Clinical and epidemiological features analysis of pneumocystis jirovecii pneumonia in kidney transplant recipients / 器官移植

Objective To investigate clinical and epidemiological features of pneumocystis jirovecii pneumonia (PJP) in kidney transplant recipients. Methods Clinical data of 68 kidney transplant recipients admitted from July, 2021 to December, 2021 were collected. All patients were divided into the PJP group (n=11), common pulmonary infection group (n=24) and non-pneumonia group (n=33) according to the status of pulmonary infection. The incidence and treatment of PJP after kidney transplantation were analyzed. Basic characteristics and laboratory parameters of the recipients were compared among all groups. The genotyping and transmission map of PJP patients were evaluated. Results Among 64 kidney transplant recipients, 11 cases were definitely diagnosed with PJP. The most common clinical manifestations included elevated body temperature, and dry cough complicated with progressive dyspnea. Chest CT scan showed diffuse interstitial inflammation and ground glass-like lesions of bilateral lungs in all patients. After diagnosis, all patients were orally given with compound sulfamethoxazole for 3-4 weeks. Two patients received non-invasive ventilator-assisted ventilation due to severe lung infection and dyspnea, and the remaining patients were given with nasal cannula oxygenation. One patient experienced elevated serum creatinine level upon discharge, and developed renal allograft failure. The remaining 10 recipients with PJP obtained normal renal allograft function, and no recipient died. Compared with the non-pneumonia group, the rejection rate was higher, the length of hospital stay was longer, the lymphocyte count was less, the lymphocyte proportion was lower, the levels of C-reactive protein, serum creatinine and lactate dehydrogenase were higher, and the levels of serum albumin was lower and CD4+T cell count was less in the PJP group (all P < 0.05). Compared with common pulmonary infection group, the lymphocyte count was less, the lymphocyte proportion was lower, the CD4+T cell count was less and 1, 3-β-D- glucan (BDG) level was higher in the PJP group (all P < 0.05). No new genotype was detected in 10 of the 12 testing samples. It was considered that PJP mainly depended on two transmission chains and two independent transmission individuals. Conclusions Kidney transplant recipients are prone to pneumocystis jirovecii (PJ) infection due to impaired cellular immune function. The most common clinical manifestations consist of elevated body temperature and dry cough complicated with progressive dyspnea, accompanied by headache and fatigue in partial patients. Chest CT scan shows diffuse interstitial inflammation and ground glass-like lesion of bilateral lungs. PJ may be transmitted through respiratory tract. Small-scale PJP might occur in the follow-up outpatient of kidney transplant recipients. Preventive measures should be delivered in a timely manner.

Sophoral flavones inhibit proliferation of cardiac fibroblasts via regulating the expression of prohibitin / 药学学报

The aim of the present study was to investigate the effect of Sophoral flavones on proliferation of cardiac fibroblasts (CFb) induced by high glucose and its underlying mechanism. Cardiac fibroblasts were exposed to different concentration of D-glucose (15, 25 and 35 mmol·L-1) at different time point (24, 48 and 72 h) in order to determine cell proliferation, and the model group was established by culturing CFb with 25 mmol·L-1D-glucose for 48 h. Sophoral flavones (12.5, 25 and 50 mg·L-1) were employed for intervention. The cell viability was measured by MTT assay, and the levels of transforming growth factor-β1 (TGF-β1), matrix metalloproteinase-2 (MMP-2), collagen Ⅰ and collagen Ⅲ were measured by ELISA. In addition, flow cytometry was employed to detect the cell cycle; while the protein expression of prohibitin (PHB) was observed via immunocytochemistry and Western blot. This animal experiment had been approved by Jilin Medical University Experiment Animal Ethics Review Committee. The results showed that 25 mmol·L-1 glucose could promote the proliferation of CFb; and the contents of TGF-β1, MMP-2, collagen Ⅰ and collagen Ⅲ in the model group were higher than that of control (P<0.05). The number of cells in S and G2 phase increased under high glucose condition. In the model group, PHB translocation occurred at 6 h and protein expression decreased at 48 h (P<0.01). Compared with the model group, 12.5-50 mg·L-1 Sophoral flavones reduced the contents of TGF-β1, MMP-2, collagen Ⅰ and collagen Ⅲ, increased the number of G1 phase cells, and increased the expression of PHB protein at 48 h (P<0.05), with no effect on the nuclear translocation of PHB. These results indicated that Sophoral flavones could prevent the proliferation of CFb induced by high glucose, the mechanism of which may be related to increasing the expression of PHB protein.

Primary sarcomatoid carcinoma of the mandibular gingiva: clinicopathological and radiological findings

Sarcomatoid carcinoma is a rare, malignant biphasic neoplasm with an epithelial and a spindle cell component. Primary sarcomatoid carcinomas arising from mandibular gingiva are known to be extremely rare, with only one case reported to date. Herein, we discuss the radiographic and computed tomographic appearances and pathological features of primary mandibular sarcomatoid carcinoma, which was confirmed by clinicopathology, in a 72-year-old man. In addition, we present a brief review of the relevant literature.

Mitochondrial DNA mutations in gastric endothelial cells induced by extract of helicobacter pylori in vitro / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the relationship between the helicobacter pylori (HP) infection and the genetic instability of mitochondrial DNA (mtDNA) in human gastric adenocarcinoma epithelial cells (AGS).</p><p><b>METHODS</b>After treated with extracts of HP11638 (CagA+, VacA+) or Hp11638 mutant strain (CagA+, VacA-), AGS cells were collected, and mitochondrial DNA was extracted and Cox-I, Cox-II, Cox-III, ATPase6, ATPase8 and Cytb genes and the D-Loop region were amplified by PCR and then sequenced.</p><p><b>RESULTS</b>The mutation rates of the mtDNA in AGS cells were correlated with the extracts of the two HP strains in a concentration- and time-dependent manner. But the mtDNA mutation rate in AGS cells treated with the HP11638 extract was higher than that treated with the Hp11638 mutant extract. Total of 616 mutations in D-Loop region were detected, including 489 point mutations, 81 insertions and 46 deletions. Among them, 70.9% (437/616) belonged to GC to AT and AT to GC transition. Seventeen out of 20 (85%) AGS cells treated with extract of HP had mutations in 303PolyC, 16184PolyC and 514CA regions of mtDNA D-Loop. No mutation was detected in Cox-I, Cox-II, Cox-III, ATPase6 and ATPase8 genes, three point mutations were found in the Cytb gene.</p><p><b>CONCLUSION</b>HP can cause the accumulation of mutations in mtDNA, in particular, in the D-Loop region, and the VacA participated in the process.</p>

Clinical analysis on 75 cases of aluminosis caused by black fused alumina / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the hazards of aluminum dusts to the exposed workers and the clinical features of aluminosis.</p><p><b>METHOD</b>Retrospective investigation on 75 aluminosis patients from a certain factory diagnosed in Shanghai Occupational Diseases Hospital from 1972 to 2004 was carried out.</p><p><b>RESULTS</b>There were 27 cases of aluminosis I (36.0%), 28 cases of aluminosis II (37.3%) and 20 cases of aluminosis III (26.7%) among 75 cases. The shortest exposure duration was 3 years, and the longest 17 years, and 37 cases of aluminosis occurred after exposure less than 10 years. hest radiographic examination mainly showed irregular micro-shadows: t (22/75), s (4/75), t/u (1/75), t/s (2/75), or predominantly irregular mixed microshadows s/p (5/75), s/r (1/75), t/p (9/75), t/q (5/75); some showed round shape micro-shadows: p (6/75), q (1/75), p/q (3/75), q/p (1/75). 27 cases showed large shadows, 20 cases of them were diagnosed as pneumoconiosis III. A lot of irregular micro-shadows gathered and developed to form uneven, loose and border-irregular masses. Most massive fibrosis looked like stripe or plait, located mostly in middle and upper lung field. 8 patients suffered from aluminosis with single side of massive fibrosis and 12 with both sides of massive fibrosis, accounting for 40% and 60% respectively. Mediastinal and bronchopulmonary lymph nodes were enlarged and calcified, accompanied with pleural thickening.</p><p><b>CONCLUSIONS</b>Short exposure to high concentration of black fused alumina may cause serious aluminosis to the exposes. The hazards of aluminum dusts should not be ignored.</p>

Imaging diagnosis of skull epidermoid cyst:analysis of four cases / 中华放射学杂志

Objective To study the CT and MR imaging features of skull epidermoid cyst. Methods CT and MR findings of 4 cases of pathologically proved skull epidermoid cyst were analyzed and correlated with operative and pathologic reports.Results CT and MR appearances of skull epidermoid cyst were as follows:(1)crater-form or scalloping deossification with sclerotic border and fatty density focus was detected on CT.(2)The lesions were isointense to hypointense relative to normal white matter in T1-weighted image,prominent hyperintense in T_2-weighted image,mild to moderate hyperintense in diffusion-weighted imaging(DWI),and isointense to hypointense in apparent diffusion coefficient(ADC) map on MR.Proton MRS revealed lactate(Lac)peaks at 1.3 ppm and amino acids(AAs)at 0.9 ppm. (3)No enhancement was found in substance region of all tumors on both enhanced CT and enhanced MR examinations.Conclusion CT and MR appearances of skull epidermoid cyst have unique features which are very helpful in the diagnosis of skull epidermoid cyst.