不同全血过滤方法用于去白细胞血液制备的临床对照研究

目的:观察不同全血过滤方法用于去白细胞血液制备的效果。方法:采用两种全血过滤方法进行对比研究,对照组采用常规法,将采集后全血混匀后直接与白细胞滤器连接直接过滤;实验组采用湿润滤盘法,血液采集完成混匀后静置,先用上层血清10～20 m L湿润滤盘,再混匀与白细胞滤器连接后进行过滤。比较两组制备方法所用的过滤时间、血液回收率、过滤前后血液指标情况及24小时内溶血的发生情况。结果:两组全血过滤方法过滤前后白细胞、红细胞、血红蛋白、血小板及血浆游离血红蛋白水平比较差异均无明显统计学意义(P0.05)。而实验组过滤时间短于对照组,血液回收率高于对照组,且24小时内溶血比例明显低于对照组(P0.05)。结论:常规法与湿润滤盘法均能达到去白细胞血液标准,但湿润滤盘法较常规法能有效的降低过滤时间、增加血液回收率,减少去白细胞悬浮红细胞因溶血造成的血液不合格率,值得临床推广应用。     

一例喉真菌病病例报道并文献复习

目的:探讨喉真菌病的临床特征、诊断要点和治疗方案。方法:回顾我院收治的一例喉真菌病患者的临床病例资料,并对1992年至今国内外报道的类似病例33例进行文献复习。本研究共纳入患者34例,男性16例,女性18例,年龄14-67岁,临床表现以声嘶为主,可伴有咽痛、咽干等咽喉不适感,其中有16例患者被误诊为急性喉炎,27例患者有不同程度的抗生素和(或)糖皮质激素使用史。结果:34例患者中,13例通过病理确诊为喉真菌病。所有患者均予抗真菌药物治疗,其中有1例同时行手术治疗,均治愈。结论:喉真菌病临床罕见,症状无特异性,易误诊,但病理学检查可靠,全身或局部使用抗真菌药物疗效佳,预后良好。     

血府逐瘀汤联合四联疗法治疗Hp阳性慢性萎缩性胃炎的临床观察

目的:探究血府逐瘀汤联合四联疗法治疗幽门螺旋杆菌(Hp)阳性慢性萎缩性胃炎的效果。方法:回顾性分析2014年5月-2017年12月在我院进行诊治的80例Hp阳性慢性萎缩性胃炎患者的临床资料,按照其入院顺序经随机数字表分为研究组和对照组,每组各40例患者。其中,对照组患者采用四联疗法,研究组患者在对照组基础上联合血府逐瘀汤进行治疗,对比两组患者的Hp转阴率、治疗前后胃黏膜病理积分的变化情况、临床症状积分的变化情况和不良反应发生率。结果:治疗后,研究组患者的Hp转阴率[85.0%(34/40)]显著高于对照组[62.5%(25/40)](P0.05)。两组上腹痛、纳差、上腹胀、反酸、嗳气等临床症状积分以及胃黏膜萎缩、肠化、不典型增生等病理积分均显著低于治疗前(P0.05),且研究组以上指标均明显低于对照组(P0.05)。研究组患者的不良反应发生率[5.0%(2/40)]与对照组[12.5%(5/40)]无显著性差异(P0.05)。结论:血府逐瘀汤联合四联疗法治疗Hp阳性慢性萎缩性胃炎的效果显著优于单用四联疗法,其可有效改善患者的病变程度和临床症状,且无明显不良反应产生。     

Changes in retinal and choroidal morphology after cerebrospinal fluid pressure reduction: a Beijing iCOP study

正Dear Editor,Glaucoma is a multifunctional neurodegenerative disease and is the leading cause of irreversible blindness. It is characterized by progressive loss of retinal ganglion cells and their axons leading to visual field defects. Two mechanisms of glaucomatous optic nerve damage have been     

Nanopore sequencing: a rapid solution for infectious disease epidemics

<正>Emerging and re-emerging infectious diseases have given rise to a large number of human infections, morbidity, and heavy economic burden, including the Middle East respiratory syndrome caused by a coronavirus in 2012, global influenza pandemic caused by the H7N9 influenza A virus in2013, Ebola epidemic in West Africa in 2014, and Lassa fever epidemic in Nigeria in 2019. The healthcare war against viruses deserves constant surveillance due to the continuous emergence of new viruses and rapid evolution of     

氰酸盐诱导氧化应激促进肾小管上皮细胞上皮–间充质转化

该研究探讨氰酸盐(cyanate)诱导肾小管上皮细胞氧化应激损伤和促进肾纤维化的作用。氰酸盐作用HK-2肾小管上皮细胞后, CCK8法检测其对细胞活力的影响;倒置显微镜观察细胞形态的改变; DCFH-DA法检测细胞ROS水平;细胞免疫荧光和Western blot分别检测E-cadherin、Fibronectin、α-SMA的表达; Western blot检测TGF-β的表达水平。结果显示, 2 mmol/L氰酸盐明显下调HK-2细胞的活力(P<0.05),细胞形态变为长梭形。氰酸盐作用24 h后, HK-2细胞内ROS水平呈浓度依赖性升高。免疫荧光和Western blot结果均显示,氰酸盐作用24 h后, HK-2的Fibronectin、α-SMA表达升高, E-cadherin表达下降; TGF-β的表达水平随氰酸盐浓度升高而上调(P<0.05)。以上结果表明,氰酸盐诱导肾小管上皮细胞产生过量ROS,上调TGF-β水平促进细胞上皮–间充质细胞转化(epithelia-mesenchymal transition, EMT)。     

Identification of a novel COL4A5 mutation in the proband initially diagnosed as IgAN from a Chinese family with X-linked Alport syndrome

Alport syndrome(AS) is a hereditary progressive nephropathy characterized by hematuria, ultrastructural lesions of the glomerular basement membrane, ocular lesions and sensorineural hearing loss. Germline mutations of COL4 A5 are associated with X-linked AS with an extreme phenotypic heterogeneity. Here, we investigated a Chinese family with Alport syndrome. The proband was a 9-year-old boy with hematuria and proteinuria. Based on the test results of renal biopsy and immunofluorescence,the proband was initially diagnosed as Ig A nephropathy and the treatment was recommended accordingly. Meanwhile, we found that the treatment outcome was poor. Therefore, for proper clinical diagnosis and appropriate treatment, targeted exome-based next-generation sequencing has been undertaken. We identified a novel hemizygous single nucleotide deletion c.1902 del A in COL4 A5 gene. Segregation analysis identified that this novel mutation is co-segregated among the affected family members but absent in unaffected family members. The clinical diagnosis of the proband was revised as AS accompanied by Ig A nephropathy,which has been rarely reported. Our findings demonstrated the significance of the application of Genetic screening, expanded the mutation spectrum of COL4 A5 associated AS patients with atypical renal phenotypes and provided a good lesson to be learned from our detour during the diagnosis.     

Doxorubicin‐induced cardiotoxicity is maturation dependent due to the shift from topoisomerase IIα to IIβ in human stem cell derived cardiomyocytes

Doxorubicin (DOX) is widely used to treat various cancers affecting adults and children; however, its clinical application is limited by its cardiotoxicity. Previous studies have shown that children are more susceptible to the cardiotoxic effects of DOX than adults, which may be related to different maturity levels of cardiomyocyte, but the underlying mechanisms are not fully understood. Moreover, researchers investigating DOX‐induced cardiotoxicity caused by human‐induced pluripotent stem cell‐derived cardiomyocytes (hiPSC‐CMs) have shown that dexrazoxane, the recognized cardioprotective drug for treating DOX‐induced cardiotoxicity, does not alleviate the toxicity of DOX on hiPSC‐CMs cultured for 30 days. We have suggested that this may be ascribed to the immaturity of the 30 days hiPSC‐CMs. In this study, we investigated the mechanisms of DOX induced cardiotoxicity in cardiomyocytes of different maturity. We selected 30‐day‐old and 60‐day‐old hiPSC‐CMs (day 30 and day 60 groups), which we term ‘immature’ and ‘relatively mature’ hiPSC‐CMs, respectively. The day 30 CMs were found to be more susceptible to DOX than the day 60 CMs. DOX leads to more ROS (reactive oxygen species) production in the day 60 CMs than in the relatively immature group due to increased mitochondria number. Moreover, the day 60 CMs mainly expressed topoisomerase IIβ presented less severe DNA damage, whereas the day 30 CMs dominantly expressed topoisomerase IIα exhibited much more severe DNA damage. These results suggest that immature cardiomyocytes are more sensitive to DOX as a result of a higher concentration of topoisomerase IIα, which leads to more DNA damage.