Clinical Impacts and Outcomes With Possible Donor-Derived Infection in Infected Donor Liver Transplantation: A Single-Center Retrospective Study in China.

BACKGROUND: Information on possible donor-derived transmission events in China is limited. We evaluated the impacts of liver transplantation from infected deceased-donors, analyzed possible donor-derived bacterial or fungal infection events in recipients, and evaluated the etiologic agents' characteristics and cases outcomes. METHODS: A single-center observational study was performed from January 2015 to March 2017 to retrospectively collect data from deceased-donors diagnosed with infection. Clinical data were recorded for each culture-positive donor and the matched liver recipient. The microorganisms were isolated and identified, and antibiotic sensitivity testing was performed. The pathogens distribution and incidence of possible donor-derived infection (P-DDI) events were analyzed and evaluated. RESULTS: Information from 211 donors was collected. Of these, 82 donors were infected and classified as the donation after brain death category. Overall, 149 and 138 pathogens were isolated from 82 infected donors and 82 matched liver recipients, respectively. Gram-positive bacteria, Gram-negative bacteria, and fungi accounted for 42.3% (63 of 149), 46.3% (69 of 149), and 11.4% (17 of 149) of pathogens in infected donors. The incidence of multidrug-resistant bacteria was high and Acinetobacter baumannii was the most concerning species. Infections occurred within the first 2 weeks after liver transplantation with an organ from an infected donor. Compared with the noninfection recipient group, the infection recipient group experienced a longer mechanical ventilation time (P = .004) and intensive care unit stay (P = .003), a higher incidence of renal dysfunction (P = .026) and renal replacement therapy (P = .001), and higher hospital mortality (P = .015). Possible donor-derived infection was observed in 14.6% of cases. Recipients with acute-on-chronic liver failure were more prone to have P-DDI than recipients with other diseases (P = .007; odds ratio = 0.114; 95% confidence interval, .025-.529). CONCLUSIONS: When a liver recipient receives a graft from an infected deceased-donor, the postoperative incidence of infection is high and the infection interval is short. In addition, when a possible donor-derived, drug-resistant bacterial infection occurs, recipients may have serious complications and poor outcomes.

Two new species of the sac-spider genus Clubiona Latreille, 1804 (Araneae, Clubionidae) and the female of C. subcylindrata from China.

Two new species of the genus Clubiona Latreille, 1804 are described: C. tianpingshan sp. nov. (♂♀) and C. flammaforma sp. nov. (♂♀) from central and south China. The female of C. subcylindrata Wang et al., 2018 is described for the first time. Detailed descriptions, photographs of somatic features and copulatory organs, as well as a distribution map of these three species, are provided.

Acute pancreatitis as a rare complication of gastrointestinal endoscopy: A case report.

BACKGROUND: Acute pancreatitis is an uncommon complication of gastrointestinal endoscopy, especially if the patient has none of the common risk factors associated with pancreatitis; such as alcoholism, gallstones, hypertriglyceridemia, hypercalcemia or the use of certain drugs. CASE SUMMARY: A 56-year-old female patient developed abdominal pain immediately after the completion of an upper gastrointestinal endoscopy. The pain was predominantly in the upper and middle abdomen and was persistent and severe. The patient was diagnosed with acute pancreatitis. Treatment included complete fasting, octreotide injection prepared in a prefilled syringe to inhibit pancreatic enzymes secretion, ulinastatin injection to inhibit pancreatic enzymes activity, esomeprazole for gastric acid suppression, fluid replacement and nutritional support. Over the next 3 d, the patient's symptoms improved. The patient remained hemodynamically stable throughout hospitalization and was discharged home in a clinically stable state. CONCLUSION: Pancreatitis should be considered in the differential diagnosis of abdominal pain after upper and lower gastrointestinal endoscopy.

Changes of monocyte human leukocyte antigen-DR expression as a reliable predictor of mortality in severe sepsis.

INTRODUCTION: Many studies have shown that monocyte human leukocyte antigen-DR (mHLA-DR) expression may be a good predictor for mortality in severe septic patients. On the contrary, other studies found mHLA-DR was not a useful prognostic marker in severe sepsis. Few studies have taken changes of mHLA-DR during treatment into consideration. The objective of this study was to estimate the prognostic value of changes of mHLA-DR to predict mortality in severe sepsis. METHODS: In this prospective observational study, mHLA-DR was measured by flow cytometry in peripheral blood from 79 adult patients with severe sepsis. mHLA-DR levels were determined on day 0, 3, 7 after admission to the surgical intensive care unit (SICU) with a diagnosis of severe sepsis. ΔmHLA-DR3 and ΔmHLA-DR7 were defined as the changes in mHLA-DR value on day 3 and day 7 compared to that on day 0. Data were compared between 28-day survivors and non-survivors. Receiver operating characteristic (ROC) curves were plotted to measure the performance and discriminating threshold of ΔmHLA-DR3, ΔmHLA-DR7, ΔmHLA-DR7-3, mHLA-DR0, mHLA-DR3 and mHLA-DR7 in predicting mortality of severe sepsis. RESULTS: ROC curve analysis showed that ΔmHLA-DR3 and ΔmHLA-DR7 were reliable indicators of mortality in severe sepsis. A ΔmHLA-DR3 value of 4.8% allowed discrimination between survivors and non-survivors with a sensitivity of 89.0% and a specificity of 93.7%; similarly, ΔmHLA-DR7 value of 9% allowed discrimination between survivors and non-survivors with a sensitivity of 85.7% and a specificity of 90.0%. Patients with ΔmHLA-DR3 ≤ 4.8% had higher mortality than those with ΔmHLA-DR3 > 4.8% (71.4% vs. 2.0%, OR 125.00, 95% CI 13.93 to 1121.67); patients with ΔmHLA-DR7 ≤ 9% had higher mortality than those with ΔmHLA-DR7 > 9% (52.9% vs. 2.0%, OR 54.00, 95% CI 5.99 to 486.08). The mean change of mHLA-DR significantly increased in the survivor group with the passage of time; from day 0 to day 3 and day 7, changes were 6.45 and 16.90 (P < 0.05), respectively. CONCLUSIONS: The change of mHLA-DR over time may be a reliable predictor for mortality in patients with severe sepsis.

[Prenatal diagnosis of a fetus in a family with mandibulofacial dysostosis].

OBJECTIVE: To measure the feasibility of application of comparative genomic hybridization technique in the prenatal diagnosis of fetus with mandibulofacial dysostosis. METHODS: A pregnant woman having a fetus with mandibulofacial dysostosis diagnosed by prenatal ultrasound test was selected. The amniotic fluid and blood of the pregnant and blood of her husband were collected and conventional cytogenetic analysis was performed. The whole genome was scanned by array comparative genomic hybridization assay (array-CGH). Reverse transcription fluorescence quantitative PCR (RT-qPCR) analysis was used to verify the result of array-CGH. RESULTS: No abnormality was found in conventional cytogenetic analysis while a duplicated region in 1p36.33 was detected by array-CGH assay. The region spans 722 kb and contains two genes, VWA1 and PYGO2, which play roles in the development of cartilage. The result of array-CGH was confirmed by the RT-qPCR assay. The diagnosis of mandibulofacial dysostosis was confirmed after birth. CONCLUSION: Author diagnosed a fetus with mandibulofacial dysostosis by array-CGH assay and found two candidate genes related to the development of craniofacial bone: VWA1 and PYGO2.

[The study of the mechanism of the effect of heparin on tissue perfusion of sepsis patients].

OBJECTIVE: To assess the role of heparin administration in the early stage of sepsis and its mechanism of action. METHODS: This was a prospective study. One hundred and nineteen patients were enrolled in the study and were randomly divided into control group (64 cases) and therapy group (55 cases). Except the basic therapy of sepsis given to patients in both groups, the patients in the control group received normal saline, while the patients in the therapy group received heparin 2 mg.kg(-1).d(-1) with the aid of intravenous pump continuously after the onset of sepsis. The platelet count (PLT), D-dimer, and lactic acid in the blood were analyzed before therapy and on the 1st, 3rd, 5th and 10th day. The bleeding tendency was also observed. In every patient an acute physiology and chronic heath evaluation II (APACHE II) score was made. RESULTS: Patients in both groups had a similar APACHE II score. The pathogenetic and therapeutic condition were similar in both groups. The rate of the active bleeding in the therapy group was lower significantly than that of the control group (12.5% vs. 5.4%, P < 0.05). The PLT of the therapy group decreased on the 1st day, but began to rise on the 3rd day gradually, and up to the same level of the admission day on the 10th day. The PLT of the control group decreased progressively every day (P < 0.05 or P < 0.01). D-dimer in the therapy group raised significantly on the 1st day, but lowered to normal level after 3 days. D-dimer in the control group went up progressively every day (all P < 0.01). Lactic acid in the therapy group went up significantly on the 1st day (P < 0.01), but it no longer rose after 3 days (all P > 0.05). The lactic acid level in the control group rose progressively every day (all P < 0.01). There were no significant differences for the PLT, D-dimer, and lactic acid between the two groups before therapy and on the 1st day (all P > 0.05). However, on the 3rd, 5th and 10th day, the PLT in the therapy group was significant higher than that of the control group, the D-dimer and the lactic acid level in the therapy group were significantly lower than that of the control group (P < 0.05 or P < 0.01). CONCLUSION: The use of heparin at the earlier period of sepsis can inhibit the lowering of PLT and increase of D-dimer and lactic acid significantly, prevent microvascular thrombosis, improve the tissue perfusion, and decrease active bleeding.

[Establishment of a model of endoplasmic reticulum stress response in dental pulp cells induced by tunicamycin].

PURPOSE: The aim of this study was to establish a model of endoplasmic reticulum (ER) stress in dental pulp cells(DPCs) induced by tunicamycin to better understand the molecular mechanism of DPCs related diseases mediated by ER stress. METHODS: DPCs were cultured using modified tissue explant technique in vitro and cultured in presence or absence of tunicamycin. DPCs' viability was measured by methylthiazol tetrazolium (MTT) assay. The mRNA level of ER stress markers was examined by RT-PCR. The data were analyzed with SPSS17.0 software package. RESULTS: The proliferative ability of DPCs decreased when exposed to tunicamycin in a dose-dependent manner. Treatment with tunicamycin resulted in up-regulation of ER stress genes, such as splicing x-box binding protein-1(sXBP1), activating transcription factor 4(ATF4), glucose-regulated protein 78(GRP78) and C/EBP homologous protein (CHOP). CONCLUSIONS: The results indicate that ER stress response is induced in DPCs by tunicamycin, and the ER stress model is successfully established.

[Effect of low molecular heparin sodium cream on the content of serum nitric oxide in random pattern skin flap: experiment with rats].

OBJECTIVE: To explore the mechanism of improvement of blood circulation in random pattern skin flap by low molecular heparin sodium cream. METHODS: 48 Wistar rats underwent formation of random skin flap of the size of 2 cm x 8 cm on the back and then were randomly divided into 2 equal groups: experiment group with low molecular heparin sodium cream smeared on the skin flaps and control group with Vaseline smeared on the skin flaps. 24, 48, and 72 hours, and 7 days after the smearing blood samples were collected from 6 rats respectively to detect the content of serum nitric oxide a (NO). Seven days after the smearing specimens were collected from the upper, middle, and lower parts of the skin flaps to undergo pathological examination. RESULTS: (1) The serum NO content of the experiment group was (53 +/- 15) micromol/L, significantly higher than that of the control group [(27 +/- 20) micromol/L, P < 0.05] 7 days after the operation. (2) The skin flap survival rate of the experiment group was (66 +/- 18)%, significantly higher than that of the control group [(22 +/- 16)%, P < 0.01]. (3) Histomorphology showed formation of neo-vessels with integrated endangium of capillary, stability of structure of mitochondria, and milder cell swelling in the flaps treated with heparin cream. CONCLUSION: Low molecular heparin sodium cream increases the content of serum NO, thus increasing the survival of skin flaps.

Influence of Adsorption Orientation on the Statistical Mechanics Model of Type I Antifreeze Protein: The Thermal Hysteresis Temperature.

The antifreeze activity of type I antifreeze proteins (AFPIs) is studied on the basis of the statistical mechanics theory, by taking the AFP's adsorption orientation into account. The thermal hysteresis temperatures are calculated by determining the system Gibbs function as well as the AFP molecule coverage rate on the ice-crystal surface. The numerical results for the thermal hysteresis temperatures of AFP9, HPLC-6, and AAAA2kE are obtained for both of the cases with and without inclusion of the adsorption orientation. The results show that the influence of the adsorption orientation on the thermal hysteresis temperature cannot be neglected. The theoretical results are coincidental preferably with the experimental data.

[Study of endoplasmic reticulum stress response in osteogenic differentiation of human periodontal ligament cells].

PURPOSE: The aim of this study was to establish whether endoplasmic reticulum (ER) stress is involved in osteogenic differentiation of periodontal ligament cells (PDLCs) and to better understand the mechanism of PDLCs osteogenic differentiation. METHODS: PDLCs were isolated from extracted teeth and cultured in presence or absence of osteogenic medium, which can induce osteogenic differentiation of PDLCs. Alkaline phosphatase and alizarin red S staining were performed to characterize the osteogenic differentiation of PDLCs. The mRNA and protein levels of ER stress markers were examined by RT-PCR and Western blot analysis. The data were analyzed with SPSS 17.0 software package. RESULTS: Cell treated with osteogenic medium showed increased expression of alkaline phosphatase, increased matrix, and mineralized nodule formation compared with untreated controls. Treatment with osteogenic induction resulted in up-regulation of genes, such as splicing x-box binding protein-1 (sXBP1), activating transcription factor 4 (ATF4) and glucose-regulated protein 78 (GRP78). The expressions of ER stress protein markers, phosphorylated RNA-activated protein kinase-like ER-resident kinase (p-PERK), phosphorylated eukaryotic initiation factor-2α (p-eIF2α), increased in osteogenic induction cells compared with controls. CONCLUSIONS: The results indicate that ER stress response is involved in the process of osteogenic differentiation of PDLCs.

[The drug resistance of pathogenic bacteria of nosocomial infections in surgical intensive care unit].

OBJECTIVE: To investigate the drug resistance of pathogenic bacteria of nosocomial infections in the surgical intensive care unit. METHODS: The drug resistance of pathogenic bacteria of nosocomial infections in the SICU in our hospital from January 2001 to December 2004 were analyzed. RESULTS: The average nosocomial infections rate was 11.3%. The major sites of nosocomial infections were respiratory tract (30.9%), abdominal cavity (29.0%), bloodstream (9.7%) and biliary ducts (7.2%). The most common pathogens were pseudomonas aeruginosa (11.6%), methicillin-resistant coagulase negative staphylococci (11.1%) and candida albicans (9.7%). ESBLs-producing strains accounted for 66.2% and 58.5% of escherichia coli and klebsiella spp. respectively. Methicillin-resistant staphylococcus aureus accounted for 94.7% and methicillin-resistant coagulase negative staphylococci accounted for 88.2% in staphylococcus aureus and coagulase negative staphylococci. Carbapenems were the most powerful antibiotics against enterobacteriaceae. The non-fermenters were high resistant to antimicrobial agents. Vancomycin was the most potent antimicrobial against gram positive cocci. Amphotericin B was the most active antibiotic against fungi. CONCLUSIONS: Most strains of pathogens were antibiotic resistant in SICU. The main pathogenic bacteria of each infection site were different. So it is essential to establish nosocomial infections surveillance system in order to prevent, control and treat nosocomial infections effectively.

Steamed root of Rehmannia glutinosa Libosch (Plantaginaceae) alleviates methotrexate-induced intestinal mucositis in rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Intestinal mucositis induced by chemotherapy is a severe clinical problem in cancer patients that currently lack effective interventions. In traditional Chinese medicine, chemotherapeutic toxicity is diagnosed as Qi and Yin deficiency, and steamed rehmannia root (SRR) is frequently prescribed to these patients. Whether SRR can prevent the adverse effects remains to be confirmed experimentally. The present study used a rat model to investigate potential efficacy and action mechanisms of SRR in attenuating the adverse effects caused by chemotherapy. MATERIALS AND METHODS: Intraperitoneal injection of a single dose of anti-metabolite methotrexate (MTX, 25mg/kg) was given to adult Wistar rats, which also received oral gavage of water or SRR (1.08g/kg twice daily 3 days before and 4 days after MTX treatment), or calcium folinate (CF, a clinically used MTX antidote as a comparison, at 1mg/kg twice daily 36h after MTX treatment), or SRR and CF in combination. Animals were sacrificed 4 days after MTX treatment. Complete blood cell counting was carried out. Jejunum was analyzed histologically for mucosal damage, immunohistochemically for proliferating cell nuclear antigen (PCNA), and biochemically for thiobarbituric acid reactive substances (TBARS) and reduced glutathione (GSH), as well as for tumor necrosis factor alpha (TNF-α). RESULTS: MTX treatment led to weight loss, leucopenia, polycythemia, increase in large thrombocyte ratio, intestinal villus atrophy, crypt loss and reduction in PCNA positive crypt cells, increases in mucosal TBARS and TNF-α and decrease in GSH. All these alterations were inhibited by SRR administration except leucopenia, and the effects of CF or CF plus SRR supplementation were found to be inferior to those of SRR. CONCLUSIONS: SRR can alleviate MTX-induced gut mucositis, which may be achieved by inhibiting MTX-induced oxidative stress and inflammatory response. These findings support the application of SRR in chemotherapy but not the combined application of SRR and CF.

Effects of deferoxamine on the repair ability of dental pulp cells in vitro.

INTRODUCTION: In previous studies, we found that hypoxia promoted the mineralization of dental pulp cells (DPCs). However, the clinical application of hypoxia as a therapy is questionable or unfeasible. Deferoxamine (DFO), a medication for iron overload, has also been shown to induce hypoxia. The purpose of this study was to investigate the effects of DFO on the repair ability of DPCs. METHODS: DPCs were obtained by using a tissue explant technique in vitro and were treated with different concentrations of DFO or hypoxia culture for 2 days. The viability, proliferation, migration, and odontogenic differentiation of DPCs were assayed and analyzed. The expression of hypoxia-inducible factor 1-alpha (HIF-1α) was assessed through Western blotting. RESULTS: Ten micromolars of DFO enhanced the expression of HIF-1α similarly to hypoxia and did not affect the viability of DPCs for 2 days. Furthermore, the proliferation, migration, and odontogenic differentiation of DPCs were promoted by DFO. CONCLUSIONS: These results suggest that DFO might improve the repair ability of DPCs by HIF-1α.

Hydrogen peroxide induces apoptosis in human dental pulp cells via caspase-9 dependent pathway.

INTRODUCTION: Reactive oxygen species are a group of metabolic intermediates produced during oxidative metabolism in eukaryotic cells. They include superoxide anion (O2(-)), hydrogen peroxide (H2O2), hydroxyl radical (·OH), and (1)O2. Of these intermediates, H2O2 is the most stable. Dental pulp cells can be invaded by tooth bleaching, laser radiation, and dental materials. This can influence the intracellular level of reactive oxygen species. Apoptosis, which is the best-known form of programmed cell death, is pivotal to tissue development and regeneration. Little information is available regarding the relationship between H2O2 and apoptosis of human dental pulp cells (hDPCs). The purpose of this study was to investigate whether H2O2 can induce apoptosis in hDPCs and its signaling way. METHODS: HDPCs were obtained by using a modified tissue explant technique in vitro and cultured at 37°C, 20% O2 (5% CO2, 95% air) in Dulbecco modified Eagle medium. Cell viability was investigated by methyl-thiazol-tetrazolium assay. Cell apoptosis was detected by using the annexin V-fluorescein isothiocyanate/propidium iodide apoptosis assay and flow cytometry. Expression of activated caspase-3, cleaved caspase-9, and ß-actin was analyzed by using Western blot. RESULTS: Cell viability of hDPCs decreased more in treated groups than in the control group from days 1 to 7. The relative number of apoptotic cells and the expression of activated caspase-3 and cleaved caspase-9 were much higher in groups exposed to 20 and 50 µmol/L H2O2. CONCLUSIONS: These results imply that low concentrations of H2O2 are cytotoxic to hDPCs and induce apoptosis in hDPCs in a caspase-9-dependent way.

[The influence of zi-hua burn cream on the survival of random skin flaps in rats].

OBJECTIVE: To observe the effect of zi-hua burn cream on the survival of skin flaps in rats, and its mechanisms. METHODS: 72 Wistar rats, were randomly divided into four groups as zi-hua group(n = 18, external application of alfalfa burn cream), control group (n = 18, external application of heparin sodium cream), model group (n = 18, external application of vaseline) , negative control (n = 18, no operation). 8 cm x 2 cm random skin flaps with pedicle on the side of head were designed on the back of Wistar rats. The drug was applied on the flap surface, 2 times a day. The survival of skin flaps was observed. The change of serum superoxide dismutase (SOD), malondialdehyde (MDA), nitric oxide (NO), turner necrosis factor-alpha(TNF-alpha)and interleukin-6(IL-6)were compared at 1,2,3,7 d after operation, and histologic examination was performed. RESULTS: The survival rate of zi-hua group (73.58 - 10. 74)% was significantly higher than that of model group (33.40 - 16.05) %, showing a statistical difference (Q = 10.63, P <0.01). There was no significant difference between the zi-hua group and control group (71.65 +/- 11. 92) %. The level of serum SOD, NO in zi-hua group and control group was higher than that in model group, while the level of serum MDA, TNF-alpha and IL-6 was lower than that in model group(P <0.01). On 7 day after operation, skin flaps tissue edema,necrosis and inflammatory cell infiltration in zi-hua group and control group was less obvious than that in model group. There was significant proliferation of granuloma and fibroblast and formation of neonatal capillary in zi-hua group and control group. The vascular density in zi-hua group was obviously higher than that in the model group and control group(P <0. 01). CONCLUSIONS: Zi-hua burn cream could significantly improve the blood supply of skin flaps, increase the survival rate of skin flaps in rats. Its mechanism may be associated with the anti-free-radical-damage action, improve local microcirculation, improve the NO content, reduce the TNF-alpha and IL-6 level, reduce inflammation factor release, improve oxidative stress state, and reduce inflammation reaction.

A novel COL7A1 gene mutation causing pretibial epidermolysis bullosa: report of a Chinese family with intra-familial phenotypical diversity.

Pretibial epidermolysis bullosa (PEB) is an extremely rare subtype of dominant dystrophic epidermolysis bullosa (DDEB) caused by mutation of the COL7A1 gene. More than 730 mutations have been identified in patients with DDEB, but only five mutations have been found to be related to PEB. In this study, a novel heterozygous nucleotide G>T transition at position 6101 in exon 73 of COL7A1 was detected, which resulted in a glycine to valine substitution (G2034V) in the triple-helical domain of type-VII collagen. This is the first report to show that one mutation caused a broad range of severity of disease in one family with PEB. These data suggest that c.6101G>T may influence the phenotype of PEB. They also contribute to the expanding database on COL7A1 mutations.

[Detection of reactive oxygen species of human dental pulp cells by flow cytometry].

PURPOSE: To establish a method for detection of reactive oxygen species(ROS) of human dental pulp cells(HDPCs) by flow cytometry. METHODS: HDPCs were obtained using tissue explant technique in vitro. The subcultured cells were exposed to peroxide oxygen(H2O2) of different concentrations from 50 µmol/L to 400 µmol/L for 30 minutes, then incubated with two different concentrations of 2',7'-dichlorofluorescein diacetate (DCFH-DA), which were 10 µmol/L and 20 µmol/L for 20 minutes at 37 degrees centigrade in dark. The fluorescence intensities of intracellular dichlorofluorescein(DCF) were detected by flow cytometry. Statistical analysis was carried out by SPSS 13.0 software software. RESULTS: The positive rate varied with different concentrations of detectors. The fluorescence intensities remained insignificant difference among samples incubated with the same concentration of detector and H(2)O(2),and increased by rising of the incubating concentration of H(2)O(2). CONCLUSIONS: The detector with concentration of 20 µmol/L shows higher detector loading rate(positive rate). The intracellular ROS level changes as the H(2)O(2) treatment concentration rising from 50 to 400 µmol/L. The application of flow cytometry to measure the ROS in HDPCs is simple, reliable and stable.

Isolation and identification of CXCR4-positive cells from human dental pulp cells.

INTRODUCTION: In previous studies, we found expression of stromal cell-derived factor-1α (SDF-1α)/CXC chemokine receptor 4 (CXCR4) in human dental pulp and the SDF-1α-CXCR4 axis might play a role in the recruitment of CXCR4-positive dental pulp cells (CXCR4(+) DPCs) toward the damaged sites. However, the specific function of CXCR4(+) DPCs in the injured dental pulp was still unknown. The purpose of this study was to isolate CXCR4(+) DPCs from dental pulp cells in vitro to pave the way for further study of their characteristics. METHODS: CXCR4(+) DPCs were isolated with magnetic-activated cell sorting (MACS). Freshly isolated CXCR4(+) DPCs were identified by immunohistochemistry with light microscopy or confocal microscopy. Then the phenotypes CXCR4, stromal cell surface marker-1 (STRO-1), CD146, and CD34 in 3 groups (ie, CXCR4(+) DPCs, CXCR4(-) DPCs, or non-sorted DPCs) were analyzed by flow cytometry after they were cultured and expanded in vitro. RESULTS: The results indicated the isolated subpopulation of DPCs was enriched with CXCR4(+) DPCs, and the positive rates of STRO-1 and CD146 in CXCR4(+) DPCs group were higher than CXCR4(-) DPCs or non-sorted DPCs groups (P < .05). There was no expression of CD34 in each group. CONCLUSIONS: We can isolate CXCR4(+) DPCs from DPCs with MACS and identify them by immunohistochemistry and flow cytometry.

Proliferation and multilineage potential of CXCR4-positive human dental pulp cells in vitro.

INTRODUCTION: Although the results of our previous studies showed that the stromal cell-derived factor (SDF)-1α-CXC chemokine receptor 4 (CXCR4) axis may play a role in the recruitment of CXCR4-positive dental pulp cells (CXCR4(+) DPCs) toward the damaged sites, the specific function of CXCR4(+) DPCs in the injured dental pulp was still unknown. The purpose of this study was to verify whether CXCR4(+) DPCs possessed stem cells properties so that we can understand their role in area of injury. METHODS: CXCR4(+) DPCs were isolated from normal DPCs with magnetic-activated cell sorting. The characteristics of the cells from the 3 groups of cells (ie, CXCR4(+) DPCs, CXCR4(-) DPCs, or nonsorted DPCs) were analyzed in colony formation, proliferation, and multilineage differentiation including odontogenic and adipogenic lineages. RESULTS: The results showed that CXCR4(+) DPCs were the most dominant population in colony formation, proliferation, alkaline phosphatase activity, calcium content, and adipogenic differentiation among the 3 groups. CONCLUSIONS: CXCR4(+) DPCs may contain more stem cells than nonsorted DPCs.

[Analysis of Down syndrome screening by maternal serum detection in mid-pregnancy].

OBJECTIVE: To study the clinical value of screening chromosomal diseases and abnormal pregnancy by maternal serum examination in mid-pregnancy. METHODS: Maternal serum AFP and F-beta hCG were detected in the mid-pregnancy (16-20 weeks) using commercially available detection kits, and the risk of Down syndrome was calculated taking into account of such factors as the maternal age, gestational age, and body weight. Those at high risk underwent amino fluid or cordocentesis for fetal karyotpying. The pregnant women were divided into >or=35 years and <35 years groups, and high and low risk for Down syndrome groups for test results and pregnancy outcome analysis. RESULTS: Of the 6000 pregnant women undergoing antenatal screening, 552 were identified to be at high risk of Down syndrome (9.2%) with one missing case of detection, and 463 of the high-risk cases underwent amino fluid or cordocentesis examination. Twenty-seven cases were found to have abnormal chromosomes, and abortion was suggested in 14 cases but not in the other 13 cases where other chromosomal abnormalities such as polymorphic mutations were found. The screening positive rate in >or=35 years and <35 years group was 95.5% and 8.2% (P<0.0001), with fetal chromosomal abnormality rate of 4.5% and 2.9%, respectively (P>0.5). The rate of abnormal pregnant outcomes for high and low risk groups was 5.6% and 0.05% (P<0.0001), with pregnancy complication rate of 11.8% and 3.7% (P<0.0001) and fetal chromosomal polymorphic mutation rate of 2.8% and 1.1% (P>0.5), respectively. CONCLUSION: Maternal serum AFP and F-beta hCG levels in second trimester have important values in predicting fetal chromosomal diseases, and their detection may help reduce the birth defect rate and prevent abnormal pregnancy outcomes and complications.