Cerebrospinal Fluid Rhinorrhea ; surgery ; Endoscopy ; Humans

BACKGROUND:Several studies have demonstrated that mesenchymal stem cel s exhibit strong immunomodulation on al ergic asthma. However, there are no reports to compare therapeutic effects under different administration ways.
OBJECTIVE:To examine the immunomodulatory effects of MSCs via different administration routes on asthmatic mice.
METHODS:Seventy-two Balb/c mice experienced three independent tests, and 24 mice were selected for each test. Twenty-four mice were randomly divided into four groups (n=6):control group, model group, intravenous treatment group and intratracheal treatment group. The mouse model of asthma was induced via intraperitoneal injection of ovalbumin at 1, 7, 14 days and 30-minute aerosol inhalation of ovalbumin at 22-26 days. In the latter two groups, mesenchymal stem cel s were injected intravenously (200μL, 5×109/L) or intratracheal y (50μL, 2×109/L) into the mice at 1 day before aerosol inhalation.
RESULTS AND CONCLUSION:Compared with the control group, the airway inflammatory response was significantly increased in the model group. Intravenous administration of mesenchymal stem cel s significantly al eviated the symptoms of al ergic airway inflammation, including the airway hyperreactivity, the inflammatory cel counting in the bronchoalveolar lavage fluid, inflammatory cel infiltration in the lung tissue. Meanwhile, the levels of Th2 type cytokines in the bronchoalveolar lavage fluid and IgE in serum also decreased after intravenous administration of mesenchymal stem cel s. However, the intratracheal application of mesenchymal stem cel s did not exhibit the similar effects. Intravenous, not intratracheal, application of mesenchymal stem cel s can exert immunomodulatory effects through the blood circulation.

Objective:To retrospectively analyze the influencing factors during the hospitalization of premature infants in the neonatal intensive careunit (NICU) based on the breast-feeding choices of the primary family caregivers of premature infants discharged from NICU.Methods:According to the breast-feeding status of 342 premature infants discharged from the NICU from The First hospital of Jilin University from June 1st, 2019 to December 31th, 2019, a self-designed data collection form for premature infants was used to investigate them, and the influencing factors of NICU hospitalization on breast-feeding selection were retrospectively analyzed.Results:The factors influencing breastfeeding included gestational age ( tvalue was-2.177, P=0.029), birth weight ( tvalue was-2.036, P=0.043), feeding mode during hospital stay ( χ2value was 6.582, P=0.010), length of hospital stay ( Zvalue was-2.205, P=0.027), maternal age ( Zvalue was-2.975, P=0.003), maternal education level ( χ2value was 8.350, P=0.04) and twin pregnancy ( χ2value was 7.367, P=0.007). The results of multivariate Logistic regression analysis showed that breast-feeding during hospitalization ( P=0.003) and older age of the mother ( P<0.001) were favorable factors to promote breast-feeding. Twin pregnancy ( P=0.006), low maternal education ( P=0.001) and gestational age ( P=0.006) were the risk factors that were not conducive to the implementation of breastfeeding. Conclusion:During the hospital period, the implementation of breastfeeding and the old age of the mother are conducive to the choice of breastfeeding after discharge, while twin pregnancy, low education of the mother and premature infants of large gestational age are not conducive to the implementation of breastfeeding.

Objective:To establish the quality control method for compound Jieyu granules. Methods:Liquorice was identified by TLC. saikosaponin a, Saikosaponin d and rutin were determined by HPLC. Results:The spots on TLC plates were clear without any in-terference. The linearity was achieved within the range of 0. 508-16. 200 μg (r=0. 999 8) for saikosaponin a, 0. 503-16. 100 μg(r=0.999 7) for saikosaponin d, and 0.130-4.250 μg(r =0.999 9) for rutin. The average recovery was 99.7%(RSD =2.03%), 99. 8%(RSD=1. 44%) and 102. 6%(RSD=1. 40%), respectively. Conclusion:The method is simple, reliable and accurate, and can be applied as the quality control method for compound Jieyu granules.

Objective:To investigate whether hepatitis B virus X protein (HBx) mediates the podocyte injury through reactive oxygen species (ROS) /nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) signaling pathway.Methods:HBx-overexpressing lentivirus was transfected into renal podocytes of mouse to mimic the pathogenesis of hepatitis B virus-associated glomerulonephritis. Podocytes were divided into the following five groups: blank control group (no special treatment), negative control group (transfected with control lentivirus), HBx overexpression group (transfected with HBx overexpression lentivirus), HBx overexpression+NLRP3 siRNA group (transfected with HBx overexpression lentivirus and NLRP3 siRNA), and HBx overexpression+ROS inhibitor group (transfected with HBx overexpression lentivirus and adding ROS inhibitor). The morphological changes of podocytes were observed with electron microscope. The generation of ROS was detected by dichlorodihydrofluorescein diacetate assay (DCFH-DA). Hoechst 33342 staining was used to observe the morphological and quantitative changes of podocyte nuclei. Enzyme-linked immunosorbent assay was used to detect caspase-1 activity, and the levels of lactate dehydrogenase, interleukin (IL)-1β and IL-18. Quantitative real-time polymerase chain reaction and Western blotting were used to detect the expression levels of mRNA and protein of pyroptosis-related protein, such as NLRP3, apoptosis-associated speck-like protein containing card (ASC), caspase-1, IL-1β and IL-18. TUNEL staining and flow cytometer were used to detect the number of pyroptosis cells. Immunofluorescence staining was used to detect the expression levels of desmin and nephrin.Results:After successful infection of podocytes with HBx-overexpressing lentivirus, pyroptosis-related morphological changes in the cells were observed under electron microscope. The level of ROS in the HBx overexpression group was significantly higher compared to the negative control group ( P<0.05). Hoechst 33342 staining revealed condensed nuclei in the HBx overexpression group. TUNEL staining and flow cytometer demonstrated that podocytes underwent increased pyroptosis in the HBx overexpression group. The mRNA and protein expression levels of pyroptosis-related proteins such as NLRP3, ASC, caspase-1, IL-1β and IL-18 were up-regulated upon HBx overexpression (all P<0.05). Caspase-1 enzyme activity, lactate dehydrogenase and desmin expression levels were enhanced after HBx overexpression (all P<0.05). However, NLRP3 knockdown or addition of ROS inhibitors attenuated the pyroptosis and increased expression levels of pyroptosis-related proteins caused by HBx overexpression (all P<0.05). Conclusion:ROS/NLRP3 pathway plays an important role in HBx-induced podocyte pyroptosis.

Objective: To study the value of olfactory cleft scores through computed tomography (CT) in predicting the oral glucocorticoids (GC) sensitivity in chronic rhinosinusitis with nasal polyps. Methods: Fourty-seven consecutive patients with CRSwNP from the Fifth Affiliated Hospital of Sun Yat-sen University between January and March of 2018 were recruited in this prospective, single-blinded study. There were 28 males and 19 females, with age ranging from 17 to 66 years old. After a course of oral prednisone (30 mg/d for 14 d), these patients were subsequently classified into objectively GC-sensitive and -insensitive subgroup according to the change in nasal polyp size score, or subjectively GC-sensitive and -insensitive subgroup according to the change in total nasal symptom score. The following parameters were compared between GC-sensitive and -insensitve subgroups: Lund-Mackay scores, olfactory cleft scores, and blood eosinophil counts and ratio. T test and χ² test were used. Multivariate Logistic regression analysis was used for factor prediction and receiver operating characteristic (ROC) curve was used to analyze the predictive ability of those factors. Results: There were 53.2% (25/47) and 61.7% (29/47) of patients objectively and subjectively sensitive to GC therapy, respectively. All data conformed to normal distribution. The olfactory cleft score and the blood eosinophil counts and ratio in objectively GC-sensitive subgroup were significantly higher than those in objectively GC-insensitive subgroup (3.6±1.0 vs 2.2±1.4, (404.4±200.3)/μl vs (209.5±233.1)/μl, (5.25±2.59)% vs (3.17±3.46)%, t value was 3.98, 3.08, respectively, χ²=2.35, all P<0.05). The cleft score, the blood eosinophil counts and ratio also showed the same trend in subjectively GC-sensitive and -insensitive subgroup (3.6±1.0 vs 1.9±1.3, (401.4±213.6)/μl vs (171.1±200.2)/μl, (5.39±2.76)% vs (2.48±2.99)%, t value was 5.05, 3.68, respectively, χ²=3.40, all P<0.05). Multivariate Logistic regression revealed that olfactory cleft score was an independent risk factor for objective or subjective GC-sensitivity (OR=2.882, 95%CI: 1.301-6.384; OR=2.508, 95%CI: 1.248-5.039). The olfactory cleft score exhibited comparable accuracy with the blood eosinophil ratio as predictor of objective and subjective GC-sensitivity (Area under curve of olfactory cleft score was 0.775, 0.829, respectively). An olfactory cleft score of 3.5 could act as a reliable indicator for predicting the clinical response to GC therapy in CRSwNP. Conclusion Olfactory cleft score through CT scan has the potential value in predicting GC-sensitivity in CRSwNP patients.

Objective: To investigate the efficacy and safety of the new investigational drug pegylated interferon α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 µg/week) combined with ribavirin in the treatment of patients with genotype 1/6 chronic hepatitis C (CHC), with standard-dose Peg-IFN-α-2a combined with ribavirin as a positive control. Methods: A multicenter, randomized, open-label, and positive-controlled phase III clinical trial was performed. Eligible patients with genotype 1/6 CHC were screened out and randomly divided into Peg-IFN-α-2b(Y shape, 40kD) group and Peg-IFN-α-2a group at a ratio of 2:1. The patients in both groups were given oral ribavirin for 48 weeks in addition and then followed up for 24 weeks after drug withdrawal. Abbott Real Time HCV Genotype II was used to determine HCV genotype, and Cobas TaqMan quantitative real-time PCR was used to measure HCV RNA level at 0, 4, 12, 24, 48, and 72 weeks. Adverse events were recorded in detail. The primary efficacy endpoint was sustained virological response (SVR), and a non-inferiority test was also performed. Results: A total of 561 patients with genotype 1/6 CHC were enrolled, among whom 529 received treatment; 90.9% of these patients had genotype 1 CHC. The data of the full analysis set showed that SVR rate was 69.80% (95% CI 65.00%-74.60%) in the trial group and 74.16% (95% CI 67.73%-80.59%) in the control group (P = 0.297 0). The data of the per protocol set (PPS) showed that SVR rate was 80.63% (95% CI 76.04%-85.23%) in the trial group and 81.33% (95% CI 75.10%-87.57%) in the control group (P = 0.849 8), and the 95% CI of rate difference conformed to the non-inferiority standard. The analysis of the PPS population showed that of all subjects, 47.9% achieved rapid virologic response, with a positive predictive value of 93.8%. The incidence rate of adverse events was 96.30% in the trial group and 94.94% in the control group, and the incidence rate of serious adverse events was 5.13% in the trail group and 5.06% in the control group. Conclusion In the regimen of Peg-IFN-α combined with ribavirin for the treatment of genotype 1/6 CHC, the new investigational drug Peg-IFN-α-2b(Y shape, 40 kD) has comparable clinical effect and safety to the control drug Peg-IFN-α-2a.