This study is to investigate the effect of artesunate on transforming growth factor-beta1 (TGF-beta1) induced epithelial-mesenchymal transition (EMT) and its possible mechanism. After the in vitro cultured RLE-6TN cells were treated with TGF-beta1 then artesunate intervened on it, after 24 h, expression of the markers of mesenchymal cell was assayed using Western blotting and real-time PCR analysis. Western blotting was also used to detect the effect of TGF-beta1 on the Smad3 and Smad7 expressions of RLE-6TN cells. Morphological alterations were examined by phase-contrast microscope, and ultrastructure changes by electron microscope. Incubation of RLE-6TN cells with TGF-beta1 resulted in the up-regulation of the expression of the mesenchymal cell markers, after artesunate intervened on it, resulted in the down-regulation of the expression. Meanwhile, incubation with artesunate intervened on RLE-6TN cells could lead to the apparent down-regulation of the expression of Smad3 and up-regulation of Samd7 and the transition of RLE-6TN cells to mesenchymal-like by TGF-beta1 induction, after artesunate intervened on it, RLE-6TN cells to epithelial-like. TGF-beta1 induced epithelial-mesenchymal transition process; artesunate can inhibit TGF-beta1-induced epithelial-mesenchymal transition process, the possible mechanism is up-regulation of the expression of Smad7 and down-regulation of the expression of Smad3, meanwhile inhibits phosphorylation of Smad3.
Actins ; genetics ; metabolism ; Animals ; Artemisia ; chemistry ; Artemisinins ; isolation & purification ; pharmacology ; Cell Line ; Cell Proliferation ; drug effects ; Epithelial Cells ; cytology ; metabolism ; Epithelial-Mesenchymal Transition ; drug effects ; Idiopathic Pulmonary Fibrosis ; pathology ; Plants, Medicinal ; chemistry ; Pulmonary Alveoli ; cytology ; RNA, Messenger ; metabolism ; Rats ; Smad3 Protein ; genetics ; metabolism ; Smad7 Protein ; genetics ; metabolism ; Transforming Growth Factor beta1 ; pharmacology ; Vimentin ; genetics ; metabolism

Adolescent ; Aortic Valve ; abnormalities ; Aortic Valve Insufficiency ; complications ; pathology ; surgery ; Aortic Valve Stenosis ; complications ; pathology ; surgery ; Child ; Endocarditis ; complications ; pathology ; surgery ; Female ; Heart Defects, Congenital ; complications ; pathology ; surgery ; Heart Valve Prosthesis Implantation ; Humans ; Male ; Rheumatic Heart Disease ; complications ; pathology ; surgery

Adolescent ; Child ; Collagen Type I ; metabolism ; Extracellular Matrix ; metabolism ; Female ; Fibrillin-1 ; Fibrillins ; Heart Defects, Congenital ; metabolism ; pathology ; Humans ; Male ; Microfilament Proteins ; metabolism

Objective To detect the expression of matrix metallproteinases(MMPs) in aortic valve of children who suffered from rheumatic heart disease(RHD) and to explore the pathological role of MMPs in children′s rheumatic aortic valve disease.Methods RHD group composed of 18 aortic valves from children suffered from RHD.Controls were 8 children who were died accidentally without cardiovascular system diseases.Hematoxylin and eosin stain observing the histological characteristic of the 2 groups.Immunohistochemistry was used to detect expression of MMP2 and MMP9 on aortic valves in 2 groups.Results Hematoxylin and eosin stain showed:in RHD the valves′ structure were destroyed along with fibrous tissue proliferation,mucinous degeneration,collagen and fiber hyalinization,blood vessel and blood capillary proliferation,lymphocyte,plasmocyte,monocyte infiltration.Immunohistochemistry showed that MMP2 and MMP9 expression were significantly higher than those in the aortic of RHD(68.85?13.08,64.35?9.59) compared with control group(107.31?23.39,116.28?6.99)(t=3.92,10.18 all P

OBJECTIVETo evaluate the role of human leukocyte antigen G (HLA-G) in the better effect of allogenetic bone marrow transplantation than that of peripheral blood stem cell transplantation.

METHODSFlow cytometry was used to detect the expression of membrane-bound HLA-G (mHLA-G) on donor peripheral blood (PBC) or bone marrow (BM) mononuclear cells. The levels of soluble HLA-G (sHLA-G) in the plasma and bone marrow fluid were determined using enzyme-linked immunosorbent assay (ELISA) before and after granulocyte colony-stimulating factor (G-CSF) mobilization.

RESULTSThe mean levels of mHLA-G after G-CSF mobilization in the PBC and BM were significantly higher than that before G-CSF mobilization (P=0.001 and 0.000), but the plasma levels of sHLA-G showed no significant changes after the mobilization (P=0.279). The mean levels of sHLA-G in the BM fluid significantly increased (P=0.002) to a level higher than that in the PBC after G-CSF mobilization (P=0.004).

CONCLUSIONHLA-G plays an important role in immune tolerance after hematopoietic stem cell transplantation with G-CSF mobilization.

Adult ; Bone Marrow Transplantation ; immunology ; Female ; Granulocyte Colony-Stimulating Factor ; pharmacology ; HLA Antigens ; immunology ; metabolism ; HLA-G Antigens ; Hematopoietic Stem Cell Mobilization ; methods ; Hematopoietic Stem Cell Transplantation ; Histocompatibility Antigens Class I ; immunology ; metabolism ; Humans ; Immune Tolerance ; Male ; Middle Aged

This study was purposed to analyse the immunophenotypic characteristics of chronic myelomonocytic leukemia (CMML), myelodysplastic syndromes (MDS) and acute monocytic leukemia (AML-M5b) by using multiparameter flow cytometry, and to explore its significance in diagnosis and differential diagnosis. The immunophenotypic characteristics of bone marrow samples from 14 CMML patients, 48 MDS patients, 46 AML-M5b patients and 18 normal persons were analyzed and compared by multiparametric flow cytometry. The results showed that the ratio of monocytes in CMML patients was obviously higher than that in MDS, AML-M5b patients and normal persons (P < 0.05), but there was no statistically significant difference between bone marrow samples of MDS and AML-M5b patients as well as normal persons. The ratio of blast cells in MDS patients was obviously higher than that in normal persons (P < 0.05), but did not show significant difference as compared with CMML patients. The ratio of mature granulocytes in AML-M5b patients was obviously lower than that in CMML and MDS patients as well as normal person bone marrow (P < 0.05). Certain differences of CD45/SSC characteristics in MDS, AML-M5b and CMML patients were found in comparison with normal persons. The abnormal expression of CD2, CD56, and CD14 tailing phenomenon were observed in CMML patients in comparison with bone marrow samples of MDS, AML-M5b and normal persons (P < 0.05). Lack and decrease of CD15 expression in MDS and CMML patients was significant different from AML-M5b and normal persons marrow, abnormal expression rate of CD15 in CMML patients was higher than that in MDS patients (P < 0.05), the CD13/CD11b/CD16 abnormal expression of granulocytes was seen in both CMML and MDS patients, but there was no statistically significant difference between them. Other antigens showed abnormality of varying degrees, but did not have any statistical significance. It is concluded that MDS, CMML and AML-M5b displayed a certain degree of similarity, and also possess their own immunophenotype characteristics. Comprehensive analysis of immunophenotype by multiparameter flow cytometry may be important for differential diagnosis among CMML, MDS and AML-M5b. High percentage of monocytes, abnormal coexpression of CD2, CD56 and CD14 tailing phenomenon, lack or decrease of CD15 as well as abnormal expression of CD13/CD11b/CD16 in granulocytes may play important roles in diagnosis of CMML.
Case-Control Studies ; Flow Cytometry ; methods ; Humans ; Immunophenotyping ; methods ; Leukemia, Monocytic, Acute ; diagnosis ; immunology ; Leukemia, Myelomonocytic, Chronic ; diagnosis ; immunology ; Myelodysplastic Syndromes ; diagnosis ; immunology

Objective To investigate the incidence and its secular trends of gastroschisis in Chinese perinatal infants.Methods Data on perinatal infants was collected at hospitals under surveillance program in Chinese Birth Defects Monitoring Network from 1996 to 2007.Data on incidence,trend and related factors of gastroschisis in perinatal infants were carried out.Both x2 test and Poisson regression model were used to test the differences between residential areas,sex and maternal age.Both x2 trends test and Poisson regression model were applied to analyze the trends.Results A total of 6 308 594 perinatal infants were monitored during 1996-2007,including 1601 infants with gastroschisis to show the incidence as 2.54 per 10 000 births.The overall prevalence of gastroschisis in China did not change remarkably during the period of our research.The incidence rates of gastroschisis were significantly different between urban and rural areas,between different sex and different maternal age groups.The incidence of gastroschisis was lower in urban area than in rural area (RR=0.58) and lower in female fetuses than in male fetuses (RR=0.76),highest in the group younger than 20 years of age,which was 11.43 times than incidence of the 30-34 age group (RR=11.432).Conclusion The overall prevalence of gastroschisis in China did not show remarkable change during 1996-2007 but the incidence of gastroschisis a bit increased in the area of study and significant differences were seen in different sex,regions and maternal age groups.Mothers aged younger than 20 years old appeared to be a significant risk factor for the occurrence of gastroschisis.

OBJECTIVESevere respiratory distress syndrome (RDS) caused by pulmonary surfactant (PS) deficiency is described not only in preterm infants but also in term babies delivered via caesarean section, especially before the onset of labour (elective caesarean section). Once RDS of term neonates happened, mechanical ventilation is needed, and the infants were at high risk of developing further complications such as persistent pulmonary hypertension of neonates (PPHN), pulmonary air leak and cardiovascular instability, even fatal outcome cannot be avoided. The present study aimed to analyze the association between the elective caesarean section and respiratory distress syndrome (RDS) in term neonates, and to determine the related factors and outcomes of RDS cases in neonatal intensive care unit (NICU) and neonatology ward.

METHODSA retrospective study was conducted at the NICU and the Neonatology Ward of A center (Children's Hospital of Zhejiang University) and the NICU of center B (Obstetrics and Gynecology Hospital of Zhejiang University) on 90 term infants who were diagnosed as RDS between June 2006 and June 2008. The general clinical data, mode of delivery, severity of the radiological sign, pulmonary surfactant (PS) application, the onset time and duration of mechanical ventilation, the ratio of PaO(2) to FIO(2) before mechanical ventilation, oxygenation index (OI), duration of oxygen supplementation, the length of hospital stay and complications including pulmonary air leaks (pneumothorax, pulmonary interstitial emphysema), PPHN, systemic hypotension and ventilator-associated pneumonia (VAP) were collected. The gestational age distribution was studied in RDS cases delivered by elective caesarean section, and the comparative analysis and non-conditional logistic regression analysis wer performed for clinical characteristics and risk factors between the RDS cases with or without complications. P < 0.05 was considered to be significant.

RESULTSThere were 88 episodes of elective caesarean section in 90 RDS patients. The proportion of elective caesarean section was 97.8% (88/90). The number of RDS cases was reduced gradually with the increase of gestational age and the constituent ratio of RDS at 39 w and at 40 w was significantly lower than that of 37 w and 38 w. By logistic regression analysis, the onset time of mechanical ventilation > 12 h independently predicted complications in RDS of term neonates (odds ratio 12.667, 95% confidence interval, i.e., CI 1.455 to 110.300, P = 0.021). Moreover, there was a significant difference in the admission age (t = 11.833, P = 0.001), severity of the radiological findings (t = 4.85, P = 0.028), PS application (t = 11.911, P = 0.002), the onset time of mechanical ventilation (t =10.051, P = 0.018), the ratio of PaO(2) to FIO(2) before mechanical ventilation (chi(2) = 4.184, P = 0.005), OI > 25 (t = 4.737, P = 0.03), duration of oxygen supplementation (chi(2) = 10.475, P = 0.001), systemic hypotension (t = 11.020, P = 0.01) and the length of hospital stay (t = 9.827, P = 0.002) between the two centers.

CONCLUSIONSevere RDS can occur in term babies after elective caesarean section, gestational age at the time of elective caesarean section may also be important for RDS in term neonates. The onset time of mechanical ventilation > 12 h independently predicted complications in RDS of term neonates. The main complications of RDS in term neonates were PPHN, pulmonary air leaks and systemic hypotension. Early diagnosis, early intervention can significantly reduce the complications, alleviate the severity and shorten their time for oxygen therapy and their length of stay in NICU in term RDS infants.

Cesarean Section ; Contraindications ; Elective Surgical Procedures ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Pregnancy ; Respiratory Distress Syndrome, Newborn ; diagnosis ; epidemiology ; Retrospective Studies ; Risk Factors ; Term Birth

Objective:To study the effect of cluster nursing care based on 10S continuous quality improvement(CQI)on the incidence of postoperative delirium in patients with BPH.Methods:This study included 96 BPH patients undergoing transurethral resection of the prostate(TURP)in our department from August 2021 to February 2023.We randomly divided the patients into two groups of equal number to receive routine postoperative nursing care(the control group)and postoperative cluster nursing care based on the 10S DQI mode(the observation group),respectively.We recorded and compared the delirium scores of the patients at 2,6,12 and 24 hours after operation,their status of recovery,scores on Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS)and quality of life(QOL),and incidence of complications between the two groups.Results:Compared with the controls,the pa-tients in the observation group showed significantly lower delirium scores at 2 h(12.72±3.54 vs 10.65±2.87,P＜0.05),6 h(20.17±4.92 vs 14.19±4.64,P＜0.01),12 h(16.82±4.24 vs 10.69±3.18,P＜0.01)and 24 h(13.61±2.86 vs 9.13± 2.12,P＜0.01)after operation,and shorter time to ambulation([3.65±1.41]vs[2.84±0.83]d,P＜0.01)and time of postop-erative catheterization([6.28±1.65]vs[4.28±1.14]d,P＜0.01),bladder irrigation([3.41±1.08]vs[2.25±0.71]d,P＜0.01)and hospitalization([10.33±2.41]vs[7.82±2.06]d,P＜0.01).No statistically significant differences were observed between the two groups in either the SAS and SDS scores(P＞0.05)or the QOL scores before operation(P＞0.05),but the former two were dramatically decreased(P＜0.01)while the latter one increased in the observation group postoperatively(P＜0.01).Post-operative complications included delirium,bladder spasm,urethral pain,and secondary bleeding,with a significantly lower total inci-dence rate in the observation than in the control group(12.50％vs 52.08％,P＜0.01).Conclusion:Cluster nursing care based on 10S CQI can promote the postoperative recovery of BPH patients,improve their psychological status and quality of life,and reduce the incidence of delirium and complications.

Objective To study the value of a new measurement that divided obstructive sleep apnea-hypopnea syndrome (OSAHS) into rapid-eye-movement (REM) related and non-rapid-eye-movement (NREM) related subgroups.Methods According to Siddiqui classification, 137 adult patients with OSHAS were diagnosed as REM-related OSAHS [REM apnea hyponea index (AHI)/NREM AHI > 1] or NREM-related OSAHS (REM AHI/NREM AHI < 1).Polysonmographic data were compared and discussed.Results ①There were 72 cases defined as REM-related OSAHS (52.6％) and 65 cases defined as NREM-related OSAHS (47.4％).②In all cases, total AHI and NREM AHI in REM-related OSAHS were significantly lower than those in NREM-related OSAHS, while lowest arterial oxygen saturation (LSaO_2), REM LSaO_2 and NREM LSaO_2 were significandy higher than those in NREM-related OSAHS (t were - 6.466, - 7.638, 3.426, 2.472, 4.873 respectively, P < 0.05).No significance was found in sleep structure, REM AHI and REM LSaO_2 between REM-related and NREM-related OSAHS (P > 0.05).③Given the severity of OSHAS, the constituent ratio of REM-related OSAHS decreased (77.8％ ,61.5％, 37.3％) from mild to severe OSAHS, while that of NREM-related OSAHS rose (22.7％ ,38.5％ ,62.7％ ; X~2 = 16.996, P < 0.01). In mild and moderate groups, REM LSaO_2 of REM-related OSAHS was significantly lower than those in NREM-related OSAHS (t were -4.273 and -2.136, P < 0.05), while the differences of total AHI and LSaO_2 ,NREM LSaO_2 between these two types were not significant.In severe group, AHI in NREM-related OSAHS was significantly higher than that in REM-related OSAHS, while LSaO_2,REM LSaO_2 and NREM LSaO_2 was significantly lower than those in REM-related OASHS (t were -4.943, 2.574, 1.996, 3.571, P≤0.05).④There was no significance in sleeping latency and efficiency between REM-related and NREM-related OSHAS.Conclusions REM-related OSHAS mainly exists in mild and moderate OSHAS, while NREM-related one mainly exists in severe OSHAS.NREM-related OSAHS may be more severe in AHI and hypoxia than REM-related one.Whenever obstructive apnea happened in REM or NREM period, its impacts on sleep structure, efficiency and latency have no difference.