The Characteristics of T Lymphocyte Reconstitution after Haploid Hematopoietic Stem Cell Transplantation in SAA and Its Relationship with aGVHD / 中国实验血液学杂志

OBJECTIVE@#To investigate the recovery characteristics of T cell subsets in patients with severe aplastic anemia (SAA) who received haploid hematopoietic stem cell transplantation(HSCT) and its relationship with acute graft-versus-host disease(aGVHD).@*METHODS@#The clinical data of 29 SAA patients who received haploid hematopoietic stem cell transplantation in the department of hematology, Shanxi Bethune Hospital from June 2018 to January 2022 were retrospectively analyzed. The absolute counts of CD3+T, CD4+T, CD8+T lymphocytes and the ratio of CD4+T/CD8+T lymphocytes in all patients before transplantation, 14, 21, 30, 60, 90 and 120 days after transplantation were analyzed. The proportion of T lymphocytes was compared in the non-aGVHD group, the grade Ⅰ-Ⅱ aGVHD group and the grade III-IV aGVHD group.@*RESULTS@#The counts of all T cells in 27 patients were far below the normal level at 14 and 21 days after transplantation, but there was obvious heterogeneity. There was a certain relationship between T cell immune reconstitution and conditioning regimen, age, and immunosuppressive treatment before transplantation. CD3+T cells showed a steady upward trend at 30, 60, 90, and 120 days after transplantation, and returned to the normal levels at 120 days after transplantation; faster recovery of CD4+T cells was closely related to aGVHD, which was at 30, 60, 90, 120 days after transplantation showed a slow upward trend, and which was still far below the normal level of 120 days after transplantation. CD8+T cell counts began to recover at 14 and 21 days after transplantation, and the recovery was earlier than the CD4+T cells, and its recovery speed was rapid 30 and 60 days after transptantation, which showed an upward trend and exceeded the normal levels 90 days after transplantation. Since CD8+ T cells reconstituted quickly, while the CD4+ T cells reconstitution was slowly, which made the long-term CD4+T/CD8+T cell ratio after transplantation was inverted . Compared with the non-aGVHD group, the absolute counts of CD3+T, CD4+T, and CD8+T cells in the aGVHD group were significantly higher than those in the non-aGVHD group at each time period after transplantation. In the aGVHD group, grade Ⅲ-Ⅳ aGVHD occurred more frequently in the early post-transplantation period (within 14-21 days), the grade Ⅰ-Ⅱ aGVHD group mostly occurred within 30-90 days after transplantation, and CD3+T, CD4+T, CD8+T cell counts in the grade Ⅲ-Ⅳ aGVHD group were significantly higher than those in the grade Ⅰ-Ⅱ aGVHD group; and the greater the proportion of CD4+T, the more severe the degree of aGVHD.@*CONCLUSION@#The speed of T cell immune reconstitution after SAA haploid transplantation is different, which is related to the conditioning regimen, age, and immunosuppressive therapy before transplantation. The rapid recovery of CD4+ T cells is closely related to the occurrence of aGVHD.

Ultrasonic analysis on the effect of strengthening exercise with strong tendon on lumbosacral multifidus muscles / 中国骨伤

<p><b>OBJECTIVE</b>To study effects of strengthening exercise with strong tendon on the lumbosacral multifidus muscle.</p><p><b>METHODS</b>Among 30 healthy volunteers, there were 21 males and 9 females, with an average age of(31.30±6.48) years old(ranged, 25 to 55 years old). The mean BMI was (21.70±1.95) kg/m²(ranged, 18.1 to 24.9 kg/m²). The ultrasonic image was used to analyze the thickness of lumbosacral multifidus(LM) under the follow conditions: supine position, and supine position with leg lifting 30°, 60°, 90°; seat and hip flexion, flexion to limit position, front to limit position with both hands climbing and strengthening the kidneys and the waist.</p><p><b>RESULTS</b>The average lumbosacral multifidus thickness was (16.867±2.460) mm, (19.010±2.510) mm, (22.477±2.220) mm, and(27.593±2.370) mm respectively in supine position with leg lifting 0°, 30°, 60°, 90°. There were statistical differences(=423.619,<0.05). The average lumbosacral multifidus thickness was (25.810±2.440) mm, (15.677±2.130) mm, and (15.533±2.110) mm respectively in seat and hip flexion, flexion to limit, front to limit positions with both hands climbing and strengthening the kidneys and the waist. There were statistical differences(=597.789,<0.05).</p><p><b>CONCLUSIONS</b>When healthy volunteers in Shi's Orthopedics strengthen muscle exercises training, multifidus thickness is increased with the increasing of leg degree, reduced with the increasing of the flexion degree. It can change the stretching state of multifidus muscle by a specific training, so as to achieve the purpose of training the multifidus muscle.</p>

Whole-liver perfusion imaging by multi-slice spiral computed tomography based on Couinaud segments for evaluation of the blood flow state in patients with hepatitis B cirrhosis / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the blood flow characteristics of hepatitis B cirrhosis based on Couinaud's hepatic segments and to analyze the correlation between perfusion parameters of liver cirrhosis in the hepatic segments and between the different Child-Pugh classifications by using the pattern of whole liver perfusion detected by multi-slice spiral computed tomography (MSCT).</p><p><b>METHODS</b>Whole-liver perfusion enhanced CT imaging scan was performed for 51 patients with hepatitis B cirrhosis (including 24 classified as Child-Pugh A, 19 as Child-Pugh B, and 8 as Child-Pugh C) and 20 patients without any liver abnormalities (who served as the control group).The perfusion parameters of Couinaud's segments were measured in order to compare the blood perfusion differences among the Couinaud's hepatic segments in liver cirrhosis. The blood flow characteristics were analyzed for each lobe and compared between groups, and the time to peak and peak of enhancement values of the aorta and portal veins and spleen were recorded and compared between groups.The F-test was used for statistical analysis.</p><p><b>RESULTS</b>The liver cirrhosis group showed higher time to peak for aorta and portal veins and spleen but lower peak of enhancement values than the control group. The hepatic arterial perfusion (HAP) was significantly higher in segment 3 than in segment 7 were (11.40+/- 5.72 vs.9.46+/-5.18 mL/min/100 mL; P less than 0.05). In addition, the differences of the portal venous perfusion (PVP) and total hepatic perfusion (THP) were significant between the liver lobes in various groups (P less than 0.05). The HAP and hepatic perfusion index (HPI) were not significantly different between the groups, but the HAP and HPI in every lobe were higher in the Child C subgroup than in either the Child A or Child B subgroups.</p><p><b>CONCLUSION</b>The cirrhotic liver has different blood flow in the various Couinaud's segments. Whole-liver perfusion MSCT can reflect the hemodynamic changes of liver cirrhosis and Child-Pugh classification, and as such may be helpful for distinguishing the normal liver from the cirrhotic liver.</p>

Clinical trial of treating stress-induced hyperglycemia patients with sepsis by supplementing QI, nourishing yin, and promoting blood flow / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the effects of the treatment of supplementing qi, nourishing yin, and promoting blood flow (SQNYPBF) on the serum levels of CRP, TNF-alpha, IL-1 and IL-6, as well as the expression of HLA-DR in the peripheral monocytes in septic patients suffering from stress-induced hyperglycemia.</p><p><b>METHODS</b>In the prospective randomized controlled study, eighty-five stress-induced hyperglycemia patients with sepsis were randomly assigned to the experimental group (45 cases) and the control group (40 cases). On the basis of routine therapies, including anti-infection, nutrition support, and the glucose control with insulin pump, patients in the experimental group additionally received the treatment of SQNYPBF (They were intravenously dripped with Shenmai Injection and Sulfotanshinone Sodium Injection, once daily, for 7 successive days). The serum levels of CRP, TNF-alpha, IL-1, and IL-6 and the HLA-DR expression of the peripheral monocytes were detected using ELISA before treatment and on the 8th day of the treatment. The total dose and the duration of insulin used, the morbidity of hypoglycemia, the APACHE II scores, and the mortality within 28-day hospitalization were compared between the two groups.</p><p><b>RESULTS</b>The total dose of insulin used, the duration of insulin used, the morbidity of hypoglycemia, the APACHE II score on the 8th day of treatment, and the mortality within 28-day hospitalization significantly decreased in the experimental group, when compared with the control group (P < 0.05, P < 0.01). There was no difference in the expression of HLA-DR, the serum levels of CRP, TNF-alpha, IL-1, or IL-6 before treatment between the two groups (P > 0.05). After treatment the serum levels of CRP, TNF-alpha, IL-1, and IL-6 significantly decreased (P < 0.05) and the expression of HLA-DR significantly increased in the two groups (P < 0.05). Better effects were shown in the experimental group (P < 0.05, P < 0.01).</p><p><b>CONCLUSION</b>SQNYPBF combined intensive insulin therapy could better improve the sepsis patients' immunity, decrease the plasma glucose level and duration, increase their survival rate, and improve their prognosis.</p>

Effect of neuropeptide Y and neurotensin on diurnal rhythm of blood pressure and target organ damage for essential hypertension / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the effect of plasma neuropeptide Y (NPY), neurotensin (NT) and their relationships on the diurnal rhythm of BP and target organ damage for essential hypertension.</p><p><b>METHODS</b>Ambulatory BP monitoring (ABPM) for 24 hours was performed in ninety patients with essential hypertension and thirty healthy subjects. The patients were divided into two groups: 55 dippers and 35 non-dippers according to the ABPM results. Plasma NPY and NT levels in subjects were measured at 8:00, 16:00 and 2:00 o'clock by using radioimmunoassay method. Target organ functions were measured.</p><p><b>RESULTS</b>The plasma NPY level was higher and NT was lower in patients with hypertension those in normal controls (P < 0.001). Compared with dippers, non-dippers had a higher NPY and a lower NT plasma levels, especially appearing at 2:00 o'clock. The patients with left ventricular hypertrophy, stroke or kidney damage had a higher NPY and a lower NT levels compares with those without target organ damage.</p><p><b>CONCLUSION</b>The changes in plasma NPY and NT may contribute to disturbance of the diurnal rhythm of blood pressure in patients with essential hypertension, especially in those with target organ damages, which may serve as a pathophysiologic mechanism for target organ damages in hypertension.</p>