[Number and Function of Myeloid-Derived Suppressor Cells in Patients with Adult Primary Immune Thrombocytopenia].

OBJECTIVE: To analyze the number of myeloid-derived suppressor cells(MDSC) and the level of prostaglandin E2(PGE2) in the bone marrow of adult ITP patients, and to explore their possible mechanisms involved in the pathogenesis of this disease. METHODS: Twenty-five patients of newly diagnosed ITP, 25 patients of complete remission group and 15 patients of control group were selected. The number of MDSC in the bone marrow between 3 groups was detect by flow cytometry (FCM). The serum level of prostaglandin E2 (PGE2) in 3 groups was determined by enzyme linked immunosorbent assay (ELISA). The relative expression of IFN-γ mRNA in bone marrow mononuclear cells was measured by real time fluorescence quantitative polymerase chain reaction (RT-qPCR) in each groups. RESULTS: The number of MDSC in the complete remission group was significantly higher than that in the control group (P<0.05); the number of MDSC in the newly diagnosed group was higher than that in the control group; the number of MDSC in the complete remission group was higher than that in the newly diagnosed group. The serum level of PGE2 in bone marrow of ITP patients in the newly diagnosed group was higher than that of the control group（P<0.05）. The serum level of PGE2 in the bone marrow of ITP patients of the complete remission group was higher than that of the control group (P<0.05）. The level of PGE2 in bone marrow serum of ITP patients of the newly diagnosed group was lower than that in the complete remission group(P<0.05）. The relative expression level of IFN-gamma in bone marrow mononuclear cells of the ITP patients in newly diagnosed group was higher than that in the control group and the complete remission group（P<0.001）. The relative quantification (RQ) of IFN-γ in bone marrow mononuclear cells was 2.60 between the newly diagnosed group and the complete remission group. CONCLUSION: When adult ITP disease is remitted, the number of MDSC rises and correlates with the therapeutic response and PGE2 level in the bone marrow.

Nitrate effects on chromate reduction in a methane-based biofilm.

The effects of nitrate (NO3-) on chromate (Cr(VI)) reduction in a membrane biofilm reactor (MBfR) were studied when CH4 was the sole electron donor supplied with a non-limiting delivery capacity. A high surface loading of NO3- gave significant and irreversible inhibition of Cr(VI) reduction. At a surface loading of 500 mg Cr/m2-d, the Cr(VI)-removal percentage was 100% when NO3- was absent (Stage 1), but was dramatically lowered to < 25% with introduction of 280 mg N m-2-d NO3- (Stage 2). After ∼50 days operation in Stage 2, the Cr(VI) reduction recovered to only ∼70% in Stage 3, when NO3- was removed from the influent; thus, NO3- had a significant long-term inhibition effect on Cr(VI) reduction. Weighted PCoA and UniFrac analyses proved that the introduction of NO3- had a strong impact on the microbial community in the biofilms, and the changes possibly were linked to the irreversible inhibition of Cr(VI) reduction. For example, Meiothermus, the main genus involved in Cr(VI) reduction at first, declined with introduction of NO3-. The denitrifier Chitinophagaceae was enriched after the addition of NO3-, while Pelomonas became important when nitrate was removed, suggesting its potential role as a Cr(VI) reducer. Moreover, introducing NO3- led to a decrease in the number of genes predicted (by PICRUSt) to be related to chromate reduction, but genes predicted to be related to denitrification, methane oxidation, and fermentation increased.

Evaluation of two observational pain assessment scales during the anaesthesia recovery period in Chinese surgical older adults.

AIMS AND OBJECTIVES: To evaluate the reliability and validity of the Pain Assessment in Advanced Dementia scale and the Checklist of Nonverbal Pain Indicators in Chinese older adults post surgery during the anaesthesia recovery period. BACKGROUND: Pain assessment in older surgical patients is complicated by factors such as anaesthesia and opioid administration. Although observational pain behavioural assessment tools have been validated for those unable to self-report, research on their application during the anaesthesia recovery period is limited. DESIGN: A prospective correlational design. METHODS: Ninety-three older patients admitted for scheduled abdominal surgery were recruited in a university-affiliated hospital. The two observational scales were used to conduct pain assessments during the anaesthesia recovery period. On the first and the third postoperative day, participants recalled their pain intensity during the recovery period using the Numeric Rating Scale or the Faces Pain Scale-Revised. RESULTS: The internal consistency reliability of the Pain Assessment in Advanced Dementia scale and the Checklist of Nonverbal Pain Indicators was 0·81 and 0·69 respectively. The correlation between scores of the two observational scales was 0·95. The recalled self-reports of pain intensity were significantly correlated. The correlation of the Pain Assessment in Advanced Dementia scale and patients' recalled self-reports was 0·55, 0·54, and the correlation between the Checklist of Nonverbal Pain Indicators and the two recalled pain scores was both 0·60. CONCLUSIONS: Both the two observational scales had good reliability and validity when used to assess pain in Chinese surgical older adults during the anaesthesia recovery period. RELEVANCE TO CLINICAL PRACTICE: Observational pain scales can be useful as a tool for patients unable to self-report. Accurate use of one of the observational pain tools can help identify pain during the anaesthesia recovery period, when patients are unable to self-report, to support effective pain management during this period.