Experience in diagnosis and treatment of 10 COVID-19 patients with history of thoracotomy / 中华胸心血管外科杂志

Objective:To study the outcomes of coronavirus disease 2019 (COVID-19) patients with history of thoracotomy.Methods:A retrospective analysis of clinical diagnosis, treatment data and outcomes of 10 COVID-19 patients with history of thoracotomy were studied in Tongji Hospital of Wuhan.Results:10 COVID-19 patients with history of thoracotomy were severe or critical cases. The clinical manifestations of all patients were mainly represented in respiratory system, and these patients were all confirmed by chest CT and virus nucleic acid detection. After admission, all patients were given oxygen therapy, antiviral therapy (abidol and Lianhuaqingwen), and antibiotic therapy (Moxifloxacin and / or Cefoperazone Sodium and Sulbactam Sodium). Finally, 3 patients died of respiratory failure and 7 patients were cured and discharged smoothly.Conclusion:COVID-19 patients with a history of thoracotomy are easy to develop progression, and the use of antibiotics might be more active. At present, there is no specific treatment, and the combination of multiple methods may be effective.

Phenotypic diversity of human nature and induced CD4+CD25+FoxP3+CD127-regulatory T cells / 中国组织工程研究

BACKGROUND:Regulatory T cels (Treg) are classified into two subsets, nature Treg (nTreg) and induced Treg (iTreg). Although there is consensus that CD4+CD25+FoxP3+CD127-is the widely accepted phenotype of Treg, it remains unclear what is the difference in phenotypes including cytokine patterns of nTreg and iTreg. OBJECTIVE:To understand and compare the plasticity of nTreg and iTreg and to search the exact mechanism of cytokine secretion in Tregs. METHODS: We investigated the frequency and cytokine pattern of CD4+CD25+FoxP3+CD127-nTreg in freshly separated peripheral blood mononuclear cels of five healthy individuals using 8-color fluorescence flow cytometry (FACSCanto II). Subsequently, after 9 days of alostimulation in mixed lymphocytes, the frequency and cytokine pattern of CD4+CD25+FoxP3+CD127-iTreg were determined and analyzed. RESULTS AND CONCLUSION:In fresh cels, (1.5±0.70)% of CD4+ T cels were CD4+CD25+FoxP3+CD127- nTregs. Almost al these cels expressed interferon (IFN)-γ-, interleukin (IL)-2- or transforming growth factor-β+, and partial cels expressed IL-10+ or IL-10-. After 9-day alostimulation, the number of CD4+CD25+FoxP3+CD127- iTreg expressing IFN-γ+, IL-2-, IL-2+, IL-10+ or TGF-β+increased strongly. The main subsets of human nTregs were CD4+CD25+FoxP3+CD127-IFN-γ-IL-2-IL-10+TGF-β+and CD4+CD25+FoxP3+CD127-IFN-γ-IL-2-IL-10-TGF-β+ T cels. The proportion of each subset in CD4+ T cels was (1.1±0.59)% and (0.39±0.16)%, respectively. Whereas the main subsets of human iTregs were CD4+CD25+FoxP3+CD127-IFN-γ+IL-2-IL-10+TGF-β+ and CD4+CD25+FoxP3+CD127-IFN-γ+IL-2+IL-10+TGF-β+. Human nTregs were characterized as IFN-γ-IL-2- double negative, producing IL-10 and TGF-β or only TGF-β without IL-10, and not proliferatingin vitro. During the alostimulation in mixed lymphocytes, IFN-γ+ iTregs proliferated remarkably. One-third of IFN-γ+ iTreg expressed IL-2+, and two-thirds of IFN-γ+ iTregs expressed IL-2, both of which produce IL-2 and TGF-β. Our results imply that CD4+CD25+FoxP3+CD127- Treg are potentialy immunosuppressive probably because of their mandatory TGF-β and optional IL-10 production.

The first paired-exchange kidney transplantation between two couples in China / 中华器官移植杂志

Objective To review the first case of paired-exchange kidney transplantation between two couples in China.Methods In April 2006,two cases of paired-exchange living kidney transplantations were successfully performed.Husband 1 in blood type O received a kidney donated from husband 2 in blood type O,while wife 2 in blood type A received a kidney from wife 1 in blood type A.Results The transplantation was performed smoothly.Renal graft in husband 1 functioned for 21 months,and the recipient died at 9th month due to infection.Graft survival and patient survival in wife 2 were 30 month and 31 month respectively.Conclusion Paired-exchange of living-related kidney donation and transplantation,as an effective pathway to resolve the shortage of organ,could be programmed with cautious medical guideline,ethical consideration and legal framework in China.

Relief on fibrosis past acute rejection of the rat allograft artery from the specific 5-HT2A receptor blocker,sarpogrelate / 中华器官移植杂志

Objective To investigate the effect of sarpogrelate, a specific 5-HT2A receptor blocker,on fibrosis past acute rejection of abdominal aortic allotransplantation in rats. MethodsThe rat models of abdominal aortic transplantation were divided into three groups: allograft control group (Wistar→ SD), isograft control group ( SD→ SD) and sarpogrelate-treated group (Wistar→ SD).Sarpogrelate-treated group receivedintragastric administration of sarpogrelate every day. The pathologic and immunohistochemical findings of the transplant aorta were observed at 14th and 60th day after transplantation. ResultsAt 14th day, visible acute rejection could be observed in allograft control group,but not in isograft control group. At 60th day, vascular intimal index of sarpogrelatetreated group was significantly lower than that in allograft control group[( 16. 71 ± 3. 94)％ versus (62. 41 ± 6. 54)％ ,P＜0. 05). The expression of PCNA and α-SMA in sarpogrelate-treated group wasalso significantly lower than that in allograft control group[(7. 37 ± 4. 61)％ versus (22. 43 ±3.40)％,(8.21 ± 3. 11)％ versus. (23.70 ± 2.78)％, P＜0.05, respectively). Conclusion The expression of PCNA and α-SMA of the transplant aorta could be suppressed by sarpogrelate, and sarpogrelate could relieve the fibrosis past acute rejection of aortic allograft.