Objective To investigate the effects of granulocyte-macrophage colony-stimulating factor (GM-CSF) on the generation of human myeloid derived suppressor cells (MDSCs) relied on peripheral blood monocytes,and to establish efficient induction system in vitro of MDSCs.Methods Kidney transplantation recipients between January and March 2017 were included in this study.Purified CD14 + cells isolated from peripheral blood were cultured in the presence of GM-CSF with different concentrations for 7 days.Phenotypes and immunosuppressive abilities of induced MDSCs (iMDSCs) were investigated with FACS analyses.Inducible nitric oxide synthase (iNOS) mRNA expression was detected by qRT-PCR to determine the influence of iNOS-pathway on the immunosuppressive abilities of iMDSCs.Results A total of 11 recipients were included in this study.HLA-DR expression decreased sharply after the culture with GM-CSF.iMDSCs showed the similar phenotype characteristics with monocytic-MDSCs (M-MDSCs) as well as significant ability to suppress T cells proliferation and cytokines production.iMDSCs expressed higher levels of iNOS than monocytes,and the inhibitor effects of iMDSCs were significantly reduced after treatment with L-NMMA (1 mmol/L).The variations of phenotype and suppressive ability were concentrationdependent,and more significant changes could be revealed in the group of 10 μg/L GM-CSF.Conclusion GM-CSF-treated peripheral blood monocytes can be efficiently transformed to M-MDSCs,and suppress T cells proliferation and cytokines secretion via iNOS-dependent pathway.These results may contribute to establish MDSCs induction system,which would provide a basis for the clinical application of MDSCs.

Objective:To explore the effect of multidisciplinary team (MDT) model on prognosis of patients with traumatic amputation.Methods:A retrospective case-control study was conducted to analyze the clinical data of 54 patients with traumatic amputation admitted to Chongming Branch of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from July 2014 to June 2019. There were 41 males and 13 females, aged 39-72 years with an average age of 52.7 years. A total of 29 patients treated using MDT model intervention were served as observation group, and 25 patients treated using routine responsibility system holistic nursing as control group. The self rating anxiety scale (SAS) score, self rating depression scale (SDS) score and improved Barthel index were compared between the two groups on the day of admission and at 2 weeks, 4 weeks and 8 weeks after operation.Results:There was no significant difference in SAS, SDS and improved Barthel index between the two groups on the day of admission ( P>0.05). At 2 weeks, 4 weeks and 8 weeks after operation, the SAS score in observation group was respectively (52.5±7.6)points, (48.3±7.1)points and (41.3±6.1)points, lower than those in control group [(58.0±12.0)points, (54.4±10.7)points and (50.4±9.3)points]; the SDS scores in observation group was respectively (52.6±8.8)points, (47.9±7.6)points, (43.8±5.7)points, lower than those in control group [(58.4±12.4)points, (53.2±10.9)points, (49.5±8.7)points]; the Barthel index score in observation group was respectively (57.2±8.9)points, (80.7±7.7)points, (94.7±3.9)points, higher than those in control group [(50.4±11.4)points, (70.9±9.5)points, (85.6±6.8)points] (all P<0.05). Conclusion:For patients with traumatic amputation, MDT model is conducive to reducing anxiety and depression of patients, can improve the quality of life, and is worthy of clinical application.