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Objective:To explore the application value of Jiawei Yangyin Jiedu Decoction in the treatment of epidermal growth factor receptor (EGFR)- tyrosine kinase inhibitor (TKI)- related rash of lung cancer, and observe its influence on inflammatory index and immune function of patients, aiming to provide effective treatment for this disease.Methods:From December 2016 to January 2019, 90 patients with EGFR-TKI-related rash belonging to Yin deficiency and toxic type in Traditional Chinese Medicine (TCM) syndromes in Yongkang Traditional Chinese Medicine Hospital of Zhejiang Province were included. The patients were divided into control group and observation group by random digits table method with 45 case each. The patients in control group were treated with mupirocin ointment, and the patients in observation group were treated with Jiawei Yangyin Jiedu Decoction on the basis of the control group. The clinical efficacy was compared after 4 weeks.Results:After treatment, the number of lesions and the number of sites, rash area estimation, rash color and other symptoms in observation group were significantly lower than those in control group: (0.71 ± 0.27) scores vs. (1.36 ± 0.32) scores, (0.68 ± 0.14) scores vs. (1.24 ± 0.27) scores, (0.53 ± 0.17) scores vs. (1.31 ± 0.24) scores, the total effective rate was significantly higher than that in control group: 80.00% (36/45) vs. 28.89% (13/45), and there were statistical differences ( P<0.01). The blood samples of the elbows were taken before and after treatment. The immune function indexes of CD 4+/CD 8+, CD 4+ and CD 3+ after treatment in observation group were significantly higher than those in control group: 1.46 ± 0.20 vs. 1.27 ± 0.23, 0.378 ± 0.042 vs. 0.323 ± 0.031 and 0.573 ± 0.062 vs. 0.518 ± 0.060, and there were statistical differences ( P<0.05). The levels of carcinoembryonic antigen and cancer antigen 125 after treatment in observation group were significantly lower than those in control group: (28.17 ± 8.45) μg/L vs. (35.37 ± 9.73) μg/L and (25.29 ± 6.15) kU/L vs. (36.42 ± 12.06) kU/L, the quality of daily life score was significantly higher than that in control group, and there were statistical differences ( P<0.05). After treatment, the levels of inflammatory markers such as tumor necrosis factor-α and interleukin-1β in observation group were lower than those in control group, and there were statistical differences ( P<0.05). Conclusions:For patients with lung cancer EGFR-TKI-related rash, it is important to treat them with Jiawei Yangyin Jiedu Decoction, which can reduce inflammation, improve immunity and improve rash. It is worth promoting.
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@#Soluble guanylate cyclase is a key signal transduction enzyme in the body, which can activate the NO-sGC-cGMP signaling pathway and inhibit the TGF-β signaling pathway. cGMP is one of the most important second messengers and also involved in a series of physiological or pathological responses including vasodilation, inhibition of platelet aggregation, inhibition of cell proliferation and so on. When TGF-β signaling pathway is inhibited, it can inhibit issue fibrosis and cell proliferation. Recent studies have shown that sGC can be activated directly to treat a variety of diseases. As a new class of potential drugs, sGC stimulators have shown many unique advantages. Herein, the mechanism and the latest research progress of sGC stimulators are reviewed, which could provide a useful information for further research of sGC stimulators.
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Objective To explore the efficacy and safety of probiotics combined with kangfuxin solution in treatment of mild and moderate active ulcerative colitis.Methods 80 cases of patients with mild and moderate active ulcerative colitis(UC)in Nanyang Central Hospital were divided into two groups according to order of admission,each group had 40 cases.The study group of patients were treated with probiotics combined with kangfuxin solution,while the control group of patients were given probiotics alone.All patients were treated for eight weeks,to compare comprehensive efficacy and colonoscopy disease activity score between two groups of patients. Results The total effective rate of the study group was 97.5%,significantly higher than 80%of the control group,and the difference was statistically significant(P<0.05 );The colonoscopy disease activity score of the study group after treatment was significantly lower than before treatment and of the control group,the difference was statistically significant(P<0.05 );The two groups of patients had no serious adverse reactions.Conclusion Probiotics combined with kangfuxin solution has a significant efficiency in treatment of active mild and moderate ulcerative colitis.
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Objective To investigate the clinical distribution and the drug resistance of carbapenemresistant Proteus mirabilis strains isolated from 2009 to 2012 ; and to study carbapenemase genotypes of the isolates.Methods A total of 15 non-repetitive carbapenem-resistant Proteus mirabilis strains were selected from 422 Proteus mirabilis strains isolated from Ningbo First Hospital during January 2009 to December 2012.The minimal inhibitory concentrations (MIC) of 6 antibacterial agents,including imipenem (IPM),meropenem (MEM),ertapenem (ETP),ciprofloxacin (CIP),amikacin (AK) and minocycline (MIN),against 15 isolates were determined by E-test.The modified Hodge test (MHT) was used to detect the carbapenemase production in isolates.The PCR assay was performed to detect drug resistance genes of blaKPC,blaNDM-1,blaGES,blaSME,blaIMI-1/NmcA and blaSHV-38.Plasmids were extracted from the blaKPC-positive strains and then transformed into Escherichia coli J53 strains by electroporation.The transformed and untransformed Escherichia coli J53 strains were tested for MIC values and blaKPC gene by E-test and PCR respectively.Results The resistance rates of the 15 carbapenem-resistant Proteus mirabilis strains to IPM,MEM,ETP,CIP,AK and MIN were 100％,100％,100％,86.7％ (13/15),33.3％ (5/15) and 80％ (12/15),respectively.7 out of 15 strains were Hodge test positive,and 11 strains were blaKPC-2 positive.Results of PCR amplification showed that the transformed Escherichia coli J53 strains,whose MIC values to IPM,MEM,and ETP were increased by 2 to 64 times,were blaKPC-2 gene positive.Conclusion The carbapenem-resistant Proteus mirabilis strains in this study were resistant to many commonly used antibiotics,however,the resistance rates to AK were relatively low.The dominant carbapenemase genotype was blaKPC-2 carried by the plasmid.Attention should be paid to its easily transmissible feature among the strains in clinic.
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ObjectiveTo find out the antimicrobial resistance of clinical sequential isolates of Serratia marcescens,investigate the primary antimicrobial resistant mechanism of Serratia marcescens to β-lactams antibiotics.MethodsReview the antimicrobial resistance data of 247 Serratia marcescens isolates collected sequentially from different clinical wards during 2007 to 2010 in the First Hospital of Ningbo,which their antimicrobial susceptihility testing was got by using Vitek2-Compact system and matching products of gram-negative susceptibility card (GNS).The antimicrobial resistant genes of 20 carbapenems resistant isolates were detected by PCR.Results The Serratia marcescens resistant rates to ceftriaxone,aztreonarn and ciprofloxacin in our hospital were 70.4％ ( 174/247 ),64.8％ ( 160/247 ),57.4％ ( 142/247),respectively,the resistant rates were lower to amikacin,gentamicin,imipenem and meropenem,which were 3.5％ ( 8/229 ),5.4％ ( 13/241 ),5.9％ ( 14/237 ),8.1％ ( 20/247 ),respectively.PCR experiment showed that the expression levels of the AmpC gene in 4 strains were higher than that of the negative reference strains.The expression levels were 98.3,102.3,121.5,87.3 times compared to the negative reference strains,respectively.Twelve strains (strain no.2,3,5,6,9,10,14,15,16,17,18 and 19)produce bothblaCTX-MandblaKPC-2 enzymes.Highly detecedhlaCTX-Mof Serratia marcescens in our hospital included CTX-M1,CTX-M2,CTX-M9.Isolates no.7 and 18 were carrying blaSHV gene,Isolates no.8 and 13 were carrying blaSME,Isolates no.11 and 20 were carrying blaTEM.There were 5 strains (no.3,4,5,7 and 16) lose the outer membrane protein (OMP) genes ompC and ompF.Two strains( no.1 and 12 ) lose OMP gene ompF only,and one strain ( no.20 ) was lose OMP gene ompC only.ConclusionsThe cause of β-lactam antibiotics resistance of Serratia marcescens was complicated,and the most important mechanism is producing β-1actams and loss of OMP.Understanding the evolution and drug resistant mechanisms will help for best use of antibiotics and reducing the selection of antibiotics to resistant isolates.
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ObjectiveTo analyze the homology of Citrobacter freundii strains and detect multidrug resistant genes.MethodsThe minimum inhibition concentration was tested with standard agar dilution method and the the homology of C.freundii strains was measured with pulsed field gel electrophoresis (PFGE) and the PCR was used to perform the drug resistant genes such as β-lactamase,disappearing of outer membrane channel protein.ResultsThe four strains ( No.1,2,4,5 ) showed nineteen banding patterns with PFGE.PCR experiment showed that there were 2 strains (No.1,4) with blaCTX-M,3 strains (No.2,3,5 ) with blaDHA,1 strains(No.3) with blaACT/MIR,and 4 strains(No.1,2,4,5) with blaKPC-2.PCR analysis comfirmed that No.2 and No.4 disappearing of OmpF and No.3 disappearing both of OmpC and OmpF.The expression levels of the chromosomal ampC gene of No.3 isolates was 106.7 times higher than the negative isolates.ConclusionThere is high homology in carbapenem-resistant isolates and the mechanism of drug resistance is complex including blaKPC,AmpC,ESBLs,disappearing of outer membrane channel protein.The spreading of drug resistance result from above genes.
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Objective To investigate the impact of peritoneal albumin leakage on malnutrition-inflammation-atherosclerosis (MIA) syndrome in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods A cross-sectional study of a cohort of 130 CAPD patients without edema or active infection was performed. In order to identify peritoneal transport characteristics in CAPD patients, a standard peritoneal equilibration test (PET) was carried out. For malnutrition and inflammation, serum albumin and high-sensitivity C-reactive protein (hs-CRP) levels were measured. Mean-carotid artery intima media thickness (IMT) was used to determine atherosclerosis. Residual glomerular filtration rate (rGFR) was defined as the average of 24-hour urinary urea and creatinine clearances. Results Pearson and Spearman correlation analysis showed that peritoneal albumin leakage amount was positively correlated with age, body mass index, night dwell time, blood glucose, 4 h D/P creatinine levels and hs-CRP levels (r=0.204, P<0.05 ;r=0.314, P<0.01; r=0.265, P<0.01; r=0.212, P<0.05; r=0.401, P<0.01; r=0.216, P<0.05); whereas it was negatively correlated with diastolic perssure, serum albumin levels, glucose level of dialyzate and peritoneal Kt/V (r=-0.209, P<0.05; r=-0.123, P<0.05; r=-0.271, P<0.01; r=-0.212, P<0.01). Overall, there was no correlation between peritoneal albumin leakage and IMT. Patients was significantly greater (P<0.01), and there was a positive correlation between peritoneal albumin leakage amount and IMT (r=0.650, P<0.01). Conclusions Peritoneal albumin leakage is significantly associated with peritoneal transport characteristics, malnutrition and inflammatory state in CAPD patients. High peritoneal albumin leakage amount is a risk factor for atherosclerosis in patients with rGFR less than 1 ml·min-1(1.73 m2)-1.