Role of high mobility group box-1 protein in pathogenesis of acute kidney injury induced by heat stroke in mice

Objective To observe the differential expression of high mobility group box-1 protein (HMGB1) in renal tissues of heat stroke mice models, and to explore its role in the pathogenesis of heat stroke associated acute kidney injury(HS-associated AKI). Methods According to random number table, 20 healthy male C57BL/6J mice were randomly divided into 2 groups, including normal control (n=10) and heat stroke group (n=10). The mice in heat stroke group were given with a 2-hour-exposure in biological simulation chamber (temperature 41℃, humidity 70%). Heat stroke was defined as anal temperature lasting more than 40 degrees Celsius. A 18F-deoxyglucose nuclide labeled vivo imaging was conducted with micro- positron emission tomography(PET)/computer tomography (CT). Serum creatinine was examined with blood example. In order to evaluate the pathological changes, HE stain was conducted with kidney tissue, and mitochondrial morphological changes in kidney tissue were observed by transmission electron microscopy. The expressions of HMGB1 and apoptosis inducing factor mitochondria associated 2 (Aifm2) were examined by immunohistochemical method, and the levels of HMGB1 and RAGE were examined by Western blotting. The cell apoptosis of renal tissue was detected by terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay (TUNEL). The metabolomics of kidney tissue in mice were detected by liquid chromatography-mass spectrometry (LC-MS), and the pathway enrichment analysis was carried out by KEEG database. Results (1) The body temperature of the mice in heat shock group was significantly higher than that in normal control group 45 min after model establishment (P＜0.05). The level of serum creatinine in heat shock group was significantly higher than that in normal control group (P＜0.05), and the levels of 18F-deoxyglucose increased in skeletal muscle and visceral tissue of the mice in heat-shock group. (2) HE staining showed hemorrhage in collecting duct and tubular endothelial cell swelling, and mitochondrial swelling and deformation were observed by transmission electron microscopy in kidney tissue of the heat shock group. (3)Immunohistochemical method showed that the levels of Aifm2 and HMGB1 in heat shock group were higher (P＜0.05). (4) Western blotting showed that the levels of HMGB1 and RAGE in heat shock group were higher than those in normal control group (P＜0.05). (5) TUNEL showed that the number of cells with positive stain in kidney tissue of the heat shock group was higher than that in normal control group (P＜0.05). (6) Between normal control group and heat shock group, 136 differential metabolites were detected in kidney tissues. After analysis by KEGG database, pathway abnormalities such as unsaturated fatty acid metabolism disorder may be associated with HS-associated AKI, and many differential metabolites such as adrenic acid may be important regulatory points in the pathogenesis. Conclusion Acute kidney injury is a common complication of heat shock. It may be related to the dysfunction of renal mitochondria and activation of apoptotic pathway caused by systemic hypercatabolism, which may be related to the disorder of unsaturated fatty acid metabolism and activation of HMGB1. Some differential metabolites may be of high value in HS- associated AKI studies.     

激素联合环磷酰胺治疗视神经脊髓炎谱系疾病:1例报告及文献复习

目的:报道激素联合环磷酰胺治疗视神经脊髓炎谱系疾病患者1例,并对相关文献进行复习。方法:对1例诊断为视神经脊髓炎谱系疾病患者进行相关实验室检查(包括水通道蛋白4)和辅助检查,并基于临床实践,给予激素联合环磷酰胺治疗。结果:该患者以渐进性右眼视物模糊伴右侧肢体无力、麻木起病,诊断为视神经脊髓炎谱系疾病。治疗方面,先给予激素冲击治疗,但患者病情不断进展且对激素产生依赖性,遂加用环磷酰胺,使患者的病情得到了有效控制。结论:对于视神经脊髓炎谱系疾病激素治疗不佳的患者,激素联合环磷酰胺治疗可以明显改善其临床症状。     

Comparative study of clinical characteristics between Chinese Han and German Caucasian patients with coronary heart disease

Background  

The differences of the clinical characteristics, risk factors, treatment and prognosis in coronary heart disease (CHD) patients from different races, area and countries are rarely reported.     

The efficacy of neoadjuvant chemotherapy in different histological types of cervical cancer

Objective

To determine whether the efficacy of neoadjuvant chemotherapy (NACT) is different among cervical cancer types, squamous cell carcinoma (SCC) and non-SCC, including adenocarcinoma of the cervix (ACC) and adenosquamous carcinoma (ASC).

Methods

We searched PubMed, MEDLINE, ScienceDirect, Springerlink and CNKI for studies published between Jan 1987 and Sep 2012 and evaluated the studies published in English and Chinese on NACT and cervical carcinoma based on specific inclusion and exclusion criteria. Because there was a relative lack of relevant randomized controlled trials (RCTs), we included 2 RCTs and 9 observational studies in our analysis. Meta-analysis was applied to calculate the efficacy of NACT in different histological types of cervical cancer with 95% confidence intervals. The risk of bias was assessed by Begg's adjusted rank correlation test and Egger's regression asymmetry tests.

Results

As many as 11 articles, 2 RCTs and 9 observational studies, were selected according to the eligibility criteria for a total of 1559 participants. For the short-term efficacy of NACT, either in terms of CR + PR or CR only, there was no difference between SCC and non-SCC when the data were pooled (P > 0.05) in stratified studies based on the International Federation of Gynecology and Obstetrics (FIGO) stage (P > 0.05) or histological type (P > 0.05) or in observational studies (P > 0.05). Nevertheless, SCC was associated with a higher short-term response rate than non-SCC in RCTs [6.57 (95%CI 1.72–25.12) in CR + PR]. For the long-term outcome of NACT, patients with SCC experienced a significant 5-year overall survival (OS) and progress-free survival (PFS) when compared to patients with non-SCC in pooled [1.47 (95%CI 1.06–2.06)] and observational studies [1.96 (95%CI 1.61–2.38)] other than RCTs (P > 0.05). Moreover, this difference was especially obvious when the subgroup analysis was restricted to patients in stages above IIB [2.06 (95%CI 1.79–2.36)] rather than in stages IB–IIB [1.33 (95%CI 0.99–1.79)].

Conclusion

Although no significant differences exist in the short-term efficacy of NACT, the histological type may be used to predict the long-term efficacy of NACT in patients with cervical cancer, especially those with FIGO stages above IIB.     

榄香烯乳剂治疗中晚期肝癌的疗效与安全性的临床观察

目的:探讨榄香烯乳剂联合TACE治疗中晚期肝癌的疗效与安全性。方法:选取2015年2月至2017年2月在上海中医药大学附属上海市中医医院肿瘤科收治的中晚期肝癌患者80例,将患者随机分为观察组(n=40)和对照组(n=40)。对照组给予TACE治疗,观察组在对照组的基础上联合榄香烯乳剂治疗。观察2组患者中医证侯疗效、肝功能、生命质量以及不良反应发生率。结果:观察组中医证侯改善率(80.00%)明显大于对照组(47.50%)(P0.05);观察组在改善患者ALT、AST、GGT、TBIL方面均优对照组(P0.05);观察组治疗后KPS评分(86.49±12.03)明显大于对照组(74.14±13.67)(t=4.289,P0.05);2组不良反应情况比较差异无统计学意义(P0.05)。结论:榄香烯乳剂联合TACE治疗中晚期肝癌患者能明显改善患者中医临床症状、肝功能以及生命质量,而不良反应均可缓解,值得临床推广。     

胰管支架表面括约肌预切开在ERCP困难胆管插管中的应用效果

目的 探讨胰管支架表面括约肌预切开(PPDS)在ERCP困难胆管插管中的应用效果.方法 回顾性统计分析2016年6月1日至2021年5月31日上海交通大学医学院附属瑞金医院北部院区所有ERCP术病例资料,将在ERCP操作过程中导丝意外进入胰管的困难胆管插管者,根据术中选择插管方法,分为两组:(1)PPDS组,(2)双导...     

花生四烯酸代谢产物12-HETE与结核病发生发展的相关性

目的 检测结核病患者血浆中12羟基二十烷四烯酸（12-HETE）的含量以及治疗前后其含量的变化,明确12-HETE与结核病发生发展的关系。方法 收集结核病患者（TB）、结核病潜伏感染者（LTB）、健康对照（HD）和非结核感染疾病（Non-TB）的血浆标本,同时收集结核病患者组病例经抗结核治疗3个月、6个月、12个月的随访血浆标本,以ELISA检测12-HETE的含量,比较不同组别和抗结核病治疗不同时间12-HETE的含量的差异;收集结核病患者的肺泡灌洗液标本,ELISA检测12-HETE的含量并计数肺泡灌洗液中的中性粒细胞数量。结果 12-HETE在结核患者血浆中为（277.3±23.2）ng/mL,在健康对照血浆中为（233.4±25.1）ng/ mL,差异具有统计学意义（P<0.01）。经过抗结核药物治疗3个月、6个月、12个月后,12-HETE的含量逐渐降低,与治疗前的含量相比差异具有统计学意义（P <0.01）;在肺泡灌洗液中,12-HETE的含量与中性粒细胞的数量呈显著正相关（r=0.619,P <0.001）。结论 结核菌感染诱导的12-HETE代谢失调是结核病发生发展的重要原因。     

xCT基因rs13120371位点单核苷酸多态性与肺结核易感性的相关性

目的 通过大样本病例与对照研究明确xCT基因功能性SNP与结核病易感性的相关性,明确其调控结核病发生发展的分子机制。方法 从健康对照和结核患者的全血样本中提取基因组DNA,采用TaqMan探针技术对xCT基因rs13120371位点进行基因分型并对基因频率进行关联性分析,结核菌特异性抗原IFN-γ斑点形成细胞的数量和放射影像学分数反应不同基因型与临床指标的相关性,Real-time PCR方法检测健康对照和结核患者外周血单个核细胞中xCT基因及其相关的CXCL1、CXCL2、IL1B基因的表达水平。结果 等位基因位点基因频率分布符合Hardy-Weinberg平衡定律(χ²=0.678,P>0.05),选择的样本具有群体代表性。rs13120371位点的单核苷酸多态性与结核病的易感性相关,其中结核患者组等位基因A的基因频率为70.2%,等位基因G的基因频率为29.8%;健康对照组等位基因A的基因频率为66.8%,等位基因G的基因频率为33.2%,两组之间的等率基因频率差异具有统计学意义(P=0.02,OR=0.86)。AA基因型患者的结核菌特异性刺激分泌的IFN-r斑点形成细胞数量及炎症反应指标明显高于基因型GG的患者,基因型AA的细胞xCT基因的表达水平也明显上调。结论 xCT基因rs13120371位点的单核苷酸多态性与汉族人群结核感染的易感性相关,并且rs13120371位点是功能性SNP,等位基因A可能增加结核菌感染的风险。     

粒细胞集落刺激因子及其受体在儿童肾母细胞瘤中的表达

目的 检测粒细胞集落刺激因子(granulocyte colony-stimulating factor,G-CSF)及其受体(G-CSFR)在儿童肾母细胞瘤中的表达.方法 收集我院2009年1月至2011年6月确诊的肾母细胞瘤患者手术标本27例.应用免疫组织化学方法检测肿瘤标本的G-CSF、G-CSFR的表达和分布情...     

大前庭水管综合征与内耳其他畸形的听性脑干反应特性分析

目的:通过对大前庭水管综合征(LVAS)与内耳其他畸形的听性脑干反应(ABR)特性进行分析,了解在进行ABR检查过程中出现声诱发短潜伏期负相波(ASNR)对诊断LVAS的特异性.方法:对2008-01-2009-09患感音神经性聋(SNHL)的患儿进行颞骨薄层CT扫描,将其中70例内耳其他畸形患儿的影像学结果进行分析,并将研究对象分组,LVAS组(包括大前庭伴其他内耳畸形)38例(76耳),内耳其他畸形组32例(64耳),在进行行为测听或纯音测听、声导抗、耳声发射听力学检查项目的基础上,均进行ABR检测.结果:ABR检查发现24例(41耳)大前庭水管,在2～3 ms处记录到特征性的负相波,检出率为54%,在这41耳中,轻度听力下降2耳、中度听力下降1耳,重度听力下降5 耳,极重度听力下降33 耳. 内耳其他畸形组未检测到负相波.2组差异有统计学意义(P<0.05).结论:在 LVAS与内耳畸形的ABR特性分析中,LVAS无论是否伴其他内耳畸形,无论听力损失的程度如何,均有可能检测出负相波,认为ASNR是大前庭水管综合征临床听力学特征性表现之一.