Clinical manifestation,lifestyle,and treatment patterns of chronic erosive gastritis:A multicenter real-world study in China

BACKGROUND Although chronic erosive gastritis(CEG)is common,its clinical characteristics have not been fully elucidated.The lack of consensus regarding its treatment has resulted in varied treatment regimens.AIM To explore the clinical characteristics,treatment patterns,and short-term outcomes in CEG patients in China.METHODS We recruited patients with chronic non-atrophic or mild-to-moderate atrophic gastritis with erosion based on endoscopy and pathology.Patients and treating physicians completed a questionnaire regarding history,endoscopic findings,and treatment plans as well as a follow-up questionnaire to investigate changes in symptoms after 4 wk of treatment.RESULTS Three thousand five hundred sixty-three patients from 42 centers across 24 cities in China were included.Epigastric pain(68.0%),abdominal distension(62.6%),and postprandial fullness(47.5%)were the most common presenting symptoms.Gastritis was classified as chronic non-atrophic in 69.9%of patients.Among those with erosive lesions,72.1%of patients had lesions in the antrum,51.0%had multiple lesions,and 67.3%had superficial flat lesions.In patients with epigastric pain,the combination of a mucosal protective agent(MPA)and proton pump inhibitor was more effective.For those with postprandial fullness,acid regurgitation,early satiety,or nausea,a MPA appeared more promising.CONCLUSION CEG is a multifactorial disease which is common in Asian patients and has non-specific symptoms.Gastroscopy may play a major role in its detection and diagnosis.Treatment should be individualized based on symptom profile.

Efficacy of borneol-gypsum in skin regeneration and pain control in toxic epidermal necrolysis:A case report

BACKGROUND Toxic epidermal necrolysis(TEN)is a life-threatening dermatological emergency mainly induced by drug hypersensitivity reactions.Standard management includes discontinuation of culprit drug and application of immunomodulatory therapy.However,mortality remains high due to complications like septic shock and multiorgan failures.Innovative approaches for skin care are crucial.This report introduces borneol-gypsum,a traditional Chinese drug but a novel dressing serving as an adjuvant of TEN therapy,might significantly improve skin conditions and patient outcomes in TEN.CASE SUMMARY A 38-year-old woman diagnosed with eosinophilic granulomatosis with polyangiitis experienced gangrenous complications and motor nerve involvement.After initial treatment of high-dose corticosteroids and cyclophosphamide,symptom of foot drop improved,absolute eosinophil counts decreased,while limb pain sustained.Duloxetine was added to alleviate her symptom.Subsequently,TEN developed.Additional topical application of borneol-gypsum dressing not only protected the skin lesions from infection but also significantly eased localized pain.This approach demonstrated its merit in TEN management by promoting skin healing and potentially reducing infection risks.CONCLUSION Borneol-gypsum dressing is a promising adjuvant that could significantly improve TEN management,skin regeneration,and patient comfort.

自然电位法在海洋矿产勘探中的理论、正反演计算及应用进展

自然电位法是一种被动地球物理勘探方法,其通过在地表、井中或(海)水中测量由电化学、电动和热电机制引发的自然电位异常进而开展相关勘探工作。自然电位法与地下水流及(电)化学梯度有直接关联,已在矿产勘探、环境调查以及水文地球物理问题中受到越来越多的关注和应用。本文主要回顾自然电位法在矿产勘探领域的源机制、数值模拟和反演解释理论,以及该方法在矿产勘探中的应用。同时,总结3个海底硫化物矿床勘探案例,以说明自然电位法在海洋矿产勘探中的特点及应用效果。本研究对探讨自然电位法在深海找矿中的应用具有重要意义。

医务人员使用糖尿病足智能APP的意愿调查及影响因素分析

目的分析医务人员使用糖尿病足智能APP的意愿及其影响因素。方法采取便利抽样法,于2021年10月采用自制问卷对全国16个省45家医院的193例医务人员进行糖尿病足智能APP的使用意愿问卷调查。结果159例(82.4%)医务人员愿意在临床工作中使用智能APP。多因素Logistic回归分析结果显示:年龄大[OR=0.488(95%CI:0.275,0.866)]、女性[OR=2.509(95%CI:1.116,5.645)]、科室不鼓励使用APP[OR=1.968(95%CI:1.214,3.189)]是医务人员使用APP意愿低的因素(P<0.05)。医务人员不愿意使用APP的前4个因素为界面不够友好、需要连接网络、操作复杂、测量真实性不佳。结论医务人员对糖尿病足智能APP的使用意愿较高,希望将来进一步优化和完善系统,使其更加简单、便捷、易操作。

Effect of IL-10 on the expression of HSC growth factors in hepatic fibrosis rat

瞄准：在生长因素的表示上学习 IL-10 的效果--转变生长 factor-beta1 ( TGF-beta1 )，表皮的生长因素( EGF )， hepatocyte 生长因素( HGF )和肝的纤维变性老鼠的肝的星形细胞( HSC )和外长的 IL-10 的 anti-fibrogenic 角色的导出血小板的生长因素( PDGF )。方法：肝的纤维变性被 CCl (4 ) 管理 intra-peritoneally 导致。六十只干净男 Sprague-Dawley (SD ) 老鼠随机被划分成三个组：正常控制组(GN， 8 只老鼠) ，肝的纤维变性模型组(GC， 28 只老鼠) 并且 IL-10 对待组(官方补给， 24 只老鼠) 。在第 7 和第 11 wk 的开始，在每个组的老鼠习惯性地通过一根门静脉导管与 pronase E 和类型 IV 胶原酶被酒，从肝获得的暂停被远心沉淀与 11% Nycodenz 密度坡度旋转孤立 HSC。组织学的检查被用来决定肝的纤维变性的度。RT-PCR 被采用从刚孤立的房间分析 mRNA 表示。Immunocytochemistry 被执行在主要有教养的 HSC 检测蛋白质表示。结果：老鼠肝的纤维变性随 CCl (4 ) 的注射频率的增加被开发，并且 HSC 成功地被孤立。与 GN 相比显然在在 GC 的第 7 和第 11 wk， TGF-beta1， EGF，和 HGF mRNA 增加了(P = 0.001/0.042， 0.001/0.001， 0.001/0.001 ) 并且官方补给(P = 0.001/0.007， 0.002/0.001， 0.001/0.001 ) 。为 TGF-beta1，没有差别被观察在之间官方补给并且 GN。为 EGF， mRNA 铺平在官方补给在第 7 wk 期间与 GN 相比增加了(P = 0.005 ) 并且第 11 wk (P = 0.049 ) 。为 HGF， mRNA 铺平在官方补给在第 7 wk 与 GN 相比减少了(P = 0.001 ) 并且第 11 wk (P = 0.021 ) 。两次在这些之间指，在第 7 wk 的 TGF-beta1 表示比第 11 wk 的高(P = 0.049 ) ，要不是 EGF，前者比后者低(P = 0.022 ) 。至于 PDGF mRNA，在这些组之间没有有效差量，但是差别似乎在蛋白质层次存在。由 TGF-beta1 和 EGF 的免疫细胞化学的结果是有上述调查结果的 paralleled。结论：TGF-beta1， EGF 和 HGF 的表示在肝的纤维变性老鼠的 HSC 增加了并且减少有 IL-10 的术后疗法。IL-10 由压制生长因素表示起一个 anti-fibrogenic 作用。

Serum Amyloid A Protein: A Potential Biomarker Correlated With Clinical Stage of Lung Cancer

Objective To identify serum diagnosis or progression biomarkers in patients with lung cancer using protein chip profiling analysis. Method Profiling analysis was performed on 450 sera collected from 213 patients with lung cancer, 19 with pneumonia, 16 with pulmonary tuberculosis, 65 with laryngeal carcinoma, 55 with laryngopharyngeal carcinoma patients, and 82 normal individuals. A new strategy was developed to identify the biomarkers on chip by trypsin pre-digestion. Results Profiling analysis demonstrated that an 11.6kDa protein was significandy elevated in lung cancer patients, compared with the control groups （P〈0.001）. The level and percentage of 11.6kDa protein progressively increased with the clinical stages Ⅰ-Ⅳ and were also higher in patients with squamous cell carcinoma than in other subtypes. This biomarker could be decreased after operation or chemotherapy. On the other hand, 11.6kDa protein was also increased in 50% benign diseases of lung and 13% of other cancer controls. After trypsin pre-digestion, a set of new peptide biomarkers was noticed to appear only in the samples containing a 11.6kDa peak. Further identification showed that 2177Da was a fragment of serum amyloid A （SAA, MW 11.6kDa）. Two of the new peaks, 1550Da and 1611Da, were defined from the same protein by database searching. This result was further confirmed by partial purification of 11.6kDa protein and MS analysis. Conclusion SAA is a useful biomarker to monitor the progression of lung cancer and can directly identify some biomarkers on chip.

Changes of serum p53 antibodies and clinical signifi cance of radiotherapy for esophageal squamous cell carcinoma

AIM: To explore the relationship between serum p53 antibodies (p53-Abs) and clinicopathological characteristics and therapeutic effect in patients with esophageal carcinoma (EC), and to investigate sequential changing regularity of serum p53-Abs after radiotherapy. METHODS: The serum p53-Ab levels were detected in 46 EC patients and 30 healthy adults by enzyme linked immunosorbent assay (ELISA). The blood samples were collected on the day before radiotherapy and on the administration of an irradiation dose of 20 Gy/10 f/12 d, 40 Gy/20 f/24 d and 60 Gy/30 f/36 d after radiotherapy. RESULTS: The level and positive rate of serum p53-Abs in EC patients were significantly higher than those in normal individuals (P < 0.05). Serum anti-p53 antibodies were positive in 18 of 46 EC patients (39.1%). The positive rate of p53-Abs in EC was related to histological grade, disease stage and lymph node metastasis (P < 0.05), but it was not signif icantly related to sex, age and to the size and site of tumor. The level and positive rate of p53-Abs had signif icant differences between before radiotherapy and after administration of an irradiation dose of 40 Gy/20 f/24 d and 60 Gy/30 f/36 d (P < 0.05 or P < 0.01). The positive rate of p53-Abs in EC patients with effect was significantly lower than that in those without effect after radiotherapy (P < 0.0001).CONCLUSION: Detection of serum p53-Abs is helpful to the diagnosis of esophageal carcinoma. Monitoring for sequential change of serum p53-Abs before and after radiotherapy in patients with esophageal carcinoma is also useful to evaluate the response to the treatment and prognosis of the patients.

Risk factors for intraocular metastasis of primary liver cancer in diabetic patients:Alpha-fetoprotein and cancer antigen 125

BACKGROUND In rare instances,primary liver cancer can be associated with intraocular metastasis(IOM).AIM To investigate the correlation between a diverse range of clinical characteristics and IOM in diabetic patients with primary liver cancer,and to determine potential risk factors in predicting IOM.METHODS We recruited a total of 722 diabetic patients with primary liver cancer.The differences between the IOM and non-intraocular metastasis(NIOM)groups in these patients were assessed using the chi-squared test and Student’s t-test.Binary logistic regression analysis was subsequently used to determine risk factors.Finally,the diagnostic value of IOM in this cohort with primary liver cancer was analyzed by receiver operating characteristic(ROC)curve analysis.RESULTS In all,13 patients had IOM.There were no remarkable intergroup differences with respect to age,sex,histopathological sub-types,or blood biochemical parameters.However,the IOM group had significantly higher alpha-fetoprotein(AFP)and cancer antigen 125(CA125)values than the NIOM group.Binary logistic regression identified AFP and CA125 to be significant risk factors for IOM in diabetic patients with primary liver cancer.ROC curve analysis showed that the area under the curve values for AFP and CA125 were 0.727 and 0.796,with the cut-off values of 994.20 ng/mL and 120.23 U/mL,respectively.The sensitivity and speci
city for AFP were 92.3%and 59.9%,while those for CA125 were 84.6%and 70.1%,respectively.CONCLUSION Elevated AFP and CA125 represent significant risk factors for IOM in diabetic patients with primary liver cancer.

Effect of temperature on formation and evolution of solid electrolyte in terphase on Si@Graphite@C anodes

Studies on the formati on and evolutio n of the solid electrolyte in terface(SEI)film under different ambient temperatures are important to understand the failure behavior of lithium-ion batteries(LIBs).Herein,in-situ electrochemical impedance spectroscopy(EIS)test is performed on the whole discharge process of Si@Graphite@C/Li cell at 0,25 and 55℃,respectively.Combining with scanning electron microscopy,transmission electron microscopy and X-ray photoelectron spectroscopy characterizations,it is found that the SEI film undergoes a complicated evolution process of pre-formation,self-improvement and gradual decay in succession at 25℃.Besides,due to the dissolution of organo-alkyl lithium at high temperature,the formed film is mainly composed of LiF,Li_(2)CO_(3) and other in organic salts,which helps to decrease the impedance.However,the electrolyte is consumed continuously on the new exposed in terface,leading to the degraded performance of the cell.Moreover,the dyn amic properties of Li^(+) ions are poor at low temperature,though the migration ability of Li^(+) ions in the solid phase can be improved as the cycle goes on.Therefore,the development and application of in-situ EIS tech no logy are expected to become an important means to explain the electrochemical performance of batteries.

Gemcitabine and cisplatin combined with the Chinese herbal medicine compound Fuzhenggubenfang improve quality of life and progression-free survival in patients with advanced non-small cell lung cancer

目的：评估化疗联合扶正固本方治疗晚期非小细胞肺癌的作用.方法：2013年10月至2016年7月共收治符合条件的患者84例.随机分配到接受化疗的对照组和化疗联合扶正固本方的实验组.研究的主要终点指标是生活质量（QOL）和无进展生存期（PFS）.次要终点指标是肿瘤反应率,化疗相关毒性,出组率,QOL和PFS临床病理因素的单因素和多因素分析.结果：实验组较对照组总体生活质量包括躯体功能、角色功能、情绪功能、认知功能、社会功能均有显著改善（均P〈0.001）,疲乏、恶心或呕吐、失眠、食欲减退、便秘亦显著改善（均P〈0.001）.实验组较对照组获得更好的PFS且有显著性差异（P=0.032）.两组肿瘤反应率无显著性差异.扶正固本方明显减少化疗引起的贫血,中性粒细胞减少、恶心、呕吐（均P〈0.001）,且只有轻微的副作用.本研究中影响QOL的临床病理因素包括：中药（P〈0.001）、体力状态评分（P=0.027）、临床分期（P=0.009）、性别（P=0.044）.影响PFS的临床病理因素包括中药（P=0.043）和既往化疗次数（P=0.003）.结论：扶正固本方可通过改善晚期非小细胞肺癌患者QOL,改善患者对治疗的治疗依从性,减轻化疗相关毒副反应,从而改善PFS,提高生存率,是晚期非小细胞肺癌治疗期间可选择的辅助用药.

The properties of surface nanobubbles formed on different substrates

The properties and stability of the reported surface nanobubbles are related to the substrate used and the generation method. Here, we design a series of experiments to study the influence of the hydrophobicity of the substrate and the produc- tion method on the formation and properties of nanobubbles. We choose three different substrates, dodecyltrichlorosilane （DTS） modified silicon, octadecyltrichlorosilane （OTS） modified silicon, and highly oriented pyrolytic graphite （HOPG） as nanohubble substrates, and two methods of ethanol-water exchange and 4-℃ cold water to produce nanobubbles. It is found that using ethanol-water exchange method could produce more and larger nanobubbles than the 4-℃ cold water method. The contact angle of nanobubbles produced by ethanol-water exchange depends on the hydrophobicity of sub- strates, and decreases with the increase of the hydrophobicity of substrates. More interestingly, nanoscopic contact angle approaches the macroscopic contact angle as the hydrophobicity of substrates increases. It is believed that these results would be very useful to understand the stability of surface nanobubbles.

Altered spontaneous brain activity in patients with diabetic optic neuropathy:A resting-state functional magnetic resonance imaging study using regional homogeneity

BACKGROUND Diabetes is a common chronic disease.Given the increasing incidence of diabetes,more individuals are affected by diabetic optic neuropathy(DON),which results in decreased vision.Whether DON leads to abnormalities of other visual systems,including the eye,the visual cortex,and other brain regions,remains unknown.AIM To investigate the local characteristics of spontaneous brain activity using regional homogeneity(ReHo)in patients with DON.METHODS We matched 22 patients with DON with 22 healthy controls(HCs).All subjects underwent resting-state functional magnetic resonance imaging.The ReHo technique was used to record spontaneous changes in brain activity.Receiver operating characteristic(ROC)curves were applied to differentiate between ReHo values for patients with DON and HCs.We also assessed the correlation between Hospital Anxiety and Depression Scale scores and ReHo values in DON patients using Pearson correlation analysis.RESULTS ReHo values of the right middle frontal gyrus(RMFG),left anterior cingulate(LAC),and superior frontal gyrus(SFG)/left frontal superior orbital gyrus(LFSO)were significantly lower in DON patients compared to HCs.Among these,the greatest difference was observed in the RMFG.The result of the ROC curves suggest that ReHo values in altered brain regions may help diagnose DON,and the RMFG and LAC ReHo values are more clinically relevant than SFG/LFSO.We also found that anxiety and depression scores of the DON group were extremely negatively correlated with the LAC ReHo values(r=-0.9336,P<0.0001 and r=-0.8453,P<0.0001,respectively).CONCLUSION Three different brain regions show ReHo changes in DON patients,and these changes could serve as diagnostic and/or prognostic biomarkers to further guide the prevention and treatment of DON patients.

Decreased retinal microvasculature densities in pterygium

AIM:To investigate the retinal vascular network alterations in eyes of patients with pterygium.METHODS:Totally 18 left eyes from 18 female pterygium patients and 18 left eyes from 18 female healthy control subjects were enrolled.Optical coherence tomography angiography(OCTA)images were generated of the superficial retinal layer and deeper retinal layer of the macular retina for each eye.The microvascular(MIR)and macrovascular(MAR)densities were calculated and MIR,MAR,and total microvascular(TMI)density was compared in the healthy control and pterygium groups.RESULTS:In pterygium group,in the superficial retinal layer,the vascular density in superficial MIR,superior right(SR),inferior right(IR),right(R),superficial central annuli(SC)1,SC2,and SC3 decreased significantly in the macular area(P<0.05).Furthermore,the vascular density in all those decreased regions except R,was significantly and negatively correlated with the disease course(r=-0.6038 to-0.7762,P=0.0008),and the area size of pterygium(r=-0.6043 to-0.9508,P<0.05).For the deeper retinal layer,the density of deep total microvessel(DTMI),deeper MIR,SR,IR,R,DC2,and DC3 decreased significantly in macular area of pterygium patients(P<0.05).Furthermore,the vascular density in all those decreased regions was significantly and negatively correlated with the disease course(r=-0.6901 to-0.7795,P=0.0015),and the area size of pterygium(r=-0.6043 to-0.9563,P<0.05).No statistically significant differences and correlation was found in other region density(|r|<0.47,P>0.05).CONCLUSION:OCTA findings suggest that pterygium patients present with decreased retinal MIR density,and the major vascular alterations occurr mainly on the bitamporal side.The vascular density of the superficial SC1,SC2,SC3 adjacent to the foveal and deep layer of DC2,DC2 regions,significantly decreased.

Effectiveness of six-step complex decongestive therapy for treating upper limb lymphedema after breast cancer surgery

BACKGROUND Complex decongestive therapy(CDT)is currently recommended as the standard treatment for lymphedema.CDT is a four-step detumescence therapy that can effectively treat upper limb lymphedema after breast cancer surgery,and is considered non-invasive,painless and without side effects.AIM To determine the effectiveness of a six-step CDT involving a foam granule bandage for the treatment of upper extremity lymphedema pressure after breast cancer surgical intervention.METHODS The study included 100 patients with upper extremity lymphedema after breast cancer surgery.The surgical methods were mastectomy plus axillary lymph node dissection and breast preservation plus sentinel lymph node biopsy.The study population was further divided into the experimental group and control group with 50 cases in each group.The control group was given conventional CDT(four-step method),which included skin care,freehand lymphatic drainage,foam granule pressurized bandage,and functional exercise.In the experimental group,a six-step CDT method was applied that involved a foam particle bandage combined with air wave pressure therapy in addition to the four steps of conventional CDT.Patients in both groups were given one course of treatment daily(20 times),and the changes in body moisture and subjective symptoms were measured before and after treatment,preoperatively and 20 times after treatment.RESULTS No statistically significant differences in 50-Hz bioelectrical impedance and extracellular moisture ratio were observed between the two groups before treatment,suggesting comparability of the baseline data.After treatment,the 50-Hz bioelectrical impedance of the experimental group was significantly higher than that in the control group,and the extracellular moisture ratio was significantly lower than that in the control group.A comparison of the differences between the two groups before and after treatment indicated that the treatment effect in the experimental group was better than that in the control group.After 20 treatments,according to subjective evaluations,the tightness and swelling of the limbs in the experimental group were significantly reduced as compared with those in the control group.CONCLUSION The six-step CDT method can effectively reduce lymphedema,promote lymphatic circulation,and alleviate the subjective symptoms of patients,and thereby improve the quality of life and treatment compliance among patients.

Fetal lung surfactant and development alterations in intrahepatic cholestasis of pregnancy

AIM: To investigate the association between total bile acid(TBA) level during intrahepatic cholestasis of pregnancy(ICP) and fetal lung surfactant alteration. METHODS: We recruited 42 ICP and 32 normal pregnancy women in this study. The maternal blood, fetal blood and amniotic fluid TBA level were detected using a circulating enzymatic method. Umbilical blood pulmonary surfactant protein A(SP-A) was evaluated with enzyme-linked immunosorbent assay. High performance liquid chromatography was used for the determination of phosphatidyl choline(PC), phosphatidyl inositol(PI), lysolecithin(LPC) and sphingomyelin(SM). Amniotic fluid lamellar body was counted with a fully automatic blood cell counter. Fetal lung area and fetal body weight were calculated from data obtained with an iu22 color supersonic diagnostic set. Clinical information of a nonstress test, amniotic fluid properties and neonatal Apgar score, and birth weight were recorded for review. RESULTS: The TBA level in maternal blood, fetal blood and amniotic fluid in the ICP group were significantly higher than that in the control group(maternal blood: 34.11 ± 6.75 mmol/L vs 4.55 ± 1.72 mmol/L, P < 0.05; fetal blood: 11.9 ± 2.23 mmol/L vs 3.52 ± 1.56 mmol/L, P < 0.05; amniotic fluid: 3.89 ± 1.99 mmol/L vs 1.43 ± 1.14 mmol/L, P < 0.05). Amniotic fluid PC and PI in the ICP group were significantly lower than that in the control group(PC: 65.71 ± 7.23 μg/m L vs 69.70 ± 6.68 μg/m L, P < 0.05; PI: 3.87 ± 0.65 μg/m L vs 4.28 ± 0.74 μg/m L, P < 0.05). PC/LPC ratio of the ICP group was lower than that of the control group(14.40 ± 3.14 vs 16.90 ± 2.52, P < 0.05). Amniotic LB in the ICP group was significantly lower than that of the control group((74.13 ± 4.37) × 109/L vs(103.0 ± 26.82) × 109/L, P < 0.05). Fetal umbilical blood SP-A level in the ICP group was significantly higher than that of the control group(30.26 ± 7.01 ng/m L vs 22.63 ± 7.42 ng/m L, P < 0.05). Fetal lung area/body weight ratio of the ICP group was significantly lower than that of the control group(5.76 ± 0.63 cm2/kg vs 6.89 ± 0.48 cm2/kg, P < 0.05). In the ICP group, umbilical cord blood TBA concentration was positively correlated to the maternal blood TBA concentration(r = 0.746, P < 0.05) and umbilical blood SP-A(r = 0.422, P < 0.05), but it was negatively correlated to the amniotic fluid lamellar corpuscle(r = 0.810, P < 0.05) and fetal lung area/body weight ratio(r = 0.769, P < 0.05). Furthermore, umbilical blood TBA showed a negative correlation to PC, SM and PI(r pc = 0.536, r sm = 0.438, r pi = 0.387 respectively, P < 0.05). The neonatal asphyxia, neonatal respiratory distress syndrome, fetal distress and perinatal death rates in the ICP group are higher than that of theCONCLUSION: ICP has higher TBA in maternal and fetal blood and amniotic fluid. The high concentration of TBA may affect fetal pulmonary surfactant production and fetal lung maturation.

Direct antiglobulin test-negative autoimmune hemolytic anemia in a patient withβ-thalassemia minor during pregnancy:A case report

BACKGROUND Severe refractory anemia during pregnancy can cause serious maternal and fetal complications.If the cause cannot be identified in time and accurately,blind symptomatic support treatment may cause serious economic burden.Thalassemia minor pregnancy is commonly considered uneventful,and the condition of anemia rarely progresses during pregnancy.Autoimmune hemolytic anemia(AIHA)is rare during pregnancy with no exact incidence available.CASE SUMMARY We report the case of a 30-year-oldβ-thalassemia minor multiparous patient experiencing severe refractory anemia throughout pregnancy.We monitored the patient closely,carried out a full differential diagnosis,made a diagnosis of direct antiglobulin test-negative AIHA,and treated her with prednisone and intravenous immunoglobulin.The patient gave birth to a healthy full-term baby.CONCLUSION Coombs-negative AIHA should be suspected in cases of severe hemolytic anemia in pregnant patients with and without other hematological diseases.

Altered spontaneous brain activity patterns in patients with hyperthyroidism exophthalmos using amplitude of low-frequency fluctuation:a resting-state fMRI study

AIM:To assess changed spontaneous brain activity in hyperthyroid exophthalmos(HE)patients by the amplitude of the low-frequency fluctuation(ALFF)method,and to analyze the correlation between brain activity and ALFF values in these patients.METHODS:Totally 18 HE and 18 hyperthyroid nonexophthalmos(HNE)patients were enrolled.The participants were tested by resting-state functional magnetic resonance imaging,and receiver operating characteristic(ROC)curves were generated to classify the ALFF values of the study population.Pearson’s correlation analysis was utilized to evaluate the relationship between the ALFF values obtained from different brain areas and clinical manifestations.RESULTS:Contrary to HNE patients,we observed lower ALFF values in the left calcarine fissure and surrounding cortex(LCFSC)in HE patients.In the ROC curve analysis of the LCFSC,the area under the curve reflected a high degree of accuracy.In addition,there was positive correlation between mean ALFF values of the LCFSC and the bestcorrected visual acuity of the affected eyes.CONCLUSION:The study displays abnormal brain activity in LCFSC in patients with HE,which might suggest pathological mechanism of visual impairment of HE patients.

小鼠骨髓间充质干细胞自噬与衰老的关系

目的探讨小鼠骨髓间充质干细胞(BM-MSCs)自噬与衰老的关系。方法通过体外分离培养年轻组小鼠(8周龄)和老年组小鼠(18个月龄)BM-MSCs,流式细胞术检测细胞表型,TUNEL染色检测细胞凋亡,ELISA试剂盒检测BM-MSCs分泌蛋白VEGF、b FGF、IGF-1、HGF的表达,Western blot检测自噬相关蛋白LC3-Ⅰ、LC3-Ⅱ、Beclin 1、ATG12-5、p62及信号通路蛋白p-Akt、Akt、p-m TOR、m TOR的表达。结果与年轻组比较,老年组BM-MSCs凋亡增加(P<0.05),分泌功能下降(P<0.05),自噬相关蛋白LC3-Ⅰ、LC3-Ⅱ、Beclin 1、ATG12-5表达水平下降(P<0.05),相反p62蛋白表达水平升高(P<0.05),自噬信号通路相关蛋白p-Akt、Akt、p-m TOR、m TOR表达升高。结论老年小鼠BM-MSCs凋亡增加,自噬活性及旁分泌功能下降。

Effect of the maternal-fetal interface immunoregulation on the occurrence of intrahepatic cholestasis of pregnancy

Maternal immune tolerance of the fetus is indispensable for a healthy pregnancy. Currently, the study of the immune microenvironment of the maternal-fetal interface has been a heated topic in reproductive immunology research. More and more studies show that the immune imbalance in the maternal-fetal interface plays a very important role in the incidence of intrahepatic cholestasis of pregnancy(ICP). However, the precise etiology and mechanism of immune imbalance in the occurrence of ICP is still unknown. In order to clarify the potential immunologic mechanisms of ICP, this review summarizes the recent studies of the decidual immunology microenvironment and the potential immunologic mechanisms related to the development of ICP.

Why more attentions to fetus in cases of intrahepatic cholestasis of pregnancy?

Intrahepatic cholestasis of pregnancy(ICP) is a peculiar disease in middle-late pregnancy with the pathological characteristics of hepatic capillary bile duct silts and is accompanied by clinical presentations of pruritus and bile acid(BA) elevation in serum. Maternal outcomes for patients diagnosed with ICP are usually good. However, fetal outcomes can be devastating with high frequencies of perinatal complications. Patients with ICP generally have an early delivery due to fetal complications. The current hypothesis is that ICP has higher frequencies of fetal complications due to high concentrations of BA which has toxic cellular effects to many organs. In lungs, it destroys the AT-II cells, decreasing phospholipids synthesis leading to the alveolar capillary permeability to increase and pulmonary surfactant to decrease. In heart, cholate can cross into the fetal compartment and causing fetal arrhythmias and decreased contractility. In the nervous system, high BAs can cause nerve cell denaturation and necrosis, mitochondria edema and membrane dissolve. In the placenta, high BA concentration can cause edema of the villous, decrease number of villous, intervillous thickening and balloon formation.In addition, high total BA can result in chorionic vein constriction and impaired fetal adrenal function.