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Objective:To study the efficacy and influencing factors of ursodeoxycholic acid (UDCA) in the treatment of cholesterol gallstone, so as to provide reference for the treatment of cholesterol gallstone by internal medicine.Methods:From March 1, 2017 to March 31, 2018, at outpatient department of gastroenterology of 9 Beijing medical centers including Peking University People′s Hospital, the Sixth Medical Center of PLA General Hospital, Beijing Huaxin Hospital, PLA Rocket Force Characteristic Medical Center, Peking University Aerospace Center Hospital, Beijing Youan Hospital of Capital Medical University and Beijing Tiantan Hospital of Capital Medical University, Beijing Tongren Hospital of Capital Medical University, and Beijing Shijitan Hospital of Capital Medical University, the data of patients with cholesterol gallstone treated by UDCA were collected. The inclusion criteria were that the largest diameter of stone was ≤10 mm and the stone was not detected under X-ray. The treatment plan was taking UDCA orally for 6 months at a dose of 10 mg·kg -1·d -1. The basic information of patients, the ultrasound examination results before treatment and 6 months after treatment, and scores of biliary abdominal pain and dyspepsia symptom were collected. Univariate and multivariate logistic regression were used to analyze the influencing factors of the efficacy in gallstrone dissolution by UDCA, and Wilcoxon signed rank test was used for statistical analysis. Results:A total of 215 patients were enrolled. The complete dissolution rate of gallstone was 19.5% (42/215) and partial dissolution rate was 50.7% (109/215), and the total effective rate was 70.2% (151/215). The complete dissolution rate of sandy stone was significantly higher than that of lumped stones (37.0%(17/46) vs. 14.8%(25/169); OR=3.377, 95% confidence interval (95% CI) 1.621 to 7.035, P=0.001). In lumped stones, the complete dissolution rate of the stones with diameter ≤5 mm was significantly higher than that of the stones with diameter >5 mm (37.5%(9/24) vs. 11.0%(16/145); OR=4.837, 95% CI 1.823 to 12.839, P=0.002). The complete dissolution rate of patients with higher body mass index ( OR=0.872, 95% CI 0.764 to 0.995, P=0.043) and longer disease course ( OR=0.942, 95% CI 0.912 to 0.973, P<0.001) was low. The results of multivariate logistic analysis indicated that long disease course of gallstone ( OR=0.940, 95% CI 0.908 to 0.974, P=0.001), rough gallbladder wall ( OR=0.438, 95% CI 0.200 to 0.962, P=0.040) and lumped stone ( OR=0.236, 95% CI 0.101 to 0.550, P=0.001) were independent risk factors of influencing the efficacy of stone dissolution by UDCA. As for lumped stones, the independent risk factors included long disease course of gallstone ( OR=0.926, 95% CI 0.877 to 0.978, P=0.006) and stone diameter >5 mm ( OR=0.142, 95% CI 0.043 to 0.470, P=0.001). After 6 months of UDCA treatment, score of biliary abdominal pain decreased from 0 (0 to 6) to 0 (0 to 0) and the score of dyspepsia symptom decreased from 1 (0 to 2) to 0 (0 to 0), and the differences between before treatment and after treatment were statistically significant ( Z=-8.50, and -9.13, both P<0.001). Conclusions:UDCA has a certain efficacy in cholesterol gallstone dissolution and can ease biliary abdominal pain and dyspepsia symptom. Long disease course of gallstone, rough gallbladder wall and stone diameter >5 mm are independent risk factors of poor efficacy in gallstone dissolution by UDCA.
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Objective@#To set up a chyle (n-hexane) testing method based on n-hexane extraction system.@*Methods@#The hydrothorax specimen which was positive in chyle testing was selected and the feasibility was evaluated by replace Diethyl ether with n-hexane. The optimal extraction volume ratio for the new chyle testing was confirmed and sultan Ⅲ dye process was improved. Then, the new chyle testing method and its standard operation process was established.A total of 120 specimens with triglyceride(TG)in different levels were collected and divided into three groups with 40 specimens for each group (group A. TG≤1.7 mmol/L; B. 5.6<TG<12.8 mmol/L; C. TG≥12.8 mmol/L). Then, 50 body fluid specimens were collected and used to confirm the above test results. A total of 134 real body fluid specimens were used to assessment the clinical using by review and calculating the clinical coincidence rate.@*Results@#N-hexane can replace Diethyl ether in the Chyle test. The extraction volume ratio of 1 ml sample plus 400 μl N-hexane is the best one and the sultan Ⅲ tube dying method is better than former direct smear. Compared with the old Chyle test using Diethyl ether, the new Chyle test using N-hexane is in good consistency with the Kappa value 0.95. The clinical coincidence rate of the above Chyle test reaches 94.8%(127/134) after the verification of 134 specimens.@*Conclusions@#A new N-hexane test is established successfully. It was convenient to operate with high security and little contamination and thus has a wide clinical application value.(Chin J Lab Med, 2018, 41: 527-530)
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Objective:To determine the plasma level of apelin in patients of maintenance hemodialysis (MHD) and to explore the relationship between apelin level and carotid atherosclerosis (AS) in MHD patients.Methods:A total of 92 MHD patients and 36 sex-and age-matched healthy subjects were enrolled in this study.The plasma level of apelin was evaluated by radiation immunoassay;serum endothelial injury markers including thrombomodulin,von Willebrand factor (vWF),and CD 146,and inflammatory factors including high sensitive C-reactive protein (hsCRP),IL-6 and TNF-α were determined by ELISA.Common Carotid arteries intima media thickness (CCA-IMT),cross-sectional calculated intima-media area (cIM area) area and atherosclerotic plaque were measured by non-invasive high-resolution B-mode ultrasonography.Results:The plasma levels of apelin was significantly decreased in MHD patients compared with healthy subjects (P＜0.01),accompanied with elevated plasma levels of thrombomodulin,vWF,CD 146,hsCRP,IL-6 and TNF-α (all P＜0.01).The plasma levels of apelinin in MHD patients with carotid artery plaques were obviously lower than those without plaques [(43.16± 10.12) pg/mL vs (61.43±16.25) pg/mL,P＜0.01].Plasma level of apelin was inversely related with CCA-IMT and cIM area (r=-0.355 and r=-0.297 respectively,all P＜0.01).Multiple stepwise regression analysis showed that plasma level of apelin was an independent risk factor for CCA-IMT and cIM area.Conclusion:The plasma apelin in MHD patients might take part in vascular endothelial injury and the progress of atherosclerosis.It plays an important role in the initiation and development of uremia associated atherosclerosis through elevating inflammatory factors including hsCRP,IL-6 and TNF-α levels.
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Objective To study the sonographic features of fetal lung in normal and preeclampic pregnancies,with follow-up on the occurrence of neonatal respiratory distress syndrome (NRDS),as well as,examine the effects of preeclampsia (PE) on fetal lung maturity (FLM).Methods We collected data from 140 cases during the early pregnancy period (29 to ＜34 weeks),100 cases during the late pregnancy period (34 to 39 weeks),as well as 240 cases of normal pregnancies with the same gestational ages for the contwl group.Data included the parameters of fetal lung maturity measured by ultrasound and the incidence of NRDS postpartum.We analyzed the effects of PE on fetal lung maturity.Results The right fetal lung from the early onset PE group was significantly smaller than that of the normal group.There was no difference in the right lung area between the PE group and the normal group of the same gestational age.Compared with the normal group of the same gestational age,the LHR group had no difference in the early and late PE groups.The acceleration time/ejection time of the main pulmonary artery in the early and late PE group was significantly higher than that of the normal group.There was no difference in the incidence of NRDS among all the groups of the same gestational age.Conclusion PE has no significant effect on fetal lung function or maturation of the pulmonary tissues.Lung maturation may precede the same gestational age without PE.
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Objective To investigate the effect and mechanism of HPV16-E7 gene specific CRISPR/Cas (clustered regularly interspaced short palindromic repeat/CRISPR associated system) on the cell apoptosis and proliferation of human cervical cancer SiHa cell line.Methods HPV16 positive cervical cancer SiHa cells and HPV16 negative human embryonic kidney HEK293 cells were cultured and each of the cells were divided into 3 groups respectively in the experiment:the control group was untreated,the C9 group was transfected only with Cas9 plasmid,and the Cri group was cotransfected with guide RNA (gRNA) plasmid and Cas9 plasmid (1∶3).T-7endonuclease Ⅰ assay was used to detect double strand break (DSB) formation in SiHa cells.The apoptosis rates of SiHa and HEK293 cells were detected by flow cytometry (FCM).CCK-8 was used to evaluate the proliferation of SiHa and HEK293 cells.Western blotting was applied to detect E7 and pRb protein expression.Results The SiHa cells in Cri group showed DSB formation at 48 h after transfection.The apoptosis rate of Cri group at 48 h was 26.6％,higher than 2.6％ in control group (x2 =5.455,P =0.020) and 3.1％ in C9 group (x2 =6.279,P =0.012).The apoptosis rates of control,C9 and Cri group were 7.4％,7.6％,7.9％ for HEK293 cells respectively.Compared with the control and C9 group,the apoptosis rate of the Crigroup showed no statistical significance (x2 =0.032,P =0.858;x2 =0.034,P =0.853).After 72 h transfection,the inhibition rate of SiHa cells in Cri group was 29.4％,higher than 15.0％ in control group (x2 =22.481,P =0.000) and 18.0％ in C9 group (x2 =24.879,P =0.000).The inhibition rate of the HEK293 cells in Cri group was 3.2％,and it showed no significant difference compared with the inhibition rate of C9 group (2.2％,x2 =2.857,P =0.091) and control group (2.3％,x2 =3.438,P =0.064) respectively.Down-regulated expression of E7 protein and up-regulated expression of pRb protein were detected of the SiHa cells in Cri group compared with the control group,while the E7 protein and pRb protein level did not show difference in the C9 group.Conclusion CRISPR specifically targeting HPV16-E7 oncogene can promote apoptosis of SiHa cells,and inhibit the cell proliferation.It is speculated that CRISPR system may induce DSB event of E7 gene,and result into increased expression of tumor suppressor protein pRb.
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Objective:To identify the epitope of mAb15A11 which is specific against RA associated autoantigen cartilage oligomeric matrix protein ( COMP ).Methods: A filamentous phage library displaying random linear dodecapeptides was used to mapping the epitope of mAb15A11.After three rounds of screenings,40 phage clones were selected at random and sequenced.The specificity of phages was confirmed by enzyme immunoassays.Homology search by ClustalW2 and structure analysis by PyMol to identified the epitope amino acid sequence.Western blot analysis of COMP and ELISA analysis of COMP-derived peptides were used to confirm epitope′s characterization.Results: After repeated screenings using bio-panning method, 2 clones were identified, which interacted specifically with mAb 15A11.Homology search did not find succession consensus sequence within COMP molecular,which indicated that the epitope was not linear.PyMol Structure analysis identified the rationality of conformational epitope.Western blot analysis and ELISA of EDTA-treated COMP further prove an conformational structure of the epitope recognized by mAb 15A11.ELISA analysis of COMP-derived peptides demonstrated both disulfide bonds between 229 C-243 C and 237 C-253 C and every epitope amino acid of 232 G,238 H,240 H,241 A,244 V,247 R and 251 R were essential to the binding of mAb 15A11 with COMP.Conclusion: In this study, the potential B cell antigentic epitopes of mAb 15A11 was identified by phage display library.The epitope amino acids sequence and char-acterization were also recognized.It may have important theoretical value for the study of reaction mechanism of COMP antibody and antigen and may also show application significance in the detection of rheumatoid arthritis.
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Objective To explore the risk factors and targeted therapy for fungus infection in acute exacerbation of chronic obstructive pulmonary disease (COPD) pulmonary.Methods 83 acute exacerbations of COPD patients with pulmonary fungus infection were selected as the observation object(COPD fungal infection group),according to the time sequence of random month by month in acute exacerbations of COPD no secondary fungal infection of the 80 patients hospitalized patients as control group,analysis of risk factors lead to fungal infection.Results Two groups in age,live ICU time,antibiotic use time,hormone use time,albumin level mechanical ventilation people with diabetes mellitus,merger,as cor pulmonale had statistically significant differences (P ＜ 0.05) ; The conditional Logistic multiariate analysis,age,ICU patients live time,antibiotics use time,hormone use time,albumin level was acute exacerbations of COPD factors such as pulmonary fungus infection independent risk factors(P ＜0.01) ;Fungus infection were combined with antimycotic,cured 69 cases (83.13％) improved 12 cases (14.46％),there was no change in 1 case(1.20％),death 1 case (1.20％).Conclusion Patients older age,live long,long time ICU antibiotics and hormones and the low level of albumin is acute exacerbations of COPD pulmonary fungus infection independent risk factors,timely diagnosis and prognosis of patients with antifungal treatment is good.
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Ultrasound imaging is a valuable tool in the detection of breast lesions, and the breast imaging and reporting data system (BI-RADS) guides the ultrasound diagnosis of breast lesion to improve the diagnosis accuracy. The research of breast ultrasound computer-aided diagnosis (CAD) with BI-RADS-US is a hot topic now. In this paper, we reviewed the research progress of breast ultrasound CAD with BI-RADS-US, summarized the present problems, and discussed the future development.
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Female , Humans , Algorithms , Artifacts , Breast Neoplasms , Diagnostic Imaging , Diagnosis, Computer-Assisted , Methods , Information Systems , Reference Standards , Sensitivity and Specificity , Ultrasonography, Mammary , MethodsABSTRACT
Objective To study the influence of dl-3n-butyphthalide on serum C-reactive protein(CRP)level in patients with acute cerebral infarction.Methods A total of 68 patients with acute cerebral infarction were chosen and divided into two groups randomly.Both the groups were treated with normal method and the treatment group was given dl-3n-butyphthalide 200 mg,tid.Serum CRP levels in the two groups were measured by immunoturbidimetry within 24 h after final diagnosis and at two weeks after treatment.Results Serum CRP levels all increased in the patients.After treatment for two weeks the level decreased obviously in treatment group.The difference was significant compared with control group.Conclusion The dl-3n-butyphthalide can markedly decrease the serum CRP level in acute cerebral infarction patients and has important significance for the pathogenetic condition change and prognosis of cerebral infarction.