The value of CXorf67 and H3K27me3 for diagnosing germ cell tumors in central nervous system / 中华病理学杂志

Objective: To investigate immunohistochemical patterns of CXorf67 and H3K27me3 proteins in central nervous system germ cell tumors (GCTs) and to assess their values in both diagnosis and differential diagnosis. Methods: A total of 370 cases of central nervous system GCTs were collected from 2013 to 2020 at Huashan Hospital of Fudan University, Shanghai, China. The expression of CXorf67, H3K27me3 and commonly-used GCT markers including OCT4, PLAP, CD117, D2-40, and CD30 by immunohistochemistry (EnVision method) was examined in different subtypes of central nervous system GCTs. The sensitivity and specificity of each marker were compared by contingency table and area under receiver operating characteristic (ROC) curve. Results: Of the 370 cases there were 282 males and 88 females with a mean age of 19 years and a median age of 17 years (range, 2-57 years). Among the GCTs with germinoma, the proportions of male patients and the patients with GCT located in sellar region were both higher than those of GCTs without germinoma (P<0.05), respectively. CXorf67 was present in the nuclei of germinoma and normal germ cells, but not in other subtypes of GCT. H3K27me3 was negative in germinoma, but positive in the nuclei of surrounding normal cells and GCTs other than germinoma. In the 283 GCTs with germinoma components, the expression rate of CXorf67 was 90.5% (256/283), but no cases were positive for H3K27me3. There was also an inverse correlation between them (r2=-0.831, P<0.01). The expression rates of PLAP, OCT4, CD117 and D2-40 were 81.2% (231/283), 89.4% (253/283), 73.9% (209/283) and 88.3% (250/283), respectively. In 63 mixed GCTs with germinoma components, the expression rate of CXorf67 was 84.1% (53/63), while all cases were negative for H3K27me3. The expression rates of PLAP, OCT4, CD117 and D2-40 were 79.4% (50/63), 79.4% (50/63), 66.7% (42/63) and 87.3% (55/63), respectively. The 6 markers with largest area under ROC curve in ranking order were H3K27me3, CXorf67, D2-40, OCT4, PLAP and CD117 (P<0.05). Conclusions: CXorf67 and H3K27me3 have high sensitivity and high specificity in diagnosing germinoma. There is a significant inverse correlation between them. Therefore, they can both be used as new specific immunohistochemical markers for the diagnosis of GCTs.

Effect of Addition and Subtraction Therapy of Yiyiren Tang with External Application Therapy on Inflammatory Factors of Patients with Acute Gouty Arthritis and Damp-heat Obstruction Syndrome / 中国实验方剂学杂志

Objective::To observe the clinical effect of addition and subtraction therapy of Yiyiren Tang with external application therapy in the patients with acute gouty arthritis (AGA) and damp-heat obstruction syndrome, and to investigate its effect on inflammatory factors. Method::One hundred and fifty-three patients were randomly divided into control group (77 cases) and observation group (76 cases) by random number table. Patients in control group got meloxicam tablets after the meal, 1 tablet/day, 1 time/day, diclofenac sodium gel, 3 times/days. On the basis of meloxicam tablets, patients in observation group additionally received addition and subtraction therapy of Yiyiren Tang by oral and topical applications. The course of treatment was 7 days in both groups. Scores of visual analogue score of pain (VAS) were graded everyday, and the relief time and disappearance time of pain were recorded. Before and after treatment, scores of damp-heat obstruction syndrome were recorded. Levels of uric acid (UA), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), interleukin-1 beta (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF-α), serum cyclooxygenase-2 (COX-2), prostaglandin E2 (PGE2), thromboxane B2 (TXB2) and 6-keto-prostatic factor F1alpha (6-keto-PGF1α) were all detected, and the safety was evaluated. Result::The clinical efficacy in observation group was better than that in control group (Z=2.205, P<0.05). The relief time and disappearance time of pain were shorter than those in control group (P<0.01). At the 1st, 3rd, 5th and 7th day after treatment, scores of VAS were lower than those in control group (P<0.01). After treatment, the scores of main symptoms such as joint pain, tenderness, swelling and dyskinesia, scores of the secondary symptoms and the total scores of damp-heat obstruction syndrome were all lower than those in control group (P<0.01). After treatment, levels of ESR, CRP, UA, IL-1β, IL-6, IL-8, TNF-α, COX-2, PGE2 and TXB2 were all lower than those in control group (P<0.01). Conclusion::Based on the treatment of meloxicam, addition and subtraction therapy of Yiyiren Tang by oral and topical administration methods can quickly relieve and eliminate pain, alleviate the main clinical symptoms and inhibit inflammation in patients with damp-heat obstruction syndrome, showing good clinical efficacy and safety.

Metabolic Characteristics of Leucocyte-deplated and Suspended RBC Produced by Using Lipid Whole Blood During Routine Storage / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the differences of metabolic pathways of leucocyte-deplated RBCs prepared by using lipid whole blood and nomal blood during routine storage so as to provide some reference for clinical blood use.</p><p><b>METHODS</b>Twenty U whole blood from 20 donors, including 10 U lipid blood and 10 U normal whole blood, were selected for preparing leukodepleted red blood cells, red blood cells were taken from storage bags on day 0, 14 and 35, respectively. Metabolites in the red blood cells were analyzed, red blood cell metabolic extracts were detected by UPLC-MS/MS. The metabolite data of RBC from 2 groups were analyzed by SIMCA-P 13.0 software using OPLS-DA and by SPSS 19.0 using Mann-Whitney U test. Difference of metabolic pathways was described according to different metabolites.</p><p><b>RESULTS</b>The glucose, adenine, pyruvic acid, GSH, GSSG and niacinamide levels on day 0 in lipid RBCs were higher than those in the control group(P<0.05). The glucose, pyruvic acid and GSH levels on day 14 in lipid RBCs were lower than those in the control group (P<0.05), and the levels of adenine, GSSG and niacinamide were higher than that in the control group (P<0.05). The glucose level on day 0 was lower than that in the control group (P<0.05), and the levels of adenine and niacinamide were higher than those in the control group (P<0.05). but the pyruvic acid, GSH and GSSG levels were not significantly different between 2 groups (P>0.05).</p><p><b>CONCLUSION</b>Compared with the normal red blood cells, the energy metabolism pathway decreases in lipid red blood cells within the storage period and pentose phosphate pathway increases.</p>

Factors related to clinical pregnancy outcomes of in vitro fertilization-embryo transfer in women with secondary infertility / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the factors related to clinical pregnancy outcomes of in vitro fertilization-embryo transfer (IVF-ET) in women with secondary infertility.</p><p><b>METHODS</b>The clinical, laboratory and follow-up data of 1129 cycles in 1099 patients with secondary infertility undergoing IVF-ET in Women's Hospital, Zhejiang University School of Medicine between July 2012 to July 2014 were retrospectively reviewed. The factors related to pregnancy outcomes were analyzed by univariate and logistic regression methods. The clinical pregnancy rates in women with different age and different number of embryos transferred were compared. The clinical outcomes of stimulation with gonadotropin releasing hormone (GnRH) agonist long protocol, GnRH agonist short protocol and GnH antagonist protocol were evaluated in secondary infertile patients aged ≥ 40 years.</p><p><b>RESULTS</b>Among 1129 cycles, 376 cases (33.30%) had clinical pregnancy and 753 cases (66.70%) had no clinical pregnancy. There were significant differences in age, body mass index, basal follicle-stimulating hormone level, antral follicle number,paternal age and number of embryos transferred between pregnancy and no pregnancy groups (P<0.05); while only maternal age (OR=0.900, 95% CI: 0.873~0.928, P<0.001) and the number of embryos transferred (OR=2.248, 95% CI: 1.906~2.652, P<0.001) were the independent factors affecting the clinical pregnancy outcome of IVF-ET. There was no significant difference in clinical pregnancy rate between women aged 30~40 years with two embryos transferred and those aged<30 years with two or three embryos transferred(P>0.05). There were no significances in clinical pregnancy rate among women aged ≥ 40 years using GnRH agonist long protocol,GnRH agonist short protocol and GnRH antagonist protocol for stimulation (P>0.05).</p><p><b>CONCLUSION</b>Maternal age and number of embryos transferred have independent effect on IVF-ET clinical pregnancy outcome of secondary infertile women. We suggest that no more than two embryos should be transferred for women in their thirties to minimize the risk of multiple pregnancy while still having an acceptable pregnancy rate. The pregnancy rate of patients over 40 years decreases significantly, and there is no difference in pregnancy rate by using GnRH agonist long protocol, GnRH agonist short protocol or GnRH antagonist protocol.</p>

Influence of neutrophils from severe burn patients on morphology and function of vascular endothelial cells and the protective effect of intervention with Shenmai concoction / 中华烧伤杂志

<p><b>OBJECTIVE</b>To study the influence of neutrophils from severe burn patient on the morphology and function of vascular endothelial cells (VEC), and the protective effect of Shenmai concoction on VEC.</p><p><b>METHODS</b>Neutrophils were isolated from the venous blood of healthy volunteers and burn patients [at 6, 24, 48 post burn hour (PBH)], and they were cocultured with VECs (ECV304) in vitro. The viability of VECs was assessed by MTT. The contents of endothelin (ET) land nitric oxide (NO) in supernatant were determined by radioimmunoassay, the ratio between ET-1 and NO (ET-1/NO) was also calculated. Blood samples from burn patients were collected at 24 PBH to repeat experiment as above, but 100 L microL isotonic saline or 100 microL Shenmai concoction in concentrations of 0.5, 2.0, 8.0 g/L was added to the cultures respectively. The effect of Shenmai concoction on above indices and morphology of ECV3O4 were also observed.</p><p><b>RESULTS</b>Compared with neutrophils from healthy volunteers, the activity of VECs cocultured with neutrophils from burn patients at 6 PBH was obviously decreased, the content of ET-1 obviously increased, especially with neutrophils obtained at 24 PBH (P < 0.01). The content of NO in supernatant of VEC co-cultured with neutrophils from burn patients at 6 PBH was increased obviously (48.9 +/- 2.6 micromol/L, P < 0.01). There were no obvious difference in the content of NO under the stimulation of neutrophils between that of healthy volunteers and burn patients blood obtained at 24, 48 PBH (P > 0.05). With different concentrations of Shenmai, the activity of VECs and the content of NO were obviously increased , while the content of ET-1 was significantly decreased. The morphology of VECs after treatment of neutrophils of 24 PBH and 2.0 g/L Shenmai was similar to normal VECs.</p><p><b>CONCLUSION</b>The morphology, activity of VEC, and ET/NO can be affected by neutrophils after severe burn, especially that of 24 PBH in vitro. Shenmai concoction can ameliorate above indices, thus might possibly exert protective effects on VECs after severe burn.</p>