Objective To explore the effects of injection of wnt3a gene-modified bone marrow mesenchymal stem cells (MSCs) on acute graft-versus-host disease (aGVHD) in a murine allogeneic bone marrow transplantation (allo-BMT) model.Methods C57BL/6 mice were used as the donors and Balb/c mice as the recipients in the murine allo-BMT model.The recipient mice were divided into four groups by random number table method: transplantation control group (group A) (infusion of 5 × 106bone marrow cells via the tail vein of recipient mice); aGVHD group (group B) (infusion of 5 × 106bone marrow cells and 5 × 106 splenocytes via the tail vein of recipient mice); aGVHD + empty vector group (group C) (infusion of 5 × 106 bone marrow cells,5 × 106 splenocytes and 1 × 106 pAd-GFP-transfected MSCs via the tail vein of recipient mice) ; experimental group (group D) (infusion of 5 ×106 bone marrow cells,5 × 106 splenocytes and 1 × 106 wnt3a gene-modified MSCs).The general performance and survival were monitored,the occurrence of aGVHD was observed,the changes of donor T lymphocyte quantity present in the spleen,and interleukin-2 (IL-2) and interferon-γ (IFN γ)levels of the recipient mice were detected in each group after transplantation.Results The survival time of recipient mice in group A was all more than 60 d,and that in groups B,C and D was (19.1 ±6.19),(32.6 ± 19.6) and (47.2 ± 15.6) d,rcspcctivcly.The survival time in group D was significantly longer than in groups B and C (P＜0.05).After the transplant,the aGVHD score points in groups B,CandDwere (8.0±0.41),(6.7±0.29) and (4.0± 1.0),respcctively.The aGVHD score points in group D were significantly less than in groups B and C (P＜0.05),and the pathological grade in group D was significantly reduced.The number and proliferation rate of T lymphocytes were reduced significantly in group D as compared with groups B and C at 3rd and 5th day after transplantation (P ＜ 0.05).The levels of IL-2 and IFN-γ in peripheral blood were decreased significantly in group D as compared with those in groups B and C at 7th,14th,21st and 28th day after transplantation (P＜0.05).The chimeric rate of the murine H-2Kb cells in the bone marrow cells of long-term survival mice was all in the range of 95％ to 100％ 60 d after transplantation.Conclusion The injection of wnt3a gene-modified MSCs can more effectively alleviate aGVHD in murineallo-BMT model,which may be correlated with the Wnt3a overexpression which activating the Wnt/β-catenin signaling pathway of MSCs,thereby inhibiting the early activation and amplification of donor T lymphocytes and the IL-2 and IFN-γ expression.

Objective To investigate the efficacy and safety of autologous cryopreserved platelet transfusion in the management of thrombocytopenia after chemotherapy in hematological malignancy.Methods A total of 40 patients diagnosed as hematological malignancy with complete remission were equally assigned into study group and control group.During chemotherapy interval in the study group,when platelet counts exceeded 120 × 109/L,autologous platelets were collected with CS3000 Cell Separator and cryopreserved at-80℃ with 5％ dimethylsulfoxide.When platelet counts dropped below 15 × 109/L after chemotherapy,autologous platelets were thawed with 40℃ water bath and transfused back to each patient.In the control group,when platelet counts dropped below 15 × 109/L after chemotherapy,allogeneic fresh platelets were transfused.Median loss during the freeze-thaw-wash procedure in study group was observed,and the 1 h,24 h corrected count increments(CCI)were calculated in the both groups.The hemostatic effects and adverse reactions were also observed.Results In the control group,1hCCI and 24hCCI were (19.3 ±6.1)× 109/L and(12.2 ± 7.0)× 109/L,respectively,with the effective rate of 80％ and the transfusion reaction rate of 45％.Totally 20 collection and transfusions were finished in the study group.A total of(3.4-8.5)× 1011 platelet were obtained in each collection.Platelet recovery after freezing and thawing was(73.51 ±9.03)％(62％-83％).1hCCI was(17.4±7.6)× 109/L,24h CCI was(10.5 ±5.8)× 109/L and the effective rate was 85％.There was no significant different between the two groups (P ＞ 0.05).The transfusion reaction rate was 15 ％,which was significantly lower than that of the control group(P ＜ 0.05).Meanwhile,adverse reactions were occurred less in the study group.Conclusion This study demonstrates that autologous cryopreserved platelet transfusions can be safely administered for supporting thrombocytopenia in hematological malignancy patients undergoing chemotherapy.

Objective:To valuate the treatment value and analyse the effect on the cellular immune functions by studying the differences of T-lymphocyte subsets and CD4+CD25+Treg cells in peripheral blood after adoptive immunotherapy ( dendritic cells and cytokine-induced killer cells,DC-CIK) combined with chemotherapy on MM.Methods:50 patients with MM were randomly divided into two groups.24 patients in chemotherapy group were treated by chemotherapy only,26 patients in joint group were treated by adoptive immunotherapy( DC-CIK) combined with chemotherapy,and the clinical outcomes and the levels of T-lymphocyte subsets and CD4+CD25+Treg cells in peripheral blood between two groups were compared.Moreover,the differences of cellular immune indicators (Th1/Th2,the ratio of AgNOR,and TGF-β)between two groups were also compared.Results: After treatment,quality of life,clinical index and survival in joint group were better than in chemotherapy group( P<0.05);the proportion of CD3+CD8+,the ratios of CD4+CD25+,CD4+CD25+/CD4+and the level of TGF-βof joint group wes clearly lower than chemotherapy group(P<0.05),and the ratios of CD3+CD4+/CD3+CD8+, Th1/Th2 and AgNOR of joint group wes clearly higher than chemotherapy group .Conclusion: DC-CIK combined with chemotherapy could be an effective and promising treatment to patients with MM,and it maybe strengthen the anti-tumor action of bodies by regulating the balance between Th1 and Th2 reaction.

Objective To explore the effects of accumulated 60CD,γ-ray irradiation on small molecular metabolites in rats urine.Methods Ten healthy male SD rats were irradiated by 60Co γ-rays in 5 days and the accumulated doses were 0,0.2,0.4,0.6,0.8,1.0 Gy,respectively.The metabolites in urine of different groups were measured with 1 H-NMR combined with principal components analysis (PCA) and partial least square discriminate analysis (PLS-DA). Results The metabolites in rat urine were obviously changed after irradiation. Compared with control group,the amount of acetoacetate decreased after irradiation(t =29.7 -30.7,P ＜ 0.05 ),but its relative level was stable when the dose increased ( P ＞ 0.05 ).Meanwhile,the relative level of hippuric acid increased ( t =4.4 - 21.6,P ＜ 0.05 ) especially when the accumulated dose was higher than 1 Gy (t =21.6,P＜0.05). The relative level of proline,taurine and trimethylamine-N-oxide increased after irradiation with the same trend( t =3.5 - 13.4,4.7 - 11.5,2.9- 12.7,P＜0.05). Conclusions The acetoacetate,hippuric acid,proline,taurine,and trimethylamine-N-oxide may be applicable for biomarkers of accumulative irradiation on rat.

Objective To explore the effects of mesenchymal stem cells ( MSC ) treatment on platelet counts in mice with immune-mediated thrombocytopenia ( ITP) and the possible mechanism .Meth-ods ITP was induced by daily intraperitoneal injection of anti-platelet membrane CD 41 antibody (MWReg30) into BALB/c mice.The mice were then divided into experiment and control groups with 20 mice in each.Each mouse in experimental group was injected with 2×107 mesenchymal stem cells (MSC) through the tail vein .The numbers of blood platelets in mice from two groups were counted on days 5, 7 and 14 after MSC injection .Reverse transcriptase polymerase chain reaction ( RT-PCR) was performed to meas-ure T-bet and GATA-3 gene expression in peripheral blood mononuclear cells ( PBMCs ) at mRNA level on day 14.The levels of IFN-γ, IL-2, IL-4 and IL-10 in serum were detected by ELISA .Results The platelet counts in experimental group were significantly higher than those in control group on days 7 and 14 after MSC injection [(588.0±81.6)×109/L and (623.0±78.9) ×109/L vs.(317.0±90.1) ×109/L and (288.0± 87.8)×109/L ] (P<0.05).On day 14 after MSC injection, the T-bet expression at mRNA level in PBMCs from mice in experimental group was significantly lower than that in control group [(0.04±0.03) vs.(0.27 ±0.05)] (P<0.05), while the GATA-3 expression at mRNA level was higher than those in control group [ (0.14±0.04) vs.(0.07±0.05)] (P<0.05).Compared with control group, the concentrations of Th1 type cytokines such as IFN-γand IL-2 were remarkably down-regulated in experimental group [(3.1±1.7) pg/ml and (3.2±2.1) pg/ml vs.(10.3±4.8) pg/ml and (16.3±5.7) pg/ml](P<0.05), while the con-centrations of Th2 type cytokines such as IL-4 and IL-10 were up-regulated in experimental group [(88.6± 15.2) pg/ml and (38.3±11.8) pg/ml vs.(32.7±5.7) pg/ml and (22.1±3.4) pg/ml ] (P<0.05). Conclusion MSC treatment can effectively increase platelet counts in mice with immune-mediated thrombo-cytopenia, which may be associated with the suppression of Th 1-dominant response mediated by abnormal ex-pression of T-bet and GATA-3.

Objective:To investigate the effect of elevated low-density lipoprotein(LDL)cholesterol on the release of endothelial microvesicles into the circulatory system in elderly patients with obstructive sleep apnea(OSA).Methods:This was a case-control study.A total of 69 elderly inpatients aged ≥ 60 years were divided into the OSA group(n=48)and the normal control group(n=21)based on the apnea/hypopnea index(AHI). Sleep monitoring was carried out in the two groups, and venous blood samples were taken after the monitoring.Density gradient centrifugation was used to extract microparticles and flow cytometry was used to analyze patients' blood levels of endothelial microvesicles.Blood lipid levels of patients were measured by biochemical analysis methods.The correlation between LDL cholesterol levels and endothelial microvesicles in OSA patients was analyzed.Results:LDL cholesterol levels were higher in OSA patients than in normal controls(2.6±0.6 mmol/L vs.2.2±0.7 mmol/L, t=2.089, P=0.041). Endothelial microvesicle levels were elevated in OSA patients compared with the normal controls[(28.2±12.2)×10 -6events/L vs.(19.6±7.8)×10 -6 events/L, t=-3.164, P=0.003]. Endothelial microvesicle levels increased in OSA patients with elevated LDL cholesterol compared with OSA patients with normal LDL cholesterol[(39.3±12.6)×10 -6 events/L vs.(28.2±12.2)×10 -6 events/L, t=2.899, P=0.006]. There was a significant correlation between LDL cholesterol levels and endothelial microvesicle levels in OSA patients( r=0.497, P=0.032), while levels of HDL, total cholesterol, triglycerides, blood pressure and blood glucose had no significant correlation with endothelial microvesicle levels. Conclusions:The level of endothelial microvesicles released into the circulation is higher in elderly OSA patients than in normal elderly people, and the elevated concentration of LDL can further promote the release of endothelial microvesicles in OSA patients.

Objective: This study aimed to analyze the association between the characteristics of egocentric network and HIV prevalence among men who have sex with men (MSM) through social network analysis. Methods: The study was conducted in Guangzhou city from November 2016 to June 2017 using convenient sampling method. Participants were recruited from 13 voluntary counseling and testing (VCT) locations. Data were collected by using nomination generation and nomination interpretation methods. Questionnaire includes two parts, the first part about the social tie, and the second one about social demography and behavioral characteristics of respondents and their nominees. The multivariate logistic regression was applied to quantify the association. Results: 8.67%(93/1 073) HIV antibody positive MSM had been detected in 1 073 respondents who nominated 4 301 partners in total. Compared to egocentric sexual network with a size of 1-2, the size of sexual network larger than 3 (OR=1.68, 95%CI: 1.07-2.65) were associated with HIV infection. Compared to egocentric risk sexual network with a size of 1-2, the size of risk sexual networks larger than 3 (OR=1.87, 95%CI: 1.06-3.31) were associated with HIV infection. There were no significant association between marital similarity of respondents and their nominees, the type of the relationship of sexual partners and HIV prevalence (P>0.05). Conclusion The composition of social network in MSM is related to their susceptibility of HIV infection. MSM population with a large sexual network is more susceptible to HIV infection.

Objective:To investigate the mortality and causes of death in neonates from different medical institutions in Henan province.Methods:A retrospective analysis was performed on the death cases of 62 different medical institutions in 18 cities of Henan province in 2018, in order to compare the differences of neonatal mortality, age of death and the causes of death between maternal and child health care hospitals and general hospitals.Results:(1) A total of 80 780 newborns were admitted to 62 hospitals and 311 neonates died with a mortality rate of 3.85‰.A total of 33 339 newborns were admitted to 24 maternal and child health care hospitals, and 102 neonates died with a mortality rate of 3.06‰.Among them, 54 cases(52.9%) were premature infants and 48 cases(47.1%)were full-term infants.A total of 47 441 newborns were admitted to 38 general hospitals, and 209 neonates died with a mortality rate of 4.41‰.Among them, 111 cases(53.1%) were premature infants and 98 cases (46.9%) were full-term infants.Neonatal mortality in general hospitals was higher than that in maternal and child health care hospitals( P<0.05). (2) Neonatal death mainly occurred within one week after birth, especially within the first day.There were 67 cases of death(65.7%) in 24 maternal and child health care hospitals within the first day, including 34 cases (50.7%) of full-term infants and 33 cases (49.3%)of premature infants.And there were 87 cases of death(41.6%) in 38 general hospitals within the first day, including 50 cases (57.5%) of premature infants and 37 cases (42.5%) of full-term infants.Neonatal mortality within the first day after birth in maternal and child health care hospitals was higher than that in general hospitals( P<0.05). (3) The leading causes of neonatal death were non-infectious pulmonary diseases(128 cases, 41.2%), followed by birth asphyxia(73 cases, 23.5%) and infection(51 cases, 16.4%), but the causes of death in sequence varies from maternal and child health care hospitals and general hospitals.(4) For early death (within one week after birth) in both general hospitals and maternal and child health care hospitals, the main causes were birth asphyxia for full-term neonates, and pulmonary diseases(mainly respiratory distress syndrome)and birth asphyxia for premature infants.For late-stage death (2-4 weeks after birth) of neonates, infection was the leading cause in both term and preterm infants in general hospitals.For maternal and child health hospitals, the main causes of death for full-term infants were infection, and pulmonary diseases (mainly pulmonary hemorrhage and respiratory distress syndrome) for premature infants. Conclusion:There are some differences between maternal and child health care hospitals and general hospitals in neonatal mortality, mortality within the first day after birth, and causes of death.Therefore, it is necessary to strengthen the corresponding software and hardware constructions for newborns in different medical institutions to further reduce the neonatal mortality rate.

Objective:To summarize the concept, theoretical basis, evaluation tools and mechanisms, influencing factors, and intervention measures of kinesiophobia.Methods:The literature on kinesiophobia in patients undergoing total knee replacement was electronically searched on databases such as China National Knowledge Infrastructure, China Biology Medicine disc, WanFang Data, PubMed, CINAHL, Web of Science, Embase, Scopus, PsycINFO, Cochrane Library. The search period was from database establishment to June 24, 2023. This study extracted and analyzed data from the included literature.Results:A total of 32 articles were included. The Tampa Scale for Kinesiophobia was a widely used tool for evaluating kinesiophobia. The influencing factors of kinesiophobia were demographic and disease factors, body motor function, and psychological and social factors. The intervention measures for kinesiophobia mainly included cognitive behavioral intervention, pain health education, exercise, art video or music intervention, multidisciplinary collaborative intervention, and so on.Conclusions:The concept and theoretical basis of kinesiophobia are not yet complete. It is necessary to revise and improve the theoretical model and assessment tool for kinesiophobia and construct an intervention program for kinesiophobia in combination with the concept of rapid rehabilitation.

Objective To investigate the feasibility of the automatic cystocele severity grading software for quantitative evaluation of prolapse of bladder posterior wall by transperineal ultrasound . Methods One hundred and seventy transperineal ultrasound video clips were recorded when the female patients performing the Valsalva maneuver and those clips were divided into training group ( 85 cases) and test group ( 85 cases) randomly ,then the ralated structures of the images from the training group offline were marked . Through machine learning algorithm ,the computer had learned and was able to analyzed the marking information ,then the automatic cystocele severity grading software was obtained . And later the software was ran to mark the structures and get the cystocele severity grading in the images from the test group . Meanwhile , the same structures of the same images manually were marked and after an interval of more than two weeks the process were repeated by 3 doctors . Finally the grading results obtained from the software and the measurers of the 3 doctors were compared . Results The intelligent identification and automatic measurement software obtained from the machine learning algorithm was able to identify the related structures . The grading results of each measurer were of good consistency ( κ :0 .72 －0 .78 ;ICC :0 .980－0 .990) . The grading results between different measurers were of good consistency ( κ :0 .65－0 .75 ;ICC :0 .985－0 .992) . The grading results between automatic software and three different measurers were of good consistency ( κ :0 .63－0 .67 ;ICC :0 .967－0 .969 ; r ＝0 .936 ,0 .943 ,0 .936 ,all P ＜0 .01) . Conclusions The automatic cystocele severity grading software is able to identify the related structures in the images and reliable to apply the software in pelvic floor ultrasound .