Interleukin (IL)-27 is a new member of the IL-6/IL-12 family composed of p28 subunit and Epstein-Barr virus induced gene 3 (EBI3) subunit. Its receptor is composed of WSX-1 and gp130. It has dual properties including pro-inflammatory and anti-inflammatory function at different conditions. Studies have shown that IL-27 exerts its biological activities through stimulating JAK1/STAT1, JAK1/STAT3 signal pathways and regulating the production of Th1, Th17 as well as their related-cytokines. Furthermore, IL-27 can exert the role of anti-tumor activity by enhancing the effect of cytotoxic T cells and anti-angiogenesis.

BACKGROUND:For autoimmune diseases, it is difficult to effectively solve the lack of immunological tolerance in patients by traditional treatments. Mesenchymal stem cells have the biological functions of tissue and organ regeneration and immune regulation. OBJECTIVE:To explore the effects and mechanisms of human umbilical cord-derived mesenchymal stem cells on the development of thymus in nude mice. METHODS:Human umbilical cord-derived mesenchymal stem cells were intraperitoneal y injected into BABL/c nude mice at a dose of 2×106 per mouse. We analyzed the maturation and distribution of thymic epithelial cells in the thymus rudiment of nude mice and the thymopoiesis of this newly developed thymus rudiment;furthermore, we explored the therapeutic effects of human umbilical cord-derived mesenchymal stem cells. RESULTS AND CONCLUSION:Our data showed wel-organized cortex-medul a structure and an obvious improvement in the maturation of thymic epithelial cells in the rudiment. We further demonstrated the improved thymopoiesis and the enhanced export of mature T cells with the T regulatory cells increase in peripheral blood. Furthermore, we found that human umbilical cord-derived mesenchymal stem cells could be engrafted in the thymus and express many cytokines, especial y keratinocyte growth factor which is essential for the thymus development. These findings indicate that a new mechanism of human umbilical cord-derived mesenchymal stem cells can provide a proper microenvironment for the reconstitution and functional maturation of thymus in nude mice, and elicit another insight in terms of therapeutic efficacy of human umbilical cord-derived mesenchymal stem cells in many autoimmune diseases.

Military pilot selection is an effective way to lower the training cost, ensure the safety of pilots and aircraft, and improve the military efficiency, which involves a comprehensive evaluation of medical fitness, psychology and flying aptitude of a pilot candidate.The concept and classification of comprehensive evaluation methods were introduced in this paper.Comprehensive evaluation methods used in domestic and overseas military pilot selection were reviewed.Finally, suggestions on the research and application of the military pilot selection system in China were raised.

OBJECTIVE:To establish a method for simultaneous determination of liquiritin and glycyrrhizic acid in Wuwei shaji granules.METHODS:HPLC method was adopted.The determination was performed on Thermo scientific ODS-2 Hypersil column with mobile phase consisted of acetonitrile-0.5％ phosphoric acid (gradient elution) with flow rate of 1.0 mL/min.The detection wavelength was set at 237 nm,and column temperature was 25 ℃.The sample size was 20 μL.RESULTS:The linear ranges of liquiritin and glycyrrhizic acid were 48-480 μg(r=0.999 9) and 90-900 μg(r=0.999 9),respectively.The limits of quantitation were 0.55,2.10 μg/mL,and the limits of detection were 0.16,0.62 μg/mL.RSDs of precision,stability and reproducibility tests were all lower than 2.0％.The recoveries were 95.08％-97.58％ (RSD=0.93％,n=6)and 95.86％-99.89％ (RSD=1.67％,n=6),respectively.CONCLUSIONS:The method is simple,accurate and reproducible,and can be used for the content determination of liquiritin and glycyrrhizic acid in Wuwei shaji granules.

Objective:To investigate the clinical significance and correlation of serum alpha fetoprotein(AFP), alkaline phosphatase (ALP), and protein induced by vitamin K antagonist-Ⅱ(PIVKA-Ⅱ) in patients with primary hepatoculellar carrcinoma (PHC).Methods:A total of 72 patients with PHC who admitted to Dajiangdong Hospital from May 2017 to June 2019 were selected as observation group and they were divided into metastasis group (25 cases) and non-metastasis group (47 cases) according to the presence or absence of lymph node metastasis.Another 72 healthy people who had physical examinations during the same period were selected as the control group.The serum levels of AFP, ALP and PIVKA-Ⅱ were measured in all patients.ROC curves were used to analyze the clinical value of these three indicators in the early diagnosis and prognosis of PHC.The correlation between serum AFP, ALP, PIVKA-Ⅱ levels and clinical stage of PHC was analyzed by Pearson method.Results:The serum levels of AFP, ALP and PIVKA-Ⅱ in the observation group were significantly higher than those in the control group( t=36.64, 24.53, 47.89, P=0.012, 0.005, 0.001). The serum AFP, ALP and PIVKA-Ⅱ levels were higher in the metastasis group than in the non-metastatic group( t=20.98, 38.12, 54.17, P=0.04, 0.001, 0.000). ROC analysis showed that the serum AFP, ALP and PIVKA-Ⅱ had diagnostic value for PHC, and the combined detection had higher diagnostic efficacy ( P=0.021, 0.014, 0.003, 0.001). Compared with single index, the clinical value of three indicators in predicting whether PHC had lymph node metastasis increased significantly( P=0.036, 0.027, 0.018, 0.005). The specificity(89.57%), sensitivity(92.60%), positive predictive value(89.53%) and negative predictive value(83.75%) of the three indicators in detecting PHC increased significantly( P<0.05). Pearson analysis showed positive correlations between serum AFP, ALP, PIVKA-Ⅱ and tumor stage( P<0.05). Conclusion:Serum AFP, ALP and PIVKA-Ⅱ have certain clinical value in the early diagnosis of PHC, and the combination of these three indicators can improve the diagnostic efficacy.

OBJECTIVE: To diagnoze active ankylosing spondylitis (AAS) by magnetic resonance imaging (MRI). METHODS: MRI of the sacroiliac joint (SIJ) was performed on 48 patients who were clinically diagnosed as probable AS without radiologic evidence of sacroiliitis. Among them 21 were diagnozed as active sacroiliitis with MRI, whose examination was terminated; 27 whose MRI of SIJ did not diagnoze as active sacroiliitis were performed MRI in the thoracic spine. The diagnostic criteria of MRI for AAS of SIJ and/or the thoracic spine were fomulated by consulting documents. The definite diagnosis of AAS was finally made after follow-up for half a year. The sensitivity and specificity of the MRI of SIJ and/or MRI of thoracic spine were assessed. RESULTS: In the 48 patients without radiologic evidence of sacroiliitis, 38 were finally diagnosed as AAS, with established consensus criteria as reference standard. The sensitivity and specificity of the MRI of SIJ were 52.6% and 90.0%, and for the MRI of SIJ and/or the MRI of the thoracic spine 76.3% and 90.0%, respectively. CONCLUSION Clinically probable AS without MRI evidence of sacroiliitis, MRI of the thoracic spine can increase the sensitivity of AAS diagnosis.
Adolescent ; Adult ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Radiography ; Sacroiliac Joint ; diagnostic imaging ; pathology ; Spondylitis, Ankylosing ; diagnosis ; Thoracic Vertebrae ; pathology ; Young Adult

Objective:To detect the levels of γ-glutamyl transferase (GGT) in the amniotic fluid of normal pregnancies at 19-23 +6 gestational weeks and to analyze the changes in GGT level with gestational age. Methods:This study retrospectively collected the amniotic fluid supernatant from 383 singleton pregnant women (102, 103, 82, 68 and 28 cases at 19-19 +6, 20-20 +6, 21-21 +6, 22-22 +6, 23-23 +6 weeks of gestation, respectively) who underwent amniocentesis for prenatal diagnosis but had normal genetic diagnosis results in Cheeloo Hospital of Shandong University from January 2021 to September 2022. The levels of GGT in the amniotic fluid supernatant were tested and the statistical parameters including xˉ± s, min-max, median ( M), P1, P2.5, P5, P95, P97.5 and P99 values of GGT levels at each gestational week were calculated. GGT were non-normal data and converted into natural logarithms (lnGGT), and a least square linear regression equation was established to analyze the relationship between lnGGT and gestational week. Results:At 19-19 +6, 20-20 +6, 21-21 +6, 22-22 +6, and 23-23 +6 gestational weeks, the xˉ± s of amniotic fluid GGT were (385.8±235.7), (331.8±219.4), (253.7±197.9), (226.7±166.4), and (155.3±96.8) U/L, and the weekly declines were 14.0%, 23.5%, 10.6%, and 31.5%, respectively; the M values were 311.0, 288.0, 199.0, 160.5, and 105.5 U/L, and the weekly declines were 7.4%, 30.9%, 19.3%, and 34.3%, respectively; the P1- P99 were 67.1-1 404.5, 63.2-1 189.1, 36.0-849.8, 44.0-787.3, and 32.0-375.6 U/L, respectively. lnGGT was negatively correlated with gestational age ( R 2=0.148, P<0.001). Conclusions:In normal pregnancies at 19-23 +6 gestational weeks, GGT levels in amniotic fluid decrease with gestational age. Therefore, gestational age should be considered when establishing the reference value for amniotic fluid GGT in normal pregnancies.

Objective: To explore the roles and mechanisms of long non-coding RNA (lncRNA) small nucleolar RNA host gene 6 (SNHG6) in promoting invasion and metastasis of esophageal squamous carcinoma (ESCC). Methods: Real time quantitative polymerase chain reaction (qPCR) was used to detect the expression of SNHG6 in ESCC and matched para-carcinoma tissues. Reverse transcription-polymerase chain reaction (RT-PCR) was performed to detect the expression of SNHG6 in ESCC cell lines (TE1, Yes-2, Eca9706 and Kyse150). Then, TE1 cell line which harbored highest expression of SNHG6 was used in following experiments. siRNAs were used to knock down the expression of SNHG6. Clone formation, wound-healing and transwell assay were used to detect the abilities of proliferation, migration andinvasionofTE1cells,respectively.Westernblottingwasusedtodetecttheexpressions of MMP-2, MMP-9andZEB1 protein before and after knockdownofSNHG6inTE1cells.Results:SNHG6washighlyexpressedinESCC tissues, compared to para-carcinoma tissues (P<0.01). The expression of SNHG6 was significantly decreased after transfection of SNHG6siRNA (all P<0.01). The abilities of proliferation, migration and invasion of TE1 cells in si-SNHG6-1 and si-SNHG6-2 group were significantly lower than those in the control group (all P<0.01). The expressions of ZEB1, MMP-2and MMP-9 in si-SNHG6-1 and si-SNHG6-2 group were significantly lower than those in the control group (all P<0.05). Conclusion: SNHG6 is highly expressed in ESCC tissues and promotes the malignant biological behavior of ESCC cells. Its mechanism of promoting the occurrence and development of ESCC may be related to the upregulation of ZEB1 expression.

Objective:To investigate the long-term efficacy and complications of augmentation uretero-enterocystoplasty (AUEC).Methods:The clinical data of 262 patients with lower urinary tract dysfunction who underwent AUEC at our center from January 2003 to June 2022 were analyzed retrospectively. There were 193 males and 69 females, the median age was 24 (4, 67) years, the median disease duration was 12.0 (0.2, 56.0) years and the preoperative creatinine was 91.5 (68.1, 140.0) μmol/L. 320 ureters had high-grade UUTD, 216 ureters had VUR, 14 of which had low-pressure reflux.The number of low-grade VUR ureter was 22 (10.2%) and the number of high-grade VUR ureter was 194 (89.8%). Video-urodynamics showed that the maximum bladder capacity was 102 (47, 209) ml, the maximum detrusor pressure was 33.0 (15.5, 50.5) cmH 2O, and the bladder compliance was 6.4 (3.0, 12.3) ml/cmH 2O. All patients underwent AUEC. The surgical method is to cut a segment of sigmoid colon, open the sigmoid colon along the mesenteric margin, fold and suture it into " U" or " S" shaped intestinal mesh according to the principle of " detubulization" . At the same time, perform ureteroplasty and replanting, and then anastomosis the intestinal mesh with the opened bladder flap to form an expanded new bladder. Follow-up was performed via outpatient clinic or telephone. The creatinine, maximum bladder capacity, maximum detrusor pressure, bladder compliance, ureteral reflux and upper urinary tract dilatation were compared preoperatively and postoperatively. The postoperative complications were also evaluated. Results:The median follow-up time was 57.4 (4, 151) months after surgery. At 1-3 months after surgery, the maximum bladder capacity and bladder compliance increased to 303.9% and 189.9% of the preoperative level, and the maximum detrusor pressure decreased to 63.6% of the preoperative level. At 6-10 years after surgery, the maximum bladder capacity and bladder compliance increased to 490.2% and 627.9% and the maximum detrusor pressure decreased to 25.8% of the preoperative level. The UUTD of the patients was significantly reduced after surgery. The number of the high grade UUTD decreased to 116 (116/398, 29.2%) at 1-3 months and 51 (51/274, 18.6%) at 4-6 months. At 6-10 years, the number of the high-grade UUTD decreased to 4 (4/76, 5.3%) ( P<0.001), which was significantly lower than that before operation. The VUR was significantly relieved after operation, and 393 ureters had no VUR at 1-3 months, accounting for 97.8% (393/402) of the total ureters. Sustained remission of VUR was observed during follow-up. 73 ureters had no VUR at 6-10 years, accounting for 96.1% (73/76) of total ureters ( P<0.001). Patients' creatinine decreased to 79.0 (65.0-128.2) μmol/L at 1-3 months postoperatively, with a downward trend but no statistical difference, and creatinine levels were not significantly elevated at any postoperative time point compared with preoperative levels ( P>0.05). Postoperative complications included metabolic acidosis in 26 cases (9.9%), vesicoureteral anastomosis stenosis in 15 cases (5.7%), recurrent urinary tract infection in 16 cases (6.1%), and urinary calculi in 20 cases (7.6%), and intestinal obstruction requiring laparotomy in 8 cases (3.1%), all of them could be improved after treatments. Conclusions:AUEC is a safe and effective method for treating high-grade VUR or VUR with impaired anti-reflux mechanism, high-grade UUTD or UUTD with ureteral or vesicoureteral junction obstruction, and all of the complications can be improved after treatment. This technique can increase the bladder capacity and compliance, reconstruct the anti-reflux mechanism, and release upper urinary tract obstruction. It may play an important role in stabilizing and protecting the residual renal function from further deterioration.

Objective:To investigate the long term outcome of artificial urinary sphincter implantation for patients with stress urinary incontinence.Methods:The data of 46 patients who underwent artificial urethral sphincter implantation in China Rehabilitation Research Center from April 2002 to April 2022 were retrospectively analyzed.The patients’ age ranged from 19-80 years old (median 45.6 years). There were 45 males and 1 female. The history of illness was 8 months to 33 years. The patients category were urethral injuries associated urinary incontinence ( n=24), neurogenic urinary incontinence ( n=9) and post-prostatectomy incontinence ( n=13). Preoperative daily pad usage was 3.5±1.0. The impact of incontinence on the quality of life (QOL)measured by the visual analogue scale (VAS)was 7.1±1.2. All 46 patients underwent artificial urethral sphincter implantation, of which 20 patients were treated with anticholinergic drugs (5 cases) or urinary tract related surgery (urethral stenosis incision in 2 cases, sphincterectomy in 3 cases, urethral dilation in 5 cases, urethral calculus lithotripsy in 1 case, and augmentation cystoplasty in 4 cases) before artificial urethral sphincter implantation. Of the 45 male patients, 25 patients had the transperineal approach and 20 had the trans-scrotal approach. The female case had a trans-retropubic approach. Different cuffs size was used based on individual circumference of bulbar urethra (45 male cases: 4.5cm in 16 cases, 4.0cm in 29 cases; one female case: 8.0cm). Long-term surgical efficacy was evaluated. Assessments included postoperative urinary continence (socially continent: one pad per day or less; complete dry: wearing no pads), artificial urinary sphincter status and complications. The influences of patients of different etiologies, surgical approaches and cuff size on surgical results were compared. Results:The mean follow-up time was 7.1 years ranged from 6 months to 19 years. At the latest visit, 32 patients (69.6%) maintained the primary functional artificial urinary sphincter. Three patients (6.5%) had artificial urinary sphincter revisions and maintained continence with the new device. 11 patients (23.9%) removed the artificial urinary sphincter because of post-complications. Thirty-five patients were socially continent, of which 16 patients were totally dry, leading to the overall social continent rate as 76.1%(35/46). There was a significant reduction in pad usage to 1.2±0.6 diapers per day ( P<0.001). The impact of incontinence on the QOL measured by the VAS dropped to 2.6±1.9 ( P<0.001). The complication rate was 32.6%(15/46), including infections ( n=4), erosions ( n=5), mechanical failure ( n=3), dysurie ( n=2) and urethral atrophy ( n=1). There were no significant differences in social continent rate between patients with different etiologies[75.0%(18/24)vs. 66.7%(6/9) vs. 84.6%(11/13)], perioperative complications [37.5%(9/24)vs. 33.3%(3/9) vs. 23.1%(3/13)] and device re-intervention rate[37.5%(9/24) vs. 33.3%(3/9)vs. 15.4%(2/13)]. There were no statistically significant differences in postoperative complete dry rate [32%(8/25)vs. 40%(8/20), P=0.76] and postoperative device failure free rate [60%(15/25)vs. 80%(16/20), P=0.20] between trans-perineal group and trans-scrotal group. There was no statistically significant difference in postoperative social continent rate between 4.5cm cuff and 4.0 cuff[75%(12/16) vs. 65.5%(19/29), P=0.74]. Conclusions:Artificial urethral sphincter implantation is an effective treatment for stress urinary incontinence due to intrinsic sphincter deficiency. There was no difference in the continent rate and complication rate between patients of different etiologies, different surgical approaches and cuff size selection.