Female ; Humans ; Pregnancy ; Pregnancy Complications ; diagnosis ; therapy ; Thyroid Nodule ; diagnosis ; therapy

Objective To summarize the ten cases of pheochromocytoma with special clinical manifestations at onset so as to improve the level of diagnosis and treatment for pheochromocytoma.Methods Clinical data of 10 pathologically diagnosed pheochromocytoma patients after operation with special clinical manifestations at onset were analyzed.The onsets of their illness were respectively presented as acute coronary syndromes,diabetes or abdominal pain.We retrospectively summarized the clinical manifestations,the biochemical characters,the treatment,and the outcomes of these 10 cases.Results The 24-hour urinary vanillylmandelic acid(VMA)87.6~175.5 ?mol,catecholamine(CA)611.1~5 421.0 nmol,epinephrine(E)168.2~2 402.0 nmol and norepinephrine(NE)422.9~3 019.0 nmol were all elevated in the 10 patients before operation.And B mode ultrasonography or CT showed positive findings in adrenal.Ten patients were all pathologically diagnosed as with pheochromocytoma after operation.The angina pectoris attacks disappeared after operation in the 2 cases with acute coronary syndromes,while in 4 cases with diabetes,their blood glucose rebound to normal range gradually after operation without any treatment,and for the other 4 cases their upper abdominal pain also disappeared after operation.Conclusion For those pheochromocytoma patients with atypical clinical manifestations,the key points for the diagnosis are based on biochemical detections and imageological findings.

Objective:To investigate the clinical value of the changes of serum complement,immunoglobulin and inflammatory cytokines in children with mycoplasma pneumonia (MP).Methods:60 cases of children with MP infection were collected as MPP group,60 cases of healthy children as control group.The serum levels of complement (C3,C4) and immunoglobulin (IgA,IgG,IgM) were detected by INA,the serum levels of inflammatory cytokines (IL-8,IL-10,IL-13,TNF-α) were detected by ELISA.Results:①The serum levels of IgM,C3,C4,IL-8,TNF-et and IL-13 in MPP group in acute stage were significantly higher than those in the recovery stage and control group (P＜0.05),the levels of IL-8,TNF-et,IL-13 in the recovery stage were significantly higher than those in control group (P＜0.05);the serum levels of IgA,IL-10 in MPP group in acute stage were significantly lower than those in the recovery stage and control group,and these were still significantly lower than the control group (P＜0.05);the IgG in MPP group in acute stage was not significant difference with control group (P＞0.05),but it in recovery stage was significantly higher than the acute stage and the control group (P＜0.05).②The serum levels of IgM,IgG,C3,C4,IL-8,TNF-et and IL-I 3 in MPP group in severe were significantly higher than those in the mild stage and control group (P＜0.05),and the levels of IgM,IL-8,TNF-αt,IL-13 in the severe stage were significantly higher than those in control group (P＜0.05);the serum levels of IgA,IL-10 in MPP group in severe stage were significantly lower than those in the mild stage and control group,and these in mild stage were still significantly lower than the control group (P＜ 0.05).Conclusion:Children with MP infection have a significant cellular and humoral immune dysfunction,the detection of the changes of serum complement,immunoglobulin and inflammatory cytokines is valuable to assessing the disease staging and degree.

Objective To explore the effects of iPS cells-derived chimeric thymus transplantation on T cells reconstitution and graft versus host disease of murine after allo-BMT. Methods iPS cells-derived chimeric thymus was grafted under the renal capsules of mice after allogeneic IBM-BMT. The mice were divided into three groups:IBM-BMT group, IBM-BMT+TT group and IBM-BMT+DLI group. Four weeks after BMT, T lymphocyte subsets in the peripheral blood were analyzed by flow cytometry, the degree and pathological examination of GVHD were observed, respectively. Results Percentage of CD8+T cells in IBM-BMT group, IBM-BMT+TT group and IBM-BMT+DLI group was(5.52 ± 0.83)%,(11.10 ± 1.49)%and(8.49 ± 0.82)%respectively, there was signifi-cant difference between pairwise comparisons(P<0.05), and percentage of CD4 + T cells of the peripheral blood in IBM-BMT+TT group(9.60 ± 0.69)%was significantly higher than IBM-BMT group(6.42 ± 1.40)%and IBM-BMT+DLI group(8.07 ± 0.65)%(P<0.05) . IBM-BMT group and IBM-BMT+TT group showed less clinical and histopathological scoring of GVHD than IBM-BMT + DLI group. Conclusion iPS cells-derived chimeric thymus transplantation could effectively accelerate T cells reconstitution and prevent GVHD after allo-BMT.

Objective:To investigate the effect of Na + , K + -ATPase on the increase of cytosolic Ca 2+ level induced by hypoxia in rat cortical neurons. Methods: Using confocal laser scanning microscope and video based motion edge detection system, we measured the intracellular Ca 2+ concentration (\ i ) and Na + concentration (\ i ) in cortical neurons exposed to hypoxia for different time periods and at presence of different concentrations of dihydroouabain (DHO, an inhibitor of Na + , K + -ATPase). We also observed the effect of Na + , K + -ATPase on the increase of cytosolic Ca 2+ level induced by hypoxia in rat cortical neurons. Results: DHO (10 -9 -10 -3 mol/L) dose-dependently and hypoxia(4-20 min) time-dependently increased the levels of \ i and \ i in cultured cortical neurons. \ i and \ i increased significantly 4 min after cortical neurons were exposed to hypoxia, and addition of DHO (10 -3 mol/L) further increased their concentrations. While 15 min after hypoxia exposure, different concentrations of DHO did not further increase \ i and \ i. We also found that hypoxia exposure did not enhance DHO pretreatment-induced \ i increase. Conclusion: Inhibition of Na + , K + -ATPase activity is one of the mechanisms responsible for hypoxia-induced elevation of \ i in cortical neurons.

Clinical features of 2 cases of ectopic ACTH syndrome with manifestation of severe hypercortisonism are described with the aim of exploring effective therapies.

Objective To examine an in vivo method for the differentiation of induced pluripotent stem cells (iPSCs) into thymic epithelial cells (TECs) in mice. Methods Green fluorescent protein-expressing iPS cells, derived from C57BL/6 mice, were injected into blastocysts from ICR mice. Chimeric blastocysts were then transferred into uteri of E2.5 pseudopregnant mice. Chimeric mouse could be identified by coat color 10 days after birth. The chimeric thymus was transplanted under the renal capsule of BALB/c nude mice. The spleen was cut out from the thymus-transplanted nude mice and the cells were dispersed and analyzed by a flow cytometer 4 weeks after transplantation. Results Chimeras were born 17 days after embryo transfer and 13 live-born chimeras were obtained. The contribution of iPSC-derived cells in the chimeras ranged from 5% to at most 90%. Typical thymic epithelium structure consisted of green fluorescent protein-expressing cells in chimera. The iPSCs-derived thymic epithelial cells could support the generation of new T cells. Conclusion The results indicate that mouse iPS cells can differentiate in vivo towards normally functioning TECs.

Objective To explore the value of serum microRNA-155-5p and -133a-3p (miR-155-5p and miR-133a-3p) expression for the diagnosis and prognosis evaluation of sepsis. Methods A prospective observational study was conducted. 105 sepsis patients admitted to emergency intensive care unit (EICU) of the First Affiliated Hospital of Zhengzhou University from January 2015 to January 2016 were enrolled. They were divided into three groups according to the severity: 35 patients with sepsis, 35 with severe sepsis, and 35 with septic shock. At the same time, 35 healthy persons were selected as the control group. According to the prognosis, the patients were divided into improved group (n = 70) and in-hospital death group (n = 35). The clinical data of all the subjects were collected. The mRNA expressions of miR-155-5p and miR-133a-3p were determined by reverse transcription-polymerase chain reaction (RT-PCR). The receiver-operating characteristic curve (ROC) was plotted to evaluate their clinical value for the diagnosis and prognosis of sepsis. The binary logistic regression was used to analyze the risk factors affecting the prognosis of sepsis patients. Results ① The mRNA expressions of serum miR-155-5p and miR-133a-3p were gradually increased with the aggravation of sepsis. The mRNA expression of miR-155-5p (2-ΔCt) in sepsis, severe sepsis, sepsis shock groups was 1.89±0.48, 2.21±0.41, 2.79±0.73 (F = 23.737, P = 0.000), and the mRNA expression of miR-133a-3p (2-ΔCt) was 1.38±0.31, 1.74±0.65, 2.08±0.47, respectively (F = 27.710, P = 0.000). It was shown by ROC curve analysis that the area under the ROC curve (AUC) of serum miR-155-5p and miR-133a-3p for the diagnosis of sepsis was 0.855 [95% confidence interval (95%CI) = 0.761-0.949] and 0.769 (95%CI = 0.666-0.872) respectively. The cut-off value of miR-155-5p for the diagnosis of sepsis was 1.64, the sensitivity was 85.3%, and specificity was 80.6%. While the cut-off value of miR-133a-3p was 0.82, the sensitivity and specificity were 97.9% and 54.8% respectively. ② Compared with improved group, the patients of in-hospital death group were more serious, and procalcitonin (PCT), C-reactive protein (CRP), D-dimer, lactic acid (Lac), sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, and the mRNA expressions of miR-155-5p and miR-133a-3p were significantly increased (all P < 0.05). While there was no statistically significant difference in gender, age, white blood cells (WBC), serum creatinine (SCr) between the two groups (all P > 0.05). It was shown by binary logistic regression analysis that Lac [odds ratio (OR) = 0.514, 95%CI = 0.260-0.893, P = 0.024], sepsis severity (OR = 0.039, 95%CI = 0.023-2.955, P = 0.016), SOFA score (OR = 0.668, 95%CI = 0.474-0.825, P = 0.001), serum miR-155-5p expression (OR = 0.117, 95%CI = 0.020-0.530, P = 0.007) were the risk factors affecting the prognosis of patients with sepsis. Conclusions The expression of serum miR-155-5p and miR-133a-3p may be used as specific indicators for the diagnosis of sepsis. And the expression of miR-155-5p can be used as independent impact factor for the estimation of sepsis prognosis.

Objective To evaluate the effects of stepwise and fine-grained dietary management on the diet control of liver cirrhosis patients complicated with gastrointestinal hemorrhage. Methods Eighty liver cirrhosis patients complicated with gastrointestinal hemorrhage were assigned to experimental group (41 cases) and control group(39 cases) by random digits table method. The patients in experimental group were treated with stepwise and fine-grained dietary management and the patients in control group were given conventional dietary treatments. The compliance diet, mastery of nutrition knowledge, malnutrition risk at admission, intake food, discharge and 2 months after discharge between two groups were monitored. The incidence of rebleeding was tracked after 1 year of discharge. Results The incidence of malnutrition risk in Child-Pugh class C was higher than that in Child-Pugh class B( Z=-4.3, P<0.05 ) . The incidence of malnutrition risk in patients with high education level was lower than that in patients with lower education( r=-0.453, P<0.05 ). The experimental group significantly outperformed control group in mastery of nutrition knowledge at discharge:80(70, 84) points vs. 52(42, 64) points, in compliance diet and malnutrition risk after 2 months after discharge:86(76, 91)%vs. 53(46,57)%, 1(1, 2) points vs. 2(1,3) points, the rebleeding rate in experimental group was significantly less than that in control group within 1 year after discharge 14.6%(6/41) vs. 35.9%(14/39), and the differences were statistically significant between two groups ( χ2 = 4.226- 51.232, all P < 0.05 ). Conclusions Stepwise and fine-grained dietary management can improve the mastery of nutrition knowledge, compliance diet and nutritional status, and reduce the occurrence of rebleeding, worth popularizing further in clinical care of liver cirrhosis patients complicated with gastrointestinal hemorrhage.

Objective To evaluate insulin resistance and ?-cell function in patients with systemic lupus erythematosus(SLE).Methods The study group included thirty-two female SLE patients who were hospitalized or received outpatient treatment in our hospital;the control group consisted of twenty-two healthy females.Their fasting plasm glucose and serum insulin were all tested.Homeostasis model assessment(HOMA) was used to calculate HOMA-IR and HOMA-?-cell function,and these parameters were compared between the study group and control group.Results Compared with control group,the SLE patients had significantly higher fasting insulin levels(12.13?4.32 vs.8.84?2.19,P0.05).Conclusion Patients with SLE have a higher risk of insulin resistance and abnormal insulin secretion than controls.