Objective To explore the role of dendritic cell-specific intercellular adhesion molecule-3-grabbing nonintegrin (DC-SIGN) in the tubulointerstitial lesions of immune-mediated nephrotoxic nephritis (NTN) and the intervention regulation by anti-P-selectin lectin-EGF domain monoclonal antibody (PsL-EGFmAb). Methods WKY rats were randomly divided into control,NTN and PsL-EGFmAb-treated groups. The mrs in NTN group were injected with 1 ml nephrotoxic rabbit serum per kilogram of rat body weight; the ones in PsL-EGFmAb-treated group were injected with 2 mg PsL-EGFmAb per kilogram of rat body weight simultaneously and 2 h later after nephrotoxic rabbit serum injection; and those in control group were injected with equal volume of 0.9% saline. Renal function and pathology were observed at day 4, 7 and 14 after the induction of NTN. Distribution of DC-SIGN + dendritic cells (DCs) in renal tissues was measured by immunofluorescence. Real-time PCR was performed to examine the expression of P-selectin,RANTES, TNF-α, IL-10, IFN-γ and IL-4. Expression of MHC Ⅱ , CD80 and DC-SIGN on dendritic cells was analyzed by flow cytometry. Transendothelial migration was used to detect the ability of DCs migration. DCs ability to activate T cells was determined by mixed lymphocyte reaction (MLR). ELISA was used to detect the concentration of IFN-γ and IL-4 in the supernatant of MLR. Results At day 4, immature DC-SIGN+ DCs infiltrated the rat renal tubulointerstium of NTN group, matured at day 14, and enhanced the ability to migrate and activate T cells. The distribution of DC-SIGN + DCs was significantly related to the form of crescent, tubulointerstial lesions and renal function. In addition, expression of chemokine RANTES and proinflammatory cytokine TNF-α continuously augmented since day 4, while anti-inflammatory eytokine IL-10 decreased after markedly increased at day 4. At day 14, IFN-γ/IL-4 mRNA increased, which was obviously related to DCs maturation. The intervention of PsL-EGFmAb supressed the expression of DC-SIGN and CD80 on DCs, depressed DCs maturation, migration and ability to activate T cells,down-regulated proinflammatory cytokines and up-regulated anti-inflammatory cytokines in kidney,and thus regulated Th1/Th2 bias. At the same time, kidneys showed the decrease of crescents,improvement of tnbulointerstium damage and renal function. Conclusions DC-SIGN may mediate DCs tubulointerstitial infiltration. It may be also a potent regulator of local immune reaction imbalance and pathology of tubulointerstium. PsL-EGFmAb may depress DCs migration and downregulate DCs maturation and function through DC-SIGN, and thus having a role in prevention and treatment.

OBJECTIVETo analyse the efficacy and safety of thalidomide (Thal) for patients with multiple myeloma (MM).

METHODSEffectiveness and adverse events of 102 MM patients treated with thalidomide at a median dosage of 200 mg/d. Thirteen cases were treated with Thal alone (group A), and 105 case with Thal in combination with other therapeutic agents (group B) were retrospectively analyzed.

RESULT1) The response rate (RR) (CR + PR) was 65.4% for induction therapy in 52 cases and 45.5% for salvage therapy in 66 cases. RR in group B was higher than that in group A (58.1% versus 23.1/%, P= 0.017), and the non-response/progress (NR) rate was lower (15.2% versus 46.2%, P= 0.015). In group B, the NR rate was lower in 50 cases of newly diagnosed MM than in 55 cases of refractory or relapsed MM (6.0% versus 23.6%, P=0.012). In group B, RR between Thal+VAD or M, regimen (72 cases) and Thal + MP regimen (33 cases) was not statistically significant (62.5% versus 48.5%, P >0.05). 2) The median duration of response maintenance was 15.5 (1.0-58.0) months in 21 cases. 3) Among 97 patients with follow-up data, the estimated median duration of OS was 44 months in a median follow-up duration of 20 months and the accumulative time for use of Thal was 8 months. In univariate analysis,the accumulative duration for use of Thal 6 months, hemoglobin > or = 100 g/L and bone marrow megakaryocytes > 20 per smear were associated with longer OS (P = 0.0014, 0.0101, 0.019, respectively). 4) Multivariate analysis suggested that the accumulative time for use of Thal and bone marrow megakaryocytes > 20 were independent good prognostic factors for OS (P = 0.006, 0.036, respectively). 5) The adverse events of Thal were mostly endurable, the rate of thrombus events was lower than that reported in literature.

CONCLUSIONThalidomide alone or combined with chemotherapy is an useful therapy for MM. The accumulative time for use longer than 6 months may improve survival.

Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; drug therapy ; Prognosis ; Retrospective Studies ; Thalidomide ; adverse effects ; therapeutic use ; Treatment Outcome

Objective To compare the difference of cutpoint and clinical significance of HbA1C for the diagnosis of abnormal glucose metabolism in two population groups with different ages.Methods According to oral glucose tolerance test(OGTT),the cutpoint and clinical significance of HbA1C for the diagnosis of type 2 diabetes and impaired glucose regulation(IGR)were investigated in the two population groups.Results The mean HbA1C of 1 064 young subjects in an academy and 1 671 aged subjects in a community were 5.31% ±0.41% and 5.79% ±0.71%,respectively.The cutpoints of HbA1C for diagnosis of diabetes were 5.7%(specificity 86.7%,sensitivity 66.7%)and 5.9%(specificity 73.8%,sensitivity 80.1%)in the two population groups,and 5.6% for diagnosis of IGR (specificity 82.8%,sensitivity 55.8%)and 5.7%(specificity 60.9%,sensitivity 64.3%),respectively.87.8%,78.7%,and 38.5% were diagnosed diabetes by current OGTT criteria at HbA1C levels of ≥5.7%,≥5.9%,and≥6.5%,IGR being 61.6%,39.6%,and 4.1%,and normal glucose tolerance being 24.4%,10.0%,and 0.4%.Conclusion The cutpoints of HbA1C for diagnosis of diabetes and IGR are different in populations with different ages and HbA1C levels.As one of diagnostic criteria for diabetes,HbA1C 6.5% with relatively higher specificity and lower sensitivity must be combined with fasting blood glucose,random blood glucose,and OGTT.

Objective To study the effect of application of plan-do-check-act (PDCA) on reducing the incidence of healthcare-associated infection(HAI) in department of neurosurgery.Methods Quality control circle activity group was established,programme of activities was formulated,four stages and ten steps of PDCA were adopted,incidences of H AI in department of neurosurgery before (September-November 2015) and after (May-July 2016) the implementation of PDCA were observed,causes were analyzed based on implementation of hand hygiene,aseptic technique manipulation,and environmental sanitation,countermeasures were found out,and continuous quality improvement was performed for 6 months.Results Comparison between before and after implementation of PDCA was conducted,incidence of HAI in department of nerosurgery decreased from 10.9％ to 5.8％,difference was significant(P＜0.05),control rate was 100％,incidence of HAI dropped by 46.8％;hand hygiene implementation rate increased from 27.2％ to 76.9％,aseptic technique implementation rate increased from 76.0％ to 96.9％,environmental sanitation increased from 51.0 ％ to 90.0 ％,differences before and after implementation were all statistically significant(all P＜0.001).Conclusion Quality control circle activities implemented jointly by multiple departments can reduce the incidence of HAI in department of neurosurgery,rules can be observed,measures can be further improved,it is worthy of clinical application.

Objective To collect more data on the epidemiology of hantavirus in rodents in Cixi,Zhejiang province.Methods Rodents were captured in Cixi,where hemorrhagic fever with renal syndrome (HFRS)appeared endemic.Hantavirus antigens in the rat lungs were detected by immunofluorescence assay.Partial S segment sequences were amplified by reverse transciption-polymerase chain reaction(RTPCR)and then sequenced.The phyologenetic trees were constructed by maximum likelihood method to detect the genetic characteristics of hantavirus.Results A total of 243 rodents were trapped in the epidemic areas,and hantavirus antigens were identified in 7 out of these lung samples(2.88%).Partial S segment sequences(620-999 nt)were recovered from 6 samples and sequenced.Data from phylogenetic analysis of these S segment sequences indicated that all viruses belonged to Seoul virus(SEOV),despite the origins of sources were either from Rattus norvegicus or from R.fzabipectus.These viruses could further be divided into two distinct lineages but the viruses carried by R.norvegicus were different from those carried by R.flabipectus.Conclusion Two distinct lineages of SEOV had been cocirculating in rodents in Cixi.

OBJECTIVE: To explore the effects of exogenous transforming growth factor-beta 1 (TGFbeta1) on peripheral nerve regeneration after the peripheral nerve injury and if TGFbeta1 regulates the expression of basic fibroblast growth factor (bFGF) in the anterior horn motoneurons of spinal cord during regeneration. METHODS: Forty-eight rats were crushed on the right sciatic nerve and then randomly divided into 2 groups: TGFbeta1 group and NS group. In TGFbeta1 group, TGFbeta1 50 microL (0.1 microg/mL) was injected into the proximal nerve near to the crushed nerve and after the operation the injured leg was injected with equal TGFbeta1 whereas the NS was replaced in the NS group. The rats of each group survived for 3, 7, 14 and 21 days after the lesion. The bFGF expression in the anterior horn motoneurons of spinal cord was detected by immunohistochemistry (IHC). Semi-thin section and Fast Blue retrograde tracing were also performed with the rats surviving for 21 days to observe the regeneration of distal end in the injured right sciatic nerve. RESULTS: The number of bFGF immunoreactive positive motoneurons in TGFbeta1 group was obviously higher than that of the NS group (P < 0.05). In the distal sciatic nerve of the rats treated with TGFbeta1, the number and diameter of regenerating myelinated axons and the thickness of myelinated sheath were more than those of the NS group (P < 0.05). The number of motoneurons in spinal cord and neurons in dorsol root ganglia (DRG) labelled with Fast Blue in the NS group was obviously lower than in the TGFbeta1 group (P < 0.01). CONCLUSION Exogenous TGFbeta1 plays an important role in promoting the peripheral nerve regeneration; TGFbeta1 up-regulates the bFGF expression in the anterior horn motoneurons of spinal cord during the peripheral nerve regeneration.
Animals ; Female ; Fibroblast Growth Factor 2 ; biosynthesis ; genetics ; Male ; Motor Neurons ; metabolism ; Nerve Regeneration ; drug effects ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Sciatic Nerve ; injuries ; metabolism ; physiology ; Spinal Cord ; metabolism ; Transforming Growth Factor beta ; pharmacology ; Transforming Growth Factor beta1

Objective To observe the clinical efficacy of closed-loop rehabilitation therapy by brain-computer interface(BCI)combined with exoskeleton robotic hand in patients with hand dysfunction after cerebral infarction and analyze the influence of patients'cognitive function and implicit motor imagery ability on the recognition rate of BCI.Methods A total of 50 patients with cerebral infarction were randomly assigned to the observation group and the control group,25 patients in each group.Both groups received routine rehabilitation programs.In addition to the conventional rehabilitation treatment,the observation group received the closed-loop BCI rehabilitation trainingby brain-computer interface(BCI)combined with exoskeleton robotic hand.The scores of Fugl-Meyer Assessment of the Upper Extremity(FMA-UE),Action Research Arm Test(ARAT),Wolf Motor Function Test(WMFT),and Modified Ashworth scale(MAS)of the wrist flexors were compared between the two groups before and after treatment.Before intervention,the mental rotation test and Montreal Cognitive Assessment(MoCA)were used to assess the baseline implicit motor imagery ability and cognitive level of patients in the observation group.The correlation analysis between these scores and the recognition rate of BCI was conducted to analyze the relevant factors affecting the closed-loop rehabilitation effects of BCI.Results The two groups showed no significant difference in all outcomes before treatment(both P>0.05).After intervention,the observation group exhibited the significantly higher scores of FMA-UE,ARAT,and WMFT(all P<0.05),and significantly lower MAS scores of wrist and finger flexors compared with the control group(all P<0.05).In addition,the recognition rate of BCI was positively correlated with the accuracy of mental rotation test and MoCA score(P<0.05),and negatively corre-lated with the reaction time of mental rotation test(P<0.05).Conclusions Closed-loop rehabilitation training with BCI combined with exoskeleton robot hand can promote the recovery of upper limbs and hand motor function in patients with cerebral infarction.Additionally,the implicit motor imagery ability and cognitive function of patients are suggested to be used for screening the patients suitable for BCI training before the implementation of BCI treatment.

Objective To establish a high performance liquid chromatography-tandam mass spectrometry (LC-MS/MS) method for determining the concentration of nifedipine and its main metabolite dehydronifedipine in rat plasma.Methods The nifedipine,dehydronifedipine and internal standard diazepam were extracted from plasma with protein precipitation by acetonitrile,then the supernatant was separated on SHIMADZU Shim-pack VP-ODS C18 column(2.0 mm ± 150 mm,5 μm),and eluted by acetonitrile-water (containing 0.1％ formic acid) with a gradient elution.The flow rate was 0.35 mL · min-1 Detection of the analytes were achieved using positive ion electrospray ionization in the multiple reaction monitoring mode.The MS/MS ion transitions monitored were m/z 347.2/315.3,345.1/268.1,and 285.3/154.2 for nifedipine,dehydronifedipine and diazepam respectively.Results Nifedipine had a good linear relationship in the range of 2-1000 ng · mL-1 with the calibration curve y =3.07 × 10-2x + 8.42 × 10-2 (r =0.998 9),and the lowest of quantification was 2 ng · mL-1 Dehydronifedipine had a good linear relationship in the range of 2-200 ng · mL-1 with the calibration curve y =4.53 × 10-2x + 2.28 × 10-2 (r =0.996 6),and the lowest of quantification was 2 ng· mL-1.Intra-day and inter-day relative standard deviations (RSDs) of blood samples were less than 15％,and the absolute recovery in plasma was above 90％.Conclusion The established method in this study was simple,rapid,sensitive,specific,and suitable for the determination of nifedipine and dehydronifedipine in rat plasma.

Objective:To evaluate the value of susceptibility-weighted imaging(SWI) in diagnosis of Parkinson disease (PD) and assessment of disease severity.Methods:Totally 30 PD patients and 30 healthy volunteers underwent SWL The phase values of nuclei in extracorticospinal tract were measured and compared between PD patients and healthy subjects.Results:The phase values of sustantia nigra pars compacta,globus pallidus,putamen in PD group were all significantly lower than those in control group(P＜0.01).The phase values of sustantia nigra pars compacta,globus pallidus and putamen reduced at the early stage in PD group,and then further reduced along with the severity of disease(P＜0.05).Conclusions:SWI has important clinical value in diagnosing PD and evaluating the disease severity.

OBJECTIVETo investigate the effect of pre-freezing equilibration on the cryo-survival of human sperm and to optimize the protocol of direct fumigation for the freeze-thawing of human sperm.

METHODSWe collected 50 semen samples from healthy donors, each subjected to cryopreservation with 3 different methods: non-equilibration freezing (Group A), 10-min equilibration at room temperature before freezing (Group B), and 10-min equilibration at 4 degrees C before freezing (Group C). We examined all the post-thaw semen samples by computer-assisted semen analysis for the sperm motility parameters, and detected the sperm vitality and deformity index (SDI).

RESULTSThe recovery rate of progressive sperm motility was (61.88 +/- 16.94)% in Group C, remarkably higher than in A ([48.61 +/- 16.44]%) and B ([49.41 +/- 13.77]%) (P < 0.05), but with no significant difference between the latter two. And there were no significant differences in sperm vitality and SDI among the three groups.

CONCLUSIONTen-minute equilibration at 4 degrees C before freezing can evidently improve the progressive motility of sperm in addition to its advantages of easy operation and controllable experimental condition.

Adult ; Cryopreservation ; methods ; Humans ; Male ; Semen Analysis ; Semen Preservation ; methods ; Sperm Banks ; Sperm Count ; Sperm Motility ; Young Adult