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The clinical date of 5 adult patients with severe tetanus admitted in the ICU of Jiangsu Provincial Subei People′s Hospital between October 2019 and January 2021 were analyzed retrospectively. There were 2 males and 3 females, aged 19-65 years. Patients had a history of trauma 5 to 30 days before the onset of the disease, and were admitted 1 to 11 days after the onset of the disease. The main manifestations were neck pain with limited movement, difficulty in opening the mouth, paroxysomal convulsions of the neck and both upper limbs, generalized paroxysomal convulsions or abdominal muscle tension, and abdominal pain. At the time of admission, the wounds of 2 patients had healed. After admission, all patients were treated with local debridement, metronidazole combined with penicillin/cephalosporin for anti-infection, and human tetanus immunoglobulin (HTIG) 3 000 U was injected into the gluteus and deltoid muscles to neutralize the free toxin in the body. Midazolam combined with magnesium sulfate was intravenously infused to control and relieve skeletal muscle spasm.Among them, 3 patients received tracheotomy and ventilation due to respiratory failure. One patient underwent bedside continuous renal replacement therapy (CRRT) for severe skeletal muscle spasm resulting in rhabdomyolysis syndrome and acute kidney injury. All five patients with severe tetanus were cured and discharged.
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Preclinical evaluation is related to the clinical safety of radiopharmaceuticals.There are different research foci on preclinical evaluation of different radiopharmaceuticals.This article summarizes the Food and Drug Administration (FDA) preclinical evaluation guidelines of diagnostic and therapeutic radiopharmaceuticals,in order to provide reference for domestic research and preclinical evaluation of radiopharmaceuticals.
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Objective To discuss the clinical value of IL-6 combined with CA125 and HE4 as a new association marker in the diagnosis of early ovarian cancer.Methods The expression of IL-6, CA125 and HE4 in 21 cases of early ovarian cancer (stageⅠ-Ⅱ), 36 cases of advanced ovarian cancer (stageⅢ-Ⅳ), 40 cases of benign ovarian tumor and 40 healthy women were measured by the Roche automatic chemiluminescence analyzer (electrochemiluminescence).The sensitⅣity, specificity, positive predictive value, negative predictive value and ROC curves were used to evaluate the diagnostic value.Results The serum levels of IL-6, CA125 and HE4 in patients with ovarian cancer were significantly higher than those in the benign ovarian tumor and the healthy control (P＜0.05).The sensitⅣity, specificity, positive predictive value and negative predictive value of IL-6 combined with CA125 and HE4 were respectively 85.7％, 90％, 81.8％, 92.3％in the diagnosis of early ovarian cancer (stageⅠ-Ⅱ) patients and respectively 94.4％, 97.5％, 97.1％and 95.1％for advanced ovarian cancer (stageⅢ-Ⅳ) patients.For IL-6 combined with CA125 and HE4, the ROC AUC was respectively 0.955 4 and 0.974 0 for early ovarian cancer (stageⅠ-Ⅱ) patients and advanced ovarian cancer (stageⅢ-Ⅳ) patients.It performed significantly better than any single test of IL-6, CA125 and HE4 and the 2-marker combination of CA125+HE4.Conclusion The marker panel, IL-6, CA125 and HE4, shows higher sensitⅣity, positive predictive value and ROC AUC.It is an ideal serum marker combination for the diagnosis of early ovarian cancer (stageⅠ-Ⅱ) patients, which can improve the diagnostic efficiency of early ovarian cancer.
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Radiopharmaceuticals have been widely used in the diagnosis, treatment and monitoring of diseases, and they play an important role in new drug development. Food and Drug Administration(FDA) has rich experience in the administration of radiopharmaceuticals. This article mainly interprets the regulato-ry policy of FDA for radiopharmaceuticals from the aspects of definition, regulations and registration, trying to provide reference for domestic research of radiopharmaceuticals.
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Objective To investigate the correlation between admission hyperglycemia and clinical prognosis in elderly patients with community-acquired pneumonia.Methods Based on the electrical medical record (EMR),information of the patients with pneumonia was retrospectively collected and the necessary data were prepared and arranged.Based on clinical outcomes,demographic characteristics and clinical indicators were compared between groups in order to screen potential variables affecting clinical outcomes.Then,the random blood glucose level 8.6 mmol/L was considered to be the cutoff point for grouping patients,with clinical outcomes as outcome variables,random blood glucose levels as grouping variables,propensity score value analysis method was applied along with the ratio of 1:1 nearest neighbor matching method to generate paired samples in order to assess the impact of blood glucose level on mortality rate;With hospitalization time serving as time variable,survive analysis method was used to analyze COX proportional model.Results Five hundred and fifty-eight patients were enrolled in the analysis,197 patients of which were recorded dead during hospitalization (the dead group).After the correction of demographic characteristics,past medical history and blood test indexes,white blood cells,C reactive protein,random blood glucose at admission and triglyceride levels were regarded as potential factors for the deaths of patients (P<0.05).However,the propensity score analysis method suggested that there was no significant difference between the blood glucose levels and mortality.The survival analysis showed that the mortality in the high blood glucose group was higher than that in the normal blood glucose group (HR=1.68,95%CI(1.22,2.31)).Conclusion Admission hyperglycemia is an important indicator of adverse prognosis in elderly patients with pneumonia.It may be of significance for screening and identifying high-risk patients.
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Objective To investigate the changes of gene expression profile in Beagle dogs' peripheral blood lymphocytes after acute irradiation.Methods Totally 20 male adult Beagle dogs were randomly divided into four groups including non-treatment blank control group and three radiation groups exposed to 0.5,2.0,and 5.0 Gy of γ-rays,respectively.Six hours after radiation,the peripheral blood were collected for lymphocytes isolation.Total RNA was extracted from the lymphocytes and analyzed by microarray hybridization.The differential gene profiles of radiation groups were analyzed by gene ontology (GO) analysis and kyoto encyclopedia of genes and genomes (KEGG) pathways analysis,and the alerted genes were further confirmed by the real time quantitative PCR (qRT-PCR) assay.Results Compared to the blank control group,the expressions of 308 genes in the radiation groups were perturbed over 2-fold of control,including 61 genes up-regulated and 247 genes down-regulated,which were mainly associated with immune response and cancer occurrence.The GO analysis indicated that the differential expressed genes were associated with cell connection,signal transduction,oxidation-reduction reaction and metabolism.The KEGG pathway analysis showed that some physiological and biochemical processes were involved,such as phagocytosis,tumor pathway,p53 signaling pathway,JAK-STAT signal pathway,cell differentiation,and proliferation,oxidative phosphorylation,glycogen dysplasia and other pathways.The microarray data of the alterations of apoptosis enhancing nuclease (AEN) and mitogenactivated protein kinase 13 (MAP3K13) gene expressions were further confirmed by qRT-PCR.Conclusions Exposure to different doses of acute γ-ray irradiation had significant impact on the gene expressions in Beagle dogs' peripheral blood lymphocytes and those differential expressed genes were related to a series of biological processes and pathways including immune response,metabolism and carcinogenesis.
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OBJECTIVES: Lyme disease is the most common tick-borne disease. People seek health information on Lyme disease from YouTube™ videos. In this study, we investigated if the contents of Lyme disease-related YouTube™ videos varied by their sources. METHODS: Most viewed English YouTube™ videos (n = 100) were identified and manually coded for contents and sources. RESULTS: Within the sample, 40 videos were consumer-generated, 31 were internet-based news, 16 were professional, and 13 were TV news. Compared with consumer-generated videos, TV news videos were more likely to mention celebrities (odds ratio [OR], 10.57; 95% confidence interval [CI], 2.13–52.58), prevention of Lyme disease through wearing protective clothing (OR, 5.63; 95% CI, 1.23–25.76), and spraying insecticides (OR, 7.71; 95% CI, 1.52–39.05). CONCLUSION: A majority of the most popular Lyme disease-related YouTube™ videos were not created by public health professionals. Responsible reporting and creative video-making facilitate Lyme disease education. Partnership with YouTube™ celebrities to co-develop educational videos may be a future direction.
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Cross-Sectional Studies , Education , Health Communication , Insecticides , Lyme Disease , Protective Clothing , Public Health , Social Media , Tick-Borne DiseasesABSTRACT
Objective To investigate the impacts of γ-ray radiation on gene expressions of peripheral blood lymphocytes in SD rats,and to screen differential expression genes and biological pathways closely related to radiation injury.Methods The differential gene expression of peripheral blood lymphocytes in SD rats was selected by microarray at 6 h after 2 Gy 60Co γ-ray exposure in vitro and in vivo.Bioinformatics analysis of the differentially expressed genes was performed by using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) databases.Real-time quantitative PCR was applied to verify the screen results of the microarray.Results Fifty-five genes with three times over-expressed level were screened out from the radiation groups both in vitro and in vivo and they were involved in 6 signaling pathways.There were two differentially expressed genes of microarray assay were verified by PCR assay.Conclusions Differential expressed genes in the peripheral blood lymphocytes of SD rats could be induced by γ-ray radiation and they cooperatively contributed to a variety of biological processes.
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Objective:To investigate the differentially expressed miRNAs in serum collected post operation and compared these miR-NAs with those collected pre-surgery among patients suffering from glioblastoma multiform (GBM) and undergoing regular clinical fol-low-up. These miRNAs may be potential biomarkers for the post-operative evaluation of patients with GBM. Methods:Forty-eight pa-tients with GBM and clinical pathological diagnosis were enrolled in this study. In the initial biomarker screening stage, total RNAs were extracted and subjected to Solexa sequencing to select miRNAs with significantly altered expression pre-and post-operation. Some of these differentially expressed miRNAs were chosen and verified through TaqMan probe-based qRT-PCR assay. A t-test was performed to determine the miRNAs that satisfied the two criteria, namely, fold change>2 and P<0.05. All of the patients were fol-lowed-up, and survival data were collected. The patients were then classified into two groups, namely, long-and short-survival groups, on the basis of the median of the miR-30e expression levels in the sera collected post-operation. Kaplan-Meier method and Log-rank test (SPSS version 19.0, IBM) were employed to determine the possible relationships between miR-30e expression levels in the sera collected post-operation and patients' overall survival. Results: Solexa revealed 63 differentially expressed miRNAs. Four miRNAs, namely, miR-26b, miR-30e, miR-129-3p, and miR-206, were selected on the basis of previous and present findings. These miRNAs were then verified in the RT-qPCR phase. Among these miRNAs, only miR-30e was significantly upregulated post-operation. The serum miR-30e expression level post-operation was not significantly associated with the overall survival of the patients. A low miR-30e expression level corresponded to prolonged survival. Conclusion:miR-30e was upregulated in the sera collected post-operation from patients with GBM. This miRNA may be negatively related to the tumor load of these patients. The miR-30e expression level in the serum col-lected post-surgery serum was not significantly associated with overall survival. Therefore, miR-30e may serve as a novel potential non-invasive biomarker for the post-operative evaluation of patients with GBM.
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Objective To explore the diagnostic value of cerebrospinal fluid(CSF) biochemical indexes in central nervous system (CNS) infection .Methods The results of CSF culturing and detection of biochemical indexes including glucose(Glu) ,lactate dehy‐drogenase(LDH) ,chloride ion(Cl) and protein(PRO) were collected from the First Affiliated Hospital of Xi′an Jiaotong University from September to December 2013 .Taking the results of CSF culturing as golden standard ,the biochemical indexes were analyzed by using receiver‐operating characteristic(ROC) curve for single index and combined indexes .Results A total of 157 CSF speci‐mens were collected ,including 39 culture‐positive specimens and 118 culture‐negative specimens .Areas under ROC curve(AUC) of Glu ,LDH ,Cl and PRO were 0 .653 ,0 .633 ,0 .626 ,0 .671 ,respectively .The AUCs of combined detection of these biochemical inde‐xes were higher than those of single index ,and the AUC of combined detection of these four indexes was the largest ,up to 0 .694 , but all were less than 0 .7 .Conclusion Glu ,LDH ,Cl and PRO all could be independent biochemical indexes for diagnosing CNS in‐fection ,among which PRO has the highest diagnostic value .And combined detections of these indexes are better than single detec‐tions ,especially combination of four indexes ,which is the strongest indicator ,but accuracy is low whether single or combined detec‐tion .More sensitive and specific biomarkers of CSF should be explored for rapid diagnosis of CNS infection .
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Objective To investigate the application value of nutritional support therapy after resection of esophageal cancer.Methods The clinical data of 125 patients with esophageal cancer who were admitted to the Shandong Provincial Hospital Affiliated to Shandong University between May and November 2013 were retrospectively analyzed.According to the Nutritional Risk Screening 2002 (NRS 2002), 58 patients with scores of NRS 2002 ≥3 were allocated to the A group including 43 receiving nutritional support therapy in the A1 group and 15 receiving no nutritional support therapy in the A2 group;67 patients with scores of NRS 2002 ＜ 3 were allocated to the B group including 29 receiving nutritional support therapy in the B1 group and 38 receiving no nutritional support therapy in the B2 group.The NRS 2002 was used as a screening tool of nutritional risk within 48 hours after admission.There was nutritional risk in patients with scores of NRS 2002 ≥ 3 and no nutritional risk in patients with scores of NRS 2002 ＜ 3.Patients and their families would choose whether or not underwent nutritional support therapy after the risks being informed.Parenteral nutritional support therapy used any 2 kinds of intravenously infusions of glucose, fat emulsion and amino acid, and enteral nutritional support therapy included tube feeding enteral nutrition or oral nutriments.The calories ≥ 10 kcal/(kg · d) were offered for more than 5 days.The incidence of malnutrition in patients with nutritional risk was calculated, and the level of serum Alb and prealbumin before operation, at postoperative day 3 and day 7, postoperative recovery time of gastrointestinal function and duration of hospital stay were detected.Count data were analyzed using the chi-square test.Measurement data with normal distribution were presented as-x ± s.Comparison among groups was analyzed using the LSD-t test, and repeated measures data were analyzed by the repeated measures ANOVA.Results Of 58 patients in the A group, 51 patients were complicated with malnutrition with a incidence of 87.9％, and nutritional support therapy in 43 patients was well tolerated without abdominal pain, distension and diarrhea.The level of serum Alb before operation, at postoperative day 3 and day 7 were (29.4 ± 1.7) g/L, (29.8 ± 1.5) g/L, (32.2 ± 2.3) g/L in the A1 group, (28.5±1.9)g/L, (27.0±1.8)g/L, (28.3 ±1.7)g/L in the A2 group, (35.8±1.3)g/L, (36.0± 1.4) g/L, (37.4 ± 2.1) g/L in the B1 group and (34.5 ± 1.3) g/L, (35.3 ± 1.7) g/L, (36.3 ± 1.5) g/L in the B2 group, showing a significant difference in the changing trends between the A1 and A2 groups (F =2.541, P ＜0.05) and no significant difference between the B1 and B2 groups (F =0.734, P ＞ 0.05).The number of patients with level of prealbumin ＜2.5 g/L and ≥2.5 g/L before operation, at postoperative day 3 and day 7 were 17 and 26, 13 and 30, 10 and 33 in the A1 group, 6 and 9, 9 and 6, 10 and 5 in the A2 group, 5 and 24, 6 and 23, 7 and 22 in the B1 group and 7 and 31, 9 and 29, 13 and 25 in the B2 group, with a significant difference between the A1 and A2 groups (x2 =4.183, P ＜ 0.05) and no significant difference between the B1 and B2 groups (x2 =0.795, P ＞ 0.05).The postoperative recovery time of gastrointestinal function and duration of hospital stay were (3.2 ± 0.8) days and (11.6 ± 1.1) days in the A1 group, (3.8 ± 1.0) days and (15.5 ± 2.7) days in the A2 group, (2.7 ± 1.0) days and (10.6 ± 2.6) days in the B1 group and (3.2 ± 0.8) days and (11.3 ±1.5) days in the B2 group, with significant differences between the A1 and A2 groups (t =0.921, 3.005, P ＜0.05) and no significant difference between the B1 and B2 groups (t =0.927, 0.440, P ＞ 0.05).Conclusions Application of NRS 2002 for evaluating nutritional status and guiding nutritional support therapy in patients with esophageal cancer is accurate and trusted.The postoperative nutritional support therapy should be selectively and reasonably applied to patients with nutritional risk, and it can improve the nutritional status of patients with esophageal cancer, enhance postoperative recovery and reduce duration of hospital stay.
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Purpose To explore the effect of Levothyroxine on spatial working memory in patients with subclinical hypothyroidism (SCH) using blood oxygenation level dependent-functional MRI (BOLD-fMRI). Materials and Methods Sixteen patients with SCH before and after 6 months levothyroxine (LT4) treatment and 16 matched euthyroid volunteers underwent n-back task fMRI scanning. AFNI software was used for localization and quantification. Results All the subjects demonstrated activated areas including bilateral dorsolateral prefrontal cortex (DLPFC), bilateral premotor area (PreMA), supplementary motor area/anterior cingulate cortex, bilateral parietal area (PA) and right caudate nucleus/thalamus, with right hemisphere dominance. Quantitative analysis of regions of interests showed that all these regions had load effect related to memory load in the control group (P<0.001), whereas only left DLPFC, left PA, bilateral PreMA and right caudate nucleus/thalamus showed the same effect in SCH group. After 6-month treatment with LT4, BOLD signal change was observed in SCH patients within the right DLPFC, right PA and anterior cingulate/supplementary motor cortex (P<0.001). The activation intensity of working memory related brain regions was lower in SCH group compared with that of the control group. Conclusion Spatial working memory impairments in SCH patients are likely related to decreased right DLPFC and right posterior parietal function. LT4 replacement therapy is important to improve and reverse the memory impairment.
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Objective To observe the protective effects of different doses of hydrogen-rich water on radiation injury in mice,so as to provide scientific basis for the application of hydrogen-rich water.Methods The ICR mice were randomly divided into control group,irradiation group,amifostine group and hydrogen-rich water of low,medium and high dose groups.The 30 days survival rate,body weight,hematology parameters,serum biochemical parameters,organ weight and coefficient,bone marrow micronucleus rate,bone marrow nucleated cell count were observed after total body irradiation with 9.0 Gy gamma rays.Results After 30 d of irradiation,the hydrogen-rich water showed obvious protective effect on the survival rate and body weight in a dose dependent manner so that the survival was significantly higher than that of irradiation group (t =-2.67,P ＜ 0.05).The biochemical index,such as TP,ALB and CRE in the low dose group,TP,ALB,TBIL and CRE in the medium dose group,and TP,ALB,GLU,TBIL,BUN,GRE and UA in the high dose group also indicated the protective effects of hydrogen-rich water (t =-2.04--4.11,P ＜ 0.05).But the protective effect of hydrogen-rich water was not observed in hematology,organ weight and coefficient,and bone marrow micronucleus induction.Conclusions The hydrogen-rich water has anti-radiation effect,which may depend on the dose of hydrogen.
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Objective To explore the feasibility of coronary magnetic resonance angiography(CMRA) with a T2-prepared turbo field echo(T2-TFE) sequence at 3.0T MR scanner.Methods 33 objects underwent CMRA at 3.0T MR imaging unit.The CMRA was performed with a 3D T2-TFE sequence.Electrocardiographically gating combined with real-time respiratory navigator gating and tracking was used to suppress the cardiac motion and correct for respiratory-induced coronary artery motion.The original images were reconstructed with MIP and Soap Bubble software.The quality of CMRA was evaluated and the lengths of the main coronary arterial branches were measured.Results 115 of 128 coronary arteries were scored higher than 3 with the standard of image quality.The lengths of LM,LAD,LCX and RCA were(12.0?3.8) mm,(79.4?18.9) mm,(60.0?12.7) mm and(110.7?27.2) mm,respectively.Conclusion CMRA with T2-TFE sequence is feasible at 3.0T.