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Objective@#To investigate the effects of direct-acting antiviral agents (DAA) therapy on the frequency of myeloid-derived suppressor cells (MDSC) and their subset of monocytic myeloid-derived suppressor cells (M-MDSC) in chronic hepatitis C (CHC) patients.@*Methods@#A total of 32 treatment-naive CHC patients and 16 healthy controls were recruited at Third Affiliated Hospital of Sun Yat-Sen University from June 2016 to June 2017. The peripheral blood mononuclear cells (PBMC) were separated from the peripheral blood of patients with CHC before DAA therapy, at four weeks after DAA therapy, at 12 weeks after DAA therapy and 12 weeks after the end of DAA therapy. The frequencies of MDSC and M-MDSC were detected by the flow cytometer. The t test, U test and chi-square test was employed to analyze the data.@*Results@#All the 32 treatment-naive patients achieved the rapid virological response and no virological breakthrough was observed. Before DAA therapy, the frequency of MDSC in CHC patients was 2.18%, which was higher than healthy individuals (0.60%; Z=-4.593, P<0.01), and positively correlated with the plasma levels of hepatitis C virus (HCV) RNA (r=0.688, P<0.01) and aspartate aminotransferase (r=0.735, P<0.01). After four weeks of DAA therapy, the frequency of MDSC decreased significantly to 1.07%, with no statistical significance compared to the controls (Z=-1.221, P>0.05). However, at 12 weeks after DAA therapy, the MDSC frequency increased, with statically significance compared to the controls (1.64% vs 0.60%, Z=-3.117, P=0.002). At 12 weeks after the end of DAA therapy, the MDSC frequency had decreased to 1.29% again, with no statistical significance compared to the controls (Z=-1.387, P=0.664). The changes of M-MDSC frequency were slightly different. Before DAA therapy, the frequency of M-MDSC in CHC patients was higher compared to healthy controls (1.66% vs 0.81%, Z=-2.745, P<0.01). The frequencies of M-MDSC were 0.91%, 1.09% and 1.10% at four, 12 weeks after DAA and 12 weeks after the end of DAA therapy, respectively. The differences were not statistically significant compared to the controls (Z=-0.589, -1.028 and -0.486, respectively, all P>0.05).@*Conclusion@#Immune status of the peripheral MDSC and M-MDSC can return to normal after DAA therapy in CHC patients.
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Objective To investigate the effects of direct-acting antiviral agents (DAA) therapy on the frequency of myeloid-derived suppressor cells (MDSC) and their subset of monocytic myeloid-derived suppressor cells (M-MDSC) in chronic hepatitis C (CHC) patients.Methods A total of 32 treatment-naive CHC patients and 16 healthy controls were recruited at Third Affiliated Hospital of Sun Yat-Sen University from June 2016 to June 2017.The peripheral blood mononuclear cells ( PBMC) were separated from the peripheral blood of patients with CHC before DAA therapy , at four weeks after DAA therapy , at 12 weeks after DAA therapy and 12 weeks after the end of DAA therapy.The frequencies of MDSC and M-MDSC were detected by the flow cytometer.The t test, U test and chi-square test was employed to analyze the data.Results All the 32 treatment-naive patients achieved the rapid virological response and no virological breakthrough was observed . Before DAA therapy, the frequency of MDSC in CHC patients was 2.18%, which was higher than healthy individuals (0.60%; Z＝-4.593, P＜0.01), and positively correlated with the plasma levels of hepatitis C virus (HCV) RNA (r＝0.688, P＜0.01) and aspartate aminotransferase (r＝0.735, P＜0.01).After four weeks of DAA therapy, the frequency of MDSC decreased significantly to 1.07%, with no statistical significance compared to the controls ( Z＝-1.221, P＞0.05).However, at 12 weeks after DAA therapy , the MDSC frequency increased , with statically significance compared to the controls (1.64%vs 0.60%, Z＝-3.117, P＝0.002).At 12 weeks after the end of DAA therapy , the MDSC frequency had decreased to 1.29%again, with no statistical significance compared to the controls ( Z ＝-1.387, P ＝0.664).The changes of M-MDSC frequency were slightly different.Before DAA therapy, the frequency of M-MDSC in CHC patients was higher compared to healthy controls (1.66%vs 0.81%, Z＝-2.745, P＜0.01).The frequencies of M-MDSC were 0.91%, 1.09% and 1.10% at four, 12 weeks after DAA and 12 weeks after the end of DAA therapy , respectively.The differences were not statistically significant compared to the controls (Z＝-0.589,-1.028 and -0.486, respectively, all P＞0.05).Conclusion Immune status of the peripheral MDSC and M-MDSC can return to normal after DAA therapy in CHC patients.
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Objective To analyze the clinical distribution and drug resistance of Staphylococcus aureus isolated from the speci‐mens of inpatient and outpatient in 2013 .Methods All of the isolated Staphylococcus aureus were identified and tested drug sensi‐tivity in 2013 ,and the results were analyzed .Results 286 strains of Staphylococcus aureus were isolated with the detection rate of MRSA accounting for 46 .9% .The respiratory specimens had the highest detection rates of Staphylococcus aureus and MRSA .The isolated strains of Staphylococcus aureus were mainly distributed in ICU ,Department of Neurosurgery ,Department of Orthopedic trauma ,and Department of Respiratory Medicine .The isolated Staphylococcus aureus had high drug resistant rates to penicillin and ampicillin .The drug resistant rates of most of the drugs were different between MSSA and MRSA .Conclusion Monitoring the drug resistance of Staphylococcus aureus is very important to rational choice of antimicrobial agents .
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Objective To study the clinical characteristics and HBeAg status in HBV liver cirrhosis patients with different HBV DNA levels, Method Three hundred and thirty-seven patients with liver cirrhosis caused by chronic HBV infection were investigated. HBV DNA levels were detected by PCR, and HBV markers were detected by MEIA. The ratio of patients with HBeAg positive or negative in groups with different HBV DNA levels was compared, and the clinical characteristics in patients with different HBV DNA levels and HBeAg status were evaluated. Results The positive ratio of HBV DNA and HBeAg were 80.4% (271/337) and 31.5% (106/337). The negative ratio of HBeAg was 68.5% (231/337). The proportion of patients with Child-Pugh grade A, B or C and hepatocellular carcinoma (HCC) in different groups of HBV DNA levels and in different HBeAg status showed no significant difference, but the ratio of HCC in patients with HBV DNA 3-4 lg copies/ml was higher than that in patients with HBV DNA <3 lg copies/ml (P=0.014) and ≥7 lg eopies/ml (P =0.009). No significant difference of HBV DNA levels was found in different age groups, but the negative ratio of HBeAg increased with the increasing of the age. Conclusions More than 80% of patients with liver cirrhosis caused by chronic HBV infection axe HBV DNA positive, and 2/3 of them are HBeAg negative. Suppressing HBV replication may improve the prognosis of HBV related cirrhosis and HCC.
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Objective To investigate whether the spleen diameter,serum albumin and periphefial blood cells might be as non-invasive predictive indicators for the presence of esophageal varices(EV)in patients with liver cirrhosis.The predictive values of these parameters to the large esophageal varices were evaluated.Methods OBe hundred and sixty-seven patients with liver cirrhosis underwent endoscopic examination.Among them,127 patients(mild in 41,medium in 38,severe in 48)were found with EV and 40 patients without(NEV).The diameters of portal vein and spleen vein,the sizes of spleen and the ratio of platelet count/spleen size were examined by Doppler ultrasound.The platelet count and the level of albumin were calculated.Results The average of age,diameter of portal vein and spleen vein,and sizes of spleen were higher in EV group than those in NEV group,while the platelet count,the level of albumin and the ratio of platelet count/spleen size in EV groups were lower than those in NEV group.Multifactor analysis revealed that the index related to serious EV were the blood platelet count(＜70×109/L),the ratio of platelet count/spleen size(＜1.0)and albumin level (＜35 g/L).Conclusions The degree of EV in patients with liver cirrhosis were paralleled with the degree of portal hypertension.The patients who present with platelet count＜70×109/L,or platelet count/spleen size＜1.0 or albumin＜35 g/L should be considered as EV,and endoscopic examination is needed.
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The research is focused on the current situation and shortcomings in teaching of practical physical diagnostics.In the experimental group regular teachers are in charge of teaching and strengthening the physical examination training of students,and in the contrast group the teaching missions are distributed to different teachers in different departments,and the differences of the teaching effects between the two groups are thus discussed.The result reveals that the scores of the physical examination test in the experimental group is better than that in the contrast group,and the difference is significant(P
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Objective To assess the effects of early correction of anemia with recombinant human erythropoietin (rHuEPO) on the development and progression of left ventricular hypertrophy (LVH) in patients with mild-to-moderate chronic renal insufficiency (CRI) who are not on hemodialysis. Methods A total of 158 patients with serum creatinine from 147μmol/L to 400μmol/L were nrolled in this prospective, multicenter study. Eighty-six patients with hemoglobin (Hb)＜110g/L received rHuEPO treatment with a target Hb of ≥110g/L (Group A). Forty patients with comparable Hb concentration (＜110g/L) but did not receive rHuEPO (Group B) and 32 patients with Hb≥110g/L and without rHuEPO treatment (Group C) were served as controls. Left ventricular mass index (LVMI) was evaluated by echocardiography at baseline and every 3 months for 2 years. Results There was no difference in age, gender, etiology of renal failure, blood pressure and cardiovascular risk factors among the 3 groups. At baseline, the prevalence of LVH was 72.1% in group A,72.5% in group B and 59.4% in group C. LVMI was inversely correlated with Hb levels (r=0.70, P＜0.01). During the 2-year period, the mean LVMI decreased from 142.6±25.7g/m2 to 132.4±18.5 g/m2 in group A, while increased significantly in both group B and group C. The mean Hb concentration increased from 93.8±14.6g/L to 111.2±10.3g/L (P＜0.05) in group A, but tended to decrease in group B and group C. There was no significant change of the mean blood pressure, number of anti-hypertensive drugs and serum creatinine concentrations in all 3 groups. However, patients' serum creatinine doubled more often in group B and group C than in group A.Conclusions LVH was common in predialysis CRI patients and was associated with the severity of anemia. Early intervention with rHuEPO may reverse LVH in these patients.
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OBJECTIVE:To analyze the characteristics and regularity of cross allergic reaction between carbopenems and penicillin.METHODS:2 cases about cross allergic reaction between ertapenem and penicillin were reported,716 cases of cross allergic reaction between carbopenems and penicillin in 9 literatures were collected from databases from Jan.1986 to Jan.2010 and analyzed statistically.RESULTS:The incidence of allergic reactions caused by carbopenems in patients with allergic history were higher than that in patients without allergic history.Allergic reaction mostly occurred within 15 min～49 d.Sound therapeutic efficacy can be achieved because of immediate withdrawal of drug and anti-allergy treatment,patients were with good prognosis.CONCLUSION:Great importance should be attached to monitoring of cross allergic reaction between carbopenems and penicillin and rational use of drugs.