PRSS50-mediated inhibition of MKP3/ERK signaling is crucial for meiotic progression and sperm quality

Serine protease 50(PRSS50/TSP50)is highly expressed in spermatocytes.Our study investigated its role in testicular development and spermatogenesis.Initially,PRSS50 knockdown was observed to impair DNA synthesis in spermatocytes.To further explore this,we generated PRSS50 knockout(Prss50^(−/−))mice(Mus musculus),which exhibited abnormal spermatid nuclear compression and reduced male fertility.Furthermore,dysplastic seminiferous tubules and decreased sex hormones were observed in 4-week-old Prss50^(−/−)mice,accompanied by meiotic progression defects and increased apoptosis of spermatogenic cells.Mechanistic analysis indicated that PRSS50 deletion resulted in increased phosphorylation of extracellular signal-regulated protein kinases 1 and 2(ERK1/2)and elevated levels of MAP kinase phosphatase 3(MKP3),a specific ERK antagonist,potentially accounting for testicular dysplasia in adolescent Prss50−/−mice.Taken together,these findings suggest that PRSS50 plays an important role in testicular development and spermatogenesis,with the MKP3/ERK signaling pathway playing a significant role in this process.

Response of soil bacterial community to biochar application in a boreal pine forest

Boreal forests commonly suff er from nitrogen defi ciency due to low rate of nitrogen mineralization.Biochar may promote soil organic matter decomposition and accelerate nitrogen mineralization.In this study,Illumina NovaSeq sequencing combined with functional annotation of prokaryotic taxa(FAPROTAX)analysis was used to investigate the eff ect of biochar pyrolysis temperatures,the amount of applied biochar,and the period since the biochar application(2-and 3-year)on soil bacterial communities.The results show that biochar pyrolysis temperatures(500℃ and 650℃)and the amount of applied biochar(0.5 kg m^(−2)and 1.0 kg m^(−2))did not change soil properties.Nevertheless,the interaction of biochar pyrolysis temperature and the amount had signifi cant eff ects on bacterial species richness and evenness(P<0.05).The application of biochar produced at 500℃ had a lower abundance of Actinobacteria and Verrucomicrobia,while that produced at 650℃ had a higher abundance of Conexibacter and Phenylobacterium.When biochar produced at 650℃ was applied,applying 0.5 kg m^(−2)had a higher abundance of Cyanobacteria,Conexibacter,and Phenylobacterium than that of 1.0 kg m^(−2)(P<0.05).Functionally,the abundance of the aromatic compound degradation group increased with the extension of application time and increase of pyrolysis temperature.The time since application played an important role in the formation of soil bacterial communities and their functional structure.Long-term studies are necessary to understand the consequence of biochar on bacterial communities in boreal forests.

miRNA-21-5p is an important contributor to the promotion of injured peripheral nerve regeneration using hypoxia-pretreated bone marrow-derived neural crest cells

Our previous study found that rat bone marrow–derived neural crest cells(acting as Schwann cell progenitors)have the potential to promote long-distance nerve repair.Cell-based therapy can enhance peripheral nerve repair and regeneration through paracrine bioactive factors and intercellular communication.Nevertheless,the complex contributions of various types of soluble cytokines and extracellular vesicle cargos to the secretome remain unclear.To investigate the role of the secretome and extracellular vesicles in repairing damaged peripheral nerves,we collected conditioned culture medium from hypoxia-pretreated neural crest cells,and found that it significantly promoted the repair of sensory neurons damaged by oxygen-glucose deprivation.The mRNA expression of trophic factors was highly expressed in hypoxia-pretreated neural crest cells.We performed RNA sequencing and bioinformatics analysis and found that miR-21-5p was enriched in hypoxia-pretreated extracellular vesicles of neural crest cells.Subsequently,to further clarify the role of hypoxia-pretreated neural crest cell extracellular vesicles rich in miR-21-5p in axonal growth and regeneration of sensory neurons,we used a microfluidic axonal dissociation model of sensory neurons in vitro,and found that hypoxia-pretreated neural crest cell extracellular vesicles promoted axonal growth and regeneration of sensory neurons,which was greatly dependent on loaded miR-21-5p.Finally,we constructed a miR-21-5p-loaded neural conduit to repair the sciatic nerve defect in rats and found that the motor and sensory functions of injured rat hind limb,as well as muscle tissue morphology of the hind limbs,were obviously restored.These findings suggest that hypoxia-pretreated neural crest extracellular vesicles are natural nanoparticles rich in miRNA-21-5p.miRNA-21-5p is one of the main contributors to promoting nerve regeneration by the neural crest cell secretome.This helps to explain the mechanism of action of the secretome and extracellular vesicles of neural crest cells in repairing damaged peripheral nerves,and also promotes the application of miR-21-5p in tissue engineering regeneration medicine.

Fermented Chinese formula Shuan-Tong-Ling attenuates ischemic stroke by inhibiting inflammation and apoptosis

The fermented Chinese formula Shuan-Tong-Ling is composed of radix puerariae（Gegen）,salvia miltiorrhiza（Danshen）,radix curcuma（Jianghuang）,hawthorn（Shanzha）,salvia chinensis（Shijianchuan）,sinapis alba（Baijiezi）,astragalus（Huangqi）,panax japonicas（Zhujieshen）,atractylodes macrocephala koidz（Baizhu）,radix paeoniae alba（Baishao）,bupleurum（Chaihu）,chrysanthemum（Juhua）,rhizoma cyperi（Xiangfu） and gastrodin（Tianma）,whose aqueous extract was fermented with lactobacillus,bacillus aceticus and saccharomycetes.ShuanTong-Ling is a formula used to treat brain diseases including ischemic stroke,migraine,and vascular dementia.Shuan-Tong-Ling attenuated H_2O_2-induced oxidative stress in rat microvascular endothelial cells.However,the potential mechanism involved in these effects is poorly understood.Rats were intragastrically treated with 5.7 or 17.2 m L/kg Shuan-Tong-Ling for 7 days before middle cerebral artery occlusion was induced.The results indicated Shuan-Tong-Ling had a cerebral protective effect by reducing infarct volume and increasing neurological scores.Shuan-Tong-Ling also decreased tumor necrosis factor-α and interleukin-1β levels in the hippocampus on the ischemic side.In addition,Shuan-Tong-Ling upregulated the expression of SIRT1 and Bcl-2 and downregulated the expression of acetylated-protein 53 and Bax.Injection of 5 mg/kg silent information regulator 1（SIRT1） inhibitor EX527 into the subarachnoid space once every 2 days,four times,reversed the above changes.These results demonstrate that Shuan-Tong-Ling might benefit cerebral ischemia/reperfusion injury by reducing inflammation and apoptosis through activation of the SIRT1 signaling pathway.

High prevalence of aspirin resistance in elderly patients with cardiovascular disease and metabolic syndrome

Background Metabolic syndrome is known to be a prothrombotic state. We undertook this study to examine a hypothesis that aspirin resistance may be associated with metabolic syndrome, and to assess other potential determinants of aspirin resistance in patients with cardiovascular disease （CVD）. Methods A total of 469 elderly patients with CVD were recruited. One hundred and seventy-two patients with metabolic syndrome and 297 without metabolic syndrome （control group） received daily aspirin therapy （〉 75 mg） over one month. Platelet aggregation was measured by light transmission aggregometry （LTA）. Aspirin resistance was defined as 〉 20% arachidonic acid （AA）- and 〉 70% adenosine diphosphate （ADP）-induced aggregation according to LTA. Aspirin semi-responders were defined as meeting one （but not both） of these criteria. Results By LTA, 38 of 469 （8.1%） patients were aspirin resistant. The prevalence of aspirin resistance was higher in the metabolic syndrome group compared with the control group [11.6 % vs. 6.6%, odds ratio （OR） = 2.039; 95% confidence interval （CI）： 1.047-3.973]. In the multivariate logistic regression analysis, metabolic syndrome （OR = 4.951, 95% CI： 1.440-17.019, P = 0.011） was a significant risk factor for aspirin resistance. Conclusions A significant number of patients with CVD and metabolic syndrome are resistant to aspirin therapy. This might further increase the risk of cardiovascular morbidity and mortality in these patients.

Blood exosomal micro ribonucleic acid profiling reveals the complexity of hepatocellular carcinoma and identifies potential biomarkers for differential diagnosis

BACKGROUND Hepatocellular carcinoma(HCC)is one of the leading causes of cancer-related deaths worldwide,but there is a shortage of effective biomarkers for its diagnosis.AIM To explore blood exosomal micro ribonucleic acids(miRNAs)as potential biomarkers for HCC diagnosis.RESULTS The principal component analysis suggested that daily alcohol consumption could alter the blood exosomal miRNA profiles of hepatitis B virus positive non-HCC patients through miR-3168 and miR-223-3p.The miRNA profiles also revealed the tumor stages of HCC patients.High expression of miR-455-5p and miR-30c-5p,which significantly correlated with better overall survival in tumor tissues,could also be detected in blood exosomes.Two pairs of miRNAs(miR-584-5p/miR-106-3p and miR-628-3p/miR-941)showed a 94.1%sensitivity and 68.4%specificity to differentiate HCC patients from non-HCC patients.The specificity of the combination was substantially influenced by alcohol consumption habits.CONCLUSION This study suggested that blood exosomal miRNAs can be used as new noninvasive diagnostic tools for HCC.However,their accuracy could be affected by tumor stage and alcohol consumption habits.

Effect of green flickering light on myopia development and expression of M1 muscarinic acetylcholine receptor in guinea pigs

AIM： To investigate the effects of green flickering light on refractive development and expression of muscarinic acetylcholine receptor（mAChR） M1 in the eyes of guinea pigs.METHODS： Thirty guinea pigs（15-20 days old） were randomly divided into three groups（n=10/group）. Animals in group I were raised in a completely closed carton with green flickering light illumination. Those in group II were kept in the open top closed carton under normal natural light. Guinea pigs were raised in a sight-widen cage under normal natural light in group III. The refractive status and axial length were measured before and after 8 weeks＇ illumination. Moreover, total RNA extracted from retinal, choroidal, and scleral tissues were determined by real-time reverse transcription polymerase chain reaction（RT-PCR）. The expressions of the receptor M1 were also explored in the retina, choroid, and sclera using immunohistochemistry.RESULTS： There was a remarkable reduction in refractive error and increase in axial length after 8-weeks＇ green flickering light stimulation（P〈0.001）. The expression of M1 receptor mRNA in sclera and retina in myopia group were remarkably lower than that in group II and III（P〈0.01）. Significant reduced expression of M1 receptor stimulated by green flickering light in retina and sclera tissues were also observed（P〈0.05）. However, there was no M1 receptor expression in choroid in 3 groups.CONCLUSION： Myopia can be induced by 8 weeks＇ green flickering light exposure in the animal model. M1 receptor may be involved causally or protectively in myopia development.

Availability and toxicity of Fe(II) and Fe(III) in Caco-2 cells

The objective of the present study was to compare the toxicity and availability of Fe(II) and Fe(III) to Caco-2 cells. Cellular damage was studied by measuring cell proliferation and lactate dehydrogenase (LDH) release. The activities of two major antioxidative enzymes [superoxide dismutase (SOD) and glutathione peroxidase (GPx)] and differentiation marker (alkaline phosphatase) were determined after the cells were exposed to different levels of iron salts. The cellular iron concentration was investigated to evaluate iron bioavailability. The results show that iron uptake of the cells treated with Fe(II) is significantly higher than that of the cells treated with Fe(III) (P<0.05). Fe(II) at a concentration >1.5 mmol/L was found to be more effective in reducing cellular viability than Fe(III). LDH release investigation suggests that Fe(II) can reduce stability of the cell membrane. The activities of SOD and GPx of the cells treated with Fe(II) were higher than those of the cells treated with Fe(III), although both of them increased with raising iron supply levels. The results indicate that both Fe(II) and Fe(III) could reduce the cellular antioxidase gene expression at high levels.

Successful treatment of pyoderma gangrenosum with concomitant immunoglobulin A nephropathy: A case report and review of literature

Pyoderma gangrenosum(PG)is an uncommon ulcerative cutaneous condition of an unknown etiology and is often associated with immune diseases.However,PG rarely shows visceral involvement,especially in the kidney.A 20-year-old female presented with pedal edema and skin ulceration of both lower limbs.The skin lesion began as an erythematous plaque and then became a blister.She also complained of abdominal distension and a decreasing urine volume.Laboratory data showed high proteinuria,hypoalbuminemia and hyperlipidemia.Her skin and kidney were biopsied.The pathological results indicated PG and immunoglobulin A(IgA)nephropathy.The patient was finally cured with prednisolone in combination with cyclosporine A(CsA).

A three-year clinical investigation of a Chinese child with craniometaphyseal dysplasia caused by a mutated ANKH gene

BACKGROUND Craniometaphyseal dysplasia(CMD)is a rare genetic disorder.Autosomal dominant CMD(AD-CMD)is caused by mutations in the ANKH gene.Affected individuals typically have distinctive facial features including progressive thickening of the craniofacial bones.Treatment for AD-CMD primarily consists of surgical intervention to release compression of the cranial nerves and the brain stem/spinal cord.To alleviate progression of the clinical course and improve the quality of life in children waiting to undergo the necessary surgery,we investigated clinical changes in a diagnosed patient with AD-CMD over three years.CASE SUMMARY A 17-mo-old boy presented with progressive nasal obstruction,snoring and hearing loss symptoms.Physical examination showed enlargement of the head circumference and clinical features such as wide nasal bridge,paranasal bossing,widely spaced eyes with an increased bizygomatic width,and a prominent mandible.The patient underwent otolaryngological examination,endoscopy,hearing test,laboratory examination of phosphorus and bone metabolism,cranial and femoral computed tomography,X-ray and next-generation sequencing.The patient was diagnosed with AD-CMD due to p.Phe377 deletion(c.1129_1131del)on exon 9 of the ANKH gene.After adherence to a prescribed low-calcium diet,the boy’s alkaline phosphatase(ALP)levels continuously decreased to within the normal range.However,after 14 mo of dietary intervention,his parents altered his diet to an intermittent low-calcium diet to include milk and eggs.The patient’s ALP was slightly higher than normal after the dietary change but remained close to the normal range.His serum osteocalcin changed to within normal levels after dietary regulation for 33 mo.His serum combined beta C-terminal telopeptide of type I collagen also continuously decreased after the nutritional intervention,although still slightly higher than normal levels.Despite fluctuating blood test results,the boy’s nasal symptoms were markedly relieved and steadily improved after dietary intervention.No significant changes were found in the craniofacial bones by cranial radiography.Close monitoring of clinical features is still ongoing.Calcitriol treatment is currently under consideration and a surgical procedure is planned as necessary in the future.CONCLUSION We herein report the first Chinese case of AD-CMD with heterozygous mutation of p.Phe377 deletion(c.1129_1131del)on the ANKH gene.Biochemical alterations were significantly improved after dietary intervention indicating that a lowcalcium diet may be applied in pediatric AD-CMD patients with ANKH mutations to help alleviate phenotypic manifestations and improve the quality of life before surgical intervention.Further large scale studies are needed to replicate these findings and to establish the appropriate timing for nutritional and surgical interventions。

Clinical effect of ambroxol hydrochloride combined with rehabilitation training on COPD and its effect on pulmonary function

Objective:To explore the clinical effect of ambroxol hydrochloride combined with rehabilitation training on COPD and its effect on pulmonary function.Methods:92 patients with COPD from May 2017 to may 2019 were randomly divided into control group(n=46)and observation group(n=46).The control group was treated with oxygen inhalation,expectorant,antispasmodic,anti infection and so on.The observation group was treated with ambroxol hydrochloride combined with rehabilitation training on this basis.Blood gas,lung function and inflammatory factors were compared before and after treatment.Results:the levels of SaO2 and PaO2 in the two groups were significantly higher than those before treatment P There was significant difference between the two groups(P<0.05-0.01).Besides,the level of lung function related indexes in the observation group was significantly higher than that in the control group(P<0.05).Conclusion:ambroxol hydrochloride combined with rehabilitation training has a significant clinical effect on COPD,which can effectively improve the blood gas index and reduce the level of blood gas inflammatory factors,thus affecting the lung function of COPD patients.

Preoperative 3D reconstruction and fluorescent indocyanine green for laparoscopic duodenum preserving pancreatic head resection:A case report

BACKGROUND Duodenum-preserving pancreatic head resection(DPPHR)is the choice of surgery for benign or low-grade malignant tumors of the pancreatic head.Laparoscopic DPPHR(LDPPHR)procedure can be improved by preoperative 3D model reconstruction and the use of intravenous indocyanine green fluorescent before surgery for real-time navigation with fluorescent display to guide the surgical dissection and prevention of from injury to vessels and biliary tract.CASE SUMMARY Here we report the successful short-and long-term outcomes after one year following LDPPHR for a 60-year lady who had an uneventful recovery and was discharged home one week after the surgery.CONCLUSION There was no bile leakage or pancreatic leakage or delayed gastric emptying.The histopathology report showed multiple cysts in the pancreatic head and localized pancreatic intraepithelial tumor lesions.The resected margin was free of tumor.

混合现实技术辅助全腹腔镜下胰十二指肠切除术

目的探讨应用混合现实技术辅助全腹腔镜下胰十二指肠切除术(LPD)的可行性。方法选取中南大学湘雅医院肝胆胰外科收治的十二指肠肿瘤患者1例,术前检查完善,无绝对手术禁忌,拟行LPD。术前利用患者腹部CT对患者体表及靶病变进行三维重建及手术规划,术中应用混合现实(MR)技术导航手术入路、明辨重要解剖结构、辅助进行LPD,顺利完成手术。结果患者恢复顺利,无明显并发症,术后2周顺利出院。结论MR技术对手术部位解剖结构重建及定位精确,有望为普外科手术带来更多的发展和进步,应用前景良好。

鼻后神经下鼻甲支切断术联合玉屏风颗粒治疗慢性鼻-鼻窦炎伴有鼻息肉合并哮喘的疗效分析

目的探讨鼻后神经下鼻甲支切断术联合玉屏风颗粒治疗慢性鼻-鼻窦炎伴有鼻息肉合并哮喘的疗效。方法选取该院确诊的慢性鼻-鼻窦炎伴有鼻息肉合并哮喘的患者46例。分成两组,对照组(n=25)予以鼻窦开放和鼻息肉切除术,实验组(n=21)在常规手术基础上行鼻后神经下鼻甲支切断术。两组术后口服玉屏风颗粒治疗2个月。随访6个月,采用视觉模拟量表(VAS)和Lund-Mackay评分法进行疗效评估。结果实验组术后6个月疗效明显高于对照组,两组比较,差异有统计学意义(χ2=6.40,P=0.041)。结论鼻后神经下鼻甲支切断术联合玉屏风颗粒治疗慢性鼻-鼻窦炎伴有鼻息肉合并哮喘,可有效提高临床疗效,提升患者生活质量。

腹腔镜辅助联合肝脏离断、门静脉结扎的二步肝切除术经验报道

目的总结腹腔镜辅助联合肝脏离断和门静脉结扎的二步肝切除术(ALPPS)治疗无法行一期根治性肝切除手术的原发或转移性肝肿瘤的经验。方法选取2014年1月-2018年10月中南大学湘雅医院因巨大型肝肿瘤行腹腔镜辅助ALPPS的10例患者,术前予肝功能、B超、CT等检查,评估后予腹腔镜辅助ALPPS术式,检测围手术期血常规、肝功能、甲胎蛋白、凝血功能等相关指标变化。结果腹腔镜辅助ALPPS均顺利完成,第1步手术时间(245±48)min,出血量(650±194)ml,第2步手术时间(155±45)min,出血量(875±85)ml,两次手术间隔时间(14.0±3.5)d,总住院时间(40.8±11.2)d。术后2例发生胆漏,无肝衰竭、严重感染等手术并发症,无围手术期死亡病例。结论腹腔镜辅助ALPPS是一种安全有效的治疗巨大型肝肿瘤的手术方式,3D打印技术为腹腔镜辅助ALPPS术前规划提供重要依据。

回旋状脉络膜视网膜萎缩一家系的新型突变与临床观察

目的:探讨一个回旋状脉络膜视网膜萎缩(GA)中国家系各家庭成员OAT基因的致病性突变及临床表现。方法:对该家系中的6名家庭成员均进行详细的眼科检查,通过全外显子组测序、生物信息学分析及Sanger验证明确基因测序结果及致病性突变。结果:先证者因其临床表现及体征诊断为GA。全外显子组测序结果显示先证者OAT基因分别于第6外显子和第10外显子上发现致病突变c.722C>T(p.P241L)、c.1186C>T(p.R396X),该复合杂合性突变在家系中呈现共分离状态。先证者的父亲和哥哥均检出杂合型p.R396X致病变异,母亲检出杂合型p.P241L致病变异。除先证者外,其他家庭成员均无临床症状。结论:该家系的先证者为复合杂合性突变,其中p.P241L为首次报道的基因突变类型。这一研究结果扩大了OAT基因变异的范围,有利于在分子基础水平进一步理解GA的致病因素。新型突变类型的发现与证实也将有助于为GA的临床诊断和基因治疗提供新的依据。

Protective effect of fasudil hydrochloride against acute renal injury in septicopyemia rats

Objective:To observe the protective effect of fasudil hydrochloride against acute renal injury in septicopyemia rats.Methods:A total of 60 Wister rats were included in the study and divided into control group(n = 10),model group(n = 25) and treatment group(n = 25).Model group and treatment group received intraperitoneal injection of endotoxin(ET) to establish acute renal injury models while the control group only received daily intraperitoneal injection of normal saline 1 mL.Five rats were taken out of model group and treatment group respectively at 1 h(T1),6 h(T2),12 h(T3),24 h(T4) and 48 h(T5),for intraperitoneal injection of ET 30 mg/kg.Treatment group received intraperitoneal injection of fasudil hydrochloride 30 mg/kg 1 h before injection of ET.For three groups,5 mL blood samples were collected from postcava for determination of serum creatinine and urea nitrogen levels at different time points.Concentrations of serum tumor necrosis factor and ET-1 were determined by using ELISA.The renal pathologic changes were observed under the microscope.Results:Serum creatinine levels in both model group and treatment group were significantly higher than control group at T2-T5(P < 0.05) while the levels in treatment group were significantly lower than control group at T3-T5(P < 0.05).At T2-T5,blood urea nitrogen levels in model group and treatment group were significantly higher than control group(P < 0.05) while the levels in treatment group were significantly lower than model group at T3-T5(P < 0.05).Concentrations of serum tumor necrosis factor in model group and treatment group were significantly higher than control group at T1-T5(P < 0.05) while the levels in treatment group were significantly lower than model group at T1-T5(P < 0.05).Serum ET-1 concentrations in model group and treatment group were significantly higher than control group at T1-T5(P <0.05) while the levels in treatment group at T1-T4 were significantly lower man model group(P <0.05).Rats in control group showed no swelling or hyperaemia in kidney cells but normal structure and normally arranged renal tubular epithelial cells.Obvious injury was observed in model group at T3 and renal tubular epithelial cells in disorder and at swelling condition,hyperaemia and angiectasis in glomerulus,degenerative opacities and vacuolar degeneration,and maximized injury were observed at T4.Injury in renal tissue in treatment group was significantly milder than model group.Conclusions:Fasudil hydrochloride has the significantly protective effect against acute renal injury in septicopyemia rats.

Chemical constituents from the aerial parts of Euphorbia sikkimensis and their bioactivities

Phytochemical investigation of the aerial parts of Euphorbia sikkimensis led to the isolation of one new diterpenoids,named sikkimenoid E(1),together with thirteen other known compounds(2-14).Their structures were established by means of spectroscopic methods.Compound 2 was identified to be a trinortriterpenoid,and derived for the first time from a natural source.In this paper we reveal for the first time its comprehensive spectral data and NMR spectral assignment.Compound 4 showed anti-angiogenic activity with an IC_(50) value of 5.66μM in a zebrafish model,and compounds 5 and 6 exhibited cytotoxicity toward A549 cell line with IC_(50) values of 12.12 and 6.45μM,respectively.

Chemical constituents from Munronia sinica and their bioactivities

Two new minor constituents,musinisins A(1)and B(2),together with five known compounds(3-7),were isolated from the aerial parts of Munronia sinica.Their structures were established by means of spectroscopic methods and the absolute stereochemistry of 1 was determined by single crystal X-ray experiment.Compound 4 showed antiangiogenic activity evaluated by a zebrafish model and apoptosis-inducing effect on A549 lung cancer cells.

Blood hemoperfusion with resin adsorption combined continuous veno-venous hemofiltration for patients with multiple organ dysfunction syndrome

BACKGROUND:Blood hemoperfusion with resin adsorption can clean larger molecules that exceed the molecular weight cutoff of combined continuous veno-venous hemofiltration(CWH).Hence blood hemoperfusion with resin adsorption combined CWH(HP+CWH) has higher ability of mediator clearance,and can improve clinical outcomes in theory.This study aimed to investigate the effect of blood hemoperfusion with resin adsorption combined continuous veno-venous hemofiltration(HP+CWH) on plasm cytokines like TNF-α,IL-1β,IL-6,cellular immunity and prognosis in patients with multiple organ dysfunction syndrome(MODS).METHODS:This was a prospective,randomized clinical trial.A total of 30 patients who had been diagnosed with MODS were enrolled in this study.Patients were randomly allocated to routine treatment+HP+CWH group(treatment group) and routine treatment+only CWH group(control group).In the treatment group,patients received blood hemoperfusion with resin adsorption for 2hours,and then received CWH for 10 hours every day.In the control group,patients received CWH for 12 hours only every day.The patients in the two groups received blood purification therapy for three days.The plasma of patients in the treatment group was obtained at 0,2,12,24,26,36,48,50,60 hours,5th day,7th day and 10 th day,respectively.The plasma of patients in the control group was obtained at 0,12,24,36,48,60 hours,5th day,7th day and 10 th day,respectively.APACHE Ⅱscore,T-lymphocytes subpopulations,blood lactate acid concentration,heart rate,breathing rate,and oxygenation index were observed.RESULTS:Plasma cytokines like TNF-α,IL-1β,IL-6 decreased markedly after HP(P<0.01);T-lymphocytes subpopulations CD3+,CD4+,CD8+,CD4+/CD8+ increased after HP+CWH or only CWH.The plasma concentrations of TNF-α,IL-1β and IL-6 in the two groups were not markedly different at 12,36,and 50 hours.But on the 5th day,the plasma concentrations of TNF-α,IL-1β and IL-6 in the treatment group were lower than those in the control group(P<0.05).On the 28 th day,5patients died in the treatment group,and 6 patients in the control group.CONCLUSIONS:Both HP+CWH and CWH can clean plasma cytokines like TNF-α,IL-1β,and IL-6,and improve cellular immunity and clinical symptoms and signs of patients.Compared with only CWH,the plasma concentrations of TNF-α,IL-1β and IL-6 were lower on the 5th day,and patients have an increased survival rate on the 28 day in the HP+CWH group.