Establishment of PCR assays and genetic polymorphism analysis of genes encoding Clostridium perfringens β2 toxin from different sources / 中华流行病学杂志

Objective: To establish and optimize PCR methods for the gene encoding of Clostridium perfringens β2 toxin (cpb2) and atypical-cpb2 (aty-cpb2), analyze the epidemiological characteristics and genetic polymorphism of the cpb2 of Clostridium perfringens in 9 Chinese areas from 2016 to 2021. Methods: The cpb2 of 188 Clostridium perfringens strains were examined by PCR; the cpb2 sequences were acquired by whole-genome sequencing to analyze the genetic polymorphism. Using Mega 11 and the Makeblastdb tool, a phylogenetic tree, and cpb2-library based on 110 strains carrying the cpb2 were produced. Using the Blastn technique, a comparison was made to discover sequence similarity between consensus-cpb2 (con-cpb2) and aty-cpb2. Results: The specificity of PCR assay for the cpb2 and aty-cpb2 was verified. The PCR results for cpb2 amplification were highly consistent with the whole-genome sequencing approach (Kappa=0.946, P<0.001). A total of 107 strains from nine regions in China carried cpb2, 94 types A strains carried aty-cpb2, 6 types A strains carried con-cpb2, and 7 types F strains carried aty-cpb2. The nucleotide sequence similarity between the two coding genes was 68.97%-70.97%, and the similarity between the same coding genes was 98.00%-100.00%. Conclusions: In this study, a specific PCR method for cpb2 toxin was developed, and the previous PCR method for detecting aty-cpb2 was improved. aty-cpb2 is the primary gene encoding of β2 toxin. There is a significant nucleotide sequence variance between the various cpb2 genotypes.

Study on the features of Clostridioides difficile infection among diarrhea patients in Kunming from 2018 to 2020 / 中华流行病学杂志

Objective: We analyze the characteristics of Clostridioides difficile (C. difficile) infection among diarrhea patients in Kunming from 2018 to 2020 and provide evidence for follow-up surveillance and prevention. Methods: A total of 388 fecal samples of diarrhea patients from four sentinel hospitals in Yunnan Province from 2018 to 2020 were collected. Real-time quantitative PCR was used to detect the fecal toxin genes of C. difficile. The positive fecal samples isolated the bacteria, and isolates were identified by mass spectrometry. The genomic DNA of the strains was extracted for multi-locus sequence typing (MLST). The fecal toxin, strain isolation, and clinical patient characteristics, including co-infection with other pathogens, were analyzed. Results: Among the 388 fecal samples, 47 samples with positive reference genes of C. difficile were positive, with a total positive rate of 12.11%. There were 4 (8.51%) non-toxigenic and 43 (91.49%) toxigenic ones. A total of 18 strains C. difficile were isolated from 47 positive specimens, and the isolation rate of positive specimens was 38.30%. Among them, 14 strains were positive for tcdA, tcdB, tcdC, tcdR, and tcdE. All 18 strains of C. difficile were negative for binary toxins. The MLST results showed 10 sequence types (ST), including 5 strains of ST37, accounting for 27.78%; 2 strains of ST129, ST3, ST54, and ST2, respectively; and 1 strain of ST35, ST532, ST48, ST27, and ST39, respectively. Fecal toxin gene positive (tcdB+) results were statistically associated with the patient's age group and with or without fever before the visit; positive isolates were only statistically associated with the patient's age group. In addition, some C. difficile patients have co-infection with other diarrhea-related viruses. Conclusions: The infection of C. difficile in diarrhea patients in Kunming is mostly toxigenic strains, and the high diversity of strains was identified using the MLST method. Therefore, the surveillance and prevention of C. difficile should be strengthened.

Effect of intravitreal injection of anti-vascular endothelial growth factor agents on systemic concentration of vascular endothelial growth factor / 国际眼科杂志(Guoji Yanke Zazhi)

Chorioretinal disease has become a significant problem affecting human vision. Abnormal expression of vascular endothelial growth factor(VEGF)leads to increased fundus permeability and neovascularization. Vitreous injection of anti-VEGF agents can rapidly inhibit the level of VEGF in the eye and effectively control the development of the disease. At present, anti-VEGF agents are widely administered in ophthalmology. However, studies have shown that intravitreal anti-VEGF agents can reduce plasma VEGF concentration after entering the circulatory system, and the pointless off-target effects of drugs may lead to systemic adverse reactions. For elderly patients, patients with serious comorbidities, lactating women, premature infants and other special populations, attention should be paid to systemic VEGF inhibition after multiple injections. In this paper, in order to provide reference for clinical anti-VEGF therapy, the pharmacokinetics therapy, systemic adverse reactions, contralateral eye effects, and effects of anti-VEGF on breast milk and preterm infants were discussed, and the systemic effects of vitreous injection of anti-VEGF agents were reviewed.

Design of non-metallic crown for primary molars and analyzation of stress distribution: a finite element study / 中华口腔医学杂志

Objectives: To study the design of nonmetallic crowns for deciduous molars by means of computer aided design and to analyze the key parameters of the nonmetallic crowns of deciduous molars using finite element method. Methods: The three-dimensional model of a mandibular second primary molar was constructed by using a micro-CT system. The thickness of the crown was limited to 0.5 mm and four different crown shapes (chamfer+anatomic, chamfer+non-anatomic, knife edge+anatomic and knife edge+non-anatomic) were designed. Then, the crown shape was limited as chamfer+non-anatomic and five different thicknesses of the crown (0.50, 0.75, 1.00, 1.25, 1.50 mm) were designed, and three different materials, including polyetherketoneketone (PEKK), polymethylmethacrylate (PMMA) resin and resin-infiltrated ceramic, were applied to make the crown. Stress distribution and fatigue of each component of the model under vertical and oblique loadings were analyzed by using finite element method. Non-axial retention analysis was performed on chamfer+non-anatomic crowns, made of PMMA resin, with thicknesses of 0.50, 0.75, 1.00, 1.25 and 1.50 mm. Results: Among the four crown shape designs, the chamfer+non-anatomic type crown showed the lowest von Mises stress and the highest safety factor. By comparing three different materials, the resin-infiltrated ceramic group showed obvious stress concentration on the buccal edge of the crown and the PEKK group showed stress concentration in the adhesive layer. Results of non-axial retention analysis showed that the torques required by the crowns with five thicknesses at the same rotation angle were as follows: 4 856.1, 4 038.1, 3 497.3, 3 256.3 and 3 074.3 N⋅m, respectively. The comparison of areas of the adhesives fracture among groups were as follows: 0.5 mm group < 0.75 mm group < 1.00 mm group < 1.25 mm group < 1.50 mm group. Conclusions: In the design of nonmetallic crowns for primary molars, the edge of the crown should be designed as chamfer, the shape of the inner crown should be non-anatomical and the minimum preparation amount of the occlusal surface should be 1.00 mm. Among the three materials, PMMA resin, of which elastic modulus is similar to the dentin and the dental adhesive, might be the most suitable material for the crowns of primary molars.

Current situation and the latest progress in the treatment of pyoderma gangrenosum / 中华烧伤杂志

Pyoderma gangrenosum (PG) is a rare chronic inflammatory non-infectious skin dermatosis, and there is no clear treatment guideline for this disease at home and abroad. There are a variety of clinical treatment methods for PG, including local therapy and systemic application of glucocorticoids, immunosuppressants, intravenous immuno- globulin, and biologics. Glucocorticoids are the first-line drugs commonly used in clinical practice, and immunosuppressants can be used alone or in combination with glucocorticoids. In recent years, more and more evidence has shown that biologics are a new trend in the treatment of PG, mainly including tumor necrosis factor α inhibitors, interleukin-1 (IL-1) inhibitors, IL-12/23 inhibitors, IL-17 inhibitors, rituximab, and small molecular inhibitors. This article summarizes the current status and latest progress in the treatment of PG, hoping to provide clinicians with ideas for the treatment of PG.

Growth and development of children and related influencing factors: a cross-sectional study of the families with children aged 0-6 years in Jiangsu Province / 中国当代儿科杂志

OBJECTIVES@#To investigate the growth and development of children aged 0-6 years in Jiangsu Province of China and the effects of family factors on the children's growth and development.@*METHODS@#The stratified random sampling method was used to select 2 004 families with children aged 0-6 years of Jiangsu Province. A questionnaire survey on nutritional knowledge, attitude, and behavior was performed for the main caregivers. The Z-score method was used to evaluate nutritional status. The ordinal polytomous logistic regression analysis model was used to investigate the influencing factors for nutritional status.@*RESULTS@#A total of 2 290 questionnaires were distributed, among which 2 004 valid questionnaires were collected (87.51%). The mean age of the children was (28±14) months, and there were 1 105 boys (55.14%) and 899 girls (44.86%). The primary caregivers were mostly parents (1 867 families, 93.16%), and the caregivers of 1 466 families (73.15%) had a university/college degree. Most families had an annual income of 50 000-100 000 yuan/year or 100 000-200 000 yuan/year, accounting for 32.88% and 34.23%, respectively. The results of Z-score showed the growth retardation rates of 1.45% (16/1 105) in boys and 1.78% (16/899) in girls, the underweight rates of 0.54% (6/1 105) in boys and 0.67% (6/899) in girls, the emaciation rates of 1.36% (15/1 105) in boys and 2.00% (18/899) in girls, and the obesity rates of 8.78% (97/1 105) in boys and 10.12% (91/899) in girls, respectively. The multivariate logistic regression analysis showed that a higher annual family income and a higher nutrition knowledge level of caregiver were beneficial to the growth and development of children (P<0.05).@*CONCLUSIONS@#Children aged 0-6 years in Jiangsu Province have a good status of growth and development but a relatively high obesity rate, and therefore, the monitoring of obesity should be taken seriously. Family economic status and the level of nutritional knowledge of caregivers have a significant impact on children's growth and development.

Effects of ring finger and tryptophan-aspartic acid 2 on dendritic spines and synapse formation in cerebral cortex neurons of mice / 南方医科大学学报

OBJECTIVE@#To clarify the functional effects of differential expression of ring finger and tryptophan-aspartic acid 2 (RFWD2) on dendritic development and formation of dendritic spines in cerebral cortex neurons of mice.@*METHODS@#Immunofluorescent staining was used to identify the location and global expression profile of RFWD2 in mouse brain and determine the co-localization of RFWD2 with the synaptic proteins in the cortical neurons. We also examined the effects of RFWD2 over-expression (RFWD2-Myc) and RFWD2 knockdown (RFWD2-shRNA) on dendritic development, dendritic spine formation and synaptic function in cultured cortical neurons.@*RESULTS@#RFWD2 is highly expressed in the cerebral cortex and hippocampus of mice, and its expression level was positively correlated with the development of cerebral cortex neurons and dendrites. RFWD2 expression was detected on the presynaptic membrane and postsynaptic membrane of the neurons, and its expression levels were positively correlated with the length, number of branches and complexity of the dendrites. In cultured cortical neurons, RFWD2 overexpression significantly lowered the expressions of the synaptic proteins synaptophysin (P < 0.01) and postsynapic density protein 95 (P < 0.01), while RFWD2 knockdown significantly increased their expressions (both P < 0.05). Compared with the control and RFWD2-overexpressing cells, the neurons with RFWD2 knockdown showed significantly reduced number of dendritic spines (both P < 0.05).@*CONCLUSION@#RFWD2 can regulate the expression of the synaptic proteins, the development of the dendrites, the formation of the dendritic spines and synaptic function in mouse cerebral cortex neurons through ubiquitination of Pea3 family members and c-Jun, which may serve as potential treatment targets for neurological diseases.

Clinical results of critical rehabilitation pathway after total knee arthroplasty / 中国骨伤

OBJECTIVE@#To investigate the clinical results of the application of critical rehabilitation pathway in the rehabilitation after total knee arthroplasty.@*METHODS@#From March 2015 to December 2019, 67 patients with total knee arthroplasty (TKA) were included. There were 49 females and 18 males, 42 cases on the left and 25 cases on the right, with an average age of 60 to 81(70.72±5.92) years old. Critical rehabilitation paths included intensive strength and gait rehabilitation exercises. All patients were evaluated before operation and 3, 12 months after operation. The evaluation indexes included stair climbing test (SCT), six minute walk test (6MWT), quadriceps and hamstring strength, range of motion, visual pain scale (VAS), Western Ontario McMasterUniversity Osteoarthritis score(WOMAC).@*RESULTS@#All the patients completed the entire pathway and the assessment. The results of pre-operative, 3 months after surgery and 12 months after surgery were as follows respectively. SCT-up: (16.32±3.58) s, (18.16±2.46) s, (11.00±1.29) s, @*CONCLUSION@#Critical rehabilitation path is safe and effective. The knee function of patients who receive critical rehabilitation path after TKA is significantly improved in the first 12 months after operation.

Baseline left ventricular ejection fraction associated with symptom improvements in both children and adolescents with postural tachycardia syndrome under metoprolol therapy / 中华医学杂志(英文版)

BACKGROUND@#Postural tachycardia syndrome (POTS) is a common childhood disease that seriously affects the patient's physical and mental health. This study aimed to investigate whether pre-treatment baseline left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) values were associated with symptom improvement after metoprolol therapy for children and adolescents with POTS.@*METHODS@#This retrospective study evaluated 51 children and adolescents with POTS who received metoprolol therapy at the Peking University First Hospital between November 2010 and July 2019. All patients had completed a standing test or basic head-up tilt test and cardiac echocardiography before treatment. Treatment response was evaluated 3 months after starting metoprolol therapy. The pre-treatment baseline LVEF and LVFS values were evaluated for correlations with decreases in the symptom score after treatment (ΔSS). Multivariable analysis was performed using factors with a P value of  0.050). However, responders had significantly higher baseline LVEF (71.09% ± 4.44% vs. 67.17% ± 4.88%, t = -2.789, P = 0.008) and LVFS values (40.00 [38.00, 42.00]% vs. 36.79% ± 4.11%, Z = -2.542, P = 0.010) than the non-responders. The baseline LVEF and LVFS were positively correlated with ΔSS (r = 0.378, P = 0.006; r = 0.363, P = 0.009), respectively. Logistic regression analysis revealed that LVEF was independently associated with the response to metoprolol therapy in children and adolescents with POTS (odds ratio: 1.201, 95% confidence interval: 1.039-1.387, P = 0.013).@*CONCLUSIONS@#Pre-treatment baseline LVEF was associated with symptom improvement after metoprolol treatment for children and adolescents with POTS.

Correlation of An Ultrasonic Scoring System and Intraoperative Blood Loss in Placenta Accreta Spectrum Disorders: A Retrospective Cohort Study / 生物医学与环境科学（英文）

Objective@#This study aims to investigate the correlation of an ultrasonic scoring system with intraoperative blood loss (IBL) in placenta accreta spectrum (PAS) disorders.@*Methods@#A retrospective cohort study was conducted between January 2015 and November 2019. Clinical data for patients with PAS have been obtained from medical records. Generalized additive models were used to explore the nonlinear relationships between ultrasonic scores and IBL. Logistic regressions were used to determine the differences in the risk of IBL ≥ 1,500 mL among groups with different ultrasonic scores.@*Results@#A total of 332 patients participated in the analysis. Generalized additive models showed a significant positive correlation between score and blood loss. The amount of IBL was increased due to the rise in the ultrasonic score. All cases were divided into three groups according to the scores (low score group: ≤ 6 points, @*Conclusions@#The risk of blood loss equal to or greater than 1,500 mL increases further when ultrasonic score greater than or equal to 10 points, the preparation for transfusion and referral mechanism should be considered.

Effects of Three Needling Manipulations of Zusanli (ST 36) on Deqi Sensations and Surface Myoelectricity in Healthy Participants / 中国结合医学杂志

OBJECTIVE@#To investigate the effects of different acupuncture manipulations on Deqi sensations and surface myoelectricity, and explore the correlation between Deqi sensations and needling manipulations.@*METHODS@#Forty-five healthy participants accepted twirling, lifting-thrusting, and twirling plus lifting-thrusting manipulanions at right Zusanli (ST 36), respectively. The acupuncturist's and participants' Deqi sensations were collected by MGH Acupuncture Sensation Scale (MASS). The intensity and occurrence rate of soreness, dull pain, pressure, heaviness, fullness, numbness, sharp pain, warmth, coolness, and throbbing feelings of participants, and tightness, smooth, and tangle feelings of acupuncturist were measured. The correlation between the acupuncturist's and participant's Deqi sensations was analyzed. Surface electromyogram (EMG) were recorded before, during and after needling in 30 participants. The integrated EMG (iEMG), mean power frequency (MPF) and media frequency (MF) were analyzed.@*RESULT@#Both fullness and soreness of participants and tightness of acupuncturist were the most frequently occurred ones. A positive correlation between participants' fullness and acupuncturist's tightness was observed during the three aforementioned needling manipulations (P1). Almost all the needling sensations measured in the present study could be induced by the three needling manipulations. However, strength of Deqi sensations was exhibited as lifting-thrusting > twirling plus lifting-thrusting > twirling according to MASS index. The iEMG values were increased and MPF, MF values were decreased during needling compaired to those before needling, especially during lifting-thrusting (P<0.01).@*CONCLUSIONS@#The intensity and occurrence rate of the different Deqi sensations induced by different needling manipulations were basically similar. The fullness and soreness were both the most frequently induced Deqi sensations. The strongest Deqi sensation could be induced by lifting-thrusting manipulation. There is a positive correlation between participants' fullness and acupuncturist's tightness during the three needling manipulations. The myoelectricity around the acupoint is related to Deqi responses. (Registration No. AMCTR-IOR-20000314).

Exploration of Potential Mechanisms of Corylin Against Lung Cancer By High-throughput Sequencing / 中国实验方剂学杂志

Objective:To explore the potential molecular mechanism of corylin in the treatment of lung cancer. Method:A549 cells were treated with different concentrations of corylin， and their proliferation was detected using methye thiazolye telrazlium （MTT） reagent. Then the trend analysis and gene ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis were conducted to screen the key genes and pathways of corylin against A549 cell proliferation， followed by the verification of sequencing results by real-time polymerase chain reaction （Real-time PCR）. Result:Corylin inhibited the proliferation of A549 cells and regulated the expression of 4 364 genes in cells. The trend analysis revealed that these genes were clustered into 20 distinct modules， among which four were significantly down-regulated， suggesting that corylin exerted the anti-proliferation effect by inhibiting the expression of some genes. The inter-group comparison of differentially expressed genes （DEGs） showed that the elevation in the concentration of corylin resulted in more down-regulated genes but weakened proliferation， consistent with the findings by trend analysis. The GO and KEGG enrichment analysis of 278 DEGs in the high-dose corylin group demonstrated that corylin mainly changed the cellular and metabolic processes， which was attributed to its regulation of steroid biosynthesis， fatty acid metabolism， biosynthesis of unsaturated fatty acids， synthesis and degradation of ketone bodies， and steroid hormone biosynthesis. The Real-time PCR results confirmed that corylin down-regulated the mRNA expression levels of LSS， stearoyl-CoA desaturase （SCD）， 3-hydroxy-3-methylglutaryl-CoA synthase 1 （HMGCS1）， but up-regulated the mRNA expression of recombinant human angiopoietin-like protein 4 （ANGPTL4）， basically consistent with the transcriptomics results. Conclusion:Corylin inhibits A549 cell proliferation and alleviates lung cancer by targeting the related genes in lipid metabolism pathways.

Effects of three self-etch adhesives and mild salivary contamination on the bonding durability of deciduous teeth / 北京大学学报(医学版)

OBJECTIVE@#To compare the bonding durability of three different self-etch adhesives to primary enamel and dentin, and to investigate the effect of mild salivary contamination followed by air drying on the bonding durability.@*METHODS@#Two hundred and forty enamel specimens were divided randomly into 16 groups (n=15/group)according to the adhesive system [self-etch adhesives: Clearfil SE Bond(SE), AdperTM Easy One (EO), Scotchbond Universal (SBU); total-etch adhesive: AdperTM Single Bond Plus(SL)], contamination status (non-contaminated vs. salivary-contaminated) and storage condition (stored in distilled water for 24 h vs. aging mode 5 000 thermal cycles in 5 ℃ and 55 ℃). Two hundred and forty dentin specimens were assigned in the same way. Shear bond strength for 12 specimens in each group were measured. The adhesive interface for the residual specimens in each group was observed by scanning electron microscopy(SEM). Data were analyzed by three-way analysis of variance and Tukey test(P < 0.05).@*RESULTS@#For primary enamel, total-etch adhesive showed higher initial shear bond strength values (28.92±1.83) MPa and shear bond strength values (27.27±3.03) MPa after thermal cycles compared with the other groups, and the difference between the groups was statistically significant (P < 0.01). Shear bond strength values of EO decreased significantly in salivary-treated groups, regardless of storage conditions, and the difference was statistically significant (P < 0.01). For primary dentin, shear bond strength values of EO decreased significantly in salivary-treated groups after 24 h (P < 0.01). After 5 000 thermal cycles, total-etch adhesive showed significantly lower shear bond strength values (14.31±1.97) MPa compared with the other groups, and the difference between the groups was statistically significant (P < 0.01), and shear bond strength values of EO were significantly lower than those in SE and SBU groups (P < 0.01), regardless of contamination status.@*CONCLUSION@#Total-etch adhesive SL has better bonding durability to primary enamel. SE and SBU have better bonding durability to primary dentin and have a certain resistance to salivary contamination, while the bonding performance of EO is compromised greatly by mild salivary contamination followed by air drying.

MiR-542-5p Inhibits Hyperglycemia and Hyperlipoidemia by Targeting FOXO1 in the Liver

Purpose@#This research was designed to investigate how miR-542-5p regulates the progression of hyperglycemia and hyperlipoidemia. @*Materials and Methods@#An in vivo model with diabetic db/db mice and an in vitro model with forskolin/dexamethasone (FSK/DEX)-induced primary hepatocytes and HepG2 cells were employed in the study. Bioinformatics analysis was conducted to identify the expression of candidate miRNAs in the liver tissues of diabetic and control mice. H&E staining revealed liver morphology in diabetic and control mice. Pyruvate tolerance tests, insulin tolerance tests, and intraperitoneal glucose tolerance test were utilized to assess insulin resistance. ELISA was conducted to evaluate blood glucose and insulin levels. Red oil O staining showed lipid deposition in liver tissues. Luciferase reporter assay was used to depict binding between miR-542-5p and forkhead box O1 (FOXO1). @*Results@#MiR-542-5p expression was under-expressed in the livers of db/db mice. Further in vitro experiments revealed that FSK/DEX, which mimics the effects of glucagon and glucocorticoids, induced cellular glucose production in HepG2 cells and in primaryhepatocytes cells. Notably, these changes were reversed by miR-542-5p. We found that transcription factor FOXO1 is a target of miR-542-5p. Further in vivo study indicated that miR-542-5p overexpression decreases FOXO1 expression, thereby reversing increases in blood glucose, blood lipids, and glucose-related enzymes in diabetic db/db mice. In contrast, anti-miR-542-5p exerted an adverse influence on blood glucose and blood lipid metabolism, and its stimulatory effects were significantly inhibited by sh-FOXO1 in normal control mice. @*Conclusion@#Collectively, our results indicated that miR-542-5p inhibits hyperglycemia and hyperlipoidemia by targeting FOXO1.

Inner-heating acupuncture of lumbar degenerative lesions based on β-catenin signaling pathway / 中国骨伤

OBJECTIVE@#By observing the effect of inner-heating acupuncture on the expression of Wnt1, Axin and β-catenin in the intervertebral disc of rats with lumbar degenerative disease and to explore the regulatory mechanism of inner-heating acupuncture on the apoptosis of annulus fibrosus cells in rats with lumbar degenerative disease.@*METHODS@#Forty SD rats were randomly divided into normal group, model group, inner heating acupuncture group and acupuncture group with 10 rats in each group. Except for normal group, all rats were modeled. Bilateral were selected for inner-heating acupuncture and acupuncture treatment. Western-bolt assay was used to detect the expression of Wnt1, Axin and β-catenin in rat intervertebral discs.@*RESULTS@#Compared with the model group, Wnt1 and β-catenin expression in annulus fibrosus cells of rats in the inner heating acupuncture group and the acupuncture group were significantly decreased(0.05).@*CONCLUSION@#Inner heating acupuncture can down regulate the expression of Wnt1 and β-catenin and up regulate the expression of Axin in annulus fibrosus of rats with lumbar degenerative desease. It is suggested that the mechanism may be to regulate the expression of related factors in the β-catenin signaling pathway, so as to achieve the goal of treating lumbar degenerative diseases.

Mechanism of Hematopoietic Reconstruction in Mice Treated with Danggui Buxue Decoction combined with Muscle-Derived Stem Cell Transplantation / 中国实验血液学杂志

OBJECTIVE@#To investigate the mechanism of hematopoietic reconstruction in mice treated with Danggui Buxue Decoction (DBD) combined with the muscle-derived stem cell transplantation (MDSCT).@*METHODS@#Female Kunming mice were randomly divided into the 6 groups: irradiation model, the bone marrow transplantation, the MDSC transplantation, the DBD 1 (4.5 g/kg), 2 (13.5 g/kg), and 3 (22.5 g/kg) + MDSC transplantation. After a week of oral administration of normal saline or different doses of DBD, The mice were exposied to 8 Gy Cs γ ray and were followed by bone marrow or MDSC transplantation. The expression levels of Notch1, Jagged1 and Hes1 in bone marrow, thymus and spleen were measured at 3 and 8 weeks after irradiation and transplantation.@*RESULTS@#In the bone marrow, 3 weeks after above-mentioned treatment, the expression of Notch1 mRNA increased obviously and the expression of Jagged1, Hes1 mRNA decreased obviously in each intervention group, compared with the irradiation model group. 8th week after treatment, the expression of Notch1 mRNA decreased obviously in each intervention group, the Jagged1 mRNA expression decreased obviously except the bone marrow group, and Hes1 mRNA expression increased (P＜0.05) in each intervention group. 3 weeks after treatment, compared with the irradiation model group, the expression of Notch1 mRNA in the thymocytes increased only in DBD1+MDSC group, Jagged1, Hes1 mRNA was increased in the MDSC transplantation group and the DBD1、2+MDSC group. 8th week after treatment, the expression of Notch1, Jagged1 mRNA expression decreased in each intervention group, the expression of Hes1 mRNA increased obviously in the MDSC transplantation group and the DBD1、2+MDSC group (P＜0.05). In the spleen, 3 weeks after treatment, the expression of Notch1, Jagged1 mRNA in the spleen of each intervention group decreased obviously, compared with the irradiation model group. The expression of Jagged1, Hes1 mRNA in each intervention group were increased obviously 8th week after treatment (P＜0.05).@*CONCLUSION@#MDSC transplantation after pretreatment of DBD can improve the hematopoietic reconstitution in mice with lethal dose radiation damage. Notch1、Jagged1 and Hes1 play different roles in this process, but the concrete mechanism needs to be further studied.

Analysis of Factors Influencing Overall Survival of MDS Patients Transplanted with HSCs / 中国实验血液学杂志

OBJECTIVE@#To analyze the effect of clinical features, routine laboratory examination and related gene mutation on the OS of patients with myelodysplastic syndrome (MDS) after hematopoietic stem cell transplantation (HSCT).@*METHODS@#121 patients diagnosed as MDS and underwent hematopoietic stem cell transplantation in the First Affiliated Hospital of Soochow University from October 2013 to August 2018 were selected. Basic information of the patients was collected, and blood cells, bone marrow blasts at initial diagnosis, chromosomal karyotypes and gene mutations of the patients were detected.The effect of different factors on overall survival (OS) was analyzed by statistical method.@*RESULTS@#Kaplan-Meier univariate analysis shows that OS was significanly different among different age groups. The 3-year OS rate of patients aged 0-29 years was (83.3±7.7) %, the 3-year OS rate in patients aged 30-49 years was (58.1±7.7 %), and the 3-year OS rate of patients aged 50-69 years was (31.0±22.6) %, which was statistically different (P＜0.05) between different groups. There were also significant differences in OS among patients with different transplantation types. 3-year OS rate: HLA-matched sibling HSCT＞unrelated HLA-matched HSCT＞haploidentical HSCT＞micro HSCT. The OS rate of patients with bone marrow blasts≥10% seems lower than blasts＜10%, but there was no statistical difference.The 3-year OS rate of patients with chromosomal karyotype complex abnormality was (47.7±11.5) %, and that of patients without complex abnormality was (80±4.2) % which was statistical difference (P＜0.05). Patients with DNMT3A, NRAS, TP53 and GATA2 mutations had shorter OS time compared with patients without mutation of these genes, which shows statistically significant (P＜0.05). COX multivariate analysis showed that age, chromosome karyotype, DNMT3A, TET2, GATA2 and NRAS were the independent factors influencing OS of patients after HSCT, with statistically significant difference.@*CONCLUSION@#age of patients, donor selection of HSCT, chromosome karyotype, DNMT3A, NRAS, TP53, GATA2 and TET2 gene mutations are all independent factors affecting the OS of patients after HSCT. Therefore, the assessment of the OS of MDS patients with transplantation requires comprehensive consideration.

Clinical experience of professor 's external treatment of supporting the middle for pediatric diseases / 中国针灸

It is well believed that children's spleen is often insufficient, as the structure and of spleen-stomach are incomplete. The deficiency of spleen-stomach plays an important role in the occurrence, development and pathogenesis of pediatric diseases. Professor has inherited the academic thought of , a famous physician of TCM, and proposed the external treatment method of "supporting the middle". This method emphasizes the constant care of the spleen-stomach of children in the aspect of acupoint selection, and adoptes the external treatment of children's , supporting- cupping therapy (including warming , warming moxibustion and warm scrapping), acupuncture (including abdominal acupuncture, intradermal needling) to treat children's diseases of spleen, lung, kidney and others, which has achieved satisfactory therapeutic effects.

Expression and filtering of TGF-β2 in aqueous humor and trabecular meshwork of Han and Kazakh patients with PACG / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the expression level of transforming growth factor β2(TGF-β2)in the aqueous humor and trabecular tissue of patients with primary angle-closure glaucoma(PACG)of Han and Kazakh ethnic groups and the formation of filter bleb after trabeculectomy.<p>METHODS: Prospective research. Between July 2018 to April 2019, 46 PAGG patients(49 eyes)underwent trabeculectomy in our hospital, including 25 Han nationality(26 eyes)and 21 Kazak nationality(23 eyes). Aqueous humor and trabecular tissue were obtained through trabeculectomy. ELISA method was used to detect the content of total aqueous TGF-β2(tTGF-β2)and activated TGF-β2(aTGF-β2). And the expression of TGF-β2 in trabecular tissue was detected by immunohistochemistry and immunofluorescence.<p>RESULTS:Immunohistochemical staining and immunofluorescence staining showed that the expression of TGF-β2 in the trabecular meshwork of Han patients was significantly higher than that of Kazakh patients. ELISA quantitative analysis showed that the aTGF-β2 content of Han and Kazak patients were 172.015±79.367pg/mL and 83.436±41.743pg/mL, respectively, the difference was statistically significant(<i>t</i>=4.794, <i>P</i><0.001). In patients ≥70 years old, the content of tTGF-β2 in the aqueous humor of patients of the two nationalities was 480.124±152.997 and 338.858±72.497pg/mL, respectively, the difference was statistically significant(<i>t</i>=2.421, <i>P</i>=0.026). In the comparison between preoperative and postoperative, there were time differences and interaction effects in intraocular pressure between Han and Kazak patients. At 6mo postoperatively, the formation of type Ⅰ and Ⅱ filter blebs in Han and Kazak patients was different, and the difference was statistically significant(50% <i>vs</i> 78%; χ2=4.841, <i>P</i>=0.028).<p>CONCLUSION: The expression of TGF-β2 in the aqueous humor and trabecular meshwork of patients with PACG in the two ethnic groups is different. The expression of TGF-β2 in the aqueous humor and trabecular meshwork of Kazakh patients is significantly lower, which reduces the promotion of postoperative filtering scar Functional filtration filtration bleb.

Differential diagnosis of amniotic fluid embolism / 中国实用妇科与产科杂志

Amniotic fluid embolism(AFE)is one of the leading causes of maternal mortality.Our understanding of its diagnosis,differential diagnosis and treatment is hampered by the nonspecific clinical manifestation and a lack of uniform definition.AFE is often overdiagnosed or missed in peripartum women.It makes great significance to improve perinatal outcomes through differential and early diagnosis of AFE.