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OBJECTIVE@#To analyze the clinicopathological features, molecular changes and prognostic factors in angioimmunoblastic T-cell lymphoma (AITL).@*METHODS@#Sixty-one cases AITL diagnosed by Department of Pathology of Peking University Cancer Hospital were collected with their clinical data. Morphologically, they were classified as typeⅠ[lymphoid tissue reactive hyperplasia (LRH) like]; typeⅡ[marginal zone lymphoma(MZL)like] and type Ⅲ [peripheral T-cell lymphoma, not specified (PTCL-NOS) like]. Immunohistochemical staining was used to evaluate the presence of follicular helper T-cell (TFH) phenotype, proliferation of extra germinal center (GC) follicular dendritic cells (FDCs), presence of Hodgkin and Reed-Sternberg (HRS)-like cells and large B transformation. The density of Epstein-Barr virus (EBV) + cells was counted with slides stained by Epstein-Barr virus encoded RNA (EBER) in situ hybridization on high power field (HPF). T-cell receptor / immunoglobulin gene (TCR/IG) clonality and targeted exome sequencing (TES) test were performed when necessary. SPSS 22.0 software was used for statistical analysis.@*RESULTS@#Morphological subtype (%): 11.4% (7/61) cases were classified as type Ⅰ; 50.8% (31/61) as type Ⅱ; 37.8% (23/61) as type Ⅲ. 83.6% (51/61) cases showed classical TFH immunophenotype. With variable extra-GC FDC meshwork proliferation (median 20.0%); 23.0% (14/61) had HRS-like cells; 11.5% (7/61) with large B transformation. 42.6% (26/61) of cases with high counts of EBV. 57.9% (11/19) TCR+/IG-, 26.3% (5/19) TCR+/IG+, 10.5% (2/19) were TCR－/IG－, and 5.3% (1/19) TCR－/IG+. Mutation frequencies by TES were 66.7% (20/30) for RHOA, 23.3% (7/30) for IDH2 mutation, 80.0% (24/30) for TET2 mutation, and 33.3% (10/30) DNMT3A mutation. Integrated analysis divided into four groups: (1) IDH2 and RHOA co-mutation group (7 cases): 6 cases were type Ⅱ, 1 case was type Ⅲ; all with typical TFH phenotype; HRS-like cells and large B transformation were not found; (2) RHOA single mutation group (13 cases): 1 case was type Ⅰ, 6 cases were type Ⅱ, 6 cases were type Ⅲ; 5 cases without typical TFH phenotype; 6 cases had HRS-like cells, and 2 cases with large B transformation. Atypically, 1 case showed TCR－/IG－, 1 case with TCR－/IG+, and 1 case with TCR+/IG+; (3) TET2 and/or DNMT3A mutation alone group (7 cases): 3 cases were type Ⅱ, 4 cases were type Ⅲ, all cases were found with typical TFH phenotype; 2 cases had HRS-like cells, 2 cases with large B transformation, and atypically; (4) non-mutation group (3 cases), all were type Ⅱ, with typical TFH phenotype, with significant extra-GC FDC proliferation, without HRS-like cells and large B transformation. Atypically, 1 case was TCR－/IG－. Univariate analysis confirmed that higher density of EBV positive cell was independent adverse prognostic factors for both overall survival (OS) and progression free survival(PFS), (P=0.017 and P=0.046).@*CONCLUSION@#Pathological diagnoses of ALTL cases with HRS-like cells, large B transformation or type Ⅰ are difficult. Although TCR/IG gene rearrangement test is helpful but still with limitation. TES involving RHOA, IDH2, TET2, DNMT3A can robustly assist in the differential diagnosis of those difficult cases. Higher density of EBV positive cells counts in tumor tissue might be an indicator for poor survival.
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Humans , Epstein-Barr Virus Infections/genetics , Herpesvirus 4, Human/genetics , T-Lymphocytes, Helper-Inducer/pathology , Immunoblastic Lymphadenopathy/pathology , Lymphoma, T-Cell, Peripheral/pathology , Receptors, Antigen, T-CellABSTRACT
Objective:In the era of precision medicine, there is an urgent need for a preclinical evaluation method with a high cost-benefit ratio to improve the effectiveness and value of clinical trials.Methods:Taking clinical needs and scientific research purposes as the starting point, the platform focused on four aspects of project management, information retrieval, quality control, and practical application, and introduced in detail the management practice of building a patient-derived xenograft model platform system.Results:With the support of the institutional system, quality control system, and information system, the patient-derived xenograft model platform was formed with standardization as the core. With the assistance of this platform and scientific research management, as of December 2021, there are 48 animal models of patient-derived xenograft in the database. In total of 6 SCI scientific and technological articles were published using these animal models, with a total impact factor of 36.77 (the highest single article was 7.333). In total of 6 direct industrial projects, 6 clinical trial-related projects, and 4 NSFC projects were approved with a total research fund of 1.5 million yuan.Conclusions:Continuous construction and improvement of the existing platform will help promote the development of basic research translation and clinical research in the field of oncology, and accelerate the development of new oncological diagnosis and treatment models, thereby benefiting more patients.
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Objective:Considering the large amount and poor quality of clinical data, this study aims to explore the establishment of high-quality research database and its role in real-world research by taking the establishment of lymphoma research database as an example.Methods:The expert opinions in the field of lymphoma were collected, and the relevant guidelines and standards were referenced to establish a standard medical knowledge dataset. The electronic diagnosis and treatment data of lymphoma patients treated in Peking University Cancer Hospital from February 2005 to December 2020 were retrospectively extracted, the deep Learning, natural language processing were adopted to build a dynamic intelligent information integration and processing system of " lymphoma database based on electronic medical record system - biological sample information database - extended genetic information database" .Results:The research database not only meets the research needs of clinical researchers, but also realizes the management of traces in the whole process of application, approval, traceability and analysis of hospital medical record data and biological sample data. The total number of research variables in the database was 668, and the structured variables accounted for 46.0%. On December 25, 2021, there were 68 687 lymphoma patients in the database, the ratio of male to female patients was 8/9, and the proportion of patients with ≥3 visits accounted for 23.0%. In addition, researchers can superimpose searches in the database according to the target conditions, display the targeted medical records according to research hypothesis, and then establish a research cohort, conducting statistical modeling, and mining data information.Conclusions:By integrating management processes and using new natural language artificial intelligence technology to establish a high-level evidence-based database, it is helpful for the interconnection and resource sharing of hospital information systems, so as to achieve the purpose of providing reliable and detailed data for real-world research.
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Objective@#To analyze the characteristics of the second primary tumor affecting the survival of patients with lymphoma, and to explore the risk factors of death from the second primary tumor.@*Methods@#The medical records and related death information of 1 173 lymphoma patients who had already died with known causes were collected. The basic causes of death and the characteristics of patients who died of the second primary tumor were analyzed. Cox regression model was used to analyze the risk factors of lymphoma patients who died of the second primary tumor.@*Results@#Among the 1 173 patients who had died, 94 (8.0%) died of the second primary tumor, 935 (79.7%) died of the primary lymphoma and 144 (12.3%) died of other diseases. The second primary tumor accounted for 17.5% (38/217) of all causes of death in patients with the survival period of more than 5 years, and the second primary tumor accounted for 28.3% (17/60) of all causes of death in patients with the survival period of more than 10 years. Among 94 cases who died of second primary tumors, 31 died of lung cancer, 15 died of gastric cancer, 13 died of liver cancer, 9 died of pancreatic cancer, 6 died of colorectal cancer, 6 died of second primary lymphoma and 14 died of other types of tumors. Univariate Cox regression analysis showed that age, first-line treatment effect, and chest or mediastinal radiotherapy were associated with the death from second primary tumors for lymphoma patients (all P<0.05). Multivariate Cox regression analysis showed that the effect of first-line treatment (P=0.030) and the chest or mediastinal radiotherapy (P=0.039) were independent factors for the death of lymphoma patients from the second primary tumor.@*Conclusions@#The second primary tumor is an important factor affecting the survival of lymphoma patients, and the risk of death from second primary tumors increases significantly over time. The effect of first-line treatment and radiotherapy in the chest or mediastinum are independent factors for the death of lymphoma patients from the second primary tumor.
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Objective@#To evaluate the clinical characteristics and survival outcomes of patients with de novo grade 3 or transformed follicular lymphoma (FL).@*Methods@#Fifty-two patients treated at Peking University Cancer Hospital between January 2009 and September 2017 were assessed, including 28 patients with FL 3A grade, 13 patients with FL 3B grade, 11 patients with transformed FL. Baseline characteristics, survival and prognostic factors were analyzed.@*Results@#① Twenty-six male and 26 female patients were enrolled, including 28 patients with FL 3A grade, 13 patients with FL 3B grade, 11 patients with transformed FL. ②The 3-year progression-free survival (PFS) and overall survival (OS) for the entire cohort were 56.0% and 80.6%, respectively. Patients with international prognostic index (IPI) score 0-1 demonstrated significantly better 3-year PFS (80.3% vs 20.1%; t=18.902, P<0.001) and OS (95.7% vs 57.0%; t=10.406, P<0.001) than patients with IPI score 2-3. Three-year PFS (94.1% vs 37.2% vs 25.2%; P=0.002) and OS (100.0% vs 76.0% vs 59.8%; P=0.020) were also significantly different among patients with FLIPI 1 score 0-1, 2, ≥3. FLIPI 2 score was also identified as a prognostic factor for 3-year PFS (68.4%, 0, 0; P=0.001) and OS(87.5%, 76.2%, 0; P=0.003). ③Multivariate analysis indicated a significant association of PFS (HR=3.536, P=0.015) and OS (HR=15.713, P=0.015) with IPI. FLIPI 2 was associated with OS (score 0-1, HR=0.078, P=0.007; score 2, HR=0.080, P=0.022).@*Conclusion@#De novo grade 3 or transformed FL might be a group of curable disease with current treatment strategies. IPI is still a prognostic tool in this scenario.
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Objective@#To evaluate the prognostic value of 18F-fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) in patients with diffuse large B cell lymphoma (DLBCL) undergoing autologous hematopoietic stem cell transplantation (auto-HSCT).@*Methods@#Forty-eight patients with DLBCL treated at Peking University Cancer Hospital between November 2010 and December 2014 were assessed. All patients underwent PET/CT scanning prior to or after auto-HSCT. Correlation analysis was done based upon patients characteristics, PET/CT scan results and survival.@*Results@#①Among 48 patients, 27 was male, 21 female, median age was 43 (17-59) years old. ② Patients with negative pre-auto-HSCT PET/CT assessment demonstrated significantly better 3-year progression free survival (PFS) (87.1% vs 53.3%, χ2=7.02, P=0.019) and overall survival (OS) (90.3% vs 60.0%, χ2=6.51,P=0.022) than patients with positive pre-auto-HSCT PET/CT assessment. Three-year PFS (94.1% vs 30.0%, χ2=22.75, P=0.001) and OS (97.1% vs 40.0%, χ2=21.09, P=0.002) were also significantly different between patients with negative and positive post-auto-HSCT PET/CT assessment. ③ Multivariate analysis indicated a significant association of PFS (HR=13.176, P=0.005) and OS (HR=20.221, P=0.007) with post-auto-HSCT PET/CT assessment. Number of prior treatment regimens was associated with PFS (HR=10.039, P=0.040). ④ Harrell’s C index revealed that the value of combined use of number of prior treatment regimens and post-auto-HSCT PET/CT assessment was superior to either one used alone in PFS (Harrell’s C values were 0.976, 0.869 and 0.927 in combined use, number of prior treatment regimens and post-auto-HSCT PET/CT assessment, respectively), and the combined use of ECOG performance status and post-auto-HSCT PET/CT assessment significantly increased the Harrell’s C index in OS (Harrell’s C values were 0.973, 0.711 and 0.919 in combined use, ECOG performance status and post-auto-HSCT PET/CT assessment, respectively).@*Conclusions@#Post-auto-HSCT PET/CT assessment is the main predictor of outcomes in DLBCL patients receiving auto-HSCT. Combined use of post-auto-HSCT PET/CT assessment and number of prior treatment regimens and ECOG performance status is a better prognostic tool in patients with DLBCL undergoing transplantation.
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Objective To evaluate the efficacy,safety of rigid gas permeable contact lens (RGPCL) wearing for over 5 years in different degrees of keratoconus eyes.Methods A retrospective case study was performed.The clinical data of 217 eyes with different degree of keratoconus from 126 keratoconus patients who fitted with RGPCL in Beijing Tongren Hospital from 2000-2010 over 5 years were analyzed.The eyes were divided into mild keratoconus group (Ks≤45.0 D),moderate keratoconus group (45.0 D＜ Ks ＜ 52.0 D) and severe keratoconus group (Ks ≥52.0 D) according to the severity.Uncorrected visual acuity (UCVA,LogMAR),spectacle corrected visual acuity (SCVA) and RGP corrected visual acuity (RGPVA) was examined before RGPCL wearing and the end of followingup after RGPCL wearing.The refraction,corneal curvature,corneal astigmatism were measured with auto-refractomer/keratometer and keratoconus screening analysis system of computer-assisted corneal topography.Comparisons of the changes of corrected visual acuity and corneal parameters were assessed.Results The RGPVA was 0.09±0.17,0.05±0.07 and 0.07 ±0.07 in the mild,moderate and severe keratoconus group,respectively,showing a significant difference among the three groups (F=0.522,P=0.594);The △Ks was (2.25±5.42),(0.26±3.44) and (-4.52±3.44)D,and △Kf was (2.06±4.98),(1.02±3.41) and (-2.03±5.05)D,and the change value of corneal astigmatism was (0.19±2.87),(-0.78±2.84) and (-2.44±3.77)D in the mild,moderate and severe keratoconus group(all at P＜ 0.05),respectively,with the minimum amount of change in the severe keratoconus group.The variation of differential sector index (△DSI) was-0.33 ± 1.64,0.14±3.01 and-2.11 ±4.28;the variation of center/ surround index (△CSI) was-0.41 ± 1.07,0.03±2.22 and-2.49±4.15;the variation of standard deviation of power (△SDP) was-0.43 ±0.64,-0.02 ±0.89 and-1.67 ± 1.68;the variation of keratoconus prediction index (△KPI)was 0.00±0.07,0.03±0.09 and-0.05±0.11 in the mild,moderate and severe keratoconus group,respectively,and the reduced amount in above parameters was much more in the severe keratoconus group than that in the mild and moderate keratoconus group (all at P＜0.01).Mild conjunctivitis and corneal affection occurred in 12 eyes (5.5％)during the follow-up.Conclusions Long-term wearing RGPCL can improve the visual acuity and slow the tendency of corneal curvature increase in keratoconus eyes,and this procedure is safe and effective for the correction of different degree of keratoconus.
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<p><b>OBJECTIVE</b>To study the role of integrin-linked kinase (ILK) on the proliferation and differentiation of human fibroblast in hypertrophic scar and its effect on the scar formation.</p><p><b>METHODS</b>The human scar fibroblasts were isolated and cultured in vitro. The cells were divided into 4 groups. (1) control group: only contains DMEM; (2) jetPRIME group: DMEM with 200 microl jetPRIME buffer and 4 microl jetPRIME; (3) ILK siRNA group: DMEM and ILK siRNA; (4) ILK cDNA group: DMEM and ILK cDNA. The cell proliferation was detected by XTT assay and the mRNA and protein expressions of ILK and alpha-SMA were detected by Real-time qPCR and Western blot.</p><p><b>RESULTS</b>(1) XTT results showed that the cellular proliferation level after 48 h in four groups were 0.820 +/- 0.065, 0.873 +/- 0.041, 0.554 +/- 0.013 and 1.296 +/- 0.094, respectively. The cellular proliferation curve showed that the cellular proliferation level was very flat in ILK siRNA group while the cellular proliferation level gradually increased from 12 h. 48 h after transfection, the cellular proliferation level in ILK siRNA group was significant lower than those in other groups (P value were 0.021, 0.034, 0), while the cellular proliferation level in ILK cDNA group was the highest among all 4 groups (P value were 0.017, 0.009, 0). (2) The Real-time qPCR showed that the expressions of ILK mRNA and alpha-SMA mRNA were 0.693 +/- 0.412 and 0.422 +/- 0.037 in control group, were 0.621 +/- 0.183 and 0.388 +/- 0.005 in jetPRIME group, were 0.052 +/- 0.019 and 0.073 +/- 0.023 in ILK siRNA group, were 240.193 +/- 35.170 and 138.056 +/- 24.060 in ILK cDNA group. The expressions of ILK mRNA and alpha-SMA mRNA in ILK siRNA group were significantly lower than those in other three groups (P < 0.05). And the expressions of ILK mRNA and alpha-SMA mRNA in ILK cDNA group were significantly higher than those in other three groups (P < 0.05). (3) The Western blot also showed that the expression of ILK and alpha-SMA proteins were decreased in ILK siRNA group and increased in ILK cDNA group.</p><p><b>CONCLUSION</b>ILK may promote the proliferation and differentiation of human scar fibroblast. It may play an important role in scar formation and contracture.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Actins , Metabolism , Cell Differentiation , Cell Proliferation , Cells, Cultured , Cicatrix, Hypertrophic , Metabolism , Fibroblasts , Cell Biology , Metabolism , Protein Serine-Threonine Kinases , Pharmacology , RNA, Messenger , Genetics , TransfectionABSTRACT
Background Traction of epiretinal membrane results in macular morphologic change and visual functional impairment in eye with idiopathic epiretinal membrane (IERM),therefore figuring out their relationship is helpful for evaluation of disease prognosis.Objective This study was to observe the morphological change of macula and microstructure,and analyze the relationship between retina thickness,integrity of cone outer segment tips (COST) line in fovea and visual acuity.Methods This was a retrospective case-observational study.Fifty-six consecutive cases diagnosed as IERM in Zhongshan Ophthalmic Center from March 2011 to December 2011 were enrolled in this study,and all the patients showed unilateral IERM with the normal fellow eyes.Sixteen patients were males and 40 were females,with a mean age of (61.05 ± 6.58) years old.Spectral-domain optical coherence tomography (SD-OCT) examination was performed on the eyes,and Macular Cube (512×128) and HD 5 Line program were selected.Mean retinal thickness of central area (＜1 mm diameter),inner ring area (1-3 mm diameter) and outer ring area (＞3-6 mm diameter) of macula and the status of COST line (intact or fractured) was recorded.Mean thickness of whole macular areas and the difference of foveal microstructure were compared,and the correlation between retinal thickness and visual acuity was analyzed using Pearson linear correlation analysis.Related parameters including age,visual acuity,retinal thickness were also compared between the continuous COST lines group and the fractured COST lines group by independent sample t test.Results The flatted or disappeared fovea was seen in IERM eyes on the SD-OCT image.Retinal thicknesses were (446±89)μm,(418±64)μm and (328±34)ttm in the central area,inner ring area and outer ring area of macula in the IERM eyes,exhibiting significant increasing in comparison with (250±22) μm,(319±17) μm and (279±17) μm in the normal fellow eyes (t=13.370,9.523,7.769,all P =0.000).Significantly negative correlations were found between the visual acuity and the central macular thickness,inner ring thickness or outer ring thickness (r=-0.686,-0.653,-0.417,P＜0.05).In the IERM eyes,COST band was intact in 20 eyes and lack in 36 eyes.Compared with COST band intact group,aging,worse vision and increased retinal thickness were seen in the COST band absent group (t =2.109,P =0.039 ; t =-4.093,P =0.000 ; t =6.669,P=0.000;t=5.376,P=0.000;t=4.247,P=0.000).COST band was clear in all the normal fellow eyes on the SD-OCT image.Conclusions Increase of macular thickness and disruption of COST band reflect the visual function damage in IERM eye.Deficiency of COST band on OCT image seems to be an early indication of photoreceptor damage.Incomplete fovea COST band is often seen in older patients.
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<p><b>OBJECTIVE</b>To explore the expression of integrin-linked kinase (ILK) in fibroblasts (Fbs) of scar induced by cobalt chloride (CoCl2) and its effect on cell proliferation.</p><p><b>METHODS</b>The human hypertrophic scar Fbs of seven patients were isolated and cultured in vitro. Cells from the 5th to the 6th passages were used in the experiment. Six bottles of Fbs were obtained from each of the seven patients, and they were respectively cultured with DMEM nutrient solution containing CoCl2 in the concentration of 0, 50, 100, 150, 200, and 250 µmol/L for 24 h. The expression of ILK mRNA was determined with real-time fluorescence quantitative PCR. Fbs were stimulated by CoCl2 in the most suitable concentration (100 µmol/L) and the protein expression of ILK was determined 0, 1, 2, 4, 12, and 24 h after the stimulation. Then the Fbs were divided into control group (cultured with nutrient solution), negative control group (transfected with con-siRNA), and ILK siRNA group (transfected with ILK siRNA). They were cultured with nutrient solution containing CoCl2 in different concentrations 24 h after transfection, with 4 wells for each concentration in each group. The cell proliferation was detected by XTT assay. Data were processed with one-way analysis of variance (ANOVA) and ANOVA for repeated measurement, and LSD method was used in multiple comparisons.</p><p><b>RESULTS</b>The expression level of ILK mRNA was highest in Fbs cultured with 100 µmol/L CoCl2 for 24 h, with significant difference compared with those of Fbs cultured with other concentrations of CoCl2 (F = 50.958, P < 0.001). The expression of ILK protein in Fbs cultured with 100 µmol/L CoCl2 for 1 h (0.243 ± 0.009) was lower than that cultured for 0 h (0.387 ± 0.017), and it started to increase from 2 h (0.361 ± 0.010), and exaggerated at 4 h (0.584 ± 0.028), 12 h (0.730 ± 0.029), and 24 h (0.785 ± 0.031). The expression levels of ILK protein at 1, 4, 12, 24 h were statistically different from that at 0 h (P values all below 0.05). XTT showed that cell proliferation level was highest in control group when cultured with 100 µmol/L CoCl2 (F = 488.026, P < 0.001), which decreased from 150 µmol/L. The cell proliferation level in control group cultured with 250 µmol/L CoCl2 was significantly lower than that with 0 µmol/L (P values all below 0.05). There was no significant change in cell proliferation in ILK siRNA group among different concentrations of CoCl2 (F = 2.542, P = 0.056). The cell proliferation level in ILK siRNA group was significantly lower than that in control group and negative control group (F = 2519.542, P < 0.001).</p><p><b>CONCLUSIONS</b>ILK may be a key protein in response of hypoxia in Fbs. The mild hypoxia can stimulate the expression of ILK and promote the proliferation of Fbs, while severe hypoxia can reduce the expression of ILK and inhibit cell proliferation.</p>
Subject(s)
Humans , Cell Proliferation , Cells, Cultured , Cicatrix , Metabolism , Pathology , Cobalt , Pharmacology , Fibroblasts , Metabolism , Pathology , Protein Serine-Threonine Kinases , MetabolismABSTRACT
Objective To investigate the vaginal flora characteristics,clinical symptoms and signs of lactating women 6-8 weeks after delivery and the influence factors.Methods Two hundred and twenty-three puerpera 6-8 weeks after delivery who went to outpatient department of Peking University First Hospital for postpartum review (study group) and 200 normal non-pregnant women (control group) from April to May,2010 were enrolled into this study.All in study group were evaluated by a questionnaire regarding their symptoms,sexual behavior,breast-feeding situation and delivery mode.Vaginal secretions from upper 1/3 of vagina were collected and evaluated by vaginal microbial evaluation system.Bacterial vaginosis (BV) was diagnosed if Nugent score ≥ 7.Enumeration data between groups was compared by t test,and quantitative data by Chi-square test.Results The density of vaginal flora in study group was different from that of control group (x2 =96.302,P＜0.001) ; so did the flora diversity of two groups (x2 =69.871,P＜0.001).There was no difference between mean age of study group [(30.5 ± 3.9) years] and control group [(30.9 ± 2.4)years],P＞0.05.The cesarean section rate was 52.7％ (89/169),13 women (7.7％) had began their sexual behavior before interview,116 women (70.3％) took breast-feeding.Dominant bacteria in the vagina of lactating women were Gram-positive cocci (69/175,39.4％) and Gram-positive bacillus (54/175, 30.9％), which was different from control group (Gram-positive bacillus,180/189,95.2％),P＜0.001.The vaginal pH of study group was 5.0±0.5,which was higher than that (＜4.5) of control group.In study group,incidence of lower hydrogen peroxide level of vagina was 84.3 ％ (177/210) ; positive rate of sialidase was 6.7 ％ (14/210) ; positive rate of leukocyte esterase was 91.0％ (191/210).A large number of postpartum women had an abnormal Nugent score,most of them showed a state of intermediate BV (132/195,67.7％) or BV (8/195,4.1％),while a few patients had symptoms of BV (23.5％,33/140).Sexual behavior had no significant effect on postpartum vaginal flora.The proportion of abnormal vaginal flora in breast feeding mothers (74.1 ％,86/116) was significantly higher than that (57.1％,28/49) in artificial feeding mothers,P=0.034.Delivery mode also affected postpartum vaginal flora.Women underwent cesarean section were more susceptible to abnormal vaginal flora (77.5％,69/89) than those underwent vaginal delivery (57.5％,46/80),x2 =7.726,P=0.005.Conclusions Vaginal flora of postpartum women 6-8 weeks after delivery had significant difference from that of nonpregnant women.The incidence of asymptomatic abnormal vaginal flora was high.Breastfeeding and delivery mode are influence factors of abnormal vaginal flora.
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Objective To evaluate the value of SPECT/CT in differentiating malignancy from benign spinal disease. Methods Fifty-three patients with foci of abnormally increased uptake in the spine detected by 99Tcm-MDP planar whole body bone scan subsequently underwent bone SPECT/CT. The final diagnosis was determined by pathological examination or clinical follow-up ( ≥6 months), which was applied to calculate the diagnostic efficacy of bone SPECT/CT. Results A total of 25 patients were confirmed to have bone malignancy. The diagnostic sensitivity, specificity, accuracy, false positive rate, false negative rate, positive predictive value and negative predictive value for 99Tcm-MDP bone SPECT/CT were 96.00% (24/25), 96.43% (27/28), 96.23% (51/53), 3.57% ( 1/28), 4.00% ( 1/25), 96.00% (24/25) and 96.43% (27/28), respectively. Conclusion 99Tcm-MDP bone SPECT/CT imaging provides good clinical value for the differential diagnosis of spinal diseases.
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<p><b>OBJECTIVE</b>To explore the expression of integrin-linked kinase (ILK) and its effect on VEGF expression in fibroblasts from human hypertrophic scar.</p><p><b>METHODS</b>Fibroblasts were isolated from hypertrophic scar of 8 patients and cultured in vitro. Then the cells were divided into three groups: (1) Cells were cultured only in DMEM containing 10% FCS in the control group; (2) Cells were transfected with empty plasmid in the empty plasmid group; (3) Cells were transfected with plasmid expressing ILKcDNA in the ILK cDNA plasmid transfection group. First, the expression of ILK and VEGF was observed by immunocytochemistry before and after ILK cDNA transfection. Second, ILK and VEGF mRNA expression was investigated by real-time PCR (RT-PCR). Third, the protein expression of ILK and VEGF was detected by Western blot. Finally, the protein level of VEGF in supernatant of fibroblasts was measured by ELISA.</p><p><b>RESULTS</b>Before ILK cDNA transfection, the expression of ILK was positive and the VEGF expression was weak in cytoplasm of fibroblasts . After ILK cDNA transfection, both the expression of ILK and VEGF was enhanced. The level of VEGF mRNA was significantly higher in ILK cDNA transfection group (0.338 +/- 0.060) than that in control group (0.022 +/- 0.001) and empty plasmid group (0.028 +/- 0.005, P < 0.05). The level of VEGF protein was significantly higher in ILK cDNA transfection group (0.819 +/- 0.019) than that in control group (0.607 +/- 0.033) and empty plasmid group (0. 591 +/- 0.024, P<0. 05). Secretion of VEGF increased remarkably in ILK cDNA transfection group comparing with the other two groups (P < 0.05).</p><p><b>CONCLUSIONS</b>ILK could up-regulate the VEGF mRNA and protein level in human scar fibroblasts. It may play an important role in the angiogenesis in hypertrophic scar.</p>
Subject(s)
Humans , Cells, Cultured , Cicatrix, Hypertrophic , Genetics , Metabolism , Pathology , Fibroblasts , Bodily Secretions , Plasmids , Protein Serine-Threonine Kinases , Genetics , RNA, Messenger , Genetics , Transfection , Vascular Endothelial Growth Factor A , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To explore the expression of integrin-linked kinase (ILK) in scar in different growth stages, as well as its relationship with angiogenesis.</p><p><b>METHODS</b>(1) Fifteen burn patients with scar formation time shorter than 6 months, ranging from 6 to 12 months, and longer than 12 months were hospitalized from December 2009 to December 2010. They were divided into A, B, and C groups according to the scar formation time, with 5 patients in each group. Scar specimens were harvested for observation of ILK expression with immunohistochemistry method, and ILK mRNA expression with real time fluorescence quantitative RT-PCR. (2) Microvascular endothelial cells (MEC) were isolated from scar tissue in A group and cultured in vitro, and then they were purified by immunomagnetic beads and identified with coagulation factor VIII marked by immunofluorescence (fibroblasts from human normal skin were used as control). The cultured cells in logarithmic growth phase were divided into control group (cultured with M131 medium containing microvascular growth supplement), transfection 1 group (transfected with empty plasmid), and transfection 2 group (transfected with ILK cDNA plasmid) according to the random number table. After 24 hours, the expressions of ILK mRNA, Flt-1 mRNA, and KDR mRNA were determined with real time fluorescence quantitative RT-PCR. Data were processed with one-way analysis of variance.</p><p><b>RESULTS</b>Immunohistochemical observation showed that ILK in A group mainly expressed in the basal layer cells of epidermis, cytoplasm of fibroblasts, and MEC in scar, while ILK in B group only distributed in the basal layer cells of epidermis, but ILK expression in C group was not obvious. The expression of ILK mRNA in A group (0.34 ± 0.16) was significantly higher than those in B and C groups (0.17 ± 0.06, 0.07 ± 0.13, F = 37.007, P = 0.000). MEC grew up showing cobble stone formation after purification. The expression of coagulation factor VIII was positive in cytoplasm of purified MEC, while that was negative in fibroblast of human normal skin. The expressions of ILK mRNA (57.807 ± 5.556), KDR mRNA (0.836 ± 0.014), and Flt-1 mRNA (0.162 ± 0.005) in transfection 2 group were higher than those in control and transfection 1 groups (0.018 ± 0.003, 0.028 ± 0.020, 0.023 ± 0.004 and 0.042 ± 0.005, 0.039 ± 0.007, 0.046 ± 0.003; F(ILK) = 87.110, F(KDR) = 11.241, F(Flt) = 18.199, with P values all below 0.01).</p><p><b>CONCLUSIONS</b>ILK mainly expressed in scar tissue with formation time shorter than 6 months, and it may affect vascularization of scar by regulating gene expressions of KDR and Flt-1 in MEC, which plays an important role in early scar formation.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Cells, Cultured , Cicatrix, Hypertrophic , Metabolism , Pathology , Endothelial Cells , Metabolism , Neovascularization, Pathologic , Metabolism , Pathology , Protein Serine-Threonine Kinases , Metabolism , Vascular Endothelial Growth Factor Receptor-1 , Metabolism , Vascular Endothelial Growth Factor Receptor-2 , MetabolismABSTRACT
Objective To investigate the role of electromyography(EMG) in diagnosis of nervous system diseases in children.(Met)-hods EMG tests were carried out in 354 patients with nervous system diseases,and the data and results of EMG tests were analyzed.Results One hundred and sixty-six patients′ results of EMG were abnormal.Among these abnormalities,36 cases were myogenic,47 cases were neurogenic,abnormalities of 69 cases were located in peripheral nerves,3 cases got positive in repetitive nerve stimulation(RNS),and 11 cases were on the borderline.In 36 myogenic patients,clinical diagnosis were as follow: progressive muscular dystrophy(PMD,18 cases),polymyositis(2 cases),mitochondrial encephalomyopathy(1 case), and the other 15 cases had no definite diagnosis.In 47 neurogenic patients,the diagnosis were spinal muscular atrophy(SMA,29 cases),sequela of poliomyelitis(2 cases),acute transverse myelitis(ATM,4 cases),and the other 12 patients had no definite diagnosis.In 69 cases of peripheral nerve abnormality,diagnosis were injury of brachial nerve(23 cases),hereditary motor sensory neuropathy(HMSN,2 cases),Guillain-Barre syndrome(GBS,9(ca)-ses),chronic inflammatory demyelinating polyradiculoneuropathy(CIDP,1 case),injury of facial nerve(4 cases),injury of common(pe)-roneal nerve(6 cases),metachromatic leukodystrophy(MLD,1 case),and the other 23 patients had no definite diagnosis.Three patients who got RNS positive were all diagnosed myasthenia gravis(MG),and ocular type(1 case),general type(2 cases).Eleven patients whose EMG results were borderline were all diagnosed indefinitely.One hundred and eighty-eight patients had normal results of EMG test.The diagnosis of these patients were included ocular MG(21 cases),cerebral palsy(CP,5 cases),ATM(2 cases),polymyositis((1 case)),and some other nervous system diseases(21 cases),and the other 138 were diagnosed indefinitely.Conclusions 1.EMG plays an important role in definite diagnosis of PMD,SMA,poliomyelitis and nerve injury;2.EMG can provide clue or basis in the differential(dia)gnosis of nervous system diseases which involved lower motor unit;3.EMG test has very low positive results in children with MG;(4.EMG) has little help in diagnosis of diseases involved upper motor unit only.