Diagnostic efficacy of prostate cancer using targeted biopsy with 6-core systematic biopsy for patients with PI-RADS 5 / 北京大学学报(医学版)

OBJECTIVE@#To investigate the diagnostic efficacy of targeted biopsy (TBx), systematic biopsy (SBx), TBx+6-core SBx in prostate cancer (PCa) / clinically significant prostate cancer (cs-PCa) for patients with prostate imaging reporting and data system (PI-RADS) score of 5, and thereby to explore an optimal sampling scheme.@*METHODS@#The data of 585 patients who underwent multiparametric magnetic resonance imaging (mpMRI) with at least one lesion of PI-RADS score 5 at Peking University First Hospital from January 2019 to June 2022 were retrospectively analyzed. All patients underwent mpMRI / transrectal ultrasound (TRUS) cognitive guided biopsy (TBx+SBx). With the pathological results of combined biopsy as the gold standard, we compared the diagnostic efficacy of TBx only, SBx only, and TBx+6-core SBx for PCa/csPCa. The patients were grouped according to mpMRI T-stage (cT2, cT3, cT4) and the detection rates of different biopsy schemes for PCa/csPCa were compared using Cochran's Q and McNemar tests.@*RESULTS@#Among 585 patients with a PI-RADS score of 5, 560 (95.7%) were positive and 25(4.3%) were negative via TBx+SBx. After stratified according to mpMRI T-stage, 233 patients (39.8%) were found in cT2 stage, 214 patients (36.6%) in cT3 stage, and 138 patients (23.6%) in cT4 stage. There was no statistically significant difference in the detection rate of PCa/csPCa between TBx+6-core SBx and TBx+SBx (all P>0.999). Also, there was no statistically significant difference in the detection rate of PCa/csPCa between TBx and TBx+SBx in the cT2, cT3, and cT4 subgroups (PCa: P=0.203, P=0.250, P>0.999; csPCa: P=0.700, P=0.250, P>0.999). The missed diagnosis rate of SBx for PCa and csPCa was 2.1% (12/560) and 1.8% (10/549), and that of TBx for PCa and csPCa was 1.8% (10/560) and 1.4% (8/549), respectively. However, the detection rate of TBx+6-core SBx for PCa and csPCa was 100%. Compared with TBx+SBx, TBx and TBx+6-core SBx had a fewer number of cores and a higher detection rate per core (P < 0.001).@*CONCLUSION@#For patients with a PI-RADS score of 5, TBx and TBx+6-core SBx showed the same PCa/csPCa detection rates and a high detection rates per core as that of TBx+SBx, which can be considered as an optimal scheme for prostate biopsy.

Prenatal diagnosis of pyruvate dehydrogenase E1-α deficiency: a case report / 中华围产医学杂志

This article reported a case of pyruvate dehydrogenase E1-α deficiency suggested by abnormal brain development during prenatal ultrasound imaging. Prenatal ultrasound revealed a mild enlargement of bilateral cerebral ventricles and the possibility of intracranial hemorrhage in the fetus at 25 +1 weeks of gestation. MRI showed the fetus with absent corpus callosum, enlarged bilateral cerebral ventricles and paraventricular cysts. After genetic counseling and careful consideration, the couple opted for pregnancy termination. To clarify the cause of the disease, whole-exome sequencing was performed on the fetal skin to detect possible variants, and which revealed a frameshift mutation c.924_930dup(p.R311Gfs*5) in exon 10 of the PDHA1 gene. Sanger sequencing confirmed the mutation was a de novo pathogenic variant, indicating that the fetus was affected by pyruvate dehydrogenase E1-α deficiency.

Predicting and overcoming resistance to CDK9 inhibitors for cancer therapy

Abnormally activated CDK9 participates in the super-enhancer mediated transcription of short-lived proteins required for cancer cell survival. Targeting CDK9 has shown potent anti-tumor activity in clinical trials among different cancers. However, the study and knowledge on drug resistance to CDK9 inhibitors are very limited. In this study, we established an AML cell line with acquired resistance to a highly selective CDK9 inhibitor BAY1251152. Through genomic sequencing, we identified in the kinase domain of CDK9 a mutation L156F, which is also a coding SNP in the CDK9 gene. By knocking in L156F into cancer cells using CRISPR/Cas9, we found that single CDK9 L156F could drive the resistance to CDK9 inhibitors, not only ATP competitive inhibitor but also PROTAC degrader. Mechanistically, CDK9 L156F disrupts the binding with inhibitors due to steric hindrance, further, the mutation affects the thermal stability and catalytic activity of CDK9 protein. To overcome the drug resistance mediated by the CDK9-L156F mutation, we discovered a compound, IHMT-CDK9-36 which showed potent inhibition activity both for CDK9 WT and L156F mutant. Together, we report a novel resistance mechanism for CDK9 inhibitors and provide a novel chemical scaffold for the future development of CDK9 inhibitors.

The Etiological Study of Three Hunter Syndrome Families in Southern China / 中山大学学报(医学科学版)

ObjectiveTo reveal the molecular pathogenesis of Hunter syndrome in three families in southern China and to clarify the correlation between phenotype and genotype， so as to lay a foundation for future prenatal or preimplantation genetic diagnosis. MethodsOn the basis of initial clinical diagnosis and pedigree analysis， qualitative detection of glycosaminoglycans in urine was performed first， and then anticoagulant blood samples were collected from the children and their relatives. DNA was extracted and the IDS gene sequence was analyzed by PCR and Sanger sequencing. Various methods such as RT-PCR and bioinformatics analysis were used to identify the pathogenicity of the new variants. ResultsThe urine test results of the patients in the three families were all strongly positive（++）. Probands were all male， with hemizygous mutations in IDS gene from their mothers， and the mutation sites were c.615_622delCATACAGT， c.847_848delGT and IVS7 ds+1 G>A， respectively. The cross-species conservation analysis showed that the amino acid of IDS gene mutation site was highly conserved during species evolution. Compared with the normal protein， mutant proteins exhibited significant differences in the predicted results of advanced structure. The variants identified in the three families were classified as pathogenic by ACMG criteria. ConclusionsThe three probands were diagnosed with Hunter syndrome. The c.615_622del（p.Il206Valfs*18）， c.847_848del（p.Val283Alafs*57） and IVS7 ds+1 G>A （p.G336Dfs*12） of IDS gene are all novel pathogenic mutations， which are the underlying causes of morbidity in children. This study has further enriched the mutation spectrum of IDS gene.

miR-125b-5p inhibits proliferation and migration of osteosarcoma cells by negatively regulating RAB3D expression / 南方医科大学学报

OBJECTIVE@#To investigate the inhibitory effect of miR-125b-5p on proliferation and migration of osteosarcoma and the role of RAB3D in mediating this effect.@*METHODS@#The expression level of miR-125b-5p was detected by qRT-PCR in a normal bone cell line (hFOB1.19) and in two osteosarcoma OS cell lines (MG63 and HOS). A miR-125b-5p mimic or inhibitor was transfected in the osteosarcoma cell lines via liposome and the changes in cell proliferation and migration were detected with EDU and Transwell experiments. Bioinformatic analysis was conducted for predicting the target gene of miR-125b-5p, and the expression level of RAB3D in hFOB1.19, MG63, and HOS cells was detected by Western blotting. In the two osteosarcoma cell lines transfected with miR-125b-5p mimic or inhibitor, the expression levels of RAB3D mRNA and protein in osteosarcoma cells were examined with qRT-PCR and Western blotting. The effects of RAB3D overexpression, RAB3D knockdown, or overexpression of both miR-125b-5p and RAB3D on the proliferation and migration of cells were assessed using EDU and Transwell experiments.@*RESULTS@#The two osteosarcoma cell lines had significantly lower expression levels of miR-125b-5p (P < 0.05). Bioinformatic analysis predicted that RAB3D was a possible target gene regulated by miR-125b-5p. In osteosarcoma cells, overexpression of miR-125b-5p significantly lowered the expression of RAB3D protein (P < 0.05); inhibiting miR-125b-5p expression significantly decreased RAB3D expression only at the protein level (P < 0.05) without obviously affecting its mRNA level. Modulation of miR-125b-5p and RAB3D levels produced opposite effects on proliferation and migration of osteosarcoma cells, and in cells with overexpression of both miR-125b-5p and RAB3D, the effect of RAB3D on cell proliferation and migration was blocked by miR-125b-5p overexpression (P < 0.05).@*CONCLUSION@#Overexpression of miR-125b-5p inhibits the proliferation and migration of osteosarcoma cells by regulating the expression of RAB3D at the post-transcriptional level.

Effect of Ganmai Dazao Decoction on ethology of rats with PTSD and its mechanism / 中国中药杂志

This study aimed to explore the effect of Ganmai Dazao Decoction on the ethology of rats with posttraumatic stress disorder(PTSD) and study the related mechanism through the changes in magnetic resonance imaging and protein expression. Sixty rats were randomly divided into 6 groups, namely the normal group, the model group, the low(1 g·kg~(-1)), medium(2 g·kg~(-1)), and high-dose Ganmai Dazao Decoction groups(4 g·kg~(-1)), and the positive control group(intragastric administration with 10.8 mg·kg~(-1) of fluoxetine), with 10 rats in each group. Two weeks after inducing PTSD by single-prolonged stress(SPS) in rats, the positive control group was given fluoxetine hydrochloride capsule by gavage, the low, medium, and high-dose groups were given Ganmai Dazao Decoction by gavage, and both the normal group and the model group were given the same volume of normal saline by gavage, each for 7 days. The open field experiment, elevated cross elevated maze, forced swimming experiment, and new object recognition test were carried out for the behavioral test. Three rats in each group were selected to detect the expression of neuropeptide receptor Y1(NPY1R) protein in the hippocampus by Western blot. Then, the other three rats in each group were selected to use the 9.4T magnetic resonance imaging experiment to observe the overall structural changes in the brain region and the anisotropy fraction of the hippocampus. The results of the open field experiment showed that the total distance and central distance of rats in the model group were significantly lower than those in the normal group, and the total distance and central distance of rats in the middle and high-dose Ganmai Dazao Decoction groups were higher than those in the model group. The results of the elevated cross maze test showed that medium and high-dose Ganmai Dazao Decoction remarkably increased the number of open arm entries and the residence time of open arm of rats with PTSD. The results of the forced swimming experiment showed that the immobility time in the water of the model group rats was significantly higher than that of the normal group, and Ganmai Dazao Decoction hugely reduced the immobility time in the water of rats with PTSD. The results of the new object recognition test showed that Ganmai Dazao Decoction significantly increased the exploration time of new objects and familiar objects in rats with PTSD. The results of Western blot showed that Ganmai Dazao Decoction significantly reduced the expression of NYP1R protein in the hippocampus of rats with PTSD. The 9.4T magnetic resonance examination found that there was no significant difference in the structural image among the groups. In the functional image, the fractional anisotropy(FA value) of the hippocampus in the model group was significantly lower than that in the normal group. The FA value of the hippocampus in the middle and high-dose Ganmai Dazao Decoction groups was higher than that in the model group. Ganmai Dazao Decoction reduces the injury of hippocampal neurons by inhibiting the expression of NYP1R in the hippocampus of rats with PTSD, thereby improving the nerve function injury of rats with PTSD and playing a neuroprotective role.

Investigation on the carriage prevalence of Neisseria meningitidis in healthy population in Jiangsu Province in 2019 and 2020 / 中华预防医学杂志

In order to investigate carriage status and serum groups distribution of Neisseria meningitidis(Nm) among healthy population in Jiangsu Province, four counties were selected as monitoring sites by random sampling method for cross-sectional study. Throat swab specimens were collected from four monitoring sites in October to November 2019 and November to December 2020 for bacterial culture and Real-time PCR detection. Chi-square test was used to compare the positive rate of Neisseria meningitidis, and multiple logistic regression model was used to analyze the influencing factors of Neisseria meningitidis carrier rate. The results showed that among 1 512 samples, 57 strains of Nm were isolated, and the carrier rate was 3.77%. Serogroup B was the dominant group (36.84%), followed by un-known serogroups (33.33%), serogroup C was the third (17.54%), serogroup W135 and serogroup A were 7.02% and 5.26%, respectively. The carriage rate (8.60%) of 15-20 years old was significantly higher than others (1.77%-3.74%)(Pearson χ2=18.211, P<0.05). Region, age and immunization history were risk factors for Neisseria meningitidis carrier rate. In summary, the Nm carrier rate of healthy population in Jiangsu Province is relatively low, which indicates that the epidemic cases will continue to be sporadic in the future. However, the prevention and control of meningococcal epidemics on campus should be strengthened, and the monitoring of neisseria meningitidis group B should be maintained as it has become the dominant epidemic strain.

Mare's milk attenuates sodium dextran sulfate induced inflammation in mouse ulcerative colitis / 细胞与分子免疫学杂志

Objective To investigate the immunomodulatory effect of mare's milk on dextran sulfate sodium (DSS)-induced ulcerative colitis (UC) mice. Methods Kunming mice were randomly divided into a blank group(0.8 mL/day saline by gavage) and a DSS modeling group. After modeling, the DSS modeling group was further divided into a control group (0.8 mL/day saline), a salazosulfapyridine (SASP) treated group(430 mg/(kg.d)) and a mare's milk group(0.8 mL/day), with 16 mice in each group. After 10 days of gavage administration, HE staining was performed to observe colonic inflammation, and the disease activity index (DAI) and colonic mucosal damage index (CMDI) were scored. ELISA was used to determine the levels of interleukin 1β (IL-1β), IL-6, and IL-10 in mouse colonic tissues, and flow cytometry was used to detect the percentages of CD4+ and CD8+ T lymphocytes in peripheral blood. Results Compared to the blank group, all indexes in mice of the control group indicated that DSS successfully induced UC. Compared to the control group, colon shortening in UC mice was attenuated in the mare's milk group; inflammation and ulcer formation in colonic tissues were inhibited; DAI and CMDI scores were lowere; IL-1β and IL-6 levels in mouse colonic tissues were significantly reduced; IL-10 levels were increased and the CD4+/CD8+ T cell ratio was reduced. Conclusion Mare's milk can inhibit the inflammation of DSS-induced UC mice through immune regulation.

Research progress of breast cancer with low HER2 expression / 国际肿瘤学杂志

Breast cancer with low expression of human epidermal growth factor receptor 2 (HER2) has unique biological behaviors. Compared with HER2-zero breast cancer, there are significant differences in molecular subtype and gene expression between the two categories of breast cancer. Novel antibody-drug conjugates represented by T-DXd provide a new treatment option for patients with HER2-low breast cancer, and relevant clinical trials are continuing. At present, the relationship between HER2-low status and prognosis of breast cancer patients remains controversial. In-depth research into HER2-low breast cancer will help further improve clinical outcomes for this population.

The effect of modified Miccoli surgery in the treatment of patients with benign thyroid diseases and its influence on the postoperative aesthetic degree of scar score and the expression of pain factors / 中国医师进修杂志

Objective:To investigate the effect of modified Miccoli surgery in the treatment of patients with benign thyroid disease and its intervention on the postoperative aesthetic degree of scar score and the expression of pain factors.Methods:The clinical data of 114 patients with benign thyroid diseases in Hankou Hospital from February 2018 to February 2020 were collected, 57 cases with traditional open thyroid surgery were enrolled in the open group, and 57 cases with modified Miccoli surgery were enrolled in the modified group. The surgery related indicators, postoperative recovery indicators, complications and preoperative, postoperative 1, 3 d serum pain factors substance P (SP), β-endorphin (β-EP), dynorphin ( DYN), immune function indexes CD 3+, CD 4+, CD 8+, parathyroid function related indexes parathyrotropic hormone(PTH), blood calcium, 3 months and 6 months after surgery of observer scar evaluation scale (OSAS), Vancouver scar scale (VSS) scores were compared between the two groups. Results:The length of incision, recovery time of neck movement, and hospital stay and the intraoperative blood loss were lower than those in the open group: (2.2 ± 0.4) cm vs. (6.5 ± 0.7) cm, (19.6 ± 4.8) h vs. (28.2 ± 7.8) h, (4.8 ± 1.4) d vs. (7.1 ± 1.8) d, (21.9 ± 5.1) ml vs. (39.5 ± 7.0) ml, the differences were statistically significant ( P<0.05). The levels of serum SP, β-EP and DYN in the modified group were lower than those in the open group at 1 and 3 d after operation: 1 d after surgery:(87.40 ± 12.25) ng/L vs. (114.96 ± 15.79) ng/L, (149.34 ± 21.49) ng/L vs.(192.15 ± 26.43) ng/L, (1.14 ± 0.21) mg/L vs. (1.59 ± 0.30) mg/L; 3 d after surgery: (80.18 ± 10.79) ng/L vs.(96.24 ± 12.36) ng/L, (137.46 ± 18.57) ng/L vs. (168.24 ± 21.50) ng/L, (0.94 ± 0.16) mg/L vs. (1.27 ± 0.25) mg/L, the differences were statistically significant ( P<0.05). The levels of CD 3+ and CD 4+ in the modified group were higher than those in the open group at 1 and 3 d after the operation, and the CD8+ level was lower than that of the open group: 1 d after surgery: 0.597 ± 0.053 vs. 0.542 ± 0.049, 0.382 ± 0.041 vs. 0.362 ± 0.036, 0.308 ± 0.048 vs. 0.332 ± 0.060; 3 d after surgery: 0.615 ± 0.060 vs. 0.580 ± 0.055, 0.408 ± 0.051 vs. 0.385 ± 0.046, 0.290 ± 0.038 vs. 0.317 ± 0.045, and the differences were statistically significant ( P<0.05). The levels of serum PTH and blood calcium in the modified group were higher than those in the open group at 1 and 3 d after operation: 1 d after surgery: (29.12 ± 6.58) ng/L vs. (20.67 ± 5.14) ng/L, (1.86 ± 0.22) mmol/L vs. (1.59 ± 0.10) mmol/L; 3 d after surgery: (36.39 ± 7.65) ng/L vs. (24.08 ± 5.97) ng/L, (2.03 ± 0.18) mmol/L vs. (1.72 ± 0.14) mmol/L, the differences were statistically significant ( P<0.05). The OSAS and VSS scores of the modified group were lower than those of the open group at 3 and 6 months after surgery: 3 months after surgery: (15.9 ± 3.3) scores vs. (24.7 ± 6.9) scores, (4.4 ± 1.5) scores vs. (8.1 ± 3.2) scores; 6 months after surgery: (10.3 ± 2.7) scores vs. (17.1 ± 5.4) scores, (3.3 ± 1.2) scores vs. (6.9 ± 2.4) scores, the differences were statistically significant ( P<0.05). The incidence of postoperative complications in the modified group was lower than that in the open group: 3.51%(2/57) vs. 15.79%(9/57), the difference was statistically significant ( P<0.05). Conclusions:The application of modified Miccoli surgery in patients with benign thyroid diseases can reduce the length of the incision, reduce the impact on postoperative pain stress, immune function, and parathyroid function, speed up the process of postoperative recovery, improve the appearance of postoperative aesthetic degree of scar, and reduce the risk of complications.

Research progress of glucocorticoid receptor ligands / 中华实用儿科临床杂志

Glucocorticoids have been applied to clinical treatment of autoimmune diseases and allergic diseases for over 60 years.In recent years, the clinical application of glucocorticoids is annually on the rise with the increased incidence of autoimmune and inflammatory diseases.Therefore, the adverse events of glucocorticoids have been well concerned.It is urgent to analyze the pharmacological mechanism of glucocorticoids, search for novel glucocorticoid receptor ligands with anti-inflammatory and immune inhibitory effects and less adverse events.This study aims to review the research progress of glucocorticoid receptor ligands.

Fundus changes presented by OCT and OCTA after scleral buckling for rhegmatogenous retinal detachment / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To observe the changes of the morphology and structure of macula, blood flow density of macula and optic disc, as well as retinal nerve fiber layer thickness by optical coherence tomography(OCT)and optical coherence tomography angiography(OCTA)in patients with rhegmatogenous retinal detachment(RRD)under went sclera buckling(SB). METHODS: As a cross-sectional case-controlled study, 25 patients(25 eyes)were diagnosed with RRD in the department of ophthalmology, Ganzhou People's Hospital from July 2014 to March 2021. The differences in the vascular density(VD)of superficial vessel cluster(SVC), the VD of deep vessel cluster(DVC)of macula, the SVC-VD of optic disc, retinal nerve fiber layer(RNFL), central macular thickness(CMT), subfoveal choroidal thickness(SFCT)and outer structure of macula between the affected eyes and healthy eyes at the last post-operative follow-up were compared, and the correlation indicators affecting best corrected visual acuity(BCVA, LogMAR)of the affected eyes at the last follow-up were analyzed. RESULTS: There were no statistically significant in SVC-VD and DVC-VD of macula, SVC-VD of optic disc, RNFL, CMT, SFCT between the affected eyes and healthy eyes at the last post-operative follow-up(all P&#x003E;0.05); At the last follow-up visit, the comparison of macular outer structure on OCT between the affected eyes and the healthy eyes showed that the light band integrity of the external limiting membrane(ELM), myoid zone(MZ), ellipsoid zone(EZ)and outer segment of photoreceptor(OS)had no statistically significant difference(all P&#x003E;0.05), while the light band integrity of interdigitation zone(IZ)had significant difference(P=0.014); The difference of BCVA(LogMAR)between the affected eyes and the healthy eyes at the last follow-up was statistically significant(P=0.002). There was significant correlation between BCVA(LogMAR)of affected eyes at the last post-operative follow-up and the presence or absence of macular involvement, the correlated with SVC-VD of optic disc, the integrity of the light bands of ELM, MZ, EZ, OS and IZ on the outer structure of macula, it was positively correlated with the presence or absence of macular involvement(rs=0.401, P=0.047)and it was negatively correlated with SVC-VD of optic disc, the integrity of the light bands of ELM, MZ, EZ, OS and IZ on the outer structure of macula(all P&#x003C;0.05).CONCLUSION: The OCT and OCTA can be used to observe fundus changes after SB surgery for RRD to obtain long-term follow-up information related to vision prognosis, and visual prognosis depends on the recovery of retinal outer structure, and the integrity of IZ structure is more important for visual recovery; The SVC-VD of optic disc is correlated with visual prognosis, and whether it was correlated with intraocular pressure require further observation and verification with postoperative continuous data.

Inspiration and Investigation of the Current Situation on the Medical Humanistic Education / 中国医学伦理学

The quality of curriculum and teaching determines the quality and level of medical students’ medical humanities cultivation. The research investigated the cognition and development suggestions of medical humanities education of 5 senior medical students (n=5 996) majoring in medicine from 67 colleges and universities in China. Some results were found, The opening rate of different medical humanities courses were different. There were different needs of the medical humanities courses that would be added. Curriculum content and learning interest were the key factors for the curriculum; The large class teaching and closed-book examination were still dominant in the current medical humanities classes. The Medical students suggested to increase PBL, O2O mixed teaching and processing assessment etc. It was found that the teacher-centered mode couldn’t meet the learning needs from the medical students. It was recommended that we should actively adopt student-centered curriculum and teaching mode to improve the curriculum goal, curriculum setting, curriculum content design, teaching means, evaluation mode. It was also very important to improve teachers’ professional ability and build an interconnected learning community for improving the quality and level of medical humanistic education.

Cellular behavior of carbon dots derived from Poria cocos polysaccharide / 药学学报

The biological behavior of carbon dots, especially the mechanism of cellular uptake and intracellular distribution, is the basis of its biomedical applications. In this paper, blue fluorescent carbon quantum dots were synthesized by hydrothermal method with Poria cocos polysaccharide as raw material, and the specific biological behavior of carbon dots entering cells was explored to evaluate its biological activity. It was characterized by transmission electron microscopy, UV-vis absorption spectroscopy, fluorescence spectroscopy, Fourier transform infrared spectroscopy, X-ray diffraction and X-ray photoelectron spectroscopy. Two different cell lines, immunocytes-RAW264.7 cells (mouse mononuclear macrophages cells) and cancer cells-4T1 cells (mouse breast cancer cells), were used as the research objects to study the uptake kinetics, uptake pathway, distribution and efflux of polysaccharide carbon dots in cells. The results showed that the carbon dots have a size distribution of 2 to 10 nm, and the average size was 6.85 nm. The carbon dots were mainly composed of C, O and N elements, with abundant surface functional groups such as -OH, C=O, C-N and C=C, and the fluorescence quantum yield was 4.72%. Carbon dots enter cells in a certain concentration and time dependence. Different cell lines have different uptake pathways. RAW264.7 cells enter the cells mainly by macrophage-specific phagocytosis, and a small part of the endocytosis is mediated by caveolin, while 4T1 cells are mainly mediated by grid protein endocytosis and giant cell drinking process. In summary, the synthesized carbon dots have good fluorescence properties, low cytotoxicity and excellent biocompatibility, which can be used for cell imaging applications.

Hydromorphone postconditioning attenuates myocardial ischemia/reperfusion-induced apoptosis in rats through PI3K/AKT pathway / 中华急诊医学杂志

Objective:To investigate the role of PI3K/Akt signaling pathway in hydromorphone postconditioning on alleviating myocardial ischemia/reperfusion (I/R)-induced apoptosis in rats.Methods:Forty healthy male SD rats were randomly(random number) divided into five groups, with 8 rats in each group:①sham group;②I/R group;③I/R+hydromorphone group (I/R+H group);④I/R+PI3K inhibitor group (I/R+W group); and⑤I/R+hydromorphone+PI3K inhibitor group (I/R+H+W group). The myocardial ischemia/reperfusion injury model was established by ligating the left anterior descending coronary artery for 30 min and reperfusion for 120 min. After the experiment, the area of myocardial infarction was measured by 2, 3, 5-triphenyl tetrazolium chloride (TTC) staining. The amount of serum lactate dehydrogenase (LDH) leakage was estimated by colorimetry . The cardiomyocyte apoptosis was detected by terminal deoxynucleotidyl transferase mediated dUTP nick-end labeling (TUNEL) assay. The protein expressions of p-Akt, Bcl-2 and Bax were detected by Western blot. Comparisons among groups were carried out by analysis of variance (ANOVA).Results:Compared with the sham group, the area of myocardial infarction, serum LDH leakage and cardiomyocyte apoptosis were significantly increased, p-Akt and Bax expression were upregulated, Bcl-2 expression was downregulated in the I/R group ( P<0.05). Compared with the I/R group, the area of myocardial infarction, serum LDH leakage and cardiomyocyte apoptosis were markedly decreased, p-Akt and Bcl-2 expression were upregulated and Bax expression was downregulated in the I/R+H group ( P<0.05). Compared with the I/R+H group, the area of myocardial infarction, serum LDH leakage and cardiomyocyte apoptosis were significantly increased, p-Akt and Bcl-2 expression were downregulated, and Bax expression was upregulated in the I/R+H+W group ( P<0.05). Conclusions:Hydromorphone postconditioning can alleviate cardiomyocyte apoptosis induced by myocardial ischemia/reperfusion, and its protection mechanism may be related to the activation of PI3K/Akt signaling pathway.

Mechanism of protective effect of hydromorphone postconditioning on myocardium in rats: PI3K/Akt signaling pathway-mediated autophagy / 中华麻醉学杂志

Objective:To evaluate the relationship between the mechanism of protective effect of hydromorphone postconditioning on myocardium and phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling pathway-mediated autophagy in rats.Methods:Forty healthy male Sprague-Dawley rats, weighing 220-250 g, were divided into 5 groups ( n=8 each) using a random number table method: sham operation group (Sham group), ischemia-reperfusion (I/R) group (group IR), hydromorphone postconditioning group (group HP), PI3K inhibitor group (group W) and hydromorphone postconditioning+ PI3K inhibitor group (group HP+ W). Myocardial ischemia was induced by 30 min occlusion of left anterior descending branch of coronary artery followed by 120 min reperfusion.In group HP, hydromorphone 0.1 mg/kg was injected via femoral vein at 5 min before reperfusion in group HP.In group HP+ W, hydromorphone 0.1 mg/kg and wortmannin (PI3K inhibitor) 15 μg/kg were injected via femoral vein at 5 min before reperfusion.In group W, wortmannin 15 μg/kg was injected via femoral vein at 5 min before reperfusion.At the end of reperfusion, the myocardial infarct size (IS) was determined by TTC staining, the activities of serum lactate dehydrogenase (LDH) was detected by colorimetry, myocardial specimens were collected for microscopic examination of the ultrastructure (with a electron microscope), the expression of phosphorylated Akt (p-Akt) and microtubule-associated protein 1 light chain 3 (LC3) was determined by Western blot and the ratio of LC3-Ⅱ/Ⅰwas calculated. Results:Compared with Sham group, IS and the activities of serum of LDH were significantly increased, p-Akt expression in myocardial tissues was up-regulated, the ratio of LC3-Ⅱ/Ⅰwas increased ( P<0.05), autophagic vacuoles were increased and the damage of ultrastructure of cardiomyocytes was obvious in group IR.Compared with group IR, IS and the activities of serum of LDH were significantly decreased, p-Akt expression in myocardial tissues was up-regulated, the ratio of LC3-Ⅱ/Ⅰwas decreased ( P<0.05), autophagic vacuoles were decreased and the damage of ultrastructure of cardiomyocytes was attenuated in group HR.Compared with group HR, IS and the activities of serum of LDH were significantly increased, p-Akt expression in myocardial tissues was down-regulated, the ratio of LC3-Ⅱ/Ⅰwas increased ( P<0.05), autophagic vacuoles were increased and the damage of ultrastructure of cardiomyocytes was aggravated in group HR+ W. Conclusion:The mechanism of protective effect of hydromorphone postconditioning on myocardium is related to activation of PI3K/Akt signaling pathway and inhibition of autophagy in rats.

Relationship between over-expression of endocannabinoid receptor 2 and macrophage pyroptosis in mice / 中华麻醉学杂志

Objective:To evaluate the relationship between the over-expression of endocannabinoid receptor 2 (CB2R) and macrophage pyroptosis in mice.Methods:Bone marrow-derived macrophages of mice were transfected by lentivirus vector and successfully screened out two stable cell lines: lentivirus LV5 negative control cells (LV5-NC) and lentivirus LV5CB2R overexpressing cells (OE). Two cell lines were respectively divided into 3 groups ( n=18 each) using a random number table method: control group (LV5-NC-C group, OE-C group), LPS/ATP group (LV5-NC-LPS/ATP group, OE-LPS/ATP group) and CB2R specific agonist HU308 group (LV5-NC-HU308 group, OE-HU308 group). Cells in group C were commonly cultured.In LPS/ATP group, cells were incubated with LPS at a final concentration of 0.5 μg/ml for 5 h, and then incubated with ATP at the final concentration of 5 mmol/L for 1 h. In group LPS/ATP+ HU308, cells were incubated for 5 h with LPS at the final concentration of 0.5 μg/ml and HU308 at the final concentration of 10 μmol/L and then with ATP at the final concentration of 5 mmol/L for 1 h. The expression of CB2R, nucleotide-binding oligomerization domain-like receptor containing pyrin domain 3 (NLRP3), caspase-1, and gasdermin D (GSDMD) mRNA was detected by real-time polymerase chain reaction, the expression of caspase-1 was detected by Western blot, and the concentrations of interleukin-18 (IL-18) and IL-1β in the culture medium were determined by enzyme-linked immunosorbent assay. Results:In each cell line, compared with group C, the expression of NLRP3, caspase-1 and GSDMD was significantly up-regulated, and the concentrations of IL-18 and IL-1β were increased in group LPS/ATP ( P<0.05). Compared with group LPS/ATP, the expression of NLRP3, caspase-1 and GSDMD was significantly down-regulated, the concentrations of IL-18 and IL-lβ were decreased in group HU308 ( P<0.05). There was no significant differences in the indicators mentioned above between group V5-NC-C and group OE-C, between group LV5-NC-LPS/ATP and group OE-LPS/ATP, and between group LV5-NC-HU308 and OE-HU308 ( P>0.05). Conclusion:Over-expression of CB2R gene cannot effectively inhibit the occurrence of macrophage pyroptosis, and only activation of CB2R can inhibit it in mice.

Research Progress in the Role of Tim3/galectin-9 in Hematological Malignancy--Review / 中国实验血液学杂志

The incidence of hematological malignant tumor is increasing year by year, and seriously affecting the human health. In addition to the traditional radiation and chemotherapy, immunotherapy has achieved a certain effect in the treatment of blood tumor, but it is limited by exhaustion of CD8

Analysis of Related Early Warning Indexes of Cytokine Release Syndrome in Multiple Myeloma Patients after CAR-T Treatment / 中国实验血液学杂志

OBJECTIVE@#To investigate the relationship between the levels of ferritin, C-reactive protein (CRP), lactate dehydrogenase (LDH) and interleukin-6 (IL-6) in peripheral serum and cytokine release syndrome (CRS) in patients with relapse and/or refractory multiple myeloma (R/R MM) after receiving chimeric antigen receptor T cells (CAR-T) immunotherapy.@*METHODS@#Twenty-eight patients with R/R MM were treated with 1×10@*RESULTS@#Among the 28 patients, 27 cases (96.4%) developed CRS, 24 cases (85.7%) in 1-2 grade CRS and 3 cases (10.7%) in 3-5 grade. The severity grade of CRS of 27 patients was positively correlated with the peak values of ferritin, CRP, LDH, and IL-6 in peripheral blood (r@*CONCLUSION@#After receiving CAR-T cellular immunotherapy, the incidence of CRS in patients with R/R MM is higher, but most of them are in grade 1 or 2. The severity of CRS is positively correlated with the levels of ferritin, CRP, LDH and IL-6 in peripheral blood.

Trans-base and trans-vault low-velocity penetrating brain injury: A retrospective comparative study of characteristics, treatment, and outcomes / 中华创伤杂志(英文版)

PURPOSE@#Low-velocity penetrating brain injury (LVPBI) caused by foreign bodies can pose life-threatening emergencies. Their complexity and lack of validated classification data have prevented standardization of clinical management. We aimed to compare the trans-base and trans-vault phenotypes of LVPBI to help provide guidance for clinical decision-making of such injury type.@*METHODS@#A retrospective study on LVPBI patients managed at our institution from November 2013 to March 2020 was conducted. We included LVPBI patients admitted for the first time for surgery, and excluded those with multiple injuries, gunshot wounds, pregnancy, severe blunt head trauma, etc. Patients were categorized into trans-base and trans-vault LVPBI groups based on the penetration pathway. Discharged patients were followed up by outpatient visit or telephone. The data were entered into the Electronic Medical Record system by clinicians, and subsequently derived by researchers. The demography and injury characteristics, treatment protocols, complications, and outcomes were analyzed and compared between the two groups. A t-test was used for analysis of normally distributed data, and a Mann-Whitney U test for non-parametric data. A generalized linear model was further established to determine whether the factors length of stay and performance scale score were influenced by each factor.@*RESULTS@#A total of 27 LVPBI patients were included in this analysis, comprised of 13 (48.1%) trans-base cases and 14 (51.9%) trans-vault cases. Statistical analyses suggested that trans-base LVPBI was correlated with deeper wounds; while the trans-vault phenotype was correlated with injury by metal foreign bodies. There was no difference in Glasgow Coma Scale score and the risk of intracranial hemorrhage between the two groups. Surgical approaches in the trans-base LVPBI group included subfrontal (n = 5, 38.5%), subtemporal (n = 5, 38.5%), lateral fissure (n = 2, 15.4%), and distal lateral (n = 1, 7.7%). All patients in the trans-vault group underwent a brain convex approach using the foreign body as reference (n = 14, 100%). Moreover, the two groups differed in application prerequisites for intracranial pressure monitoring and vessel-related treatment. Trans-base LVPBI was associated with higher rates of cranial nerve and major vessel injuries; in contrast, trans-vault LVPBI was associated with lower functional outcome scores.@*CONCLUSION@#Our findings suggest that trans-base and trans-vault LVPBIs differ in terms of characteristics, treatment, and outcomes. Further understanding of these differences may help guide clinical decisions and contribute to a better management of LVPBIs.