Bone Transplantation/adverse effects* ; Transplantation, Autologous/adverse effects*

Objective:To evaluate the effect of berberine (BBR) on morphine-induced activation of BV2 microglial cells.Methods:The BV2 microglial cells were divided into 3 groups ( n=12 each) using a random number table method: control group (C group), morphine group (Mor group)and morphine+ BBR group (Mor+ BBR group). The Mor group was treated for 24 h with a final concentration of 200 μmol/L morphine, while C group was treated for 24 h with an equal volume of PBS buffer. Mor+ BBR group was first treated for 2 h with a final concentration of 20 μmol/L berberine, followed by treatment with a final concentration of 200 μmol/L morphine for another 24 h. The viability of BV2 microglial cells was determined using the CCK-8 assay, the concentrations of interleukin-1beta (IL-1β), tumor necrosis factor-alpha (TNF-α) and IL-10 in supernatant were measured using enzyme-linked immunosorbent assay, and the expression of CD86 and NF-κB proteins in microglial cells was detected using Western blot. Results:Compared with group C, the BV2 microglial cell viability and concentrations of IL-1β and TNF-α were significantly increased, the concentrations of IL-10 were decreased, and the expression of CD86 and NF-κB in microglial cells was up-regulated in Mor group ( P<0.05). Compared with Mor group, the BV2 microglial cell viability and concentrations of IL-1β and TNF-α were significantly decreased, the concentrations of IL-10 were increased, and the expression of CD86 and NF-κB in microglial cells was down-regulated in Mor+ BBR group( P<0.05). Conclusions:BBR can inhibit morphine-induced activation of BV2 microglial cells.

BACKGROUND: Red-cell transfusion is critical for surgery during the peri-operative period; however, the transfusion threshold remains controversial mainly owing to the diversity among patients. The patient's medical status should be evaluated before making a transfusion decision. Herein, we developed an individualized transfusion strategy using the West-China-Liu's Score based on the physiology of oxygen delivery/consumption balance and designed an open-label, multicenter, randomized clinical trial to verify whether it reduced red cell requirement as compared with that associated with restrictive and liberal strategies safely and effectively, providing valid evidence for peri-operative transfusion. METHODS: Patients aged >14 years undergoing elective non-cardiac surgery with estimated blood loss > 1000 mL or 20% blood volume and hemoglobin concentration <10 g/dL were randomly assigned to an individualized strategy, a restrictive strategy following China's guideline or a liberal strategy with a transfusion threshold of hemoglobin concentration <9.5 g/dL. We evaluated two primary outcomes: the proportion of patients who received red blood cells (superiority test) and a composite of in-hospital complications and all-cause mortality by day 30 (non-inferiority test). RESULTS: We enrolled 1182 patients: 379, 419, and 384 received individualized, restrictive, and liberal strategies, respectively. Approximately 30.6% (116/379) of patients in the individualized strategy received a red-cell transfusion, less than 62.5% (262/419) in the restrictive strategy (absolute risk difference, 31.92%; 97.5% confidence interval [CI]: 24.42-39.42%; odds ratio, 3.78%; 97.5% CI: 2.70-5.30%; P <0.001), and 89.8% (345/384) in the liberal strategy (absolute risk difference, 59.24%; 97.5% CI: 52.91-65.57%; odds ratio, 20.06; 97.5% CI: 12.74-31.57; P <0.001). No statistically significant differences were found in the composite of in-hospital complications and mortality by day 30 among the three strategies. CONCLUSION: The individualized red-cell transfusion strategy using the West-China-Liu's Score reduced red-cell transfusion without increasing in-hospital complications and mortality by day 30 when compared with restrictive and liberal strategies in elective non-cardiac surgeries. TRIAL REGISTRATION ClinicalTrials.gov, NCT01597232.
Humans ; Adult ; Postoperative Complications ; Erythrocyte Transfusion/adverse effects* ; Blood Transfusion ; Hospitals ; Hemoglobins/analysis*

Arsenic is a kind of non-metallic substance with carcinogenic effect, which widely exists in the natural environment. Chronic arsenic exposure will cause a series of health damage involving multiple organs of the whole body. Because of its unclear pathogenesis, lack of specific drugs and early biomarkers, it has become the focus and hotspot of scientific and technological workers for a long time. Epigenetic modification not only correlates with arsenic exposure, but also participates in early arsenic-induced damage by regulating the expression of key molecules, which has become an important research direction of arsenic exposure mechanism. As one of the important modes of epigenetic modification, DNA methylation is expected to provide a new therapeutic target for endemic arsenism. However, how DNA methylation regulates the expression of key genes induced by arsenic and participates in the occurrence and development of arsenism and its relationship with the mechanism of arsenism need to be further studied. The research progress of DNA methylation in the pathogenesis of arsenism is reviewed.

Objective:To review and summarize the main problems that have occurred in the history of manned spaceflight worldwide and the experience of the medical rescue support for astronauts at the main landing site since the first manned spaceflight mission of the Shenzhou-5 in China in 2003, focus on the technical status and return characteristics during the construction of the space station since the Shenzhou-12, and formulate a targeted injury treatment plan to ensure the safety of astronauts.Methods:This article summarized the lessons of accidental injuries of astronauts in foreign aerospace history, especially in the space station stage, combined with the experience of medical support of astronauts in manned spaceflight in China, and put forward a series of organizations, plans and treatments according to the mission characteristics of long-term orbits and adjustments of the main landing sites of space station mission spacecraft.Results:On the basis of the original pre-cabin emergency and helicopter ICU comprehensive rescue platform, the emergency procedures were further optimized, and the treatment plans under different complex terrains and the principles of rapid treatment and evacuation of astronauts were formulated.Conclusions:The effective treatment of astronauts returning from the space station in various situations could be ensured by the comprehensive rescue plan for the medical rescue of the space station mission and the construction and organization of the helicopter rescue platform.

Objective:This study aims to analyze the characteristics and basic principles of emergency surgery risks and anesthesia care of medical support at the landing site for China’s taikonauts of the Shenzhou-12, and to summarize China’s experience in medical support at the landing site for manned spaceflight, and ensure supports in special environments such as an emergency return of manned spaceflight.Methods:This study was carried out through literature research on relevant reports on the emergency surgery risks and aids of domestic and foreign astronauts at the landing sites, and summaries of the experience in medical support for taikonauts of spacecrafts from Shenzhou-5 to Shenzhou-11 at the landing sites. At the same time, according to the characteristics of Shenzhou-12 such as the long on-orbit time, the adjustment in the landing area, the optimization of the mission mode, and new search and rescue power, a series of organization, pre-arranged planning, equipment allocation, and effective anesthesia treatment plan were proposed and inspected in practice.Results:Based on the original anesthesia care plan of medical support, the first-aid carrier was adjusted and modified, the first-aid procedure was optimized, a new generation of supraglottic airway opening tool, video laryngoscope, portable ultrasound, and other devices were added, and the anesthesia care plan at the landing site for manned spaceflight was formulated to provide strong support for the medical care of taikonauts that had stayed in the outer space for a long time.Conclusions:Upon the targeted improvement and process optimization, the anesthesia care plan of medical support for taikonauts of Shenzhen-12 in the landing area fully meets the anesthesia requirement of medical support in special environments such as the emergency return of the taikonauts that have stayed in the outer space for a long time under the new orbital altitude.

Objective:To evaluate the effect of ribosomal protein L34 (RPL34) gene knockdown on the proliferation and apoptosis of human cutaneous squamous cell carcinoma (cSCC) cells.Methods:From January 2016 to January 2017, 14 paraffin-embedded skin samples of cSCC and 16 paraffin-embedded normal skin tissue samples were collected from Department of Dermatology and Venereology, the Affiliated Hospital of Inner Mongolia Medical University, and RPL34 expression in the skin tissues was analyzed by immunohistochemical study. A lentivirus vector containing short hairpin RNA targeting RPL34 gene was constructed and used to transfect a human cSCC cell line SCL-1 (shRNA group) , SCL-1 cells transfected with an empty lentivirus vector served as control group, and the knockdown efficiency was verified by real-time quantitative PCR (RT-PCR) and Western blot analysis. At 72 hours after the transfection, flow cytometry was performed to analyze the cell cycle and detect apoptosis of SCL-1 cells, and methyl thiazolyl tetrazolium (MTT) assay to evaluate the cellular proliferative activity of SCL-1 cells. Comparisons between 2 groups were performed by using t test or rank sum test. Results:Immunohistochemical study showed that the cytoplasmic expression score of RPL34 was significantly higher in the cSCC tissues (2.143±1.956) than in the normal control tissues (0.500±0.516, z=3.53, P< 0.05) . RT-PCR showed that the relative mRNA expression of RPL34 in the SCL-1 cells was significantly lower in the shRNA group (0.149±0.016) than in the control group (1±0.018, t=36.95, P< 0.05) ; Western blot analysis revealed that the relative protein expression of RPL34 in the SCL-1 cells was significantly lower in the shRNA group than in the control group. Compared with the control group, the shRNA group showed a significantly increased proportion of S-phase cells ( t=13.76, P< 0.05) , but a significantly decreased proportion of G1-phase cells ( t=36.62, P< 0.05) ; the apoptosis rate was significantly higher in the shRNA group (9.42%±0.16%) than in the control group (4.58%±0.41%, t=19.02, P< 0.05) . MTT assay showed that the cell viability was significantly decreased in the shRNA group (0.815±0.005) than in the control group (1.886±0.005, t=265.91, P< 0.05) after additional 120-hour culture. Conclusion:The RPL34 gene was overexpressed in the cSCC tissues, and knockdown of the RPL34 gene in SCL-1 cells could interfere with cell cycle, decrease their proliferative activity, and promote their apoptosis.

Objective:To investigate the genetic correlation of interleukin-12 (IL-12) pathway-related gene single nucleotide polymorphisms (SNPs) with psoriasis vulgaris and their interaction with HLA-Cw*0602 in populations of Mongolian and Han nationalities in Inner Mongolia.Methods:From December 2012 to March 2018, 1 409 inpatients with psoriasis vulgaris (1 030 of Han nationality and 379 of Mongo-lian nationality) and 1 483 healthy controls (965 of Han nationality and 518 of Mongolian nationality) were collected from the Affiliated Hospital of Inner Mongolia Medical University, and served as patient group and control group respectively. Five milliliters of peripheral venous blood samples were collected from these subjects, and DNA was extracted. Nine SNPs located in the coding regions of IL-12 pathway-related genes were selected, including IL-12B (rs2082412, rs2288831, rs3212227, rs3213094, rs7709212) , IL-23R (rs11209026, rs2201841, rs7530511) and IL-28RA (rs4649203) genes, and detected by next-generation sequencing. HLA-Cw*0602 was genotyped by polymerase chain reaction with sequence-specific primers (PCR-SSP) . Statistical analysis was carried out with PLINK1.07 software, Chi-square test was used to compare allele frequencies between the 2 groups, relative risk estimates of alleles were calculated by using odds ratio ( OR) , and chi-square test for R × C contingency tables was used for haplotype analysis. Results:The allele frequencies of rs2082412, rs2288831, rs3212227, rs3213094 and rs7709212 in the IL-12B gene were significantly lower in the patients with psoriasis vulgaris of Han nationality than in the controls of Han nationality (all P < 0.005) ; the allele frequency of rs3213094 in the IL-12B gene was significantly lower in the patients of Mongolian nationality than in the controls of Mongolian nationality ( P < 0.005) . The prevalence of HLA-Cw*0602 was significantly lower in the patients with psoriasis vulgaris of Han and Mongolian nationalities than in the controls of corresponding nationalities (both P < 0.005) . As stratification analysis showed, the allele frequencies of rs2082412, rs2288831, rs3212227, rs3213094 and rs7709212 in the IL-12B gene were significantly lower in HLA-Cw*0602-positive patients of Han nationality than in HLA-Cw*0602-positive controls of Han nationality (all P < 0.005) , while there was no significant difference between HLA-Cw*0602-negative patients of Han nationality and HLA-Cw*0602-negative controls of Han nationality (all P > 0.05) . Among the HLA-Cw*0602-positive or negative populations of Mongolian nationality, no significant difference was observed in the allele frequencies between the patients and controls (all P > 0.005) . Haplotypes were constructed using 5 SNPs in the IL-12B gene, and there was no significant difference in the frequencies of 6 haplotypes between the patients and controls of Mongolian or Han nationality (all P > 0.005) ; stratification analysis showed that there was no significant difference in the frequencies of 7 haplotypes between HLA-Cw*0602-positive/negative patients and controls of Mongolian or Han nationality (all P > 0.005) . Conclusion:IL-12 pathway-related gene polymorphisms are associated with psoriasis vulgaris in the populations of Mongolian and Han nationalities in Inner Mongolia, and there may be interaction between IL-12B and HLA-Cw*0602 in the occurrence of psoriasis vulgaris.

Objective:To analyze culprit drugs and screen susceptible genes in patients of Han nationality with Stevens-Johnson syndrome (SJS) /toxic epidermal necrolysis (TEN) in Inner Mongolia.Methods:A total of 68 patients of Han nationality with confirmed SJS/TEN were collected from Department of Dermatology, the Affiliated Hospital of Inner Mongolia Medical University between 2015 and 2019. DNA was extracted from peripheral blood samples, and PCR was performed to screen HLA-B*5801, HLA-B*1502 and HLA-A*3101 alleles. Clinical data were collected from the patients, and culprit drugs were analyzed according to the genotypes.Results:Among the 68 patients with SJS/TEN, there were 36 males and 32 females, aged 46.06 ± 19.97 (range, 3-84) years. Five cases were positive for HLA-B*5801 allele, of which 4 were induced by allopurinol; 14 cases were positive for HLA-B*1502 allele, of which 5 were induced by carbamazepine, 4 were induced by lamotrigine, and 5 were induced or likely induced by antibiotics and antipyretic analgesics; only 1 case was positive for HLA-A*3101 allele, and the suspected culprit drug was a traditional Chinese medicine injection for promoting blood circulation with unclear ingredients.Conclusions:HLA-B*5801 has a good predictive effect on allopurinol-induced drug eruptions, and HLA-B*1502 on carbamazepine- and lamotrigine-induced drug eruptions. It is recommended to screen susceptible genes before medication. However, the positive rate of HLA-A*3101 was not very high in the population in Inner Mongolia.

Objective:To investigate the relationship of polymorphisms in metabolic syndrome-related genes with psoriasis vulgaris (PsV) and their interaction with HLA-C*06:02 in populations of Mongolian nationality.Methods:Totally, 379 PsV inpatients of Mongolian nationality and 518 healthy controls of Mongolian nationality were collected from the Affiliated Hospital of Inner Mongolia Medical University from December 2012 to March 2018. Sixteen previously reported single nucleotide polymorphisms (SNPs) and HLA-C*06:02, which were related to metabolic syndrome and its components, were selected. Next-generation sequencing and polymerase chain reaction-sequence specific primer (PCR-SSP) typing were performed to determine the genotypes of these subjects. Minor allele frequencies of the 16 mutation sites and HLA-C*06:02 were calculated in the PsV group and control group, and chi-square test was used to analyze the differences in the minor allele frequencies of SNPs between the 2 groups.Results:There was no significant difference in the minor allele frequencies of the 16 SNPs susceptible to metabolic syndrome between the Mongolian PsV patients and healthy controls (all P > 0.05), while the minor allele frequency of HLA-C*06:02 significantly differed between the 2 groups ( P = 4.09 × 10 -35, OR = 3.41). Among the HLA-C*06:02-positive subjects, the minor allele frequencies of rs7593730_T and rs6931514_G significantly differed between the 252 PsV patients and 191 healthy controls ( P = 0.016, OR = 0.64; P = 0.041, OR = 1.33, respectively) ; no significant difference was observed in the minor allele frequencies of the 16 SNPs between the PsV patients and healthy controls among the HLA-C*06:02-negative subjects ( P > 0.05) . Conclusion:The SNPs of rs7593730 and rs6931514 may be related to PsV in populations of Mongolian nationality in Inner Mongolia, and may interact with HLA-C*06:02.