[The value of serum cystatin C for the evaluation of renal function damage in patients with proliferative diabetic retinopathy]

Objective: To investigate the value of serum cystatin C for the evaluation of renal function damage in patients with proliferative diabetic retinopathy (PDR). Methods: The clinical data of PDR patients treated in ophthalmic wards of Beijing Tongren Hospital from July 2019 to January 2021 were retrospectively analyzed. The estimated glomerular filtration rate (eGFR) was calculated by the abbreviated Modification of Diet in Renal Disease (MDRD) study equation. Based on the eGFR level, the patients were divided into no obvious renal function damage group [≥ 60 ml·min⁻¹·(1.73 m²)⁻¹] and renal inadequacy group [<60 ml·min⁻¹·(1.73 m²)⁻¹]. The clinical characteristics between the two groups were compared. Multivariate logistic regression analysis was performed to identify the relevant factors of renal inadequacy. The value of cystatin C to predict the renal inadequacy was calculated by the receiver operating characteristic (ROC) curves. Results: A total of 1 009 patients [593 males and 416 females; mean age: (52±12) years] were finally included in the study, with 192 cases (19.0%) and 817 cases (81.0%) in renal inadequacy group and no obvious renal function damage group, respectively. There were no significant statistically differences in gender, age, diastolic blood pressure, body mass index, fasting blood glucose and low-density lipoprotein between the two groups (all P>0.05). The systolic blood pressure, blood urea nitrogen, creatinine, uric acid, triglyceride, cholesterol and cystatin C were higher in the renal inadequacy group than those of no obvious renal function damage group (all P<0.05). However, the glycosylated hemoglobin, albumin and high-density lipoprotein were lower in the renal inadequacy group (all P<0.05). Multivariate logistic regression analysis showed that serum creatinine (OR=1.189, 95%CI: 1.101-1.284, P<0.001) and cystatin C (OR=3.175, 95%CI: 1.272-7.923, P=0.013) were independent risk factors for renal inadequacy in PDR patients. The ROC curve showed that cystatin C had a predictive value for renal inadequacy, with an area under the curve (AUC) of 0.966 (95%CI: 0.952-0.979). Meanwhile, the cutoff value was 1.315 mg/L, and the Youden index was 0.826, with the sensitivity of 94.3% and specificity of 88.4%. Conclusion: Serum cystatin C can be used as an important laboratory indicator to evaluate the renal impairment in PDR patients.

[Clinical characteristics of patients with biopsy-proven sarcoid uveitis]

Objective: To investigate the clinical features of patients with biopsy-proven sarcoid uveitis. Methods: The clinical data of the patients with biopsy-proven sarcoid uveitis who consulted the Ophthalmic Clinic of Beijing Tongren Hospital from February 2012 to February 2020 was retrospectively reviewed and analyzed. All the patients underwent visual acuity test, slit lamp microscopy, indirect ophthalmoscopy, fundus fluorescein angiography (FFA), chest computed tomography (CT) and other auxiliary examinations. Results: A total of 9 patients (18 eyes) (6 females, 3 males) with biopsy-proven sarcoid uveitis were included in the study, with a mean age of (52.6±9.0) years. Based on the modified Scadding classification, there were 2 and 7 cases of Stage Ⅰ and Ⅱ sarcoidosis, respectively. The ocular symptoms were the initial presenting complaints in 6 patients, who had a time from onset to diagnosis of 9.0 (2.6, 20.3) months. Three patients had a history of sarcoidosis. Fever was reported in 2 patients, fatigue in 3 patients, body weight loss in 3 patients, respiratory problems in 5 patients, with bilateral ocular involvement in all the patients. Among the 18 eyes, panuveitis occurred in 10 eyes, posterior uveitis in 4 eyes, anterior uveitis in 4 eyes, mutton fat keratic precipitates (KP) in 10 eyes, granular KP or no obvious KP in 8 eyes, posterior synechia of the iris in 9 eyes, cataract in 8 eyes, inflammatory vitreous opacity in 8 eyes, macular edema in 7 eyes, epiretinal membrane in 6 eyes, retinal vasculitis in 2 eyes, glaucoma in 2 eyes, and optic disc granuloma in 2 eye. Among the 13 eyes whose peripheral ocular fundus was visible, multiple chorioretinal peripheral lesions were found in 5 eyes. Conclusions: Chest CT should be performed in the uveitis patients with older age, female gender, bilateral ocular involvement, the symptom of fever, body weight loss and respiratory problems in time to exclude the sarcoid uveitis. Sarcoid uveitis may presents with granular KP or no obvious KP, and the posterior segment of the eye ball was the most commonly involved area.

[Changes of retinal structure after systemic immunosuppressive treatment in eyes with Vogt-Koyanagi-Harada disease]

Objective: To assess structural changes in retina after systemic immunosuppressive treatment in Vogt-Koyanagi-Harada (VKH) disease using spectral-domain optical coherence tomography (SD-OCT). Methods: The clinical data of 17 VKH cases (34 eyes) who consecutively attended the Beijing Tongren Hospital between December 2015 and December 2019 were retrospectively reviewed. All the patients had acute or subacute onset, and underwent high-dose systemic corticosteroid and/or immunosuppressive treatment, with a followed-up time of at least 6 months. At the end of follow-up, the intraocular inflammation was controlled, and oral prednisone was withdrawn or being adjusted to less than 10 mg/day. The SD-OCT features of the included eyes were analyzed before treatment, 1 week, 1 month and 3 months after treatment, and at the last visit. Results: A total of 17 cases (34 eyes; 6 males and 11 females) were included, with an age of (42.2±10.6) years, and were followed up for (9.4±3.3) months. At 1 week after initiating treatment, the percentage of the eyes with extensive/multiple or multifocal retinal detachment in the macular region, membranous structures and intraretinal cysts, and undulations and bumps of retinal pigment epithelium (RPE) decreased (5.9% vs 100%, 2.9% vs 47.1%, 5.9% vs 70.6%, 11.8% vs 58.8%, respectively, all P<0.001). There was statistical significant difference of the percentage of ellipsoid zone and external limiting membrane (ELM) disruptions before treatment, at 3 months and the last visit (100% vs 35.3%, 64.7% vs 52.9%, 41.2% vs 26.5%, respectively, all P<0.001). At the last visit, there were statistical significant differences of the best corrected vision acuity (BCVA) between the intact ellipsoid zone group (20 eyes) and the discontinuous group (14 eyes), as well as between the intact ELM group (25 eyes) and the discontinuous group (9 eyes), respectively [0 (0, 0.05) vs 0.10 (0.03, 0.33) (log MAR), P=0.004; 0 (0, 0.07) vs 0.22 (0.05, 0.40) (log MAR), P=0.005]. Conclusions: The edema of choroid and retina subsided obviously at 1 week after initiating treatment. The extent of damage and recovery ability of ellipsoid zone and ELM were different before treatment, at 3 months and the last visit. At the last visit, the outer retinal layers failed to recover completely in some patients, and were related to the BCVA.

[Efficacy and safety of IA regimen containing different doses of idarubicin in de-novo acute myeloid leukemia for adult patients]

目的

探讨含不同剂量去甲氧柔红霉素（IDA 8、10、12 mg/m²）的IA方案诱导治疗成人初发急性髓系白血病（AML）（非急性早幼粒细胞白血病）的临床疗效和安全性。

方法

采用多中心、单盲、非随机、临床对照研究，纳入2011年5月至2015年3月苏州大学附属第一医院及其他36家单位收治的1 215例成人初发AML患者，根据诱导化疗方案中IDA的剂量对患者进行分组，分析不同剂量IDA联合阿糖胞苷（100 mg/m²）组成的IA方案在成人初发AML诱导治疗中的完全缓解（CR）率、血液学及非血液学不良事件。

结果

可纳入缓解率分析的AML患者共1 207例，IDA 8 mg/m²、10 mg/m²和12 mg/m²组的CR率分别为73.6%（215/292）、84.1%（662/787）和86.7%（111/128），差异有统计学意义（P<0.001）；以IDA 8 mg/m²组为参照组，在调整了年龄、骨髓原始细胞比例、FAB分型、危险度分层后，IDA 10 mg/m²和IDA 12 mg/m²为影响患者CR的有利因素[OR=0.49（95% CI 0.34~0.70），P<0.001；OR=0.36（95%CI 0.18~0.71），P=0.003]。在中、低危组中三组CR率分别为76.5%（163/213）、86.9%（506/582）和86.1%（68/79），差异有统计学意义（P=0.007）；在调整了年龄、骨髓原始细胞比例、FAB分型因素后，IDA 10 mg/m²为影响患者CR的有利因素[OR=0.47（95% CI 0.31~0.71），P<0.001]。在高危组中，三组CR率分别为50.0%（18/36）、60.6%（43/71）和81.8%（18/22），差异无统计学意义（P=0.089），但在调整了年龄、骨髓原始细胞比例、FAB分型因素后，IDA 12 mg/m²为影响患者CR的有利因素[OR=0.22（95% CI 0.06~0.80），P=0.022]。8 mg/m²、10 mg/m²和12 mg/m²组中性粒细胞≤0.5×10⁹/L的中位持续时间分别为14（11~18）、15（11~20）和18（14~22）d，差异有统计学意义（P=0.012）；三组PLT≤20×10⁹/L的中位持续时间分别为14（7~17）、15（11~20）和17（15~21）d，差异有统计学意义（P=0.001）；三组肺部感染发生率分别为9.8%、13.5%和25.2%，差异有统计学意义（P<0.001）。

结论

在中国成人（18~60岁）初发AML中，建议中、低危组患者采用含IDA 10 mg/m²的IA方案进行诱导治疗；而高危组AML建议选择含IDA 12 mg/m²的IA方案进行诱导治疗。

Clinical factors associated with sodium removal in peritoneal dialysis patients

A cross-sectional study was conducted in 156 clinically-stable peritoneal dialysis patients to identify the factors associated with sodium removal. Serum biochemistry, peritoneal function (modified peritoneal equilibration test [PET]) and the adequacy of dialysis were analysed in relation to sodium removal using multivariate linear regression. Factors significantly affecting peritoneal sodium removal included infusion volume and ultrafiltration volume per 24 h, sodium dip in the first hour of PET and sodium difference between serum and fresh dialysate. Factors significantly affecting total sodium removal included ultrafiltration and urine volume per 24 h, sodium dip in the first hour of PET and sodium difference between serum and fresh dialysate. With traditional dialysate, adequate fluid removal is required to ensure sufficient sodium removal, but a low-sodium dialysate may prevent sodium retention. Sodium removal should be included in evaluation of the adequacy of dialysis.

[Effects of intermittent artificial gravity on femur of simulated weightlessness rats]

AIM

To explore the effects of three intermittent artificial gravity on simulated weightlessness rats.

METHODS

30 male SD rats were divided into 5 groups: control group (C), tail-suspension group (S) and standing group (G1), 1.5 G group (G2), 2.6 G (G3) group; randomly and equally. G groups were given 1 h/d standing, 1.5 G or 2.6 G artificial gravity each day. The effects of 3 weeks artificial gravity on tail-suspension rats were evaluated by measuring physical and mechanical parameters of femur.

RESULTS

Compared to S rats, elastic ultimate load (EUL), the ultimate load (UL) and bending rigidity coefficient (BRC) of G1 rats (P < 0.05) improved significantly; Diameter (P < 0.01), mass (dry) and density (P < 0.05), EUL and UL (P < 0.05) of G2 rats raised significantly; EUL and UL of G3 rats (P < 0.01) improved markedly.

CONCLUSION

By using intermittent artificial gravity, the mechanical parameters of weight loading bones of simulated weightlessness rats were all improved apparently, and the one using 1.5 G 1 h/d artificial gravity was the best.

[Changes of human recombination bone morphogenetic protein-2 in bone and marrow in tail suspended rats]

OBJECTIVE

To study human recombination bone morphogenetic protein-2 (rhBMP-2) change in bone and marrow under simulated weightlessness.

METHOD

5 SD rats were tail suspended for 14, 28 d with another 5 freely active rats as control. Histological samples were in situ hybridized.

RESULT

rhBMP-2 expression of bone and marrow were lower in tail suspended rats than control levels (P < 0.05). rhBMP-2 expression tail suspended rats in 14 day were higher than that in 28 day suspended group (P < 0.05).

CONCLUSION

rhBMP-2 levels in rats bone and marrow were lower after tail suspension.

[Effects of intermittent +45 degrees head-up-tilt on mechanical parameters of femoral (correction of femural) bone in tail-suspended rats]

Objective. To study the effects of different intermittent +45 degrees head-up-tilt (IHUT) on tail-suspended rats. Method. 28 male SD rats were randomly and equally divided into: control group (C), tail-suspended group (S), IHUT 2 h group (H2), and IHUT 4 h group (H4). On the basis of tail-suspension to simulate weightlessness, H rats were given 2 h or 4 h IHUT each day. The effects of 3 wk IHUT on tail-suspended rats were evaluated by measuring physical and mechanical parameters of the femur. Result. Femoral mass (fresh, dry and ash), diameter, and density (fresh, except H2 group) in S, H2 and H4 rats were declined significantly compared to C rats (P<0.01 or P<0.05). Diameter (P<0.05) and density of femur (P<0.01) in H2 rats were significantly improved compared to S rats. Compared to C rats, the strength and stiffness of femora were obviously weakened (P<0.01) in S rats. Elastic load in H2 rats improved markedly (P<0.05) than those in S group; in H4 group, elastic load, maximum load, and bending toughness coefficient improved significantly (P< 0.01 or P<0.05). Conclusion. Using IHUT, mechanical parameters of weight bearing bones of tail-suspended rats can be improved apparently, by extending the exposure time, mechanical parameters can be improved.

[Effects of 24 h -6 degrees head-down tilt bed-rest on cardiovascular function and response to orthostatic stress]

Objective. To investigate the effects of 24 h -6 degrees head-down tilt bed-rest (HDT) on cardiovascular function and response to orthostatic stress. Method. -6 degrees head-down tilt bed rest for 24 h in 6 healthy males, aged 22-23, were observed. The changes of cardiac function were observed by electrical impedance instrument before and at 0th, 6th, 12th, 18th and 24th hour of HDT, and blood pressure were recorded and urine were collected. The changes of cardiovascular response to head up tilt (HUT 90 degrees, 10 min) before and post HDT were recorded. Result. During HDT, HR reduced significantly than that of pre-HDT (standing). HR at 6th, 12th, and 18th hour of HDT reduced significantly than that at 0th hour of HDT. Stroke output (SO) and stroke index (SI) [correction of CI] at 0th, 6th, 12th, and 24th hour of HDT were higher than pre-HDT value. Cardiac output (CO) and cardiac index (CI) at 18th hour of HDT were significantly lower than those at 0 h of HDT. Total peripheral resistance (TPR) at 18th hour of HDT were higher than that at 0th of HDT. During HUT before and post HDT, HR, MBP, TPR were significantly increased, SO, [correction of SV] SI, CO and CI were significantly reduced. DBP were significantly increased and PP were reduced significantly during HUT post-HDT. Hourly average value of urine during 0-4 h were higher than those during 4-12 h and 12-24 h. Conclusion. 24 h -6 degrees head-down tilt bed rest has significant effects on cardiovascular function and response to HUT in humans.

[Variation of several volume regulating hormones during 21 d - 6 degrees head-down bed rest]

Objective To investigate variations of plasma renin activity, a prostaglandin I2 (PGI2) during 21 d -6 degrees head-down tilt (HDT) with and without lower body negative pressure (LBNP).

METHOD

-6 degrees head-down tilt for 21 d were used to simulate weightlessness. 12 healthy male, aged 23.7 +/- 5.0, were equally and randomly divided into control group (CON) and LBNP group. The latter subjected to LBNP (-30 mm Hg, 1 h/d) in the last week of HDT. Samples of plasma were taken before HDT and on the 2nd, 4th, 11th and 22nd day during HDT.

RESULT

Compare to control levels, Ald declined significantly on the 2nd (CON -30%, P < 0. 05; V. S. LBNP -38%, P < 0.01), and increased significantly on the 11th day (CON +30%, P < 0.05; LBNP +48%, P < 0.01). PRA reached peak value on the 4th day (P < 0.05), and declined to below the control level on the 22nd day. PGI2 increased constantly during HDT, and increased significantly on the 22nd day (CON P < 0.01), 11th, 22nd (LBNP P < 0.05). No apparent difference was found between groups after LBNP concerning PRA and Ald; and PGI2 didn't increase further in LBNP group. Conclusion HDT induced a timely increasing in PRA and Ald, constant increasing in PGI2.

[In vitro expansion of human umbilical cord blood hematopiotic cells and its subpopulation]

OBJECTIVE

To study the effect of expansion of cord blood stem cells in vitro.

METHODS

The mononuclear cells of human umbilical cord blood was cultured in vitro and the cell cycle and CD34+ subset analysis was performed on these cell preparations using flow cytometry.

RESULTS

After 35 days, the number of nucleated cells showed over a comulative 252 fold expansion. CD34+ cells increased 50-fold in 7-21 days. CD33+ cells increased 280-fold during 7-28 days. CD19+ and CD34+ cells disappared after 14 days. The cells remained in G0/G1 phase and increased in the S phase.

CONCLUSION

Single umbilical cord blood would be enough to transplant to adults if suitable time and a novel expansion strategies are set.

Studies on the utilization of a plant SCE test in detecting potential mutagenic agents

In this paper a modified procedure for sister-chromatid differentiation in plant cells is reported. Using this procedure some chemicals were tested for SCE induction in Vicia faba, Hordeum vulgare and Secale cereale. The chemicals tested were ethanol, chromium oxide, sodium saccharin, fluorouracil, ascorbic acid (vitamin c), omethoate and phenol. The experimental results showed that most of them induced SCE increases in mouse spleen cells, human lymphocytes and plant cells. The increase of SCEs per cell in plant cells is in agreement with that found in human lymphocytes or in mouse spleen cells. In our opinion, the utilization of SCE in plants is a simple and inexpensive technique for detecting potential mutagenic agents in the environment.

Radioimmunolocalization of human gastric carcinoma xenografts SY 86 B and SY 86 D with 131I-labeled monoclonal antibody

The suitability of individual MAb for application in vivo should be carefully confirmed. The monoclonal antibody GL-013, with specific binding reactivity in vitro to human tumors of the gastrointestinal tract, was radioiodinated and injected intraperitoneally into nude mice bearing human gastric carcinoma xenografts SY 86 B (moderately differentiated glandular adenocarcinoma) and SY 86 D (signet ring cell carcinoma). Whole body scintigraphy indicated tumor localization with 131I-labeled MAb GL-013, but not with 131I-labeled normal mice immunoglobulin. The best tumor contrast was obtained between days 3 and 7 after injection. As confirmation of the imaging results, 131I-GL-013 preferentially localized in tumor tissue compared with normal tissue and 131I-GL-013 gave a higher tumor uptake ratio than the control 131I-NMIgG (at day 9 after injection), as determined by tissue counting of radioactivity. These results demonstrate that MAb GL-013 localizes in xenografts SY 86 B and SY 86 D and the possible clinical application of MAb GL-013 to radioimmunolocalization.