ABSTRACT
Objective:To analyze the therapeutic effect of adding interleukin (IL)-4Rα monoclonal antibody (duplizumab) to patients with multiple types of inflammatory diseases.Methods:Six patients with multiple types of inflammatory diseases who started to use duplizumab from August 2020 were enrolled. The changes of airway inflammation, lung function, sinuses computed tomography (CT), Asthma Control Questionnaire-5 (ACQ-5), Sino-Nasal Outcome Test-22 (SNOT-22), Pennsylvania Smell Identification Test (UPSIT) and Numerical Rating Scale (NRS) score before and after duplizumab treatment were retrospectively analyzed. All patients were treated with doprilumab for more than 5 months.Results:4 of the 6 patients had both severe asthma and chronic sinusitis, and 2 patients had both severe asthma, chronic sinusitis and atopic dermatitis. After treatment, the pulmonary function of 6 patients was improved, the levels of sputum eosinophils, exhaled nitric oxide and total IgE were decreased (all P<0.05), and the scores of paranasal sinus CT, ACQ-5, SNOT-22 and UPSIT were significantly improved (all P<0.05). However, 3 patients had increased peripheral blood eosinophils during the treatment. Conclusions:Duplizumab is effective for a variety of type 2 inflammatory diseases without obvious adverse reactions, and the peripheral eosinophils may increase during the treatment.
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Objective? ?To?analyze?the?risk?factors?of?delirium?in?patients?in?cardiac?surgery?intensive?care?unit?(CSICU).? Methods? A?prospective?observational?study?was?performed.?Patients?admitted?to?CSICU?of?Fujian?Medical?University?Union?Hospital?from?March?to?August?in?2017?were?enrolled.?The?combination?of?the?Richmond?agitation?sedation?scale?(RASS)?and?the?ICU-confusion?assessment?method?(CAM-ICU)?were?used?to?evaluate?delirium.?The?patient?was?assessed?on?the?second?day?after?CSICU?admission,?twice?a?day,?the?evaluation?was?stopped,?and?the?follow-up??observation?was?terminated?after?the?patient?was?discharged?from?CSICU.?The?patients?were?divided?into?two?groups?according?to?whether?delirium?occurred?in?CSICU.?The?general?and?clinical?treatment?data?(including?condition,?operation,?anesthesia?and?CSICU?treatment)?of?the?two?groups?were?compared.?The?related?factors?of?delirium?were?identified?by?univariate?analysis?and?multifactor?Logistic?regression?analysis.? Results? A?total?of?318?cases?were?included?in?this?study.?Among?them,?93?cases?had?delirium?and?the?incidence?of?delirium?was?29.2%.?It?was?shown?by?univariate?analysis?that?age,?history?of?hypertension,?type?of?surgery,?surgical?procedure,?American?Society?of?Anesthesiologists?(ASA)?anesthesia?classification,?usage?of?propofol,?plasma?transfusion,?red?blood?cells,?platelet?transfusion,?blood?loss,?operative?time,?cardiopulmonary?bypass?(CPB)?time,?myocardial?block?time,?acute?physiology?and?chronic?health?evaluation?Ⅱ?(APACHEⅡ),?duration?of?mechanical?ventilation,?the?length?of?intensive?care?unit?(ICU)?stay,?postoperative?usage?of?diazepam,?midazolam,?fentanyl,?morphine,?chlorpromazine,?etc.?which?were?related?to?delirium,?and?occupation?? (on-the-job?or?self-employed),?medical?insurance?(city?or?provincial?medical?insurance),?education?(primary?to?junior?high?school,?high?school?or?above)?could?reduce?the?risk?of?delirium.?Colinearity?diagnosis?was?performed?on?variables?with?statistically?significant?differences,?and?variables?with?variance?expansion?factor?(VIF)?<?3?were?included?in?multivariate?Logistic?regression?analysis.?The?results?showed?that?age,?education?level,?type?of?surgery,?ASA?classification,?CPB?time,?APACHEⅡ,?ICU?mechanical?ventilation?time,?and?post?operation?usage?of?midazolam?were?independently?related?to?delirium?[age:?odds?ratio?(OR)?=?1.625,?95%?confidence?interval?(95%CI)?=?1.303-2.026;?education?level:?OR?=?0.293,?95%CI =?0.171-0.504;?type?of?surgery:?OR?=?2.194,?95%CI =?1.052-4.576;?ASA?classification:?OR?=?1.916,?95%CI =?1.032-3.559;?CPB?time:?OR =?2.125,?95%CI =?1.105-4.088;?APACHEⅡ:?OR =?2.091,?95%CI =?1.005-4.349;?ICU?mechanical?ventilation?time:?OR =?1.943,?95%CI?=?1.269-2.975;?midazolam:?OR =?2.653,?95%CI =?1.328-5.299;?all?P?<?0.05],?among?which,?high?education?level?has?a?good?protective?effect?on?delirium.? Conclusions? Age,?type?of?surgery,?ASA?classification,?CPB?time,?APACHEⅡ,?ICU?mechanical?ventilation?time,?post?operation?usage?of?midazolam?were?independent?risk?factors?for?delirium,?and?high?education?level?had?a?good?protective?effect.?Among?them,?the?educational?level,?CPB?time,?duration?of?mechanical?ventilation,?and?midazolam?are?intervention?factors.?In?clinical?treatment,?not?only?the?risk?factors?should?be?identified,?but?also?intervention?should?be?taken?to?prevent?the?occurrence?of?delirium.
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AIM To observe the clinical role for Supplemented Xijiao Powder (Bubali cornu,Coptidis Rhizoma,Cimicifugae Rhizoma,etc.) in management of hepatitis B virus (HBV) associated acute-on-chronic liver failure.METHOD Seventy-five patients,including the ones receiving internal medicine treatment,were divided into control group and experimental group.The experimental group received conventional treatment and additionally took Supplemented Xijiao Powder for one month.The clinical symptoms and signs were observed.Levels of ALT,AST,TBIL,ALB,CHE,PTA were measured,and the incidence of liver failure was evaluated.RESULTS Supplemented Xijiao Powder could improve symptoms,signs and the level of PTA.The incidence of liver failure tended to reduce.The comparison of other indexes had no marked difference.CONCLUSION Supplemented Xijiao Powder has a certain therapeutic effect on HBV associated prioracute-on-chronic liver failure.Its mechanism may be related to blocking the occurrence of liver failure.
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Objective To investigate the clinical effect of laparoscopic ovarian surgery combined with gestrinone in the treatment of ovarian cysts and its effect on FSH, LH and E2, for the clinical diagnosis and treatment to provide reference. Methods 60 cases of ovarian cysts from June 2014 to June 2016 in our hospital were selected and randomly divided into control group and treatment group with 30 cases in each group. The treatment group was treated with laparoscopic ovariectomy with gestrinone, two group of patients were treated for 6 months as a course of treatment. FSH, LH and E2 were detected by radioimmunoassay, the number of antral follicles was measured under transvaginal ultrasonography. Results The total effective rate of the treatment group (80%) was significantly higher than that of the control group (40%), the difference was statistically significant (P<0.05), the treatment group and control group after oral administration of gestrinone FSH, LH and E2 levels and the number of antral follicles decreased, however, after oral administration of gestrinone FSH, LH levels and the number of antral follicles were compared with those of the control group, the differences were not statistically significant,E2 levels were compared with those before and after treatment, the difference was statistically significant (P<0.05) There was no significant difference in the incidence of adverse reactions between the two groups. Conclusion Laparoscopic ovariectomy combined with gestrinone treatment of ovarian cysts has significant curative effect, little side effect, safe and reliable, and high cost performance. And the ovarian function has a greater improvement, this method has clinical research value.
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Aim Toclarifytheeffectofacteosideon proliferation of neural stem cells (NSCs ) from adult mice,as well as the involved signaling pathway.Meth-ods NSCswereisolatedfromthesubventricularzone (SVZ)of adult C57BL/6 mice,then identified by im-munofluorescence staining with Nestin,the marker of NSCs.NSCs were exposed to acteoside (5,10,20,40μmol·L-1 )in absence of mitogen(EGF/bFGF)for 24 h.We employed CCK8 assay to detect NSCs viability and BrdU staining to identify NSCs proliferation.We performed Western blot to quantify the expression level ofp-AktinducedbyacteosideonNSCs.Results With-out mitogen,acteoside increased NSCs proliferation by activating p-Akt,which can be blocked by LY294002, the inhibitor of PI3K/AKT signaling pathway.Conclu-sion ActeosidepromotestheproliferationofNSCsfrom adult mice by activating PI3K/AKT pathway.