OBJECTIVETo study the relationship between allergic rhinitis and fractional exhaled nitric oxide (FeNO).METHODS FeNO was measured in 66 allergic rhinitis patients before and after treatment. Visual analogue scale (VAS) score was used to describe the patient's symptoms. RESULTSFeNO and VAS score were significantly decreased after treatment (t=4.25,P=0.0000;t=3.34, P=0.0008), and the decrease proportion were (14.56±27.23)% and (8.68±53.17)% respectively. Correlation analysis showed FeNO and VAS score was significantly correlated before (r=0.43,P=0.0003) and after (r=0.45,P=0.0002) treatment. After treatment, the decreased proportion of FeNO and VAS score were significantly correlated (r=0.25,P=0.0437). CONCLUSIONFeNO can provide objective evidence for the treatment efficacy of allergic rhinitis.

Objective To investigate the alteration of the whole brain functional connectivity in patients with minimal hepatic encephalopathy(MHE) by using resting-state functional MRI,and to explore its role in distinguishing the MHE from cirrhotic patients without MHE by using the receiver operator characteristic(ROC) curve.Methods Thirty cirrhotic patients with MHE,32 cirrhotic patients without MHE (non-MHE),and 49 healthy controls underwent standard resting-state functional MRI scan.Whole brain functional connectivities were compared with analysis of variance test to observe the difference among three groups,and then compared with Post-hoc test to investigate the changes between MHE and non-MHE groups.Results There were widespreadly different functional connectivities among three groups.All 115 functional conenctivities showed significant difference among three groups(all P＜0.05).Compared with non-MHE patients,MHE patients showed 6 decreased functional connectivity in the following brain regions (P＜0.05):between left supper temporal gyrus-right orbitofrontal cortex,left Heschl's gyrus-left Rolandic operculum,left Heschl's gyrus-right olfactory cortex,left hippocampus-right amygdala,left putamen-right putamen,and left temporal pole of supper temporal gyrus-right temporal pole of middle temporal gyrus (t=-4.41-3.82,P＜0.01).ROC analysis demonstrated that the left hippocampus-right amygdala had the highest value for differentiating MHE from non-MHE group(AUC=0.78,95％CI 0.66-0.90) with a cutoff value=0.56,sensitivity=73％ and specificity=81％).Conclusion Functional connectivity analysis can be used to observe the functional changes in MHE patient,and has a potential for the early diagnosis of MHE.

Objective To summarize the image features of primary retrograde type A aortic dissection by CTA examination, aiming to improve the precise diagnosis of this type of specific aortic dissection, and to provide imaging evidence for subsequent therapies.Methods The CTA data of 17 patients with primary retrograde type A aortic dissection treated in Cardiothoracic Surgery Department of Nanjing General Hospital of Nanjing Military Command from January 2010 to December 2014 were retrospectively reviewed.The image features including the dissection type, the location and quantity of intimal tear, the aorta involving area, and the origin of branch vessels were analyzed.Results Nine cases of the total 17 patients had pericardial/pleural effusion.Fourteen patients showed intramural hematoma in ascending aorta, while 3 patients showed active blood flow and thrombosis formation in false lumen of ascending aorta.Five patients showed aortic ulcers and intramural hematoma in descending aorta, and the other 12 patients showed typical dissection image with active blood flow in both true and false lumen,among the 12 patients, there were obvious intimal separations observed in 11 cases, while multiple aortic ulcers in 1 case.Abdominal aorta was involved in l0 cases of the above 11 patients.All of the abdominal branch vessels were originated from true lumen in 2 of the 10 patients,and the other 8 patients showed 1-2 vessels originated from false lumen.Conclusion Primary retrograde type A aortic dissection is relatively rare.However,specific imaging features different from typical aortic dissection can be observed in this type of aortic lesion.Careful viewing of CTA image is extremely necessary for accurate diagnosis.

Objective To investigate the changes of CD4 + CD25 + Foxp3 + regulatory T cell (Treg) and relative cell factors in peripheral blood of steroid-resistant allergic rhinitis (AR) patients,and to study their functions in occurrence of steroid-resistant AR.Methods The CD4 + CD25 + Foxp3 + Treg cell in 30 cases general physical examination (The control group),30 cases steroid-sensitive AR patients (steroidsensitive group) and 30 cases steroid-resistant AR patients (steroid-resistant group) were detected by flow cytometry.The levels of serum interleukin 10 (IL-10) and transforming growth factor β1 (TGF-β1) in the three groups were detected by enzyme-linked immunoadsorbent assay (ELISA).Results Compare to the control group,proportion of CD4 + CD25 + Foxp3 + Treg cell and the levels of serum IL-10,TGF-β1 in steroid-sensitive group and steroid-resistant group were significantly reduced (P ＜ 0.01).The proportion of CD4 + CD25 + Foxp3 + Treg cell and the levels of serum IL-10,TGF-β1 in steroid-resistant group were decreased significantly than steroid-sensitive group (P ＜ 0.01).The proportion of CD4 + CD25 + Foxp3 + Treg cell were positively correlated with the serum IL-10,and TGF-β1 (P ＜ 0.01).Conclusions The reduced proportion of CD4 + CD25 + Foxp3 + Treg cell and lower serum IL-10,TGF-β1 play an important role in the occurrence of steroid-resistant AR patients.

OBJECTIVETo detect antisense-micro ribonucleic acid-21 oligonucleotide (AS-miR-21)'s inhibiting effect to tongue squamous cell carcinoma.

METHODSLiving image and TUNEL experiments were performed, based upon the xenograft animal models set up by introduction of Tca8113-luc cells which were stably transfected with pGL6 luciferase report gene plasmid into nude mice, while the tumors were injected with AS-miR-21.

RESULTSTca8113-luc cell line which steadily expressed luciferase activity was constructed by transfecting pGL6 report gene plasmid. The subcutaneous tumor formation rate was much higher in nude mice introduced with the cells, and the tumors grew well. After injection of AS-miR-21 into mice tumors, it was obviously viewed that tumors grew slower, the volume of the tumors was smaller, the photon number in live body imaging was getting less, the necrosis in the tumor specimens was rare, cell nuclei was getting smaller, dyeing color was lighter, heteromorphism and new vessels were decreased, micro ribonucleic acid-21 expression in tumor cells was considerably lower, and apoptotic index was increased.

CONCLUSIONAll the results indicate that the injection of AS-miR-21 can inhibit growth of tongue squamous cell carcinoma in nude mice model, and effectively promote cell apoptosis of tongue squamous cell carcinoma.

Animals ; Apoptosis ; Carcinoma, Squamous Cell ; Cell Line ; Cell Line, Tumor ; Cell Proliferation ; Humans ; Mice ; Mice, Nude ; Oligonucleotides, Antisense ; Plasmids ; RNA ; Tongue Neoplasms ; Transfection

OBJECTIVETo detect the biological influence to human tongue squamous cell carcinoma (TSCC) cells of micro ribonucleic acid-21 (miR-21).

METHODSReferring to mature miR-21 sequence, the sense and antisense oligonucleotide (sense-miR-21 and AS-miR-21) modified by 2'O-Me were designed to transfect into TSCC cells (Tca8113 and high metastasis cells) by liposome transfection technology, in order to establish an in vitro TSCC cell model. The expression changes of miR-21 in the transfected cells were detected with real-time fluorescence quantitative polymerase chain reaction (real-time PCR). The changes of cell proliferation, cell cycle, cell early apoptosis, cell migration and invasion capabilities were detected respectively by the technologies of methyl thiazolyl tetrazolium (MTT), flow cytometry, Annexin V cell early apoptosis assay, scratch assay and Transwell assay, to check AS-miR-21's effect on the biological characteristics of human TSCC cell lines.

RESULTSFor the TSCC cells, the antisense oligonucleotide of targeting miR-21 could effectively inhibit cell proliferation, promoted cell apoptosis, and inhibited the capability of cell's migration and invasion.

CONCLUSIONThe expressions of miR-21 decrease after AS-miR-21 transfected into TSCC cells, and miR-21 can affect biological behavior of TSCC cells.

Apoptosis ; Carcinoma, Squamous Cell ; Cell Line, Tumor ; Cell Proliferation ; Humans ; MicroRNAs ; RNA ; Real-Time Polymerase Chain Reaction ; Tongue Neoplasms ; Transfection

Objective To summarize the clinical manifestations of 46, XX ovotesticular disorder of sex development (DSD) caused by a NR5A1 heterozygous mutation. Methods The first case of 46,XX ovotesticular DSD was caused by a NR5A1 heterozygous mutation in China and was reported with a review of 11 similar cases in the literatures since July 2016. Results A 5. 6-year-old child raised as female was born with ambiguous genitalia. The left gonad was palpable in the inguinal region while the right one was located in abdomen. Gonadal histology showed both ovotestis. Vaginoscopy revealed a short, blind-ending vagina. No uterine was detected by laparoscopy. Repeated karyotype results were 46, XX with SRY gene negative. A heterozygous de novo mutation ( p. Arg92Trp) in the accessory DNA-binding region of NR5A1 gene was found in that child. Conclusions We reported for the first time in China a new phenotype caused by a NR5A1 heterozygous mutation-46,XX ovotesticular DSD. According to the review of literatures, such mutation seemed with incomplete penetrance. It could cause both 46, XX DSD and 46, XY DSD with varied manifestations. The possible underlying mechanism might relate to the impairment of the binding between the mutant protein and target DNA which might lead to a decreased inhibition of the male developmental pathway through downregulation of female antitestis genes.

Objective:To explore the prognostic value of quantitative plaque analysis and coronary CT angiography (CCTA) derived fractional flow reserve (CT-FFR) in evaluating plaque progression (PP).Methods:A total of 118 consecutive patients who underwent serial CCTA examinations in Affiliated Hospital of Jiangnan University from December 2013 to December 2017 were retrospectively enrolled. There were 37 patients in the PP group and 81 patients in the non-PP group. All patients′ CCTA images were quantitatively analyzed using plaque analysis software. The quantitative analysis parameters included stenosis degree, plaque length, total plaque volume, calcified plaque volume, non-calcified plaque volume, minimum lumen area, remodeling index(RI) and plaque burden. Plaque progression was defined as plaque burden change rate>1%. CT-FFR analysis was performed using cFFR software and the CT-FFR value was measured at 2-4 cm distal to the coronary lesion. Baseline parameters between the two groups were evaluated using Students t-test, U-test, chi-square test. The logistic regression model was conducted to evaluate the relationship between CCTA derived parameters and PP. Receiver operating characteristic curve analysis with the areas under the curve (AUC) was used to determine the predictive performance of different CCTA parameters. Results:Compared with the non-PP group, the patients were older( t=2.391, P=0.018), the prevalence of hyperlipidemia was higher(χ2=4.550, P=0.033), and the proportion of statins use was lower (χ2=4.764, P=0.029) in the PP group. The PP group showed greater coronary stenosis, smaller minimum lumen area, larger plaque volume and non-calcified plaque volume, larger remodeling index and lower CT-FFR value on baseline CCTA (all P<0.05). Logistic regression analysis demonstrated that RI(OR=2.714, 95%CI:1.078-6.836)and CT-FFR (OR=2.940, 95%CI:1.215-7.116) were independent predictors of PP. The model based on CCTA stenosis degree, quantitative plaque features and CT-FFR (AUC 0.83, 95%CI: 0.75-0.90; P<0.001) was significantly better than the model based on CCTA stenosis degree (AUC 0.62, 95%CI: 0.52-0.70, P=0.049) and the model based on CCTA stenosis degree and quantitative plaque characteristics (AUC 0.77, 95%CI: 0.68-0.84, P<0.001). Conclusions:Compared with the prediction model derived on stenosis degree, plaque quantitative markers and CT-FFR can improve the prediction value of PP.RI and CT-FFR were important predictors of PP.

OBJECTIVE: To explore the clinical phenotype and genetic basis for a Chinese pedigree affected with familial progressive hyperpigmentation and hypopigmentation (FPHH). METHODS: Clinical data and family history for a child with FPHH were collected. Peripheral blood samples were collected from the child, his parents and two sisters. Following the extraction of DNA, high-throughput sequencing was carried out to screen for genetic variant associated with the disease. Candidate variant was verified by Sanger sequencing of his family members. RESULTS: The main clinical features of the proband have included progressive hyperpigmentation and hypopigmentation. High-throughput sequencing revealed that he has harbored a heterozygous c.105T>A (p.Asn35Lys) variant of the KITLG gene, which was unreported previously. Sanger sequencing confirmed that the variant has co-segregated with the disease phenotype in his pedigree. CONCLUSION For infants with progressive skin pigmentation and hypopigmentation spots, FPHH should be suspected. The heterozygous c.105T>A (p.Asn35Lys) variant of the KITLG gene probably underlay the FPHH in this pedigree.
Male ; Humans ; Pedigree ; Hypopigmentation/genetics* ; Phenotype ; Hyperpigmentation/genetics* ; China

Objective:To investigate the features of endoscopic ultrasonography in the diagnosis of malignant mediastinal and abdominal lymphadenopathy and to provide more evidence for endoscopic ultrasound-guided fine-needle aspiraiton (EUS-FNA).Methods:A case-control study was performed on 83 consecutive patients who underwent EUS in the Second Affiliated Hospital of Soochow University from September 2016 to February 2021. Lymph node properties were identified by pathological results of EUS-FNA and (or) surgery and follow-up for at least 6 months. According to the final diagnosis, patients were divided into malignant lymph node group ( n=56) and benign lymph node group ( n=27). Univariate analysis and multivariate logistic analysis were performed to identify independent risk factors for malignant lymphadenopathy in terms of EUS features. Results:Univariate analysis showed that the length of short axis, short-long axis ratio, shape, border, presence or absence of hilum, heterogeneous echo, and the growth pattern of lymph node were risk factors for malignant lymph nodes ( P<0.10). Multivariate logistic regression analysis showed that short axis>10 mm ( P=0.021, OR=9.751, 95% CI: 1.407-57.573), clear border ( P=0.009, OR=20.587, 95% CI: 2.149-197.251), absence of hilum ( P=0.019, OR=28.502, 95% CI: 1.725-470.864), nodal matting ( P=0.004, OR=45.539, 95% CI: 3.429-604.822), partial nodal fusion ( P=0.004, OR=50.012, 95% CI: 3.497-715.266) were independent risk factors for malignant mediastinal and abdominal lymph nodes. Conclusion:EUS is useful to differentiate the lymph node properties in the mediastinal or abdominal cavity. Short axis>10 mm, clear border, absence of hilum, nodal matting and partial nodal fusion are high-risk EUS features of malignant mediastinal or abdominal lymphadenopathy, where priority should be given to EUS-FNA.