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Objective To investigate the effect of nursing with solution focused approach in advanced schistosomiasis pa?tients. Methods Fifty three patients with advanced schistosomiasis in the Liujiahu Hospital for Schistosomiasis Control of Yiyang City were randomized selected and separated into an intervention group and a control group. The patients of the interven?tion group received the conventional nursing plus solution focused approach,while the patients of the control group received on?ly the conventional nursing. The effectiveness of nursing and treatment was evaluated in the two groups comparatively. Results The knowledge of self?care skills,medical compliance behaviors and services satisfaction degree in the intervention group were higher than those in the control group(c2=3.78,2.87,4.09 respectively,all P<0.05). The occurrence rate of upper gastroin?testinal bleeding in the intervention group was significantly lower than that in the control group(c2=4.894,P<0.05). The aver?age hospitalization duration of the intervention group was shorter than that of the control group(t=4.17,P<0.05). Conclu?sions The solution focused approach is a feasible and effective method in course of nursing of advanced schistosomiasis pa?tients. It enhances the confidence of the patients and the trustiness of the patients to the health care providers. The complications and the hospitalization duration of the patients are reduced.
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Objective To explore the possibility of bone marrow mesenchymal stem cells (MSCs) differentiating into active melanocytes in vitro.Methods Bone marrow stromal cells were harvested from femoral marrow of 6-week-old black male C57BL/6 mice,and subjected to a primary culture.After 6-passage subculture,an induction medium containing hydrocortisone,recombinant human insulin,transferrin and fibroblast growth factor was used to induce the differentiation of MSCs into melanocytes.Inverted light microscopy was applied to observe the process of cell differentiation,transmission electron microscopy to observe melanosome formation and maturation,and immunocytochemistry to determine the expression of melanocyte-associated epitopes,and flow cytometry to analyze cell cycles and yield of differentiated melanocytes.Results The total number of MSCs was close to 109 after 6 passages of subculture,and immunofluorescent studies showed an expression rate of 94.3% for CD44 and 82.3% for CD105 in these MSCs.After 180-day cultivation in the induction medium,the MSCs showed a morphological similarity to melanocytes with an increase in dendrites,formation of melanosome-like structures,and cell growth cycle was shortened to 3-4 days.Brown/black cell sediments were visualized by naked eyes.Electron microscopy revealed that intracellular melanosomes were mainly in Ⅳ phase.Immunofluorescence studies of the differentiated melanocytes showed a positive staining for tyrosinase related protein-1 (TRP-1),TRP-2,and microphthalmia-associated transcription factor (MITF).Flow cytometric analysis showed that most of the melanocytes differentiated from the MSCs were in G1 and S phases,and TRP-1-positive melanocytes amounted to 80% of gate cells.Conclusions Bone marrow MSCs can be largely differentiated into melanocytes with a close similarity to normal melanocytes in morphology,ultrastructure and specific epitopes and a certain degree of proliferative activity.
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Melanocyte-specific CD8(+) cytotoxic T lymphocytes (CTLs) play a pivotal role in vitiligo-induced depigmentation. Yet, the mechanisms underlying the high frequency of generalized autoimmune disorders associated with generalized vitiligo (GV) are unknown. We hypothesized that an imbalance between activated CD8(+) CTLs and regulatory T cells (Tregs) exists in patients with GV . Assessment of the circulating CD8(+) CTLs and Tregs by flow cytometric analysis revealed an obvious expansion of CD8(+) CTLs and a concomitant decrease in Treg cells in GV patients. The percentages of skin infiltrating CD8(+) CTLs and Tregs were evaluated by immunohistochemistry and revealed dramatically increased numbers of both CD8(+) CTLs and Tregs in the perilesional skin of GV patients. However, peripheral Tregs were impaired in their ability to suppress the proliferation and cytolytic capacity of autologous CD8(+) T cells, suggesting that a functional failure of Tregs and the hyper-activation of CD8(+) CTLs may contribute to progressive GV. Our data indicate that reduced numbers and impaired function of natural Tregs fail to control the widespread activation of CD8(+) CTLs, which leads to the destruction of melanocytes and contributes to the elevated frequency of various associated autoimmune diseases. This knowledge furthers our understanding of the mechanisms of immune tolerance that are impaired in GV patients and may aid in the future development of effective immunotherapy for GV patients.
Subject(s)
CD8-Positive T-Lymphocytes/immunology , Lymphocyte Activation/immunology , Melanocytes/immunology , T-Lymphocytes, Regulatory/immunology , Vitiligo/immunology , Adult , Cell Proliferation , China , Drugs, Chinese Herbal/therapeutic use , Female , Flow Cytometry , Humans , Immunohistochemistry , Male , Middle Aged , Skin/cytology , Skin/immunology , Vitiligo/drug therapyABSTRACT
A 69-year-old man presented with a 3-year history of scattered erythematous patches, perifollicular papules, acneiform lesions(such as milia, cysts) on the head, trunk and limbs as well as alopecia and peripheral eosinophilia. Histopathological examination revealed chronic focal dermal and perifollicular inflammatory infiltration with vascular proliferation and presence of a small number of eosinophils. He was initially diagnosed with folliculitis, and treated with antihistamines and antibiotics. Thereafter, lesional inflammation and pruritus were attenuated. However, plaques and alopecia developed in the occipital area 3 months later. The second histopathology of biopsy specimens revealed a dense dermal infiltrate of lymphoid cells and eosinophils, perifollicular infiltrate with numerous lymphoid cells, eosinophils and atypical lymphocytes migrating into hair follicles. Alcian blue stain showed epidermal mucinosis in follicles. Immunohistochemical examination showed positive staining of atypical cells for CD3, CD4, CD5, CD2, CD43 and ubiquitin carboxyl-terminal esterase L1 (UCHL1), but negative staining for CD20, CD79a, Epstein-barr virus, CD56, phosphoglucomutase-1, myeloperoxidase, CD7, or AE1 and AE3 monoclonal anti-keratin antibodies. T-cell receptor gene rearrangement was undetected. He was diagnosed with folliculotropic mycosis fungoides. Novel skin lesions still emerged after treatment with photochemotherapy (PUVA) plus acitretin. Follow up of the patient still continued.
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Objective To explore the mechanism underlying the induction of systemic lupus erythematosus (SLE) by estrogen, hydralazine and ultraviolet irradiation. Methods Peripheral blood mononuclear cells (PBMCs) were harvested from 10 patients with SLE and 9 normal human controls, and cultured with or without the intervention with estrogen, hydralazine or ultraviolet irradiation. The DNA methyltransferase-1 (DNMT1) activity of PBMCs was quantified by using DNMT activity/inhibition assay kit. Results No statistical difference was observed in DNMT1 activity between patients with SLE and normal controls (0.36 ± 0.24 vs 0.46 ± 0.17, P > 0.05). A significant decrease was noted in DNMT1 activity in PBMCs from patients with SLE after intervention with estrogen (0.32 ± 0.18 vs 0.46 ± 0.17, t = 1.725, P < 0.05), hydralazine (0.33 ±0.13 vs 0.46 ± 0.17, t = 1.739, P < 0.05) and ultraviolet irradiation (0.30 ± 0.14 vs 0.46 ± 0.17, t = 1.739,P < 0.05 ) compared with that from normal human controls. The treatment with hydralazine also induced an attenuation of DNMT1 activity in PBMCs from normal human controls (0.38 ± 0.12 vs 0.46 ± 0.17, P< 0.05).Conclusion Estrogen, hydralazine and ultraviolet irradiation can inhibit the DNMT1 activity of SLE patients,indicating that they may induce the initiation of SLE by altering the activity of DNMT1.
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Objective To assess the relationship between single nucleotide polymorphisms of FcεRIαgene and atopic dermatitis. Methods Genomic DNA samples were extracted from peripheral blood of 97 patients with atopic dermatitis and 283 normal human controls. The polymorphism at the distal promoter region of FcεRIα gene was determined by PCR-ligase detection reaction assay followed by gene sequencing. Results A G/T polymorphism was observed at position rs61828219 in the promoter region of FcεRIα gene, while all the tested individuals were homozygous for T/T at position rs12135235 and A/A at position rs36233780 in the promoter region of FcεRIα gene. The mutation frequency at position rs61828219 was 1.04% and 2.17% in patients with AD and normal human controls, respectively (both P > 0.05). Conclusions In the Chinese Han population, there is a G/T polymorphism at position rs61828219 in FcεRIα gene promoter region, which is unlikely related to the development of AD; however, no polymorphism is detected at position rs12135235 or rs36233780.
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Objective To screen single nucleotide polymorphism(SNP)of DNA methyltransferase 1 gene in patients with systemic lupus erythematosus(SLE).and to investigate the significance of abnormal expression of DNA methyltransferase in the pathogenesis of SLE.Methods Peripheral blood mononuclear cells(PBMCs)were obtained from 11 patients with SLE and 12 normal human controls.DNA was extracted from the PBMCs.and PCR was performed to amplify some exons(1 to 7)and corresponding introns followed by direct sequencing.Results There was a 21397T/C SNP in the intron 7 between exon 7 and exon 8 of DNA methyltransferase 1 gene in patients with SLE.The frequency of CC homozygote increased in patients with SLE compared with that in normal controls(5/11 vs 1/12,X~2=4.10,P<0.05).Conclusions There is a 21397T/C SNP in DNA methyltransferase 1 gene in patients with SLE.which may be a component of genetic background underlying the abnormal expression Of DNA methyltransferase 1.
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Objective To investigate the expression of lymphocyte function-associated antigen-1 (LFA-1)on peripheral blood mononuclear cells(PBMCs)from patients with SLE and its relation to the occurrence and development of SLE.Methods PBMCS were obtained from 30 patients with SLE and 24 normal human controls.Atier labeled with anti-CD3-FITC and anti-CD11 a-PE,PBMCS were detected for the expression of CD11a by flow cytometric analysis.Results The positivity rate of CD11a was significantly higher in patients with SLE and those with active SLE than in the normal controls (73.74%±7.89%and 77.11%±7.46%vs 68.21%±4.58%.both P<0.05).Furthermore,increased positivity rate of CD11a was observed in patients with active SLE compared with those with stable SLE (77.11%±7.46%vs 69.33%±6.27%,P<0.05).but there was no significant difieFence between the latter group and normal controls(P>0.05).In addition.the expression level of CD11a was positively correlated with SLE disease activity index (r=0.64,P<0.0 1)in patients.Conclusion The overexpression of LFA-1 may take part in the occurrence of SLE and correlate with the activity of SLE.
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The synthesis of a series of modularized porphyrins bearing bioactive molecule is described. Starting with meso-tetraphenylporphyrin, the compounds with two nitro functional groups were synthesized via regiospecific nitration reaction. After reduction to the amino group and subsequent coupling with l-phenylalanine or 1-carboxylmethyl-5-fluorouracil (5-Fu acid), the functionalized porphyrins were metallized with Co(II) or Mn(II) to form miscellaneous porphyrins in good yields. The spectra of all the porphyrins were furnished. In vitro photodynamic therapy of the porphyrins against Ec9706 cell line was evaluated by standard cytotoxicity assays.
Subject(s)
Esophageal Neoplasms/drug therapy , Organometallic Compounds/chemical synthesis , Organometallic Compounds/pharmacology , Phenylalanine/chemistry , Phloroglucinol/analogs & derivatives , Porphyrins/chemistry , Cell Line, Tumor , Cell Proliferation/drug effects , Cobalt/chemistry , Drug Screening Assays, Antitumor , Humans , Manganese/chemistry , Molecular Structure , Organometallic Compounds/radiation effects , Phloroglucinol/chemistry , Phloroglucinol/isolation & purification , Phloroglucinol/pharmacology , Photochemistry , Photochemotherapy , Stereoisomerism , Structure-Activity Relationship , Ultraviolet RaysABSTRACT
Objective To investigate the gene expression of methyl-CpG-binding protein 2 (MeCP2) and methyl-CpG-binding domain 2 (mbd2) in patients with systemic lupus erythematosus(SLE) and their significance in the pathogenesis of SLE. Methods Semiquantitative reverse transcriptase-PCR was applied to detect the mRNA expression of MeCP2 and mbd2 in PBMCs obtained from relieved (n=17), active (n=17) SLE patients and healthy controls (n=17). The correlations were further analyzed among these parameters. Results No significant difference was observed in the expression level of MeCP2 mRNA among active SLE patients, relieved SLE patients and healthy controls (P>0.05). The expression of mbd2 in relieved SLE patients was significantly higher than that in health controls (t=12.8, P<0.01), but lower than that in active SLE patients (t=20.0, P<0.01). The expression of mbd2 positively correlated with SLEDAI (r=0.737, P=0.0001) of patients with SLE, and a positive correlation was also observed between the expression of mbd2 and MeCP2 in healthy controls (r=0.550, P=0.0222). Conclusions The expression of MeCP2 and mbd2 may be mutually constrained in normal human, but this relationship seems to be disturbed in patients with SLE.
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Objectives In order to develop a rapid microsatellite genotyping assay for inter-strain differentiation of Candida albicans isolates and understand the transmission characteristics of the infections. Methods DNA was extracted from C. albicans isolates from genitals, anal canals and oral cavities of 39 women and 27 men with genital candidiasis. The microsatellite sequences in stabel genes(CDC3, EF3 and HIS3) were amplified by a fluorescence labeled PCR. Fluorescent signals were read with an automatic se- quencer, and the data were collected with GeneScan software followed by genotyping with Genotyper soft- ware to analyze polymorphic microsatellite loci. Results Combined analysis of the 3 microsatellite markers showed 18 gene allele associations in C. albicans from genital sites of all men and women, including 10 in women, 11 in men and 3 in both. The allele associations of dominant pathogenetic strains for both sexes were 116:124, 122:131,160:200, which covered 50% of pathogenetic infection. Three common allele associations for both sexes covered 71% of all infections. Genitals and anal canals shared strains of same allele associations in 80% of women and in only 3.8% of men. The strains of same allele associations were identified in both genitals and mouth in 2.7% of women but in none of men. In their genital sites 71% of couples shared the same allele strains, of which 80% were the dominant pathogenetic strains identified in both sexes. Conclusions The improved microsatellite genotyping assay is useful for rapid differentiation, identification of infective source, and contact tracing of C. albicans infection. There are pathogenetic C. albi- cans strains with predominant allele associations in genital infections.
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Objective To evaluate the short-term therapeutic effects for patients with primary liver cancer using three-dimensional stereotactic conformal radiotherapy(3D-CRT).Methods Twenty-eight patients with primary hepatic cancer were treated with 3D-CRT(the average overall dose was 38Gy,localized by Elscint twin flash slice CT,radiotherapy plan was designed by Leibinger three-dimensional radiotherapy planning system and operated on Varian 600C/D liner accelerator).The average follow-up time was 12 months(5-17mon.).Tumor volume response rate,rate of free from tumor progression and survival rate were analyzed.The adverse effects were studied simultaneously.Results According to follow-up CT results 3 months after radiotherapy,2 cases had full responses with disappearance of the tumors,while partial responses with decreased tumors mass were seen in 22 cases,and no response in 4 cases.Tumor volume response rate was 85.7%.The last follow-up CT results showed that in 5 patients there was tumor progression in planning target volume(PTV),in 10 cases there was intrahepatic progression but not in PTV,and in 4 cases extrahepatic tumor growth.Intrahepatic tumor free rates 6 months and 12 months after radiotherapy were 66.5% and 38.4%,respectively.6-month survival rate after radiotherapy was 88.6%,12-month survival rate was 70.5% after radiotherapy.During 3 months of radiotherapy,manifestations of subacute radiation injuries occurred in six patients:gastrointestinal hemorrhage in 2 cases,jaundice in 3 cases and subacute radiation hepatitis in 1 patient.No survivors suffered from long-term liver injury.Conclusions With little adverse effect,3D-CRT could raise the control rate of the hepatic tumor,and also short-term survival rate.There fore,3D-CRT is a valuable treatment for patients with primary liver cancer.
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Objective To evaluate the therapeutic effects and adverse effects of three-dimensional conformal radiotherapy(3D-CRT) for elderly patients with non-small cell lung cancer(NSCLC).Methods From August 2001 to October 2006,36 patients over 70 years old with NSCLC were treated with 3D-CRT.Leibinger treatment planning system was used for drafting radiotherapy plan,the prescription dose was 40-80Gy(median,60Gy).Twenty-four patients received hypofractionated radiation every two days in 8-12 fractions at a dose of 5-8Gy per fraction;12 patients accepted conventional fractionated radiation with 30-40 fractions during 6 to 7 weeks.With median follow-up time of 11 months(range,5-54 mon.),tumor volume response rate,1-year and 2-year survival rate were investigated,adverse effects of the treatment were also recorded in present research.Results Of the 36 patients,clinical symptoms were improved in 33 cases,while no changes were observed in 3 cases.According to follow-up CT results 2-3 months after radiotherapy,8 patients showed complete response(CR),22 cases with partial response(PR),with the overall tumor response rate of 83.33%(30/36).In this group,1-year and 2-year survival rate was 66.67% and 36.11% with median survival time of 8 months(range,2-53 months).No patients suffered from serious adverse effects.Conclusions 3D-CRT was an effective and safe treatment for elderly patients with NSCLC,which could raise the survival rate and improve the quality of life with little adverse effects.
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Objective To evaluate the therapeutic effects of three-dimensional conformal radiotherapy(3D-CRT) for malignant tumors.Methods From July 1999 to October 2006,830 patients with malignant tumors received non-coplanarity multifield 3D-CRT by using Leibinger three-dimensional stereotactic conformal radiotherapy machine,Varian 600C/D 6MeV X liner accelerator and multileaf collimator.Single dose was 4-8Gy per fraction,once every two days and total dose was 50-82Gy.Results All 830 cases underwent 3D-CRT.According to the WHO evaluation standard for therapeutic effects,CT results showed that complete response(CR),partial response(PR),no change(NC),and progression(PD) rates were 20.7%(172/830),68.7%(570/830),10.2%(85/830),and 0.3%(3/830),respectively.Overall response rate(CR+PR) was 89.4%(742/830).No patients suffered from serious adverse effects.The incidence of radiation penumonia was 9%.Conclusions For patients with malignant tumors who could not endure operations due to existing contraindications or other conditions,3D-RCT was a relatively effective treatment because the method could deliver an increased therapeutic dose to tumors,enhance survival rate,improve life quality,decrease injuries to adjacent normal tissue,and reduce the incidence of complications.
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Background and purpose:Increased glucose metabolism is a characteristic of malignant tumors.This characteristic might be related to a facilitative glucose transporter(Glut-1) and the proliferating activities of tumors.This study was aimed to assess the relationship among the over-expression of facilitative glucose transporter(Glut-1) and proliferating cell nuclear antigen(PCNA) as well as the fluorine-18 fluorodeoxyglucose(18F-FDG) uptake of tumors in patients with nasopharyngeal carcinoma.Methods:Between March 2005 and August 2006,40 patients with nasopharyngeal carcinoma were imaged with 18F-FDG positron emission tomography(PET).Their maximum standard uptake values(SUVmax) were measured.The expression of Glut-1 and the proliferating cell nuclear antigen(PCNA) in the 40 cases were studied in paraffin sections by SP immunohistochemistry.Results:The 18F-FDG uptake of tumors of the 40 patients with nasopharyngeal carcinoma was 9.4?1.9(SUVmax).All 40 tumors tested Glut-1 positive and PCNA positive.The Glut-1 positive cells consisted of 45.18% of the tumor cell area,whereas the PCNA positive cells consisted of 36.18% of the tumor cell area.There were correlations between Glut-1 expression levels(r=0.369,P=0.019) and the tumors' 18F-FDG uptake but no correlations were found between PCNA expression level and the tumors' 18F-FDG uptake(r=0.135,P=0.407).Conclusion:Glut-1 over-expression correlates with 18F-FDG uptake whereas PCNA over-expression does not correlate with 18F-FDG uptake in patients with nasopharyngeal carcinoma.
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Objective To evaluate the clinical characteristics,efficacy and toxicity of three dimensional conformal radiotherapy(3D-CRT)for elderly patients suffering from advanced stage of non-small cell lung cancer(NSCLC).Methods From September 1999 to October 2006,with the use of Leibinger planning system,the authors performed 3-dimensional conformal radiotherapy(3D-CRT)for 108 elderly patients suffering from advanced stage of non-small cell lung cancer who had not received operation because of medical contraindications such as cardiac insufficiency,impaired pulmonary function,etc.For the patients with positive lymph metastasis,the primary tumor was treated with high dosages.Conventional radiotherapy was delivered,and the tumor site and draining lymphatic areas received 40~45Gy of radiation,followed by 3D-CRT.Results All patients received whole course of radiotherapy,and the total survival rate for 1,2,3 years was 65%,33% and 28%,respectively.Meanwhile,the radioreaction did not exceed grade 2 in all 108 cases.Conclusions 3-dimensional conformal radiotherapy was relatively an effective treatment for non-small cell lung cancer in elderly patients who could not withstand operations because of medical contraindications or other problems.The treatment was proved to improve total survival rate and life quality,relieve complications such as radiation pneumonia and radiation esophagitis.Therefore,3-dimensional conformal radiotherapy was recommended for elderly patients with advanced stage of lnon-small cell lung cancer.