ABSTRACT
Objective To investigate the effect of Ganshuang granule combined with entecavir on portal vein thrombosis (PVT) in patients with hepatitis B cirrhosis. Methods A total of 356 patients with hepatitis B cirrhosis who attended and were hospitalized in The Third People's Hospital of Kunming from January 1, 2018 to December 31, 2020 were enrolled and randomly divided into combination group with 191 patients and control group with 165 patients. The patients in the combination group received Ganshuang granule combined with entecavir, and those in the control group received entecavir alone. The course of treatment was at least 24 weeks. The t -test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups. The Kaplan-Meier method was used to analyze the cumulative incidence rate of PVT in both groups, and the log-rank test was used for comparison between two groups. Univariate and multivariate Cox proportional-hazards regression model analyses were used to investigate the influencing factors for PVT in patients with hepatitis B cirrhosis. Results The 191 patients in the combination group were followed up for 296.25 person-years in total, with a mean follow-up time of 1.55±0.65 years, and there were 8 patients with PVT, with an incidence rate of 4.19% and an incidence density of 1.41 per ten-thousand person-years. The 165 patients in the control group were followed up for 253.25 person-years in total, with a mean follow-up time of 1.53±0.67 years, and there were 20 patients with PVT, with an incidence rate of 12.12% and an incidence density of 4.79 per ten-thousand person-years. There was a significant difference in the incidence rate of PVT between the two groups ( χ 2 =7.687, P =0.006). The cumulative incidence rate of PVT plotted by the Kaplan-Meier method showed that the combination group had a significantly lower cumulative incidence rate of PVT than the control group ( χ 2 =7.226, P =0.007), with a relative risk of 3.155 (95% confidence interval [ CI ]: 1.351-7.370). The univariate Cox analysis showed that hypertension, alanine aminotransferase, aspartate aminotransferase (AST), albumin (Alb), cholinesterase, estimated glomerular filtration rate, alpha-fetoprotein, D-dimer (D-D), Child-Pugh class, and Ganshuang granule combined with entecavir were influencing factors for PVT (all P < 0.05); the multivariate Cox analysis showed that AST (hazard ratio [ HR ]=1.002, 95% CI : 1.000-1.004, P =0.025), and D-D ( HR =1.907, 95% CI : 1.554-2.338, P < 0.001) were independent risk factors for PVT in patients with hepatitis B cirrhosis, while Alb ( HR =0.844, 95% CI : 0.755-0.944, P =0.003) and Ganshuang granule combined with entecavir ( HR =0.350, 95% CI : 0.144-0.851, P =0.021) were independent protective factors against PVT in patients with hepatitis B cirrhosis. Conclusion Ganshuang granule combined with entecavir can significantly reduce the incidence rate of PVT in patients with hepatitis B cirrhosis, thereby exerting a certain preventive effect against PVT.
ABSTRACT
Objective:To investigate the effects of Clostridium butyricum on colitis and intestinal microbiota in mice with or without antibiotic pretreatment. Methods:Thirty specific pathogen free BALB/c mice were randomly divided into the blank control group, dextran sulfate sodium (DSS) group, antibiotic + DSS group, Clostridium butyricum + DSS group and antibiotic+ Clostridium butyricum + DSS group, with 6 mice in each group. After the mice were pretreated with quadruple antibiotics (ampicillin 1 g/L, neomycin 1 g/L, metronidazole 1 g/L, and vancomycin 0.5 g/L) in normal drinking water for 30 d, the mice colitis model was induced with DSS. At the same time, the mice in Clostridium butyricum + DSS group and antibiotics+ Clostridium butyricum + DSS group were given 1×10 6colony-forming unit (CFU) Clostridium butyricum by gavage. The effect of Clostridium butyricum on mice with colitis was evaluated by disease activity index (DAI), colon length and histopathological score. The level of serum inflammatory factors was detected by enxyme linked immunosorbent assay, and the effect of Clostridium butyricum on gut microbita in mice was determined by fecal 16S rRNA sequencing. Results:The general condition of mice of the blank control group were good, and their DAI scores fluctuated around 0. Since the fourth day after DSS drinking water was given, the mice of the DSS group showed signs of colitis such as weight loss, unformed stools and bloody stools. On the fourth day after intervention, the DAI score of Clostridium butyricum + DSS group was lower than that of DSS group (0.000±0.000 vs. 0.444±0.111), and the difference was statistically significant ( t=4.000, P=0.016 1). On the tenth and twelfth day after the intervention, the DAI scores of antibiotic+ Clostridium butyricum + DSS group were both lower than those of antibiotic+ DSS group (0.000±0.000 vs. 1.111±0.222, 0.667±0.000 vs. 1.889±0.222), and the differences were statistically significant ( t=5.000 and 5.500, both P<0.05). The histopathological score of mice colon tissue of Clostridium butyricum + DSS group was lower than that of DSS group (2.50±1.73 vs. 5.50±1.00), and the histopathological score of mice colon tissue of antibiotic+ Clostridium butyricum+ DSS group was lower than that of antibiotic+ DSS group (1.25±0.96 vs. 5.00±0.82), and the differences were statistically significant ( t=3.000 and 5.960, both P<0.05). The serum level of interleukin (IL)-1β Clostridium butyricum+ DSS group was higher than that of blank control group ((4.464±0.075) ng/L vs. (3.907±0.080) ng/L), the serum levels of tumor necrosis factor-α, IL-6 and IL-1β of Clostridium butyricum+ DSS group and antibiotic+ Clostridium butyricum + DSS group were all lower than those of DSS group ((2.402±0.383) ng/L , (1.845±0.345) ng/L vs. (6.958±1.084) ng/L, (1.752±0.146) ng/L, (1.307±0.048) ng/L vs. (3.537±0.608) ng/L, (4.464±0.075) ng/L, (4.066±0.190) ng/L vs. (7.477±0.339) ng/L), and the differences were statistically significant ( t=5.005, 3.964, 4.495, 4.693, 6.294, 8.674 and 8.774 , all P<0.05). The results of 16S rRNA sequencing showed that there were a significantly large number of anti-inflammatory or short-chain fatty acid producing bacteria in the gut microbiota of mice intervened by Clostridium butyricum, among which the dominant bacteria genus in Clostridium butyricum + DSS group and antibiotic+ Colstridium butyicum+ DSS group were Mucispirillum (linear discriminant analysis (LDA)=3.667 log10, P=0.004) and Stenotrophomonas (LDA=2.778 log10, P=0.044). In the antibiotic+ Clostridium butyricum+ DSS group, the dominant bacteria genus were Peptococcus (LDA=2.685 log10, P=0.018), Butyricimonas (LDA=2.712 log10, P=0.011), Bilophila (LDA=3.204 log10, P=0.014), Intestinimonas (LDA=3.346 log10, P=0.010), Candidatus- Saccharimonas (LDA=3.363 log10, P=0.029), Desulfovibrio (LDA=3.402 log10, P=0.025), Oscillibacter (LDA=2.870 log10, P=0.019) and Akkermansia (LDA=4.031 log10, P=0.005). Conclusions:Clostridium butyricum can effectively improve colitis in mice and regulate the intestinal microbial structure of mice, whlie antibiotic pretreatment can strengthen its regulation of intestinal microbiota to and enhance the efficacy of Clostridium butyricum.
ABSTRACT
Objective:To investigate the efficacy and safety of fecal microbiota transplantation (FMT) in the treatment of irritable bowel syndrome (IBS), and to explore the effects of FMT on the gut microbiota of IBS patients.Methods:From September 2016 to August 2017, at Guangzhou First People′s Hospital, 28 hospitalized IBS patients who underwent FMT treatment were enrolled. Before FMT, four and 12 weeks after FMT, all the IBS patients completed the irritable bowel syndrome quality of life scale (IBS-QOL), irritable bowel syndrome severity scoring system (IBS-SSS) and gastrointestinal symptom rating scale (GSRS). 16S rDNA sequencing was performed before FMT and four weeks after FMT. The effects of FMT on gut microbiota diversity and microbiota structure of IBS patients were analyzed respectively from the level of phylum, family and genus, and linear discriminant analysis effect size (LEfSe) was further used to screen the different bacteria. Paired t test and paired rank sum test were used for statistical analysis. Results:Twelve weeks after FMT, the scores of the six dimensions of IBS-QOL including dysthymia, behavioral disorder, auto imagery, health concerns, eating avoidance, and relationship expansion were all lower than those before FMT (43.750, 22.656 to 56.250 vs. 48.438, 32.031 to 60.938; 37.500, 18.750 to 56.250 vs. 46.429, 21.429 to 62.500; 31.250, 14.063 to 42.188 vs. 31.250, 18.750 to 50.000; 41.667, 27.083 to 56.250 vs. 50.000, 41.667 to 66.667; 54.167, 43.750 to 72.917 vs. 66.667, 58.333 to 83.333; 8.333, 0.000 to 33.333 vs. 16.667, 8.333 to 33.333, respectively), and the differences were statistically significant ( Z=-2.157, -3.429, -2.274, -3.197, -3.042 and -2.329, all P<0.05). Twelve weeks after FMT, the scores of the two dimensions of IBS-QOL including behavioral disorder and relationship expansion were both lower than those of four weeks after FMT (37.500, 18.750 to 56.250 vs. 39.286, 19.643 to 62.500 and 8.333, 0.000 to 33.333 vs. 16.670, 2.083 to 41.667, respectively), and the differences were statistically significant ( Z=-1.998 and -2.110, both P<0.05). Four and 12 weeks after FMT, the scores of IBS-SSS and GSRS were both lower than those before FMT ((190.32±106.51), (201.43±102.48) vs. (245.93±86.10) and 5.50, 4.00 to 9.00 and 5.50, 4.00 to 8.75 vs. 7.00, 6.00 to 9.75), and the differences were statistically significant ( t=4.402 and 3.848, Z=-3.081 and -3.609; all P<0.01). No serious adverse reactions occurred in the patients after FMT. At the phylum level, after FMT the abundance of Verrucomicrobia in the feces of IBS patients was richer than that before FMT (6.74% vs. 0.37%); at the family level, after FMT the abundance of Verrucomicrobiaceae in the feces of IBS patients was richer than that before FMT (6.74% vs. 0.37%); at the genus level, after FMT the abundance of Akkermansia was richer than that before FMT (6.74% vs. 0.37%); and the differences were statistically significant (all Z=-2.589, all P=0.010). The results of LEfSe method indicated that four weeks after FMT the abundance of Akkermansia in the gut microbiota of IBS patients was richer than that before FMT (6.74% vs. 0.37%), and the difference was statistically significant (linear discriminant analysis value=4.5, P=0.049). Conclusions:FMT is safe and effective in the treatment of IBS. The mechanism may be through upregulating the diversity of gut microbiota and changing the structure of gut microbiota of IBS patients.
ABSTRACT
Objective By observing the clinical efficacy of acupuncture plusBu Shen Jie Yu Qing Xin decoction (herbal decoction for tonifying kidney, anti-depression and clearing heart fire) in treating perimenopausal depression, to discuss about the effect of acupuncture plus medication on Hamilton Depression Scale (HAMD), Self-rating Depression Scale (SDS) and hypothalamic-pituitary-ovarian (H-P-O) axis in perimenopausal depression patients.Method By following a completely randomized design, sixty perimenopausal depression patients were divided into a Chinese medication group (Bu Shen Jie Yu Qing Xin decoction) with 30 cases, and an acupuncture-medication group (acupuncture plusBu Shen Jie Yu Qing Xin decoction) with 30 cases, to receive 12-week treatment in total. The HAMD and SDS were estimated prior to the treatment and in the 4th, 8th and 12th weeks; the serum follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), testosterone (T), prolactin (PRL), and progesterone (P) contents were detected before and after the treatment.Result Acupuncture plus medication and Chinese medication alone were both effective in treating perimenopausal depression, and the therapeutic efficacy of acupuncture plus medication was superior to that of Chinese medication alone (P0.05). After 12-week treatment, the contents of FSH and LH declined significantly in both groups (P<0.01, P<0.05), and the contents of E2 and T increased significantly in the acupuncture-medication group (P<0.01,P<0.05). The decrease of FSH and LH, and the increase of E2 were more significant in the acupuncture-medication group (P<0.05,P<0.01).Conclusion Acupuncture plus medication can improve the symptoms of perimenopausal depression, and it takes a faster action than Chinese medication alone. Acupuncture plus medication can mitigate 7 items in HAMD, while Chinese medication can improve anxiety, insight, sleep and despair. Acupuncture plus medication can produce a more significant efficacy in improving anxiety, insight, sleep, diurnal-nocturnal, obstruction, and body weight compared to Chinese medication. For perimenopausal depression, acupuncture plus medication can correct the endocrine disorder and improve depression state by down-regulating the levels of FSH and LH, and up-regulating the contents of E2 and T to improve the function of H-P-O axis.
ABSTRACT
Objective To explore the effect of hepatitis B virus (HBV) X protein (HBx) on autotaxin (ATX) expression and its significance. Methods The recombinant eukaryotic expression vector of HBx ,pcD-NA3.1(+)-HBx,and the recombinant luciferase reporter gene vector of ATX promoter,pGL3-ATX,were con-structed and used to co-transfect HepG2 cells to examine the effect of HBx on the activity of ATX promoter. The sta-ble cell expressing HBx,HepG2.HBx,was constructed,and Western blot(WB)was used to detect the effect of HBx on ATX expression. Results The luciferase activity of pcDNA3.1(+)-HBx and pGL3-ATX group was 1.47 times as that of the empty vector cDNA3.1(+)and pGL3-ATX group(P<0.000). WB detection showed that the expression of ATX protein was increased in HepG2.HBx cells,and 1.75 times as that of HepG2 cells(P<0.05). Conclusion HBx can activate ATX promoter and up-regulate ATX expression ,thus suggests that HBV infection might enhance ATX/LPA signaling.
ABSTRACT
Objective To investigate the expression and significance of Toll-like receptors-4 in peripheral blood and placental tissue in gestational diabetes mellitus (GDM) patients.Methods From February 2013 to February 2015.a total of 30 cases of gestational diabetes mellitus patients(GDM group) and 30 cases of normal pregnant people(health group)were selected as research objects.Peripheral blood and placental tissue of two groups were collected.The expression of TLR4 mRNA in peripheral blood mononuclear cells was detected by RT-PCR,the expression of TLR4 protein in placenta tissue was detected by immunohistochemistry.Results The expression of TLR4 mRNA in peripheral blood mononuclear cells of the observation group was significantly higher than that of the health group[(0.63±0.12) vs.(0.32±0.07)],the difference was statistically significant(t=12.223,P<0.05).The expression of TLR4 in villous trophoblast cells,decidual cells and amniotic epithelial cells in GDM group was significantly higher than that in the health group(Z=2.325,2.374,2.162,P<0.05).Conclusion The expression of TLR4 in peripheral blood mononuclear cells,villous trophoblast cells and decidual cells in gestational diabetes mellitus patients significantly enhanced,suggesting that TLR4 might be related to the e gestational diabetes mellitus.
ABSTRACT
A high performance liquid chromatography-inductively coupled plasma mass spectrometric ( HPLC-ICP-MS) method for analysis of selenocystine (SeCys2), selenite (SeⅣ), selenomethionine (SeMet) and selenate ( SeⅥ) was described. Chromatographic separation was performed using 8 mmol/L citric acid solution (pH 5). The potentially interfering 40Ar40Ar+ at selenium masses of m/z 80 was reduced using CH4 as a reactive cell gas in the dynamic reaction cell. The selenium species was extracted using ultrasonic extraction system with a mixture of protease K and lipase. The limits of detection for SeCys2 , SeⅣ, SeMet, and SeⅥwere observed as 0. 088, 0. 033, 0. 30, and 0. 17 ng/mL, respectively. The correlation coefficients were greater than 0 . 9995 . The recoveries were observed in the range of 95 . 1%-114 . 6%. The developed method was successfully applied for the determination of selenium species in Burdock and Panax notoginseng.
ABSTRACT
Objective To analyze the HLA-A ,B and DRB1 alleles high-resolution polymorphism in Chongqing Han population . Methods The PCR-SSOP and PCR-SBT methods were applied for the HLA high-resolution genotyping of 2 067 unrelated healthy donors in the registry of Chongqing branch of Chinese National Marrow Donor Program (CMDP) .The allele frequencies of HLA-A , B and DRB1 were estimated by the direct counting method and the Hardy-Weinberg equilibrium inspection was performed by using the Arlequin software 3 .1 .Results 168 high-resolution alleles were detected out ,in which 42 alleles of A*11 :01 ,A*24:02 ,A*02:07 ,A*02 :01 and A*33:03 at the HLA-A locus were observed with the frequencies greater than 0 .05 ;81 alleles were detected at HLA-B locus ,including B*46 :01 ,B*40:01 ,B*58 :01 ,B*13 :01 and B*15 :02 with the frequencies greater than 0 .05 ;45 al-leles of DRB1*09:01 ,DRB1*15 :01 ,DRB1*12 :02 ,DRB1*08 :03 and DRB1*11 :01 at the HLA-DR locus were observed with the frequencies greater than 0 .05 .Conclusion The data of the HLA-A ,B and DRB1allelic frequencies at high-resolution level in Chongqing Han population are obtained ,which provides the reliable reference data for the studies of anthropology ,forensic medi-cine ,transplantation matching and disease association .
ABSTRACT
Objective To investigate the relationship between the numbers of deep medullary veins (DMV) beside the ipsilateral lateral ventricle and the stenotic degree of large artery of ipsilateral internal carotid artery (ICA) system and cerebrovascular reactivity (CVR) in patients with acute cerebral infarction showed on susceptibility-weighted imaging (SWI) in middle cerebral artery (MCA) territory.Methods The patients with acute cerebral infarction in MCA territory who underwent SWI,cerebral angiography and the transcranlal Doppler carbon dioxide challenge test during the hospital stay were enrolled retrospectively.According to the numbers of DMV beside the lateral ventricle on SWI,they were classified into 3 grades:Grade 1:DMV ＜5; Grade 2:DMV 5-10; Grade 3:DMV ＞ 10.The correlations of the DMV grades and the degree of ipsilateral ICA/MCA and CVR were analyzed.Results A total of 44 patients with acute cerebral infarction in MCA territory were enrolled.Twenty-four patients were DMV 1,15 were DMV2,and 5 were DMV 3.The mean stenosis degree of the main arteries of the ipsilateral ICA system was 40.52％ ±30.62％.The mean CVR of MCA was 0.41 ± 0.16.The stenosis degrees in the DMA grade 1,2,and 3groups were 31.31％ ± 26.02％,44.93％ ± 31.03％,and 71.76％ ± 26.68％,respectively.There were significant differences among the 3 groups (F=4.589,P =0.018),and the stenosis degree in the DMV grade 3 group was significantly higher than that in the DMV grade 1 group (P=0.014).The CVRs in the grade 1,2,and 3 groups were 0.45 ± 0.12,0.41 ± 0.18,and 0.22 ± 0.12,respectively.There were significant differences among the 3 groups (F=6.179,P=0.005),and the CVR in the DMV grade 3 group was significantly lower than that in the DMV grade 1 group (P =0.006) and in the DMV grade 2 group (P =0.038).Spearman correlation analysis showed that DMV grade was significantly positively correlated with the stenosis degree (rs =0.381,P =0.013),and was significantly negatively correlated with CVR (rs =-0.375,P=0.012).Conclusions The DMV grade in patients with cerebral infarction was positively correlated with the stenosis degree of responsible large artery and was negatively correlated with the MCA CVR in the responsible side.
ABSTRACT
@#ObjectiveTo investigate the clinical features and the causes of misdiagnosis of benign paroxysmal positional vertigo (BPPV) in the elderly. Methods21 aged patients diagnosed with BPPV finally were analyzed retrospectively. ResultsBPPV occurred more in female and associated with the posterior semicircular canal. The symptoms of vertigo were obviously improved with the canalith repositioning. With suffering from chronic diseases such as hypertension and cervical spondylosis etc., BPPV in the aged was easily misdiagnosed. ConclusionThe main reason for the misdiagnosis of BPPV in the aged is deficiency of knowledge of vertigo. Canalith repositioning is a safe and effective treatment for the aged with BPPV.
ABSTRACT
Objective To investigate the relationship between the genetic polymorphisms, which played roles in the pathogenesis of metabolic syndrome (MS), and susceptibility of non-alcoholic fatty liver disease (NAFLD) in Han people in Guangdong province. Methods The subjects were selected from an epidemiologie survey in Guangdong province. Fifty to 117 adult NAFLD patients, who met the criteria of Chinese guideline for diagnosis of NAFLD and had typically clinical, biochemical signs and abdominal ultrasonography, were recruited in the study. By using 1 : 1 matched method of nested case-control study, same numbers of people without NAFLD were included as controls. The genetic analyses was performed by using genomic DNA extracted from peripheral blood. Polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) was applied to detect the single nucleotide polymorphisms (SNPs) at 9 sites in 7 candidate genes. Results Most SNPs of the genes were related to the susceptibility of NAFLD. Some of them had positive relation (increasing the risk) such as tumor necrosis factor (TNF)-α-238, adiponectin-45, leptin-2548, peroxisome proliferator-activated receptors (PPAR) γ-161 and phosphatidylethanolamine N-methyltransferase (PEMT)-175. Some had negative relation (decreasing the risk) including adiponectin-276 and hepatic lipase-514. And some had no relation (TNF-α-380 and PPAR g coactivator-1α-482). Conclusion Most cytokines' SNPs of candidate genes discovered in MS patients are related to the susceptibility of NAFLD.
ABSTRACT
Objective: To investigate the value of positron emission tomography/computerized tomography(PET/CT) with fluorine-18-labeled fluorodeoxyglucose(18FDG) for gastric carcinoma.Methods: Thirty-two patients(25 males,7 females,aged 31-82 years) suspected of gastric carcinoma underwent whole-body PET/CT after taking in 600 ml of water to distend the gastral cavity.The maximal standard uptake value(SUVmax) of the region of interest(ROI) in PET and the maximum width of the gastric wall in CT were analyzed.Pathological specimens were obtained from all the patients during surgery or gastroscopy.Results: 18FDG PET/CT found gastric carcinoma in 24 of the patients.The rates of positive and negative prediction and the accuracy of PET/CT in the diagnosis of the disease were 92.3%,100% and 93.8%.SUVmax was positively correlated with the maximum width of the gastric wall,but they exhibited no statistically significant differences between the patients with involved lymph nodes and those without.Based on the PET/CT findings,the 24 gastric carcinoma patients were clinically classified as follows: 9 in stage Ⅰ,1 in stage Ⅰ-Ⅱ,3 in stage Ⅱ,1 in stage Ⅲ and 10 in stage Ⅳ.Conclusion: 18FDG PET/CT is highly valuable for gastric carcinoma in its diagnosis,the evaluation of its biological behavior and determination of its treatment strategies.
ABSTRACT
Objective To explore the effects and relationship of tert-butyl hydroperoxide (t-BHP) and hypoxia in transient ischemia-like attack (TIA-like) in Kunming mice.Methods Fifty-six mice were randomly divided into normal saline group (group A), t-BHP group (group B), t-BHP plus hypoxia group (group C) and model group (group D). Fourteen mice in group D were injected t-BHP (0.11 mol/L, 10 ml/kg) through tail vein with an interval of 24 hrs to induce TIA-like attack. The average time of TIA-like was ( 3.7? 1.1) days, and this time was used as experimental evidence to collect blood sample in other groups. Hemorheological indexes before TIA-like attack were observed in different experimental conditions.Results Compared with group A, the whole blood viscosity at shear rate 100S-1, 1S-1 and Fibrinogen were significantly increased in group B and group C (all P