Objective To investigate the effects of UVB irradiation and calciu m at different concentrations on the expression of pemphigus antigens by culture d human keratinocytes. Methods Human keratinocyte cultures were treated with eit her 2 mmol/L calcium added to the serum free media, or exposure to UVB irradiat ion. Immunofluorescence staining was performed with sera from patients with pemp higus vulgaris (PV) or pemphigus foliaceus (PF) as the first antigen. Extracts f rom both epidermis and keratinocytes were run on SDS-PAGE according to Laemmli ′s method and transferred to nitrocellulose membrane for immunoblot with PV and PF sera. Results Specific staining with PV sera was always detectable on kerati nocyte culture by immunofluorescence assay with or without high concentrations o f calcium while PF antigen was detected on stratified cells only. However, expos ure to UVB irradiation could not evoke keratinocyte culture express PF antigen. The reactivities were found at 160 kd band with PF sera while at both 160 kd and 130 kd bands with PV sera. Conclusions Monolayer or stratified keratinocytes ca n produce PV antigen, by increasing the concentration of calcium in the culture media, the human cultured kera tinocytes can be induced to stratify and express PFA. Human keratinocytes can not express PF antigen after exposure to UVB in intro.

Objective To study the action and mechanism of staphylococcal exfoliative toxin A(E-TA)on pemphigus foliaceus antigen(PFA)and pemphigus vulgaris antigen(PVA)expressed on cultured human keratinocytes.Methods Stratified human keratinocytes were incubated with ETA and then stained with sera from patients with pemphigus foliaceus or pemphigus vulgaris as the first antibodies and FITC-la-beled sheep anti-human IgG as the second antibody.Total protein was harvested from the cells pretreated with ETA and run on SDS-PAGE for Western blot with the same antibodies.Simultaneously,supernatants of the keratinocytes before and after ETA treatment were collected for detection of the levels of IL-1?,IL-6with ELISA kits.The caseinolytic activities of the supernatants were tested by spectrometry in which casein was used as a non-specific substrate.Results Down-expression of PFA was shown after ETA treatment while no change of PVA expression was found.The high intensity and continuous linear appearance of fluo-rescent staining before ETA treatment became weak and discontinuous after ETA treatment,which were re-covered gradually in24hours.The degradation of proteins recognized by PF sera after ETV treatment was revealed by Western blot.The decreasing tendency of IL-1?concentration was found in the supernatants of cell culture after ETA treatment,but IL-6level was too low to be detected.Increased caseinolytic activities were found in the supernatants,and declined36hours after ETA treatment.Conclusions ETA acts on PFA expressed on keratinocytes in vitro,which is reversible along with withdrawal of ETA.The mechanism of E-TA act on PFA may be related to proteolytic action instead of promoting cytokine secretion.

Objective To investigate the effects of interleukin -15 ( IL-15 ) on the cytotoxicity of Vδ2 γδ(Vδ2) T cells against K562 cells.Methods PBMCs were separated and cultured with zoledronate and interleukin-2 ( IL-2) to induce the proliferation of Vδ2 T cells.The obtained Vδ2 T cells were in vitro stimulated with IL-15.Flow cytometry analysis was performed to evaluate the changes of phenotypes of Vδ2 T cells and their cytotoxicity against K562 cells.Results Zoledronate effectively induced the massive prolifer -ation of V2δT cells.The Vδ2 T cells were highly activated and the expression of CD 107a and IFN-γby Vδ2 T cells were upregulated upon IL-15 stimulation.The cytotoxicity of Vδ2 T cells against K562 cells was greatly enhanced by the treatment with IL-15.Conclusion IL-15 could activate the Vδ2 T cells and en-hance their cytotoxicity against K562 cells.

Objective:To study the role of γδ T cells and Vδ1 and Vδ2 T subsets played in patients with chronic hepatitis C.Methods:The percentage of peripheral bloodγδT cells and Vδ1 and Vδ2 T subsets cells was assessed by flow cytometry ( FACS) . Results:There were no significant differences in the percentage of circulating γδ T cells and Vδ1 and Vδ2 T subsets between HCV-infected patients and healthy controls ( HCs).However,The number of peripheral blood Vδ2 T cells from HCV-infected patients was positively correlated with serum alanine aminotransferase ( ALT) levels,but showed no correlation with serum HCV RNA.Peripheral Vδ2 T cells from HCV-infected patients were in activated status.The expression of CD107a was enhanced in Vδ2 T cells from HCV-infected patients compared to HCs.Conclusion:Vδ2 T cells were involved in liver injury in chronic HCV-infected patients.

Objective To evaluate the value of diffusion tensor imaging (DTI)in the assessment of uterine fibroids by analyzing uterine fibroids and normal myometrium.Methods Forty-four patients with uterine fibroids confirmed by surgery were included in this study.DTI was performed using double gradient GE HDxt 3.0T and HD Cardiac coil.All data were transferred to GE AW4.5 Workstation software for data processing.Apparent diffusion coefficient(ADC),fractional aniso(FA),volume ratio aniso(VRA)and T2-weighted trace of uterine fibroids and normal myometrium were recorded.Diffusion tensor tractography (DTT)of uterine fibroids and normal myometrium were reconstructed and observed.The ADC,FA,VRA and T2-weighted trace of different regions of interest (ROI)were compared between uterine fibroids and normal myometrium.Results The ADC,FA,VRA and T2-weighted trace of uterine fibroids and normal myometrium were (1.65±0.32)×10 -9 mm2/s and (1.21±0.97)×10 -9 mm2/s,0.20±0.08 and 0.28±0.08,0.05 ± 0.05 and 0.09±0.07,344.22±66.1 9 and 318.97±98.48,respectively.The ADC of normal myometrium was higher than that of uterine fibroids (P =0.009).The FA and VRA of normal myometrium were lower than those of uterine fibroids (P =0.000,P =0.005). There was no statistically significant difference of T2-weighted trace between uterine fibroids and normal myometrium (P =0.1 74). There were obvious differences between uterine fibroids and normal myometrium in direction,arrangement and number of fibers. Conclusion DTI can be used to evaluate the structure difference between uterine fibroids and normal myometrium,which has the potential to improve assessment value of MRI for uterine fibroids.

In response to calls of the state to share high quality medical resources with the primary levels for easier access of the local people to best medical care instead of pouring into tertiary hospitals in metropolitans, Xiamen city joined hands with Zhongshan Hospital of Fudan University to establish Xiamen Hospital affiliated to Zhongshan Hospital of Fudan University in an innovative model of " city-university cooperation and homogeneous management" . Open for full service in January 2018, the hospital is run by Zhongshan Hospital in a closed-type medical alliance, enjoying homogenous management in terms of administrative framework, quality of care, talent training and IT management. Thanks to this practice, the hospital has grown into one of the first pilot units of the national regional medical center program, rapidly upgrading medical service level of Xiamen city and its surrounding regions. This paper highlighted the practice of homogeneous management, and analyzed the challenges and solutions for references of building trans-regional closed-type medical alliances.

Discipline construction is the main focus of the high-quality development of public hospitals. The authors elaborated on the practice of Zhongshan Hospital(Xiamen), Fudan University, based on the " double-center" homogenization management, implementing the 123456 strategy of " integrated management and homogeneous development" in discipline construction. The hospital has promoted discipline construction from six aspects: building discipline cluster, promoting talent cultivation, building science and technology innovation platform, precise personnel classification, medical and education collaborative education, and information sharing and support. It has achieved new development goals of filling weak discipline gaps, transforming talent transfusion into hematopoietic, and integrating medical, educational, research and management innovation. However, it also encountered difficulties such as homogenization barrier of discipline construction, shortage of excellent talents, and limited brand influence of superior disciplines. The authors put forward suggestions from three dimensions: deepening homogeneous management, building talent echelon, and increasing publicity, in order to provide experience for the high-quality development of other hospitals.

Objective: To explore the predictive values of routine blood test results for iron deficiency (ID) screening in children. Methods: Routine blood test results and serum ferritin (SF) levels from 1 443 healthy children (862 boys, 581 girls) aged 6 months to 18 years, who were seen for well-child visits between June 2017 and May 2019 in Children′s Hospital, Zhejiang University School of Medicine, were retrospectively analyzed. ID was defined as SF<20 μg/L, iron deficiency anemia (IDA) as ID with anemia (hemoglobin(Hb)<110 g/L at 6 months-5 years of age, Hb<120 g/L at 6-18 years of age), non-anemia ID as ID without anemia, non-ID anemia as SF≥20 μg/L with anemia, and healthy control subjects as those with SF≥20 μg/L but without anemia. The blood test results including Hb, mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), red blood cell distribution width (RDW), and the percentage of low hemoglobin density (LHD) of healthy control, non-anemia ID, non-ID anemia, and IDA groups were compared by analysis of variance (ANOVA) or non-parametric test, quantitative data were described as ±s or M(interquartile range), and receiver operating characteristic curve (ROC) analysis was applied to assess predictive values of routine blood test results and LHD for detecting IDA and ID. Results: Among 1 443 children with median age of 2.1(3.3) years, 1 061 children were in healthy control group, 292 in non-anemia ID group, 43 in non-ID anemia group and 47 in IDA group. The prevalence of ID was much higher than that of anemia (23.5% (339/1 443) vs. 6.2% (90/1 443) , χ²=169.76, P<0.01). Compared with control group, non-anemia ID group showed higher LHD (0.088 (0.093) vs.0.073 (0.068), P<0.01) and RDW (0.131±0.013 vs. 0.126±0.008, P<0.01), lower MCV ((80±4) vs. (83±4) fl, P<0.01) and MCHC values ((326±9) vs. (329±8) g/L, P<0.01). IDA group showed higher LHD (0.322(0.544)) and RDW (0.151±0.018), lower MCV ((73±6) fl) and MCHC values((309±14) g/L) than non-anemia ID group (all P<0.01). The area under curve (AUC) values of MCHC, LHD, RDW and MCV for detecting ID were 0.63 (95%CI: 0.60-0.67), 0.63 (95%CI:0.60-0.67), 0.67 (95%CI: 0.63-0.70) and 0.73 (95%CI: 0.69-0.76) respectively. With cutoff limits (MCV<80.2 fl, RDW>0.131 or MCHC<322 g/L), MCV, RDW and MCHC showed higher sensitivity for screening ID than hemoglobin (0.540, 0.469 and 0.336 vs. 0.139, χ²=121.70, 87.47, 35.56, all P<0.01). Conclusion MCV, RDW and MCHC can be used to screen ID in primary health care settings.

Objective: To discuss the feasibility and effectiveness of using micro-CT in bone-implant contact (BIC) evaluation in dogs, and to provide reference for clinical and scientific research. Methods: Bilateral mandibular second premolar and first molar of six male Beagle dogs were extracted. After 3 months′ healing, eight implants were placed in bilateral mandible of each dog, four on each side. Dogs were sacrificed at 2 weeks, 4 weeks and 8 weeks after implant placement, two on each time point. Samples were scanned with micro-CT and digitally reconstructed. Bone-implant interface was analyzed at different analysis regions (25, 50 and 100 μm from implants′ surface), different detection range models were obtained (each time point consists 48 models), and BIC was evaluated, and the results were counted as micro-CT₂₅, micro-CT₅₀, and micro-CT₁₀₀ groups. Then undecalcified slides were made (three slides for each sample) and stained with toluidine blue for observation and analysis of BIC using an optical microscope, and the results were counted as optical microscope groups. The advantages and disadvantages, evaluation efficiency and BIC of different methods were analyzed. Results: To evaluate BIC of single sample, it took about 90 minutes by micro-CT, which was much lower than the time of 14 days by optical microscope. The success rates of modeling of micro-CT₂₅, micro-CT₅₀, and micro-CT₁₀₀ groups all were 100.0% (48/48), and total success rate of micro-CT group was 100.0% (144/144). For optical microscope groups, the success rates of making slides 2, 4, 8 weeks were 89.6% (43/48), 93.8% (45/48) and 93.8% (45/48), respectively, and total success rates of optical microscope group was 92.4% (133/144). At 2, 4,8 weeks after implantation, BIC in micro-CT₂₅ group was significantly smaller than that in optical microscope group at the same time point (P<0.05). However, at 2, 4,8 weeks after implantation, BIC of the micro-CT₅₀ and micro-CT₁₀₀ groups showed no significant difference with optical microscope groups at the same time point (P>0.05). A significant correlation (P<0.001, each) was seen between slides and micro-CT (25, 50, 100 μm groups) concerning BIC (r=0.680, r=0.892, r=0.713), and error bias was -19.4%, -0.9%, 3.0%, respectively. The probability within the 95% limits of agreement were 97.9%. Conclusions Micro-CT is a faster, simpler and more efficient way to analyze BIC at the implant-bone interface than optical microscope observation. BIC analysis by selecting 50 μm from implants′ surface as analysis region using micro-CT is in consistent with that using the optical microscope.