Objective To investigate the diagnostic significance of sensory nerve action protential (SNAP) on diabetic neuropathy (DN), through measuring amplitude and amplitude ratio. Methods There were 91 patients with type 2 diabetes involing 51 cases without neurologic symptom/sign as subgroup Ⅰ, 30 cases with mild neuropathy as subgroup Ⅱ and 10 cases with severe neuropathy as subgroup Ⅲ, according to Toronto clinical scoring system (TCSS). Thirty-nine healthy volunteers with age- and gender-matched were served as controls. SNAP were antidromically recorded using surface electrodes. The observed parameters were as follows: conduction velocity and amplitude of median, radial and sural nerve, shorten for Vine, Vra and Vsu and Ame, Ara and Asu, respectively; sural/radial nerve amplitude ratio (SRAR) and median/ radial nerve amplitude ratio (MRAR). Results (1) As compared with the controls (P<0.05),conduction velocity (m/s, Vine : 46. 2 ±7.3, Vra: 45.8±6. 9, Vsu: 30. 3±9. 5) and amplitude (μV, Am: 15.4±10.5, Ar: 16.6±9.8, As: 5.9±6. 3)decreased significantly in subgroup Ⅲ; Vsu (46.2± 4. 7) significantly slowed in subgroup Ⅱ (P = 0. 002) ; both Ame (34. 5 ± 10. 2, 33. 0 ± 14. 6) and Asu (13.8± 5.6, 10.7 ± 5.5) decreased significantly in both subgroup Ⅰ and Ⅱ respectively, with Asu decreasing more significantly in subgroup Ⅱ (Z=- 3.22, P = 0. 001) ; SRAR (0. 432±: 0. 112) was significantly smaller only in subgroup Ⅰ , both SRAR (0. 330 ±0. 102) and MRAR (1. 008 ± 0. 225) were significantly smaller in subgroup Ⅱ. SRAR decreased more significantly in subgroup Ⅱ (t = - 3. 86, P = 0. 003). (2) The abnormal rate of Ame was the highest in subgroup Ⅰ (26. 0%), and Asu in subgroup Ⅱ (41.4%) ; while that of combination of Asu and SRAR (68.9%) was significantly higher than that of Asu alone (x2 = 9. 212, P = 0. 003). (3) TCSS scores were negatively related to Van (r = - 0. 583), Ame (r=-0. 406), Asu (r=-0.620) and SRAR (r=-0.527, all P<0.05), and there was no significant correlation of TCSS scores with MRAR in subgroup Ⅱ; both SRAR (r = -0.435) and MRAR (r = - 0. 319) were negatively related to the diabetic duration (both P < 0. 05). Conclusions In mild or early DN, SNAP amplitude is more sensitive than conduction velocity, combination of SRAR and Vsu may be serve as a useful indication for early diagnosis. In the DN patient, diabetic duration has more influence on the measurement of sensory NCS, and SRAR is related to the severity of neuropathy.

【Objective】 To understand the antigen profile and antibody frequency of Wr^a in voluntary blood donors in Shaanxi province. 【Methods】 Wr^a antigen and antibody screening as well as blood group typing and antibody identification were performed by serological tests and confirmed by genetic testing. 【Results】 The incidence of Wr^a antigen in 7 490 voluntary blood donors was 0.013%(1/7 490), and the frequency of anti-Wr^a in 729 voluntary blood donors was 0.823%(6/729). 【Conclusion】 This study explored the polymorphism of Wr^a antigen and antibodies in blood donors, which is informative in the risk assessment of blood transfusion and the screening and identification of respective antibodies.

OBJECTIVETo investigate DNA repair in CHL cells and HeLa cells after DNA damage induced by different oxidative agents.

METHODSCHL cells and HeLa cells were exposed to various damaging agents, CHL cells: H(2)O(2) for 25 min, K(2)Cr(2)O(7) for 105 min, doxorubicin (Dox) for 75 min HeLa cells: H(2)O(2) for 25 min, K(2)Cr(2)O(7) for 105 min; then cells were continuously cultured for 0-3 h after washing. Alkaline single cell gel electrophoresis (ASCGE) assay was used to detect DNA strand breaks.

RESULT(1) DNA strand breaks were induced in CHL cells after exposure to H(2)O(2) K(2)Cr(2)O(7) or Dox, which were repaired evidently after continuous culture for 1 h(P<0.01). The damages induced by H(2)O(2) or K(2)Cr(2)O(7) were repaired completely after culture for 2-3 h. However, the demage induced by Dox was repaired incompletely. (2) DNA strand breaks were induced also in HeLa cells after exposure to H(2)O(2) or K(2)Cr(2)O(7), which were repaired evidently after continuous culture for 0.5 h(P<0.01),and completely after culture for 1 h. (3) The regression coefficient related to the rate of comet cells and repair time was statistically different (P<0.05) between CHL cells and HeLa cells.

CONCLUSIONDNA damage induced by Dox is repaired more difficult than that induced by H(2)O(2) or K(2)Cr(2)O(7). The repair initiates immediately after DNA damage in both of cells, but more rapidly in HeLa cells than in CHL cells.

DNA ; metabolism ; DNA Damage ; DNA Repair ; HeLa Cells ; Humans ; Hydrogen Peroxide ; toxicity ; Oxidation-Reduction ; Regression Analysis

Objective To assess the effectiveness of nocturnal splinting on carpal tunnel syndrome (CTS) by clinical scores and nerve conduction studies (NCS), and explore their correlations.Methods Forty-one patients (64 wrists), chosen from 66 consecutive patients with CTS from April 2009 to January 2010 meeting the inclusion criteria, were enrolled. The enrolled subjects were clinically evaluated by symptom severity scale (SSS) and functional status scale (FSS), and electrophysiologically evaluated by conventional nerve conduction studies (NCS); distal motor latency (DML) of wrist-abductor pollicis brevis, sensory conduction velocity (SCV) of wrist-index finger and wrist-ring finger, and the differences of distal sensory latency between the median and ulnar nerves (△DSL) were measured. The patients were instructed to use each splint on dorsal and palmar surface of the hand, centered at the distal wrist crease, to fix the wrist in neutral posture at bedtime. SSS, FSS and NCS were evaluated before splinting and (3.03±1.16) months after splinting; the follow-up was completed in 29 patients (31 wrists).Results (1) The abnormality rates of DML, wrist-index finger SCV, wrist-ring finger SCV and△DSL were 85.9%, 78.1%, 81.3% and 96.9%, respectively. (2) The SSS scores (1.55±0.38), FSS scores (1.40±0.27) and△DSL (1.24±0.61) after splinting was significantly decreased as compared with those before splinting (1.77±0.38, 1.53±0.31, 0.97±0.60); and the DML [4.14±0.76 (ms)] after splinting was significantly shortened as compared with that before splinting [4.53±1.25 (ms)]. No improvement of clinical scores was noted in 9 patients (14 wrists, 45.8%) after splinting. (3) The SSS scores were less significantly correlated to DML (r=0.420, P=0.019), wrist-index finger SCV (r=-0.425, P=0.017),wrist-ring finger SCV (r=-0.519, P=0.003), and no correlation between SSS scores and△DSL was noted (r=0.189, P=0.309); no correlation between FSS scores and the parameters of NCS was found either (P＞0.05). Conclusions Splinting is effective at least in a short-term in more than halfpatients with CTS.Little correlation is noted between clinical scores and NCS, suggesting that utilization both approaches to assess the therapeutic effect is of more significance. △DSL is the most sensitive parameter in the electrodiagnosis of CTS.

OBJECTIVEWernicke's encephalopathy (WE) is an acute neuropsychiatric syndrome resulting from thiamine deficiency, which is associated with significant morbidity and mortality. The disorder is still greatly underdiagnosed in children because of either a relatively non-specific clinical presentation in some cases or unrecognized clinical setting. The aim of this literature review was to provide knowledge of pediatric WE in an effort to assist in early diagnosis, thereby reducing the morbidity and mortality.

METHODSThe clinical manifestations, characteristic magnetic resonance imaging (MRI), diagnosis and treatment of one case and the other 35 cases reported in the last decade in children were summarized.

RESULTSThirty-six cases (22 boys and 14 girls, 2-month to 16-year-old) were analyzed. All the other 35 cases except for our case had underlying diseases: improper feeding in 25/35 cases, long-time vomiting in 5/35 cases, immunosuppressive therapy in 4/35 cases, long-time total parenteral nutrition without multivitamin preparations supplementation in 3/35 cases and anorexia nervosa in 1/35 case. The classic triad (mental-status changes, nystagmus and ophthalmoplegia, and ataxia) was seen in 6/36 cases. The other clinical manifestations included consciousness disturbance in 24/36 cases, infection in 22/36 cases, pathological reflex and muscular tension changes in 18/36 cases, convulsion in 17/36 cases, developmental delay in 4/36 cases and failure to thrive in 2/36 cases. Cerebrospinal fluid examination was performed in 31/36 cases, and a slightly raised protein concentration was seen in 7/31 cases. The cerebrospinal fluid lactate levels were detected in 4/36 cases (all increased), serum lactic acid levels in 7/36 cases (6/7 cases increased), serum pyruvate in 4/36 cases (all increased), thiamine pyrophosphate effect (TPPE) in 9/36 cases (all increased), and serum thiamine in 2/36 cases (increased in 1/2 cases). The brain computed tomography (CT) scan was conducted in 20/36 cases and 16/20 cases showed abnormal hypodensity in bilateral basal ganglia, one case revealed diffuse cortical atrophy. The brain MR scan was conducted in 13/36 cases and all the 13 cases revealed symmetrical abnormal signal in bilateral mamillary body and basal ganglia, and 7/13 cases showed abnormal signals in the tegmentum of midbrain, cerebral aqueduct and white matter around the third and fourth ventricles. The diagnosis of WE was confirmed by MR in 12 cases, triad combined with MR in 3 cases, autopsy in 1 case among the 13 cases who underwent MR scan. The diagnosis of WE was confirmed by the TPPE and/or lactate levels in 9/11 cases. The initial thiamine was given by intravenous or intramuscular infusion in 33/36 cases, unknown method in 1 case, orally in 1 case and no thiamine was used in 1 case. The dosage of thiamine was 100 mg daily in 29/35 cases, unknown in 3/35 cases, 50 mg daily in 2/35 cases, 600 mg daily in 1/35 case. 34/35 patients' clinical symptoms improved during 24 hours to 1 week after initial treatment, and 1 case died due to no response to thiamine. Nineteen patients were followed up for 2-2.5 months and 17 cases recovered completely.

CONCLUSIONWernicke's encephalopathy can be difficult to diagnose because of a relatively non-specific clinical presentation. The characteristic MRI findings and the dramatic response of neurological signs to parenteral thiamine will assist early clinical diagnosis. Early and timely thiamine supplementation could reverse the clinical features and improve the prognosis in most cases.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Sepsis ; complications ; Wernicke Encephalopathy ; complications ; diagnosis

OBJECTIVETo examine the activation and cytotoxicity of human peripheral blood T lymphocyte induced in vitro by human 4-1-BB ligand (4-1-BBL) gene transfected into tumor Tca8113 cells.

METHODSThe eukaryotic expression vector pEGFP-h4-1-BBL was transfected into human oral carcinoma cell line Tca8113 by Lipofectamine 2000. The transfected cells were then selected in medium containing G-418, cloned by limited dilution and named as Tca8113-4-1-BBL. Human 4-1-BBL mRNA and protein expression of transfected cells was detected by reverse transcriptase-polymerase chain reaction (RT-PCR) and western blotting respectively. The tumor cell vaccines (TCV) were obtained by treatment with mitomycin (MMC). Human peripheral blood mononuclear cells (PBMC) were prepared from lymphoprep, and then stimulated with anti-CD-3 mAb and incubated with non-transfected or transfected TCV-Tca8113 cells, respectively. The proliferation of T cells was evaluated by trypan blue exclusion; the CCK-8 was used to detect the cytotoxic effect of T lymphocytes. Meanwhile, the secretion of interferon-gamma (IFN-gamma) and interleukin (IL)-2 in culture supernatant was detected by enzyme-linked immunosorbent assay (ELISA).

RESULTSThe Tca8113 cells transfected by pEGFP-h4-1-BBL could express human 4-1-BBL efficiently. As compared with wild type Tca8113 cells, the transfected Tca8113 cells could markedly promote proliferation, IL-2 and IFN-gamma production and cytotoxic activity of lymphocytes.

CONCLUSIONSThe transfection of human 4-1-BBL gene in Tca8113 cells is effective in enhancing its immunogenicity and inducing antitumor immune response in vitro.

4-1BB Ligand ; genetics ; Carcinoma, Squamous Cell ; genetics ; immunology ; Cell Line, Tumor ; Cell Proliferation ; Genetic Vectors ; Humans ; Interferon-gamma ; immunology ; Interleukin-2 ; immunology ; Lymphocyte Activation ; Mouth Neoplasms ; genetics ; immunology ; T-Lymphocytes, Cytotoxic ; immunology ; Transfection

OBJECTIVETo investigate the clinicopathological characteristics, differential diagnosis and prognosis of testicular cellular fibroma.

METHODSWe comprehensively analyzed the clinical presentation, histomorphology and immunohistochemistry of a case of testicular cellular fibroma, reviewed the relevant literature, and discussed its pathological features and differential diagnosis.

RESULTSA 30-year-old man presented with complaint of discomfort and painless enlargement in the right testis. The tumor was found to be a testicular fibroma characterized by a solid, thickly or thinly encapsulated, circumscribed and gray-white mass. Microscopically, fusiform cells were arranged into a storiform and herringbone pattern or fascicles. The tumor exhibited a great deal of cellularity and no nuclear polymorphisms, with a mitotic rate of 0-1/10 HP. Immunohistochemistry showed that the tumor cells were positive for Vimentin, patchily positive for S-100 and SMA, but negative for Desmin, alpha-inhibin, CD34 and CD99. The positive rate of Ki-67 was less than 1%.

CONCLUSIONTesticular cellular fibroma is a rare testicular sex cord stromal tumor, pathologically resembling its ovarian counterpart. It can be distinguished from other testicular spindle cell tumors by morphology and immunohistochemical staining. For the treatment of testicular cellular fibroma, surgical resection often has a good prognosis.

Adult ; Fibroma ; pathology ; Humans ; Immunohistochemistry ; Male ; Testicular Neoplasms ; pathology

Objective To review the existing literature and quantitatively evaluate the association of circulating vaspin levels and the risk of gestational diabetes mellitus ( GDM) ． Methods We systematically searched the PubMed，EMBASE，Web of Science，China National Knowledge Infrastructure，and WanfangData databases up to June 2019． Pooled standardized mean differences ( SMDs) with 95% confidence intervals ( CIs) were calculated using random－ or fixed－effects models based on the heterogeneity of studies． Subgroup analyses，Meta－regression，sensitivity and publication bias were assessed to analyze the heterogeneity and the robustness of the results． All statistical analyses were performed using STATA 12．0． Ｒesults Nine articles ( 11 comparisons) published from 2013 to 2019 were included in our final Meta－analysis，covering a total of 738 patients with GDM and 661 normal pregnant women． There was significant difference in the overall maternal circulating vaspin levels between GDM patients and healthy pregnant women ( SMD= 0．613，95% CI: 0．044－1．182，P= 0．035) ． Subgroup analyses stratified by trimester in which vaspin was measured and whether BMI was matched suggested the similar trend to the overall result． Subgroup analysis according to ethnicity found that circulating vaspin level might not be related to GDM in " European" subgroup; sensitivity analysis by excluding moderate－quality studies and BMI－unmatched studies found that circulating vaspin levels were still related to GDM risk． Conclusions Our Meta－analysis indicated that maternal circulating vaspin levels might be positively correlated with the risk of GDM in Asians．

OBJECTIVESTo explore the category, quantity and clinical significance of autoantibodies on bone marrow hematopoietic cells in patients with immunorelated cytopenia and evaluate the sensitivity of direct antiglobulin reaction (Coombs test ) of bone marrow mononuclear cells (BMMNC).

METHODSThe category and the positive rate of autoantibodies on bone marrow hematopoietic stem cells, nucleated erythrocytes, granulocytes in 32 patients with uncertain immunorelated cytopenia were investigated by using BMMNC-Coombs test and double immunofluorescence flow cytometry.

RESULTSThe positive rate of autoantibodies on bone marrow hematopoietic cells tested by flow cytometry was 90.63% which was higher than that by BMMNC-Coombs test (50.0%) (p < 0.05). In 29 positive cases, IgG autoantibody accounted for 6.90%, IgM13.8%, IgG+IgA 3.4%, IgG+IgM 31.0%, and IgG+IgM+IgA 44.8%. Of the 29 Patients, 25 (86.2%) with IgG autoantibody, 26 (89.7%) with IgM and 14 (48.3%) with IgA. The patients with IgG autoantibody alone had the lowest hemoglobin levels, and those with IgM autoantibody might have intravascular hemolytic findings. The response time of patients with IgG and IgG+IgM was shorter than that of the other patients. 91.3% of the patients had autoantibodies on bone marrow hematopoietic stem cells and showed pancytopenia, and 50% of the patients had autoantibodies on nucleated erythrocytes and granulocytes. Eleven of 13 patients with negative BMMNC-Coombs tests had autoantibodies on bone marrow hematopoietic stem cells detected by FACS. There was no significant difference of the quantities of the three categories of autoantibodies of nucleated erythrocytes and stem cells. The quantities of IgA on granulocytes were lower than that of IgG and IgM. There was no significant difference between IgG and IgM on granulocytes. The quantity of IgA on hematopoietic stem cells was significantly higher than that on nucleated erythrocytes or granulocytes.

CONCLUSIONSThe sensitivity of double immunofluorescence flow cytometry assay was higher than that of BMMNC-Coombs test for detecting autoantibodies. In immunorelated cytopenia patients, the predominant autoantibody was IgM which could cause intravascular hemolysis, and the second one was IgG which could cause severe anemia. Most immunorelated cytopenia patients had autoantibodies on hematopoietic stem cells and showed pancytopenia. IgA was more easily seen on the hematopoietic stem cells.

Adolescent ; Adult ; Aged ; Autoantibodies ; classification ; metabolism ; Autoimmune Diseases ; immunology ; Bone Marrow Cells ; immunology ; Child ; Coombs Test ; Female ; Flow Cytometry ; Humans ; Immunoglobulin A ; metabolism ; Immunoglobulin G ; metabolism ; Immunoglobulin M ; metabolism ; Male ; Middle Aged ; Pancytopenia ; immunology

OBJECTIVETo detect the quantity, proportion and function of producing cytokines of Th1 and Th2 cells in aplastic anemia (AA) patients and their contribution to the hematopoietic failure.

METHODS(1) Eleven patients with severe aplastic anemia (SAA) at diagnosis were observed by Marsh's method for the CFU-E, BFU-E and CFU-GM before and after depletion of CD(4)(+) T lymphocytes from bone marrow mononuclear cells (BMMNC); (2) Th1 (CD(4)(+) IFN-gamma(+)) and Th2 (CD(4)(+) IL-4(+)) cells in peripheral blood mononuclear cells (PBMNC) of 21 SAA patients and 17 normal controls were counted by FACS. (3) mRNA expression of IFN-gamma and IL-4 gene in unstimulated BMMNC from 16 SAA patients, 11 chronic aplastic anemia (CAA) patients, 26 other hematological diseases patients and 11 normal controls were measured by reverse transcriptase polymerase chain reaction (RT-PCR).

RESULT(1) CFU-E, CFU-GM and BFU-E increased significantly after depletion of CD(4)(+) T lymphocytes from BMMNC of SAA patients. (2) The percentage of IFN-gamma producing CD(4)(+) T cell (Th1) of SAA patients was significantly higher than that of controls, the percentages of IL-4 producing CD(4)(+) T cells (Th2) had no difference between SAA patients and normal controls. (3) IFN-gamma mRNA was detected in unstimulated BMMNC in 13 of 16 SAA patients, 6 of 11 CAA patients and one of 6 paroxysmal nocturnal hemoglobinuria (PNH) patients. The IFN-gamma mRNA was not detected in unstimulated BMMNC of 11 normal controls and other hematological diseases patients.

CONCLUSIONSDisbalance of CD(4)(+) T lymphocytes subsets and increases in quantity and IFN-gamma producing function of Th1 cells might be important for the development of bone marrow failure in AA and in distinguishing AA from other kinds of pancytopenic diseases.

Adolescent ; Adult ; Anemia, Aplastic ; blood ; etiology ; Colony-Forming Units Assay ; Erythroid Precursor Cells ; cytology ; Female ; Granulocytes ; cytology ; Hematopoietic Stem Cells ; cytology ; Humans ; Interferon-gamma ; genetics ; Interleukin-4 ; genetics ; Macrophages ; cytology ; Male ; Middle Aged ; RNA, Messenger ; genetics ; metabolism ; Th1 Cells ; cytology ; metabolism ; physiology ; Th2 Cells ; cytology ; metabolism