The patients of chronic lymphocytic leukemia(CLL)have great individual differences.It is important for clinicians to determine the prognosis at the beginning of diagnosis and choose proper treatment for the patients.The recent advances in biological prognostic indicators of CLL were reviewed,including IgVH gene mutation status,ZAP70,CD_(38),chromosome abnormality[t(11q;v),del(11q),del(17p),+12 and del(13q)].telomere and telomerase.

Objective To investigate the application of admission test as a medical management in the labor room.Methods Eight hundred and fifty singleton pregnant women underwent admission test in labor room at Women's Hospital,School of Medicine,Zhejiang University from Dec.2009 to Dec.2011 were enrolled into this study.They were divided into two groups:normal group (admission test was normal,n =658) and abnormal group (admission test was abnormal or undetermined,n =192).Deliveries and perinatal outcomes of them were observed.The difference between the two groups were compared with two independent sample t test and Chi-square test.Results There were no significant differences in the mean age at delivery of the women and mean birth weight of neonates between the two groups (all P＞0.05).The cesarean section rate of normal group (34.2％,225/658) was lower than that (59.4％,114/192) of abnormal group (x2=3.93,P＜0.05).The rates of prematurc rupture of membranes (72.4％,139/ 192),fetaldistress (42.2％,81/192),neonatal asphyxia (16.5％,27/192) and neonatal complications (31.8％,61/192) in abnormal group were significantly higher than those [31.0％ (204/658),24.2％ (159/ 658),0.2％(1/658) and 2.6％ (17/658)] in normal group (x2 =105.78,40.84,52.54 and 151.92,P＜0.01respectively).Conclusions Admission test is a good method to forecast placental function during labor and perinatal outcomes,which might play an important role in medical management in labor room.

Adolescent ; Adult ; Chronic Disease ; Dacryocystitis ; surgery ; Dacryocystorhinostomy ; methods ; Endoscopy ; Female ; Humans ; Male ; Microwaves ; therapeutic use ; Middle Aged ; Nasal Cavity ; surgery ; Young Adult

Twenty-three patients with pain from osteoporotic vertebral fractures,aged 65-90 yr,weighing 51-78 kg,received an image intensifier-assisted nerve-root block with a 6-8 ml mixture of 0.5 ％ lidocaine,mecobalamine 0.5 mg and betamethasone sodium phosphate injection 5.26 mg in a prone or lateral position.The VAS scores before operation,at 0,1 week,1 and 3 months after operation were 8.6 ± 0.9,1.5 ± 0.7,2.8 ± 0.9,1.6 ± 0.5 and 2.5 ± 0.7,respectively.VAS scores were significantly lower at each time pint after operation than before operation (P ＜ 0.05).According to modified MacNab standard,the effectiveness of treatment was rated as excellent/good in 87％ of the patients.No complication such as bleeding,hematoma,infection,pneumothorax,hemopneumothorax,headache was found during or after operation.Selective nerve-root block is effective in the treatment of pain resulting from osteoporotic vertebral fractures in patients.

Background Corneal transplantation is the most reliable and effective means to treat the corneal blindness in the clinical,immune rejection is a major cause of corneal graft failure after the keratoplasty.Objective This study aimed to investigate the role of Tim-1 in the immune reaction following corneal transplantation in rats.Methods Forty clean female Wistar rats were randomized into normal control group,autologous corneal transplantation group and allogeneic corneal transplantation group.Penetrating corneal transplantation was performed with the Wistar rat donors and Wistar rat receipts in the autologous corneal transplantation group,while with the SD rat donors and Wistar rat receipts in the allogeneic corneal transplantation group.The corneal graft diameter was 3.5 mm and the plant bed diameter was 3.0 mm.The inflammatory response of the grafts was examined under the slit lamp microscope 7 days and 14 days after operation and scored based on the criteria of Larkin.Rejection index (RI),mean survival time and survival rate were calculated.The histopathological examination was performed 7 days and 14 days after surgery to evaluate the inflammatory manifestation,and the expressions of Tim-1 protein and mRNA were assayed by immnunochemistry and real-time fluorescence quantitative PCR (RT-qPCR)in the time points mentioned above.Results Mild edema of the grafts were found 7 days after operation in both the autologous corneal transplantation group and the allogeneic corneal transplantation group.In postoperative 14 days,the grafts were clear in the autologous corneal transplantation group,but the thickening,neovacularization and cloudy of the grafts were exhibited in the allogeneic corneal transplantation group.The survival rate of the grafts was 100％ in the autologous corneal transplantation group and that of the allogeneic corneal transplantation group was 0 with the survival time of (9.8±1.2) days.Histopathological examination revealed the stromal infiltration of inflammatory cells in both the autologous and allogeneic corneal transplantation groups in the seventh day,however,the inflammatory cells were obvious decreased in the autologous group but increased in the allogeneic corneal transplantation group in the fourteenth day.Immunochemistry showed a gradually declined positive cells for Tim-1 protein in the autologous corneal transplantation group,but the positive cells were exactly elevated in the allogeneic corneal transplantation group from 7 days through 14 days after operation;While only few positive cells were seen in the normal control group.The expression levels of Tim-1 mRNA in the grafts were 1.24 ± 0.03,5.85 ± 0.08 and 6.54 ± 0.20 in the normal control group,autologous corneal transplantation group and that of the allogeneic corneal transplantation group,respectively,in the seventh day,and in the fourteen day after operation,the expression level declined to 1.54 ±0.10 in the autologous corneal transplantation group and elevated to 8.62±0.24 in the allogeneic corneal transplantation group,showing significant differences among the different groups and various time points (Fgroup =3 277.590,P =0.000 ; Ftime =136.000,P =0.000).Conclusions Tim-1 may play an important role not only in the inflammatory response but also in the rejection reaction of the corneal transplantation.

Objective To systematically evaluate the effect of routine insertion of double-J stents to prevent major urological complications(MUCs)in kidney transplant recipients.Methods Medline,Embase,Cochrane Library,and Chinese Biomedicine database were searched to locate relevant randomized controlled trials(RCT).Data extraction and assessment of methodologic quality were performed independently by two reviewers.Meta-analysis was performed by Revman 5.0 software.Results Ten RCT(including 1616 patients)were identified.By comparing the routine stent group with the no stent group,the meta-analysis showed:(1)incidence of urine leak,urinary obstruction and UTI was 4 times lower,6 times lower,increased by 52 % respectively(P＜0.0001);(2)Patient and graft survival,rate of acute rejection,delayed graft function and hematuria were of no significant difference.In subgroup analysis,it was found:(1)Compared with the no stent group,the group in which stent duration was≤ 4 weeks had a lower incidence of MUCs and a higher incidence of UTI;meanwhile,the group in which stent duration was ＞ 4 weeks had a much lower incidence of MUCs and the rate of UTI was increased without significant difference;(2)In the RCT of which urethral catheter duration was ＜ 5 days,there were no significant differences between the two groups in MUCs and UTI.In the RCT of which urethral catheter duration was ≥5 days,the stent group had a lower incidence of MUCs and a higher incidence of UTI.Conclusion Routine stenting reduces the incidence of MUCs.Although the double-J stent increases the risk of UTI,it seems that UTI doesn't affect the outcome of transplantation.The stent duration should be within 4 weeks.For the stent recipients,the longer duration of urethral catheter,the lower incidence of MUCs,the higher incidence of UTI;thus,it is up to clinicians to decide the optimal duration of urethral catheter.Long term prescription of 480 mg cotrimoxazole once daily,from the operation day till after stent removal,effectively reduces the risk of UTI associated with stent placement.

Objective:To study the abnormal suppressive capacity of regulatory T cells ( Tregs) to effector cells,Th17 cells and Th9 cells in patients with mild to moderate asthma attack.Methods: Recruited asthmatic patients (n=30) and healthy control (n=30),collected peripheral venous blood from healthy control and asthmatic patients in mild to moderate attack stage respectively,and then isolated CD4+CD25+CD127-/low Tregs and CD4+CD25-T effect cells with immunomagnetic beads method ( purity was above 90%).The effect cells were cultured with PHA stimulation with or without Tregs.Measured the proliferation (3H-Thymidine), expression of RORC and PU.1 ( RT-PCR) genes,production of IL-17 and IL-9 ( LUMNEX) in effect cells with or without Tregs inter-vention.Analyzed the abnormality of Th17 and Th9 cells and the supressive capacity of Tregs on Th17 and Th9 cells in patients with asthma attack,comparing with control group.Results:Tregs of asthmatic patients could suppress the proliferation of effector cells,but less effectively than healthy control (P=0.03).In asthmatic patients,RORC expression and IL-17 production increased (P<0.05), and the suppressive capacity of Tregs to RORC expression decreased, when compared with healthy group ( P<0.05 ) .In asthmatic patients,IL-9 production of effector cells increased significantly (P<0.05),but PU.1 expression was higher than healthy group only with intervention of Tregs ( P=0.04 ) .And the suppressive capacity of Tregs to the expression of PU.1 and production of IL-9 in patients with asthma attack did not decrease (P>0.05).Conclusion:The suppressive capacity and amount of Tregs decreased,but the specific gene expression and cytokines production of Th17 cells and Th9 cells were upregulated in patients with mild to moderate asthma attack.This deficiency for the suppressive capacity of Tregs to Th17 but not Th9 cells may indicate some pathogenesis of asthma devel-opment.

By summarizing the recent literatures on brain mechanisms with acupuncture intervention based on blood oxygenation level-dependent (BOLD)-functional magnetic resonance imaging (fMRI), the BOLD-fMRI examination and analysis methods, the points to be acupunctured, the corresponding meridian activation regions, the specific intensity range, functions and indications of the acupoints, the manifestation of 'bi-directional regulation' characteristics, fMRI performance of chronergy, laterality and needling qi of acupuncture were reviewed to provide the ideas for future research in this area.

Objective:To evaluate the positive rate of the bronchodilation test (BDT) in asthmatic children with normal forced expiratory volume in 1 second (FEV 1), forced vital capacity (FVC) and FEV 1/FVC, so as to improve the recognition of the importance of the BDT test in asthmatic children with normal FEV 1, FVC and FEV 1/FVC. Methods:Children aged 5-14 who were diagnosed with asthma in the outpatient clinic of Shandong Provincial Hospital Affiliated to Shandong University from September 2018 to August 2019 and willing to receive pulmonary function and BDT examinations were enrolled.Data of pulmonary function of children with normal FEV 1, FVC and FEV 1/FVC were collected to analyze the rate of positive BDT results and the status of small airway function. Results:A total of 1 631 asthmatic children with normal FEV 1, FVC and FEV 1/FVC were enrolled in this study, including 1 414 children with normal pulmonary function and 217 children with small airway dysfunction.Fifteen minutes after the bronchodilator was inhaled, 127 children (87 males and 40 females) showed positive BDT results, accounting for 7.8%.Among these children, 62 cases (28.6%) with co-existing small airway dysfunction showed positive BDT results.The improvement rate of FEV 1 was 8.0% to 11.9% in 132 cases (8.1%). The FEV 1 before bronchodilator inhalation accounted for (98.5±10.3)% of the predicted value.Fifteen minutes after terbutaline sulfate inhalation, the improvement rate was 13.5% (12.5%, 16.2%). The improvement rates of forced expiratory flow at 50% of FVC exhaled (FEF 50, r=-0.339, P<0.01), forced expiratory flow at 75% of forced vital capacity exhaled (FEF 75, r=-0.400, P<0.01), maximum mid-expiratory flow(MMEF, r=-0.375, P<0.01) were negatively correlated with their baseline values.The improvement rate of FEV 1 was not associated with its baseline value ( r=-0.128, P=0.153), but negatively correlated with the baseline value of MMEF ( r=-0.231, P<0.01). Conclusions:BDT results are positive in some asthmatic children with normal FEV 1, FVC and FEV 1/FVC.It is recommended that BDT testing should be conducted as much as possible in the diagnosis and follow-up of children with typical or atypical asthma.In this way, the diagnosis can be confirmed and the current optimal results can be obtained.Meanwhile, small airway function testing is helpful for comprehensive assessment of asthma and its control level.

OBJECTIVETo explore the binding domain of hydroxypyruvate isomerase homologues (HYI) in the interaction with protein P311 in hypertrophic scar fibroblasts (Fb).

METHODS(1) P 311 was amplified by PCR using plasmid pMD18-T-P 311 as template. The total RNA of hypertrophic scar Fb was extracted by Trizol to amplify HYI with RT-PCR. Recombinant vectors pGADT7-P 311 and pGBKT7-HYI were constructed by double-enzyme digestion, and they were verified by PCR and sequencing. The secondary structure of protein HYI was analyzed with software Prot Seale and HNN. Fragments of HYI-1 (1-447 bp), HYI-2 (247-447 bp), HYI-3 (1-279 bp), and HYI-4 (247-654 bp) were amplified based on the result of software analysis. And then the recombinant vectors pGBKT7-HYI-1, 2, 3, and 4 were constructed by double-enzyme digestion and verified by PCR and sequencing. (2) AH109 yeast cells were transformed into competent cells by lithium acetate method and divided into 7 groups roughly in the same amount, including HYI full length, HYI-1, HYI-2, HYI-3, and HYI-4 hybrid groups, positive control group, and negative control group. Cells in the first five groups were respectively transformed with recombinant vector pGBKT7-HYI full length, pGBKT7-HYI-1, pGBKT7-HYI-2, pGBKT7-HYI-3, pGBKT7-HYI-4 and recombinant vector pGADT7-P 311, and that in the rest two groups were transformed with recombinant vectors pGBKT7-53 and pGADT7-RecT, pGADT7-RecT and pGBKT7-Lam by polyethyleneglycol/lithium acetate method. Immediately after transformation, a part of the transformed cells in each group was spread onto the medium lacking leucine, tryptophan, adenine, and histidine (briefly called four-factor lacking medium), and another portion of the cells was spread onto the medium lacking leucine and tryptophan (briefly called two-factor lacking medium). After 3 to 6 days' culture, the growth of yeast was observed, and the expression of β-galactosidase of yeast was detected by color reaction with 5-bromo-4-chloro-indolyl-β-D-galactopyranoside.

RESULTS(1) Cloned P 311 and the reported P 311 (GenBank ID hsu36189) had the same sequence. The A base at 496 bp in reported HYI (GenBank ID AY775560) was replaced by G base as found in cloned HYI. It was verified that the insert segment of each recombinant vector was correct. (2) Among those 216 amino acids which composed the protein HYI, 101 amino acids might form α helices, 90 amino acids might form random coils, 25 amino acids might form extended-chains as revealed in the simulated structure analysis by computer. (3) Cloned segments HYI-1, 2, 3, 4 showed expected lengths. It was verified that the insert segment of each recombinant vector was correct. (4) Except for strains in negative control group which did not show growth on four-factor lacking medium, all strains in other groups grew on both kinds of media, and growth of colonies was less in HYI-2 (with the fewest number of α helices) and HYI-3 hybrid groups. (5) Positive expression of β-galactosidase was observed in strains of all groups growing on four-factor lacking medium except for the HYI-2 hybrid group. No expression of β-galactosidase was observed in strains of negative control group which grew on two-factor lacking medium.

CONCLUSIONSProtein HYI may closely bind with protein P311 by α helix, which plays an important role in fibroblast-to-myofibroblast transdifferentiation in hypertrophic scar.

Aldose-Ketose Isomerases ; genetics ; Cicatrix, Hypertrophic ; enzymology ; genetics ; Cloning, Molecular ; Fibroblasts ; enzymology ; Genetic Vectors ; Humans ; Molecular Sequence Data ; Nerve Tissue Proteins ; metabolism ; Oncogene Proteins ; metabolism ; Plasmids ; Protein Binding ; Protein Interaction Domains and Motifs