1.Optimizing treatment of biologics for ankylosing spondylitis
Chinese Journal of Rheumatology 2021;25(2):90-96
Objective:The current evidence suggests that tumor necrosis factor-inhibitor (TNFi) treatment can be used to achieve clinical remission or low disease activity in patients with ankylosing spondylitis (AS). After achieving remission / low disease activity, however, the follow-up treatment options are unclear. The purpose of this review is to conduct an extensive and systematic literature review of the studies conducted from September 2014 to July 2020 to assess the feasibility and effectiveness of tapering of biological agents.Methods:After searching for the related papers and abstracts and applying inclusion/exclusion criteria, a structured extraction process was used to include the studies into this study.Results:A total of 13/93 studies were included into the analysis of the tapering of biological agents in AS patients, in which 7/13 adopted the dose reduction regimen, 3/13 adopted the extended interval between doses regimen, and 5/13 did not provide or formulate the detailed reduction regimen. We summarized the feasibility of TNFi tapering schemes in the published studies and summarized the tapering rules. Only one study showed that reduced TNFi levels worsened the quality of life and resulted in a relapse within 12 months.Conclusion:More research is needed to understand the long-term effects of these strategies on efficacy, safety, and cost in the treatment of AS.
2.Application of early time window modified stereotaxic aspiration in converting operation therapy on the specified acute epidural hematoma
Liming QIU ; Zexin CHEN ; Jiebo CAI ; Yingbiao HONG
Chinese Journal of Primary Medicine and Pharmacy 2017;24(20):3109-3111
Objective To discuss the application of early time window modified stereotaxic aspiration in converting operation therapy on the specified acute epidural hematoma.Methods 21 patients with the specified acute epidural hematoma were treated with early time window modified stereotaxic aspiration drainage,using YL-1 hematoma puncture needle with silica gel ventricular drainage tube.Results The successful rate of puncture was 100%.Hematoma was completely cleared in 19 cases.A small amount of epidural effusion was remained in 2 cases.1 case had concomitant rebleeding during the puncture,and shifted to craniotomy.Conclusion Early time window modified stereotaxic aspiration drainage is a minimally invasive,safe and effective treatment on the specified acute epidural hematoma when mastering the indications,timing and skills of puncture.
3.Quantitative real-time PCR detection of DNA methylation transferase in the malignantly transformed human umbilical cord mesenchymal stem cells
Yezeng CHEN ; Qiuling TANG ; Qiurong CHEN ; Xiulan LAI ; Xiaoyan QIU ; Zexin ZHENG ; Weizhong LI
Chinese Journal of Tissue Engineering Research 2017;21(21):3320-3325
BACKGROUND:Human umbilical cord mesenchymal stem cells (hUC-MSCs) may be mutated duringin vitro culture based on the spontaneous malignant transformation of adult stem cells and tumor stem cell theory, and there may be a risk of tumorigenesis after in vivo transplantation. Therefore, to establish and perfect the in vitro safety testing procedures will actively promote the clinical application of stem cells. OBJECTIVE:To investigate the tumorigenic mechanism of hUC-MSCs and the expression level of DNA methyltransferase (DNMTs) in hUC-MSCs. METHODS:Primary hUC-MSCs were isolated and expanded by tissue adherent culture. 3-Methycholanthrene was used to cause the malignant transformation in hUC-MSCs (experimental group), followed by morphological observation and tumorigenesis experiment in nude mice. Then, the tumor tissues were obtained and identified by pathological examination and primary cell culture, and the levels of DNMTs mRNA in hUC-MSCs treated with 3-methycholanthrene and dimethyl sulfoxide (control group) were detected by real-time RT-PCR and compared. RESULTS AND CONCLUSION:hUC-MSCs treated with 3-methycholanthrene led to malignant transformation, which showed malignant growth and non-integer ploidy changes in the cell nuclei, and formed a malignant tumor in immune-deficient mice after injection. Compared with the control group, the cells in the experimental group showed higher expression of DNMTs mRNA as detected by real-time RT-PCR. To conclude, hUC-MSCs can trigger malignant transformation in the morphology and the epigenetics under certain conditions. DNMTs can be a candidate for prevention against malignant transformation of transplanted stem cells.
4.Identification and genetic characterization of Coxsackievirus B5 isolated from an outbreak of aseptic meningitis
Peng CHEN ; Zexin TAO ; Haiyan WANG ; Guifang LIU ; Jing YANG ; Xiaojuan LIN ; Lizhi SONG ; Aiqiang XU
Chinese Journal of Infectious Diseases 2012;30(3):146-151
ObjectiveTo identify the pathogen of an aseptic meningitis outbreak which occurred in Linyi City of Shandong Province during the summer of 2009,and to analyze the genetic variations of Coxsackicvirus B5 (CVB5) isolates.MethodsForty-two cerebrospinal fluids (CSF) specimens were collected from aseptic meningitis cases and virus isolation was performed. The viral RNA was extracted and amplified from the positive specimens using reverse transcription polymerase chain reaction (RT-PCR).The partial VP1 coding region was purified and sequenced. The phylogenetic trees based on VP1 sequences were constructed among CVB5 isolates and those in GenBank.ResultsSeventeen enteroviruse strains were isolated from 42 CSF samples with 40.5% isolation positive rate. All these strains were identified as CVB5 using both microneutralization test and molecular typing methods. Homology comparisons indicated that the nucleotide acid identities and amino acid sequence identities were 92.3 %- 100.0% and 98.7 %- 100.0%,respectively among these CVB5 isolate.s,and compared with the Faulkner prototype strain,which were 81.0%-82.4% and 96.6%97.0%,respectively.Phylogenetic analysis on VP1 sequences showed that all CVB5 could be separated into four genogroups of A,B,C and D.Isolates of this outbreak belonged to genogroup D.Interestingly,two distinct genogroups in the phylogenetic tree were observed among the 17 isolates.Conclusions CVB5 is responsible for the outbreak of aseptic meningitis in Linyi City of Shandong Province,China. The genetic diversity is high among the isolates and all belong to genogroup D.
5.Induced pluripotent stem cells can be reprogrammed from human umbilical cord mesenchymal cells by six transcription factors
Hanhua YANG ; Yuanguo CHEN ; Xiulan LAI ; Lichun XIE ; Zexin ZHENG ; Xuewu JIANG ; Lian MA
Chinese Journal of Applied Clinical Pediatrics 2014;29(17):1331-1336
Objective To establish and identify the induced pluripotent stem cell(iPSC) line reprogrammed from human umbilical cord mesenchymal cells(HuMSCs).Methods HuMSCs were cultured by adhesion method,and OCT4,SOX2,KLF4,c-Myc,NANOG,LIN-28 were transfected into HuMSCs with lentiviral victor to reprogramme HuMSCs into iPSC.Morphological observation,pluripotency genes (SOX2,TDGF1,THY-1,OCT4,REX1 and TERF1) expression,alkaline phosphatase detection,karyotype analysis,embryonic stem cells (ESC) specific proteins (NANOG,OCT4,SSEA-4,TRA-1-81) immunofluorescence staining,differentiated into teratomas in vivo(inject the iPSC into SCID mice) and embryniod bodies in vitro were performed to exam the pluripotency of the iPSC.Results Four days after being infected by lentivirus,the HuMSCs became round-shape; 10 days after infection,some embryonic stem(ESC)-like colonies appeared.Fourteen days after infection,picked up the regularly shaped colonies and cultured several passages.About 1.25% HuMSCs were reprogrammed into iPSC.The iPSC presented clone-like growth like ESC.All the cells were positive to alkaline phosphatase staining and expressed the pluripotency genes.The iPSC also expressed the ESC specific proteins,and karyotype analysis showed normal chromosome caryotype (46,XY).Furthermore,the iPSC could form embryoid bodies in vitro,expressed alpha fetoprotein(AFP),smooth muscle actin(SMA) and β-tubulin.The iPSC could alsoform teratomas in vivo.Conclusion OCT4,SOX2,KLF4,c-Myc,NANOG,LIN-28 can reprogram HuMSCs into iPSC efficiently.
6.A single rate meta-analysis of postoperative complications in robot arm-assisted unicompartmental knee arthroplasty
Meiping YANG ; Bojian CHEN ; Shuchai XU ; Yang LYU ; Hongliang LIU ; Zexin HUANG
Chinese Journal of Orthopaedic Trauma 2022;24(10):862-868
Objective:To observe the postoperative complications and revision rates of robot arm-assisted unicompartment arthroplasty by means of a meta-analysis.Methods:Relevant databases including Cochrane Library, PubMed, EMBASE, Wanfang, VIP, CNKI, and Web of Science were searched by computer for high-quality studies on complications and revision rates after robot arm-assisted unicompartment arthroplasty in both English and Chinese from the database establishment date to March 2021. The quality of the studies retrieved was evaluated. Relevant data including postoperative complications, infection, pain, prosthesis loosening, and revision were extracted for a meta-analysis using STATA 15.0 software.Results:A total of 16 studies were included, including one randomized controlled study, 6 case-control studies and 9 cohort studies. By the methodological index for non-randomized studies (MINORS), 7 studies scored 14 points, 3 studies 13 points, one study 12 points, 4 studies 11 points, and one study 10 points. Meta analysis showed that the total rate of complications was 2% (95% CI: 1%to 4%) . Three studies used NAVIO robot, 7 studies MAKO robot, one study NAVIO and MAKO robots, and one study Acrobot robot. Since just one study used Acrobot robot, only MAKO and NAVIO robots were included for the subgroup analysis which showed that the postoperative complication rates for NAVIO and MAKO robots were 4.0% (95% CI: -2% to 10%) and 3% (95% CI: 1% to 5%) , respectively. The incidence of postoperative pain was 0.2% (95% CI: 0.1% to 0.3%), the incidence of postoperative infection 0.5% (95% CI: 0.3% to 0.8%), the incidence of postoperative prosthesis loosening 0.5% (95% CI: 0.3% to 0.8%), and the revision rate 2% (95% CI: 1% to 2%). According to the subgroup analysis of NAVIO and MAKO robots, their revision rates were 4% (95% CI: 2% to 7%) and 2% (95% CI: 1% to 2%), respectively. Conclusion:The clinical efficacy of robot arm-assisted unicompartment arthroplasty is good, for the complications in the patients are limited and the long-term survival rate of the prosthesis is excellent.
7.Analysis of complicated virus infection and clinical characteristics in 100 infants with pertussis
Xinyi HAN ; Xiaoying CAI ; Guangyu LIN ; Chuangxing LIN ; Xiaohua ZHOU ; Junduo CHEN ; Zexin HUANG
Chinese Pediatric Emergency Medicine 2023;30(5):334-339
Objective:To investigate the complicated virus infection of infants with pertussis and its effect on the disease.Methods:From January 2019 to March 2020, a total of 100 hospitalized infants with pertussis were admitted to the Second Affiliated Hospital of Medical College of Shantou University, nasopharyngeal swabs were collected for detection of ten pathogens including pertussis, namely respiratory syncytial virus(RSV), parainfluenza virus(PIV), bordetella pertussis (BP), human rhinovirus(HRV), human bocavirus(HBoV), human metapneumovirus(hMPV), influenza B virus (INF-B), adenovirus, influenza A virus and cytomegalovirus(CMV). According to the results of pathogen detection, all infants were divided into single detection group of BP(single detection group) and co-detection group of BP combined with viruses(co-detection group). The clinical data of the two groups were retrospectively analyzed and compared to explore the differences of clinical characteristics and its impact on the course of disease.Results:Among 100 cases, there were 54(54.0%) boys and 46(46.0%)girls.The age ranged from 28 days to 2 years and 5 months, with a median age of 3.5 months.Fifty-six cases were classified as single detection group, while 44 cases were included into co-detection group.Among infants in co-detection group, fourteen cases were co-infected with CMV(31.8%, 14/44), seven cases with HRV(15.9%, 7/44), seven cases with PIV(15.9%, 7/44), four cases with RSV(9.1%, 4/44), one case with hMPV(2.2%, 1/44), eight cases with CMV+ HRV(18.2%, 8/44), one case with HRV+ HBoV (2.2%, 1/44), one case with CMV+ PIV(2.2%, 1/44)and one case with CMV+ PIV+ INF-B(2.2%, 1/44). The number of infants in the single detection group who had cyanosis before treatment, requiring repiratory support, PICU admission, severe pneumonia or abnormal myocardial enzymes were higher than those in the co-detection group( P<0.05), while the months of age were lower than that in the co-detection group( P<0.05). When comparing the clinical characteristics of infants over three months of age, only the number of cases of combined cyanosis before treatment and the number of days in hospital were higher in the single detection group than those in the co-detection group ( P<0.05), no statistically significant differences were found in the other clinical characteristics between the two groups( P>0.05). Conclusion:The cases of infants requiring repiratory support, complicated with severe pneumonia or abnormal myocardial enzymes in the single detection group are higher than those in the co-detection group, which may be attributed to the small age of months.
8.Development and Research Progress of 3D Printing Technology in Orthopedic Medical Devices.
Jingyang CHEN ; Zexin HONG ; Liang CHEN ; Yufeng WU
Chinese Journal of Medical Instrumentation 2023;47(5):533-538
With the characteristics of fast prototyping and personalized manufacturing, 3D-printing (three-dimensional printing) is an emerging technology with promising applications for orthopedic medical devices. It can complete the process of medical devices with complex shape which can not be completed by conventional fabrication process. At present, a variety of orthopedic medical devices manufactured by 3D printing technology, has been approved for marketing, and their use has been proved to be beneficial. 3D bioprinting in this area has also made a few breakthroughs. However, many challenges still remain to be addressed as well. In this study, the research status, as well as the development of the 3D-printing technology in the field of orthopedic medical devices is elaborated.
Printing, Three-Dimensional
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Bioprinting
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Commerce
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Research
9. Sequence analysis of enterovirus 71 3′UTR and construction of a recombinant cDNA infectious clone
Zhen DONG ; Lihong WANG ; Ziwei LIU ; Rui CHEN ; Zexin TAO ; Li ZHAO ; Zhiyu WANG ; Hongling WEN
Chinese Journal of Experimental and Clinical Virology 2019;33(1):83-88
Objective:
To sequence the 3′UTR of enterovirus 71 strains, investigate its foundation and impact in virulence by constructing a 3′UTR-replaced recombinant cDNA infectious clone.
Methods:
Viral RNA of EV-A71 isolated viruses were extracted, and the nucleotide analysis was performed after sequencing. The 3′UTR of a full-length infectious clone of SDLY107 strain was replaced by its corresponding part of SDLY1 strain, and then the recombinant virus was constructed and identified.
Results:
The nine isolated strains were classified into sub-genotype C4a of enterovirus (EV)-A71 by analysis, and nucleotide sequence homology for 3′UTR were 94%-100%. 3′UTR of EV-A71 strains may be associated with its pathogenicity. Identification of the rescued virus by sequencing and indirect immunofluorescence confirmed the successful construction of infectious recombinant virus.
Conclusions
Sequence analysis indicated that the 3′UTR may be involved in the pathogenicity of EV-A71. The recombinant virus SDLY107(1-3′UTR) was rescued successfully. Our study may provide evidence for further research on the influence of 3′UTR on the virulence of enterovirus 71.
10.Kidney function change after transcatheter aortic valve replacement in patients with diabetes and/or hypertension.
Jiaqi FAN ; Changjie YU ; Kaida REN ; Wanbing LIN ; Stella NG ; Zexin CHEN ; Xinping LIN ; Lihan WANG ; Qifeng ZHU ; Yuxin HE ; Jubo JIANG ; Xianbao LIU ; Jian'an WANG
Journal of Zhejiang University. Science. B 2021;22(3):241-247