滤膜法与涂抹法检测血液透析相关用水微生物的效果

目的 探讨滤膜法和涂抹法检测血液透析相关用水微生物的效果,为选择合适的检测方法提供依据。方法 回顾性收集某三级甲等综合性医院2018年1-12月同时采用滤膜法和涂抹法检测血液透析相关用水微生物的结果,对比分析滤膜法和涂抹法检测细菌检出率、单位菌落数、超干预值检出率和微生物合格率。结果 共收集274份血液透析相关用水微生物检测结果,其中透析液131份,反渗水39份,B浓缩液（下简称B液）14份,置换液34份,其他透析用水56份。滤膜法细菌检出率均高于涂抹法,其中透析液、反渗水、置换液、其他透析用水标本使用两种方法的细菌检出率比较,差异有统计学意义（均P<0.05）。透析液、B液、其他透析用水标本单位菌落数滤膜法数值上低于涂抹法,但仅其他透析用水标本使用两种方法检测结果单位菌落数差异有统计学意义（t=-3.011,P=0.004）。超干预值检出率其他透析用水滤膜法低于涂抹法,差异有统计学意义（χ²=6.596,P=0.010）。置换液、反渗水标本微生物合格率滤膜法数值上低于涂抹法,但仅置换液标本微生物合格率差异有统计学意义（χ²=18.987,P<0.001）。结论 滤膜法检出细菌的能力高于涂抹法,但其在血液透析相关用水微生物检测中存在一定局限性,除用于置换液比较适合外,应用在其余血液透析相关用水微生物的检测效果并不优于涂抹法。     

A high-fat maternal diet decreases adiponectin receptor-1 expression in offspring

In early life, over-nutrition may increase the risk of insulin resistance in the adult stage. Adiponectin and its receptor may play a key role in this process. This study aimed to identify the effect of a high-fat (HF) maternal diet on metabolic parameters and muscle adiponectin signaling in young adult offspring. We found that offspring born to dams fed HF chow (HF; 31% of calories from fat) had elevated body and adipose tissue weight and higher serum glucose levels after glucose challenge at three weeks (W3) and eight weeks (W8) of age. Offspring exposed to a HF diet also had higher serum adiponectin levels at W3 compared to controls. However, adiponectin levels were significantly decreased compared to controls by W8. Adiponectin receptor 1?mRNA expression in skeletal muscle was decreased in the HF group at W3 and W8, and there was no difference between the two groups in adiponectin receptor 2 expression. Furthermore, glucose transporter 4?mRNA and protein expression was decreased in the skeletal muscle of the HF group at W3 and W8. Our results suggest that a HF maternal diet decreases adiponectin receptor 1 expression in the offspring, which could contribute to reduced sensitivity to adiponectin and to adverse nutritional programing outcomes.     

经听觉统合训练改善听觉传导功能的孤独症谱系障碍患儿核心症状的变化分析

目的探究接受听觉统合训练(auditory integration training,AIT)后听觉传导功能障碍得到缓解的孤独症谱系障碍患儿核心症状的改善情况。方法将存在听觉诱发电位异常的ASD患儿分入AIT组(接受训练后恢复正常的组成试验组)、对照组A组(空白对照组)、对照B组(应用行为分析训练组),分别在各组入组时、入组1个月后、入组3个月后进行波特奇发育检核表、儿童孤独症评定量表(CARS)、孤独症治疗评定量表(ATEC)评估,以各因子分数的变化值评价核心症状改善水平。结果入组时试验组、对照A组及对照B组CARS[分别为(36.31±4.08)分,(36.33±3.76)分,(36.33±5.14)分]及ATEC语言[分别为(19.08±6.43)分,(16.40±6.42)分,(18.48±5.96)分]、社交[分别为(15.63±7.13)分,(16.05±7.57)分,(16.19±7.19)分]、感知[分别为(16.78±5.39)分,(16.92±6.75)分,(17.12±6.73)分]、自理[分别为(15.98±8.71)分、(17.93±8.22)分、(17.26±8.93)]评分均差异无统计学意义(均P>0.05)。入组1月、3月后,重复测量方差分析显示,试验组、对照B组、对照组A组CARS分值[1月:(33.96±3.79)分,(35.09±4.38)分,(34.30±3.98)分;3月:(32.95±3.15)分,(36.86±3.86)分,(33.95±3.90)分]的影响:时间主效应显著(F=22.308,P<0.01),组别主效应不显著(F=2.647,P>0.05),时间与组别存在交互作用(F=8.626,P<0.01);对ATEC语言[1月:(16.18±7.10)分,(18.62±6.63)分,(13.40±5.44)分;3月:(14.13±6.13)分,(18.40±6.35)分,(10.75±5.17)分]、社交[1月:(12.31±6.68)分,(17.76±6.82)分,(15.08±6.75)分;3月:(10.71±5.42)分,(16.31±6.30)分,(12.15±7.30)分]、感知觉[1月:(14.37±5.86)分,(17.43±7.22)分,(18.58±6.92)分;3月:(10.35±5.43)分,(16.44±7.05)分,(16.68±7.37)分]分量表分值的影响,时间主效应显著(F=35.534,40.729,40.401,均P<0.01),组别主效应亦显著(F=7.600,6.193,7.675,均P<0.01),时间与组别存在交互作用(F=7.602,3.355,7.649,均P<0.05),事后多重比较示:试验组与对照B组、对照A组与对照B组在干预后ATEC语言量表分值差异有统计学意义(I1-J1=-1.69,P1<0.05;I2-J2=-4.98,P2<0.01);试验组与对照A组在干预后ATEC社交量表分值差异有统计学意义(I-J=-4.54,P<0.01);试验组与对照A组、试验组与对照B组在干预后ATEC感知觉量表分值差异有统计学意义(I1-J1=-3.16,P1<0.05;I2-J2=-4.89,P2<0.01);对ATEC自理能力分量表分值影响的时间主效应显著(F=22.876,P<0.01),组别主效应亦显著(F=3.427,P<0.05),时间与组别无交互作用(F=1.885,P>0.05),事后多重比较示:试验组与对照A组在干预后ATEC自理能力量表分值差异有统计学意义(I-J=-4.46,P<0.05)。结论AIT训练后听觉传导功能恢复正常的ASD患儿的核心症状也能得到明显改善。     

Tryptophan 387 and 390 residues in ADAMTS13 are crucial to the ability of vascular tube formation and cell migration of endothelial cells

A disintegrin and metalloproteinase with thrombospondin motifs 13 (ADAMTS13) was mainly generated and secreted from endothelial cells (ECs). Our previous study showed that tryptophan (Trp) residues at 387 and 390 in ADAMTS13 are required for its secretion and enzymatic activity. However, the effects on its host cell as well as the potential mechanism have not been clear. The aim of the study was to examine the effects of Trp residues 387 and 390 of ADAMTS13 on the biological processes of ECs. Herein, Trp was substituted with alanine in ADAMTS13 to generate ADAMTS13 mutants at 387 (W387A), 390 (W390A), and double mutants at 387 and 390 (2WA), respectively. We found that substitution mutation impaired vascular endothelial growth factor (VEGF) secretion and the downstream JAK1/STAT3 activation, the binding ability to Von Willebrand factor, cell proliferation, migration, and vascular tube formation. Overall, our study concluded that Trp³⁸⁷ and Trp³⁹⁰ of ADAMTS13 play vital roles in the biological function of ECs.     

Malignant melanotic Xp11 neoplasms exhibit a clinicopathologic spectrum and gene expression profiling akin to alveolar soft part sarcoma: a proposal for reclassification

The classification of the distinct group of mesenchymal neoplasms, first described as ‘Xp11 translocation perivascular epithelioid cell tumor (PEComa)’ and for which the term ‘melanotic Xp11 neoplasm’ or ‘Xp11 neoplasm with melanocytic differentiation’ has recently been proposed, remains challenging and controversial. We collected 27 melanotic Xp11 neoplasms, the largest series to date, for a comprehensive evaluation. Fourteen of the cases, together with eight alveolar soft part sarcomas (ASPS), nine conventional PEComas and a control group of seven normal tissues were submitted to RNA sequencing. Follow-up available in 22 patients showed 5-year overall survival and 5-year disease-free survival of 47.6 and 35.7%, respectively, which were similar to ASPS and significantly worse than conventional PEComa. Univariate analysis of location (occurring in the kidney versus not kidney), infiltrative growth pattern, nuclear pleomorphism, mitotic activity ≥2/50 high-power fields (HPF), necrosis and lymphovascular invasion were found to be associated with overall survival and/or disease-free survival. Multivariate analysis identified that location was the only factor found to independently correlate with disease-free survival. More importantly, RNA sequencing-based clustering analysis segregated melanotic Xp11 neoplasm and ASPS from other tumors, including conventional PEComa and Xp11 translocation renal cell carcinoma, and formed a compact cluster representative of the largely similar expression signature. Here we clearly define the true biologic nature of melanotic Xp11 neoplasms which are distinctive malignant mesenchymal tumors, rather than simply PEComa variants with occasionally unpredictable behavior. Meanwhile, melanotic Xp11 neoplasm and ASPS more likely represent phenotypic variants of the same entity, which is distinct from conventional PEComa and Xp11 translocation renal cell carcinoma. Based on these important findings, melanotic Xp11 neoplasm might be reclassified into a distinctive entity together with ASPS, independent from PEComa, in future revisions of the current WHO categories of tumors of soft tissue and bone for the improved reclassification. © 2020 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.     

急性呼吸道感染患儿鼻咽分泌物中呼吸道合胞病毒亚型的检出分析

目的探讨急性呼吸道感染患儿呼吸道合胞病毒(RSV)亚型的流行规律。方法应用直接免疫荧光法筛检2006年1月至2012年12月苏州地区42 208份来自急性呼吸道感染住院患儿的鼻咽分泌物标本的RSV病毒抗原;随机抽取不同年份RSV流行季节的RSV阳性标本,采用实时荧光PCR鉴定亚型。结果 RSV流行呈季节性,当年11月至次年3月为高峰期,而当年5至9月为RSV检出低谷期;从2006年至2012年,不同年份间高峰期的RSV阳性检出率差异有统计学意义(χ2=280.09,P0.01)。在398份不同年份高峰期的RSV抗原阳性标本中,检出A亚型319份(80.15%),B亚型63份(15.83%),未检出16份(4.02%),不同年份高峰期之间RSV亚型分布的差异有统计学意义(P0.01)。多数年份RSV流行以A亚型为主,在高峰期RSV检出率最低的2008—2009年A、B亚型同时流行,随后的2009—2010年以B亚型为主。结论苏州地区2006年至2012年,前四个流行季RSV检出率呈现周期性隔年增高趋势,之后两个流行季RSV感染呈持续高发趋势,急性呼吸道感染住院患儿RSV以A亚型为主。     

过敏性紫癜患儿急性期外周血OX40/OX40L的表达及意义

目的探讨共刺激分子OX40/OX40L在过敏性紫癜(HSP)患儿外周血单个核细胞(PBMC)中的表达及其在过敏性紫癜发病机制中的作用及临床意义。方法选取首次住院的34例HSP患儿作为观察组,另20例健康体检儿童作为对照组。采集分离PBMC,应用逆转录-聚合酶链式反应(RT-PCR)检测OX40、OX40L mRNA的表达,并分析其与24 h尿微量白蛋白(24 h UMA)的相关性。结果 HSP患儿OX40、OX40L mRNA的表达均明显高于对照组,差异有统计学意义(P均<0.01)。24 h UMA增高的HSP患儿OX40、OX40L mRNA的表达均高于24 h UMA正常者,差异均有统计学意义(P均<0.05),且均与24 h UMA呈正相关(P<0.05)。结论过敏性紫癜患儿PBMC的OX40、OX40L mRNA表达有异常增高并与24 h UMA相关。提示OX40、OX40L可能参与了过敏性紫癜的发病,其或许可以作为监测HSP患儿病情及检测早期肾脏损害的免疫学指标。