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Objective To investigate the viral infection subtypes and epidemiological characteristics of upper respiratory tract infection (URTI) in Beijing area in 2020, and to provide references for URTI specific treatment and vaccination. Methods A total of 22 318 patients with URTI in Beijing area from January 2020 to December 2020 were enrolled in the study. Basic demographic information and clinical characteristics of the patients were collected, and their respiratory tract samples were collected. Eight major respiratory viruses (including respiratory syncytial virus, parainfluenza virus, adenovirus, coronavirus, influenza virus, rhinovirus, bocavirus, and metapneumovirus) in the respiratory samples were detected by PCR. The pathogen composition and epidemiological characteristics of URTI were analyzed. Results ① Among the 22 318 cases of URTI, most of them were children under 5 years old and elderly patients over 70 years old, accounting for 25.02% and 19.43%, respectively; ② URTI mainly occurred in spring (35.71%) and winter (37.35%); ③ The total positive rate of respiratory virus was 49.35%, among which 45.42% were infected with single virus, 3.30% were infected with two viruses, and 0.63% were infected with three or more viruses; ④ Respiratory syncytial virus (49.35%) had the highest detection rate, followed by parainfluenza virus (12.98%), rhinovirus (9.48%), influenza virus (8.40%), adenovirus (6.01%), bocavirus (4.43%), coronavirus (3.97%), and metapneumovirus (2.90%); ⑤ The detection rates of respiratory syncytial virus and parainfluenza virus in children aged 0-5 years old and the elderly aged over 71 years old were higher than those in other age groups, while the detection rates of other pathogens of all age groups were similar; ⑥ Among 22,318 URTI patients, 290 cases were complicated with pneumonia, with a complication rate of 1.300%. The complication rate of pneumonia in patients with positive virus pathogens was significantly higher than that in patients with negative virus pathogens (χ2=18.011, P2=884.085, P<0.05). Conclusion Children under 5 years old and the elderly over 70 years old are the high-risk population of URTI, and URTI mainly occurs in spring and winter. Respiratory syncytial virus and parainfluenza virus are the main pathogens leading to URTI, and patients with virus infection and mixed virus infection suffer a higher risk of pneumonia.
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The establishment of a nutritional pathway is the premise and basis of nutritional therapy for patients with malignant tumor. The nasogastric tube, nasoenteric tube, and percutaneous endoscopic gastric/jejunostomy are commonly used clinical pathways for enteral nutrition (EN) therapy. However, these EN pathways are often difficult to establish in patients with malignant obstructive jaundice (MOJ) with pyloric or duodenum primary obstruction. For this reason, a new type biliary-intestinal nutrient tube placed through percutaneous transhepatic cholangiography drainage (PTCD) pathway was designed by the medical staff of hepatobiliary surgery department of Yinchuan First People's Hospital, and National Utility Model Patent of China were obtained (ZL 2020 2 0283951.5, ZL 2020 2 0288938.9). The new biliary-intestinal nutrient tube has two types: double-lumen tube and single-lumen tube, which consists of tube head, tube body, tail ring and developing ring. The double lumen tube realizes bile internal drainage and EN simultaneously through the double lumen structure of the tube body. The single-lumen tube is used for nutrient infusion after bile duct metal stent implantation, which is not limited by the type of nutrient solution. The tail ring of the two types of nutrient tube is placed in the upper jejunum to reduce retrograde infection and unexpected extubation. Compared with the prior art, the utility model has the advantages of simple structure, reasonable design, safe and effective placement through PTCD pathway, and opens up a new EN path for MOJ patients.
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Objective:To compare the efficacy of Milrinone and Papaverine in relieving the spasm of internal mammary artery (LIMA) during off-pump coronary artery bypass grafting (OPCABG).Methods:Between April 2018 to December 2018, 200 patients who suffered obvious angina pectoris and three-vessel disease documented by coronary angiography, undergoing OPCABG at Beijing Anzhen Hospital, Capital Medical University were recruited in this study, including 103 males and 97 females, aged 46-74 years, with an average of (59.12±0.49) years old. For all patients, the LIMA was anastomosed to left anterior descending artery(LAD). According to different methods relieving LIMA spasm, all patients randomly divided into 4 groups (n=50): Papaverine surface infiltration group (group Ⅰ), Papaverine injection group (group Ⅱ), Milrinone surface infiltration group (group Ⅲ) and Milrinone injection group (group Ⅳ). The blood flow (ml/min) of the free LIMA, the blood flow of the LIMA-LAD after bypass, anastomotic time of obtuse marginal artery, the use of vasoactive drugs, the outcomes of perioperative period and 1 year after operation were compared in the four groups.Results:There was no significant difference between group Ⅲ and group Ⅰ in the blood flow of free LIMA and LIMA-LAD[(45.50±1.43)ml/min vs. (47.42±1.61)ml/min、(28.60±0.89)ml/min vs. (28.40±0.96)ml/min, all P>0.05]. The blood flow of free LIMA and the LIMA-LAD in group Ⅱ were significantly higher than those in group Ⅰ[(60.36±1.28)ml/min vs. (47.42±1.61)ml/min, (42.40±1.25)ml/min vs. (28.40±0.96)ml/min, all P<0.05]. The blood flow of free LIMA and LIMA-LAD in group Ⅳ were significantly higher than those in group Ⅲ[(70.86±2.00) ml/min vs. (45.50±1.43) ml/min, (59.46±1.25) ml/min vs. (28.60±0.89) ml/min, all P<0.05]. The blood flow of free LIMA and LIMA-LAD in group Ⅳ were significantly higher than those in group Ⅱ[(70.86±2.00) ml/min vs. (60.36±1.28) ml/min, (59.46±1.25) ml/min vs. (42.40±1.25)ml/min, all P<0.05]. The anastomotic time of obtuse marginal artery[(7.14±0.72)min vs. (8.30±0.93)min, (8.10±0.89)min, (8.14±0.90)min, P<0.05], the dopamine dose[(3.76±0.40)μg·kg -1·min -1 vs. (5.02±0.52)μg·kg -1·min -1, (4.84±0.48)μg·kg -1·min -1, (4.90±0.49)μg·kg -1·min -1,P<0.05] and the esmolol usage (32% vs. 60%, 58%, 58%, P<0.05) during the operation in group Ⅳ were significantly reduced compared with the other three groups. The V3 ST depression on the postoperative first day[(0.34±0.18)mv vs. (0.71±0.22)mv, (0.68±0.20)mv, (0.69±0.22) mv, P<0.05], and the TNI on the postoperative third day[(0.24±0.08)ng/ml vs. (0.56±0.15)ng/ml, (0.54±0.11)ng/ml, (0.53±0.12) ng/ml, P<0.05] were significantly lower in group Ⅳ than those in the other three groups. However, there was no significant difference about the first-year patency of LIMA-LAD among four groups. Conclusion:For relieving spasm of LIMA, the Milrinone injection was better than that of Papaverine, which could shorten the anastomotic time of obtuse marginal artery, maintain intraoperative hemodynamics stability, reduce myocardial damage during OPCABG.
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Objective@#To evaluate the feasibility and validity of combined directly epicardial and transapical endocardial substrate ablation guided by Carto mapping for ventricular tachycardia(VT) with left ventricular aneurysm(LVA) intra-operation in a swine model.@*Methods@#Twenty-four swine models with sustained VT and LVA were randomly divided into study group(radiofrequency ablation, RFCA, from epicardium via direct-view and endocardium via transapical access, 12 cases) and control group(endocardial RFCA via retrograde transaortic access, 12 cases). Substrate mapping for captured abnormal potentials via endocardium and epicardium was used to precisely locate the low-voltage areas. After ablation in two groups, VT was induced again to compare the effectiveness of different RFCA strategies.@*Results@#Three dimensional electro-anatomic mapping was implemented successfully in two groups under open chest. And VT substrates were largely located in the border zone of LVA. All objects in the study group underwent endocardial ablation via transapical access smoothly without operative failure. When VT inducing again, 2 cases of study group was with inducible VT, however, VT recurrence in control group was 5 cases, P=0.04.@*Conclusion@#Combined direct epicardial and transapical endocardial substrate mapping and ablation appeared to be feasible and effective for treating VT with LVA under thoracotomy.
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Objective:To investigate the protective effect of salidroside on acute lung injury or acute respiratory distress syndrome (ALI/ARDS) in rats. Methods:A total of 50 rats were randomly divided into five groups:the normal control group,the model group, salidroside high,medium and low (8.0,4.0,2.0 mg·kg-1) dose groups with 10 ones in each. ALI/ARDS model was prepared by tail vein injection of oleic acid (0.1 ml·kg-1). The administration route was intraperitoneal injection, once daily for continuous 3 days. At 24 h after the model preparation was successful,1.0 ml blood samples were collected through carotid artery for the blood gas analysis. The lung wet/dry weight ratio,arterial oxygen partial pressure and HE staining lung tissue pathology were detected and the expression of HMGB1 and KRT-14 in the blood of rats was detected after the drug was administered for 3 days. Results:The expres-sion of HMGB1 and KRT-14 in each salidroside was lower than that in the model group,and the differences were statistically significant between the medium and high dose groups and the model group(P<0.05). The dose and efficacy of salidroside were positively corre-lated,and the differences were statistically significant between the medium and high dose groups and the low dose group(P<0.05). The oxygen partial pressure of each salidroside group was higher than that of the model group, and the lung wet/dry weight ratio was lower than that of the model group,and the difference was statistically significant between the medium and high dose groups and the model group(P<0.05). The dose and efficacy of salidroside were positively correlated,and the difference was statistically significant between the medium and high dose groups and the low dose group(P<0.05). Compared with the model group,the lung pathological changes of each salidroside group were improved. Conclusion:Salidroside can reduce the expression of inflammatory factors HMGB1 and KRT-14 in blood,reduce pulmonary edema and increase oxygen partial pressure in ALI/ARDS rats, which shows obvious thera-peutic effect on ALI/ARDS.
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Objective@#To investigate the methylation status and expression of FOXP3 in CD4+ T cells of patients with chronic hepatitis B (CHB).@*Methods@#Peripheral blood mononuclear cells (PBMCs) from 59 CHB patients and 22 healthy controls (HC) were collected. The percentage of CD4+ CD25+ Foxp3+ Tregs in CD4+ T cells was estimated by flow cytometry. FOXP3 expression was measured by quantitative real time-polymerase chain reaction (RT-qPCR) and Western blotting. The methylation status of FOXP3 was determined by methylation-specific polymerase chain reaction.@*Results@#The percentage of CD4+ CD25+ pFoxp3+ Tregs in CD4+ T cells, FOXP3 mRNA and protein expression levels were significantly higher in patients with CHB than HCs (P<0.05). Meanwhile, the methylation frequency of FOXP3 was significantly lower in CHB patients than HCs (P<0.05). FOXP3 mRNA levels and the percentage of CD4+ CD25+ Foxp3+ Tregs were significantly lower (P<0.05) in patients with gene methylation than those without.@*Conclusions@#Aberrant demethylation of FOXP3 gene existed in CD4+ T cells of CHB, which contributed to an elevation in FOXP3 expression and percentage of CD4+ CD25+ Foxp3+ Tregs. It might provide a new target for prevention and treatment of CHB.
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Objective: To investigate the impact for family history of hypertension on masked hypertension (MH) morbidity with relevant cardiac damage. Methods: Our research included in 3 groups: MH group, n=250 consecutive patients treated in our hospital from 2010-01 to 2015-04, Hypertension group, n=250 and Control group, n=250 subjects with normal blood pressure. The family history of hypertension, general clinical information, routine biochemical indexes and the findings of echocardiography were studied and compared among different groups. Results: ① There were 70 (28%) patients with family history of hypertension in MH group, 87 (34.8%) in Hypertension group and 26 (10.4%) in Control group. The ratio of family history of hypertension in MH group was higher than Control group, P0.05. Logistic regression analysis presented that family history of hypertension and body mass index were positively related to the morbidities of MH (r=1.468, r=0.173) and hypertension (r=1.195, r=0.086). ② Compared with Control group, MH group had increased left ventricular mass index (85.64 ± 17.7) g/m2 vs (80.50 ± 15.53) g/m2 and the maximum blood flow velocity of aortic valve (115.74 ± 16.54) cm/s vs (112.40±14.21) cm/s, all P<0.05. In MH group, compared with those without family history of hypertension, the patients with family history had the higher left ventricular mass index (89.22 ± 19.08) g/m2 vs (84.25 ± 16.99) g/m2 and the maximum blood flow velocity of aortic valve (119.19 ± 14.97) g/m2 vs (114.39 ± 16.96) g/m2, all P<0.05. Conclusion: The subjects with family history of hypertension had the higher risk of MH morbidity with more severe cardiac damage.
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Objective To evaluate the clinical value of percutaneous catheter drainage under the guidance of ultrasound in the treatment of hepatic abscess.Method Forty-eight cases who were clinical diagnosis of liver abscess by percutaneous catheter drainage was selected as the observation group.There were 12 cases of liver abscess diagnosed by parallel surgical drainage in the treatment as the control group.To observe the clinical effect,hospitalization time and complications of two groups of patients after treatment.Results The cure rate of observation group was significandy higher than that in control group:100％ (48/48) vs.The temperature recovery time and hospitalization time of the observation group were significantly shorter than those in the control group:(1.5 ±0.3) d vs.(3.2 ±0.8) d,(9.3 ±2.3) d vs.(17.5 ±3.2) d.No complications occurred in the observation group,and there were 2 cases in the control group.Conclusions Percutaneous catheter drainage in the treatment of liver abscess has advantages of simple economy,less trauma,less complications and high cure rate.It has become the first choice for treatment of liver abscess.
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Objective To verify the association of a disintegrin and metalloproteinase domain 33 (ADAM33) polymorphisms in childhood asthma susceptibility and severity in patients with moderate and severe asthma.Methods A total of 144 controls and 110 asthmatic patients were recruited for this hospitalbased case-control study.Two polymorphic sites (V4,T2) were genotyped using the polymerase chain reaction-restriction fragment length polymorphism method.The gene-gene interactions were analyzed with the multifactor dimensionality reduction (MDR) software.Results The allele frequencies of three SNPs (V4,T2) of ADAM33 in childhood asthma group were significantly higher than control group (P ＜ 0.01,OR =2.36 ～ 2.96,95％ CI:1.56-1.78 ～ 3.56-4.94).For the SNPs V4,GC genotype frequencies of both moderate and severe groups were significantly higher from the control group (P ＜ 0.05) ; the CC genotype frequencies in severe group were significantly higher than control group (P ＜ 0.05) ; the genotype GA of T2 locus in severe group and AA genotype frequencies in moderate group were significantly higher than control group (P ＜0.01 ～0.05) ; there were no significant differences for both allele and genotype frequencies of S2 locus between the childhood asthma and control group (P ＞ 0.05).By MDR analysis,the best interaction model was the four-factor model that the V4,T2 genotypes were the subgroup to predict asthma risk.Conclusions Our results highlight the role of ADAM33 as a susceptibility gene for childhood asthma,and the interactions among ADAM33 V4 and T2 are also associated with childhood asthma.
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Hemodialysis monitoring and information management software was used to establish an intelligent electronic system to manage hemodialysis patients' information,with hardware and software moderations.The electronic information management system for hemodialysis functioned steadily since 2008.This system changed not only the existing medical process of the center,but also contributed to safer treatments,more accurate operations of doctor’ s instructions,and better medical information records as well The results indicate that the electronic information management system in hemodialysis centers not only irnproves work efficiency and management quality significantly,but also effectively ensures the safety and caliber of hemodialysis treatment with less manpower costs.
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Objective To explore whether the stimulation effect of high phosphate on hyperplasia of human parathyroid cells and hyperparathyroidism through local cyclooxygenase 2 (COX2) up-regulation pathway. Methods Parathyroid glands were collected from 19 uremic patients undergoing parathyroidectomy.Expressions of COX1,COX2 and proliferative cell nuclear antigen (PCNA) of the glands were detected by immunohistochemistry.Primary parathyroid cells were cultured and treated with high or normal phosphate for 48 hours.Then expressions of COX2 and PCNA were detected by Western blotting and real-time PCR. Results Among 62 glands from above 19 patients,43 glands were nodular hyperplasia and 19 diffuse hyperplasia.Both high expressions of COX2 and PCNA were found in these blands.Expression of COX2 was found in both oxyphil and chief cells and was more in the diffuse hyperplasia glands than that in the nodular hyperplasia (P＜0.05).80.60％ and 85.20％ of COX2 positive cells in diffuse hyperplasia glands and nodular hyperplasia also expressed PCNA. High phosphate could stimulate iPTH secretion in vitro (P＜0.05).Expressions of COX2 and PCNA were higher in high phosphate group.(P＜0.05). Conclusion High phosphate may stimulate the hyperplasia of parathyroid cells by up-regulating the local COX2 expression.
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Objective To report a simple formula to estimate phosphate removal by standard four-hour hemodialysis in Chinese patients.Methods A total of 165 MHD patients in Huashan Hospital were enrolled.Effluent dialysate samples were collected during treatment to estimate the total amount of phosphate removal.Pre-dialysis levels of serum phosphate,potassium (K+),hematocrit(Hct),parathyroid hormone(iPTH),carbon dioxide combining power(CO2CP),alkaline phosphatase (AKP),Kt/V,and ultrafiltration volume,age,gender,dry body weight,blood flow,phosphate clearance of dialyser,phosphate concentration of dialysate at 60 min after the start of HD were obtained.80％ observations were randomly selected for formula building by backward stepwise and the remaining 20％ observations were used to validate the formula.Results The formula was described as Tpo4 =88.6 ×C60-0.03 ×Age + 1.07 ×Gender +0.06 ×Clearance-4.59,where C60 was phosphate concentration in dialysate measured 60 min into HD and Clearance was the phosphate clearance of dialyser.Formula validation further suggested good predictive ability.Conclusion This study derives an approach to quantify phosphate removal by a simple formula,which will be helpful for clinicians to treat patient individually.
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Objective To observe the changes of renin-angiotensin system (RAS) in cultured mesangial cells by serum from 3/4 nephrectomized rats feeding with low protein diet and α-keto acid. Methods Thirty male SD rats received 3/4 nephrectomy (Nx) were placed on 18%normal protein diet (NPD,n=10),6% low protein diet(LPD,n=10) or 5% low protein plus 1%α-keto acid diet (LK,n=10) flor 12 weeks.Ten male SD sham-operated rats fed with 18% normal protein diet were used as control (sham group).In addition,mesangial cells were cultured in sera (10%) collected from above animals treated with or without losartan (0.02 mmol/L)for 48 hours.ELISA was applied to detect the level of Ang II,TGF-β1 and fibronectin (FN) in cell medium.Westem blotting was used to determine the protein level of ATI receptor (AT1R)and real-time PCR was used to detect the mRNA level of AT1R,TGF-β1 and FN. Results (1) Nutritional indices including body weight,total protein and albumin had no significant difference in each group. (2) Serum creatinine and 24 h pruteinuria were significantly inceased in nephrectomized groups compared to sham group(P<0.05,respectively).24 h proteinuria was greatly lower in LK group than that in NPD and LPD groups(P<0.05,respectively).(3)LK greatly decteased the level of Ang II[NPD(12.70±0.12)mg/g protein;sham(8.04±0.62)mg/g protein]in supernatant as well as the protein and mRNA expression of AT1R in cultured mesangial cells (P<0.05).(4)NPD serum directly induced higher secretion[FN:sham(20.58±0.46)g/g protein,NPD (39.84±0.06)g/g protein;TGF-β1:sham(10.12±O.56)mg/g protein,NPD(83.85±3.58)mg/g protein] and mRNA expression of FN and TGF-β1 compared with sham group (P<0.05).LPD decreased these increment (P<0.05) and LK showed stronger inhibitory effect (P<0.05). (5)Losartan application sharply reduced FN and TGF-β1 production both in supematant and in mRNA expression in NPD serum treated cells (P<0.05,respectively). Conclusion Low protein diet with α-keto acids supplement directly inhibits the RAS in mesangial cells which may contribute to its beneficial effect on the kidney.
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Objective To investigate the impact of auto and allogenic mesenchymal stem cells (MSC) transplantation on hematopoietic reconstitution. Methods MSC from auto, donor bone marrow or embryonic tissue were cultured and expanded in vitro in the serum culture system. Five patients received hematopoietic stem cell transplantation (HSCT) were investigated. Case 1 of systemic lupus erythematosus and Case 2 of non-hodgkin' s lymphoma (NHL) received auto MSC transplant before auto-HSCT. Case 3 of paroxysmal nocturnal hemoglobinuria received HLA-identical allogenic MSC transplant before HLA-identical allo-HSCT.Case 4 of chronic myelocytic leukemia and Case 5 of NHL had delayed hematopoietic reconstitution (129th and 78th day, respectively) after allo- and auto-HSCT, respectively, and received MSC from embryonic tissue.Results Case 1, 2 and 3 had no manifested side effects after MSC transplantation combined with HSCT.Neutrophil count of case 1, 2, and 3 were over 0.5 ×109/L at 1st, 10th and 10th day, respectively, platelet count were over 20 ×109/L at 1st, 8th and 33th day, respectively, and agranulocytosis at Ost, 7th and 12th day, respectively. The treatment of embryonic tissue MSC transplant was confirmed to fail for Case 4 and 5.Conclusion The time of MSC transplant has a great impact on hematopoietic reconstitution. MSC transplantation and HSCT performed simultaneously can improve hematopoietic reconstitution. However, the impact of MSC on patients with delayed hematopoietic reconstitution after HSCT needs further study.
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micro RNA (miRNA) is the fragment of non-coding small RNAs and consists of 21-25 ribonucleotide.It can regulated gene expression by either binding to or regulating the translation process of some specific mRNA. This paper summarized the characteristics of miRNA, as well as its production, mechanism of action and functions.