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Objective:To investigate clinicopathological features of 4 cases of intravascular large B-cell lymphoma (IVLBCL) .Methods:Clinical and pathological data were collected from 4 patients with histopathologically confirmed IVLBCL in Department of Dermatology, Peking Union Medical College Hospital from January 2020 to November 2020, and retrospectively analyzed.Results:The 4 patients were aged 57 - 76 years, including 2 males and 2 females. Of the 4 patients, all had neurological symptoms, 3 had fever, 3 exhibited impaired exercise tolerance and suffocation, and 3 exhibited pitting edema of the body. Case 1 presented with a cherry hemangioma-like papule measuring 0.2 cm in diameter on the back, and case 2 with telangiectasia on the left breast and upper abdomen. Six skin samples were taken from the 4 patients for histopathological and immunohistochemical studies, and tumor cells were found in 1 cherry hemangioma-like lesion and 1 lesion of telangiectasia, as well as in 2 of 4 normal skin samples. Histopathological findings mainly were dilated dermal blood vessels filled with large atypical mononuclear cells, and the atypical mononuclear cells were positive for CD20 immunohistochemically.Conclusion:For those patients with suspected IVLBCL, hemangioma-like and telangiectasia lesions tend to show characteristic histopathological and immunohistochemical findings, and a biopsy of normal skin can facilitate early diagnosis of IVLBCL.
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Objective To investigate the changes of postprandial serum insulin and C-peptide concentration of type 2diabetes mellitus (T2DM) patients with different fasting blood glucose concentrations, and to study the islet function of them.Methods There were 492T2DM patients from January 2016to June 2017in our hospital were selected and divided into three groups according to different fasting plasma glucose (FPG) levels:group A, 7.0mmol/L≤FPG＜11.1mmol/L;group B, 11.1mmol/L≤FPG＜14.0mmol/L;group C, FPG≥14.0mmol/L.Meanwhile, 50healthy examinees were collected as the control group.A standard 75g OGTT were performed in 492T2DM patients and 50healthy controls, and 2mL of venous blood of them were collected at 0.5, 1.0, 2.0and 3.0h.The concentration of insulin and C-peptide at each point was measured by chemiluminescence method, and then compared with the control group.Results The concentration of insulin and C-peptide in T2DM patients were slightly higher than those in the control group, but there was no statistical significance (P＞0.05).The serum insulin and C-peptide post-meal in the A, B and C groups and control group increased, but the 1.0hpostprandial blood glucose of control group increased to a peak, and gradually returned to normal at 3.0h;the 2.0hpostprandial blood glucose of A, B and C groups increased to a peak, and decreased at 3.0h, but did not return to normal level.The concentrations of insulin and C-peptide in the A, B and C groups at 0.5, 1.0, and 2.0hpost-meal were significantly lower than those in the control group (P＜0.05).Conclusion The function of isletβcells in T2DM patients decreases with the increase of blood glucose.The determination of insulin and C-peptide can provide a scientific evidence for judging the severity of disease and guiding treatment.
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Objective@#To study the correlation between the blood routine indicators and CD4+ T, CD8+ T lymphocytes in AIDS patients without antiviral treatment, and to find a simple, cheap and effective monitoring indicator.@*Methods@#A study of 333 AIDS patients without antiviral treatment was performed.The methods of regression analysis and other statistical methods were applied to research the correlation between WBC, W-SCC and CD4+ T, CD8+ T cell count among HIV/AIDS.@*Results@#The rate of routine blood abnormalities among 333 HIV/AIDS patients was very high, the main test indicators within the reference range only accounted for 30.63%.The proportion of late diagnosis infected with HIV among women was higher than that of males.Significant correlations were observed between CD4+ Tcell count and WBC, W-SCC, W-LCC, RBC, HGB, PLT(r=0.408, 0.541, 0.157, 0.337, 0.338, 0.166). The equation between W-SCC (x) and CD4+ cell count (y) was y=120.913x+ 90.339.@*Conclusion@#There is a strong correlation between CD4+ T lymphocyte count and lymphocyte count in AIDS patients without antiviral treatment.It can be used as an important indicator of immune status in patients with AIDS.At the same time, we should strengthen the propaganda of AIDS prevention, promote AIDS early detection, early treatment, and improve the quality of life of AIDS patients.
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Objective To investigate the causes and factors of hemoglobinuria in patients with thrombosis after AngioJet mechanical thrombectomy.Methods The clinical data of 16 patients with thrombosis treated by AngioJet thrombectomy system were retrospectively analyzed.Nine patients with hemoglobinuria during the procedure were included in group A,while 7 patients without hemoglobinuria in group B.The type of surgical procedure,time of intraoperative aspiration and the thrombus volume were compared between both groups.Results Nine (9/16,56.23 ％) of 16 patients were found hemoglobinuria during and after AngioJet mechanical thrombectomy.There were no statistically significant differences in surgical approaches (x2 =1.667,P=0.197),the time of intraoperative aspiration ([320.11±108.80]s vs [265.29±31.46]s,t=0.741,P=0.457),the thrombus volume (x2=0.442,P=0.506) between both groups.No renal function failure were noted directly relating to the use of the AngioJet thrombectomy device.Condusion There are many factors influenced the occurrence of hemoglobinuria in the patients after AngioJet thrombectomy.It can be reduced by using reasonable type of intraoperative aspiration,controled time of aspiration and active perioperative symptomatic treatment.
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Objective To design a private cloud storage system to guarantee intranet and internet data security and realize data sharing between multi platforms.Methods The idea and solution for building the system were proposed by analyzing the difficulty during hospital informatization.The infrastructure based on the idle computing resources in the existing virtual pool and the application platform by private cloud storage software were involved in the development of the system,and related software and hardware were integrated after adjustment and customization,and then the system came into being with easy operation and high performance-cost ratio.Results The system developed realized freely data storage and sharing,and implemented file encryption to control the applied range.Conclusion The system has the functions of malicious code scanning,cooperative office system and data auto-backup,synchronization,transmission,sharing and etc,which executes intranet and intemet data sharing based on physical isolation.
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Objective To explore the efficacy of multiple interventional models combined through anterior tibial veins approach in treatment of acute deep venous thrombosis (DVT).Methods The clinical data and the imaging materials of 10 patients with acute DVT were analyzed retrospectively,and the interventional treatment strategies were discussed.Results The percutaneous mechanical thrombectomy (PMT) was performed after a temporary inferior vena cava filter implanted in all patients,and thrombus clearance rate of grade Ⅲ was obtained in 7 patients while 3 patients reached grade Ⅱ criteria.There were 7 patients underwent angioplasty,then the inferior vena cava filter was retrieved during the same procedure in 5 patients while 4 patients in the second stage and 1 patient rejected to retrieve the filter.All swelling limbs alleviated significantly after those procedures.There was no critical complications occured.The total hospital stay ranged from 4 to 7 days,with a mean time of (6.00±0.94) days.All patients were followed up with a mean time of (3.60± 1.84) months (ranged from 1 to 6 months).No thrombus recurrences of the previously affected vessels were reported.Conclusion The multiple interventional models combined via anterior tibial veins for acute DVT is simple,safe and effective,combined with mechanical thrombectomy device can reduce thrombus burden quickly,and combined with angioplasty can consolidate the therapeutic effect,all those methods combined can shorten the overall hospitalization time.
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Autogenous arteriovenous fistula is the most commonly used vascular access in maintenance hemodialysis patients.However,thrombosis,stenosis and other factors are the most important causes of arteriovenous fistula dysfunction during hemodialysis.How to keep the patency of autogenous arteriovenous fistula is an urgent problem to be solved.Progresses in treatment of arteriovenous fistula dysfunction were reviewed in this article.
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OBJECTIVE:To study the effect and its mechanism of dexmedetomidine(Dex)on inflammatory response in septic mice. METHODS:Mice were randomly divided into normal control group,model group,miR-146a inhibitor (50 mg/kg)+Dex (50 μg/kg)group,Dex low-dose,medium-dose,high-dose groups(10,30,50 μg/kg),10 in each group. Except for normal con-trol group,other groups were intraperitoneally injected lipopolysaccharide to induce septic models,intraperitoneally injected rele-vant medicines after 0.5 h. After drug intervention for 6 h,miR-146a expression,IRAK1 and TRAF6 mRNA expressions in periph-eral blood mononuclear cells in each group were detected by real-time fluorescence quantitative polymerase chain reaction method. IRAK1,TRAF6 protein expressions in peripheral blood mononuclear cells in each group were detected by Western blot method. TNF-α,IL-6 levels in serum were detected by enzyme-linked immunosorbent method. RESULTS:Compared with normal control group,miR-146a expression,TNF-α and IL-6 levels,IRAK1,TRAF6 mRNA and protein expressions in peripheral blood mononu-clear cells in model group were increased(P0.05). Compared with Dex high-dose group,miR-146a expression,in peripheral blood mononuclear cells in miR-146a inhibitor+Dex group was de-creased;TNF-α and IL-6 levels,IRAK1,TRAF6 protein expressions were increased (P0.05). CONCLUSIONS:Dex can inhibit the inflammatory response in sep-tic mice. The mechanism may associate with inducing miR-146a expression and inhibiting the 2 important adaptor proteins IRAK1, TRAF6 expressions in Toll-like receptor 4/nuclear factor-κB pathway.
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Ebola virus (EBOV) is a key member of Filoviridae family and causes severe human infectious diseases with high morbidity and mortality. As a typical negative-sense single-stranded RNA (-ssRNA) viruses, EBOV possess a nucleocapsid protein (NP) to facilitate genomic RNA encapsidation to form viral ribonucleoprotein complex (RNP) together with genome RNA and polymerase, which plays the most essential role in virus proliferation cycle. However, the mechanism of EBOV RNP formation remains unclear. In this work, we solved the high resolution structure of core domain of EBOV NP. The polypeptide of EBOV NP core domain (NP(core)) possesses an N-lobe and C-lobe to clamp a RNA binding groove, presenting similarities with the structures of the other reported viral NPs encoded by the members from Mononegavirales order. Most strikingly, a hydrophobic pocket at the surface of the C-lobe is occupied by an α-helix of EBOV NP(core) itself, which is highly conserved among filoviridae family. Combined with other biochemical and biophysical evidences, our results provides great potential for understanding the mechanism underlying EBOV RNP formation via the mobility of EBOV NP element and enables the development of antiviral therapies targeting EBOV RNP formation.
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Humans , Crystallography, X-Ray , Ebolavirus , Physiology , Nucleoproteins , Chemistry , Genetics , Metabolism , Protein Structure, Tertiary , Structure-Activity Relationship , Virus Assembly , PhysiologyABSTRACT
Severe fever with thrombocytopenia syndrome virus (SFTSV), a member of the Phlebovirus genus from the Bunyaviridae family endemic to China, is the causative agent of life-threatening severe fever with thrombocytopenia syndrome (SFTS), which features high fever and hemorrhage. Similar to other negative-sense RNA viruses, SFTSV encodes a nucleocapsid protein (NP) that is essential for viral replication. NP facilitates viral RNA encapsidation and is responsible for the formation of ribonucleoprotein complex. However, recent studies have indicated that NP from Phlebovirus members behaves in inhomogeneous oligomerization states. In the present study, we report the crystal structure of SFTSV NP at 2.8 Å resolution and demonstrate the mechanism by which it processes a ringshaped hexameric form to accomplish RNA encapsidation. Key residues essential for oligomerization are identified through mutational analysis and identified to have a significant impact on RNA binding, which suggests that correct formation of highly ordered oligomers is a critical step in RNA encapsidation. The findings of this work provide new insights into the discovery of new antiviral reagents for Phlebovirus infection.
Subject(s)
Binding Sites , Crystallography, X-Ray , Mutation , Nucleocapsid Proteins , Chemistry , Genetics , Metabolism , Phlebovirus , Metabolism , Protein Binding , Protein Multimerization , Protein Structure, Quaternary , RNA, Viral , Metabolism , Recombinant Proteins , Chemistry , GeneticsABSTRACT
Objective To investigate the relationship between the cerebral circulation time and disease condition and prognosis in patients with acute subarachnoid hemorrhage. Methods DSA were performed to determine the cerebral circulation time (CCT) in 60 patients who had subarachnoid hemorrhage (SAH) within 3 days. The patients were divided into different groups according to the severity of the disease condition,patients with CSC score as 13-15 were assigned as group Ⅰ ,whose CCT was (13.45 ± 1. 89) s. Twenty two patients with GSC score as 3-12 were assigned as group Ⅱ ,whose CCT was (16.79 ± 2. 07) s. There were significant difference between the CCT of the two groups (t =3. 76,P = 0. 001). (2)Twenty-nine patients with Hunt-Hess grade as 1-2 were assigned as group 1,whose CCT was (13.06 ± 1. 83) s. Thirty one patients with Hunt-Hess grade as 3-5 were assigned as group 2, whose CCT was (15. 89 ± 2.06) s. There were significant difference between the CCT of the two groups (t = 3. 39, P =0. 003). (3) Seventeen patients with delayed ischemic damage were assigned as group A, whose CCT was (16. 84 ±1.91) s. Forty three patients without delayed ischemic damage were assigned as group B, whose CCT was (12.94 ± 1. 67) s. There were significant difference between the CCT of the two groups (t = 2. 23, P =0.025). (4)Forty-six patients with GOS score as 4-5 were assigned as group a,whose CCT was (13.07 ±1. 89)s. Fourteen patients with GSC score as 1-3 were assigned as group b,whose CCT was (17.11 ± 1. 71)s. There were significant difference between the CCT of the two groups (t = 3. 27, P = 0.008). Conclusion CCT may reflect the severity of the SAH in early onset patients and has prognostic value.
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<p><b>OBJECTIVE</b>To assess the feature of pulmonary blood flow distribution after total cavopulmonary connection (TCPC) of different types, and to provide the selection of the best type.</p><p><b>METHODS</b>Thirty-two consecutive survival patients after TCPC underwent radionuclide lung perfusion imaging. According to the radionuclide counts in the left and right lungs, analyses of the distribution of blood flow from superior venous cava (SVC) and inferior venous cava (IVC) and the whole pulmonary blood flow in both lungs were made. All patients were divided into 4 groups by the the anastomosis between IVC and pulmonary artery.</p><p><b>RESULTS</b>Group I: The flow ratio of the IVC to left lung was greater than that to the right lung, P < or = 0.01; the flow ratio of the SVC to right lung was greater than that to the left lung, P < or = 0.01; and the whole pulmonary blood flow went dominantly to the left lung, P < or = 0.05, which is not in line with physiological distribution. Group II: the flows from the SVC and IVC were mixed in the middle of the junction and ran evenly into the right and left lungs, the whole pulmonay blood flow went to both lungs, P > or = 0.05. Group III: the flow ratio of the SVC to both lungs were the same, P > or = 0.05, and major part from IVC went to the right lung, P < or = 0.01; the pulmonary blood flow go dominantly to the right lung, P < or = 0.05, which is in accord with physiological distribution. Group IV: the flows from the right SVC went to right lung by 100%, P < or = 0.01, and that from the left SVC went to left lung by 100% too, P < or = 0.01; the flows from IVC went dominantly to the left lung, with little part to the right lung, P < or = 0.05.</p><p><b>CONCLUSIONS</b>Different types of TCPC can result in different pulmonary blood distributions. The best flow distribution between the left and right lungs can be obtained by an offset of the IVC anastomosis toward the RPA with widening anastomosis for the patients without persist left superior venous cava (PLSVC).</p>