Epidemiological characteristics of SARS-CoV-2 pneumonia in kidney transplant recipients : a single-center retrospective study / 器官移植

Objective To investigate the epidemiological characteristics of SARS-CoV-2 pneumonia in kidney transplant recipients and analyze the risk and protective factors of severe/critical infection with SARS-CoV-2. Methods Clinical data of 468 kidney transplant recipients infected with SARS-CoV-2 were retrospectively analyzed. According to the severity of infection, they were divided into mild SARS-CoV-2 infection recipients (n=439) and SARS-CoV-2 pneumonia group (n=29). Among the 439 mild SARS-CoV-2 infection recipients, 87 recipients who were randomly matched with their counterparts in the SARS-CoV-2 pneumonia group according to sex, age and transplantation time at a ratio of 3∶1 were allocated into the mild SARS-CoV-2 infection group. Twenty-nine recipients in the SARS-CoV-2 pneumonia group were divided into the moderate SARS-CoV-2 pneumonia group (n=21) and severe/critical SARS-CoV-2 pneumonia group (n=8). Baseline data of all recipients were collected. The risk and protective factors of SARS-CoV-2 infection in kidney transplant recipients were identified. Results The proportion of recipients complicated with 2-3 types of complications in the SARS-CoV-2 pneumonia group was higher than that in the mild SARS-CoV-2 infection group, and the proportion of recipients treated with tacrolimus(Tac)+mizoribine+glucocorticoid immunosuppression regimen in the SARS-CoV-2 pneumonia group was lower than that in the mild SARS-CoV-2 infection group, and significant differences were observed (both P<0.05). In 29 kidney transplant recipients with SARS-CoV-2 pneumonia in the SARS-CoV-2 pneumonia group, white blood cells, the absolute values of lymphocytes, eosinophils, total T cells, CD4+T cells and CD8+T cells, and serum uric acid levels were significantly lower, whereas ferritin levels were significantly higher than the values prior to SARS-CoV-2 pneumonia, and significant differences were observed (all P<0.05). Compared with the moderate SARS-CoV-2 pneumonia group, the proportion of recipients with hypoxemia was higher, the proportion of recipients treated with Tac/ciclosporin (CsA)+mycophenolate mofetil+glucocorticoid immunosuppression regimen was higher, and the proportion of recipients administered with 2-3 doses of SARS-CoV-2 vaccine was lower in the severe/critical SARS-CoV-2 pneumonia group, and significant differences were observed (all P<0.05). Conclusions More complications and immunosuppression regimen containing mycophenolate mofetil are the risk factor for SARS-CoV-2 infection in kidney transplant recipients. Vaccination with SARS-CoV-2 vaccine and immunosuppression regimen containing mizoribine are probably the protective factors for lowering the risk of SARS-CoV-2 infection. The levels of inflammatory cytokines are associated with the severity of SARS-CoV-2 pneumonia.

Alterations in the intestinal microbiota of preterm infants with neurodevelopmental impairments: a prospective cohort study / 中国当代儿科杂志

OBJECTIVES@#To investigate the difference in intestinal microbiota between preterm infants with neurodevelopmental impairment (NDI) and those without NDI.@*METHODS@#In this prospective cohort study, the preterm infants who were admitted to the neonatal intensive care unit of Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region from September 1, 2019 to September 30, 2021 were enrolled as subjects. According to the assessment results of Gesell Developmental Scale at the corrected gestational age of 1.5-2 years, they were divided into two groups: normal (n=115) and NDI (n=100). Fecal samples were collected one day before discharge, one day before introducing solid food, and at the corrected gestational age of 1 year. High-throughput sequencing was used to compare the composition of intestinal microbiota between groups.@*RESULTS@#Compared with the normal group, the NDI group had a significantly higher Shannon diversity index at the corrected gestational age of 1 year (P<0.05). The principal coordinate analysis showed a significant difference in the composition of intestinal microbiota between the two groups one day before introducing solid food and at the corrected gestational age of 1 year (P<0.05). Compared with the normal group, the NDI group had a significantly higher abundance of Bifidobacterium in the intestine at all three time points, a significantly higher abundance of Enterococcus one day before introducing solid food and at the corrected gestational age of 1 year, and a significantly lower abundance of Akkermansia one day before introducing solid food (P<0.05).@*CONCLUSIONS@#There are significant differences in the composition of intestinal microbiota between preterm infants with NDI and those without NDI. This study enriches the data on the characteristics of intestinal microbiota in preterm infants with NDI and provides reference for the microbiota therapy and intervention for NDI in preterm infants.

Analysis on the efficacy and safety of fibrinolytic therapy in patients with acute ST-segment elevation myocardial infarction during the COVID-19 epidemic / 中华心血管病杂志

Objective: To evaluate the efficacy and safety of fibrinolysis strategy in patients with acute ST-segment elevation myocardial infarction (STEMI) during the COVID-19 epidemic, and to provide reference value for optimization of fibrinolytic process on the premise of prevention and control of COVID-19 transmission, including self-protection of medical staff. Methods: The efficacy and safety of fibrinolysis were retrospectively analyzed in 7 patients with acute STEM, who hospitalized from February 29, 2020 to April 3, 2020 in the Department of Cardiology, Wuhan Union Hospital of Tongji Medical College, Huazhong University of Science and Technology. To optimize the fibrinolytic process on the premise of prevention and control of COVID-19 transmission, including self-protection of medical staff, a full-time medical team in charge of fibrinolysis under third-grade protection was established. The acute STEMI patients were treated immediately in a fixed and isolated area in emergency department before receiving green channel fibrinolysis. Blood samples for complete blood count, COVID-19 antibody test and nasopharyngeal swab samples for COVID-19 nucleic acid test were made before fibrinolysis, while the chest CT examination was accomplished after fibrinolysis. By comparing differences of time from the first electrocardiogram (ECG) to fibrinolysis before and after the improvement of fibrinolytic process, the effect of optimization of the fibrinolytic process was evaluated. Results: In the present study, seven patients with acute STEMI received fibrinolysis therapy, 6 of them achieved reperfusion and no bleeding was observed in all of the patients. Five out of the 7 patients were hospitalized after fibrinolysis, and the hospitalization days were 19.6 days on average. By following up to April 14, 2020, none of the 7 patients died. The first 2 patients were treated according to the routine medical procedure and the time from the first ECG to fibrinolysis were 201 and 106 minutes, respectively. After the optimization of the fibrinolytic process, the time from the first ECG to fibrinolysis of the last 5 patients were 42, 46, 51, 43 and 54 minutes, respectively，which was significantly shorter than that before optimization. Conclusions: During the COVID-19 epidemic, fibrinolysis in patients with acute STEMI is safe, effective and easy to implement. Therefore, it is recommended as the top priority for the patients with acute STEMI with indications for fibrinolysis. On the premise of prevention and control of COVID-19 transmission, including self-protection of medical staff, the duration of myocardial ischemia can be shortened by optimization of the fibrinolytic process.

Combined intravitreaI injection of triamcinoIone acetonide and ranibizumab for age-reIated macuIar degeneration: study protocoI for a randomized controIIed triaI / 中国组织工程研究

BACKGROUND: Age-related macular degeneration is a condition that leads to the deterioration of the macula in the elderly, and is characterized by the presence of drusen and degenerative changes of the retinal pigment epithelium and choroidal capillaries. It is a major cause of blindness worldwide. The commonly used strategies, including antioxidant therapy and dilation of blood vessels, have shown undesired outcomes in clinical practice. Ranibizumab, an anti-vascular endothelial growth factor fusion protein, is an angiogenesis inhibitor that has been used to treat wet (neovascular) age-related macular degeneration; however, patients treated with ranibizumab are prone to develop endophthalmitis, rhegmatogenous retinal detachment, retinal tears, and iatrogenic traumatic cataract. OJECTIVE: To determine the efficacy and safety of intravitreal injection of combination of triamcinolone acetonide and ranibizumab in the treatment of age-related macular degeneration in a randomized controlled trial. METHODS: Eighty patients (160 eyes) with age-related macular degeneration admitted at Jingzhou Hospital Affiliated to Tongji Medical School of Huazhong University of Science and Technology, China will be recruited. These patients will be randomly assigned to control or treatment group at a 1:1 ratio. The patients in the control group will be treated with intravitreal injection of triamcinolone acetonide (0.1 mL, once daily), while those in the treatment group will be treated with combined intravitreal injection of triamcinolone acetonide (0.025 mL, once daily) and ranibizumab (0.05 mL, once a month). All patients will undergo continuous treatment for 3 months, followed by a 6-month follow-up. The primary outcome measure is foveal retinal thickness before and 6 months after treatment. The secondary outcome measures include best corrected visual acuity, intraocular pressure, quality of life scores before and 6 months after treatment, and the incidence of adverse events at 6 months after treatment. This study was approved by the Ethics Committee of the Jingzhou Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology, China (approval No. 20170338), and will be performed in accordance with the Declaration of Helsinki. The participants will be informed of the study protocol and procedures and asked to sign an informed consent. Participant recruitment will be initiated in January 2018. Sample and data collection will begin in January 2018 and end in June 2018. The analysis of outcome measures and the completion of trial will be in September 2018. The results of this study will be disseminated through presentations at scientific meetings and/or by publication in peer-reviewed journals. This trial was registered with the Chinese Clinical Trial Registry (registration No. ChiCTR-IOR-17013865). DISCUSSION: We aim to confirm the safety and efficacy of the intravitreal injection of combination of triamcinolone acetonide and ranibizumab in the treatment of age-related macular degeneration.

Effect of asymptomatic hyperuricemia after kidney transplantation on kidney function of graft / 中华器官移植杂志

Objective To investigate the effect of asymptomatic hyperuricemia after renal transplantation on renal function of the grafts.Methods The follow-up data were retrospectively collected and analyzed in 144 patients with renal transplantation from January 2010 to March 2015.The patients were classified into three groups according to the level of serum uric acid (SUA):group A (normal group),group B (asymptomatic hyperuricernia with average SUA less than or equal to 360 μmol/L after treatment),and group C (asymptomatic hyperuricemia with average SUA greater than 360μmol/L after treatment).The renal function indexes such as serum creatinine (SCr) and estimated glomerular filtration rate (eGFR) were compared among three groups from 12 to 48 months after transplantation.Results The SCr and eGFR showed no significant difference between group A and group B at 12th month (P＞0.05),but ther are superior than Group Ⅲ (P＜0.05).Conclusion After renal transplantation,asymptomatic hyperuricemia can lead to impaired renal function,and there are no significant differences in renal function between renal transplant recipients with normal SUA levels after treatment and those without hyperuricemia.

Role of donor human milk feeding in preventing nosocomial infection in very low birth weight infants / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the role of donor human milk in the prevention of nosocomial infection in very low birth weight infants. MeETHODS: A total of 105 hospitalized preterm infants with a very low birth weight were enrolled. They were classified into mother's own milk feeding group, donor human milk feeding group, and preterm formula feeding group, with 35 infants in each group. The three groups were compared in terms of incidence rates of nosocomial infection, necrotizing enterocolitis, and feeding intolerance, time to full enteral feeding, and early growth indices.</p><p><b>RESULTS</b>Compared with the preterm formula feeding group, the donor human milk feeding group and the mother's own milk feeding group had significantly lower incidence rates of nosocomial infection and necrotizing enterocolitis and shorter time to full enteral feeding (P<0.05). There were no significant differences in head circumference, body length, and weight growth velocity among the three groups.</p><p><b>CONCLUSIONS</b>Donor human milk can be used in case of a lack of mother's own milk and may help to reduce nosocomial infection.</p>

Effect of 15-Deoxy-Δ-prostaglandin JNanocapsules on Inflammation and Bone Regeneration in a Rat Bone Defect Model / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>15-Deoxy-Δ12,14-prostaglandin J2 (15d-PGJ2), one of the major metabolites from prostaglandin D2 in arachidonic acid metabolic pathway, has potential anti-inflammatory properties. The objective of this study was to explore the effects of 15d-PGJ2-loaded poly(D,L-lactide-co-glycolide) nanocapsules (15d-PGJ2-NC) on inflammatory responses and bone regeneration in local bone defect.</p><p><b>METHODS</b>The study was conducted on 96 Wistar rats from June 2014 to March 2016. Saline, unloaded nanoparticles, free 15d-PGJ2or 15d-PGJ2-NC, were delivered through a collagen vehicle inside surgically created transcortical defects in rat femurs. Interleukin-6 (IL-6), interleukin-1 beta (IL-1β), and tumor necrosis factor-alpha (TNF-α) levels in the surrounding soft tissue were analyzed by Western blot and in the defect by quantitative real-time polymerase chain reaction over 14 days. Simultaneously, bone morphogenetic protein-6 (BMP-6) and platelet-derived growth factor-B (PDGF-B) messenger RNA (mRNA) in the defect were examined. New bone formation and EphrinB2 and osteoprotegerin (OPG) protein expression in the cortical defect were observed by Masson's Trichrome staining and immunohistochemistry over 28 days. Data were analyzed by one-way analysis of variance. Least-significant difference and Dunnett's T3 methods were used with a bilateral P< 0.05.</p><p><b>RESULTS</b>Application of l5d-PGJ2-NC (100 μg/ml) in the local bone defect significantly decreased IL-6, IL-1β, and TNF-α mRNA and protein, compared with saline-treated controls (P < 0.05). l5d-PGJ2-NC upregulated BMP-6 and PDGF-B mRNA (P < 0.05). New bone formation was observed in the cortical defect in l5d-PGJ2-NC-treated animals from 7th day onward (P < 0.001). Expression of EphrinB2 and OPG presented early on day 3 and persisted through day 28 in 15d-PGJ2-NC group (P < 0.05).</p><p><b>CONCLUSION</b>Stable l5d-PGJ2-NC complexes were prepared that could attenuate IL-6, IL-1β, and TNF-α expression, while increasing new bone formation and growth factors related to bone regeneration.</p>

Oligodendrocyte transplantation for acute spinal cord injury：insulin-like growth factor 1 induces bone marrow mesenchymal stem cells differentiating into oligodendrocytes / 中国组织工程研究

BACKGROUND:Treatment and rehabilitation of spinal cord injury is a complicated problem,andthe reconstruction and remyelination of neural reflex pathwaysare the essentialprocess, during which oligodendrocytes play an important role in spinal cord injury repair. OBJECTIVE:To observe theeffect ofoligodendrocyte transplantation for acute spinal cord injury in rats. METHODS:Insulin-like growthfactor 1 induced bone marrow mesenchymal stem cels differentiating into oligodendrocytes, and those oligodendrocytes were transplanted into rats with acute spinal cord injury as induced cel transplantation group. Simple normal salineandnatural oligodendrocytes were transplanted into the rat injured spinal cord as control group and oligodendrocyte group, respectively. Rat behavioral changes were observed by inclined planetest and Basso-Beattie-Bresnahan (BBB) scores. Neurological recovery and survivalof the transplanted cels was detected and observed using spinal evoked potential and immunohistochemical staining, respectively. RESULTS AND CONCLUSION:Compared with the control group, BBB scores and the criticalelevation angle oftheincline planetestsignificantly increased, latencies of spinal motor and sensory evoked potential were on the decline (P< 0.05), and there were no significant differencesin above indicators between the two groups at 4 and 8 weeks after transplantation. Moreover, survivedoligodendrocytes after transplantation could be found in the lesions of spinal cord in both two groups. In conclusion, insulin-like growth factor 1-induced bone marrow mesenchymal stem cels can differentiate into oligodendrocytesthat exact an excelentrole in acute spinal cord injury repair after transplantation, which achieve the equal clinical efficacy tothenatural oligodendrocytes.

Delta12-prostaglandinJ2-nano capsule up-regulates growth factor expression and enhances bone regeneration in rats / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the effect of local delivery of delta12-prostaglandinJ2-loaded poly (lactic-co-glycolic acid) (Δ(12)-PGJ2-NC) on growth factors expression and bone formation.</p><p><b>METHODS</b>Δ(12)-PGJ2-NC was prepared by the emulsion solvent diffusion method. The physical and chemical properties of the nanoparticles were evaluated by particle size analysis, transmission electron microscopy, drug-loading ratio and the in vitro release study. Then standardized transcortical defect (5.0 mm × 1.5 mm) was conducted in the femur of 48 male Wistar rats which were randomly divided into four groups (n = 12), S, K, F, and N. Thirty microliter of saline (S), unloaded nanoparticles (K), Δ(12)-PGJ2 (F) and Δ(12)-PGJ2-NC(N) in a collagen vehicle were delivered inside a titanium chamber fixed over the defect. Then, four subgroups were randomly divided in each group named as D3, D7, D14, and D28 (n = 3) according to the days 3, 7, 14, and 28 after the surgery. At days 3, 7, 14, and 28, the mRNA expression of the bone morphogenetic protein-6 (BMP-6), platelet-derived growth factor-B (PDGF-B) in defect aera was analyzed by real time quantitive-polymerase blotting. HE staining was employed to reveal new bone formation in weeks 2 and 4.</p><p><b>RESULTS</b>Δ(12)-PGJ2-NC appeared opalescent white and remained relatively stable, with an average particle size of (135.2 ± 0.85) nm. The images from transmission electron microscopy showed that Δ(12)-PGJ2-NC was spherical in shape and homogeneously distributed. The encapsulation efficiency of Δ(12)-PGJ2 with the poly (lactic-co-glycolic acid) (PLGA) nanocapsules was about 92%. The in vitro release of Δ(12)-PGJ2-NC at 37 °C showed a sustained fashion and the average accumulated amount was 30%, 52%, 77%, 91%, and 98% respectively, at 0.5, 1, 2, 4 and 6 h. Compared with the animals treated with saline, after dose of 100 mg/L Δ(12)-PGJ2 and Δ(12)-PGJ2-NC apllication, the mRNA expression level of BMP-6, PDGF-B increased significantly (P < 0.05, P < 0.001). The protein expression of BMP-6, Ephrin-B2 also was up-regulated. Histomorphometry revealed that new bone formation increased at the same dose of 100 mg/L. But the unloaded nanoparticles did not have the same effect (P > 0.05).</p><p><b>CONCLUSIONS</b>A stable Δ(12)-PGJ2 loaded nanoparticle was successfully prepared. Δ(12)-PGJ2-NC may upregulate the expression of BMP-6, PDGF-B and Ephrin-B2, and promote new bone formation in bone defect area.</p>

Hydrophilic acrylic intraocular lens：biocompatibility and complications following implantation / 中国组织工程研究

BACKGROUND:Hydrophilic acrylic materials with good biocompatibility have been widely used in clinic. However, there are some problems about the biocompatibility and safety of hydrophilic acrylic intraocular lens after long-term clinical application. OBJECTIVE:To discuss the biocompatibility and stability issues and corresponding processing methods after hydrophilic acrylic intraocular lens implantation. METHODS:A computer-based search of Wanfang and PubMed database was performed for articles related to clinical application of hydrophilic acrylic intraocular lens published from 2005 to 2014. The keywords were “hydrophilic acrylic,intraocular lens” in Chinese and English, respectively. A total of 618 articles were initialy retrieved, and finaly 35 articles were included in result analysis. RESULTS AND CONCLUSION:As the hydrophilic acrylic intraocular lens is foldable, a smal incision is required for implantation and the operation is simple that cause less damage to the patients. In addition, the hydrophilic acrylic intraocular lens has poor bacterial and inflammatory cel adhesion, which leads to a low probability of infective endophthalmitis after implantation. But there is a high incidence of posterior capsule opacification as wel as some refractive errors and visual quality problems after implantation. Taken together, to solve these problems depends on the continuous improvements and updates of intraocular lens materials and designs.

Mortality and Morbidity of Extremely Low Birth Weight Infants in the Mainland of China: A Multi-center Study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>With the progress of perinatal medicine and neonatal technology, more and more extremely low birth weight (ELBW) survived all over the world. This study was designed to investigate the short-term outcomes of ELBW infants during their Neonatal Intensive Care Unit (NICU) stay in the mainland of China.</p><p><b>METHODS</b>All infants admitted to 26 NICUs with a birth weight (BW) < l000 g were included between January l, 2011 and December 31, 2011. All the data were collected retrospectively from clinical records by a prospectively designed questionnaire. The data collected from each NICU transmitted to the main institution where the results were aggregated and analyzed. Categorical variables were performed with Pearson Chi-square test. Binary Logistic regression analysis was used to detect risk factors.</p><p><b>RESULTS</b>A total of 258 ELBW infants were admitted to 26 NICUs, of whom the mean gestational age (GA) was 28.1 ± 2.2 weeks, and the mean BW was 868 ± 97 g. The overall survival rate at discharge was 50.0%. Despite aggressive treatment 60 infants (23.3%) died and another 69 infants (26.7%) died after medical care withdrawal. Furthermore, the survival rate was significantly higher in coastal areas than inland areas (53.6% vs. 35.3%, P = 0.019). BW < 750 g and GA < 28 weeks were the largest risk factors, and being small for gestational age was a protective factor related to mortality. Respiratory distress syndrome was the most common complication. The incidence of patent ductus arteriosus, intraventricular hemorrhage, periventricular leukomalacia, bronchopulmonary dysplasia, retinopathy of prematurity was 26.2%, 33.7%, 6.7%, 48.1%, and 41.4%, respectively. Ventilator associated pneumonia was the most common hospital acquired infection during hospitalization.</p><p><b>CONCLUSIONS</b>Our study was the first survey that revealed the present status of ELBW infants in the mainland of China. The mortality and morbidity of ELBW infants remained high as compared to other developed countries.</p>

Laser epithelial keratomileusis for the treatment of refractive errors after cataractlens implantation：a stability evaluation / 中国组织工程研究

BACKGROUND:After cataract extraction and intraocular lens implantation, some patients stil appear to suffer from refractive errors to varying degrees. In this case, excimer laser epithelial keratomileusis or excimer laser in situ keratomileusis can be used for correction of refractive errors. OBJECTIVE:To observe the therapeutic effect of excimer laser epithelial keratomileusis on the treatment of residual refractive errors after cataract extraction and intraocular lens implantation. METHODS:Thirty-eight patients with refractive errors (45 eyes) who had received cataract extraction and intraocular lens implantation were enroled, including 22 males and 16 females. Patient’s age was 24-74 years, and the central corneal thickness ranged 490-590μm. Before laser epithelial keratomileusis, the uncorrected visual acuity and corrected visual acuity were 0.1-0.3 and 0.6-1.0, respectively. The uncorrected visual acuity, best corrected visual acuity, diopter, and intraocular pressure were observed at 12 months after correction. RESULTS AND CONCLUSION:Most of the patients had foreign body sensation, pain and other symptoms of eye irritation at 3-6 postoperative hours, and then presented with eye pain, photophobia, tearing and other symptoms of corneal irritation with 2 days after surgery. The corneal epithelium healed basicaly at 7 days after surgery, and the vision recovered to top after about 20 days. After 12 months, the uncorrected visual acuity was 0.6-1.2,≥ 0.6 in al eyes,≥ 1.0 in 26 eyes (58%) and reached or exceeded the preoperative best corrected visual acuity in 35 eyes (78%). After surgery, the spherical degree was decreased from -2.5 m-1 to 0.5 m-1, and the cylinder degree was reduced from-3.85 m-1 to -0.53 m-1. High intraocular pressure occurred in 12 eyes, and 0.5-level corneal haze formed in 5 eyes. The results demonstrate that the excimer laser epithelial keratomileusis is safe and effective for treatment of refractive errors after cataract extraction and intraocular lens implantation.

Preliminary study on IL-7 receptor α combined with bacterial flagellin intervening acute graft-versus-host disease of mice after allogeneic bone marrow transplantation / 白血病·淋巴瘤

Objective To compare the effects between the impact of IL-7Rα,bacterial flagellin alone to the acute graft-versus-host disease and the combination of both,and to explore its possible mechanism.Methods The BALB/C (H-2d) female mice as recipients were divided into alone irradiation transplantation group (group A),IL-7Rα intervention group (group B),bacterial flagellin intervention group (group C),IL-7Rα combined with bacterial flagellin intervention group (group D),and 6 mice in each group.All mice were accepted 9 Gy 60Co total body irradiation,and 1×107 bone marrow cells and 2× 107 spleen cells of donors C57BL/6 (H-2b) mice were infused via the tail vein to recipient mice.The symptoms,signs,survival time and hematopoietic function recovery of the recipient mice were observed.Results Mice survival of group A was (22.5±2.30) d,30 d survival rate was 50.0 ％ (3/6),and aGVHD performances inculding the fatigue,anorexia,hair removal,arched,and so on appeared obviously.Survival of group B was (25.83±3.49) d,30 d survival rate was 33.3 ％ (2/6),aGVHD performances compared with group A was lighter.Survival of group C was (26.33±3.52) d,30 d survival rate was 33.3 ％ (2/6),also appeared aGVHD performance,which degree was same to the group B.survival of group D was (30.17±2.86) d,30 d survival rate was 66.7 ％ (4/6),aGVHD performances compared to the other three groups was lightest.The white blood cell count of four groups were reduced to minimum at +7 d,then the three intervention groups gradually recovered.The WBC recovery at 14,21,28,30 day after the transplant of group A compared with slowly was the intervention groups (P ＞ 0.05),WBC recovery of B was roughly equal to group C (P ＞ 0.05),while the WBC recovery of group D was faster than group B or C (P ＜ 0.05).At 2nd week after transplantation,CD3+ T cells was significantly decreased in 4 groups,and at 3rd week began gradually rised.Compared with group A,the proportion of CD3+ cells of other three groups were increased significantly,there was no statistical signifiance of CD3+ cell proportion between group B and group C at 2nd,3rd,4th week after transplantation (P ＞ 0.05),while the CD3+ T cell recovery in group D was faster than group B or C (P ＜ 0.05).Conclusions The stable aGVHD mouse model was established.Exogenous IL-7Rα and bacterial flagellin may reduce the incidence of aGVHD.There was no significant difference for aGVHD when they was used alone,but when combination of them,aGVHD is slighter and the hematopoietic recorery is faster.

Influencing factors for severity of bronchopulmonary dysplasia in preterm infants / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To explore the influencing factors for the severity of bronchopulmonary dysplasia (BPD) in preterm infants.</p><p><b>METHODS</b>The clinical data of 110 preterm infants who were diagnosed with BPD and had a hospital stay of over 28 days between January 2011 and December 2013 were analyzed. These BPD infants were divided into 3 groups according to the clinical criteria: mild group (n=52), moderate group (n=44), and severe group (n=14). The relationship between the severity of BPD and the gestational age, birth weight, asphyxia, oxygen therapy, pregnancy complications, intrauterine pneumonia and mechanical ventilation was analyzed.</p><p><b>RESULTS</b>The severity of BPD was correlated with the following factors: gestational age, birth weight, prenatal infection, duration of oxygen inhalation with a concentration of >40%, use of mechanical ventilation, parameters and duration of mechanical ventilation, duration of continuous positive airway pressure, adoption of intubation surfactant extubation (INSURE) approach, Ureaplasma urealyticum infection, intrauterine pneumonia and patent ductus arteriosus. Logistic regression analysis indicated that the mechanical ventilator parameter peak inspiratory pressure (OR=1.260, 95%CI: 1.096-1.448) and duration of mechanical ventilation (OR=1.010, 95%CI: 1.005-1.016) were independent risk factors for the severity of BPD, while the INSURE approach was a protective factor (OR=0.208, 95%CI: 0.060-0.923).</p><p><b>CONCLUSIONS</b>The severity of BPD is associated with various factors in preterm infants. The important measures for preventing BPD include avoiding the birth of preterm infants with a very low birth weight, shortening the duration of mechanical ventilation, preventing and reducing pulmonary infections, and applying the INSURE approach.</p>

Cellular and humoral immunity in preterm infants of different gestational ages / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the characteristics of immune function in newborn infants of different gestational ages.</p><p><b>METHODS</b>A total of 115 premature infants free of infection between June 1, 2012 and June 1, 2013 were divided into two groups according to their gestational age at birth: early preterm infant group (28-33+6 weeks, n=57) and late preterm infant group (34-36+6 weeks, n=58). Meanwhile, 88 full-term infants (37-41+6 week) were recruited to the control group. Venous blood samples were collected within 24 hours after birth. The percentages of lymphocyte subsets, such as CD3+, CD4+, CD8+, and CD19+ T cells and natural killer (NK) cells were measured by flow cytometry, and the absolute count of each population was calculated using the results from routine blood work. Concentrations of serum IgG, IgA, and IgM were measured by immunoturbidimetry.</p><p><b>RESULTS</b>Both preterm infant groups had significantly higher percentages of CD3+ and CD4+ T cells and CD4+/CD8+ ratio (P<0.05) and significantly lower percentages of CD8+ and CD19+ T cells and NK cells (P<0.05), as compared with the full-term infant group. The absolute counts of total lymphocytes, CD3+, CD4+, CD8+, and CD19+ T cells, and NK cells in both preterm infant groups were significantly lower than those in the full-term infant group (P<0.05), and the above parameters in the late preterm infant group were significantly higher than those in the early preterm infant group (P<0.05). Both preterm infant groups showed significantly lower concentrations of serum IgG than the full-term infant group (P<0.05), while no significant differences in concentrations of serum IgA and IgM were observed between the three groups (P>0.05).</p><p><b>CONCLUSIONS</b>Neonatal gestational age has an effect on cellular and humoral immunity. The immune function gradually improves with increasing gestational age.</p>

Efficacy of inhaled nitric oxide in premature infants with hypoxic respiratory failure / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the safety and efficacy of low-concentration inhaled nitric oxide (NO) in the treatment of hypoxic respiratory failure (HRF) among premature infants.</p><p><b>METHODS</b>Sixty premature infants (gestational age ≤ 34 weeks) with HRF were randomized into NO and control groups between 2012 and 2013, with 30 cases in each group. Both groups received nasal continuous positive airway pressure (nCPAP) or mechanical ventilation. NO inhalation was continued for at least 7 days or until weaning in the NO group. The general conditions, blood gas results, complications, and clinical outcomes of the two groups were analyzed.</p><p><b>RESULTS</b>The NO group showed significantly more improvement in blood gas results than the control group after 12 hours of treatment (P<0.05). After that, the change in oxygenation status over time showed no significant difference between the two groups (P>0.05). There were no significant differences in total time of assisted ventilation and duration of oxygen therapy between the two groups (P>0.05). The incidence of bronchopulmonary dysplasia (BPD), patent ductus arteriosus, necrotizing enterocolitis, retinopathy of prematurity, and pneumothorax in infants showed no significant differences between the NO and control groups (P>0.05), but the incidence of IVH and mortality were significantly lower in the NO group than in the control group (7% vs 17%, P<0.05; 3% vs 13%, P<0.05).</p><p><b>CONCLUSIONS</b>NO inhalation may improve oxygenation status and reduce the mortality in premature infants with HRF, but it cannot reduce the incidence of BPD and the total time of mechanical ventilation or nCPAP and duration of oxygen therapy. NO therapy may have a brain-protective effect for premature infants with HRF and does not increase clinical complications.</p>

Preliminary study on IL-7Rα intervening acute graft-versus-host disease after mice allogeneic bone marrow transplantation / 白血病·淋巴瘤

Objective To establish a mouse model of acute graft-versus-host disease (aGVHD) after allogeneic bone marrow transplantation,and using exogenous interleukin-7 receptor alpha (IL-7Rα) intervene mice aGVHD and analyse its possible mechanism.Methods The BALB/C (H-2d) female mice as recipients were grouped by rat: the irradiation group (group A),irradiation transplantation group (group B) and IL-7Rα in the intervention group (group C),each 10.ALL mice were accepted 9 Gy60Co total body irradiation.1×107 bone marrow cells and 2×107 spleen cells of donor C57BL/6 (H-2b) via the tail vein were infused to recipient mice.The signs of the recipient mice,hematopoietic functional recovery and survival time of change,and pathology,chimerism and cytokine levels in checkwere observed.Results Mice in A group after irradiation were gradually death,in group B and group C mice after transplantation had typical aGVHD symptoms,but lighter signs and a longer survival time of Group C than in group B.WBC count in Group C was +14 d (4.53± 0.21) ×109/L,+21 d (3.63±0.06) ×109/L,+28 d (4.31±0.04) ×109/L,was hematopoietic recovery compared with Group B [+14 d (1.81±0.05) ×109/L,+21 d (1.32±0.04) ×109/L,+28 d (1.76±0.04) ×109/L],the difference was statistically significant (t =0.237,0.108,0.359,P ＜ 0.05).The pathological results of liver,spleen,skin histopathology in group C were better than group B.Chimera implants,plasma IL-7 levels after transplant +7 d,concentration was significantly increased.IL-7 concentration in group C was +14 d (194.32±1.02) pg/ml,+21 d (131.63±1.54) pg/ml and in group B was +14 d (330.24±8.08) pg/ml,+21 d (184.09±2.05) pg/ml,the difference was statistically significant (t =1.590,1.285,P ＜0.05).Conclusion The stable aGVHD mouse model was established.In aGVHD early,plasma IL-7 levels were significantly increased.Exogenous IL-7Rαcan reduce the plasma IL-7 levels,thereby reducing the incidence of aGVHD after allogeneic bone marrow transplantation.

Effect of interstitial chemotherapy with ricin temperature-responsive gel for anti-breast cancer and immune regulation in rats / 中国结合医学杂志

<p><b>OBJECTIVE</b>To explore the effect of ricin temperature response gel on breast cancer and its regulatory effect on immune function in rats.</p><p><b>METHODS</b>Ricin was purified by chromatography and identified by immunoblotting. The rat subcutaneously transplanted breast cancer model was established. Forty model rats with a tumor diameter of about 3.0 cm were subjected to the study. They were randomized into four groups equally: the model group and three treated groups (blank gel, ricin, ricin-gel) were administered with blank gel, ricin, and ricin temperature response gel via percutaneous intratumor injection, respectively. The tumor was isolated 10 days later for the estimation of tumor inhibition rate (TIR) by weighing, pathologic examination, and detection of tumor apoptosis-associated genes bcl-2 and bax with semiquantitative RT-PCR. Also, peripheral blood was obtained to test T-lymphocyte subsets, the killing function of lymphocytes, and the contents of tumor necrosis factor-α (TNF-α) and interleukin-2 (IL-2). The outcomes were compared between groups.</p><p><b>RESULTS</b>The TIR in the ricin-gel group was 61.8%, with the pathologic examination showing extensive tumor tissue necrosis. Compared with the model group, after ricin temperature response gel treatment, bcl-2 expression was down-regulated, bax expression was up-regulated, CD4+ lymphocytes and CD4+/CD8+ ratio in peripheral blood were increased, the killing function of lymphocytes was enhanced, and the contents of TNF-α and IL-2 were elevated (P < 0.05 or P < 0.01).</p><p><b>CONCLUSION</b>Intratumor injection of ricin temperature-responsive gel showed significant antitumor effect on breast cancer and could enhance the immune function in the tumor-bearing rat.</p>

Research on drug resistance and expression of connexin 43 in bone marrow of patients with acute leukemia / 白血病·淋巴瘤

[Objective] To detect the expression levels of connexin43(Cx43),P-gp and COX-2 in bone marrow of patients with acute leukemia (AL),and investigate their relationship with the pathogenesis,prognosis and resistance of this condition.[Methods]Using SYBR green real-time quantitativereverse transcription polymerase chain reaction (SYBR-RT-PCR),the expression of Cx43,P-gp and COX-2 mRNA were detected in 77 AL patients at different phases,including 36 initially-treated,20 complete-remission (CR)and 20 relapsed.A follow-up was done in those initially lreated.[Results]Expression levels of Cx43,P-gp and COX-2 mRNA from initially-treated were 0.52±0.57,1.42 ±1.06,1.14±0.95;those from relapse AL patients were 0.20±0.40,2.29 ±1.11,1.69±0.81,respectively,those from CR patients were 0.95±0.37,0.93±-0.73,0.79±0.58,respectively,those from normal patients were 1.16 ±0.67,0.86±0.63,0.61±0.57.Expression levels of Cx43 mRNA in initially-treated and relapse AL patients were significantly lower than those in normal patients and CR patients(initially-treated P were 0.001,0.005;relapse patients were P＜0.001),while the comparison between normal patients and CR patients showed no statistical significance(P=0.185).Cx43mRNA expression level was negatively correlated with P-gp and COX-2 mRNA,and a negative correlation was noted of both two expressions in initially-treated and relapse groups (Cx43 mRNA and P-gp mRNA r were -0.471,-0.362,-0.526;Cx43 mRNA and COX-2 mRNA r were -0.479,-0.344,-0.471).A follow-up of four months was conducted in 36 initially-treated patients,eight of them died.The expression Cx43 in those who died was lower than that who survived.The difference was significant(t=2.16,P=0.042).[Conclusion] Cx43mRNA expression levels of initially-treated and relapse AL patients were lower than those in normal patients and CR patients,P-gp and COX-2 mRNA expression levels of initially-treated and relapse AL patients were higher than those in normal patients and CR patients.Cx43 expre-ssion probably is a favorable prognostic factor.Cx43 is participation in the genesis,development and drug resistance of AL.

Prophylactic effect of TLR5 agonist flagellin on acute graft versus host disease after allogeneic hematopoietic stem cell transplantation and its mechanism / 中国实验血液学杂志

This study was aimed to investigate the prophylactic effect of Toll like receptor (TLR)5 agonist flagellin on acute graft versus host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and its possible mechanism. The animal model with allo-HSCT aGVHD was established by using purebred mice (male mouse C57BL/6 as donor, female mouse BALB/c as recipient) with complete-unidentical major histocompatibility antigen. The recipient mice were randomly divided into 3 groups: group 1 in which mice were injected with high purity (95%) flagellin before and after allo-HSCT respectively, group 2 in which mice received allo-HSCT without injection of flagellin, group 3 in which mice were radiated alone. The aGVHD features of mice in group 1 and 2 were observed and compared. The results showed that the typical symptoms of aGVHD appeared in transplanted mice. The death peak of mice in group 2 appeared at day 4-5 after transplantation. The aGVHD symptoms were obviously alleviated and the mean survival time was prolonged significantly in mice group 1 as compared with mice in group 2 (P < 0.05). The comparison of WBC count in peripheral blood of mice in 3 groups before transplantation showed no significant difference (P > 0.05), while WBC count of mice in group 1 and 2 showed the significant difference at days 14 and 21 after transplantation (P < 0.05). The pathological appearances of aGVHD in mice of group 1 were obviously reduced as compared with mice in group 2. The flow cytometric detection of Treg cell/CD4(+) T cell levels at different time before and after transplantation demonstrated that the Treg cell level in mice of group 1 at weeks 2-4 after transplantation significantly increased as compared with mice in group 2 (P < 0.05). It is concluded that flagellin can effectively prevent the aGVHD occurrence after allo-HSCT, reduce the symptoms and pathological changes of aGVHD, obviously prolong mean survival time of mice in group 1. The mechanism of flagellin effect may be associated to increase of Treg cell level in mice after allo-HSCT.