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Objective To investigate the current situation of achievement transformation in tertiary medical hospitals in Shanghai and propose countermeasures for the existing problems to enhance the effectiveness of achievement transformation.Methods A questionnaire survey was done on the transformation and management of scientific research achievements in 47 terti-ary hospitals in Shanghai.Meanwhile,interviews were carried out among the managers and researchers from these hospitals.Re-sults In the past three years,the rate of transformation achievements in the hospitals was only 2.8%.In the achievement trans-formation existed such problems as weak awareness of scientific researchers,low patent quality,lack of full-time managers,and inflexible management mode.It was also believed that there is a need to improve main responsibilities,achievement management,system establishment,personnel training,resource sharing,department coordination and other related aspects.Conclusion The rate of achievement transformation in tertiary medical institutions in Shanghai is at a lower level.There are numerous problems and difficulties in the transformation.Therefore,urgent efficient countermeasures are needed to promote the transformation of a-chievement.
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Objective:To explore the incidence rates, clinical features, risk factors and its impacts on survival of central nervous system complications (CNSC) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:From June 2011 to October 2018, 237 consecutive patients undergoing allo-HSCT were retrospectively analyzed.Results:The incidence of CNSC was 10.5%(25/237) and the median time 82(-4 - 810) days post-transplantation. The most common instances of CNSC were drug-associated encephalopathy (n=6), CNS infection (n=5), unexplained convulsions (n=4), metabolic encephalopathy (n=3), immune-related encephalopathy (n=3), primary central relapse (n=3) and cerebrovasculopathy (n=1). The most common clinical symptom was epileptic seizure (n=11). CsA-related encephalopathy was manifested mainly as posterior reversible encephalopathy syndrome on brain MRI. Metabolic encephalopathy is mostly demyelination. Most hippocampal lesions were caused by immune-related encephalopathy or CNS infection. Analysis of risk factors indicated that umbilical cord blood transplantation, HLA incompatible transplantation and delayed platelet implantation were high risk factors for post-transplantation occurrence of CNSC. Survival analysis suggested that non-relapse mortality rate (42.9%, 9/21) in group with CNSC of malignant hemoblastosis was higher than that in group without CNSC (15.3%, 27/176) and inter-group difference was statistically significant ( χ2=9.511, P=0.005). The 1/3-year OS rates in group with CNSC were lower than those in group without CNSC (56.6% vs 77.8%; 37.1% vs 65.7%). And the difference was statistically significant ( P=0.022). Conclusions:With a complex etiology, CNSC is one of serious complications after allo-HSCT and it significantly reduces the overall survival rate of patients. Umbilical cord blood transplantation, HLA incompatible transplantation and delayed platelet implantation are high-risk groups for CNSC.
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OBJECTIVE: To explore the effect of occupational aluminum exposure on the blood of male workers. METHODS: A total of 249 male workers were selected as the research subjects by cluster sampling method in the electrolytic workshop of an aluminum plant. Blood samples were collected for determination of the blood aluminum concentration and blood routine. The subjects were divided into low-, medium-, and high-aluminuml groups based on the tertile of blood aluminum level(P_(33) is 13.9 μg/L, P_(67) is 37.7 μg/L). RESULTS: The red blood cell(RBC) count and hemoglobin level in patients of the high-aluminum group were lower than that of the low-aluminum group(P<0.05). There was no significant difference of the RBC count and hemoglobin level of patients in middle-aluminum group compared with that of the low-and high-aluminum groups(P>0.05). There was no statistical significant difference in white blood cell count and platelet count among the three groups(P>0.05). The results of the generalized linear regression model showed that the higher the blood aluminum level, the lower the RBC count and hemoglobin level of workers(P<0.05) after eliminating confounding factors such as age, length of service, education level, smoking, and drinking. CONCLUSION: Occupational aluminum exposure can cause a decrease of RBC count and hemoglobin level with a dose-effect relationship in workers.
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Objective To investigate the association between bicuspid aortic valve ( BAV ) morphologic findings ( raphe vs nonraphe) ,the degree of valve dysfunction and prognosis . Methods Clinical and echocardiographic data in 317 BAV patients were analyzed retrospectively . According to the Sievers classification ,the morphologic BAV findings were categorized into no raphe ( type 0) ,one raphe ( type 1) and two raphes ( type 2 ) . T he patients with type 1 were further divided into three subtypes ,including R‐L subtype ( fusion of the left and right coronary cusps ) ,R‐N subtype ( fusion of the right and noncoronary cusps) and L‐N subtype ( fusion of the left and noncoronary cusps ) . Results Of the 317 patients ,there were 83 ( 26 .2% ) of type 0 ,232 ( 73 .2% ) of type 1 and 2 ( 0 .6% ) of type 2 .Among the 232 patients of type 1 ,there were 126 ( 54 .3% ) of R‐L subtype ,88 ( 37 .9% ) of R‐N subtype and 18 ( 7 .8% ) of L‐N subtype . BAV with raphe had a significantly higher prevalence of aortic valve calcification [ 120 ( 51 .3% ) vs 19 ( 22 .9% ) , P < 0 .001 ] ,with significantly higher frequencies of aortic stenosis [ 164 ( 70 .1% ) vs 6 ( 7 .2% ) , P< 0 .001 ] ,aortic regurgitation [ 168 ( 71 .8% ) vs 40 ( 48 .2% ) , P = 0 .001 ] ,increased left ventricular mass[ ( 253 .4 ± 113 .7) g vs ( 176 .4 ± 69 .3) g , P <0 .001] and left heart failure [ 34 ( 14 .5% ) vs 3 ( 3 .6% ) , P =0 .009] . Furthermore ,the dilation of aortic root and ascending aorta in BAV patients with raphe were significantly higher than those without raphe ( P <0 .01 ) ,however ,ascending aortic aneurysm rates were not significant between BAV with and without raphe[ 23( 9 .8% ) vs 4( 4 .8% ) , P =0 .251] . T he patients in R‐N subtype had a significantly higher proportion of aortic valve calcification than those in R‐L and L‐N subtype [ 55 ( 62 .5% ) vs 57 ( 45 .2% ) vs 6 ( 33 .3% ) , P = 0 .01 ] ,with a significantly higher frequency of severe aortic stenosis [ 50 ( 56 .8% ) vs 21 ( 16 .7% ) vs 3 ( 16 .7% ) , P <0 .001 ] . However , there was no significant difference among different subtypes in other complications( P >0 .05).Conclusions T he presence of raphe is associated with a higher frequency of significant aortic valve calcification ,aortic valve dysfunction ,and increases left ventricular mass and left heart failure .T he R‐N type is also associated with aortic valve calcification and severe aortic stenosis .
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OBJECTIVE: To explore the mechanism of ubiquitin-proteasome pathway(UPP) in the degradation of hyperphosphorylated tau protein in aluminum-induced mouse neuroblastoma N2 a cells. METHODS: N2 a cells in logarithmic growth period were randomly divided into control group and MG132 group. Cells in control group were exposed to concentrations of 0 or 1 mmol/L aluminum chloride for 24 hours. Cells in MG132 group were pretreated with MG132 at a concentration of 5 μmol/L for 6 hours, then exposed to concentrations of 0 or 1 mmol/L aluminum chloride for 24 hours. After exposure, the cells were collected. Western blotting was used to detect the relative expression of tau-5, P-tau181, P-tau231, P-tau262, P-tau396, heat shock protein 70(Hsp70) and carboxyl terminus of the Hsp70-interacting protein(CHIP). The ubiquitin relative expression was detected by enzyme-linked immunosorbent assay. RESULTS: The results of factorial analysis showed that the relative expression of tau-5, P-tau231, P-tau262, P-tau396, CHIP, Hsp70 and ubiquitin in N2 a cells were statistically significant in the main effect and interaction effect of aluminum chloride and MG132 treatment(P<0.05). Both in the control group and MG132 group, the relative expression of tau-5, P-tau231, P-tau262, P-tau396, CHIP, Hsp70 and ubiquitin in N2 a cells exposed to 1 mmol/L aluminum chloride increased(P<0.05) when compared with the N2 a cells without exposed to aluminum chloride. No matter aluminum chloride exposed or not, the relative expression of tau-5, P-tau231, P-tau262, P-tau396, CHIP, Hsp70 and ubiquitin in N2 a cells of MG132 group was higher than that of control group(P<0.05). CONCLUSION: UPP is involved in the regulation of hyperphosphorylated tau protein by proteasome degradation in aluminum-induced N2 a cells. UPP mainly regulates P-tau231, P-tau262, and P-tau396 sites. CHIP and Hsp70 played an important role in the UPP pathway.
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Objective To analyze the effect of haploidentical hematopoietic stem cell transplantation (HID-HSCT) on high-risk acute lymphoblastic leukemia (ALL),and to explore the influence of minimal residual disease (MRD) before transplant on the outcomes.Methods A retrospective analysis was performed on 39 high risk ALL patients receiving HID-HSCT in our hospital from Jan.2013 to Jan.2018.The clinical features,stem cell engraftment,complications,survival and recurrence were compared between patients with pretransplant MRD + and MRD-.Results All the 39 patients presented with successful engraftment.The overall survival (OS) was 54.67%;the disease free survival (DFS) was 40.96%;the incidence rate of acute graft versus host disease (aGVHD) was 53.8%,including 23.1% Ⅱ-Ⅳ degree aGVHD and 2.6% Ⅲ-Ⅳ degree aGVHD.There was no significant difference in stem cell engraftment,GVHD,cytomegalovirus infection and hemorrhagic cystitis between MRD + and MRD-patients.DFS and OS in MRD + patients were significantly lower than those in MRD-patients;the cumulative RR rate increased significantly,and there was no significant difference in cumulative TRM.Conclusion HID-HSCT was an effective method to treat high-risk ALL,but MRD + patients had high recurrence rate and poor prognosis.Strategy adjustment should be considered to reduce tumor residual and the transplantation strategy should be optimized for these kinds of high risk patients,so as to improve long-term outcomes.
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Objective To evaluate the accuracy and value of automatically assessing left ventricular systolic function in rats with myocardial infarction ( MI) by myocardial contrast echocardiography ( MCE) based on neutrosophic similarity score( NSS) algorithm. Methods According to different infarction size (IS),SD rats were divided into large MI (MI-L,IS≥15% ) and small MI (MI-S,IS<15% ) groups. MCE was performed before MI and at 7,28 days after MI. In vitro study:the automatic segmentation of the endocardial contour based on neutrosophic similarity score algorithm was compared with the manual segmentation boundary. In vivo study:the left ventricular ejection fraction( LVEF) were calculated using the NSS system,biplane Simpson and PV-loop,respectively,and then NSS-LVEF,Simpson-LVEF and PV-LVEF were acquired,respectively. The IS was calculated by Masson and HE staining. The consistency between the two LVEFs was evaluated by Bland-Altman. The intraclass correlation coefficient ( ICC) was calculated to evaluate the reproducibility of MCE analysis system. Results ① The endocardial contour obtained by automatic segmentation had good agreement with the boundary of artificial tracing. ② There was no significant difference among the three LVEFs in same group ( F =0.028, P = 0.973),but there was significant difference in different group ( F =78.61, P <0.01). NSS-LVEF was well consistent with both Simpson-LVEF and PV-LVEF. ③ The ICC of NSS algorithm for inter-observer and intra-observer were 0.96 and 0.98,respectively. ④Compared with before MI and at 7 days after MI,the LVEF in MI-L and MI-S groups at 28 days after MI decreased significantly ( P <0.05),especially in MI-L group ( P <0.01). There was significantly negative correlation between LVEF and IS ( r = -0.917, P < 0.01). Conclusions Left ventricular endocardium can be identificated automatically and LVEF can be calculated rapidly and accurately by MCE based on neutrosophic similarity score algorithm in rats with myocardial infarction.
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Objective To examine the association between the phthalate exposure in the first trimester and fasting blood glucose level or gestational diabetes mellitus (GDM) in the third trimester in pregnant women.Methods A total of 3 474 pregnant women,receiving their prenatal examination in Ma'anshan Maternal and Child Health-Care Hospital of Anhui province,were selected from May 2013 to September 2014.Questionnaires were used to collect the information about their sociodemographic characteristics,clinical characteristics and GDM diagnostic results in the first,second and third trimesters.Urine samples and fasting venous blood samples were collected.Concentrations of 7 kinds of phthalate metabolites in urine samples were detected by solid phase extraction-high performance liquid chromatography-tandem mass spectrometry (SPE-HPLC-MS/MS),and multiple linear regression model was used for statistical analyses.Logistic regression analysis on the risk of the first trimester phthalate exposure for GDM in the third trimester was conducted.Results The prevalence of GDM in this study was 12.8%,monomethyl phthalate (MMP),monoethyl phthalate (MEP),mono-n-butyl phthalate (MBP),monobenzyl phthalate (MBzP) and mono-(2-ethyl-5-oxohexyl) phthalate (MEHHP) exposure levels were positively correlated with the fasting blood glucose level in the third trimester (P<0.05),but mono-(2-ethylhexyl) phthalate (MEHP) and mono-(2-ethyl-5-hydroxylhexyl) phthalate (MEOHP) exposure levels were negatively correlated with the fasting blood glucose level in the third trimester (P<0.05).Stratified analysis showed a positive correlation between MEHHP exposure and the third trimester fasting blood glucose level in both normal group and GDM group.However,MMP,MEP,MBP,MBzP,MEHP and MEOHP exposure levels had influences on the third trimester fasting blood glucose level in normal group but not in GDM group.MMP and MBP exposure might increase the risk of GDM,but MEOHP exposure might reduce the risk of GDM.Conclusion The phthalate exposure in the first trimester might be associated with the fasting blood glucose level in the third trimester,MMP,MEP,MBP,MBzP and MEHHP concentrations were positively associated with the third trimester blood glucose level,MEHP and MEOHP concentrations were negatively associated with the third trimester blood glucose level.Moreover,the effects of different kinds of phthalates might be different.
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Objective To examine the association between the phthalate exposure in the first trimester and fasting blood glucose level or gestational diabetes mellitus (GDM) in the third trimester in pregnant women.Methods A total of 3 474 pregnant women,receiving their prenatal examination in Ma'anshan Maternal and Child Health-Care Hospital of Anhui province,were selected from May 2013 to September 2014.Questionnaires were used to collect the information about their sociodemographic characteristics,clinical characteristics and GDM diagnostic results in the first,second and third trimesters.Urine samples and fasting venous blood samples were collected.Concentrations of 7 kinds of phthalate metabolites in urine samples were detected by solid phase extraction-high performance liquid chromatography-tandem mass spectrometry (SPE-HPLC-MS/MS),and multiple linear regression model was used for statistical analyses.Logistic regression analysis on the risk of the first trimester phthalate exposure for GDM in the third trimester was conducted.Results The prevalence of GDM in this study was 12.8%,monomethyl phthalate (MMP),monoethyl phthalate (MEP),mono-n-butyl phthalate (MBP),monobenzyl phthalate (MBzP) and mono-(2-ethyl-5-oxohexyl) phthalate (MEHHP) exposure levels were positively correlated with the fasting blood glucose level in the third trimester (P<0.05),but mono-(2-ethylhexyl) phthalate (MEHP) and mono-(2-ethyl-5-hydroxylhexyl) phthalate (MEOHP) exposure levels were negatively correlated with the fasting blood glucose level in the third trimester (P<0.05).Stratified analysis showed a positive correlation between MEHHP exposure and the third trimester fasting blood glucose level in both normal group and GDM group.However,MMP,MEP,MBP,MBzP,MEHP and MEOHP exposure levels had influences on the third trimester fasting blood glucose level in normal group but not in GDM group.MMP and MBP exposure might increase the risk of GDM,but MEOHP exposure might reduce the risk of GDM.Conclusion The phthalate exposure in the first trimester might be associated with the fasting blood glucose level in the third trimester,MMP,MEP,MBP,MBzP and MEHHP concentrations were positively associated with the third trimester blood glucose level,MEHP and MEOHP concentrations were negatively associated with the third trimester blood glucose level.Moreover,the effects of different kinds of phthalates might be different.
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Objective Based on the theory of preventive treatment and constitution regulation, to observe the clinical efficacy of point application for stable chronic obstructive pulmonary disease (COPD).Methods Seventy-nine qi deficiency or yang deficiency patients in stable COPD were randomized into a treatment group of 40 cases and a control group of 39 cases. The control group received conventional medication and the treatment group additionally received point application in canicular days or the three-nine days in winter. The frequency of catching cold, the situation of acute exacerbation of chronic obstructive pulmonary disease (AECOPD), constitution types and scores of traditional Chinese medicine (TCM), pulmonary function [the level of forced expiratory volume in one second (FEV1), the percentage of FEV1 in predicted value, FEV1’s ratio to forced vital capacity (FVC)], BODE index (body mass index, airflow obstruction, dyspnea and exercise capacity index) and therapeutic effects were recorded in the two groups before and after the treatment. The correlation analysis was performed between the scores of constitution and the frequency of catching cold, AECOPD, syndrome scores of TCM, BODE index.Results The cold times, AECOPD attack times, times of hospitalization for AECOPD and syndrome scores of TCM were significantly changed in the treatment group after treatment (P0.05). After the treatment, the change of the BODE score in the treatment group was significantly different from that in the control group (P<0.01). A significant positive correlation was found between the main abnormal constitution scores and the cold times, AECOPD attack times, times of hospitalization for AECOPD, syndrome scores of TCM in the treatment group after treatment (P<0.05,P<0.01). A significant negative correlation was found between the balanced constitution scores and the cold times, AECOPD attack times, times of hospitalization for AECOPD, syndrome scores of TCM in the treatment group after treatment (P<0.05,P<0.01).Conclusion Point application is an effective method for stable COPD.
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Objective To construct and identify lentiviral vector pGC-FU-CXCR4 gene. Methods CXCR4 gene amplification was used by real-time polymerase chain reaction. The target gene fragments with the digested plasmids were exchange. Then the lentiviral vector pGC-FU-CXCR4 was constructed successfully. Use the constructed lentiviral vector to infect the competent escherichia coli cells. Polymerase chain reaction analysis was used to identify the cultural clones and DNA sequencing and comparative analysis were used to positive fragments. The successfully constructed plasmids had the same sequence with the target gene. Results Polymerase chain reaction tests showed that am-plified target genes were inserted in pGC-FU vectors. The electrophoresis results,digestion showed that the reconstructed plasmid was consist-ent with the theoretical fragment and the sequence result of the positive fragments were exactly the same with the target gene. Conclusion Lentiviral vectors of CXCR4 gene over-expression were successfully constructed.
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of NB4 cells at S phase was lower than those in control group (P <0.05),and the number of NB4 cells at G1 phase was increased (P <0.05).The expression levels of Bcl-2 in ICA groups were significantly lower than that in control group (P < 0.05 ), while the expression levels of Bax were higher than that in control group (P < 0.05 ). Conclusion ICA can induce the apoptosis of NB4 cells via inhibiting the expression level of Bcl-2 and up-regulating the expression level of Bax.
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Adult stem cells (ASCs) are undifferentiated cells found throughout the body that divide to replenish dying cells and regenerate damaged tissues, which are the powerful sources for cell therapy and tissue engineering. Bone marrow-derived mesenchymal stem cells (BMSCs), adipose tissue-derived mesenchymal stem cells (ADSCs), and peripheral blood monocytes (PBMCs) are the common ASCs, and many studies indicated that ASCs isolated from various adult tissues could be induced to hepatocyte-like cells in vitro. However, the isolation, culture protocols, characterization of ASCs and hepatocyte-like cells are different. This review aims to describe the isolation and culture procedures for ASCs, to summarize the molecular characterization of ASCs, to characterize function of hepatocyte-like cells, and to discuss the future role of ASCs in cell therapy and tissue engineering.