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Objective To investigate the effect of orthokeratology(OK)lens decentration on peripheral retinal defo-cus in myopic eyes.Methods Totally 154 patients(234 eyes)continuously wearing OK lenses for one month or more were recruited in this study.According to the location of defocus rings in corneal topography,these eyes were divided into the centration group(118 eyes)and the decentration group(116 eyes).Peripheral retinal defocus data of each patient was collected by multispectral refraction topography,including total refraction difference value(TRDV),refraction difference value at 15°(RDV-15),refraction difference value at 30°(RDV-30),refraction difference value at 45°(RDV-45),superior refraction difference value(RDV-S),inferior refraction difference value(RDV-I),temporal refraction difference value(RDV-T)and nasal refraction difference value(RDV-N).An independent sample t-test was used to compare the differ-ences in these parameters between the two groups,and multivariate correlation analysis(generalized estimating equation,GEE)was conducted to analyze the relationship between clinical parameters and the amount of peripheral retinal defocus within the group.Results The RDV-N of patients in the decentration group was significantly lower than that in the cen-tration group(t=2.668,P=0.008),and there were no significant differences in other parameters(all P>0.05).GEE showed that age was the determinant of RDV-S,and they were positively correlated;steep K was the determinant of RDV-I,and they were negatively correlated;gender was the determinant of RDV-T,and female OK lens wearers showed less RDV-T;the determinants of RDV-N include the alignment of OK lens,eye distribution and age,among which,RDV-N was positively corrected with age,and RDV-N of the left eyes was significantly superior to that of the right eyes.Conclusion Subclinical decentration of the OK lens may result in better RDV-N of myopia patients.The peripheral retinal defocus is influenced by factors such as age,gender,steep K,amount of decentration and eye distribution of OK lens wearers.
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Objective:To analyze the clinical efficacy of arthroscopic transverse release of the iliotibial band through peritrochanteric space for the treatment of external snapping hip.Methods:A total of 30 patients (12 males and 18 females) with bilateral external snapping hip underwent arthroscopic transverse release of the iliotibial band through peritrochanteric space in Department of Sports Medicine, Senior Department of Orthopaedics, the Fourth Medical Center, Chinese PLA General Hospital were retrospectively analyzed from May 2021 and June 2022. The average age was 32.5±8.2 years (range, 17-51 years). At the same time, 30 patients who underwent arthroscopic external release of the iliotibial band through the external surface of the iliotibial band (external iliotibial band group) were selected as control group, including 13 males and 17 females, aged 29.5±6.8 years (range, 11-45 years). The visual analogue scale (VAS), modified Harris hip score (mHHS), and gluteal muscle contracture disability scale (GDS) were compared between the two groups at preoperative, 6 months postoperative, and final follow-up.Results:All patients successfully completed the operation and were followed up for 17.5±3.3 months (range, 12-25 months). The VAS scores of the two groups at the last follow-up were lower than those before operation ( P<0.05). The mHHS scores before operation, 6 months after operation and at the last follow-up in the peritrochanteric space group were 76.5 (67.0, 85.5), 98.5 (94.8, 100.0) and 100.0 (97.0, 100.0), respectively, and those in the external iliotibial band group were 80.5 (70.0, 86.0), 100.0 (96.0, 100.0) and 100.0 (99.5, 100.0). The differences in mHHS scores between the two groups were statistically significant for intragroup comparisons ( P<0.05); of these, 6 months postoperatively and at the last follow-up were greater than preoperatively, with statistically significant differences ( P<0.05); the differences at 6 months postoperatively and at the last follow-up were not statistically significant ( P>0.05). There was no significant difference in mHHS scores between groups at different time points ( P>0.05). The GDS before operation, at 6 months after operation and at the last follow-up were 47.0 (35.8, 64.5), 90.0 (81.0, 94.0) and 93.5 (89.8, 98.0) in the peritrochanteric space group, and 51.0 (38.0, 64.5), 50.0 (81.0, 94.0) and 93.5 (89.8, 98.0) in the external iliotibial band group, respectively. The differences in GDS between the two groups were statistically significant for intragroup comparisons ( P< 0.05); of these, 6 months postoperatively and at the last follow-up were greater than preoperatively, with statistically significant differences ( P<0.05); the differences at 6 months postoperatively and at the last follow-up were not statistically significant ( P>0.05). There was no significant difference in GDS between groups at different time points ( P>0.05). Conclusion:Arthroscopic transverse release of the iliotibial band through peritrochanteric space for the treatment of external snapping hip can effectively reduce hip pain and improve hip function, with satisfactory clinical results, and can be used as an alternative treatment to transverse release through the external surface of the iliotibial band.
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Atherosclerosis is a chronic inflammatory disease of vascular walls with a complex etiology. In recent years, the incidence of atherosclerosis continues to increase with obesity and diabetes as major risk factors. As an important metabolic organ in the body, adipose tissue also has a powerful endocrine function. In the case of obesity and diabetes, various cytokines and exosomes derived from adipose tissue mediate organ-organ/cell-cell crosstalk, and are involved in the occurrence and development of various diseases. As an important intercellular communicator, exosomes regulate the pathological process of various cardiovascular diseases and are closely related to atherosclerosis. In this paper, we reviewed the mechanism of adipose-derived exosomes in atherosclerosis with focus on endothelial dysfunction, inflammatory response, lipid metabolism disorder and insulin resistance, hoping to provide reference for the research, diagnosis and treatment of atherosclerosis.
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Humans , Exosomes/metabolism , Atherosclerosis , Obesity/complications , Adipose Tissue/metabolism , Insulin ResistanceABSTRACT
This study selected the top five general hospitals in the United States of America, collected the practice information of acupuncturists through the official website, and analyzed the professional department, expertise, professional title, education background, residency, fellowship, board certification, etc. of these acupuncturists to understand the practice situation of acupuncturists in the hospitals. The results of the study showed the practice of acupuncturists in the United States of America is improving. With further localization, locally trained acupuncturists have gradually become the main body of acupuncturists; acupuncture treatment is still mainly for analgesia, but the scope of treatment continues to expand, and departments that accept acupuncturists are gradually increasing. However, the group of licensed acupuncturists is still a minority in the group of acupuncturists in the United States of America. Native American physicians still use acupuncture as an alternative option and neglect to obtain a license. The entry barrier for acupuncturists still needs to be raised.
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Objective:To explore the similarities and differences of China Society of Gynecology Endoscopy (CSGE) and American Fertility Society (AFS) intrauterine adhesion (IUA) scoring criteria on IUA grading and their predictive value of reproductive prognosis.Methods:From January 2016 to January 2019, a total of 1 249 patients were diagnosed with IUA by hysteroscopy at Beijing Obstetrics and Gynecology Hospital. Totally, 378 patients with complete clinical data were enrolled, and the results diagnosed by CSGT and AFS scoring criteria were compared and analyzed.And follow-up for 2 years, the pregnancy rate and live birth rate were statistical analysis.Results:(1) The grade of IUA according to AFS and CSGE scoring criteria was less consistent ( κ=0.295, P<0.001). Compared with AFS, the proportion of severe IUA cases diagnosed by CSGE was significantly lower [45.8% (173/378) vs 15.1% (57/378); RR=0.22, 95% CI: 0.15-0.30, P<0.01); the proportions of both mild and moderate IUA cases were significantly higher ( RR=4.16, 95% CI: 2.38-7.14; RR=2.38, 95% CI: 1.75-3.23; both P<0.01). (2) The pregnancy rates of mild, moderate and severe IUA diagnosed according to CSGE were 11/13, 64.5% (147/228), 31.8% (7/22), live birth rates were 11/13, 54.8% (125/228) and 22.7% (5/22), respectively; there were statistically significant differences between the groups (all P<0.01). The pregnancy rates of mild, moderate and severe IUA diagnosed based on AFS were 3/3, 66.9% (97/145) and 56.5% (65/115), respectively, with no statistically significant difference between the groups ( P>0.05). (3) IUA grades based on both CSGE and AFS criteria were significantly negatively correlated with pregnancy rates and live birth rates (CSGE: r=-0.210, r=-0.226; AFS: r=-0.130, r=-0.147; all P<0.05). Univariate logistic regression analysis showed that CSGE had higher OR for both pregnancy rates and live birth rates compared to AFS (3.889 vs 1.657, 3.983 vs 1.554, respectrvely). Conclusions:Compared with AFS, the IUA grade based on CSGE is better related with reproductive prognosis, suggesting that the CSGE standard might be more objective and comprehensive and has better predictive value for reproductive prognosis, thus avoiding overdiagnosis and overtreatment.
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Objective:To investigate the value of brain functional connectivity density (FCD) derived from resting-state functional magnetic resonance imaging (rs-fMRI) in differentially diagnosing 2 subtypes of Parkinson's disease (PD): tremor dominant (TD) and non-tremor dominant (nTD), as well as its correlation with clinical symptom scores.Methods:A retrospective analysis was performed; 45 PD patients (25 with TD and 20 with nTD), admitted to Department of Neurology, Drum Tower Hospital Affiliated to Medical School of Nanjing University were chosen; and 24 middle-aged and elderly volunteers matched in age, gender and years of education at the same time were chosen as normal controls (NCs). The rs-fMRI data were collected and FCD map of the whole brain was computed. The FCD differences in whole brain and brain regions enjoying different FCD were compared among the 3 groups. ROC curve was used to analyze the differential diagnostic efficacy of FCD in brain regions enjoying different FCD in TD and nTD. Correlations of FCD in brain regions enjoying different FCD with disease course, Hoehn-Yahr (H-Y) grading, unified Parkinson's disease rating scale (UPDRS) III scores, tremor scores and non-tremor scores were analyzed by Pearson or Spearman correlation analyses.Results:Brain regions enjoying different FCD among the TD, nTD, and NC groups were the right lingual gyrus, right orbital medial frontal gyrus, right insula, left superior temporal gyrus, left insula, right anterior central gyrus, left posterior central gyrus, right medial and paracingulate gyrus, and left angular gyrus. FCD in the right orbital medial frontal gyrus and left angular gyrus of TD group was significantly higher than that in the nTD group ( P<0.05); while FCD in the right insula, right anterior central gyrus, left posterior central gyrus and right medial and paracingulate gyrus of TD group was significantly lower than that in the nTD group ( P<0.05). Area under the curve of combined application of FCD in brain regions enjoying different FCD in differentially diagnosing TD and nTD was 0.842, with sensitivity and specificity of 80.0%. FCD in the left superior temporal gyrus and left posterior central gyrus was positively correlated with H-Y grading ( P<0.05), while FCD in the left angular gyrus was negatively correlated with H-Y grading ( P<0.05). FCD in the left superior temporal gyrus was positively correlated with UPDRS III scores ( P<0.05). FCD in the right lingual gyrus, right insula, left insula, right anterior central gyrus, left posterior central gyrus, right medial and paracingulate gyrus was negatively correlated with tremor scores ( P<0.05). FCD in the left superior temporal gyrus, right medial and paracingulate gyrus was positively correlated with non-tremor scores ( P<0.05), whereas that in the left angular gyrus was negatively correlated with non-tremor scores ( P<0.05). Conclusion:Abnormalities in FCD exist in certain brain regions of PD patients, with disparities between TD and nTD. Combined application of FCD in brain regions enjoying different FCD can effectively differentiate TD and nTD, and this FCD is also partially correlated with the symptom scores of PD patients.
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OBJECTIVE To explore the efficacy, safety and economics of a dual therapy consisting of conventional dose of vonoprazan combined with conventional dose of amoxicillin in patients with primary treatment of Helicobacter pylori (HP) infection. METHODS Using a prospective cohort study, the patients diagnosed with HP infection and receiving initial treatment in Chengdu Xinhua Hospital from July 2021 to July 2022 were collected according to inclusion and exclusion criteria. The patients were given vonoprazan/amoxicillin dual therapy (i.e. VA group, Vonoprazan fumarate tablets 20 mg, once a day+Amoxicillin capsules 1.0 g, twice a day, 14 days) and bismuth-containing quadruple therapy (i.e. LJAF group, Rabeprazole sodium enteric- coated tablets 20 mg, twice a day+Colloidal bismuth pectin capsules 200 mg, twice a day+Amoxicillin capsules 1.0 g, twice a day+ Furazolidone tablets 100 mg, twice a day, for 14 days) according to the patient’s medication willingness. Four weeks after the end of the treatment, HP eradication rates of the two groups were compared by using intention-to-treat (ITT), modified intention-to- treat (MITT) and per-protocol (PP) analysis. The occurrence of adverse drug reactions (ADR) was recorded, and an economic evaluation was performed for them. RESULTS Among the 58 patients in VA group, 55 completed the trial, 2 were lost to follow- up and one withdrew due to rash; among the 62 patients in LJAF group, 57 completed the trial, 3 were lost to follow-up and 2 withdrew due to rash. Results of ITT, MITT and PP analysis showed that HP eradication rates of VA group were 86.2%, 89.3% and 90.9%, and those of LJAF group were 87.1%,91.5% and 94.7%, respectively; there was no statistical significance among different groups (P>0.05). The incidences of ADR in VA group and LJAF group were 6.9% and 14.5%,which were not significantly different (P>0.05). The result of cost minimization analysis showed that the treatment cost of VA group was 340.9 yuan, which was lower than 373.5 yuan of LJAF group. CONCLUSIONS In patients with primary treatment of HP infection, the efficacy and safety of dual therapy of conventional dose of vonoprazan combined with conventional dose of amoxicillin is equivalent to the bismuth-containing quadruplex therapy with low cost.
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【Objective】 To explore the epidemiological features and relational factors of accidental death among children under 5 years of age in rural area of Shaanxi Province. 【Methods】 A case-control study was conducted in the research, and children under 5 years old in nine National surveillance counties of Shaanxi were collected. The questionnaire of national survey of accidental injuries among children under 5 years of age was used to investigate the basic information of children, socio-demographic characteristics, child care status, injury occurrence condition. The mean, standard deviation and percentage were used to describe the basic situation and main characteristics of accidental death. The Chi-square test and Logistic regression methods were performed to explore the relational factors of accidental death of children. 【Results】 Of the 25 cases of accidental death of children under the age of five years old, 5 were traffic accidents (20.0%), 9 cases were falling (36.0%), and 11 were suffocation (44.0%). Age distribution showed that children of accidental suffocation were younger, with 90.9% (10 cases) of them under the age of 1 years old. Gender distribution showed that traffic accident deaths occurred to boys. Area distribution showed that falling and suffocation death mainly happened in Hanzhong, while traffic accidents death mainly in Weinan. When the accident happened, 8 caregivers were not on the scene. What was worse, among 17 caregivers who were on the scene of accident, only 4 kept an eye on children. Compared with 25 children in control group, 16 in case group had received health examination, and the difference showed statistical significance (χ2=8.672, P=0.003). Meanwhile, 9 main caregivers were mothers in the case group, compared with 14 in the control group. The Logistic regression analysis showed that compared with fathers, mothers as the children’ main caregivers could positively reduce accidental death of children (OR=0.016, 95% CI: 0.000 3-0.997, P=0.049). 【Conclusion】 To decrease the incidence rate and mortality of accidental death of children under the age of five years old, parenting behavior guidance, health examination, and targeted health education should be taken in Maternal and Child Health Care System as a routine work.
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Nuclear transporter importin-β1 is emerging as an attractive target by virtue of its prevalence in many cancers. However, the lack of druggable inhibitors restricts its therapeutic proof of concept. In the present work, we optimized a natural importin-β1 inhibitor DD1 to afford an improved analog DD1-Br with better tolerability (>25 folds) and oral bioavailability. DD1-Br inhibited the survival of castration-resistant prostate cancer (CRPC) cells with sub-nanomolar potency and completely prevented tumor growth in resistant CRPC models both in monotherapy (0.5 mg/kg) and in enzalutamide-combination therapy. Mechanistic study revealed that by targeting importin-β1, DD1-Br markedly inhibited the nuclear accumulation of multiple CRPC drivers, particularly AR-V7, a main contributor to enzalutamide resistance, leading to the integral suppression of downstream oncogenic signaling. This study provides a promising lead for CRPC and demonstrates the potential of overcoming drug resistance in advanced CRPC via targeting importin-β1.
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Objective@#The purpose of this study was to investigate the effects of sirolimus ( SIR) on proliferation and apoptosis of vascular endothelial cells of venous malformation ( VM) caused by mutations in TIE2-L914F and its potential molecular mechanism.@*Methods @#The expression of TEK receptor tyrosine kinase ( TIE2 ) in human umbilical vein endothelial cell (HUVEC) was interfered to construct vascular endothelial cells of VM model (TIE2-L914F group) .Subsequently part of vascular endothelial cells of VM was exposed to 1 000 ng / ml SIR for 48 h (TIE2-L914F + SIR group) ,and the proliferation and apoptosis of vascular endothelial cells of VM were detected by MTT and flow cytometry.The mRNA and protein expressions of CXCL1 and CXCR2 were detected by qRT-PCR and Western blot. @*Results @#Compared with the cells in TIE2-L914F group,the proliferation activity of the cells in TIE2-L914F + SIR group was inhibited,and the apoptosis rate increased (P <0. 05) .The expression of CXCL1 increased in TIE2-L914F cells but decreased after SIR treatment (P<0. 05) .Compared with TIE2-L914F + pcDNA3.1 group,the cell proliferation activity increased but apoptosis rate decreased in TIE2-L914F + pcDNA-CXCL1 group.Compared with TIE2-L914F + pcDNA-CXCL1 group,cell proliferation activity was inhibited but apoptosis rate increased in TIE2-L914F + pcDNA-CXCL1 + SIR Group (P<0. 05) .In addition,compared with TIE2-L914F group,CXCR2 expression decreased in TIE2-L914F + SIR group(P<0. 05).@*Conclusion @#SIR inhibits VM cell proliferation,induces cell apoptosis of vascular endothelial cells of VM,and inhibits the expression of CXCL1 / CXCR2.
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Objective:To investigate clinicopathological features and prognosis of transformed mycosis fungoides (TMF) .Methods:A retrospective analysis was performed on clinicopathological data collected from 24 patients with TMF, as well as on flow cytometry results of 16 peripheral blood samples obtained from 11 of the 24 patients, who visited Hospital of Dermatology, Chinese Academy of Medical Sciences between 2014 and 2020.Results:Among the 24 patients, 11 were males and 13 were females. Their average age at diagnosis of TMF was 50.0 years (range: 18 - 77 years), and patients with early-stage TMF (9 cases) and tumor-stage TMF (15 cases) were aged 44.8 and 52.6 years on average, respectively. The average time interval from diagnosis of MF to large cell transformation was 3.7 years, and 8 patients were diagnosed with TMF at the initial visit. Histopathologically, large cells infiltrated in a diffuse pattern in 20 cases, as well as in a multifocal pattern in 4, and the proportion of large cells in 7 cases was greater than 75%. Immunohistochemically, 18 patients showed positive staining for CD30, and the proportion of CD30-positive large cells was greater than 75% in 9; negative staining for CD30 was observed in 6. Flow cytometry of 16 peripheral blood samples showed the presence of cell subsets expressing clonal T cell receptor (TCR) -vβ in 2 of 4 patients with early-stage TMF and 10 of 12 with tumor-stage TMF, and tumor cells with higher forward scatter than normal lymphocytes were detected in 16 samples. During the follow-up, among the patients with early-stage TMF, 3 progressed to tumor-stage TMF 3.3 years on average after large cell transformation, 1 progressed to erythrodermic MF in stage IIIA, and the other 4 still showed an indolent course; among the patients with tumor-stage TMF, 1 progressed to stage-IV TMF, and 5 died 3.3 (1.5 - 6) years after large cell transformation.Conclusion:Large cell transformation may occur in patients with MF in any stage, some patients have poor prognosis, so close follow-up is needed for patients with TMF.
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Exosomes are small vesicles with a diameter of about 40-160 nm actively secreted by cells. They participate in a variety of pathophysiological processes and are closely related to the occurrence and development of diseases. As a newly carrier of intercellular communication and circulating biomarkers of disease diagnosis and prognosis, exosomes have attracted great attention for their potential clinical applications. However, many aspects such as exosome biogenesis, targeted transport, and mechanism of action are still unclear. This paper focuses on the exosome biogenesis, summarizes the exosome biogenesis pathways, and describes relevant molecular modulation mechanisms of importance. And this review provides a theoretical basis for disease treatment based on regulating exosome production.
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Objective To explore the effect of overwork (OW) on extracellular matrix of arterial vessel wall in rats. Methods Random number grouping method was employed to assign 18 Sprague-Dawley rats into three groups(n=6):the control group(no special treatment),group OW(forced swimming twice a day for 15 days),and sleep deficiency(SD)+OW group(in addition to forced swimming twice a day,the rats were put on the platforms in water to limit sleep for 15 days).On the 16th day,the abdominal aorta and common carotid artery were collected after blood sampling from heart under deep anesthesia.A part of the abdominal aorta sample was taken for Masson staining of collagen fiber,and Verhoeff-Van Gieson staining was carried out for the elastic fiber of common carotid artery.Image J was employed for the quantitative analysis of collagen fiber and elastic fiber content.The expression of collagen 1(Col-1) protein was quantified by immunohistochemistry and the ultrastructure of vascular matrix was examined by transmission electron microscopy.The other part of the abdominal aorta sample was used to determine the mRNA levels of matrix metalloproteinase(MMP)-1,MMP-2,MMP-9,tissue inhibitor of metalloproteinases-1(TIMP-1),and Col-1 by quantitative real-time polymerase chain reaction. Results Compared with that in control group,the content of collagen fiber in groups OW and SD+OW had no significant change(all P>0.05);the content of elastic fiber in groups OW and SD+OW decreased(all P<0.001) and had no significant difference between each other(P>0.05).The vascular vessel wall of group OW showed slight fiber breakage,while that of group SD+OW presented wormhole-like or spongy fiber fragmentation.The mRNA levels of MMP-1 and MMP-2 in groups OW and SD+OW had no significant difference between each other(P>0.05) but were higher than that in control group(all P<0.001).The mRNA levels of MMP-9 and TIMP-1 had no significant difference among the three groups(all P>0.05).Groups OW and SD+OW had lower mRNA level(all P<0.001) and protein level(all P<0.001) of Col-1 than control group,while the mRNA and protein levels of Col-1 had no significant difference between groups OW and SD+OW(P>0.05). Conclusion OW can reduce the content of Col-1 and elastic fibers in the extracellular matrix of arterial vessels,destroy the elastic lamina of vascular wall,up-regulate the expression of MMP-1 and MMP-2,thereby injuring arterial vessels.
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Animals , Rats , Collagen Type I , Extracellular Matrix/metabolism , Matrix Metalloproteinase 1/metabolism , Matrix Metalloproteinase 2/metabolism , Matrix Metalloproteinase 9/metabolism , RNA, Messenger/genetics , Rats, Sprague-Dawley , Tissue Inhibitor of Metalloproteinase-1/metabolismABSTRACT
Objective@#To systematically investigate the prevalence of anxiety among healthcare professionals during the COVID-19 pandemic, so as to provide the development of evidence-based psychological interventions among healthcare professionals.@*Methods@#The publications pertaining to the prevalence of anxiety among healthcare professionals during the COVID-19 pandemic were retrieved in national and international electronic databases from January 1, 2020 through November 30, 2021, including CNKI, Wanfang Data, VIP, SinoMed, PubMed and Web of Science. The quality of publications was evaluated using the United States Healthcare Research and Quality (AHRQ) quality assessment of included cross-sectional studies, and the pooled prevalence of anxiety was estimated among healthcare professionals using the software Open Meta Analyst version 3.0. The publication bias were evaluated with funnel plots and Begg rank correlation test.@*Results@#Totally 598 publications were retrieved, and 36 eligible publications were enrolled in the final analysis, including 33 Chinese publications and 3 English publications. There were 5 high-quality, 29 moderate-quality and 2 low-quality publications. All investigations pertaining to the prevalence of anxiety among healthcare professionals were conducted in 2020. Totally 19 872 healthcare professionals were investigated, and the prevalence of anxiety was 28.8% (95%CI: 24.0%-33.6%). Subgroup analysis showed that the prevalence of anxiety was 31.9% (95%CI: 17.6%-46.2%) among healthcare professionals from western China, 29.6% (95%CI: (17.8%-41.4%) from central China, and 25.3% (95%CI: 20.2%-30.3%) from eastern China. The prevalence of anxiety was 4.9% (95%CI: 3.3%-6.4%) among male healthcare professionals and 22.9% (95%CI: 17.7%-28.0%) among male healthcare professionals, and the prevalence of anxiety was 21.6% (95%CI: 13.2%-29.9%) among nurses, 5.2% (95%CI: 2.8%-7.5%) among doctors and 4.8% (95%CI: 2.2%-7.4%) among other healthcare professionals. The prevalence of mild, moderate and severe anxiety was 18.6% (95%CI: 14.0%-23.2%), 5.5% (95%CI: 4.1%-6.8%) and 1.9% (95%CI: 1.3%-2.5%), respectively. No publication bias was detected as revealed by funnel plots and Begg rank correlation test, and stable meta-analysis results and heterogeneity test were observed.@*Conclusions@#The prevalence of anxiety is 28.8% among healthcare professionals during the COVID-19 pandemic, and mild anxiety is predominant. A high prevalence rate of anxiety is seen female healthcare professionals and nurses, who should be given a high priority and timely psychological interventions
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Hepatocellular carcinoma (HCC) is a common malignant tumor with poor prognosis and high mortality. In this study, we demonstrated a novel vaccine targeting HCC and tumor neovascular endothelial cells by fusing recombinant MHCC97H cells expressing porcine α-1,3-galactose epitopes (αGal) and endorphin extracellular domains (END) with dendritic cells (DCs) from healthy volunteers. END+/Gal+-MHCC97H/DC fusion cells induced cytotoxic T lymphocytes (CTLs) and secretion of interferon-gamma (IFN-γ). CTLs targeted cells expressing αGal and END and tumor angiogenesis. The fused cell vaccine can effectively inhibit tumor growth and prolong the survival time of human hepatoma mice, indicating the high clinical potential of this new cell based vaccine.
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Objective:To investigate the value of flow cytometric analysis of peripheral blood in the diagnosis of erythroderma.Methods:A total of 29 patients with erythroderma were collected from Hospital of Dermatology, Chinese Academy of Medical Sciences from September 2017 to December 2020, including 6 with erythrodermic mycosis fungoides (EMF) , 5 with Sézary syndrome (SS) , 18 with inflammatory erythroderma (IE) with different etiologies. Four healthy volunteers served as healthy controls. Flow cytometry was performed to detect peripheral blood lymphocyte subsets, immunophenotypes and clonality, and their differences were analyzed between inflammatory erythroderma and lymphoma-related erythroderma. One-way analysis of variance and least significant difference- t test were used for comparisons between groups. Results:The proportions of T cells, B cells, NK cells and CD4 -CD8 - cells significantly differed among the EMF group, SS group, IE group and control group (all P < 0.001) . The proportion of T cells was significantly higher in the SS group (93.8% ± 3.4%) than in the EMF group (42.7% ± 6.4%) and IE group (46.0% ± 6.8%, t = 12.8, 14.4, respectively, both P < 0.001) , and the proportion of CD4 -CD8 - cells was significantly lower in the IE group (0.37% ± 0.40%) than in the EMF group (2.93% ± 0.84%) and SS group (2.38% ± 0.74%, t = 9.2, 6.7, respectively, both P < 0.05) . The expression of clonal T-cell receptor β-chain variable region (TCR-vβ) was not detected in healthy controls or IE patients; the T cell subsets expressing clonal TCR-vβ were detected in 3 cases of EMF and all cases of SS, and they were all identified to be cells with a CD4 +CD7 -CD26 - phenotype. There were significant differences among the above 4 groups of subjects in the proportions of CD4 + T lymphocytes expressing chemokine receptors CCR4, CXCR3, CCR5, cutaneous lymphocyte antigen (CLA) or programmed death receptor-1 (PD-1) on the cell surface (all P < 0.001) . Compared with the SS group and EMF group, the IE group showed significant decreased proportions of CD4 + T lymphocytes expressing CCR4, CLA or PD-1 (all P < 0.001) , but significantly increased proportions of CD4 + T lymphocytes expressing CXCR3 or CCR5 (all P < 0.001) . Conclusion:Flow cytometric analysis of peripheral blood lymphocyte subsets, immunophenotypes and clonality can provide a reference for the etiological diagnosis of erythroderma, and is helpful for the differential diagnosis between lymphoma-associated erythroderma and inflammatory erythroderma.
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Objective:To explore the application value of 256-layer spiral CT left atrial pulmonary vein dual phase scanning imaging (called simply CT dual phase scanning imaging) in radiofrequency ablation of nonvalvular atrial fibrillation.Methods:The clinical data of 74 patients with nonvalvular atrial fibrillation from October 2018 to September 2020 in Tiantan Hospital, Capital Medical University were retrospectively analyzed. All patients were examined by CT dual phase scanning imaging and transesophageal echocardiography (TEE). The result of TEE was as "gold standard", the value of CT dual phase scanning imaging in the diagnosis of left atrial pre-thrombotic state (PTS) and thrombus were assessed, and the variation of the pulmonary vein was observed.Results:CT dual phase scanning imaging in diagnosis of left atrial PTS had a sensitivity of 52.94% (9/17), a specificity of 92.45%(49/53), a negative predictive value of 85.96%(49/57), and a positive predictive value of 69.23%(9/13); it in diagnosis of left atrial thrombus had a sensitivity of 100.00% (4/4), a specificity of 90.74%(49/54), a negative predictive value of 100.00%(49/49), and a positive predictive value of 44.44%(4/9). The variation rate of the pulmonary vein was 21.62%(16/74).Conclusions:CT dual phase scanning imaging has relatively high values of sensitivity, specificity and negative predictive value in detecting left atrial PTS and thrombus. It can also evaluate the abnormal anatomical characteristics of the pulmonary vein, and find pulmonary vein variation. It provides a reliable basis for radiofrequency ablation of nonvalvular atrial fibrillation.
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Currently, whole breast radiotherapy (WBRT) is the standard treatment for early breast cancer after breast-conserving surgery, which effectively reduces the recurrence rate. Accelerated partial breast irradiation (APBI), a special radiotherapy that only targets the limited volume of tissues surrounding the primary lesion, has attracted more and more attention because of the high proportion of tumor recurrence adjacent to the tumor resection cavity. In recent years, a number of prospective randomized controlled trails have demonstrated its safety and effectiveness, which is a feasible choice for specific low-risk patients after breast-conserving surgery. Compared with WBRT, APBI shortens the treatment time, reduces the treatment cost and improves the cosmetic effect. At the same time, more and more APBI technologies have been developed, which enhance the accessibility and possess unique advantages for partial patients undergoing breast-conserving surgery. Nevertheless, the efficacy and side effects of APBI technologies still differ, which need to be treated differently. In this paper, multiple APBI technologies, research progresses at home and abroad and applicable population were reviewed. The unresolved problems were proposed and development prospect was predicted, aiming to provide reference for clinical application.
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Epigenetic modification is one of the important causes for the occurrence and development of cancers.Enhancer of zeste homolog 2 (EZH2),as an important member of the epigenetic suppressor polycomb group (PcG),can tri-methylate lysine at amino acid position 27 of histone H3 gene,and participates in the regulation of cell cycle,cell aging and cell differentiation.Recently,overexpression or mutation of EZH2 has been detected in a variety of solid tumors and B-cell lymphomas.However,the expression status and action mechanism of EZH2 in some T-cell lymphomas are still unclear,and its action mechanisms in different tumors are not completely consistent,which need further study.
ABSTRACT
Objective:To investigate the expression of epigenetic inhibitor polycomb group proteins such as enhancer of zeste homolog 1/2 (EZH1/EZH2), embryonic ectoderm development protein (EED) and suppressor of zeste 12 (SUZ12) in common cutaneous T-cell lymphomas and lymphoproliferative disorders (CTCL/LPD) .Methods:Totally, 93 paraffin-embedded skin samples of CTCL/LPD and 8 of lichen planus were collected from Hospital for Skin Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College between 2012 and 2019, and subjected to immunohistochemical staining to determine the protein expression of EZH2, EED, SUZ12 and EZH1. Statistical analysis was carried out with SPSS 25.0 software by using chi-square test and Spearman correlation analysis.Results:The 93 cases of CTCL/LPD included 44 cases of mycosis fungoides (MF), 17 natural killer/T cell lymphoma (NK/TCL), 8 primary cutaneous anaplastic large cell lymphoma (PC-ALCL), 8 lymphomatoid papulosis (LyP), 8 hydroa vacciniforme-like lymphoproliferative disorder (HV-like LPD) and 8 cases of subcutaneous panniculitis-like T cell lymphoma (SPTCL). Among the 93 CTCL/LPD cases, 83 (89.2%) were positive for EZH2, 81 (87.1%) for EED, 78 (83.9%) for SUZ12 and 37 (39.8%) for EZH1; among the 8 cases of lichen planus, 1 was positive for EZH2, all were positive for EZH1, and all were negative for EED and SUZ12. The expression of EZH2, EED, SUZ12 and EZH1 in lichen planus samples significantly differed from all the CTCL/LPD samples ( χ2 = 41.75, 39.74, 39.36, 32.83, respectively, all P < 0.001), and from MF, NK/TCL, PC-ALCL, LyP, HV-like LPD and SPTCL samples separately (α = 0.008 3, all P < 0.001). Meanwhile, the score of EZH2 expression was negatively correlated with that of EZH1 expression in the MF, NK/TCL, PC-ALCL, LyP, HV-like LPD and SPTCL tissues ( rs = -0.60, -0.68, -0.89, -0.74, -0.93, -0.80, respectively, all P < 0.05) . Conclusion:Polycomb group proteins EZH2, EED, SUZ12 and EZH1 are abnormally expressed in CTCL/LPD lesions.