Study of the effects of long-term outcomes of autologous peripheral blood stem cell reinfusion in patients with decompensated cirrhosis / 中华肝脏病杂志

Objective: Autologous peripheral blood stem cells (PBSC) derived from bone marrow can promote liver regeneration and improve the liver function of patients, but there are few studies on its effect on the long-term outcomes in patients with decompensated cirrhosis. Based on previous work, this study observed the clinical outcomes of PBSC treatment in patients with decompensated cirrhosis for 10 years, in order to provide more data support for the safety and efficacy of stem cells in clinical applications. Methods: Data of patients with decompensated liver cirrhosis who completed PBSC treatment in the Department of Gastroenterology of the First Affiliated Hospital of Air Force Military Medical University from August 2005 to February 2012 were included. The follow-up endpoint was death or liver transplantation, and patients who did not reach the follow-up endpoint were followed-up for at least 10 years. The patients with decompensated liver cirrhosis who met the conditions for PBSC treatment but did not receive PBSC treatment in our hospital during the same period were used as controls. Results: A total of 287 cases with decompensated liver cirrhosis had completed PBSC treatment, and 90 cases were lost to follow-up within 10 years after surgery. A total of 151 cases with complete survival follow-up data were included in the control group. There were no statistically significant differences in baseline information such as gender, age, etiological composition and liver function score between the two groups. The 10-year survival rate was higher in PBSC than control group (37.56% vs. 26.49%, P<0.05). Cholinesterase, albumin, international normalized ratio, Child-Turcotte-Pugh score, model for end-stage liver disease score, and other indicators were gradually recovered within 3 months to 1 year after PBSC treatment, and stabilized at a more desirable level in the long-term after follow-up for up to 10 years. There was no statistically significant difference in the incidence of liver cancer between the two groups (25.22% vs.31.85%, P=0.267). The age of onset of hepatocellular carcinoma was later in PBSC than control group [(56.66±7.21) years vs. (52.69±8.42) years, P<0.05]. Conclusions: This long-term observational follow-up study of more than ten years confirms that PBSC treatment can bring long-term benefits to patients with decompensated cirrhosis, with good long-term safety, thus providing more data support on the safety and efficacy of stem cells for clinical applications.

A Summary and Reflection upon LI Li-yun's Treatment Experience in Infertility Caused by Uterine Factors / 中国中医药信息杂志

This article discussed Professor LI Li-yun's treatment experience in infertility caused by uterine factors from etiology, pathogenesis, treatment and prescription. Professor LI believes that a wide variety of pathogenic factors can lead to infertility caused by uterine factors, including cold, heat, deficiency and excess. According to this, the pathogenic factors should be distinguished and treatment should be conducted based on syndrome differentiation. Medical cases were studied to further explore Professor LI's clinical thoughts.

Expression and significance of mTOR/4EBP1/HIF-1α/VEGF signaling pathway in lung tissues of asthmatic mice / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the expression and significance of the mammalian target of rapamycin (mTOR)/eukaryote initiating factor 4E binding protein 1(4EBP1)/hypoxia inducible factor-1α (HIF-1α)/vascular endothelial growth factor (VEGF) signaling pathway in asthmatic mice.</p><p><b>METHODS</b>Forty SPF level 6-8 week-old female Balb/C mice were randomly divided into control, asthma, budesonide and mTOR inhibitor (rapamycin) intervention groups (n=10 each). The asthmatic mouse model was prepared via OVA induction and challenge test. The intervention groups were administered with rapamycin at the dosage of 3 mg/kg by an intraperitoneal injection or budesonide suspension at the dosage of l mg by aerosol inhalation respectively 30 minutes before the OVA challenge. The control and asthma groups were treated with normal saline instead. The concentrations of HIF-1α and VEGF in bronchoalveolar lavage fluid (BALF) were examined using ELISA 24 hours after the last challenge. The pathological changes of lung tissue were observed by hematoxylin-eosin (HE) staining. The p-mTOR and p-4EBP1 from the lung tissues were detected by immunohistochemistry and Western blot. Pearson analysis was used to study the correlation between p-mTOR, p-4EBP1, HIF-1α, and VEGF expression.</p><p><b>RESULTS</b>Compared with the control group, inflammatory cell infiltration and secretions in the trachea increased in the asthma group. The levels of HIF-1α and VEGF in BALF and p-mTOR and p-4EBP1 expression in lung tissues also increased (P<0.01). Compared with the asthma group, inflammatory cell infiltration and secretions in the trachea were reduced in the two intervention groups, and the levels of HIF-1α and VEGF in BALF and p-mTOR and p-4EBP1 expression in lung tissues were also reduced (P<0.01). There were no significant differences in the above changes between the two intervention groups and control group (P>0.05). In the asthma group, there was a pairwise positive correlation between lung p-mTOR and p-4EBP1 expression and HIF-1α and VEGF levels in BALF (P<0.05). However, there were no correlations in the above indexes in the intervention groups and control group.</p><p><b>CONCLUSIONS</b>p-mTOR, p-4EBP1, HIF-1α and VEGF together are involved in the pathogenesis of asthma. Rapamycin treatment can block this signaling pathway, suggesting that this pathway can be used as a novel target for asthma treatment.</p>

Changes in lymphocyte subsets in infants with common lower respiratory tract infectious diseases / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the changes and clinical significance of lymphocyte subsets in infants with bronchitis, bronchopneumonia, and bronchiolitis.</p><p><b>METHODS</b>A total of 111 children with bronchitis, 418 children with bronchopneumonia, and 83 children with bronchiolitis were enrolled as disease groups, and 235 healthy children were enrolled as control group. Flow cytometry was applied to measure lymphocyte subsets.</p><p><b>RESULTS</b>The bronchitis group had significantly lower numbers of T cells and CD3+CD8+ T cells than the control group (P<0.05). The bronchopneumonia group had significantly lower numbers of T cells and CD3+CD8+ T cells, a significantly higher number of T helper (Th) cells, and a significantly higher CD4/CD8 ratio than the control group, as well as a significantly higher number of Th cells than the bronchitis group. Compared with the children with mild bronchopneumonia, those with severe bronchopneumonia showed a reduction in T cells and an increase in B cells (P<0.05). The bronchiolitis group had a significantly higher number of Th cells, a significantly higher CD4/CD8 ratio, and a significantly lower number of CD3+CD8+ T cells than the control group (P<0.01). The disease groups showed a significantly higher number of B cells and a significantly lower number of natural killer cells than the control group (P<0.05).</p><p><b>CONCLUSIONS</b>A low, disturbed cellular immune function and a high humoral immune function are involved in the development and progression of lower respiratory tract infectious diseases. The changes in immune function are related to the type and severity of diseases.</p>

Levels of myeloid-derived suppressor cells in peripheral blood of infants with recurrent wheezing / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study myeloid-derived suppressor cells (MDSC) levels in peripheral blood of infants with recurrent wheezing, and the role of MDSC in the development of recurrent wheezing.</p><p><b>METHODS</b>Thirty-one infants with recurrent wheezing at wheezing attacks were randomly enrolled in the study. Twenty-seven infants with bronchopneumonia and 27 preoperative infants (hernia or renal calculus), without infectious or neoplastic diseases, were selected as controls. The proportion of MDSC in peripheral blood mononuclear cells (PBMC) was measured by flow cytometry.</p><p><b>RESULTS</b>The proportion of MDSC in PBMC in infants with wheezing was significantly higher than in those with bronchopneumonia and preoperative infants (P<0.05).</p><p><b>CONCLUSIONS</b>MDSC levels increase in infants with recurrent wheezing, suggesting that MDSC may play a crucial role in the development of this disorder.</p>

Clinical significance of myeliod-derived suppressor cells in peripheral blood and serum interleukin-10 level detection in children with bronchiolitis / 中华实用儿科临床杂志

Objective To explore the clinical significance of detecting serum interleukin-10(IL-10) level and the proportion of myeloid-derived suppressor cells (MDSCs) in peripheral blood mononuclear cells (PBMCs) in children with bronchiolitis.Methods Fifty-one children with bronchiolitis less than 2 years old were randomly enrolled including 27 boys and 24 girls.They were divided into 2 groups:bronchiolitis group Ⅰ,25 children with atopic high risks were included in this group;bronchiolitis group Ⅱ,26 children without atopic high risks were included in this group.Children without infectious diseases such as hernia and renal calculus had been randomly enrolled as the control group (without atopic disease and atopic family disease) (n =45),including 25 boys and 20 girls.After taking 4 mL venous blood of patients in 3 groups,1 mL was used to test the serum proportion of MDSCs by flow cytometry,and the remaining blood was used to test the level of IL-10 in the serum by enzyme-linked immunosorbent assay.Results 1.The proportions of MDSCs in the PBMCs in bronchiolitis group Ⅰ [(3.17 ± 0.24) ％] and bronchiolitis group Ⅱ [(1.33 ±0.25) ％] were significantly higher than that of control group [(0.78 ± 0.25) ％] (all P ＜ 0.01),and the proportion of MDSCs in the PBMCs in bronchiolitis group Ⅰ was higher than that of bronchiolitis group Ⅱ (P ＜0.01).2.The serum levels of IL-10 in bronchiolitis bronchiolitis group Ⅰ [(31.88-± 3.91) ng/L] and bronchiolitis group Ⅱ [(23.85 ±4.10) ng/L] were significantly higher than that of control group [(13.63 ± 2.83) ng/L] (all P ＜0.01),and the levels of IL-10 in bronchiolitis group Ⅰ was higher than that of bronchiolitis group Ⅱ (P ＜ 0.01).3.There was a positive correlation between the proportion of MDSCs in the PBMCs and the serum levels of IL-10 in bronchiolitis group Ⅰ (r =0.717,P ＜ 0.01),but there was not any correlation between bronchiolitis group Ⅱ and control group (r =0.262,-0.102,all P ＞ 0.05).Conclusion MDSCs plays a crucial role by up-regulating the IL-10 level in the process of developing asthma from bronchiolitis.

Changes to CD4(+)CD25(high+)CD127(low) regulatory T cells in peripheral blood from children with bronchiolitis, and its clinical significance / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study changes to CD4(+)CD25(high+)CD127(low) regulatory T cells (Treg) in peripheral blood from children with bronchiolitis, and to explore its clinical significance.</p><p><b>METHODS</b>Thirty-one children with bronchiolitis and aged under two years were randomly enrolled as the bronchiolitis group, and 25 under two-year-olds with bronchopneumonia were randomly enrolled as the bronchopneumonia group. A further twenty-five children with non-infectious diseases such as hernia and renal calculus served as the control group. The level of CD4(+)CD25(high+)CD127(low) Treg in peripheral blood was measured by multi-color detection and multi-parameter flow cytometry.</p><p><b>RESULTS</b>The proportion of CD4(+)CD25(high+)CD127(low) Treg in peripheral blood in the bronchiolitis group (8.0%±2.1%) was significantly lower than in the bronchopneumonia (9.6%±2.6%; P<0.05) and control groups (11.3%±2.9%; P<0.05).</p><p><b>CONCLUSIONS</b>CD4(+)CD25(high+)CD127(low) Treg level in peripheral blood may be an index of immunological function in infants. A decreased level of CD4(+)CD25(high+)CD127(low) Treg in peripheral blood suggests that Treg cells may be involved in the pathogenesis and development of bronchiolitis.</p>

Expression of serum Clara cell secretory protein 10 in wheezing children under 5 years old / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the expression of serum Clara cell secretory protein 10 (CC10) and total IgE concentration in wheezing children under 5 years old.</p><p><b>METHODS</b>Fifty-nine children with recurrent wheezing under 5 years old were classified into two groups: wheezing group 1 with atopic high risks (n=33) and wheezing group 2 without atopic high risks (n=26). Twenty-three children without infectious diseases served as a control group. Serum levels of CC10 and IgE were measured using a solid-phase sandwich ELISA.</p><p><b>RESULTS</b>The serum levels of CC10 in wheezing group 1 (3.95 ± 1.26 ng/mL) and wheezing group 2 (5.41 ± 1.64 ng/mL) were significantly lower than those in the control group (8.72 ± 2.23 ng/mL; P<0.01). The wheezing group 1 showed more decreased serum levels of CC10 compared with wheezing group 2 (P<0.05). The serum IgE levels in wheezing group 1 were significantly higher than those in wheezing group 2 and the control group (P<0.05). There were no significant differences in serum IgE levels between the wheezing group 2 and control group. There was a negative correlation between serum levels of CC10 and IgE in wheezing group 1 (r=-0.912, P < 0.01).</p><p><b>CONCLUSIONS</b>Serum CC10 levels decrease remarkably in wheezing children, and more significant decrease is noted in patients with atopic high risks. Serum CC10 levels are negatively correlated to serum IgE levels in patients with atopic high risks.</p>

Measurement of eosinophils and interleukin-17 in nasopharyngeal secretions of children under 5 years old with wheezing / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the value of eosinophils (EOS) and interleukin-17 (IL-17) in nasopharyngeal secretions in the evaluation of progress of wheezing in children under 5 years old.</p><p><b>METHODS</b>Fifty-three children under five years old who had recurrent wheezing were classified into two groups: wheezing group I with atopic body (n=27) and wheezing group II without atopic body (n=26). Twenty pre-surgical children with non-infectious disease were used as the control group. Nasopharyngeal secretions were collected. Inflammatory cells in nasopharyngeal secretions were counted under the microscope. IL-17 levels in supernatants were measured using ELISA.</p><p><b>RESULTS</b>EOS counts in nasopharyngeal secretions in wheezing group I were significantly higher than those in wheezing group II and the control group (p<0.05, p<0.01, respectively). There were no significant differences in EOS counts between wheezing II and the control groups. The IL-17 levels in both wheezing groups were significantly higher than those in the control group (p<0.01), and the wheezing group I had increased IL-17 levels than wheezing group II (1 474+/-974 pg/mL vs 788+/-132 pg/mL; p<0.05). The IL-17 level was positively correlated with the EOS counts in wheezing group I (r=0.62, p<0.05).</p><p><b>CONCLUSIONS</b>EOS counts and IL-17 levels in nasopharyngeal secretions may be used as indices for identifying the tendency to develop asthma in children under 5 years old with wheezing.</p>

Expression of angiopoietin-1 and its tyrosine kinase receptor Tie-2 in the airway of asthmatic rats / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the effect of dexamethasone on airway morphology and on the expression of angiopoietin-1 (Ang-1) and its tyrosine kinase receptor Tie-2 in the airway of asthmatic rats.</p><p><b>METHODS</b>Forty-five Sprague-Dawley rats were randomly divided into control, asthmatic, and dexamethasone-treated asthmatic groups. Asthma was induced by repeated sensitization and challenge with ovalbumin in the latter two groups. The dexamethasone intervention group received an intraperitonea injection of dexamethasone (2 mg/kg) before asthma challenge. Immunohistochemistry was used to measure the expression of Ang-1 and Tie-2 in the airway. Airway thickness was estimated by a computerized digital image analyzer.</p><p><b>RESULTS</b>Airway thickness in the asthmatic group (33.9333+/-8.3791 micro m2/micro m) increased significantly compared with that in the control group (21.1333+/-2.7740 micro m2/micro m) (P<0.01). The dexamethasone intervention group also showed increased thickness of the airway (27.4000 +/- 4.6105 micro m2/micro m) compared with the control group (P<0.01), but the airway thickness in the dexamethasone intervention group was significantly reduced compared with that in the untreated asthmatic group (P<0.01). The expression of Ang-1 (103.9487+/-8.2914 vs 76.0320+/-3.7728; P<0.01) and Tie-2 (99.2307+/-8.1913 vs 75.3153+/-3.7321; P<0.01) in the airway increased significantly in the asthmatic group compared to controls. The expression of Ang-1 and Tie-2 in the airway of the dexamethasone intervention group (90.6180+/-5.2339 and 86.6633+/-3.7321, respectively) was statistically higher than that in the control group (P<0.01) but statistically lower than that in the untreated asthmatic group (P<0.01). Ang-1 and Tie-2 expression in the airway was positively correlated with the thickness of airway (r(Ang)-1=0.719r(Tie)-2=0.746P<0.01). There was also a positive correlation between Ang-1 and Tie-2 expression (r=0.742P<0.01).</p><p><b>CONCLUSIONS</b>The expression of Ang-1 and Tie-2 in the airway increased in asthmatic rats and was positively correlated with the thickness of the airway. Ang-1 and Tie-2 may participate in the process of airway remodeling in asthma. Dexamethasone can decrease the expression of Ang-1 and Tie-2 in the airway and relieve the changes of airway morphology.</p>

Expression of Serum Interleukin-17 in Wheezing Children Under 5 Years of Age / 实用儿科临床杂志

Objective To explore the clinical significance of detection of IL-17 and peripheral blood eosinophil(EOS) count in whee-zing children under 5 years old.Methods Fifty-three children with recurrent wheezing under 5 years old had been randomly enrolled including 43 boys and 10 girls.They were divided into 2 groups :wheezing group Ⅰ,in which,the patients with atopic high risks(n=27);whee-zing group Ⅱ,in which,the patients without atopic high risks(n=26).Children without infectious diseases such as hernia and renal calculus had been enrolled randomly as control group(n=20),including 11 boys and 9 girls.After taking 3 mL venous blood and centrifuging of patients in 3 groups,the level of IL-17 in the serum was measured by double-antibody sandwich enzyme-linked immunosorbent assay,peripheral blood EOS count was performed in the meantime by means of eosine staining.Results The serum levels of IL-17 in wheezing groups [(1 469.315?978.300) ng?L-1,(263.340?131.800) ng?L-1]were significantly higher than that of control group[(36.478?2.000) ng?L-1](Pa0.05);serum IL-17 and peripheral blood EOS count had positive correlation(r=0.933,P