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BACKGROUND@#Ischemic acute kidney injury (AKI) is a common syndrome associated with considerable mortality and healthcare costs. Up to now, the underlying pathogenesis of ischemic AKI remains incompletely understood, and specific strategies for early diagnosis and treatment of ischemic AKI are still lacking. Here, this study aimed to define the transcriptomic landscape of AKI patients through single-cell RNA sequencing (scRNA-seq) analysis in kidneys.@*METHODS@#In this study, scRNA-seq technology was applied to kidneys from two ischemic AKI patients, and three human public scRNA-seq datasets were collected as controls. Differentially expressed genes (DEGs) and cell clusters of kidneys were determined. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis, as well as the ligand-receptor interaction between cells, were performed. We also validated several DEGs expression in kidneys from human ischemic AKI and ischemia/reperfusion (I/R) injury induced AKI mice through immunohistochemistry staining.@*RESULTS@#15 distinct cell clusters were determined in kidney from subjects of ischemic AKI and control. The injured proximal tubules (PT) displayed a proapoptotic and proinflammatory phenotype. PT cells of ischemic AKI had up-regulation of novel pro-apoptotic genes including USP47 , RASSF4 , EBAG9 , IER3 , SASH1 , SEPTIN7 , and NUB1 , which have not been reported in ischemic AKI previously. Several hub genes were validated in kidneys from human AKI and renal I/R injury mice, respectively. Furthermore, PT highly expressed DEGs enriched in endoplasmic reticulum stress, autophagy, and retinoic acid-inducible gene I (RIG-I) signaling. DEGs overexpressed in other tubular cells were primarily enriched in nucleotide-binding and oligomerization domain (NOD)-like receptor signaling, estrogen signaling, interleukin (IL)-12 signaling, and IL-17 signaling. Overexpressed genes in kidney-resident immune cells including macrophages, natural killer T (NKT) cells, monocytes, and dendritic cells were associated with leukocyte activation, chemotaxis, cell adhesion, and complement activation. In addition, the ligand-receptor interactions analysis revealed prominent communications between macrophages and monocytes with other cells in the process of ischemic AKI.@*CONCLUSION@#Together, this study reveals distinct cell-specific transcriptomic atlas of kidney in ischemic AKI patients, altered signaling pathways, and potential cell-cell crosstalk in the development of AKI. These data reveal new insights into the pathogenesis and potential therapeutic strategies in ischemic AKI.
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Humans , Mice , Animals , Transcriptome/genetics , Ligands , Kidney/metabolism , Acute Kidney Injury/metabolism , Ischemia/metabolism , Reperfusion Injury/metabolism , Sequence Analysis, RNA , Adaptor Proteins, Signal Transducing/metabolism , Tumor Suppressor Proteins/metabolismABSTRACT
Objective@#To analyze the therapeutic effect and prognostic factors of induction chemotherapy plus intensity-modulated radiotherapy (IMRT) with or without consolidation chemotherapy for esophageal squamous cell carcinoma (ESCC).@*Methods@#One hundred and eight patients with ESCC treated between January 2010 to August 2014 were analyzed retrospectively. All patients received IMRT and platinum-based chemotherapy. The overall survival (OS) and local control (LC) rates were calculated using the Kaplan-Meier method and the univariate prognostic analyses were tested by the Log-rank test. The Cox proportional hazard model was used for multivariate prognostic analysis.@*Results@#The follow-up rate was 97.2%. The 1-, 3- and 5-year survival rates were 76.9%, 50.9% and 32.3% respectively, and the LC rates were 73.6%, 58.5% and 54.9% respectively. The median OS with and without consolidation chemotherapy were 51 and 15 months (χ2=5.076, P=0.024), respectively. Multivariate analysis showed that clinical N staging, recent curative effect and consolidation chemotherapy were important prognostic factors for OS, and recent curative effect was associated with LC. The rates of acute grade 3 radiation-induced esophagitis, gastrointestinal side effects, myelosuppression and radiation-induced pulmonary injury were 7.4%, 6.5%, 12% and 0.9%, respectively, and no grade 4 occurred. The late toxicity was mainly radiation-induced pulmonary fibrosis.@*Conclusions@#Induction chemotherapy plus IMRT with or without consolidation chemotherapy is safe and effective in the treatment of ESCC. The addition of consolidation chemotherapy may help prolong the survival of some patients and further research is necessary. Individualized treatment should be selected for patients who cannot tolerate or refuse concurrent chemoradiotherapy.
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Objective To analyze the therapeutic effect and prognostic factors of induction chemotherapy plus intensity-modulated radiotherapy (IMRT) with or without consolidation chemotherapy for esophageal squamous cell carcinoma (ESCC).Methods One hundred and eight patients with ESCC treated between January 2010 to August 2014 were analyzed retrospectively.All patients received IMRT and platinum-based chemotherapy.The overall survival (OS) and local control (LC) rates were calculated using the Kaplan-Meier method and the univariate prognostic analyses were tested by the Log-rank test.The Cox proportional hazard model was used for multivariate prognostic analysis.Results The follow-up rate was 97.2％.The 1-,3-and 5-year survival rates were 76.9％,50.9％ and 32.3％ respectively,and the LC rates were 73.6％,58.5％ and 54.9％ respectively.The median OS with and without consolidation chemotherapy were 51 and 15 months (x2 =5.076,P=0.024),respectively.Multivariate analysis showed that clinical N staging,recent curative effect and consolidation chemotherapy were important prognostic factors for OS,and recent curative effect was associated with LC.The rates of acute grade 3 radiation-induced esophagitis,gastrointestinal side effects,myelosuppression and radiation-induced pulmonary injury were 7.4％,6.5％,12％ and 0.9％,respectively,and no grade 4 occurred.The late toxicity was mainly radiation-induced pulmonary fibrosis.Conclusions Induction chemotherapy plus IMRT with or without consolidation chemotherapy is safe and effective in the treatment of ESCC.The addition of consolidation chemotherapy may help prolong the survival of some patients and further research is necessary.Individualized treatment should be selected for patients who cannot tolerate or refuse concurrent chemoradiotherapy.
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Objective To investigate the effect of the levels of serum high sensitive C reactive protein and its clinical effect by bifidobacteria combined zinc in the treatment children with diarrhea.Methods 100 children with diarrhea from June 2013 to June 2016 in our hospital were selected and randomly divided into the control group and the experiment group,50 cases in the control group were get general routine treatment,such as dehydration and zinc supplement,50 cases in the experiment group were treated on the base of the control group with bifidobacteria.The clinical curative effect,the disappearance time of clinical symptoms of diarrhea and the level of serum high sensitive C reactive protein(CRP),interleukin-10(IL-10)and interleukin-6(IL-6)were observed and compared between two groups.Results After treatment,the total effective rate of the treatment group was higher than that of the control group,the clinical symptoms disappeared earlier than the control group,the difference was statistically significant(P<0.05).The serum CRP,IL-10 and IL-6 levels were lower than before treatment and the experiment group was more lower,the difference was statistically significant(P<0.05).Conclusion The clinical efficacy and recovery time of the combined application ofbifidobacteria and zinc in children with diarrhea is related to the decrease of serum CRP,IL-10 and IL-6 levels.
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ObjectiveTo measure the expression of divalent metal transporter 1 (DMT1) in hepatocellular carcinoma (HCC) and to explore its clinical and pathological significance. MethodsFifty-seven liver cancer specimens collected from patients with HCC and preserved in paraffin in Second Affiliated Hospital of Shantou University Medical College from July 1999 to July 2011 were established as HCC tissue group, and 7 specimens of normal liver tissues from autopsy and 8 specimens of liver tissues from patients with intrahepatic bile duct stones and preserved in paraffin were established as normal control group. SP immunohistochemistry was applied to measure the expression of DMT1 in 15 specimens of normal liver tissues and 57 specimens of HCC tissues. One-way analysis of variance was applied to analyze the difference in expression of DMT1 in HCC tissues with varying degrees of differentiation, and χ2 test was applied for the comparison of rates; the correlation between expression of DMT1 and tumor size was analyzed by Pearson correlation analysis. ResultsDMT1 in the liver tissues in normal control group was negative or weakly positive, with a positive rate of 20% (3/5); in HCC tissue group, the positive rate was 789% (45/57), with a strong positive rate of 15.8% (9/57); the two groups showed a significant difference in positive rate (P＜0.05). The expression of DMT1 varied significantly between patients with varying degrees of differentiation in HCC tissues (F=4.011, P＜0.05), while the positive rate of DMT1 showed no significant differences between patients with different clinical stages and with or without blood vessel infiltration (all P＞0.05). Correlation analysis did not find the correlation between expression of DMT1 and tumor size (r=-0.047, P＞005). ConclusionThe positive expression rate of DMT1 increases significantly in HCC tissues and is closely related to the degree of tumor differentiation, which is potentially valuable for clinical and pathological grading of liver cancer.
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Objective To study the effect of the serum levels of 25-hydroxyvitamin D3 [25-(OH)D3] and total IgE (TIgE) in pathogenesis of the children bronchial asthma.Methods Twenty-two children with bronchial asthma (bronchial asthma group) and 20 healthy children (control group) were selected.The serum levels of 25-(OH)D3 and TIgE in the children of 2 groups were detected.Results The level of serum 25-(OH)D3 in bronchial asthma group was significantly lower than that in control group [(23.64 ± 3.89)μ g/L vs.(35.82 ± 4.37) μ g/L],there was statistical difference (P ＜ 0.05).The level of serum TIgE in bronchial asthma group was significantly higher than that in control group [(208.62 ± 32.59) kU/L vs.(73.84 ± 18.86) kU/L],there was statistical difference (P ＜ 0.05).There was negative correlation between the level of serum 25-(OH)D3 and TIgE in bronchial asthma group (r =-0.832,P ＜ 0.01),but there was no correlation between the level of serum 25-(OH)D3 and TIgE in control group (r =-0.038,P ＞0.05).Conclusions The lack of 25-(OH)D3 may be associated with allergy and childhood bronchial asthma.By monitor the levels of 25-(OH)D3 and TIgE may assess condition of childhood bronchial asthma.
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Objective To investigate measures of preventing asphyxia neonatorum in order to reduce the rate of asphyxia neonatorum.Methods Clinical datas on a total of 78 cases of critical asphyxia neonatorum from the year 2003～2004 in Longgang Central Hospital were collected and analyzed.Related high risk factors and effective precaution measures of reducing the rate of asphyxia neonatorum were studied.Results The rate of asphyxia neonatorum from January 2003 to December 2004 was 4.22%,of which it was 1.70% of critical asphyxia neonatorum and 8% of treated deaths.The first seven related factors to critical asphyxia neonatorum of this group were:fetal distress(47%),premature delivery(49%),umbilical factors-torsion,prolapse,shortening(32%),breech presentation(26%),high risk PIH(14%),monstrosity(6%),placental abruption and placenta praevia(6%).Conclusion Effective measures of reducing critical asphyxia neonatorum are to strengthen the monitoring of pregnant women and their antenatal care so as to find and treat PIH early and correct breech presentation in time,try to reduce premature delivery,find early and properly treat fetal distress and oafs and prohibit illegal accouchement.
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Objective To evaluate the use of laparoscopic operation in gynecological acute disease. Methods 56 cases of gynecological acute disease patients were treated with different laparoscopic operation according to pathogenetic condition. Results All were exelcymosised urinary canal, liquid diet, out-of-bed actived 6h post operation, ambulation 10h later,no infective fever,postoperative hospital stay 3～5d[mean (3.3?1.1d)] and incisal opening healing well. Conclusion Laparoscope is an effective and safe operation in gynecological acute disease.