Ultrasonographic features of incarceration of the gravid uterus / 中华超声影像学杂志

Objective:To summarize the ultrasound characteristics of incarceration of gravid uterus (IGU) for improving the diagnostic accuracy of IGU.Methods:Three cases of IGU patients were diagnosed in Peking University Third Hospital from May 2018 to May 2020. CNKI, Wanfang Data, China Science and Technology Journal Database and PubMed were searched using the search terms "incarcerate uterus" or "uterine incarceration" and "gravid" through January 2000 to July 2020, 53 IGU cases were found. The ultrasound data and outcomes of the 56 IGU patients were retrospectively analyzed. The display rate of various ultrasonic features were counted. Relevant literatures were reviewed and the experience were summarized.Results:Of the 56 cases with IGU, 45 cases (80.4%) had positive results, of which 34 cases (60.7%) were found abnormal cervix(elongated anteriorly and superiorly displaced cervix or poorly visualized cervix), 27 cases (48.2%) were found retroversion of the gravid uterus, 12 cases (21.4%) were found that the fundus of the uterus lay deeply in the Douglas pouch, 4 cases (7.1%) were found anteriorly and superiorly displaced bladder. There was statistically significant difference between the displaying rates of abnormal cervix and retroversion of the gravid uterus(χ 2=5.452, P<0.05). Conclusions:Abnormal cervix was the most common feature of IGU by ultrasound. Correct identification of the cervix is helpful to improve the detection rate of IGU.

Application of goal-oriented fluid replacement therapy in volume management of postpartum hemorrhage during cesarean section / 中华危重病急救医学

Objective:To observe the effect of fluid therapy on volume and coagulation function in patients with severe postpartum hemorrhage during cesarean section of placenta accreta under the guidance of inferior vena cava diameter (IVCD) and inferior vena cava collapse index (IVC-CI).Methods:A prospective randomized controlled study was conducted in 60 pregnant women with severe postpartum hemorrhage (blood loss ≥ 1 000 mL) who were hospitalized for delivery or referred for delivery in the Peking University Third Hospital from December 2018 to July 2019. The patients were divided into routine fluid replacement group and goal-oriented fluid resuscitation group (goal-oriented fluid replacement therapy was given) according to the different ways of fluid replacement. The hemodynamics, blood gas analysis, coagulation function, total fluid replacement, urine volume, prognosis, intraoperative vasoactive drugs utilization rate and postoperative adverse events were recorded before skin incision, after the fetus delivered, postpartum hemorrhage and at the end of operation, and the differences of these indices between the two groups were compared.Results:① Hemodynamics: the heart rate (HR) of the two groups were reached the peak during postpartum hemorrhage, but there was no significant difference in HR at each time point between the two groups. The mean arterial pressure (MAP) was decreased at first and then increased in both groups, and reached the trough at postpartum hemorrhage, but the MAP in the goal-oriented fluid resuscitation group was significantly higher than that in the routine fluid replacement group [mmHg (1 mmHg = 0.133 kPa): 75.6±10.7 vs. 69.2±8.9, P < 0.05]. In the goal-oriented fluid resuscitation group, the central venous pressure (CVP) was increased slightly after the fetus delivered and then stabilized, while in the routine fluid replacement group, the CVP was increased at first and then decreased, and reached the peak in postpartum hemorrhage. During postpartum hemorrhage, CVP in the goal-oriented fluid resuscitation group was significantly lower than that in the routine fluid replacement group [cmH 2O (1 cmH 2O = 0.098 kPa): 9.5±3.9 vs. 11.4±3.4, P < 0.05]. ② Arterial blood gas: partial pressure of oxygen (PaO 2) and partial pressure of carbon dioxide (PaCO 2) in arterial blood at the end of operation in both groups were higher than those in postpartum hemorrhage. There was no significant difference in PaO 2 at the end of operation between the goal-oriented fluid resuscitation group and routine fluid replacement group (mmHg: 189.3±100.5 vs. 240.2±126.3, P > 0.05). The PaCO 2 in the goal-oriented fluid resuscitation group was significantly lower than that in the routine fluid replacement group (mmHg: 34.6±4.6 vs. 36.8±4.1, P < 0.05). The lactic acid (Lac) at the end of operation of the goal-oriented fluid resuscitation group was significantly lower than that of the routine fluid replacement group (mmol/L: 2.2±0.6 vs. 2.6±1.1, P < 0.05). ③ Liquidintake and output volume: the total infusion volume, crystal fluid infusion volume and suspended red blood cell infusionvolume in the goal-oriented fluid resuscitation group were significantly less than those in the routine fluid replacement group [total infusion volume (mL): 3 385.9±1 144.1 vs. 4 448.3±1 194.4, crystal infusion volume (mL): 2 635.6±789.7 vs. 3 160.0±860.3, suspended red blood cell input volume (mL): 695.6±366.2 vs. 911.1±284.7, all P < 0.05], and the utilization rate of vasoactive drugs in the goal-oriented fluid resuscitation group was decreased significantly during operation [13.3% (4/30) vs. 60.0% (18/30), P < 0.05]. The amount of bleeding in the goal-oriented fluid resuscitation group was also significantly less than that in the routine fluid replacement group (mL: 1 451.7±373.8 vs. 1 725.9±372.8, P < 0.05), but there was no significant difference in urine volume between the goal-oriented fluid resuscitation group and the routine fluid replacement group (mL: 369.0±262.7 vs. 485.0±286.8, P > 0.05). ④ Coagulation function: at the end of operation, the prothrombin time (PT) in the goal-oriented fluid resuscitation group was significantly shorter than that in the routine fluid replacement group (s: 10.9±0.6 vs. 11.2±0.6), and the fibrinogen (Fib) in the goal-oriented fluid resuscitation group was significantly higher than that in the routine fluid replacement group (g/L: 3.7±0.5 vs. 2.9±0.8), and the differences were statistically significant (both P < 0.05).⑤ Prognostic index: compared withthe routine fluid replacement group, the proportion of patients transferred to intensive care unit (ICU) at the end of operation in the goal-oriented fluid resuscitation group was significantly lower [16.7% (5/30) vs. 66.7% (20/30), P < 0.05], and ICU length-of-stay was significantly shorter [hours: 0 (0, 24) vs. 24 (0, 24), P < 0.05], but there was no significant difference in the incidence of disseminated intravascular coagulation (DIC), acute renal injury (AKI) or hysterectomy between the goal-oriented fluid resuscitation group and the routine fluid replacement group [the incidence of DIC: 0% (0/30) vs. 6.7% (2/30), the incidence of AKI: 0% (0/30) vs. 3.3% (1/30), the hysterectomy rate: 10.0% (3/30) vs. 26.7% (8/30), all P > 0.05]. Conclusion:Fluid resuscitation guided by IVC-CI can effectively reduce the volume of blood and fluid transfusion and blood loss in patients with severe postpartum hemorrhage and improve their blood coagulation function.

Efficacy and Safety of Different Dosages of Decitabine in the Treatment of High-Risk Patients with Myelodysplastic Syndrome / 中国实验血液学杂志

OBJECTIVE@#To investigate the efficacy of high-risk myelodysplastic syndrome (MDS) patients treated by different doses of decitabine (DAC) and its safety.@*METHODS@#Thirty patients with high-risk MDS were all treated by demethylation drug DAC. According to the doses of DAC, 30 patients were divided into 10-day regimen [6 mg/(m@*RESULTS@#The patients were followed up to May 2020, in the 10-day regimen group, 10 cases achieved complete remission (CR), 3 cases achieved partial remission (PR), and 2 cases were progressive disease (PD). Four cases died, including 1 case for heart failure, 2 cases for respiratory failure and 1 case for serious infection. In the 5-day regimen group, 11 cases achieved CR, 1 case achieved PR, 3 cases were PD. Five cases died, including 2 cases for heart failure and 3 for serious infection. The CR rate and ORR of the patients in the two groups were 66.67% vs 73.33%, 86.67% vs 80.00%, respectively, which showed no significant differences, and the efficacy also showed no significant difference. After treatment, the levels of WBC, NE, Hb and PLT of the patients in 10-day regimen group were higher than those in 5-day regimen. In the 10-day regimen group, there were 11 cases of pneumonia, 2 cases of bacteremia, 1 case of skin infection and 1 case of urinary tract infection. While in the 5-day regimen group, 13 cases of pneumonia, 5 cases bacteremia, 1 case of skin infection and 3 cases of urinary tract infection. There were 2 cases with mild gastrointestinal response in the 10-day regimen group, and 7 cases with obvious nausea and anorexia in the 5-day regimen group. The symptoms were relieved after the treatment of acid suppression, stomach protection and antiemetic. The liver, kidney and heart function were monitored. One case liver function damage and 2 cases cardiac insufficiency were observed in the 10-day regimen group. Seven cases regimen cardiac insufficiency and 4 cases regimen liver function damage were observed in the 5-day regimen group.@*CONCLUSION@#10-day regimen and 5-day regimen are equally effective, but 10-day regimen is less myelosuppressive and more safer, which can be applied in clinical.

Prediction of spontaneous preterm birth by cervical length changes in twin pregnancies / 中国实用妇科与产科杂志

OBJECTIVE: To investigate the predictive value of cervical length（CL）changes in spontaneous preterm birth（SPTB）in twin pregnancies in the second and third trimesters of pregnancy.METHODS: A retrospective analysis was made of 166 cases of twin pregnant women who underwent transvaginal ultrasound to measure CL during the second trimester of pregnancy（20~25 weeks）and the third trimester of pregnancy（28~32 weeks）from January 2014 to December 2017 in the Third Hospital of Peking University and Tongzhou Maternal and Child Health Hospital of Beijing.Evaluate the predictive value of CL changes in SPTB before 32 and 34 weeks.The area under the receiver-operating characteristics（ROC）curve was compared by bootstrap method.Assessment of the value of CL in the third trimester of pregnancy and CL in the second trimester of pregnancy alone in predicting SPTB before 32 and 34 weeks.RESULTS: Of the 166 cases,90 were full-term delivery and 76 were premature delivery.The median CL of mid and late pregnancy was 34 mm and 29 mm respectively,and it was 35.5 mm and 31 mm,and in full-term delivery.32.5 mm and21 mm in premature delivery,respectively.There were significant differences among the three groups（All P25 mm and CL shortening≥ 20%,it can better predict preterm birth before 32 weeks.

Prenatal ultrasonographic diagnosis of the fetal ductus venosus abormalities / 中华超声影像学杂志

Objective To explore the prenatal ultrasound image features and clinical significance of fetal ductus venosus abormalities . Methods Fifteen fetuses with ductus venosus abormalities diagnosed by prenatal ultrasonography at Peking University T hird Hospital were retrospective review . T he prenatal findings ,umbilical shunting type ,perinatal outcomes ,and autopsy reports were analyzed . Results Fourteen fetuses were found with absence of ductus venosus . In 6 fetuses the umbilical vein connected to the portal vein ,5 fetuses the umbilical vein connected to the inferior vena cava and 3 fetuses the umbilical vein connected to the right atrium . T he remaining 1 fetus was found obliteration of ductus venosus . Absence of ductus venous showed no normal ductus venous and the umbilical vein almost always drained directly into portal vein ,inferior vena cava or right atrium . Obliteration of ductus venous showed normal ductus venous was replaced by a tiny echogenic string without blood flow . T hree cases had intracardiac and extracardiac abnormalities ; 4 cases had extracardiac abnormalities only ; 8 of these ,ductus venosus abormality were isolated . T wo cases had trisomy 21 syndrome . Four patients underwent legal termination of pregnancy ; 2 were intrauterine fetal death ; and 8 carried to term wit normal outcome ; the remaining one underwent operation due to extracardiac abnormality and postoperative course was uneventful . Conclusions Prenatal ultrasound can be used to diagnose fetal ductus venosus abormalities . Hemodynamic depends on umbilical venous drainage site and diameter . T he prognosis for this group of anomalies depends on the chromosomal abnormalities and additional findings . Chromosome and ultrasonic monitoring are suggested for following pregnancy .

Diagnostic Value of Peripheral Blood Smear Spherical Erythrocyte Count in ABO-Hemolytic Disease of the Newborn / 现代检验医学杂志

Objective To evaluate the clinical value of neonatal peripheral blood smear spherical erythrocyte count in the diagnosis of ABO-HDN.Methods 165 cases clinically diagnosed with ABO-HDN in Zhongshan Boai Hospital from 2009 to 2015 were listed as the experimental group by retrospective analysis,68 cases of non-ABO-HDN were listed as control group.Besides,relevant clinical data and experimental examination were investigated,and the results of their hemolysis test were analysed.Results Peripheral blood smear spherical erythrocyte count were positive in 110 cases of 165 patients with ABO-HDN,the positive rate of spherical erythrocytes was 66.7 ％ (x2 =58.069,P＜ 0.05).The spherical erythrocyte positive rates were 68.8 ％,60.5 ％ and 66.7 ％ in patients aged ≤2d,3 ～4d,≥5d respectively.The diagnostic sensitivity of spherical erythrocytes to ABO-HDN was 66.7 ％,the specificity was 88.2 ％,the positive predictive value was 93.2 ％,and negative predictive value was 52.2 ％.When spherical erythrocyte count positive point was set as ≥5 ％ spherical erythrocytes,the diagnostic sensitivity of spherical erythrocytes to ABO-HDN was 66.7％ and the specificity was 88.2％.If the positive point was set as ≥10％ spherical erythrocytes,the sensitivity of ABO-HDN decreases to 9.3％,and the specificity reaches 98.5 ％.In ABO-HDN group,the levels of nucleated red blood cell,RDW and Ret were higher,along with the lower level of hemoglobin compared with non-ABO-HDN group (all P＜0.05).Conclusion The peripheral blood smear spherical erythrocyte count had a high sensitivity and specificity for the diagnosis of ABOHDN.Combined with jaundice,anemia and RDW,peripheral blood smear spherical erythrocyte count can provide guidance for the early diagnosis,prevention and treatment of ABO-HDN.

The Regulatory Effect of PPARγ in the Apoptosis against Renal Cell Carcinoma / 昆明医科大学学报

Objective To explore the effects of PPARγ agonist rosiglitazone and inhibitor T0070907 on apoptosis and anti-tumor in renal carcinoma A498 cells.Methods A498 cells were divided into three groups and PBS, rosiglitazone (50 μmol/L) and T0070907 50 (μmol/L) were added respectively of 24 h incubation completely. each group of cell proliferation was determined by MTT method and Western Blot analysis and RT-qPCR were applied to detect the expression level of BAX, Caspase 3, Cyt C and Bcl-2. A498 cell morphological changes were observed under light microscope and fluorescence microscope. Results MTT experiment results showed that rosiglitazone and T0070907 could significantly inhibit A498 cell proliferation rate (P＜0.05), increased the protein and mRNA expression levels of Caspase 3, Cyt C and Bax in A498 cell, and decreased the protein and mRNA expression levels of Bcl-2 (P＜0.05); Microscopic observation and Hochest staining also found that rosiglitazone and T0070907 could promote apoptosis of A498 cells. Conclusion Rosiglitazone and T0070907 can inhibit the proliferation of renal cell carcinoma A498 cells and induce apoptosis. The anti-tumor mechanism may be related to PPARγ mediation.

The ultrasound diagnosis of gynecologic severe case and analysis of sonogram echogram / 中华医学超声杂志（电子版）

Objective To analyze the ultrasonic features of gynecological emergency and severe cases.Methods To analyze 431 cases in clinical,ultrasonic images and examination data of gynecological emergency and severe patients in Peking University Third Hospital from September 2014 to September 2015,and to study clinical pathological and ultrasonic imaging examination.Results In 431 severe cases of gynecologic emergency,the clinical symptom were shown as acute abdominal pain or and vaginal bleeding.They were divided into seven types by clinical examination,operation or conservative treatment under dynamic observation.There were 137 cases of fracture disease,accounting for 31.8％,with corpus luteum rupture in 67 cases,ectopic pregnancy burst in 59 cases and tumor rupture in 11 cases.There were 114 cases of pelvic inflammatory disease,accounting for 26.5％,with hemorrhagic disease of department of gynaecology in 67 cases (15.5％),dysfunctional uterine bleeding in 39 cases,cervical cancer in 11 cases,submucosal myoma in 7 cases,endometrial carcinoma in 6 cases,carcinosarcoma in 4 cases.There were 58 cases of early pregnancy related diseases,accounting for 13.5％.Among them,32 cases were incomplete abortion,and 21 cases were inevitable abortion and 5 cases were hydatidiform mole.Forty-six cases were torsion of pedicle (10.6％).Five cases were genital tract malformation,accounting for 1.2％,with vaginal septum obliquumevery 4 cases and cervical atresia in one case.There were damages after the operation in 4 cases (0.9％),uterus perforation in 2 cases,abdominal wall hematoma in 1 case after cesarean section,and false aneurysm in 1 case after cesarean section.In the 431 cases,there was emergency surgery oroperation after symptomatic treatment in 329 cases,interventional treatment in one case and non-operative treatment in 101 cases.Conclusions There are corresponding typical ultrasonographic characteristics in different diseases of emergency and severe gynaecologic cases,combined with clinical symptoms and medical history.The right diagnosis can be made.Therefore,there are important clinical values of ultrasound in the treatment of emergency and severe gynecologic cases.

The ultrasonic diagnosis of abnormal fetal genitalia / 中华医学超声杂志（电子版）

Objective To explore the clinical significance of abnormal fetal genitalia detected by routine prenatal ultrasound. Methods In Peking University Third Hospital from January 2014 to January 2016, the ultrasonic diagnosis and sonographic features in 14 suspected cases of abnormal fetal genitalia were analyzed retrospectively and compared with postpartum morphological and pathological characteristics. Results The fetal ultrasound findings and clinical outcomes in 14 cases were: (1) There were 4 cases of partial penoscrotal transposition (28.6%, 4/14), in which all fetus hadshort penis and hypospadias. In 2 termination cases, unilateral hydronephrosis and anal atresia was found in one case, while ventricular septal defect was found in the other case. In 2 term-birth cases, there was one case of recessive spina bifida. In the 4 cases, prenatal ultrasonographic manifestation showed that the short penis was located between the division of the scrotum, named as ″tulip sign″. (2) There were 2 cases (14.3%, 2/14) of complete penoscrotal transposition, in which all the pregnancies were terminated. On prenatal ultrasound of external genitalia, the location of the penis and scrotum was reversed. In one case, anal atresia and small eye malformation were found. In one case, the tetralogy of Fallot, duodenal atresia and anal atresia were found. (3) There were 4 cases of the micropenis (28.6%, 4/14). On prenatal ultrasound, the penis was difficult to demonstrated and was shown merely as an echoic dot. Among 2 cases of FGR, one infant dies for unexplained reasons after birth, and one infant has hypospadias after birth. The pregnancy was terminated in two cases of 18-trisomia and microdeletion in chromosome 9. (4) There were 2 cases of penis absence (14.3%, 2/14), in which all pregnancies were terminated. The sonographic manifestations show the absence of penis and bladder eversion. (5) In 2 cases, sex couldn`t be identified (14.3%, 2/14). In one case, the 46 xy infant showed a female external genitalia appearance after birth. In one case, the clitorism and congenital adrenal cortical hyperplasia were found in a 46 xx infant after birth. Conclusions Prenatal ultrasonography is effective and feasible in detecting genitalia abnormalities, especially for penis scrotal transposition and penis absence. When the fetal gender cannot be identified on ultrasound, chromosome examination is warranted. For indeterminable cases, ultrasound follow-up in 2nd and 3rd trimester is necessary.

CD4+CD25+regulatory T cells and graft-versus-host disease after hematopoietic stem cell transplantation / 中国组织工程研究

BACKGROUND: Autoreactive T cells are a group of specialized cells that exert a peripheral immunosuppressive effectthrough certain mechanisms ensuring self-tolerance within the adaptive immune system. The discovery of the latestsurface markers for natural CD4+CD25+ regulatory T cells has re-emphasized the concept of peripheral regulation orsuppression of T cells. Several groups have begun to investigate the role of regulatory T cells in animal models ofallogeneic hematopoietic stem cell transplantation.OBJECTIVE: To review the recent results regarding protection from graft-versus-host disease by adoptively transferredCD4+ CD25+ regulatory T cells in mice and to discuss the latest findings from clinical studies on hematopoietic stem celltransplantation.METHODS: We retrieved CNKI, PubMed and Medline databases for articles concerning CD4+CD25+ regulatory T cellsand graft-versus-host disease published from 2000 to 2015. According to inclusion and exclusion criteria, 46 paperswere included in result analysis.RESULTS AND CONCLUSION: CD4+CD25+ regulatory T cells expressing the transcriptional repressor FOXP3 mediateimmunoregulatory functions and are critical for the prevention of autoimmune diseases. As peripheral tolerance inductionis a prerequisite for successful allogeneic hematopoietic stem cell transplantation, the role of CD4+CD25+ regulatory Tcells in transplantation models and clinical trials is now under investigation in many laboratories. CD4+CD25+ regulatoryT cells play an important role in the development of graft-versus-host disease after allogeneic hematopoietic stem celltransplantation. CD4+CD25+ regulatory T cells not only effectively prevent and treat graft-versus-host disease but alsoretain graft-versus-leukemia effect.

Clinical Significance of Monitoring T Lymphocyte Subsets after Allogeneic Hematopoietic Stem Cell Transplantation / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To evaluate the relationship between T lymphocyte subsets and the incidence of graft-versus-host disease (GVHD) and its clinical significance of monitoring the changes of T lymphocyte subsets dynamicly on 1, 3, 6, 12 month after allogeneic hematopoietic stem cell transplantation (allo-HSCT).</p><p><b>METHODS</b>Twenty cases received allo-HSCT in Department of Hematology of General Hospital of Beijing Military Command from January 2013 to January 2014, including 10 males and 10 females with average age of 20.3 years (3-46 years old), among them 4 cases rectived HLA matched transplantation and 16 cases rectived HLA mismatched transplantation. The levels of T lymphocyte subsets including CD3(+), CD4(+), CD8(+), CD4(+)/CD8(+), CD4(+)CD25(high) FOXP3(+) in the peripheral blood were manitored with flow cytometry (FCM) on +1, +3, +6, +12 month after transplantation dynamicly.</p><p><b>RESULTS</b>(1) Follow up to March 2015, the levers of CD3(+), CD4(+), CD8(+), CD4(+)/CD8(+), CD4(+) CD25(high) FOXP3(+) showed a different degree of recovery after transplantation for all cases and returned to the lever of pre-transplantation on 12 month basically, and CD8(+) T cells recovered earlier than CD4(+) T cells, while the decrease of CD4(+) T cells lasted more than 1 year; The proportion inversion of CD4(+)/CD8(+) also lasted for more than 1 year;(2) The level of CD4(+) CD25(high) FOXP3(+) in patients with acute GVHD was lower than that in patients without acute GVHD.</p><p><b>CONCLUSION</b>The dynamic monitoring of the T lymphocyte subsets, especially CD4(+) CD25(high) FOXP3(+) after transplantation has importent clinical significance, it can forecast the incidence of acute GVHD before symptoms appeared; the dynamic monitoring of the T-lymphocyte subsets also can be used as reference indicator for prediction of GVHD, theraby it can reduce mortality of patients after transplantation.</p>

Chemical constituents from Barringtonia racemosa / 中国中药杂志

To investigate the chemical constituents from Barringtonia racemosa, twelve compounds were isolated by chromatography methods and identified as 3β-p-E-coumaroymaslinic acid (1), cis-careaborin (2), careaborin (3), maslinic acid (4), 2α, 3β, 19α-trihydroxyolean-12-ene-24, 28-dioic acid (5), 3β-p-Z-coumaroylcorosolic acid (6), corosolic acid (7), 1α, 2α, 3β, 19α-tetrahydroxyurs-12-en-28-oic acid (8), 19α-hydroxyl ursolic acid (9), 3α, 19α-dihydroxyurs-12-en-24, 28-dioic acid (10), tormentic acid (11), 3-hydroxy-7, 22-dien-ergosterol（12） by the NMR and MS data analysis. Among them, compounds 1-4,7-12 were obtained from the genus Barringtonia for the first time. All the compounds didn't show nocytotoxic activity against MCF-7 and A549 cell lines (IC₅₀>50 mg•L⁻¹).

The preliminary research of immune function monitoring before and after allogeneic hematopoietic stem cell transplantation in children with aplastic anemia / 中华实用儿科临床杂志

Objective To explore the clinical significance of the relationship between the immune function and the pathogenesis of aplastic anemia in children with aplastic anemia(AA),along with the incidence of graft versus host disease (GVHD)by monitoring the changes of T lymphocyte subsets dynamically in +1 ,+3,+6,+1 2 months for blood disease patients after allogeneic hematopoietic stem cell transplantation.Methods Twelve AA patients re-ceived allogeneic hematopoietic stem cell transplantation in Department of Hematology,the Affiliated General Hospital of Beijing Military Region of Anhui Medical University,from January 201 3 to January 201 4,including 4 male and 8 fe-male,with average age of 7.92 years old(3 -1 4 years old)with 5 cases of human leukocyte antigen(HLA)matched and 7 cases of HLA mismatched.The level of T lymphocyte subsets including CD3 +,CD4 +,CD8 +,CD4 +/CD8 +, CD56 +,CD4 +CD25 high +FOXP3 +were monitored with flow cytometry before transplantation and in +1 ,+3,+6,+1 2 months after transplantation dynamically in the peripheral blood.While in the same period the level of T lymphocyte subsets was monitored in 1 2 cases of healthy children at the same period as the healthy control group.Results Fol-lowed up to March 201 5,1 0 cases had abnormal cellular immunity (CD4 +/CD8 + ratio inversion)in the 1 2 AA pa-tients.Compared with the control group,in the AA group,CD3 + was slightly higher,(66.79 ±7.35)% and (62.74 ± 5.58)% respectively(P =0.043),CD4 + was decreased by (33.73 ±7.26)% and (39.54 ±3.46)% respectively (P =0.037),CD8 + was increased by (35.69 ±6.78)% and (25.34 ±4.36)%,respectively (P =0.000),CD4 +/CD8 + decreased by 1 .23 ±0.56 and 1 .78 ±0.34 respectively(P =0.001 )and CD56 + was decreased by (7.46 ± 2.80)% and (1 6.73 ±3.70)% respectively(P =0.000),CD4 +CD25 high +FOXP3 + was decreased by (3.3 ± 1 .5)% and (8.1 ±1 .3)% respectively (P =0.003),whose difference was statistically significant (P <0.05).The lever of CD3 +,CD4 +,CD8 +,CD4 +/CD8 +,CD56 +,CD4 +CD25 high +FOXP3 + had a different degree of recovery after transplantation for all cases and returned to normal in +1 2 months basically.In +1 ,+3,+6,+1 2 months after transplantation,the levels of CD4 +CD25 high +FOXP3 + in GVHD positive group and negative group were (0.4 ± 0.6)% and (1 .6 ±0.7)% respectively,(0.7 ±0.3)% and (2.7 ±0.4)% respectively,(1 .1 ±0.5 )% and (2.9 ±0.7)% respectively,(1 .4 ±0.3)% and (3.6 ±0.2)% respectively,which had statistical significance (P <0.05).Conclusions There was abnormal cell immune function in some cases with AA.After transplantation,the level of CD4 +CD25 high +FOXP3 + is closely related to the acute GVHD,which can be used to predict the occurrence of GVHD.

Haploidentical allogeneic hematopoietic stem cell transplantation for severe aplastic anemia:a retrospective analysis / 中国组织工程研究

BACKGROUND:Al ogeneic hematopoietic stem cel transplantation is currently recognized as the first-line therapy for severe aplastic anemia. However, with the popularity of the one-child families, the source of ful y matched hematopoietic stem cel transplantation is limited, so haploidentical hematopoietic stem cel transplantation is favored. OBJECTIVE:To retrospectively compare and analyze the clinical efficacy and safety of haploidentical al ogeneic hematopoietic stem cel transplantation and ful y matched hematopoietic stem cel transplantation for the treatment of severe aplastic anemia. METHODS:Clinical data of 15 patients with severe aplastic anemia (treatment group) who underwent haploidentical al ogeneic hematopoietic stem cel transplantation in the Department of Hematology General Hospital of Beijing Military Region from January 2013 to January 2015 were retrospectively analyzed. Pretreatment regimen was cyclophosphamide, fludarabine, Busulfex, combined with anti-human lymphocyte immune globulin. Donors received granulocyte colony-stimulating factor, and the transplantation method was bone marrow mobilization combined with peripheral blood stem cel transplantation. Combined immunosuppressive agents including cyclosporine A, methotrexate, tacrolimus, were adopted for prevention of graft versus host disease. Another 15 cases of severe aplastic anemia undergoing ful y matched hematopoietic stem cel transplantation served as control group over the same period. Complications and survival of the two groups were statistical y analyzed. RESULTS AND CONCLUSION:By the end of July 2015, the median fol ow-up time of the treatment group was 20.7 months (6-30 months), and hematopoietic reconstruction was achieved in al cases, including four cases of graft versus host disease, five cases of pulmonary infection, three cases of sepsis, and one case died of pulmonary infection, one cases died of sepsis, and two cases died of graft versus host disease. In the control group, the median fol ow-up time was 19.7 months (5-28 months), hematopoietic reconstruction was achieved in al cases. There were three cases of graft versus host disease, four cases of pulmonary infection, one case died of pulmonary infection, and two cases died of graft versus host disease. The total survival rates of the two groups were 73%and 80%respectively, with no significant difference (P=0.67). The haploidentical al ogeneic hematopoietic stem cel transplantation for severe aplastic anemia is safe and effective, and the clinical efficacy is comparable to the ful y matched hematopoietic stem cel transplantation.

Influence of luxS of Streptococcus mutans on biofilm of dental plaque / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To construct luxS mutant aften luxS gene of Streptococcus mutans (S. mutans) was knocked out, and examine their ability of biofilm formation.</p><p><b>METHODS</b>A recombinant plasmid containing the flanking fragment of luxS of S. mutans was transformed into S. mutans UA159, and selected by brain heart infusion (BHI) agar medium with kanamicin. The luxS mutant further confirmed via polymerase chain reaction (PCR) and the autoinducer-2 (AI-2) bioluminescence assay of Vibrio harveyi (V. harveyi), and ability of luxS mutant and S. mutans UA159 biofilm formation was examined in different phases, in BHI medium with 1% sucrose and 1% glycose by scanning electron microscopy (SEM).</p><p><b>RESULTS</b>LuxS-deficient S. mutans strains were successfully constructed. Compared with S. mutans UA159, the luxS mutant maintained in BHI medium containing 1% sucrose displayed an apparent defect in biofilm formation, while they showed no significant deviation in BHI medium containing 1% glycose.</p><p><b>CONCLUSION</b>luxS gene in S.mutans can play a role in dental plaque biofilm formation, and the luxS gene is possible to regulate sucrose-dependent biofilm formation.</p>

Assessment of right ventricular free wall longitudinal myocardial deformation using speckle tracking imaging in normal subjects / 华中科技大学学报（医学）（英德文版）

To assess right ventricular free wall longitudinal myocardium deformation and examine the changes with normal age by speckle tracking imaging (STI), myocardial systolic peak strain (epsilon), systolic peak strain rate (SRs), early diastolic peak strain rate (SRe), late diastolic peak strain rate (SRa), the ratio of SRe/SRa were measured in the basal, middle and apical segments of right ventricular free wall in 75 healthy volunteers (age range: 21-71 y) by STI from the apical 4-chamber view. RV longitudinal strain and strain rate were highest in the basal segment of the free wall. Older subjects had lower early diastolic strain rate (SRe) than younger subjects, but they had higher late diastolic strain rate (SRa). A negative correlation between age and the ratio of SRe/SRa was found in all RV free wall segments (r=-0.466 - -0.614, P<0.01). It is concluded that RV diastolic strain rate changes with age and STI can be used for the study of RV myocardial deformation.

Evaluation of left ventricular rotation and twist using speckle tracking imaging in patients with atrial septal defect / 华中科技大学学报（医学）（英德文版）

Speckle tracking imaging (STI) was employed to investigate the effect of right ventricular (RV) volume and pressure overload on left ventricular (LV) rotation and twist in 35 patients with atrial septal defect (ASD), 18 of which with pulmonary hypertension, and 21 healthy subjects serving as controls. The peak rotations of 6 segments at the basal and apical short-axises and the average peak rotation and interval time of the 6 segments in the opposite direction during early systolic phase were measured respectively. LV twist versus time profile was drawn and the peak twist and time to peak twist were calculated. LV ejection fraction (EF) was measured by Biplane Simpson. Compared to ASD patients without pulmonary hypertension and healthy subjects, the peak rotations of posterior, inferior and postsept walls at the basal level were lower (P<0.05), and the average counterclockwise peak rotation of 6 segments at the basal level during early systolic phase was higher (P<0.05), and the average interval time was delayed (P<0.05). LV peak twist was also lower (P<0.05), and had a significant negative correlation with pulmonary arterial systolic pressure (r=-0.57, P=0.001). No significant differences were found in LVEF among the three groups. It was suggested that although RV volume overload due to ASD has no significant effects on LV rotation and twist, LV peak twist is lower in ASD patients with pulmonary hypertension. Thus LV twist may serve as a new indicator of the presence of pulmonary hypertension in ASD patients.

Evaluation of left ventricular rotation and twist using speckle tracking imaging in patients with atrial septal defect / 中华超声影像学杂志

Objective To investigate the effect of right ventricular(RV)volume and RV pressure overload on left ventricular(LV)rotation and twist in patients with atrial septal defecl(ASD).Methods Using speckle tracking imaging(STI),the peak rotation of 6 segments in basal and apical short-axises was measured respectively in 35 patients with ASD(18 of which with pulmonary hypertension)and 21 healthy subjects as controls.The average peak rotation and duration time of the 6 segments in basal and apical short-axises in negative direction during early systolic phase were also measured respectively.LV twist versus time profile was drawn and the peak twist and time to peak twist were calculated.LV ejection fraction(EF)was measured by biplane Simpson method.Results Compared to ASD patients without pulmonary hypertension and healthy subjects,the peak rotation of posterior wall,inferior wall and postsept wall in basal was lower(P＜0.05).And at the basal level,the averagepeak rotation of 6 segments in negative direction during early systolic phase was higher(P＜0.05),and the average duration time was delayed(P＜0.05).LV peak twist was also lower(P＜0.05),and had a significant negative correlation with pulmonary arterial systolic pressure(r=-0.57,P=0.001).There were no significant differences in LVEF among 3 groups.Conclusions Although RV volume overload due to ASD has no significant effects on LV rotation and twist,LV peak twist is lower in ASD patients with pulmonary hypertension.Thus LV twist may be a new index which predicting whether ASD patients also has pulmonary hypertension or not.

Development of an identification method for Streptococcus oligofermentans: a new species of oral streptococci with molecular markers / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To establish a quick and reliable method to identify Streptococcus oligofermentans, a new species of oral streptococci.</p><p><b>METHODS</b>With two-step PCR, a pair of the 16S rDNA-specific primers of Streptococcus oligofermentans and a pair of primers of lactate oxidase gene (lox) were used to amplify the gene fragments from the genomic DNAs of 11 strains consisting of 9 species of the pure culture of oral streptococci. Pooled plaque samples from 9 caries-free volunteers were cultured on a selective medium of MSA with erythromycin and tentative strains of Streptococcus oligofermentans were isolated. The isolates were further identified by the two-step PCR and finally confirmed by 16S rDNA sequence analysis.</p><p><b>RESULTS</b>With the two-step PCR, the two gene fragments were only amplified from the three identified strains of Streptococcus oligofermentans, but not the rest of 8 strains of oral streptococci. Isolates from the dental plaque of caries-free volunteers were identified as Streptococcus oligofermentans by PCR and then further confirmed by 16S rDNA sequence homology analysis.</p><p><b>CONCLUSIONS</b>Streptococcus oligofermentans could be identified by the two-step PCR approach with the specific 16S rDNA primers and lactate oxidase gene primers.</p>