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Objective@#To investigate the characteristics of intestinal microflora in patients with neuromyelitis optica spectrum disorders (NMOSDs) and related clinical significance.@*Methods@#The data about basic clinical features, fecal specimens as well as cerebrospinal fluid samples of 28 patients with NMOSDs, 15 patients with multiple sclerosis (MS) and 16 healthy controls admitted to the Department of Neurology, the First Affiliated Hospital of Zhengzhou University from July 2017 to January 2019 were collected. The differences about intestinal microbial characteristics and inflammatory index levels in each group were analyzed. The relevance between the diversity of intestinal microbiota and inflammatory index was explored.@*Results@#Compared with healthy controls, the intestinal microfloras of patients with NMOSDs and MS respectively were structurally disordered. The levels of the microbial diversity (chao 1 index) were significantly decreased in patients with NMOSDs compared with healthy controls, while their inflammation indexes, including IL-6, IL-10 and transforming growth factor (TGF)-α, in cerebrospinal fluid were significantly increased ((12.9±4.6) pg/ml vs (2.6±1.8) pg/ml, t=4.197, P=0.001; (3.4±2.1) pg/ml vs (0.9±0.2) pg/ml, t=2.265, P=0.037; (21.4±12.7) ng/ml vs (13.7±7.8) ng/ml, t=3.702, P=0.004). Compared with control group, the relative abundance of butyrivibrio, prevotella and anaerostipes was decreased significantly in NMOSDs group (6.8%±3.5% vs 13.0%±4.7%, t=4.941, P<0.001; 3.9%±2.2% vs 6.9%±3.3%, t=3.282, P=0.003; 5.1%±2.5% vs 7.3%±3.0%, t=2.641, P=0.012), while the relative abundance of ackermania was increased obviously (7.0%±3.1% vs 4.4%±2.8%, t=2.802, P=0.008); Besides, the quantitative Streptococcus thermophilus and butyrivibrio reduced in MS group (3.4%±2.4% vs 5.5%±2.1%, t=2.784, P=0.009; 7.9%±5.4% vs 13.0%±4.7%, t=2.501, P=0.018). In the comparison between subgroups, the relative abundance of bacteroides of aquaporin (AQP) 4-IgG-positive patients was lower than that of AQP4-IgG-negative patients (23.1%±8.9% vs 32.6%±10.4%, t=2.572, P=0.016), while the former subgroup had the higher level of the relative abundance of bifidobacterium (3.4%±1.6% vs 1.7%±1.4%, t=2.977, P=0.006). Moreover, there was a significant relevance between the diversity of intestinal microflora and the level of inflammatory factor IL-6 in cerebrospinal fluid (r=-0.548, P=0.003).@*Conclusions@#The intestinal microflora structural disorder and diversity reduction exist in patients with NMOSDs. Moreover, there is a significant correlation between the intestinal microflora and the level of inflammatory factors in NMOSDs, which can be used as an important means of clinical auxiliary examination.
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Objective To investigate the characteristics of intestinal microflora in patients with neuromyelitis optica spectrum disorders (NMOSDs) and related clinical significance.Methods The data about basic clinical features,fecal specimens as well as cerebrospinal fluid samples of 28 patients with NMOSDs,15 patients with multiple sclerosis (MS) and 16 healthy controls admitted to the Department of Neurology,the First Affiliated Hospital of Zhengzhou University from July 2017 to January 2019 were collected.The differences about intestinal microbial characteristics and inflammatory index levels in each group were analyzed.The relevance between the diversity of intestinal microbiota and inflammatory index was explored.Results Compared with healthy controls,the intestinal microfloras of patients with NMOSDs and MS respectively were structurally disordered.The levels of the microbial diversity (chao 1 index) were significantly decreased in patients with NMOSDs compared with healthy controls,while their inflammation indexes,including IL-6,IL-10 and transforming growth factor (TGF)-α,in cerebrospinal fluid were significantly increased ((12.9±4.6) pg/ml vs (2.6±1.8) pg/ml,t=4.197,P=0.001;(3.4±2.1) pg/ml vs (0.9±0.2)pg/ml,t=2.265,P=0.037;(21.4± 12.7) ng/ml vs (13.7±7.8) ng/ml,t=3.702,P=0.004).Compared with control group,the relative abundance of butyrivibrio,prevotella and anaerostipes was decreased significantly in NMOSDs group (6.8％±3.5％ vs 13.0％±4.7％,t=4.941,P＜0.001;3.9％±2.2％ vs 6.9％±3.3％,t=3.282,P=0.003;5.1％±2.5％ vs 7.3％±3.0％,t=2.641,P=0.012),while the relative abundance of ackermania was increased obviously (7.0％±3.1％ vs 4.4％±2.8％,t=2.802,P=0.008);Besides,the quantitative Streptococcus thermophilus and butyrivibrio reduced in MS group (3.4％±2.4％ vs 5.5％±2.1％,t=2.784,P=0.009;7.9％±5.4％ vs 13.0％±4.7％,t=2.501,P=0.018).In the comparison between subgroups,the relative abundance of bacteroides of aquaporin (AQP) 4-IgG-positive patients was lower than that of AQP4-IgG-negative patients (23.1％±8.9％ vs 32.6％± 10.4％,t=2.572,P=0.016),while the former subgroup had the higher level of the relative abundance of bifidobacterium (3.4％± 1.6％ vs 1.7％± 1.4％,t=2.977,P=0.006).Moreover,there was a significant relevance between the diversity of intestinal microflora and the level of inflammatory factor IL-6 in cerebrospinal fluid (r=-0.548,P=0.003).Conclusions The intestinal microflora structural disorder and diversity reduction exist in patients with NMOSDs.Moreover,there is a significant correlation between the intestinal microflora and the level of inflammatory factors in NMOSDs,which can be used as an important means of clinical auxiliary examination.
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Objective To investigate the effects of dopamine combined with norepinephrine on blood lactate and inflammatory factors in elderly patients with severe septic shock.Methods 120 elderly patients with severe septic shock were randomly divided into control group and observation group,60 cases in each group.The control group was treated with dopamine.The observation group was treated with norepinephrine on the basis of the control group at the same time.The treatment was evaluated 48 h after treatment.The changes of heart rate(HR),mean arterial pressure(MAP),central venous pressure(CVP),blood lactate(Lac),urine output,central venous oxygen saturation(SC-VO2),tumor necrosis factor alpha(TNF-α),C-reactive protein(CRP),serum calcitonin(PCT),cardiac function index(CI),peripheral vascular resistance index(SVRI)and extravascular lung water index(ELVWI)were observed before and after treatment for 48h.Results After treatment,the HR of the patients of the two groups decreased,there was no significant difference between before and after treatment in the control group(t=1.551,P=0.062),HR of the observation group were significantly lower than those of the control group and before treatment,the differences were statistically significant(t=15.847,14.960,all P=0.00).The MAP of the control group and the observation group after treatment were higher than those of before treatment(t=32.949,44.344,all P=0.00),and CVP were higher than before treatment(t=12.620,18.959,all P=0.00),urine volume increased significantly compared with before treatment(t=83.213,94.562,all P=0.00),and SC-VO2 were higher than those of before treatment(t=36.589,42.899,all P=0.00),Lac were lower than before treatment(t=15.653,24.016,all P=0.00).The improve degree of HR,MAP,CVP,Lac,urine volume,SC-VO2 of the observation group were higher than those of the control group(t=14.960,15.267,4.857,7.022,20.395,5.704,all P=0.00).The TNF-α levels of the control group and the observation group were lower than those of before treatment(t=13.300,33.004,all P=0.00),the CRP decreased significantly compared with before treatment(t=24.759,24.756,all P=0.00),the PCT were lower than those of before treatment(t=15.235,26.693,all P=0.00),the TNF-α,CRP and PCT of the observation group were decreased more significantly compared with the control group(t=17.470,6.079,10.550,all P=0.00).The CI of the control group and the observation group was higher than before treatment(t=16.050,34.124,all P=0.00),the SVRI were higher than those of before treatment(t=60.357,68.434,all P=0.00),the ELVWI were lower than those of before treatment(t=4.523,8.013,all P=0.00),the CI,SVRI,ELVWI of the observation group were improved more significantly than those of the control group(t=13.176,12.483,2.100,all P=0.00).Conclusion Dopamine combined with norepinephrine can improve the vital signs of patients with severe septic shock,reduce the concentration of lactate in blood,improve the level of inflammatory factors,and heart index.However,due to the subjective factors such as the size of the subject,the lack of research,the future study can increase the sample size to demonstrate the above speculation.
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Objective To investigate the prevalence rate of ovine hepatic cystic echinococcosis (HCE) in sheep in Quaker Wusu area of Bayinbuluke of Xinjiang by ultrasonography and provide evidence for the prevention and control of HCE in sheep.Methods The prevalence screening of HCE in sheep was conducted based on ultrasound images in this area in July 2014.The sheep were divided into different groups by dental age to calculate the age specific prevalence rate of HCE and analyzed the correlation between the dental age and the prevalence rate.Results The total prevalence rate of HCE in sheep in this area was 36.9％.The prevalence rates of none-calcified HCE and calcified HCE were 7.3％ and 29.6％,respectively.The prevalence rates of none-calcified HCE in different age groups were 1.2％ (1-2 years old),1.4％ (2-3 years old),14.0％ (3-4 years old),10.0％ (4-5 years old),15.6％(5-6 years old) and 4.2％(＞6 years old) respectively.The prevalence rate of calcified HCE in different age groups were 9.9％(1-2 years old),16.2％ (2-3 years old),31.6％(3-4 years old),47.8％(4-5 years old),42.2％(5-6 years old) and 41.7％(＞6 years old) respectively.The prevalence rate of HCE in 1-2 years old group was lower than those in other groups,the prevalence rate of HCE in age groups ＞3 years increased significantly.There was positive correlation between the prevalence rate of HCE and dental age (r=0.372,R2=0.107,F=44.176,P=0.000).Conclusion HCE is highly endemic in Quaker Wusu area.The prevalence rate of HCE is low in sheep with young age and high in sheep aged 3-4 years.It is necessary to conduct early prevention of HCE in sheep in this area.
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PurposeAs a main method to detect thyroid nodules, ultrasonography seems to have a rather low accuracy in differentiating benign and malignant ones. The present study aims to explore the diagnostic value of thyroid imaging reporting and data system (TI-RADS) in identifying benign and malignant thyroid nodules.Materials and Methods A total of 168 patients with thyroid nodules conifrmed pathologically (with 251 suspicious nodules) underwent ultrasonography and were further grouped into category 3-5 according to TI-RADS classiifcation standard. The results were retrospectively compared with histopathological ifndings. The sensitivity, speciifcity, accuracy, positive predictive value and negative predictive value of TI-RADS classiifcation in the diagnosis of benign and malignant thyroid nodules were calculated, and the differences in ultrasonic features between benign and malignant thyroid nodules were also compared.Results The surgical and pathological findings showed that 94 nodules were benign and 157 were sinister; TI-RADS regarded 93 nodules were benign and 185 were malignant. The difference of the two means of identification was significant (χ2=149.6,P<0.01). The sensitivity, speciifcity, accuracy, positive predictive value and negative predictive value of TI-RADS were 91.2% (144/157), 85.1% (80/94), 89.3% (224/251), 91.2% (144/158) and 86.0% (80/93), respectively. The ultrasonic manifestations of benign and malignant nodules were signiifcantly different with regard to aspect ratio, echogenicity, shape, calciifcation inside the nodule (χ2=8.7-121.4,P<0.01).Conclusion TI-RADS classiifcation standards have a high accuracy in the differentiation of benign and malignant thyroid nodules as a means of ultrasound examination, and thus can serve as an important guiding method in clinical diagnosis and treatment.
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OBJECTIVE:To establish a rapid,sensitive,accurate and stable method for the determination of voriconazole in human plasma in order to monitor clinical use of voriconazole. METHODS:HPLC-UV detection method was applied using carba-mazepine as internal standard. Plasma samples were treated with acetonitrile protein precipitation. The determination was performed on Phecda C18 column with 20 mmol/L monopotassium phosphate buffer solution (pH 6.0)-acetonitrile (50∶50,V/V) as mobile phase at flow rate of 1 ml/min. The column temperature was 40℃ and detection wavelength was 255 nm. The injection volume was 50 μl. RESULTS:The retention time of voriconazole and internal standard were 8.34 and 6.24 min. The linear range of voricon-azole in plasma were 0.10-20.00 μg/ml(r=0.999 5). The lowest limit of quantitation was 0.05 μg/ml. Intra-day and inter-day RSD were below 1.57% and 1.45%,respectively. The extraction recovery of low,medium and high concentrations were between 81.40%to 128.29%. CONCLUSIONS:The method is simple and accurate for therapeutic drug monitoring(TDM)of voriconazole.