Clustering of risk factors among residents at high risk of cardiovascular diseases in Shaoxing City / 预防医学

Objective@#To investigate the clustering of risk factors among populations at high risk of cardiovascular diseases in Shaoxing City, Zhejiang Province, so as to provide the evidence for formulating the cardiovascular disease control measures among populations at high risk of cardiovascular diseases.@*Methods@#The populations with hypertension, diabetes, dyslipidemia and a history of cardio-cerebrovascular disease at ages of 35 to 70 years were sampled from 6 districts (counties) of Shaoxing City using a multi-stage cluster random sampling method from May to July 2021. Participants' demographics, history of disease, smoking, alcohol consumption and drug use were collected through questionnaires, and height, body weight and blood lipid were measured. The participants at high risk of cardiovascular diseases were enrolled, and the prevalence and clustering of five risk factors were investigated, including current smoking, current alcohol consumption, overweight/obesity, never exercise and daily sedentary duration of 3 hours and longer. Factors affecting the clustering of risk factors were identified with an ordinal logistic regression model.@*Results@# Totally 1 695 participants were enrolled, including 940 men (55.46%) and 755 women (44.54%), with a mean age of (62.56±6.08) years old. There were 213 participants with a history of cardio-cerebrovascular disease (12.57%), and the prevalence of hypertension, diabetes and dyslipidemia was 78.53%, 61.95% and 46.78%, respectively, and there were 32.63% of participants with current smoking, 35.99% with current alcohol consumption, 49.38% with overweight/obesity, 62.12% with never exercise and 61.24% with daily sedentary duration of 3 hours and longer, respectively. There were 28.85% of participants with two risk factors, and 46.90% with three to five risk factors. Ordinal logistic regression analysis showed that male (OR=5.430, 95%CI: 4.389-6.726), and development of hypertension (OR=1.655, 95%CI: 1.313-2.090) led to present more numbers of clustering of risk factors, and annual household income of 20 000 to 50 000 Yuan (OR=0.620, 95%CI: 0.473-0.812), a history of cardio-cerebrovascular diseases (OR=0.430, 95%CI: 0.324-0.572), presence of diabetes (OR=0.592, 95%CI: 0.476-0.736) led to less numbers of clustering of risk factors among populations at high risk of cardiovascular diseases. @*Conclusions @#There is clustering of risk factors among populations at high risk of cardiovascular diseases in Shaoxing City. Men, income, history of cardio-cerebrovascular diseases, hypertension and diabetes are factors affecting the clustering of risk factors.

Factors affecting blood lipid control among residents at a high risk of atherosclerotic cardiovascular disease / 预防医学

Objective@#To investigate the proportion of achieving the blood lipid control target and its influencing factors among residents at a high risk of atherosclerotic cardiovascular disease (ASCVD), so as to provide insights into management of blood lipid among residents at a high risk of ASCVD.@*Methods@#Residents at a high risk of ASCVD and at ages of 35 to 70 years were sampled using a multi-stage cluster sampling method from 6 counties (districts) in Shaoxing City from May to July 2021. The residents' demographics, smoking, alcohol consumption and medical history of chronic diseases were collected using questionnaires, the height, weight, waist circumference (WC) and blood pressure were measured, and the total cholesterol (TC), triacylglycerol (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and fasting blood glucose were detected. The proportion of blood lipids achieving the control target was analyzed, and factors affecting the proportion of blood lipids achieving the control target were identified using a multivariable logistic regression model.@*Results@#A total of 1 695 individuals at a high risk of ASCVD were enrolled, including 940 men (55.46%) and 755 women (44.54%), with a mean age of (62.56±6.08) years. There were 285 participants that achieved the target of blood lipid control (16.81%). Multivariable logistic regression analysis identified gender (male, OR=1.962, 95%CI: 1.396-2.758), age (OR=1.037, 95%CI: 1.013-1.061), WC (OR=0.979, 95%CI: 0.964-0.995), diastolic blood pressure (OR=0.981, 95%CI: 0.967-0.994), smoking (OR=1.485, 95%CI: 1.034-2.133), alcohol consumption (OR=0.684, 95%CI: 0.498-0.941), hypertension (OR=1.428, 95%CI: 1.006-2.207), administration of hypoglycemic drugs (OR=2.326, 95%CI: 1.720-3.144) as factors affecting the achievement of the target for blood lipid control among residents at a high risk of ASCVD. @*Conclusions @#Individuals at a high risk of ASCVD with higher WC, higher diastolic blood pressure and alcohol consumption are less likely to achieve the target for blood lipid control, while male individuals with older age, hypertension and administration of hypogcemic drugs are more likely to achieve the target for blood lipid control.

Investigating the current status of occupational disease prevention and control in micro, small and medium-sized manufacturing enterprises in Jiangxi Province / 中国职业医学

@#Objective To investigate the current status of occupational hazards and prevention and control of occupational ， - Methods ， diseases in micro small and medium sized manufacturing enterprises in Jiangxi Province. A total of 1 034 micro - small and medium sized manufacturing enterprises in Jiangxi Province were selected as the research subjects using a stratified cluster sampling method. The exposure of occupational hazards and the implementation of occupational hazards prevention and Results ， control measures were investigated. Among the 1 034 enterprises the small and micro enterprises accounted for ， 91.5%. The enterprises with serious occupational hazards were mainly concentrated in metallurgy building materials industry ， and machinery equipment and electrical appliance manufacturing industry. The exposure rate of occupational hazard factors in ， ， （ vs the categories of occupational hazard factors from high to low was physical factors dust and chemical factors 78.9% 52.8% vs ，P ） （ ）， ， 25.0% <0.01 . The exposure rate from high to low was metallurgy and building materials industry 60.8% machinery （ ）， ， equipment and electrical equipment manufacturing industry 42.9% light industry textile and tobacco processing industry （ ）， ， （ ）（P ） 32.0% chemical petrochemical and pharmaceutical industry 21.0% <0.01 . Noise exposure accounted for 98.3% in the workers exposed to physical factors. The implementation rate of prevention and control measures for occupational hazards ， in enterprises from high to low was the staffing of occupational health management personnel the establishment of ， ， occupational health management institutions the establishment of occupational health management systems the detection ， ， of occupational hazards the evaluation of the control effect of occupational hazards of construction projects and the - （ vs vs vs vs vs ，P ） pre evaluation of occupational hazards of construction projects 32.5% 25.7% 23.7% 16.2% 6.9% 4.2% <0.01 . Conclusion The focus of prevention and control of occupational hazards in manufacturing industry in Jiangxi Province is noise ， - and dust in small and micro metallurgy and building materials industry. Most of the micro small and medium sized manufacturing enterprises have not carried out the detection of occupational hazards and evaluation of occupational hazards in accordance with the law. The situation of occupational disease prevention and control is still challenging.

Investigating the current status of occupational disease prevention and control in micro, small and medium-sized manufacturing enterprises in Jiangxi Province / 中国职业医学

@#Objective To investigate the current status of occupational hazards and prevention and control of occupational ， - Methods ， diseases in micro small and medium sized manufacturing enterprises in Jiangxi Province. A total of 1 034 micro - small and medium sized manufacturing enterprises in Jiangxi Province were selected as the research subjects using a stratified cluster sampling method. The exposure of occupational hazards and the implementation of occupational hazards prevention and Results ， control measures were investigated. Among the 1 034 enterprises the small and micro enterprises accounted for ， 91.5%. The enterprises with serious occupational hazards were mainly concentrated in metallurgy building materials industry ， and machinery equipment and electrical appliance manufacturing industry. The exposure rate of occupational hazard factors in ， ， （ vs the categories of occupational hazard factors from high to low was physical factors dust and chemical factors 78.9% 52.8% vs ，P ） （ ）， ， 25.0% <0.01 . The exposure rate from high to low was metallurgy and building materials industry 60.8% machinery （ ）， ， equipment and electrical equipment manufacturing industry 42.9% light industry textile and tobacco processing industry （ ）， ， （ ）（P ） 32.0% chemical petrochemical and pharmaceutical industry 21.0% <0.01 . Noise exposure accounted for 98.3% in the workers exposed to physical factors. The implementation rate of prevention and control measures for occupational hazards ， in enterprises from high to low was the staffing of occupational health management personnel the establishment of ， ， occupational health management institutions the establishment of occupational health management systems the detection ， ， of occupational hazards the evaluation of the control effect of occupational hazards of construction projects and the - （ vs vs vs vs vs ，P ） pre evaluation of occupational hazards of construction projects 32.5% 25.7% 23.7% 16.2% 6.9% 4.2% <0.01 . Conclusion The focus of prevention and control of occupational hazards in manufacturing industry in Jiangxi Province is noise ， - and dust in small and micro metallurgy and building materials industry. Most of the micro small and medium sized manufacturing enterprises have not carried out the detection of occupational hazards and evaluation of occupational hazards in accordance with the law. The situation of occupational disease prevention and control is still challenging.

Trend of lung cancer incidence in Shaoxing from 2014 to 2019 / 预防医学

Objective @#To analyze the trend of lung cancer incidence in Shaoxing, Zhejiang Province from 2014 to 2019, so as to provide the basis for lung cancer prevention and control.@*Methods @#The data of lung cancer were collected through the information management system of chronic disease surveillance in Zhejiang Province.The crude incidence rate, age-standardized incidence rates by Chinese standard population ( ASIRC ) and by world standard population ( ASIRW ), truncated rate ( 35-64 ) years old ), and cumulative rate (0-74 years old) were calculated. The annual percentage change ( APC ) was used to analyze the trend of lung cancer. The annual contribution rate was used to analyze the contribution of the incidence trend with age to the total trend. @*Results @#Totally 22 261 cases of lung cancer were reported in Shaoxing from 2014 to 2019. The crude incidence rate, ASIRC, ASIRW, truncated rate ( 35-64 years old ), and cumulative rate ( 0-74 years old ) were 83.51/100 000, 41.28/100 000, 41.01/100 000, 57.00/100 000 and 5.11%, respectively. The crude incidence rate, ASIRC and ASIRW increased significantly from 2014 to 2019, with the APC values of 8.56%, 6.42% and 6.05%, respectively ( P<0.05 ). The crude incidence rate, ASIRC, ASIRW, truncated rate ( 35-64 years old ), and cumulative rate ( 0-74 years old ) of man were 105.25/100 000, 48.09/100 000, 50.69/100 000, 62.03/100 000 and 6.42%, respectively, which were higher than those of women ( 61.84/100 000, 33.05/100 000, 31.35/100 000, 51.71/100 000 and 3.76% ).The crude incidence rate increased with age. The annual contribution rates of lung cancer incidence in people aged 15-<45 years, 45-<55 years, 55-<65 years and ≥65 years were 51.20%, 30.86%, 15.79% and 2.15%, respectively. The crude incidence rate in people aged 15-<45 years, 45-<55 years and 55-<65 years increased significantly from 2014 to 2019, with the APC values of 23.84%, 13.79% and 6.78%, respectively ( P<0.05 ). @*Conclusion @#From 2014 to 2019, the incidence of lung cancer in Shaoxing shows an increasing trend, and the age of onset is getting younger.

Research progress on extracellular vesicles and bone regeneration / 口腔疾病防治

@#Extracellular vesicles (EVs) are lipid bilayers secreted by a variety of cells that contain nucleic acids, proteins, etc. They can be used as a carrier for cell-to-cell communication. In related research on bone regeneration, mechanisms for transmitting regeneration signals to target cells to achieve the desired goal of osteogenesis have become one of the most important and unsolved topics. Therefore, this review aims to explore the role of mesenchymal stem cells and EVs derived from osteoblasts in bone regeneration in four processes, immunity, angiogenesis, osteogenesis and mineralization, and to provide new ideas for basic and clinical research.

Research progress in the regulation of macrophages in foreign body reaction in bone tissue repair / 口腔疾病防治

@#The foreign body reaction refers to a chronic inflammatory reaction and a wound-healing reaction that mainly involve macrophages and foreign body giant cells, which occur after a biological material is implanted into the body. Since macrophages in the foreign body reaction are recruited to the surface of the material after implantation of the material, subsequent secretion of a series of inflammatory factors and fusion into foreign body giant cells may lead to the degradation of the biological materials and environmental stress cracking. Moreover, the prolongation of macrophage polarization and the influence of related receptors may also lead to the phenomenon of fiber encapsulation, resulting in poor prognosis. Some scholars are committed to reducing the response of foreign bodies from the perspective of macrophages and foreign body giant cells, specifically by regulating the secretion of related inflammatory factors, reducing the subtypes of M1 macrophages, promoting their polarization to M2 macrophages, and regulating the fusion of macrophages and selective expression of macrophage-associated receptors to regulate fibrosis. The new immunological view holds that macrophages have the potential to repair bone tissue via angioplasts and osteogenesis in foreign body reactions. Therefore, the gold standard that has long been considered in regenerative medicine, which is that an inert material does not cause a foreign body reaction, is expected to be gradually replaced by tissue engineering that regulates tissue activity and function.

Henoch-Schönlein purpura nephritis associated with monoclonal gammopathy of renal significance: a case report

Monoclonal gammopathy of renal significance (MGRS) can present with different morphologic features and lead to kidney failure. The Henoch-Schönlein purpura nephritis (HSPN) that cannot be relieved by treatment with glucocorticoid and immunosuppressive agents suggests the presence of monoclonal gammopathy in adult patients. The present study reports on a single case of HSPN associated with IgA-κMGRS. The patient who suffered from recurrent skin purpura for 6 months and nephrotic syndrome for 2 months was admitted to our hospital. Bone marrow biopsy showed monoclonal gammopathy of undetermined significance. Kidney biopsy indicated a Henoch-Schönlein purpura nephritis (HSPN, ISKDC classified as type III) with positive staining with κ-light chain in the glomeruli and renal tubular epithelial cells. Furthermore, skin biopsy showed leukocytoclastic vasculitis and negative staining for Congo red and light chain. Given both the renal and cutaneous involvement, the patient was considered to have HSPN associated with IgA-κMGRS. The patient experienced an exacerbation in his purpura-like lesions and clinical status after treatment with glucocorticoid and immunosuppressive agents. Consequently, the patient was put on a regimen that included dexamethasone (20 mg on the 1st, 4th, 8th, and 11th days of each month, iv) and bortezomib (2.4 mg on the 1st, 4th, 8th, and 11th days of each month, iv). Eight weeks after treatment, he had complete resolution of his cutaneous purpura and his biochemical parameters improved. The latent presence of MGRS in cases of HSPN should be considered in adult patients. Increased cognizance and correct treatment options could improve patient outcomes.

Relationship between T cells and bone regeneration: recent progress and perspectives / 口腔疾病防治

@#Bone is capable of regeneration after injury, but the process of properly restoring form and function is highly complex and prone to failure. The restoration process requires highly ordered and sequential interplay at the injury site between the host immune system and bone tissue. The dynamic process that occurs after bone injury includes the formation of a hematoma, the development of an inflammatory response and callus, and the remodeling of newly formed bone tissue. The inflammatory response at the injury site is essential for the onset of bone regeneration. This inflammatory response is tightly linked with the host immune system, in which various immune cells and molecules are involved. Recently, the relationship between T cells and bone regeneration has become a popular topic; however, currently, there are no summaries of the relationship between T cells and bone regeneration. Thus, this review aimed to elucidate the modulatory functions of T cells in bone regeneration.

Morphological Features of Complex Congenital Cardiovascular Anomalies in Fetuses: as Evaluated by Cast Models / 华中科技大学学报（医学）（英德文版）

Accurate prenatal diagnosis of complex congenital cardiovascular anomalies,vascular ones in particular,is still challenging.A fetal cardiovascular cast model can provide a copy of the cardiac chambers and great vessels with normal or pathological structures.This study was aimed to demonstrate three-dimensional anatomy of complex congenital cardiovascular anomalies in fetuses by means of corrosion casting.Twenty fetuses with prenatal-ultrasound-diagnosed complex cardiovascular anomalies were enrolled in this study (19 to 35 gestational weeks).Fetal cardiovascular cast models were made by a corrosion casting technique.The specimens were injected with casting material via the umbilical vein,and then immersed in strong acid after casting fluid was solidified,to disclose the geometries of cardiovascular cavities.Nineteen cast models were successfully made from 20 specimens.The casts distinctly showed the morphological malformations and spatial relationship between cardiac chambers and great vessels.One hundred and eleven abnormalities were revealed by casting in the 19 specimens,including 34 abnormalities located in the cardiac chambers (3,4 and 27 anomalies in the atria,atrioventricular valves and ventricles,respectively),and 77 in the great vessels (28,20,24 and 5 anomalies in the aorta and its branches,the pulmonary artery,the ductus arteriosus and the major veins,respectively).Corrosion casting can display three-dimensional anatomy of fetal complex cardiovascular anomalies.This improves our understanding of related pathomorphology and prenatal diagnosis.

Simultaneously preparation of grams of high purity tyrosol, crenulatin and salidroside from Rhodiola crenulata / 中国中药杂志

Tyrosol, crenulatin and salidroside are the main active constituents of Rhodiola crenulata, with extensive pharmacological activities. In the study, grams of high purity tyrosol, crenulatin and salidroside were simultaneously separated from R. crenulata by the first time. Firstly, R. crenulata was extracted by 70% alcohol. Then, with the yields of three compounds as the index, the macroporous resin was optimized. At last, grams of high purity tyrosol, crenulatin and salidroside were isolated by D-101 macroporousresin, purified by column chromatography. Detected by HPLC, the purity of three compounds were higher than 98%. This method has the advantages of simple process and operation, less dosage of organic solvent, highly yield and reproducibility, suitable for the simultaneously preparation of tyrosol, crenulatin and salidroside.

Anatomy basis and clinical significance of various types of abductor hallucis superior margin arterial arcades / Bases anatómicas e importancia clínica de varios tipos de arcos arteriales del margen superior del músculo abductor del hálux

The aim of this study was to group arteries of arterial arch at the superior margin of the abductor hallucis muscle according to their constitutes and provide anatomical basis for reverse bifolicated flap based on it. The constitute, track-way and distribution of the artery, which supply the medial pedis flap, the medial plantar and the medial tarsal flap, especial the arterial arch at the superior margin of the abductor hallucis muscle were observed and analyzed on 81 lower limbs cast specimens and 2 fresh feet specimens. According to their constitute, arterial arch at the superior margin of the abductor hallucis muscle can be classified into 3 types: i) type I, It was constituted mainly by the branch of anterior medial malleolus artery and (or) the medial tarsal artery. ii) type II, It was constituted mainly by the superficial branch of the medial plantar artery; iii) type II, It was constituted mainly by the branch of anterior medial malleolus artery and the branch of medial tarsal artery anastomose with the superficial branch of the medial plantar artery, which was divided into two subtypes according to the different anastomosis of the artery: Type III 1, the type of anastomosed directly was about 48.2 percent, type III 2, The type of anastomosed indirectly was about 24.1 percent. According to the constitute of arterial arch at the superior margin of the abductor hallucis muscle can be classified into three types: The type of anterior medial malleolus artery and medial tarsal artery, the type of superficial branch of the medial plantar artery and the type of mixed. For the type mixed, two subtypes can be classified according to the different anastomosis of the artery.

El objetivo fue clasificar las arterias de arco arterial del margen superior del músculo abductor del hálux según su constitución, y proporcionar una base anatómica para el colgajo bilobulado reverso basado en él. La constitución, recorrido y distribución de las arterias que suministran los colgajos pedicular medial, plantar medial y medial del tarso, en especial el arco arterial del margen superior del músculo abductor del hálux fueron observados y analizados en 81 modelos de miembros inferiores y 2 pies frescos. De acuerdo con su constitución, el arco arterial del margen superior del músculo abductor del hálux se pueden clasificar en 3 tipos: i) tipo I, constituido principalmentepor la rama de la arteria anterior del maléolo medial y/o la arteria medial del tarso. ii) tipo II, constituido principalmente por la rama superficial de la arteria plantar medial, iii) tipo III constituido principalmente por la rama de la arteria maleolar medial anterior y la rama de la anastomosis de la arteria tarsiana medial de la rama superficial de la arteria plantar medial, que se divide en 2 subtipos diferentes de acuerdo con el tipo de anastomosis: tipo III 1, una anastomosis directa que se observó en el 48,2 por ciento, y tipo III 2, una anastomosis indirecta observada en aproximadamente el 24,1 por ciento de los casos. Según la constitución, el arco arterial del margen superior del músculo abductor del hálux se puede clasificar en 3 tipos: el tipo de arteria anterior del maléolo medial y la arteria tarsiana medial, el tipo de rama superficial de la arteria plantar medial y el tipo mixto. En el tipo mixto, pueden ser clasificados 2 subtipos de acuerdo a la diferente anastomosis de la arteria.

Effect of alexandrite laser treatment for hair removal in Tibet mini-pigs / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the histological and ultrastructural changes of the skin and hair follicles following hair removal by alexandrite laser in Tibet mini-pigs.</p><p><b>METHODS</b>Twelve healthy Tibet mini-pigs with dark hair were treated with alexandrite laser for hair removal. The skin specimens were taken immediately and at 1 h and 1, 3, 5, 10, 15, 30, 60 days after the laser treatment for observation under optical and transmission electron microscope.</p><p><b>RESULTS</b>Laser hair removal resulted in extensive coagulation necrosis, carbonization and falling of the subcutaneous hair shafts, and some of the cells in the outer root sheath and hair bulb underwent degenerative and necrotic changes. One hour after laser treatment, the cells in the outer root sheath and bulb exhibited nuclear condensation, fragmentation and or karyolysis characteristic of cell apoptosis. The cell apoptosis reached the peak level on day 3 after the laser exposure, accompanied by endothelial degeneration in the hair papilla vessels, edema and lymphocyte infiltration in the dermal tissues. Tissue reaction and inflammation were relieved on day 5, and the dermal tissue and follicles recovered their normal structures on day 10. At 60 days after the treatment, the hair follicles decreased markedly but the structure of the residue follicles remained normal.</p><p><b>CONCLUSION</b>Alexandrite laser exposure results in selective destruction of the follicles by inducing direct coagulation and cell apoptosis to achieve permanent hair removal. Tibet mini-pigs with black hair can be used as the animal model of clinical laser hair removal.</p>

Predictive factors of outcome and stroke recurrence in patients with unilateral atherosclerosis-related internal carotid artery occlusion.

Background: Clinical outcome of internal carotid artery (ICA) occlusion is highly variable and the reason is uncertain. Aim: To study the predictive factors of clinical outcome and stroke recurrence in patients with ischemic stroke associated with unilateral atherosclerosis-related ICA occlusion. Settings and Design: Prospective study in neurology department of a single hospital. Materials and Methods: We prospectively studied 66 patients who suffered from first-ever ischemic stroke associated with unilateral atherosclerosis-related ICA occlusion over a period of two years. The end point was death or stroke recurrence. Statistical Analysis: Chi-square or Fisher's exact test was used to analyze predictors of early functional outcome. Multivariate analysis was used to analyze predictors of death or stroke recurrence within two years. Result: Higher age ((3)70 years) predicted a worse functional outcome ( P = 0.049). Total anterior circulation syndrome (TACS) was associated with a poor functional outcome ( P P = 0.001). Stroke in evolution predicted a poor outcome ( P = 0.001), while those with symptom improvement had a better outcome ( P = 0.016). Pneumonia predicted a poor outcome ( P = 0.021). Five patients expired and 22 patients suffered from recurrent stroke in the following 24 months. Previous transient ischemic attack (TIA) and anemia were associated with a higher risk of death or recurrent stroke within two years ( P = 0.036, P = 0.012). Conclusion: High age, TACS, stroke in evolution and pneumonia were predictors for poor functional outcome. Previous TIA and anemia were predictors for death and recurrent stroke within two years.

Pathological changes of lungs in patients with severity acute respiratory syndrome / 中华病理学杂志

<p><b>OBJECTIVE</b>To evaluate the progression in morphologic changes of lungs in SARS patients.</p><p><b>METHODS</b>Four cases of SARS with lung tissue samples available (including one for ultrastructural examination) were enrolled into the study. Histochemical study for VG, Masson, reticulin, orcein, PAS, sirius red stains and immunohistochemical study for vimentin, desmin, smooth muscle actin, HHF-35, CD34, F8, collagen types I and III were also performed.</p><p><b>RESULTS</b>According to the morphologic changes, lung lesions in SARS were subcategorized into 3 phases: acute exudative inflammation, fibrous proliferation and the final fibrotic stage. Two cases belonged to the acute exudative phase, in which the course was less than 20 days. The principal lesions consisted of acute alveolar exudative inflammation, hyperplasia of alveolar epithelium, necrosis, alveolar hyaline membrane formation, alveolar desquamation and focal fibroplasia. The acute exudative protein was PAS-positive. There was an increase in reticulin fiber formation. The reactive fibroblasts were highlighted by desmin and vimentin. One case belonged to the fibroproliferative stage, in which the course was around 25 days. Major lesions included proliferative interstitial pneumonia with early pulmonary fibrosis. There was also evidence of organizing pneumonia, with an increase in reticulin fiber formation, which had a glomeruloid appearance on special stain. The mesenchymal cells showed either myofibroblastic (which expressed desmin, HHF-35, smooth muscle actin and vimentin) or fibroblastic (which expressed vimentin only) differentiation. Fibroelastosis and fibroplasia was also noted. The remaining case belonged to the fibrotic stage, in which the course was around 75 days. The main features included diffuse fibrosis and honeycomb change, which were highlighted by sirius red stain. Immunohistochemistry showed mainly types I and IV collagen fibers. In all lesions, there was also an increase of number of CD68-positive macrophages.</p><p><b>CONCLUSIONS</b>The morphologic progression in lungs of SARS patients is characterized by the development of increased fibrosis. The primitive mesenchymal cells, hyperplastic alveolar epithelial cells and macrophages play an important role in the pathogenesis.</p>

Development of toxin targeting to VEGF-KDR / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To develop toxin targeting vascular endothelial growth factor receptor II (VEGF-II/KDR) fused with a KDR-binling peptide screened from peptide library.</p><p><b>METHODS</b>By affinity to KDR molecular which expressed specifically by new born vascular endothelial cell, peptides to KDR were screened from C7 peptide library by phage display. Among them, a peptide binding to KDR with high affinity termed as P5 was selected and fused to the N-terminal of Shiga toxin subunit A (StxA). The protein (P5-StxA) was expressed in E. coli.</p><p><b>RESULTS</b>ELISA and Western blot were applied to characterize the binding interaction between the fusion protein, P5-StxA and KDR. Cytotoxicity assay showed that P5-StxA maintained similar toxicity to cell as StxA. In the model of angiogenesis, P5-StxA inhibited selectively VEGF-induced growth of preexisting vessels of the chick chorioallantoic membrane.</p><p><b>CONCLUSION</b>These studies demonstrate the small peptide, P5, maybe be used as carrier of toxin targeting to KDR.</p>

Pathological and ultramicrostructural changes of tissues in a patient with severe acute respiratory syndrome / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the morphological, ultramicrostructural and pathological changes of tissues from a patient with severe acute respiratory syndrome (SARS).</p><p><b>METHODS</b>One autopsy case of diagnosed SARS was investigated. Lung puncture was performed immediately after the patient died, and the autopsy was done after 12 h. The specimens from lymph nodes, spleen, small intestine, colon and bone marrow were studied by immunohistochemical technique. The antibodies used included CD20, CD45RO (UCHL-1), CD4, CD8, CD68 and CD34.</p><p><b>RESULTS</b>The principal lesions of the SARS case consisted of acute lobular intrastitial pneumonia, hyaloid membranes of pulmonic alveoli and hyperplasia and shedding of alveolar epithelium of. Virus-like inclusions occasionally contained cytoplasm of the alveolar epithelium, which were positive by histochemical staining. The adjacent blood-vessels were changed by hyperplasia and enlargement. The structures of lymph nodes and spleen were damaged with lymph follicles depletion and splenic nodules atrophy. The specific changes included reduction of lymphocytes and hyperplasia of histiocytes, depletion of the follicles of small intestine and colon wall, decreased hyperplasia of the bone marrow and increased number of the megakaryocyte. Meanwhile, in the immunohistochemical study, CD(20)(+) B cells were fully expressed in lymph nodes and spleen, and the CD45RO (UCHL-1)(+) T cells were scatteredly expressed. The number of CD4(+) help T cell was markedly decreased, while the number of CD8+ poisonal T cells increased, and the ratio of the former and latter was no more than 0.5. Under the electronic microscopy observation, virus-like particles with 80 - 160 nm diameter and halo or garland envelope were found in mononuclear macrophage and cytoplasm of alveolar epithelium.</p><p><b>CONCLUSION</b>The specific lesions of SARS consist of lobular intrastitial pneumonia with the formation of hyaline membranes of lung, haemorrhage, necrosis, inflammation of blood vessels and the damages of extralung lymphohemopioetic system. The damages were very similar to the pathological features of tissues infected by human immunodeficiency virus, in which numbers of T cells decreased and CD(4)(+) T cell/CD(8)(+) T cell ratio was no more than 0.5. According to the virus-like particles found in lung of the SARS case, it is considered that these virus-like particles may be a new kind of coronavirus which caused the "atypical pneumonia".</p>