mild tenderness. Preoperative pathological biopsy showed: "retroauricular" trichilemmal carcinoma. The patient underwent right retroauricular tumor resection, partial auriculectomy, neck adjacent skin flap repair and auricle reconstruction. Postoperative pathological report: "retroauricular" trichilemmal carcinoma. The margin of incision was negative, and the lymph nodes in zone II were negative. Immunohistochemistry: Tumor cells were CK5/6（++）, p63（++）, p40（++）, CD10（-）, EMA（-）, Ki-67（+, about 60%）.

[Efficacy and safety of IA regimen containing different doses of idarubicin in de-novo acute myeloid leukemia for adult patients]

目的

探讨含不同剂量去甲氧柔红霉素（IDA 8、10、12 mg/m²）的IA方案诱导治疗成人初发急性髓系白血病（AML）（非急性早幼粒细胞白血病）的临床疗效和安全性。

方法

采用多中心、单盲、非随机、临床对照研究，纳入2011年5月至2015年3月苏州大学附属第一医院及其他36家单位收治的1 215例成人初发AML患者，根据诱导化疗方案中IDA的剂量对患者进行分组，分析不同剂量IDA联合阿糖胞苷（100 mg/m²）组成的IA方案在成人初发AML诱导治疗中的完全缓解（CR）率、血液学及非血液学不良事件。

结果

可纳入缓解率分析的AML患者共1 207例，IDA 8 mg/m²、10 mg/m²和12 mg/m²组的CR率分别为73.6%（215/292）、84.1%（662/787）和86.7%（111/128），差异有统计学意义（P<0.001）；以IDA 8 mg/m²组为参照组，在调整了年龄、骨髓原始细胞比例、FAB分型、危险度分层后，IDA 10 mg/m²和IDA 12 mg/m²为影响患者CR的有利因素[OR=0.49（95% CI 0.34~0.70），P<0.001；OR=0.36（95%CI 0.18~0.71），P=0.003]。在中、低危组中三组CR率分别为76.5%（163/213）、86.9%（506/582）和86.1%（68/79），差异有统计学意义（P=0.007）；在调整了年龄、骨髓原始细胞比例、FAB分型因素后，IDA 10 mg/m²为影响患者CR的有利因素[OR=0.47（95% CI 0.31~0.71），P<0.001]。在高危组中，三组CR率分别为50.0%（18/36）、60.6%（43/71）和81.8%（18/22），差异无统计学意义（P=0.089），但在调整了年龄、骨髓原始细胞比例、FAB分型因素后，IDA 12 mg/m²为影响患者CR的有利因素[OR=0.22（95% CI 0.06~0.80），P=0.022]。8 mg/m²、10 mg/m²和12 mg/m²组中性粒细胞≤0.5×10⁹/L的中位持续时间分别为14（11~18）、15（11~20）和18（14~22）d，差异有统计学意义（P=0.012）；三组PLT≤20×10⁹/L的中位持续时间分别为14（7~17）、15（11~20）和17（15~21）d，差异有统计学意义（P=0.001）；三组肺部感染发生率分别为9.8%、13.5%和25.2%，差异有统计学意义（P<0.001）。

结论

在中国成人（18~60岁）初发AML中，建议中、低危组患者采用含IDA 10 mg/m²的IA方案进行诱导治疗；而高危组AML建议选择含IDA 12 mg/m²的IA方案进行诱导治疗。

[Recombinant human bone morphogenetic protein 7 inhibits the proliferation and extracellular matrix secretion of fibroblast of urethral scars]

Objective: To study the effect and its mechanism of recombinant human bone morphogenetic protein 7 (rhBMP-7) on urethral keloid fibroblast. Methods: Urethral fibroblasts were extracted and cultured, and the fourth-generation fibroblasts were used for experiment. Urethral fibroblasts were treated with rhBMP-7. Proliferation rate was detected by CCK-8 method. RT-PCR was applied to test changes of mRNA in α smooth muscle actin (α-SMA) and type Ⅰ collagen protein (COL-1) of each group. Western blot was used to measure α-SMA protein expression and the effect of rhBMP-7 on signaling pathway of urethral keloid fibroblasts. Results: With the increase of rhBMP-7 concentrations, the proliferation rate of urethral keloid fibroblast was generally decreased. Cells kept proliferating with time at the same concentration of rhBMP-7. mRNA level of COL-1 and α-SMA in rhBMP-7-treated (>20 ng/ml) urethral keloid fibroblasts was greatly reduced with statistical significance (P<0.05) and dose dependency. It was found rhBMP-7 inhibited the overexpression of p-smad2/3 and α-SMA mediated by transforming growth factor beta 1 (TGF-β(1)) signaling pathway. Conclusion: rhBMP-7 could adjust TGF-β(1) signaling pathway to inhibit gene expression of COL-1 and a-SMA in urethral keloid fibroblast, which provided evidences for further animal experiments or clinical trials.

[Clinical research of second resection on early stage primary bladder adenocarcinoma and literature review]

OBJECTIVE

To investigate the clinical and pathological characteristics, as well as the diagnosis and treatment of primary bladder adenocarcinoma in the early stage.

METHODS

The clinical features, pathological results, diagnosis and treatment profiles of 7 cases of primary bladder adenocarcinoma admitted in Affiliated Hospital of Nantong University from January 2010 to July 2015 were analyzed ret rospectively.

RESULTS

All seven cases were diagnosed pathologically as primary bladder adenocarinoma.Histological staging T1 was revealed in six cases, while T2 in one case after the first resection.After four weeks, all patients received the second resection while one patient underwent immediately radical cystectomy. Multimodality therapy such as radiotherapy or chemotherapy was performed for longer postoperative survival.only one man died while another patient had been healthy for 6 years till January 2016.

CONCLUSION

Primary bladder adenocarcinoma is a highly malignant disease in bladder cancer.According to the results of the second resection, multimodality therapy for patients in early stage with no lymph node or other organs metastasis can improve the quality of life without affectiong their lives.

Variation of craniocervical junction volume as an effective parameter for basilar invagination treatment

OBJECTIVE

The major pathological change in basilar invagination (BI) is represented in the decrease of craniocervical junction (CVJ) volume resulting from abnormal bone protrusion around the foramen magnum. The diagnosis and clinical evaluation of BI is mainly based on the clinical manifestations and radiographic measurements by means of calculation of the scan lines of CVJ in X-ray, CT and MRI. With the transoral decompression atlantoaxial reduction plate (TARP III) system, the decompression, reduction and fixation can be achieved to decompress and stabilize medulla spinalis change the position of the dens in CVJ, thus expand the CVJ relative volume, relieve the compression on medulla spinalis and the nerve injury. However, the correlation between the dens position change and the variation of CVJ has not been established previously. This study focused on the clinical significance of the variation of craniocervical junction (CVJ) volume caused by the dens position change for the treatment of BI.

PATIENTS AND METHODS

We've performed an analysis of data from 62 BI patients admitted from January 2008 to May 2013, who were treated by TARP III system. The data include preoperative, postoperative JOA scores (Japanese Orthopaedic Association scores, 17 points method), preoperative and postoperative X-ray, thin-slice CT scan with three-dimensional reconstruction and MRI scan to measure the cervicomedullary angle (CMA). We have analyzed the preoperative and postoperative three-dimensional CT data by means of MIMICS 10.01 software system according to the Box volume (BV) method to determine the changes of CVJ volume resulting from preoperative and postoperative dens position change, assessed the correlation between the CVJ volume changes and the JOA scores with correlation between CMA change and the JOA scores. All data were analyzed by paired t-test and Pearson correlation analysis.

RESULTS

In all 62 patients, JOA scores were recovered from preoperative 9.26 ± 1.66 to postoperative 13.02 ± 1.44, CMA change rate was 21%, and CVJ volume change rate was 36%. The CMA change rate and the JOA score recovery rat exhibited relevance, as Pearson's correlation coefficient was 0.46 (p < 0.005). The Pearson's correlation coefficient between CVJ volume change rate and JOA score recovery rate was 0.63 (p < 0.005), and the CVJ volume change rate was significantly different while compared with the correlation between CMA change rate and JOA score (p < 0.005).

CONCLUSIONS

the CVJ volume change rate is a sensitive and reliable parameter for the evaluation of neurological function improvement in patients with BI. It can be used as a predictor to evaluate the postoperative neurological recovery.

Discoloration of methylene blue and wastewater from a plant by a Fe/Cu bimetallic system

Using a Fe/Cu bimetallic system (Fe/Cu system), the discoloration of both methylene blue in aqueous solution and the colored wastewater from a plant was investigated under the anaerobic condition in batch or continuous reactors. Results show that the Fe/Cu system effectively removed the color with over 88% of color removal efficiency for both methylene blue solution and the wastewater from the plant in batch test. Color removal efficiencies increased rapidly with Fe/Cu dosage and reaction time, respectively, at initial time and slowly to stable values. Optimum pH was neutral range. In addition, in continuous test it also removed the color of the wastewater from the plant with 63% of discoloring efficiency under the condition of 2 h of hydraulic retention time and neutral range of pH (7.0-8.3). High discoloring efficiencies with low chemical oxygen demand removal efficiencies were found in all experiments. The reduction of chromophores in pollutants was the main mechanism of the discoloration in the Fe/Cu system.

Performance of triple ditch: effects of duration and periodic operation programs

The periodic variation of operation states in triple ditch (BIO-DENITRO process) was investigated in a pilot-scale and a full-scale triple ditch treating raw wastewater containing 70% petrochemical wastewater and 30% domestic wastewater. Mathematical models describing the periodic variation of activated sludge concentrations in each ditch were proposed based on theoretical analysis and were verified in the pilot-scale and full-scale triple ditches respectively. The existence of optimal cycle time and time arrangement of periodic operation programs were demonstrated and discussed according to the mathematical models and the experimental results of the pilot-scale triple ditch operated in four different stages. Four rulers determining the duration and operation programs are suggested.

[Study on preparation and pharmacodynamics of insulin-loaded polyester microparticles]

AIM

To investigate the possibility of using poly (epsilon-caprolactone-block-D, L-lactide) (PLCA) as a kind of materials to prepare the microparticles drug carrier.

METHODS

PCLA-MP (microparticle, MP) was prepared by double-emulsification solvent evaporation method. Its morphology was examined by scanning electron microscope. Its size diameter was examined by particle analyser. Insulin (INS), as a model drug, was then encapsulated into PCLA-MP (INS-PCLA-MP). HPLC method was established for determining INS in INS-PCLA-MP. An "antibody-capture" procedure was devised for investigating encapsulation mechanism. The in vitro release behaviour of INS-PCLA-MP was determined in phosphatic buffer solution (pH 7.4). The diabetic rat model was established and blood glucose levels were measured using glucose oxidase (GOD-PAP) method to evaluate the hypoglycaemic effects after subcutaneous administration of INS-PCLA-MP. The pharmacological bioavailability (PBA) of INS-PCLA-MP was calculated from the area above the curve (AAC) in contrast with INS-solution.

RESULTS

The mean diameter of INS-PCLA-MP was 1.9 microns, while the encapsulation ratio of INS reached to 76.46%. Only 18.25% encapsulated INS was on the surface of the microparticles, it could be measured by "antibody-capture" experiment. The in vitro release curve of INS-PCLA-MP consists of initial rapid release stage followed by slower exponential stage. In pharmacodynamic studies, after subcutaneous administration of INS-PCLA-MP 12 u.kg-1, the hypoglycaemic effect was significant. The PBA of INS-PCLA-MP was 123.08%.

CONCLUSION

PCLA might become a new drug carrier material in the future.