On the Relationship between Doctors and Patients in Court in Qing Dynasty from the Perspective of Famous Doctors’ Diary / 中国医学伦理学

In Qing Dynasty, doctor-patient relationship in the imperial court had distinct characteristics because of the particularity of the objects of diagnosis and treatment. Diaries of famous doctors has become an important research material from a unique perspective. Ji En Lu and Bei Xing Ri Ji contain many research materials on doctor-patient relationship in Qing Palace. By systematically sorting out the contents of the royal doctor-patient relationship in the two diaries, and analyzing them in detail from the three dimensions of doctors, patients and diagnosis and treatment situations, it can be known that patients’ strong performance will interfere with the diagnosis and treatment process to a great extent, and doctors’ low status makes it difficult for them to cope with the complicated diagnosis and treatment environment and affects the curative effect. Learn from the past and the present, further provide reference for the current patient strong special doctor-patient relationship.

Optimum duration of extended adjuvant endocrine therapy in patients with hormone receptor-positive breast cancer: protocol for a network meta-analysis of randomised controlled trials.

INTRODUCTION: The type of extended adjuvant endocrine therapy is not clear, nor is the optimum duration of extended adjuvant endocrine therapy for patients with early breast cancer. Our study aims to satisfy the requirements for systematically identifying and synthesising the available evidence on the clinical safety and efficacy of extended adjuvant endocrine therapy for patients with hormone receptor-positive early breast cancer. METHODS AND ANALYSIS: A comprehensive electronic literature database search will be performed using three electronic databases: PubMed, Cochrane Library and Embase (Ovid interface). Our main outcomes of interest were overall survival, disease-free survival, relapse-free survival, invasive contralateral breast cancer, acceptability and grades 3 and 4 non-haematological toxicities in this study. We will assess the risk of bias and overall quality of evidence using the Cochrane Collaboration's tool and Grades of Recommendation, Assessment, Development and Evaluation, respectively. We will perform subgroup and sensitivity analyses in the selected trials. We will assess the three key assumptions of network meta-analysis: transitivity, consistency and homogeneity. ETHICS AND DISSEMINATION: The protocol was preregistered in the International Prospective Register of Systematic Reviews (PROSPERO) database. Ethics approval and patient consent are not required for the network meta-analysis. The final results of this network meta-analysis will be disseminated through national and international conferences and published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42021278271.

The preliminary development and psychometric properties of the Psychotherapy Side Effects Scale.

BACKGROUND: Side effects in psychotherapy are common and have a negative impact on patients or clients. However, effective evaluation tools are still lacking and have not been fully studied. The present study aims to develop a scale with good reliability and validity to measure the side effects of psychotherapy. METHODS: The 25 items in the Psychotherapy Side Effects Scale (PSES) were condensed and distributed to 420 subjects online to test its psychometric properties. RESULTS: The internal consistency of the PSES was satisfactory to excellent (Cronbach's ɑ coefficient was .95, and the Guttman split-half coefficient was 0.88). A statistically significant negative correlation between the satisfaction score and the total score of the PSES was shown (r = -0.51, p < .001). The PSES could effectively discriminate between two groups with and without side effects (F = 250.95, p < .001) and was able to predict the occurrence of side effects in psychotherapy with an area under curve of 0.932 and a 95% confidence interval of 0.900-0.964 (p < .001). A cutoff was set at 36 points in total PSES score, from which the maximum Youden's index (= 0.72) could be obtained. The positive rate of the PSES was 24% (101/420). CONCLUSION: The PSES showed good internal consistency, content validity, concurrent validity, discriminant validity and predictive validity in evaluating and identifying side effects in psychotherapy. More advanced reliability testing methods and structural validity testing for PESE need to be practiced in the future to better serve clinical practice.

Anticarin-β shows a promising anti-osteosarcoma effect by specifically inhibiting CCT4 to impair proteostasis

Unlike healthy, non-transformed cells, the proteostasis network of cancer cells is taxed to produce proteins involved in tumor development. Cancer cells have a higher dependency on molecular chaperones to maintain proteostasis. The chaperonin T-complex protein ring complex (TRiC) contains eight paralogous subunits (CCT1-8), and assists the folding of as many as 10% of cytosolic proteome. TRiC is essential for the progression of some cancers, but the roles of TRiC subunits in osteosarcoma remain to be explored. Here, we show that CCT4/TRiC is significantly correlated in human osteosarcoma, and plays a critical role in osteosarcoma cell survival. We identify a compound anticarin-β that can specifically bind to and inhibit CCT4. Anticarin-β shows higher selectivity in cancer cells than in normal cells. Mechanistically, anticarin-β potently impedes CCT4-mediated STAT3 maturation. Anticarin-β displays remarkable antitumor efficacy in orthotopic and patient-derived xenograft models of osteosarcoma. Collectively, our data uncover a key role of CCT4 in osteosarcoma, and propose a promising treatment strategy for osteosarcoma by disrupting CCT4 and proteostasis.

Review and reflection on effectiveness and cultural adaptability of family therapy in China / 中华行为医学与脑科学杂志

Family therapy has been introduced to China for more than 30 years.The research of domestic family therapy mainly focuses on two aspects: the promotion of methods and theories, and the study on the application of Chinese culture.This research reviewed the present research status for family therapy in application effectiveness and acculturation in China, pointed out the deficiencies of the current national family therapy in depth, methods and technologies, object of research and research methods, and offered several advices. At the same time, it offered advices on the acculturation of family therapy in China's clinic and proposed that the implementation of family therapy under the background of Chinese culture should enhance the "understanding" on China’s family history and culture, and firmly carry out the clinical research on individual case.

Clinicopathological characteristics and treatment strategies of undifferentiated carcinoma with osteoclast-like giant cells of pancreas / 中华消化外科杂志

Objective:To investigate the clinicopathological characteristics and treatment strategies of undifferentiated carcinoma with osteoclast-like giant cells of pancreas (UCOGCP).Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 5 patients with UCOGCP who were admitted to Peking University First Hospital from January 2004 to January 2019 were collected. There were 1 male and 4 females, aged from 33 to 71 years, with a median age of 56 years. Patients underwent preoperative laboratory test, imaging and histopatho-logical examinations. Patients with pancreatic head tumors underwent pancreaticoduodenectomy, and those with tumors in the body or tail of pancreas underwent distal pancreatectomy combined with splenectomy. All patients underwent standard lymph node dissection. Postoperative adjuvant therapy was individually decided by a multidisciplinary team. Observation indicators: (1) preopera-tive examination and treatment; (2) postoperative histopathological situations; (3) follow-up. Follow-up using outpatient examination and telephone interview was performed to detect tumor recurrence of patients up to January 2020. Measurement data with normal distribution were represented as Mean± SD. Measurement data with skewed distribution were described as M (range). Count data were described as absolute numbers. Results:(1) Preoperative examination and treatment: of the 5 UCOGCP patients, CA19-9 was elevated as 65.43 U/mL in only 1 patient preoperatively, while the CA19-9 was normal in other 4 patients. Four patients showed a solid cystic mass on preoperative contrast-enhanced computed tomography (CT) scan, and 1 patient showed a delayed peripheral enhancement of the solid tumor with central necrosis. The magnetic resonance imaging (MRI) scan showed hypointense signals on T1, T2 and weighted diffusion sequences in all 5 patients. Three of the 5 patients were resectable according to imaging data, 1 patient had locally advanced tumor, infiltrating the transverse colon, stomach, and partial small intestine, with the portal vein thrombus, and 1 patient had pancreatic head tumor with a liver metastatic lesion of 0.4 cm diameter which was detected on position emission tomography CT and was diagnosed as UCOGCP by endoscopic ultrasound-guided fine-needle aspiration biopsy. All patients underwent radical resection. Of the 3 patients with resectable tumors, 2 patients underwent pancreaticoduo-denectomy and 1 patient underwent distal pancreatectomy combined with splenectomy. One patient with locally advanced tumor in the body and tail of pancreas underwent distal pancreatectomy + transverse colostomy + partial gastrectomy + portal vein thrombectomy, and 1 patient with pancreatic head tumor and liver metastasis underwent pancreatoduodenectomy combined with left lateral hepatectomy. Of the 5 patients, 2 received postoperative adjuvant chemotherapy with single-agent gemcitabine, 1 received albumin-paclitaxel+gemcitabine combination chemotherapy, 1 received S1 as single agent chemotherapy, and 1 did not receive adjuvant chemotherapy. (2) Postoperative histopathological situations: of the 5 patients, 4 cases showed a cystic solid appearance of gross specimens, and 1 case had a solid appearance with central hemorrhagic necrosis. The tumor diameter was 5.2 cm(range, 2.0?14.0 cm). All the 5 patients achieved negative margins. Of the 5 patients, there was 1 case with portal vein invasion, 2 cases with vascular invasion, 3 cases with perineural invasion, and 2 cases with regional lymph node metastasis. One patient may had multiple tumor invasion and metastasis. Four of 5 patients had paraffin specimens available for immuno-histochemical staining. Four patients were positive for both CD68 and vimentin stains, while 3 patients were positive for programmed death ligand-1 (PD-L1), including 2 samples with 5% positive cells and 1 sample with 25% positive cells. Postoperative pathological examination showed a large number of spindle histiocytoid sarcoma cells scattered with osteoclast like giant cells and pleomorphic carcinoma giant cells. The tumor mutation burden in the 4 patients was 3.23 Muts/Mb(range, 2.61?21.77 Muts/Mb). Microsatellite status was stable in 4 patients. The next generation sequencing of 4 patients showed that all patients had KRAS mutation which was the most frequently mutation in pancreatic ductal adenocarcinoma. Of the 4 patients, 1 case had germline pathogenic mutation in TP53, 1case had somatic mutation in TP53, 1 case had somatic mutation in TP53, BLM, CDKN2A, and 1 case had somatic mutation in ARID1A. (3) Follow-up: 5 patients were followed up for 14?173 months, with a median follow-up time of 46 months. During the follow-up, 4 patients achieved disease-free survival and 1 patient had local recurrence at postoperative 11 months.Conclusions:UCOGCP is a rare variant of pancreatic tumor that exhibits a cystic solid mass in imaging examinations. High expression of PD-L1 is common in UCOGCP. The prognosis for UCOGCP is favorable following radical surgery. Patients may benefit from extended radical surgery even if the tumor has locally progression or distant metastasis.

Transferrin receptor is another receptor for SARS-CoV-2 entry

Angiotensin-converting enzyme 2 (ACE2) has been suggested as a receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) entry to cause coronavirus disease 2019 (COVID-19). However, no ACE2 inhibitors have shown definite beneficiaries for COVID-19 patients, applying the presence of another receptor for SARS-CoV-2 entry. Here we show that ACE2 knockout dose not completely block virus entry, while TfR directly interacts with virus Spike protein to mediate virus entry and SARS-CoV-2 can infect mice with over-expressed humanized transferrin receptor (TfR) and without humanized ACE2. TfR-virus co-localization is found both on the membranes and in the cytoplasma, suggesting SARS-CoV-2 transporting by TfR, the iron-transporting receptor shuttling between cell membranes and cytoplasma. Interfering TfR-Spike interaction blocks virus entry to exert significant anti-viral effects. Anti-TfR antibody (EC50 ~16.6 nM) shows promising anti-viral effects in mouse model. Collectively, this report indicates that TfR is another receptor for SARS-CoV-2 entry and a promising anti-COVID-19 target.

Evaluation of neoadjuvant therapy for pancreatic cancer: is it the best choice? / 中华消化外科杂志

Currently the treatment strategy of pancreatic cancer has shifted from the mode "surgery first" to multidisciplinary team.More and more evidences have revealed that neoadjurant therapy will help to increase the R0 resection rate,reduce the recurrence rate,and improve the prognosis of the patients with borderline resectable pancreatic cancer.Furthermore,neoadjuvant therapy is also recommended for resectable pancreatic cancer patients with high risk factors of tumor recurrence.In this article,the current controversy and research progress of neoadjuvant therapy for pancreatic cancer are reviewed and commented in order to deepen the understanding of the hot topic in clinial surgeons.

Evaluation of neoadjuvant therapy for pancreatic cancer: is it the best choice? / 中华消化外科杂志

Currently the treatment strategy of pancreatic cancer has shifted from the mode "surgery first" to multidisciplinary team. More and more evidences have revealed that neoadjuvant therapy will help to increase the R0 resection rate, reduce the recurrence rate, and improve the prognosis of the patients with borderline resectable pancreatic cancer. Furthermore, neoadjuvant therapy is also recommended for resectable pancreatic cancer patients with high risk factors of tumor recurrence. In this article, the current controversy and research progress of neoadjuvant therapy for pancreatic cancer are reviewed and commented in order to deepen the understanding of the hot topic in clinial surgeons.

NEMA NU-4 performance evaluation of a non-human primate animal PET.

The Eplus-260 primate PET is an animal PET imaging system developed by the Institute of High Energy Physics, Chinese Academy of Sciences, which is designed to image non-human primates, especially the brain of large non-human primates. The system consists of 48 block detectors arranged in two 24-sided rings with a ring diameter of 263 mm and an axial extent of 64 mm. Each block detector is composed of a 16 × 16 cerium-doped lutetium-yttrium orthosilicate crystal array with a pixel size of 1.9 × 1.9 × 10 mm3. This article presents a performance evaluation of the PET scanner according to the National Electrical Manufacturers Association NU-4 2008 standards. All measurements were made for an energy window of 360-660 keV and a coincidence timing window of 2 ns. In terms of the FWHM, the FBP reconstructed spatial resolution results in all three directions at the radial position of 5 mm were better than or approached to 2 mm, and remained below 3.0 mm within the central 5 cm diameter of the FOV. The peak absolute sensitivity of the scanner was measured 1.80%. For a monkey-sized phantom, the scatter fraction was 34.2% and the peak noise equivalent count rate (NECR) was 26.5 kcps at 64.3 kBq/cc. The overall imaging capabilities of the scanner were also assessed using in vivo imaging study of a rhesus macaque. The performance measurements demonstrate that the Eplus-260 primate PET scanner has the potential ability to obtain good quality and high-contrast images for non-human primates, especially the brain of large non-human primates and could be considered as one technologically advanced dedicated non-human primate PET scanner available today.

Circulating tumor cells in pancreatic cancer patients: progression in the detection methods and clinical application / 中华外科杂志

Circulating tumor cells (CTC) disseminate from primary tumors by undergoing epithelial mesenchymal transition that allow their entry into the circulation to drive metastatic formation in pancreatic cancer patients.Technological advances in detection and characterization of CTC are conducive to the early diagnosis, differential diagnosis, monitoring disease progression and predicating the probability of canceration or the chemotherapeutic efficacy. Nowadays, detection methods of CTC can be based on immunomagnetic beads technique, cell filtration or microfluidic chips technology, but there are great differences in the sample throughput, CTC recovery rate, purity, and CTC viability among them.Owing to the dilemma in detection methods, the intrinsic relevance between the biological characteristics of CTC and clinical manifestations is still not exactly elucidated. By the improved methodology, next generation sequencing technology and exploring the technique for culturing CTC in vitro and establishing xenotransplanted tumor model in nude mice, more and more biological information will be revealed, and finally, individualized treatment is achieved.

Related factors of sociodemographic characteristics and systemic family dynamics of different self-esteem groups of junior middle school students / 中国心理卫生杂志

Objectives: To explore related factors of sociodemographic characteristics and family dynamics of different self-esteem groups of junior middle school students. Methods: A total of 1059 junior middle school students were recruited. The Self-designed sociodemographic characteristic questionnaire, the Self-Esteem Scale and the Selfrating scale of systemic family dynamic were applied. According to SES scores, the high self-esteem group, the middle group and the low group were constructed. The differences of sociodemographic characteristics and systemic family dynamics were compared between these groups by χ2-test and ANCOVA. Ordinal logistic regression was conducted to determine the relation between self-esteem and sociodemographic characteristics and family dynamic factors. Results:The higher self-esteem group had the better of parental education attainment, family life quality, parent relationship, and the more subjects born in Shanghai (Ps ＜ 0. 05). After controlling the above sociodemographic characteristics, family atmosphere scores and individuality scores in the high self-esteem group were the lowest and these in the low group were highest (Ps ＜ 0. 05). Not being born in Shanghai (OR = 1. 57, 95％ CI: 1. 15-2. 14) was a risk factor for low self-esteem, while the lower scores of family atmosphere (OR = 0. 48, 95％ CI: 0. 36-0. 65) and the lower scores of individuality (OR = 0. 66, 95％ CI: 0. 52-0. 83) were protective factors for low self-esteem. Conclusion:It suggests that there are significant different sociodemographic characteristics and family dynamic factors among different self-esteem junior middle school students. Self-esteem may be related to whether being born natively, family atmosphere, and individuality in junior middle school students.

Effect of cognitive behavior therapy on the symptoms and conversion of ultra-high-risk of schizophrenia / 中华行为医学与脑科学杂志

Objective To investigate the effect of cognitive behavior therapy (CBT) on the conversion of individuals with ultra-high-risk (UHR) of schizophrenia,and to find out the related influence factors.Methods Patients were randomly divided into study group (50 cases) and control group (49 cases) by the digital random table method.The study group received cognitive behavioral therapy,and the control group only got follow-up questionnaire.Structured Interview for Prodromal Syndromes (SIPS) was used to evaluate psychosis risk symptoms of each UHR individuals at baseline,3 months,6 months,12 months and 18 months respectively and the effects of CBT on conversion and related influencing factors were analyzed.Results There was no significant difference in the conversion rate (P＞ 0.05) between study group and control group after 3 months,but the conversion rate of study group was significantly lower than the control group after 6 months(6.00％ vs 20.41％,P＜0.05),12 months(10.00％ vs 24.49％,P＜0.05)and 18 months(10.00％ vs 28.57％,P＜0.05).CBT could effectively improve conditions for individuals with positive symptom (study group:5.30±3.62,5.04±3.89,4.38±4.13,5.26±3.65,5.94±4.19,control group:5.59±3.62,6.33±5.29,6.98 ±4.96,7.02±5.02,8.39±6.42,F=4.326,P=0.000) of UHR,but the improvement was not significant for negative individuals (F=1.555,P=0.215).CBT could be effective for disorganized symptom (F=6.901,P =0.010) and general symptom (F=7.752,P=0.006) as well.The poor family relationship was the risk factor of conversion to the schizophrenia (OR=3.411,95％CI=1.016-11.453,P=0.047).Conclusion CBT can effectively reduce the conversion rate of UHR individuals.CBT has a good remission effect on the positive symptoms,disintegrating symptoms and general symptoms of UHR.Family relationship affects prognosis of UHR individuals.

Effective and persistent antitumor activity of HER2-directed CAR-T cells against gastric cancer cells in vitro and xenotransplanted tumors in vivo

Human epidermal growth factor receptor 2 (HER2) proteins are overexpressed in a high proportion of gastric cancer (GC) cases and affect the maintenance of cancer stem cell (CSC) subpopulations, which are used as targets for the clinical treatment of patients with HER2-positive GC. Despite improvements in survival, numerous HER2-positive patients fail treatment with trastuzumab, highlighting the need for more effective therapies. In this study, we generated a novel type of genetically modified human T cells, expressing a chimeric antigen receptor (CAR), and targeting the GC cell antigen HER2, which harbors the CD137 and CD3ζ moieties. Our findings show that the expanded CAR-T cells, expressing an increased central memory phenotype, were activated by the specific recognition of HER2 antigens in an MHC-independent manner, and effectively killed patient-derived HER2-positive GC cells. In HER2-positive xenograft tumors, CAR-T cells exhibited considerably enhanced tumor inhibition ability, long-term survival, and homing to targets, compared with those of non-transduced T cells. The sphere-forming ability and in vivo tumorigenicity of patient-derived gastric cancer stem-like cells, expressing HER2 and the CD44 protein, were also inhibited. Our results support the future development and clinical application of this adoptive immunotherapy in patients with HER2-positive advanced GC.

A review of effects of disrupted primary caregiver infant relationship on brain development and psychopathology / 中国心理卫生杂志

The disrupted caregiver infant relationships are not unpopular (infant abuse and non-traumatic caregiver-infant relationship).Animal and human studies have demonstrated this disruptive relationship exerts the fundamental and enduring impacts on stress system, limbic system and relevant cortex.Individual carrying such biological susceptibility might develop psychopathology under stresses at later life.The assessment needs to get involved the measures with more objectivity,real time and moment-to-moment components.The study on caregiverinfant relationship also should focus on the historical and cultural aspects of China.

The Association between self-differentiation and mental health among medical students / 中华医学教育探索杂志

Objective This study is to explore the association between self-differentiation and men-tal health among medical students. Methods Differentiation of self inventory-revised (DSI-R) and univer-sity personality inventory (UPI) were used to measure the self-differentiation and mental health of 526 med-ical students from Grade One to Grade Five at a comprehensive university in Shanghai. Result The mean score of DSI-R was (171.25±19.65). 32.2％ of participants had different levels of mental health prob-lems. Female students got higher score of DSI-R than male students (P=0.007). Statistically significant dif-ferences of medical students' self-differentiation were found among years of school attended (P=0.039). Sta-tistically significant differences of self-differentiation were also found between the first class and the third class of UPI (P<0.001) as well as the second class and the third class of UPI (P=0.004). Ordinal regression analysis indicated that self-differentiation was a risk factor for medical students' mental health (OR=1.036, P=0.000). Conclusion The average score of medical students' self-differentiation was higher than college students of other specialties. But their mental health condition was worse. Medical students with higher self-differentia-tion had worse mental health situation.

Perceived stress and coping style in college students with psychosis-risk syndrome / 中国心理卫生杂志

Objective:To investigate the characteristics of perceived stress and coping style and their relationship withsymptoms in college students with psychosis-risk syndrome (PRS).Methods:A two-stage screening process was conducted in 3160 college students.Participants were screened with 16-Item Version of the Prodromal Questionnaire (PQ-16).The students with scores of PQ-16 ≥9 were further interviewed with Structured Interview for Prodromal Syndromes (SIPS).Twenty-two individuals who met the criteria of PRS on SIPS were enrolled as the PRS group.The control group (n =22) were randomly selected from the participants with scores of PQ-16 ＜9 who were matched with age,gender and education level.Two groups were assessed with Chinese Perceived Stress Scale (CPSS),Trait Coping Style Questionnaire (TCSQ) and Self-rating depression scale (SDS) to measure subjective stress,coping style and depressive symptoms.Results:PRS group reported higher CPSS total scores [(34 ± 8)vs.(22 ± 8)] and negative coping styles scores [(35 ± 5)vs.(28 ± 7)],and lowerTCSQ positive coping styles scores [(31 ±6)vs.(37 ±4)] than the controls (Ps ＜0.05).The CPSS scores in PRS group were positively correlated with the scores of negative coping style (r =0.57,P ＜0.01),and the SDS scores were positively correlated with CPSS total scores and scores of negative coping style (r--0.86,0.66,Ps ＜ 0.01).There was no significant relation of psychosis-risk symptoms to scores of CPSS and TCSQ (P ＞0.05).Conclusion:It suggests that college students with PRS have a higher perceived stress and tend to use more negative coping style,which may be positively correlated with depression.

Side effects of psychotherapy / 中国心理卫生杂志

Psychotherapy is a kind of medical treatments based on interpersonal interaction that is highly context-dependent.While psychotherapy is an important treatment in clinical work and its effectness has been confirmed with wide practical application,its adverse effects has received little attention.This article will review the literaturesand discuss the possible side effects and relatedfactors of psychotherapy.

The correlation between communication skills attitude and general self-efficacy among medical in-terns / 中华医学教育探索杂志

Objective This study is to explore the correlation between communication skills attitude and general self-efficacy among medical interns. Methods Medical intern students of three medical colleges in Shanghai were participated in this study, and questionnaire survey was conducted by cluster sampling of class. SPSS 19.0 was used to process descriptive analysis, t-test, F-test, correlation analysis and hierarchical regression analysis for data analysis. Result 600 questionnaires were handed out and 575 valid samples were collected. The effective rate was 95.83％. The mean score of positive and negative attitude dimension in CSAS were (51.880 ±7.003) and (31.550 ±5.839). The mean score of GSES was (26.230 ±4.820). A positive correlation was found between positive attitude of communication skills and general self-efficacy (r=0.165, P<0.01). Hierarchical regression analysis indicated that school, cognition about importance of com-munication skills and general self-efficacy significantly predicted positive attitude of communication skill.These three variables could explain 21.8％ of total variance and general self-efficacy can explained 2.1％after control other variables. Conclusion Communication skills attitudes of medical interns is positive on the whole. Enhancing their general self-efficacy is beneficial to improving their positive attitude towards communication skills.

Expression changes and significance of ATP-binding cassette transporter B5 in pterygium / 中华实验眼科杂志

Background Limbal stem cells (LSCs) deficiency leads to many ocular surface diseases,such as pterygium and so on.ATP-binding cassette transporter B5 (ABCB5) is a recently discovered marker of LSCs.Understanding the expression changes of ABCB5 in pterygium tissue has an important clinical significance for pterygium.Objective This study was to investigate the expression changes of ABCB5 in pterygium tissue.Methods Thirty-seven pterygium tissue specimens were collected from primary pterygium patients who received pterygium surgery,and 22 normal conjunctival tissue specimens were obtained from the strabismus patients and retinal detachment patients during surgery in 474 Hospital of Chinese PLA from January 2015 to November 2015.Immunochemistry was employed to detect the cxpression and location of ABCB5 in the specimens,and the protein and mRNA expressions of ABCB5 were detected by Western blot and real-time fluorescence quantitative PCR,respectively.The results were compared between normal conjunctival tissues and pterygium tissue.Results ABCB5 protein was expressed in the cytoplasm and nuclei of stratified squamous epithelium of 22 normal counjunctival tissue specimens,especially in the basal layer cells,and showed obvious polarity in normal conjunctiva.In pterygium group,ABCB5 protein was positively expressed in 91.89％ specimens (34/37) and the expression was absent in 8.11％ specimens (3/37).The relative expression levels of ABCB5 protein were 0.90±0.31 and 0.59±0.41,and those of ABCB5 mRNA were 1.01±0.26 and 0.65±0.32 in the normal conjunctival tissues and pterygium tissue,respectively,showing significant differences between them (protein:t =-0.266,P =0.011;mRNA:t =-4.560,P =0.000).Conclusions Down-regulation of ABCB5 in pterygium indicates the decreasing and losing of LSCs,which may play an important role in the development of pterygium.ABCB5 may be a useful indicator for the prediction of development and recurrence of pterygium and has an important implication for treating evaluation,and it may also be a target for the management of pterygium.