Objective To evaluate the changes of the upper airway of the patients with obstructive sleep apnea syndrome (OSAS) before and after operations and to know the effects of operations by MSCT. Methods The upper airway dimensions of 26 patients with OSAS were measured on multiplanar reformatted (MPR), curved-planar reformatted (CPR), volume rendering(VR) images of 16-slice spiral CT. The measurements include the anteroposterior calibres and the areas on the reformatted axial images on the pharyngeal cavity levels, the calibres and the minimum areas in retropalatal and retroglossal regions, the areas of the soft palate and uvula on the reformatted sagittal view with maximum thickness, the maximum wall thickness of the right and left the upper airway on the coronary images, the volume of the upper airway before and after the operations. The measurements were correlated with the polysomnography (PSG) records. The data were analyzed paired-samples t-test and Pearson correlations. Results By comparison, the anteroposterior calibres and the cross-sectional areas on the reformatted axial view of the lower retropalatal region (slice 4) of the upper airway increased significantly after operations. The anteroposterior diameter increased from 5. 9 mm before operations to 12.8 mm after operations, where t = - 5.506, P < 0.05. The areas increased from 51.0 mm~2 before operations to 275.0 mm~2 after operations, where t = -5.011, P <0.05. In the higher retropalatal region (shce 2) of the upper airway, the anteroposterior diameter decresased from 14.8 mm before operations to 9.2 mm after operations, where t = 2.867, P < 0.05. The areas decreased from 241.0 mm~2 before operations to 128.0 mm~2 after operations, where t = 3.087, P < 0.05. The anteroposterior calibres of retroglossal region (slice 7) decreased from 12.7 mm before operations to 10.3 mm after operations,where t = 3.718, P <0.05. The L-R calibres and the minimum areas of of retropalatal increased significantly from 6.4 mm, 33.0 mm~2 before operation to 10.9 mm, 76. 0 mm~2 after operation, where t = -3.413, -2. 216, respectively and P < 0.05. Of the 9 cases whose apnea and hypopnea index (AHI) ≤5 events/hour after operations, the minimum areas of retropalatal region, the anterio-posterior diameter, L-R calibres increased significantly. The areas increased from 41.0 mm2 before operations to 76.0 mm~2 after operations, were t = -4. 932, P <0.05. The anteroposterior calibres increased from 4.6 mm before operations to 6.6 mm after operations, where t = - 7. 308, P < 0.05. The L-R calibres increased from 8.3 mm before operations to 13.6 mm after operations, where t = - 4.320, P < 0.05. Conclusions MPR、CPR、VR of MSCT can evaluate the not only the morphology but the function changes of the upper airways on the OSAS patients. The increasing of the minimum cross-sectional area may be one of the important indications for evaluating operations. The narrowing of the higher retropalatal region of the upper airway after operations should be an alert to the clinicians.

Objective To evaluate the clinical value of multislice-CT angiography (MSCTA)in planning for the patients undergoing deep inferior epigastric artery perforator (DIEAP) flap operations. Methods Eighteen patients were performed with a 16-slice CT scanner to evaluate the deep inferior epigastric artery perforator prior to DIEAP flap operations. Axial, multiplanar reconstruction( MPR), maximum intensity projection(MIP) and volume rendered (VR) images were analysed and the origins, calibers, courses and anatomic relationships of the deep inferior epigastric artery perforator were evaluated. The anastomosis between the superficial inferior epigastric artery and the main perforator was observed as well. The images were classified into three grades based on the vessels'appearance. A + indicated the vessel appeared clear,continuous and thick. A- indicated the vessel appeared foggy,discontinuous and thin or the vessel partly showed. B indicated no related vessel can be seen. Other 18 patients undergoing conventional abdomen-pelvis CT scans for other reasons were used for control group to compare their CT findings of the deep inferior epigastric artery perforator. Results MSCTA well showed the course of the deep inferior epigastric artery (DIEA). Of the 18 cases, 17 cases appeared as A +, another one A -. It precisely displayed the origins, subcutaneous and intramuscular courses, relations of the main perforators on all cases of showing A +. The exact points where the chosen perforator vessels emerged from the rectus abdominis muscle fascia were located precisely. The superficial inferior epigastric arteries were mostly displayed and the connection between the arteries and the largest-caliber perforator from the deep system could also be shown clearly. Strict concordance with operative findings was found in CTA. Conclusion MSCTA can precisely locate the chosen perforator vessels emerging from the rectus abdominis muscle fascia and it may be a feasible, fast, safe and effective method for preoperative evaluation of DIEAP.

Objective To construct lentiviral vectors containing peptide P1-GFP fusion genes.Umbilical cord derived mesenchymal stem cells were infected with lentivirus carrying peptide P1 and GFP fusion genes.To inject the targeted umbilical cord derived mesenchymal stem cells into mice and to detect GFP expression in the spleen.Methods Umbilical cord derived mesenchymal stem cells were cultured with adhered tissues of umbilical cord smaller than 1 mm3 . Lentiviral vector containing P1-GFP fusion genes with engineering technology was constructed and infected the umbilical cord derive mesenchymal stem cells.Targeted umbilical cord derived mesenchymal stem cells were intravenously injected in the mouse tail vein and after 18 hours GFP expression was detected with immunohistochamical staining of the spleen tissues.Results Harvested umbilical cord derived mesenchymal stem cells grew well in culture medium. Green fluorescence on umbilical cord derived mesenchymal stem cells were observed under fluorescence microscope at 18 hours after infected with lentivirus.Green fluorescence intensity of umbilical cord derived mesenchymal stem cells was increasing over time and reached a peak at 72 hours.Umbilical cord derived mesenchymal stem cells highly expressed CD105 (90.0%)/CD44 (98%) and CD73 (85.0%)/CD90 (98.5%) molecules.GFP expression was detected in the spleen after intravenous injection of targeted umbilical cord derived mesenchymal stem cells in the mice 18 hours later.GFP expressing cells intimately contacted with lymphocytes.Conclusions Targeted umbilical cord derived mesenchymal stem cells contain P1-GFP fusion genes are constructed.Targeted umbilical cord derived mesenchymal stem cells can be targeted to mouse spleen and intimately contact with lymphocytes after intravenous injection.Our results lay the groundwork for further studies.

The purpose of this study was to examine the effects of calcitonin gene-related peptide (CGRP) on coronary flow and various parts of cardiac conduction system (CCS) in the isolated guinea pig heart by recording the cardiac electrogram and His bundle activity simultaneously. The coronary flow (CF) was measured and the right atrium was paced at incremental frequencies periodically. Perfusing heart with CGRP at the concentrations of 3～30 nmol/L increased CF strikingly and dose-dependently. CGRP (30 nmol/L) caused a moderate and significant increase in the spontaneous heart rate, but failed to influence the atrioventricular nodal and His bundle-Purkinje fiber conduction time and the longest atrial pacing cycle length inducing 3∶2 Wenckebach and 2∶1 AV nodal conduction. The results indicate that CGRP in the guinea pig heart might act mainly on coronary vessels and then the sinus node, but did not affect the conductivity and refractoriness of the AV conduction system.

Anemia, Iron-Deficiency ; etiology ; Antibodies, Bacterial ; blood ; Child ; Child, Preschool ; Female ; Helicobacter Infections ; complications ; Helicobacter pylori ; immunology ; isolation & purification ; Humans ; Immunoglobulin G ; blood ; Male

Objective:To obtain a high specificity and high affinity anti-PcrV protein monoclonal antibody which can be used for the treatment of Pseudomonas aeruginosa infected.Methods: The PcrV gene was amplified by PCR using P.aeruginosa PAO1 genome DNA as the template.The expression vector(pET-28a-PcrV) was constructed and transformed into E.coli BL21(DE3).The re-combinant PcrV protein was expressed by IPTG induction and purified by Ni2+affinity chromatography.The specific binders of PcrV were screened by phage display.The genes encoding VH and VL were amplified respectively by PCR using the plasmid of positive clone as the template.Then the recombinant expression vectors were constructed and transfected into 293E cells.Monoclonal antibody were purified by the Protein A affinity resin from the culture supernatants.The affinity of antibody was detected by ELISA and the function of YG5 was verified in murine pneumonia model caused by P.aeruginosa.Results: Recombinant PcrV protein was expressed and purified.A full human monoclonal antibody(named as YG5) against PcrV was obtained by phage display.The results of ELISA showed that YG5 had a high affinity with EC50=61 ng/ml.Furthermore,it was found that YG5 could protect mice from infection caused by P.aeruginosa.Conclusion:Our findings present a novel human monoclonal antibody YG5 against PcrV,which inhibits the infection casued by P.aeruginosa and may be a potential drug for treatment of P.aeruginosa infection.

Objective To compare the therapeutic effects and adverse reactions between intravenous and oral iron,and the effects of erythropoietin (EPO)in patients with chronic renal failure.Methods Between November,2007 and October,2008,48 patients with renal anemia were randomized into 2 groups:intravenous group and oral group,24 in each.The duration of administration lasted for 10 weeks.All patients received regular EPO,with the dose of 100U·kg~(-1),per week. If the patient's hemoglobin (Hb) was more than 100 g·L~(-1),then the dose of EPO decreased by 50%.If the patient's Hb was more than 120 g·L~(-1),then the dose decreased by 75%.The levels of Hb,hematoerit,serum ferritin,adverse reaction and dose of EPO before and 4 weeks,8 weeks and 10 weeks after the administration were observed.Results The levels of Hb,Hematocrit (Hct)and ferritin(SF)in both groups after administration increased compared with before administration;and there was significant difference between the intravenous group and the oral group(P<0.01).The dosages of EPO in both groups after administration were lower than before administration,whereas the dosage in the intravenous group decreased significantly(P<0.05).In the intravenous group,the adverse reactions were significantly lower and the effect of EPO was significantly higher than in the oral group.Conclusion The intravenous iron can not only supply the iron the patients with renal anemia needed,but also increase the effect of EPO and reduce the dosage of EPO.The adverse reactions of intravenous iron are lower and it is safe and convenient.

Objective To investigate the effect of hyponatremia on the survival of cancer patients treated with camrelizumab.Methods The clinical and follow-up data of 100 patients treated with camrelizumab for the first time in Zhongshan Hospital,Fudan University from May 2019 to May 2020 were collected retrospectively,and the patients were divided into hyponatremia group and normal blood sodium group according to the blood sodium level at baseline before immunotherapy.Chi-square test was used to compare categorical variables between the two groups.Kaplan-Meier method with log-rank test was used to analyze survival of patients.Cox regression analysis was conducted to evaluate the impact of hyponatremia on prognosis.Results There were no statistically significant differences in gender,age,body mass index,Eastern Cooperative Oncology Group performance status(ECOG PS)score,nutritional risk screening 2002(NRS2002)score,tumor site,TNM stage,metastasis site number,and concurrent medication between the two groups.The median overall survival in the hyponatremia group and the normal sodium group was 3.9 months(95%CI 2.864-5.136)and 14.967 months(95%CI 6.840-23.093),respectively(P＜0.05);the median progression-free survival in the hyponatremia group and the normal sodium group was 2.933 months(95%CI 2.420-3.447)and 7.0 months(95%CI 4.103-9.897),respectively(P＜0.05).After adjusting for primary tumor,statistically differences were also observed in both overall survival and progression-free survival between the two groups(P＜0.05).The multivariate Cox analysis showed that both the death and disease progression risks of patients with hyponatremia increased(P＜0.05).After adjusting for age,gender,primary tumor site,and TNM staging,the blood sodium level remained independent influences on both overall survival and progression-free survival of patients(P＜0.05).Conclusion Baseline hyponatremia may be associated with the prognosis of patients with malignant tumors treated with camrelizumab,and further validation is warranted through large-scale prospective studies.

The objective of this study was to explore the clinical significance of measuring serum free light chains (sFLC) and to compare with serum total light chains (free and binded) in multiple myeloma (MM). sFLC in 20 newly diagnosed MM patients and 20 cases of healthy people as control were measured by immuno-nephelometric assays; the serum light chains and kappa/lambda ratio were measured in all patients, while immunofixation electrophoresis (IFE) tests were carried out at the same time in 18 out of 20 patients. The results showed that the abnormality of serum free light chains and kappa/lambda ratio were found in all of the 20 newly diagnosed MM patients (p < 0.01). The measurement of sFLC showed higher sensitivity than the total serum chains (p < 0.01). It is concluded that the method testing sFLC by immuno-nephelometric assay combined with kappa/lambda ratio is valuable for MM diagnosis, and the measurement of sFLC can be used as one of indicators for MM diagnosis.
Adult ; Aged ; Biomarkers, Tumor ; blood ; Female ; Humans ; Immunoglobulin kappa-Chains ; blood ; Immunoglobulin lambda-Chains ; blood ; Male ; Middle Aged ; Multiple Myeloma ; blood

Chromatography, High Pressure Liquid ; methods ; Cyclic AMP Response Element-Binding Protein ; genetics ; Female ; Humans ; Male ; Nerve Tissue Proteins ; genetics ; Prenatal Diagnosis ; methods ; RNA-Binding Proteins ; genetics ; SMN Complex Proteins ; Sequence Analysis, DNA ; Spinal Muscular Atrophies of Childhood ; diagnosis ; genetics