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Objective: To predict the in-hospital incidence of acute respiratory distress syndrome (ARDS) in COVID-19 patients by developing a predictive nomogram. Methods: Patients with COVID-19 admitted to Changsha Public Health Centre between 30 January 2020, and 22 February 2020 were enrolled in this study. Clinical characteristics and laboratory variables were analyzed and compared between patients with or without ARDS. Clinical characteristics and laboratory variables that were risk factors of ARDS were screened by the least absolute shrinkage and selection operator binary logistic regression. Based on risk factors, a prediction model was established by logistic regression and the final nomogram prognostic model was performed. The calibration curve was applied to evaluate the consistency between the nomogram and the ideal observation. Results: A total of 113 patients, including 99 non-ARDS patients and 14 ARDS patients were included in this study. Eight variables including hypertension, chronic obstructive pulmonary disease, cough, lactate dehydrogenase, creatine kinase, white blood count, body temperature, and heart rate were included in the model. The area under receiver operating characteristic curve, specificity, sensitivity, and accuracy of the full model were 0.969, 1.000, 0.857, and 0.875, respectively. The calibration curve also showed good agreement between the predicted and observed values in the model. Conclusions: The nomogram can be used to predict the in-hospital incidence of ARDS in COVID-19 patients.
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@#Objective To explore the effects of PKD1 gene on mouse aortic smooth muscle (MOVAS) cells autophagy. Methods The shRNA and over-expression lentiviral vectors for the target gene of PKD1 were constructed. MOVAS cells were infected by a number of successful packaging shRNA (PKD1 knockdown) or ETS-1 (PKD1 over-expressing) lentiviral vectors, and qPCR was used to test interference and over-expressing effects. Then qPCR and Western blotting were used to detect the expression levels of autophagy markers including Atg5, Beclin1 and LC3 in control group, shPKD1 group and ETS-1 group. Results Compared with the control group, PKD1 mRNA level was decreased in the shPKD1 group (P<0.05); ETS-1 and PKD1 mRNA levels were increased in the ETS-1 group (P<0.05). In contrast with the control group, the mRNA levels of autophagy markers including Atg5 (P<0.05) and Beclin1 (P<0.01) were obviously decreased in the shPKD1 group, but they were obviously increased in the ETS-1 group (P<0.001). Protein levels of Atg5, Beclin1 and LC3 were significantly decreased in the shPKD1 group (P<0.05), but they were increased obviously in the ETS-1 group (P<0.05) in contrast with the control group. Conclusion PKD1 gene is involved in MOVAS cells autophagy, low expression of PKD1 gene can inhibit autophagy and high expression of PKD1 promotes autophagy in vascular smooth muscle cells.
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Objective To analyze the literature of snakebite and tetanus infection at home and abroad, and understand the situation of tetanus in snakebite patients.Methods The retrieval of China CNKI database, Wanfang database, VIP database and MEDLINE, Web of Science Embase and Science Direct database was performed with “snake bite” and “tetanus” as the key words, and the retrieval time from January 1953 to October 2017.Results A total of 98 articles was retrieved, which clearly records the snakebite patient data with tetanus has collected 8 literatures, Chinese 6 literatures, English 2 articles;a total of 16 patients, including 11 cases of Chinese, 4 in Nigeria, 1 in Thailand;the bite sites were limbs;9 patients with blood circulation the snake wound, 7 cases of mixed snakebite;snake bite patients with tetanus before;1 patients were injected with Tetanus Antitoxin, 13 patients were treated with Chinese herbal medicine on the wound, 2 patients were untreated.Prognosis analysis showed that in 16 cases, 12 cases were cured, 4 cases died, and the death of the patients had the history of herbal.Conclusions The prevention of tetanus infection should be strengthened in patients with extremities trauma, external application of herbs, blood based drugs, or mixed venomous snake bites.
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Objective To observe the results of broth dilution method and disc diffusion method to test the synergistic effect of Reduning and cefoperazone sodium / sulbactam sodium(SCF) on extensive drug resistant Acinetobacter bauman (XDR-AB) in vitro environment ,and compare their compliance to guide the clinical medication .Methods A total of 12 strains of XDR-AB from infec-tion patients in our hospital in 2015 were collected ,the strain was sub cultured .Firstly ,observe the minimum inhibitory concentra-tion (MIC) of SCF and Reduning on XDR-AB alone and in combination by broth dilution method .And then judge the synergy effects through calculation .Secondly ,the inhibition ring diameter and the synergy effects was detected using the disc diffusion meth-od .Results The MIC of Reduning and SCF in combination on XDR-AB was declined compared with them alone .The Fractional in-hibitory concentration of Reduning and SCF in combination on XDR-AB were equal or less than 0 .5 ,they had synergistic effect on XDR-AB .The inhibition ring diameter of Reduning was 10 mm tested by disk diffusion method .Different strains of XDR-AB on SCF bacteriostatic annulus diameter difference ,5 strains were 15 mm ,3 strains were 16 mm ,and 4 strains were 17 mm .Reduning and SCF appeared synergistic effect according to the inhibition ring diameter expanded when they effected on XDR -AB in combina-tion .Conclusion In vitro ,Reduning combined with SCF on XDR-AB has good synergistic effect .Compared with broth microdilution checkerboard dilution method ,disk diffusion method is more simple and convenient ,but it has a certain subjective on judging re-sults ,which is better to operate by experienced person .
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Objective To compare the efficacy of bowel-cleansing,patients′compliance, tolerability and side effects of different doses of polyethylene glycol(PEG)electrolyte solution for colonoscopy preparation.Methods Single-blind prospective randomized trial was performed.A total of 100 inpatients undergoing elective colonoscopy were randomized into three groups to receive 4 L PEG(n =35),2 L PEG (n =31)or 2 +1 L PEG(n =34),respectively,on the day of colonoscopy from May to July 2014.Bowel-cleansing efficacy was separately assessed with the Ottawa Scale for the right,middle,and left colon.Total score was obtained by adding the scores for individual evaluation of the three colon segments with the score of overall fluid in the entire colon.All patients filled in a questionnaire and were interviewed about their com-pliance to the assigned bowel preparation,tolerability,and side effects.Results Patients who did not complete the colonoscopy were excluded.A total of 91 patients were included in the last analysis:31 cases of 4 L group,30 cases of 2 L group and 30 cases of 2 +1 L group.The efficacy of bowel-cleansing of the three groups of patients according to the Ottawa Scale were similar(P >0.05),but the excellent and good rate of cleansing quality of the right colon was higher in 4 L group than in 2 L group(P <0.05).Compared with 4 L group and 2 +1 L group,patients in the 2 L group had higher compliance and tolerability,as well as lower rate of side effects(P <0.05 ).Conclusion The efficacy and safety of taking 2 L polyethylene glycol electrolyte solution in bowel-cleansing on the day of colonoscopy is good and suitable for use.Taking 4 L polyethylene glycol electrolyte solution for bowel preparation on the day of colonoscopy is more suitable for patients who are suspected highly with lesions of the right colon.
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ObjectiveToinvestigatetheeffectandmechanismofaChinesetraditionalprescription,YuebiBanxia decoction, on allergic asthma in mice by observing the changes of serum immunoglobulin E ( IgE ) and lung tissue superoxide dismutase ( SOD) activity in the mouse model of allergic asthma .Methods Forty healthy Kunming mice were randomly divided into normal control group , asthma model group , dexamethasone intervention group and Chinese medicine preparation group .The mouse model of asthma was generated by peritoneal injection of ovalbumin ( OVA) and suspension of aluminium hydroxide .The mice of traditional Chinese medicine group received Yuebi Banxia decoction in a dose of 1 mL/100 g, daily for 30 days.The mice of dexamethasone group were given intraperitoneal injection of dexamethasone 1 mg/kg.The normal control group and asthma model group were given gastric gavage of physiological saline.After 30 days administration, the serum levels of IgE and SOD activity of lung tissue were determined , and the pathological changes of lung tissue were observed using HE staining .Results The mice of traditional Chinese medicine preparation group showed significantly decreased serum IgE level , and significantly increased SOD activity than those of the asthma model group mice (P<0.05 for both).Conclusions Reduced serum IgE and increased SOD activity in the lung tissue of mice with allergic asthma , improving the antioxidant ability of lung tissue , may be involved in the anti-allergic asthma mechanism of the Chinese traditional prescription Yuebi Banxia decoction .
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Objective To explore the relationship between gene MTDH expression and its role in promo-ting gastric carcinoma metastasis .Methods We collected clinical specimens and cultured gastric carcinoma cell lines.By Western blotting and Real -time PCR methods,protein and mRNA levels in tissues and MTDH relation-ship with EMT were detected .Results There was 86%of patients who expressed MTDH positively and 13%of normal gastric mucosa was positive expression .The results showed that the expressive level of MTDH gene in gas-tric carcinoma was higher than in the normal tissues .The expression of MTDH was correlated with TNM stage、mi-crovascular invasion、recurrence and metastasis .The expressive level of MTDH was correlated with two epithelial mesenchymal transition markers ( E-cadherin and N-cadherin ) .Conclusion MTDH may promote gastric car-cinoma metastasis through the induction of EMT process and may be a candidate biomarker for therapeutic target .
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Objective To screen the prevalence of celiac disease with serologic markers in the central Chinese population,specifically in patients with chronic diarrhea-predominant irritable bowel syndrome (D-IBS).Methods A total of 282 adult patients with D-IBS were selected based on ROME Ⅲ criteria with 296 age and sex matched consecutive healthy individuals as controls.A gluten-free diet (GFD) was advised in subjects positive for IgA/IgG anti-htTG/DGP antibodies and the serologic antibodies were retested after the GFD.Results Among the 578 study subjects,five D-IBS patients (5/282,1.77％) and two healthy controls (2/296,0.68％) were positive for anti-htTG/DGP antibodies.Among the seven positive cases,one was lost to follow-up and only four were evaluated during GFD therapy for an average of 5.2 months with clinical and/or serological manifestations improved.Conclusions The prevalence of celiac disease may not be uncommon in China.Compared with the healthy population,patients with D-IBS tend to be affected more.Thus,it is significantly important to conduct routine screening for celiac disease in patients with D-IBS.
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The clinicopathological data of 173 cases of inflammatory myofibroblastic tumor (IMT)were retrospectively analyzed.Among them 125 were males and 48 females with a mean age of 47.9 y (5-78 y).The lesions of 117 cases were located in lungs,41 cases in eyes,8 in ileocecum,2 in liver,2 in spleen,1 in abdominal wall,1 in maxillary sinus and 1 in face.The average diameter of lesions were 3.5 cm,ranging from 1.0 cm to 7.0 cm.The clinical manifestations were not specific,depending on the locations of tumor.The imaging examinations were helpful for diagnosis.The prcsence of slender-spindled myofibroblasts and proliferation of fibroblast cells,with infiltration of chronic inflammatory cells were the basic histopathological features of the disease.Combined with the histological characteristics and immunohistochemical staining IMT can be differentiated from other spindle cell tumors.Appropriate surgical resection is the main treatment for IMT.
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Objective To retrospectively study histopathologic features of ulcerous colitis (UC) and Crohn's disease (CD) by endoscopic biopsy. Methods Data of age, gender and intestinal involvement of 106 cases of CD and 180 cases of UC confirmed by pathology were reviewed. Mucosal architecture, chronic inflammation, acute inflammation and epithelial features were evaluated based on histopathological criteria.These features were compared between the two groups. Results Compared with CD cases, UC showed significantly higher percentage of architectural disorders ( P ＜ 0. 05 ), lower percentage of discontinuous chronic inflammation ( P ＜ 0. 05 ) and higher incidence of cryptitis, crypt abscesses and polymorph cells in lamina propria (P ＜0. 05 ), and higher rate of epithelium damage, flattened and less mucous cell as well. Granuloma, pseudo pylorus glands metaplasia and narrow ulcer only occurred in CD cases. Lesions of 90% (162/180) cases of UC were limited to colon, while those of 28% (30/106) of CD cases to ileocecum, and those of 56% (59/106) CD cases involved different parts of gastrointestinal tract. Conclusion Diagnosis of CD and UC needs comprehensive analysis. Diagnostic evidence for CD includes focal involvement of ileocecum, the multifocal involvement in gastrointestinal tract, granuloma, discontinuous inflammation, pyloric gland metaplasia, while that for UC includes mucosal damage limited to colon, continuous chronic inflammation, architectural disorders, or epithelial damage.
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Objective To evaluate mechanical radial scanning endoscopic ultrasonography (EUS) for preoperative tumor and lymph node ( TN ) staging of esophageal cancer. Methods From January 2010 to June 2010, a total of 60 patients with esophageal cancer underwent preoperative staging with mechanical radial scanning EUS. The findings of EUS were compared with postoperative pathological outcomes. Results EUS accurately predicted T stage in 80 % of cases and N stage in 71% cases. Sensitivities to T1 , T2 , T3 and T4 were 75% , 100% , 96% and 50% , respectively, and those to N0 and N1 were 55% and 100% , respectively. With exclusion of 11 patients with un-passable lesions, the accurate rate of EUS in T staging of focal and advanced cancers was 90% ( 44/49 ). Conclusion Mechanical radial scanning EUS can accurately predict T and N stages in preoperative patients with esophageal cancer, which also exhibits high differential accuracy in focal and advanced esophageal cancer.
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Objective To investigate the expression of Notch1 protein and its clinicopathologieal characteristics in colorectal carcinomas. Methods The expression and location of Notch1 protein were determined using immunohistochemical S-P method in 30 colorectal carcinomas and 18 normal colorectal tissues. Results The average positive rate of Notch1 protein was 45.5 ± 0. 7% in colorectal carcinomas and 6. 8 ± 0. 9% in normal colorectal tissues. There was significant difference between colorectal carcinomas and normal colorectal tissues (P ＜ 0. 05). The expression of Notchl protein in different age, sex, tumor site, nodal involvement and Dukes stage had no significant difference. The expression of Notch1 protein in different histology grade had significantly statistical difference. Conclusion Notch1 expression was associated with the development of colorectal carcinoma. Notch1 was the potential oncagenic gene. Nothe1 would become the new target of the colorectal tumor therapy in the future.
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Objective To investigate the clinical characteristics of primary gastrointestinal lymphoma (PGIL) on different origin site in order to improve its diagnosis.Methods The clinical data from 202 patients with PGIL diagnosed by histology from January 1999 to June 2007 were identified from the clinical databases of 8 hospitals in Wuhan area and retrospectively analyzed.The patients were divided into gastric,small intestinal and large intestinal lymphoma groups according to the site of origin and there clinical characteristics were compared.Results The PGIL localization was gastric in 113 (56.0%) cases, small intestine in 37(18.3%) cases and large intestine in 52 (25.7%) cases.One hundred and thirty (64.4%) were males and 72 (35.6%) were females.The male patients were predominant.The median duration of symptoms in gastric lymphoma group was longer than small intestinal lymphoma group (3.0 months vs.1.0 month,P=0.013).The most common symptoms were abdominal pain and anemia. The clinical stage was Ⅰ E and Ⅱ E in 71.3% of cases.The large intestinal lymphoma group presented more advanced-stage disease compared with gastric lymphoma group (P = 0.014).The frequent histological type was mucosa-associated lymphoid tissue lymphoma (MALT),diffuse large B-cell lymphoma and T-cell lymphoma.Gastric,small intestinal and large intestinal lymphomas presented more frequently as low-grade MALT lymphoma (56.9%),T-cell lymphoma (34.4%) and high-grade B-cell lymphoma (51.1%),respectively (all P value ＜0.05).The common macroscopic type of PGIL were nodular protruding and ulcerative type.Compared with gastric lymphoma,nodular protruding type was more common and ulcerative type was less common in large intestinal lymphoma (P = 0.000).The diagnosis confirmed by endoscopic biopsy were 58.7% (61/104),25.0% (4/16),48.2% (13/27) in gastric,small intestinal and large intestinal lymphoma groups,respectively.Conclusions The clinical characteristics are different in patients with different localization of PGIL including patient characters, initial symptoms,histological classification,clinical stage,macroscopic feature,endoscopic findings. Analysis of these clinical characteristics is helpful to improve its diagnosis.
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Objective To re evaluate the diagnosis and outcome in patients with inflammatory bowel disease (IBD) by long term follow up at Wuhan University Zhongnan Hospital in Wuhan, China. Methods One hundred patients with ulcerative colitis (UC) and 15 with Crohn's disease (CD) treated in this hospital from 1980 to 1999 were re evaluated with the uniform diagnostic criteria proposed by National Workshop of Chronic Non infectious Intestinal Diseases, 1993. All patients were followed up by questionnaire, telephone and face to face interview 1～16 years after the initial diagnosis. Results Of 115 patients with IBD, 75(65%) were available for follow up study. Of 64 cases of UC, 46 had their diagnosis confirmed, 9 diagnosed as possible UC, and 9 cases were reclassified as other diseases. Of 11 cases with CD, 7 were diagnosed correctly, 2 were possible CD, and 1 were intestinal tuberculosis. In the remaining 55 UC, 3 died and 1 due to complication of UC. Other 52 UC, 37 had relapse. In the 10 patients with CD, 1 died due to complication. In other 9 cases 7 had relapse. In 46 patients with UC and 6 patients with CD there were symptom free or symptoms improved. Conclusions At follow up 1 to 16 years after the diagnosis of IBD, the initial diagnosis of UC and CD was confirmed in 86% and 82% respectively. Relapse rates of UC and CD were 71% and 78% respectively. The prognosis of patients with UC is better with 88% symptom free and improvement, while only 67% of patients with CD were symptom free and symptoms improved.