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Objective@#To investigate the recurrence of pulmonary tuberculosis patients 5 years after successful treatment in Hengyang City, Hunan Province, and to analyze its influencing factors.@*Methods@#The data of pulmonary tuberculosis patients who were successfully treated in Hengyang City in 2014 were collected through the tuberculosis management information system. The recurrence of pulmonary tuberculosis was defined as the endpoint, and all patients were observed for five consecutive years. Factors affecting recurrence of pulmonary tuberculosis were identified using Kaplan-Meier estimates, log-rank test and multivariable Cox proportional hazards regression analysis.@*Results@#A total of 6 626 patients with successfully treated pulmonary tuberculosis were included, including 4 961 males and 1 665 females, with a median age of 54 years. There were 536 cases with recurrence of pulmonary tuberculosis within five years, with a 8.09% cumulative proportion of recurrence and annual recurrence rate of 1.75 per 100 person-years. Multivariable Cox proportional hazards regression analysis showed that men ( HR=1.592, 95%CI: 1.256-2.019 ), age of 40 years and greater ( age of 40 to 59 years, HR=7.025, 95%CI: 1.739-28.377; age of 60 years and greater, HR=8.175, 95%CI: 2.024-33.023), farmers ( HR=1.379, 95%CI: 1.070-1.778 ), retreatment ( HR=6.398, 95%CI: 5.163-7.929 ) and positive etiology ( HR=1.255, 95%CI: 1.042-1.511 ) were risk factors for five-year recurrence of pulmonary tuberculosis among successfully-treated patients.@*Conclusions@#High recurrence rate is found among pulmonary tuberculosis patients within five years after successful treatment in Hengyang City. There is a high risk of pulmonary tuberculosis recurrence among male, etiologically positive, retreated farmers at ages of 40 years and older, and targeted interventions are recommended.
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Objective:To analyze the adverse reactions of patients with multidrug-resistant pulmonary tuberculosis treated with linezolid, and to provide reference for clinical rational use of drugs.Methods:A total of 189 patients with multidrug-resistant pulmonary tuberculosis who were admitted to Hunan Chest Hospital between June 2019 and June 2020 were retrospectively included, and were divided into the linezolid group and the control group. The control group was given a standardized anti-tuberculosis treatment without linezolid, and the linezolid group was given linezolid in addition to standardized regimens. The occurrences of hematological toxicity, peripheral neuritis, optic neuritis and other adverse reactions in the two groups after anti-tuberculosis treatment were recorded. The risk factors for adverse reactions of linezolid were analyzed. Statistical analysis was performed using independent samples t test and chi-square test, and logistic regression was used to analyze the risk factors for adverse reactions of linezolid. Results:A total of 189 patients with MDR-TB were included in this study, including 108 in the linezolid group and 81 in the control group. There were no significant differences in baseline characteristics between the linezolid and control groups. The frequencies of leukopenia, anemia, thrombocytopenia, peripheral neuritis and optic neuritis in the linezolid group were 20.4%(22/108), 47.2%(51/108), 21.3%(23/108), 20.4%(22/108) and 13.9%(15/108), respectively, which were all significantly higher than those in the control group (8.6%(7/81), 27.2%(22/81), 9.9%(8/81), 1.2%(1/81) and 4.9%(4/81), respectively), and the differences were all statistically significant ( χ2=4.90, 7.86, 4.40, 15.86 and 4.10, respectively, all P<0.050). Patients older than 45 years of age was independent risk factor for leukopenia (odds ratio ( OR)=3.08, 95% confidence interval ( CI) 1.03 to 9.25, P<0.050) and thrombocytopenia ( OR=2.41, 95% CI 1.09 to 5.35, P<0.050) after linezolid administration. The higher value of white blood cell at baseline ( OR=0.48, 95% CI 0.30 to 0.76, P=0.002) was an independent protective factor for leukopenia associated with linezolid. Conclusions:Pancytopenia, peripheral neuritis and optic neuritis are prone to appear when linezolid is used to treat patients with multidrug-resistant pulmonary tuberculosis. In clinical practice, closely monitoring the adverse reactions during the use of linezolid for anti-tuberculosis treatment is needed.
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Objective To investigate the effects of ferulic acid (FA) and adipose-derived mesenchymal stem cells(ADMSCs)on rat hepatic stellate cells (HSCs) by regulating TGF-β/smad signal transduction pathway.Methods HSCs were divided into 4 groups:blank control group,FA control group,ADMSCs control group and FA+ADMSCs group.The apoptosis rate of HSCs in each group was detected by flow cytometry.The expression levels of TGF-β1,Smad2,Smad3 and Smad7 mRNA in HSCs were detected by qRT-PCR.The TGF-β1 and Smad7 protein levels,and phosphorylated-Smad2/3 (p-Smad2/3)expression were detected by Western blot.Results Compared with the other 3 groups,the apoptosis rate of HSCs in the FA+ADMSCs group was significantly increased(P＜0.05),while the expression levels of TGF-β1,Smad2 and Smad3 mRNA were significantly decreased,and the Smad7 mRNA expression was increased;moreover,the expression levels of TGF-β1 protein and p-Smad2/3 were significantly decreased,while the Smad7 protein expression was significantly increased(P＜0.05).Conclusion FA can enhance the effect of ADMSCs for down-regulating the TGF-β1 expression in HSCs,and then leads to the decrease of downstream p-Smad2/3 activity and Smad7 expression increase,thus participates in promoting cellular apoptosis.
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Objective To explore the protective roles of Emodin in the intestinal mucosal lay of rats with severe acute pancreatitis (SAP) and its mechanism. Methods SD rats (n=30) were divided into 3 groups: sham operation group, SAP group and Emodin group (SAP rats treated with Emodin). The SAP rat models were established via retrograde injection of 3%sodium taurocholate to pancreatic duct. Rats in Emodin group were peritoneally injected with Emodin (2.5 mg/100 g) at both 1 hour and 3 hour after sodium taurocholate injection. Apoptosis of intestinal epithelial cell was detected by TUNEL analy?sis. The expression of glucose-regulated protein78 (GRP78) protein was assessed by immunohistochemistry. Results Com?pared with sham operation group, apoptosis in intestinal epithelial cells and the expression of GRP78 protein were increased significantly in SAP group(P0.05). Conclusion Emodin has a protective effect on intestinal layer in rats with SAP through inhibiting intestinal epithelial cell apoptosis. However, ER stress is not likely to be involved in this protective effect.
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Objective To observe the clinical effects of treating acute upper gastrointestinal bleeding(AUGIB) with freezing Zidi mixture lavage. Method 183 UGIB patients from the First Affiliated Hospital to Guanzhou University of TCM in August 2013 were randomly recruited into a control group with 91cases and a treatment group with 92 cases. The treatment group was treated with intragastric administration of freezing Zidi mixture, while the control group was treated with intragastric administration of cryohydrate and norepinephrine. The changes of clinical effects, blood pressure, hemoglobin, blood urea nitrogen, pulse and dark stool were observed and the bad emotions as anxiety, depression and fear were evaluated. Results ① On therapeutic effect, the total effective rate was 96.7% and 85.7% in the treatment group and the control group respectively, with statistical difference(χ2=2.943,P0.05). ④ On changes of anxiety, depression and fear:the treatment group [the(42.5±9.4), (41.6±9.7), (26.3±5.4)for each]was obviously improved after the treatment than the control group[the score was(51.2±10.1),(50.4±11.5),(30.4±6.9)for each],P<0.05. Conclusion Freezing Zidi mixture lavage can obviously elevate systolic pressure, decrease heart rate, enhance hemoglobin, decrease blood urea nitrogen, relieve body stress reaction and other clinical symptoms. Its effects were better than intragastric administration of cryohydrate and norepinephrine in treating AUGIB.