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BACKGROUND@#Radiation enteritis (RE) is a common complication of abdominal or pelvic radiotherapy, which when severe, could be life-threatening. Currently, there are no effective treatments. Studies have shown that mesenchymal stem cells (MSCs)-derived exosomes (MSC-exos) exhibit promising therapeutic effects in inflammatory diseases. However, the specific role of MSC-exos in RE and the regulatory mechanisms remain elusive. @*METHODS@#In vivo assay was carried out by injecting MSC-exos into the total abdominal irradiation (TAI)-induced RE mouse model. For in vitro assay, Lgr5-positive intestinal epithelial stem cells (Lgr5+ IESC) were extracted from mice, followed by irradiation along with MSC-exos treatment. HE staining was performed to measure histopathological changes. mRNA expression of inflammatory factors TNF-a and IL-6 and stem cell markers LGR5, and OCT4 were quantified by RT-qPCR. EdU and TUNEL staining was performed to estimate cell proliferation and apoptosis. MiR-195 expression in TAI mice and radiation-induced Lgr5+ IESC was tested. @*RESULTS@#We found that the injection of MSC-exos inhibited inflammatory reaction, increased stem cell marker expression, and maintained intestinal epithelial integrity in TAI mice. Furthermore, MSC-exos treatment increased the proliferation and simultaneously suppressed apoptosis in radiation-stimulated Lgr5+ IESC. MiR-195 expression increased by radiation exposure was decreased by MSC-exos therapy. MiR-195 overexpression facilitated the progress of RE by counteracting the effect of MSC-exos. Mechanistically, the Akt and Wnt/b-catenin pathways inhibited by MSC-exos were activated by miR-195 upregulation. @*CONCLUSION@#MSC-Exos are effective in treating RE and are essential for the proliferation and differentiation of Lgr5+ IESCs. Moreover, MSC-exos mediates its function by regulating miR-195 Akt b-catenin pathways.
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Objective:To probe into the influence of adhesive tape and string fixation on postoperative catheter-associated urinary tract infection(CAUTI) and comfort degree of patients undergoing percutaneous nephrolithotomy.Methods:A total of 106 cases of male urinary tract calculi patients undergoing percutaneous nephrolithotomy in Urology Department of First Affiliated Hospital of Zhengzhou University from January 2018 to April 2019 were selected. They were divided into the experimental group (55 cases) and the control group (51 cases) by random digits tbale method. The control group received platform fixation method, the experimental group implemented adhesive tape and string fixation method for catheter fixation. The incidence of CAUTI were compared between two groups, the catheter exposed length changes and catheter-related discomfort changes was also compared.Results:The incidence of CAUTI were 3.9%(2/51) in the experimental group, significantly lower than 16.7%(8/48) in the control group, the difference was statistically significant ( χ2=4.42, P<0.05). After 3 days, 5 days and 7 days of indwelling catheter, the catheter exposed length were (17.76 ± 1.41), (17.12 ± 1.28), (16.49 ± 1.63) cm, significantly longer than those in the control group (16.04 ± 1.96), (15.81 ± 1.78), (15.29 ± 1.96) cm ( t=5.00, 4.17, 3.32, all P<0.05); the catheter-related discomfort symptom scores at above mentioned time were 0.82 ± 0.09, 0.53 ± 0.07, 0.49 ± 0.08, significantly lower than those in the control group (1.17 ± 0.23, 0.92 ± 0.09, 0.77 ± 0.11), the differences were statistically significant ( t=2.10, 2.88, 2.46, all P<0.05). Conclusions:Adhesive tape and string fixation method for catheter fixation can reduce the incidence of CAUTI of patients with urinary tract calculi, improve the catheter fixed state as well as reduce the patient′s catheter-related discomfort.
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Objective:To explore the effects of video combined with action-oriented teaching on self-management skill and complications in patients with urinary calculus after indwelling tube, and to provide basis for improving the effect of clinical health education.Methods:A total of 100 patients with urinary calculus after indwelling double J tube from department of urological surgery of the First Affiliated Hospital of Zhengzhou University from March 2018 to October 2019 were divided into experimental group and control group, 45 cases in each group by ramdom digits table method. The patients in the control group recieved routine care and oral health education, the experimental group implemented video combined with action-oriented teaching. The levels of health self-management skill as well as complications were compared between the two groups.Results:After extubation, self-management behavioral scores, self-management cognitive scores, self-management environment scores and total scores in Adults Health Self-Management Skill Rating Scale were (54.26 ± 4.39), (57.22 ± 6.93), (39.91 ± 7.91), (151.39 ± 13.37) points, which were significantly higher than those in the control group (47.92 ± 6.96) , (52.69 ± 6.45), (34.63 ± 8.53), (135.24 ± 12.71) points, the difference were statistically significant ( t values were 2.64-6.04, all P<0.05). The total incidence of tube related complications was 39.1% (18/46) in the experimental group, which was significantly lower than that in the control group 61.2% (30/49). The incidence of lumbago, bladder irritation symptom and shematuria were 10.9% (5/46), 13.0% (6/46), 10.9% (5/46) in the experimental group, significantly lower than those in the control group 28.6% (14/49), 32.7% (16/49), 30.6%(15/49), the differences were statistically significant ( χ2 values were 4.63-5.56, all P<0.05). Conclusions:Video combined with action-oriented teaching can effectively improve self-management skill and reduce tube-related complications of patients with urinary calculi after indwelling double J tube.
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Neurosyphilis is one of the most serious clinical manifestations of syphilis. In recent years, more and more neurosyphilis cases have been reported in Chinese literature. However, the exact incidence of neurosyphilis is unknown, and there are still some key scientific problems urgent to be solved in clinical diagnosis and treatment, pathogenesis, and prevention and control of neurosyphilis. Therefore, in order to provide a reference for the prevention and treatment of neurosyphilis, this article proposes the CARE-NS strategy, including the following 6 aspects: Comprehensive management including multiple disciplinary treatment (C) , Alleviating neurological impairment and sequelae (A) , Risk factors and clinical epidemiology (R) , Etiology and pathogenesis (E) , New diagnostic indicators and strategies (N) , Social impact and cost-effectiveness analysis (S) .
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Objective:To investigate the phagocytosis of Treponema pallidum (Tp) by macrophages and the polarization direction of macrophages after Tp stimulation. Methods:Human THP-1 monocyte-derived M0 macrophages were stimulated with the Tp Nichols strain, and the phagocytosis of Tp by macrophages and changes in the intracellular structure of macrophages were observed by transmission electron microscopy and immunofluorescence staining. After 12-hour stimulation by Tp, Tp was removed, the M0 macrophages continued to be cultured for 24, 48, 72 hours and 6 days. Western blot analysis and immunofluorescence staining were performed to determine the expression of the M1 macrophage marker CD86 and M2 macrophage marker CD163, and enzyme-linked immunosorbent assay was conducted to detect levels of M1-type cytokines interleukin (IL) -12 p70, interferon (IFN) -γ, chemokine ligand 10 (CXCL10) , IL-6, tumor necrosis factor (TNF) -α and IL-1β, as well as the M2-type cytokine transforming growth factor (TGF) -β1 in the culture supernatant of macrophages. Dunnett- t test was used for multiple comparisons. Results:As transmission electron microscopy showed, after the stimulation by Tp, the macrophages extended pseudopodia and engulfed Tp, leading to swelling and obviously irregular hyperplasia of endoplasmic reticulum as well as enlargement of mitochondria. Moreover, after additional culture for 24, 48, 72 hours and 6 days, CD86 was highly expressed, but CD163 was lowly expressed in the Tp-treated macrophages; at 24 hours, the supernatant levels of IL-12 p70, IFN-γ, CXCL10, IL-6, TNF-α and IL-1β were significantly higher in the Tp-treated group than in the control group (all P<0.001) , but there was no significant difference in the TGF-β1 supernatant level between the 2 groups ( P>0.05) . Conclusions:After engulfment of Tp, the structures of endoplasmic reticulum and mitochondria in THP-1-derived macrophages markedly changed. Tp could induce the polarization of M0 macrophages into M1 macrophages, and phenotypic switch from M1 to M2 macrophage polarization was not observed within 6 days after Tp stimulation.
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Objective:To analyze the urodynamic and clinical features of detrusor underactivity(DU)in elderly men aged 60 years and over.Methods:Five hundred and seventy-three men aged 60 years and over underwent urodynamic measurements due to dysuria were retrospectively analyzed.According to the urodynamic parameters of bladder contractibility index(BCI)and bladder outlet obstruction index(BOOI), they were divided into the three groups: only detrusor underactivity(DU group)(BCI<100 and BOOI<20), only bladder outlet obstruction(BOO group)(BCI≥100 and BOOI≥40), and the combined non-DU and non-BOO group(NDB group)(BCI≥100 and BOOI<20). The urodynamic and clinical features were compared between the three groups.Results:The internalized 323 patients meeting inclusion and exclusion criteria were divided into 3 groups: 75 in the DU, 207 in the BOO and 41 in the NDB.The age was higher in DU and BOO groups than in NDB group( P<0.05). The DU group versus the NDB group showed the higher levels or values in the volume at first desire(FDV)[(279±80)ml vs.(238±72)ml], the proportions of incomplete bladder emptying(41% vs.17%), urine flow interruption(39% vs.15%)and retention(26% vs.7%), and the lower levels in the voiding efficiency(VE)[(61±32)% vs.(110±41)%], (all P<0.05). The DU group vs.the BOO group showed the increased levels or values in the FDV[(279±80)ml vs.(206±67)ml]and maximum cytometric capacity(MCC)(353±113 ml vs.281±94 ml)and the proportions of urine flow interruption(39% vs.22%), TURP(26% vs.6%), and retention(26% vs.14%), and the decreased levels or values in the VE[(61±32)% vs.(78±37%)], the proportions of DO(41% vs.77%), urgency(26% vs.43%)and nocturia(23% vs.39%)(all P<0.05). Conclusions:The main urodynamic and clinical features are manifested as the reduction of bladder sensation and bladder emptying rate, urine flow interruption, urinary retention and having a TURP history in elderly man with detrusor underactivity.The proportions of DU and BOO are increased along with aging.
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Objective@#To investigate the relationship between sleep beliefs and attitudes and sleep quality in patients with stable coronary heart disease.@*Methods@#Totally 390 patients with stable coronary heart disease were investigated by the Pittsburgh Sleep Quality Index (PSQI), Dysfunctional Beliefs and Attitudes about Sleep Scale-16(DBAS-16) and a general information questionnaire which was designed by researchers.@*Results@#48.2% of patients with stable coronary heart disease reported poor sleep quality at home, and the total score of PSQI was (7.99 ± 4.061), the total score of DBAS was (47.44 ± 9.77). Univariate anova showed that age (F=14.567, P<0.01), gender (H=16.657, P<0.01), marital status (F=4.706, P=0.031), job status (F=15.738, P<0.01) and the number of comorbid diseases (F=4.674, P=0.003),are factors affecting sleep quality. Pearson correlation analysis showed that there were significantly negative correlation between PSQI and DBAS (r=-0.260, P<0.01). Multiple Linear Regression showed that sleep beliefs and attitudes, gender, age, the number of comorbid diseases were influencing factors of sleep quality (R2=0.247, F=17.907, P<0.01).@*Conclusions@#The sleep quality at home in patients with stable coronary heart disease was closely related to sleep beliefs and attitudes. Nurses should pay more attention to the sleep quality of patients, correct their incorrect sleep cognition timely, and improve their sleep quality.
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Chimeric antigen receptor T (CAR-T) cell therapy is a novel cellular immunotherapy that is widely used to treat hematological malignancies, including acute leukemia, lymphoma, and multiple myeloma. Despite its remarkable clinical effects, this therapy has side effects that cannot be underestimated. Cytokine release syndrome (CRS) is one of the most clinically important and potentially life-threatening toxicities. This syndrome is a systemic immune storm that involves the mass cytokines releasing by activated immune cells. This phenomenon causes multisystem damages and sometimes even death. In this study, we reported the management of a patient with recurrent and refractory multiple myeloma and three patients with acute lymphocytic leukemia who suffered CRS during CAR-T treatment. The early application of tocilizumab, an anti-IL-6 receptor antibody, according to toxicity grading and clinical manifestation is recommended especially for patients who suffer continuous hyperpyrexia, hypotensive shock, acute respiratory failure, and whose CRS toxicities deteriorated rapidly. Moreover, low doses of dexamethasone (5-10 mg/day) were used for refractory CRS not responding to tocilizumab. The effective management of the toxicities associated with CRS will bring additional survival opportunities and improve the quality of life for patients with cancer.
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Objective To investigate the relationship between sleep beliefs and attitudes and sleep quality in patients with stable coronary heart disease. Methods Totally 390 patients with stable coronary heart disease were investigated by the Pittsburgh Sleep Quality Index (PSQI), Dysfunctional Beliefs and Attitudes about Sleep Scale-16(DBAS-16) and a general information questionnaire which was designed by researchers. Results 48.2% of patients with stable coronary heart disease reported poor sleep quality at home, and the total score of PSQI was (7.99 ± 4.061), the total score of DBAS was (47.44 ± 9.77). Univariate anova showed that age (F=14.567, P＜0.01), gender (H=16.657, P＜0.01), marital status (F=4.706, P=0.031), job status (F=15.738, P＜0.01) and the number of comorbid diseases (F=4.674, P=0.003),are factors affecting sleep quality. Pearson correlation analysis showed that there were significantly negative correlation between PSQI and DBAS (r=-0.260, P＜0.01). Multiple Linear Regression showed that sleep beliefs and attitudes, gender, age, the number of comorbid diseases were influencing factors of sleep quality (R2=0.247, F=17.907, P＜0.01). Conclusions The sleep quality at home in patients with stable coronary heart disease was closely related to sleep beliefs and attitudes. Nurses should pay more attention to the sleep quality of patients, correct their incorrect sleep cognition timely, and improve their sleep quality.
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Objective To detect sHLA-G expression in plasma exosomes in patients with colorectal cancer and evaluate its clinical significance.Methods Retrospective study.Plasma was collected from 52 primary CRC patients,20 colorectal polyps patients,20 inflammatory bowel disease patients and 25 healthy donors in the Taizhou Hospital of Zhejiang Province from May 2017 to August 2018.The exosomes were extracted by exoEasyMaxikit and identified by nanoparticle tracking analysis (NTA) and Western blot.Exosomal sHLA-G was detected by flow cytometry (FCM) and enzyme-linked immunosorbent assay (ELISA).The diagnostic values of exosomal sHLA-G detected by FCM and ELISA were assessed,and their diagnostic performances were compared with carcinoembryonic antigen (CEA) and carbohydrate antigen CA19-9 by ROC curve and Youden index.Results The peak size of exosomes extracted from plasma in CRC patients was 101.1 nm and Western blot showed these exosomes expressed marker CD63,CDS1,and TSG101.Exosomal sHLA-G of CRC patients [28.0(21.5-35.1)U/ml] was significantly higher than that in healthy controls[19.6(16.8-21.3) U/ml,U=143.0,P＜0.001],colorectal polyps patients[19.7(16.2-22.5)U/ml,U=180.0,P＜0.001] as well as inflammatory bowel disease patients[19.9(16.7-25.2)U/ml,U=197,P＜0.001].The postoperative sHLA-G level[19.6(17.8-26.3)U / ml,U=325.5,P=0.015] was significantly lower than that in pre-operation.Exosomal sHLA-G was significantly different in different tumor status(U=64.0,P=0.006),lymph node metastasis (U=81.0,P=0.003) and TNM stage (U=105.0,P=0.015) in patients with CRC.ROC curve showed the area under the curve (AUC) of exosomal sHLA-G detected by FCM and ELISA,CEA and CA19-9 was 0.962±0.019,0.899±0.038,0.786±0.058,0.680±0.068,respectively.The difference of AUC was operated by Z test,and it showed that the exosomal sHLA-G detected by FCM was superior to CEA(Z=2.884,P=0.004)and CA19-9(Z=3.994,P＜0.001),and the exosomal sHLA-G detected by ELISA was superior to CA19-9(Z=2.811,P=0.005).Conclusion Plasma exosomal sHLA-G was associated with the progression of CRC and its diagnostic value was superior to the traditional tumor markers CEA and CA 19-9.
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Objective@#To compare the consistency of thyroid stimulating hormone (TSH) results from four chemiluminescence assays. @*Methods@#A total of 102 fresh serum samples from Peking Union Medical College Hospital during March 2018 and April 2018 were collected for precision evaluation and methodological comparison referring to CLSI EP15-A2 and EP9-A2 protocols. The levels of serum TSH were detected by Abbott i2000 (system A), Beckman DXI800 (system B), Siemens ADVIA Centaur XP (system C) and Roche e601 (system D) automatic chemiluminescence analyzers and their matching reagents, respectively. The obtained results were compared with the passing-bablok and Bland Altman methods. Taking 0.27 μIU/mL and 5.33 μIU/mL as the medical decision level, the expected bias of each detection system was compared. @*Results@#The precisions of systems A,B,C and D were 1.7%-3.3%， 2.3%- 3.9%，0.7%-2.3% and 0.6%-1.5%,respectively. The median (P 25,P 75) of TSH concentrations detected by systems A,B,C and D were 1.898 (0.518,4.809)μIU/mL, 2.819 (0.719,7.020)μIU/mL,2.502 (0.692,6.888)μIU/mL and 3.105 (0.886, 7.905)μIU/mL, respectively. The coefficients of determination (R 2 ) of regression equation were above 0.975 for 4 detection systems. The correlation coefficients (r), intercepts and slopes of 4 detection systems were 0.993 5-0.997 1, 0-0.06 and 0.59-1.15, respectively, and systems B and C had the best correlations with 1.02 of slope and 0 of intercept. The deviation plot showed that the bias% of 4 detection systems was between -48.1% and 17.3%. Among them, systems A and D had the largest bias, while systems B and C had the lowest bias. The expected bias of 4 detection systems at the medical decision level was -40.7%-37.2%. @*Conclusion@#The consistency between Beckman and Siemens TSH detection systems is good, while those of Roche and Abbott TSH detection systems are different from the other two.
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Objective To investigate the significance of blood oxygenation level dependent functional magnetic resonance imaging (BOLD-fMRI) and ambulatory urodynamics monitoring (AUM) to find the cause of primary monosymptomatic nocturnal enuresis (PMNE) in children.Methods Thirty-seven children with PMNE (20 males and 17 females) were selected,with a mean age of (11.3 ±4.1) years old.A clinical management tool,3-day urination record,daytime BOLD-fMRI scan,conventional urodynamics (CUD) and AUM were performed respectively.Thirty-seven gender-age matched children(19 males,18 females) who would receive surgery treatment because of upper urinary tract disease and were confirmed to have no lower urinary tract dysfunction by CUD were enrolled as controls,with a mean age of (11.1 ± 2.9) years old,and 13 cases underwent BOLD-fMRI scanning.Results It was found that the ALFF value of the left middle frontal gyrus of PMNE was decreased and the ReHo value of the left superior occipital gyrus was increased compared with the control group by the resting BOLD-fMRI.The maximum voiding volume of PNME children was (303.11 ± 87.48) mL,the total urine volume at night was (568.65 ± 208.48) mL,and the nighttime bladder volume was (217.43 ± 81.53) mL.The incidence of maximum voiding volume reduction,nocturnal polyuria and decreased nocturnal bladder volume were 24.32％ and 56.76％,and 64.86％,respectively.However,AUM results showed that maximum detrusor pressure in the PMNE group was (39.22 ± 7.78) cmH2O (1 cmH2O =0.098 kPa),which was statistically significantly higher than that in CUD (32.22 ±9.00) cmH2O,and the difference was statistically significant (P ＜0.05).In PMNE group,29 cases (78.37％) had detrusor overactivity (DO),which was significantly higher than that in CUD group [16 cases (43.24％)],and the difference was statistically significant(t =-3.047,P =0.004).CUD and AUM were all detected in children with DO,the frequency of DO detected by AUM was significantly higher than that detected by CUD[(2.00 ±0.55 times/h) vs.(1.38 ±0.50) times/h,P ＜0.05],and the maximum amplitude of detrusor pressure when DO occurring was significantly higher in AUM than in CUD [(19.56 ± 6.01) cmH2O vs.(14.38 ± 3.07) cmH2O],and the differences were statistically significant (all P ＜ 0.05);however,there was no significant difference in bladder compliance detected by AUM or CUD (P ＞ 0.05).Conclusions The abnormal functions of the left middle frontal gyrus and left superior occipital gyrus,nighttime DO and the decrease of bladder capacity at night are considered to be key causes of enuresis in children with PMNE.AUM and resting state BOLD-fMRI evaluations are helpful in differentiating the pathogenesis of PMNE.
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Objective To investigate whether there are differences in the detection of biochemical items such as electrolytes , total protein and urea between arterial plasma and venous plasma .Methods Self paired design was used to compare and study the biochemical results of different samples .70 samples ( 36 samples from male patients and 34 from female patients ) that were performed with both arterial blood gas analysis and biochemical item test of venous blood in Clinical Laboratory of Peking Union Medical College Hospital during the period from June to September of 2017 were collected.18 biochemical items like electrolytes in arterial blood and venous blood were synchronously detected by automatic biochemical analyzer.Statistic analyses were carried out by SPSS 18.00.Whether the deviation was of clinic significance was determined by National Health Standards ( WS/T 403-2012 ) and the total error admitted by Royal Society of Pathology of Australia .Regression analysis of Passing-Bablok was performed by MedCalc software . The difference between the results of different samples was investigated by drawing Bland -Altman diagram.Results The results of Ca, Cl, K, Na, P, TP, ALB, ALT, AST, LDH, Glu, Cr, Urea, TG, CHO, UA, CHE, TBA in the samples of arterial blood plasma were 2.46(2.25-2.56) mmol/L,(105.68 ±7.29)mmol/L, 3.81(3.54-4.03) mmol/L, 140.45(137.08-144.20) mmol/L, 0.97(0.77-1.11) mmol/L,(60.39 ±9.40)g/L,(31.23 ±6.81)g/L, 17.4(11.95 -30.05)U/L, 20.85(14.9 -34.03) U/L, 210.1(163.15-342.60) U/L, 7.58(5.95-10.04) mmol/L, 76.35(51.05-110.7) μmol/L, 6.94(3.98-11.08) mmol/L, 1.15(0.84-1.89) mmol/L, 3.31(2.73-4.35) mmol/L, 271.55(187.78-423.30) μmol/L,(4.71 ±2.17)KU/L, 2.19(1.09 -4.19) μmol/L,respectively, and 2.24(2.05-2.35) mmol/L,(103.98 ±7.32)mmol/L, 3.84(3.58 -4.19) mmol/L, 139.30(136.08 -142.33) mmol/L, 0.99(0.78-1.14) mmol/L,(60.37 ±9.67) g/L,(32.62 ±6.89) g/L, 17.6(12.75-31.2) U/L, 20.6(15.28-36.6) U/L, 233.95(176.48-363.75) U/L, 7.55(5.62-9.52) mmol/L, 77.15 (56.08-111.98) μmol/L, 6.94(3.97 -10.53) mmol/L, 1.13(0.83 -1.93) mmol/L, 3.23(2.71-4.37) mmol/L, 273.4(187.30-401.55) μmol/L,(4.74 ±2.21) KU/L, 2.29(1.02 -4.23) μmol/L respectively in the samples of venous blood plasma .The difference of results of TP、Glu、Cr、TG、CHE、TBA between two types of samples were of no statistic significance ( the values of t or Z were 0.121,-0.054,-0.269,-0.480,-1.730 and -1.843 respectively, P>0.05), among these items the difference of Glu was of notable clinical significance (>1/2 TE percentage:50％).The difference of results of Ca , Cl, K, Na, P, ALB, ALT, AST, LDH, Urea, CHO, UA between two types of samples were of statistic significance (the values of t or Z were -7.115,6.794,-2.119,-4.996,-3.483,-8.839,-2.419,-2.742,-3.833,-5.010,-2.060 and -2.467 respectively, P<0.05), among these items the difference of Urea, CHO, UA, Na, P and ALT was of no notable clinical significance ( >total TE percentage: 0％, 2.86％, 0％, 2.9％, 4.3％, 1.43％ respectively), while the difference of Ca, Cl, K, ALB, AST and LDH was of clinical significance (>total TE percentage:90％, 10％, 14.3％, 32.9％, 10.00％, 32.9％respectively).Conclusions The differences in the detected data of some biochemical items between venous plasma and arterial plasma demonstrated clinical significance .When detecting those biochemical items , clinicians should pay attention to the selection of arterial blood sample .It should be considered to establish a reference interval for related biochemical items of arterial blood when necessary .
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Objective To evaluate the clinical efficacy and safety of adalimumab for the treatment of severe psoriasis.Methods Between December 2015 and August 2017,14 patients with severe psoriasis who showed no response to traditional therapy were enrolled into this study.All the patients received subcutaneous injection of adalimumab at an initial dose of 80 mg,which decreased to a dose of 40 mg once every 2 weeks after l-week treatment.At week 4,8 and 12,the psoriasis area severity index (PASI)and physician's global assessment (PGA) scores were recorded,and clinical efficacy and adverse drug reactions were observed.In patients with psoriatic arthritis,the improvement of arthritis was evaluated according to the American College of Rheumatology 20％ response criteria (ACR20).Results All the 14 patients received the drug treatment for at least 12 weeks.At week 4,8 patients achieved 50％ reduction in PASI (PASI 50).At week 8,8 patients achieved PASI 75,and 2 of the 8 patients achieved PASI 90.At week 12,14 patients achieved PASI 75,7 of them achieved PASI 90,and 3 of them achieved PASI 100.Before the treatment,the average PGA score of the 14 patients were 4.92 ± 0.02,and decreased to 1.21 ± 0.02 at week 12.The arthritis symptom was markedly improved in the 3 patients with psoriatic arthritis.At week 8,2 patients achieved ACR20,and 3 achieved ACR20 at week 12.There were no serious adverse drug reactions such as serious infections and malignant tumors in any of the patients.Urticaria occurred in 3 patients,and was relieved after antihistamine treatment.Conclusion Subcutaneous injection of adalimumab every other week is markedly effective and safe for the treatment of severe psoriasis with few adverse drug reactions,and it provides a new treatment choice for patients with severe psoriasis who show no response to traditional therapy.
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Objective To investigate characteristics of Treponema pallidum (Tp)-induced macrophage-derived exosomes and its effect on the proliferation of human umbilical vein endothelial cells (HUVEC).Methods Tp strains were collected from the testis of male rabbit,which were infected with Tp (Nichols strain).The human mononuclear macrophages (THP-1) were induced into macrophages by incubation with propylene glycol methyl ether acetate (PMA),and then the macrophages were divided into 2 groups:experimental group incubated with Tp for 12 hours followed by 48-hour normal culture,and control group receiving normal culture.After the treatment,exosome suspensions were collected,and exosomes were extracted by differential centrifugation and exoEasy Maxi Kit.Transmission electron microscopy and Western blot analyses were performed to identify the exosomes,and nanoparticle tracking analysis (NTA) was conducted to measure the diameters and concentrations of exosomes.In vitro cultured HUVECs were divided into 3 groups,which were cultured with the 10 μl of suspensions containing exosomes derived from Tp-stimulated macrophages at a concentration of 4.5 × 108/ml (experimental group),10 μl of suspensions containing exosomes derived from untreated macrophages at a concentration of 4.5 × 108/ml (control group),and 10 μl of exosome eluents (exosome eluent group),respectively.After the treatment,confocal laser scanning microscopy was performed to observe the phagocytosis of exosomes of HUVECs,and cell counting kit-8 to evaluate the proliferative activity of HUVECs.Results The exosomes were saucer-like microvesicles with diameters of 30-100 nm under the transmission electron microscope.Western blot analyses showed that membrane proteins CD63,CD9 and CD81 were abundantly expressed by exosomes.Under the same conditions,NTA revealed that there were no significant differences in the particle diameter (u =1.90,P ＞ 0.05) and concentration of exosomes (Z =-1.604,P =0.109) between the experimental group and the control group.After co-culture with HUVECs for 5 hours,confocal laser scanning microscopy showed scatteredly distributed exosomes with green fluorescence in the HUVECs in the experimental group and control group.After 12-hour co-culture with the exosome suspensions,the proliferative activity of HUVECs was significantly higher in the experimental group and the control group than in the exosome eluent group (both P ＜ 0.05).After 24-and 48-hour treatment with exosome suspensions,the proliferative activity of HUVECs in the control group was still significantly increased compared with that in the exosome eluent group,and peaked at 48 hours (all P ＜ 0.05).Moreover,there were no significant differences in the proliferative activity of HUVECs between the experimental group and exosome eluent group at 24 and 48 hours (both P ＞ 0.05).At 72 hours,no significant differences in the proliferative activity of HUVECs were observed among the experimental group,the control group and the exosome eluent group (all P ＞ 0.05).Conclusions The exosomes secreted by THP-1 cells-derived macrophages evidently increased the proliferative activity of HUVECs within 48 hours,which peaked at 48 hours.After the stimulation with Tp,the exosomes secreted by THP-1 cells-derived macrophages were similar to those without Tp stimulation in morphology,size and concentration,and only increased the proliferative activity of HUVECs within 12 hours.
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Objective To identify the risk factors associated with recurrent urinary tract infection (RUTI) in children with neurogenic bladders (NB) who received clean intermittent catheterization (CIC) in order to provide recommendations for reducing the risk of RUTI.Methods Records of 184 children with NB managed by CIC at the Department of Urology Surgery,the First Affiliated Hospital of Zhengzhou University from July 2011 to September 2015 were reviewed and analyzed.According to UTI incidence,they were divided into 2 groups as occasional UTI group (0-1 time/year,OUTI group) and RUTI group (＞ 1 time/year).The clinical and urodynamic data were compared between 2 groups,and the risk factors were identified by regression analysis.Results Of the total patients,147 patients (79.9％) were diagnosed as OUTI and 37 cases (20.1％) as RUTI.Median follow-up lasted for average 27 months (12-39 months).The characteristics of RUTI group was indicated significantly in the study,which included increasing age(7.4 years old vs.5.9 years old),a higher level of spinal lesions,and more vesicoureteral reflux(VUR),and there were significant differences in bladder wall thickness(4.7 cm vs.3.6 cm) and lower bladder compliance compared with RUTI group (all P ＜ 0.05).But there was no statistical significance in gender,antibiotics,hydronephrosis,incontinence,bladder capacity,detrusor overactivity,detrusor sphincter dyssynergia and detrusor leakage point pressure between 2 groups (all P ＞ 0.05).Increasing age,increased bladder wall thickness,lower bladder com-pliance and the presence of VUR were independent risk factors associated with RUTI group (all P ＜ 0.05).Conclusions Increasing age,increasing bladder wall thickness,lower bladder compliance and VUR are the risk factors for RUTI in NB children managed with CIC.It is necessary to follow up video-urodynamic and ultrasound findings in order to identify the high-risk patients and provide the evidence for preventing RUTI.
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An asymptomatic 71-year-old woman was admitted to the hospital due to aneurysm of visceral artery. CT angiography revealed that she possessed a hepatosplenic artery aneurysm with hepatosplenomesenteric trunk anomaly. The aneurysm was big with diameter about 28 mm, and is very adjacent to the superior mensenteric artery. The neck of the aneurysm is wide (the diameter of the neck was 5.5-6.0 mm) and short (length of the proximal landing zone was about 2.0 mm). The patient received endovascular reconstruction of the hepatosplenic artery and coil embolization of the aneurysm, and got satisfactory result.
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Aged , Female , Humans , Aneurysm , Diagnostic Imaging , Pathology , General Surgery , Arteries , Diagnostic Imaging , Pathology , General Surgery , Computed Tomography Angiography , Embolization, Therapeutic , Endovascular Procedures , Treatment OutcomeABSTRACT
Objective To observe the effects of Coix seed injection on the cell viability and radiosensitivity of human hepatoma cell line Bel-7402.Methods Bel-7402 cells were irradiated by X-rays,or treated with Coix seed injection,or treated with both of them.The cells proliferation and apoptosis were detected by MTT and by flow cytometry respectively.Cell cloning was used to observe the number of viable cells and to draw the cell survival curve.The mRNA and protein level of Bax,Bcl-2 were detected by RT-PCR and Western blot respectively.Results It was found that the Coix seed injection group (12 μmol/L) and X-ray group (8 Gy) had a significant inhibitory effect on the growth of hepatocellular carcinoma cells (t =17.03,11.26,P ＜ 0.05).And compared with Coix group and irradiation group,the combined treatment group showed higher inhibition rate (t =24.80,20.19,P ＜0.05).The mRNA and protein levels of Bax were gradually elevated (F =437.92,67.91,P ＜ 0.05),while the expressions of Bcl-2 reflected a decreased trend (F =31.18,48.50,P ＜ 0.05).The D0 values of pure irradiation group and combined treatment group were 4.27 and 3.34,respectively,and the sensitization enhancement ratio was 1.27.Conclusions The Coix seed injection inhibit cell growth and induce apoptosis,as well as increase radiative sensitization may via the apoptosis related factors Bax and Bcl-2 in hepatocellular carcinoma.
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Objective:To study the inhibitory effect of γδT cells on the proliferation of ovarian cancer SKOV3 cells,and to clarify its possible mechanism of inducing apoptosis. Methods:The human ovarian cancer SKOV3 cells cultured in vitro were used as control group,and theγδT and SKOV3 cells were co-cultured for 72 h as γδT cells treatment group.Laser scanning confocal microscope was used to obeserve the morphological changes of nucleus SKOV3 cells,and the inhibitory rate of proliferation of SKOV3 cells in two groups were detected by MTT method;Transwell Chambers was used to detect the cell migration ability,then the apoptotic rates of SKOV3 cells were tested by flow cytometry (FCM).Results:The apoptotic morphology of nucleus of SKOV3 cells in γδT cells treatment group were found under microscope,such as nuclear shrinkage.The MTT resultes displayed that the inhibitory rate of proliferation of SKOV3 cells in γδT cells treatment group was higher than that in control group (P <0.05).The Transwell Chambers results showed that the number of transmembrane cells in γδT cells treatment group was lower than that in control group,and the migration rate was decreased compared with control group (P <0.05).The FCM results showed that the apoptotic rate of SKOV3 cells in γδT cells treatment group was higher than that in control group (P < 0.05 ).Conclusion:γδT cells can inhibit the proliferation and the migration abilities of ovarian cancer SKOV3 cells,and promote the apoptosis.
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Objective To explore effect of 5 -aminolevulinic acid -photodynamic therapy combined with thymopentin -5 on IL -17,IL -23 expression of recurrent condylomata acuminata patients.Methods 140 patients with recurrent condylomata acuminata were randomly divided into 3 groups.53 cases in observation group were treated by 5 -aminolevulinic acid -photodynamic therapy combined with thymopentin -5,42 cases in control group 1 were treated by 5 -aminolevulinic acid -photodynamic therapy,and 45 cases in control group 2 were treated by thymopen-tin -5.24 healthy subjects were served as normal controls.IL -17,IL -23 levels were determined by enzyme linked immunosorbent assay before and after the clinical therapy.Results IL -17,IL -23 levels in the patients with recur-rent condylomata acuminata were significantly lower than those in healthy subjects(t =28.10,P <0.01;t =11.10, P <0.01).There were significant differences in IL -17,IL -23 between recurrent condylomata acuminata patients and healthy persons before treatment.There was significant difference after treatment(t =61.17,P <0.01;t =28.02, P <0.01).Conclusion 5 -aminolevulinic acid -photodynamic therapy combined with thymopentin -5 in the treat-ment of recurrent condylomata acuminata inhibited IL -17,IL -23 expression,so as to achieve therapeutic effect.