ABSTRACT
Objective:To investigate the perinatal prognosis and its impact factors for premature infants with twin-twin transfusion syndrome (TTTS) who were born at ≤34 weeks of gestation.Methods:A retrospective study was conducted on 68 pregnancies of TTTS with gestational age ≤34 weeks at delivery, among them 106 preterm infants (TTTS group) were admitted to the neonatal intensive care unit of the First Affiliated Hospital, Sun Yat-sen University from January 2003 to February 2019. During the same period, another 178 twins without TTTS, congenital malformation, and intrauterine intervention who matched the TTTS group in maternal age (differences within two years) and gestational age (differences within one week) were assigned as non-TTTS group. Perinatal prognosis of TTTS infants born at ≤34 weeks was analyzed by comparing the differences in postnatal early complications and perinatal outcomes (survival time morn than 28 days or not) between the TTTS and non-TTTS groups, recipient and donor twins, mild and severe TTTS infants, and among TTTS infants with different intrauterine interventions. The risk factors for perinatal survival in TTTS infants with gestational age ≤34 weeks were analyzed. Two independent samples t-test, one-way analysis of variance, rank-sum test, Chi-square test, and ordered logistic regression were used for statistical analysis. Results:(1) Among the 68 pregnancies, the overall perinatal survival rate of the neonates was 72.1% (98/136), the double-twin survival rate was 48.5% (33/68), and the rate of at least one survivor was 95.6% (65/68). (2) In the TTTS group, 62 were recipients and 44 were donors. Stage Ⅰ-Ⅱ TTTS was found in 41 cases (mild TTTS group) and stage Ⅲ-Ⅴ in 65 cases (severe TTTS group). (3) The rate of severe brain injury was higher in the severe-TTTS group than those in the mild-TTTS group [9.2% (6/65) vs. 0.0% (0/41), χ 2=4.01, P=0.045]. (4) Gestational age ≤28 weeks ( OR=101.90, 95% CI: 5.07-2 048.37), stage Ⅳ ( OR=14.04, 95% CI: 1.56-126.32) and stage Ⅴ TTTS ( OR=51.09, 95% CI: 3.58-728.81) were independent risk factors for death within 28 days (all P<0.05). (5) Compared with the non-TTTS group, the TTTS group had higher rates of neonatal anemia [51.9% (55/106) vs. 33.1% (59/178), χ 2=9.71], polycythemia [5.7% (6/106) vs. 0.6% (1/178), χ 2=7.18], neonatal persistent pulmonary hypertension [3.8% (4/106) vs. 0.0% (0/178), χ 2=6.81], sepsis [15.1% (16/106) vs. 7.3% (13/178), χ 2=4.40], state Ⅲ or higher retinopathy of prematurity [3.8% (4/106) vs. 0.0% (0/178), χ 2=6.81], congenital cardiac structural abnormality [19.8% (21/106) vs. 0.6% (1/178), χ 2=33.45], heart failure [8.5% (9/106) vs. 0.6% (1/178), χ 2=12.29], and renal insufficiency [14.2% (15/106) vs. 1.1% (2/178), χ 2=20.04] (all P<0.05). Conclusions:Compared with the twin premature infants without TTTS, those with TTTS and ≤34 gestational age were more likely to have cardiac, cerebral, and renal complications. The more severe the TTTS, the higher the incidence of severe brain injury. TTTS preterm infants with gestational age ≤28 weeks and stage Ⅳ or above have high risk of death.
ABSTRACT
Lymphangioleiomyomatosis (LAM) is a rare, multisystemic, low-grade neoplasm character-ized by diffuse cystic lesions in the lung.In recent years, emerging imaging examination such as 68Ga-NEB PET-CT scan provides efficient and precise non-invasive diagnostic methods to detect lymphatic circulation abnormalities in LAM patients. The long-term efficacy and safety of sirolimus for LAM has accumulated further evidence, and genetic profiling studies have unveiled more information of genetic mechanisms. Prognosis of LAM has been much improved. We briefly reviewed the research advances of LAM in China and other countires.
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Objective To examine the effect of positive and negative evaluative conditioning (EC) on neutral faces.Methods The experiment consisted of three phases:baseline phase,conditioning phase,and re-evaluative phase,in which 41 college students participated,watching sequences of neutral faces (CS) pairing to either a positive stimulus (USpos) or a negative stimulus (USneg).Their emotional experiences (valence and arousal) and physiological reactivity (eyeblink startle reflex and skin conductance) were recor ded.Results (1) In the re-evaluative phase,CSpos was rated significantly more positive than CSneg and CSneut,while CSneg was rated significantly more negative than CSneut (CSpos (5.05± 1.24),CSneg (3.73± 1.48),CSneut (4.46± 1.04),P＜0.05).(2)In the re-evaluative phase,the mean startle eyeblink response magnitude(T score) to CSpos was significantly smaller than the responses elicited by CSneg and CSneut (CSpos (45.04±5.56),CSneg (51.44±9.30),CSneut (54.52± 10.60),P＜0.01).Conclusion The findings suggest that neutral faces can acquire valences and approach motivation through EC.
ABSTRACT
Objective To investigate the destructive effect of CSC-DC-CIK who were induced by cytokine induced killer (CIK) cells co-cultured with dendritic cells (DCs) on homologous tumor cells and to explore the possibility of CSC anti-gen involving in killing tumor. Methods Kidney cancer stem cells (KSCs) and lung cancer stem cells (LSCs) were isolated through FACS using CD133 +as a selection marker from cultured kidney cancer cell line A498 and lung cancer cell line A549 respectively. Freeze-thaw method was used to obtain the cancer stem cells(CSCs)antigens. DC cells and CIK cells were collected by in vitro expansion and inducted from the mononuclear cells isolated from human cord blood. The CIK cells were co-cultured with the DCs which were pulsed with the CSCs antigens(CSC-DC-CIK)mentioned above. Immunopheno-types of DC and CIK were analyzed by flow cytometry;cytokines levels were detected by ELISA kits and the destructive ef-fects of two kinds of CSC-DC-CIKs were tested by lactate dehydrogenase (LDH) release assay. Results The expression of phenotypes CD40+, CD80+, CD86+and HLA-DR+were higher in CSC-DC than in CD(P<0.01);the expression of pheno-types CD40+, CD80+, CD86+and HLA-DR+of DC and CSC-DC were higher after co-culture than those before co-culture( P<0.01);the expression of phenotypes CD40+, CD80+, CD86+and HLA-DR+of CSC-DC after been co-cultured with CIK were higher than those of DC after been co-cultured with CIK(P<0.01). The CIK phenotypes:CD3+, CD8+, CD56+were in-creased in CIK co-cultured with both CSC-DC and DC than those before co-culture (P<0.01);the expression of pheno-types CD3+, CD8+, CD56 +were higher in CSC-DC co-cultured with CIK than in DC co-cultured with CIK. DC-CIK and CSC-DC-CIK groups were more capable to express IFN-γ, TNF-α, IL-2 than they were before co-cultured with CIK (P<0.01). CSC-DC-CIK group can secrete more above cytokines than DC-CIK group does(P<0.01). The destructive rates of KSC-DC-CIK and LSC-DC-CIK on target cells were (50.21 ± 4.24)%and (49.32 ± 3.89)%respectively which were much higher than that in DC-CIK(30.25±3.11)%(F=89.157,P<0.01). Conclusion CSC-DC-CIKs have destructive effects on homologous tumor cells. More researches are needed to explore the mechanism and to evaluate the clinical applications.