Objective To explore the role of IL-18 in the pathogenesis of chronic eczema. Methods Twenty-seven patients with chronic eczema were enrolled into this study along with 12 normal human controls. The severity of eczema was evaluated by eczema area and severity index (EASI) in patients. Skin specimens and vein blood samples were obtained from all the subjects. Reverse-transcription PCR was performed to detect the mRNA expression of IL-18 and IFN-γ in the skin tissue, and enzyme linked immunosorbent assay (ELISA) to measure the protein expression of IL-18 and IFN-γ in the sera of these subjects. Results The mRNA expression level in patients and controls was 1.04±0.29 pg/mL and 0.52±0.15 pg/mL for IL-18, respectively, 0.96±0.34 pg/mL and 0.47±0.12 pg/mL for IFN-γ, respectively; a significant increase was observed in the mRNA expression level of both IFN-γ and IL-18 in the patients than in the controls (both P<0.01). Moreover, the mRNA expression level of both IFN-γ and IL-18 positively correlated with the severity of eczema in patients (r=0.737, 0.883, both P<0.01). The protein expression level of IL-18 and IFN-γ was 475.8±59.4 pg/mL and 10.1±7.0 pg/mL, respectively, in the patients, 123.6 ±29.5 pg/mL and 11.1±3.4 pg/mL, respectively, in the controls; a statistical difference was observed in the protein expression level of IL-18 (P<0.01), but not in that of IFN-γ(P>0.01), between the patients and controls. No significant correlation was observed betweenthe serum level of IL-18 or IFN-γ and sererity of eczema in the patients (both P>0.01). Conclusions IL-18 may be involved in the pathogenesis of chronic eczema. Also, in local lesions, IL-18 seems to correlate with the induction of production of Th1 type cytokines, such as IFN-γ which could subsequently mediate hypersensitivity response.

Objective To study the expression of active efflux pump AdeABC,AdeIJK,AdeFGH,AbeM,AbeS,CraA,MdtL in clinical Acinetobacter baumannii isolates and whether the efflux pumps confers resistance to antibiotics.Methods Thirty-two multi-drug resistant Acinetobacter baumannii islates and 10 sensitive isolates were collected.Genes of the exporter protein were amplified by PCR.The expression of adeB,adeJ,adeG,abeM,abeS,craA,mdtL were examined by real-time fluorescence quantitative RT-PCR.The controlling genes adeRS and adeL were amplified by PCR and sequenced.Results The positivity rates of adeB,adeJ,adeG,abeM,abeS,craA,mdtL were 100％,100％,100％,96.88％,100％,100％ and 93.75％ respectively in 32 multi-drug resistant Acinetobacter baumannii isolates,and all 100％ in 10 sensitive isolates.The difference of expression of adeB,abeM and mdtL were significant( P＜0.001,P =0.001,P=0.013) between 21 multi-drug resistant isolates of C clone and 10 sensitive isolates.The mutations of adeRS existed in 2 multi-drug resistant isolates,no point mutation of adeL.Conclusion The expression of AdeABC,AbeM and MdtL may involved in the resistant mechanisms of the clinical Acinetobacter baumannii islates.

Objective To study the expression of active efflux pump AdeABC in clinical Acineto-bacter baumannii islates and whether this efflux pump confers resistance to antibiotics. Methods The anti-biotic susceptibility and the function of efflux pump inhibitor were tested by micro-dilution broth method. The expression of adeB was examined by RT-PCR. The controlling gene adeRS was amplified by PCR and se-quenced. Results Thirty multidrug resistance Acinetobacter baumannii isolates and 5 sensitive isolates for PCR were both abtained the expected products of adeB and adeRS. The mRNA expression of adeB in 15 multidrug resistance(MDR) isolates were positive, but there was no expression of adeB in 5 sensitive iso-lates. The mutations of adeRS existed in 2 MDR isolates. Conclusion The expression of AdeABC may in-volved in the resistant mechanisms of the clinical MDR Acinetobacter baumannii isolates.

Objective To investigate the setup error for nasopharyngeal carcinoma (NPC) patients with poor compliance using kV cone-beam computed tomography,and to calculate the expansion margin from the clinical target volume (CTV) to planning target volume (PTV).Methods In 45 NPC patients from 2013 to 2015,the setup error,95％ confidence interval (CI)-1 for random error,and PTV-1 value were calculated.Moreover,in 16 NPC patients with poor compliance based on five verifications (random error not within 95％ CI-1),the setup error,95％ CI-2 for random error,and PTV-2 value were calculated.For the 16 special patients,PTV-1 and PTV-1 combined with PTV-2 were used to develop the plan-1 and plan-2,respectively.The dosimetric difference between plan-1 and plan-2 was evaluated.Results Both PTV-1 and PTV-2 had the largest expansion margin in the y direction.The CTV of plan-1 could not meet the requirement of the prescription dose after the setup error was introduced.Compared with plan-1,the V95％ and D95 values for the CTV of plan-2 were increased by 6.26％ and 4.43％,respectively.The D01 value was significantly larger in plan-2 than in plan-1 (P=0.005),which,however,met the clinical requirement.Conclusions In patients with poor compliance,the dose to target volume can be effectively elevated and the normal tissue can be spared from damage when PTV-1 combined with PTV-2 is selected as expansion margin.

Objective To understand genetic distribution, drug resistance, molecular typing and the epidemiological relativeness between strains of the Shigella boydii virulence. Methods Nine Shigella boydii strains were isolated form stool samples of patients with diarrhea from the Enteric Disease Clinic of the Second Hospital of Tianjin Medical University in June-October 2015. The strains were identified by biochemical test and serum agglutination test. Antibiotics susceptibility test was carried out using the Kirby-Bauer method. Polymerase chain reaction was used for detecting virulence genes. Pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) technique were used to determine the epidemiological relationship between nine Shigella boydii strains. Results There were three subtypes in nine isolated Shigella boydii samples, including one, three and five isolates inⅠ,Ⅱ,Ⅳsubtypes respectively. All of the 9 isolates were multi-drug resistant. The resistant rate of these strains for ampicillin was 100%(9/9), and then the resistant rates of these strains for ceftazidime, streptomycin, gentamicin, trimethoprim/sulfamethoxazole, cefotaxime, ceftriaxone, norfloxacin and levofloxacin were 1/9, 4/9, 4/9, 4/9, 5/9, 5/9, 6/9, 6/9 and 6/9, respectively. All of these strains were sensitive to amikacin, cefperazone-sulbactam and imipenem. The ipaH was carried by all the testing strains, and none of the strains carried the sen, set1A, set1B, ial, virA, icsA and SigA. The detective rates of pic, sepA and sat were 4/9, 5/9 and 7/9 strains, respectively. Nine shigella boydii strains were divided into 8 PFGE types. The similarity between the spectrums of PFGE was 63.21%-100%. Multilocus sequence typing showed that six isolates were belonged to ST648, two isolates were ST131 and one isolate was ST10. Conclusion Nine isolates of Shigella boydii (divided into three subtyping) isolated from our hospital are multi-drug resistant and they have distant relationships, belonging to the dissemination of case.

Objective To analysis the human cytomegalovirus (HCMV)and human T lymphotropic virus(HTLV)infection status in Beijing among voluntary blood donors.Methods Randomly selected 2 010 blood samples from five districts and counties of Beijing City to screen HCMV-IgG,HCMV-IgM and HTLV-Ⅰ/Ⅱ antibody by ELISA method.The positive samples were reexamined two times,two test results of samples were positive that were determined positive by ELISA. HTLV positive samples was confirmed by nested PCR.Results The HCMV-IgM and HCMV-IgG positive rates of Beijing blood donors were 2.19% and 92.59%,screened 1 case of anti-HTLV positive by ELISA method,then confirmed to be neg-ative result by nested PCR.The statistics showed that the HCMV-IgG positive rate female blood donors was higher than male (P <0.05).The positive rates of HCMV-IgM and HCMV-IgG among18~25 years old donors was lowest (P <0.05). Positive rate of HCMV-IgG in college students was lower than other occupation blood donars (P <0.05)and education de-gree was independent of HCMV-IgG,HCMV-IgM positive rates (P >0.05).Conclusion In this investigation,2 010 cases of voluntary blood donors from five districts of Beijing were not found in cases of HTLV infection,HCMV infection was prevalent.

BACKGROUND: A great quantity of cell loss in early stage following stem cell transplantation can significantly affect transplantation effect. Presently, it is confirmed that overexpression of AKT1 gene significantly inhibit cell apoptosis. OBJECTIVE: To explore whether AKT1 gene overexpression can block stem cell apoptosis under hypoxic condition following pig autologous bone marrow mesenchymal stem cell (BMSC) transplantation, and the effect of repairing damaged myocardium. DESIGN, TIME AND SETTING: The randomized controlled animal study was performed at the Soochow University from August 2005 to February 2007.MATERIALS: A total of 24 healthy male Meishan pigs were supplied by the Animal Experimental Center of Soochow University. METHODS: The CDS (regulation domin of AKT1) AKT1-cDNA fragment was amplified. Lentivector Packaging Kit was used to transfect BMSCs after synthesized with pCDH1-AKT1 shuttling plasmid. Following BrdU labeling, models of myocardial infarction were constructed by occluding the distal left anterior descending coronary artery in pigs with gelatin sponge. 4 weeks later, pigs were randomly divided into four groups: the model control group, the DMEM group, the BMSCs group, and the AKT-transfected group. In model control group, there was no other injection after occluding the left anterior descending coronary artery. In the DMEM group, 5 mL DMEM was injected into the coronary artery. 5 mL BMSCs (1×10~7 cells) were infused into the coronary artery in the BMSCs group. 5 mL BMSCs transfected with the AKT1 gene were injected in the AKT-transfected group MAIN OUTCOME MEASURES: Western blot analysis and real time RT-PCR were used to test the plasmid. The cardiac function was evaluated by magnetic resonance image. Histological characteristics of the myocardium were observed using immunohistochemistry. Serum vascular endothelial growth factor and transforming growth factor β1 levels were determined by ELISA. RESULTS: AKT1-cDNA was cloned into pCDH1-MCS1-EF1-copGFP and the sequence was confirmed in comparison with the published one. AKT mRNA expression could be detected distinctly 24 and 48 hours after transfecting cells. The expression of AKT1 intensity in MSCs remained strong 2 weeks later with detected by real time RT-PCR and Western blot analysis. AKT1-mRNA transcriptional levels were 120 times of primary cells. Before the cell implantation, the left ventricular end-diastolic dimension increased and the stroke volume decreased in the myocardial infarction hearts. The cardiac function was significantly improved after cell implantation, and the implanted MSCs prevented the infarct region from thinning and expanding, improved contraction and increased perfusion in all groups relative to the control hearts. The left ventricular chamber size was smaller in the hearts with being transplanted cells than that in the control hearts. Moreover, the improvement was even markedly greater in AKT-transfected group (P < 0.05). Hematoxylin-eosin staining results showed that fibering was significant in the model control group and DMEM group. Island-like myocardium was observed in the infarct zone of the BMSCs group and AKT-transfected group, and plenty of small vessels-shape structure was detected in the AKT-transfected group. Immunohistochemistry demonstrated that Von Willebrand Factor (vWF) and Cx-43 expression was determined in the myocardium in the BMSCs group and AKT-transfected group, and the proportion of BrdU and Cx-43-positive cells to BrdU-positive cells was significantly greater in the AKT-transfected group compared with the BMSCs group 4 weeks following transplantation (P < 0.05). Following cell transplantation, vascular endothelial growth factor levels were gradually increased, peaked at 1 week, gradually decreased, and reached a normal level at 4 weeks. Transforming growth factor p1 levels were gradually reduced, and significantly less than the model control group, DMEM group 4 weeks later (P < 0.05), and significantly lower than that pretransplantation (P < 0.05).CONCLUSION: Using lentiviral vector to construct with AKT1 gene could stably make BMSCs overexpress AKT1. The BMSCs engraftment in host myocardium might improve the left ventricle function by attenuating the contractile dysfunction and pathologic thinning in this model of left ventricular wall infarction. AKT1 overexpression can significantly improve cardiac function following infarction.

OBJECTIVETo evaluate the effect of annular electrode lacrimal duct reconstruction in improving the safety and efficacy of nasolacrimal duct stent implantation for treatment of nasolacrimal duct obstruction.

METHODSThis randomized clinical trial was performed to compare the efficacy, success rate of intubation, time used for stent implantation, intraoperative pain, and extubation-assciated complications between nasolacrimal stent implantation with and without annular electrode lacrimal duct reconstruction.

RESULTSA total of 119 eligible patients were enrolled in this trial. The total curative rate at 6 months of follow up after extubation was 70.9% (83/117) in these patients, and was significnatly higher in pateinets with lacrimal duct reconstruction than in those without [80.6% (54/67) vs 58.0% (29/50); χ(2)=7.093, P<0.05]. The total success rate of stent implantation was 98.3% (117/119) in all the patients initially enrolled, and two patients experienced failure of stent implantation and were excluded; the success rate was signfiicantly higher in patients initially enrolled in the lacrimal duct reconstruction group (χ(2)=6.282, P<0.05). The median time required for intubation was shorter in lacrimal duct reconstruction group (12 s vs 33 s; Z=-36.722, P<0.05). The intendity of intraoperative pain was comparable between the two groups (t=0.833, P=0.405). The total rate of puncta injury was 43.6% (51/117) in these patients and similar between the two groups (χ(2)=1.459, P=0.227). The total rate of extubation difficulty was 9.4% (11/117) in all the patients, and was lower in lacrimal duct reconstruction group [4.5% (3/67) vs 16% (8/50); χ(2)=4.463, P<0.05]. Stent breakage in extubation occurred in 4.3% (11/117) of the patients with similar rates between the two groups (χ(2)=2.964, P=0.085). Spearman bivariate correlation analysis showed that the time required for intubation was inversely correlated with the treatment efficacy (r=-0.584, P<0.05) and positively with the occurrence of extubation difficulty (r=0.491, P<0.05); extubation difficulty was inversely correlated with the curative effect (r=-0.511, P<0.05).

CONCLUSIONAnnular electrode nasolacrimal duct reconstruction can increase the safety and efficacy of nasolacrimal duct stent implantation for treatment of nasolacrimal duct obstruction.

Dacryocystorhinostomy ; methods ; Electrodes ; Humans ; Intubation ; Lacrimal Duct Obstruction ; Nasolacrimal Duct ; surgery ; Pain ; Reconstructive Surgical Procedures ; methods ; Stents ; Treatment Outcome

Objective:Due to the low contrast between tumors and surrounding tissues in CBCT images, this study was designed to propose an automatic segmentation method for central lung cancer in CBCT images.Methods:There are 221 patients with central lung cancer were recruited. Among them, 176 patients underwent CT localization and 45 patients underwent enhanced CT localization. The enhanced CT images were set as the lung window and mediastinal window, and elastic registration was performed with the first CBCT validation images to obtain the paired data set. The CBCT images could be transformed into" enhanced CT" under the lung window and mediastinal window by loading the paired data sets into cycleGAN network for style transformation. Finally, the transformed images were loaded into the UNET-attention network for deep learning of GTV. The results of segmentation were evaluated by Dice similarity coefficient (DSC), Hausdorff distance (HD) and the area under the receiver operating characteristic curve (AUC).Results:The contrast between tumors and surrounding tissues was significantly improved after style transformation. The DSC value of cycleGAN+ UNET-attention network was 0.78±0.05, HD value was 9.22±3.42 and AUC value was 0.864, respectively.Conclusion:The cycleGAN+ UNET-attention network can effectively segment central lung cancer in CBCT images.

OBJECTIVETo explore the relationship between DNA mismatch repair (MMR) and clinicopathologic features and prognosis in patients with stages II and III colon cancers.

METHODSThe clinical and pathological data of 440 patients with stage II/III colon cancer after radical resection were retrospectively reviewed and analyzed. Immunohistochemical staining was used to assess the expression of MMR proteins (MLH1, MSH2, MSH6 and PMS2), and the correlation between DNA MMR and clinicopathological features and prognosis of colon cancers was analyzed.

RESULTSOf the 440 tumor samples tested for DNA mismatch repair status, 90 (20.5%) demonstrated defective DNA mismatch repair and 350 (79.5%) had proficient DNA mismatch repair. Defective DNA mismatch repair (dMMR) was associated with young patients (≤ 60), proximal colon cancer, stage II, poorly differentiated adenocarcinoma and mucinous adenocarcinoma (P<0.05 for all). Among the 440 patients, 126 (28.6%) cases had recurrence or metastasis and 93 (21.1%) died during the median follow-up of 61.0 months. The five-year disease-free survival (DFS) rate was 82.2% among the patients with tumor exhibiting dMMR, significantly higher than that in patients with tumors exhibiting pMMR (68.9%, P=0.02). The univariate and mutlivariate analyses showed that the MMR status is an independent factor affecting 5-year disease-free survival and overall survival (OS) in colon cancer patients (P<0.05 for both).

CONCLUSIONSDefective DNA mismatch repair (dMMR) is associated with patients with proximal colon cancer, stage II and poorly defferentiated adenocarcinoma and mucinous adenocarcinoma. The prognosis for patients with dMMR is better than those with pMMR. dMMR may be a useful biomarker for the prognosis of colon cancer.

Adaptor Proteins, Signal Transducing ; metabolism ; Adenocarcinoma ; genetics ; metabolism ; mortality ; pathology ; Adenocarcinoma, Mucinous ; genetics ; metabolism ; mortality ; pathology ; Adenosine Triphosphatases ; metabolism ; Age Factors ; Analysis of Variance ; Colonic Neoplasms ; genetics ; metabolism ; mortality ; pathology ; DNA Mismatch Repair ; DNA Repair Enzymes ; metabolism ; DNA-Binding Proteins ; metabolism ; Disease-Free Survival ; Humans ; Mismatch Repair Endonuclease PMS2 ; MutL Protein Homolog 1 ; MutS Homolog 2 Protein ; metabolism ; Neoplasm Recurrence, Local ; Nuclear Proteins ; metabolism ; Prognosis ; Retrospective Studies ; Survival Rate