[A case report of bronchial granular cell tumor].

Granular cell tumor (GCT) is a relatively rare tumor that develops in soft tissues at various sites in the body, and GCT originating in the bronchus is rather rare. Here, we reported a case of primary GCT of the bronchial to improve the understanding of this disease.

[Analysis of the association between diurnal temperature difference and relative humidity and myocardial infarction in Shantou residents].

Objective: To analyze the effect of meteorological conditions on mortality and population susceptibility of patients with acute myocardial infarction (AMI) in the Shantou area and to provide a scientific basis for the local public health system to prevent AMI. Methods: The AMI mortality data recorded in the resident cause of death surveillance database of Shantou from January 1, 2015, to December 31, 2020, were collected and the distribution lag nonlinear model was used to analyze the diurnal temperature range (DTR) and relative humidity (RH) on AMI mortality and the lag effect. Results: There were 13 932 deaths due to AMI in Shantou during the study period, with a male-to-female sex ratio of 1.3∶1. There was a significant association between high diurnal temperature difference exposure and low RH exposure and AMI deaths, with both single-day lag effects appearing and reaching a maximum at lag 2 day (RR=1.019, 95%CI: 1.000-1.039; RR=1.018, 95%CI: 1.003-1.034); the cumulative lag effect was all maximal at lag 0-14 day (RR=1.199, 95%CI: 1.025-1.401; RR=1.279, 95%CI: 1.117-1.465). The elderly (≥75 years) and female populations were susceptible to high DTR exposure and low RH exposure conditions. Conclusions: There was a significant association between DTR and RH and mortality of AMI in Shantou with a significant lag in their effects. Both female and elderly populations ≥75 years old were susceptible populations under high DTR and low RH exposure conditions.

CREG improves cardiac function by regulating cardiomyocytes' autophagy in diabetic myocardial infarction rats.

OBJECTIVE: We aimed to observe the changes of cardiac function, cell morphology, cellular repressor of E1A-stimulated genes (CREG) and LC3-II after myocardial infarction (MI) in non-diabetic and diabetic rats, and to explore the relationship between myocardial damage and CREG and autophagy in diabetic rats. MATERIALS AND METHODS: Diabetic rat models were prepared by intraperitoneal injection of low concentration (50 mg/kg) streptozotocin (STZ). MI models were established in normal rats and diabetic rats. The cardiac function of each group was detected by echocardiography. The pathological results of myocardial tissue in the infarcted area were observed under light microscope. The expression of CREG was detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). Myocardial protein CREG LC3-II expression was measured by Western blot. Autophagy levels were also detected at the cellular level. Construction of CREG overexpressing adenovirus transfected H9c2 cells, and injection of rats with AAV-CREG to achieve the purpose of overexpressing CREG. In vitro and in vivo experiments were conducted to explore the effects of CREG on autophagy and cardiac function in a diabetic MI model. RESULTS: Compared with the non-diabetic sham (NS) group, there were no marked differences in cardiac function and CREG levels in the diabetic sham (DS) group. Compared with the NS group, the cardiac function of the non-diabetic myocardial infarction (NI) group and the diabetic infarction myocardial (DI) group were reduced, and the levels of autophagy were increased. However, the cardiac function of the DI group was worse than that of the NI group, and the autophagy level of the DI group was lower than the NI group. The results at the cellular level were similar to the experiments in vivo. The overexpression of CREG in vivo or in vitro can increase autophagy levels and improve cardiac function. CONCLUSIONS: The exacerbation of myocardial injury after MI in diabetic rats may be related to the inhibition of CREG in myocardial cells of infarcted area by diabetes.

[Impact and related mechanism on the improvement of hyperglycemia-induced pyroptosis in H9c2 cells by mircoRNA-214].

Objective: To investigate whether microRNA(miR)-214 can improve hyperglycemia induced pyroptosis in H9c2 cells through targeting caspase-1. Methods: H9c2 cells of rats those in good growth condition were selected and incubated into the T25 culture bottle after digestion and passage. Cells were cultured in an incubator at 37 ℃ with 5%CO(2), repeat passage was made after cell density reached about 80%, The 5(th) to 8(th) generations of cells were selected for the subsequent experiments. To observe the effect of overexpression of miR-214 on pyroptosis and caspase-1 expression in H9c2 cells induced by hyperglycemia, the cells were divided into 4 groups: Control group(H9c2 cells cultured normally), Hyperglycemia group (HG group, 50 mmol/L glucose was used to intervene H9c2 cells for 24 hours), miR-214 mimics+hyperglycosis group (mimics+HG group, H9c2 cells were transfected with miR-214 mimics for 24 hours and then treated with 50 mmol/L hyperglycosis for 24 hours), miR-214 mimic-negative control+hyperglycaemic group(MNC+HG group, H9c2 cells were transfected with miR-214 mimic-negative control for 24 hours and then treated with 50 mmol/L hyperglycaemic for 24 hours). In order to further verify the anti-pyroptosis effect of miR-214 was mediated by targeted inhibition on caspase-1, cells overexpressing caspase-1 were used in the rescue experiment. The cells overexpressing caspase-1 were divided into 4 groups: Hyperglycemia group (HG group, 50 mmol/L glucose was used to intervene H9c2 cells for 24 hours), miR-214 mimics+hyperglycosis group (mimics+HG group, H9c2 cells were transfected with miR-214 mimics for 24 hours and then treated with 50 mmol/L hyperglycosis for 24 hours), miR-214 mimics+hyperglycosis+recombinant adenovirus (Ad-caspase-1-EGFP) group with caspase-1 gene and EGFP green fluorescent protein expression (mimics+HG+Ad-caspase-1-EGFP group, H9c2 cells were transfected with caspase-1-green fluorescent protein-carrying adenovirus for 48 hours, followed by transfection of miR-214 mimics for 24 hours, and then treated with 50 mmol/L hyperglycaemia for 24 hours), miR-214 mimics+HG+Ad-EGFP empty virus group (mimics+HG+Ad-EGFP group, H9c2 cells were transfected with empty adenovirus containing green fluorescent protein for 48 hours, followed by transfection with miR-214 mimics for 24 hours, and then treated with 50 mmol/L hyperglycosis for 24 hours). The mRNA expression levels of miRNA-214 and caspase-1 in cells were detected by real-time quantitative PCR. The expression and localization of caspase-1 protein were detected by immunofluorescence assay. Western blot was used to detect protein expression levels of procaspase-1, cleaved caspase-1, NLRP3 and ACS with ß-actin as internal reference. The secretion of IL-1ß and IL-18 in cell culture medium was detected by ELISA. The correlation between miR-214 and caspase-1 was detected by double luciferase reporter gene. Results: (1) The mRNA expression levels of miR-214 and caspase-1 in each group: the mRNA expressions of miR-214 in HG group and MNC+HG group were significantly lower than that in control group(P<0.05). The mRNA expression of miR-214 in mimics+HG group was significantly higher than that in control group (P<0.05). The mRNA expression levels of caspase-1 in HG group and MNC+HG group were significantly higher than that in control group(P<0.05). The mRNA expression level of caspase-1 in mimics+HG group was lower than that in control group(P<0.05). (2) The expression of caspase-1 in each group: the green fluorescence intensity in the control group was weak, which was strong in the HG group and MNC+HG group. The green fluorescence expression was weaker in mimics+HG group than in HG group. (3) ASC and NLRP3 protein expression levels in each group: ASC and NLRP3 protein expression levels in HG group and MNC+HG group were higher than those in control group(P<0.05). ASC and NLRP3 protein expression levels were significantly lower in mimics+HG group than in mimics+HG group (P<0.05). (4) The secretion of IL-1ß and IL-18 in the cell culture medium of each group: the content of IL-1ß and IL-18 in the cell culture medium of HG group and MNC+HG group was significantly higher than that of control group (P<0.05). The content of IL-1ß and IL-18 in the cell culture medium of mimics+HG group was significantly lower than that of the HG group (P<0.05). (5) Correlation between miR-214 and caspase-1: miR-214 specifically binds to caspase-1 3 'UTR. Meanwhile, Western blot results showed that cleaved caspase-1 protein expression levels were significantly higher in both HG group and MNC+HG group than in control group (P<0.05). The levels of cleaved caspase-1 were significantly lower in mimics+HG group than in HG group (P<0.05). There was no significant difference in procaspase-1 expression among groups (P>0.05). (6) The expression levels of procaspase-1, cleaved caspase-1, ASC and NLRP3 in each group in rescue experiment: there was no significant difference in the expression of procaspase-1 in each group (P>0.05). Cleaved caspase-1, ASC and NLRP3 protein expressions were significantly lower in mimics+HG group than in HG group (P<0.05). However, cleaved caspase-1, ASC and NLRP3 protein expressions were significantly higher in mimics+HG+ Ad-caspase-1-EGFP group than in mimics+HG group (P<0.05). (7) The expression of IL-1ß and IL-18 in rescue experiment: the secretions of IL-1ß and IL-18 in the cell culture medium of the mimics+HG group were significantly lower than that of HG group (P<0.05), which were significantly higher in mimics+HG+Ad-caspase-1-EGFP group than in mimics+HG group (P<0.05). Conclusion: miR-214 can improve the hyperglycemia induced pyroptosis in H9c2 cells by targeted inhibition of the caspase-1.

[The postnatal development of perineuronal net, Nogo receptor and the effect of fluoxetine on remodeling it in the visual cortex of rats].

Objective: To investigate the postnatal development of perineuronal net (PNN), Nogo receptor (Nogo R) in visual development and the effect of fluoxetine(Flx) on remodeling it in the visual cortex of adult rats. Methods: Experimental study. (1) Wistar rats were divided into postnatal weeks (PW)1,PW3,PW5,PW7,PW9 group (8 rats in each group) according to the age of PW. The changes of PNN and Nogo R were observed in the visual cortex of each group. (2) The adult rats (10 weeks after birth) were randomized into Flx 0W, Flx 2W, Flx 4W, Flx 6W and Flx 8W group (8 rats in each group) according to Flx administrational weeks. The influence of Flx on the expression of PNN and Nogo receptor in the visual cortex was detected by immunofluorescence and western blots. (3) The adult rats were randomized into Cont (negative control), Flx, binocular form deprivation(BFD,positive control) and BFD+Flx group (8 rats in each group). Flx group accepted oral administration at the dosage of 0.2 mg/ml once per day for 4 weeks. The eyelids were binocularly sutured for 2 weeks to form the BFD group, and the combination of Flx administration and BFD was performed in the BFD+Flx group.No intervention was conducted in the control group (Cont group). Immunofluorescence was used to observe the expression pattern of PNN staining by biotinylated wisteria floribunda lectin (WFA). The expression of Nogo R in the visual cortex was detected by immunofluorescence and Western blots. The expression of PNN and Nogo R were examined in each group. And t test, analysis of variance and rank sum test were employed for inter-group comparison based on the homogeneity of variance. Bonferroni method was used for multiple comparison and simple linear regression analysis was used for the trend. Results: (1) The expression of PNN (standardized b=0.97, P=0.005) and Nogo R (standardized b=0.96, P=0.010) increased during the postnatal development and the Nogo R reached the matured level at PW7 (PW7 vs. PW9, 131.83±3.78 vs. 135.11±3.92, Z=1.93, P=0.062). (2) Flx significantly decreased PNN in the visual cortex of adult rats. The density of PNN-positive cells in the visual cortex of healthy adult rats fed with Flx for 4 weeks was (86.22±7.68)/mm(2), which was similar to that of 3 weeks old rats [(84.21±6.68)/mm(2), t=2.08, P=0.073]. The expression of PNN (standardized b=-0.88, P=0.040) and it's receptor Nogo R (standardized b=-0.90, P=0.007) decreased with prolongation of Flx use. (3) The expression of Nogo R (t=13.42,11.47, 18.13; P=0.012, 0.013, 0.001; Flx, BFD and BFD+Flx group vs. Cont group) and the density of PNN (t=10.09, 7.64, 13.01; P=0.007, 0.011, 0.001; Flx, BFD and BFD+Flx group vs. Cont group) could be modulated by Flx and BFD after the critical period. There are no differences in BFD and Flx group on Nogo R changes (t=2.41, P=0.153). The expression of Nogo R protein was also different among the 4 groups (H=5.69, P=0.041). The effect of Flx combined with BFD was better than the Flx or BFD alone (Flx vs. BFD+Flx, Z=4.22, P=0.005; BFD vs. BFD+Flx, Z=3.09, P=0.010). Conclusions: The expression of PNN and Nogo R increase during the postnatal development. Chronic Flx treatment decrease the expression of PNN and Nogo R after the critical period in the visual cortex of adult rats, that is the same as BFD. (Chin J Ophthalmol, 2019, 55:37-45).

[Survey on Toxoplasma gondii infections among three types of populations in Wuxi City].

OBJECTIVE: To investigate the seroprevalence of Toxoplasma gondii infections among patients with rheumatoid arthritis, malignant tumors and schizophrenia in Wuxi City, so as to provide data support for the control of toxoplasmosis in these patients. METHODS: A total of 205 cases with definitive diagnosis of rheumatoid arthritis, 257 cases with definitive diagnosis of malignant tumors and 235 cases with definitive diagnosis of schizophrenia were recruited, while 250 healthy volunteers served as controls. The demographic features were captured from the study subjects and serum samples were collected. The serum IgG and IgM antibodies against T. gondii were detected using an enzyme-linked immunosorbent assay (ELISA) in all study subjects, and the positive rates of anti-T. gondii IgG and IgM antibodies were compared between the patients and controls. RESULTS: The seroprevalence of the anti-T. gondii IgG antibody was 20.98%, 24.12% and 24.68% in patients with rheumatoid arthritis, malignant tumors and schizophrenia, which were all significantly greater than in healthy controls (χ2 = 31.54, 42.12 and 42.98, all P values < 0.01), and the seroprevalence of the anti - T. gondii IgM antibody was 1.46%, 2.72% and 1.70% among patients with rheumatoid arthritis, malignant tumors and schizophrenia, which were all significantly higher than in healthy controls (χ2 = 0.06, 1.52 and 0.21, all P values > 0.05). CONCLUSIONS: The patients with rheumatoid arthritis, malignant tumors and schizophrenia present with higher seroprevalence of the anti-T. gondii IgG antibody than healthy controls in Wuxi regions. Screening of T. gondii infections among the patients with rheumatoid arthritis, malignant tumors and schizophrenia should be intensified to prevent the damages caused by T. gondii infections.

[Optical coherence tomographic analysis of in-stent neoatherosclerosis in lesions with restenosis after drug-eluting stent implantation].

Objective: To explore the imaging characteristics and related influencing factors of in-stent neoatherosclerosis (ISNA) in patients with restenosis after drug-eluting stent(DES) implantation with optical coherence tomography(OCT). Methods: A total of 25 cases of coronary heart disease patients(DES placement time ≥8 months) with coronary artery angiography showing DES in-stent restenosis (ISR) in Zunyi medical college affiliated hospital from July 2013 to December 2015 were included in this study and patient's data were retrospectively analyzed.In these patients with ISR, OCT images were acquired before percutaneous coronary intervention. Patients were divided into the ISNA group (12 patients and 12 lesions) and non-ISNA group(13 patients and 13 lesions) according to the result of OCT. ISNA on OCT was defined as neointima formation with the presence of lipids or calcification. Results: (1) The incidence of chronic kidney disease and increased low-density lipoprotein cholesterol level in ISNA group were significant higher than that in non-ISNA group(all P<0.05). The stent implantation time in ISNA group was longer than that in the non-ISNA group(53.0(14.0, 81.0) months vs. 15.0(8.5, 32.5) months, P<0.01). In addition, clinical manifestation of acute coronary syndrome was present in 8 out of 12 patientsin ISNA group, and stable angina pectoris was found in 10 out of 13 casesin non-ISNA group(P<0.01). (2) Quantitative analysis of OCT showed that the lumen area was less in ISNA group than in non-ISNA group((3.45±1.82)mm(2) vs. (4.17±1.68)mm(2), P<0.01), and neointimal area(3.89(2.26, 5.52)mm(2) vs. 2.96(1.99, 4.22)mm(2), P<0.01), neointimal load (53.15(40.18, 67.30)% vs. 41.54(32.08, 56.91)%, P<0.01), neointimal thickness(0.98(0.63, 1.36)µm vs. 0.72(0.51, 1.03)µm, P<0.01) were higher in ISNA group than in non-ISNA group.(3)Qualitative analysis of OCT showed that the prevalence of homogeneous intima was less in the ISNA group than in the non-ISNA group ((41.42±22.56)% vs.(72.06±18.68)%, P<0.05), on the contrary, the heterogeneous intima was more common in the ISNA group ((58.57±22.56)% vs. (27.94±18.68)%, P<0.05). There was no significant difference between two groups in the peri-stentmicrovessels (9/12 vs. 5/13,P>0.05), and prevalence of intraintimalmicrovessels was higher in the ISNA group than in non-ISNA group (7/12 vs. 2/13, P<0.05). In addition, thin cap fibrous plaque(7/12 vs. 0, P<0.01), disrupted intima with visible cavity (7/12 vs. 1/13, P<0.05),andintraluminal red thrombus(7/12 vs. 1/13, P<0.05) were significantly higher in ISNA group than in non-ISNA group. Conclusions: Results of OCT show that ISNA occurs frequently in patients with ISR after DES implantation. The stent implantation time, incidence of chronic kidney disease and higher low-density lipoprotein cholesterol level are associated with the formation of ISNA in these patients.

[A brief textual research on Mei shi fang (Prescriptions of Master Mei) and Yi men fang (Prescriptions of Medical Professionals)].

Mei shi fang (Prescriptions of Master Mei) cited in Zheng lei ben cao (Classified Syndromes Materia Medica) and Yi men fang (Prescriptions of Medical Professionals) cited in Yi xin fang (Ishinpo) are actually the same book with different titles, which is actually called Yi men mi lu (Secret Records of Medical Professionals) with 5 volumes or the 5-volume Mei chong xian fang (Prescriptions of Mei Chongxian) approximately compiled during the years of Zhenyuan to Yuanhe reigns of the Tang Dynasty (785-820) written by Mei Chongxian, a Tang taoist. Mei Chongxian and Mei Biao, the author of Shi yao er ya (Dictionary of Mineral Medicines), might probably be the same person. According to the citations of Yi xin fang and Zheng lei ben cao, Yi men mi lu should be a comprehensive medical book including theories, methods, prescriptions and medications, recorded classical prescriptions of predecessors extensively, with some innovations and high clinical and documentary significance.

Effect of early enteral nutrition (EN) on endotoxin in serum and intestinal permeability in patients with severe acute pancreatitis.

OBJECTIVE: This work aimed at studying the effect of early enteral nutrition (EN) on serum endotoxin and intestinal permeability in patients with severe acute pancreatitis. PATIENTS AND METHODS: 70 cases of patients with severe acute pancreatitis were cured in our hospital from April 2015 to January 2016. Patients selected were randomly divided into two groups including a group of patients having parenteral nutrition (group PN) and that had enteral nutrition (group EN). The results were assessed by: 1) the differences of serum endotoxin level; 2) the differences of the lactulose/mannitol ratio of urine, before intervention and one and two weeks after the intervention. RESULTS: Before the intervention, both groups had similar levels of serum endotoxin and the same lactulose/mannitol excretion rate of urine (p>0.05). One and two weeks after the intervention, the serum endotoxin level and the lactulose/mannitol excretion rate of urine of the group PN were significantly higher than the group EN (p<0.05). CONCLUSIONS: Compared with PN, EN has a bigger effect on serum endotoxin and intestinal permeability in patients with severe acute pancreatitis. EN can better promote the elimination of serum endotoxin and reduce intestinal permeability. Therefore, EN deserves clinical expansion.

[Analysis of optical coherence tomography of early and very late stent restenosis after drug-eluting stent implantation].

Objective: Using optical coherence tomography (OCT) to analyze the morphological characteristics of lesions between early in-stent restenosis (E-ISR) and very late in-stent restenosis (VL-ISR) after drug-eluting stents (DES) implantation. Methods: In 25 patients (DES) with ISR, OCT images were acquired before percutaneous coronary intervention (PCI), the morphological characteristics of E-ISR (<1 years, n=14) and VL-ISR (>3 years, n=11) were compared.The quantitative and qualitative analysis of the entire stent and the minimum lumen area (MLA) site were carried out respectively. OCT quantitative restenotic tissue analysis included the assessment of mean lumen area, mean stent area, mean neointimal area and mean neointimal burden.OCT qualitative restenotic tissue analysis included the assessment of tissue structure [homogeneous or heterogeneous intima (lipid-rich neoitima, thin-cap fibroatheroma (TCFA)-like intima)], presence of microvessels, intraluminal material (red thrombus, pale thrombus), disrupted intima with cavity and tissue prolapse and was performed at every 1-mm slice of the entire stent. Results: Compared with the E-ISR group, the proportion of cross-sections with heterogeneous intima in the entire stent was significantly higher in the VL-ISR group (60.57% vs 32.93%, P=0.005), and both peristent and intraintimal microvessels were more frequently observed in the VL-ISR group (P<0.05). In addition, lipid-rich neointima (72.7% vs 21.4%, P=0.017), TCFA-like intima (54.5% vs 7.1%, P=0.021), disrupted intima with visible cavity (63.6% vs 7.1%, P=0.007) and red thrombus (63.6% vs 7.1%, P=0.007) were observed more frequently in the VL-ISR group compared with E-ISR group for the entire stent.The heterogeneous intima was observed more frequently in the VL-ISR group (90.9% vs 35.7%, P=0.012) at the MLA sites.Intraintimal microvessels and disrupted intima with visible cavity were observed only in the VL-ISR group. Conclusions: OCT imaging indicates that the morphological characteristics of restenosis lesions in VL-ISR are different from those in E-ISR.The atherosclerotic changes of neointima, such as lipid-rich neointima, disrupted intima with cavity and microvessels are more often observed in VL-ISR lesions after DES implantation compared with E-ISR.Progression of the atherosclerosis within neointima after DES implantation may be associated with VL-ISR.

[Application value of whole brain 3D artery spin labeling in diagnosis of intracranial tumors].

Objective: To investigate the perfusion characteristics of arterial spin labeling (ASL) in intracranial tumor and its application value in classification. Methods: The clinical, pathological and imaging data of 44 patients with gliomas confirmed by pathology were analyzed retrospectively, including 9 low grade gliomas, 15 high grade gliomas, 11 cases of meningiomas, 6 cases of neurilemmoma, 3 cases of metastatic tumors.Conventional plain scan, 3D- ASL and MRI dynamic enhanced imaging (DSC-MRI) were performed.The mean maximal cerebral blood flow (CBF) of the solid component of tumor was obtained based on the region of interest.Immunohistochemical staining was performed in 24 patients with glioma.The differences of cerebral blood flow map (CBF) and relative cerebral blood flow (rCBF) in 44 patients with intracranial tumors were compared. The results of paired t test between the tumor area and the contralateral mirror area were measured by the two methods. Results: Taken the normal control-lateral grey matter(GM) as reference to normalize the CBF of tumor, three normalized tumor blood flow (nTBF) acquired by ASL showed statistical difference between low grade and high grade gliomas respectively (P<0.05). While taken the mirror region (M) and normal control-lateral white matter (WM) as reference to normalize the CBF of tumor, it showed no statistical difference (P>0.05). There was no 1p deletion in the cases of ASL perfusion in low-grade glioma group.In the case of 1p deletion in high grade glioma group, ASL was low perfusion, and there was no 1p deletion in the cases of ASL perfusion. Conclusion: 3D ASL can be used to identify high-grade and low-grade gliomas which has important reference value in the qualitative diagnosis of brain tumors and preoperative grading of gliomas.A separate use of 3D-ASL might cause over-or underestimation of tumor diagnosis, therefore a comprehensive analysis is needed.

[Expression of PD-1/PD-L1 in triple-negative breast carcinoma and its significance].

Objective: To investigate the correlation between the expression of PD-1, PD-L1 and clinicopathologic parameters in triple negative breast carcinoma (TNBC). Methods: Samples from 151 patients with TNBC and 65 cases of other breast carcinomas (non-TNBC) were examined for PD-L1 and PD-1 expression by immunohistochemical staining on tissue microarray. Results: The expression of PD-L1 and PD-1 in the tumor cells and interstitial lymphocytes in TNBC was significantly (P<0.05)higher than that in non-TNBC.In TNBC, the expression rates of PD-L1 in the cancer nests and stroma were 16.6%(25/151) and 25.2%(38/151)respectively.The former was positively correlated with tumor histological grade and lymph node metastasis (P<0.05), and the latter only with tumor histological grade (P<0.05). The expression rate of PD-1 was 27.2% (41/151), and correlated with PD-L1 expression in stromal tumor-infiltrating lymphocytes (P<0.05). Conclusion: The expression of PD-L1 in TNBC is significantly correlated with high-grade histology, lymph node metastasis and PD-L1 expression in stromal tumor-infiltrating lymphocytes.

[Risk factors for hepatitis B recurrence after liver transplantation for HBV-related liver disease].

Objective: To investigate the risk factors for hepatitis B recurrence after liver transplantation for HBV-related liver disease, and to provide a basis for effective preventive measures. Methods: A retrospective analysis was performed for the clinical data of 907 patients with HBV-related liver disease who underwent liver transplantation from April 2002 to December 2013. The chi-square test was used to determine the risk factors for hepatitis B recurrence, and multivariate Cox regression analysis was used for identifying the independent risk factors. Results: There were 907 patients with HBV-related liver disease who underwent liver transplantation. The patients were followed up for 1-144 months, with a median follow-up time of 50.9 months. Among them, 56 experienced hepatitis B recurrence, yielding a recurrence rate of 6.17%. The univariate analysis showed that positive HBeAg before surgery, positive HBV DNA before surgery, positive anti-HBc in liver donor, postoperative tumor recurrence, and postoperative regimen for the prevention of hepatitis B recurrence were significantly correlated with hepatitis B recurrence after liver transplantation (P < 0.05). The multivariate Cox regression analysis showed that positive HBeAg before surgery (OR = 1.891, 95% CI 1.064-3.360, P < 0.05), positive anti-HBc in liver donor (OR = 3.128, 95% CI 1.591-6.151, P < 0.01), and postoperative tumor recurrence (OR = 4.365, 95% CI 2.152-8.857, P < 0.01) were independent risk factors for hepatitis B recurrence. Conclusion: Positive HBeAg before surgery, postoperative tumor recurrence, and positive anti-HBc in liver donor are independent risk factors for hepatitis B recurrence after liver transplantation. For the patients who plan to undergo liver transplantation, antiviral therapy should be given before surgery to reduce HBV viral load, and effective preventive measures after surgery are the key to the prevention and reduction of postoperative hepatitis B recurrence.

Modeling the cost-effectiveness of ilaprazole versus omeprazole for the treatment of newly diagnosed duodenal ulcer patients in China.

OBJECTIVES: To evaluate the cost-effectiveness of 10 mg ilaprazole once-daily vs 20 mg omeprazole once-daily to treat newly-diagnosed duodenal ulcer patients in China. METHODS: A decision tree model was constructed and the treatment impact was projected up to 1 year. The CYP2C19 polymorphism distribution in the Chinese population, the respective cure rates in the CYP2C19 genotype sub-groups, the impact of Duodenal Ulcer (DU) on utility value and drug-related side-effect data were obtained from the literature. The total costs of medications were calculated to estimate the treatment costs based on current drug retail prices in China. Expert surveys were conducted when published data were not available. Probabilistic sensitivity analysis was performed to gauge the robustness of the results. RESULTS: Ilaprazole, when compared with omeprazole, achieved a better overall clinical efficacy. For the overall population, ilaprazole achieved an incremental cost effectiveness ratio (ICER) of ¥132 056 per QALY gained. This is less than the WHO recommended threshold of 3-times the average GDP per capita in China (2014). Furthermore, sub-group analysis showed that ilaprazole is cost-effective in every province in CYP2C19 hetEM patients and in the most developed provinces in CYP2C19 homEM patients. Probabilistic sensitivity analysis suggests that the results are robust with 97% probability that ilaprozole is considered cost-effective when a threshold of 3-times China's average GDP per capita is considered. LIMITATION: This study didn't have the data of ilaprazole combined with Hp eradication therapy. Caution should be taken when extrapolating these findings to DU patients with an Hp eradication therapy. CONCLUSIONS: The cost-effectiveness analysis results demonstrated that ilaprazole would be considered a cost-effective therapy, compared with omeprazole, in Chinese DU patients based on the efficacy projections in various CYP2C19 polymorphism types.

Expression and function of PDGF-α in columnar epithelial cells of age-related cataracts patients.

We studied the expression and function of platelet-derived growth factor A (PDGF-α) in the lens epithelial cells of cataracts patients. Ninety age-related cataracts patients were recruited in our hospital between January 2012 and January 2014. The expression levels of platelet-derived growth factor receptor (PDGFR) in the anterior capsule of the lens at different degrees of turbidity, and PDGF-α in the aqueous humor were detected. A human lens epithelium cell line was also cultured and studied. To investigate its function, PDGF-α was used to treat a PDGFR-silenced human lens epithelium cell line to observe changes in the proliferation, transfer, and epithelial mesenchymal transition (EMT). The expression of PDGF-α and its receptor increased in patients with more serious cataracts. Lens epithelium cells stimulated by PDGF-α showed greater proliferation and migration. The degree of EMT was also upregulated in cells stimulated by PDGF-α. However, silencing the expression of PDGFR inhibited the effects. The development and severity of age-related cataracts was related to the secretion and expression of PDGF-α. This may be a new therapeutic target for cataracts treatment.

Expressions of survivin, P16(INK4a), COX-2, and Ki-67 in cervical cancer progression reveal the potential clinical application.

PURPOSE OF INVESTIGATION: To explore the significance of survivin, P16(INK4a), COX-2, and Ki-67 expressions for prediction of cervical cancer progression. MATERIALS AND METHODS: A retrospective study was performed in 129 cases including 24 squamous carcinoma of the cervix (SCC), 70 cervical intraepithelial neoplasias (CIN), 15 cervical condyloma acuminatum (CCA), ten chronic cervicitis (CC), and ten normal cervix (NC). Protein expressions were evaluated using immunohistochemistry. RESULTS: Survivin, P16(INK4a); COX-2, and Ki-67 were highly expressed in SCC and CIN compared with others. Their expression rates were gradually increased in CIN I, CIN II, CIN III, and SCC groups, showing 72.00%, 88.00%, 90.00%, and 95.83% for P16(INK4a), 68.00%, 84.00%, 95.00% and 100.00% for COX-2, 76.00%, 96.00%, 100.00%, and 100.00 for Ki-67, respectively. There were significant correlations between survivin and P16(INK4a), COX-2, Ki-67, as well as P16(INK4a) and Ki-67. CONCLUSION: Survivin, P16(INK4a), COX-2 and Ki-67 play critical roles for development and progression of cervical cancer.

Omentin-1 plasma levels and omentin-1 expression are decreased in psoriatic lesions of psoriasis patients.

Previous studies have suggested that psoriasis is associated with individuals who are overweight or obese. Omentin is a recently discovered adipokine that is involved in chronic inflammatory processes. This study evaluated the relationship between omentin and psoriasis, focusing on omentin-1 serum levels, skin expression of omentin-1, and omentin-1 gene polymorphism (rs2274907; Val109Asp). Levels of omentin-1 in serum samples from 44 patients with psoriasis and 38 healthy controls were analyzed by enzyme-linked immunosorbent assay. The expressions of omentin-1 were measured by immunohistochemistry in 3 psoriasis affected skins and 3 normal skins. The rs2274907 variant was typed using a SNaPshot assay in 354 cases and 214 controls. We found significantly lower serum levels of omentin-1 in psoriasis patients compared with healthy controls (p < 0.001) with an inverse correlation with the Psoriasis Area and Severity Index (p < 0.01). The comparison of genotype and allele distribution revealed no significant difference in genotype frequency between psoriasis patients and controls. Therefore, omentin-1 may have a role in the pathogenesis of psoriasis and might be a potential biological marker for psoriasis severity.

Bilateral Bispectral Index (BIS)-Vista as a measure of physiologic sleep in sleep-deprived anesthesiologists.

BACKGROUND: Anesthesiologists who work extended hours exhibit acute and chronic sleep deprivation. The newest bilateral Bispectral Index (BIS)-Vista monitor offers new advantages over earlier models, which include a new algorithm (version 1.4). One possible useful application for BIS monitoring of physiological sleep would be in critically ill patients who almost uniformly suffer from sleep disruption and deprivation because they loose their circadian rhythm due to the harsh noisy environment of critical care units. Previous studies, which used earlier versions of the BIS monitor to depict normal physiologic sleep, produced widely conflicting results. The aim of our study was to assess whether the new BIS-Vista monitor would exhibit a temporal decline that corresponds to natural physiologic sleep stages in healthy sleep-deprived, post-call anesthesiologists. METHODS: BIS-Vista sensors were bilaterally mounted, according to the manufacturer guidelines, onto the forehead of 10 healthy sleep-deprived volunteer anesthesiologists. Using the conventional Rechtschaffen and Kales criteria, BIS values during the awake, S1, S2, S3, S4, and rapid eye movement (REM) sleep stages were recorded. RESULTS: Mean±SD BIS values during the awake, S1, S2, S3, S4, and REM sleep stages significantly declined for the left (96±2, 82±11, 73±10, 53±13, 43±11, 66±9) and right (97±2, 78±11, 69±9, 50±10, 39±13, 61±14) hemispheres respectively. There were no significant interhemispheric differences in BIS values over time (two-way ANOVA). However, in one subject, the left and right BIS values were mostly discordant throughout the recordings. CONCLUSION: We demonstrated that although the BIS-Vista monitor was neither designed nor validated for monitoring normal physiologic sleep, it depicted a temporal decline that corresponds to normal physiologic sleep stages in sleep-deprived anesthesiologists.

De novo urothelial carcinoma in kidney transplant patients with end-stage aristolochic acid nephropathy in China.

OBJECTIVE: Aristolochic acid nephropathy (AAN) is a progressive renal interstitial fibrosis disease that was initially reported among a Belgian cohort of about 50 patients after the intake of diet pills containing the Chinese herb Aristolochia fangchi. In addition to renal disease, foci of AAN show increased incidences of urothelial carcinomas (UC). Immunosuppression is associated with an increased risk for the development of different malignancies. Our aim was to examine the outcomes of UC among patients with AAN after transplantation in China, the cradle of this traditional medicine. PATIENTS AND METHODS: We performed a retrospective evaluation of the charts and pathology reports of 1612 renal transplant recipients treated at our 2 institutions. RESULTS: From January 1998 to December 2006, we performed cadaveric kidney transplantations in 17 patients with AAN, all of whom were treated with cyclosporine plus azathioprine or mycophenolate mofetil plus prednisone. One-year graft survival was 100%. During the mean follow-up of 57 months (range, 21-108 months), 9 recipients (52.9%) developed UC, compared with a 0.46% prevalence of urinary tract tumors among other Chinese kidney transplant recipients. The age at which the diagnosis was made ranged from 39 to 66 years (mean, 53.6 +/- 6.8 years). Among the 9 patients with UC, 8 cases (88.9%) involved the upper urinary tract: bilateral, 3 cases, 37.5%; unilateral, 5 cases, 62.5%. In 1 patient only a bladder tumor was detected. Two patients showed the bladder, synchronous bilateral ureter, and pelvis to be involved. All patients with UC underwent surgical treatment, recovering uneventfully with functioning grafts after tumor excision, except 1 patient who underwent nephrectomy of the transplanted kidney. Six patients (75%) experienced recurrences during the follow-up period. Three patients died within a mean of 20 months (range, 1-42 months) after tumor excision. CONCLUSIONS: The risk for UC is increased among patients with AAN after transplantation. Regular screening for early detection of malignancy is mandatory. Longer follow-up and results from other transplant centers are needed to further investigate the relationship between AAN and UC among renal transplant patients.