Objective To explore the value of bone marrow megakaryocyte counts in predicting clinical response of thrombocytopenia (TP) in systemic lupus erythematosus (SLE) patients. Methods Thirty-one patients of SLE with severe TP (platelet ≤50×109/L) from Peking Union Medical College Hospital during 2007 to 2014 with appreciable bone marrow aspiration results were retrospectively analyzed. Their therapeutic responses were stratified and the correlation with clinical and laboratory findings including the megakaryocyte counts in bone marrow were evaluated with logistic multivariate regression. Results Totally fifteen patients obtained complete response (CR), eight patients obtained partial response (PR) and eight no response (NR). Megakaryocyte counts in bone marrow were (101±26)/slide, (156±48)/slide and (34±15)/slide respectively with statistically significant difference (χ2=6.632, P=0.036). Those NR patients had less megakaryocytes in their bone marrow compared with those with clinical response (CR+PR) (Z=-2.438, P=0.015). By ROC curve method, we found 20/slide might be a good cutoff of megakaryocyte counts in bone marrow for determining the therapeutic response of immunotherapy with a sensitivity of 91% and a specificity of 63% and a AUC (area under the curve) of 0.793. Those with 20/slide or less megakaryocytes in bone marrows only had a clinical effective response rate of 29% verse a response rate of 88% in those with more megakaryocytes in bone marrow. Conclusion Megakaryocyte counts in bone marrow may provide predictive value for therapeutic response of severe TP in SLE patients. Those patients with equal or less than 20/slide megakaryocytes in their bone marrow tend to have poor therapeutic response.

Objective To explore the protectional function of CpG ODN 1826 against radiation pulmonary fibrosis in rats.Methods The rat left lung was exposed to 20 Gy of 6 MV X-rays for establishing a radiation pulmonary fibrosis model.SD rats were randomly divided into control group,irradiated group and intervention group,with 30 rats in each group.CpG ODN 1826 was intraperitoneally injected into rats at 0,1,2,5 and 7 d post-irradiation.The rats were terminated at 5,15,30 and 90 d post-irradiation,and the lung indexes were recorded.Paraffin sections of the radiated lung were conducted with HE staining and Masson staining,the pulmonary fibrosis scores were recorded.The serum concentrations of TGF-β1 and hydroxyproline (Hyp) were measured.Results The radiation pulmonary fibrosis rat model was successfully established.The lung indexes of the control group were lower than those of the irradiated and intervention groups at 5 d post-irradiation (t =3.046,2.252,P ＜ 0.05).The lung indexes of the intervention group were lower than those of the irradiated group (t =4.120,5.226,5.719,P ＜ 0.05).Pulmonary fibrosis scores of intervention group were lower than those of irradiated group (t =3.212,4.959,P ＜ 0.05).The serum concentrations of TGF-β1 of irradiated group were higher than those of the intervention group (t =4.138,5.924,4.138,5.924,P ＜ 0.05).The Hyp in the lung of irradiated group was higher than that of intervention group (t =7.527,8.416,P ＜ 0.05).Conclusions CpG ODN1826 will not worse the radiation pulmonary fibrosis,on the contrary,it could reduce the serum concentrations of TGF-β1 and the lung content of Hyp in radiation pulmonary fibrosis,and protects rat against radiation pulmonary fibrosis.

Humans ; Estazolam ; Chromatography, High Pressure Liquid

Objective To observe the curative effect of autologous bone marrow stem cells implantation to bone inducing active material combined with core decompression in the treatment of early femoral head osteonecrosis (FHON).Methods From April,2010 to March,2012,in Department of Orthopaedics,the First Affiliated Hospital of Zhengzhou University,a total of 79 adult patients with 108 hips suffered from the early stage FHON were treated with autologous bone marrow stem cells implantation to bone inducing active material combined with core decompression through the core of the femoral canal,male of 65 cases,female of 14 cases,the mean age was 29.5 (20-50) years old.According to the etiology classification:the alcohol-induced FHON was in 54 patients with 66 hips,steroid-induced FHON in 14 patients with 20 hips,steroid and alcohol-induced ONFH was in 11patients with 22 hips.According to association research circulation osseous (ARCO)classifying,Ⅰ-A,Ⅰ-B,Ⅱ-A,Ⅱ-B phases were 6,16,8,and 78 hips,respectively.There were 43 hips in left side and 65 hips in the right side.Results All patients were followed up from 4 to 6 (4.8 ± 0.6) years.Compared with before operation,the scores of all patients were significantly increased (P ＜ 0.05).All patients with hip pain symptoms were relieved or disappeared.The healing tine of the patients in all age groups was statistically significant (P ＜ 0.05),and with the increase of age,the healing time was prolonged.The excellent and good rates of Ⅰ-A,Ⅰ-B,Ⅱ-Aand Ⅱ-B were 100％ (6 / 6),100％ (16/16),100％ (8/8),and 98.7％ (77/78).The X-ray showed that coarse channel osteogenic phenomenon is obvious,there is 1 case collapse of femoral head of stage Ⅱ-B,the rest were not collapse.Conclusion The treatment of early osteonecrosis of the femoral head with autologous bone marrow stem cells implantation to bone inducing active material combined with core decompressionis definitely effective,especially in patients with ARCO:Ⅰ-A,Ⅰ-B and Ⅱ-A phase,and the effect of ARCO:Ⅰ-A and Ⅱ-A is the best.

OBJECTIVETo explore the scientificity of Yunqi theory based on incidence of disease related recognitions such as year evolutive phase, host climatic qi, six climatic factors, celestial manager qi, qi in the earth by analyzing data of hypertension incidence.

METHODSA total of 1,265 inpatients with confirmed first diagnosis as hypertension were recruited at Dongzhimen Hospital, Beijing University of Chinese Medicine from February 4, 1999 to February 4, 2011. Each period (including year evolutive phase, host climatic qi, guest climatic qi) was deducted based on Yun-qi theory. Their ratios of different phases and qi in the total number of hypertension inpatients number were calculated and statistically tested.

RESULTSThere was statistical difference in ratios at year evolutive phase, celestial manager qi, and qi in the earth (P < 0.05).

CONCLUSIONThe incidence of hypertension has certain difference in each period, which is consistent with Yun-qi theory.

Beijing ; epidemiology ; Humans ; Hypertension ; epidemiology ; Incidence ; Medicine, Chinese Traditional ; Qi ; Research

Objective: To explore the correlation between antithrombotic strategy and its prognostic value in coronary artery disease (CAD) patients combining with atrial ifbrillation (AF) after percutaneous coronary intervention (PCI).
Methods: A total of 570 CAD patients with AF received PCI in our hospital from 2012-01 to 2013-12 were retrospectively analyzed by CHADS2 and HAS-BLED Score system. According to CHADS2 < 2 and CHADS2 ≥ 2 or with/without warfarin medication, the patients were divided into 2 groups:①CHADS2 < 2 (Low risk of stroke) group,n=339 including 309 patients without warfarin and 30 with warfarin medication;②CHADS2 ≥ 2 (High risk of stroke) group,n=231 including 200 patients without warfarin and 31 with warfarin medication. All patients were followed-up for 15 months to compare the different anti-platelet/ anti-coagulation strategies for the occurrence rate of MACCE, ischemic and bleeding events.
Results: Compared with Low risk of stroke group, the patients in High risk of stroke group had the worse prognosis and higher rate of MACCE occurrence,P<0.001, HR=2.677, 95% CI (1.535-4.635), more ischemic events,P=0.013, HR=2.080, 95% CI (1.167-3.709). Multi-factor Cox surving analysis indicated that compared with low risk patients without warfarin medication, the high risk patients without warfarin had the higher rate of MACCE occurrence,P=0.001, HR=2.985, 95% CI (1.532-5.816), more ischemic events,P=0.026, HR=2.068, 95% CI (1.090-3.925). Whereas, the occurrence rates of MACCE and ischemic events in high risk, low risk patients with warfarin and low risk patients without warfarin were similar, all P>0.05. The major bleeding events in patients with warfarin were a little higher than those without warfarin,P>0.05. The minor bleeding events were increased in both Low risk stroke group asP<0.001, OR=4.458, 95% CI (1.934-10.277) and High risk stroke group asP=0.002, OR=4.155, 95% CI (1.717-10.055).
Conclusion: Warfarin medication may obviously decrease the occurrence rates of MACCE and ischemic events in high risk of stroke patients, while in low risk patients, warfarin could not further decrease the occurrence of MACCE and ischemic events. Warfarin could increase the risk for minor bleeding in both low risk and high risk of stroke in CAD patients combining with AF after PCI.

Objective To evaluate the homogeneity of the proficiency test samples to verify whether it meets the requirements of the comparison in international reference laboratory.Methods According to the Guidance on Evaluating the Homogeneity and Stability of Samples Used for Proficiency Testing (CNAS-GL03),14 biochemical indexes including ALT,AST,ALP,GGT,CK,LDH,TP,T-Bil,Urea,Cr,UA,Glu,TG and TC in the past three years (from 2014 to 2016)were tested by the Roche detection system Modular P800 Biochemical analyzer.The mean ((x)),standard deviation (s)and coefficient of variation (CV)of the samples were calculated.One-way analysis of variance (ANOVA)was performed and the guideline of Ss ≤0.3σ was used to evaluate the between-bottle differences.Results The results showed that the CVs of AST in RELA 2014A and B were higher than 2.0％.The CVs of CK were over 2％ in all tests except for RELA 2016B.The results of ANOVA for RELA samples demonstrated that the F value of CK was over the critical value 4.39,which was statistically significant (P ＜ 0.05).The F values of the ALT and T-Bil in 2015B and the Cr in 2014A were also over 4.39 (P ＜ 0.05) respectively,while the F values of other measurements were less than the critical value of F,indicating there was no statistical significance (P ＞ 0.05).The CK measurement data Ss ＞ 0.3σ in all the samples by the guideline of Ss ≤ 0.3σ,suggesting that there was a between-bottle difference in CK.The other indexes were Ss ≤ 0.3σ,showing no between-bottle difference in those items.Conclusion There were significant differences between the bottles of the CK item in the past three years,and the homogeneity of all the other items in the samples could meet the requirements of Proficiency Testing for the international reference laboratory.

OBJECTIVETo observe the therapeutic effect of transcutaneous point electric stimulation on periarthritis of shoulder at different stages and compare with electroacupuncture.

METHODSThree hundred and sixty cases of periarthritis of shoulder at different stages were divided into a treatment group (n=186) treated with transcutaneous point electric stimulation, and a control group (n=174) treated with electroacupuncture. Same acupoints were selected in the two groups.

RESULTSThe total effective rate of transcutaneous point electric stimulation was 96.6% at the adhesion prophase and 96.9% at the adhesive stage, but electroacupuncture stimulation was 93.5% and 97.9%, respectively, with no significant differences between the two groups; transcutaneous point electric stimulation not only could relieve pain, but also significantly improve dysfunction of shoulder joints at the adhesive stage.

CONCLUSIONTranscutaneous point electric stimulation is an effective and convenient therapy for periarthritis of shoulder.

Acupuncture Points ; Electric Stimulation ; Humans ; Periarthritis ; therapy ; Shoulder ; Transcutaneous Electric Nerve Stimulation

OBJECTIVETo investigate the expression of matrix metalloproteinase-2 (MMP-2) and insulin-like growth factor-1 (IGF-1) in gastric carcinoma and their clinicopathological significance.

METHODSExpressions of MMP-2 and IGF-1 were examined by using immunohistochemical SP staining and cross-compared with clinicopathological features of gastric carcinoma.

RESULTSHigh expression of MMP-2 and IGF-1 were observed in 70.4% (307/436) and 49.5% (216/436) of gastric carcinoma tissues respectively, significantly higher than those in non-tumor gastric mucosa (3.3% and 5.4%, respectively; all P < 0.05). The high expression rate of MMP-2 and IGF-1 were significantly associated with the patient age, tumor size, tumor location, Lauren classification, TNM staging, depth of tumor infiltration, presence of vessel invasion, lymph node and distant metastasis (all P < 0.05). In addition, the expression of MMP-2 was positively linked with the expression level of IGF-1 (P < 0.05). Univariate analysis showed that high expression of MMP-2, was significantly associated with poor prognosis of tumor of TNM stage I and II (all P < 0.05), high expression of IGF-1 was significantly correlated with poor prognosis of patients with TNM stage I, II and III tumor (all P < 0.05). Cox multivariate analysis indicated that the high expressions of MMP-2 and IGF-1 could be independent prognostic indices for gastric carcinoma.

CONCLUSIONSHigh expression of MMP-2 and IGF-1 proteins are significantly correlated with the invasion and metastasis of gastric carcinoma, it is helpful to simultaneously detect the expressions of MMP-2 and IGF-1 proteins in predicting prognosis of patients with gastric carcinoma.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Insulin-Like Growth Factor I ; metabolism ; Lymphatic Metastasis ; Male ; Matrix Metalloproteinase 2 ; metabolism ; Middle Aged ; Neoplasm Invasiveness ; Prognosis ; Stomach Neoplasms ; metabolism ; pathology ; Young Adult

Objective:To explore whether EZH2 can regulate the expression of miR-200b/a/429 and,thus,affect human tongue squamous cell carcinoma(TSCC).Methods:EZH2 was knocked down in TSCC lines SCC15 and UM-1 with siRNA(si-EZH2)method.The expression levels of EZH2 and epithelial mesenchymal transition related proteins were detected by Western blot.qPCR was used to determine the expression level of miR-200b/a/429 after knockdown of EZH2.Transwell and wound-healing assays were employed to detect the invasion and migration ability of tumor cells.The cytoskeleton was observed with an immunofluorescence assay.EZH2 expression in human head and neck squamous cell carcinoma(HNSCC)was detected by an immunofluorescence assay and qPCR.Results:EZH2 was significantly knocked down by siRNA, thus the expression level of miR-200b/a/429 and E-cadherin increased.While the expression of the N-cadherin,Vimentin,MMP2,and MMP9 proteins decreased;the migration and invasion of HNSCC cells in the si-EZH2 group was markedly inhibited.The EZH2 expression level in patients with lymph node metastasis in HNSCC specimens was higher than those without lymph node metastasis(P<0.01).Conclusions:EZH2 inhibits the expression of miR-200b/a/429 and promotes the invasion and migration of TSCC cells.