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Objective To investigate the abnormalities of gray matter volume in obsessive-compulsive disorder (OCD) patients relative to controls using the method of voxel-based morphometry (VBM), and to analyze the extent of change relative to clinical symptom. Methods Using VBM to compare the MRI images of 31 adult OCD patients with 31 healthy controls. Correlation analyses were conducted between the structural abnormalities of gray matter volume in each brain area among patients relative to their clinical scores. Results Compared with the healthy controls, the OCD patients showed reductions of gray matter volume in left putamen, insula, premotor area, superior parietal and right angular gyrus (P<0.01, Alphasim corrected). The gray matter volumes of left putamen and insular in the OCD patients showed a negative correlation with the Beck anxiety inventory (BAI) scores. Conclusion The changes in gray matter volumes of left putamen, insula, premotor area, superior parietal lobule and right angular gyrus may be related to the pathogenesis of OCD. The declines of left putamen and insula are related to the abnormal anxiety in the OCD patients.
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Cirrhosis is the end stage of chronic liver disease. For some patients it is difficult to identify the cause of cirrhosis. Imaging and histopathological examination are important methods for assessing the degree and stage of cirrhosis and identifying the cause of cirrhosis. This article reviews the imaging and pathological feature of cirrhosis and how to identify cause of cirrhosis with unknown pathogen.
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Objective To explore the effect of aripiprazole combined with risperidone on serum prolactin and glucolipid metabolism in male patients with schizophrenia. Methods A total of 113 male patients with schizophrenia who were treated with risperidone in the Second Affiliated Hospital of Xinxiang Medical University from October 2016 to May 2017 were select-ed. The patients were randomly divided into observation group and control group. Fifty-nine patients in the control group were given risperidone 4 - 6 mg·d - 1 orally,while fifty-four patients in the observation group were given risperidone 4 - 6 mg·d - 1 combined with aripiprazole 10 mg·d - 1 orally,the course of treatment was 8 weeks. The serum prolactin(PRL)levels were measured before treatment and at 2,4,8 weeks after treatment. Positive and negative syndrome scale(PANSS)was used to eval-uated the psychiatric symptoms in the two groups before treatment and at 4,8 weeks after treatment. The levels of fasting plas-ma glucose(FPG),total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL),high density lipoprotein(HDL), body mass index(BMI)were measured in the two groups before treatment and at 4,8 weeks after treatment. Results A total of 113 patients completed the experiment,with 53 cases in the observation group and 59 cases in the control group. There was no significant difference in the level of PRL,FPG,TC,TG,HDL,LDL and the total score,positive symptom score,negative symptom score,general pathologic score of PANSS and BMI between the two groups before treatment(P > 0. 05). At 2,4,8 weeks after treatment,the level of PRL in the control group was higher than that before treatment(P < 0. 05),and in the obser-vation group it was lower than that before treatment(P < 0. 05). Compared between any two time points,there was significant difference in the PRL level at 2,4,8 weeks after treatment in the two groups(P < 0. 05). Compared with the control group,the level of PRL in the treatment group was significantly lower at 2,4,8 weeks after treatment (P < 0. 01). The total score,positive symptom score,negative symptom score,general pathologic score of PANSS in the two groups at 4,8 weeks after treatment were lower than those before treatment and at 4 weeks after treatment (P < 0. 05). The total score,positive symptom score,negative symptom score,general pathologic score of PANSS in the two groups at 8 weeks after treatment were lower than those at 4 weeks after treatment(P < 0. 05). The total score,negative symptom score,general pathologic score of PANSS in the observation group at 4,8 weeks after treatment were lower than those in the control group(P < 0. 05),but there was no significant difference in the positive symptom score of PANSS between the two groups at 4,8 weeks after treatment(P > 0. 05). There was no significant difference in the level of FPG,TC,TG,HDL,LDL and BMI in the control group at 4,8 weeks after treatment compared with that before treatment(P > 0. 05). There was no significant difference in the level of FPG,TC,TG,HDL,LDL and BMI in the observation group at 4 weeks after treatment compared with that before treatment(P > 0. 05). There was no significant differ-ence in the level of FPG,TC,TG,HDL in the observation group at 8 weeks after treatment compared with that before treatment and at 4 weeks after treatment(P > 0. 05). But the level of LDL and BMI in the observation group at 8 weeks after treatment were lower than those before treatment and at 4 weeks after treatment(P < 0. 05). There was no significant difference in the level of FPG,TC,TG,HDL,LDL and BMI between the observation group and the control group at 4 weeks after treatment(P >0. 05). There was no significant difference in the level of FPG,TC,TG,HDL between the observation group and the control group at 8 weeks after treatment (P > 0. 05). But the level of LDL and BMI in the observation group at 8 weeks after treatment were lower than those in the control group(P < 0. 05). At 8 weeks after treatment,the incidence rate of akathisia,thirst,somno-lence,tremor,nausea and salivation in the control group was 5. 08％,10. 16％,10. 16％,15. 25％,6. 77％,11. 86％,respec-tively;the incidence rate of akathisia,thirst,somnolence,tremor,nausea and salivation in the observation group was 3. 70％, 14. 81％,9. 25％,16. 67％,11. 11％,9. 26％,respectively. There was no significant difference in the incidence rate of akathi-sia,thirst,somnolence,tremor,nausea and salivation between the two groups(χ2 = 0. 207,0. 106,0. 159,0. 326,0. 091,0. 162;P > 0. 05). Conclusion Risperidone combined with aripiprazole in the treatment of male schizophrenia patients is beneficial to reduce the level of serum high PRL induced by risperidone and to improve lipid metabolism.
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<p><b>OBJECTIVE</b>To evaluate the changes in programmed death 1 (PD-1) and programmed death ligand 1 (PD-L1) expression on peripheral blood T lymphocytes of patients with chronic hepatitis C (CHC) over the 24 weeks course of antiviral therapy.</p><p><b>METHODS</b>Twenty-four CHC patients administered 24 weeks of combination antiviral therapy with pegylated-interferon-alpha-2a (Peg-IFNa-2a) and ribavirin (RBV) were enrolled for study from the Nanjing Second Hospital between October 2008 and October 2011. Peripheral blood was collected before treatment initiation, at treatment weeks 4, 12 and 24, and post-treatment week 24 (to investigate sustained virologic response (SVR), and used to measure expression of PD-1 and PD-L1 on CD4+ and CD8+ T lymphocytes by flow cytometry, load of serum hepatitis C virus (HCV) RNA by real-time polymerase chain reaction, and level of serum alanine aminotransferase (ALT) by auto-biochemical analyzer. Intergroup differences were analyzed by the two-sample t-test, and the significance of differences between pre- and post-treatment measurements was determined by one-way or two-way repeated measurements analysis of variance tests.</p><p><b>RESULTS</b>At treatment week 4, 19 of the CHC patients were HCV RNA-negative. Among those patients the PD-1 expression on both T lymphocyte subsets showed a significant decrease from pre-treatment to post-treatment week 24 (CD4+: 18.6 +/- 6.1% vs. 10.3 +/- 7.7%, F = 12.406, P = 0.002; CD8+: 16.6 +/- 13.8% vs. 9.4 +/- 4.6%, F = 4.955, P = 0.039). However, the CD8+ lymphocyte subset showed significant increase in PD-L1 expression during treatment (pre-treatment: 17.5 +/- 13.7% vs. treatment week 4: 25.9 +/- 11.1%, F = 9.063, P less than 0.01; 12: 29.6 +/- 15.1%, F = 8.365, P less than 0.01; 24: 32.0 +/- 15.7%, F = 9.736, P less than 0.01). Among the five CHC patients showing HCV RNA-positivity at treatment week 4 there was only a significant difference observed in the increased expression of PD-L1 on CD8+ lymphocyte subset from pre-treatment to treatment week 24 (17.4 +/- 16.7% vs. 39.2 +/- 15.6%, F = 10.292, P = 0.033). Twenty of the CHC patients achieved SVR. among whom the PD-1 expression was significantly decreased during treatment on the CD4+ lymphocyte subset (pre-treatment: 20.2 +/- 7.5% vs. treatment week 4: 14.4 +/- 7.5%, F = 6.133, P less than 0.05; 12: 14.0 +/- 6.9%, F = 5.541, P less than 0.05; 24: 10.7 +/- 7.6%, F = 14.780, P less than 0.05) and on the CD8+ lymphocyte subset (pre-treatment: 16.8 +/- 13.4% vs. treatment week 12: 10.2 +/- 4.6%, F = 4.964, P less than 0.05; 24: 10.1 +/- 4.9%, F = 4.613, P less than 0.05). Additionally, the PD-L1 expression was significantly increased during treatment on the CD8+ lymphocyte subset (pre-treatment: 19.0 +/- 14.5% vs. treatment week 12: 30.8 +/- 16.6%, F = 6.442, P = 0.020; 24: 35.2 +/- 16.5%, F = 12.349, P = 0.002). Among the four CHC patients who relapsed there were no significant differences observed in the expressions of PD-1 or PD-L1 on the CD4+ or CD8+ T lymphocytes.</p><p><b>CONCLUSION</b>The standard Peg-IFNa-2a + RBV combination antiviral therapy reduces PD-1 expression on CD4+ and CD8+ T lymphocytes and increases PD-L1 expression on CD8+ T lymphocytes in peripheral blood. The clinical outcome of CHC patients may be related to the antiviral therapy-induced changes in expressions of PD-1 and PD-L1 on T lymphocytes.</p>
Subject(s)
Humans , Antiviral Agents , Therapeutic Uses , Hepatitis C, Chronic , Drug Therapy , Interferon-alpha , Therapeutic Uses , Real-Time Polymerase Chain Reaction , Ribavirin , Therapeutic UsesABSTRACT
<p><b>OBJECTIVE</b>Conducting a meta-analysis to evaluate the efficacy of artificial liver support system (ALSS) in the treatment of hepatic failure in China.</p><p><b>METHODS</b>Clinical trials comparing ALSS vs. routine medical treatment of hepatic failure in China were identified from computer-based literature. The pooled odds ratio and 95% confidence interval (CI) of prognostic indicators, such as survival rate and clinical improvement rate at discharge, were used to measure the magnitude of the efficacy.</p><p><b>RESULTS</b>Ten trials including 1030 patients were identified. The odds ratio (95% CI) of survivorship or improvement of ALSS over routine medical treatment in early, intermediate and advanced stages of hepatic failure were 3.72 (2.03-6.83), 2.79 (2.88-4.14) and 1.85 (0.96-3.56) respectively.</p><p><b>CONCLUSION</b>ALSS treatment is more effective in early and intermediate stages of hepatic failure than routine medical treatment, but not in its advanced stage.</p>
Subject(s)
Humans , Liver Failure , Therapeutics , Liver, Artificial , Prognosis , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To establish a cell model of secreted alkaline phosphatase (SEAP) co-controlled by HCV 5'NCR and NS3 serine protease in an effort to develop new antiviral agents.</p><p><b>METHODS</b>The fragments of HCV 5'NCR and NS3/4A-SEAP were amplified by PCR. They were fused into pBluescript SK+ to generate 5'NCR-NS3/4A-SEAP chimeric plasmid. The resulting chimeric gene was subcloned into HindIII/Bsu36 I site of pSEAP2-Control (a SEAP eukaryotic expression plasmid), to generate pNCR-NS3/4A-SEAP, in which the SEAP was fused in-frame to the downstream of NS4A/4B cleavage site. The SEAP activity in the culture media of transiently transfected cells was monitored quantitatively. The regulatory effect of HCV 5'NCR and NS3 serine protease on SEAP expression was measured by treatment of transfected cells with antisense oligodeoxynucleotide (ASODN) against HCV 5'NCR and TPCK, a irreversible serine protease inhibitor.</p><p><b>RESULTS</b>The SEAP activity in the culture media reached 80801+/-4794 RLU, and was significantly inhibited by 5 micromol/L, 10 micromol/L of ASODN (t=4.315, p<0.01; t=6.985, p<0.001) and 100 micromol/L of TPCK (t=6.949, P<0.001).</p><p><b>CONCLUSION</b>A cell model of SEAP co-controlled by HCV 5'NCR and NS3 serine protease has been successfully established. This might promote the screening of anti-viral drugs</p>