Objective To determine the cardiac and renal arteriole pathological changes in autopied elderly hypertensive patients with left vcntricular hypertrophy (LVH).Methods Autopsy samples from 25 essential hypertension (EH) patients with LVH aged over 60 years and age-matched 8 controls were analyzed.LVH was further divided into three degrees from Ⅰ to Ⅲ according to left ventricular free wall thickness in EH patients.Quantitative measurements of arteriolar morphometric parameters in heart and kidney were performed under light microscope with computer image analysis post HE and Maeson staining.The lesion index and plasma albumen infiltration of arteriole were evaluated by the semiquantitative method.Results The inner diameter (ID) and lamina] cross-sectional area (LCSA) were significantly decreased while wall thickness (WT),wall cross-sectional area (WCSA),ratio of WCSA to LCSA (WCSA/LCSA) and ratio of WT to ID (WT/ID) were significantly increased in EH patients in proportion to LVH degree.Both cardiac and renal arterioles WCSA/LCSA and WT/ID were significantly decreased with increasing outer diameters (OD).Under the same OD rang,the pathological changes were more significant in the renal arterioles compared to those in the cardiac arterioles (P＜0.05).The arterio]ar lesion index and the plasma albumen infiltration index of cardiac and renal arterioles in EH group were significantly higher than those in the control group (P＜0.01) and the arteriolar lesion index and the plasma albumen infiltration of arteriole in the renal tissue were significantly higher than those in the cardiac tissue (P＜0.01).Conclusion Concentric remodeling occurs in the cardiac and renal arterioles of EH patients in proportion to LVH degree and renal arterioles lesions were significantly severer than that of cardiac arterioles in EH patients with LVH.

High mobility group A2 protein (HMGA2), an architectural factor, is highly expressed in various cancer types including lung cancers. It is a candidate target for cancer therapy. RNAi is an effective gene silencing method with low cost and less time-consuming. It is possible to exploit this technology in therapy. Here, 5 siRNAs targeting Hmga2 gene (HMGA2 siRNA1-5) were designed and synthesized. MTT assay, colony formation assay, transwell assay and flow cytometry were used to evaluate the effects of these siRNAs on lung cancer cell lines (NCI-H446 and A549). Results from cell proliferation, clone formation, migration and apoptosis showed that HMGA2 siRNA1, 3, 5 could affect these aspects for both lung cancer cell lines. Among the five siRNAs, HMGA2 siRNA5 showed the greatest inhibition effects. The inhibition effects of HMGA2 siRNA5 are sequence specific and are not due to the induction of interferon response. Taken together, siRNAs targeting Hmga2 gene are potential candidates for lung cancer gene therapy.
Apoptosis ; Cell Line, Tumor ; Cell Movement ; Cell Proliferation ; Colony-Forming Units Assay ; Gene Silencing ; Genetic Therapy ; HMGA2 Protein ; genetics ; metabolism ; Humans ; Interferons ; metabolism ; Lung Neoplasms ; genetics ; metabolism ; pathology ; Point Mutation ; RNA, Messenger ; metabolism ; RNA, Small Interfering ; genetics ; Transfection

Objective To explore the efficacy and safety of autologous peripheral blood stem cell transplantation (APBSCT) in the treatment of systemic lupus erythematosus.Methods Nine patients with systemic lupus erythematosus were enrolled in this study.Patients were given cyclophosphamide and granu- locyte colony-stimulating factor(G-CSF)as the mobilization regimen.Urine was alkalinized and hydrolyzed to protect the function of the heart,liver and kidney of the patients.A CS3000 Plus blood cell separator was used to collect peripheral blood stem cells,which were preserved in liquid nitrogen.Two to five days before the administration of the stem cells,the patients were pretreated with intravenous injection of cyclophos- phamide (50 mg?kg~(-1)?day~1) for 4 consecutive days and antithymocyte globulin (ATG,2.5 mg?kg~(-1)?day~1) for 3 consecutive days.Granulocytes were recoverd by G-CSF stimulation.Then,the peripheral blood stem cells were reinfused.Therapeutic effect was evaluated by assessment of alteration of clinical manifestation (skin erythema),levels of proteinuria and antoantibodies,hematopoietic reconstitution and occurrence of transplantation related complications.Results After transplantation,all patients had been successfully en- grafted.The time for peripheral leucocyte count to reach 1.0?10~9/L was 7～15d;the time for platelets to reach 20?10~9/L was 0～21 d.The skin erythema resolved in all patients;proteinuria decreased to normal level and the autoantibodies became negative in most of the patients.Serum sickness-like response occurred in all patients,renal and heart failure in 1 patient,hemorrhagic cystitis in 3 patients,psychiatric disorders in 1 patient,candidal infection in 1 patient.Conclusion One-year follow up suggests that autologous stem cell transplantation is markedly effective and relatively safe for systemic lupus erythematosus.However,the duration of remission remains to be investigated in a long-term follow up study.

Objective To explore the association of serum cytokine levels with disease activity in patients with dermatomyositis (DM) and clinically amyopathic dermatomyositis (CADM),especially their association with skin lesions and interstitial lung disease (ILD).Methods Enzyme-linked immunosorbent assay (ELISA) and cytometric beads array (CBA)were performed to detect the serum levels of interleukin (IL)-2,IL-4,IL-6,IL-10,IL-17A,IL-18,tumor necrosis factor (TNF) and interferon (IFN)-γin 40 patients with DM or CADM,as well as in 16 health checkup examinees (healthy control group).Then,the association of serum cytokine levels with skin lesions,inflammatory biomarkers and severity of ILD was analyzed.Results The patients with DM/CADM showed significantly higher serum levels of IL-6 (37.8 ±45.8 pg/ml),IL-10 (16.1 ± 7.2 pg/ml) and IL-18 (492.0 ± 193.1 pg/ml) compared with the healthy controls (12.0 ± 2.7 pg/ml,7.7 ± 1.4 pg/ml,191.1 ± 39.2 pg/ml,respectively,all P ＜ 0.001),and there were no significant differences in the serum levels of the other 5 cytokines between the above 2 groups.The serum level of IL-6 was significantly higher in patients with elevated erythrocyte sedimentation rate (ESR) than in those with normal ESR (49.7 ± 46.8 pg/ml vs.29.1 ± 45.4 pg/ml,P =0.008).The patients with raised C-reactive protein (CRP) levels showed significantly higher serum levels of IL-6 (68.7 ± 59.7 pg/ml) and IL-18 (635.1 ± 232.8 pg/ml) compared with those with normal CRP levels (IL-6:30.6 ± 40.3 pg/ml,P =0.013;IL-18:440.2 ± 164.7 pg/ml,P =0.020).Moreover,the patients with elevated levels of lactate dehydrogenase (LDH) showed significantly higher serum levels of IL-10 (18.4 ± 6.9 pg/ml),IL-17A (19.6 ±6.7 pg/ml) and IL-18 (529.4 ± 197.2 pg/ml) compared with those with normal LDH levels (IL-10:10.7 ±4.8 pg/ml,P ＜ 0.001;IL-17A:11.4 ± 6.6 pg/ml,P =0.001;IL-18:404.9 ± 158.0 pg/ml,P =0.037).No significant difference in the cytokine levels was observed between the patients with elevated creatine kinase (CK) levels and those with normal CK levels.The patients with Gottron's papules/sign showed significantly higher serum levels of IL-18 (513.7 ± 187.2 pg/ml) compared with those without Gottron's papules/sign (297.1 ± 140.4 pg/ml,P ＜ 0.05).The serum levels of IL-10 and IL-18 were significantly higher in the patients with DM/CADM complicated by ILD (18.0 ± 6.7 pg/ml,552.3 ± 192.8 pg/ml,respectively) than in those without ILD (11.6 ± 6.5 pg/ml,351.4 ± 101.0 pg/ml,respectively,both P =0.001).Conclusion Serum levels of IL-6,IL-10 and IL-18 are highly associated with inflammatory biomarkers,skin lesions and ILD in patients with DM/CADM.

Rational nutritional support shall be based on nutritional screening and nutritional assessment.This study is aimed to explore nutritional risk screening and its influencing factors of hospitalized patients in central urban area.It is helpful for the early detection of problems in nutritional supports,nutrition management and the implementation of intervention measures,which will contribute a lot to improving the patient's poor clinical outcome.A total of three tertiary medical institutions were enrolled in this study.From October 2015 to June 2016,1202 hospitalized patients aged ≥18 years were enrolled in Nutrition Risk Screening 2002 (NRS2002) for nutritional risk screening,including 8 cases who refused to participate,5 cases of same-day surgery and 5 cases of coma.A single-factor chi-square test was performed on 312 patients with nutritional risk and 872 hospitalized patients without nutritional risk.Logistic regression analysis was performed with univariate analysis (P＜0.05),to investigate the incidence of nutritional risk and influencing factors.The incidence of nutritional risk was 26.35％ in the inpatients,25.90％ in male and 26.84％ in female,respectively.The single-factor analysis showed that the age ≥60,sleeping disorder,fasting,intraoperative bleeding,the surgery in recent month,digestive diseases,metabolic diseases and endocrine system diseases had significant effects on nutritional risk (P＜0.05).Having considered the above-mentioned factors as independent variables and nutritional risk (Y=1,N=0)as dependent variable,logistic regression analysis revealed that the age ≥60,fasting,sleeping disorders,the surgery in recent month and digestive diseases are hazardous factors for nutritional risk.Nutritional risk exists in hospitalized patients in central urban areas.Nutritional risk screening should be conducted for inpatients.Nutritional intervention programs should be formulated in consideration of those influencing factors,which enable to reduce the nutritional risk and to promote the rehabilitation of inpatients.

OBJECTIVETo analyze the molecular characteristics and genetic correlations of Vibrio cholerae isolates in Hainan in 2008, so as to provide pathogenic proof to diagnose the plague.

METHODSSeventy six cholera strains were isolated from this cholera epidemic.69 strains were obtained from patients, 7 were isolated from external environment, among which, one was from patient's toilet, one from water sample, three were isolated from fish pond near patient's home, one came from swab of the patient vomit on the ground of health center and one from swab of kitchen knife from Hainan University canteen respectively. With conventional aetiological methods, pulse-field gel electrophoresis was conducted and the patterns of the 76 isolates were analyzed. The PFGE image was analyzed using BioNumerics (Version4.0, Applied Maths BVBA, Belium). Image bands were identified and similarity coefficient was automatically generated.

RESULTSSeventy six strains were isolated from Vibrio cholerae outbreaks in Hainan in 2008.5 PFGE patterns of patient's isolates in June were the same, sharing a similarity coefficient of 100%. 70 PFGE patterns of patients and water in October and November were completely same, the similarity coefficient being 100%. But they were not same as that of June. 1 PFGE pattern of isolate from the sample in Hainan University was different, only sharing a similarity coefficient of 79.7%, which showed no correlation with the outbreak.

CONCLUSIONDifferent outbreaks of Vibrio cholera occurred in Hainan in 2008. The epidemic in October and November at different counties was one outbreak. The pollution of water in environment was an important factor for outbreak.

Bacterial Typing Techniques ; methods ; China ; epidemiology ; Cholera ; epidemiology ; microbiology ; DNA, Bacterial ; Disease Outbreaks ; Electrophoresis, Gel, Pulsed-Field ; methods ; Humans ; Vibrio cholerae ; classification ; isolation & purification

Objective: To investigate differentially expressed genes and related signaling pathways in patients with dermatomyositis/clinical amyopathic dermatomyositis (DM/CADM) complicated by interstitial lung disease or malignant tumors. Methods: From January 2017 to January 2018, 27 DM/CADM patients were enrolled from Department of Dermatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, and divided into 3 groups according to the complications: 10 with interstitial lung disease, 8 with malignant tumors, and 9 without interstitial lung disease or malignant tumors. Meanwhile, 7 healthy controls were enrolled into this study. High-throughput RNA sequencing was performed to screen differentially expressed genes in peripheral blood in the above 4 groups. Then, these genes were subjected to gene ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. Results: Compared with the healthy controls, 4 820 up-regulated genes and 137 down-regulated genes were identified in DM/CADM patients; GO analysis revealed 49 significantly enriched items in the DM/CADM patients, 37 (75.5%) of which were associated with biological processes; KEGG analysis showed that differentially expressed genes were mainly enriched in infection-, tumor- and immune-related pathways in DM/CADM patients. Compared with the patients without interstitial lung disease or malignant tumors, 272 up-regulated genes and 158 down-regulated genes were identified in the patients with interstitial lung disease; GO analysis revealed 157 significantly enriched items, 114 (72.6%) of which were associated with biological processes; KEGG analysis showed that differentially expressed genes were mainly enriched in bacterial infection- and autoimmune/inflammatory-related pathways in the patients with interstitial lung disease. Compared with the patients without interstitial lung disease or malignant tumors, 398 up-regulated genes and 68 down-regulated genes were identified in the patients with malignant tumors; GO analysis revealed 117 significantly enriched items, 94 (80.3%) of which were associated with biological processes; KEGG analysis showed that differentially expressed genes were mainly enriched in glycosylation-, metabolism- and tumor-related signaling pathways in the patients with malignant tumors. Conclusions Differences existed in transcriptomes and pathways between the DM/CADM patients and healthy controls, as well as between the patients with interstitial lung disease or malignant tumors and patients without these complications. Bacterial infection- and cytokine/chemokine-related pathways were significantly enriched in the patients with DM/CADM complicated by interstitial lung disease, while those pathways related to glycosylation, protein metabolism, angtigen presentation and cytotoxic effects of natural killer cells were significantly enriched in the patients with DM/CADM complicated by malignant tumors.

Objective: To investigate the clinical features of anti-signal recognition particle (SRP) antibody-positive patients with dermatomyositis/clinically amyopathic dermatomyositis (DM/CADM) . Methods: Clinical data were collected from 90 patients with DM/CADM, who were hospitalized at the Department of Dermatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from June 2015 to July 2017. Immunoblotting assay was performed to determine the serum level of anti-SRP antibody in these patients. Statistical analysis was carried out using t test and Chi-square test. Results: Of the 90 patients with DM/CADM, 11 (12.2%) were positive for serum anti-SRP antibody, including 6 with DM and 5 with CADM. Among 82 adult patients with DM/CADM, the prevalence of malignant tumors was significantly higher in the patients with anti-SRP antibody than in those without (7/9 vs. 31.5%[23/73], χ² = 7.394, P = 0.006) . The 11 patients with anti-SRP antibody had typical DM skin lesions, and their cutaneous dermatomyositis disease area and severity index (CDASI) was 18.1 ± 2.9. The prevalence of "angel wings sign" (aliform erythema on the trunk) was significantly higher in the patients with anti-SRP antibody than in those without (7/11 vs. 29.9%[20/67], Fisher′s exact test, P = 0.028) . The positive rate of antinuclear antibody was significantly higher in the patients with anti-SRP antibody than in those without (4/8 vs. 16.7%[13/78], χ² = 6.053, P = 0.014) . Magnetic resonance imaging of muscles of both thighs of the 10 patients with anti-SRP antibody (6 with DM and 4 with CADM) showed the presence of abnormal signals in the thigh muscle group in 8, swelling of the muscle group in 2, subcutaneous edema in 2, myofascial swelling in 1, and no abnormities in 2. No interstitial lung disease or myocardial involvement was observed in the patients with anti-SRP antibody. Conclusions The anti-SRP antibody-positive patients with DM/CADM showed a high prevalence of "angel wings sign" , and a high risk of malignant tumors. Early detection of the anti-SRP antibody in patients with DM/CADM is helpful to predict the occurrence of malignant tumors.