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Hemophilic arthropathy is the most common complication of hemophilia and is also the main factor of disability in hemophilia patients. Using high-resolution musculoskeletal ultrasound examination technology, the joints of hemophilia patients can be rapidly evaluated and injury grade can be established, which can provide the basis and guidance for clinical evaluation, treatment and prognosis. Standardized ultrasound operation and scoring are very important for objective evaluation of joint condition. This paper introduces the ultrasonic examination and scoring method of hemophilic arthropathy which is suitable for the clinical needs of China in detail in order to improve the consistency of ultrasonic evaluation of hemophilia centers.
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Objective:To explore the effect of maternal stress perception and plasma serotonin level in the first or second trimester on breastfeeding behavior, and to provide evidence for promoting exclusive breastfeeding.Methods:This prospective cohort study recruited pregnant women (≤20 gestational weeks) from Maternal and Child Health Center of Gulou District from April 2019 to March 2020. Stress perception at study enrollment was evaluated using Perceived Stress Scale (PSS) and the maternal plasma serotonin level was detected. Telephone interviews were conducted 42 d after delivery to collect information on childbirth and breastfeeding. Chi-square test, two independent samples t-test, and logistic regression model were used to analyze the risk factors of non-exclusive breastfeeding. Results:A total of 366 pregnant women were enrolled and 353 (96.4%) of them completed telephone interviews, who were divided into the exclusive ( n=194) and non-exclusive breastfeeding group ( n=159). Univariate analysis showed that the PSS scores [(19.4±6.9) vs (21.1±6.9) scores, t=－2.25, P=0.026] and the proportion of high-stress perception [23.7% (46/194) vs 34.0% (54/159), χ 2=4.03, P=0.045] in the exclusive group were all significantly lower than those in non-exclusive group. In the logistic regression analysis, exclusive breastfeeding was set as the dependent variable and the independent variables included factors with P<0.200 in the univariate analysis (PSS scores or PSS rating, plasma serotonin level, age, delivery mode) and potential clinical risk factors (parity, preterm birth). The results showed that when PSS was considered as a continuous variable, total PSS scores in the first or second trimester was an independent risk factor for non-exclusive breastfeeding ( OR=1.043, 95% CI: 1.010-1.077, P=0.011) and so was the high-stress perception when PSS was considered as a categorical variable (PSS rating) ( OR=1.765, 95% CI: 1.097-2.854, P=0.020). Conclusions:Overstress in the first or second trimester will affect breastfeeding patterns. Mental health counseling may help relieve perinatal stress, which will further increase the exclusive breastfeeding rate.
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In China, malignant tumor is the main cause of death in both urban and rural areas. Mesenchymal stem cells (MSCs) have multidirectional differentiation potential, self-renewal ability and good immunomodulatory properties. Exosomes, as important paracrine substances of MSCs, mediate information exchange and transmission between cells in tumor microenvironment and influence the occurrence and development of tumors. Recently, conflicting findings have been reported on the effects of MSCs and their exosomes on tumors. On the one hand, MSCs and their exosomes are tumorigenic and can target specific sites to inhibit tumor growth; On the other hand, there is also evidence that MSCs could affect tumor growth and migration as part of the tumor microenvironment. In this paper, we will review the relationship between MSCs and exosomes and tumorgenesis and development, as well as how MSCs and exosomes play different roles in tumorgenesis and development, in order to provide beneficial help for tumor diagnosis, prognosis and precise treatment. .
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Humanos , Diferenciación Celular , Exosomas , Neoplasias Pulmonares , Células Madre Mesenquimatosas , Microambiente TumoralRESUMEN
Objective@#To assess the feasibility of HEAD-US scale in the clinical application of hemophilic arthropathy (HA) and propose an optimized ultrasound scoring system.@*Methods@#From July 2015 to August 2017, 1 035 joints ultrasonographic examinations were performed in 91 patients. Melchiorre, HEAD-US (Hemophilic Early Arthropathy Detection with UltraSound) and HEAD-US-C (HEAD-US in China) scale scores were used respectively to analyze the results. The correlations between three ultrasound scales and Hemophilia Joint Health Scores (HJHS) were evaluated. The sensitivity differences of the above Ultrasonic scoring systems in evaluation of HA were compared.@*Results@#All the 91 patients were male, with median age of 16 (4-55) years old, including 86 cases of hemophilia A and 5 cases hemophilia B. The median (P25, P75) of Melchiorre, HEAD-US and HEAD-US-C scores of 1 035 joints were 2(0,6), 1(0,5) and 2(0,6), respectively, and the correlation coefficients compared with HJHS was 0.747, 0.762 and 0.765 respectively, with statistical significance (P<0.001). The positive rates of Melchiorre, HEAD-US-C and HEAD-US scale score were 63.0% (95%CI 59.7%-65.9%), 59.5% (95%CI 56.5%-62.4%) and 56.6% (95%CI 53.6%-59.6%) respectively, and the difference was statistically significant (P<0.001). Even for 336 cases of asymptomatic joints, the positive rates of Melchiorre, HEAD-US-C and HEAD-US scale score were 25.0% (95%CI 20.6%-29.6%), 17.0% (95%CI 12.6%-21.1%) and 11.9% (95%CI 8.4%-15.7%) respectively, and the difference was statistically significant (P<0.001). There were significant changes (P<0.05) in the ultrasonographic score of HA before and after onset of hemorrhage in 107 joints of 40 patients. The difference in variation amplitude of HEAD-US-C scores and HEAD-US scores before and after joint bleeding was statistically significant (P<0.001).@*Conclusion@#Compared with Melchiorre, there were similar good correlations between HEAD-US, HEAD-US-C and HJHS. HEAD-US ultrasound scoring system is quick, convenient and simple to use. The optimized HEAD-US-C scale score is more sensitive than HEAD-US, especially for patients with HA who have subclinical state, which make up for insufficiency of sensitivity in HEAD-US scoring system
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Objective@#To explore the evaluation of joint injury by HEAD-US-C (Hemophilic Early Arthropathy Detection with UltraSound in China, HEAD-US-C) in patients with moderate or severe hemophilia A treated with prophylaxis vs on-demand.@*Methods@#The patients from June 2015 to July 2017 with moderate or severe hemophilia A were examined by ultrasound imaging of the elbows, knees and ankles; Meanwhile the HEAD-US-C ultrasound assessment scale and hemophilia joint health score scale 2.1 (HJHS2.1) were used to score the joint status. The correlation between the HEAD-US-C and HJHS score was performed in prophylaxis group and on-demand group patients, respectively.@*Results@#A total of 925 cases of joint ultrasonography were conducted in 70 patients with moderate or severe hemophilia A. Among patients with moderate hemophilia, the median (IQR) of HEAD-US-C score and HJHS score in on-demand group were significantly higher than those in the prophylaxis group[1 (0, 6) vs 0.5 (0, 3) , z=0.177, P=0.046],[2 (0, 4) vs 2 (0, 3) z=0.375, P=0.007], even though there was no significant difference of the median (IQR) number of annualized target joints bleeding episodes between on-demand and prophylaxis groups[1 (0, 7) vs 1 (0, 5) , z=1.271, P=0.137]. Unlike in moderate cases, on-demand treatment group had more annualized target joints bleeding episodes than prophylaxis group among patients with severe hemophilia[3 (0, 8) vs 2 (0, 8) , z=0.780 P=0.037]. The prophylaxis group compared favorably with on-demand therapy group in terms of HEAD-US-C score[1 (0, 6) vs 4 (0, 7) , z=2.189, P=0.008], and HJHS score[2 (0, 5) , 4 (1, 6) , z=3646, P<0.001]for the severe hemophilia patients. The positive correlation between HEAD-US-C score and HJHS score was identified (P<0.05) , whether on-demand treatment or prophylaxis groups. The correlation coefficient between HEAD-US-C score and HJHS score in on-demand treatment and prophylaxis groups were 0.739 (95% CI 0.708-0.708) , 0.865 (95% CI 0.848-0.848) respectively, and 95% CI didn’t overlap (P<0.05) , indicating that the correlation coefficient in prophylaxis group had stronger correlation than that in on-demand group.@*Conclusions@#Clinical effects of prophylaxis were significantly better than those of on-demand treatment in patients with moderate or se-vere haemophilia A. HEAD-US-C scoring system could effectively evaluate joints damage in hemophilia A patients treated with on-demand or prophylaxis, companied by significantly positive correlation with HJHS clinical evaluation system, and provided objective index for clinical effect assessment.
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Objective To observe the clinical effects of therapy to neonatal jaundice by Yinzhihuang particles.Methods72 cases from July 2015 to December 2016, were randomly divided into two groups and made all 36 cases in the control group, children in the control group given blue light therapy observation group were treated in the control group on the basis of Yinzhihuang particle therapy, follow-up and record two serum C-reactive protein (CRP), total bilirubin (TBIL), γ-alanine amino acyltransferase (γ-GT), alkaline phosphatase (AKP) and free fatty acid (FFA) levels and incidence of adverse reactions, the use ofstatistical methods for data analysis.Results① observation group after treatment CRP,TBIL, γ-GT values were better than the control group, and the difference was significant (P<0.05).② observation group in the AKP, FFA values after treatment than the control group, and the difference was significant (P<0.05).③ observation group rash during treatment, the incidence of diarrhea were (0.00%, 2.78%), were lower than the control group (11.11%, 16.67%), and the difference was significant (P<0.05).ConclusionYinzhihuang particle treatment of neonatal jaundice effect is good, worthy of further research and application.
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Objective To analyze the epidemiological characteristics of measles in Jinshan District of Shanghai from 2004 to 2015 in order to provide guidelines for measles control. Methods A descriptive epidemiological analysis was conducted on measles cases reported in Jinshan District during 2004 to 2015. Epidemiological data of those cases were collected from surveillance system of infectious disease, Measles Surveillance System ( MSS) and case study records. Results A total of 225 confirmed measles cases were analyzed in this study with an annual incidence of 2. 66/100 000. The highest incidence was 11. 27/100 000 in 2005 and the lowest incidence was 0. 14/100 000 in 2011, taking on a descending trend (Z=-6. 689, P<0. 000 1). The number of cases from March to May accounted for 65. 33%. The incidence of measles in floating population (4. 00/100 000) was higher than that in resident population (2. 18/100 000) (χ2=20. 467, P<0. 000 1). The measles cases mainly concentrated in age groups of ≥20 years and <5 years. Workers, scattered children, domestic workers, farmers and fishermen had high incidences of measles. Mea-sles vaccine immunization history was clear in nine cases. Conclusion The incidence of measles in Jinshan District shows a general trend of decline in this decade with time and population clusters in occurrence, sug-gesting that the occurrence of measles in Jinshan is under control. It is necessary to strengthen measles sur-veillance, regular immunization among children and supplementary immunization among adults, especially in floating population, in order to maintain high levels of immune protection.
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<p><b>OBJECTIVE</b>To investigate the characteristics of ultrasonography in haemophilic arthropathy in knee joints.</p><p><b>METHODS</b>The knee joints (n=135) of 68 patients with haemophilia A (n=59) or haemophilia B (n=9) were consecutively evaluated with ultrasonography and scored according to MELCHIORRE ultrasound score. The correlations between ultrasound score and the number of knee joint bleeding episodes, age, and World Federation Haemophilic orthopedic (WFHO) score were studied.</p><p><b>RESULTS</b>68 male patients with median age 20 (3-48) years old were enrolled in this study. The prevalences of hydrops articuli, fibrotic septa, synovial hypertrophy, synovial hypertrophy with angiogenesis, haemosiderin deposition were 39.2% (53/135), 3.0% (4/135), 77.0% (104/135), 49.6% (67/135), 37.8% (51/135), respectively; and the prevalences of cartilage damage, bone erosion, bone remodeling, osteophytes were 63.7% (86/135), 48.1% (65/135), 3.0% (4/135), 13.3% (18/135) respectively. The average ultrasound score was 5.21[95% CI (4.50-5.93)]. The ultrasound score of knees joints according to age 0-6, 7-18 and > 18 years old groups were 0.63[95% CI (0.15-1.10)], 2.88[95% CI (1.90-3.85)], 7.83[95% CI (7.07-8.60)], respectively; and the difference among groups was statistically significant (P<0.01). The significant difference of ultrasound score was not found among moderate, mild and severe haemophilia (F=0.90, P=0.914). A significant positive correlation between ultrasound and WFHO scores was demonstrated (r=0.745, P<0.01). The ultrasound score increased significantly with the increase of number of knee bleed Episodes (F=49.926, P<0.01).</p><p><b>CONCLUSION</b>The main characteristics of ultrasonography of haemophilic arthropathy in knee joints were identified as followings: synovial hypertrophy, cartilage damage, bone erosion, hydrops articuli, and haemosiderin deposition. Ultrasonography was a fast, effective, safe, and available inspection method in assessment of haemophilic arthropathy.</p>
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Adolescente , Adulto , Niño , Preescolar , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Hemofilia A , Hemofilia B , Artropatías , Diagnóstico por Imagen , Articulación de la Rodilla , Diagnóstico por Imagen , UltrasonografíaRESUMEN
Objective To investigate the expression of galectin-3 in pancreatic cancer cell and its effect on the proliferation and invasion of SW1990.Methods Immunocytochemistry and semi-quantitative RT-PCR was used to detect the expression of galectin-3 protein and mRNA in SW1990,PANC1 and ASPC-1 cell lines.Galectin-3 mono-antibody of different concentrations ( 1,2,3,5 μg/ml) was used to treat SW1990 cells for 24,48,72 h,CCK-8 kits were used to detect the proliferation in SW1990 cells; Transwell chamber was used to study the invasion in SW1990.Results Expression of galectin-3 protein and mRNA was present in SW1990,PANC1,and ASPC-1.Galectin 3 mono-antibody inhibited the proliferation and number of invasive cells in a dose and time dependant manner.The inhibitory rates at 72 h were 19.8％,29.9％ and 42.7％ in 2,3,5 μg/ml galectin 3 mono-antibody groups,the difference among them and control group was statistically significant ( P ＜ 0.05 ).The inhibite rate of permeating membrane cells in 3 μg/ml galectin-3 mono antibody was 37.1％,the difference between this group and control group was statistically significant (P ＜0.05 ).ConcLusions Galectin-3 is highly expressed in pancreatic cancer cells.Galectin-3 antibody can inhibit the proliferation and migration capability of SW1990 cells.
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Objective To investigate the dynamic expressions of CXCL11 and its role in the pathogenesis of acute necrotizing pancreatitis (ANP).Methods Forty-eight SD rats were randomly divided into control group and ANP group,with 24 rats in each group.ANP model was induced by retrograde injection of 4％ sodium taurocholate (1 ml/kg body weight) into the biliary and pancreatic duct.The rats were sacrificed at 1,3,6,12 hours.Serum level of amylase was determined,pathological changes in pancreatic tissue were routinely observed and scored.The expression of CXCL11 mRNA and proteon in pancreas was measured by fluorescence quantitative polymerase chain reaction and immunohistochemical method.The serum levels of CXCL11 were measured by enzyme-linked immunoadsorbent assay.Results The serum levels of amylase in ANP rats were significantly higher than those in control group [(6153 ± 355)U/L vs (185 ± 32)U/L at 6 h,P ＜0.05],pathological changes in pancreatre tisues were more significant in ANP rats,and the pathological score was significantly higher than that in control group [(9.00 ± 0.63) vs (0.33 ± 0.12) points at 6 h,P ＜ 0.05] ; the expressions of CXCL11 mRNA and protein in pancreatic tissue were significantly increased than those in control group (3.13 ± 0.43 vs 0.99 ± 0.24,2.76 ± 0.27 vs 0.33 ± 0.12 at 6 h,P ＜ 0.05).The serum level of CXCL11 was significantly higher than that in control group [(112.1 ± 14.2)ng/L vs (56.8 ±4.3) ng/L at 6 h,P ＜0.05)].Conclusions CXCL11 is an early inflammatory mediator in acute pancreatitis,and involved in the pathogenesis of ANP in rats.
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Objective To investigate the effects of two inhibitors of arachidonic acid metabolic pathway (5-cyclooxygenase blockade MK886 and COX 2 blockade celecoxib) on growth and VEGF mRNA expression of human pancreatic cancer cell SW1990.MethodsPancreatic cancer cells SW1990 were cultured with different concentrations of MK886,celecoxib,MK886 and celecoxib,then the cell proliferation was detected by using CCK-8,BLT1 mRNA,PGE2 mRNA and VEGF mRNA expressions were determined by RTPCR.ResultsAfter 10 μmol/L MK886 or 20 mmol/L celecoxib treatment for 24 h,the growth of SW1990 was greatly suppressed ( 1.80 ±0.06 vs 1.65 ±0.10,2.04 ±0.03 vs 1.86 ±0.02,P ＜0.01 ),and the growth suppression of SW1990 cells was increased accompanying the raised concentration of MK886 or celecoxib.After both MK886 and celecoxib treatment for 12 h,the growth of SW 1990 cells was much obviously suppressed (1.72 ±0.05 vs 1.52 ±0.05,P ＜0.01 ).After celecoxib treatment for 48 h,the BLT1 mRNA,PGE2 mRNA and VEGFmRNA expressions were not significantly changed,but the expressions of PGE2 mRNA were significantly decreased ( P ＜ 0.05 ).After MK886 or MK886 + celecoxib treatment,the expressions of BLT1 mRNA,VEGF mRNA were significantly decreased ( P ＜ 0.05 ),but the expressions of PGE2 mRNA were not significantly changed when compared to control group.ConclusionsTwo metabolic pathways of arachidonic acid have a close relation with occurrence and proliferation of pancreatic cancer,when both of the pathways were blocked,the proliferation of the pancreatic cancer cell was suppressed obviously.
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Objective To study the efficacy of RNA interference targeting 5-LOX on 5-LOX and VEGF expression as well as the growth of tumor xenografts in the nude mice,in order to evaluate the value of the clinical application.Methods SW1990 cells were injected into the back of BALB/c nude mice.Once the visible tumors were evidenced about 100mm3,the animals were divided randomly into 4 groups (6 animals/group) and treated with shRNA1 and shRNA2 targeting 5-LOX,negatrve control shRNA (shNC) or control LipofectamineTM 2000 (Lipo) by intratumoral injection.Observing the effect of the shRNA on the growth of tumor xenografts,investigating the expression of 5-LOX and VEGF by immunohistochemistry and RT-PCR.Results Two nude mice were dead in shNC group and Lipo group because of the wasting disease.Other nude mice had no changes in body weight,spirit,appetite,and activity.The growth of tumor xenografts was suppressed potently when administered with shRNA.Compared with shNC and Lipo group,the mean tumor size in groups treated with shRNA was reduced markedly at every point of test time.Between two treat groups,they did not have significant difference.5-LOX and VEGF were both expressed in the pancreatic cancer tissue.The level of the 5-LOX expression in shRNA groups was stronger than that in shNC or Lipo group.The VEGF had the game situation.Between the two treat groups,the difference was not significant.Conclusions RNA interference targeting 5-LOX can inhibit the growth of tumor tumor xenografts in the nude mice by depressing the expression of 5-LOX directly and depressing the expression of VEGF indirectly.
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Objective To investigate the role of CC chemokine ligand 20 (CCL20) and CC chemokine receptor 6 (CCR6) in the pathogenesis of acute necrotizing pancreatitis (ANP). Methods 48 SD rats were randomly divided into two groups: control group and ANP group. The ANP model was induced by retrograde infusion of 4 % sodium taurocholate into the biliary and pancreatic duct in SD rats. The same amount of saline was injected in the control group. The rats were sacrificed at 1, 3, 6, 12 h, the serum amylase levels and the pathological score of the pancreas were measured. The expressions of CCL20 and CCR6 mRNA and protein in pancreas were detected by immunohistochemistry and semi-quantitative RT-PCR,respectively. Results The levels of serum amylase and the histological score of ANP group were significantly higher than those of control group (P ＜ 0.01 ). The expression of pancreatic CCL20 mRNA and protein was increased in a time-dependant manner ( P ＜ 0.05 ). The expression of pancreatic CCR6 mRNA at 6h was significantly higher than that of control group (0.88 ± 0.05 vs 0. 23 ± 0.09, P ＜ 0.01 ). The expression of pancreatic CCR6 mRNA at 12h was decreased when compared with that of 6h group, but it was still higher than that of control group (0.37 ± 0. 10 vs 0. 15 ± 0.07, P ＜ 0.05 ), the change of CCR6 protein was consistent with that of CCR6 mRNA. Conclusions CCL20 and CCR6 may play an important role in the pathogenesis of ANP.
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Objective To investigate the effects of inhibition of 5-LOX by RNA interference on proliferation suppression and apoptosis induction of pancreatic cancer cell line. Methods Plasmid expression vectors containing four 5-LOX siRNA array and one negative control array were established, resoectively, and were transfected into pancreatic cancer cell line SW1990 with Lipofectamine TM2000. Cell proliferation inhibition rate was measured by MTT assay; apoptotic rate was examined by flow cytometry. Results The inhibitory rate of expression of 5-LOX mRNA in negative control group and four 5-LOX siRNA groups was (3.0 ±1.4)%, (18.8±1.5)%, (53.5±2.3)%, (56.1±2.0)%, (52.4±2.5)%; the inhibitory rate of expression of 5-LOX protein was (4.5 ± 2.0) %, (18.1 ± 2.5) %, (50.4 ± 4.3) %, (48.9 ± 4.4) %, (45.9 ± 4.0) %. The inhibitory rates of cancer cell proliferation at 24 h and 48 h after the transfection were (2.1±1.0)%, (5.5±1.3)%, (11.9±1.2)%, (13.4±1.1)%, (13.8±1.3)% and (3.0±1.3)%, (16.0 ± 2.2) %, (25.7 ± 2.5) %, (25.3 ± 3.1) %, (27.2 ± 3.2) %, respectively. The apoptotic rates at 48 h after the transfection were (3.0 ± 1.0) %, (7.1 ± 1.10%, (17.5 ± 0. 9) %, (21.5 ± 1.1) %, (15.7 ± 1. 0)%, respectively. Conclusions The plasmid vector containing siRNA against 5-LOX could suppress 5-LOX expression in SW1990 cells effectively and specifically, and could inhibit proliferation and induce the apoptosis of pancreatic cancer cells.
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Objective To investigate the suppression effects of Tripotolide (TL) on the pancreatic cancer xenograft models and angiogenesis. Methods The growth suppression effect of TL on SW1990 was determined using cell count kit (CCK-8), apoptotic cells induced by TL were examined by morphology and terminal deoxynucleotidyl transferase-mediated nick end labeling (TUNEL) assay. The inhibitory effects of TL on the growth of tumor xenografts and tumor microvascular density (MVD) were investigated. ResultsTL inhibited the growth and proliferation of SW1990 cells in a concentration-dependent and time-dependent manner. The inhibition ratios of cells treated at 160 mg/ml TL for 24 h was 50. 6%, the apoptotic rate increased from 9.6% in the control group to 45.1% (P <0.01 ). The inhibition rate of cancer xenograft growth was 89.9% when TL was intratumorally injected at the dose of 0.5 mg/kg. The expression of VEGF in tumor tissue decreased while MVD also decreased from 36.25±8.64 to 9.87±3.34 (P <0.01 ). ConclusionsTL induced prominent growth inhibition and apoptosis in human pancreatic cancer cell lines. TL.can attenuate the growth of pancreatic caner xenografts through its effect on antiangiogenesis.