Assessment of risk factors for bronchopulmonary dysplasia with pulmonary hypertension and construction of a prediction nomogram model / 中华儿科杂志

Objective: To explore the risk factors of pulmonary hypertension (PH) in premature infants with bronchopulmonary dysplasia (BPD), and to establish a prediction model for early PH. Methods: This was a retrospective cohort study. Data of 777 BPD preterm infants with the gestational age of <32 weeks were collected from 7 collaborative units of the Su Xinyun Neonatal Perinatal Collaboration Network platform in Jiangsu Province from January 2019 to December 2022. The subjects were randomly divided into a training cohort and a validation cohort at a ratio of 8∶2 by computer, and non-parametric test or χ2 test was used to examine the differences between the two retrospective cohorts. Univariate Logistic regression and multivariate logistic regression analyses were used in the training cohort to screen the risk factors affecting the PH associated with BPD. A nomogram model was constructed based on the severity of BPD and its risk factors,which was internally validated by the Bootstrap method. Finally, the differential, calibration and clinical applicability of the prediction model were evaluated using the training and verification queues. Results: A total of 130 among the 777 preterm infants with BPD had PH, with an incidence of 16.7%, and the gestational age was 28.7 (27.7, 30.0) weeks, including 454 males (58.4%) and 323 females (41.6%). There were 622 preterm infants in the training cohort, including 105 preterm infants in the PH group. A total of 155 patients were enrolled in the verification cohort, including 25 patients in the PH group. Multivariate Logistic regression analysis revealed that low 5 min Apgar score (OR=0.87, 95%CI 0.76-0.99), cesarean section (OR=1.97, 95%CI 1.13-3.43), small for gestational age (OR=9.30, 95%CI 4.30-20.13), hemodynamically significant patent ductus arteriosus (hsPDA) (OR=4.49, 95%CI 2.58-7.80), late-onset sepsis (LOS) (OR=3.52, 95%CI 1.94-6.38), and ventilator-associated pneumonia (VAP) (OR=8.67, 95%CI 3.98-18.91) were all independent risk factors for PH (all P<0.05). The independent risk factors and the severity of BPD were combined to construct a nomogram map model. The area under the receiver operating characteristic (ROC) curve of the nomogram model in the training cohort and the validation cohort were 0.83 (95%CI 0.79-0.88) and 0.87 (95%CI 0.79-0.95), respectively, and the calibration curve was close to the ideal diagonal. Conclusions: Risk of PH with BPD increases in preterm infants with low 5 minute Apgar score, cesarean section, small for gestational age, hamodynamically significant patent ductus arteriosus, late-onset sepsis, and ventilator-associated pneumonia. This nomogram model serves as a useful tool for predicting the risk of PH with BPD in premature infants, which may facilitate individualized early intervention.

Advances in mechanisms of microglial function on demyelination and remyelination in EAE model / 中国免疫学杂志

Inflammatory cells infiltration and demyelination in the central nervous system (CNS) are the main pathological characteristics of multiple sclerosis(MS),an autoimmune disease in the CNS.Most of the related pathological studies are carried out in the animal model experimental autoimmune encephalomyelitis(EAE).Microglia(MG) are the primary immune effector cells of the CNS and their activation can play complex roles in demyelination and remyelination during EAE.In detail,M1 phenotype is an important cause of demyelination and detrimental to remyelination while M2 phenotype can promote remyelination and inhibit demyelination.In this review,we not only focus on advances in the direct mechanisms of microglial function on demyelination and remyelination in EAE model,also the indirect mechanisms by astrocytes.

Relationship between Immunosuppressive Cells Treg,MDSCs and Clinicopathological Characteristics of Gastric Cancer / 胃肠病学

Background:The ability of tumor cells to evade destruction by immune system is known as tumor immune escape. Regulatory T cells( Treg cells)and myeloid-derived suppressor cells( MDSCs)are considered to be the most critical cell subsets participating in tumor immune escape. Aims:To determine the percentages of Treg cells and MDSCs in peripheral blood of patients with gastric cancer for investigating the effects of these two cell subsets on development and progression of gastric cancer. Methods:Peripheral blood specimens from 77 patients with gastric cancer and 20 healthy controls were collected for measurements of CD4+CD25+Foxp3+ Treg cells and MDSCs by flow cytometry. Correlations between Treg cells,MDSCs and clinicopathological characteristics of gastric cancer were analyzed. Results:Percentage of CD4+CD25+Foxp3 + Treg cells in peripheral blood CD4+ T cells and percentage of MDSCs in peripheral blood mononuclear cells were both significantly higher in gastric cancer patients than in healthy controls( Treg cells:4. 72% ± 1. 01% vs. 1. 57% ± 0. 99%,P<0. 01;MDSCs:21. 72% ± 10. 12% vs. 2. 90% ± 1. 80%,P<0. 01). Percentage of Treg cells in peripheral blood was correlated with the clinical stage,depth of invasion and lymph node metastasis of gastric cancer(P<0. 05), while percentage of MDSCs was correlated with the clinical stage of gastric cancer(P<0. 05). Furthermore,a significant positive correlation was observed between percentages of Treg cells and MDSCs in peripheral blood of gastric cancer patients ( rs =0. 681,P<0. 01). Conclusions:Gastric cancer patients are characterized by high expressions of immunosuppressive cells in peripheral blood,such as Treg cells and MDSCs,which might be related with the development and progression of gastric cancer via tumor immune escape.

The Application and Prospect of Platelet Glycoprotein ⅡbⅢa Receptor Antagonist in Ischemic Stroke / 国际脑血管病杂志

Platelet glycoprotein ⅡbⅢa receptor antagonists is a class of novel antiplatelet agents. This article explores the application and prospect of platelet glycoprotein ⅡbⅢa receptor antagonists in ischemic stroke from the aspects of its combination with thrombolytic agents, the application of carotid artery angioplasty and stenting (CAS), and be used alone.

THE PROTECTIVE EFFECTS OF VITAMIN B_(12) ON SPATIAL COGNITIVE ABILITY IMPAIRED BY HOMOCYSTEINE IN RATS / 营养学报

Objective: To observe the relationship between homocysteine(Hcy)and spatial cognitive ability and to evaluate whether vitamin B12 supplementation could protect spatial cognitive ability in rats. Methods: The rats were randomized into three groups. The experimental group was given methionine subcutaneously. The intervention group was given methionine and vitamin B12 subcutaneously. The control group received isometric normal saline. After being raised for 8 weeks, all rats were examined for plasma Hcy and serum vitamin B12 and scores of Y-maze test. The brain tissues of hippocampus were checked immunohistochemically for acetylcholinesterase (AChE). Results: The experimental group developed hyperhomocysteinemia and descreased spatial cognitive ability significantly (P0.05). Conclusion: Homocysteine can impair the spatial cognitive ability in rats and vitamin B12 is effective in lowering Hcy level and protect the spatial cognitive ability of rats.