Alpha-GalCer Administration after Allogeneic Bone Marrow Transplantation Improves Immune Reconstitution in Mice

Objective To explore the effect of α-galactosyleramide (α-GalCer) on immune reconstitu-tion under acute graft-versus-host disease (aGVHD). Methods BALB/c mice were transplanted with allogeneic C57BL/6 bone marrow cells and splenocytes (both 1×107) after receiving lethal total-body irradiation. α-GalCer (100 ug/kg) or vehicle (dimethylsulfoxide) was administered intraperitoneally immediately after transplantation. The effects of α-GalCer on immune reconstitution, proliferation of T cells and B cells, hemato-poiesis, and thymic microenvironment were assessed. Results The α-GalCer group exhibited higher percentages of CD3+, CD4+, CD8+, B220+, CD40+, and CD86+ cells compared with the vehicle group. The number of colony forming unit per 1000 CD34+ cells in the α-GalCer group was higher than in the vehicle group (P=0.0012). In vitro proliferation assays showed that the α-GalCer group had higher percentages of CD3+, CD4+, CD8+, and B220+ cells compared with the vehicle group. As for the results of in vivo prolifera-tion assays, the numbers of CD3+, CD4+, CD8+, and B220+ cells were higher in the α-GalCer group than in the normal group, especially the number of B220+ cells (P=0.007). Significant difference was not found in thymocyte count between the α-GalCer group and the vehicle group, nor in the percentages of CD3+, CD4+, and CD8+ cells. Conclusion Administration of α-GalCer after allogeneic bone marrow transplantation may promote immune reconstitution in the presence of aGVHD.

人乳腺癌外周血中hMAM mRNA表达及临床意义(英文)

Objective: To study the clinical significance of human mammaglobin (hMAM) mRNA in peripheral blood of patients with breast cancer. Methods: The expression of hMAM mRNA was detected in peripheral blood from patients with breast cancer, breast benign lesions, healthy volunteers by nested reverse transcription polymerase chain reaction (nested-RT-PCR) method. The possible correlations of hMAM mRNA expression with clinico-pathological parameters and related molecular markers such as p53, PCNA and HER-2 were analyzed. The hMAM mRNA changed in peripheral blood after chemotherapy was observed. Results: The positive rate of hMAM mRNA was 34.0% in peripheral blood of breast cancer, hMAM mRNA was not expressed in peripheral blood from other cancers, breast benign lesions or healthy volunteers. The expression of hMAM mRNA in peripheral blood was correlated with lymph nodes status and TNM stage. After 2-3 cycles adjuvant chemotherapy, In 13 of 17 cases, the positive hMAM mRNA turned to be negative, and there was statistical difference between pre-chemo- therapy and post-chemotherapy. Conclusion: hMAM mRNA has specific expression in breast cancer, the positive expression of hMAM mRNA in peripheral blood might predict hematogenous metastatic spreading of tumor cells, and hMAM mRNA may be potential biological marker for detecting breast cancer micrometastasis.

Asymptomatic patients of chronic obstructive pulmonary disease in China

Background Chronic obstructive pulmonary disease （COPD） has a variable natural history and not all individuals follow the same course. This study aimed to identify the prevalence and characteristics of asymptomatic COPD patients from a population-based survey in China.Methods A multistage cluster sampling strategy was used in a population from seven different provinces/cities. All residents （over 40 years old） were interviewed with a standardized questionnaire and spirometry.Post-bronchodilator forced expiratory volume in 1 second （FEV1）/forced vital capacity （FVC） of less than 70% was defined as the diagnostic criterion of COPD. All COPD patients screened were divided into symptomatic group and asymptomatic group according to the presence or absence of chronic respiratory symptoms. Socio-demographic,personal and exposure variables were collected and analyzed.Results Among the 1668 patients who were diagnosed with COPD from the 25 627 sampling subjects, 589 （35.3%）were asymptomatic. The age, sex, body mass index （BMI）,rural and urban distributions, smoking habit and education levels were similar in the two groups. A total of 64.7% of the asymptomatic patients had no comorbidities. Cardiovascular diseases and lung cancer were more common among symptomatic COPD patients than asymptomatic group.Asymptomatic COPD group were less likely to present with poor ventilation in the kitchen, a family history of respiratory disease and recurrent childhood cough. Asymptomatic COPD patients had significantly higher FEV1 （73.1% vs. 61.0%）, FVC （91.9% vs. 82.0%）, and a higher ratio of FEV1/FVC （62.9% vs.58.7%） （all P 〈0.001） than symptomatic group. More asymptomatic patients were underdiagnosed （91.9% vs.54.3%, P〈0.001） than symptomatic patients.Conclusions This large population-based survey confirmed a high prevalence of asymptomatic COPD patients in China. More use of spirometry screening test may be important to the early detection of COPD.

Chinese Trauma Surgeon Association for management guidelines of vacuum sealing drainage application in abdominal surgeries-Update and systematic review

Vacuum sealing drainage (VSD) is frequently used in abdominal surgeries. However, relevant guidelines are rare. Chin ese Trauma Surge on Associati on orga nized a committee composed of 28 experts across China in July 2017, aiming to provide an evidence-based recommendation for the application of VSD in abdominal surgeries.Eleven questions regarding the use of VSD in abdominal surgeries were addressed:(1) which type of materials should be respectively chosen for the intraperitoneal cavity, retroperitoneal cavity and superficial incisions?(2) Can VSD be preventively used for a high-risk abdominal incision w让h primary suture?(3) Can VSD be used in severely contaminated/infected abdominal surgical sites?(4) Can VSD be used for temporary abdominal cavity closure under some special conditions such as severe abdominal trauma, infection, liver transplantation and intra-abdominal volume increment in abdominal compartment syndrome?(5) Can VSD be used in abdominal organ inflammation, injury, or postoperative drainage?(6) Can VSD be used in the treatment of intestinal fistula and pancreatic fistula?(7) Can VSD be used in the treatment of intra-abdominal and extra-peritoneal abscess?(8) Can VSD be used in the treatment of abdominal wall wounds, wound cavity, and defects?(9) Does VSD in crease the risk of bleeding?(10) Does VSD increase the risk of intestinal wail injury?(11) Does VSD increase the risk of peritoneal adhesion? Focusing on these questions, evidence-based recommendations were given accordingly. VSD was strongly recommended regarding the questions 2-4. Weak recommendations were made regarding questions 1 and 5-11. Proper use of VSD in abdominal surgeries can lower the risk of infection in abdominal incisions with primary suture, treat severely contaminated/infected surgical sites and facilitate temporary abdominal cavity closure.

Plasma biomarkers and plaque strain predict long-term cardiovascular events in patients with acute coronary syndrome

To test whether circulating and intracoronary biomarkers and coronary plaque strain have additive values to Global Registry of Acute Coronary Events(GRACE) score for predicting long-term cardiovascular events in ACS patients. One hundred ACS patients were enrolled and the GRACE score and plasma levels and intracoronary gradients of a number of biomarkers were measured. Coronary plaque burden and morphology in non-critical stenotic plaques were determined by intravascular ultrasound(IVUS) technique, and the maximal shear strain(SSmax) and maximal area strain(ASmax) were determined by intravascular ultrasound elastography(IVUSE) technique. Patients were followed for cardiovascular events and the predictive values of clinical characteristics, plasma biomarkers and plaque parameters were compared with GRACE score, and the incremental values of these measurements to the GRACE score were assessed. GRACE score, plasma biomarkers and plaque strain were independent predictors of cardiovascular events. Combination of GRACE score, plasma biomarkers and plaque strains significantly improved the predictive value of the GRACE score alone with the receiver-operating characteristic area increased from0.457 to 0.667(P=0.014). The combination of circulating and intracoronary biomarkers, plaque strain and GRACE score provides a better predictive tool than GRACE score alone in patients with ACS.