Adsorptive Granulocyte and Monocyte Apheresis in the Treatment of Ulcerative Colitis: The First Multicenter Study in China

BACKGROUND/AIMS: Patients with active ulcerative colitis (UC) have elevated levels of activated myeloid-derived leukocytes as a source of inflammatory cytokines. The selective depletion of these leukocytes by adsorptive granulocyte/monocyte apheresis (GMA) with an Adacolumn should alleviate inflammation, promote remission and enhance drug efficacy. However, studies have reported contrasting efficacy outcomes based on patients’ baseline demographic variables. This study was undertaken to understand the demographic features of GMA responders and nonresponders. METHODS: This was a multicenter study in China involving four institutions and 34 patients with active UC. Baseline conventional medications were continued without changing the dosage. The treatment efficacy was evaluated based on the endoscopic activity index and the Mayo score. RESULTS: Thirty of the 34 patients completed all 10 GMA treatment sessions. The overall efficacy rate was 70.59%. The receiver operating characteristic analysis showed that the area under the curve was approximately 0.766 for a Mayo score of ≤5.5 with 0.273 specificity and 0.857 sensitivity (Youden index, 0.584) for GMA responders. No GMA-related serious adverse events were observed. CONCLUSIONS: The overall efficacy of GMA in patients with active UC who were taking first-line medications or were corticosteroid refractory was encouraging. Additionally, GMA was well tolerated and had a good safety profile.

Comparison research of transcutaneous bilirubin measurement and serum bilirubin measurement during phototherapy in neonates / 中华护理杂志

Objective To compare the correlation between transcutaneous bilirubin(TcB) measurement and serum bilirubin (TSB) measurement at covered and exposed skin sites during phototherapy in neonates.Methods Two sites of exposed skin and two sites of covered skin were chosen to measure the transcutaneous bilirubin.The serum bilirubin was monitored at admission and during phototherapy,while the transcutaneous bilirubin was tested and recorded at the same time of monitoring the serum bilirubin.Results A total of 112 cases were included from January 29th to April 15th in 2016.At the four monitoring points during phototherapy,the differences between the transcutaneous bilirubin of the two exposed sites and the serum bilirubin were statistically significant (P＜0.01).For the covered site 4,there were no significant differences between transcutaneous bilirubin and serum bilirubin at every test point (P＞0.05).When the serum bilirubin was higher than 307.8 μmol/L (18mg/dl),the serum bilirubin measurement was larger than the transcutaneous bilirubin measurement.Conclusion The transcutaneous bilirubin level of covered skin was more close to serum bilirubin,especially when the covered median skin of the second rib was chosen to monitor the transcutaneous bilirubin.When the serum bilirubin was greater than 307.8 μmol/L(18mg/dl),the transcutaneous bilirubin couldn't represent serum bilirubin quite well.

Study of Clinical and Genetic Risk Factors for Aspirin-induced Gastric Mucosal Injury / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Current knowledge about clinical and genetic risk factors for aspirin-induced gastric mucosal injury is not sufficient to prevent these gastric mucosal lesions.</p><p><b>METHODS</b>We recruited aspirin takers as the exposed group and healthy volunteers as the control group. The exposed group was categorized into two subgroups such as subgroup A as gastric mucosal injury diagnosed by gastroscopy, including erosion, ulcer or bleeding of the esophagus, stomach, or duodenum; subgroup B as no injury of the gastric mucosa was detected by gastroscopy. Clinical information was collected, and 53 single nucleotide polymorphisms were evaluated.</p><p><b>RESULTS</b>Among 385 participants, 234 were in the aspirin-exposed group. According to gastroscopy, 82 belonged to subgroup A, 91 belonged to subgroup B, and gastroscopic results of 61 participants were not available. Using the Chi-square test and logistic regression, we found that peptic ulcer history (odds ratio [OR] = 5.924, 95% confidence intervals [CI]: 2.115-16.592), dual anti-platelet medication (OR = 3.443, 95% CI: 1.154-10.271), current Helicobacter pylori infection (OR = 2.242, 95% CI: 1.032-4.870), male gender (OR = 2.211, 95% CI: 1.027-4.760), GG genotype of rs2243086 (OR = 4.516, 95% CI: 1.180-17.278), and AA genotype of rs1330344 (OR = 2.178, 95% CI: 1.016-4.669) were more frequent in subgroup A than subgroup B. In aspirin users who suffered from upper gastrointestinal bleeding, the frequency of the TT genotype of rs2238631 and TT genotype of rs2243100 was higher than in those without upper gastrointestinal bleeding.</p><p><b>CONCLUSIONS</b>Peptic ulcer history, dual anti-platelet medication, H. pylori current infection, and male gender were possible clinical risk factors for aspirin-induced gastric mucosal injury. GG genotype of rs2243086 and AA genotype of rs1330344 were possible genetic risk factors. TT genotype of rs2238631 and TT genotype of rs2243100 may be risk factors for upper gastrointestinal bleeding in aspirin users.</p>

A hemophagocytic lymphohistiocytosis patient initiated with prominent liver dysfunction: a case report / 中国医学科学杂志(英文版)

Hemophagocytic lymphohistiocytosis (HLH) is an aggressive and potentially fatal syndrome that results from inappropriate activation of lymphocytes and macrophages. It is characterized by fever, hepatosplenomegaly, cytopenias, hypertriglyceridemia, hypofibrinogenemia, and pathologic findings of hemo- phagocytosis in the bone marrow or other tissues. We report an adult HLH case admitted to hepatology department.

Value of transrectal ultrasound in diagnosing middle ureteral calculi / 中华医学超声杂志（电子版）

Objective To explore the value of transrectal ultrasound (TRS) in diagnosing middle ureteral calculi.Methods Patients who were suspected as middle urinary calculi by clinicians underwent transabdominal ultrasound (TAS) and transrectal ultrasound in the First Affiliated Hospital of Guangzhou Medical University and Guangzhou Hospital of Integrated Traditional and West Medicine from 2011 to 2012. The diagnosis were finally confirmed by a variety of methods .Results Forty patients were eventually diagnosed as middle ureteral calculi by X-ray,computer tomography (CT),surgery,intravenous pyelography (IVP)imaging and magnetic resonance imaging (MRI).The other 5 cases were diagnosed as ureteral tumor , ureteral cystis(confirmed by MRI)and oppressed ureteral by gynecology cystis (confirmed by surgery).TRS detected 37 of 40 middle ureteral calculi(92.5%).TAS detected 8 of 40 middle ureteral calculi(20.0%). The detection ratio of TRS was higher than that of TAS and the difference was statistically significant (P=0.00).TAS could display ureter across iliac blood vessels expansion in all 40 patients.Conclusions Using TRS in diagnosing middle ureteric calculi is quick , convenient with high sensitivity and worthy of wide application.TAS can display ureter across iliac blood vessels expansion and can help to diagnosis of middle ureteral calculi.

Relationship among symptoms, mucosal injury, and acid exposure in gastroesophageal reflux disease / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Symptoms, endoscopy, and pH monitoring form the basis of diagnosis of gastroesophageal reflux disease (GERD). Their relationship was meaningful for primary care physicians, but still unclear. Our research aimed to compare questionnaire, endoscopy, and pH monitoring and to analyze their correlations.</p><p><b>METHODS</b>Three hundred patients who underwent the Reflux Disease Questionnaire (RDQ), endoscopy, and esophageal 24-hour pH monitoring from March 2007 to December 2010 in Peking University People's Hospital were enrolled. We analyzed the characteristics of different investigations and their relationships.</p><p><b>RESULTS</b>Male (OR for mild reflux esophagitis (RE) = 2.433, severe RE = 8.386), body mass index (BMI) (OR for mild RE = 1.222, severe RE = 1.297), and hernia (OR for mild RE = 6.059, severe RE = 17.547), were found to be the risk factors for RE; age (OR = 1.074) was correlated with severe RE. The consistency of questionnaire, endoscopy, and pH monitoring was poor: RDQ did not agree well with pH monitoring (κ = 0.061), nor with endoscopy (κ = 0.044); pH monitoring did not agree well with endoscopy (κ = 0.316). However, the severity of mucosa injury in RE was associated with pathological acid exposure (PAE): reflux episodes of >5 minutes (P = 0.035), the percentage time pH <4 (P = 0.017), and the DeMeester score (P = 0.016) increased significantly in patients with severe RE. Chest pain had poor relationship with RE or PAE.</p><p><b>CONCLUSIONS</b>Male, age, BMI, and hernia were probably risk factors for esophagitis. RDQ, endoscopy, and pH monitoring have their own focus and reinforce each other in diagnosis. Of the GERD symptoms, chest pain had negative correlation with RE or PAE.</p>

Intestinal immune barrier integrity in rats with nonalcoholic hepatic steatosis and steatohepatitis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Nonalcoholic fatty liver disease (NAFLD) has emerged as the major cause of chronic liver injury. Intestinal barrier plays an important role in the pathogenis of NAFLD. The aim of this article was to assess intestinal immune barrier function during the development of NAFLD.</p><p><b>METHODS</b>Totally 60 male Sprague-Dawley (SD) rats were divided into 2 groups: normal diet (ND) group and high-fat diet (HFD) group. NAFLD rat model was established in the HFD rat group. Portal blood endotoxin level was assessed by limulus test. The percentage of CD4+ cells and CD8+ cells in peripheral blood mononuclear cells (PBMC) and lymphocytes in Peyer's patches (PP) were analysed by flow cytometry. Intestinal secretory immunoglobulin A (SIgA) level was evaluated by enzyme-linked immunosorbent assay. Paired Student's t test was used for the statistic analysis.</p><p><b>RESULTS</b>HFD rats presented with simple steatosis at the 4th and 8th week and progressed to nonalcoholic steatohepatitis at the 12th week. Elevated lipopolysaccharides (LPS) level in HFD rats was observed at the 8th week ((1.54 ± 0.30) times of ND group, P < 0.01). CD4/CD8 ratios in PBMC and PP of HFD rats were increased at the 4th week ((1.50 ± 0.47) and (1.63 ± 0.34) times of ND group, P < 0.05) and decreased at the 8th week ((0.50 ± 0.16) and (0.61 ± 0.26) times of ND group, P < 0.05). At the 12th week, CD4/CD8 ratio ((1.47 ± 0.46) times, P < 0.05) in PP increased to levels observed in the 4th week. Intestinal SIgA expression of HFD rats was remarkably up-regulated at 12th week ((2.70 ± 1.65) times, P < 0.05).</p><p><b>CONCLUSION</b>Liver-gut axis in rats with NAFLD may mediate and improve intestinal immune function by increased CD4/CD8 ratio in PP and increased production of SIgA.</p>

Inhibitory effects of an antisense PCDGF vector on proliferation and invasion of highly malignant ovarian cancer cells and the related mechanism / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the inhibitory effects of an antisense PC cell derived growth factor (PCDGF) vector on proliferation and invasion of highly malignant ovarian cancer cell lines Sw626 and A2780 cells, and preliminarily explore the related mechanisms.</p><p><b>METHODS</b>MTT assay and Boyden chamber in vitro invasion assay were employed to detect the changes of proliferation and invasion ability in the Sw626 and A2780 cells transfected with anti-sense PCDGF. The expression levels of cyclin D1 and CDK4 proteins before and after transfection were detected by Western blotting. The effects on the expression and activity of MMP-2 were evaluated by quantitative RT-PCR and zymography, respectively.</p><p><b>RESULTS</b>Comparing with the blank group, the proliferation inhibition rate of the Sw626 and A2780 cells transfected with anti-sense PCDGF was 72.9% and 70.9%, respectively, and the invasion ability was inhibited by 62.9% and 59.0%, respectively. The levels of cyclin D1 and CDK4 protein expression in antisense PCDGF transfected cells were 0.38 +/- 0.08 and 0.37 +/- 0.13, respectively, all significantly lower than 0.84 +/- 0.11 and 0.64 +/- 0.11, respectively, in the blank group (P < 0.01). The MMP-2 mRNA expression level in antisense PCDGF transfected cell group was 0.66 +/- 0.11, not significantly decreased in comparison with 0.89 +/- 0.09 in the blank group (P > 0.05), but the activity of MMP-2 was inhibited significantly.</p><p><b>CONCLUSION</b>The antisense PCDGF vector may inhibit markedly the proliferation and invasion of highly malignant ovarian cancer cells, and partially reverses their malignant phenotype. It seems to be related with down-regulating the expression of cyclin D1 and CDK4 and inhibiting the activity of MMP-2. Our findings indicate that PCDGF may become a new target for antisense gene therapy of ovarian cancer.</p>

Experiment on autologous free granular fat transplantation with rhVEGF gene in rats / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the effects of rhVEGF on autologous free granular fat grafts in rats.</p><p><b>METHODS</b>Forty-eight Sprague-Dawley rats were randomly divided into three groups, sixteen of each. After the autologous free granular fat transplantation, all groups were treated with the plasmid DNA containing cDNA encoding rhVEGF, the blank plasmid DNA and normal saline respectively as the experimental group, the negative group and the saline group. After 3, 7, 15, 30 days, the rats were sacrificed and the grafts were weighted accurately. Histological pathology was evaluated. Micro-vessel count and the expression of vascular endothelial growth factor (VEGF) were examined by immunohistochemical staining.</p><p><b>RESULTS</b>The weights of the two latter groups were significantly reduced on the 7, 15, 30 day compared with the experimental group. The expression of VEGF and the micro-vessel count in the experimental group were significantly higher than the other two groups during the latter periods.</p><p><b>CONCLUSION</b>The cDNA encoding VEGF can induce the expression of VEGF in fat graft, angiogenesis and reduce the free fat graft absorption.</p>

Effects of vibration therapy on bone mineral density in postmenopausal women with osteoporosis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Jaw osteonecrosis possibly associated with the administration of bisphosphonates is expected to be treated with a non-pharmacologic approach. This study aimed to determine whether noninvasive, mechanically mediated vibration would inhibit the decline in bone mineral density (BMD) that follows menopause, enhance the BMD of the lumbar and femoral neck, and reduce chronic back pain in postmenopausal women with osteoporosis.</p><p><b>METHODS</b>A total of 116 postmenopausal women with osteoporosis participated in this study, and they were divided into groups A (66 patients) and B (50). Group A received vibration treatment (Subjects vertically stand on the vibration platform, with a vibration frequency of 30 Hz, amplitude of 5 mm; they received the treatment five times per week, ten minutes each time and totally for six months), whereas women of group B served as controls without any treatment. L2 - 4 BMD, bilateral femoral neck BMD, and body mass index (BMI) were recorded before the treatment or at the third and sixth months of the treatment respectively. After the ending of the treatment, the change of BMD in each group was compared and analyzed. Chronic back pain was evaluated by visual analogue scale (VAS) at baseline and the third and sixth months of the treatment.</p><p><b>RESULTS</b>Of the 116 women, 94 including 51 women from group A ((61.23 +/- 8.20) years) and 43 women from group B ((63.73 +/- 5.45) years), completed the study. There were no significant differences in baseline characteristics including age, BMI, menopausal years, lumbar BMD, femoral neck BMD, and VAS between the two groups. The lumbar BMD of the 51 women in group A increased by 1.3% (P = 0.034) after vibration treatment for 3 months and by 4.3% at the sixth month (P = 0.000). The lumbar BMD in group B was decreased at the third month, but there was not statistical significance (P > 0.05). At the sixth month, it was decreased by 1.9% (P < 0.05). The femoral neck BMD of the 51 women in group A was slightly increased after vibration treatment for 3 months, but without statistical significance (P > 0.05). At the sixth month, the BMD was increased by 3.2% (P < 0.05). In group B, the BMD was not decreased significantly (P = 0.185) at the third month, but decreased significantly at the sixth month (1.7%) (P < 0.05) compared with the baseline. Chronic back pain (VAS) reduced more significantly in group A at the third and the sixth months (P < 0.05) after vibration therapy in comparison with the baseline. The BMI was not significantly changed in the two groups during the period of follow-up.</p><p><b>CONCLUSIONS</b>Vibration therapy appears to be useful in reducing chronic back pain and increasing the femoral neck and lumbar BMD in postmenopausal women with osteoporosis.</p>

Effect of rhVEGF gene transfection on survival of grafts after autologous free granular fat transplantation in rats / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the effect of recombinant human vascular endothelial growth factor (rhVEGF) on autologous free granular fat grafts in rats.</p><p><b>METHODS</b>Forty-eight Sprague Dawley (SD) rats, weighing 190-280 g and regardless sex, were randomly divided into three groups, sixteen in each. After fat transplantation, the rats were treated with plasmid DNA encoding rhVEGF protein (the experimental group), plasmid DNA (the negative group) and normal saline (the blank control group), respectively. At 3, 7, 15 and 30 days after transplantation, the rats were killed and the grafts were weighed, respectively. Histopathological changes were evaluated. Microvessel density and the expression of VEGF were examined by immunohistochemical staining and Western blotting.</p><p><b>RESULTS</b>The weights of the negative and blank control groups were significantly reduced on the 7th, 15th and 30th days compared with those of the experimental group. The expression of VEGF and the microvessel density in the experimental group were significantly higher than the other two groups during the latter periods.</p><p><b>CONCLUSION</b>The plasmid encoding VEGF can induce expression of VEGF and angiogenesis in fat grafts and reduce the absorption of free fat grafts.</p>

Colonoscopy in the diagnosis of intestinal graft versus host disease and cytomegalovirus enteritis following allogeneic haematopoietic stem cell transplantation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Gastrointestinal graft versus host disease (GI-GVHD) and cytomegalovirus (CMV) enteritis are important complications following allogeneic haematopoietic stem cell transplantation (allo-HSCT). We explored the role of colonoscopy in the diagnosis of GI-GVHD and CMV enteritis following allo-HSCT to identify the endoscopic manifestations of GI-GVHD and CMV enteritis was made.</p><p><b>METHODS</b>A retrospective analysis of the colonoscopic manifestations of GI-GVHD, CMV enteritis and GI-GVHD with concurrent CMV enteritis (GconC) and their related clinical issues.</p><p><b>RESULTS</b>Forty-seven patients underwent 50 colonoscopies with diagnoses of 32 GI-GVHD, 7 CMV enteritis and 11 GconC. Both GI-GVHD and CMV enteritis had colonic mucosal lesions with various manifestations under colonoscopy. Tortoise shell like changes of the mucosa (12 of 32) and deep ulcers (2 of 7) were specific endoscopic manifestations for GI-GVHD and CMV enteritis, respectively, while mucosal oedema, erythema, congestion, erosion and shallow ulcers could not be used to differentiate GI-GVHD from CMV enteritis. GconC patients were prone to have oozing bleeding of the end ileal mucosa and typhlodicliditis. Of the biopsed specimens for GI-GVHD, CMV enteritis and GconC, 64%, 70% and 44% were taken from the rectum and sigmoid colon respectively.</p><p><b>CONCLUSIONS</b>Following allo-HSCT, tortoise shell like changes and deep ulcers of the colonic mucosa are characteristic changes for GI-GVHD and CMV enteritis, respectively, while the other lesions are not. Most of the GI-GVHDs and CMV enteritis cases can be diagnosed by left colon examination and tissue biopsy, but total colon examination to the terminal ileum is preferred.</p>

Effects of shengmai for injection on cardiogenic shock / 中国中药杂志

<p><b>OBJECTIVE</b>To study the protective effects and the possible mechanism of shengmai for injection(SM) against the experimental acute cardiogenic shock.</p><p><b>METHOD</b>The experimental acute cardiogenic shock model was established by ligating the anterior descending cornonary in dogs. The effects of SM on cardiogenic shock were investigated by measuring the hemodynamics parameter, the activity of LDH, CK, SOD and the contents of MDA in blood serum.</p><p><b>RESULT</b>In the dogs treated with SM, the mean arterial pressure (MAP), heart rate (HR), left ventricular pressure (LVP), the maximum of its first derivative (+/- dp/dtmax), the cardiac output (CO) and the cardiac index (CI) were increased significantly. The left ventricular end diastolic pressure (LVEDP) and the peripheral vascular resistance (TPVR) were decreased significantly, the myocardial infarct size was redused observely. In addition, the activity of LDH, CK and the contents of MDA in serum were decreased significantly, however the activity of SOD was increased observely.</p><p><b>CONCLUSION</b>The results indicate that SM has the protective effects on cardiogenic shock.</p>

Correlation of expression of RhoA (RhoC and their effector ROCK-1 with malignant phenotype of ovarian cancer cells in vitro / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the expression of RhoA, RhoC and their effector ROCK-1 in four ovarian cancer cell lines in vitro and their correlation with invasiveness.</p><p><b>METHODS</b>Expression of RhoA, RhoC and ROCK-1 mRNA and protein in four ovarian cancer cell lines SW626, Skov-3, A2780 and Caov-3 was detected by RT-PCR and Western blot assay. Invasion assay was done in Boyden chamber.</p><p><b>RESULTS</b>The expression levels of RhoA, RhoC and ROCK-1 mRNA and protein varied in the four different cell lines examined. The expression level of RhoC, but not RhoA and ROCK-1, was significantly correlated with the invasive capability of these cells in vitro (r = 0.95, P < 0.01). Expression of RhoA at the level of transcription was not correlated with that at the translation level. The expression of RhoA and RhoC did not correlate with that of ROCK-1.</p><p><b>CONCLUSION</b>Expression level of RhoC may serve as an independent parameter in evaluating metastasis and become a new target in inhibiting ovarian cancer metastasis.</p>