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<p><b>OBJECTIVE</b>To explore the role of inducible costimulatory molecule (ICOS) signaling pathway-mediated Th17 cells polarization in renal damage in essential hypertension.</p><p><b>METHODS</b>Four-week-old spontaneously hypertensive rats (SHR) were randomly divided into control (SHR-C) group and intervention (SHR-I) group and subjected to intraperitoneal injections of PBS and ICOS monoclonal antibody for 2 weeks, respectively. Blood pressure of the rats was monitored using noninvasive tail artery blood pressure measuring instrument. The percentage of Th17 cells in the splenocytes was analyzed using flow cytometry, and the expression levels of IL-17A mRNA in the rat's kidneys were detected using RT-PCR. The levels of IL-17A and TGF-β1 in the plasma and kidneys were dynamically detected using ELISA and immunohistochemistry, respectively. Renal pathological changes in the rats were detected using Masson staining.</p><p><b>RESULTS</b>At the age of 10 and 30 weeks, the rats in SHR-C group had a significantly higher blood pressure than those in SHR-I group (P<0.05 or 0.01). In rats in SHR-C group, Th17 cells percentage in the splenocytes and IL-17A mRNA level in the kidney was significantly higher than those in SHR-I group from the age of 6 weeks (P<0.05). The expressions of IL-17A and TGF-β1 in the plasma and kidney were significantly higher in SHR-C group than that in SHR-I group at 6 weeks (P<0.05). Compared with those in SHR-C group, the rats in SHR-I group showed significant alleviation of renal fibrosis from the age of 30 weeks (P<0.05).</p><p><b>CONCLUSION</b>The ICOS signaling pathway-mediated Th17 cells polarization plays an important role in renal fibrosis in hypertensive rats.</p>
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BACKGROUND: Because of scaphoid irregular shape and the wrist joint and adjacent bones overlap, so the diagnosis and treatment of scaphoid fracture and treatment became so difficult. Which imaging methods hold highest diagnosis rate, and which kind of surgical approaches with less impact on fracture healing are still under discussion.OBJECTIVE: To review the imaging examinations of scaphoid fracture and the research advance in surgical approaches.METHODS: The first author retrieved CJFD and PubMed databases for the literature addressing the imaging examinations and surgical approaches of scaphoid fracture published from 2005 to 2015 with the keywords of "scaphodl bone, fracture, iconography, surgical approach" in Chinese and English, respectively. The old and repetitive articles were excluded, totally 3021 articles were retrieved. In accordance with inclusion and exclusion criteria, finally 24 eligible articles were included for result analysis.RESULTS AND CONCLUSION: (1) The wrist joint at positions of pronation 60°, supination 45°, oblique and lateral can reveal the scaphoid from different angles on X-ray, which improves the diagnosis rate. At present, CT is the most reliable method, but there is a lack of quantization parameter for evaluating scaphoid fracture, especially for occult fracture. MRI can completely show the structure of scaphoid, even blood supply. Bone scintigraphy possesses a higher diagnosis rate than X-ray and CT examinations. (2) The surgical approaches of scaphoid fracture include volar, dorsal, radiocarpa approaches, but none is ideal. (3) The ideal surgical approach still needs a in-depth study, which can well reveal the scaphoid, achieve good reduction, reduce the damage to the remaining blood supply, confirm the position of scaphoid benifical for internal fixator implantation, and can be minimally invasive and easy to operate.
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<p><b>BACKGROUND</b>Some leukemia patients before hematopoietic stem cell transplantation (HSCT) have nutritional risk or undernutrition, which was one of the main reasons that caused series of complications during transplantation. The aim of this study was to find out some appropriate methods to learn about the nutritional status of leukemia patients before HSCT.</p><p><b>METHODS</b>Nutritional status of patients with leukemia was assessed with three common methods of nutritional assessment (nutritional risk screening 2002 (NRS2002), mini nutritional assessment (MNA) and subjective global assessment (SGA)) before HSCT. The assessment results of NRS2002 and MNA were compared by paired χ(2) test. The consistency was analyzed by Kappa test.</p><p><b>RESULTS</b>In this study, 13 of 50 patients (26.0%) with leukemia had nutritional risk before HSCT assessed by NRS2002, including 7 patients (14.0%) with undernutrition. Of 50 patients assessed by SGA, only 1 case (2.0%) was mild or moderate undernutrition, and the remaining 49 patients (98.0%) were well-nutrition. Assessed by MNA, 1 case (2.0%) was undernutrition, 11 cases (22.0%) were potential undernutrition, and 38 cases (76.0%) were well-nutrition. Paired χ(2) test results showed that the difference between NRS2002 and MNA was statistically significant (χ(2) = 13.64, P < 0.05); Kappa test results showed that they were consistent between NRS2002 and MNA (Kappa = 0.62, P < 0.05).</p><p><b>CONCLUSIONS</b>It is important to know the nutritional status of patients with leukemia before HSCT, and NRS2002 should be the first choice of nutritional assessment for patients with leukemia. If NRS2002 and MNA used at the same time, the accuracy and comprehensiveness of the assessment can be improved.</p>