Research on the current situation and reflection of core competency of medical professional postgraduate / 中华医学教育探索杂志

Objective:To recognize the overall situation of the core competency of medical professional postgraduate, analyze the advantages and disadvantages of the training process, and provide basis for better optimization and revision of training objectives and training plans.Methods:An anonymous online questionnaire was conducted among 264 postgraduates majoring in clinical medicine to recognize the cognition and self-evaluation of core competence, and analyze the differences in scores of different grades and types. SPSS 23.0 was used for independent-samples t test; and one-way analysis of variance to analyze categorical variables. Results:The doctoral degree students' core competency results were higher than those of master degree students, and those of the senior students were higher than junior students ( P<0.05). "System Improvement Ability" [master degree students (2.94±1.07), first-year students (2.82±0.97)], "Patient Management" [(first-year students (2.77±1.22)], "Academic Research" [first-year students (2.90±1.03)], and 4 other indicators were the weakness of students (all less than 3 scores). Conclusion:The students have a good sense of professional identity for doctors. The different depth of the clinical practice education is the possible cause which brings about the differences among students with different degrees. We should focus on strengthening the training for the "shortcomings" in the core competence of students.

Reflection on the application-audit system for medical doctoral enrollment in Peking Union Medical College Hospital / 中华医学教育探索杂志

Objective:To analyze the situation of doctoral enrollment work in Peking Union Medical College Hospital after the change of enrollment mode from "unified enrollment examination" to "application-assessment" system, and summarize the enrollment work.Methods:The information of candidates in two different enrollment methods of the unified enrollment examination in 2016 and the application-assessment system in 2017 and 2018 was collected and compared. The opinions of doctoral candidates in 2018 on the application-assessment system were collected by questionnaires. Excel 2016 was used to input data for descriptive statistical analysis and SPSS 20.0 was used to analyze the quantitative data by chi-square tested and t-tested.Results:Since 2016, the total number of candidates applying for Peking Union Medical College Hospital has shown a downward trend, and the age of candidates has shown a trend towards younger age. However, there was no statistical difference in candidate's gender, source of students, and their Master's Graduation Schools. Only among the 2017 and 2018 academic degree candidates, there was a statistical difference in scores between the freshman and the previous student ( P=0.025). The results of the questionnaire showed that students were highly satisfied with "application-audit" system of Peking Union Medical College Hospital (82.54%, 52/63). More than 90.00% of the students agreed with the evaluation indexes. Additionally, 85.71%(54/63) of students suggested that professional and academic types use different enrollment evaluation indicators, which could fully reflect the quality of professionalism and the training potential of cultivation. Conclusion:The change of enrollment model from "unified admission examination" to "application-audit" system has little impact on the candidates of Peking Union Medical College Hospital. In the process of implementing the "application-assessment" system, the Educational Management Department of Peking Union Medical College Hospital has actively explored the system construction and standardization process, and supervised the whole enrollment process, which has gained the trust and recognition of candidates as well as high student satisfaction.

A brief introduction to the cultivation of traditional Chinese medicine students based on the phenomenon of "traditional Chinese medicine experimental class" / 国际中医中药杂志

High education plays the most important part in the cultivation of TCM students at present. One of the main problems TCM facing is the professional accomplishment of TCM students cultivation underlying the modes of college education. Based on the data of "TCM Experimental Class" in universities, we analyzed the effecting factors and related prospects behind this cultivation mode as well as made a preliminary discussion on the training objectives and contents of this model combined with the history and fundamental law of TCM students training.

Evaluation of research quality for medical graduates / 中华医学教育探索杂志

Objective To investigate the research quality of present medical graduates and propose suggestions for improvement.Method A self-designed questionnaire entitled Investigating Questionnaire for Research Quality Analysis of Medical Graduates in Peking Union Medical College Hospital was distributed to the clinical and academic medical graduates in the hospital from July to August 2015.Among 276 collected questionnaires,270 were validated as effective.SPSS 18.0 software was used to statistically describe the result and to perform t test on different subgroups.Results The research quality average of the surveyed hospital was 10.28.Results revealed that in regard of the three aspects of research quality,research consciousness ranked first,followed by the research ability,while scientific spirit was the weakest.Academic medical graduates showed significantly higher scores than clinical graduates in terms of total research quality and every single aspect (P values less than 0.05).Conclusions To better cultivate the academic leaders in medical research,it is necessary to strengthen the research training for the graduates,practice their scientific thinking especially the clinical graduates,reinforce tutors' guidance,and promote communication and collaboration.

Role of Treg Cells in Pathogensis of Mouse ITP / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the role of Treg cells in the pathogenesis of idiopathic thrombocytopenic purpura (ITP).</p><p><b>METHODS</b>The ITP mouse model was established, the Treg cell ratio in peripheral blood and spleen was detected by flow cytometry, the CD4+ CD25+ T cells were sorted by immunomagnetic beads, the Treg cell associated transcription factors (Foxp3, Smad7, STAT5 and Akt-1) and cytokines (IL-10, TGF-β) in CD4+ CD25+ T cells were enriched from spleen mononuclear cells, and the mRNA expression of Treg cell was measured by real-time PCR.</p><p><b>RESULTS</b>The ratio of Tregs in peripheral blood and spleen decreased significantly in ITP mouse, as compared with the controls (P<0.01). In addition, the mRNA expression of IL-10, TGF-β and Foxp3 decreased significantly in spleen CD4+ CD25+ T cells (P<0.05). Expression of Smad 7 mRNA was higher than that of controls.</p><p><b>CONCLUSION</b>The alteration in Treg frequency and function may be responsible for the immune dysfunction in ITP disease. It is also speculated that the lower mRNA expression of Foxp3 and higher mRNA expression of Smad 7 may inhibit the proliferation and differentiation of Treg cells.</p>

Effect factors of trabeculectomy with intraoperative application of mitomycin C for neovascular glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the effect factors of trabeculectomy combined with intraoperative application of mitomycin C in the treatment of neovascular glaucoma. METHODS: Fifty patients (50 eyes) with neovascular glaucoma collected from January 2013 to August 2015 in our hospital were treated by trabeculectomy combined with intraoperative application of mitomycin C. Single factor and multi factor variables analysis were used for effect factors of trabeculectomy combined with intraoperative application of mitomycin C in the treatment of neovascular glaucoma. RESULTS: By results of single factor variable analysis,0. 05 ). By multivariate analysis, 0.05). CONCLUSION: For patients < 50 years old with neovascular glaucoma, should be careful on the selection of surgical treatment. For high- risk patients, we should strengthen the monitoring and give timely intervention, which are helpful to improve the prognosis.

The investigation for the relationship between tutors and postgraduates in Peking Union Medical College Hospital / 基础医学与临床

Teacher student relationship is the most important part in educational activities.It’s quality and quantity have a significant impact on educational and teaching effectiveness.This article aims to analyze the exiting status of the relationship between the tutors and the postgraduates in Peking Union Medical College Hospital, focusing on the some main factors which affect the said relationship, including education environment factor, tutor factor, postgrad-uate factor and etc., and combining the characteristics of Medical Colleges’studying.On the basis of the concerned survey, this article initially discusses the key issues during the establishment of the harmony relationship between tutors and postgraduates.

Effect of flumatinib mesylate on C-MYC, HIF-1α and VEGF in U226 line / 中国实验血液学杂志

The objective of this study was to investigate the effect of the new generation of tyrosine kinase inhibitor flumatinib mesylate on C-MYC, HIF-1α and VEGF in multiple myeloma (MM) cell line U266. Different concentrations (1, 5, 10 µmol/L) of flumatinib mesylate were used to act on U266 cell line for 8, 16 and 24 h, and the expression of C-MYC, and HIF-1α genes was detected by real-time fluorescence-quantitative PCR, the expression of C-MYC, HIF-1α and VEGF was measured by Western blot. The results showed that the gene expression of C-MYC and HIF-1 genes decreased gradually with the increasing of flumatinib mesylate concentration (P < 0.05). At the same concentration of flumatinib mesylate, the expression of C-MYC and HIF-1α gene decreased gradually with prolonging of treatment time with the flumatinib mesylate (P < 0.05). When the flumatinib mesylate acted the U266 cell line for 16 h, the expression of C-MYC, HIF-1α and VEGF decreased gradually with the increasing of flumatinib mesylate concentration (P < 0.05). It is concluded that the flumatinib mesylate can reduce the expression of C-MYC, HIF-1 α and VEGF in U266 cell line in a time- and dose-dependent manners, so flumatinib mesylate may become a new drug for MM therapy.

Repair of damaged intestinal mucosa in a mouse model of sepsis / 世界急诊医学杂志（英文）

BACKGROUND:The intestine is not only the main target attacked by sepsis but also the vital organ which mediated sepsis. The recovery of the damaged intestinal barrier structure and function is related to the occurrence and outcome of multiple organ dysfunction syndrome (MODS). How to protect and reduce the damage of the intestinal mucosa and how to promote the reconstruction of the intestinal mucosa have been the important topics in sepsis for many years. This study aimed to investigate the influential factors of intestinal mucosal reconstruction after intestinal epithelial injuryin vivo in a mouse model of sepsis.METHODS:Mice were subjected to cecal ligation and puncture (CLP) for induction of sepsis to assess intestinal mucosal damage, epithelial cell apoptosis, and transformed number of goblet cells, and to detect the concentration of TNF-α, IL-1 and TGF-β1 and TFF3 (trefoil factor 3) expression in the small intestinal mucosa. All above were performed by HE staining, western blot, ELISA and immunohistochemistry respectively. The experimental animals were divided into a sepsis group and a sham-operation group. The animals with sepsis were separately killed at 6 (7 animals), 24 (7 animals) and 48 hours (7 animals) after CLP.RESULTS:Injured intestinal mucosa was observed in the 3 groups under a light microscope, in which damage scores in the 24-hour and 48-hour groups were higher than in the 6-hour group and no difference was found between the two groups. Moreover, less of goblet cells or other epithelial cells adjacent to the injured surface migrated into the wound to cover the denuded area. The number of goblet cells was substantially decreased in the three CLP groups compared with the sham-operation group. Protein levels of IL-1 and TNF-α were significantly increased by 3-4 fold at all time points when compared with the sham-operation group, and cleaved caspase-3 by 4 fold. Although TFF3 expression was modestly increased for 6 hours after the onset of CLP, it appeared to decline at 24 hours and 48 hours as shown by Western blot. A similar tendency was observed upon TGF-β1, i.e. the protein level was not elevated at 24 hours and 48 hours, but increased modestly at 6 hours.CONCLUSIONS:Sepsis from CLP shows less restitution on the surface of injured intestinal mucosa. There is evidence that both constant inflammatory reaction and epithelial cell apoptosis may affect mucosal reestablishment of the intestine at the onset of sepsis. Mucosa after severe sepsis showed the state of high inflammation, and declined goblet cell function and mucosal reconstruction, which affected the repair of damaged intestinal barrier. Constant inflammatory reaction, and declined goblet cell function and mucosal reconstruction ability may affect the reestablishment of intestinal mucosa at the onset of sepsis.

Comparison of periodontal indices and Porphyromonas gingivalis between conventional and self-ligating brackets / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To compare the periodontal indices and Porphyromonas gingivalis (P. gingivalis) between the use of self-ligating brackets and conventional brackets.</p><p><b>METHODS</b>Thirty patients were divided into 2 groups(n=15). Self-ligating brackets were used in the experimental group. Conventional brackets were used in the control group. Clinical periodontal indices, including plaque index (PLI), gingival index (GI) and probing depth (PD) of observed teeth were examined at three different time points: Before orthodontic treatment, the first month after treatment and the third month after treatment. Subgingival plaques were collected simultaneously at each time point. The number of total bacteria and P. gingivalis in each sample were detectd and quantitated by real-time quantitative polymerase chain reaction, the percentage of P. gingivalis in total bacteria was obtained.</p><p><b>RESULTS</b>Before treatment, the periodontal indices and the percentage of P. gingivalis in total bacteria had no difference between the two groups (P>0.05). After 1 and 3 months respectively, the periodontal indices and the percentage of P. gingivalis in total bacteria increased with time (P<0.05) and were obviously lower than those of the control group (P<0.05).</p><p><b>CONCLUSION</b>Compared with conventional brackets, the self-ligating brackets are better for periodontal health. But it is adverse effect on oral health.</p>

Inhibitory effect of histone deacetylase inhibitor LBH589 on multiple myeloma MM1R cells in vitro / 中国实验血液学杂志

This study was purposed to explore the effect of a new generation of histone deacetylase inhibitor LBH589 alone or combined with bortezomib (Bor) on multiple myeloma cells (MM1R) in vitro. The effect of LBH589 (10, 20, 50 nmol/L) alone or combined with Bor (10, 20 nmol/L) on MM1R proliferation was detected by MTT method; the effect of LBH589 on cell cycle and apoptosis of MM1R cells were determined by flow cytometry; the histone H4 acetylation level of MM1R cells treated with LBH589 (10, 20, 50 nmol/L) for 24 h was analyzed by Western blot. The results showed that the LBH589 alone or combined with Bor all could inhibit the proliferation of MM1R cells in a concentration- and time-dependent manner. After MM1R cells were treated with drugs for 48 h, the cells in G(0)/G(1) phase increased, the cells in G(2)/M and S phase decreased, suggesting the arrest of cells in G(0)/G(1) phase, at the same time, the apoptosis rate of MM1R cells treated with drugs increased in a concentration-dependent manner, while the effect of LBH589 combined with Bor was more obvious than that of LBH589 alone (P < 0.001). Western blot analysis showed that the histone H4 acetylation level was enhanced in concentration-dependent manner after MM1R cells were treated with different concentrations of LBH589 for 24 h. It is concluded that the LBH589 can inhibit the proliferation of MM1R cells, block the cell cycle, induce cell apoptosis, moreover LBH589 combined with Bor has synergistic effect on MM1R cells.

Silencing of ICSBP/IRF8 expression in U226 cells and bone marrow mononuclear cells from patients with multiple myeloma / 中国实验血液学杂志

The objective of this study was to investigate expression of interferon regulatory factors (ICSBP/IRF8) and the potential role of DNA methylation in silencing ICSBP/IRF8 gene in multiple myeloma (MM) cell line U266 and bone marrow mononuclear cells from 10 MM patients (MM-BMMNC). The bone marrow mononuclear cells from 10 healthy persons (N-BMMNC) were collected and used as normal controls. Expression of ICSBP/IRF8 gene was detected by real-time fluorescence quantitative PCR (using 2(-ΔΔCT) to calculate); DNA methylation level of the ICSBP/IRF8 gene was measured using methylation-specific PCR (using the ratio of interest gene ICSBP/IRF8 and internal reference β-actin expression as results). The results showed that as compared with N-BMMNC the lower expression of ICSBP/IRF8 gene was found in U266 cells and MM-BMMNC, the hypermethylation of the CpG island in the ICSBP/IRF8 promoter was observed, there were significant differences between N-BMMNC and MM-BMMNC or U266 cells (P < 0.05). It is concluded that the expression of ICSBP/IRF8 gene can be silenced in the MM-BMMNC and U226 cells. As the hypermethylation of CpG island in ICSBP/IRF8 promoter is a frequent event in MM cells, the ICSBP/IRF8 gene silencing caused by DNA methylation may take part in the pathogenesis and development of MM.

Analysis of CD4(+)CD25(+)CD127(low/-) Treg cells in mice / 中国实验血液学杂志

The quantitative identification and enrichment of viable regulatory T cells (Treg) requires reliable surface markers that are selectively expressed on Treg. Foxp3 is the accepted marker of natural Treg, but it cannot be used to isolate cells for functional studies. CD127 is a new surface marker expressed in Treg cells. In this study, two populations of Treg, including CD4(+)CD25(+)CD127(low/-) and CD4(+)CD25(+)Foxp3(+)T cells, and profiles of the Foxp3 expression in CD4(+)CD25(+)CD127(low/-) cells were compared to evaluate which population is better. The peripheral blood cells were collected and spleen suspension of BALB/C mice were prepared, and using triple staining CD4, CD25, CD127 and CD4, CD25, Foxp3. The profiles of Treg, including CD4(+)CD25(+)CD127(low/-) and CD4(+)CD25(+)Foxp3(+) were detected by flow cytometry. The quadruple staining CD4, CD25, Foxp3 and CD127 were used to determine the CD127 expression in CD4(+)CD25(+)Foxp3(+) cells. The results showed that on T cell subset the median expression levels of CD4(+), CD4(+)CD25(+) were 39.02%, 5.35% in peripheral blood and 23.49%, 3.86% in spleen. On CD4(+) T cell subset, the median expression level of CD4(+)CD25(+)CD127(low/-) and CD4(+)CD25(+)Foxp3(+)T cells were 7.13%, 3.97% in peripheral blood and 12.8%, 8.23% in spleen. The ratio of CD4(+)CD25(+)CD127(low/-) T cells was higher than that of CD4(+)CD25(+)Foxp3(+) cells in both peripheral blood and spleen cells (P < 0.01). The CD4(+)CD25(+)CD127(low/-) cells highly expressed Foxp3, while the CD4(+)CD25(+)Foxp3(+)T cells lowly expressed CD127. It is concluded that compared with the CD4(+)CD25(+)Foxp3(+) populations, CD4(+)CD25(+)CD127(low/-) T cells better fit the definition of naturally occurring regulatory T cells in peripheral blood cells and spleen of BALB/C mice. CD127(low/-) is a characteristic marker on surface of CD4(+)CD25(+) Treg cells, and has been confirmed to be more specific marker for quantitatively sorting Treg cells.

Clinicopathologic study on 61 cases of uterine papillary serous carcinoma with or without adjuvant therapy / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features of uterine papillary serous carcinoma (UPSC) and the roles of adjuvant therapy.</p><p><b>METHODS</b>Sixty-one cases of UPSC with operation done and followed up for a period of 4 to 9 years were enrolled into the study. The histology of slides specimens were reviewed and immunohistochemical study was performed. The follow-up and survival data were analyzed.</p><p><b>RESULTS</b>All of the 61 patients were post-menopausal, with a median age of 68 years. The clinical presentations included abnormal vaginal bleeding, abdominal symptoms and abnormal Pap smears. The median size of the tumors was 7.5 cm (range=1.2 to 14.8 cm). There were 27.9% cases in FIGO stage I (8.2% in stage IA, 14.8% in stage IB and 4.9% in stage IC), 9.8% in stage II, 32.8% in stage III and 29.5% in FIGO stage IV. The histologic features were similar to those of the ovarian counterpart, with tumor cells containing the high-grade nuclei and arranged in complex papillae. Psammoma bodies were identified in 24.6% of the cases. Immunohistochemical study showed that the tumor cells demonstrated diffuse and strong nuclear staining for p53 and Ki-67. They were negative for estrogen receptor and progesterone receptor. Fifteen of the 61 cases (24.6%) showed no evidence of myometrial invasion. However, ten of the 15 cases had extrauterine disease, with peritoneal (6/15) and nodal (9/15) involvement. Tumors with deep myometrial invasion, lymphovascular permeation and nodal metastasis were associated with worse prognosis by univariate analysis. Fifty-six patients received adjuvant therapy. The number of patients receiving adjuvant chemotherapy alone, adjuvant radiotherapy alone and combined adjuvant chemotherapy/radiotherapy were 42, 24 and 10, respectively. The median survivals of the chemotherapy group and non-chemotherapy group (with or without radiotherapy) were 66.4 months and 32.8 months, respectively.</p><p><b>CONCLUSIONS</b>UPSC has distinctive clinical and pathologic features. The tumor stage, lymph node status, lymphovascular permeation and depth of myometrial invasion were important prognostic factors. Adjuvant chemotherapy for stage III/IV tumors or recurrent UPSC may have survival benefit.</p>

Levels of serum brain natriuretic peptide and the correlation to heart function in children with Kawasaki disease / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study serum levels of brain natriuretic peptide (BNP) in children with Kawasaki disease (KD) and the correlation between BNP levels and the heart function.</p><p><b>METHODS</b>Forty-three children with KD and thirty healthy children were enrolled. Serum levels of BNP were measured using ELISA. KD children received an echocardiographic examination, including measurements of left ventricular ejection fraction (LVEF), left ventricular shorten fraction (LVSF), cardiac index (CI) and left ventricular inflow velocity through the mitral annulus.</p><p><b>RESULTS</b>Mean serum level of BNP at the acute stage in children with KD was significantly higher than that at the recovery stage as well as the control group (p<0.01). The LVEF, LVSF and CI levels at the acute stage were significantly lower than those at the recovery stage in children with KD (p<0.05). The linear regression analysis showed that the BNP level was negatively correlated with the levels of LVEF, LVSF and CI (r=-0.63, -0.52, -0.53, p<0.05).</p><p><b>CONCLUSIONS</b>The serum BNP levels increase significantly in KD children at the acute stage, and are negatively correlated with the levels of LVEF, LVSF and CI. Measurement of serum BNP level is useful for the early diagnosis of KD.</p>

Changes of the immunological barrier of intestinal mucosa in rats with sepsis / 世界急诊医学杂志（英文）

BACKGROUND:Sepsis has become the greatest threat to in-patients, with a mortality of over 25％.The dysfunction of gut barrier, especially the immunological barrier, plays an important role in the development of sepsis. This dysfunction occurs after surgery, but the magnitude of change does not differentiate patients with sepsis from those without sepsis. Increased intestinal permeability before surgery is of no value in predicating sepsis. The present study aimed to observe the changes of intestinal mucosal immunologic barrier in rat models of sepsis induced by cecal ligation and puncture. METHODS:Sixty Sprague-Dawley rats were randomly divided into a sepsis group (n=45) and a control group (n=15). The rats in the sepsis group were subjected to cecal ligation and puncture (CLP), whereas the rats in the control group underwent a sham operation. The ileac mucosa and segments were harvested 3, 6 and 12 hours after CLP, and blood samples were collected. Pathological changes, protein levels of defensin-5 (RD-5) and trefoil factor-3 (TFF3) mRNA, and lymphocytes apoptosis in the intestinal mucosa were determined. In an additional experiment, the gut-origin bacterial DNA in blood was detected. RESULTS:The intestinal mucosa showed marked injury with loss of ileal villi, desquamation of epithelium, detachment of lamina propria, hemorrhage and ulceration in the sepsis group. The expression of TFF3 mRNA and level of RD-5 protein were decreased and the apoptosis of mucosal lymphocyte increased (P<0.05) in the sepsis group compared with the control group. Significant differences were observed in RD-5 and TFF3 mRNA 3 hours after CLP and they were progressively increased 6 and 12 hours after CLP in the sepsis group compared with the control group (P<0.05, RD-5 F=11.76, TFF3 F=16.86 and apoptosis F=122.52). In addition, the gut-origin bacterial DNA detected in plasma was positive in the sepsis group. CONCLUSION:The immunological function of the intestinal mucosa was impaired in septic rats and further deteriorated in the course of sepsis.

Serum brain natriuretic peptide in children with Kawasaki disease / 世界急诊医学杂志（英文）

BACKGROUND:Kawasaki disease (KD) is a common cause of acquired heart disease in children. Recent studies have focused on the biochemical markers of the myocardium, their high sensitivity and specificity and significance in the diagnosis of KD. This study aimed to determine the serum level of brain natriuretic peptide (BNP) and its relation with the heart function of children with KD and to explore its clinical value in diagnosis of KD. METHODS:Forty-three KD children, aged from 5 months to 8 years (mean 2.3±0.6 years ), were admitted to Qingdao Children's Hospital from February 2007 to April 2009. Among them 27 were male, and 16 female. The 43 patients served as a KD group. Patients with myocarditis, cardiomyopathy, congenital heart disease and other primary heart diseases were excluded. Thirty healthy children, aged from 3 months to 15 years (mean 2.5±0.8 years) or 17 males and 13 females served as a control group. There were no significant differences in age and gender between the two groups (P>0.05). In the KD group, ELISA was used to measure the levels of serum BNP in acute and convalescent stages;and in the control group, the levels of serum BNP were measured once randomly. Left ventricular ejection fraction (LVEF), left ventricular shorten fraction (LVSF), cardiac index (CI) and left ventricular inflow velocity through the mitral annulus (including E-velocity and A-velocity) were measured by two-dimensional echocardiography in the acute and convalescent stages in the KD group. All data were expressed as mean±SD. The methods of analysis included Student's t test and the linear regression analysis test. P<0.05 was considered statistically significant. RESULTS:The level of serum BNP in the acute stage (517.26±213.40) ng/ml was significantly higher than that in the convalescent stage (91.56±47.97) ng/ml in the control group (37.55±7.56) ng/ml (P<0.01). The levels of LVEF, LVSF and CI in the acute stage were significantly lower than those in the convalescent stage (P<0.05), but the E/A level was not significantly different between the acute and convalescent stages (P>0.05). Linear regression analysis showed that the BNP level was negatively correlated with the levels of LVEF, LVSF and CI(r=-0.63, -0.52, -0.53, P<0.05) , but not significantly correlated with the E/A level (r=-0.18, P>0.05). CONCLUSION:The levels of serum BNP are significantly increased in KD patients, and are negatively correlated with the levels of LVEF, LVSF, and CI. The detection of serum BNP level is of clinical significance in the diagnosis of KD.

Toll-like receptor 4 expression mediates the activation of platelets induced by LPS / 中国实验血液学杂志

The study was aimed to investigate the expression of Toll-like receptor 4 (TLR4) on platelets and to determine whether platelet TLR4 involves in its activation induced by lipopolysaccharide (LPS). Human platelet-rich plasma (PRP) and platelet suspension obtained from 15 healthy individuals pretreated with a concentration of 0.2 microg/ml of LPS in the presence or absence of thrombin (1 U/ml) for 1 hour. The expressions of TLR4, CD62P (P-select) and CD40L on platelets were detected by flow cytometry, and platelet TLR4 expression was further determined by Western blot analysis. The results indicated that the percentage of TLR4-positive platelets induced by thrombin was increased by 32.34% compared with the resting platelets (25.44%, p < 0.05). TLR4 expression on platelets treated with LPS was remarkably elevated in the presence or absence of thrombin. However, the expression level of the former was much higher than that of the latter and thrombin stimulation alone (p < 0.05). Moreover, the similar results were found in Western blot analysis. Synchronously, expressions of CD62P and CD40L on resting platelets were 6.39% and 2.45%, they were also markedly increased when treated with thrombin (42.68% and 14.8%) and LPS respectively, and the increases of expression of CD62P and CD40L were more significant when stimulated with both LPS and thrombin (63.03% and 13.94%). Although anti-TLR4 antibody inhibited significantly the increase of TLR4, CD62P and CD40L on platelets induced by LPS, which did not affect their increase induced by thrombin. In conclusion, the evidence has been shown that functional TLR4 can be expressed on human platelets. It may involve in platelet activation as an important mediator of LPS-induced CD62P and CD40L expressions on platelets.

The effect of Ulinastatin on the delivery of cytokines in patients with septic shock / 中华急诊医学杂志

Objective To investigate the effect of Ulinastatin on the delivery of cytokines in patients with septic shock.Methods It was a prospective and controlled clinical study.Seventy-eight patients with septic shock were randomly divided into control group and treatment group and thirty-nine in every group.Patients in treatment group received Ulinastatin 200 000 units intravenous everyday for 3 days,while those in control group received equal volume of normal saline as placebo.At different time points (at 24 th,48 th,72 th hour after start of treatment),the levels of tumor necrosis factor-alpha (TNF-?),interleukin-1 (IL-1),interleukin-6 (IL-6 ),interleukin-8 (IL-8) and superoxide dismutase (SOD) in serum were assayed.Results In comparison with control group,the levels of TNF-?,IL-1,IL-6,IL- 8 of treatment group decreased markedly (P＜0.05,P＜0.01) at different time points,whereas the level of SOD was higher markedly (P＜0.05,P＜0.01) at various time points.Conclusion Ulinastatin has protective effect on patients with septic shock through decreasing the levels of TNF-?,IL-1,IL-6,IL-8 and increasing in the level of SOD.

Features of intestinal T-cell lymphomas in Chinese population without evidence of celiac disease and their close association with Epstein-Barr virus infection / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Intestinal T-cell lymphoma (ITCL) is a heterogeneous lymphoid neoplastic group with variable clinical and pathological features. ITCL in oriental countries is different from enteropathy-type intestinal T-cell lymphoma (ETCL) in relation to celiac disease and Epstein-Barr virus (EBV). The objective of this study was to investigate the clinicopathological features, immunophenotype, expression of cytotoxic molecule (TIA-1), T-cell receptor (TCR)-gamma gene rearrangement, and Epstein-Barr virus (EBV) latent infection in primary ITCL without celiac disease in Chinese.</p><p><b>METHODS</b>The clinical data of 42 patients were analyzed, and the patients were followed up. Compared with human reactive lymphoid tissues, in situ hybridization for EBER1/2, polymerase chain reaction for TCR-gamma gene rearrangement, and immunohistochemical staining for immunophenotypes, TIA-1 and EBV latent membrane proteins (LMP-1) were investigated. Survival curves of different clinicopathological features, immuno-phenotypes, expression of LMP1, TCR-gamma gene rearrangement and therapy were analyzed.</p><p><b>RESULTS</b>Three fourths of the patients suffered from ITCL in China were men with a peak age incidence in the 4th decade. Common presenting features included fever and hemotochezia. The prognosis was poor with a median survival of 3.0 months. The lesions were mostly localized in the ileocecum and colon. About 38/42 (90.5%) patients demonstrated pleomorphic medium-sized on large cells. Histological features of celiac disease were rarely seen. All 42 patients with ITCL revealed CD45RO positive. Neoplastic cells partially expressed T-cell differentiated antigens (CD3epsilon, CD4, CD8) and NK cell associated antigen (CD56). The positive frequency of CD3epsilon, CD4, CD8 and CD56 was 28/42 (66.7%), 7/42 (16.7%), 10/42 (23.8%) and 12/42 (28.6%) respectively. Thirty-nine cells (92.9%) expressed TIA-1, but none expressed CD20 and CD68. More than half of the patients (64.3%, 64.3% and 59.5%) revealed TCR-gamma gene rearrangement by three different TCR-gamma primers respectively. EBER1/2 was detected in 41 (97.6%) of the 42 patients. The expression frequency of LMP-1 was 38.1% (16/42).</p><p><b>CONCLUSIONS</b>Primary ITCL without celiac disease in Chinese is a special highly EBV-associated clinicopathological entity. There are few similarities in patients with celiac disease in western countries. A small proportion of primary ITCLs in Chinese and extranodal NK/T-cell lymphoma of nasal type belong to the same spectrum.</p>