Humans ; Liver Diseases ; Practice Guidelines as Topic ; Prognosis

This paper presents some ideas and practices to realize the homogeneity quality management process within the Beijing Children Hospital Group,the largest specialized medical group in the country.This research aims at providing references and thoughts on homogeneity quality management for trans-regional medical unions in the country.

Objective To explore the application value of quantitative analysis of tissue diffusion by ultrasound elastography in evaluating the evolution of achilles tendinopathy and indirectly reflecting the feature of tendon biomechanics.Methods Rabbits underwent 0.1 ml (group M) or 0.3 ml (group S)collagenase or 0.2 ml saline (group C) injection.The percentage of area displaying blue (％AREA) in the area of interest was measured by the diffusion quantitative technique of ultrasound elastography at baseline and 1,3,7 and 14 days after model.The achilles tendon was obtained for pathological examination to observe the changes of collagen fibers and tested to measure the maximum tensile load by the universal testing machine.Results (1) The ％AREAs in group M and S at 1,3,7 and 14 days after model were smaller than those in group C (P ＜0.05),and reached its lowest value at 3 days after model.％ AREA in groupSwas significant lower than that in group M at 3 or 7 days after model (P ＜0.05).(2) The maximum tensile loads in group M at 1,3 and 7 days after model were smaller than those in group C (P ＜0.05),but there was no significant difference between group M and C at 14 days after model (P ＞0.05).The maximum tensile load in group S was significant lower than those in group M and C after model (P ＜0.05),and arrived its lowest point at 3 days after model.(3) The ％AREA was positively associated with the maximum tensile load of achilles tendon (r =0.87,P ＜0.001).Conclusions Ultrasound elastography can dynamically monitor the evolution of achilles tendinopathy and reflect the biomechanical state of achilles tendon.

Liver biopsy has been regarded as the gold standard for the assessment of liver fibrosis regression. In 2017, Liver Research Center, Beijing Friendship Hospital, proposed a new classification called PIR classification for the evaluation of liver fibrosis regression in patients with chronic hepatitis B after antiviral therapy, which was also called “Beijing classification”. This classification is new breakthrough based on conventional staging and grading systems, quantitative assessment methods for liver fibrosis, and the concept of liver biopsy. This article discusses the prospects and shortcomings of PIR classification.

Objective:To investigate the difference in the radiation sensitivity of hematopoietic stem and progenitor cells (HSPCs) derived from fetal liver and bone marrow.Methods:HSPCs from fetal liver of 14.5 d embryo or bone marrow of 8 week-old mice were isolated to receive a single dose of 5 or 10 Gy irradiation in vitro using a 60Co irradiator. Twelve hours later, the cell apoptosis, mitochondrial reactive oxygen species (ROS) level, colony formation ability and DNA damage in HSPCs were detected. Freshly isolated HSPCs were injected into lethally irradiated CD45.1 + C57BL/6J mice (4.5 Gy+ 5 Gy with an interval of 30 min) Chimerism rate, lineage constitution, and cell cycle were analyzed 12 weeks after transplantation. Results:Compared with bone marrow HSPCs after irradiation, the percentage of apoptosis in fetal liver HSPCs was significantly higher ( t=16.21, 12.27, P<0.05), the level of ROS was dramatically elevated ( t=68.72, 18.89, P<0.05). At 10 Gy, fetal liver HSPCs could not form colonies at all ( t=12.41, 15.67, 9.46, P<0.05). γ-H2AX immunofluorescence staining showed that the DNA damage of fetal liver HSPCs was more severe after irradiation, and the number of Foci formed was significantly higher than that of bone marrow HSPCs ( t=2.27, 2.03, P< 0.05), which indicated that fetal liver HSPCs were more sensitive to radiation. The chimerism rate of transplanted fetal liver HSPCs was lower than that of bone marrow cells ( t=5.84, P<0.05) with a higher proportion of myeloid lineage, suggesting that fetal liver HSPCs had lower in vivo reconstitution capacity than bone marrow HSPCs and were more prone to myeloid differentiation. The cell cycle of bone marrow HSPCs from transplanted chimeric mice was examined, and the proportion of S-phase was significantly higher in the fetal liver group than that in the bone marrow group ( t=2.89, P<0.05). Mitochondrial stress results showed that fetal liver HSPCs had higher basal respiratory capacity ( t=39.19, P<0.05), proton leakage ( t=6.64, P<0.05), ATP production ( t=9.33, P<0.05), and coupling efficiency ( t=7.10, P<0.05) than bone marrow c-Kit + cells, while respiratory reserve capacity ( t=5.53, P< 0.05) was lower than that of bone marrow c-Kit + cells. Conclusions:HSPCs derived from fetal liver display higher radiosensitivty compared with bone marrow HSPCs, laying the foundation for an in-depth illustration of the effects of radiation on hematopoietic stem cells at different developmental stages.

Objective:To study the effect of different doses of 60Co γ-ray ionizing radiation on mitochondrial function in mouse hematopoietic stem and progenitor cells (HSPCs). Methods:C57BL/6 mice were divided into control group, 1 Gy irradiation group and 4.5 Gy irradiation group. The mitochondrial functions were detected at 12 h and 24 h after irradiation, including ROS level, membrane potential, mitochondrial structure, and mitochondrial stress. Bone marrow c-Kit + cells received a single 15 Gy irradiation in vitro, after 24 h, mitochondrial function was detected. Results:It was found that mice leukocytes ( t=12.41, 18.31, 16.48, 14.16, 19.08, 20.25, P<0.05), red blood cells ( t=4.81, 6.62, P<0.05) and platelets ( t=4.33, 6.68, P<0.05) were significantly reduced. The numbers of bone marrow colony formation unit ( t=16.27, 55.66, 17.06, 43.75, P<0.05), and HSPCs ( t=5.16, 11.55, P<0.05) were decreased dose-dependently post-irradiation. Under 1 Gy irradiation, the mitochondrial function and mitochondrial basal metabolic index of HSPCs ( t= 7.36, 3.68, 4.58, 3.15, 3.15, P<0.05) were enhanced at 24 h post-irradiation. Under 4.5 Gy irradiation, mitochondrial number, mitochondrial membrane potential ( t=12.29, 10.46, P<0.05), maximal respiration and spare respiratory capacity were decreased ( t=7.81, 5.78, 6.70, 5.83, P<0.05), ROS level was increased ( t=4.63, 4.12, P<0.05). The basal respiration and oxidative phosphorylated ATP production were reduced at 12 h after irradiation ( t=8.48, 3.80, P<0.05); and the proton leakage was increased ( t=6.57, P<0.05) and coupling efficiency was reduced ( t=11.43, P<0.05) at 24 h after irradiation. In cultured c-Kit + cells, the level of ROS ( t=11.30, P<0.05) and the maximum respiration and spare respiratory capacity were increased ( t=4.25, 3.44, P<0.05) while the mitochondrial membrane potential was decreased ( t=34.92, P<0.05) significantly. Conclusions:A method for systematically assessing mitochondrial function in HSPCs was established, and the effect of ionizing radiation on mitochondrial function of HSPCs was clarified, laying a foundation for further revealing the mechanism of ionizing radiation-induced mitochondrial damage in HSPCs.

Objective To investigate the epidemic characteristics of pulmonary tuberculosis (TB) in Minhang District of Shanghai, and to provide a scientific basis for TB prevention and control. Methods Data from active TB patients registered in Minhang District of Shanghai from 2009 to 2019 was collected and analyzed using descriptive epidemiological method. Results From 2009 to 2019 the registration rates of TB patients in Minhang district of Shanghai showed a downward trend, with an average annual registration rate of 32.35/100 000, including 3 611 (41.08%) patients who were registered permanent residents of Shanghai and 5 179 (58.92%) patients who were non-permanent residents. The ratio of men to women was 2.04:1. Workers accounted for more cases (22.77%) than other occupations among patients without registered permanent residence, while retirees accounted for the majority of cases (38.60%) among patients with registered permanent residence. Among the TB patients without registered residence, the highest proportion (45.86%) was in the 20-29 years old group, while the highest proportion in permanent residents was in the 50-59 years old group (19.47%). The peak incidence occurred in May in patients without registered permanent residence, while the peak incidence was in June in patients with registered permanent residence. Conclusion It is necessary to strengthen the prevention and control of TB in people without registered permanent residence of Shanghai, and at the same time, to strengthen the prevention and control of TB in old people and students with registered permanent residence of Shanghai.

Coronary artery disease (CAD) is a chronic disease but causes the highest mortality and morbidity among the cardiovascular diseases worldwide. Correlations between CAD and gut microbiota have been observed. This suggests that the gut microbiota could become a vital diagnostic marker of CAD, and restoring the gut habitat may become a promising strategy for CAD therapy. The elevated level of trimethylamine-N-oxide (TMAO), a gut microbiota-derived metabolite, was found to be associated with the increased risk of cardiovascular disease and the all-cause mortality. Preclinical studies have shown that it has pro-arteriosclerosis properties. It is likely that regulating the production of TMAO by gut microbiota may become a promising strategy for anti-atherosclerosis therapy. This review summarizes the clinical and preclinical researches on the intervention of CAD by regulating the gut microbiota and the microbiota-derived metabolite TMAO, with the aim to provide new target for the therapy of CAD.
Coronary Artery Disease ; Gastrointestinal Microbiome ; Humans ; Methylamines ; Oxides