Cardioprotective effects of sinomenine in myocardial ischemia/reperfusion injury in a rat model

BackgroundIschemia reperfusion (I/R) play an imperative role in the expansion of cardiovascular disease. Sinomenine (SM) has been exhibited to possess antioxidant, anticancer, anti-inflammatory, antiviral and anticarcinogenic properties. The aim of the study was scrutinized the cardioprotective effect of SM against I/R injury in rat.MethodsRat were randomly divided into normal control (NC), I/R control and I/R + SM (5, 10 and 20 mg/kg), respectively. Ventricular arrhythmias, body weight and heart weight were estimated. Antioxidant, inflammatory cytokines, inflammatory mediators and plasmin system indicator were accessed.ResultsPre-treated SM group rats exhibited the reduction in the duration and incidence of ventricular fibrillation, ventricular ectopic beat (VEB) and ventricular tachycardia along with suppression of arrhythmia score during the ischemia (30 and 120 min). SM treated rats significantly (P < 0.001) altered the level of antioxidant parameters. SM treatment significantly (P < 0.001) repressed the level of creatine kinase MB (CK-MB), creatine kinase (CK) and troponin I (Tnl). SM treated rats significantly (P < 0.001) repressed the tissue factor (TF), thromboxane B2 (TXB2), plasminogen activator inhibitor 1 (PAI-1) and plasma fibrinogen (Fbg) and inflammatory cytokines and inflammatory mediators.ConclusionOur result clearly indicated that SM plays anti-arrhythmia effect in I/R injury in the rats via alteration of oxidative stress and inflammatory reaction.     

Bench to bedside: recent advances in lung cancer pathological research with implications for diagnostic clinical practice

After decades of relative stagnation lung cancer is emerging as a disease type where rapid progress is being made in diagnosis and therapy, as well as in our understanding of disease biology. Much of this progress is of immediate impact to diagnosticians, and more is likely to affect diagnostic practice in the near future. In this review we seek to briefly summarize several key areas of active research of immediate or probable imminent value to trainee and consultant pulmonary pathologists alike. We cover some major changes in tumour classification, grading, and patient stratification, as well as considering the state of the art in machine-assisted interpretation of lung cancer histology, and the use of genetically modified lung cancer models.     

超声引导下关节腔内注射重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白(益赛普)治疗血友病性关节病

目的 观察超声引导下关节腔内注射重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白（益赛普）治疗血友病性关节病（HA）的价值。方法 回顾性分析32例接受超声引导下穿刺关节腔注射益赛普的HA患者，对比观察治疗前及治疗后1个月血友病关节健康评分（HJHS）、视觉模拟评分（VAS），以及超声所示目标关节增生滑膜厚度、血流信号、Melchiorre及中国早期血友病性关节病超声检测（HEAD-US-C）评分，评估其治疗价值。结果 对32例均成功完成超声引导下穿刺关节腔及腔内注射益赛普，共对18例膝关节、7例肘关节及7例踝关节进行治疗。术后未出现感染、出血等并发症。治疗后1个月，目标关节HJHS、VAS、Melchiorre评分、HEAD-US-C评分及增生滑膜最大厚度、平均厚度、血流信号均低于治疗前（P均<0.01）。结论 超声引导下关节腔内注射益赛普治疗HA安全、有效。     

核因子κB受体活化因子配体和肿瘤坏死因子α经炎性牙周膜干细胞外泌体促进破骨细胞分化

目的　慢性牙周炎表现的病理性骨吸收非常常见，牙周膜干细胞（PDLSCs）的外泌体（Exo）对骨吸收的作用和影响尚不明确，本研究分析了该Exo蛋白组分对破骨细胞分化的影响。方法　分别从正畸前拔牙患者和慢性牙周炎患者的牙周膜组织中提取PDLSCs，通过流式细胞术检测表面标记物；通过差速离心分别提取2种细胞的Exo，即Exo-WT和Exo-CP，并通过Western blot、透射电子显微镜（TEM）、蛋白浓度检测、纳米粒径追踪检测Exo特征；通过蛋白质谱检测2种Exo的蛋白组分；通过酶联免疫吸附（ELISA）验证了差异表达蛋白肿瘤坏死因子α（TNF-α）、核因子κB受体活化因子配体（RANKL）、白细胞介素（IL）-1α、转化生长因子β（TGF-β）、骨形态发生蛋白2（BMP-2）表达水平；将10、100、1 000 μg·mL^-1的Exo-CP或Exo-WT加入RAW264.7培养基中并于5 d时通过实时荧光定量聚合酶链反应（RT-qPCR）、Western blot、抗酒石酸酸性磷酸酶（TRAP）染色检测破骨分化相关指标表达情况；采用SPSS 24.0软件对实验数据进行统计学分析。结果　Exo-CP富集的差异表达蛋白主要与破骨细胞分化的TNF信号通路、核转录因子κB（NF-κB）信号通路相关；ELISA实验证实了Exo-CP中高表达TNF-α、RANKL、IL-1α，低表达TGF-β1、BMP-2（P<0.05）；Exo-CP作用于RAW264.7，显著提高了细胞的破骨分化相关基因及蛋白的表达水平，TRAP染色可见分化的破骨细胞，且呈现浓度依赖性，100、1 000 μg·mL^-1浓度Exo-CP对破骨细胞分化的促进作用显著高于10 μg·mL^-1浓度组（P<0.05）。结论　慢性牙周炎的病理性骨吸收可能由炎性PDLSCs所分泌的Exo通过促进破骨细胞分化引起，Exo中主要的作用蛋白可能为RANKL和TNF-α，本研究为慢性牙周炎骨吸收的发病机制提供了新视角。     

Retrospective study on the predictive factors in chronic trismus

Trismus is one of the most debilitating and treatment-resistant complications resulting from head and neck oncological treatments. The objective of this study was to assess how primary tumour variables could assist in predicting chronic trismus. From a (retrospective) oncological database (Department of Oral and Maxillofacial Surgery, University Hospitals Leuven), tumour-related, surgical, and oral functional variables were reviewed. Contributing factors for chronic trismus, defined as a mouth opening of less than 35 mm, at least one year after treatment for oral squamous cell cancer, were assessed via logistic regression. A mediational analysis was conducted on the significant predictive variables. Thirteen out of 52 patients were observed to have chronic trismus. A significantly higher prevalence of trismus was found for increasing clinical T classification (p < 0.01), tumours based in the maxilla or the retromolar trigone (p = 0.04), after adjuvant radiotherapy (p = 0.04), and/or with masticatory muscle tumour invasion (p ≤ 0.02). Furthermore, radiotherapy significantly impacted T classification in chronic trismus, while T classification was significantly related to masticatory muscle invasion. Although radiotherapy and clinical T classification are well-established risk factors for postoperative trismus, masticatory muscle invasion should be considered as one of the main predictive factors.     

低氧刺激鼻息肉黏膜上皮细胞炎性因子变化的初探

目的研究低氧刺激慢性鼻窦炎伴鼻息肉(CRSwNP)与正常鼻黏膜上皮细胞炎性因子的变化与异同,探讨其在CRSwNP发病机制中的作用。方法选择2015年6月至2018年1月在吉林大学中日联谊医院就诊的68例CRSwNP患者,其中男性36例,女性32例,年龄(45.2±12.5)岁(xˉ±s,下同),患者的鼻息肉黏膜纳入慢性鼻窦炎鼻息肉组(CRS-NP组),下鼻甲黏膜纳入慢性鼻窦炎下鼻甲组(CRS-IT组),并根据组织病理学结果进一步分成嗜酸粒细胞浸润及非浸润两种类型,即嗜酸粒细胞浸润性鼻息肉组(Eos-NP组,n=34)、非嗜酸粒细胞浸润性鼻息肉组(Non-Eos-NP组,n=34)、嗜酸粒细胞浸润性鼻息肉患者的下鼻甲组(Eos-IT组,n=20)和非嗜酸粒细胞浸润性鼻息肉患者的下鼻甲组(Non-Eos-IT组,n=20);同期25例鼻窦囊肿或鼻中隔偏曲患者的下鼻甲黏膜作为对照组(n=25),其中男性14例,女性11例,年龄(42.8±10.2)岁。免疫组织化学染色分析各组黏膜上皮组织中白细胞介素(IL)17A、干扰素γ(IFN-γ)、肿瘤坏死因子α(TNF-α)与乏氧诱导因子(hypoxia-inducible factor 1α,HIF-1α)的表达情况。酶联免疫吸附试验检测低氧刺激0、24和48 h后各组原代鼻黏膜上皮细胞分泌IL-17A、IFN-γ和TNF-α的差异;免疫荧光、固态光源高内涵与免疫印记实验检测原代鼻黏膜上皮细胞HIF-1α的表达情况。应用SPSS 17.0软件对数据进行统计学分析,采用双向方差分析作为主要统计学方法。结果免疫组织化学染色结果显示,IL-17A和TNF-α在对照组中表达最高(光密度值分别为0.37±0.03、0.53±0.02),IFN-γ和HIF-1α在Eos-IT组中表达最高(光密度值分别为0.47±0.03、0.39±0.02)。未接受低氧刺激时,IL-17A与TNF-α在对照组中水平较低;低氧刺激48 h后,对照组的IL-17A与TNF-α分泌量明显高于其他各组。未接受低氧刺激时,Eos-NP组分泌的IFN-γ明显高于对照组[(13.7±1.3)pg/ml比(11.1±1.6)pg/ml,P<0.05];低氧刺激48 h后,IFN-γ在对照组和Eos-NP组中的分泌量没有显著区别。对照组与CRS-IT组表达的HIF-1α随低氧时间延长而增加,Eos-NP组与Non-Eos-NP组表达的HIF-1α随低氧时间延长而减少。对照组与CRS-IT组HIF-1α主要表达于鼻黏膜上皮细胞的细胞质内,CRS-NP组HIF-1α主要表达于鼻黏膜上皮细胞的细胞核内。结论低氧刺激下,CRSwNP患者的鼻息肉、下鼻甲与正常鼻黏膜上皮细胞中IL-17A、TNF-α、IFN-γ的分泌以及HIF-1α的表达水平存在差异,且呈现不同的亚细胞定位,提示其可能参与了CRSwNP发病相关基因的转录与调控。     

Application of metagenomic next-generation sequencing for suspected infected pancreatic necrosis

BackgroundMetagenomic next-generation sequencing (mNGS) is increasingly used for the clinical diagnosis of infectious diseases, but there is a paucity of data regarding the application of mNGS in the early diagnosis of infected pancreatic necrosis (IPN).ObjectiveTo investigate the clinical application value of mNGS in the pathogenic diagnosis of IPN.MethodsForty-two patients with suspected IPN were prospectively and consecutively enrolled from August 2019 to August 2021. Blood samples were collected for mNGS and microbial culture simultaneously during fever (T ≥ 38.5 °C). For patients who had indications of surgical interventions, peri-pancreatic specimens were collected for mNGS and microbial culture simultaneously during the first surgical intervention to confirm IPN. The clinical performance of mNGS and microbial culture were compared.ResultsA total of 21 patients (50.0%) were confirmed to have IPN during hospitalization. The sensitivity of blood mNGS was significantly higher than blood culture (95.2% vs. 23.8%, P < 0.001) in diagnosing IPN. The negative predictive value of blood mNGS was 90.0%. The turnaround time of mNGS was significantly shorter than that of microbial culture [(37.70 ± 1.44) vs. (115.23 ± 8.79) h, P < 0.01] and the average costs of mNGS accounted for 1.7% of the average total cost of hospitalization. The survival analysis demonstrates that the positive blood mNGS result was not associated with increased mortality (P = 0.119).ConclusionsWith more valuable diagnostic performance and shorter turnaround time, clinical mNGS represents a potential step forward in the early diagnosis of IPN.