Effect of Human Bone Marrow Mesenchymal Stem Cells with Ectopic High OCT4 Expression on T Lymphocyte Function / 中国实验血液学杂志

OBJECTIVE@#To explore the effect of human bone marrow mesenchymal stem cells (MSCs) with ectopic high OCT4 expression on T-cell proliferation, activation and secretion in vitro.@*METHODS@#Peripheral blood mononuclear cells were isolated from healthy children. Anti-CD3 and anti-CD28 monoclonal antibodies were used to activate T lymphocytes, which were stimulated by interleukin (IL)-2 for one week in vitro. Then MSCs with ectopic high OCT4 expression (MSC-OCT4) were co-cultured with activated T lymphocytes. After one week of co-culture, the supernatant was collected and the levels of Th1/Th2 cytokines [IL-2, IL-4, IL-6, IL-10, tumor necrosis factor (TNF)-α and interferon (IFN)-γ] were determined by flow cytometry. The lymphocytes after one week of co-culture were collected and counted by Countstar software. After the proportions of activated/inactivated T cell subsets were determined by flow cytometry, the absolute lymphocyte counts were calculated and expressed as mean ± standard deviation.@*RESULTS@#Compared with control T cell alone culture group, the proliferation of CD3+ T cells, CD3+CD4+ T cells, and CD3+CD8+ T cells were significantly inhibited in MSC group and MSC-OCT4 group. Compared with MSC, MSC-OCT4 could inhibit CD3+CD8+ T cell proliferation better (P =0.049), and mainly inhibited early T cell activation. Compared with control T cell alone culture group, the levels of IL-2 and INF-γ were significantly down-regulated both in MSC group and MSC-OCT4 group.After co-culture with T cells for one week, the level of IL-6 significantly increased in MSC group and MSC-OCT4 group compared with that before co-culture. Compared with control MSC group, MSC-OCT4 group had higher viable cell numbers after 1 week of co-culture (P =0.019), and could resist the inhibition of proliferation by higher concentration of mitomycin C.@*CONCLUSION@#Both MSC and MSC-OCT4 can inhibit the proliferation and activation of IL-2-stimulated T cells in vitro. After overexpression of OCT4, MSC has better proliferation ability in vitro and can inhibit the proliferation of CD3+CD8+ T cells more effectively, which may have a better and more lasting immunosuppressive ability to regulate the balance of Th1/Th2.

Finite element analysis on stress concentration improvement in patellofemoral joint by releasing lateral patellar retinaculum with stiletto needle based on the theory of Jinshugu() / 中国骨伤

OBJECTIVE@#To study mechanism of improvement of stress concentration on patellofemoral joint by stiletto needle releasing lateral patellar retinaculum guided by the theory of Jinshugu() and based on the finite element model of knee joint. and to elucidate the biomechanical mechanism of stiletto needle releasing changing patellar trajectory and reducing patellofemoral joint pressure.@*METHODS@#CT data of knee joint from a normal male (aged 29, heighted 171 cm, weighted 58 kg) was selected. Starting with construction of three-dimensional model of knee joint by using finite element software, the finite element model of knee joint with complete tendonand bone structures were established through several steps, such as geometric reconstruction, reverse engineering, meshing, material assignment and loading analysis. The loading condition was set as 500 N load on knee joint, and the average tensile stress of quadriceps femoris tendon was about 200 N. To simulate the release of lateral patellar retinaculum by stiletto needle at 30 and 90 position of knee flexion in finite element model separately, and to compare the improvement of stress concentration of patellofemoral joint by stiletto needle intervention under different knee flexion conditions.@*RESULTS@#The peak stress of patellofemoral joint and tibiofemoral joint decreased after stiletto needle releasing of patellofemoral lateral retinaculum compared with before intervention, which was(1) knee flexion at 30 degrees:patellar cartilage decreased by 0.498 MPa (decreased 9.06%), femoral trochlea decreased by 0.886 MPa(decreased 16.27%);(2) knee flexion at 90 degrees:patellar cartilage decreased by 0.558 MPa (decreased 8.6%), femoral trochlea decreasedby 0.607 MPa (decreased 9.94%).@*CONCLUSION@#Releasing lateral patellofemoral retinaculum with stiletto needle could effectively alleviate the stress concentration of patellofemoral joint and reduce local stress peak value, which it is helpful to improve patellar trajectory and make stress distribution more uniform.

Impact of metabolic syndrome on short-term outcome of carotid revascularization: a large sample size study in Chinese population / 中华医学杂志(英文版)

BACKGROUND@#Metabolic syndrome (MetS) is relatively common worldwide and an important risk factor for cardiovascular diseases. It is closely linked to arterial stiffness of the carotid artery. However, the association of MetS with the safety of carotid revascularization has been rarely studied. The aim of this study was to observe the current status of MetS and its components in Chinese carotid revascularized patients, and investigate the impact on major adverse clinical events (MACEs) after carotid endarterectomy (CEA) or carotid artery stenting (CAS).@*METHODS@#From January 2013 to December 2017, patients undergoing CEA or CAS in the Neurosurgery Department of Xuanwu Hospital were retrospectively recruited. The changes in prevalence of MetS and each component with time were investigated. The primary outcome was 30-day post-operative MACEs. Univariable and multivariable analyses were performed to identify the impact of MetS on CEA or CAS.@*RESULTS@#A total of 2068 patients who underwent CEA (766 cases) or CAS (1302 cases) were included. The rate of MetS was 17.9%; the prevalence rate of MetS increased with time. The occurrence rate of MACEs in CEA was 3.4% (26 cases) and in CAS, 3.1% (40 cases). There was no statistical difference between the two groups (3.4% vs. 3.1%, P = 0.600). For CEA patients, univariate analysis showed that the MACE (+) group had increased diabetes history (53.8% vs. 30.9%, P = 0.014) and MetS (34.6% vs. 15.8%, P = 0.023). For CAS patients, univariate analysis showed that the MACE (+) group had increased coronary artery disease history (40.0% vs. 21.6%, P = 0.006) and internal carotid artery tortuosity (67.5%% vs. 37.6%, P < 0.001). Furthermore, the MACE (+) group had higher systolic blood pressure (143.38 ± 22.74 vs. 135.42 ± 17.17 mmHg, P = 0.004). Multivariable analysis showed that the influencing factors for MACEs in CEA included history of diabetes (odds ratio [OR] = 2.345; 95% confidence interval [CI] = 1.057-5.205; P = 0.036) and MetS (OR = 2.476; 95% CI = 1.065-5.757; P = 0.035). The influencing factors for MACEs in CAS included systolic blood pressure (OR = 1.023; 95% CI = 1.005-1.040; P = 0.010), coronary artery disease (OR = 2.382; 95% CI = 1.237-4.587; P = 0.009) and internal carotid artery tortuosity (OR = 3.221; 95% CI = 1.637-6.337; P = 0.001).@*CONCLUSIONS@#The prevalence rate of MetS increased with time in carotid revascularized patients. MetS is a risk for short-term MACEs after CEA, but not CAS.

Construction and simulation mechanical analysis of dynamic knee joint finite element model based on CT image / 中国骨伤

OBJECTIVE@#To construct a dynamic knee joint finite element model based on CT image data and verify the validity of the model. To provide a simulation model and basic data for biomechanical research of the knee joint by further finite element analysis.@*METHODS@#The CT data of a healthy male knee joint was selected. With the help of Mimics 19.0 and Hypermesh 12.0 software, a high simulation finite element model of knee joint was established following steps, including geometric reconstruction, reverse engineering, meshing and material characterization. The dynamic knee flexion model was generated by determining the boundary conditions and torque loading, and the validity of themodel was confirmed. The biomechanical changes of the tibiofemoral and patellofemoral joints under different knee flexion angles were analyzed by applying the loads (500 N) to the finite element model during knee flexion.@*RESULTS@#A finite element model of knee joint was established based on CT images and anatomical characteristics. The model included three-dimensional elements such as bone, ligament, cartilage, meniscus and patellar retinaculum. The different finite element models of knee flexion states were produced by applying different torques after establishing boundary conditions. According to equivalent conditions (knee flexion 30 degrees, quadriceps tendon under 200 N stretch), the peak stress value of patella was 2.209 MPa and the average Mises stress was 1.132 MPa; the peak stress value of femoral trochlear was 1.405 MPa and the average Mises stress was 0.936 MPa. The validity of the model was proved by the difference between the model and previous studies of 1% to 13.5%. Dynamic model loading showed that the Mises stressof tibiofemoral joint decreased with the increase of knee flexion angle, while the Mises stress of patellofemoral joint was positively correlated with knee flexion angle. The Mises stress of cartilage stress planes at different knee flexion angles was significantly different(<0.05).@*CONCLUSION@#The finite element model established in this study is more comprehensive and can effectively simulate the biomechanical characteristics of dynamic knee joint, which provides support for further simulation mechanics researches of the knee joint.

Independent external verification of the nomograms for predicting lymph node metastasis in penile cancer / 中华男科学杂志

<p><b>Objective</b>To evaluate the two newly established nomograms for predicting lymph node metastasis in penile cancer based on the clinical data on a large cohort of patients.</p><p><b>METHODS</b>We retrospectively studied the clinical data on 93 patients with penile cancer treated in the Center for Tumor Prevention and Treatment. Using the two recently established nomograms (Bhagat nomogram and Zhu nomogram), we predicted lymph node metastasis in the patients, analyzed the differences between prediction and the results of postoperative pathology, and compared the accuracy of prediction between the two nomograms with the receiver operating characteristic (ROC) curve and the area under the curve (AUC).</p><p><b>RESULTS</b>The median age of the patients was 55 (27－82) years. Positive lymph nodes were found in 31 cases (33.3%) postoperatively and in 9 (21.9%) of the 41 clinically negative cases. The AUC of the Bhagat nomogram was 0.739 and that of Zhu nomogram was 0.808, both of which were similar to the prediction accuracy of internal verification and manifested a medium predictive ability.</p><p><b>CONCLUSIONS</b>The newly established Bhagat and Zhu nomograms can be used for predicting lymph node metastasis in penile cancer, but with a low precision, and therefore cannot be relied exclusively for the option of inguinal lymphadenectomy.</p>

Investigation of disease spectrum in the PICU of Shengjing Hospital of China Medical University between 2005 and 2012 / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To summarize the spectrum of disease and common diseases that cause death in children admitted to the Pediatric Intensive Care Unit (PICU), Shengjing Hospital of China Medical University between 2005 and 2012.</p><p><b>METHODS</b>A retrospective analysis was carried out on the clinical data of 4484 children admitted to the PICU of Shengjing Hospital between 2005 and 2012.</p><p><b>RESULTS</b>Acute bronchopneumonia, which was found in 1099 (24.51%) of the 4484 cases, was the most common disease in the PICU between 2005 and 2012. The incidence of intracranial infection, sepsis, hand-foot-mouth disease and trauma showed an increasing trend from 2005 to 2012, but that of non-traumatic intracranial hemorrhage, epilepsy and congenital heart disease showed a decreasing trend. The mortality decreased from 11.5% in 2005 to 3.1% in 2012, and the overall mortality was significantly higher in 2005-2008 than in 2009-2012 (11.98% vs 4.41%; P<0.01). The main causes of death included severe acute bronchial pneumonia, severe sepsis, complex congenital heart disease, severe cerebral trauma, respiratory failure, severe hand-foot-mouth disease, acute poisoning and circulatory failure.</p><p><b>CONCLUSIONS</b>Acute bronchopneumonia was the most common disease in the PICU of Shengjing Hospital between 2005 and 2012, but the spectrum of disease changed over time. The mortality showed a decreasing trend among the children in the PICU between 2005 and 2012, and the main causes of death included severe acute bronchial pneumonia and severe sepsis.</p>

Thirty-day outcome of carotid artery stenting in Chinese patients: a single-center experience / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Carotid artery stenting (CAS) as a competing treatment modality has had to adhere to limits to gain widespread acceptance in some studies. This study analyzed the clinical data of 1700 consecutive patients after CAS to retrospectively evaluate the 30-day outcome of CAS for internal carotid artery stenosis in a Chinese population.</p><p><b>METHODS</b>Medical records of 1700 patients who underwent CAS at Xuanwu Hospital affiliated to Capital Medical University between January 2001 and August 2012 were reviewed. Postoperative 30-day complication rates were analyzed and compared with those of other studies. Univariate and multivariate Logistic regression analyses were used to identify factors associated with perioperation myocardial infarction (MI), stroke, and death.</p><p><b>RESULTS</b>The overall 30-day rate of MI, stroke, and death after CAS was 2.53%. In univariate analysis, patients who were symptomatic, had a neurological deficit (modified Rankin score (mRS) ≥3; P = 0.001), and who were not taking statins experienced a significantly increased rate of MI, stroke, and death (P = 0.017). In multivariate Logistic regression analysis, the presence of symptoms (odds ratio (OR) = 2.485; 95% confidence interval (CI) = 1.267-4.876; P = 0.008) and a neurological deficit (mRS ≥3) (OR = 3.025; 95% CI = 1.353-6.763; P = 0.007) were independent risk factors for perioperative MI, stroke, and death.</p><p><b>CONCLUSIONS</b>According to this single-center experience, CAS may effectively prevent and treat carotid artery stenosis that would otherwise lead to stroke. Being symptomatic and having a neurological deficit (mRS ≥3) increased the risk of perioperative MI, stroke, and death.</p>

Objective evaluation of otolithic end organs in sudden sensorineural hearing loss patients / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To observe the function of the otolithic end organs and their input pathways in sudden sensorineural hearing loss (SSHL) patients.</p><p><b>METHODS</b>Forty cases of unilateral SSHL were enrolled as the observing group from May, 2011 to May, 2012. Thirty age- and gender-matched normal subjects were recruited as the control group. Both patients and normal subjects underwent conventional air-conducted ocular vestibular evoked myogenic potential (oVEMP) and cervical vestibular evoked myogenic potential (cVEMP) in bilateral ears. The results were compared between the affected ears, the contralateral ears and the normal controls.</p><p><b>RESULTS</b>Overall, oVEMP was elicited in 16 affected ears (40.0%), 23 contralateral ears (57.5%) and 43 normal ears (71.7%). cVEMP could be elicited in 25 affected ears (62.5%), 30 contralateral ears (75.0%) and 49 normal ears (81.7%) respectively. Significant statistical significance could be found in the oVEMP response rate between the affected ears and the normal ears (χ(2) = 9.949, P = 0.002) and in the cVEMP response rate between the affected ears and the normal ears (χ(2) = 4.582, P = 0.032). Significant statistical difference could not be found in all oVEMP and cVEMP parameters (threshold, N1 latency, P1 latency, latency interval and amplitude) among groups (P > 0.05).</p><p><b>CONCLUSIONS</b>The otolithic vestibular end organs and their input pathways could be damaged in SSHL patients. Such damages could be monitored objectively by cVEMP and oVEMP examinations.</p>

Characteristics of the air-conducted ocular evoked myogenic potential in the young normal Chinese subjects / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To identify the characteristics of the air-conducted ocular vestibular-evoked myogenic potential (oVEMP) in the young normal Chinese subjects.</p><p><b>METHODS</b>Twenty five normal subjects were recruited for conventional examinations of oVEMP. The subjects were 19 - 45 years of age [(24.3 ± 5.6) years], 12 males and 13 females. 500 Hz air-conducted tone burst was employed for examination. The threshold of oVEMP in each ear was examined; patterns of these waves were observed and the normal ranges of the oVEMP waves responded to 100 dBnHL were calculated.</p><p><b>RESULTS</b>All subjects were elicited with normal oVEMP N1-P1 waves in both ears. The response rate in these subjects was 100%. The threshold of oVEMP examination was (86.6 ± 3.6) dBnHL (x(-) ± s), latency N1 (10.1 ± 0.4) ms, latency P1 (14.7 ± 1.2) ms, interval N1-P1 (4.5 ± 1.0) ms, amplitude (7.9 ± 4.4) µV.</p><p><b>CONCLUSIONS</b>Air-conducted oVEMP is a kind of vestibular-ocular reflex respond to intensive sound generated by otolithic vestibular end organs. It is stable in the young normal subjects with minor variabilities.</p>

Extracranial-intracranial vascular bypass graft for chronic ischemic cerebrovascular disease: A follow-up study / 中国脑血管病杂志

Objective: To investigate the effect of extracranial-intracranial vascular bypass graft on stroke prevention in patients with chronic ischemic cerebrovascular disease. Methods: The clinical data of 217 patients with chronic ischemic cerebrovascular disease whom underwent extracranial-intracranial bypass graft in Xuan Wu Hospital, the Capital Medical University from October 2000 to October 2009 were analyzed retrospectively. The angiographic data after the procedure, clinical symptoms, and xenon CT detecting the improvement of cerebral blood flow were followed-up. Results: Circled digit oneThe mean age of 217 patients was 42±13 years (86 females [39.6%], 131 males [60.4%]). All patients had ischemic symptoms six months before the procedure, including transient ischemic attack (117,53.9%), reversible ischemic neurological deficit (37,17.1%), and complete stroke (63,29.0%). All patients received hemodynamic evaluation before the procedure. It showed regional cerebral blood flow reduction in the affected vascular territory. Circled digit twoPreoperative angiography showed that there were 62 patients (28.6%) with moyamoya disease, 72(33.2%) with unilateral carotid artery occlusion, 57(26.3%) with unilateral middle cerebral artery occlusion, and 26 (12.0%) with carotid or middle cerebral artery severe stenosis which was difficult to be treated by intervention. Circled digit threeOf the 388 anastomoses, 380 was patent. The patency rate was 98.0%. After the procedure, 9 patients(4.1%) patients had intracranial hematoma, 1 (0.5%) died of intracranial hematoma caused cerebral hernia. Circled digit fourOf the 217 patients, 10(4.6%) were lost to follow-up. The mean follow-up period was 38±18 months in 172 patients. One year after the procedure, the clinical symptoms in 81 patients disappeared completely after the procedure. Circled digit fiveA total of 50 patients performed xenon CT for quantitative measurement of brain blood flow one month after the procedure. It showed that the regional cerebral blood flow was improved more significantly than that before the procedure (t = 3.312, P < 0.05). Conclusion: By the medium- and long-term clinical follow-up study for patients with chronic hemodynamic ischemic cerebrovascular disease after extracranial-intracranial bypass graft, it showed that the extracranial-intracranial bypass graft has better efficacy for patients with chronic ischemic cerebrovascular disease.

Investigation of drinking water fluoride and fluorosis in Shaanxi Province from 2005 to 2007 / 中国地方病学杂志

Objectives To investigate fluoride in drinking waters and fluorosis status and evaluate the effectiveness of fluoride-reducing projects in Shaanxi Province from 2005 to 2007. Methods In the Shaanxi province-wide, the 10 endemic areas of fluorosis were chosen according to historical data as focusing areas for investigation. The village was considered as investigation spot, 5 water samples were collected from each village for investigating of fluoride content. Four water samples were collected from each fluoride-reducing project for evaluating its effectiveness. Fluoride concentrations in drinking water were measured by fluoride-selective electrode method or speetrophotometry. When fluoride content in drinking water was greater than 1.00 mg/L, the epidemical study wasd conducted to investigate fluorosis patients, focusing on investigating of dental fluorosis prevalence in 8 to 12-year-old children and skeletal fluorosis prevalence in adults. Dental fluorosis of children was diagnosed by using Dean's method, and adult skeletal fluorosis was diagnosed according to National Standard for Clinical Diagnosis of Endemic Skeletal Fiuorosis(GB 16396-1996). Results The fluoride content in drinking water from 6390 villages was measured. The fluoride content of drinking water of 2619 villages ranged from 1.0 to<2.0 mg/L, where 1 654 998 people exposed. Additionally, the fluoride content of water of 845 villages ranged from 2.0 to<4.0 mg/L, where 355 623 people exposed. Moreover, the fluoride contents of water of 272 villages exceeded 4.0 mg/L, where 111 466 people exposed. The median of fluoride content in drinking water was 1.15% in the whole province, and fluoride content in drinking water exceeded 1.00 mg/L in Weinan, Xianyang and Yulin where were concentrated distribution areas of high fluoride water. Among 3115 fluoride-reducing projects, the fluoride content of drinking water of 1269 projects ranged from 1.0 to<2.0 mg/L, where 1 415 877 people exposed. Additionally, the fluoride content of drinking water of 120 projects ranged from 2.0 to<4.0 mg/L, where 43 888 people exposed. Moreover, the fluoride content of drinking water of 14 projects exceeded 4.0 mg/L, where 5960 people exposed. The detectable rate of dental fluorosis of 8 to 12 year-old children and skeletal fluorosis of adults reached 37.4%(16 489/44 081) and 5.1%(15 877/310 993), respectively. Conclusions The widely distribution of high-fluoride in drinking water still contributes to the prevalence of fluorosis in Shaanxi Province. The quality of fluoride-reducing projects should be further improved.

Establishment of murine cell line transfected with human CD14 gene / 中国实验血液学杂志

This study was aimed to construct the CD14 eukaryotic expression vector, establish the transgeneic CD14 positive cell line in order to facilitate the establishment of a mouse model of antibody targeting therapy for human acute monocytic leukemia (AML-M(5)). Total RNA extracted from peripheral blood mononuclear cells was treated with RNAase-free DNAase, the human CD14 gene was cloned and sequenced through the RT-PCR and T-A clone techniques. Eukaryotic expressional vector pcDNA3.1(+)/CD14 was constructed by cleaving with double restriction endonuleases and ligating with T4 ligase. A murine melanoma cell line B16 was transfected with the pcDNA3.1(+)/CD14 recombinant with Superfect transfection reagent. Positive clones were selected by G418 and the expression of human CD14 on the transfectant was confirmed by flow cytometry (FCM). The results indicated that the sequence of the human CD14 cDNA cloned was exact to be same as the one from GenBank database. The recombinant pcDNA3.1(+)/CD14 was identified with double-enzyme cleaving. The expression of the human CD14 on the transfectant (B16/CD14) was confirmed by FCM. In conclusion, the murine cell line B16/CD14 fransfected with human CD14 gene has been established which can be used for the study of human AML-M(5) antibody targeting therapy with mouse model.

A Chinese genetic prion disease:clinical,pathological manifestation and prion protein gene mutation analysis / 中华神经科杂志

Objective To report a large family with an autosomal dominant dementia associated with mutation in the prion protein gene(PRNP)and the detailed clinical,neuroimaging and pathological manifestations.Methods Two patients from a large family of dementia were admitted to our ward and the data of their medical history,physical examination,video electroenceplialogram,neuroimaging were colleted.A sterotactic biopsy of the right frontal lobe of the proband was done.After the informed consent from the family members obtained,the genomic DNA was extracted from peripheral blood leucocytes of 5 persons followed by in,vitro amplification using polymerase chain reaction(PCR).The PCR products were directly sequenced by Sanger method.PRNP gene sequence was also examined in 150 normal Chinese to exclude single nueleotide polymorphism.Results A missense mutation of PRNP gene in 5 farnily members was detected,resulting in Gll4V mutation in the prion protein,with M/M genotype of eodon 129.This mutation was not detected in 150 normal Chinese.The proband was diagnosed as inherited prion disease by her clinical features,including neuropsychiatrie disturbances and progressive dementia,and manifestations of neuroimaging,EEG,neuropathology and PRNP gene mutation.Conclusion The first autosomal dominant pedigree of family prion disease is found in China with G114V mutation in PRNP gene which may lead to the prion disease directly.