Abstract:Recently, exosome has gained great attention in the field of biomedical research, especially in precision medicine-related diagnostic technology and clinical transformation of therapeutic strategies. There have been a large number of exosome-related studies involving non-invasive diagnosis of diseases, liquid biopsy of tumor, development of precision drugs and observation of clinical efficacy. Exosomes possess four biological characteristics:stable, trackable, active and real-time, which make them the key factors for the next generation"STAR"of translational medicine. Since 2014 exosome-related studies began to show an explosive increase, and several exosome-associated patent technologies or products have appeared. This article summarizes the research history, biological characteristics and clinical exploration of exosomes, and analyzes the prospects of exosome-related technology.

Abstract:Exosomes actively secreted by prostate cancer cells are mediators of signal transduction between prostate tumor cells and mesenchymal cells, and they can promote the progress of prostate cancer by altering the microenvironment of primary tumors and metastasis tumors. In particular, exosomes participate in various molecular events related to prostate cancer progress by carrying bioactive molecules, such as RNAs and proteins. Therefore, exosomes and their carrying molecules are expected to be novel biomarkers for predicting the progress of prostate cancer and therapeutic targets of prostate cancer. In recent years, there are many researches in the field of prostate cancer-derived exosomes which have shown great values in predicting and preventing the progress of prostate cancer, and this review sums up the current advances.

Abstract:Exosomes are the microvesicles released from cells during fusion of multivesicular endosomes with plasma membrane. In recent years, most studies have focused on the function of some molecules contained in exosomes, such as messenger RNA (mRNA), microRNA and long intergenic non-coding RNA (lincRNA). The studies about glycoproteins contained in exosomes are rarely reported. Recent researches have shown that many diseases, including tumor, are closely associated with glycoproteins contained in exosomes. In this review, we described the role of exosome glycoproteins in tumors and other diseases.

Abstract:Oxidative stress damage is known to be a major factor leading to many diseases. Mesenchymal stem cell-derived exosomes (MSC-exos) are enriched with various proteins, lipids, coding RNAs and non-coding RNAs, and alleviate oxidative stress damage and stimulate the regeneration response of damaged tissues and cells. MSC-exos hold a great potential for the treatment of diseases caused by oxidative stress. In this review, we summarized the research progress of MSC-exos in cardiovascular injury, lung injury, kidney injury and liver cell injury caused by oxidative stress.

Abstract:Exosome is a nanoscale membranous vesicle formed by fusion of multivesicular body with cell membrane and secreted into the extracellular matrix, playing important roles in the intercellular communication of cells. Mesenchymal stem cell (MSC)-derived exosome (MSC-exo) is an important paracrine pathway of MSC to promote tissue injury repair and immune regulation. Compared with the MSC, MSC-exo has specific advantages. Recent research reveals that MSC-exo targets the damaged tissues to ameliorate kidney injury by delivery of protein, mRNA and microRNA. In this review, we summarized the research progress of MSC-exo in kidney diseases.

Abstract:Objective To compare the differences and characteristics of extracellular vesicles in different tissues extracted by different methods, and to explore the separation and purification methods of extracellular vesicles in tissues, so as to lay a foundation for studying the function and mechanism of extracellular vesicles in tissue microenvironment. Methods Collagenase digestion was performed on four tissues:kidney, prostate, skin and stomach, to obtain decellularized tissues and to prepare extracellular matrix suspensions. Qiagen exosome extraction kit and SBI exosome extraction kit and ultracentrifugation (UC) method were used to extract the extracellular vesicles. The ATS particle size analyzer qNano technique was used to measure the particle size and concentration of the extracellular vesicles. Results Purified extracellular vesicles were obtained by the three methods from the extracellular matrix suspensions of the four tissues, and the main vesicle type was exosomes. The distribution of particle size was different among the different types of tissues, but the difference of particle size was not significant (P>0.05). In homogeneous tissues, the extracellular vesicles obtained by UC method had the highest concentration, which were significantly different compared with the concentrations of the extracellular vesicles obtained by the other two methods (P<0.01). The concentrations of the extracellular vesicles from prostate and kidney were higher, and those from stomach and skin were lower, and the difference was statistically significant (P<0.05). Conclusion The concentration of extracellular vesicles extracted by UC method is the highest in the various types of tissue microenvironments. There is a significant difference in the concentrations of extracellular vesicles from different types of tissue microenvironments.

Abstract:Objective To explore a suitable separation protocol for exosomes derived from urine of patients with aortic dissection. Methods Urine samples were collected from the patients with aortic dissection. The exosomes were extracted and purified by ultracentrifugation, dialysis-ultrafiltration and precipitation kit methods. The biological morphology of exosomes was observed under transmission electron microscope. The particle size, distribution and concentration of the exosomes were detected by nanoparticle tracking analysis. Results The exosomes extracted with ultracentrifugation method had half cup-like or concave-hemispherical morphology; the particle size was large and well-distributed; the range of the particle size was wide with a mean value of (236.4±46.5) nm; and the concentration was low, being (2.82±0.21)×10¹² per 1 mL urine. The exosomes extracted by dialysis-ultrafiltration method had normal morphology and large quantity; the particle size was small and concentrated; the range of the particle size was narrow with a mean value of (128.7±6.3) nm; and the concentration was high, being (2.16±0.15)×10¹⁴ per 1 mL urine. There were no exosomes in the extractive by precipitation kit method under transmission electron microscope. Conclusion Dialysis-ultrafiltration method is a suitable method for extracting exosomes from urine of the aortic dissection patients and can yield a high concentration, while it is not suitable when exosomes of very high purity are required.

Abstract:Objective To explore the effect of human umbilical cord mesenchymal stem cell (hucMSC)-derived exosomes on fracture healing and its related mechanisms. Methods Twelve male SD rats with tibial fracture were randomly divided into 3 groups with 4 rats in each group. The rats in control group were treated with phosphate buffer solution by intra-bone marrow injection on 7 day after fracture operation, the rats in hucMSC-exosome group were treated with hucMSC-derived exosomes, and the rats in hucMSC-supernatant group were treated with exosome-free hucMSC supernatant. After treatment for 3 weeks, the healing of fracture gap was evaluated by micro-CT examination and tissue section H-E staining, and the expression levels of osteogenesis-related genes osteocalcin (OCN), osteopontin (OPN), alkaline phosphatase (ALP) and Runt-related transcription factor 2 (Runx-2) were detected by qPCR. Results Micro-CT examination showed that fracture was not been joined in the control group and the hucMSC-supernatant group, with clear fracture line and discontinuous wall of cortical bone, while fracture was anastomosed in the hucMSC-exosome group, with continuous wall of cortical bone and disappeared fracture line. Tissue section H-E staining showed no fibrous callus or structure of new bone trabeculae in the control group and the hucMSC-supernatant group, while complete fibrous callus was formed and structure of new bone trabeculae was in order in the hucMSC-exosome group. The expression levels of OCN, OPN, ALP, and Runx-2 in the hucMSC-exosome group were significantly higher than those in the control group and the hucMSC-supernatant group (all P<0.05). Conclusion HucMSC-derived exosomes can promote fracture healing of rats, which may be related to the upregulated expressions of OCN, OPN, ALP, and Runx-2.

Abstract:Objective To determine the expression level of microRNA-21 (miR-21) in serum exosomes of patients with different severities of asthma, and to explore the diagnostic value. Methods A total of 82 patients with asthma who did not received any treatment and 80 healthy control volunteers were enrolled in this study. The asthma cases were divided into four groups according to the severity of asthma, including intermittent group (n=20), mild sustained group (n=22), moderate sustained group (n=22), and severe sustained group (n=18). Expression levels of miR-21 were determined using qPCR and the differences were compared among the five groups. Spearman correlation analysis was used to analyze the correlation between miR-21 expression level and severity of asthma. The receiver operating characteristic (ROC) curve was used to evaluate the diagnosis performance of miR-21 expression level in serum exosomes for different severities of asthma. Results The expression levels of miR-21 were significantly higher in the intermittent, mild sustained, moderate sustained and severe sustained groups than that in the healthy control group (all P<0.01). The difference of miR-21 expression level was statistically significant between the intermittent, mild sustained, moderate sustained and severe sustained groups (all P<0.01). Spearman correlation analysis showed that the relative expression level of miR-21 in serum exosomes was positively correlated with the severity of asthma (r=0.974, P=0.016 7). The areas under ROC curve of exosome miR-21 for diagnosing intermittent, mild sustained, moderate sustained and severe sustained asthma were 0.657, 0.769, 0.847 and 0.916, respectively (all P<0.01). Conclusion The expression level of miR-21 in serum exosomes is effective in diagnosing different severities of asthma, and miR-21 in serum exosomes may be a new non-invasive biomarkers.

Abstract:Objective To establish a long-term survival prediction model for hepatocellular carcinoma (HCC) patients after liver transplantation based on up-to-seven (Up7) criteria, and to validate the prediction model in different liver transplantation criteria, so as to assist clinical decision-making for the treatment of HCC. Methods We retrospectively analyzed the clinical and follow-up data of 251 HCC patients who underwent liver transplantation with Up7 criteria. Stepwise regression method was used to conduct multivariate Cox regression analysis to obtain the independent predictors of long-term survival after HCC liver transplantation, and to establish the survival Cox regression prediction model. R 3.4.3 software was used to score the prediction model, and the decision tree technique was used to determine the cut-off value. The Kaplan-Meier survival curve of the HCC patients after liver transplantation was drawn to validate the prediction model in different criteria (Shanghai Fudan criteria, University of California, San Francisco[UCSF] criteria and Italy Milan criteria), and the difference between groups was analyzed by log-rank test. The receiver operating characteristic (ROC) curve was used to test the predictive effectiveness of the model. Results Multivariate Cox regression analysis suggested that α-fetoprotein (AFP), total bilirubin (T-Bil), microvascular invasion (MVI) and tumor maximal diameter (Diameter) were the independent predictors of long-term survival of HCC liver transplant recipients after liver transplantion. We built the ATMD (AFP, T-Bil, MVI, Diameter) model using these factors:h (t, x)=h0 (t) exp (0.284×Diameter[cm]+0.773×MVI[yes=1; no=0]+0.404×lg AFP[ng/mL]+0.003×T-Bil[μmol/L]). The cut-off value of ATMD model was 1.44. The scores being more than 1.44 were defined as the high-risk group, and scores being 1.44 or less were defined as the low-risk group. The cases in the high-risk and low-risk groups who met the Up7 criteria, Shanghai Fudan criteria, UCSF criteria and Italy Milan criteria had 87 and 164, 33 and 144, 29 and 134, and 29 and 131, respectively. Kaplan-Meier survival analysis showed that the cumulative survival rates of the liver transplantation recipients with Up7 criteria, Shanghai Fudan criteria, UCSF criteria or Milan criteria were significantly different between the high- and low-risk groups (P<0.001, P=0.008, P<0.001, P=0.001). The areas under the ROC curve of the three-year survival of the liver transplantation recipients predicted by ATMD model were 76.63%, 75.87%, 73.32% and 69.41%, respectively. Conclusion The ATMD model has a good survival prediction ability for the HCC patients meeting Up7 criteria, Shanghai Fudan criteria, UCSF criteria or Milan criteria. It is of great significance for preoperative decision-making and postoperative risk assessment of HCC liver transplantation recipients meeting the above criteria.

Abstract:Objective To investigate the distribution and drug susceptibility profile of pathogens causing nosocomial infection in organ transplant patients, so as to provide a basis for clinical diagnosis and treatment. Methods The clinical samples were collected from 149 organ transplant patients in Changhai Hospital of Navy Medical University (Second Military Medical University) between Jan. 2016 and Dec. 2017. The isolates were identified using VITEK 2 Compact automatic microorganism analyzer system or Microflex matrix-assisted laser desorption ionization-time of flight mass spectrometry. The susceptibility test for bacteria was carried out by VITEK 2 Compact automatic microorganism analyzer system, and the susceptibility test for fungus was carried out by ATB Fungus 3 susceptibility kit. Results Most pathogenic specimens were derived from flushing fluid samples (42.3%, 101/239). A total of 239 strains of pathogens were isolated from 149 patients, including 135 (56.5%) of Gram-negative pathogens, 77 (32.2%) of Gram-positive pathogens, and 27 (11.3%) of fungi. Klebsiella pneumoniae was the most found Gram-negative pathogens (13.8%, 33/239), and its resistance to common antibiotics, such as piperacillin, was generally high with the resistance incidence being more than 50.0% and it had a tendency of multi-drug resistance. Escherichia coli had high sensitivity to carbapenems, with incidence of drug resistance being less than 5.0%. Acinetobacter baumannii had high resistance to carbapenems, with incidence of drug resistance being 81.0%. Among Gram-positive pathogens, Enterococcus had 40.0%-77.2% resistance incidence to penicillin and ampicillin, but was sensitive to linezolid and vancomycin. The sensitivity of fungi for most antifungal agents was higher than 80.0%, especially for voriconazole (96.3%). Conclusion Gram-negative pathogens are the primary pathogens causing nosocomial infection in organ transplant patients. Klebsiella pneumoniae is the main pathogen and has a tendency of multi-drug resistance. Gram-positive pathogens are susceptible to linezolid and vancomycin. Fungi are susceptible to commonly used antifungal agents.

Abstract:Objective To explore the factors influencing the implantation of permanent pacemaker in patients after cardiac surgery, and the timing and approach of pacemaker for early implantation. Methods Patients undergoing permanent pacemaker implantation (excluding implanted defibrillators and cardiac resynchronization therapy) after cardiac surgery between Jan. 2007 and Dec. 2016 were retrospectively enrolled, and their clinical data were collected, including gender, age, clinical diagnosis, preoperative heart rhythm, type of cardiac surgery, indication of pacemaker implantation, duration from cardiac surgery to pacemaker implantation, and type of permanent pacemaker. According to the time between cardiac surgery and pacemaker implantation, the patients were divided into three groups:early group (≤ 1 month), mid-term group (1 month to 1 year) and long-term group (>1 year). The type of cardiac surgery and the indication of pacemaker implantation were compared between the three groups. Results A total of 103 patients were included in this study, among which 86 cases received valvular surgery, 9 received surgery for congenital heart disease, and 8 received coronary artery bypass grafting (CABG). Twenty-two patients (21.36%) had sick sinus atrial node syndrome, and 81 patients (78.64%) had atrioventricular block. Sixty-eight cases (66.02%) had grade Ⅲ or advanced atrioventricular block, including 29 (28.16%) atrial fibrillation with long RR interval, and 13 cases (12.62%) had atrial fibrillation with slow ventricular rate. Twenty-seven patients (26.21%) were included in the early group, 16 patients (15.53%) in the mid-term group, and 60 patients (58.25%) in the long-term group. There were no significant differences in the proportions of aortic valve surgery, double valve surgery or more complex surgery (including valve replacement or valve plasty) between the three groups (all P>0.05). The proportion of atrioventricular block was higher among the pacemaker implantation indications, and the difference in the proportion of atrioventricular block among the three groups was statistically significant (χ²=6.089, P=0.048). The average time between surgery and implantation of patients in the early group was (13.43±7.24) d, and the major approach for implanting electrode leads was elective percutaneous endocardial implantation after surgery (25 cases), occasionally the electrode leads was implanted during the surgery (one case of endocardial leads and one case of epicardial leads). Conclusion Atrioventricular block is the most common indication of permanent pacemaker implantation after cardiac surgery. Reasonable time is required for recovery of atrioventricular conduction or sinus node function before early implantation. Major approach for implanting endocardial leads is elective percutaneous endocardial implantation; if necessary, endocardial or epicardial leads can be implanted during surgery.

Abstract:Objective To isolate and purify ebracteolatain A from the roots of Euphorbia ebracteolata Hayata, and to explore its anti-breast cancer activity. Methods Ebracteolatain A was isolated and purified from the roots of Euphorbia ebracteolata Hayata using reflux extraction, solvent extraction and absorption chromatography techniques. The chemical structure was identified by mass spectrometry and nuclear magnetic resonance spectrometry. The anti-breast cancer activity of ebracteolatain A was determined by MTT assay in the breast cancer cell lines including SUM149 (triple-negative), MCF-7 (luminal A), ZR-75-1 (luminal B) and SK-BR-3 (HER2-positive). The effect of ebracteolatain A on cell cycle was determined by flow cytometry. A tumor model was established in nude mice by transplanting SUM149 cells, and the inhibitory effect of ebracteolatain A on breast cancer was evaluated. Results The ebracteolatain A was 3, 3'-diacetyl-2, 4'-dimethoxy-2', 4, 6, 6'-tetrahydroxy-5'-methyl diphenylmethane. The half maximal inhibitory concentrations of ebracteolatain A on SUM149, MCF-7, ZR-75-1 and SK-BR-3 cells were 5.50, 6.16, 7.08 and 8.64 μmol/L, respectively. With the increase of drug concentration (2.5, 5, 10 μmol/L), the percentage of the cells at G₀/G₁ phase was decreased (P<0.05, P<0.01) and the percentage of the cells at S phase was increased (P<0.05, P<0.01) after treatment with ebracteolatain A for 12, 24 and 48 h. After intraperitoneal injection of ebracteolatain A 35 mg/kg, the inhibition rates of the tumor volume and mass in nude mice were 37.94% and 41.38%, respectively. Conclusion Ebracteolatain A can inhibit the proliferation of the four types of breast cancer cells and the growth of transplanted-SUM149 cell tumor on nude mice, which may be related to suppressing the transition of cell cycle from S phase to G₂/M phase.

Abstract:Orthopaedic implants in the body brings a high risk of microbial infections. Infection is one of the main reasons for failure of implant in department of orthopaedics, and is more common in open fracture surgery. Fracture nonunion after internal fixations is not rare clinically, and reoperation or even multi-operations are required, which will be a heavy burden for the patients physically, mentally and economically. The aggregation and activation of macrophages can increase the cell count around the implants, which improves the immune function of the implant/tissue interface, thus contributing to prevention or treatment of infection. In addition, surface modification of titanium and its alloys, and loading antibiotics or bioactive substances also play a role in prevention or treatment of infection and nonunion. This review summarizes the current research on anti-infection function and fracture healing promotion in the surface modification of titanium and its alloys, so as to provide references for designing orthopaedic implants with anti-infection and fracture healing promotion functions.

Abstract:Aquaporins (AQPs) are the specific channel proteins located in cell membrane for transporting water, and they play an important role in maintaining the body's water balance. AQPs are widely distributed in human tissues and organs, and their abnormal expressions are closely related to a series of diseases caused by water balance disorders. In recent years, great advances have been made in molecular researches, specific inhibitors, and targeted therapies of AQPs. In this review, we summarized the recent research progresses.

Abstract:Depression is a common clinical mental disease and has posed a serious threat to human health. Recent studies have found that immune-effecting microglia is closely related to the occurrence of depression. Microglia induces depression through a variety of inflammatory and non-inflammatory mechanisms. It is of great significance to study the role of microglia in the occurrence of depression, which can help to explore new targets of depression treatment and novel antidepressants.

Abstract:Objective To analyze the clinical efficacy of cataract phacoemulsification combined with implantation of artificial lens for patients with cataract in seven African countries during"Mission Harmony-2017"task. Methods We retrospectively analyzed the data from 51 cataract patients (52 eyes) receiving cataract phacoemulsification combined with implantation of artificial lens between Aug. 2017 and Nov. 2017 on Ark-peace Hospital Ship. The preoperative and 1 d postoperative best-corrected visual acuity and astigmatism were compared, the postoperative ocular recovery was observed, and the intraoperative and postoperative complications were analyzed. Results One day postoperation, 4 (7.7%) of 52 eyes had a best-corrected visual acuity ranging from 0.06 to 0.3, 26 (50.0%) 0.4 to 0.6, and 22 (42.3%) 0.8 to 1.2. Slit-lamp examination showed that 48 eyes (92.3%) had corneal hyaline on 1-3 d after operation, 4 eyes (7.7%) had corneal edema, and 50 eyes (96.2%) had round pupil with diameter being 2.0-3.0 mm, and posterior corneal deposits and Tyndall effect were negative in all eyes. The mean astigmatism of 52 eyes before operation was significantly higher than that on 1 d after operation ([1.13±1.02] D vs[2.67±0.87] D, t=2.365, P<0.05). Posterior capsular rupture and vitreous prolapse occurred in 2 eyes (3.8%), prolapse of iris in 1 eye (1.9%), and progressive pupil reduction in 2 eyes (3.8%) during operation. Corneal edema occurred in 4 eyes (7.7%) on 1 d after operation. Conclusion Cataract phacoemulsification combined with implantation of artificial lens can be safely and effectively performed on Ark-peace Hospital Ship.

Abstract:Objective To evaluate the surgical outcomes of anterior controllable anteriodisplacement and fusion (ACAF) for the reoperation of the cervical ossification of posterior longitudinal ligament (OPLL). Methods Twelve cervical OPLL patients aged 52-74 (63.92±6.54) years, who had poor curative effect or aggravated symptoms after posterior decompressive surgery, were included in this study, with 7 males and 5 females. All patients underwent reoperation with ACAF between Feb. 2016 and Feb. 2017. The Japanese Orthopaedic Association (JOA) score and visual analogue scale (VAS) were used to evaluate neurological function and pain preoperatively and 3, 6, 12 months postoperatively and at final follow-up. Results The patients were followed up for 9-21 months (average[14.92±3.75] months). The neurological function was recovered to varying degrees after ACAF in all patients. The JOA score was significantly improved from 9.33±1.93 preoperatively to 14.67±2.01 at final follow-up (t=3.184, P<0.05), and the neurological function recovery rate was (71.9±21.8)%. The VAS score was significantly decreased from 5.25±1.42 preoperatively to 0.92±0.83 at final follow-up (t=4.025, P<0.05). Conclusion The outcomes of ACAF for the reoperation of cervical OPLL are satisfactory. ACAF significantly improves the patients'neurological function, and it is an alternative surgical treatment of the reoperation for cervical OPLL.

Abstract:Objective To investigate the correlation between chronic hepatitis B virus (HBV) infection and coronary heart disease (CHD), so as to provide basis for decision-making in the prevention of CHD. Methods A total of 759 healthy volunteers without history of CHD, who received coronary computed tomography angiography (CTA) examination between Jan. 2013 and Jun. 2017 in our hospital, were included in the study. According to the levels of hepatitis B virus surface antigen (HBsAg), they were divided into HBV infection group (38 cases, all had chronic HBV infection) and control group (721 cases). Then we compared coronary artery lesions between the two groups, and analyzed the correlation between chronic HBV infection and CHD. Results Coronary CTA examination results showed that there was no significant difference in the prevalence of CHD between the two groups (21.05%[8/38] vs 28.02%[202/721], P>0.05). In addition, there were no significant differences in the number of coronary artery lesions, the type of plaque lesions or the distribution of diseased vessels with plaque between the HBV infection group and the control group (all P>0.05). Bivariate correlation analysis showed that there was no correlation between chronic HBV infection and CHD (r=0.034, P>0.05). Conclusion There is no clinical correlation between chronic HBV infection and CHD.

Abstract:Objective To study the effect of negative polarity electret on the dielectric properties and structure of insulin, and to observe the influence of electrostatic field on the hypoglycemic effect of insulin. Methods Negative polarity electrets of -500, -1 000 and -1 500 V were prepared using polypropylene film by a gate voltage corona charging system, and were used to treat insulin, respectively. The equivalent surface potential of each electret within 48 h was measured by compensation method. The relationship between the polarization of insulin and the electrostatic field was measured by the dielectric constant d₃₃. The influence of the electrostatic field on the molecular structure of insulin was examined by nuclear magnetic resonance and gel electrophoresis. Insulin exposed to -500, -1 000 and -1 500 V negative polarity electret for 12 h was injected into the diabetic rats, and then the hypoglycemic effect of insulin were observed. Results The potential differences between the two sides of insulin solution effected by negative polarity electrets with different surface potentials were exponentially increased within 0-4 h and gradually became constant at 4-48 h. Compared with the insulin patch treated by non-electret electrostatic field, the d₃₃ values of insulin patch effected by -500, -1 000 and -1 500 V electret for 12 h were increased by 14.7 times, 26.7 times and 45.0 times, respectively, and all tended to be stable after 12 h. The spatial structure of insulin exposed to electrostatic field did not change, but the hydrogen bond content of most perssad was decreased; the proportion of monomers of the insulin was increased, and the main structures of the insulin were monomers and dimers. Compared with the electret-free insulin treatment group, the blood glucose content of diabetic rats treated with the -500 V and -1 000 V negative polarity electrets insulin for 8 h were decreased by 50.9% and 22.1%, respectively (P<0.05). Conclusion Negative polarity electret can further improve the hypoglycemic effect of insulin.

Abstract:Objective To explore the expression of activation-induced cytidine deaminase (AICDA) in renal tissues of patients with systemic lupus erythematosus (SLE) and its clinical significance. Methods The renal biospy tissues from 73 patients with SLE and 36 patients with primary membranous nephropathy, who underwent biopsy between Mar. 2013 to Jun. 2017 in Central South University Xiangya School of Medicine Affiliated Haikou Hospital, were collected. Immunohistochemical method was used to detect the expression of AICDA in renal tissues. The correlations between the expression level of AICDA and the clinicopathological parameters, including pathological classification, system damage, SLE disease activity index (DAI) score and treatment outcome of SLE patients were analyzed. Results The expression level of AICDA in renal tissues of SLE patients was significantly higher than that of primary membrane nephropathy patients (6.12±2.47 vs 3.33±1.91, P<0.05). There was no significant difference in the expression level of AICDA between the type Ⅲ (5.25±4.06), type Ⅳ (6.88±2.20), type Ⅴ (6.10±1.66), type Ⅲ+Ⅴ (5.75±2.34), and type Ⅳ+Ⅴ(5.72±2.37) lupus nephritis patients (all P>0.05). The expression levels of AICDA were significantly higher in renal tissues of SLE patients with oral ulcer, interstitial pneumonia, nervous system damage, arthritis, blood system damage or serositis than those in the patients without above symptoms (7.02±2.14 vs 4.17±1.97, 7.86±2.39 vs 4.98±1.76, 9.83±1.34 vs 5.39±1.92, 6.88±2.04 vs 2.93±1.21, 7.51±1.81 vs 3.70±1.23, and 7.29±2.33 vs 5.34±2.29; all P<0.01). The SLE disease activity index (SLEDAI) score was positively correlated with the expression level of AICDA (P<0.01). The expression level of AICDA in renal tissues of SLE patients with complete remission was lower than that of the patients without complete remission, but the difference was not statistically significant (5.84±2.39 vs 6.80±2.56, P>0.05). Conclusion AICDA is related to the occurrence and development of SLE, and it is expected to bring new targets for the treatment of SLE.

Abstract:Objective To explore the factors influencing patient compliance to automatic continuous positive airway pressure (auto-CPAP) treatment in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods Retrospective analysis was done on 102 patients diagnosed as OSAHS by polysomnography (PSG), who were treated for sleep snoring symptoms between Oct. 2016 and Dec. 2017. All patients received auto-CPAP treatment. The age, gender, body mass index (BMI), Epworth sleepiness scale (ESS) score, nasal obstruction symptom evaluation (NOSE) score and Mallampati score were recorded and analyzed. The patients were divided into compliance group and non-compliance group by the Kribbs standard, and χ² test and two sample t test were used to analyze the differences of the above indicators between the two groups. Logistic regression model was used to evaluate the risk factors of treatment compliance of OSAHS by auto-CPAP. Results The 102 patients, aged (42.2±10.0) years (ranging from 31 to 83 years), included 89 males and 13 females. Sixty-five (63.7%) patients had good compliance and were assigned to the compliance group, and 37 (36.3%) patients had poor compliance and were assigned to the non-compliance group. The ESS score, NOSE score and Mallampati score were significantly different between the two groups (all P<0.01), while the age, gender and BMI were not significantly different (all P>0.05). Logistic regression analysis showed that the ESS score (OR=1.183, 95% CI 1.046-1.338; P=0.008) and Mallampati score (OR=2.075, 95% CI 1.121-3.839; P=0.020) were independent risk factors of compliance. Conclusion ESS score, NOSE score, and Mallampati score are the influencing factors of treatment compliance to auto-CPAP in the OSAHS patients. ESS score and Mallampati score are the independent risk factors for treatment compliance.

Abstract: