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DNA N6-methyladenine (6mA) modification is the most prevalent DNA modification in prokaryotes, but whether it exists in human cells and whether it plays a role in human diseases remain enigmatic. Here, we showed that 6mA is extensively present in the human genome, and we cataloged 881,240 6mA sites accounting for â¼0.051% of the total adenines. [G/C]AGG[C/T] was the most significantly associated motif with 6mA modification. 6mA sites were enriched in the coding regions and mark actively transcribed genes in human cells. DNA 6mA and N6-demethyladenine modification in the human genome were mediated by methyltransferase N6AMT1 and demethylase ALKBH1, respectively. The abundance of 6mA was significantly lower in cancers, accompanied by decreased N6AMT1 and increased ALKBH1 levels, and downregulation of 6mA modification levels promoted tumorigenesis. Collectively, our results demonstrate that DNA 6mA modification is extensively present in human cells and the decrease of genomic DNA 6mA promotes human tumorigenesis.
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Adenina/análogos & derivados , Histona H2a Dioxigenasa, Homólogo 1 de AlkB/metabolismo , Genoma Humano , Metiltransferasa de ADN de Sitio Específico (Adenina Especifica)/metabolismo , Adenina/metabolismo , Histona H2a Dioxigenasa, Homólogo 1 de AlkB/genética , Animales , Carcinogénesis/genética , ADN/genética , Metilación de ADN , Xenoinjertos , Humanos , Ratones , Ratones Desnudos , Metiltransferasa de ADN de Sitio Específico (Adenina Especifica)/genéticaRESUMEN
OBJECTIVE: To investigate the changes in the size of the penis after radical prostatectomy (RP) and the possible influencing factors. METHODS: This study included 45 cases of RP for PCa performed by the same surgeon from January to June 2019. Before and at 2 weeks after surgery, we measured the stretched penile length (SPL), flaccid penile length (FPL) and penile circumference of the patients. We conducted an IIEF-5 questionnaire investigation on the preoperative characteristics of the patients and their attitudes towards postoperative penile rehabilitation. We also analyzed the factors associated with the postoperative changes in the size of the penis. RESULTS: Compared with the baseline, the postoperative SPL (ï¼»9.72 ± 1.87ï¼½ vs ï¼»7.80 ± 1.57ï¼½ cm, P = 0), FPL (ï¼»6.26 ± 1.14ï¼½ vs ï¼»5.13 ± 1.10ï¼½ cm, P = 0) and penile circumference (ï¼»7.69 ± 0.83ï¼½ vs ï¼»7.26 ± 0.78ï¼½ cm, P = 0.012) were decreased significantly, by (1.92 ± 0.12) cm, (1.13 ± 0.09) cm and (0.43 ± 0.08) cm, respectively. The age of the patients was significantly correlated with the change of the FPL (P = 0.042), but not the other factors with the change of the penile size. Twenty-six (57.7%) cases of severe and moderate ED were observed in the patients postoperatively. Those with better preoperative sexual function took a more positive attitude towards penile rehabilitation and treatment postoperatively (n = 3, 75.0%). CONCLUSIONS: The penile size of the PCa patient is decreased markedly after radical prostatectomy, with a significant correlation between the patient's age and the postoperative change of the flaccid penile length. The patients with better preoperative sexual function are more likely to seek penile rehabilitation and treatment postoperatively.
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Prostatectomía , Neoplasias de la Próstata , Humanos , Masculino , Pene , Periodo Posoperatorio , Neoplasias de la Próstata/cirugíaRESUMEN
Vertebral fractures are the most common osteoporotic fractures. To perform percutaneous vertebral body cement augmentation, it is essential to accurately identify the affected vertebrae. The study evaluated the role of radionuclide bone imaging in identifying fresh osteoporotic vertebral compression fractures. A prospective study of 39 patients with acute osteoporotic vertebral compression fractures was carried out. All patients underwent magnetic resonance imaging (MRI) and radionuclide bone imaging to determine if the fractures were fresh, followed by percutaneous kyphoplasty for the fresh fractures. The positive rate on radionuclide bone imaging was 92.1% (82/89), and the positive rate on MRI was 93.3% (83/89), with no statistically significant difference (Pâ>â0.05). Eighty-one vertebrae had the same positive identification by both radionuclide bone imaging and MRI, and 5 of the same vertebrae were diagnosed negative by both techniques. One patient with positive radionuclide bone imaging was negative according to MRI, and 2 patients were entirely positive by MRI but negative by radionuclide bone imaging. A kappa test showed good consistency between the 2 methods for detecting the affected vertebrae (Kappaâ=â0.751, Pâ<â0.01). Radionuclide bone imaging is as sensitive as MRI in the diagnosis of fresh osteoporotic vertebral compression fracture, making it an effective method for detecting affected vertebrae for percutaneous vertebroplasty.
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Fracturas por Compresión/diagnóstico por imagen , Imagen por Resonancia Magnética , Fracturas Osteoporóticas/diagnóstico por imagen , Cintigrafía , Fracturas de la Columna Vertebral/diagnóstico por imagen , Columna Vertebral/diagnóstico por imagen , Columna Vertebral/cirugía , Vertebroplastia/métodos , Anciano , Anciano de 80 o más Años , Femenino , Fracturas por Compresión/cirugía , Humanos , Masculino , Persona de Mediana Edad , Fracturas Osteoporóticas/cirugía , Estudios Prospectivos , Fracturas de la Columna Vertebral/cirugíaRESUMEN
AIM: To evaluate the clinical effect of the nitinol (NiTi)-patellar concentrator (NT-PC) for the treatment of comminuted patellar fractures. MATERIAL AND METHODS: A total of 32 patients with acute comminuted patellar fracture accepted open reduction and internal fixation with the NT-PC, and the curative effects were evaluated using the Böstman clinical grading scale. RESULTS: All fractures were anatomically reduced by surgery and all cases were followed-up for six to 18 months. The mean score of patients according to the Böstman clinical grading scale was 25.6, with 29 of 32 (90.7%) patients achieving excellent or good results. Two patients had traumatic arthritis, one had slippage of the NT-PC, and all patients received pharmacotherapy. CONCLUSIONS: The application of the NT-PC is a satisfactory approach to the treatment of comminuted patellar fractures.
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Fijación Interna de Fracturas/métodos , Fracturas Conminutas/cirugía , Rótula/cirugía , Adolescente , Adulto , Aleaciones , Artritis/etiología , Femenino , Estudios de Seguimiento , Fijación Interna de Fracturas/instrumentación , Humanos , Masculino , Persona de Mediana Edad , Rótula/lesiones , Resultado del Tratamiento , Adulto JovenRESUMEN
Porous hydroxyapatite (HA)-containing composite films were prepared by a novel method consisting of micro-arc oxidation (MAO) combined with microwave-hydrothermal (M-H) treatment. The morphology, composition and phase composition of the bioactive films were investigated with scanning electron microscopy with energy dispersive X-ray spectroscopy and X-ray diffraction. MTT assay was carried out to investigate the in vitro effects of the different surfaces on bone integration properties. The prepared MAO films consisted mainly of anatase, rutile and tricalcium phosphate along with amorphous calcium (Ca) and phosphorus (P) phases. The M-H-treated composite films were composed primarily of anatase, rutile and HA. As the time and temperature of the M-H treatment increased, the number of HA crystals gradually increased. Using the M-H method, HA was obtained at a lower temperature and in a shorter period of time compared to the conventional hydrothermal method. The results suggest that the M-H method significantly decreases the hydrothermal reaction temperature and also greatly shortens the reaction time. Due to the nanocrystallinity and porosity of the prepared composite films, the method presented here shows promise for the formation of bioactive materials for medical applications.
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Materiales Biocompatibles Revestidos , Durapatita , Titanio , Células 3T3 , Animales , Proliferación Celular , Materiales Biocompatibles Revestidos/química , Humanos , Ensayo de Materiales , Ratones , Microscopía Electrónica de Rastreo , Microondas , Oseointegración , Oxidación-Reducción , Porosidad , Prótesis e Implantes , Espectrometría por Rayos X , Propiedades de Superficie , Difracción de Rayos XRESUMEN
The finite element method (FEM) is a mathematical technique using modern computer technology for stress analysis, and has been gradually used in simulating human body structures in the biomechanical field, especially more widely used in the research of thoracolumbar spine traumatology. This paper reviews the establishment of the thoracolumbar spine FEM, the verification of the FEM, and the thoracolumbar spine FEM research status in different fields, and discusses its prospects and values in forensic thoracolumbar traumatology.
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Simulación por Computador , Análisis de Elementos Finitos , Vértebras Lumbares/lesiones , Modelos Teóricos , Vértebras Torácicas/lesiones , Fenómenos Biomecánicos , Humanos , Estrés Mecánico , TraumatologíaRESUMEN
BACKGROUND: We report a rare case of cervical spinal canal penetrating trauma and review the relevant literatures. CASE SUMMARY: A 58-year-old male patient was admitted to the emergency department with a steel bar penetrating the neck, without signs of neurological deficit. Computed tomography (CT) demonstrated that the steel bar had penetrated the cervical spinal canal at the C6-7 level, causing C6 and C7 vertebral body fracture, C6 left lamina fracture, left facet joint fracture, and penetration of the cervical spinal cord. The steel bar was successfully removed through an open surgical procedure by a multidisciplinary team. During the surgery, we found that the cervical vertebra, cervical spinal canal and cervical spinal cord were all severely injured. Postoperative CT demonstrated severe penetration of the cervical spinal canal but the patient returned to a fully functional level without any neurological deficits. CONCLUSION: Even with a serious cervical spinal canal penetrating trauma, the patient could resume normal work and life after appropriate treatment.
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Microwave gas sensors have garnered attention for their high sensitivity and selectivity in the detection of volatile organic compounds (VOCs). However, traditional gas sensors generally rely on sensitive materials that degrade over time and are easily affected by the environment, compromising their stability and accuracy. This study proposes a microwave VOC gas sensor based on the condensation effect. The sensor adopts a novel design without sensitive materials, utilizing the condensation effect to detect acetone gas. The sensor system consists of a microwave sensor and a temperature control device. As the sensor temperature is lowered below the boiling point of acetone, the condensation of acetone gas on the sensor surface is achieved, enabling accurate detection of acetone gas. Experimental results indicate that the accumulated amount of acetone on the sensor surface is positively correlated with its response, with the maximum response of 3000 ppm acetone gas reaching 0.34 dB. Additionally, this study investigated the detection mechanism of the sensor after adding the sensitive material MXene and compared the performance of the sensor at different temperatures (-10 °C, 0 °C, and 60 °C). The results show that at -10 °C the sensor mainly captures acetone through physical adsorption, while at 25 and 60 °C, it primarily responds through chemical adsorption, with a maximum response of 0.29 dB. The VOC sensor based on the condensation effect without sensitive materials not only achieves the same sensitivity as traditional microwave sensors but also demonstrates stronger stability and anti-interference capabilities.
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Micro/nanomotors (MNMs) emerge as a vital candidate for biosensing due to its nano-size structure, high surface-to-area ratio, directional mobility, biocompatibility, and ease of functionalization, therefore being able to detect objects with high efficiency, precision, and selectivity. The driving mode, nanostructure, materials property, preparation technique, and biosensing applications have been thoroughly discussed in publications. To promote the MNMs-based biosensors from in vitro to in vivo, it is necessary to give a comprehensive discussion from the perspective of sensing performances enhancement. However, until now, there is few reviews dedicated to the systematic discussion on the multiple performance enhancement schemes and the current challenges of MNMs-based biosensors. Bearing it in mind and based on our research experience in this field, we summarized the enhancement methods for biosensing properties such as sensitivity, selectivity, detection time, biocompatibility, simplify system operation, and environmental availability. We hope that this review provides the readers with fundamental understanding on performance enhancement schemes for MNMs-based biosensors.
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BACKGROUND AIMS: The aim of this study was to evaluate the efficacy and safety of cytokine-induced killer (CIK) cell therapy for solid carcinomas. METHODS: We performed a computerized search of phase II/III clinical trial databases of CIK cell-based therapy using a combination of the terms 'cytokine-induced killer cells', 'tumor' and 'cancer'. RESULTS: Treatment with CIK cells was associated with a significantly improved half-year survival (P = 0.003), 1-year survival (P = 0.0005), 2-year survival (P < 0.01) and mean survival time (MST) (P < 0.001). Patients in the CIK group showed a prolonged half-year progression-free survival (PFS) (P < 0.01), 1-year PFS (P < 0.01) and median time to progression (MTTP) (P < 0.001). A favored disease control rate (DCR) was observed in patients receiving CIK cell therapy, while the objective response rate (ORR) was not altered (P = 0.05) compared with the non-CIK group (P = 0.007). CIK cell therapy could also reduce the adverse effects of grade III and IV leukopenia caused by chemotherapy (P = 0.002) and diminish hepatitis B virus (HBV)-DNA content (P < 0.01). However, the incidence of fever in the CIK therapy group was significantly higher than in the non-CIK group (P = 0.02). The percentage of CD3(+), CD4(+), CD4(+)CD8(+), CD3(-) CD56(+) and CD3(+) CD56(+) T-lymphocyte subsets in the peripheral blood of cancer patients was significantly increased, whereas the percentage of CD8(+) T-lymphocyte cells was significantly decreased in the CIK group compared with the non-CIK group (P < 0.01). CONCLUSIONS: CIK cell therapy has demonstrated a significant superiority in prolonging the MST, PFS, DCR and quality of life (QoL) of patients.
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Carcinoma/terapia , Tratamiento Basado en Trasplante de Células y Tejidos/métodos , Células Asesinas Inducidas por Citocinas/citología , Células Asesinas Inducidas por Citocinas/trasplante , HumanosRESUMEN
The high geological background and the residual pollution of historical zinc smelting in the karst area of northwest Guizhou has led to serious soil heavy metal pollution. In order to understand the characteristics of soil heavy metal pollution in agricultural land, wasteland, and forestland, 126 surface and profile soil samples were collected from a typical zinc powder factory-polluted small watershed in Weining County, Northwest Guizhou Province. The concentrations and distribution characteristics of Cd, As, Pb, Cu, and Zn in soils were studied. The results showed that the average ω(Cd), ω(As), ω(Pb), ω(Cu), and ω(Zn) in the surface soil were 8.14, 45.07, 263.97, 41.36, and 716.98 mg·kg-1, respectively, which were 1.29-12.33 times higher than the background values. The content of heavy metals in soil of different land uses in descending order was agricultural land, wasteland, and forestland. From the perspective of spatial distribution, the soil with high heavy metal concentration was concentrated around the zinc smelting plant and slag, and the accumulation of heavy metals in soil was greatly affected by the pollution sources of mining activities but less affected by the land use mode. In soil profile, heavy metals in the surface layer were generally higher than those in bottom layers, showing a significant difference (P<0.05) in wasteland. Five heavy metals in 80-100 cm soil were higher than the background value, reflecting the existence of a high geological background value. Correlation analysis and principal component analysis showed that Pb, Zn, and As in the surface soil were mainly affected by human activities such as mining and transportation, whereas Cd and Cu were both affected by high geological background and human activities. The single ecological risk coefficient of Cd in soil was the highest, which reached very strong or very strong risk, whereas As, Zn, Cu, and Pb reached slight or medium risk. The comprehensive potential ecological risk index indicated strong ecological risk, which in agricultural land was higher than that in wasteland and forestland. In the karst high geological background area, the influence of lead and zinc smelting on the distribution and accumulation of heavy metals in soils was greater than that of land use; soil heavy metal pollution was serious, and ecological risk was high in this area. Therefore, strict control of heavy metal-contaminated soil should be strengthened.
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Metales Pesados , Contaminantes del Suelo , Cadmio/análisis , China , Monitoreo del Ambiente/métodos , Humanos , Plomo/análisis , Metales Pesados/análisis , Medición de Riesgo , Suelo , Contaminantes del Suelo/análisis , ZincRESUMEN
OBJECTIVE: To explore forensic identification of causality between injury and the consequence in cases of cervical spinal cord injury without fracture or dislocation. METHODS: Twenty-five cases of cervical spinal cord injury without fracture or dislocation were collected. The age, mode of injury, imaging reports, cervical vertebral degeneration, clinical manifestations, diagnosis, treatment and injury consequences were summarized. The causality between injury and its consequence were classified as direct cause, main cause, same cause, minor cause and no cause. RESULTS: Age, mode of injury, cervical vertebral degeneration and spinal stenosis were important factors in the analysis of causality. In the injured younger than 8-year-old trauma was generally the direct cause to the damage. While in other injured, it was needed to analyze the various factors comprehensively. CONCLUSION: Comprehensive analysis of age, mode of injury, cervical vertebral degeneration, spinal stenosis and other factors would contribute to accurate identification of the causality between the injury and the consequences in cases of cervical spinal cord injury without fracture or dislocation.
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Vértebras Cervicales , Medicina Legal , Traumatismos de la Médula Espinal/diagnóstico , Traumatismos de la Médula Espinal/etiología , Estenosis Espinal/complicaciones , Accidentes de Tránsito , Adolescente , Adulto , Factores de Edad , Niño , Preescolar , Femenino , Humanos , Puntaje de Gravedad del Traumatismo , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Traumatismos de la Médula Espinal/patología , Espondilosis/complicaciones , Adulto JovenRESUMEN
OBJECTIVE: To evaluate the radical debridement and single stage posterior spinal fusion and instrumentation for the treatment of spinal tuberculosis. METHODS: From 1999 to 2004, 57 patients (29 males, 26 females) with spinal tuberculosis were operated at our department. The age range was 20 to 77 years old (mean: 39 years old). There were 30 cases of thoracic vertebra and 27 cases of lumbar vertebra. All the patients received a standard pre-operative 4 - 8-week anti-tuberculosis treatment. RESULTS: The follow-up period ranged from 1 - 4 years and 95.9% of patients achieved an excellent outcome. Solid bony fusion was seen at last in all cases. The mean post-operative kyphosis angle reduced to 20 degrees from 32 degrees pre-operation. CONCLUSION: Single stage anterior spinal fusion and instrumentation is curative for spinal tuberculosis.
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Trasplante Óseo , Fijación Interna de Fracturas , Fusión Vertebral , Tuberculosis de la Columna Vertebral/cirugía , Adulto , Anciano , Desbridamiento/métodos , Femenino , Humanos , Vértebras Lumbares/patología , Masculino , Persona de Mediana Edad , Vértebras Torácicas/patología , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND: Patellar fractures account for approximately 1% of all fractures. Due to the patella's importance as regards the extensor mechanism, effort should be made to preserve the patella. Several operative treatment methods have been introduced for patella fractures. OBJECTIVES: This study aims to compare the clinical effect of a titanium cable tension band and nickeltitanium (NiTi) patella concentrator (NT-PC) in treating patella fractures. MATERIAL AND METHODS: Thirty-nine patients with patella fractures were enrolled in this retrospective study. All the patients were treated via the open reduction internal fixation procedure using a titanium cable tension band or NT-PC. All the patients were followed up over an average period of 13 months. The main outcome measures were operation time, time of fracture union, postoperative complications, and Böstman knee scores. Statistical analyses were conducted between the 2 groups. RESULTS: All the patients were operated on successfully. The operation time of the NT-PC treatment group was less than that of the titanium cable tension band treatment group (p < 0.05). The mean scores at the final follow-up were 28.2 and 27.6 points in the titanium cable tension band and NT-PC groups, respectively. No significant difference was observed between the excellent and good results (p > 0.05). CONCLUSIONS: Both titanium cable tension band and NT-PC showed good efficacy for the treatment of patellar fractures. NT-PC fixation, a new option for the treatment of patella fractures, is a simple and effective fixation method.
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Fijación Interna de Fracturas/métodos , Fracturas Óseas/cirugía , Rótula/lesiones , Adulto , Anciano , Hilos Ortopédicos , Femenino , Fijación Interna de Fracturas/instrumentación , Humanos , Fijadores Internos , Masculino , Persona de Mediana Edad , Níquel , Estudios Retrospectivos , TitanioRESUMEN
OBJECTIVE: To investigate the efficacy of autologous cytokine-induced killer (CIK) cell therapy combined with chemotherapy versus chemotherapy alone for the treatment of stage IV gastrointestinal (GI) cancer in the first-line setting. METHODS: Thirty-three patients diagnosed with stage IV GI cancer were divided into chemotherapy plus CIK group (chemo-CIK, n = 16) and chemotherapy-alone group (chemo-alone, n = 17). Autologous peripheral blood mononuclear cells were separated by flow cytometry, cultured in vitro to induce CIK cells, and transfused into patients on days 14 and 16 of the first and second chemotherapy cycles. RESULTS: The median progression-free survival (PFS) was 5.6 months for patients in the chemo-CIK group and 3.83 months for those in the chemo-alone group. The difference was borderline significant (P = 0.06), indicating a potential advantage for combined CIK cell transfusion with chemotherapy in improving PFS. A favored objective response rate was also observed in the chemo-CIK group than in the chemo-alone group. This study also revealed that CIK cell transfusion restored the cellular immunity in these GI cancer patients. The percentage of natural killer T cells, NK cells, CD3(+) T cells, and T-cell subgroups CD4(+) proportion in the peripheral blood of cancer patients significantly increased after the CIK cell transfusion, while the change in T-cell subgroups CD8(+) and CD4(+)/CD8(+) did not differ significantly. CONCLUSIONS: The study showed that the addition of CIK cell transfusion to traditional chemotherapy in the first-line setting was associated with a prolonged PFS and enhanced T-lymphocyte subset activity, supporting a potential treatment choice for advanced GI cancer patients.
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Antineoplásicos/uso terapéutico , Trasplante de Células , Células Asesinas Inducidas por Citocinas/inmunología , Neoplasias Gastrointestinales/terapia , Adulto , Anciano , Biomarcadores de Tumor , Terapia Combinada , Femenino , Neoplasias Gastrointestinales/tratamiento farmacológico , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Most herbal medicines could be processed to fulfill the different requirements of therapy. The purpose of this study was to discriminate between raw and processed Dipsacus asperoides, a common traditional Chinese medicine, based on their near infrared (NIR) spectra. Least squares-support vector machine (LS-SVM) and random forests (RF) were employed for full-spectrum classification. Three types of kernels, including linear kernel, polynomial kernel and radial basis function kernel (RBF), were checked for optimization of LS-SVM model. For comparison, a linear discriminant analysis (LDA) model was performed for classification, and the successive projections algorithm (SPA) was executed prior to building an LDA model to choose an appropriate subset of wavelengths. The three methods were applied to a dataset containing 40 raw herbs and 40 corresponding processed herbs. We ran 50 runs of 10-fold cross validation to evaluate the model's efficiency. The performance of the LS-SVM with RBF kernel (RBF LS-SVM) was better than the other two kernels. The RF, RBF LS-SVM and SPA-LDA successfully classified all test samples. The mean error rates for the 50 runs of 10-fold cross validation were 1.35% for RBF LS-SVM, 2.87% for RF, and 2.50% for SPA-LDA. The best classification results were obtained by using LS-SVM with RBF kernel, while RF was fast in the training and making predictions.
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Dipsacaceae/química , Medicamentos Herbarios Chinos/química , Espectroscopía Infrarroja Corta/métodos , Dipsacaceae/clasificación , Análisis Discriminante , Medicamentos Herbarios Chinos/clasificación , Análisis de los Mínimos Cuadrados , Modelos Estadísticos , Sensibilidad y Especificidad , Máquina de Vectores de SoporteRESUMEN
OBJECTIVE: The anemia of chronic disease (ACD) is usually defined as mild to moderate anemia occurring during the chronic infection, inflammation, neoplasm or trauma. It is the most common anemia among in-hospital adults. The insufficient endogenous erythropoietin (EPO) production is probably one of the pathogenic mechanisms of ACD. Inflammatory cytokines play an important role in the ACD pathogenesis. But nowadays there are few published papers on the childhood ACD in the world. This study aimed to detect the EPO levels in children's ACD, to explore the relationship between EPO and tumor necrosis factor alpha (TNF alpha) and interleukin-6 (IL-6) and, to evaluate the effect of recombinant human TNF alpha (rhTNF-alpha) on EPO gene expression. METHODS: Sixty children were divided into ACD group (20 children), non-anemia (NA) group (19 children) and iron deficiency anemia (IDA) group (21 children) according to clinical diagnosis. Serum TNF alpha and IL-6 levels were detected with ELISA method. The EPO level was detected by chemical immulite method. The effect of rhTNF alpha on the expression of EPO gene was studied by culturing Hep G2 cell line and RT-PCR method. RESULTS: Serum EPO levels were different among the 3 groups (F = 44.68, P < 0.01). Serum EPO levels in ACD group were higher than those in NA group, while the hemoglobin levels were similar between the two groups. Serum EPO levels in ACD patients were lower than those in IDA patients. Serum TNF alpha levels were different among the 3 groups (F = 25.15, P < 0.01), and serum IL-6 levels were also different among the 3 groups (F = 13.16, P < 0.01). Serum TNF alpha and IL-6 levels in ACD group were higher than those in NA group. In ACD group, serum levels of both TNF alpha and IL-6 were not correlated to the serum level of EPO (r = -0.35, P > 0.05 and r = -0.05, P > 0.05, respectively). In vitro, rhTNF alpha inhibited the expression of EPO mRNA in hypoxia, and the inhibitory effects became stronger with the increase of rhTNF alpha (F = 64.20, P < 0.01). CONCLUSION: EPO levels increased incompensatively in ACD children, which may be a cause of ACD. TNF alpha may cause anemia by inhibiting EPO production.