Effect of increased mitophagy of chondrocytes in tibial growth plate of young rats with chronic renal failure on apoptosis / 中华肾脏病杂志

Objective:To explore the level of tibial growth plate chondrocyte mitophagy in young rats with chronic renal failure (CRF) and its effect on chondrocyte apoptosis.Methods:Male 4-week-old Sprague-Dawley rats were randomly divided into two groups according to random number table method: normal control group ( n=20, intragastric administration with distilled water) and CRF group ( n=20, given adenine suspension 150 mg·kg -1·d -1). All the young rats were sacrificed after continuous gavage for 6 weeks. The length of tibia was measured on X ray film, the width of tibia growth plate was measured and compared on histological section, and the apoptosis rate of chondrocytes in growth plate was detected by terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) assay. The growth plate chondrocytes of two groups were isolated and cultured to the third generation in vitro, and the apoptosis rate of chondrocytes was detected by TUNEL assay. The co-localization of mitochondria and autophagy lysosomes in chondrocytes was observed by double fluorescence staining. Western blotting was used to detect the level of mitochondrial marker protein translocate of the outer mitochondrial membrane-20 (Tom-20) and autophagy marker light chain-3 protein (LC-3). The mitophagy of growth plate chondrocytes was observed by transmission electron microscope. Results:Compared with the normal control group, the tibia length of CRF group was shorter [(27.32±5.81) mm vs (35.43±3.61) mm, t=5.226, P<0.001], and the relative width of growth plate in histological section was narrower (0.56±0.19 vs 1.00±0.21, t=6.744, P<0.001). The apoptosis rate of chondrocytes in growth plate in CRF group was higher than that in the normal control group (17.2%±4.8% vs 5.1%±3.4%, t=6.505, P<0.001). The apoptosis rate of chondrocytes cultured in vitro in CRF group was higher than that in the normal control group (11.8%±6.2% vs 3.1%±1.2%, t=4.357, P<0.001). The result of double influorescence staining showed that there was co-localization between mitochondria and autophagy lysosomes in CRF group. Western blotting results showed that the levels of LC-3 protein ( t=8.944, P<0.001) and Tom-20 protein ( t=6.708, P<0.001) in CRF group were lower than those in the normal control group. Conclusion:The level of tibial growth plate chondrocyte mitophagy in young rats with CRF increases, which will lead to a decrease in the number of mitochondria, an increase in the apoptosis and a decrease in the number of chondrocytes, and eventually lead to dysplasia of tibia.

Development of acute kidney injury prognostic model for critically ill patients based on MIMIC-Ⅲ database / 中华危重病急救医学

Objective:To investigate the risk factors affecting the prognosis of patients with acute kidney injury (AKI) in the intensive care unit (ICU) based on the Medical Information Mart for Intensive Care Ⅲ (MIMIC-Ⅲ) database, and to establish a prognostic model for AKI.Methods:Patients (aged ≥ 18 years) with acute renal failure, admitted to the ICU for the first time, and had complete hospital records (the RIFLE diagnostic criteria were used in the database, and the diagnosis was expressed as AKI in this article) were screened from MIMIC-Ⅲ database according to diagnostic codes. Patients were divided into two groups based on survival state at discharge, and the general information, underlying diseases, injury factors, vital signs and laboratory indicators within 24 hours after AKI, related intervention and prognostic indicators were analyzed. Univariate and multivariate Logistic regression analysis were used to determine the risk factors affecting mortality in patients with AKI and established a prediction model. The receiver operator characteristic curve (ROC curve) was used to analyze the predictive value of the prediction model for the prognosis of AKI patients.Results:There were 4 554 patients with AKI included and 862 died, with mortality of 18.93%. Univariate Logistic regression analysis was performed for factors that might be associated with death in AKI patients, and the results showed that age, hypertension, lymphoma, metastatic carcinoma, vancomycin, aspirin, coagulation abnormalities, cardiac arrest, sepsis or septic shock, invasive mechanical ventilation, white blood cell count (WBC), platelet count (PLT), K +, blood urea nitrogen (BUN), total bilirubin (TBil), renal replacement therapy (RRT) and length of stay (LOS) were independent risk factors [odds ratio ( OR) and 95% confidence interval (95% CI) were 1.002 (1.001-1.003), 0.764 (0.618-0.819), 1.749 (1.112-2.752), 2.606 (1.968-3.451), 1.779 (1.529-2.071), 0.689 (0.563-0.842), 1.871 (1.590-2.201), 2.468 (1.209-5.036), 2.610 (2.226-3.060), 2.154 (1.853-2.505), 1.105 (1.009-1.021), 0.998 (0.997-0.998), 1.132 (1.057-1.212), 1.008 (1.006-1.011), 1.061 (1.049-1.073), 2.142 (1.793-2.997), 0.805 (0.778-1.113), all P < 0.05]. Further binary Logistic regression analysis showed that lymphoma, metastatic cancer, vancomycin, cardiac arrest, sepsis or septic shock, coagulation dysfunction, invasive mechanical ventilation, increased BUN, increased TBil, increased or decreased blood K + and increased WBC were independent risk factors for death [β values were 0.636, 1.005, 0.207, 0.894, 0.787, 0.346, 0.686, 0.006, 0.051, 0.085, and 0.009; OR and 95% CI were 1.889 (1.177-3.031), 2.733 (2.027-3.683), 1.229 (1.040-1.453), 2.445 (1.165-5.133), 2.197 (1.850-2.610), 1.413 (1.183-1.689), 1.987 (1.688-2.338), 1.006 (1.003-1.009), 1.052 (1.039-1.065), 1.089 (1.008-1.176), and 1.009 (1.004-1.015), respectively, all P < 0.05]. The Hosmer-Lemeshow test showed that the AKI prognostic model was able to fit the observed data well ( P = 0.604). ROC curve analysis showed that the area under ROC curve (AUC) of the AKI prognostic model was 0.716 (95% CI was 0.697-0.735), when the cut-off value was 0.320, the sensitivity was 71.9%, the specificity was 60.1%, the positive likelihood ratio was 1.80, and the negative likelihood ratio was 0.47. Conclusion:The prognostic prediction model of AKI in critically ill patients established and based on the MIMIC-Ⅲ database may have practical significance for prognostic risk assessment of AKI and later intervention.

Using ultrasound for hemodynamic therapy among infants with septic shock / 中国小儿急救医学

Objective:To investigate the effects of critical care chest ultrasonic examination(CCUE)on different fluid management phases among septic shock infants in pediatric intensive care unit(PICU).Methods:Twenty-two infants who were hospitalized in PICU during January 2017 to December 2018 and diagnosed as septic shock were included in this study.These infants received shock and infection management as well as mechanical ventilation according to the septic shock management guidelines.CCUE was applied as needed to monitor the hemodynamic status for titrated adjustment in fluid and vasoactive drug management and its impacts were evaluated.Results:The change frequencies of treatment regimen according to CCUE evaluation were different among different phases( P<0.001). Compared with the other 3 phases, the number of adjustment made to fluid management scheme caused by CCUE during the first phase was the largest(75.0%, P<0.001), and that during the fourth phase was the smallest(2.3%, P<0.01). The frequency of change during the second phase(30.5%) and the third phase(23.5%) showed no difference( P=0.210). During the first phase, compared with the group with intravenous infusion speed<10 mL/(kg·h), the group with faster intravenous infusion speed had lower LUS score and more proportion of LVEF and RVEF above 50%( P<0.05). During the second phase and the third phase, compared with group receiving slower intravenous infusion, group with faster intravenous infusion had more LVEF>50%( P<0.05). Conclusion:Application of CCUE to monitor dynamic hemodynamic of infants with septic shock in PICU has different effects on fluid management scheme adjustment at different phase.CCUE evaluation during the early 3 phases, especially during the first phase has greater influence on fluid management strategy.Rapid infusion under CCUE monitoring is often limited by cardiac ejection fraction, LUS, and mainly LVEF, especially during the first phase.Multiple ultrasonic indicators should be combined with clinical data for full evaluation.

Clinical study of fluid management in children with septic shock guided by ultrasound / 中国小儿急救医学

Objective:To investigate the effects of critical care chest ultrasonic examination (CCUE) by intensive care physician on fluid management among septic shock patients in pediatric intensive care unit (PICU).Methods:Forty children from PICU who were diagnosed as septic shock in Shenzhen Bao′an Maternal and Child Health Hospital were included in this study.Twenty-two of them who were hospitalized in PICU during January 2017 to December 2018, under the care of 4 PICU physicians who had certificates of the Chinese Critical Ultrasound Study Group(CCUSG) were defined as CCUE group.Eighteen PICU patients from January 2014 to December 2015 having no access to CCUE were recruited as control group.Both groups were treated according to the septic shock management guidelines with routine anti-shock and anti-infection therapy, as well as mechanical ventilation.Fluid management following conventional protocol was performed in the control group.While in the CCUE group, CCUE was applied to monitor the hemodynamic status for adjustment in fluid management.Results:Compared with the control group, the CCUE group had shorter mechanical ventilation time as well as less fluid intake and output within 48 hours after admission[(4.68±2.06)d vs.(7.33±0.49)d, (6.34±1.85)ml/(kg·h) vs.(8.55±0.39) ml/(kg·h), (2.47±1.22)ml/(kg·h) vs.(6.18±1.72)ml/(kg·h)] ( P<0.05). The CCUE group also had a more positive fluid balance and larger dosage of midazolam and fentanyl administration[(3.87±2.33)ml/(kg·h) vs.(2.37±2.10)ml/(kg·h), (5.62±2.39)μg/(kg·min) vs.(1.68±0.82)μg/(kg·min), (1.41±0.39)μg/(kg·h) vs.(0.95±0.56)μg/(kg·h)] ( P<0.05). The two groups showed no differences in vasoactive-inotropic score within 48 h(11.11±6.08 vs.9.90±4.12), dosage of furosemide[(1.07±0.52)mg/(kg.d) vs.(0.94±0.15)mg/(kg·d)], length of PICU stay[(10.73±7.48)d vs.(10.00±2.91)d], intubation rate after 1 hour of volume resuscitation[54.5%(12/22)vs.33.33%(6/18)] or mortality[8.3%(2/24)vs.5.3%(1/19)] ( P>0.05). Conclusion:Application of CCUE helps to optimize fluid management and shorten the ventilation time among children with septic shock in PICU.

Clinical study of fluid management in children with septic shock guided by ultrasound / 中国小儿急救医学

Objective@#To investigate the effects of critical care chest ultrasonic examination (CCUE) by intensive care physician on fluid management among septic shock patients in pediatric intensive care unit (PICU).@*Methods@#Forty children from PICU who were diagnosed as septic shock in Shenzhen Bao′an Maternal and Child Health Hospital were included in this study.Twenty-two of them who were hospitalized in PICU during January 2017 to December 2018, under the care of 4 PICU physicians who had certificates of the Chinese Critical Ultrasound Study Group(CCUSG) were defined as CCUE group.Eighteen PICU patients from January 2014 to December 2015 having no access to CCUE were recruited as control group.Both groups were treated according to the septic shock management guidelines with routine anti-shock and anti-infection therapy, as well as mechanical ventilation.Fluid management following conventional protocol was performed in the control group.While in the CCUE group, CCUE was applied to monitor the hemodynamic status for adjustment in fluid management.@*Results@#Compared with the control group, the CCUE group had shorter mechanical ventilation time as well as less fluid intake and output within 48 hours after admission[(4.68±2.06)d vs.(7.33±0.49)d, (6.34±1.85)ml/(kg·h) vs.(8.55±0.39) ml/(kg·h), (2.47±1.22)ml/(kg·h) vs.(6.18±1.72)ml/(kg·h)] (P<0.05). The CCUE group also had a more positive fluid balance and larger dosage of midazolam and fentanyl administration[(3.87±2.33)ml/(kg·h) vs.(2.37±2.10)ml/(kg·h), (5.62±2.39)μg/(kg·min) vs.(1.68±0.82)μg/(kg·min), (1.41±0.39)μg/(kg·h) vs.(0.95±0.56)μg/(kg·h)] (P<0.05). The two groups showed no differences in vasoactive-inotropic score within 48 h(11.11±6.08 vs.9.90±4.12), dosage of furosemide[(1.07±0.52)mg/(kg.d) vs.(0.94±0.15)mg/(kg·d)], length of PICU stay[(10.73±7.48)d vs.(10.00±2.91)d], intubation rate after 1 hour of volume resuscitation[54.5%(12/22)vs.33.33%(6/18)] or mortality[8.3%(2/24)vs.5.3%(1/19)] (P>0.05).@*Conclusion@#Application of CCUE helps to optimize fluid management and shorten the ventilation time among children with septic shock in PICU.

Combined anterior and posterior approach revision for complex acetabular fractures / 中华创伤杂志

Objective@#To investigate the clinical effect of combined anterior and posterior approach revision on complex acetabular fractures.@*Methods@#A retrospective case series study was performed on the clinical data of 21 patients with complex acetabular fractures who underwent failed surgery through single approach from June 2012 to June 2017. There were 16 males and five females, averagely aged 34.6 years (range, 24-45 years). According to Letournel-Judet classification, there were seven patients with transverse+ posterior wall fracture, five patients with anterior column+ posterior semi-transverse fracture, four patients with double column fracture and five patients with "T" fracture. The first operation was performed by ilioinguinal approach in nine patients and by Kocher-Langebeck (K-L) approach in 12 patients. Revision surgery was performed using a combined anterior and posterior approach. The operation time and intraoperative blood loss were recorded, and the fracture healing was observed. The quality of fracture reduction was assessed according to Matta reduction criteria, and hip function by the modified D Aubigne and Postel score. The complications during and after operation were recorded. Heterotopic ossification was evaluated according to Brooker's criteria.@*Results@#The patients were followed up for 12 to 36 months, with an average of 27 months. The operation time ranged from 180 to 360 minutes, with an average of 270 minutes. Intraoperative bleeding was 1 000-3 800 ml, with an average of 2 000 ml. Fractures were healed, with the healing time ranging from 3.5 to 7 months, with an average of 5 months. According to Matta reduction criteria, there were eight patients with anatomical reduction, 12 with satisfactory reduction and one with unsatisfactory reduction. The improved D Aubigne and Postal score was (11.1±1.9)points preoperatively and (15.6±1.7)points six months after operation (P<0.05), the outcome of hip function was excellent in three patients, good in 14, fair in three, and poor in one, with the excellent and good rate of 81%. There were three patients with transient injury of sciatic nerve, one patient with traumatic arthritis and one with heterotopic ossification of Brooker II. No femoral head necrosis or deep venous thrombosis in the lower extremities was found.@*Conclusion@#For complex acetabular fractures, combined anterior and posterior approach revision can promote fracture reduction, fracture healing, and functional recovery, with low incidence of complications.

Clinical characteristics of chronic myeloid leukemia with T315I mutation and the efficacy of ponatinib / 南方医科大学学报

OBJECTIVE@#To analyze the clinical features of chronic myeloid leukemia (CML) with T315 I mutation (CML-T315I) and compare the effectiveness of different treatments.@*METHODS@#We retrospectively analyzed the clinical data and outcomes of 19 patients with CML-T315I receiving different treatments. The T315 I mutations in these patients were detected by examination of BCR-ABL kinase domain (KD) mutation by RTQ-PCR and Sanger sequencing. The relapse following the treatments, defined as hematological, cytogenetic and molecular biological recurrences, were analyzed in these patients.@*RESULTS@#Of the 19 patients with CML-T315I, 14 (73.7%) were in CML-CP stage at the initial diagnosis, and 13 (81.2%) were high-risk patients based on the Sokal scores. All the 19 patients were treated with TKI after the initial diagnosis, and during the treatment, 15 (78.9%) patients were found to have additional chromosomal aberrations, and 10 (52.6%) had multiple mutations; 13 (68.4%) of the patients experienced disease progression (accelerated phase/blast crisis) before the detection of T315I mutation, with a median time of 40 months (5-120 months) from the initial diagnosis to the mutation detection. After detection of the mutation, 12 patients were treated with ponatinib and 7 were managed with the conventional chemotherapy regimen, and their overall survival rates at 3 years were 83.3% and 14.2%, respectively ( < 0.001).@*CONCLUSIONS@#CML patients resistant to TKI are more likely to have T315I mutations, whose detection rate is significantly higher in the progressive phase than in the chronic phase. These patients often have additional chromosomal aberrations and multiple gene mutations with poor prognoses and a high recurrence rate even after hematopoietic stem cell transplantation. Long-term maintenance therapy with ponatinib may improve the prognosis and prolong the survival time of the patients.

Effects of parathyroid hormone - related peptide receptor in tibial growth plate on tibial extension in chronic renal insufficiency rats / 中华肾脏病杂志

Objective To observe the expression of parathyroid hormone - related peptide (PTHrp) receptor in tibial growth plate and its effects on tibial extension in chronic renal insufficiency rats. Methods Two-week-old male Sprague-Dawley rats were randomly divided into sham group, model group and enalapril group, each with 20 rats. In model group and enalapril group rats had chronic renal insufficiency induced by left ureteral obstruction, and rats were respectively given saline and enalapril by gavage after the operation. In sham group, left ureter was only exposed without ligation, and rats were given saline. The urine was collected 4 weeks after the operation and the total protein content was measured. Then all rats were killed. The concentrations of PTHrp, creatinine and urea nitrogen in intracardiac blood were detected. HE staining and Masson staining were performed on the left kidney to observe pathological changes of glomeruli and renal tubules. The total length of bilateral tibia was measured. The number of columnar cells in the growth plate proliferative zone was measured by safranin O staining and the expression of PTHrp receptor in the growth plate was detected by immunohistochemistry. Results The 24 h urine total protein, creatinine and urea nitrogen in model group were higher than those in sham group (all P＜0.05), while these 3 renal functional parameters in enalapril group were lower than those in model group (all P＜0.05). In model group and enalapril group rats had higher blood concentrations of PTHrp than that in sham group (all P＜0.05), but blood PTHrp in enalapril group was lower than that in model group (P＜0.05). HE staining and Masson staining showed that in the model group rats had severe tubular dilation, inflammatory cell infiltration and the tissue fibrosis, while in enalapril group renal tubules slightly dilated and had a few inflammatory cell infiltration and tissue fibrosis. Compared with those in the sham group, in model group the tibia length, the chondrocyte number of column structure in the growth plate proliferative zone and the PTHrp receptor decreased (all P＜0.05). But in enalapril group those indexes increased than model group (all P＜0.05). Conclusions Chronic renal insufficiency rats had increased PTHrp concentration in the blood but decreased PTHrp receptors expression in tibial growth plate, which lead to their limited tibial extension.

Combined anterior and posterior approach revision for complex acetabular fractures / 中华创伤杂志

Objective To investigate the clinical effect of combined anterior and posterior approach revision on complex acetabular fractures. Methods A retrospective case series study was performed on the clinical data of 21 patients with complex acetabular fractures who underwent failed surgery through single approach from June 2012 to June 2017. There were 16 males and five females, averagely aged 34. 6 years (range, 24-45 years). According to Letournel-Judet classification, there were seven patients with transverse+posterior wall fracture, five patients with anterior column+posterior semi-transverse fracture, four patients with double column fracture and five patients with "T" fracture. The first operation was performed by ilioinguinal approach in nine patients and by Kocher-Langebeck ( K-L ) approach in 12 patients. Revision surgery was performed using a combined anterior and posterior approach. The operation time and intraoperative blood loss were recorded, and the fracture healing was observed. The quality of fracture reduction was assessed according to Matta reduction criteria, and hip function by the modified D Aubigne and Postel score. The complications during and after operation were recorded. Heterotopic ossification was evaluated according to Brooker 's criteria. Results The patients were followed up for 12 to 36 months, with an average of 27 months. The operation time ranged from 180 to 360 minutes, with an average of 270 minutes. Intraoperative bleeding was 1000-3800 ml, with an average of 2000 ml. Fractures were healed, with the healing time ranging from 3. 5 to 7 months, with an average of 5 months. According to Matta reduction criteria, there were eight patients with anatomical reduction, 12 with satisfactory reduction and one with unsatisfactory reduction. The improved D Aubigne and Postal score was ( 11. 1 ± 1. 9 ) points preoperatively and ( 15. 6 ± 1. 7 ) points six months after operation (P<0. 05), the outcome of hip function was excellent in three patients, good in 14, fair in three, and poor in one, with the excellent and good rate of 81％. There were three patients with transient injury of sciatic nerve, one patient with traumatic arthritis and one with heterotopic ossification of Brooker II. No femoral head necrosis or deep venous thrombosis in the lower extremities was found. Conclusion For complex acetabular fractures, combined anterior and posterior approach revision can promote fracture reduction, fracture healing, and functional recovery, with low incidence of complications.

Induced Pluripotent Stem Cells-derived chimeric Thymus transplantation enhances T cells Reconstitution and prevents GVHD in Murine after allogeneic Bone Marrow Transplantation / 实用医学杂志

Objective To explore the effects of iPS cells-derived chimeric thymus transplantation on T cells reconstitution and graft versus host disease of murine after allo-BMT. Methods iPS cells-derived chimeric thymus was grafted under the renal capsules of mice after allogeneic IBM-BMT. The mice were divided into three groups:IBM-BMT group, IBM-BMT+TT group and IBM-BMT+DLI group. Four weeks after BMT, T lymphocyte subsets in the peripheral blood were analyzed by flow cytometry, the degree and pathological examination of GVHD were observed, respectively. Results Percentage of CD8+T cells in IBM-BMT group, IBM-BMT+TT group and IBM-BMT+DLI group was(5.52 ± 0.83)%,(11.10 ± 1.49)%and(8.49 ± 0.82)%respectively, there was signifi-cant difference between pairwise comparisons(P<0.05), and percentage of CD4 + T cells of the peripheral blood in IBM-BMT+TT group(9.60 ± 0.69)%was significantly higher than IBM-BMT group(6.42 ± 1.40)%and IBM-BMT+DLI group(8.07 ± 0.65)%(P<0.05) . IBM-BMT group and IBM-BMT+TT group showed less clinical and histopathological scoring of GVHD than IBM-BMT + DLI group. Conclusion iPS cells-derived chimeric thymus transplantation could effectively accelerate T cells reconstitution and prevent GVHD after allo-BMT.

Effects of thymus transplantation combined with CD4--DLI on T cell reconstitution after allogeneic hemato-poietic stem cell transplantation / 实用医学杂志

Objective To study the effects of thymus transplantation(TT)combined with CD4--DLI on T cell reconstitution after allogeneic hematopoietic stem cell transplantation(allo-HSCT). Methods BALB/c mice were randomly divided into three groups:hematopoietic stem cell transplantation (HSCT group),hematopoietic stem cell transplantation combined with thymus transplantation(TT group)and hematopoietic stem cell transplanta-tion combined with thymus transplantation plus CD4+ T cell-depleted lymphocyte infusion(CD4--DLI group). On day-1,the mice were treated with the lethal dose of radiotherapy. On day 0,C57BL/6 mice were used as donor for hematopoietic stem cell transplantation. The mice were sacrificed on 5 days,2 weeks,4 weeks and 3 months after transplantation,respectively. The peripheral blood and spleen cells of mice were collected for determinations of T cell surface antigen,T cell receptor,naive T cells and intracellular cytokines. HE staining was used to assess the development of donor thymus. Results TT and CD4--DLI did not impair each other′s effects on T cell reconstitu-tion. TT combined with CD4--DLI increased the number of T cell reconstruction. CD4--DLI promoted the effect of TT on enlargement naive CD4+and CD8+T cell pool. Combination of TT and CD4--DLI enhanced the cytokine pro-duction of T cells. Conclusion TT combined with CD4--DLI had no side effects on TCR repertoire and thymus. Conclusion TT combined with CD4--DLI can enhance the reconstitution of T cell number and function via thymus dependent and thymus independent mechanism.

Establishment of a animal model of allogeneic bone marrow transplantation plus thymic epithelial cells transplantation / 中华器官移植杂志

Objective To explore the establishment of animal model of allogeneic bone marrow transplantation plus thymic epithelial cells transplantation,and then examine the feasibility and effects of thymic epithelial cells transplantation applied in allogeneic bone marrow transplantation.Methods One day before transplantation the recipient BALB/C mice were given total-body irradiation,then transplanted with bone marrow cells from donor C57BL/6 mice and thymic epithelial cells from E14-16 embryonic thymus of donor C57BL/6 mice.In order to explore the appropriate irradiation dose,we set up three different dose groups:7 Gy;6.5 Gy;6 Gy.The recipient mice transplanted with BMT plus TCT served as experimental group,and those transplanted with BMT only served as control group (n =8 each).Then in vivo imaging in mammals was done to observe the thymic epithelial cells transplantation.Thymus index was measured.The thymus in each group was collected for histological examination and immunohistochemical staining of K5 and K8.Flow cytometry was used to examine the T cells subsets in peripheral blood of recipient mice 4 weeks after thymus transplantation.Results The recipient mice with 6.0 Gy TBI had long-term survival but implantation was done unsuccessfully,and those with 6.5 Gy had lower survival rate but implantation was done successfully.6.5 Gy was the minimum lethal dose and could be used as the appropriate irradiation does in this study.In vivo imaging in mammals detecting system showed the experimental group obvious fluorescent signals could be detected in the experimental group,but no fluorescence was found in the control group.Four weeks after transplantation,the thymus was bigger and thymus index was higher in the experimental group than in the control group.And the chiemra thymus of the experimental group also had normal cortex and medulla histological structure.Four weeks after transplantion,the percentages of CD4+ and CD8+ T cells of the peripheral blood in experimental group were significantly higher than in control group (P＜ 0.05).Conclusion Thymic epithelial cells can be transplanted in the thymus of the recipient mice with allogeneic bone marrow transplantation and promote the reconstitution of T lymphocytes of peripheral blood in the recipient mice.

Analysis of influence factors on anemia in preterm infants / 临床儿科杂志

Objective To study the influencing factors on anemia in preterm infants at the corrected age of 6-month-old based on gestational age (GA),birth weight (BW) and feeding pattems.Method Preterm infants with GA＜37 weeks (n=124)were followed up to 6 months of corrected age (CA) between June 2014 and November 2015.The incidence of anemia in preterm infants among different groups according to GA,BW and feeding pattem was statistically analyzed.Results Preterm infants included are of 70 males and 54 females.Median age of GA was 33.7 weeks with an average BW of 1910g.The incidences of anemia was 30.6％ (95％ CI:23％,38％) in preterm infants at 6 months of CA,66％ in breast-fed preterm infants.which is significantly higher than 19％ in those receiving mixed feeding and 13％ in those receiving formula feeding (P=0.000).No significant differences in anemia incidence were found among preterm infants of different GA and BW.Conclusions Anemia incidence in 6-month-old preterm infants is associated with feeding pattern,which conferrs greatest risk.It is necessary to undergo further analysis and treatments for preterm infants with anemia.

A Progress on the Effects of Resveratrol on Tumor Cells / 世界科学技术-中医药现代化

Resveratrol is a natural polyphenolic substance with a variety of bioactivities,such as anti-oxidation,anti-tumor and apoptosis induction.This paper summarized the recent research progress of resveratrol induced cancerous cell apoptosis,including human cervical cancer HeLa cells,leukemia cells,hepatoma cells and gastric cancer cells,and analyzed the molecular mechanism behind resveratrol-induced cell apoptosis in tumor.In addition,resveratrol was investigated by blocking the cell cycle,regulating the expressions of related genes and proteins and mitochondria-induced apoptosis pathways as a potential application of cancer drugs to clinical researches.

Generation of thymic epithelial cells in mouse by blastocyst injection of induced pluripotent stem cells / 实用医学杂志

Objective To examine an in vivo method for the differentiation of induced pluripotent stem cells (iPSCs) into thymic epithelial cells (TECs) in mice. Methods Green fluorescent protein-expressing iPS cells, derived from C57BL/6 mice, were injected into blastocysts from ICR mice. Chimeric blastocysts were then transferred into uteri of E2.5 pseudopregnant mice. Chimeric mouse could be identified by coat color 10 days after birth. The chimeric thymus was transplanted under the renal capsule of BALB/c nude mice. The spleen was cut out from the thymus-transplanted nude mice and the cells were dispersed and analyzed by a flow cytometer 4 weeks after transplantation. Results Chimeras were born 17 days after embryo transfer and 13 live-born chimeras were obtained. The contribution of iPSC-derived cells in the chimeras ranged from 5% to at most 90%. Typical thymic epithelium structure consisted of green fluorescent protein-expressing cells in chimera. The iPSCs-derived thymic epithelial cells could support the generation of new T cells. Conclusion The results indicate that mouse iPS cells can differentiate in vivo towards normally functioning TECs.

Autophagy and apoptosis of acute myelogenous leukemia U937 cell induced by Sirolimus / 中华实用儿科临床杂志

Objective To investigate the autophagy and apoptosis in acute myelogenous leukemia U937 cell induced by Sirolimus.Methods U937 cells were subcultured, and blank control group(normal) and Sirolimus treated groups(12 h, 24 h,48 h) were established.The Sirolimus treated groups were treated by 2 μmol/L concentration of Sirolimus for 12 h,24 h and 48 h, respectively.The cell morphology of U937 cells treated by Sirolimus was observed after 12 h,24 h and 48 h.The survival rate of cells was detected by cell counting kit-8 method.Cell apoptosis was detected by flow cytometry using Annexin V-FITC/PI double labeled.Real-time PCR was used to detect the level of mRNA expression in autophagy specific protein maker mictotubule-associated protein light chain 3 (LC3)-Ⅱ in different treated times by Sirolimus.Sirolimus LC3 protein expression levels after treatment were detected by Western blot method.Results Under inverted microscope, the cell number of Sirolimus treatment group reduced gradually after 12 h ,24 h and 48 h culture, volume of cells became smaller, cells got ruptured, and the nucleus pycnosis and cellular debris increased.With the extension of time, U937 cells survival rate was falling, and there was statistical differences compared with those of the control group(P =0.031).With Sirolimus treatment, U937 cells after 12 h,24 h and 48 h, U937 cell apoptosis rate increased, and there were statistically significances, compared with those of the control group (P =0.027).With Sirolimus treatment U937 cells after 12 h,24 h and 48 h,LC3-Ⅱ mRNA expression and protein expression were down-regulated compared with those of the control group, and there were statistically significances (P =0.029).Conclusions Sirolimus can induce autophagy and apoptosis in U937 cells.Autophagy protein LC3-Ⅱ in gene and protein expression levels were lowered, and LC3-Ⅱ may play an important role in regulating the leukemia cell autophagy.

Clinical analysis of laparoscopic resection for large volume of adrenal tumor in 39 cases / 中国医师进修杂志

Objective To explore the clinical efficacy of laparoscopic resection for large volume of adrenal tumor.Methods Eighty patients with adrenal tumor who were treatment by laparoscopic resection were divided into large volume group (diameter ≥ 6 cm) and small volume group (diameter ＜ 6 cm) according to the size of the tumor.The intraoperative and postoperative complications of the two groups were compared.Results The operation time,intraoperative bleeding volume and postoperative hospitalization time of large volume group were significantly higher than those in small volume group:(187.4 ±39.2) min vs.(153.7 ± 31.6) min,(458.2 ± 87.3) ml vs.(105.9 ± 25.1) ml and (10.9 ± 2.7) d vs.(7.3 ± 1.5) d,and the difference were statistically significant (P ＜ 0.05).The postoperative complications in two groups had no significant difference:10.3％ (4/39) vs.7.3％ (3/41),P ＞ 0.05.Conclusion The laparoscopic resection for large volume of adrenal tumor have the advantages of less invasion,faster recovery and less complications,and it has become the main mode of treatment.

New techniques for umbilical cord blood transplantation / 南方医科大学学报

Umbilical cord blood is an alternative hematopoietic stem cell source for treatment of hematological diseases that can be cured by allogeneic hematopoietic stem cell transplantation. Since the first case of umbilical cord blood transplantation performed successfully in a child with Fanconi anemia, the field of umbilical cord blood transplantation has grown exponentially, and a great progress has been made worldwide in the treatment of children with malignant hematological diseases, including some congenital metabolic disorders. Umbilical cord blood transplantation was initially intended only in the treatment of pediatric patients, given the small volume collected and the low hematopoietic stem cell dose infused. In recent years, the application of new techniques for hematopoietic stem cell transplantation has greatly improved the outcomes of umbilical cord blood transplantation in adult patients. In this review article, we summarize the latest techniques for umbilical cord blood transplantation.

Value of magnetic resonance imaging T2* tests in detecting heart and liver iron overload in patients with β-thalassemia major / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the value of magnetic resonance imaging T2* tests in the detection of myocardial and liver iron overload in patients with β-thalassemia major (β-TM).</p><p><b>METHODS</b>From 2010 to 2011, 28 β-TM patients over 10 years old under blood transfusion therapy and chelation care with serum ferritin (SF)>1000 µg/L underwent myocardial and liver MRI T2* tests on a voluntary basis. The results were analyzed in relation with age, SF, and left ventricular ejection fraction (LVEF).</p><p><b>RESULTS</b>Fourteen out of the 28 cases (50%) were found to have myocardial iron overload, including 7 severe cases, 2 moderate cases, and 5 mild cases. All the 28 cases had liver iron overload, including 2 mild cases, 7 moderate cases, and 19 severe cases. Two out of the 28 cases had lowered LVEF (7.14%), and one of them had severe myocardial iron overload. There was a negative correlation between myocardial MRI T2* and SF (r=-0.479, P=0.01). Myocardial MRI T2* was positively correlated with liver MRI T2* (r=0.378, P=0.047). Age was not significantly correlated with SF, LVEF, or liver MRI T2*.</p><p><b>CONCLUSION</b>Magnetic resonance imaging (T2*) detection is an effective and non-invasive means for detecting myocardial and liver iron overload in patients with β-thalassemia major receiving blood transfusion. T2* combined with SF is the main diagnostic indicator to assess iron overload in the vital organs.</p>

Application of comprehensive teaching mode in cataract clinical teaching / 中华医学教育探索杂志

Objective To explore teaching effect of comprehensive teaching mode of PBL combined with CBL in ophthalmologic cataract clinical teaching.Methods 2008 grade clinical majors (n =80) in class 1 as experimental group were taught by comprehensive teaching mode of PBL combined with CBL while those (n =83) in class 2 as control group were taught by traditional LBL teaching mode.After the courses,the teaching effects of two methods were compared.SPSS 11.5 software was used for statistical analysis,x2 test for satisfaction survey and t-test for theoretical examination scores.The test level is α =0.05.Results There were significant differences between experimental group and control group in improving comprehensive quality and developing clinical thinking.Scores of understanding knowledge,case analysis and total scores of experimental group were higher than those of control group (all P ＜ 0.05).Conclusions Comprehensive teaching mode may improve the teaching effect of cataract clinical teaching,but it need to be explored and improved continually in practice.