ObjectiveTo assess the relationship of filaggrin expression with atopic diathesis and disease severity in patients with alopecia areata (AA).MethodsThirty-seven patients with AA aged (26.3 ± 10.6) years were enrolled in this study.Atopic diseases were noted in 8 of these patients.Clinical data and laboratory test resuhs were reviewed.Immunohistochemical staining was performed to quantify the expression of filaggrin protein in scalp biopsy specimens from all of the 37 patients with AA and from 10 human controls,and fluorescence-based semiquantitative reverse transcription-PCR to detect the expression of filaggrin mRNA in scalp biopsy specimens from 22 patients with AA and 13 healthy controls.Data were statistically analyzed by Mann Whitney U test,chi-square test,and Spearman's rank correlation test.ResultsThe expressions of filaggrin protein and mRNA were significantly lower in patients with AA than in the controls(P ＜ 0.05 or 0.01 ),and the decrease seemed more obvious in patients with large areas of lesions,long duration of disease,and nail abnormalities,but the degree of decrease was unrelated to the complication with atopic diseases.No significant differences were observed in sex ratio,age at onset,disease duration,area of hair loss,the prevalence of family history or incidence of nail abnormalities and increase in serum IgE and eosinophils,between patients with atopic diseases and those without.ConclusionsThe expressions of filaggrin protein and mRNA are decreased in patients with AA,suggesting that filaggrin may participate in the development of AA and is correlated with the severity of AA.

Objective To detect the expressions of apoptosis-related factors and inflammatory cytokines in superficial and deep layers of as well as anagen hair follicles in lesions of early alopecia areata (AA).Methods Scalp biopsy samples were collected from 25 patients with early AA and 15 healthy human controls.Fluorescence-based quantitative PCR was performed to detect mRNA expressions of apoptosis-related genes p53,caspase 3,Fas,survivin and bcl-2,as well as those of inflammatory cytokines interleukin (IL)-4,IL-10,IL-12 and interferon (IFN)-γ.An immunohistochemical assay was conducted to measure the expression of p53 protein in anagen hair follicles.Results Compared with control skin samples,anagen hair follicles in AA lesions showed significantly increased mRNA expression levels (expressed as 2-△△Ct) of pro-apoptotic factors caspase 3,p53 and Fas (6.78,8.01,9.74,respectively,all P ＜ 0.05),but decreased mRNA expression levels of antiapoptotic factors bcl-2 and survivin (0.08 and 0.03 respectively,both P ＜ 0.01),and similar mRNA expression levels of inflammatory cytokines.There was a significant increase in mRNA expression levels of Th1 cytokines IFN-γ and IL-12 (2.75 vs.1.00,P ＜ 0.05; 85.67 vs.1.00,P ＜ 0.01),but a significant decrease in the expression level of the Th2 cytokine IL-10 (0.002 vs.1.000,P ＜ 0.01) in superficial layers of AA lesions compared with those of normal control skin.The degree of changes in mRNA expression levels of IL-10 and IL-12 was significantly higher in superficial layers than in deep layers of AA lesions (P＜0.01 and 0.05 respectively).The immunohistochemical assay showed that the number of p53-positive cells per 100 cells in anagen hair follicles of AA lesions was higher than that in those of control skin (t =23.79,P ＜ 0.01).Conclusions Anagen hair follicles in AA lesions exhibit high expressions of pro-apoptosis factors,but low expressions of antiapoptotic factors,suggesting that apoptotic factors play a role in the occurrence of AA.

Objective To explore the relationship between gene mutation and different syndromes of TCM in the early stage of diabetic nephropathy(DN).Methods Sixty-three patients with diabetic nephropathy in the early stage were observed.The methylene tetrahydrofolate reductase(MTHFR)C676T polymorphism was determined by polymerase chain reaction restriction fragment length polymorphism(PCR-RFLP)assay.The levels of homocysteine(Hcy),acidum folicum,fasting glucose,postprandial glucose,glycosylated hemoglobin(HbA1C),urinary albumin excretion rate(UAER),and blood lipid were measured respectively,and the TCM syndromes were recorded.Results Of the 63 patients,19 were genotype CC,17 were genotype TT,and 27 were genotype CT.The genotypic frequency of TT was 27.00%,that of CT was 42.85%,and that of CC was 30.15%.The T allele frequency was 48.41% and C allele frequency 51.59%.The MTHFR C676T mutation was related with plasma Hcy level(P

OBJECTIVETrace and toxic elements have great influences on the fetus growth during the pregnancy. The status of Pb, As, Cd, Mn and Zn in maternal and umbilical cord blood and influence factors were analyzed.

METHODSFrom September 2006 to April 2007, 130 pairs of maternal blood and cord blood in total were collected at the time of spontaneous delivery or cesarean section. At the same time, the development of newborn was measured immediately. The concentrations of elements were determined by inductively coupled plasma mass spectrometry, the relationship of these elements between maternal and cord blood were also analyzed.

RESULTSThe median (microg/L) concentration of blood Pb, As, Cd, Mn and Zn in maternal blood were 64.32, 3.81, 0.84, 54.26 and 6312.50. And the median (microg/L) of those elements in cord blood were 35.72, 2.84, 0.32, 78.99 and 2250. The levels of Cd (r=0.341, P=0.000) and As (r=0.552, P=0.000) in maternal blood were positively correlated with the elements in the cord blood. From the questionnaire we conclude that the occupational hazardous factors and room decorated were the risk factors for the blood As and Zn levels. After multilinear regression analysis we also found mother weight, occupational hazardous factors and mother systolic pressure might affect the levels of blood Mn, Zn, As and Cd.

CONCLUSIONSThe levels of these elements were affected by environmental and maternal factors. In this study, although the levels of all heavy metals in pregnant women were below those considered hazardous, however, they were still higher than those in the developed countries. The effects of heavy metals of maternal exposure on developing fetuses should deserve attention further.

Adult ; Arsenic ; blood ; Cadmium ; blood ; Environmental Exposure ; Female ; Fetal Blood ; chemistry ; Humans ; Infant, Newborn ; Lead ; blood ; Male ; Manganese ; blood ; Maternal Exposure ; Pregnancy ; Zinc ; blood

BACKGROUNDThis meta-analysis was to determine the association of the cumulative dose of 130/0.4 or 0.42 (hydroxyethyl starch [HES] 130/0.4*) or delta daily fluid balance (i.e., daily fluid balance in HES group over or below control group) with the heterogeneity of risk ratio (RR) for mortality in randomized control trials (RCTs).

METHODSThree databases (PubMed, EMBASE, Cochrane) were searched to identify prospective RCTs reporting mortality in adult patients with sepsis to compare HES130/0.4* with crystalloids or albumin. Meta-analysis was performed using random effects. Sensitivity and meta-regression analyses were used to examine the heterogeneity sources of RR for mortality.

RESULTSA total number of 4408 patients from 11 RCTs were included. The pooled RR showed no significant difference for overall mortality in patients with administration of HES130/0.4* compared with treatment of control fluids (RR: 1.02, 95% confidence interval: 0.90-1.17; P = 0.73). Heterogeneity was moderate across recruited trials (I2 = 34%, P = 0.13). But, a significant variation was demonstrated in subgroup with crystalloids as control fluids (I2 = 42%, P < 0.1). Sensitivity analysis revealed that trials with high risk of bias did not significantly impact the pooled estimates for mortality. Meta-regression analysis also did not determine a dose-effect relationship of HES130/0.4* with mortality (P = 0.298), but suggested daily delta fluid balance being likely associated with mortality in septic patients receiving HES130/130/0.4* (P = 0.079).

CONCLUSIONSInappropriate daily positive fluid balance was likely an important source of heterogeneity in these trials reporting HES130/0.4* associated with excess mortality in septic patients.

Humans ; Hydroxyethyl Starch Derivatives ; therapeutic use ; Randomized Controlled Trials as Topic ; Sepsis ; mortality ; therapy

Objective To analyze the safety of renal transplant from donors with primary central nervous system (CNS) tumors.Methods We retrospectively analyzed the clinical data of 33 donors with primary CNS tumors and the 63 corresponding renal recipients between January 2013 and December 2016 in Tongji Hospital.Results The mean period from diagnosis as primary CNS tumor to donation was about (21.8± 46.4) months (range:0.5 to 192.0 months).The pathological classification of these tumors included gliomas,meningioma,medulloblastoma,etc.Besides,there were 10 donors with high-grade CNS malignancies.Eleven donors have ever been through at least one of the four treatments (craniotomy,V-P/V-A shunt,radiotherapy and chemotherapy),14 donors have undergone none,and the clinical data of rest were unavailable.All the 63 recipients got well renal function after transplant.During an average follow-up of (15.9 ± 8.2) months (range:2.7 to 35.5 months),one recipient got donor-derived rhabdoid tumor 4 months posttransplant,underwent comprehensive treatments,including allograft nephrectomy,radiotherapy,chemotherpy and returned to hemodialysis,while the 62 cases got no donor-derived tumors.Conclusion Tumor transmission of renal allograft from donors with primary CNS tumors is inevitable but with low risk,which means this kind of donors can be used with careful assessment,full informed consent and good balance between wait-list death and tumor transmission.

OBJECTIVETo explore the surgical strategy for ectopic kidney and evaluate the clinical outcomes.

METHODSFrom January 2000 to October 2009, 35 cases of ectopic kidney were treated surgically in our hospital. Definite diagnoses were established in all the cases by ultrasound, intravenous urography (IVU), cystoscope, CT, magnetic resonance urography (MRU) and radionuclide imaging before the surgery. In these patients, 26 had ipsilateral ectopic ureteral orifice (including 5 with bilateral duplicated kidneys and ureter), 9 had moderate or severe hydronephrosis (including 3 with ectopic kidney calculi), and 24 had dysplastic kidney (24/35). All the patients underwent operations, including 26 with ectopic nephrectomy, 7 with ectopic ureterovesical reimplantation, and 3 with ectopic renal pelvis incision.

RESULTSThe clinical effect was satisfactory in all the cases during the follow up of 7 to 29 months.

CONCLUSIONAppropriate surgical approaches according to the concurrent deformities and complications can achieve good clinical results in patients with ectopic kidneys.

Abnormalities, Multiple ; diagnosis ; surgery ; Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Humans ; Kidney ; abnormalities ; surgery ; Nephrectomy ; methods ; Ureter ; abnormalities ; surgery ; Young Adult

OBJECTIVE: To investigate the feasibility and safety of substituting tacrolimus(FK506) for cyclosporin A(CsA) on delaying the pace of renal dysfunction in patients with biopsy-proven chronic allograft nephropathy(CAN). METHODS: Seventy-three renal transplantation patients with CAN proved by allograft biopsy were collected in this study. Patients were randomly divided into 2 groups. Patients were either converted to FK506(FK506 group, n=43) or remained on their initial CsA-based immunosuppression(CsA group, n=30). The clinical data at study entry and after 12 months including blood urea nitrogen(BUN), serum creatinine(SCr), glomerular filtration rate(GFR), 24-hour urine protein excretion, serum total cholesterol(TC), triglyceride(TG), low density lipoprotein(LDL) and the side effects of calcineurin inhibitors were monitored during a follow-up of over 12 months. RESULTS: Twelve months later, the level of SCr was statistically reduced and GFR levels were obviously elevated in the FK506 group as compared with CsA group [(194.8+/-42.5)micromol/L vs. (245.4+/-52.8)micromol/L and (50.14+/-3.92)mL/(min.1.73 m(2)) vs. (40.58+/-2.49)mL/(min.1.73 m2), P<0.01]. Quantity of 24-hour urine protein excretion in the FK506 group was (2.0+/-0.5)g which is significantly lower than (3.9+/-0.7)g in the CsA group(P<0.01). TC, TG, and LDL levels remained unchanged in the CsA group, while those were statistically reduced in the FK506 group respectively [(5.19+/-0.73)mmol/L vs. (6.94+/-1.37)mmol/L, (1.86+/-0.84)mmol/L vs. (3.14+/-1.38)mmol/L, (3.03+/-0.71)mmol/L vs. (3.82+/-0.89)mmol/L, P<0.01]. Tremor obviously increased (P<0.01) and hypertension obviously decreased (P<0.05) in the FK506 group compared with the CsA group. CONCLUSION FK506 treatment can greatly improve the proteinuria and hyperlipidemia. Conversion from CsA to FK506 is an effective and safe alternative therapy for delaying the progression of renal dysfunction induced by CAN.
Adult ; Aged ; Cholesterol ; blood ; Creatinine ; blood ; Cyclosporine ; therapeutic use ; Female ; Follow-Up Studies ; Glomerular Filtration Rate ; Graft Rejection ; complications ; Humans ; Immunosuppressive Agents ; therapeutic use ; Kidney Failure, Chronic ; blood ; drug therapy ; etiology ; Kidney Transplantation ; adverse effects ; Lipoproteins, LDL ; blood ; Male ; Middle Aged ; Tacrolimus ; therapeutic use ; Treatment Outcome ; Triglycerides ; blood

OBJECTIVESevere acute respiratory syndrome (SARS) is an emerging infectious disease that first manifested in humans in November 2002. The SARS-associated coronavirus (SARS-CoV) has been identified as the causal agent, but the pathology and pathogenesis are still not quite clear.

METHODSPost-mortem lung samples from six patients who died from SARS from April to July 2003 were studied by light and electron microscopy, Masson trichromal staining and immunohistochemistry. Evidence of infection with the SARS-CoV was determined by reverse-transcription PCR (RT-PCR) , serological examination and electron microscopy.

RESULTSFour of six patients had serological and RT-PCR evidence of recent infection of SARS-CoV. Morphologic changes are summarized as follows: (1) Diffuse and bilateral lung consolidation was seen in all patients (6/6) with increasing lung weight. (2) Diffuse alveolar damage was universal (6/6) with hyaline membrane formation (6/6), intra-alveolar edema/hemorrhage (6/6), fibrin deposition (6/6), pneumocyte desquamation (6/6). A marked disruption in the integrity of the alveolar epithelium was confirmed by immunostaining for the epithelial marker AE1/AE3 (6/6). (3) Type II pneumocytes, with mild hyperplasia, atypia, cytomegaly with granular amphophilic cytoplasm and intracytoplasmic lipid accumulation (5/6). (4) Giant cells in the alveoli were seen in five of 6 patients (5/6) , most of which were positive for the epithelial marker AE1/AE3 (5/6), but some cells were positive for the macrophage marker CD68(2/6). (5) A pronounced increase of macrophages were seen in the alveoli and the interstitium of the lung (6/6), which was confirmed by histological study and immunohistochemistry. (6) Haemophagocytosis was present in five of the 6 patients(5/6). (7) Lung fibrosis was seen in five patients(5/6), with alveolar septa and interstitium thickening(5/6), intraalveolar organizing exudates (6/6) and pleura thickening (4/6). Proliferation of collagen was confirmed by Masson trichromal staining, most of which was type III collagen by immunostaining. The formation of distinctive fibroblast/myofibroblast foci was seen in five patients (5/6) by light microscopy and immunochemistry. (8) Squamous metaplasia of bronchial mucosa was seen in five patients(5/6). (9) Thrombi was seen in all patients(6/6). (10) Accompanying infection was present in two patients, one was bacteria, the other was fungus. In addition, electron microscopy revealed viral particles in the cytoplasm of alveolar epithelial cells and endothelial cells corresponding to coronavirus.

CONCLUSIONDirect injury of SARS-CoV on alveolar epithelium, prominent macrophage infiltration and distinctive fibroblast/myofibroblast proliferation may play major roles in the pathogenesis of SARS.

Adult ; Antibodies, Monoclonal ; metabolism ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Epithelium ; pathology ; Female ; Humans ; Keratins ; immunology ; Lung ; pathology ; ultrastructure ; virology ; Male ; Middle Aged ; Pulmonary Alveoli ; pathology ; Pulmonary Fibrosis ; etiology ; pathology ; SARS Virus ; isolation & purification ; Severe Acute Respiratory Syndrome ; complications ; metabolism ; pathology ; virology

OBJECTIVETo explore the occupational and reproductive health problems of migrant female workers in electron factory.

METHODSA total number of 2000 female migrant workers were randomly sampled from three electronic factories for the study. All were investigated by questionnaire and data were input to EpiData 3.0 data base, SPSS17.0 statistical software and analyzed by Chi-square test.

RESULTS1971 complete questionnaires were received, the recovery rate reached over 98.6%. The average age of interviewees is (21.1 ± 3.9) years. Junior employee between 16 and 18 years accounted for 19.04%. The average working age was (1.1 ± 2.2) years and about 90% were single including 0.11% of them were divorced. The main occupational hazards were: sodium hydroxide, sodium carbonate, formaldehyde, hydrochloric acid, stannic anhydride, benzene analogues, n-hexane methanol, glycol isopropanol, sulphuric acid, nitric oxide, noise, ultraviolet radiation, etc. Workplace monitoring indicated that benzene and noise levels and ultraviolet radiation were over the national OEL at fewer worksites. More than 50% female workers worked over 8 hours per day and 83% of them worked 22 days per month. The ergonomic problems: 63.86% of them worked with tedious repetitiveness and monotonous job task. About 42% of them need to be continuously with standing posture. As a consequence, there were 30% workers complain about LBP, 21% had experienced work injury; 15% ∼ 18% had some non-specific discomfort, such as insomnia, dysacusis, dizzy and headache. The incidence rate of reproductive system such as abnormal menstrual cycle (5.71%), dysmenorrhea (25.11%), congestion (8.91%), etc. The first four reproductive system disease were pelvic inflammation, adnexitis, cervical erosion, and vaginitis. There are significant differences between continuous and temporary standing work, and repeated and unrepeated job action in terms of dysmenorrheal and congestion related-discomfort(P < 0.05).

CONCLUSIONThere are many occupational hazards in electronic industry. And there is somewhat a serious occupational and reproductive health problems among female migrant workers, that seem to be a matter of great concern.

Adolescent ; Adult ; Female ; Health Status ; Humans ; Industry ; Occupational Exposure ; Occupational Health ; Reproductive Health ; Surveys and Questionnaires ; Transients and Migrants ; Workplace ; Young Adult