Antigens, CD19 ; analysis ; Asthma ; blood ; Child ; Child, Preschool ; Female ; Flow Cytometry ; Humans ; Immunoglobulin E ; blood ; Lymphocytes ; immunology ; Male ; Receptors, IgE ; analysis

Objective To investigate the effects of enteral nutrition (EN) for diabetes mellitus on the clinical outcomes of critically ill patients with hyperglycemia.Methods Sixty-four critically il1 patients with hyperglycemia were randomly divided into the control group and intervention group.The control group was given homemade homogenized meals and the study group was given EN for diabetes mellitus.Both were given the same total energy and nitrogen content.EN was applied 3 days after ICU admission and then lasted 14 days.Blood glucose was controled at 6.1-8.5 mmol/L by insulin therapy.No albumin,blood plasma,or parenteral nutrition was provided to all patients.The lactulose mannitol ratio,biochemical indicators,total insulin dosage,and short-term and longterm outcomes were analyzed before and after EN support.The quality of life was evaluated using Stroke Specific Quality of Life Scale.Results Finally 59 patients were enrolled in the study,with 30 in the intervention group and 29 in the control group.The lactulose mannitol ratios in the intervenion group were significantly lower than those in the control group 7 days (0.221 ±0.117 vs.0.299 ±0.154,t =-2.199,P =0.032) and 14 days (0.169 ±0.122 vs.0.305 ±0.129,t =-4.191,P =0.000) after EN support.Meanwhile,the total insulin dosages were also significantly less in the intervention group [7 days,(195 ± 54) vs.(227 ± 60) U ; t =-2.096,P =0.041 ;14 days,(392 ±114) vs.(459 ±118) U; t =-2.221,P =0.030].Compared with the control group,the intervention group had significantly shorter duration of mechanical ventilation [(8.00 ± 1.75) d vs.(6.73 ±2.05) d,t=-2.547,P=0.014] and ICU stay[(10.00±1.95) vs.(8.80±2.17) d,t=-2.233,P=0.030],lower total hospitalization expenses [(56 238.39 ± 17 869.61) vs.(70 395.63 ±20 111.69) Yuan,t =-2.861,P =0.006],and faster recovery of daily activities [(17.59 ± 3.21) vs.(35.34 ± 8.65) scores,t =10.030,P =0.000] and living quality of life [(22.67 ± 4.51) vs.(40.55 ± 8.88) scores,t =9.397,P =0.000] after 90 days of treatment.Conclusion The EN for diabetes mellitus may improve the outcomes of critically ill patients with hyperglycemia compared with blend diet.

Objective To establish and evaluate criteria applied to review of complete blood counts (CBC)and differential results from automated hematology analyzers.Methods Temporary criteria were established by using alarm system of XE-2100 automated hematology analyzer and by consulting the 41 suggested rides of international consensus group.2 795 out-and in-patient samples were run as clinical samples.Stained blood films were prepared and manual differential with smear review were performed on all samples.Statistical analysis was done for each temporary rule and instrument flag which indicated abnormal cell quantity and morphology.Results Of all rules,instrument flags of ‘Immature Gran/Left Shift?’, ‘ Atypical Lympho?’and‘NRBC(nucleated red blood cell)?’showed most frequent false positive and false negative instrument flag.Evaluation on rnles about cell quantity change showed false positive and false negative rates were both low.Results of morphology evaluation showed that true positive rate was 17.44%, false positive rate was 15.82%,true negative rate was 63.49%,false negative rate was 3.25%.‘ Atypical Lymphocyte?’,‘Immature Gran?’and‘blast?’were the most frequent false positive flags.According to those results and clinicians opinions,our hematology review criteria for action following automated CBC and leukocytes differential was established.Conclusions The hematology review criteria have high true positive rate and low false negative rate.To clinical hematology laboratory using automated hematology analyzer,new criteria can reduce work load,bring lower false negative rate and higher work efficiency.

Hepatitis associated anti-tuberculous treatment (HATT) has been a main obstacle in managing patients co-infected with Mycobacterium tuberculosis and hepatitis B virus (HBV).Therefore,we evaluated the factors related to the severity of adverse effects during HATT,especially those associated with liver failure.A retrospective study was carried out at Tongji Hospital from 2007 to 2012.Increases in serum transaminase levels of＞3,5,and 10 times the upper limit of normal (ULN) were used to define liver damage as mild,moderate,and severe,respectively.Patients with elevated total bilirubin (TBil) levels that were more than 10 times the ULN (＞171 μrnol/L) with or without decreased (＜40％) prothrombin activity (PTA) were diagnosed with liver failure.A cohort of 87 patients was analyzed.The incidence of liver damage and liver failure was 59.8％ (n=52) and 25.3％ (n=22),respectively.The following variables were correlated with the severity of hepatotoxicity:albumin (ALB) levels,PTA,platelet counts (PLT),and the use of antiretroviral therapies (P＜0.05).Hypo-proteinemia and antiretroviral therapy were significantly associated with liver failure,and high viral loads were a significant risk factor with an odds ratio (OR) of 2.066.Judicious follow-up of clinical conditions,liver function tests,and coagulation function,especially in patients with high HBV loads and hypoalbuminemia is recommended.It may be advisable to reconsider the use of antiviral drugs failure during the course of anti-tuberculous treatment of HBV infection patients to avoid the occurrence of furious liver failure.

Adult ; Female ; Humans ; Sarcoma, Myeloid ; diagnosis ; Uterine Cervical Neoplasms ; diagnosis

OBJECTIVETo generate rescued viruses with deletion mutation of capsid protein from dengue virus type 2 isolated in China (DEN2-43).

METHODSOn the basis of infectious full-length cDNA clone pD212 of DEN2-43 strain virus, the deletion mutants were constructed by fusion PCR, from which the rescued viruses with deletion mutation of capsid protein were generated by transcription in vitro and electroporation.

RESULT AND CONCLUSIONSequence analysis demonstrated that the deletion mutations had been successfully inserted into the rescued viruses obtained. These mutant viruses may hold the key for elucidating the effects of deletion mutation of capsid protein on the biological characteristics of dengue virus.

Amino Acid Sequence ; Animals ; Base Sequence ; Capsid Proteins ; genetics ; Cell Line ; Cloning, Molecular ; DNA Mutational Analysis ; Dengue Virus ; genetics ; isolation & purification ; Electroporation ; Molecular Sequence Data ; Sequence Deletion ; Sequence Homology, Nucleic Acid ; Transcription, Genetic ; Virus Replication ; genetics

Objective: To investigate the clinical significance of tumor associated macrophages (TAM) in multiple myeloma (MM) and the relationship with angiogenesis and immunosuppression. Methods: Seventy cases of MM patients diagnosed from August 2015 to June 2017 were enrolled in the study as experimental group, 20 cases of benign hematological diseases (13 with iron deficiency anemia and 7 with megaloblastic anemia) patients as control group. Immunohistochemical method was used to detect the expression of CD163, CD34 and VEGF in bone marrow samples, and flow cytometry was used to detect the proportion of regulatory T cell (Treg cells), ELISA was used to detect the level of IL-10, and the clinical features were analyzed. Results: ①Among the 70 patients, there were 31 males and 39 females with a median age of 65 (50~78) years old. TAM infiltration density, microvascular density (MVD), VEGF expression level, Treg ratio and IL-10 level in bone marrow samples of 70 MM patients were significantly higher than those of benign hematological diseases (P<0.05). ②In the MM group, the above indexes of the patients with disease stabilized (15 cases) were lower than those of the newly diagnosed group (35 cases) and the relapse refractory group (20 cases) (P<0.05), those of relapse refractory group were higher than those of newly diagnosed group (P>0.05). ③Of the 35 newly diagnosed MM patients, 27 completed 4 courses of treatment. In the effective group (15 cases), the TAM infiltration density after treatment was significantly lower than that before treatment, the difference was statistically significant[(20.20±7.66) vs (28.87±11.97), t=2.362, P=0.025]; while in the ineffective group of 12 cases, the difference of the TAM infiltration density before and after treatment was not statistically significant[(42.00±13.76) vs (48.25±13.59), t=1.119, P=0.275]. ④TAM infiltration density in the effective group after bortezomib treatment (21 cases) were lower than those in the non-bortezomib treatment group (18 cases)[(16.52 ±4.26) vs (19.27 ±5.82), t=1.662, P=0.170]. ⑤The TAM infiltration density in MM patients was positively correlated with MVD, VEGF expression level, Treg cell ratio and IL-10 level (P<0.001). Conclusion: The infiltration of TAM in the microenvironment of MM, which may promoting angiogenesis and inhibiting immune response, is related to the occurrence, development, therapeutic effect and drug resistance of MM.
Aged ; Female ; Humans ; Macrophages ; Male ; Middle Aged ; Multiple Myeloma ; Neoplasm Recurrence, Local ; Neovascularization, Pathologic

OBJECTIVEElectron microscopical study of infected cells to identify the pathogenic agent of SARS.

METHODSVero E6 cells infected with lung autopsy samples or nasopharyngeal swabs from SARS patients of Beijing and Guangzhou were inoculated. The supernatant and cultured cells exhibiting identifiable cytopathic effect (CPE) were prepared for electron microscopic study.

RESULTSExamination of CPE cells on thin-section revealed characteristic coronavirus particles within the cisternae of endoplasmic reticulum, Golgi apparatus, vesicles and extracellular space. They were mainly spherical or oval in shape, annular or dense, about 80 nm in diameter. Negative-stain electron microscopy identified coronavirus particles in culture supernatant, 80 - 120 nm in diameter, with club-shaped surface projections. Elongated, rod-, kidney- or other irregular shaped virons with the size of 100 - 200 nm by 60 - 90 nm were also found in the cultured cells infected with the lung samples from the Guangdong patients. Infectious virons entered cells by endocytosis or membrane fusion and released through a budding process.

CONCLUSIONThese data indicate a novel coronavirus as the causative agent of SARS. Most viral particles showed typical characteristics of coronavirus. The potential role of special shape viruses is expected to be further investigated.

Animals ; Cercopithecus aethiops ; Humans ; Microscopy, Electron ; SARS Virus ; ultrastructure ; Severe Acute Respiratory Syndrome ; virology ; Vero Cells

Objective:To study the expression and interaction between miR-194 and PTPN12 in the process of age-related atrophy of thymus for clarifying the regulatory mechanism in the process of this disease.Methods:C57BL/6 mouse were divided into 4 groups as 1 month,6 months,10 months and 19 months old and each group has 6 cases.Thymus tissue was removed and thymic stromal cells were isolated.And thymus epithelial cells were washed out by CD45 antibody and LS column after anesthesia.Fluorescence quantitative real-time PCR and Western blot were used to detect the changes of miR-194 and PTPN12 gene expression in thymus epithelial cells with aging.miR-194 and PTPN12 luciferase reporter vectors were transfected into HEK293 cells,and the auto fluorescence values were detected at 24 h and 48 h,respectively in vitro.Results:The expression level of miR-194 decreased (P<0.05),while the expression level of PTPN12 mRNA increased (P<0.05) as the age increased.And the correlation between miR-194 and PTPN12 mRNA expression was found to be negative(P<0.05).In vitro,luciferase reporter gene results show that miR-194 has a direct effect on the 3'UTR region of PTPN12 gene and had the highest binding efficiency in 48 h.Conclusion:PTPN12 is one of the target genes of miR-194,which is involved in the aging process of thymus and is an important factor regulating the function of thymic ep-ithelial cells.

OBJECTIVETo evaluate the trabecular bone micro-structure from different sites of spine in adolescent idiopathic scoliosis patients. The target site consisted of the bilateral facet joints from apical vertebrae and from end vertebrae.

METHODSNine AIS patients with mean age 14.9 years (range 12-17 years) and mean Cobb angle 56 degrees (ranged 48 degrees-84 degrees) were recruited into this study. Corrective surgery was indicated to these patients, and facet joint biopsies were collected during decortications for spinal fusion. Biopsy consents were obtained from patients. Bone specimens were fixed with routine histology procedures and scanned by micro computer tomography (muCT40, Scanco Medical, Switzerland). Ten pairs of facet joint were harvested from apical vertebrae and 12 pairs from end vertebrae. Three-dimensional reconstructed images with the resolution of 20 microm were achieved for histomorphometric analysis.

RESULTSThe values of BV/TV (0.268 vs. 0.354, P < 0.05), TbTh (0.20 vs. 0.24, P < 0.05), TbSP (0.66 vs. 0.56, P < 0.05) and BS/BV (12.7 vs. 10.4, P < 0.05) between convex and concave side at the apex area were significantly different. No difference was found in any structural parameters between left and right side at end area, and upper thoracic (T5, 6) and thoracolumbar (T12, L1).

CONCLUSIONDue to asymmetric compression and tension shared between convex and concave side, more bone and thicker and more profound trabecular bones are observed in the concave side than in the convex side, which seems to resist the progression of spinal curvature. This finding suggests that the provocative factors which cause the progression of the curve in certain patients may not lie in the bone component of spine.

Adolescent ; Child ; Female ; Humans ; Scoliosis ; diagnostic imaging ; pathology ; physiopathology ; Tomography, X-Ray Computed ; Zygapophyseal Joint ; pathology ; physiopathology