OBJECTIVEYoung C57BL/6 (B6) mice were treated with a specific tolerogen-dual analogue (Lys262-Ala207) intranasally to observe its effect on the invasion process of mice model and the clinical symptoms, to assess its clinical effects, and to explore the underlying mechanisms and feasibility of nasal mucosal tolerance explored.

METHODSPassively transferred myasthenia gravis (PTMG) was induced by mAb35 on B6 young female mice. Sixty mice were divided equally into three groups: tolerance group, model group and control group. Lys262-Ala207 was given intranasally (250 microg/mouse) to tolerance group with mAb35 for 10 successive days before immunization. Model group received PBS 50 microl only. The body weight and clinical scores were evaluated. The serum levels of AChRAb and the main cytokines (IL-4, IFN-gamma, TGF-beta1) were detected with ELISA.

RESULTSThe model group had typical myasthenia symptoms. B6 mice of tolerance group had less severe symptoms compared with control groups. The clinical symptoms of tolerance group were relieved. The level of AChRAb in tolerance group [(16.01 +/- 1.09) mg/L] was significantly lower than that of model group [(28.12 +/- 1.28) mg/L] (t = 44.37, P < 0.01). IL-4 and IFN-gamma levels in tolerance group [(141.02 +/- 3.11) ng/L, (187.99 +/- 4.67) ng/L] were significantly lower than those of model group [(193.37 +/- 3.95) ng/L, (320.46 +/- 2.14) ng/L] (t = 37.20, 51.69, P < 0.01). The level of TGF-beta1 in tolerance group [(437.19 +/- 1.93) ng/L] was higher than that of model group [(175.63 +/- 3.12) ng/L] (t = 36.07, P < 0.01). But there were still significant change as compared to those in control group (t = 26.65, 31.05, 49.02, P < 0.01).

CONCLUSIONSNasal administration of Lys262-Ala207 ameliorated muscular weakness in PTMG young mice. The therapeutic effect is possibly correlated with the function of immune system.

Animals ; Female ; Immune Tolerance ; Immunity, Mucosal ; Interleukin-4 ; blood ; Mice ; Mice, Inbred C57BL ; Myasthenia Gravis ; blood ; immunology ; Nasal Mucosa ; immunology ; Transforming Growth Factor beta1 ; blood

OBJECTIVE: To eludicate the risk factors of mechanical ventilation and prolonged mechanical ventilation in patients with severe multiple injuries. METHODS: Consecutive patients with severe multiple injures who were treated in Peking University People's Hospital Trauma Medical Center between December 2016 and December 2019 were enrolled in this restropective chart-review study. According to mechanical ventilation and ventilatory time, the patients were divided into mechanical ventilation (MV) group and non-mechanical ventilation (NMV) groups, prolonged mechanical ventilation (PMV) group and shortened mechanical ventilation (SMV) groups. Clinical data such as gender, age, base excess, mechanism of injury, Glasgow Coma Scale (GCS), abbreviated injury scale (AIS) and injury severity score (ISS) were collected. To indentify the risk factors of mechanical ventilation and prolonged mecha-nical ventilation, univariate and multivariate Logistic analyses were carried out. RESULTS: In the present study, 112 patients (82 male, 30 female) with severe multiple injuries having a median age of 52 (range: 16-89 years) and a median ISS of 34 (range: 16-66) were enrolled. The primary mechanism of injury was traffic accident injury and falling injury. In the study, 62 and 50 patients were assigned to MV and NMV groups, respectively. Logistic analysis showed that GCS (OR=0.72, 95%CI: 0.53-0.92, P=0.03), base excess (OR=0.56, 95%CI: 0.37-0.88, P=0.002) and multiple rib fracture (OR=1.72, 95%CI: 1.60-2.80, P=0.012) were independent significant risk factors for mechanical ventilation after severe multiple injuries. Within the mechanical ventilation group, 38 and 24 patients were assigned to PMV and SMVgroups, respectively. Compared with the SMV group, the PMV group had a higher ISS and higher rate of severe head trauma. The length of hospital stay of PMV group was longer than that of SMV groups. Meanwhile, the incidence of tracheotomy in PMV group was high. CONCLUSIONS GCS, base excess and rib fracture might be independent risk factors for mechanical ventilation. Higher ISS and lower GCS might prolong the ventilatory time and the length of hospital stay. Meanwhile, the incidence of tracheotomy was high in PMV group because of the longer ventilatory time and poor consciousness.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Injury Severity Score ; Male ; Middle Aged ; Multiple Trauma ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Young Adult

The experiment explored the influence of glutamic acid (Glu) and the NMDA-receptor antagonist dizocilpine maleate (MK-801) on the pain-evoked responses of pain-excitation neurons (PEN) in the nucleus accumbens (NAc) of rats. The trains of electric impulses applied to the sciatic nerve were used as noxious stimulation. The discharges of PEN in NAc were recorded by glass microelectrode. We observed the influence of intracerebroventricular (icv) injection of Glu and microinjection of MK-801 into the NAc on the noxious stimulation-evoked activities of PEN in NAc. The results showed that the noxious stimulation potentiated the electric activities of PEN in NAc. Intracerebroventricular injection of Glu (10 nmol/10 microl) increased the frequency of the discharge of PEN evoked by the noxious stimulation in NAc, the Glu-induced response was blocked by the injection of MK-801 (1.0 nmol/0.5 microl) into NAc. MK-801 partly inhibited the response of PEN upon the noxious stimulation. It is therefore suggested that the facilitatory effect of Glu on PEN response in NAc to the noxious stimulation is mediated by NMDA receptors, and that Glu and NMDA receptors are involved in the modulation of nociceptive information transmission in the NAc.
Animals ; Dizocilpine Maleate ; pharmacology ; Electric Stimulation ; methods ; Electrophysiological Phenomena ; Female ; Glutamic Acid ; physiology ; Male ; Neurons ; physiology ; Nociceptors ; physiology ; Nucleus Accumbens ; physiology ; Pain ; physiopathology ; Rats ; Rats, Wistar ; Receptors, N-Methyl-D-Aspartate ; antagonists & inhibitors ; physiology

Objective To explore the effect of potato chips soaking in brine external application to protect arteriovenous fistula.Methods A total of 60 cases with oozing and swelling patients after intravenous fistula puncturing were randomly divided into group A (50％ magnesium sulfate wet,n =20),group B (potato chips soaked in brine external application,n =20) and group C (Hirudinous external rub,n =20).Observed three groups of patients with arteriovenous fistula exudation markedly time,exudative healing time,pain relief time and improved the situation of patients blood flow by Doppler ultrasound detected.Results In Group B,exudative effectual time (3.95 ± 1.00)h,oozing healing time(13.05 ±2.11)h,pain relief time in advance (4.65 ± 0.67)h,comparing with group A and group C,the difference were statistically significant (F =89.345,162.116,144.510,respectively;P ＜ 0.01).And the improving blood flow of Group B was significantly better than that in group A and group C (x2 =7.800,P ＜ 0.05).Conclusions Potato chips soaked in brine external application can protect the arteriovenous fistula,with low price,simple operation,rapid onset,which is worthy of clinical application.

Objective To explore the efficacy of application of clinical pathway for hemodialysis patients with indwelling dialysis catheter via deep vein. Methods A total of 80 hemodialysis patients with indwelling dialysis catheter via deep vein were divided into observation and control group. All of patients were treated with indwelling dialysis catheter via deep vein. Patients in observation group were managed by clinical pathway, while those in control group were managed by routine mode. Then, the time for indwelling dialysis catheter, the complication and satisfaction rate of patients were compared between the two groups. Results The complication rate in the observation group were significantly lower than those of the control group (P < 0. 01). The time for indwelling dialysis catheter, the satisfaction rate of patients were significantly superiory than those of the control group (P <0. 05). Conclusions Clinical pathway can improve clinical efficacy of hemodialysis patients with indwelling dialysis catheter via deep vein, which should be worth widespread.

OBJECTIVETo examine the reliability and validity of the 66-item version on the gross motor function measure (GMFM-66) to assess the gross motor functions of children below 3 years oldwith cerebral palsy.

METHODS298 valid samples were obtained from 171 children with cerebral palsy (male 126, female 45 with mean age 19 months, age range 3-36 months) measured with GMFM-88. Then a 73-item version of GMFM (GMFM-73) special for these children was obtained by Rasch analysis. Both GMFM-66 and GMFM-73 scores of to each sample were obtained. The reliability and validity of GMFM-66 were evaluated through analyzing the correlation between the scores and between the changed scores of these two GMFM versions. The relative precision of GMFM-73 versus GMFM-66 was also analyzed.

RESULTSSignificant correlations were found between the scores and between the changed scores of these two versions of GMFM. A 14% less gain in relative precision was achieved when using GMFM-73 versus GMFM-66.

CONCLUSIONResults indicated that the GMFM-66 had good reliability and validity in assessing the gross motor functions of children below 3 years old with cerebral palsy.

Cerebral Palsy ; physiopathology ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Motor Skills ; classification ; Reproducibility of Results ; Surveys and Questionnaires

Objective To investigate the feasibility of complicate myomectomy.Methods Six- seven patients with complicated uterine myomas undergoing laparoscopic myomectomy were retrospectively analyzed.The myomectomy was done using ureteral infravision imaging system or/and with self-made myoma segregate-stick.Among the total,there are 29 cases of multiple myomas(the number of myomas≥5)and 23 cases of single myoma(the diameter of myoma≥7cm,including 19 cases of intramural myoma,4 cases of subserous myoma),6 cases of myoma of broad ligament of uterus and 9 cases of cervical myoma.Results All cases were performed successfully laparoscopically.No intra-operative laparotomy or complications occurred.The average operating time and blood loss were(114?32)min and(114?78)ml respectively. The average time of hospital stay was 5.1 d.The average operating time and blood loss in the group (including multiple myoma group,intramural myoma group and cervical myoma)were significantly exceeded the other groups(including myoma of broad ligament of uterus group and subserous myoma group). Conclusions Laparoscopic complicate myomectomy can be performed and the operation indication is enlarged using Ureteral Infravision Imaging System.Advancement in surgical instruments and expert operating skills are the key to operation success.

Albuminuria ; drug therapy ; Diabetes Mellitus, Type 2 ; complications ; drug therapy ; Diabetic Nephropathies ; drug therapy ; Humans ; Tetrazoles ; therapeutic use

OBJECTIVETo explore the killing effect of the mutant herpes simplex virus thymidine kinase (HSV-sr39tk) and its wild-type (HSV-tk) mediated by lentiviral vector on T lymphocytes in vitro and compare T cell survival rate after GCV or ACV treatment.

METHODSThe three-plasmid lentiviral vector system including packaging plasmid DeltaNRF, envelope plasmid VSV-G and vector plasmid (pTK151 + HSV-sr39tk or pTK151 + HSV-tk) were cotransfected into human embryonic kidney 293T cells using modified calcium phosphate precipitation methods. The packaged virus was harvested 72 h later. The survival of T cells expressing HSV-sr39tk or HSV-tk was measured by MTT assay after 4 day-culture against a gradient of GCV or ACV concentrations.

RESULTSThe three plasmids were effectively cotransfected and a high titre of lentivirus was obtained (2 x 10(6) IU/ml). 39tk(+) T cell survival rates declined promptly when the prodrug GCV/ACV concentrations increased from 0 micromol/L to 10 micromol/L. The T cell survival rates in GCV group declined from (96.04 +/- 3.23)% to (36.76 +/- 4.38)% while in ACV group from (97.31 +/- 4.61)% to (43.75 +/- 8.99)%. However, when GCV/ACV concentrations were more than 10 micromol/L, further decline of 39tk(+) T cell survival rates became unobvious. The growth rate of 39tk(+) T cell exposed to GCV or ACV was obviously lower than that in un-transfected T cells (P < 0.05). Tk(+) T cells were sensitive to GCV (P < 0.05), but not to ACV (P > 0.05). There was a significant difference in killing effects between 39tk(+) T cell + GCV group and tk(+) T cell + GCV group (P < 0.05).

CONCLUSIONThe lentiviral vectors containing HSV-sr39tk gene could infect T lymphocytes effectively and stably without affecting the proliferation of the transduced cell. In contrast to HSV-tk gene, T cells infected HSV-sr39tk were more sensitive not only to GCV but also to ACV.

Acyclovir ; pharmacology ; Animals ; Cell Survival ; drug effects ; Cells, Cultured ; Ganciclovir ; pharmacology ; Genetic Vectors ; Lentivirus ; genetics ; Mice ; Mice, Inbred C57BL ; Plasmids ; genetics ; T-Lymphocytes ; cytology ; drug effects ; Thymidine Kinase ; genetics ; Transfection

OBJECTIVETo explore the value of dual-time-point (18)F-fluorodeoxyglucose integrated positron emission and computed tomography ((18)F-FDG PET-CT) in differentiation of malignant from benign gastrointestinal diseases.

METHODSSixty five patients with suspected gastrointestinal lesions underwent dual-time-point (18)F-FDG PET-CT imaging. Standardized uptake value (SUV) was calculated for semi-quantitative assessment. The SUV of the two acquisitions were signed SUV(early) and SUV(delayed), respectively. Then the change of SUVmax (ΔSUVmax) was calculated. The ROC curves of the SUV(early), SUV(delayed) and ΔSUV were drawn to find the best cut-off point value for differential diagnosis, and then the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated, respectively.

RESULTSOf the malignant lesions, the SUVmax in delayed imaging were significantly higher than those in early imaging, while there were no significant differences of SUVmax between the two images of the benign lesions. The ΔSUVmax of the malignant lesions were significantly higher than that of the benign ones. Taking the SUVmax higher than 9.2 in early imaging as positive diagnostic criteria, the sensitivity was 72.7%, the specificity was 85.7%, the positive predictive value was 91.4%, the negative predictive value was 60.0%, and the accuracy was 76.9%. Taking the SUVmax higher than 10.9 in delayed imaging as positive diagnostic criteria, the sensitivity was 75.0%, the specificity was 90.5%, the positive predictive value was 94.3%, the negative predictive value was 63.3%, and the accuracy was 80.0%. Taking the ΔSUVmax higher than 5.1% as positive diagnostic criteria, the sensitivity was 95.5%, the specificity was 85.7%, the positive predictive value was 93.3%, the negative predictive value was 90.0%, and the accuracy was 92.3%. The accuracy of dual-time-point (18)F-FDG PET-CT imaging was significantly higher than that of single-time point (18)F-FDG PET-CT imaging.

CONCLUSIONDual-time-point (18)F-FDG PET-CT imaging is a useful method for differentiating malignant from benign gastrointestinal diseases, and it is superior to the single-time point (18)F-FDG PET-CT imaging.

Adenocarcinoma ; diagnosis ; pathology ; Adult ; Aged ; Aged, 80 and over ; Colitis ; diagnosis ; pathology ; Colorectal Neoplasms ; diagnosis ; pathology ; Diagnosis, Differential ; Female ; Fluorodeoxyglucose F18 ; Follow-Up Studies ; Gastritis ; diagnosis ; pathology ; Gastrointestinal Diseases ; diagnosis ; pathology ; Gastrointestinal Neoplasms ; diagnosis ; pathology ; Humans ; Male ; Middle Aged ; Positron-Emission Tomography ; methods ; Predictive Value of Tests ; Proctitis ; diagnosis ; pathology ; Proctocolitis ; diagnosis ; pathology ; ROC Curve ; Radiopharmaceuticals ; Sensitivity and Specificity ; Stomach Neoplasms ; diagnosis ; pathology ; Tomography, X-Ray Computed ; methods