Objective:To explore the therapeutic effects of intravenous injection of small extracellular vesicles (sEVs) derived from human umbilical cord mesenchymal stem cells (MSCs) on experimental autoimmune uveitis (EAU) in mice.Methods:MSCs from human umbilical cord were cultured and the supernatant was collected.The sEVs were isolated by ultracentrifugation method and a NanoSight instrument was used to analyze the particle size.The expression of surface markers sEVs, CD9, CD81 and CD63 was determined via Western blot.The morphology of sEVs was observed with a transmission electron microscope.Forty-eight 7-week-old female C57BL/6 mice were seclected to establish the EAU model through immunization with interphotoreceptor retinoid-binding protein peptide 651-670 (IRBP 651-670). The mice were divided into sEVs treatment group and phosphate buffer solution (PBS) control group using a random number table, with 24 mice in each group.The mice in the sEVs treatment group were injected with 50 μg of MSCs-derived sEVs via tail vein on the 11th day after modeling.In the PBS control group, the mice were injected with the same volume of PBS.Six mice in each group were randomly selected to observe the inflammation of the retina after mydriasis with an ophthalmoscope every other day from 8th day following modeling and the inflammation scores were evaluated.Six mice were randomly selected and sacrificed on the 14th day and 6 on the 18th day following modeling in each group, and both eyeballs of the mice were enucleated.Retinal tissue sections of the 6 mice sacrificed on the 18th day were stained with hematoxylin-eosin and the pathological scores were evaluated.The infiltration of helper T 1 (Th1) cells and Th17 cells in the eyeballs of the 6 mice sacrificed on the 18th day following modeling was detected by flow cytometry.T cells were isolated from spleen and lymph nodes of the 6 mice sacrificed on the 14th day, and the proliferation of T cells under different concentrations of IRBP 651-670 (0, 1, 10 and 20 μg/ml) was detected using a 5-bromodeoxyuridine (BrdU) method.To further study the effects of MSCs-derived sEVs on Th1/Th17 cells differentiation, naive T cells of spleen from another 3 normal mice were isolated by magnetic bead negative sorting and incubated with 10 μg/ml MSCs-derived sEVs or 10 μg/ml PBS, and then were cultured under Th1/Th17 cell differentiation conditions, respectively.Flow cytometry was used to measure the differentiation of naive T cells into Th1/Th17 cells.This study protocol complied with the regulations of the care and use of laboratory animals in China and was approved by an Ethics Committee of Tianjin Medical University (No.TJYY2019103022). Results:The isolated human MSCs-derived sEVs was with an average diameter of (102.4±33.6) nm and showed a double-layer membrane vesicle structure under the transmission electron microscope.The CD9, CD63 and CD81 proteins were highly expressed in sEVs.The inflammation scores of the sEVs treatment group were significantly lower than those in the control group on day 14, 16, 18, 20 and 22 after modeling (all at P<0.05). The pathological score of mice in the sEVs treatment group was significantly lower than that of PBS control group on the 18th day following modeling ( P<0.05). The flow cytometry results showed that on day 18 after modeling, the proportions of Th1 and Th17 cells in eyeballs in the sEVs treatment group were (15.55±2.03)% and (15.67±2.15)%, respectively, which were significantly lower than (21.35±0.72)% and (20.90±1.10)% in the PBS control group ( t=6.58, 5.31; both at P<0.01). BrdU results showed that when the IRBP 651-670 concentration was 20 μg/ml, the T cell proliferation ability in the sEVs treatment group was inhibited obviously compared with the control group ( P<0.05). The proportions of naive T cells differentiated into Th1 cells and Th17 cells in the sEVs treatment group were (28.15±1.32)% and (11.60±2.23)% respectively, which were significantly lower than (31.58±1.75)% and (23.52±1.76)% of the PBS control group, and the differences were statistically significant ( t=3.93, 10.26; both at P<0.05). Conclusions:Intravenous injection of human umbilical cord MSCs-derived sEVs can reduce the inflammation in EAU mice.The mechanism may be related to inhibiting the differentiation of naive T cells to Th1 and Th17 cells, and reducing the infiltration of Th1 and Th17 cells in the eyeballs.

The widespread application of next generation sequencing (NGS) in clinical settings has enabled testing, diagnosis, treatment and prevention of genetic diseases. However, many issues have arisen in the meanwhile. One of the most pressing issues is the lack of standards for reporting genetic test results across different service providers. The First Forum on Standards and Specifications for Clinical Genetic Testing was held to address the issue in Shenzhen, China, on October 28, 2017. Participants, including geneticists, clinicians, and representatives of genetic testing service providers, discussed problems of clinical genetic testing services across in China and shared opinions on principles, challenges, and standards for reporting clinical genetic test results. Here we summarize expert opinions presented at the seminar and report the consensus, which will serve as a basis for the development of standards and guidelines for reporting of clinical genetic testing results, in order to promote the standardization and regulation of genetic testing services in China.

PPP2R2A is one of the regulatory subunits of the PP2A phosphatase complexes, and previous studies showed that its upregulation promotes cancer cell survival and growth. In this research, we used the tandem affinity purification and the HPLC-Chip-ESI/MS/MS mass spectrometry to screen the PPP2R2A-binding proteins and the results indicated that the GFPT-1/-2 were the potential partners of PPP2R2A. We further validated the interaction between PPP2R2A and GFPT-1/-2 through GST Pull-down, co-immunoprecipitation and immunofluorescence assays. And we found that knockdown of PPP2R2A by lentivirus-mediated shRNA enhanced the phosphorylation of GFPT2, whereas the phosphorylation of GFPT1 had no significant change. GFPT2 is a rate-limiting enzyme in the hexosamine pathway. Our results showed that the knockdown of PPP2R2A promoted the total cellular O-GlcNAcylation in MDA-MB-231 breast cancer cells. These results suggest that PPP2R2A interacts with GFPT1/2, and leads to the phosphorylation of GFPT2, which can regulate the cellular O-GlcNAcylation.

Objective To investigate the therapeutic effect of short thrust needling on osteoporotic vertebral compression fractures.Method Seventy-two patients with osteoporotic vertebral compression fractures were randomly allocated to observation and controlgroups, 36 cases each.In the observation group,short thrust needlingwas used with lifting-thrusting and twirling manipulation; the bone was rubbed with the needle tip up anddownin the place near the bone; reinforcing manipulation was performed for nine times after arrival of qi.The control group received conventional acupuncture with uniform reinforcing-reducing manipulation.Both groups were treated four weeks as a course for two courses.The Visual Analogue Scale(VAS) score and the Oswestry Disability Index (ODI)score were recorded in the two groups before and after four and eight weeks of treatment.The clinical therapeutic effects were evaluated.Result The total efficacy rate was 94.4% in the observation group.Which was higher than 66.7% in the control group (P<0.05).Boththe VAS and ODI scores were lower after treatment compared with before (P<0.05) and decreased significantly more in the observation than in the control group(P<0.05).Conclusion Short thrust needling canmarkedly relieve the pain and dysfunction in patients with osteoporotic vertebral compression fractures.Its the rapeutic effect is significantly better than that of conventional acupuncture.

Objective To observe the clinical efficacy of filiform fire-needle therapy plus mild moxibustion in treating flat warts.Method Ninety patients with flat warts were randomized into group A, group B and group C, 30 cases in each group. Group A was intervened by filiform fire-needle therapy plus mild moxibustion, group B was intervened by filiform fire-needle therapy alone and group C by mild moxibustion alone. The three groups all received treatment 3 times a week, 2 weeks as a treatment course, for 2 courses in total. The clinical efficacies of the three groups were compared.Result In group A, 12 subjects were recovered, 13 showed improved, and 5 cases failed; in group B, 7 subjects were recovered, 12 showed improved, and 11 failed; in group C, 5 cases showed recovered, 10 were improved, and 15 failed. The total effective rates were respectively 83.3% in group A, 63.3% in group B, and 50.0% in group C, and the total effective rate in group A was significantly higher than that in group B and C (P<0.05). Conclusion Filiform fire-needle therapy plus mild moxibustion can significantly help the skin rashes subside in treating flat warts, and the therapeutic efficacy is obviously superior to that of either of the two methods used alone.

Objective To observe the clinical efficacy of stuck-moving needling plus modified Bu Zhong Yi Qi (supplementing qi in the middle energizer) decoction in treating gastroptosis due to qi deficiency in the middle energizer. Method Sixty patients with gastroptosis due to qi deficiency in the middle energizer were randomized into a treatment group and a control group, 30 cases in each group. The treatment group was intervened by stuck-moving needling plus the modified Bu Zhong Yi Qi decoction, while the control group was treated with the modified Bu Zhong Yi Qi decoction alone. The two groups were treated once a day, 20 sessions as a treatment course. The lower limit of the stomach was measured before and after the treatment in the two groups, and the clinical efficacy and long-term efficacy of the two groups were compared.Result The height of the lower limit of stomach was significantly changed after the treatment in both groups (P<0.01), there was a significant difference in comparing the height of the lower limit of stomach between the two groups after the intervention (P<0.01), and there was a significant difference in comparing the change of the height of lower limit of stomach between the two groups (P<0.01). The total effective rate was 93.3% in the treatment group versus 73.3% in the control group, and the between-group difference was statistically significant (P<0.01); the clinical efficacy in the treatment group was statistically different from that in the control group (P<0.05). The long-term total effective rate was 76.7% in the treatment group versus 50.0% in the control group, and the between-group difference was statistically significant (P<0.01); the long-term clinical efficacy in the treatment group was statistically different from that in the control group (P<0.05).Conclusion The stuck-moving needling plus modified Bu Zhong Yi Qi decoction can produce a more significant efficacy than the decoction alone in treatinggastroptosis due to qi deficiency in the middle energizer, and its long-term therapeutic efficacy is also consistent.

Objective To investigate the characteristics of clinical and cardiovascular magnetic resonance imaging(CMR) of arrhythmogenic cardiomyopathy with left ventricular(ALVC) involvement. Methods Ten cases of arrhythmogenic cardiomyopathy with left ventricular involvement and sixteen randomly chosen cases of arrhythmogenic cardiomyopathy with right ventricular (ARVC) involvement were enrolled in this study. Clinical symptoms, cardiac electrophysiological changes as well as the cardiac morpharage, ventricular functions and delayed enhancement of myocardium assessed by CMR were compared between the two groups. The size of heart chambers, global ventricular functions and the fat/fibrosis infiltration were evaluated by turbo fast spin echo, ture FISP cine and delayed enhancement. These were statistically analyzed by independent samples t test, respectively.Results There was no significant difference in age and gender between two groups. All the patients in two groups presented non-specific clinical manifestations with no significant differences (P>0.05) except for short of breath(P=0.034). The end-diastolic diameter of left ventricular, left ventricular end-diastolic volume index, left and right ejection fraction in ALVC and ARVC group were (64.2±7.7), (49.2±5.9) mm(t=5.551,P<0.001), (113.9±24.0), (69.2± 30.0) ml/m2(t=3.962, P<0.001), (38.5±3.1)%, (56.0±8.4)%(t=-6.733,P<0.001), (42.0±5.5)%, (18.0±7.3)%(t=8.817, P<0.001) respectively. An medium of 11 and 14 segments of fat or fat/fibrosis were found in intramural wall of the LV myocardiumin patients with ALVC,while only 0 segment(all P<0.001)was found in patients with ARVC.Conclusions The clinical manifestations of arrhythmogenic cardiomyopathy with left ventricular involvement was similar to ARVC, however, with regarding to cardiac morphological, functional and myocardial lesions, these two diseases have different characteristics in CMR features.“one-stop-shop”MRI examination has high value in the diagnosis of arrhythmogenic cardiomyopathy with Left ventricular involvement.

Objective To explore the clinical features of invasive fungal infection in 27 children treated at nephrology department between 1999 and 2014.Methods Twenty-seven cases of invasive fungal infection at nephrology department were analyzed retrospectively.Results Candida urinary infection was found in 9 cases,pneumocystis carinii pneumonia were found in 8 cases,invasive pulmonary aspergillosis and urinary aspergillosis found in 4 cases and 1 case respectively,cryptococcus neoformans meningitis and pulmonary candidiasis found respectively in 2 cases,and pulmonary filamentous fungal disease was found in 1 case.These 27 cases showed different features of illness:10 primary nephrotic syndrome,7 secondary nephrotic syndrome,6 malformation of urinary development and 4 preterm birth ＜ 32 weeks gestational age with low birth weight.All of the cases had the history of taking antibiotics.Seventeen cases of them had used corticosteroid and cytotoxic drugs in a long-term.Sixteen cases had experienced invasive procedures.All children had fever in varying degrees,14 cases showed gasp,7 cases had progressive hypoxia and respiratory failure,and 5 cases developed into multiple organs failure.Chest computed tomographic (CT) imaging data showed diffuse ground-glass opacity with mosaic sign of pneumocystis carinii pneumonia(8 cases).The features of pulmonary aspergillosis included multiple nodules and cavity in bilateral lungs (4 cases).The radiologic findings showed patching lesions with indistinct edge and uncertained density of bilateral middle-lower lung fields with pulmonary candidiasis (2 cases).Full dose of antifungal drug was given to 23 cases of them,16 cases recovered completely,3 got better,4 cases died.Four cases gave up full dose antifungal therapy.Conclusions Long-term use of corticosteroid and cytotoxic drugs,use of broad-spectrum antibiotics,invasive therapies,such as indwelling centralvenous catheters,endotracheal intubation with mechanical ventilation,and preterm birth with low birth weight were risk factors in predicting invasive fungal infection.Chest CT findings were different among these cases.Even though not specific,the relatively differences were helpful to the differential diagnosis of these diseases.

Objective To investigate the chest HRCT characteristics of pediatric perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA) associated systemic vasculitis. Methods Retrospectively analysis of the clinical and HRCT data of 15 pediatric cases diagnosed as p-ANCA related pneumonia according to the classification and diagnostic criteria of Chapel Hill meeting of 1994 in our hospital were retrospectively analyzed. They were 13 girls and 2 boys. The age range was 1—17 years and the median was about 10 years old, In the 15 patients, 12 were diagnosed as primary MPA, 2 were secondary MPA, 1 was CSS. Two radiologists with 10 years of radiological experience read the CT imaging together. Results 1 of 12 primary MPA were found large opacities and ground glass shades in both sides of lung,especially the posterior parts on CT images with bilateral pleural effusion; 1 case had focal opacities in left lower lobe, around with thickened interlobular septa and pleural effusion; Another 1 case only had focal thickened interstitial in right middle lobe; The other 9 cases showed scattered or diffused ground glass opacity, with thickened pulmonary interstitial and (or) pleura. 1 of the 2 secondary MPA who had hemoptysis showed ground glass opacity on CT images with no thickened septal nodules or pleural effusion. The other one who had renal anomalies and no respiratory symptoms showed subpleural nodules with halo sign in right low lobe. The CSS showed diffused patchy ground glass opacity, consolidation of both lingular lobes, nodules of centri-and peri-lobular, thickened septa near the pleura, obviously thickened bronchial wall, slightly widened bronchial lumen and thickened pleura. Conclusion The classic imaging features of p-ANCA pneumonia on HRCT is the non-specific small pulmonary vessel hemorrhage.

Objective:To observe the clinical efficacy of interaction acupuncture combining with routine acupuncture for intractable facial palsy.
Methods:A total of 60 eligible cases were randomly allocated into a treatment group (n=30) and a control group (n=30). Cases in the treatment group received interaction and routine acupuncture, whereas cases in the control group received routine acupuncture alone. The treatment was done once a day and 10 times made up a course of treatment. The patients were treated for a total of 3 courses and there were no intervals between two courses.
Results:The total effective rate was 93.3% in the treatment group (including 17 recovery cases, 11 improvement cases and 2 failure cases), versus 76.7% in the control group (including 8 recovery cases, 15 improvement cases and 7 failure cases), showing a statistical difference (P<0.05).
Conclusion:Combining interaction and routine acupuncture can obtain better effect than routine acupuncture alone for intractable facial palsy.