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Objective:To explore the values of ultrasound, pathology combined with inflammatory indicators in predicting high nodal burden (HNB) in patients with early breast cancer and to construct a nomogram to provide reference for individualized diagnosis and treatment.Methods:The ultrasonographic, pathological features and preoperative inflammatory indicators of 378 female patients diagnosed with early breast cancer confirmed by pathology in the South Hospital of the Sixth People′s Hospital Affiliated to Shanghai Jiaotong University from January 2014 to July 2022 were retrospectively analyzed. They were randomly divided into training set ( n=302) and test set ( n=76) in a ratio of 8∶2, and the baseline data of the two groups were compared. The optimal cutoff values of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and lymphocyte to monocyte ratio (LMR) were obtained by ROC curve. In the training set, with axillary high lymph node load (≥3 metastatic lymph nodes) as the dependent variable, independent influencing factors of HNB were identified by univariate and multivariate Logistic regression analyses, and the nomogram was established. The test set data were used to verify the model. The discrimination, calibration and clinical applicability of the model were assessed by the area under the ROC curve (AUC), C-index, the calibration curve, Brier score and the decision curve analysis, respectively. Results:There were no significant differences in all variables between the training set and the test set (all P>0.05). ROC curve analysis results showed that AUCs of NLR, PLR and LMR were 0.578, 0.547 and 0.516, respectively, and the optimal cut-off values were 2.184, 150 and 3.042, respectively. Univariate Logistic regression analysis showed that age, pathological type, histological grade, Ki-67, lymphovascular invasion, NLR, PLR, ultrasonic characteristics (maximum diameter of primary tumor, shape, long/short diameter of lymph node, cortical thickness, cortical and medullary boundary, lymph node hilum, lymph node blood flow pattern) were correlated with HNB of early breast cancer (all P<0.05). Multivariate Logistic regression analysis showed that ultrasonic characteristics (maximum diameter of primary tumor >2 cm, effacement of lymph node hilum, non-lymphatic portal blood flow), lymphovascular invasion, Ki-67>14% and NLR>2.184 were independent risk factors for HNB in early breast cancer ( OR=7.258, 8.784, 6.120, 8.031, 3.394 and 3.767, respectively; all P<0.05) and were used to construct the nomogram model. The AUC of the training set was 0.914 (95% CI=0.878-0.949), C-index was 0.914; The AUC of the test set was 0.871 (95% CI=0.769-0.973), C-index was 0.871, indicating good discrimination. Calibration curve and Brier score were 0.090, indicating high calibration degree of the model. The clinical decision curve indicated good clinical benefit. Conclusions:The nomogram based on ultrasonic characteristics (maximum diameter of primary tumor, lymph node hilum, lymph node blood flow pattern), lymphovascular invasion, Ki-67 and NLR can effectively predict the risk of HNB in patients with early breast cancer, and provide a reference for precision diagnosis and treatment to avoid excessive or insufficient treatment.
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It is believed that the fundamental pathogenesis of the connective tissue diseases-associated interstitial lung disease （CTD-ILD） is kidney essence deficiency， with lung collateral obstruction throughout the disease， and environmental toxin pathogen is the important causative factors for the development of CTD-ILD. This article proposed to restore origin and alleviate bi （痹） for CTD-ILD， for which restoring origin means tonifying the lungs， spleen and kidneys to bank up the roots and consolidate the original qi， with modified Erxian Decoction （二仙汤） plus Liu Junzi Decoction （六君子汤）； alleviating bi means expelling wind and dredging collaterals， and eliminating the mass to restore the smoothness of the lung collaterals， with paired medicines of Chuanshanlong （Dioscorea nipponica）-Dilong （Kalanchoe pinnata）， Vinegar-processed Sanleng （Sparganium stoloniferum）-Vinegar-processed Ezhu （Curcuma zedoaria）， and stem-type medicines， and emphasized on removing the environmental toxin pathogens to facilitate the recovery of healthy qi.
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Objective:To evaluate the role of improved management procedures in placenta accreta spectrum disorders (PAS) and its impact on maternal and infant outcomes.Methods:This retrospective study involved 164 pregnant women who were diagnosed with PAS complicated with placenta previa and delivered at Nanjing Drum Tower Hospital, Nanjing University Medical School from January 2019 to December 2022. All subjects were allocated to pre-improvement group (January 2019 to December 2020, n=96) and post-improvement group (January 2021 to December 2022, n=68). The management was improved in the following five aspects: (1) The time for scheduled delivery was postponed to 37 weeks from 34-36 weeks;(2) Intraoperative cell salvage was encouraged despite autologous blood donation during pregnancy;(3) Original surgical incision was utilized instead of mid-longitudinal incision in the lower abdomen to reduce operative trauma; (4) A lower segment incision of the uterus was not prohibited based on pre-operative PAS classification and intra-operative situation to enter the uterine cavity, even through the placenta instead of pass-by;(5) The interface between lower uterine segment and bladder was dissected before instead of after the baby was born and uterine blood supply was stopped by tourniquet or Scharr forceps. Statistical methods such as t-test, Chi-square test or Fisher exact probability method were used to compare the difference in maternal and infant outcomes between the two groups. Results:After the improvement, the delivery rate beyond 37 weeks decreased significantly [83.3% (80/96) vs 69.1% (47/68), χ 2=4.60, P=0.038]. There was no significant difference in the distribution of elective, subemergency and emergency surgeries before and after the improvement ( χ 2=0.36, P=0.834). Compared to the pre-improvement group, the proportion of women who underwent cesarean section through previous abdominal incisions increased significantly [74.0% (71/96) vs 91.1% (64/68), χ 2=11.11, P=0.001] in the post-improvement group, while the proportion of application of abdominal longitudinal incision and classical cesarean section decreased significantly [84.3% (81/96) vs 57.3% (39/68), χ 2=14.81, P<0.001; 83.3% (80/96) vs 61.8% (42/68), χ 2=9.72, P=0.003]. No significant difference was found between the two groups in terms of the transfusion rate of allogeneic red blood cell, platelet and other blood components, pre-discharge hemoglobin level, subtotal hysterectomy rate, bladder injury, thrombus event, the admission rate of intensive care unit and unplanned reoperation rate (all P>0.05). The incidence of admission in neonatal intensive care unit (NICU) and necrotizing enterocolitis decreased significantly after improvement [24.7% (24/97) vs 11.8% (8/68), χ 2=4.31, P=0.038; 4.1% (4/97) vs 0.0% (0/68), χ 2=58.06, P<0.001]. The incidence of respiratory distress syndrome, mechanical ventilation, and neonatal septicemia also decreased, but without statistical difference. Conclusions:After adopting a series of improvement measures, such as delaying planned delivery to 37 weeks of gestation, individualized cesarean section plan, and changing the method of obtaining autoblood, the number of premature infants and the NICU admission rate decreased significantly without increasing the risk of maternal complications and emergency operation. Furthermore, the incidence of adverse events such as maternal organ injury, unplanned reoperation, and re-admission remains at a low level. Therefore, this improved management is feasible.
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This review comprehensively summarizes clinical assessment tools which have been developed and validated for cholinergic urticaria (CholU) , involving diagnosis and severity assessment of CholU, assessment of patients′ quality of life, and assessment of disease control. The application methods and status of relevant tools in clinical practice are introduced in detail.
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Objective:To investigate the role of kinesin family proteins(KIF)2C in chemoresistance of epithelial ovarian cancer and its potential molecular mechanism.Methods:The differential expression of KIF2C in cisplatin-sensitive cell line A2780 and cisplatin-resistant cell line A2780DDP was detected.Different concentrations and time of cisplatin were added to A2780 cell line to detect the differential expression of KIF2C.The ovarian cancer cell line KIF2C-OV with stable overexpression of KIF2C was constructed by lentivirus infection of A2780DDP cell line.The same concentration of cisplatin was added to KIF2C-OV and its control group(Ctrl-OV)cell lines.The effect of KIF2C overexpression on the proliferation of drug-resistant cell line A2780DDP was detected by Cell Counting Kit-8(CCK-8). Finally, the molecular mechanism of KIF2C resistance in ovarian cancer cell lines was preliminarily explored.Results:KIF2C was significantly down-regulated in A2780DDP cells.After cisplatin was added to A2780 cell line, the expression of KIF2C decreased with the increase of cisplatin concentration and action time.The ovarian cancer cell line KIF2C-OV with stable overexpression of KIF2C was constructed by lentivirus infection of A2780DDP cell line.After adding cisplatin, the proliferation ability of KIF2C-OV cell line was significantly lower than that of Ctrl-OV cell line.The expression of p-Erk was increased in A2780DDP cell line.The expression of p-Erk in A2780 cell line was increased with the increase of cisplatin concentration and time.After overexpression of KIF2C in A2780DDP ovarian cancer cell line, the expression level of p-Erk decreased.Conclusions:KIF2C may be a potential target gene of chemotherapy resistance in ovarian cancer, which may play its role through MAPK/ERK pathway.
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Objective:To investigate the clinical characteristics of congenital esophageal atresia with gastric perforation, and to improve pediatricians′ understanding of this disease.Methods:The clinical data of five neonates with congenital esophageal atresia and gastric perforation treated in the neonatal intensive care unit of the Affiliated Hospital of Qingdao University from 2012 to 2022 were analyzed retrospectively.Results:Among the five neonates, four were boys and one was girl.The gestational age was 28 + 5 to 37 + 6 weeks, the birth weight was 1 100~2 350 g. All of them had dyspnea and feeding difficulties after birth.Gastric perforation occurred in three cases during invasive mechanical ventilation, one case during non-invasive ventilation, and one case during nasal catheter oxygen inhalation.Emergency primary gastric repair was performed, followed by secondary esophageal anastomosis.All the patients were cured and discharged from hospital. Conclusion:Gastric perforation is a rare complication of congenital esophageal atresia, which is more common in premature infants and low birth weight infants.Mechanical ventilation may promote the occurrence of gastric perforation.If gastric perforation is complicated, repair should be performed as soon as possible, and esophageal anastomosis surgery should be performed early after stability to improve the final outcome.
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Objective:To identify the risk factors for postoperative pulmonary complications (PPCs) in elderly patients undergoing hip surgery.Methods:The medical records of elderly patients, aged ≥ 65 yr, of American Society of Anesthesiologists (ASA) physical statusⅠ-Ⅳ, who underwent hip surgery from June 2013 to May 2019, were retrospectively collected.The patients′ sex, age, body weight, preoperative comorbidities, history of smoking and alcohol, results of the last laboratory test before surgery; mode of anesthesia, intraoperative medication, body temperature monitoring, fluid intake and output, operation time, anesthesia time; postoperative PPCs and postoperative nausea and vomiting, requirement for rescue analgesia, length of hospital stay, and perioperative blood transfusion were all collected.According to the occurrence of PPCs, patients were divided into PPCs group and non-PPCs group.Multivariable logistic regression was used to determine the risk factors for PPCs.Results:A total of 1 204 patients were finally enrolled in this study, 75 patients developed PPCs, and the incidence was 6.22%.The results of multivariate logistic regression showed that ASA physical status Ⅲ or Ⅳ, preoperative respiratory disease, postoperative transfer to intensive care unit, and perioperative blood transfusion were risk factors for PPCs, and general anesthesia combined with nerve block was a protective factor for PPCs in elderly patients undergoing hip surgery ( P<0.05). Conclusions:ASA physical status Ⅲ or Ⅳ, preoperative respiratory disease, postoperative transfer to intensive care unit, and perioperative blood transfusion are risk factors for PPCs, and general anesthesia combined with nerve block is a protective factor for PPCs in elderly patients undergoing hip surgery.
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Objective To explore the effect of Linc00460 on the aerobic glycolysis of breast cancer (BC) cells through sponge adsorption of miR-320a. Methods The qRT-PCR method was used to detect Linc00460 and miR-320a expression levels in normal breast epithelial cell line MCF-10A and five BC cell lines. The effect of interfering Linc00460 on miR-320a expression was detected by qRT-PCR. The double luciferase reporter gene experiment was used to analyze the targeting relationship between miR-320a and Linc00460. In addition, the si-Linc00460 and miR-320a inhibitor were co-transfected into MDA-MB-231 cells, and the expression level of miR-320a in the cells was detected by qRT-PCR; cell proliferation ability was measured by the MTT method; glucose uptake rate was detected by 2-NBDG method; the content of lactic acid in the cell supernatant was detected by colorimetric method; the key enzymes of glycolysis was detected by the enzyme activity kit; and the expression levels of the key proteins in the glycolysis pathway were detected by Western blot. Results Linc00460 was highly expressed in five BC cell lines, while miR-320a was lowly expressed as compared with MCF-10A cells. The expression of miR-320a in MDA-MB-231 cells significantly increased after interfering with Linc00460. The double luciferase reporter gene experiment confirmed that miR-320a and Linc00460 could target binding. Interfering with the expression of Linc00460 could inhibit MDA-MB-231 cells proliferation (all P=0.000), reduce the rate of cellular glucose uptake and the content of lactic acid in the cell supernatant (all P=0.000), inhibit the activities of PFK, PK, and LDH enzymes (all P=0.000), and downregulate the protein expression levels of PFKM, GLUT1, and LDHA (all P=0.000). Meanwhile, inhibition of miR-320a could reverse the inhibitory effect of si-Linc00460 on the proliferation and glycolysis of MDA-MB-231 cells (all P=0.000 or 0.001). Conclusion Linc00460 might adsorb miR-320a, consequently leading to upregulation of PFKM expression, thereby promoting aerobic glycolysis in BC cells.
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OBJECTIVE@#To investigate the clinical features and SLC35A2 variant of a case of congenital disorder of glycosylation type IIm (CDG-IIm), and to identify the possible causes of the disease.@*METHODS@#Trio-whole exome sequencing (WES) was used to analyze the gene variant of the children and their parents. The suspicious gene variants were screened for Sanger verification and the bioinformatics prediction was used to analyze the hazard of variant.@*RESULTS@#The clinical manifestations of the child were epilepsy, global growth retardation, nystagmus, myocarditis and other symptoms. MRI showed brain dysplasia such as wide frontal temporal sulcus and subarachnoid space on both sides. Echocardiography showed left ventricular wall thickening and patent foramen ovale. According to the results of gene detection, there was a heterozygous missense variant c.335C>A (p.Thr112Lys) in SLC35A2 gene. The parents were wild-type at this locus, which was a de novo variant. At the same time, there was no report of this variant in the relevant literature, which was a novel variant in SLC35A2 gene. According to the genetic variant guidelines of American College of Medical Genetics and Genomics, SLC35A2 gene c.335C>A (p.Thr112Lys) variant was predicted to be likely pathogenic (PS2+PM2+PP3).@*CONCLUSION@#The variant of SLC35A2 gene c.335C>A(p.Thr112Lys) may be the cause of the disease in the child.
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Child , Humans , Congenital Disorders of Glycosylation/genetics , Glycosylation , Magnetic Resonance Imaging , Monosaccharide Transport Proteins/genetics , Exome SequencingABSTRACT
Objective To summarize the brain protection application experiences of combined internal and external blood shunt technologies for the in-situ three-fenestration revascularization of aortic arch.Methods From Feb 2017 to Jun 2018,8 patients with aortic arch leisons were treated by the in-situ three-fenestration techniques,including 3 aortic dissection,2 aortic aneurysm,3 postoperative TEVAR patients.We adopt the method of internal and external blood shunt technologies for brain protection using the vascular sheath for fenestration combined with carotid shunt tube skills,and using TCD to monitor the blood flow of brain.Results All operations completed successfully,and TCD showed no significant cerebral ischemia when aortic stent was used to cover the three branches of the aorta.The mean time of brain protection was (17.62 ± 6.87) minutes.One patient developed transient cerebral ischemia after surgery,and another one developed cerebral infarction.Conclusions The brain protection strategy of internal bypass combined with external converter technology maintain the brain blood flow,while is simple and feasible,it cannot completely avoid neurological complications.
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This study was a single-center large-sample case-control study.Data of 1 106 elderly patients who underwent unilateral total hip arthroplasty from June 2013 to May 2019 were collected, including items such as patient′s baseline characteristics, comorbidities, perioperative medication, intraoperative blood pressure, and postoperative outcomes.Patients were divided into postoperative nausea and vomiting(PONV)group and non-PONV group according to whether nausea and vomiting occurred within 24 h after operation.Logistic regression analysis was used to determine the risk factors for PONV.The incidence of PONV was 11.03%.Female, intraoperative use of dezocine, and intraoperative hypotension(duration>3 min or cumulative time>6 min)are independent risk factors for PONV, while femoral neck fractures and intraoperative use of dexamethasone are protective factors.
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Objective:To investigate the expression of interleukin-10 (IL-10) and chemokine receptor 7 (CXCR7) in papillary thyroid carcinoma (PTC) tissues and their correlation with invasion and metastasis.Methods:According to the inclusion and exclusion criteria, 68 cases of cancer tissues (cancer tissue group) and para-cancer tissues (para-cancer tissue group) collected from PTC patients in Wenzhou Hospital of Traditional Chinese Medicine from Jun. 2015 to Jun. 2018 were selected. Meanwhile, pathological specimens from 32 cases of thyroid follicular adenoma patients (thyroid follicular adenoma group) undergoing thyroidectomy during the same period were also enrolled. Immunohistochemical SP staining was used to observe the expression of IL-10 and CXCR7 in different tissues, and the correlation between the expression of IL-10 and CXCR7 and the pathological characteristics of tumor was analyzed.Results:The positive expression rates of IL-10 and CXCR7 in cancer tissues were significantly higher than those in para-cancer tissues and thyroid follicular adenoma group (88.24% vs. 14.71% vs. 0.00%, 75.00% vs. 32.35% vs. 15.63%; P<0.05) . Among 68 PCT patients, 38 (55.88%) had high expression of IL-10, 30 (44.12%) had low expression of IL-10, 32 (47.06%) had high expression of CXCR7, and 36 (52.94%) had low expression of CXCR7. IL-10 expression was positively correlated with tumor multifocal, TNM stage, central lymphatic metastasis, central + cervical lymphatic metastasis, invasion degree and tumor maximum diameter ( r=0.486, 0.509, 0.468, 0.422, 0.629, 0.674, P<0.05) . CXCR7 expression was positively correlated with tumor multifocal, TNM staging, central lymphatic metastasis, central + cervical lymphatic metastasis, and infiltration (r=0.425, 0.563, 0.490, 0.287, 0.481, P<0.05) . Conclusions:IL-10 and CXCR7 are highly expressed in cancer tissues of PTC patients, among which IL-10 expression level is closely related to tumor differentiation degree, TNM stage, cervical lymphatic metastasis, infiltration degree and tumor maximum diameter. CXCR7 is related to TNM stage, cervical lymphatic metastasis and infiltration degree, both of which may be involved in the occurrence and development of tumor.
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Shanxi Provincial Cancer Hospital has a history of 67 years. The continuous development of the hospital reflects the tremendous advances of cancer prevention and treatment in China. The article reviews the development process of Shanxi Provincial Cancer Hospital and puts forward some ideas for hospital development under the new situation.
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Acute radiation exposure usually causes severe dysfunction in various tissues of the organism, among which hematopoiesis, digestion, skin, cardiovascular and nervous system are most obviously affected, often leading to extensive apoptosis and acute radiation syndrome. Apoptosis inhibition or loss could increase proliferation of tumor cells through p53 and NF-κB pathways. Toll-like receptors ( TLRs) are a class of protein molecules involved in non-specific immunity. Up-regulation of the NF-κB pathway results in a significant increase in the radioresistance of cells. TLR4 has a basal cell radiation damage protection effect. Traditional TLR4 agonist lipopolysaccharide is limited in clinical application due to severe toxicity. Recently, some new TLRs agonists have been reported, which have protective effects against the lethal effects of ionizing radiation and lower toxic side effects. Among them, TLR2, TLR4, TLR5 and TLR9 play key roles in radiation protection, such as TLR2 receptor agonist bacterial lipoprotein (BLP), TLR4 receptor agonist heat-activated Salmonella typhimurium (HKST), TLR5 receptor agonism Bacterial flagellin and TLR9 receptor agonist. However, those different TLRs recognize specific components of the pathogen and thus initiate different downstream signaling pathways with different protective effects.
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Objective To explore the effect of neostigmine in treatment of severe acute pancreatitis (SAP) combined with intra-abdominal hypertension (IAH).Methods 42 patients diagnosed as SAP combined with IAH and meeting standard were collected from Aug.2012 to Jul.2016 in our hospital.They were randomly divided into two groups:observation group and the control group.General information of the two groups was comparable.Patients of the control group received conventional treatment methods such as fasting,gastrointestinal decompression,nutritional support,antispasmodic,analgesia,intravenous infusion of omeprazole and octreotide.Patients of the observation group received intramuscular injection of neostigmine methylsulfate on the basis of the control group for seven days.The intra-abdominal pressure,recovery time of bowel sounds,the first exhaust and defecation time,remission time of abdominal distention,modified Marshall score,APACHE-Ⅱ score,SIRS score,total hospitalization time and total hospitalization expenses,MODS rate,operation rate and mortality of the two groups were recorded during the treatment.Results The intra-abdominal pressure of the observation group was (14.25±1.03) mmHg,(13.52 ±1.23) mmHg,(12.73±1.14)mmHg respectively,lower than that of the control group (15.14± 1.12) mmHg,(14.60± 1.11) mmHg,(13.84±1.08) mmHg at the 3rd,4th,and 5th day after treat ment (P＜0.05).For the observation group,the recovery time of bowel sounds was (7.24±1.35) d,the first exhaust and defecation time was (11.33±1.51) d,(8.36±1.63) d,remission time of abdominal distention was (13.62±2.26) d,lower than those of the control group ((9.56±1.17)d,(13.42±1.26)d,(10.45±1.54)d,(16.75±3.05)d) (P＜0.05).The recovery time of bowel sounds,the first exhaust and defecation time,remission time of abdominal distention of the observation group were lower than those of the control group (P＜0.05).The modified Marshall score,APACHE-]Ⅱ score,SIRS score of the two groups had no significant difference (P＞0.05).The total hospitalizationtime and total hospitalization expenses of the two groups had no significant difference (P＞0.05).MODS rate,operation rate and mortality of the two groups had no significant difference (P＞0.05).Conclusions Neostigmine can significantly reduce intra-abdominal pressure of patients suffering from SAP combined with IAH,improve the symptoms of paralytic ileus,promoting exhaust and defecation.However,it has limited effects on prognosis of patients suffering from SAP combined with IAH.
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To develop a new recombinant hepatitis E vaccine, we used Hansenula polymorpha expression system to express recombinant hepatitis E virus-like particles (HEV VLPs), to construct a recombinant engineered strain HP/HEV2.3. The fermentation conditions and purification process were studied next. The first working seed lots were fermented in liquid culture, and the fermentation products were collected, then crushed, clarified, purified by ultrafiltration, silica gel adsorbed and desorbed, concentrated by ultrafiltration, purified by liquid chromatography and sterilized by filtration. The purity reached 99% with a yield of 33%. Electron microscopy analysis revealed that both the purified recombinant HEV VLPs from HP/HEV2.3 and natural hepatitis E virus particles appear identical of being 32 nm. The resulting DNA sequence obtained from VLPs is identical to the published HEV sequence. The SDS-PAGE analysis has revealed that the protein molecular weight of the HEV VLPs is 56 kDa, and the expression product HEV VLPs were accumulated up to 26% of total cellular protein. The expression level is 1.0 g/L. Western blotting, enzyme-linked immunosorbent assay (ELISA) results of the protein and ED₅₀ of the vaccine showed that the HEV VLPs have good antigenicity and immunogenicity. In summary, the recombinant HEV VLPs from Hansenula polymorpha can be used in the manufacture of a new genetically engineered vaccine against hepatitis E.
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Objective To discuss the curative effects of alfacalcidol combined with losartan potassium tablets in the treatment of early diabetic nephropathy (EDN).Methods 90 EDN patients in our hospital were chosen and randomly divided into the observation group and control group (45 cases in each group).The control group was given losartan potassium tablets treatment,while the observation group was given alfacalcidol combiend with telmisartan treatment.All the two groups were treated for 3 months.Before and after treatment,the fasting blood glucose (FBG), 24h urine trace albumin quantitative (UAER),24h urine protein (24h pro),serum creatinine (SCr),25 -hydroxyl vitamin D [2 5 (OH )D ],blood calcium (Ca2+),potassium (K+),glycosylated hemoglobin (HbA 1 C )and serum inflammatory factors[C-reactive protein (CRP),tumor necrosis factor alpha (TNF-α),interleukin-6 (IL-6 )] were observed,and the correlation between 25 (OH)D and UAER,24h pro was analyzed.At the same time,the clinical curative effects and adverse reactions during treatment were evaluated.Results In the observation group,the total effective rate was 93.3%,which was significantly higher than 71.1% in the control group (χ2 =7.601,P0.05).After treatment,Scr,24h pro and UAER in the two groups were all significantly reduced compared with before treatment (P0.331).After treatment,25(OH)D in the observation group decreased significantly compared with before treatment (t=12.000,P0.436).Pearson correlation analysis showed that 25 (OH)D level was negatively correlated with 24h pro and UAER (r=0.483,0.778,all P0.151 ).Conclusion Alfacalcidol combined with losartan potassium tablets can significantly reduce the proteinuria levels of EDN patients and inflammation,which has better clinical curative effects and higher safety.
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BACKGROUND:Fibroblast-like synoviocytes (FLS) in the synovial lining layer are related to the cell proliferation, invasion, migration and apoptosis as well as bone resorption in rheumatoid arthritis. OBJECTIVE:To compare the migration and invasion abilities of FLS (MH7A) in rheumatoid arthritis and normal FLS (HFLS). METHODS:The capacities of cell migration and invasion were evaluated by Transwell cell migration and invasion assays. The primers of the indicated microRNAs were designed and synthesized, and the expression levels of miRNAs were determined by real-time PCR according to the SYBR?PrimeScript?miRNA RT-PCR Kit instruction. RESULTS AND CONCLUSION:MH7A possessed stronger migration and invasion abilities than HFLS. Compared with HFLS, obviously upregulated miR-132, -155, -203, -223 and -124, and significantly downregulated miR-15a, -16, 18a, -19a, -26a and -146a were found in MH7A. These findings suggest that the differentially expressed 11 kinds of rheumatoid arthritis-associated miRNAs participate in the pathogenesis of rheumatoid arthritis probably by enhancing the migration and invasion capacities of MH7A.
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Aim To observe the effect of total flavonoid from Mori folium(TFMF) on renal interstitial fibrosis in type 1 diabetic mice and its possible mechanism.Methods Diabetic mice were induced by intraperitoneal injection of streptozotocin(STZ) dissolved in 0.01 mol·L-1 citrate buffer(pH 4.5) at 150 mg·kg-1 body weight after 12 h of food deprivation.Forty model mice were divided randomly into four groups: model group, and low-(0.25 g·kg-1), moderate-(0.5 g·kg-1), high-dose groups(1 g·kg-1) fed with TFMF once daily.In addition, eight normal mice were used as normal group.After 12 weeks, the fasting blood glucose(FBG), serum creatinine(Cr), blood urea nitrogen(BUN) and microalbuminuria(mAlb) were measured.Masson staining, Sirius red staining and collagen type Ⅳ immunohistochemical staining were used to detect the expression of collagen protein in the cortex, while laminin staining to assess the degree of glomerular and renal tubular basement membrane thickening.The protein expressions related to epithelial-mesenchymal transition and PI3K/Akt/mTOR in the renal cortex of mice were detected by Western blot.Results The moderate and high dose of TFMF could significantly decrease the levels of FBG, Cr, BUN and mAlb in diabetic mice, meanwhile decreasing the expression of α-SMA protein by inhibiting the activation of PI3K/Akt/mTOR signaling pathway, which led to the amelioration of the pathological alterations of renal tissue.Conclusions The moderate and high dose of TFMF can reduce the level of renal interstitial fibrosis in type 1 diabetic mice, and its mechanism may be related to the inhibition of activation of PI3K/Akt/mTOR signaling pathway.
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Objective To identify iron nutritional status in very low birth weight infants (VLBWI) and its influence factors.Methods A total of 115 babies admitted from January to December 2014 were included in the study.Serum ferritin of new born infants was analyzed.The clinical data of gestational age,birth weight,hemoglobin,iatrogenic blood loss,cumulative volume of blood transfusion and pregnancy maternal diseases(diabetes,hypertension and anemia) were analyzed.Results The serum ferritin of 115 VLBWI were 100.8 to 210.3 μg/L,the average were(140.32 ± 13.21) μg/L;the minimum serum ferritin of babies born ＜ 32 weeks gestational age were(124.5 ± 31.3) μg/L.Smaller the VLBWI gestational age,the lower the basic baby serum ferritin(F =14.367,P =0.000).More severe the maternal anemia,the lower the basic baby serum ferritin levels [no anemia:(230.9 ± 68.7) μg/L,mild anemia:(189.5 ± 75.3) μg/L,moderate anemia:(133.5 ± 88.1) μg/L,severe anemia:(122.2 ± 56.8) μg/L;P ＜ 0.05].Lower the level of hemoglobin,the lower the basic level of serum ferritin(P ＜ 0.05).Volume of blood transfusion had a huge impact on the last serum ferritin levels (P ＜ 0.05).Conclusion Improvement of the basic baby serum ferritin level in the early stage is useful to ensure the VLBWI iron reserves.It is necessary to regularly monitor serum ferritin during hospitalization and even after discharge.