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Two female patients with acute onset of sporadic food-borne botulism are reported. Both patients presented cranial nerve palsy symptoms and rapidly involving respiratory muscles causing respiratory failure. The tracheal intubation, mechanical ventilation and active supportive measures were given at admission. The skull imaging and cerebrospinal fluid examination were negative, and the electromyography showed peripheral motor nerve damage. One patient was complicated with severe pneumonia. The botulinum toxin test was positive, and botulism poisoning was diagnosed. After early targeted treatment, patients were improved and discharged. Both patients had no complications and recurrence after discharge in 8 months of follow-up.
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Objective@#To explore the effect of lipopolysaccharide intervention program on Legionella pneumonia.@*Methods@#C3H/HeN mice (6-8 weeks old) were used as experimental animals. The mice were randomly divided into lipopolysaccharide intervention, non-lipopolysaccharide intervention and control groups. Each group was again divided into three time points: 12 h, 24 h and 48 h. Mice in the lipopolysaccharide intervention group were intraperitoneally injected with E. coli lipopolysaccharide (100 ng per mice), and the rest groups were intraperitoneally injected with normal saline. After 24 hours, mice in the lipopolysaccharide intervention and the non-intervention groups mice were infected with Legionella by tracheal injection and the control group was given the same amount of saline. All the mice were killed at 12, 24 and 48 hours respectively. The mice were anatomized, lungs of the mice were separated and weighed. Organ coefficients (lung weight/body weight of mice) were calculated. 1 ml Orbital blood was collected. Toll-like receptor 4 (TLR4) levels of peripheral blood mononuclear cells were measured by flow cytometry. The contents of TNF-α and IL-1β in the upper left lung lobe were measured by ELISA.@*Results@#In the lung organs, the coefficients of lipopolysaccharide non-intervention group were higher than the other groups and there was no significant difference seen between the lipopolysaccharide intervention group and the controls. TLR4 peaked at 12 hours in both the lipopolysaccharide intervention and the non-intervention groups while the TLR4 level in the intervention group was higher than that in the non-intervention group. There were no significant differences appeared on the TLR4 expression levels between the two Legionella pneumonia modelled groups at 24 or 48 hours. There was no significant difference seen regarding the concentration of TNF-α and IL-1β between the intervention and the control groups. The secretion levels of TNF-α and IL-1β in the non-intervention group were higher than those in the intervention group at each time point.@*Conclusion@#The lipopolysaccharide intervention program may alleviate the inflammatory symptoms of Legionella infection.
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<p><b>OBJECTIVE</b>To investigate the changes of cytokines in induced sputum at different stages of silicosis patients.</p><p><b>METHODS</b>A total of 200 workers from one of the Shandong Province gold mine were chosen as object of observation. Among which 40 patients at silicosis stage I and 40 patients at silicosis stage II were divided into silicosis observed object group, silicosis stage I group, silicosis stage II group, and another 80 workers exposed to silica dust without suffering from silicotic Clinical symptoms, however, were chosen as group of dust exposed, and 40 logistical workers without being exposed and history of silicosis's illness were chosen as control group. And ask their basic information by questionnaire. Then, spray-inhalation the induced sputum and apply the ELISA to assess the level of tumor necrosis factor (TNF), interleukin (IL), macrophage inflammatory protein-1 (MIP-1α), monocyte chemotactic factor-1 (MCP-1), metalloproteinases (MMP), transforming growth factor-β (TGF-β), platelet derived growth factor (PDGF) in induced sputum from subjects.</p><p><b>RESULTS</b>The level of TGF-β [(901.60 ± 30.09) ng/L] in the induced sputumof patients in silicosis stage I group is lower than that in the observed object group [(913.02 ± 20.51) ng/L], and the level of MMP-9 [(212.49 ± 5.97) ng/L], MCP-1 [(129.91 ± 4.30) ng/L] has various degrees of increase than that in control group, observed object group and dust exposed group. All the differences have statistical significances (P < 0.05). The level of TNF-α [(85.76 ± 3.78) ng/L] in the induced sputum of patients in silicosis stage I group reaches the maximum, there are significant differences comparing with that level in the silica dust exposure group and the control group, whose differences are statistically significant (P < 0.05). Compared with the control group, the level of MMP-2 (427.95 ± 23.64) in the induced sputum of patients in silicosis stage I group has increased, whose differences also have statically significant (P < 0.05). Compared with the control group, silica dust exposed group, the observation group of objects, the pneumosilicosis patients of IL-16 in induced sputum IL-16 (21.40 ± 9.24) decreased, the content of PDGF [(5.96 ± 0.51) ng/L], MMP-2 [(447.86 ± 27.10) ng/L], MMP-9 [(223.91 ± 12.28) ng/L], MCP-1 [(122.87 ± 6.08) ng/L] increased, the differences are statistically significant (P < 0.05).</p><p><b>CONCLUSION</b>As silicosis biomarkers, TNF-alpha, TGF-beta, IL-16, PDGF, MMP-2, MMP-9 and MCP-1 have certain significance, further suggesting that early detection rate of patients with silicosis can be improved by employing the multiple indexes discriminate equation.</p>
Subject(s)
Humans , Biomarkers , Metabolism , Case-Control Studies , Chemokine CCL2 , Metabolism , Chemokine CCL3 , Metabolism , Cytokines , Metabolism , Discriminant Analysis , Dust , Interleukin-16 , Metabolism , Matrix Metalloproteinase 2 , Metabolism , Matrix Metalloproteinase 9 , Metabolism , Platelet-Derived Growth Factor , Metabolism , Silicosis , Diagnosis , Sputum , Chemistry , Transforming Growth Factor beta , Metabolism , Tumor Necrosis Factor-alpha , MetabolismABSTRACT
Objective To evaluate the diagnostic value and limitation of MRI for chromophobe renal cell carcinoma.Methods MRI features of 5 cases with pathology proved chromophobe renal cell carcinoma were analyzed retrospectively.Results All tumors showed homogenous isoin-tensity or slightly hypointensity on T1 weighted images and isointensity or slightly hyperintensity on T2 weighted images.Slightly hyperintensity were showed on DWI images,the mean ADC value of tumors was 1.42×10-3 mm2/s.On the contrast enhanced images,all the mass showed slight to moderate enhancement ,1 case had spoke-wheel-like enhancement,1 case showed flowed out blood vessels in the tumor.Conclusion The preoperative diagnosis is difficult for chromophobe renal cell carcinoma,MRI is a valuable method which could provide useful information for qualitative diagnosis.
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Objective To understand the epidemiology and clinical features of avian influenza,improve the prophylaxis and treatment.Methods Clinical data of a fatal case caused by H7N9 avian influenza A virus in Shanghai was retrospectively reported and analyzed,literature on avian influenza A virus infection in human was reviewed.Results A severe case of H7N9 avian influenza was reported,with typical clinical characteristics.The epidemiology history of the patient was unclear,all the contacts were tested negative for H7N9 avian influenza A virus.Literature search,H7 subtype of avian influenza in 2012 was only sporadic,the majority of patients with mild symptoms.People did not have immunity against avian influenza.Conclusions Severe case of H7N9 avian influenza progress quickly and its infection pattern is not clear up-to the time point.It needs further exploration and discovery.
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RNA interference (RNAi) is a newly developed technology. It is the different levels of gene silencing induced by specific degradation of targeted genes in vivo, and both exogenous and endogenous double-stranded RNAs could induce the specific degradation. RNAi has been applied in tumor therapy, viral infection, hepatitis B and many other diseases. siRNA is the effector molecule which induces the RNAi in vivo. But naked siRNA is easily degradated by RNases in vivo, and the half-life is short. Meanwhile, the transfection efficiency of the naked siRNA is comparatively low. So the naked siRNA needs the help of vectors to penetrate the cell membrane and take action. Viral vectors have the potential immunogenicity and mutagenicity in gene therapy. Therefore, non-viral vectors are drawing more and more attention. The latest development of the non-viral vectors is summarized in this review.
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Background An ethylnitrosourea(ENU)-induced mutant strain C57BL/6 mouse model has been established by our research group.This model is proved to have the spontaneous phenotype of corneal opacity and the typical pathological process similar to human keratitis.Therefore,this model is expected to be a good animal model in the research of the mechanism,hereditary property,and development of drugs for corneal infectious diseases.Objective The present study is to investigate the biological features of opportunistic pathogens using a mouse Staphylococcus-infected corneal model(C57BL/6 mouse) induced by N-ethyl-N-nitrosourea(ENU),and offers an evidence of stability in this animal model.Methods Ten-week-old male C57BL/6 mice were treated with ENU at 150mg/kg by intraperitoneal injection,and then mated with female mice after 60 days.Corneal opacity mutant mice in the F1 generation were selected to backcross with C57BL/6 mice.The bacteria were isolated from the eyeballs of the mutants and cultivated,purified and identified.Drug sensitivity assay was carried out to screen for effective antibiotics for clinic medical care.Results The staphylococcus-infected corneal mouse model(B6-Co) was established successfully,and the Staphylococcus sciuri strain was separated and purified,and then the sensitive antibiotics were distinguished from resistant ones.The sensitive drugs for Staphylococcus sciuri included azithromycin,clindamycin,chloramphenicol,gentamicin,rifampicin,tetracycline,amikacin,sulfamethoxazole compound sinomin,minocycline,levofloxacin,cephalothin,cefotaxime,and furazolidone;whereas this Staphylococcal strain was resistant to cefoxitin,penicillin,ampicillin,novobiocin.Nitrofurantoin showed an intermediate sensitivity.Conclusion The C57BL/6 mouse model is a spontaneous-derived animal model that is infected by coagulase-negative staphylococci,among which the most abundant strain is Staphylococcus sciuri.
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Objective To investigate the effects of andrographolide on the expressions of Th1 cytokine [interferon (IFN)-γ] mRNA and Th2 cytokines [interleukin (ID-4, IL-10] mRNA of peripheral blood mononuclear cells (PBMCs) from patients with chronic hepatitis B (CHB) and its anti-hepatitis B virus (HBV) activity. Methods PBMCs from CHB patients were cultured with 10 mg/L andrographolide (experimental group) or 0.1% DMSO (control group). HepG2. 2. 15 cells were stimulated with andrographolide of different concentrations (experimental group) or adefovir (control group). The expressions of IFN-γ mRNA, IL-4 mRNA and IL-10 mRNA of PBMCs and the replication of HBV DNA in HepG2. 2. 15 cell line were detected by fluorescence quantitative PCR. Results The expression of IFN-γ mRNA in PBMCs cultured with 10 mg/L andrographolide for 16 h was higher than that in control group (Z=-2. 78, P=0. 05), and the expressions of IL-4 and IL-10mRNA in experimental group were lower than control group (Z= -3. 82, P<0. 01), while the ratio of IFN-γ/IL-4 mRNA was higher than control group (Z= - 3. 82, P<0. 01). Andrographolide with different concentrations had no effect on the replication of HBV DNA in HepG2. 2.15 cells ((=11. 88, P>0.05). However, adefovir had inhibitory effect on the replication of HBV DNA (t =15. 95,P< 0. 05). Conclusion Andrographolide can regulate the expressions of IFN-γ mRNA, IL-4 mRNA and IL-10 mRNA in PBMCs from CHB patients and improve Thl/Th2 balance, while it has no effect on the replication of HBV DNA.
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Objective To investigate the clinical features, diagnosis, treatment and prognosis of muhisystemic invasive fungal diseases. Methods Twenty-one patients with multisystemic invasive fungal diseases who were hospitalized in department of infectious diseases from January 2001 to June 2008 were retrospectively reviewed. The pathogenic bacteria, involved organs, underlying diseases, clinical manifestations, treatments and prognoses of muhisystemic invasive fungal diseases were analyzed. Results Among 21 recruited cases, 17 had underlying diseases and 11 were treated with long-term immunosuppressive agents. The main pathogenic bacteria were Cryptococcus neoformans, Aspergillus and Candida parapsilosis. Lung and brain were involved in 16 cases (skin involve in 2 cases and lymph node involved in 1 case simultaneously), lung and lumbar involved in 2 cases, heart valves involved in 2 cases, and liver, spleen and bone marrow involved in 1 case. Eight cases were cured, 6 were improved and 7 died. Conclusions In this study, most of the 21 cases with multisystemic invasive fungal diseases are immunocompromised. The main pathogenic bacterium is Cryptococcus neoformans. The lung and brain are common organs involved. Prognosis is associated with early diagnosis and active anti-fungal treatment.
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Objective To evaluate clinical features,therapeutic effects and outcomes of patients with non-human immunodeficiency virus(HIV)-infected cryptococcal meningitis treated with fluconazole or fluconazole and flucytosine.Methods Twenty-four cases of non-HIV-infected cryptococcal meningitis(fluconazole with or without flucytosine as initial therapy)in Huashan Hospital,Fudan University from 1997 to 2007 were retrospectively reviewed.Clinical manifestations,therapeutic effects and outcomes of the patients were collected.Results Fluconazole was administered with median dosage of 400 mg/d,for a median duration of 20.5 days.After fluconazole initial therapy for 2 weeks,16.7% showed partial response,83.3% showed no response,and the overall response rate was 16.7%.After 10 weeks,33.3% showed partial response,29.2% showed complete response,16.7% showed no response,and the overall response rate was 62.5%.Mortality at week 10 was 20.8%.Twenty-two patients who failed to respond to initial therapy were switched to other antifungal drugs(amphotericin B,amphotericin B colloidal dispersion,itraconazole)or other fluconazole containing combined therapy.Eleven out of the 24 patients died during one-year follow-up,8 of whom died of eryptococcal meningitis,and 3 died of other diseases.Conclusions The initial therapy of fluconazole with or without flucytosine is inefficient,and most of the patients need other antifungal drugs because of initial therapy failure.Therefore,fluconazole might not be appropriate for initial therapy in non-HIV-infected cryptococcal meningitis.
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@#Objective To observe the effect of Edaravone pharmacological postconditioning and ischemic postconditioning on acute myocardial ischemia and reperfusion injury.Methods 40 rats were randomly divided into the sham operation group,ischemia/reperfusion group,ischemic postcondition group,Edaravone group A(injected through artery before reperfusion)and Edaravone group V(injected through vein before reperfusion)with 8 animals in each group.The animal model of acute myocardial ischemic and reperfusion was established.ECG changes were monitored during the procedure,dynamic parameters and serum biochemical markers creatine kinase MB(CK-MB),malondialdehyde(MDA),superoxide dismutase(SOD)of different groups were assessed and evaluated at the end of reperfusion.Ischemic and infarct areas were measured by Evans blue and TTC staining respectively.Results The myocardial infarct area and levels of serum CK-MB,MDA all significantly reduced(P<0.01)and activity of SOD enhanced(P<0.05)in the ischemic postcondition group and Edaravone group A compared with the ischemia/reperfusion group.The myocardial infarct area and levels of serum CK-MB,MDA reduced and activity of SOD enhanced(P<0.05)in the Edaravone group V compared with the ischemia/reperfusion group.There were no statistical differences in the foregoing indexes among the ischemic postcondition group,Edaravone group A and Edaravone group V group(P>0.05).Conclusion Edaravone injected through artery just before the onset of coronary reperfusion can reduce myocardial infarct area,which is similar to the cardio protective effect of mechanical postconditioning.The common potential mechanism of them might be associated with decreasing the injury by reactive oxygen species and strengthening the resistance to oxidation stress.The effect of intra aorta root-coronary injection is not worse than that of intra vein
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@#Objective To evaluate the safety and efficacy of stenting on unprotected left main coronary artery(LMCA) lesions.Methods 126 patients underwent unprotected LMCA stenting were analyzed retrospectively.Results 151 coronary stents were deployed in 126 patients without acute myocardial infarction(AMI) and death.Inhospital major adverse cardiac events(MACE) developed in 3 cases,including 3 cases of AMI,1 case of target lesion revascularization(TLR) and 2 died.The patients were followed up for 1～43 months.MACE developed in 15 cases,including 12 cases of TLR,3 cases died.Angiography was performed in 40 cases during follow-up,the restenosis happened in 19 cases.The focus or the type of operation didn't influence the restenosis rate.Conclusion Selective stenting for left main coronary artery disease is safe and feasible.It can bring good in-hospital and long-term outcomes.