Herramientas ómicas en el diagnóstico de enfermedades ultra-huérfanas: Síndrome de haploinsuficiencia MED13L

Introducción: Las tecnologías de nueva generación han permitido un avance en el diagnóstico y abordaje de enfermedades genéticas ultra-huérfanas ofreciendo mayores posibilidades en tratamiento y consejería genética a las familias. El síndrome de MED13L afecta la proteína MED13L, importante en el desarrollo temprano del corazón, células nerviosas del cerebro y estructuras de la cara. Sus variantes pueden ser las causantes del síndrome de retraso del desarrollo y dismorfia facial con o sin defectos cardíacos. Presentación de caso: Paciente de 4 años, historia de hipotonía generalizada, retraso global del neurodesarrollo, discapacidad cognitiva y rasgos dismórficos, dada la complejidad clínica se realizó secuenciación del exoma clínico completo con análisis de ADN mitocondrial y variación en el número de copias (CNV) con detección de alteración del Gen MED13L variante c.2965C>G (p.Pro989Ala), significado clínico incierto, con posterior implementación de tecnologías de última generación, y reclasificación de la significancia de la variante a patogénica a través del análisis bioinformático, lo cual permitió llegar al origen específico de la patología. Conclusiones: Se resalta la importancia del uso de tecnologías de última generación y herramientas bioinformáticas en el diagnóstico específico de las enfermedades complejas. Las nuevas tecnologías actúan como una herramienta de ayuda para instaurar un protocolo dirigido, un asesoramiento genético y así evaluar el riesgo de heredabilidad, pronóstico y perspectivas terapéuticas de las patologías genéticas ultra-huérfanas. (provisto por Infomedic International)

Introduction: New generation technologies have allowed an advance in the diagnosis and approach of ultra-orphan genetic diseases, to offer greater possibilities in treatment and genetic counseling to families. MED13L syndrome affects the MED13L protein, which is important in early development of the heart, nerve cells in the brain, and structures of the face. Its variants can be the cause of developmental delay syndrome and facial dysmorphia with or without heart defects. Case presentation: 4-year-old patient with history of generalized hypotonia, global neurodevelopmental delay, cognitive disability and dysmorphic features, given the clinical complexity a complete clinical exome sequencing was performed with analysis of mitochondrial DNA and copy number variation (CNV) with detection of alteration of the MED13L gene variant c.2965C>G (p.Pro989Ala), uncertain clinical significance, with subsequent implementation of new generation technologies and reclassification of significance to pathogenic variant through bioinformatic analysis, which allowed reaching the a specific origin of the pathology. Conclusions: The importance of the use of new generation technologies and bioinformatic tools in the specific diagnosis of complex diseases is highlighted. New technologies act as a tool to help establish a targeted protocol, genetic counseling and thus assess the risk of heritability, prognosis, and therapeutic perspectives of ultra-orphan diseases. (provided by Infomedic International)

Three years of COVID-19 pandemic: comparative analysis of incidence, lethality and mortality among the States of the south region of Brazil / Três anos de pandemia da COVID-19: análise comparativa da incidência, letalidade e mortalidade entre os Estados da região sul do Brasi

Introduction: the first COVID-19 case in Brazil was confirmed on February 26, 2020. As of March 17, 2023, the Ministry of Health reported 699,634 deaths from COVID-19, with a case fatality rate of 1.9%. The impact of the COVID-19 pandemic in Brazil extends to socioeconomic and healthcare systems, reflecting significant regional disparities. Objective: To analyze mortality, incidence, and case fatality rates for COVID-19 in the states of Paraná and Santa Catarina, in the southern region of Brazil. Methods: This is an ecological time-series study using official Brazilian secondary data for COVID-19 cases and deaths. Data were extracted from the dashboard of the State Health Department of Santa Catarina and Paraná. Temporal series were developed for trend analysis using the Prais-Winsten regression model. Statistical analyses were performed using STATA 14.0 software (College Station, TX, USA, 2013). Results: In the analysis of rates over the entire period, trends for mortality, case fatality, and incidence in the state of Santa Catarina are decreasing, decreasing, and stationary, respectively. In Paraná, rates over the entire period showed a stationary trend for mortality, decreasing for case fatality, and increasing for incidence. Conclusion: COVID-19 had a devastating effect on the states of Santa Catarina and Paraná. Both states experienced the progression of the COVID-19 pandemic, with higher case fatality and mortality rates observed in Paraná, while Santa Catarina had a higher incidence rate over the three years of the COVID-19 pandemic.

Macrophage MED1 deficiency promotes the development of atherosclerosis in female ApoE and LDLR knockout mice / 西安交通大学学报(医学版)

【Objective】 To study the effect of macrophage mediator 1 (MED1) deficiency on atherosclerosis in female mice. 【Methods】 ApoE knockout (ApoE-/-), LDLR knockout (LDLR-/-), MED1fl/fl, and macrophage MED1 knockout (MED1△Mac) mice were recruited in the study. Two types of mouse model were constructed:ApoE and macrophage MED1 double knockout (MED1△Mac/ApoE-/-) mice and their littermate controls (MED1fl/fl/ApoE-/-). ② LDLR knockout (LDLR-/-) mice receiving bone marrow from MED1△Mac (MED1△Mac→LDLR-/-) or MED1fl/fl (MED1fl/fl→LDLR-/-) mice. Female mice from these two models were fed a Western diet (21% fat and 0.15% cholesterol) for 12 weeks to promote the development of atherosclerosis. Body weight, total cholesterol (TC), and total triglyceride (TG) content in plasma were measured dynamically. After Western diet feeding for 12 weeks, aortic tree and aortic root were collected and hematoxylin-eosin (H&E) and oil red O staining were performed. 【Results】 Plasma TC and TG did not significantly differ between MED1fl/fl/ApoE-/- control group and MED1△Mac/ApoE-/-experimental group. However, the plaque area in aortic tree and aortic root was significantly increased in MED1△Mac/ApoE-/-mice. Moreover, compared with that in MED1fl/fl→LDLR-/- control group, the plaque area of aortic tree and aortic root had an increasing trend in MED1△Mac→LDLR-/- mice group. 【Conclusion】 MED1 deficiency in macrophages promotes the development of atherosclerosis in female ApoE or LDLR knockout mice.

Estrogen receptor coactivator Mediator Subunit 1 (MED1) as a tissue-specific therapeutic target in breast cancer / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Breast cancer, one of the most frequent cancer types, is a leading cause of death in women worldwide. Estrogen receptor (ER) α is a nuclear hormone receptor that plays key roles in mammary gland development and breast cancer. About 75% of breast cancer cases are diagnosed as ER-positive; however, nearly half of these cancers are either intrinsically or inherently resistant to the current anti-estrogen therapies. Recent studies have identified an ER coactivator, Mediator Subunit 1 (MED1), as a unique, tissue-specific cofactor that mediates breast cancer metastasis and treatment resistance. MED1 is overexpressed in over 50% of human breast cancer cases and co-amplifies with another important breast cancer gene, receptor tyrosine kinase HER2. Clinically, MED1 expression highly correlates with poor disease-free survival of breast cancer patients, and recent studies have reported an increased frequency of MED1 mutations in the circulating tumor cells of patients after treatment. In this review, we discuss the biochemical characterization of MED1 and its associated MED1/Mediator complex, its crosstalk with HER2 in anti-estrogen resistance, breast cancer stem cell formation, and metastasis both in vitro and in vivo. Furthermore, we elaborate on the current advancements in targeting MED1 using state-of-the-art RNA nanotechnology and discuss the future perspectives as well.

Estrogen receptor coactivator Mediator Subunit 1 (MED1) as a tissue-specific therapeutic target in breast cancer / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Breast cancer, one of the most frequent cancer types, is a leading cause of death in women worldwide. Estrogen receptor (ER) a is a nuclear hormone receptor that plays key roles in mammary gland development and breast cancer. About 75% of breast cancer cases are diagnosed as ER-positive; however, nearly half of these cancers are either intrinsically or inherently resistant to the current anti-estrogen therapies. Recent studies have identified an ER coactivator, Mediator Subunit 1 (MED1), as a unique, tissue-specific cofactor that mediates breast cancer metastasis and treatment resistance. MED1 is overexpressed in over 50% of human breast cancer cases and co-amplifies with another important breast cancer gene, receptor tyrosine kinase HER2. Clinically, MED1 expression highly correlates with poor disease-free survival of breast cancer patients, and recent studies have reported an increased frequency of MED1 mutations in the circulating tumor cells of patients after treatment. In this review, we discuss the biochemical characterization of MED1 and its associated MED1/Mediator complex, its crosstalk with HER2 in anti-estrogen resistance, breast cancer stem cell formation, and metastasis both in vitro and in vivo. Furthermore, we elaborate on the current advancements in targeting MED1 using state-of-the-art RNA nanotechnology and discuss the future perspectives as well.

Study on influencing factors of the choice of hospitalization behaviors among agricultural trans-fer population / 中国卫生政策研究

The choice of hospitalization behaviors among agricultural transfer population plays an important role in promoting the system of hierarchical diagnosis and treatment. The data of 2014 National Floating Population Dy-namic Monitoring Survey was used to study the influencing factors of the choice of hospitalization behaviors among 6168 agricultural transfer population who needed hospitalization and find out the influencing factors of their hospitali-zation choice. The results of this study show that 85.7% of agricultural transfer population chooses hospitalization when there is hospitalization demand. Among the people who choose to be hospitalized,70.6% of agricultural trans-fer population chooses to be in the local hospital, and 55.8% of the agricultural transfer population chooses to be hospitalized at the county level and below. Gender, age, marital status, education level, economic status, mobility characteristics,reasons for hospitalization, health education and health records have different effects on agricultural transfer population's choices of hospitalization behaviors. Health insurance has an impact on the choice of hospital and hospital location,but doesn't play a guiding role in hospital level selection.

Comparison of the short-term curative effect of visualization of percutaneous transforaminal endoscopic discectomy and microendoscopic discectomy in the treatment of lumbar spinal stenosis / 中国脊柱脊髓杂志

Objectives:To compare the early curative effect of visualization of percutaneous transforaminal endoscopic discectomy(VPTED) and microendoscopic discectomy (MED) in the treatment of lumbar spinal stenosis.Methods:49 patients with single segmental lumbar spinal stenosis combined with lumbar disc herniation(LDH) were treated in our hospital from March 2016 to March 2017.Among them,21 cases accepted VPTED,and 28 cases underwent MED.The length of incision,amount of bleeding during operation,operation time,length of hospital stay and the cost of hospitalization were recorded in the both groups.Visual analogue scale(VAS) was used to evaluate the effect of surgery,Oswestry disability index(ODI) was used to evaluate the clinical efficacy.The modified MacNab criteria were used to evaluate the efficacy of the patients at final follow-up.Results:There were no statistical differences among the age,the ratio of male to female,follow-up time,low back pain,weakness,sensory disturbance,general reflexes and prominent segments(P＞0.05).There were statistically significant differences between the two groups in preoperative and postoperative VAS and ODI scores(P＜0.05).There was no significant difference in VAS or ODI score between groups at the same time (P＞0.05).The length of incision(0.78±0.06cm vs 1.95±0.12cm),the amount of intraoperative perspective(15.86± 2.66 vs 2.18±0.38) and the operation time(87.51±30.46min vs 47.53±13.61min) had significant difference between VPTED and MED group(P＜0.05).There was no significant difference in hospitalization time or hospitalization expenses between the two groups(P＞0.05).At final follow-up,based on the MacNab standard,it was excellent in 17 cases,good in 3 cases,fair in 1 case in VPTED group;it was excellent in 22 cases,good in 4 cases,fair in 2 cases in MED group.Excellent rate of the VPTED group was 95.24％,and that was 92.86％ in the MED group,there was no significant difference between the two groups(P＞0.05).Conclusions:Visualization of percutaneous transforaminal endoscopic discectomy (VPTED) and microendoscopic discectomy (MED) in the treatment of lumbar spinal stenosis have good short-term curative effect,it iproves that VPTED is a safe and effective minimally invasive surgery.

Four new phenolic glycosides from Baoyuan decoction

Four new phenolic glycosides, including two flavonoid glycosides (and) and two lignan glycosides (and), were isolated from the traditional Chinese medicine formula, Baoyuan decoction. Their structures were established by detailed analysis of the NMR and HR-ESI-MS spectroscopic data and their absolute configurations were determined by the experimental electronic circular dichroism data as well as chemical methods. Furthermore, the sources of the four new compounds were determined by the UPLC-Qtrap-MS method, which proved thatandare originated from, andandare from.

Expression of MED27 in lung cancer tissues and cells and its significance / 临床与实验病理学杂志

Purpose To investigate the expression level of MED27 in lung cancer tissue samples and lung cancer cell lines and to further study the biological function of MED27 in lung cancer cells.Methods Immunohistochemistry and Western blot were used to detect MED27 expression in 70 lung cancer tissues and 5 different lung cancer cell lines,and the correlation between MED27 expression and gender,age as well as PTNM was also analyzed.The silence sequence of MED27 was designed by the siRNA technique.Western blot was used to detect the silence efficiency of MED27.The proliferation,migration and invasion ability of cells were assessed by CCK-8 assay,Scratch assay and Transwell assay after the MED27 was knocked down.Western blot was used to detect the expression of protein involved in the cell proliferation,migration and invasion.Results The results of immunohistochemistry and Western blot showed that MED27 expression was higher in lung cancer tissues and cells (P ＜ 0.05).The expression of MED27 was positively correlated with lymph node metastasis (x2 =9.438,P =0.002,P ＜ 0.05).However,it was not related with gender,age,tumor size and distant metastasis (P ＞ 0.05).The knockdown of MED27 by MED27 specific siRNA could inhibit the proliferation,migration and invasion of H460 cells (P ＜ 0.05).The expression of MMP-2 and MMP-9 involved in the cell migration that were significantly inhibited in H460 cells transfected by MED27 siRNA,and the expression of E-cadherin,related with cell invasion was also decreased,while E-cadherin negative regulatory protein Snail was increased.Conclusion MED27 is highly expressed in lung cancer tissues and cells and high expression of MED27 predicts poor prognosis in lung cancer patients.The knockdown of MED27 inhibits the proliferation,migration and invasion ability of lung cancer cells.All of the above results suggest that MED27 is expected to be a candidate target of lung cancer gene therapy.

Compilation ideas on TED-Med Viewing, Listening & Speaking / 中华医学教育探索杂志

TED-Med Viewing, Listening&Speaking is compiled to serve academic audio-visual-oral English teaching in medical colleges. This paper elaborates some compilation ideas concerning this text-book. First, both the urgent needs of academic English teaching and the unique advantages of TED speech are the major stimulus to compiling this textbook. Second, its compiling philosophy adheres to learning centered, meaningful input. Third, compiling process is divided into three stages-preparation, writing and evaluation. Third, compiling principles includes four aspects: language and medical knowledge integrate organically, the text and the task are authentic; proficiency training approaches are scientific; and the text-book is suitable for autonomous learning. Forth, the main content covers four medicine-related themes-humanity, health, disease, science and technology; each theme consists of three sub topics with 12 units (topics) in total; the content is interesting, informative and reflective. These compilation ideas prove to be scientific and feasible demonstrated by English teachers and medical experts. TED-Med Viewing, Listening&Speaking is expected to be completed and published earlier in order to promote academic English teach-ing and research in medical colleges.

Narrative medicine is of benefit to cultivating the medical humanistic spirit / 中华医学教育探索杂志

Humanistic spirit is the core of narrative medicine, which belongs to the cross field of medicine combined with literature. It is helpful to bridging the gap between technology and human nature, breaking the diaphragm between doctors and patients, and establishing doctor-patient emotional community. The narrative medicine can also be seen as humanistic medicine and let the medical hu-manistic spirit carry forward. In this article, author discussed the narrative medical background and medical value and how to cultivate medical narrative, and then explored whether the narrative medicine can become a way of cultivating medical humanistic spirit.

Informationization of military medicine / 军事医学

Military medicine has to restructure itself to meet military needs and e-Science patterns of the information age.This restructuration is known asinformationization of military medicine ( IMM).IMM is a process of vision refresh-ing into information thinking, mission expansion to the information field and paradigm shift to normal forms of information. The result is the emergence of military med-information technologies, military med-information research fields, and military med-informatics disciplines.

Ethical Thinking on Improving the Nursing Quality in Department of Nephrology / 中国医学伦理学

Based on the understanding the main characteristics of patients as well as the importance of nursing in department of nephrology , this paper proposed some ethical suggestions for improving the nursing quality and nurse-patient relationship in department of nephrology .They are:strengthening the construction of nursing culture and correct the nurses'attitudes towards the relationship between nurses and patients;insisting on continuing educa-tion training , grasping the nursing technical operation standard; paying attention to communication and language skills, effectively carrying out health education and psychological counseling; setting up supervision and manage-ment system, truly standardizing medical service , etc.

Influence of silencing Med19 on metastasis and invasion of human breast cancer MCF-7 cells / 实用医学杂志

Objective To investigate the influence of silencing Med19 on metastasis and invasion of human breast cancer MCF-7 cells. Methods lentivirus expression vector delivering small hairpin RNA (shRNA) against Med19 gene was constructed, then transfected of human breast cancer MCF-7 cell line. There were three experimental groups: non-infected (CON) group, Lv-NC-infected (NC) group, and Lv-shMed19-infected (KD) group. To determine the lentiviral infection efficiency, expression of GFP was detected with fluorescence microscopy. The mRNA and protein levels of Med19 in three groups MCF-7 cells were detected by real-time PCR and Western blotting. Scratching and transwell tests were employed to determine the ability of metastasis and invasion of cells. Results The highest infection efficiency was obtained, resulting fluorescent expression identified in more than 90%of MCF-7 cells 120 h after infection. The expression of Med19 mRNA in the KD group was dramatically decreased by 72.3%compared with the NC group, and by 72.1% compared with the CON group, respectively (P < 0.05). The Med19 protein expression in the KD group was significantly lower than that of the NC group and the CON group, with a reduction of 85.4%and 85.3%, respectively (P<0.05). No statistical significance was detected between the NC groups and the CON groups. Thus, the constructed Lv-shMed19 was demonstrated to be active and specific in inhibiting the expression of Med19. Moreover, the invasive distances of KD group, NC group and CON group MCF-7 cells were compared at 6 hour, 12 hour and 24 hour. The invasive ability of MCF-7 cells decreased significantly with the extension of time (P<0.05). The cells passed through polycarbonate membrane in KD group, NC group and CON group were 23.8 ± 4.32, 43.4 ± 3.65 and 45.8 ± 5.81 respectively. The metastatic ability of KD group was significant reduced (P<0.05). Conclusion Silencing of Med19 gene significantly decreases the ability of metastasis and invasion of human breast cancer MCF-7 cells, and then suppresses the malignant biological behavior of breast cancer.

Determination of minimal erythema dose of normal skin to ultraviolet rays / 中华医学美学美容杂志

Objective To investigate the minimal erythema does (MED) of normal skin to UV in Guangzhou city,and to observe its relationship to sex,age,skin type,seasons and the years lived in Guangzhou.Methods 621 healthy subjects were exposed to Solar Simulator (GS2004) and the MED was measured and observed by two professional technicians after (24±2) hours.Results The average MED value of all subjects was (1170.2±333.2) mJ/cm2.In male and female group,the average MED values were (1132.8-339.4) mJ/cm2 and (1182.1 ± 330.7) mJ/cm2,respectively,and there was no significant difference between male and female (P=0.20).The MED value in subjects aged from 30 to 50 (1014.7 ± 359.7) mJ/cm2 was significantly lower than those aged from 20 to 29 (1222.9±304.3) mJ/cm2 and over 50 years (1179.0±374.3) mJ/cm2 (P＜0.01).The MED value in skin type Ⅱ (673.53±228.3) mJ/cm2 was significantly lower than those in type Ⅲ (1224.3±254.2) mJ/cm2 and Ⅳ(1363.1±278.5) mJ/cm2(P＜0.01).There was significant difference of the MED value between different seasons (P＜0.01).The MED value in spring (969.2±355.8) mJ/cm2 was lowest,and followed by summer (969.2± 355.8) mJ/cm2.However,there was no significant difference between autumn and winter (P＞0.05).The MED value in subjects lived in Guangzhou from 5 to 10 years was significantly lower than those whose residence time was from 1 to 4 years and over 10 years,respectively.Conclusions The MED value of the subjects in Guangzhou is quite different from other cities of China,and related to age,skin types,seasons and the years lived in Guangzhou city,while there is no correlation between MED value and gender difference.

Knowledge, Attitudes and Practices of Sexually Transmitted Diseases in Reproductive Health-Related Medical Professionals in Tianjin / 天津医药

Objective To understand the knowledge, attitudes, practices (KAP) and relative training demand of AIDS and other sexually transmitted diseases (STDs) in reproductive health-related medical professionals in Tianjin. Meth-ods By using random, stratified and clustered sampling approach, 507 reproductive health-related medical professionals were selected in Tianjin area. A self-administered KAP questionnaire on AIDS and other STDs was used to collect the data included in the general condition, understanding of AIDS and other STDs knowledge, attitudes to AIDS and syphilis patients, occupational exposure of medical staffs and request of continuing education. Results The score of STD knowledge was (75.59±12.15) in respondents coming from the secondary medical institutions, which was significantly higher than that of ter-tiary medical institutions (70.11±10.07) and primary health care institutions (67.62±12.20,F=15.817,P<0.001). Multiple-factor analysis showed that there was a higher cognitive level for STD in professionals working in the department of obstetrics and gynecology and women’s health care (β=-3.765,P=0.048). A total of 86.34%respondents worried about HIV or syphilis infection due to occupational exposure. Only 25.88% respondents expressed a willingness to provide medical services for AIDS and syphilis patients. About 60.46%medical staffs experienced occupational exposure. Only 13.04%respondents were familiar with emergency treatment and reporting procedures while occupational exposure occurring. The 94.62%medical per-sonnel showed demand on relative training. Conclusion It’s necessary to perform continuing education to medical staffs via different intervention, so as to improve their cognitive level and attitudes to AIDS and other STDs, and help them provid-ing better service to the patients and the public.

Role of Med19 in the proliferation and tumorigenicity of human bladder cancer cells / 中华泌尿外科杂志

Objective To study the role of Med19 in bladder cancer by analyzing the effects of lentivirus-mediated suppression of Med19 expression on T24 bladder cancer cells in vitro.Methods The lentivirus vectors containing a small hairpin RNA (shRNA) to target Med19 were constructed.After T24 bladder cancer cells were infected,real-time PCR and Western-blotting were used to study the Med19 expressions in the CON group (non-infected cells),the NC group (Lv-NC-infected cells) and the KD group (Lv-shMed19-infected cells).The influence of Med19 on the proliferation of bladder cancer cells were assessed using MTT,BrdU,colony formation assay and tumorigenicity experiment in mice.Cell cycle was analyzed with flow cytometry assay.Results Med19 relative mRNA level (0.35 ± 0.03) and Med19 protein expressing in the KD group were significantly inhibited (P ＜ 0.05).The KD group displayed an increased proportion of cells (77.50 ± 0.29)％ in the G0/G1 phase compared with the CON group (69.81 ± 0.81)％and NC group (67.53 ± 0.67) ％ (P ＜ 0.05).Compared with the CON group and the NC group,the KD group displayed a significant cell proliferation defect by MTT and BrdU assay and the number of colonies (91.33 ± 6.11) was significant decreased (P ＜ 0.05).On the day 24,the tumor volume (596.64 ± 485.36) mm3 and weight (0.57 ± 0.44) g of the KD group mice were decreased after inoculation into nude mice (P ＜ 0.05).Specific lentivirus-mediated knockdown of Med19 significantly impacted the cell cycle and proliferation of bladder cancer cells.Infected T24 cells nearly lost their tumorigenicity when being inoculated into nude mice.Conclusion Our results provide new evidence of an important role for Med19 in the development of bladder cancer,suggesting that lentiviruses delivering shRNA against Med19 may be a promising tool for bladder cancer therapy.

Diagnostic value of magnetic susceptibility weighted imaging in diffuse axonal injury / 中华放射学杂志

Objective To study the diagnostic value of susceptibility weighted imaging (SWI) in diffuse axonal injury (DAI) and investigate the relationship between SWI and clinical prognosis. MethodsTwenty patients (15 males and 5 females) with DAI were included in this study. Routine sequences (T1WI, T2WI and FLAIR) and SWI were performed on a 3.0 T MRI scanner. There were 8 cases whose Glasgow score scale (GCS) ranged from 3.0 to 5.0, 4 cases from 6.0 to 8.0 and 8 from 9.0 to 12.0. The interval time between injury and examination were from 3 hours to 20 days. The number and volume of lesions observed on SWI and routine sequence were compared using Mann-Whitney U-test and paired t-test. Pearson correlation was used to analyze the relationship between the number and volume of all lesions and GCS. Results The lesions showed punctate, beaded, patchy and cord-like hypointense signal with various size on SWI (lesion diameter <2.0 cm). Distribution of lesions was multifocal with clear boundary. Routine MRI scan found a total of 78 lesions, while SWI sequence detected 424 lesions. The number of the lesions found on SWI was more than that on conventional MRI (U=-15.447,P＜0.01). The total volume of the lesions measured on routine MRI and SWI were 19 340 mm3 and 38 042 mm3, respectively. The total volume measured on SWI was more than that on routine MR (t=5.870,P＜0.01). The number and volume of all lesions were negatively correlated with GCS (r=-0.802, -0.767, P＜0.01). Conclusion SWI sequence could find more bleeding lesions than the routine MRI sequences. The number and the volume of the lesions were closely related to GCS. SWI showed high value in the diagnosis and prediction of the prognosis of DAI.

Biologic Characteristic Study of β-mercaptoethanol and bFGF to Induce Rat Mesenchymal Stem Cells to Neuron-like Cells / 中山大学学报(医学科学版)

[Objective] To compare the biological characteristics of neuron-like cells from rat mesenchymal stem cells (MSC) induced by β-mercaptoethanol (BME) and basic fibroblast growth factor (bFGF) respectively. [Method] BME and bFGF were added to rat MSC respectively for 9 h and 5 days. The neuron-like cells from MSC with the neuron specific protein NF200 were identified using immunofluorescence. The gene expression of NF were analyzed using RT-PCR and the protein expression of NF200 were analyzed using Western blotting. [Results] MSC induced by BME appeared morphology change in an hour and the neurite can be seen at six hour. Some cell bodies became lighter and died. MSC induced by bFGF had neurite in the third day, and appeared network structure in the fifth day, then cells died in the seventh day. At the same time, The result of immunofluorescence showed the NF200 expression of neuon-like cells induced by two ways were beth positive, but MSC induced by bFGF were stronger than those induced by BME. The results of RT-PCR and western blotting were same as that of immunofluorescence. [Conclusion] Both bFGF and BME can induce rat MSC to neuron-like cells, but the neuon-like cells induced by bFGF were more like real neurons in morphology and expression of neuron specific protein and mRNA.

Comparative Study of the Gross Interpretation of Phototesting and Objective Measurement with Using a Spectrophotometer for Patients with Psoriasis and Vitiligo Treated with Narrow-band UVB

BACKGROUND:Determination of the minimal erythema dose (MED) is important for developing a phototherapy protocol and to diagnosis photosensitivity disorders. But obtaining a precise and reproducible MED is quite difficult because a phototest for erythema is based on subjective assessment. OBJECTIVE: The objective of our study was to compare the gross interpretation of a phototest and the objective measurement using a spectrophotometer for determining the parameters of cutaneous narrow-band UVB (NBUVB) therapy. METHODS: A total of 14 psoriasis and 10 vitiligo patients who receiving NBUVB phototherapy with skin types III and IV were selected for this study. To perform phototesting, ten sites on the skin of the back were vertically exposed to a series of 10 NBUVB doses among 14 doses between 340 and 1,400 mJ/cm2. We interpreted the gross findings of erythema and measured the L*a*b* values with using a spectrophotometer at each phototest spot and at the control skin. Also, we evaluate the relationship between the gross presentation and the spectrophotometric analysis by delta E for the assessment of the minimal perceptible erythema (MPE) and MED. RESULTS: For all the subjects, the MEDs were measured in the 490~1,000 mJ/cm2 range. The average of the colorimetric values for the control skin were L*: 64.8, a*: 7.9 and b*: 19.8. Among them, the L* value and MED value were shown to be inversely correlated, and as the L* value was decreased, the MED was increased. For the MPE, the delta E, which was the color difference of the normal skin and the phototest area, was within the range of 1.5~3.0 in 17 of the 21 patients, and 4 patients were within the range of 1.0~1.5. For the MED, among the 21 patients, the delta E of 17 patients was within the range of 3.0~6.0, and 4 patients were within the range of 6.0~12.0. CONCLUSION: A spectrophotometer enables UV erythema to be assessed objectively and quantitatively, and this can compensate for the disadvantages of subjective gross interpretation when determining the MED. Delta E is a good novel and objective indicator for determining the MPE and MED. So, a spectrophotometer is a very useful instrument for developing a phototherapy protocol for psoriasis and other dermatoses and for making the diagnosis of photosensitivity disorders.