Objective To investigate the impact of prior cerebral infarction (PCI) on in-hospital mortality in patients with Acute Myocardial Infarction (AMI).MethodsA retrospective analysis of documents of a total of 3572 consecutive patients with AMI admitted to Xuanwu Hospital of Capital Medical University from 2002 Jan.1 to 2009 Dec.31 were performed.Results There were 564 patients ( 15.8% )with PCI.Compared with the group of without PC1,the group with PCI were substantially older[(69.4 ±9.9) vs (64.2 ± 12.9)years,P =0.000],and had a higher prevalence of hypertensive disease,diabetes mellitus,prior myocardial infarction (MI) and non-ST-segment elevation myocardial infarction(NSTEMI)( respectively,71.0% vs 57.3%; 41.0% vs 25.7%,12.9% vs 9.5%; 14.9% vs 10.7%,P ＜ 0.01 ),and a higher in-hospital mortality ( 16.5% vs 10.0%,P= 0.000).Univariate analysis demonstrated that in-hospital mortality associated with age,gender,extensive anterior MI,anterior MI,diabetes mellitus,prior cerebral infarction,prior myocardial infarction,coronary angiography and percutaneous coronary intervention.Logistic regression analysis found that risk factors were age,extensive anterior MI,anterior MI,diabetes mellitus and prior cerebral infarction,and protective factors were coronary angiography and percutanous coronary intervention.PCI was independently associated with in-hospital mortality,OR 1.368,95% CI 1.047-1.787,P = 0.022.Conclusion In patients with acute myocardial infarction,the presence of PCI increases the risk of worse in-hospital outcome.

In order to improve the clinical skills of medical students,the First Clinical School of Tongji Medical College,Huazhong University of Science and Technology strengthened the construction of teaching base,teaching materials,teaching team,curriculum and assessment methods,and established a comprehensive experimental teaching system of clinical skills.

Objective To investigate the risk factors of pancreatic pseudocysts(PPC) in patients with acute pancreatitis (AP) in a retrospective cohort study. Methods 460 AP patients with complete follow-up data admitted in Affiliated Hospital of Qingdao University from January 2004 to March 2012 were retrospectively analyzed,who were divided into PPC group and control group. Age,gender,body mass index(BMI),history of diabetes,etiology,the presence of ascites and hydrothorax,the presence of abdominal mass,the presence of acute fluid collection, APACHEⅡ score at 48 h admission, CT severity index (CTSI), serum albumin, amylase,LDH,ALP, BUN, Cr, TG, TB, conjugated bilirubin, CRP, serum calcium and other laboratory markers were recorded. Univariate logistic regression analysis was used to select the factors that were statistically different between two groups, and multivariate logistic regression analysis was performed to determine the independent risk factors for AP complicated with PPC. Results 143(31.1%) of 460 AP patients developed PPC. On univariate analysis, a total of 11 factors including male sex, BMI ≥28 kg/m2, history of diabetes, alcoholic pancreatitis, ascites, pleural effusion, palpable abdominal mass, acute fluid collections,APACHEⅡscore,CTSI≥7 and serum albumin were statistically different between two groups. On multiple logistic regression analysis, it was shown that male sex (OR 3.23, 95% CI 1.560~ 6.301, P=0.03),history of diabetes (OR 2.23,95% CI 1.021~3.920,P=0.04), ascites (OR 1.62,95% CI 0.652~2.432, P=0.01), pleural effusion (OR 2.43, 95% CI 1.201~7.201, P=0.03), a palpable abdominal mass(OR 1.83,95% CI 0.737~4.320,P<0.001) and CTSI≥7(OR 5.12,95% CI 1.890~14.012, P<0.001) were independent risk factors significantly associated with the PPC formation. Conclusions The male sex, diabetic history, ascites, pleural effusion, palpable abdominal mass and high CTSI score were the independent risk factors of PPC formation in AP.

Objective To investigate the feasibility of sequential intensity-modulated radiotherapy (sIMRT)and simultaneously integrated boost intensity-modulated radiotherapy(SIB-IMRT)in the radiotherapy of brain metastasis,the dosimetric difference of target volumes and organs at risk(OARs). Methods Twenty pa-tients diagnosed as brain metastasis were randomly selected,with SIB-IMRT and sIMRT programs developed for each patient. Dosimetric differences between target areas and OARs were compared between the two radiotherapy protocols. Results Compared with sIMRT,SIB-IMRT had no significant difference in the average irradiation dose of the brainstem[(42.69 ± 2.18)Gy vs.(41.98 ± 0.96)Gy]and homogeneity index(HI)(1.46 ± 0.04 vs.1.42 ± 0.13)of P-CTV(P > 0.05). However,SIB-IMRT plan achieved higher than sIMRT in the conformation index (CI)(0.68 ± 0.05 vs. 0.44 ± 0.04)and HI(1.03 ± 0.01 vs. 1.06 ± 0.01)of P-GTV. Meanwhile,both maximum exposure dose of OARs and CI of P-CTV(0.68 ± 0.05 vs.0.44 ± 0.04)of SIB-IMRT were significant in comparison with sIMRT(P<0.05).Conclusions Both radiotherapies can meet target coverage and dose requirements.Com-pared to sIMRT technique,SIB-IMRT technique can decrease effectively the exposure dose of surrounding organs, and can give the tumor target more uniform physical dose conformation.

OBJECTIVETo establish the association between the geometric anatomical characteristics of the patients and the corresponding three-dimensional (3D) dose distribution of radiotherapy plan via feed-forward back-propagation neural network for clinical prediction of the plan dosimetric features.

METHODSA total of 25 fixed 13-field clinical prostate cancer intensity-modulated radiation therapy (IMRT)/stereotactic body radiation therapy (SBRT) plans were collected with a prescribed dose of 50 Gy. With the distance from each voxel to the planned target volume (PTV) boundary, the distance from each voxel to each organ-at-risk (OAR), and the volume of PTV as the geometric anatomical characteristics of the patients, the voxel deposition dose was used as the plan dosimetric feature. A neural network was used to construct the correlation model between the selected input features and output dose distribution, and the model was trained with 20 randomly selected cases and verified in 5 cases.

RESULTSThe constructed model showed a small model training error, small dose differences among the verification samples, and produced accurate prediction results. In the model training, the point-to-point mean dose difference (hereinafter dose difference) of the 3D dose distribution was no greater than 0.0919∓3.6726 Gy, and the average of the relative volume values corresponding to the fixed dose sequence in the DVH (hereinafter DVH difference) did not exceed 1.7%. The dose differences among the 5 samples for validation was 0.1634∓10.5246 Gy with percent dose differences within 2.5% and DVH differences within 3%. The 3D dose distribution showed that the dose difference was small with reasonable predicted dose distribution. This model showed better performances for dose distribution prediction for bladder and rectum than for the femoral heads.

CONCLUSIONWe established the relationships between the geometric anatomical characteristics of the patients and the corresponding planning 3D dose distribution via feed-forward back-propagation neural network in patients receiving IMRT/SBRT for the same tumor site. The proposed model provides individualized quality standards for automatic plan quality control.

After search at hematopoietic stem cell banks for transplant donors, there may be several donors matched with given standards. To determine the most appropriate donor for a specific patient, the potential donors were analyzed and compared by three methods. The first is cross-reactive group (CREG) antigens, which defined as the public antigens that shared specific serological reaction patterns. The second is residue match theory, which concerned the three residues oriented upward toward the T-cell receptor. The third is comparing HLA three-dimensional structure models. The results of the three methods were not completely accorded in our case. However, some less matched donors could be excluded from the candidates and the range of selection was further reduced. It is concluded that combined application of three methods would contribute in selecting donor for hematopoietic stem cell transplantation in clinics.
Cross Reactions ; HLA Antigens ; immunology ; Hematopoietic Stem Cell Transplantation ; Histocompatibility Testing ; Humans ; Tissue Donors

OBJECTIVETo investigate the tumor-associated antigen CA125 expression in the serum and cervical and vaginal secretions in women during normal reproductive period, and explore the clinical value of detecting tumor markers in the cervical and vaginal secretions.

METHODSA total of 145 women in reproductive period were divided into 3 age groups (20-29 years, 30-39 years, and over 40 years), and their CA125 levels in cervical secretion, vaginal secretion and serum were detected by automatic electro-chemiluminescent immunoassay.

RESULTSCA125 levels in the cervical secretion, vaginal secretion and serum showed no significant difference between the 3 age groups (P>0.05). In each group, CA125 levels differed significantly between the cervical secretion, vaginal secretion and serum (P<0.001). In the 145 women, the average CA125 level was 497.82 - or + 75.29 U/ml in the cervical secretion, 114.66 - or + 26.40 U/ml in vaginal secretion and 18.06 - or + 3.35 U/ml in serum, showing significant differences between them (P<0.001).

CONCLUSIONCA125 expression level is significantly higher in the cervical and vaginal secretions than in the serum in women in normal reproductive period, and its levels in cervical and vaginal secretions can be more sensitive and convenient for early detection of related diseases.

Adult ; Biomarkers ; analysis ; CA-125 Antigen ; blood ; metabolism ; Cervix Mucus ; metabolism ; Female ; Humans ; Middle Aged ; Vagina ; secretion ; Young Adult

The present study was aimed to investigate the mechanism of the granulocyte colony-stimulating factor (G-CSF) on the viability of the bone marrow mesenchymal stem cells (MSCs). MSCs were cultured by classical whole bone marrow adhering method, and the MSCs were analyzed for the cell surface differentiation markers CD34, CD133, CD90 and CD105 by flow cytometry (FCM). The ability of the MSCs to differentiate into osteocytes and adipocytes was tested in osteogenic and adipogenic mediums, separately. The effect of G-CSF (20 mug/mL) on the passage 3 MSCs viability was evaluated by MTT method, and the molecular mechanism of the G-CSF mediated effects was assayed through the pretreatment of the signal pathway inhibitors including 50 nmol/L wortmannin (phosphatidylinoesitol 3 kinase inhibitor), 50 mumol/L PD98059 [extracellular signal-regulated-kinase1/2 (ERK1/2) inhibitor], 30 mumol/L SB203580 (p38 mitogen-activated protein kinase inhibitor), 10 mumol/L H89 (protein kinase A inhibitor), 20 mumol/L Y27632 (Rho kinase inhibitor), 1 mumol/L rapamycin [mammalian target of rapamycin (mTOR) inhibitor], 10 mmol/L straurosporine [protein kinase C (PKC) inhibitor], 6 nmol/L G0697 (PKCalpha inhibitor) and 50 mumol/L Pseudo Z (PKCzeta inhibitor). Cultured passage 3 MSCs expressed CD90 and CD105 strongly, and showed the ability of multi-differentiation into osteocytes and adipocytes. G-CSF promoted the viability of MSCs, and the promotion was completely inhibited by PKC inhibitor straurosporine and partially inhibited by wortmannin, rapamycin, PD98059, SB203580 or G0697. However, its effect was not inhibited by H89, Y27632 and Pseudo Z. It is thus suggested that the promoting effect of G-CSF on MSCs viability was closely related to AKT-mTOR-PKC signal pathway, and PKC maybe the central role in the signal pathway.
Animals ; Bone Marrow Cells ; cytology ; Cell Differentiation ; Cell Survival ; Cells, Cultured ; Enzyme Inhibitors ; pharmacology ; Granulocyte Colony-Stimulating Factor ; pharmacology ; Hematopoietic Stem Cells ; Humans ; Mesenchymal Stromal Cells ; cytology ; Signal Transduction

In order to investigate the expression of heavy chain of HLA-B * 2705 in prokaryotic system and identify its activity, the extra-membrane gene fragment of HLA-B * 2705 was amplified from full-length HLA-B*2705 cDNA by PCR and cloned into pGEM-T vector. After identification by sequencing, the prokaryotic expressing vector pET32a (+)-B * 2705 was constructed. The antigenic activity of expressed protein was identified by Western blot and antibody blocking reaction. The results indicated that the fused HLA-B * 2705 protein expression with high efficiency was obtained. The expressed product was more than 50% of the total bacteria protein. The antigenic activity of expressed protein was confirmed by Western blot and antibody blocking reaction. It is concluded that HLA-B * 2705 fusion protein are obtained as basis for the further studies.
Escherichia coli ; genetics ; metabolism ; Genetic Vectors ; genetics ; HLA-B27 Antigen ; classification ; genetics ; immunology ; metabolism ; Humans ; Immunoglobulin Heavy Chains ; genetics ; immunology ; metabolism

OBJECTIVETo study the expression of recombinant human SCF-TPO fusion protein and its biological function.

METHODSFour primers were designed according to known sequences of TPO and SCF. The functional amino acid domains of TPO and SCF were amplified by RT-PCR from fetus hepatocytes, respectively. The expression plasmid pET32a/SCF-TPO was constructed by VOE gene fusion technique and expressed in E. coli BL21(DE3) plysS as inclusion body after isopropyl-beta-D-1-thiogalactopyranoside (IPTG) induction. The fusion protein was tested by SDS-PAGE and Western blot. The biological functions of SCF-TPO fusion protein in MO7e cells was investigated by MTT method after purification with metal chelating chromatography.

RESULTSThe high expression SCF-TPO fusion protein was obtained, reaching up to 30% of the total cellular protein. Western blot verified the correct fusion expression and MTT results showed the growth promoting effect of the SCF-TPO fusion protein on MO7e cells, with a higher promoting activity at 100 ng/ml.

CONCLUSIONSExpressed SCF-TPO fusion protein after renaturation has biological activity in promoting the proliferation of MO7e cells.

Blotting, Western ; Cell Line, Tumor ; Cell Proliferation ; Cell Survival ; genetics ; physiology ; Cloning, Molecular ; Electrophoresis, Polyacrylamide Gel ; Escherichia coli ; genetics ; Genetic Vectors ; Humans ; Recombinant Fusion Proteins ; genetics ; metabolism ; physiology ; Reverse Transcriptase Polymerase Chain Reaction ; Stem Cell Factor ; genetics ; metabolism ; physiology ; Thrombopoietin ; genetics ; metabolism ; physiology