A intermediate concentration of atmospheric nitrogen dioxide enhances PSII activity and inhibits PSI activity in expanded leaves of tobacco seedlings.

Nitrogen dioxide (NO2) is a major air pollutant that affects plant growth, development and yields. Previous studies have found that atmospheric NO2 changes plant photosynthesis in a concentration-dependent manner. Low concentrations of NO2 (4.0 µL L-1) can increase photosynthetic rates, while high concentrations of NO2 (16.0 µL L-1) can have an inhibitory effect. However, the specific effects of a critical intermediate concentration of NO2 on the photosynthetic apparatus of plants has remained unknown. Therefore, in this study, tobacco seedlings at three-leaf ages were fumigated with a intermediate concentration of 8.0 µL L-1 NO2 for 15 days to determine the effects on leaf weight, leaf number per plant, chlorophyll content, net photosynthetic rate, the reaction center activity of photosystems I and II (PSI and PSII, respectively) and core protein gene expression (PsbA and PsaA). Fumigation with 8.0 µL L-1 NO2 increased the number of leaves per plant and the weight of leaves, and the leaves became dark green and curly after 10 days of fumigation. During NO2 fumigation for 15 days, the chlorophyll content, PSII maximum photochemical efficiency (Fv/Fm), electron transfer rate (ETR) and non-photochemical quenching (NPQ) increased most in the oldest leaves (Lmax leaves), but decreased PSI activity (∆I/Io). The Fv/Fm, ETR and NPQ in the youngest leaves (Lmin leaves) were lower than those of Lmax leaves, but the actual photochemical efficiency (ΦPSII) of PSII increased most and ∆I/Io was the highest in these samples. The Fv/Fm, ETR, NPQ and ΦPSII in the leaves at the middle leaf age (Lmid leaves) were lower than those of Lmin and Lmax leaves, but the relative fluorescence intensity of point L (VL) and the relative fluorescence intensity of point K (VK) decreased the most in these samples. Thus, this critical concentration of atmospheric NO2 increased the activity of PSII and inhibited PSI activity in expanded leaves of tobacco seedlings.

Elevated air temperature damage to photosynthetic apparatus alleviated by enhanced cyclic electron flow around photosystem I in tobacco leaves.

High temperature can lead to increased production of excess light energy, thus reducing photosynthetic capacity in plants. Photosynthetic cyclic electron flow (CEF) in photosystem I (PSI) can effectively protect photosystems, but its physiological mechanism under high temperature is poorly understood. In this study, antimycin A (AA) and thenoyltrifluoroacetone (TTFA) were used to inhibit PGR5-and NDH-dependent CEF pathways, respectively, to reveal the photoprotective functions of CEF for PSII in tobacco leaves under high temperature stress (37 °C, HT). High temperatures caused decreases in maximal photochemistry efficiency (Fv/Fm) and damaged photosystem II (PSII) in tobacco leaves. Under AA inhibition of PGR5-dependent CEF, high temperature increased the fluorescence intensity of point O (Fo) in OJIP curves, i.e., the energy absorption per active reaction center (ABS/RC), the trapping rate of the reaction center (TRo/RC), and the electron transport efficiency per reaction center (ETo/RC) in tobacco leaves. High temperature induced an increase in the hydrogen peroxide content and a decrease in pigment content in tobacco leaves. Under the high temperature treatment, inhibition of PGR5-dependent CEF reduced the activities of the PSII reaction center significantly, destroyed the oxygen-evolving complex (OEC), and impeded photosynthetic electron transfer from PSII to the plastoquinone (PQ) pool in tobacco leaves. The TTFA treatment inhibited the NDH-dependent pathway under high temperature conditions, with the relative fluorescence intensity of point I (VI) decreased significantly, and the content of hydrogen peroxide and superoxide anion increased significantly. Additionally, Fo and the redox degree of the PSII donor side (Wk) increased, and pigment content decreased compared to the control, but with little change compared to high temperature treatment, indicating that the inhibition of the NDH-dependent pathway directly weakened the capacity of the PQ pool to lead to the accumulation of reactive oxygen species (ROS) in tobacco leaves. In conclusion, CEF alleviated damage to the photosynthetic apparatus in tobacco leaves by increasing PSII heat dissipation, reducing ROS production, and maintaining the stability of the PQ pool to accommodate photosynthetic electron flow.

Physiological and proteomic responses of reactive oxygen species metabolism and antioxidant machinery in mulberry (Morus alba L.) seedling leaves to NaCl and NaHCO3 stress.

In this paper, the effects of 100 mM NaCl and NaHCO3 stress on reactive oxygen species (ROS) and physiological and proteomic aspects of ROS metabolism in mulberry seedling leaves were studied. The results showed that NaCl stress had little effect on photosynthesis and respiration of mulberry seedling leaves. Superoxide dismutase (SOD) activity and the expression of related proteins in leaves increased by varying degrees, and accumulation of superoxide anion (O2·-) not observed. Under NaHCO3 stress, photosynthesis and respiration were significantly inhibited, while the rate of O2·- production rate and H2O2 content increased. The activity of catalase (CAT) and the expression of CAT (W9RJ43) increased under NaCl stress. In response to NaHCO3 stress, the activity and expression of CAT were significantly decreased, but the ability of H2O2 scavenging of peroxidase (POD) was enhanced. The ascorbic acid-glutathione (AsA-GSH) cycle in mulberry seedling leaves was enhancement in both NaCl and NaHCO3 stress. The expression of 2-Cys peroxiredoxin BAS1 (2-Cys Prx BAS1), together with thioredoxin F (TrxF), thioredoxin O1 (TrxO1), thioredoxin-like protein CITRX (Trx CITRX), and thioredoxin-like protein CDSP32 (Trx CDSP32) were significantly increased under NaCl stress. Under NaHCO3 stress, the expression of the electron donor of ferredoxin-thioredoxin reductase (FTR), together with Trx-related proteins, such as thioredoxin M (TrxM), thioredoxin M4 (TrxM4), thioredoxin X (TrxX), TrxF, and Trx CSDP32 were significantly decreased, suggesting that the thioredoxin-peroxiredoxin (Trx-Prx) pathway's function of scavenging H2O2 of in mulberry seedling leaves was inhibited. Taken together, under NaCl stress, excessive production of O2·- mulberry seedlings leaves was inhibited, and H2O2 was effectively scavenged by CAT, AsA-GSH cycle and Trx-Prx pathway. Under NaHCO3 stress, despite the enhanced functions of POD and AsA-GSH cycle, the scavenging of O2·- by SOD was not effective, and that of H2O2 by CAT and Trx-Prx pathway were inhibited; and in turn, the oxidative damage to mulberry seedling leaves could not be reduced.

Chlorophyll synthesis and the photoprotective mechanism in leaves of mulberry (Morus alba L.) seedlings under NaCl and NaHCO3 stress revealed by TMT-based proteomics analyses.

Chlorophyll (Chl) and effective photoprotective mechanism are important prerequisites to ensure the photosynthetic function of plants under stress. In this study, the effects of 100 mmol L-1 NaCl and NaHCO3 stress on chlorophyll synthesis and photosynthetic function of mulberry seedlings were studied by physiological combined with proteomics technology. The results show that: NaCl stress had little effect on the expression of Chl synthesis related proteins, and there were no significant changes in Chl content and Chl a:b ratio. However, 13 of the 15 key proteins in the process of Chl synthesis were significantly decreased under NaHCO3 stress, and the contents of Chl a and Chl b were significantly decreased (especially Chl a). Although stomatal conductance (Gs) decreased significantly under NaCl stress, net photosynthetic rate (Pn), PSII maximum photochemical efficiency (Fv/Fm) and electron transfer rate (ETR) did not change significantly, but under NaHCO3 stress, not only Gs decreased significantly, PSII activity and photosynthetic carbon were the same. In the photoprotective mechanism under NaCl stress, NAD(P)H dehydrogenase (NDH)-dependent cyclic electron flow (CEF) enhanced, the expression of related proteins subunit, ndhH, ndhI, ndhK, and ndhM, the key enzyme of the xanthophyll cycle, violaxanthin de-epoxidase (VDE) were up-regulated, the ratio of (A + Z)/(V + A + Z) and non-photochemical quenching (NPQ) was increased. The expressions of proteins FTR and Fd-NiR were also significant up-regulated under NaCl stress, Fd-dependent ROS metabolism and nitrogen metabolism can effectively reduce the electronic pressure on Fd. Under NaHCO3 stress, the expressions of NDH-dependent CEF related proteins subunit (ndhH, ndhI, ndhK, ndhM and ndhN), VDE, ZE, FTR, Fd-NiR and Fd-GOGAT, were significant down-regulated, and ZE, CP26, ndhK, ndhM, Fd-NiR, Fd-GOGAT and FTR genes expression also significantly decreased, the photoprotective mechanism, like the xanthophyll cycle，CEF and Fd-dependent ROS metabolism and nitrogen metabolism might be damaged, resulting in the inhibition of PSII electron transfer and carbon assimilation in mulberry leaves under NaHCO3 stress.

Toxic effects of heavy metals Pb and Cd on mulberry (Morus alba L.) seedling leaves: Photosynthetic function and reactive oxygen species (ROS) metabolism responses.

To explore the mechanism of how lead (Pb) and cadmium (Cd) stress affects photosynthesis of mulberry (Morus alba L.), we looked at the effects of different concentrations of Pb and Cd stress (at 100 and 200 µmol L-1), which are two heavy metal elements, on leaf chlorophyll (Chl), photosynthesis gas exchange, Chl fluorescence, and reactive oxygen species (ROS) metabolism in mulberry leaves. The results showed that higher concentrations of Pb and Cd reduced leaf Chl content, especially in Chl a where content was more sensitive than in Chl b. Under Pb and Cd stress, the photosynthetic carbon assimilation capacity of mulberry leaves was reduced, which was a consequence of combined limitations of stomatal and non-stomatal factors. The main non-stomatal factors were decreased photosystem II (PSII) and photosystem I (PSI) activity and carboxylation efficiency (CE). Damage to the donor side of the PSII reaction center was greater than the acceptor side. After being treated with 100 µmol L-1 of Pb and Cd, mulberry leaves continued to be able to dissipate excess excitation energy by starting non-photochemical quenching (NPQ), but when Pb and Cd concentrations were increased to 200 µmol L-1, the protection mechanism that depends on NPQ was impaired. Excessive excitation energy from chloroplasts promoted a great increase of ROS, such as superoxide anion (O2•-) and H2O2. Moreover, under high Pb and Cd stress, superoxide dismutase (SOD) and ascorbate peroxidase (APX) were also inhibited to some extent, and excessive ROS also resulted in a significantly higher degree of oxidative damage. Compared with Cd, the effect of Pb stress at the same concentration level displayed a significantly lower impact on Chl content, photosynthetic carbon assimilation, and stomatal conductance. Meanwhile, Pb stress mainly damaged activity of the oxygen-evolving complex (OEC) located on PSII donor side, but it reduced the electronic pressure on the PSII acceptor side and PSI. Furthermore, under Pb stress, the NPQ, SOD, and APX activity were all significantly higher than those under Cd stress. Thus under Pb stress, the degree of photoinhibition and oxidative damage of PSII and PSI in mulberry leaves were significantly lower than under Cd stress.

Elevated NO2 damages the photosynthetic apparatus by inducing the accumulation of superoxide anions and peroxynitrite in tobacco seedling leaves.

This study aimed to further understand the toxicity of high concentrations of nitrogen dioxide (NO2) to plants, especially to plant photosynthesis. Tobacco plants in the six-leaf stage were exposed to 16.0 µL L-1 NO2 to determine the activities of photosystem II (PSII) and photosystem I (PSI) reaction centers, the blocking site of PSII electron transport, the degree of membrane peroxidation and the relative expression of PsbA, PsbO and PsaA genes in the third fully expanded leaves by using gas exchange and chlorophyll fluorescence techniques, biochemical and RT-PCR analysis. The results showed that 16.0 µL L-1 NO2 caused necrotic lesions to form on leaves and significantly increased the generation rate of superoxide anions (O2-) and the content of peroxynitrite (ONOO-) in leaves of tobacco seedling, leading to damage to cell membrane, chlorophyll content and net photosynthetic rate reduction, and photosynthetic apparatus destruction. Fumigation with 16.0 µL L-1 NO2 decreased the activity of PSII reaction center and oxygen evolution complex, and the relative expression of PabA in leaves of tobacco seedlings to inhibit the electron transport from the donor side to the receptor side of PSII, especially blocking the electron transport from QA to QB on the receptor side. The activity of the PSI reaction center and the relative expression of PsaA decreased, weakening the ability to accept electrons and inhibiting the electron transfer from PSII to PSI, which further increased the damage of PSII of tobacco seedling leaves caused by 16.0 µL L-1 NO2. Therefore, 16.0 µL L-1 NO2 leaded to the accumulation of O2- and ONOO-, which damaged the cell membrane and thylakoid membrane, inhibit the electron transport, and destroyed the photosynthetic apparatus in leaves of tobacco seedlings. The results from this study emphasized the importance of reducing the NO2 concentration in the atmosphere.

Abscisic acid plays a key role in the mechanism of photosynthetic and physiological response effect of Tetrabromobisphenol A on tobacco.

The toxicity of bromide to animals and microorganisms has been widely studied, but the mechanism by which bromide toxicity affects plants is rarely studied. This study used the bromophenol compound Tetrabromobisphenol A (TBBPA) as a representative of bromide to explore the physiological and molecular response mechanism of tobacco leaves to TBBPA. In addition, physiological determination, transcriptomics, weighted gene co-expression network analysis (WGCNA) analysis, and random forest prediction model were conducted. The findings from this study indicated that TBBPA limited the photoreaction process by destroying the light-catching antenna protein of tobacco leaves, the activity of the photosystem reaction centers (PSII and PSI), and the linear electron transport efficiency. TBBPA also reduced the rate of the Calvin-Benson cycle by inhibiting the activities of gene such as Rubisco, PGK, and TPI, and finally destroyed the photosynthesis process. Although cyclic electron transport was enhanced under stress conditions, it could not reverse the damage caused by TBBPA on photosynthesis. TBBPA exposure resulted in the accumulation of reactive oxygen species (ROS) in tobacco leaves, and the activities of Superoxide dismutase (SOD), Ascorbate peroxidase (APX), and Glutathione peroxidase (GPX) and their coding genes were significantly down-regulated. Although POD activity and proline (Pro) content were increased, they were insufficient to remove excess O2·- free radicals to relieve ROS stress. WCGNA and random forest models predicted that the damage of TBBPA to the above processes in tobacco was closely related to the increase in abscisic acid (ABA) content. TBBPA affects the Calvin cycle by inducing ABA signal transduction and stomatal closure, which leads to a series of chain reactions, such as electron transport chain obstruction, excess of ROS, decrease in chlorophyll synthesis, and photosystem reaction center damage.

Characteristics of acute graft-versus-host disease of the intestine after unrelated cord blood transplantation / 中国组织工程研究

BACKGROUND:Despite unrelated cord blood transplantation is expected to become an important method for treating malignant hematological diseases,the manifestation and clinical characteristics of acute graft-versus-host disease in the gastrointestinal tract still require further in-depth investigation. OBJECTIVE:To analyze the clinical characteristics of intestinal acute graft-versus-host disease after unrelated cord blood transplantation. METHODS:A retrospective analysis was conducted on 668 malignant hematological disease patients after unrelated cord blood transplantation who underwent hematopoietic stem cell transplantation subspecialty in the Department of Hematology,First Affiliated Hospital of University of Science and Technology of China from December 2016 to December 2020.Among them,clinical data of 138 patients with intestinal acute graft-versus-host disease were analyzed,including 76 males and 62 females,with a median age of 13(1-62)years.All patients were treated with a myeloablative regimen(without antihuman thymocyte globulin)and cyclosporin A combined with mycophenolate mofetil to prevent graft-versus-host disease. RESULTS AND CONCLUSION:(1)The patients with intestinal acute graft-versus-host disease had diarrhea of varying degrees,most of which were yellow-green,yellow-brown watery stools or mucous stools.53 patients(38.4%)had blood stools,82 patients(57.9%)had skin involvement,18 patients(13.0%)had a secondary intestinal bacterial infection,and 90 patients(65.2%)had cytomegaloviremia.(2)The clinical characteristics of patients(70 cases,50.7%)with grade 1-2 intestinal acute graft-versus-host disease were compared with those(68 cases,49.3%)with grade 3-4 intestinal acute graft-versus-host disease.It was found that the age of grade 3-4 intestinal acute graft-versus-host disease patients was higher than that of grade 1-2 intestinal acute graft-versus-host disease patients(P<0.001),and they were complicated with cytomegaloviremia probably(P=0.035).Diarrhea lasted longer(P=0.00)and the length of hospital stay increased substantially(P<0.001).However,there were no significant differences in recipient gender,pre-transplant disease status,HLA matching,diagnosis,combined skin graft-versus-host disease,and secondary intestinal infection rate in patients of the two groups.(3)These findings conclude that the clinical characteristics of intestinal acute graft-versus-host disease after unrelated cord blood transplantation are complex,which affects the prognosis and quality of life of patients seriously and requires early identification and precise treatment.

The Response of Photosynthetic Functions of F1 Cutting Seedlings From Physocarpus amurensis Maxim (♀) × Physocarpus opulifolius "Diabolo" (♂) and the Parental Seedlings to Salt Stress.

This paper selected clonal cutting seedlings from the F1 hybrid varieties of Physocarpus amurensis Maxim (♀) × P. opulifolius "Diabolo" (♂) as research material to study the response of the photosynthetic gas exchange parameters and chlorophyll fluorescence parameters of P. amurensis hybrids and their parental leaves to NaCl stress (with concentrations of 0, 50, 100, and 200 mmol⋅L-1). The results showed that under salt stress, the stomatal conductance (Gs), transpiration rate (Tr), and net photosynthetic rate (Pn) of the three kinds of P. amurensis all significantly decreased. When the NaCl concentration was below 100 mmol⋅L-1, the intercellular CO2 concentration (Ci) of leaves of the three samples declined with the increase of salt concentration; however, when the concentration increased to 200 mmol⋅L-1, Ci did not decrease significantly, especially when the Ci of P. opulifolius "Diabolo" presented a slight increase. This indicated that the decline of photosynthetic carbon assimilation capacity induced by salt stress was the consequence of interaction between stomatal factors and non-stomatal factors, and the stomatal factors played an important role when the salt concentration was below 200 mmol⋅L-1. Compared with P. amurensis, the photosynthetic gas exchange capability of P. opulifolius "Diabolo" leaves was more sensitive to salt stress, and the limitation of non-stomatal factors was relatively evident. However, the photosynthetic capacity of hybrid P. amurensis leaves with the desired purple color was improved compared with P. amurensis. Under salt stress, the PSII activity of the three kinds of P. amurensis leaves declined, the electron transfer was inhibited, and obvious signs of photoinhibition were present. The PSII activity of P. opulifolius "Diabolo" leaves was more sensitive to salt stress than that in P. amurensis. Under salt stress, the NPQ of P. opulifolius "Diabolo" leaves decreased greatly, while under high salt concentrations the degree of photoinhibition in P. amurensis and hybrid P. amurensis were reduced due to a relatively high NPQ. With the increase of salt concentration, the Vk of P. amurensis and hybrid P. amurensis leaves presented a decreasing trend. However, the Vk of P. opulifolius "Diabolo" leaves increased slightly. This suggested that the effects of salt stress on the oxygen-evolving complex (OEC) of the three P. amurensis sample types were relatively limited and only the OEC of P.s opulifolius "Diabolo" leaves were slightly sensitive to salt stress. The VJ of all leaves from the three P. amurensis types increased under salt stress, and the VJ increased significantly when the salt concentration increased to 200 mmol⋅L-1, indicating that salt stress obviously impeded the electron transfer chain from QA to QB on the PSII receptor side. Moreover, high salt concentrations caused thylakoid membrane dissociation. The electron transfer and degree of damage to the thylakoid membrane of P. opulifolius "Diabolo" leaves were obviously higher than that of P. amurensis. However, the electron transfer capacity on the PSII receptor side as well as the degree of damage of the thylakoid membrane of hybrid P. amurensis leaves was obviously lower than those of P. opulifolius "Diabolo." The salt tolerance of photosynthetic functions of hybrid P. amurensis (♀) × P. opulifolius "Diabolo" (♂) leaves was improved compared with that of parental P. opulifolius "Diabolo," and the hybrid shows obvious hybrid vigor for photosynthesis.

Application of umbilical cord blood transplantation in the treatment of paroxysmal nocturnalhemoglobinuria / 中华器官移植杂志

Objective:To explore the feasibility and efficacy of umbilical cord blood transplantation (UCBT) in the treatment of paroxysmal nocturnal hemoglobinuria (PNH).Methods:From May 2014 to December 2019, clinical data were retrospectively reviewed for 7 PNH patients undergoing UCBT. The grades were severe ( n=6) and extremely severe ( n=1). The causes were primary PNH ( n=4) and PNH-aplastic anemia (AA) syndrome ( n=3). There were 5 males and 2 females with a median age of 29 (20-47) years, a median weight of 60(50-71) kg and a median time from diagnosis to transplantation of 62.5(7.7-171) months. All of them were accompanied by transfusion dependence. Myeloablative ( n=6) and reduced-intensity ( n=1) pretreatment was offered. The regimen of preventing GVHD was cyclosporine A plus short-term mycophenolate mofetil without ATG. The median number of input nucleated cells was 2.4(1.71-4.28)×10 7/kg and the median number of CD34+ cells 1.58(0.88-3.02)×10 5/kg. Results:Neutrophil and erythroid engraftment was obtained with a median neutrophil engraftment time of 17(15-21) days and a median erythroid engraftment time of 27. Engraftment time of 37(25-101) days for platelets >20×10 9/L and 62(27-157) days for platelets >50×10 9/L. The incidence of 100-day acute GVHD was 28.6%(95%CI 0-55.3%). The severity of GVHD was grade Ⅱ° acute ( n=2) and mild ( n=1). The median follow-up period was 13.5(3-71.4) months. Six patients survived while another with PNH-AA syndrome with iron overload died of gastrointestinal hemorrhage. The 2-year overall survival rate was 83.3%(95%CI 27.3-97.5%). Conclusions:With excellent engraftment and survival in the treatment of PNH, UCBT is indicated for patients without HLA full-match donor. PNH-AA syndrome with iron overload may be one of the important prognostic factors.

Preliminary study on the relationship between chronic inflammation and biopsy results in prostate biopsy / 中华泌尿外科杂志

Objective:To investigate the correlation between chronic inflammation and biopsy results in the first prostate biopsy and the predictive effect of chronic inflammation on the results of repeated prostate biopsy.Method:From January 2016 to January 2019, 771 patients who underwent transperineal prostate biopsy for the first time in the Second Hospital of Tianjin Medical University were included. The average age was 69.6 years old(39-89), with PSA level of 16.1 ng/ml(4-50), PSAD level of 0.6 ng/ml 2(0.1-1.3), prostate volume(PV)of 40.2 ml(16.7-129.5), transition zone volume(TZ) of 23.9 ml(0.7-49.5). The biopsy was performed under general anesthesia in the lithotomy position, and transrectal ultrasound(TRUS)and prostate puncture template were used to guide the biopsy. The association between chronic inflammation and pathological results or Gleason scores in prostate cancer (PCa) were analyzed. The univariate and multivariate logistic regression analyses were performed to select the independent risk factors for prostate biopsy results. The relationship between chronic inflammation and pathological results in patients with repeated biopsy within 3 years after the first biopsy was assessed. The independent risk factors related to the results of the repeated biopsy were also evaluated. Result:A total of 771 patients were included, including 354 cases of PCa and 144(40.7%) cases associated with chronic inflammation. In addition, 332 cases were benign prostatic disease (BPD), including 263(79.2%) cases with chronic inflammation, and 85 cases were prostate high-grade intraepithelial neoplasia group (HGPIN), including 13(15.3%) cases with chronic inflammation. The PV, TZ and chronic inflammation rates were statistically significantly lower in PCa and HGPIN than those in BPD, while the level of PSA and PSAD were significantly higher than those in BPD. Multivariate logistics regression analysis showed that PSAD and chronic inflammation rates were independent risk factors for PCa and HGPIN. According to the biopsy results of Gleason score from 6 to 10, the chronic inflammation rates was 70%(35/50), 61%(36/59), 33%(69/209), 12%(3/25) and 9%(1/11) respectively ( P<0.05), which indicated that the chronic inflammation was negatively correlated with higher grade tumors. The repeated biopsy was performed in 30 patients within 3 years after the first biopsy. The average age was 71.2 years old (45-80), with PSA level of 20.1 ng/ml (4-39), PSAD level of 0.7 ng/ml 2(0.2-1.3), PV of 39.3 ml(18.5-119.0), and TZ of 19.9 ml(12.5-40.5). The results of the repeated biopsy showed that there were 9 cases with PCa(3 cases with chronic inflammation)and 21 cases without PCa (16 cases with chronic inflammation). The level of PSA ( P=0.031) and PSAD ( P=0.032) were statistically significantly higher in PCa than those in benign disease, while the chronic inflammation rates were significantly lower than those in benign disease( P=0.042). Multivariate logistics regression analysis showed that PSAD ( OR=0.7, P=0.012) and chronic inflammation( OR=13.7, P<0.001)were independent risk factors in the positive repeated biopsy. In patients with repeated biopsy, considering PSAD (cut off value 0.15) and first biopsy with chronic inflammation, the predicted results were positive in 8 cases and negative in 22 cases. The real number of cases in the two groups is 6 and 19 respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of repeated biopsy results were 66.7%, 90.4%, 75.0%, and 86.3%, respectively. Conclusion:Chronic inflammation was negatively correlated with positive biopsy results and high-grade tumors. For the patients with PSAD<0.15 and the first biopsy with chronic inflammation, the repeated biopsy should be avoided in most of the cases.

Effect of pretransplant iron overload on clinical efficacy of allogeneic hematopoietic stem cell transplantation on severe aplastic anemia / 器官移植

Objective To evaluate the effect of pretransplant iron overload on the clinical efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with severe aplastic anemia (SAA). Methods Clinical data of 80 SAA recipients who underwent allo-HSCT for the first time were retrospectively analyzed. According to the incidence of iron overload, all recipients were divided into the iron overload group (n=20) and non-iron overload group (n=60). The engraftment rate, incidence of postoperative complications and clinical prognosis of the recipients afterallo-HSCT were statistically compared between two groups. The influencing factors of 2-year overall survival (OS) and 180 d transplantation related mortality (TRM) were analyzed by Cox proportional hazards regression model. Results The engraftment rate of neutrophils in the non-iron overload group was 98% (59/60), significantly higher than 75% (15/20) in the iron overload group (P < 0.05). The engraftment rate of platelet in the non-iron overload group was 90% (54/60), significantly higher than 65% (13/20) in the iron overload group (P < 0.05). The incidence rate of bloodstream infection in the non-iron overload group was 23% (14/60), remarkably lower than 40% (8/20) in the iron overload group (P < 0.05). The 180 d TRM of the recipients in the non-iron overload group was 17%, significantly lower than 45% in the iron overload group (P < 0.05). The 1- and 2-year OS of the recipients in the non-iron overload group were 82% and 80%, significantly higher than 50% and 44% in the iron overload group (both P < 0.05). Iron overload or not was an independent risk factor of the OS and TRM of the recipients (both P < 0.05). Conclusions Iron overload can affect the OS and TRM of SAA patients after allo-HSCT.

Etiology and clinical features of post-engraftment blood stream infection in UCBT recipients / 中华器官移植杂志

Objective To analyze the epidemiologic and clinical features of post-engraftment blood stream infection (pePSI) after unrelated cord blood transplant (UCBT) in our hospital,and provide the basis for empiric antibacterial treatment.Methods 484 patients with hematological malignancies who received single-unit high intensity myeloablative UCBT in our hospital between April 2011 and November 2017 were enrolled.The incidence,etiology of BSI and associated mortality,drug resistance rate in the post-engraftment phase were investigated.Results Totally 25 episodes of BSI among 22 patients in the post-engraftment phase were documented,and the incidence of peBSI was 5 ％.Gram-negative organisms predominated over Gram positive,with Escherichia coli being the most frequent Gram-negative organism isolated (31.5％).Among Gram positive organisms,methicillin resistant Staphylococcus (MRS) was the most frequent species isolated (66％).Nearly 33％ of Escherichia coli isolates and 60％ Klebsiella pneumonia isolates were carbapenem-resistant.All Grampositive bacteria were sensitive to vaneomyein and linezolid.Among the 22 patients,14 patients were cured and survived (63％) eventually.Conclusion The most frequent causative agents of the peBSI after UCBT were Escherichia coli,Klebsiella pneumonia and MRS,etc.Combined antibacterial treatment including a carbapenem or beta lactamase inhibitor can be used for patients suffering fever in the post-engraftment phase as empiric antibacterial therapy.Vaneomyein and linezolid can be used as the first-line therapy for Gram-positive bacteria.

The research of double antiplatelet drug combined with pantoprazole in the treatment of ischemic stroke / 中国基层医药

Objective To research whether double antiplatelet drug combined with pantoprazole can reduce digestive tract damage,or aggravate cardiovascular system side effect.Methods 270 patients diagnosed as ischemic stroke received double antiplatelet drug were randomly divided into two groups.The treatment group received panto-prazole,the control group did not took any gastric drug.The side effect of the digestive and cardiovascular system was observed.Results 268 patients were followed up for 90 days,and digestive system side effect of the treatment group (136 cases)included indigestion in 26 cases(19.11%),stool occult blood(+)in 11 cases(8.08%),melena in 8 cases(5.89%),hematemesis in 0 case,and the control group (132 cases)included indigestion in 42 cases (31.82%),stool occult blood(+)in 23 cases(17.42%),melena in 19 cases(14.39%),hematemesis in 4 cases. There were significant differences between the two groups(χ2 =6.66,4.56,11.2 and 4.18,all P 0.05 ).Conclusion Double antiplatelet drug combined with pantoprazole had a positive significance in reducing the digestive tract damage of ischemic stroke patients,and didn't increase the incidence of cardiovascular sys-tem side effect.

Impacts of ABO incompatibility on early outcome after single unit unrelated cord blood transplantation: a retrospective single center experience / 中华血液学杂志

<p><b>OBJECTIVE</b>To retrospectively study the impacts of ABO incompatibility on early outcome after single unit unrelated cord blood transplantation（UCBT）, such as cumulative incidence of engraftment, incidence of acute graft- versus- host disease （aGVHD） and 180- day transplant- related mortality（TRM）.</p><p><b>METHODS</b>208 patients underwent single unit UCBT from April 2008 to October 2014 were analyzed, included 99 ABO- identical, 60 minor, 38 major and 11 bidirectional ABO- incompatible recipients. All the patients received intensified myeloablative conditioning, and a combination of cyclosporine A and mycophenolate mofetil was given for GVHD prophylaxis.</p><p><b>RESULTS</b>Cumulative incidences of neutrophil engraftment, platelet recovery, erythroid lineage reconstitution, Ⅱ-Ⅳ aGVHD, Ⅲ-Ⅳ aGVHD and 180- day TRM showed no significant difference among the patients receiving ABOidentical, minor, major, and bidirectional UCBT（all P>0.05, respectively）. What's more, none of the patients developed pure red- cell aplasia（PRCA）after UCBT. Group A donor and a group O recipient patients didn't appeared to influence the clinical results when compared with others（all P>0.05, respectively）.</p><p><b>CONCLUSION</b>Patients receive ABO- incompatible UCBT may not develop PRCA. The presence of ABO- incompatibility did not influence the hematopoietic reconstitution, the incidence of aGVHD and 180-day TRM in this cohort. There is not support for the need to regard ABO-compatibility as an UCB-graft selection criterion.</p>

Efficacy analysis of unrelated cord blood transplantation for 58 acute myelogenous leukemia patients / 中华血液学杂志

<p><b>OBJECTIVE</b>To evaluate the therapeutic efficacy and related risk factors of acute myelogenous leukemia （AML） patients treated with unrelated cord blood transplantation （UCBT）.</p><p><b>METHODS</b>A retrospective analysis was performed on the clinical data of 58 AML patients that consisted of 1 case of M0, 1 case M1, 35 cases M2, 3 cases M4, 14 cases M5, 3 cases M6, and 1 case acute mixed leukemia, respectively. Of them, 1 case AML secondary to myelodysplastic syndrome, and 36 in first complete remission （CR1）, 14 in second complele remission （CR2）, 8 in non- remission （NR）, 43 cases were refractory or high-risk patients（70.1%）. The median age was 14.5 years with the median weight of 45 kg, 49 patients received sUCBT and 9 dUCBT. All the patients conditioned with intensified myeloablative regimen and received a combination of Cyclosporine A（CsA）and mycophenolate mofetil（MMF）to prevent graft- versus- host disease（GVHD）.</p><p><b>RESULTS</b>56 out of 58 patients achieved engraftment with implantation rate 96.6%. The median time of ANC≥0.5×10⁹/L was 17（12-37）days, and that of PLT≥20× 109/L 33（17-140）days respectively. 24 cases developed acute GVHD（aGVHD）, the incidence rate of grade Ⅱ to Ⅳ aGVHD was 30.4%. The chronic GVHD（cGVHD）was occured in 7 patients of the 49 evaluable patients, all were limited. The estimated 3-year overall survival（OS）and disease-free survival （DFS）were（60.3±6.4）% and（60.1±6.5）% respectively. And the cumulative incidences of 3-year nonrelapse mortality（NRM）and relapse were 33.3% and 9.1% respectively. The 3- year OS rates of AML patients were（66.0 ± 6.7）% for CR and（25.0 ± 15.3）% for NR, differences were statistical significance.</p><p><b>CONCLUSION</b>For AML patients, UCBT was conducive to improve outcome with lower incidences of cGVHD and relapse, the patients after transplantation could obtain high quality of life.</p>

Effect of second line treatment with S-1 and thalidomide in patients with advanced pancreatic cancer / 中华胰腺病杂志

Objective To investigates the efficacy and tolerability of second line treatment with S-1 plus thalidomide in patients with advanced pancreatic cancer.Methods Sixty patients hospitalized in Department of Oncology of Cangzhou Central Hospital from July 2010 to October 2012 were included in this study.All the patients were diagnosed as having pancreatic carcinoma.The patients were randomly divided into two groups,one group was treated with S-1 alone,and the other group was treated with S-1 plus thalidomide.Then the efficacy and toxicity of two groups was evaluated.Results The disease control rates were 36.7％ and 46.7％ in the S-1 alone group and the S-1 plus thalidomide group,and the difference between the two groups was not statistically significant (P =0.31).The progression free survival (PFS) was 2.9 months and 3.3 months,and the difference between the two groups was statistically significant (P ＜ 0.05),the Karnofsky score,pain,sleep and weight improvement rate was 63.3％,46.7％,66.7％ and 53.3％ in combination group,which were significantly better than those in control group (30.0％,13.3％,30.0％ and 20.0％),and the difference between the two groups was statistically significant (P ＜ 0.05).The major adverse events were nausea,vomiting,fatigue and drowsiness,mainly of grades Ⅰ ～ Ⅱ.Conclusions S-1 plus thalidomide as second line treatment of pancreatic cancer can prolong the PSF of patients with advanced pancreatic cancer with excellent safety,and patients' quality of life is also improved.

The impact of HLA matching on outcome of single unit unrelated cord blood transplantation: a retrospective single center clinical analysis / 中华血液学杂志

<p><b>OBJECTIVE</b>To retrospectively study the impact of human leukocyte antigen (HLA) mtyping mismatching between donor and recipient on outcome of single unit unrelated cord blood transplantation (sUCBT).</p><p><b>METHODS</b>139 patients with hematological malignancies received sUCBT in single center from May 2008 to August 2012 were analyzed. Of 139 patients at enrollment, 22 were 0 mismatched (mm), 69 1 mm, 48 2 mm by low-resolution HLA-A, -B, and high-resolution (HR) DRB1. All patients'conditioning regimen was myeloablative, and a combination of cyclosporine A (CsA) and mycophenolate mofetil (MMF) was given for graft-versus-host disease (GVHD) prophylaxis for all patients. The cohort of patients were followed-up until December 15, 2013.</p><p><b>RESULTS</b>Patients of 0 mm had a statistically significant higher cumulative incidence of neutrophil engraftment by day 42 than those of 1 and 2 mm (P=0.042 and 0.002, respectively), patients of 0 mm with either a higher prefreeze total nucleated cell (TNC) dose (>5 × 10⁷/kg) or lower dose (<5 × 10⁷/kg) had a statistically significant higher cumulative incidence of neutrophil engraftment by day 42 than those of 2 mm (P=0.01 and 0.02, respectively). Patients of 0 mm had a statistically significant lower cumulative incidence of acute GVHD by day 100 than those of 1 and 2 mm (P=0.006 and 0.001, respectively). The difference of 1-year transplant-related mortality (TRM) between 0 and 2 mm patients was statistically significant (P=0.03). Patients of 2 mm received UCB units with a TNC dose less than 5 × 10⁷/kg had a higher 1-year TRM than of 0 mm patients (P=0.03). Patients of 0 mm had a statistically significant higher 3-year disease free survival (DFS) than those of 2 mm (P=0.03), compared with patients of 2 mm given CB units with a TNC dose less than 5 × 10⁷/kg, 0 mm patients and 1mm patients received UCB units with a TNC dose greater than 4 × 10⁷/kg had higher DFS rates (P=0.02 and 0.02, respectively).</p><p><b>CONCLUSION</b>The HLA typing mismatching between donor and recipient had a great impact on neutrophil engraftment and long term DFS after sUCBT, 2mm cord blood unit with less TNC (<5 × 10⁷/kg) was not an optimum UCB graft.</p>

A clinical observation of simethicone, mosapride combined with flupentixol-meiltracen for treatment of patients with functional dyspepsia / 中国基层医药

ObjectiveTo observe the efficacy of simethicone, mosapride combined with flupentixol-meiltracen in the treatment for functional dyspepsia(FD). MethodsThe diagnosis of functional dyspepsia patients treated according to Zung Self-rating Anxiety Scale (SAS) ＞ 40, Hamilton Depression Scale(HAMD) ＞ 17 for inclusion criteria,a total of 64 patients were selected and randomly divided into two groups. The treatment group( simethicone,mosapride combined with flupeentixol-meiltracen) in 33 cases and the control group ( single flupenthixol melitracen) in 31cases. 2 groups of the period of treatment was 4 weeks. Evaluation before and after treatment with mood disorder scale score changes and syndrome efficacy and adverse reactions. ResultsThe treatment group after treatment, regardless of scale score change of mood disorders, syndrome treatment efficacy were significantly better than the control group,especially in the syndrome efficacy difference was significant( P ＜0.05 ,P ＜0.01 ) ;after the treatment without obvious adverse reaction. ConclusionThe simethicone, mosapride combined with flupentixol-meiltracen treatment with anxiety and depression in patients with functional dyspepsia could effectively relieve the symptoms of functional dyspepsia,and relieve the patient's psychological disorder;certainly result in fewer adverse reactions.

The clinical effects of tumor necrosis factor-α antagonist combined with glucocorticoid in patients with ulcera tive colitis / 中国基层医药

Objective To explore the effect of tumor necrosis factor-α antagonist (Remicade) on the patients with active moderate to severe ulcerative colitis (UC) who failed to response to mesalazine or sulfasalazine Sah'cyloyl treatment for six months period.Methods The patients were collected in our hospital,who diagnosed by colonoscopy as moderate to severe ulcerative colitis and failed to response to mesalazine or sulfasalazine Salicyloyl treatment for six months period;These patients were randomly divided into control group(22 cases) and treatment group(28 cases) ;glucocorticoid was used alone in control group while it was combined with Remicade in treatment group.After treatment for six months,they were suffered from colonoscopy and clinical evaluation.Results There were significant differences between control and treatment group of the recover rate concerning the clinic symptoms such as abdominal pain,diarrhea,and mucous bloody stool.There were 7 cases complete remission,13 cases effective outcome and 9 cases ineffective,with complete remission rate of 31.67% .efficiency rate 59.09% in control group.There are 17 cases complete remission,25 cases effective outcome and 3 cases ineffective,with complete remission rate of 60.71% ,efficiency rate 89.28% in treatment group.There was significant difference (P<0.05) between two groups of complete remission rate and efficiency rate.There were 3 cases recurring in control group,with the recurrence rate of 13.67% ,while there were 2 cases recurring in treatment group with the recurrence rate of 7.14%.There was significant dif-ferene( P<0.05) between two groups with regards to recurrence rate;Besides,there were no significant adverse effect.Conclusion The combination with Remicade and glucocorticoids in the treatment of refractory severe ulcerative colitis was more effective and can also reduce the relapse rate.