Clinical evidence of hematopoietic restoration with umbilical cord blood (UCB) grafts indicates the UCB can be a useful source of hematopoietic stem cells for routine bone marrow reconstitution. Considering (10 +/- 5) x 10(8) nucleared cells per cord blood unit, there is a potential limitation for the use of cord blood in adults, which, however, can be overcome by ex vivo expansion of cells. A prerequisite for expansion is the significantly higher recovery of MNC, CD34+ cells and colony-forming cells (CFC) by thawing cryopreserved MNC. Cooling rate always acts as a critical factor that can affect the recovery of cells. Although the rate of - 1 degrees C/min is adopted in most of the cryopreservations, no data has been reported about the detailed effects of different cooling rates. The aim of the study was to reveal the different effects of cooling rates on cryopreservation of hematopoietic stem cells from cord blood. UCB samples were collected, and cryopreserved as mononuclear cells (MNC) with different cooling rates of - 0.5 degrees C/min, - 1 degrees C/min, - 5 degrees C/min, and the recovery and viability of MNC and CD34+ cells, the clonogenic capacity and the ex vivo expansion potential of UCB progenitor cells were evaluated after thawing. With - 1 degrees C/min cooling rate, the recovery of MNC reached 93.3% +/- 1.8% , viability 95.0% +/- 3.9% , recovery of CD34+ cells 80.0% +/- 17.9% , and clonogenic recovery were 87.1% +/- 5.5%, 88.5% +/- 8.9%, 86.2% +/- 7.4% for BFU-E CFU-GM CFU-MK, respectively. After 14 days of liquid culture, no significant difference was detected in CFC expansion between fresh and cryopreserved MNC cells with - 1 degrees C/min cooling rate, but this was not the case with - 0.5 degreesC/min and - 5 degrees C/min. In conclusion, it was demonstrated that controlling the rate at - 1 degrees C/min is more suitable for cryopreservation of hematopoietic stem cells than - 0.5 degrees C/min and - 5 degrees C/min.
Cell Survival ; physiology ; Cells, Cultured ; Cryopreservation ; methods ; Erythroid Precursor Cells ; cytology ; Fetal Blood ; cytology ; Flow Cytometry ; Granulocyte-Macrophage Progenitor Cells ; cytology ; Hematopoietic Stem Cells ; cytology ; Humans

OBJECTIVETo investigate and explain the composing mechanism by observing enhancement property of disassembled compositions of Yiqi Huoxue decoction (YQHXD) on platelet aggregation of health adults.

METHODVenous whole blood was obtained from healthy human subjects and anti-coagulated, and then centrifuged to produce platelet-rich plasma (PRP) and platelet-poor plasma (PPP). Disassembled compositions of YQHXD and sodium chloride were placed in different translucent tubes containing PRP and PPP, calculated the maximum percents of platelet aggregation stimulated by platelet agonists: adenosine diphosphate (ADP), platelet activating factor (PAF) and arachidonic acid (AA).

RESULTThe maximum percents of platelet aggregation induced by ADP and PAF were largely improved by YQHXD, both astragalus membranaceus and Angelica Scinesis played the most important roles in the decoction, the herbs of Yiqi and Huoxue must work together to enhance platelet aggregation.

CONCLUSIONIn vitro study, YQHXD can markedly improve platelet aggregation of health adults, but the exact mechanism should be proved by further experiments.

Adenosine Diphosphate ; pharmacology ; Adult ; Angelica sinensis ; chemistry ; Arachidonic Acid ; pharmacology ; Astragalus membranaceus ; chemistry ; Drug Combinations ; Drug Synergism ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Female ; Humans ; Male ; Middle Aged ; Plants, Medicinal ; chemistry ; Platelet Activating Factor ; pharmacology ; Platelet Aggregation ; drug effects ; Young Adult

Objective:To analyze influencing factors of coronary heart disease(CHD)in advanced aged population and the therapeutic effect of percutaneous coronary intervention(PCI).Methods:According to diagnosed as CHD or not,a total of 209 aged patients underwent cardio-and cerebrovascular examination in our hospital were divided into CHD group(n=104)and no CHD group(n=105),and general clinical data were compared between two groups.According to treatment method,CHD group was divided into routine treatment group(received routine medication)and PCI group;and recovery time,hospital stay,incidence rate of adverse events during admission and prognosis within one-year follow-up were compared between two groups.Influencing factors of CHD in aged population was analyzed.Results:Compared with no CHD group,there were significant rise in percentages of age＞80 years,smoking,diabetes mellitus,hypertension,total cholesterol＞5.17mmol/L,triglyceride＞1.7mmol/L,high density lipoprotein cholesterol(HDL-C)＜0.96mmol/L,low density lipoprotein cholesterol＞3.37mmol/L,uric acid＞420μmol/L and fibrinogen＞4 g/L in CHD group(P＜0.05 or＜0.01).Compared with routine treat-ment group,there were significant reductions in recovery time,hospital stay,incidence rates of adverse events,lu-men loss/restenosis,primary and secondary endpoint events within one-year follow-up in PCI group(P＜0.05 or＜0.01).Binary Logistic regression analysis indicated that age＞80 years,uric acid＞420μmol/L and HDL-C＜0.96mmol/L were independent risk factors for CHD in advanced aged population(OR=1.755～6.103,P＜0.05 or＜0.01).Conclusion:Age＞80 years,uric acid＞420μmol/L and HDL-C＜0.96 mmol/L are independent risk fac-tors for coronary heart disease in advanced aged population.PCI can significantly shorten recovery time and treat-ment time in advanced aged patients with coronary heart disease with good safety.

OBJECTIVETo investigate the predictive value of low dose volume of the lung on acute radiation pneumonitis (RP) in patients with esophageal cancer treated with three-dimensional conformal radiotherapy (3D-CRT) only, and to analyze the relation of comprehensive parameters of the dose-volume V5, V20 and mean lung dose (MLD) with acute RP.

METHODSTwo hundred and twenty-two patients with esophageal cancer treated by 3D-CRT have been followed up. The V5-V30 and MLD were calculated from the dose-volume histogram system. The clinical factors and treatment parameters were collected and analyzed. The acute RP was evaluated according to the RTOG toxicity criteria.

RESULTSThe acute RP of grade 1, 2, 3 and 4 were observed in 68 (30.6%), 40 (18.0%), 8 (3.6%) and 1 (0.5%) cases, respectively. The univariate analysis of measurement data:The primary tumor length, radiation fields, MLD and lung V5-V30 had a significant relationship with the acute RP. The magnitude of the number of radiation fields, the volume of GTV, MLD and Lung V5-V30 had a significant difference in whether the ≥ grade 1 and ≥ grade 2 acute RP developed or not. Binary logistic regression analysis showed that MLD, Lung V5, V20 and V25 were independent risk factors of ≥ grade 1 acute RP, and the radiation fields, MLD and Lung V5 were independent risk factors of ≥ grade 2 acute RP. The ≥ grade 1 and ≥ grade 2 acute RP were significantly decreased when MLD less than 14 Gy, V5 and V20 were less than 60% and 28%,respectively. When the V20 ≤ 28%, the acute RP was significantly decreased in V5 ≤ 60% group. When the MLD was ≤ 14 Gy, the ≥ 1 grade acute RP was significantly decreased in the V5 ≤ 60% group. When the MLD was >14 Gy, the ≥ grade 2 acute RP was significantly decreased in the V5 ≤ 60% group.

CONCLUSIONSThe low dose volume of the lung is effective in predicting radiation pneumonitis in patients with esophageal cancer treated with 3D-CRT only. The comprehensive parameters combined with V5, V20 and MLD may increase the effect in predicting radiation pneumonitis.

Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; radiotherapy ; Dose-Response Relationship, Radiation ; Esophageal Neoplasms ; radiotherapy ; Female ; Follow-Up Studies ; Humans ; Lung ; radiation effects ; Male ; Middle Aged ; Radiation Pneumonitis ; etiology ; pathology ; Radiotherapy Dosage ; Radiotherapy, Conformal ; adverse effects ; Retrospective Studies

OBJECTIVETo investigate the proportion of methadone maintenance treatment (MMT) clients continuing to use heroin and to explore its associated risk factors.

METHODSAll 1003 heroin addictive patients were recruited from eight MMT clinics in Guizhou province and followed up for 14 months. During the 14 months, each MMT client received random urine tests. MMT clinics, gender, marital status, employment, ethnicity, religion, previous drug using method, having a history being in detoxification program, age, methadone dosage, education level and length of drug use were treated as potential predicting variables into the GEE model.

RESULTSThe average age of the 1003 clients was (33.3 +/- 6.1) years old, the average length of drug use was (8.0 +/- 4.0) years, and the average daily methadone dosage was (38.0 +/- 16.6) mg. Among the 1003 clients, 26.0% were female drug users, 15.5% were divorced and 35.8% had a full time job. The rate of positive urine samples was approximately 30% for the first 10 months of follow-up, after which the positive rate decreased. The model found that different MMT clinics, the average daily methadone dosage (RR = 0.98, P = 0.003), treatment duration (RR = 0.95, P = 0.029) and years of education (RR = 0.94, P = 0.014) were associated with patients positive urine test.

CONCLUSIONContinued heroin use was common in MMT clinics in Guizhou province; increasing the dosage of methadone and the duration in the treatment program might decrease the continued use of heroin among clients in MMT clinics.

Adolescent ; Adult ; Ambulatory Care ; China ; epidemiology ; Female ; Heroin Dependence ; drug therapy ; epidemiology ; Humans ; Male ; Methadone ; therapeutic use ; Risk Factors ; Risk-Taking ; Young Adult

OBJECTIVETo evaluate HIV risk behaviors among heroin drug users who were treated in methadone maintenance treatment (MMT) clinics.

METHODSA prospective cohort study recruited and followed up clients of eight MMT clinics treated no more than two and half months in Guizhou province, China. Through face-to-face interviews, the baseline and following up informations were collected. And the baseline information included both demographic information and HIV risk behaviors, the following up informations included only HIV risk behaviors. The baseline investigation started in June, 2006 and the following up investigation finished in June, 2007. A total of 1003 heroin drug users were recruited at baseline, among them 666 (66.4%) were still at treatment by the end of follow up and 469 (70.4%) clients participated in the follow up interview. Wilcoxon two sample test and McNemar test were used to test for changes in HIV risk behaviors between baseline and following up investigation.

RESULTSAmong the 469 MMT clients who were followed up, the average days of reported heroin use decreased from 26.4 to 0.9 in the past 30 days (Z = 27.21, P < 0.05). Average days of alcohol use at baseline were 3.3 but 3.7 at follow up (Z = 0.45, P = 0.96). Needle-sharing behavior reported in the past 30 days decreased from 1.3% at baseline to 0.2% at follow up (χ(2) = 5.00, P = 0.025). At baseline, 5.5% (26/469) subjects reported having multiple sex partners in the past 30 days compared to 3.4% (16/469) at following up (χ(2) = 3.18, P = 0.08).6.4% (30/469) subjects reported casual sex with non-regular sex partners in the past 30 days at baseline compared to 5.1% (24/469) at following up (χ(2) = 0.95, P = 0.33). Of those who reported having casual sex relationship in the past 30 days 56.7% (17/30) reported using condoms at baseline but 58.3% (14/24) reported using condoms at follow up (χ(2) = 1.96, P = 0.16).

CONCLUSIONMMT was observed to decrease needle-sharing HIV risk behavior. However, decreased HIV sexual risk behaviors were not observed at statistical significant level.

Adult ; Female ; HIV Infections ; psychology ; Heroin Dependence ; drug therapy ; psychology ; Humans ; Male ; Methadone ; administration & dosage ; therapeutic use ; Opiate Substitution Treatment ; Prospective Studies ; Risk-Taking ; Sexual Behavior

Objective To explore the effects of benzalkonium bromide and citalopram on the corneal epithelium and corneal thickness of mice using optical coherence tomography angiography (OCTA).Methods Together 60 mice were randomly divided into 5 groups (group A,B,C,D and E;n =12),with group A left untreated,group B receiving PBS eye drops,group C given benzalkonium bromide eye drops,group D undergoing intraperitoneal administration of citalopram suspension,and group E treated with combination of benzalkonium bromide eye drops and citalopram suspension.After 2 weeks,OCTA was applied for corneal subarea,followed by measurement of the thickness of corneal epithelium and full-thickness of the cornea of all mice,and then the mean values were calculated.Results The thickness of corneal epithelium and fullthickness of the cornea was (66 ±7) μm and (141 ± 11) μm in the group A,(66 ± 8) μm and (140 ± 12) μm in the group B and D,(73 ± 10) μm and (141 ± 14) μm in the group C,(76 ± 12) μm and (141 ± 15) μm in the E group,respectively.And there was no significant difference in the thickness of corneal epithelium and full-thickness of the cornea before treatment and 2 weeks after treatment in the group A,B and D (all P ＞ 0.05),but both variables were markedly thickened in group C and E 2 weeks after treatment,and the difference was statistically significant (all P ＜0.05).Moreover,the increased levels on the both variables in the group E was higher than those in the group C 2 weeks after treatment,and the difference was statistically significant (both P ＜ 0.05).The average thickness of corneal epithelium and full-thickness of the cornea in the group C and E were significantly thickened after treatment,and the difference was statistically significant (all P ＜ 0.05).The average values of both variables in the group C and E were obviously larger than those in the group A,and the difference was statistically significant (all P ＜ 0.05).Conclusion Citalopram alone has no significant effects on the corneal thickness by OCTA,whereas both the thickness of corneal epithelium and fullthickness of the cornea tend to thicken by benzalkonium bromide treatment,which has a synergistic effect on corneal thickening with citalopram.

Objective To investigate the effects of blue light on the thickness of corneal epithelium and full-thickness of the cornea in mice by optical coherence tomography angiography (OCTA).Methods Totally 40 mice were collected and randomly divided into experimental group and control group,with 20 mice in each group,and the experimental mice were raised in the blue light environment from 8 to 16 hours per day,while the controls were reared in normal environment.Then the thickness of corneal epithelium and full-thickness of the cornea in both groups were measured by OCTA before irradiation and one week,two weeks,one month,two months and three months after irradiation,respectively.Results Compared with pre-irradiation,the thickness of corneal epithelium of all regions did not change significantly in both groups at 1 week,2 weeks,and 1 month after irradiation,and the differences were not statistically significant (all P ＞ 0.05).Compared with before irradiation,the corneal epithelium thickness of the control group at 2 months and 3 months after irradiation did not change significantly,and there was no significant difference (both P ＞ 0.05).Compared with the control group,the corneal epithelium at central,nasal 5 mm,inferior 5 mm,and temporal 5 mm regions in the experimental group were significantly thickened,and the differences were statistically significant (all P ＜0.05).Three months after irradiation,compared with the control group,the thickness of corneal epithelium in the central and inner regions of the cornea and nasal 6 mm and temporal 6 mm regions of the experimental group were significantly thickened,and the differences were statistically significant (all P ＜ 0.05).There was no significant change in the corneal full thickness between the experimental group and the control group before irradiation and 1 week,2 weeks,1 month,2 months,and 3 months after irradiation,and the differences were not statistically significant (all P ＞ 0.05).Furthermore,the difference in the extremum value of corneal epithelial thickness,namely the maximum and the minimum,was significantly different in both groups (P ＜ 0.05),but the difference in the extremum value of the full-thickness of the cornea was not significant in the two groups (P ＞ 0.05).Conclusion The blue light can change the thickness of corneal epithelium in mice,and the change of the central region is obvious,but the full-thickness of the cornea do not significantly change in a short term.

Objective To demonstrate the clinicopathological characteristics and determine the prognostic factors for women with synchronous primary endometrial and ovarian cancer(SEOC). Methods A retrospective analysis of 63 pathologically proven cases of SEOC diagnosed in Peking Union Medical College Hospital from January 2000 to May 2018 was carried out. Results (1)Clinical features: mean age at diagnosis was(48.3±10.0)years, and the mean body mass index(BMI)was(23.4±3.7)kg/m2. The most common presenting symptom was abnormal uterine bleeding with a ratio of 73%(46/63). Forty-three patients(68%,43/63)were premenopausal, and 30%(19/63)were nulliparous.(2)Pathological features:for the endometrial cancer, 90% patients were diagnosed at stageⅠ, and 81% were low grade tumors(G1- G2). The histological type of endometrial cancer was mainly endometrioid carcinoma(86%)and majority (81%)of patients were proved without or with superficial myometrial invasion. For the ovarian cancer, 70% patients were diagnosed at stage Ⅰand 65% were low grade tumors(G1-G2). Sixty-two percent of ovarian cancers were endometrioid carcinoma and 68% of patients had unilateral involvement of the ovaries.(3) Treatment and prognosis: all patients underwent surgery, of which 56 (89%) underwent staging surgery including retroperitoneal lymphadenectomy, and 57(90%)received postoperative adjuvant therapy. The median follow-up time was 48.0 months(range, 2-176 months), and 13% of the patients experienced tumor recurrence during the follow-up period. The median time to recurrence was 38.5 months, and 6 patients (10%)died of tumor recurrence. The 5-year progression-free survival(PFS)and 5-year overall survival(OS) for all patients were 69% and 80%, respectively.(4)Prognostic factors: univariate analysis showed that the presence of lymphovascular space invasion(LVSI), non-endometrioid histology of ovarian cancer and stage of ovarian cancer above stageⅠwere associated with significantly worse PFS(P<0.05). LVSI, high grade of endometrial cancer, and above stage Ⅰof ovarian cancer were associated with significantly worse OS(P<0.05). On multivariate analysis, LVSI, non-endometrioid type ovarian cancer and stage of ovarian cancer above stageⅠwere associated with significantly worse PFS(P<0.05). In addition, LVSI and stage of ovarian cancer above stage Ⅰwere also associated with significantly worse OS(P<0.05). Conclusions Women with SEOC are young, premenopausal and have a favorable overall prognosis. Presence of LVSI, non-endometrioid type ovarian cancer and stage of ovarian cancer above stageⅠare independent prognostic factors for PFS,and stage of ovarian cancer above stageⅠare independent prognostic factors for OS.

BACKGROUNDMyocarditis is an uncommon but serious manifestation of systemic lupus erythematosus (SLE). This study aimed to investigate clinical characteristics and outcomes of lupus myocarditis (LM) and to determine risk factors of LM in hospitalized Chinese patients with SLE.

METHODSWe conducted a retrospective case-control study. A total of 25 patients with LM from 2001 to 2012 were enrolled as the study group, and 100 patients with SLE but without LM were randomly pooled as the control group. Univariable analysis was performed using Chi-square tests for categorical variables, and the Student's t-test or Mann-Whitney U-test was performed for continuous variables according to the normality.

RESULTSLM presented as the initial manifestation of SLE in 7 patients (28%) and occurred mostly at earlier stages compared to the controls (20.88 ± 35.73 vs. 44.08 ± 61.56 months, P = 0.008). Twenty-one patients (84%) experienced episodes of symptomatic heart failure. Echocardiography showed that 23 patients (92%) had decreased left ventricular ejection fraction (<50%) and all patients had wall motion abnormalities. A high SLE Disease Activity Index was the independent risk factor in the development of LM (odds ratio = 1.322, P < 0.001). With aggressive immunosuppressive therapies, most patients achieved satisfactory outcome. The in-hospital mortality was not significantly higher in the LM group than in the controls (4% vs. 2%,P = 0.491).

CONCLUSIONSLM could result in cardiac dysfunction and even sudden death. High SLE disease activity might potentially predict the occurrence of LM at the early stage of SLE. Characteristic echocardiographic findings could confirm the diagnosis of LM. Early aggressive immunosuppressive therapy could improve the cardiac outcome of LM.

Adult ; Case-Control Studies ; China ; Echocardiography ; Female ; Humans ; Lupus Erythematosus, Systemic ; complications ; Male ; Multivariate Analysis ; Myocarditis ; diagnosis ; etiology ; Retrospective Studies ; Risk Factors