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The clinical data of 4 patients with atypical neurosyphilis (NS) mimicking viral encephalitis (VE) admitted to Beijing Ditan Hospital from July 2015 to January 2020 were retrospectively analyzed. All the 4 patients were males with an average age of (43±8) years. The patients manifested with mental and behavior disorders and cognitive impairment. Three patients had epilepsy and 1 patient had fever. The treponemal pallidum particle agglutination (TPPA) , fluorescent treponemal antibody-absorption test (FTA-ABS) -IgG and toluidine red unheated serum test (TRUST) were all positive in blood and the cerebral spinal fluid (CSF) , and white blood cell count and protein level in CSF were all evaluated. The head MRIs were all abnormal, 3 of which showed hyperintensity in fluid attenuated inversion recovery (FLAIR) and T2-weighted image located in limbic system and 1 showed hyperintensity in the bilateral cortex and the subcortical areas. All patients improved evidently and the lesions became smaller after penicillin treatment. Atypical NS mimicking VE is rare, and at early diagnosis and timely treatments can contribute to a good clinical prognosis.
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The clinical manifestations,serum and cerebrospinal fluid (CSF) results,EEG and imaging findings of 4 cases of encephalitis with positive leucine-rich glioma inactivated protein 1 (LGI1)antibody admited from March 2017 to January 2019 were retrospectively analyzed.All 4 patients were males with a mean age of (42±17) years.Two patients had faciobrachial dystonic seizure(FBDS)as the main symptom,and 3 patients had epilepsy.There were normal blood sodium and no memory deficits in all 4 patients.The LGI1 antibody was positive in the serum and negative in the CSE.The longest diagnosis time was 5 months.The head MRIs were normal in 3 patients;and abnormal signals in the right basal ganglia were found in one case,and the lesicl became smaller after the treatment.Chest CT,abdominal CT,and pelvic CT did not detect tumors.All patients were treated with gamma globulin and glucocorticoids,they all had good prognosis.LGI1 antibody-positive encephalitis is mainly characterized by epilepsy. ldentifying FBDS would be helpful for early diagnosis.Timely treatments often result in good clinical prognosis.
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Objective To evaluate the efficacy of the new treatment regimen versus the standardized scheme for the initial treatment of smear-positive tuberculosis in the elderly.Methods A total of 302 elderly patients meeting the inclusion and exclusion criteria were selected from 14 tuberculosis-designated medical institutions in Beijing.The patients received the initial treatment of smear-positive tuberculosis from January 2014 to August 2016 in the combined prospective and retrospective study.All patients were divided into observation group(n=63)receiving treatment with 6L2 HELfx regimen from August 1,2015 to August 31,2016,and control group (n =239) receiving treatment with 6L2HELfx regimen from January 1,2014 to January 31,2015.The nation-unified standard chemotherapy regimen 2RHZE/4RH was used in tuberculosis medical service institutions for all patients.The differences between the two groups were analyzed and compared in the completion of treatment,negative conversion of sputum culture or smear,adverse drug reactions and treatment outcome.Results The completion rate of long-course therapy was significantly higher in the observation group than in control group [90.5％ (57/63) vs.79.5％ (190/239),x2 =4.034,P =0.045].The rate of negative conversion of sputum culture or smear at the end of the 2nd month was higher in the observation group than in control group,but had no significant difference[87.0％ (47/54)vs.81.6％(155/190),x2 =0.879,P=0.349].The incidence of adverse reactions was much lower in observation group than in control group[46.0％ (29/63) vs.65.3％ (156/239),x2 =7.777,P =0.005].The success rate of treatment(cure or completion of long-course therapy)was higher in observation group than in control group [90.5％ (57/63) vs.77.4％ (185/239),x2 =5.350,P =0.021].ConclusioNS As compared with the standard chemotherapy regimen,the L and Lfxcontaining treatment regimen has better effects,higher success rate of treatment and less adverse reactions in elderly patients with the initial treatment of smear-positive tuberculosis.
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Objective To prepare the vascular endothelial grow th factor receptor 2 ( VEGFR2 )/Integrinαv β3 dual‐targeted contrast ultrasound agent ,and further evaluating the physical properties ,imaging characteristics and targeted ability in v itro . Methods VEGFR2 targeted microbubble ( MBV ) ,Integrinαv β3 targeted microbubble ( MBI) and VEGFR2/Integrinαv β3 dual targeted microbubble ( MBD) were prepared by attaching VEGFR2 antibody ,Integrinαv β3 antibody and both of VEGFR2/Integrinαv β3 antibody with no targeted USphere LA respectively , using biotin‐avidin linkage method . USphere LA with no antibody attached were used as non‐targeted microbubble( MBN ) . M icrobubble′s physical properties were observed , and its stability was detected by caculating bubble′s concentration at different time points . MBD′s ultrasound imaging characteristics were evaluated by comparing its grey level of ultrasound imaging with SonoVue at the time of preparation and 3 days after preparation . To detect the targeted ability of microbubble ,different types of microbubble were added into Hepa 1‐6 and C3H10 cells ,respectively . T he above procedure was repeated using the pre‐antibody blocking test in Hepa 1‐6 cell . Results MBD had a mean size of 1 256 nm .T he concentration of microbubble in the first duration of three days was declining slowly ,and its speed was accelerated after five days of preparation . T he grey level of new prepared MBD was similar to that of SonoVue in the same concentration ( P ＝0 .113) ,while the level was higher than that of SonoVue within 3 days after preparation( P ＜0 .001) . T he number of microbubble binding to Hepea1‐6 led a tendency of MBD＞ single targeted microbubble ＞ MBN ( all P ＜0 .05 ) . T he number of C3H10 and pre‐blocked Hepa1‐6 cell attached to each group of microbubble had no statistical difference ( all P ＞0 .05) . In addition ,following the pre‐blocked precedure ,the number of Hepa 1‐6 cell attached to each group of microbubble had no statistical difference either ( all P ＞ 0 .05 ) . Conclusions VEGFR2/Integrinαv β3 dual‐targeted contrast ultrasound agent is a stable microbubble and it has excellent ultrasound imaging and targeting ability in v itro .
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Objective To research the pyrazinamide drug susceptibility of Mycohacterium tuberculosis,and provide reference for clinical medication and prevention.Methods Bactec MGIT 960 system was used to test the resistance of isoniazid,rifam picin,ethambutol,streptomycin and pyrazinamide for 153 strains of Mycobacterium tuberculosis.Results Of 153 Mycobacterium tuberculosis,34 were resistant to PZA,and the resistant rate was 22.2 ％.There was no PZA single drug resistance.A mong patients with and without INH resistance,RFP resistance,EMB resistance and Sm resistance,the proportions of PZA resistance were respectively 40.5 ％ (34/84) vs 0％(0/69),47.5％(29/61) vs 5.4％(5/92),75％(6/8) vs 19.3％(28/145),53.1％ (26/49) vs 7.7％ (8/104).Among the 54 multidrug-resistant (MDR) strains 53.7％ were resistant to PZA,which was significantly higher than 5.1 ％ (5/99) among the nonMDR-TB strains (x2 =47.854,P＜0.05).In multivariate logistic analysis,resistance to Sm (OR=0.270,95％CI:0.091～0.802) and MDR-TB (OR=0.281,95％CI:0.087～0.911) were risk factors to PZA resistance.Conclusion The PZA resistance rate among MDR-TB isolates was high.PZA resistance would be associated with SM resistance and MDR-TB.The drug susceptibility test for PZA is very important to MDR-TB patients.
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Objective To analyze the clinical characteristics of cerebral syphilitic gunma.Method The clinical characteristics,brain CT and MRI results and prognosis of 7 patients with cerebral syphilitic gumma admitted in Beijing Ditan Hospital from June 2012 to October 2016 were retrospectively analyzed.Results There were 5 females and 2 males in 7 patients.The symptoms or signs at onset were headache (n =5),increased white blood cells in cerebrospinal fluid (n =6) and increased protein contents in cerebrospinal fluid (n =6).Total 10 lesions were detected in 7 cases,including 7 in cerebral lobe,and 3 in cerebellum,corpus callosum or intercrural space.The brain MRI showed nodular reinforcement in 5 cases,irregular circular reinforcement in 2 cases and obvious edema around the lesions in 6 cases.The patients were given intravenous infusion of 400 million units common penicillin,q.4h for 2 wks,sequential intramuscular injection of 240 million units long-term penicillin q.w for 3 wks.Among 7 patients,1 case died,1 case showed symptomatic improvement and 5 cases obtained complete improvement with the significant imaging improvement.Conclusion Headache is the most common symptom at onset of cerebral syphilitic gumma,and the lesions mostly are located in the cerebral lobes with nodular enhancement in brain imaging,and the prognosis is generally good.
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Objective To explore the clinical significance of B7 family homology factor-3 (B7-H3),an expression membrane type of myeloid-derived suppressor cell (MDSC),in patients with acute pancreatitis (AP).Methods A total of 63 patients with AP initially treated in the Emergency Department at the First Affiliated Hospital of Soochow University from January,2014 to December,2015 were selected.Of them,25 suffered from mild AP (MAP),20 had moderate AP (MSAP) and 18 had severe AP (SAP).Another 20 healthy subjects with matching age and gender served as the control group.All patients with AP conformed to the diagnostic criteria of Guidelines or Diagnosis and Treatment of Acute Pancreatitis set in 2013 in China.Patients with other underlying diseases that might influence the clinical outcomes were excluded,including those with tumors,autoimmune diseases,viral infections,trauma and other disorders.A flowcytometer was used to detect the expression rate of MDSC in peripheral venous blood and the expression of B7-H3 on MDSC membrane.The continuous monitoring was carried out for 24 h,48 h and 72 h in patients with AP.Results Compared with healthy subjects,the MDSC cells in patient groups 24 hours after AP onset increased notably (P ＜0.01) especially the highest increase in the SAP group,followed by the MSAP group and the lowest in the MAP group.There were significant differences in pairwise comparisons (P ＜ 0.05).From successive observation of each group,there was no significant difference in MDSC between the MAP group and the MSAP group 24 hours,48 hours and 72 hours after AP onset.However,MDSC reached its peak 48 hours after AP onset,but it declined 72 hours after AP onset in the SAP group (P ＜ 0.05).B7-H3 expressed significantly 24 hours after AP onset,but there was no expression of B7-H3 in the healthy group.Meanwhile,B7-H3 was expressed most highly in the SAP group,followed by the MSAP group and lowest in the MAP group.There were significant differences in expression of B7-H3 found in pairwise comparisons (P ＜ 0.05).The successive observation showed that there was no significant difference in B7-H3 expression between the MAP group and the MSAP group 24 hours,48 hours and 72 hours after AP onset.However,there was a trend of increase in B7-H3 expression as time prolonged found among 24 hours,48 hours and 72 hours after AP onset in the SAP group (P ＜ 0.05).Conclusions The expressions of MDSC and B7-H3 were high in AP,and there were significant differences in both expressions among MAP,MSAP and SAP groups.These phenomena offer clues in further understanding about the immunological disorders during AP giving better guidelines for clinical practice.
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Objective The aim of this study was to investigate how different concentrations of dextran sulfate sodi-um ( DSS) influence the establishment of mouse model of inflammatory bowel disease ( IBD) and the effect of DSS on the expression of colitis-associated immune factors.Methods The DSS solution in different concentrations (3%, 5%, 7%) were given to male C57BL/6J mice to generate mouse inflammatory bowel disease model.The IBD mice were observed by defecation characteristics, body weight, and survival time.The animals were sacrificed at 6 days after the start of DSS drinking.The general appearance of colons was observed and scored.Moreover, the pathological changes of the colon were examined and analyzed by routine histology.The expression of immune factors in the spleen was detected by real-time PCR.Results The mice in the 3%, 5%, 7% DSS groups developed murine colitis.In addition, the incidence of IBD and mouse mortality rate was directly proportional to the increase of DSS concentration.Furthermore, the higher concentra-tion of DSS induced the expression of proinflammatory factors including TNF-α, IFN-γand IL-17A, but cause a decrease of anti-inflammatory factors such as IL-4, IL-10 and Treg-related transcription factor Foxp3.Conclusions Our data suggest that giving 5%DSS solution to C57BL/6J mouse is appropriate to efficiently establish a murine IBD model.This laid an important foundation for further studies of the pathogenesis of IBD, biological characteristics, and intervention factors.
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Objective To explore the clinical features of female recurrent major depression(MD) patients with and without suicidal ideation.Methods 301 female recurrent major depression patients were interviewed by specially trained interviewers using computer evaluation system and divided into suicidal ideation group and non-suicidal ideation group according to suicidal ideation.The comparisons between the two groups were investigated on items of demographic, clinical data, assessment of psychopathology, Eysenck neuroticism questionnaire, stressful life events.Results 66.4％ of MD patients have suicidal ideation.Compared with non-suicidal ideation group, there were more total number of MD symptoms (8.58±0.77, OR=2.476, P=1.154× 10-9) and melancholia symptoms (6.74±1.07, OR=1.546, P=0.001) and it was more common in the factors of less appetite (OR=2.201, P=0.011), lose weight (OR=2.030, P=0.004), early morning awakening (OR=1.774, P=0.045), worthless (OR =2.352, P=0.014), impaired decision-making (OR=2.044, P=0.018), hopelessness (OR=7.130, P=6.651 × 10-9) ,helpless (OR=2.046, P=0.049) in suicidal ideation group.Also in suicidal ideation group the scores of neuroticism dimension (OR=1.631, P=0.024) were higher, and they were more suffered from stressful life events (OR=1.302, P=0.008).Binary logistic regression analysis indicated that total number of MD symptoms (OR=4.840, P=1.154×10-8) ,stressful life events (OR=1.392, P=0.014) and hopelessness (OR=3.528, P=0.008)were significantly associated with suicidal ideation.Conclusion Specific clinical features are associated with suicidal ideation among female patients of recurrent depression disorder.Hopelessness, stressful life events are risk factors of suicide ideation in female recurrent major depression patients.Integrated clinical assessment should be taken for recurrent major depression patients with suicidal ideation.
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Objective To explore the clinical features of female diagnosed recurrent major depression (MD) comorbidity with general anxiety disorder (GAD).Methods 301 females patients with recurrent major depression were interviewed by specially trained interviewers with using computer evaluation system and divided into comorbidity group and non-comorbidity group according to whether comorbid MD with GAD or without GAD.The comparison between the two groups included items of demographic,clinical data,assessment of psychopathology,Eysenck neuroticism questionnaire (EPQ),stressful life events,parental bonding instrument.Results 25.2％ of patients of MD coexistence GAD.There was no significant difference in sociodemographic data between the two groups.Significant differences among total number of depression symptoms(OR=1.439,95％ CI =1.049-1.975,P =0.024),duration of illness(OR=1.253,95％ CI =1.010-1.475,P=0.048),psychomotor agitation(OR=2.031,95％ CI =1.123-3.676,P=0.019),suicidal thought(OR=2.228,95％ CI =1.010-4.912,P=0.047),anxiety(OR =5.547,95％ CI =1.935-15.896,P=0.001),irritable(OR=1.956,95％ CI =1.081-3.542,P=0.027) were identified between the two group.In the comorbidity group,the score of nenroticism dimention derived from EPQ was also higher(OR=2.287,95％ CI =1.674-3.124,P=2.287× 10-7) than that of non-comorbidity group.There was no significant difference of stressful life events between two groups(OR=1.118,95％ CI =0.913-1.368,P=0.280).Conclusion This study suggests the phenomena that female patients of recurrent depression disorder comorbidity with general anxiety disorders is common in clinical.The patients comorbid MD and GAD have more symptoms,neuroticism and be worse in severity.
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Objective: Through treatment based on differentiation of symptoms and signs and classification of defi nited patients of maternofetal blood group incompatibility, detecting anti-A or Anti-B antibody and erythrocyte immune complex chaplet rate(RICR) and erythrocyte receptor chaplet rate(RC3bR) , etc, to observe the therapeutic effect and mechanism of prescriptions mainly with Yinchenhao Decoction. Methods: Patients definited maternofetal blood group incompatibility were divided into control group and observation group according to random principle in 1:3 ratio. Then, observation group was divided into moist heat group(SRG), moist heat and defi ciency of spleen qi group (SR+PQXG) and moist heat and defi ciency of kidney qi group(SR+SQXG) according to syndrome differentiation. Corresponding prescriptions were used, every 30 doses 1 course. Before and after treatment, the anti-A or anti-B antibody and RICR, RC3bR were detected in peripheral blood. Results: In Yinchenhao Decoction group with 21 cases, the anti-A or anti anti-B antibody decreased, including 5 case (1:64) and 4 case (1:32). In group of syndrome differentiation with 63 cases, the anti-A or anti anti-B antibody decreased, including 33 case(1:64) and 20 case (1:32). Before and after treatment, RICR of control group and observation group were(19.43?5.29), (19.57?6.50)and (20.59? 7.96), (23.77?5.12), respectively. RC3bR were(11.62?4.16), (12.42?6.60)and(11.93?4.10), (13.96?6.40)respectively. There was signifi cant difference of before and after treatment in obserbation group(P0.05). Conclusion: In cutting down anti-A and anti-B antibody, and increasing RICR and RC3bR fi eld, the observation groups were better than control group.
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Objective To study the changes of platelet function in patients with hypertensive disorder complicating pregnancy (HDCP). Methods Forty non-pregnant women, 40 normal late pregnant women and 50 women with HDCP were in cluded in this study. Platelet count were determined by cell-DYN, the platelet alphagranule membrane protein (GMP-140) by radio-immunoassay and thrombosis bla smixgenz (TXB_2) and ?tissue platelet protein (?-tg) by ELISA. Platelet aggregation rate (Pagt) and pletelet adhesion rate (PADT) were also measured. Results The platelet count in non-pregnant, late pregnant and HDCP group were (206?48)?109/L, (204?52)?109/L and (172?51)?109/L, respectively, and that in the HDCP group was significantly lower than the other two. The levels of GMP-140, TXB_2, ?-TG, PAdT and PAgT were (7.9?2.8) ?g/L, (73.6?40.8) ng/L, (16.3?9.5) ?g/L, (18?9)% and (28?10)% in the non-pregnant group, (12.2?3.8) ?g/L, (80.0?39.6) ?g/L, (18.5?9.8) ?g/L, (20?8)% and (29?10)% in the late pregnant group and (25.1?3.8) ?g/L, (107.6?32.8) ng/L, (23.9?9.2) ?g/L, (30?10)% and (40?12)% in the HDCP group. All the above values in the HDCP group were significantly higher than those in the other two groups (P
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The fibronectin was purified from human plasma by Gelatin-Sepharose 4B affinity chromatography. The rabbits were immunized with the fibronectin. the raw anti-fibronectin sera were absorbed bythe solid phase of the fibronectin free human serum. Then the specific anti-fibronectin sera were obtained. The fibronectins deposited on human bullet wounds, incised wounds as well as on blunt forceinJuries were demonst.ated by PAP immunohistochemical study using diluted anti-fibronectin serum.The results were quite sati factory.