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Objective:To investigate gender differences in arterial velocity pulse index(AVI), which is an indicator of vascular stiffness, across various age groups.Additionally, the study will also examine the risk factors associated with AVI.Methods:This cross-sectional study enrolled 4311 patients with an average age of 57.8±12.8 years at Jiading Branch of Shanghai First People's Hospital between August 2020 and September 2021.Patients were divided into three groups based on age: young(<45 years old, n=755), middle-aged(45-59 years old, n=1260), and elderly(≥60 years old, n=2 296). The AVI of the subject was obtained using the cuff oscillation wave method.The subject's AVI was acquired using the cuff oscillation wave.High AVI, indicating arteriosclerosis, was defined as AVI≥33.The subjects were then divided into two groups: the high AVI group(122 cases)and the normal AVI group(4 189 cases).Results:The ankle-brachial index(AVI)was found to be 12.8±3.7, 17.5±5.7, and 19.8±6.5 in the young, middle-aged, and elderly groups, respectively.The study revealed that AVI increased with age( Ftrend=767.819, P<0.01). Additionally, the incidence of high AVI in middle-aged women was found to be(2.8% or 20/722), which was higher than that in men 0.9%(5/538)in the same age group.This difference was statistically significant( χ2=5.371, P<0.05). The results of the multivariate logistic regression analysis indicate that being overweight, having a higher height, and a pulse rate greater than 80 BPM are protective factors in preventing a high incidence of AVI.The odds ratios( OR)with 95% confidence intervals( CI)for these factors were 0.468(0.317-0.690), 0.926(0.895-0.958), and 0.143(1.026-2.432), respectively, all with a P-value less than 0.01.On the other hand, old age, systolic blood pressure of 140 mmHg or higher, and diastolic blood pressure of 90 mmHg or higher were identified as risk factors for AVI.The ORs with 95% CIs for these factors were 2.119(1.322-3.396), 6.652(4.136-10.699), and 1.580(1.026-2.432), respectively, all with a P- value less than 0.05l. Conclusions:Arterial stiffness, as measured by the ankle-brachial index(ABI), tends to increase with age.In middle-aged subjects, women have a higher incidence of high ABI than men.Independent risk factors for high ABI include age and increased blood pressure, while factors such as overweight and height may affect the measured value of ABI.
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Because of the widespread development and application of rapid response system (RRS) in medical institutions in developed countries, such as Europe, America and Australia, the clinical adverse events (cardiac arrest, accidental death, etc.) in hospital patients have been reduced and improved. Meanwhile, the hospitalization rate and mortality rate of intensive care unit in hospital patients have been reduced, thus shortening the hospitalization time and reducing the medical expenses. Nevertheless, RRS is still in the exploration stage in our country. Therefore, the article reviews the RRS model and application development.
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Objective@#To investigate the drug resistance pattern and drug resistance genotypes of Salmonella. spp isolated from fecal specimens and anal swabs of diarrhea cases in Anhui Province.@*Methods@#The 149 strains of Salmonella.spp isolated from feces and anal swabs of diarrhea cases in Anhui Province from April to October 2017 were selected. The serotypes of Salmonella.spp were identified by slide agglutination. The susceptibility of all strains to 14 antibiotics were determined by micro-broth dilution method. Sixty of the cephalosporin-resistant antibiotics were selected. The β-lactamase encoding genes blaTEM, blaSHV, blaOXA-1, blaOXA-2, blaPER, blaCMY, blaCTX-M, and colistin resistance genes mcr-1 and mcr-2 were performed using the multi-PCR method.@*Results@#Of the 149 diarrhea cases, the median (P25, P75) of the age was 5.0 (1.1, 38.5). The 92 of them were male and 54.4% were children. Of the 149 strains of Salmonella.spp, 105 strains had different degrees of resistance to 13 antibiotics other than imipenem. The resistance rate of ampicillin was 55.0% (82/149), which was the highest. 53.0% strains (79 strains) were multidrug resistant, main of which were Salmonella typhimurium and Salmonella enteritidis. A total of 53 resistance patterns were detected, and 10 strains were resistant to ampicillin-ampicillin/sulbactam-tetracycline-chloramphenicol-cefazolin-trimethoprim/sulfamethoxazole, which was the most common resistance pattern. Among the 60 cephalosporin resistant strains, 45 strains carried blaTEM-1, 6 of which also carried blaCTX-M-14 and 3 of which also carried blaCTX-M-65. All the 32 strains carried only blaTEM-1 show resistance to ampicillin and 31 of them show resistance to cefazolin. There were 2 strains showing negative results of gene detection. mcr-1 was detected in a multidrug resistant strain.@*Conclusion@#The resistance of Salmonella.spp to ampicillin shows a serious situation in this region, and there were a number of multidrug resistant strains. The blaTEM-1 was the major drug resistance gene detected in this research. Detection of the mcr-1 suggests the emergence of surveillance to colistin resistance of Salmonella.spp in this area.
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Objective:To investigate whether TNM staging combined with systemic immune inflammation index (SII) has a high predictive value for the clinical prognosis of elderly patients with esophageal cancer.Methods:Clinical data of 118 elderly patients with esophageal cancer who received radiotherapy and chemotherapy were retrospectively analyzed, and the SII was calculated. SII and clinicopathological features were included in the Cox proportional risk model, and the prognostic index (PI) equation was obtained. Kaplan- Meier survival analysis was adopted. According to PI, the survival of patients was predicted and the predictive values of PI and TNM were statistically compared. Results:Univariate analysis showed that SII, N staging and TNM staging were closely correlated with the overall survival (all P<0.01). Cox multivariate analysis revealed that SII and N staging were the independent risk factors for overall survival. According to the results of Cox analysis, the equation of PI=0.961 × SII grouping+ 0.523 × N staging was obtained. The receiver operating characteristic (ROC) curve was drawn according to PI and overall survival, and the critical value was obtained and divided into different groups. The 1-, 2-and 3-year survival rates in the low-risk group were significantly higher than those in the high-risk group ( HR=0.365, 95% CI: 0.221-0.604, P<0.001). The prediction of overall survival by SII-N[area under curve (AUC)=0.707] was significantly better than that by TNM staging (AUC=0.560, P<0.001). Conclusion:This study preliminarily proves that the SII-N prognosis score model is better than the traditional TNM staging, which may have guiding significance for the selection of therapeutic strategies for elderly patients with esophageal cancer, and is worthy of further study.
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Objective:To investigate and analyze the current status and influencing factors of loss to follow-up among moderate to severe chronic periodontitis patients with long-term periodontal therapy.Methods:A total of 196 patients with moderate to severe chronic periodontitis receiving treatment from January 2016 to June 2017 were recruited by convenient sampling. A self-developed Clinical and Demographic Questionnaire, Self-efficacy Scale for Self-care (SESS), Dental Fear Scale (DFS) were used to obtain data at baseline. The outcome of loss to follow up within 20 months after the initial treatment of periodontitis was further recorded. Multivariate Logistic regression analysis was conducted to identify the influencing factors of loss to follow-up in patients with long-term periodontal therapy.Results:112 of 196 patients were lost during follow-up period(observation group), and 84 patients were lost during follow-up period (control group). Compared with control group, there were significant differences in age [(47.8±9.8) years vs. (42.2±11.2)years, t value was 6.672], education level[≤college: 23.2% (26/112) vs.13.1%(11/84), χ2 value was 5.033], disease severity [moderate:53.6% (60/112) vs.34.5% (29/54), χ2 value was 9.027], the proportion of patients undergoing periodontal surgery [4.5% (5/112) vs. 23.8% (20/84) χ2 value was 8.264], the low-level of self-efficacy for self-care [53.6% (60/112) vs. 6.0% (5/84), χ2 value was 18.992] and the score of SESS (52.6±8.2 vs. 62.9±7.1), t value was 5.996] in observation group ( P<0.05) . Multivariate logistic regression analysis showed that the risk factors of loss to follow-up in chronic periodontitis patients with long-term periodontal therapy included age increase ( OR=1.043, 95% CI 1.013-1.085, P=0.007), moderate disease severity ( OR=4.894, 95% CI 2.291-10.588, P<0.01), non-surgical treatment ( OR=11.356, 95% CI 2.236-27.483, P=0.004), low-level self-efficacy for oral self-care ( OR= 31.884, 95% CI 20.812-56.173, P<0.01). Conclusions:Age, severity of periodontitis, the way of periodontal treatment and the level of self-efficacy for oral self-care are influencing factors of loss to follow-up in chronic periodontitis patients with long-term periodontal therapy.
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OBJECTIVE@#To investigate the effect of Chinese medicine Wubi Shanyao pills on sexual function of kidney-yang-deficiency mice induced by hydrocortisone.@*METHODS@#Male Kunming mice were injected with hydrocortisone for 10 days to prepare the kidney-yang-deficiency model, and administrated with Wubi Shanyao pills (0.91, 1.82, 2.73 g/kg) for 9 weeks. The general behaviors of mice (autonomous activity, grasping power) were observed; sexual behaviors (capture, straddle, ejaculation frequency and incubation period) of mice were detected by mating experiment. The serum levels of cortisol, adrenocorticotropic hormone (ACTH), luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol (E@*RESULTS@#Wubi Shanyao pills increased the number of independent activities, grasping power, capture frequency of model mice and shortened the capture latency (all @*CONCLUSIONS@#Wubi Shanyao pills can improve the sexual function of mice with kidney-yang-deficiency induced by hydrocortisone, which may be related to regulating the hypothalamus-pituitary-adrenal axis (HPA axis), promoting the proliferation of testicular cells, and inhibiting cell apoptosis.
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Animals , Male , Mice , Follicle Stimulating Hormone/blood , Hydrocortisone , Hypothalamo-Hypophyseal System , Kidney/drug effects , Kidney Diseases/drug therapy , Pituitary-Adrenal System/drug effects , Random Allocation , Sexual Behavior, Animal/drug effects , Yang Deficiency/drug therapyABSTRACT
Objective@#To evaluate the role of prognostic nutritional index (PNI) in the radiotherapy for elderly patients with esophageal squamous cell carcinoma.@*Methods@#Clinical data of 108 elderly patients (aged>65 years) with esophageal squamous cell carcinoma who underwent radical radiotherapy were retrospectively analyzed. The PNI value of each patient was calculated, and the optimal cutoff value of PNI before treatment was determined by establishing the receiver operating characteristic curve (ROC curve). All patients were divided into the low and high PNI value groups. The overall survival rate was calculated by Kaplan-Meier method. Log-rank test, univariate and Cox’s multivariate prognosis analyses were performed.@*Results@#The ROC curve demonstrated that the optimal cutoff value of PNI was 50.1(n=52 in high PNI group and n=56 in low PNI group). Age, gender and treatment did not significantly differ between two groups, whereas the TNM staging significantly differed (P=0.022). The effective rate of radiotherapy in the high PNI group was 96%, significantly higher than 73% in the low PNI group (P=0.001). In the high PNI group, the 1-, 2-, and 3-year overall survival rates were 94%, 69%, and 62%, significantly higher compared with 70%, 32% and 27% in the low PNI group (all P<0.001). Univariate analysis showed that PNI, T staging, N staging and TNM staging were significantly correlated the overall survival of patients (all P<0.01). Cox’s multivariate analysis revealed that N staging (RR=1.94, 95%CI=1.29-2.94, P=0.002) and PNI (RR=0.83, 95%CI=0.77-0.90, P<0.001) were independent risk factors affecting overall survival.@*Conclusions@#PNI before treatment has a good correlation with the prognosis and radiotherapy efficacy of patients, which can be used as a pivotal index to predict the clinical benefit of radiotherapy for elderly patients with esophageal squamous cell carcinoma.
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Objective To evaluate the role of prognostic nutritional index (PNI) in the radiotherapy for elderly patients with esophageal squamous cell carcinoma.Methods Clinical data of 108 elderly patients (aged ＞ 65 years) with esophageal squamous cell carcinoma who underwent radical radiotherapy were retrospectively analyzed.The PNI value of each patient was calculated,and the optimal cutoff value of PNI before treatment was determined by establishing the receiver operating characteristic curve (ROC curve).All patients were divided into the low and high PNI value groups.The overall survival rate was calculated by Kaplan-Meier method.Log-rank test,univariate and Cox's multivariate prognosis analyses were performed.Results The ROC curve demonstrated that the optimal cutoff value of PNI was 50.1 (n =52 in high PNI group and n=56 in low PNI group).Age,gender and treatment did not significantly differ between two groups,whereas the TNM staging significantly differed (P=0.022).The effective rate of radiotherapy in the high PNI group was 96％,significantly higher than 73％ in the low PNI group (P=0.001).In the high PNI group,the 1-,2-,and 3-year overall survival rates were 94％,69％,and 62％,significantly higher compared with 70％,32％ and 27％ in the low PNI group (all P＜0.001).Univariate analysis showed that PNI,T staging,N staging and TNM staging were significantly correlated the overall survival of patients (all P＜ 0.01).Cox's multivariate analysis revealed that N staging (RR =1.94,95％CI=1.29-2.94,P=0.002) and PNI (RR=0.83,95％CI=0.77-0.90,P＜0.001) were independent risk factors affecting overall survival.Conclusions PNI before treatment has a good correlation with the prognosis and radiotherapy efficacy of patients,which can be used as a pivotal index to predict the clinical benefit of radiotherapy for elderly patients with esophageal squamous cell carcinoma.
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Objective@#To investigate the role of p75 neurotrophin receptor (p75NTR) in the irradiation-induced hippocampal neurogenesis impairment.@*Methods@#Thirty Sprague-Dawley rats were subject to whole brain irradiation with a single dose of 10 Gy 4 MeV electron beam. At 1 month after irradiation, the hippocampal tissues of the rats were collected. Western blot was used to detect the changes in the expression level of p75NTR protein. Immunofluorescence confocal laser microscopy was performed to observe the variations in the hippocampal neurogenesis. The stereotatic method was adopted for intra-hippocampal injection of AAV-shp75NTR to specifically knock out p75NTR.The relationship between p75NTR and hippocampal neurogenesis was analyzed.@*Results@#Western blot demonstrated that the expression of p75NTR protein was significantly up-regulated by 43.8% after irradiation (P<0.05). Immunofluorescent staining showed that the quantity of BrdU+ NeuN+ cells in rats was significantly decreased by 81.5% at 1 month after irradiation compared with that in the control group (P<0.01). After the specific knockout of p75NTR, hippocampal neurogenesis was obviously protected.@*Conclusion@#p75NTR plays a pivotal role in the irradiation-induced hippocampal neurogenesis impairment.
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Objective: To analyze the prescriptions of analgesic drugs for the patients with cancer pain, and promote the rational use of narcotic and analgesic prescriptions. Methods: Using the PCNE classification system, the list of all drug-related problems (DRPs) from 115 patients admitted to the standardized treatment of cancer pain from January to December 2017 was analyzed. Re-sults: In our hospital from January to December 2017, there were 52 cases of prescribed DRPs for narcotic and analgesic drugs in the standardized treatment of cancer pain with the incidence of 45. 22% . DRPs mainly focused on treatment safety with the incidence of 72. 31% . The drug choice caused the highest incidence of DRPs accounting for 63. 24% , followed by dose selection accounting for 20. 59% . Conclusion: There are still unreasonable prescriptions of narcotic analgesia in our hospital. According to the PCNE classifi-cation system, it is necessary to strengthen the communication with clinicians, carry out education for the patients with cancer pain, and further educate pharmacy staff on the knowledge of analgesic drugs. Through the above measures, the regulation of prescription medication for narcotic analgesics can be intensified.
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Objective To compare the therapeutic efficacy of reteplase(r-PA) and alteplase(t-PA) in the high risk patients with pulmonary embolism during a pulmonary artery catheter broken bolt in the interventional treatment,and to evaluate the clinical safety.Methods 54 high risk patients were selected as the research subjects,and they were randomly divided into treatment group(24 patients) and control group(30 patients).Patients in both two groups were given general treatment,low molecular heparin sodium anticoagulation therapy.Besides,the control group was given local perfusion thrombolysis enzyme treatment.While the treatment group was given local perfusion at enzyme thrombolysis treatment.Results Two-way Chi-square test results showed that before treatment,there were no significant differences in HR,RF,PaO2,PaCO2 and SaO2 between the two groups(all P>0.05).After 3-day treatment,in the treatment group,HR[(83.39±14.25)times/min],RF[(17.80±1.65)times/min],PaO2[(87.59±7.34)mmHg],PaCO2[(37.60±7.62)mmHg],SaO2[(97.29±6.72)%] in the treatment group group,which in the control group were (97.7±15.51)times/min,(20.49±1.68)times/min,(81.53±6.42)mmHg,(35.69±4.57)mmHg,(93.91±3.27)%,the differences between the two groups were statistically significant(t=8.01,7.33,6.32,all P<0.05).After three days therapy,the total effective rate was 86.67% in the treatment group,which was significantly higher than 75.00% in the control group (x2=1.21,P=0.55).After thrombolysis treatment,there was no significant difference between the treatment group and control group in hemorrhage rate(x2=2.24,P=0.53),which were 13.33% and 12.50%,respectively.Besides,the hemorrhage patients were all got effectively treated and their condition was significantly improved,and none of them occurred severe bleeding during the observation periods in the two groups.Conclusion Local perfusion reteplase therapy in high-risk patients with PE through the pulmonary artery catheter broken bolt in the interventional treatment is safe and is worthy of clinical promotion.
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Objective This study is to investigate the changes in the NFATc 4/3 signaling pathway in rat hippocampus after whole brain radiation. Methods A total of 120 one?month?old male Sprague?Dawley rats were randomly divided into four groups to receive whole brain radiation using 4?MeV electron beams with doses of 0( control) ,2,10,and 20 Gy,respectively,in a single fraction. At 6 hours,12 hours,1 day,3 days,1 week,and 2 weeks after radiation,Western blot and real?time PCR were used to evaluate the changes in expression levels of CaN, NFATc 4/3, p?NFATc 4/3, and GSK?3β. Results There were no significant changes in the expression of NFATc 4/3 or p?NFATc 4/3 at 6 and 12 hours after whole brain radiation. At 1 day after radiation,compared with the control group,the expression of p?NFATc 4/3 in the radiation groups was significantly increased in a dose?dependent manner ( 2 Gy:P= 0. 014;10 Gy:P=0. 011;20 Gy:P=0. 000 );however, there was no significant difference in the expression of NFATc 4/3 between the radiation group and the control group. The expression of NFATc 4/3 was significantly decreased in the radiation groups than in the control group at day 3 ( 2 Gy:P=0. 040;10 Gy:P=0. 000;20 Gy:P=0. 000),1 week (2 Gy:P=0. 692;10 Gy:P=0. 032;20 Gy:P=0. 021),and 2 weeks (2 Gy:P=0. 001;10 Gy:P=0. 000;20 Gy:P=0. 000) after radiation,while there was no significant difference in the expression of p?NFATc 4/3 between any two groups. There were no time?or dose?dependent changes in expression of CaN or GSK?3β. Conclusions Ionization radiation has an inhibitory effect on the NFATc 4/3 signaling pathway in rat hippocampus. Combined with our previous results,this study suggests that radiation?induced cognitive dysfunction is associated with the NFATc 4/3 signaling pathway.
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<p><b>OBJECTIVE</b>To assess the accuracy of copy number variations (CNVs) detection by non-invasive prenatal testing (NIPT) in addition to its routine targets and clinical significance of such CNVs for the reduction of fetuses born with chromosomal microdeletion/duplication syndromes.</p><p><b>METHODS</b>From October 2014 to October 2015, 14 235 pregnant women volunteered to participate in the study. Fifteen cases detected with chromosomal CNVs by the NIPT decided to undergo prenatal diagnostic procedures including amniocentesis, G-banded karyotyping and chromosomal microarray analysis (CMA). All such cases were routinely followed up after birth.</p><p><b>RESULTS</b>Among the 14 235 subjects underwent NIPT, 18 cases were detected with Down syndrome, 4 with trisomy 18, and 2 with trisomy 13, in addition with 24 cases of CNVs. For the latter, 15 (including 11 cases with microdeletions and 4 cases with microduplications) participated in further prenatal diagnosis. In 13 cases (86.7%), the results of CMA were consistent with those of NIPT. On the other hand, only 7 out of the 15 cases showed a positive result with karyotyping, suggesting a rather high rate of missed diagnosis (46.2%). Of note, karyotyping has identified partial inversion of chromosome 9 in one case.</p><p><b>CONCLUSION</b>As a screening tool, NIPT has a high accuracy for the detection of CNVs. However, as this method is still under improvement, it is more of a reminder rather than a diagnostic tool with full capability.</p>
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Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Pregnancy , Young Adult , Chromosome Aberrations , Chromosome Banding , Chromosome Disorders , Diagnosis , Embryology , Genetics , DNA Copy Number Variations , Fetal Diseases , Diagnosis , Genetics , Karyotyping , Microarray Analysis , Prenatal DiagnosisABSTRACT
Objective To explore the combination clinical effects of salbutamol and budesonide on bronchial asthma .Methods 120 patients withbronchial asthma in First People's Hospital of Yuhang District were selected and randomly divided into two groups of control group and experimental group with 60 cases in each group.Patients in the control group was treated monotherapy with salbutamol, patients in the experimental group were given albuterol and budesonide combination therapy.The treatment effect on symptoms and lung function of the two groups were compared after two weeks . Results After treatment, the breathing, wheezing sound, gasp and cough remission time were significantly shorter in the experimental group than in the control group,the difference was statistically significant ( P <0.05 ) .The effective rate of the control group was 78.33%, the effective rate of the experimental group was 95.00%,the difference was statistically significant(P<0.05).The improvement of lung function in the experimental group was significantly higher than that in the control group,the difference was statistically significant(P<0.05).Conclusion Compared with monotherapy, the combination of salbutamol and budesonide can improve the efficacy of bronchial asthma patients and improve the quality of life of patients .
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OBJECTIVE:To investigate the role of clinical pharmacists in the therapy for sever acute pancreatitis induced by hy-perlipidemia(HL-SAP)patient. METHODS:Clinical pharmacists participated in the therapy for a pregnant patient with HL-SAP af-ter cesarean section,assisted physicians to optimize therapy plan through analyzing the disease condition according clinical guide and relevant literatures. Clinical pharmacists suggested to decrease atorvastatin 20 mg,qd to 10 mg,qd in order to avoid the risk of rhabdomyolysis and liver injury. When patient’s hemogram kept stable and infection had been controlled,clinical pharmacists suggested antibiotics de-escalation treatment:Levofloxacin injection 0.5 g,ivgtt,qd+Metronidazole injection 0.5 g,ivgtt,q12 h in-stead of meropenem. RESULTS:Physicians adopted the suggestions of clinical pharmacists. The patient was recovered and transfer to gastroenterology department 15 d later. CONCLUSIONS:Clinical pharmacists provide pharmaceutical care for HL-SAP patient after cesarean section,and assist physicians to formulate therapy plan so as to reduce the incidence of ADR effectively and guaran-tee the safe and effective use of drugs.
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Objective To compare the efficacy and adverse reaction of teniposide (VM-26) plus carboplatin (TC regimen) and etoposide (VP-16) plus carboplatin (EC regimen) in treatment of newly diagnosed small cell lung cancer (SCLC), and the possible role of VM-26 on prevention of brain metastasis of SCLC. Methods A total of 102 previously untreated SCLC patients without brain metastasis were divided into VP-16 group received EC regimen (n=64) and VM-26 group received TC regimen(n=38). The carboplatin dosages in two groups were calculated by blood concentration-area under the curve(AUC)=5, and intravenous infusion of 1 h for the first day. In VM-26 group, VM-26 70 mg/m2+normal saline 500 mL was intravenously infused of 2 h for 1-3 days. VP-16 100 mg/m2+normal saline 500 mL was given to VP-16 group, 1 h for 1-3 days. Twenty-one day was for 1 treatment cycle. The curative effect, prognosis and adverse reaction were compared between two groups. Results The overall response rates (ORR) and disease control rates (DCR) were 78.9%(30/38) and 97.4%(37/38) in VM-26 group, respectively, and 76.6%(49/64) and 95.3%(61/64) in VP-16 group, respectively, with no significant differences between the two groups (χ2=0.078 and 0.283, P0.05). The brain metastasis rate was significantly higher in VP-16 group [43.8%(28/64)] than that of VP-26 group [21.1%(8/38),χ2=5.379,P=0.02). The adverse reactions were mainly grade 1/2 bone marrow suppression in two groups. Conclusion TC is a highly active regimen for treatment of SCLC. There is no difference in the ef?fectiveness and adverse reactions versus EC. Application of VM-26 can reduce the incidence of brain metastasis in SCLC patients.
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Objective To establish a high throughput phenotypic test for the detection of drug re-sistance in human immunodeficiency virus(HIV)strains. Methods The gene encoding luciferase was in-activated through restriction enzyme digestion and ligation. LacZ gene was used to replace the genes encoding original protease and reverse transcriptase. pol genes were amplified from pSG3△env plasmid and cloned in-to a new backbone plasmid through infusion. The factors that might affect the results of the test were opti-mized. Results The parental backbone plasmid pNL4-3. Lac was constructed,of which the gene encoding luciferase was inactivated and bearing the LacZ gene instead of genes encoding protease and reverse tran-scriptase. Several influential factors including cell numbers(10 000 / well),virus inoculation(200 TCID50 /well)and the concentration of DEAE-dextran(15 μg/ ml)were optimized. The reproducibility of this test was confirmed by testing 12 anti-HIV drugs against 2 pseudovirus strains 8 times,presenting the coefficient of variations(CVs)from 4. 32% to 28. 46% . Six types of pseudovirus were constructed and tested against the 12 anti-HIV drugs,the results of which were compared with those by using the pSG3△env-based pseud-ovirus test. The results of the two tests presented good consistency. Conclusion The high throughput phe-notypic test based on pNL4-3. Lac plasmid,combining the advantages of pSG3△env and pNL4-3 systems, could be used to analyze the drug resistance patterns of HIV-1 infectors and screen new drugs for antiretrovi-ral therapy in a rapid and effective way.
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Castleman disease (CD) is a rare polyclonal lymphoproliferative disorder characterized by enlarged hyperplastic lymph node(s). Unicentric Castleman disease (UCD) is an indolent condition often treated by local approaches. On the contrary, pa-tients with multicentric Castleman disease (MCD) have less favorable prognoses and require systemic treatments. Cytotoxic chemother-apy has been widely used to treat MCD with varying degrees of response because of the toxicity risk of the treatment. The pathogenesis remains unknown;however, most pieces of evidence to date point toward human herpes virus 8 (HHV-8) and deregulated overproduc-tion of interleukin (IL-6). Discovery of putative etiologic factors and targets in MCD, particularly HHV-8, CD20, and IL-6, has translat-ed to the use of rituximab, anti-IL-6-based, and antiviral therapy. Good results have been realized through targeting HHV-8 replication, CD20, and IL-6 pathways. In this article, we reviewed the classification, pathogenesis, and current treatments of CD and provided in-sights into future treatment strategies based on disease biology.
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Objective:To explore the correlation among serum cardiac troponin I (cTnI),N terminal pro brain natri-uretic peptide (NT-proBNP)and main endpoint events of heart in patients with chronic stable heart failure.Meth-ods:The present study enrolled 95 patients with NYHA cardiac function class III~IV from Feb 2010 to Feb 2011.According to levels of cTnI and NT-proBNP,the patients were divided into cTnI negative group (n=60)and cTnI positive group (n=35);NT-proBNP negative group (n=40)and NT-proBNP positive group (n=55),all patients were followed up for two years,and the main endpoint events were cardiogenic sudden death and rehospitalization caused by acute aggravation of heart failure.Results:Compared with negative group,the hazard ratio (HR)of end-point events was 2.69 and confidence interval (CI)was 1.54~ 4.72,P = 0.002 in cTnI positive group;HR was 2.54 and CI was 1.35~4.78,P =0.003 in NT-proBNP positive group;further interclass crossover analysis found that,when patients'cTnI and NT-proBNP were both positive,the hazard ratio of cardiac endpoint events was the highest (HR=6.34,CI 2.26~17.9,P <0.001).Conclusion:In patients with chronic stable heart failure,serum elevated levels of cardiac troponin I and N terminal pro brain natriuretic peptide are important predictors reflecting prognosis of patients with heart failure.
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Objective: We investigated the clinical significance and prognostic value of peripheral blood absolute lymphocyte count (ALC) in the diagnosis of diffuse large B-cell lymphoma. Methods:The medical records of 143 patients with diffuse large B-cell lymphoma were reviewed. These patients were diagnosed and underwent surgery in Tianjin Medical University Cancer Institute and Hospital, China, between February 2002 and April 2008. The correlation between different ALC levels and clinical features was statisti-cally analyzed. Results:Patients with low ALC (<1.0×109/L) at diagnosis showed B symptoms, an international prognostic index score of ≥2, advanced clinical stage (Ann Arbor III/IV), high lactate dehydrogenase level, and high β2-microglobulin level (P<0.05). Pa-tients with high ALC (≥1.0 × 109/L) responded well to treatment (P=0.003). In multivariate analysis, Ann Arbor stage and ALC level were independent prognostic factors of patients with diffuse large B-cell lymphoma. Patients with low ALC often exhibited advanced clinical stage (Ann ArborⅢ/Ⅳ). Conclusions:ALC level obtained at diagnosis is a novel, powerful prognostic factor of diffuse large B-cell lymphoma.