Cloning the full-length CDNA of actin gene and analysing alliinase gene expression in tillering onion

Tillering onion is a herbaceous plant belonging to the Liliaceae family. We cloned the cDNAs of the actin gene (AcACT, GenBank: MF919598) of tillering onion using rapid amplification of the cDNA ends. The full-length cDNA of AcACT was 1,357 bp long with an open reading frame of 1,131 bp encoding 376 amino acids. The amino acid sequence of AcACT shared > 96% similarity with the amino acid sequences of other ACTs and was found (by means of phylogenetic tree analysis) to be closely related to those of Ananas comosus and Papaver somniferum. AcACT expressions showed no significant differences (p > 0.01) in two cultivars L-SH and L-SY over three growth periods and under suitable conditions, low temperature, and short-day conditions. In addition, AcACT was used as an internal reference gene to analyse the expression of the alliinase gene (AcALL). AcALL expression trends in the roots, stems and leaves were consistent with those of diallyl disulphide and diallyl trisulphide. Thus, AcACT is highly conserved and can be used as a suitable internal reference gene when analysing gene expression in tillering onion.

Clinical effects of autologous follicular unit extraction transplantation in the treatment of small area secondary cicatricial alopecia after burns / 中华烧伤杂志

Objective: To explore the clinical effects of autologous follicular unit extraction (FUE) transplantation in the treatment of small area secondary cicatricial alopecia (hereinafter referred to as cicatricial alopecia) after burns. Methods: A retrospective observational study was carried out. According to the adopted treatment methods, 18 patients (12 males and 6 females, aged (29±6) years) who received autologous FUE transplantation for small area cicatricial alopecia after burns from March 2017 to November 2019 in the First Affiliated Hospital of Air Force Medical University were included in FUE transplantation group, and 18 patients (13 males and 5 females, aged (33±5) years) who were treated with expanded flap transplantation for small area cicatricial alopecia after burns by the same surgery team during the same period in the same hospital were included in expanded flap transplantation group. All the patients were followed up for more than 1 year. At the last follow-up, the follicular unit density in the transplanted area was measured by Folliscope hair detection system and the hair survival rate was calculated; the visual analogue scale (VAS) method was adopted to evaluate the treatment effect; patients were asked their satisfaction with the treatment effect and the occurrence of complications during follow-up; the hair growth and the scalp thickness, pain, pruritus, pigmentation, and surface roughness of the transplanted area were recorded. Data were statistically analyzed with Fisher's exact probability test and independent sample t test. Results: At the last follow-up, the follicular unit density in the transplanted area of patients in FUE transplantation group was (46.8±2.0)/cm2, which was significantly higher than (42.5±4.3)/cm2 in expanded flap transplantation group (t=3.84, P<0.01); the hair survival rates of patients were similar between the two groups (P>0.05). At the last follow-up, VAS scores evaluating the treatment effect of patients were similar between the two groups (P>0.05); the satisfaction score of patients toward the treatment effect in FUE transplantation group was 8.6±1.1, which was significantly higher than 7.6±0.8 in expanded flap transplantation group (t=2.89, P<0.01). During the follow-up, no inflammation or infection occurred in patients of the two groups, but only 2 patients in expanded flap transplantation group had postoperative pain. At the last follow-up, the transplanted area of patients in the two groups was covered with new hair, and the hair growth direction was basically consistent with the surrounding normal hair; scalp thickness, pain, pruritus, pigmentation, and surface roughness of the transplanted area of patients were similar between the two groups (P>0.05). Conclusions: Autologous FUE transplantation has better long-term follicular unit density and patients' satisfaction than expanded flap transplantation in the treatment of small area cicatricial alopecia after burns, showing better postoperative effect and a good prospect of clinical application.

The Genome-Wide Changes in Expression Profile of CML T Cells After Up-regulation of TCRζ Chain Expression / 中国实验血液学杂志

OBJECTIVE@#To analyze the changes in the gene expression profile of T cells in CML patients after TCRζ up-regulation expression, and to explore the molecular mechanism of T cell reactivation after transgenic up-regulation of TCRζ.@*METHODS@#The peripheral blood mononuclear cells(PBMCs) from 3 newly untreated chronic-stage CML patients were collected, and the CD3@*RESULTS@#A total of 2248 differentially-expressed genes were obtained, including 553 up-regulated genes and 1695 down-regulated genes in experimental group as compared with those in control group (P<0.05) . The GO and KEGG enrichment analyses showed that differentially expressed genes involved in the biological processes related to T cell immune function, such as TCR signaling pathway, T cell proliferation and activation. Some of core genes involved in promoting the TCR signaling pathway, T cell proliferation, activation and apoptosis pathways were significantly up-regulated, while some core genes involved in inhibiting T cell activation were significantly down-regulated.@*CONCLUSION@#The molecular mechanism of the significantly improved T cell activation and proliferation ability in CML patients after TCRζ up-regulation may be related to the differential transcripts mediated signaling pathways of T cell activation, proliferation and apoptosis.

Research Advances in the Mechanisms of BRD4 and Its Inhibitors in Hematologic Malignancies--Review / 中国实验血液学杂志

Bromodomain-containing protein 4 (BRD4) is one of the most important members in the bromodomain and extra terminal domain(BET) family, it plays an important role in cellular physiology in human body, such as cell cycles, cell proliferation, and immune response. Recent studies have shown that BRD4 is associated with occurrence and development of acute myeloblastic leukemia, multiple myeloma and lymphoma. The mechanisms of BRD4 in hematologic malignancies including the regulation of c-Myc expression, and participation of the composition of super-enhancer, etc. At present, many kinds of inhibitors have been developed to target inhibit BRD4 for therapy in hematologic malignancies, and some of BRD4 inhibitors have entered phase Ⅱ clinical trials, which suggested that BRD4 inhibitors are expected to become new therapeutic agents for hematologic malignancies. In this review, the research advance of BRD4 and BRD4 inhibitors in hematologic malignancies was summarized briefly.

Research progress of polycystic ovarian syndrome and cardiovascular disease / 中国医师杂志

Polycystic ovary syndrome (PCOS) is the most common endocrine and reproductive disorder in women of childbearing age. It is characterized by persistent anovulation and hyperandrogen. Its clinical manifestations are heterogeneous, which seriously affects the mental health and quality of life in patients with PCOS. Due to the characteristics of obesity and metabolic abnormalities in PCOS women, the risk of cardiovascular disease (CVD) has attracted extensive attention. In recent years, more and more studies have confirmed that the incidence of CVD in PCOS women is significantly higher than that in the general population. Therefore, it is very important to fully understand the relevant risk factors leading to the increased risk of CVD in women with PCOS, so as to timely prevent and intervene the relevant risk factors and reduce the incidence and mortality of cardiovascular events in the future.

Retrospective Analysis on Traumatic Rupture of Intracranial Internal Carotid Artery in 11 Cases / 法医学杂志

Objective To retrospectively analyze the characteristics of the traumatic rupture of intracranial internal carotid artery in order to provide reference for forensic expertise examination and identification. Methods A total of 11 autopsy cases of traumatic rupture of intracranial internal carotid artery were collected. The gender, age, cause of injury, blood loss on the scene, location of internal carotid artery rupture, hardening degree of the rupture of the wall, brain injury, blood ethanol content and cause of death were also recorded. Results All 11 cases died on the scene, of which 7 died from traffic accidents, 2 falls from height and 2 from bare handed injuries. None of the 11 victims suffered serious head and body surface injury. The internal carotid artery rupture in the 9 cases of traffic injury and fall from height injury occurred in the cavernous segment. In all these cases, there were transverse fractures of the middle cranial fossa with the carotid sulcus involved, and minor intracranial hemorrhage and brain contusion. In 2 cases of bare handed injuries, internal carotid artery rupture occurred in the ophthalmic artery segment, accompanied by fatal intracranial hemorrhage and diffuse axonal injury, but no skull fracture. All 11 cases showed full-thickness rupture of the vessel wall, and the long axis of the wounds was perpendicular to those of the artery. Conclusion The incidence of intracranial internal carotid artery rupture in high-energy trauma events such as traffic accidents and high falls deserves attention. Injuries of the cavernous segment or ophthalmic segment might be more common. The main injury mechanism of intracranial internal carotid artery rupture might be that the blood vessels were pulled and the bone fragments caused damage.

Forensic Analysis of 105 Autopsy Cases of Psychiatric Patients / 法医学杂志

Objective To provide reference for medical and health services and forensic expertise, the causes and manners of death of psychiatric patients were analyzed retrospectively. Methods A total of 105 autopsy cases of psychiatric patients accepted and settled by Institute of Forensic Science of Criminal Investigation Police University of China from 2004 to 2019 were collected. The cases were divided into four groups： disease death, suicidal death, accidental death and homicidal death. The common causes of death of each group were statistically analyzed and the differences in age, disease duration, body mass index （BMI） and gender among the groups were assessed. Results Of the 105 cases, 60 were male and 45 were female, the course of psychosis was （12.9±10.4） years, the age of the deceased was （51.3±11.4） years, and 61.0% was schizophrenic. There were 50 cases （47.6%） in the disease death group, in which the psychiatric patients were the oldest and had the longest course of psychosis and lowest BMI. Pulmonary thromboembolism, respiratory infections, and cardiogenic disease were the most common causes of death in the group. There were 26 accidental deaths （24.8%）, among which traffic accidents were the most common cause of death. There were 15 homicidal deaths （14.3%）, all of which were male, with craniocerebral injury being the most common cause of death. There were 14 suicidal deaths （13.3%）. In suicidal death group, the age of the deceased was the youngest, the course of psychosis was the shortest and falling from the height was the most common way to commit suicide. Conclusion Understanding the common causes of death of psychiatric patients may contribute to developing measures to reduce the mortality rate of the population. It is necessary to investigate the age, course of psychosis and gender of the deceased when assessing the manner of death.

Effect of parathyroidectomy on renal anemia in maintenance hemodialysis patients with secondary hyperparathyroidism of uremia / 中国实用内科杂志

OBJECTIVE: To investigate the effect of parathyroidectomy(PTX)on the progression of renal anemia and erythropoietin dose in maintenance hemodialysis(MHD)patients with secondary hyperparathyroidism(SHPT)of uremia. METHODS: A total of 58 MHD patients with SHPT treated with PTX were retrospectively analyzed. The changes of serum intact parathyroid hormone(iPTH), calcium(Ca), phosphorus(P), alkaline phosphatsae(AKP), hemoglobulin(Hb), hematocrit(Hct), serum ferritin(SF), transferrin saturation(TS), c-reactive protein(CRP), albumin(Alb)and Kt/V at 3 months and6 months after PTX treatment were evaluated. The Hb level at 3 and 6 months after surgery and the doses of recombinant human erythropoietin(EPO)were recorded. RESULTS: Serum iPTH decreased dramatically(before PTX 1828.88±811.2 ng/L,three months after PTX 56.75±158.4 ng/L,six months after PTX 64.52±178.5 ng/L, P<0.05); Ca, P and AKP levels also decreased significantly after PTX(P<0.05). Hb increased after PTX(before PTX 99.92±14.26 g/L, six months after PTX123.2±13.65 g/L, P<0.05); meanwhile, the dose of EPO decreased after the operation[before PTX 235.18±62.65 U/（kg·W), three months after PTX 158.78±34.24 U/（kg·W),six months after PTX 112.53±25.37 U/（kg·W), P<0.05]. CONCLUSION: PTX can effectively control secondary hyperparathyroidism, significantly improve the renal anemia, and decrease dose of erythropoietin in MHD patients with SHPT.

Comparison of Apixaban and Low Molecular Weight Heparin in Preventing Deep Venous Thrombosis after Total Knee Arthroplasty in Older Adults

PURPOSE: To compare the effect of apixaban and low molecular weight heparin (LMWH) in the prevention and treatment of deep venous thrombosis (DVT) after total knee arthroplasty in older adult patients. MATERIALS AND METHODS: A total of 220 patients (average age of 67.8±6.4 years) undergoing total knee arthroplasty were randomly selected as research subjects and were divided into apixaban and LMWH groups (110 in each group). RESULTS: The incidence of DVT was lower in the apixaban group than in the LMWH group (5.5% vs. 20.0%, p=0.001). Activated partial thromboplastin times (35.2±3.6 sec vs. 33.7±2.2 sec, p=0.010; 37.8±4.6 sec vs. 34.1±3.2 sec, p<0.001; 39.6±5.1 sec vs. 35.7±3.0 sec, p=0.032) and prothrombin times (14.0±1.0 sec vs. 12.8±0.9 sec, p<0.001; 14.5±1.2 sec vs. 13.0±1.1 sec, p<0.001; 15.3±1.4 sec vs. 13.2±1.3 sec, p=0.009) in the apixaban group at 1 week after surgery, 3 weeks after surgery, and the end of treatment were higher than those in the LMWH group. Platelet and fibrinogen levels in the apixaban group were lower than those of the LMWH group. Also, capillary plasma viscosity and erythrocyte aggregation in the apixaban group at 1 week after surgery, 3 weeks after surgery, and the end of treatment were lower than those in the LMWH group. CONCLUSION: Apixaban, which elicits fewer adverse reactions and is safer than LMWH, exhibited better effects in the prevention and treatment of DVT after total knee arthroplasty in older adults.

The relationship between thyroid stimulating hormone within normal range and several metabolic indexes in type 2 diabetes mellitus / 中国医师进修杂志

Objective To investigate the relationship between thyroid stimulating hormone(TSH) and uric acid (UA), blood pressure, blood glucose, blood lipid and body mass index (BMI) in patients with type 2 diabetes. Methods A total of 254 patients with type 2 diabetes and normal thyroid function who were admitted to the Shengjing Hospital Affiliated to China Medical University from 2017 to 2019 were selected. Height, weight, systolic blood pressure (SBP) and diastolic blood pressure (DBP) and test fasting blood glucose (FBG), glycated hemoglobin (HbA1c), total cholesterol (TC), triacylglycerol (TG), low density lipoprotein cholestorol (LDL-C), free triiodothyronine (FT3), free theroxine (FT4), TSH and UA was measured. The correlations between TSH and blood pressure, blood lipid, FBG, BMI and UA was analyzed. Results According to gender, there were two groups. The levels of FT3, UA and BMI of males were significantly higher than that of females (P<0.05). Age, course of disease, TSH and TC of females were significantly higher than that of males (P<0.05). According to the TSH values of males and females, 254 patients were divided into TSH < 2.5 mU/L group and TSH ≥ 2.5 mU/L group respectively. The levels of BMI, FBG and UA in TSH≥2.5 mU/L group were significantly higher than those in TSH<2.5 mU/L group within females:(26.38 ± 4.06)kg/m2 vs.(23.91 ± 2.79)kg/m2,(10.29 ± 4.52)mmol/L vs. (8.38 ± 2.72)mmol/L,(406.53 ± 79.48)μmol/L vs.(270.17 ± 17.15)μmol/L. The levels of BMI, DBP and UA in TSH≥2.5 mU/L group were significantly higher than those in TSH<2.5 mU/L group within males:(27.87 ± 3.85)kg/m2 vs.(25.09 ± 3.10)kg/m2,(85.98 ± 9.75)mmHg(1 mmHg＝0.133 kPa) vs. (80.79 ± 8.44)mmHg,(430.35 ± 101.01)μmol/L vs.(318.10 ± 65.25)μmol/L, and the differences were statistically significant (P<0.05). Pearson correlation analysis was used to analyze the correlation between TSH and various indexes of all selected subjects. Only BMI, UA, FT4 and TG were statistically significant, and the correlation coefficients were 0.297, 0.550, - 0.208 and 0.127, P < 0.05, respectively. BMI, FBG and UA levels of females were positively correlated with TSH (P < 0.05), and the correlation coefficients were 0.332, 0.219 and 0.632, respectively. BMI, DBP, HbA1c and UA of males were positively correlated with TSH (P<0.05), and the correlation coefficients were 0.316, 0.204, 0.176 and 0.541, respectively. FT4 was negatively correlated with TSH, with a correlation coefficient of 0.248, which was statistically significant (P < 0.05), and UA had a stronger correlation with TSH. Conclusions Even in type 2 diabetics with normal thyroid function, small changes in TSH can affect weight, UA, FBG in women and DBP in men.

Using dorsal digital flap to repair donor site of the digital artery perforator flap / 中华整形外科杂志

Objective@#To investigate the application and clinical efficacy of dorsal finger flap on repairing donor site of the digital artery perforator flap.@*Methods@#From July 2015 to February 2017, the reversed digital artery perforator flaps were used to repair soft tissue defects at distal part of the fingers. Donor site defects were reconstructed with the dorsal finger flaps in 21 fingers of 18 cases.Male 11 cases, female 7 cases. The defect areas of donor sites were about 1.4 cm×2.0 cm-1.8 cm×2.5 cm.@*Results@#Primary wound healing were achieved in 21 finger of 18 cases. All the flaps survived.19 fingers of 16 cases were follow-up for 6 to 18 months(average 9.2 months), while 2 cases were lost to follow-up.The results of hand function were excellent 14 fingers, good 4 fingers, bad 1 finger. The sensory evaluation of the digital artery perforator flap were 3 fingers S3, 14 fingers S4 and 2 fingers S5, and the distance between two points of flap was 5-9 mm.@*Conclusions@#Using proximal dorsal transverse flaps to reconstruct the defects of digital artery perforator flap can avoid skin graft.It is an effective method for the treatment of the skin and soft tissue defects of the dorsal fingers.

Utility of endovascular simulation to improve technical performance and stimulate interest of medical students in vascular surgery / 基础医学与临床

Objective To determine whether endovascular simulation training in medical students may increase technical proficiency,enhance interest in vascular surgery. Methods We recruited 30 medical students from Pe-king Union Medical College prospectively. We gave these students an eight-week course with a structured curricu-lum comprised of weekly simulator sessions and theoretical lessons. A test of iliac artery balloon dilatation was con-ducted in pre-and post-course. Performance was assessed. Demographics and subjective survey data,including in-terest in vascular surgery were obtained pre-and post-course from the students too. Results Parameters measured on the standardized global endovascular rating scale,including angiography skills,wire handling and interventional criteria as well as simulator-generated metrics such as fluoroscopy time and volume of contrast used significantly im-proved from pre-to post-course values for the medical students(P<0.05) All the students agreed or strongly agreed that the simulation course increased their interest in vascular surgery. Conclusions A simulation-based endovascu-lar course improves technical performance with interest in vascular surgery training of medical students. The simula-tor is quite potential in the medical students training.

High expression level of TAL1 gene in newly diagnosed acute myeloid leu-kemia / 中国病理生理杂志

AIM:To investigate the characteristic of T-cell acute lymphocytic leukemia 1 (TAL1) gene expres-sion in acute myeloid leukemia (AML) cell lines and in primary AML cells from de novo AML patients with different sub-types. METHODS:Real-time PCR was used to determine the expression of TAL1 mRNA in acute leukemia cell lines (Jurkat, CCRF-CEM, HL-60 and NB4 cell lines) and peripheral blood mononuclear cells from 47 newly diagnosed AML patients. Twelve healthy individuals were served as healthy control group. RESULTS:A significantly increased level in TAL1 mRNA was found in AML cell lines (HL-60 and NB4), T-cell acute lymphacytic leukemia (T-ALL) cell lines (Jur-kat, CCRF-CEM) and primary AML cells compared with the healthy controls. Over-expression of TAL1 was found in all detected AML subtypes, the highest level of TAL-1 mRNA was found in AML-M1 and AML-M5 subtype ( P <0.05). CONCLUSION:High expression of TAL1 in AML might influence the differentiation and proliferation of myeloid cells, further investigation needs to confirm whether it would be as a biomarker for pathogenesis of AML.

Role of N-methyl-D-aspartic acid receptor 2B in neuropathic pain induced by spinal nerve ligation in rats / 医学研究生学报

Objective Spinal cord injury-induced neuropathic pain(NP)does not respond well to any existing therapies clinically.This study aimed to explore the molecular metabolisms neuropathic pain by observing the expressions of the N -methyl-D-as-partic acid receptor 2B(NR2B),tumor necrosis factor-alpha(TNF-α)and brain-derived neurotrophic factor(BDNF)in different sta-ges of the condition in SD rats. Methods Thirty-six adult SD rats were randomly divided into a control,a sham operation and an NP model group.The NP model was established by spinal nerve ligation. At 5 and 14 days after modeling,the hindlimb motor function and paw withdrawal threshold(PWT)of the rats were evaluated by the open-field test and the expressions of NR 2B,TNF-αand BDNF in the dor-sal root ganglia of the L4-6 spinal cord were determined by Western blot. Results At 5 days after modeling,the open-field test showed a significantly shorter total distance of movement in the sham operation group than in the control([14 927.93 ±560.87]vs [18 225.15±371.76]mm,P<0.05)and even shorter in the NP model group([3 224.92±89.64]vs[18 225.15±371.76]mm, P<0.01).The time of activity was markedly decreased in the NP model group as compared with that in the control([203.48±19.94]vs [745.95±13.48]s,P<0.01),but with no statistically significant difference between the sham operation and control groups([727.93± 16.29]vs[745.95±13.48]s,P>0.05).At 14 days after modeling,both the total distance of movement and time of activity were re-markably shorter in the NP model than in the sham operation and control groups([3 395.53±96.12]vs[17 382.26±482.31]and [17 975.40±416.56]mm,P<0.01;[195.53±96.12]vs[739.31±18.36]and[775.20±16.84]s, P<0.01).The PWT showed no statistically significant difference among the three groups of rats before modeling(P>0.05)but markedly decreased in the NP model as compared with the sham operation and control groups(P<0.01),with no significant difference between the latter two(P>0.05).The expressions of NR2B,TNF-αand BDNF were remarkably up-regulated in the NP model group in comparison with the sham operation and control groups at 5 days after modeling(P>0.05)and even more significantly at 14 days(P<0.01). Conclusion NR2B and BDNF may be involved in the development and progression of neuropathic pain in rats.

Screening and evaluation of Smo-siRNA targeted to inhibition of Molt-4 cell proliferation / 中国组织工程研究

BACKGROUND: Studies have shown that the occurrence and development of T lymphocytic leukemia is related to the abnormality of Hedgehog pathway. The Smo gene is a key gene in this signaling pathway and controls the transmission of Hedgehog signaling into the cell membrane. OBJECTIVE: To design and screen a highly efficient and specific Smo-siRNA which is able to downregulate the Smo gene expression in Molt-4 cells, thereby inhibiting the Molt-4 cells proliferation and inducing apoptosis. METHODS: (1) Smo-siRNAs numbered 1, 2 or 3, and the scrambled non-siRNA control (SC) were obtained by chemosynthesis. Untreated and sc-treated cells were used as controls. (2) Smo expression levels in Molt-4 cells were analyzed using qRT-PCR at 24, 48, 72 hours after siRNAs delivered by NuclefectorTM.Cell proliferation in vitro was assayed by the cell counting kit-8.The morphology and percentage of apoptotic cells were revealed by Hoechst33258 staining and flow cytometry, respectively. RESULTS AND CONCLUSION: (1) Smo-siRNAs were successfully transferred into Molt-4 cells, and exhibited best silencing results. After transfection with Smo-siRNA1, the mRNA level of Smo was significantly reduced (P < 0.05), and the lowest level was at 48 hours after transfection. (2) Cell proliferation of Molt-4 cells was significantly inhibited by Smo-siRNA at 24 hours after transfection. (3) Hoechst staining results showed morphological changes of Molt-4 were in accordance with those of apoptotic cells. (4) The apoptotic rate was significantly increased in the Smo-siRNA group compared with the control group (P < 0.05). Findings from this study showed that suppression of Smo by RNA interference could effectively inhibit proliferation and induce apoptosis in Molt-4 cells, indicating that Smo-siRNA as gene targeted therapy or synergistic treatment has therapeutic potential in T-cell malignancies.

Safety and efficacy of conversion from calcineurin inhibitors to mammalian-target-of-rapamycin inhibitors in liver transplant recipients: a meta-analysis of randomized controlled trials / 中华器官移植杂志

Objective To investigate the safety and efficacy of conversion from calcineurin inhibitors (CNI) to mammalian target of rapamycin (mTORi) in liver transplant recipients.Methods Such databases as MEDLINE (PUBMED),EMBASE,Cochrane Library and clinical trial registries (ClinicalTrials.gov,WHO International Trial Registry Network,Australian & New Zealand Clinical Trials Registry) were searched from the inception of each resource up to April 2015 for collecting the randomized controlled trials (RCTs) about liver transplant recipients after conversion from CNIs to mTORi,and the references of those trials were also searched by hand.After study selection,assessment and data extraction conducted by two reviewers independently,meta-analyses were performed by using the RevMan5.3 software.The quality of those trials was assessed by using the Jadad Score.Then,the safety and efficacy of conversion from CNI to mTORi were systematically assessed as a strategy for eliminating CNI exposure in liver transplant recipients.Results Ten RCTs (1917 patients) were included in this meta-analysis.The follow-up duration post-randomization was 6 to 36 months.The mean mTORi conversion time after transplantation was ≤6 months in 4 trials,and ＞6 months in 6.The meta-analysis revealed that the estimated glomerular filtration rate was significantly increased,and the incidence of renal failure and hyperglycemia was significantly reduced in mTORi conversion group as compared with those in CNI treatment group (P＜0.05 for all).The incidence of acute rejection in mRORi conversion group and CNI treatment group was 11.3％ and 6.3％ respectively (P＜0.01),and that confirmed by biopsy was 14.0％ and 8.4％ respectively (P＜0.01).The percentage of recipients discontinuing the medication in mRORi conversion group and CNI treatment group was 41.6％ and 21.5％ respectively (P＜0.01).The main reasons for drug withdrawal were drug-related adverse events (Aes),including acute rejection,bone marrow depression,anemia,leucopenia,thrombocytopenia,mouth sores/stomatitis,hyperlipidemia,hypercholesterolemia,rash,edema,and pyrexia.There was no significant difference between the two groups with regard to death,graft loss,loss to follow-up,infection,gastrointestinal symptoms,malignancy,and hypertension.Conclusion Conversion from CNI to mTORi therapy results in a significant improvement in renal function.However,this conversion strategy may lead to the high discontinuation rate due to mTORi-associated Aes,indicating that conversion may only be a treatment option in selected patients.

ABO-incompatible living donor kidney transplantation / 中华器官移植杂志

Objective To investigate the clinical efficacy and safety of individualized preconditioning in ABO-incompatible living donor kidney transplantation.Methods A series of 36 living donor kidney transplants across a wide range of ABO blood group incompatibilities using individualized preconditioning protocols were performed from September 2014 to June 2017.Preconditioning included oral immunosuppressants with or without the administration of rituximab,PE or DFPP.Medical records and electronic databases were reviewed for isoagglutinin titers,patient and graft survivals,graft function,rejections,infections as well as surgical complications.Results Of 30 ABO blood group incompatibilities,there were 6 cases of AB to A,2 cases of AB to B,4 cases of A to B,3 cases of B to A,13 cases of A to O (13),and 8 cases of B to O.Median initial ABO antibody titers were 1∶32 (1∶2-1∶256) (IgM) and 1 ∶ 8 (0-1∶64) (IgG),respectively.Individualized preconditioning included oral immunosuppressants alone (10 cases),oral immunosuppressants + PE (4 cases),oral immunosuppressants + PE + DFPP (1 case),oral immunosuppressants + rituximab + PE (16 cases),oral immunosuppressants + rituximab + DFPP (2 cases),and oral immunosuppressants + rituximab + PE+ DFPP (3 cases).After individualized preconditioning,an acceptable ABO antibody titer (≤1 ∶ 16) was obtained on the day of transplantation.Median follow-up duration was 12 months (1-33).Graft and patient survival rate was 94.4％ (34/36) and 100％ (36/36) respectively.Median value of serum creatinine at one year posttransplantation was 89 μmol/L,and eGFR was (81.07 mL/min/1.73 m2).In total,there was one episode of urinary tract infection and upper gastrointestinal tract hemorrhage,two cases of hyperacute rejection (leading to graft loss),acutecelluar-mediated rejection,delayed graft function,bone marrow suppression and pneumonia,and 3 cases of acute antibody-mediated rejection and wound fat liquefaction,respectively.Conclusion Our initial experience indicates that individualized preconditioning protocol based on initial ABO antibody titers is safe and technically feasible,and leads to excellent short-term survival of ABOi living donor kidney transplantation.

Preparation of Double-layer Osmotic Pump Controlled Release Tablets of Fenofibrate-starch Source Mesoporous Carbon Carrier Solid Dispersion / 中国药学杂志

OBJECTIVE: To improve the dissolution rate of fenofibrate (FNB) by using starch source mesoporous carbon (SMC) as a carrier and achieve controlled release of the drug by utilizing double-layer osmotic pump technology to improve the oral bioavailability. METHODS: FNB was loaded into the mesoporous of NMS by adsorption method to prepare the drug loading system (FNB-SMC). Differential scanning calorimetry (DSC) and powder X-ray diffraction (PXDR) were used to characterize the present state of the drug before and after being loaded. The dissolution rate of FNB-SMC was investigated by in vitro dissolution test, and the formulation of the double-layer osmotic pump tablets of FNB-SMC was optimized. The oral bioavailability of the self-made tablet was investigated by in vivo experiment in rabbits. RESULTS: FNB existed in the mesoporous of SMC in an amorphous state. The in vitro dissolution test showed that NMS could significantly increase the dissolution rate of FNB, and the double-layer osmotic pump technology could achieve Zero-order release of the drug. The in vivo experiments showed that the oral bioavailability of the self-made tablets was significantly improved. CONCLUSION: The combination of starch source mesoporous carbon carrier and double-layer osmotic pump technology prevente the burst effect and significantly improve the oral absorption of FNB.

Interpretation of laboratory test results in early and late onset severe preeclampsia / 中华检验医学杂志

Objective To analyze the difference of laboratory test results between early-onset and late-onset severe preeclampsia and to investigate their clinical application values.Methods Totally 108 blood samples were collected from patients with severe preeclampsia who were diagnosed according to the Diagnostic Standard of Obstetrics and Gynecology(7th Edition) published by People′s Medical Publishing House,in Shandong Provincial Hospital affiliated to Shandong University from March to November 2016,which consisted of 64 early-onset severe preeclampsia before 34 weeks gestation(early onset group) and 44 late-onset severe preeclampsia after 34 weeks gestation(late onset group).In addition,42 women with normal pregnancies as the control group were selected.General clinical data were collected,and the blood sample was analyzed through detecting Hb,PLT,fibrinogen (FIB),D-dimer,AST,ALT,urea,creatinine (Cr),uric acid,CRP,urine protein.The tested results were analyzed and compared.Flow cytometry was used to analyze the proportion of T helper 1 cells(Th1) and T helper 2 cells(Th2),and the ratio of Th1/Th2 was also calculated.All data and F test were performed by use of statistical software SPSS19.0.Results The pre-pregnancy body mass index(29.55±4.49,30.66±5.13,26.62±3.17,F=9.829,P<0.05),diastolic blood pressure[(105.17±14.46)mmHg(1 mmHg=0.133 kPa),(99.80±12.56)mmHg,(74.36±8.42)mmHg,F=82.088,P<0.05],Hb[(123.22±14.38)g/L,(117.03±16.48)g/L,(112.62±11.24)g/L,F=7.133,P<0.05],urea[(6.56±2.36)mmol/L,(4.51±1.35)mmol/L,(3.04±0.87)mmol/L,F=51.733,P<0.05],Cr[(68.47±18.05)μmol/L,(61.37±14.37)μmol/L,(48.54±8.73)μmol/L,F=23.737,P<0.05],CRP[(7.68±8.76)mg/L,(5.88±6.03)mg/L,(3.56±2.41)mg/L,F=4.735,P<0.05],urine protein[(3.66±0.76)g/L,(2.20±1.05)g/L,(0.19±0.40)g/L,F=249.714,P<0.05]had a statistically significant difference among the early-onset,late-onset and control groups.The flow cytometry results demonstrated that the proportion of Th1 in early-onset group(19.83±3.04)was higher than that in both late-onset (14.49±2.79)and control groups(11.78±1.17),on the contrary,the result of Th2 was much lower(early-onset:1.02±0.12,late-onset: 1.11±0.12,control: 1.56±0.11),there was statistical significance among these three groups(Th1: F=135.110,P<0.05;Th2: F=293.687,P<0.05).Conclusions It′s necessary to real-time monitor the laboratory indicators,such as liver and kidney function,especially the immunologic function indicators for evaluating the disease of early-onset and late-onset severe preeclampsia and personal treatment,and for ensuring the health of mother and fetus and improving the prognostic of mother and fetus.

Comparison of compound flumethasone ointment and clobetasol propionate cream on serum and skin lesion Th cell related cytokines secreted in eczema / 中国生化药物杂志

Objective To compare the effect of compound flumethasone ointment and clobetasol propionate cream on serum and skin lesion Th cell related indicators in patients with eczema. Methods 156 patients with chronic eczema were chosen. According to the type of topical drugs, they were divided into two groups: the flumethasone group and the clobetasol propionate group. The changes of eczema treatment effect, serum and skin lesions Th cell related indicators of the two groups were compared. Results After treatment, the serum interferon-γ (IFN-γ) of the flumethasone group was (27.57 ± 5.67) pg/mL, IL-2 was (36.51 ± 8.03) pg/mL and IL-4 was (26.37 ± 5.29) pg/mL, IL-10 was (25.38 ± 4.64) pg/mL and INF-γof skin lesions was (56.53 ± 21.81) pg/L , IL-2 was (51.69 ± 15.67) pg/L, IL-4 was (159.42 ± 25.64) pg/L and (139.62 ± 24.58) pg/L, significantly lower than those of clobetasol propionate group (P <0.05), but the clinical benefit rate (94.87%) was significantly higher than (80.77%) of clobetasol propionate group (P <0.05). Conclusion Compared with clobetasol propionate cream, the effect of compound flumetasone ointment is more effective in treating eczema, and its mechanism may regulate the expressions of Th cell related cytokines.