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OBJECTIVE To develop an individualized medication list for elderly patients by evidence-based pharmacy method， and to support clinical decisions on rational use of METHODS Firstly， drugs with risk genetic information were screened out by systematically reviewing evidence-based pharmacy information. Secondly， researchers investigated the included drugs in lists from different data E- sources. Drugs included in three or more data sources and drugs proposed by the expert committee were then included in the medication list. Thirdly， for the drugs included in two data sources， researchers designed questionnaires to investigate the necessity of drug-related gene testing. According to the scoring results of the expert questionnaire， drugs with higher scores were included in the list. Data sources included real-world data （list of high frequency medication in hospitals， high frequency medication for elderly outpatients and inpatients in National Health Care Claims Data， drugs related to frequent medication errors and so on） and evidence-based pharmacy evidence （the websites of Clinical Pharmacogenomics Implementation Consortium， Dutch Pharmacogenetics Working Group， Food and Drug Administration and so on）. RESULTS The study obtain 68 drugs with risk genetic information which were included in three data sources. Combined with 23 drugs proposed by the expert committee， a list containing 74 drugs was preliminarily formed after de-duplication. A total of 37 drugs included in two databases with risk genetic information were scored through the questionnaire survey to form a supplementary list of 26 drugs. This is the final composition of the list of 100 drugs developed in this study. Among them， there are 43 drugs for the central nervous system， 15 drugs for the cardiovascular system， 12 anti-tumor drugs and so on. Twelve drugs were included in six or more data sources， which mainly consisted of drugs for digestive system， all proton pump inhibitors. CONCLUSION In this study， a list of 100 commonly used drugs which require individualized medication for the elderly was developed by evidence-based pharmacy method. The drug list will be updated in time as available evidence changes， and can provide guidance for rational use of medicines for elderly patients.
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Background@#Hypothermia is a crucial environmental factor that elevates the risk of cardiovascular disease, but the underlying effect is unclear. @*Objectives@#This study examined the role of cold stress (CS) in cardiac injury and its underlying mechanisms. @*Methods@#In this study, a chronic CS-induced myocardial injury model was used; mice were subjected to chronic CS (4°C) for three hours per day for three weeks. @*Results@#CS could result in myocardial injury by inducing the levels of heat shock proteins 70 (HSP70), enhancing the generation of creatine phosphokinase-isoenzyme (CKMB) and malondialdehyde (MDA), increasing the contents of tumor necrosis factor-α (TNF-α), high mobility group box 1 (HMGB1) interleukin1b (IL-1β), IL-18, IL-6, and triggering the depletion of superoxide dismutase (SOD), catalase (CAT), and glutathione (GSH). Multiple signaling pathways were activated by cold exposure, including pyroptosis-associated NOD-like receptor 3 (NLRP3)-regulated caspase-1-dependent/Gasdermin D (GSDMD), inflammation-related toll-like receptor 4 (TLR4)/myeloid differentiation factor 88 (MyD88)-mediated nuclear factor kappa B (NF-κB), and mitogen-activated protein kinase (MAPK), as well as oxidative stressinvolved thioredoxin-1/thioredoxin-interacting protein (Txnip) signaling pathways, which play a pivotal role in myocardial injury resulting from hypothermia. @*Conclusions@#These findings provide new insights into the increased risk of cardiovascular disease at extremely low temperatures.
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[This corrects the article DOI: 10.1016/j.apsb.2021.03.043.].
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Drug-metabolizing enzymes (DMEs), a diverse group of enzymes responsible for the metabolic elimination of drugs and other xenobiotics, have been recognized as the critical determinants to drug safety and efficacy. Deciphering and understanding the key roles of individual DMEs in drug metabolism and toxicity, as well as characterizing the interactions of central DMEs with xenobiotics require reliable, practical and highly specific tools for sensing the activities of these enzymes in biological systems. In the last few decades, the scientists have developed a variety of optical substrates for sensing human DMEs, parts of them have been successfully used for studying target enzyme(s) in tissue preparations and living systems. Herein, molecular design principals and recent advances in the development and applications of optical substrates for human DMEs have been reviewed systematically. Furthermore, the challenges and future perspectives in this field are also highlighted. The presented information offers a group of practical approaches and imaging tools for sensing DMEs activities in complex biological systems, which strongly facilitates high-throughput screening the modulators of target DMEs and studies on drug/herb‒drug interactions, as well as promotes the fundamental researches for exploring the relevance of DMEs to human diseases and drug treatment outcomes.
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Gastrointestinal mucositis is one of the most debilitating side effects of the chemotherapeutic agent irinotecan (CPT-11). Andrographolide, a natural bicyclic diterpenoid lactone, has been reported to possess anti-colitis activity. In this study, andrographolide treatment was found to significantly relieve CPT-11-induced colitis in tumor-bearing mice without decreasing the tumor suppression effect of CPT-11. CPT-11 causes DNA damage and the release of double-stranded DNA (dsDNA) from the intestine, leading to cyclic-GMP-AMP synthase (cGAS)‒stimulator of interferon genes (STING)-mediated colitis, which was significantly decreased by andrographolide both in vivo and in vitro. Mechanistic studies revealed that andrographolide could promote homologous recombination (HR) repair and downregulate dsDNA‒cGAS‒STING signaling and contribute to the improvement of CPT-11-induced gastrointestinal mucositis. These results suggest that andrographolide may be a novel agent to relieve gastrointestinal mucositis caused by CPT-11.
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Objective:To explore the effect of step-by-step fusion sandplay therapy on clinical symptoms, emotional cognition and quality of life in children with autism spectrum disorder(ASD).Methods:Eighty children with ASD who were admitted in Zhumadian Central Hospital and the Third Affiliated Hospital of Zhengzhou University from January 2019 to January 2021 were selected as the research objects, and they were divided into the study group( n=45) and the control group ( n=35) according to the random number table method.The children in control group were given structured education combined with auditory system training intervention, while the children in study group were given step-by-step fusion sandplay therapy combined with pretend play training on the basis of the control group.Children in the two groups were intervened for 6 months.Autism behavior checklist (ABC), childhood autism rating scale (CARS), social responsiveness scale (SRS), emotion recognition tools and pediatric quality of life (PedsQL) were applied before and after 6 months of intervention.The scores of ABC, SRS, CARS, emotion recognition and PedsQL were compared between the two groups, and Pearson correlation analysis was used to analyze the relationships between the scores of ABC, SRS, CARS, emotion cognition and PedsQL. Results:Compared with pre-intervention, the two groups of children after 6 months of intervention, the sensation, social interaction, body movement, language, self, ABC total score, social perception, social cognition, social communication, social motivation, autistic behavior, SRS total score and CARS scores decreased ( tstudy group= 5.182, 7.200, 6.778, 7.302, 5.140, 36.178, 3.955, 15.294, 9.014, 11.063, 9.723, 45.354, 25.827, all P<0.05, tcontrol group= 1.971, 2.612, 1.665, 2.294, 2.129, 10.809, 2.305, 5.544, 2.650, 2.955, 2.849, 16.485, 5.910, all P<0.05), upright, inverted, upper half face, lower half face emotion discrimination rate, physiological function, emotional function, social function, school function and PedsQL total scores all increased ( tstudy group= 16.723, 31.037, 10.951, 7.234, 7.572, 7.393, 9.036, 7.236, 6.223, all P<0.05. tcontrol group= 5.458, 14.008, 4.196, 2.653, 3.260, 3.566, 3.298, 2.766, 3.876, all P<0.05). After 6 months of intervention, the ABC total score and the scores of sensation, social interaction, body movement, language, and self-care of children in the study group were all lower than those in the control group (ABC total score difference: the study group (21.9±2.8) points, the control group (7.5±2.6) points), t=23.537, P<0.05). The scores of social perception, social cognition, social communication, social motivation, autistic behavior and SRS total score were all lower than those in the control group (SRS total score difference: study group (18.7±0.7) points, control group (8.1±0.6) points, t=71.448, P<0.05). The CARS score of study group was lower than that in control group (CARS score difference: study group (7.7±1.1) points, control group (2.2±0.8) points, t=24.887, P<0.05), while the scores of upright, inverted, upper and lower face emotion discrimination rate, physiological function, emotional function, social function, school function and the PedsQL total score were all higher than those in the control group (PedsQL total score difference: study group (8.4±1.2) points, control group (0.7±0.9) points, t=31.648, P<0.05). Correlation analysis showed that the ABC total score, SRS total score, and CARS score of children with ASD were negatively correlated with physiological function, emotional function, social function, school function and PedsQL total score ( rABC total score=-0.387, -0.334, -0.324, -0.289, -0.349, all P<0.05. rSRS total score = -0.390, -0.343, -0.299, -0.283, -0.378, all P<0.05. rCARS score = -0.321, -0.298, -0.293, -0.235, -0.319, all P<0.05). Upright, inverted, upper and lower faces were positively correlated with physiological function, emotional function, social function, school function and PedsQL total score ( rupright=0.837, 0.650, 0.669, 0.710, 0.680, all P<0.05. rinversion=0.688, 0.611, 0.615, 0.602, 0.647, all P<0.05. rupper half face=0.755, 0.669, 0.638, 0.740, 0.629, all P<0.05. rlower half face=0.738, 0.724, 0.553, 0.568, 0.560, all P<0.05). Conclusion:The step-by-step fusion sandplay therapy can effectively alleviate the clinical symptoms of children with ASD, improve their social responsiveness, and improve their emotional cognitive function and quality of life.
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Purpose@#There is no optimal prognostic model for T-cell lymphoblastic lymphoma (T-LBL). Here, we discussed the predictive value of total metabolic tumor volume (TMTV) and total lesion glycolysis (TLG) measured on 18F-fluorodeoxyglucose positron emission tomography–computed tomography (PET-CT) in T-LBL. @*Materials and Methods@#Thirty-seven treatment naïve T-LBL patients with PET-CT scans were enrolled. TMTV was obtained using the 41% maximum standardized uptake value (SUVmax) threshold method, and TLG was measured as metabolic tumor volume multiplied by the mean SUV. Progression-free survival (PFS) and overall survival (OS) were analyzed by Kaplan-Meier curves and compared by the log-rank test. @*Results@#The optimal cutoff values for SUVmax, TMTV, and TLG were 12.7, 302 cm3, and 890, respectively. A high SUVmax, TMTV, and TLG indicated a shorten PFS and OS. On multivariable analysis, TMTV ≥ 302 cm3, and central nervous system (CNS) involvement predicted inferior PFS, while high SUVmax, TLG and CNS involvement were associated with worse OS. Subsequently, we generated a risk model comprising high SUVmax, TMTV or TLG and CNS involvement, which stratified the population into three risk groups, which had significantly different median PFS of not reached, 14 months, and 7 months for low-risk group, mediate-risk group, and high-risk group, respectively (p < 0.001). Median OS were not reached, 27 months, and 13 months, respectively (p < 0.001). @*Conclusion@#Baseline SUVmax, TMTV, and TLG measured on PET-CT are strong predictors of worse outcome in T-LBL. A risk model integrating these three parameters with CNS involvement identifies patients at high risk of disease progression.
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OBJECTIVE：To ex plore the effects of solamargine on the growth and apoptosis of human hepatocarcinoma cells HepG2 and its underlying mechanism. METHODS ：The effects of 0（blank group ）-12 μmol/L solamargine treatment of 24，48 h on survival rate of HepG 2 cells were investigated. The effects of 0（blank group ），6 μmol/L solamargine treatment of 10 days on cell clone formation were also investigated. The effects of 0（blank group ），4，6，8 μmol/L solamargine for 24 h on the apoptotic rate of cells，mRNA expression of Bcl- 2，Bax and caspase- 3， protein expression of Bcl- 2 and cleaved caspase- 3 as well as ratio of p-AMPKα to AMPKα were all tested. The effects of AMPK inhibitor as compound C on the protein expression of AMPKα and Bcl- 2 in cells were investigated after treated with 6 μmol/L solamargine for 24 h. RESULTS ：Compared with 020-39318678。E-mail：wujingjing6028@gzucm.edu.cn blank group ，1-12 μ mol/L solamargine for 24，48 h could significantly decrease the survival rates of cells （P＜0.05）in a concentration-dependent manner ；IC50 of them were 8.310 and 7.996 μmol/L，respectively；the rate of cell clone formation was decreased significantly after treated with 6 μmol/L solamargine for 10 days（P＜0.05）. The apoptotic rate of HepG 2 cells，mRNA expression of Bax and caspase- 3，protein expression of cleaved caspase-3（except for 8 μmol/L）as well as ratio of p-AMPKα to AMPKα（except for 8 μmol/L）were all increased significantly after treated with 6，8 μmol/L solamargine（P＜0.05）；mRNA and protein expression of Bcl- 2 were decreased significantly （P＜ 0.05）；the changes of some indexes were in a concentration-dependent manner. The compound C could inhibit protein expression of AMPKα，and reverse the inhibitory effect of solamargine on Bcl- 2 protein. CONCLUSIONS ：Solamargine can inhibit the proliferation of HepG 2 cells and induce apoptosis ，the mechanism of which may be associated with activating AMPK signaling pathway.
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Purpose@#There is no optimal prognostic model for T-cell lymphoblastic lymphoma (T-LBL). Here, we discussed the predictive value of total metabolic tumor volume (TMTV) and total lesion glycolysis (TLG) measured on 18F-fluorodeoxyglucose positron emission tomography–computed tomography (PET-CT) in T-LBL. @*Materials and Methods@#Thirty-seven treatment naïve T-LBL patients with PET-CT scans were enrolled. TMTV was obtained using the 41% maximum standardized uptake value (SUVmax) threshold method, and TLG was measured as metabolic tumor volume multiplied by the mean SUV. Progression-free survival (PFS) and overall survival (OS) were analyzed by Kaplan-Meier curves and compared by the log-rank test. @*Results@#The optimal cutoff values for SUVmax, TMTV, and TLG were 12.7, 302 cm3, and 890, respectively. A high SUVmax, TMTV, and TLG indicated a shorten PFS and OS. On multivariable analysis, TMTV ≥ 302 cm3, and central nervous system (CNS) involvement predicted inferior PFS, while high SUVmax, TLG and CNS involvement were associated with worse OS. Subsequently, we generated a risk model comprising high SUVmax, TMTV or TLG and CNS involvement, which stratified the population into three risk groups, which had significantly different median PFS of not reached, 14 months, and 7 months for low-risk group, mediate-risk group, and high-risk group, respectively (p < 0.001). Median OS were not reached, 27 months, and 13 months, respectively (p < 0.001). @*Conclusion@#Baseline SUVmax, TMTV, and TLG measured on PET-CT are strong predictors of worse outcome in T-LBL. A risk model integrating these three parameters with CNS involvement identifies patients at high risk of disease progression.
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OBJECTIVE： To study direct medical expense and its influential factors， and to provide empirical reference for medical expenses control of pulmonary embolism and the adjustment of anticoagulant drug reimbursement strategy. METHODS： Based on the national urban basic medical insurance data in 2014， the data of patients with pulmonary embolism were extracted by equidistant sampling method to form a sample database. According to related therapy information and expense information of pulmonary embolism patients in sample database， descriptive analysis was performed for demographic characteristics of patients （including gender， age， type of medical insurance， region， type of medical institution， etc.）， direct medical expenses and direct medical expenses of patients with different anticoagulants， etc. Multiple linear regression analysis was used to analyze potential influential factors for the medical expenses of patients. RESULTS： A total of 475 pulmonary embolism patients were included， a total of 1 090 visits were recorded， and the average length of stay was 12.37 days. The annual medical expense per capita of patients was 10 847.42 yuan （median was 4 113.00 yuan）， hospitalization expense per capita was 19 056.30 yuan （median was 13 042.86 yuan）， and outpatient expense per capita was 1 049.61 yuan （median was 418.70 yuan）. Results of subgroup analysis showed that annual medical expense in eastern， central and western cities were 9 203.54， 16 931.99 and 15 891.21 yuan. Per capita annual medical expenses of patients in tertiary hospitals were the highest （11 733.40 yuan）， followed by secondary hospitals， and the lowest was other medical related institutions. Among different anticoagulants treatment groups， the annual medical expense per capita （24 553.80 yuan） and annual drug expense per capita （12 088.96 yuan） were the highest in anticoagulant regimen of combined use of LMWH and UFH， while patients treated with warfarin alone had the lowest annual medical expense per capia （2 350.24 yuan） and annual drug expense per capita （1 163.67 yuan）. The multiple linear regression showed that the factors affecting medical expense per visit were type of patient （inpatient or outpatient），type of medical institution and type of complications. CONCLUSIONS： Direct medical expense per capita of patients with pulmonary embolism is still high， and the economic burden of disease is still heavy. Patients with pulmonary embolism treated with combination of LMWH and UFH had the highest medical expense per capita. The types of visit， types of medical institutions and complications can influence medical expense of patients significantly.
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Uridine-diphosphate glucuronosyltransferase 1A1 (UGT1A1) is an important conjugative enzyme in mammals that is responsible for the conjugation and detoxification of both endogenous and xenobiotic compounds. Strong inhibition of UGT1A1 may trigger adverse drug/herb-drug interactions, or result in metabolic disorders of endobiotic metabolism. Therefore, both the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) have recommended assaying the inhibitory potential of drugs under development on the human UGT1A1 prior to approval. This review focuses on the significance, progress and challenges in discovery and characterization of UGT1A1 inhibitors. Recent advances in the development of UGT1A1 probes and their application for screening UGT1A1 inhibitors are summarized and discussed in this review for the first time. Furthermore, a long list of UGT1A1 inhibitors, including information on their inhibition potency, inhibition mode, and affinity, has been prepared and analyzed. Challenges and future directions in this field are highlighted in the final section. The information and knowledge that are presented in this review provide guidance for rational use of drugs/herbs in order to avoid the occurrence of adverse effects UGT1A1 inhibition, as well as presenting methods for rapid screening and characterization of UGT1A1 inhibitors and for facilitating investigations on UGT1A1-ligand interactions.
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Objective@#To understand the serum levels of thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), triiodothyronine (T3), and thyroxine (T4) and identify the related influencing factors of thyroid dysfunction in drug users.@*Methods@#From June to August 2018, a face-to-face questionnaire survey was conducted in 788 male drug users in a drug rehabilitation center in Jiangsu province to collect their socio-demographic information. Then, venous blood sample was collected from each participant for the detection of various hematological indicators, such as thyroid hormones.@*Results@#The abnormal rates of T3, T4, FT3, FT4 and TSH were 4.57%, 1.27%, 0.51%, 0.38% and 0.89%, respectively, in the male drug users. HCV infection was an influencing factor for abnormal T3 level in the male drug users (OR=8.52, 95%CI: 2.36-30.74, P=0.001). And serum T3 (P<0.001) and T4 (P=0.048) levels increased with increasing HCV viral load.@*Conclusions@#HCV infection was an influencing factor for the abnormality of serum T3 level in drug users. Therefore, thyroid-related knowledge should be added in the health education for drug users, and the monitoring of thyroid function should be strengthened for drug users infected with HCV.
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Objective@#To investigate the tumor necrosis factor receptor superfamily 1B gene (TNFRSF1B) polymorphism in relation to the outcomes of hepatitis C virus (HCV) infection.@*Methods@#One thousand six hundred and forty-five cases without HCV infection, 545 cases with HCV clearance, and 783 cases with chronic HCV infection were enrolled. TaqMan probe method was used to investigate genotype rs1061622 (T > G) and rs1061624 (G > A). Two single nucleotide polymorphisms (SNPs) sites were genotyped and haplotypes were constructed to evaluate their relation with the outcome of HCV infection.@*Results@#Logistic regression analysis showed that there was no relation to the two SNPs with HCV infection susceptibility and chronicity (P > 0.05). Haplotype analysis showed that carrier TA had an increased susceptibility to HCV infection [adjusted odds ratio (OR) = 1.15, 95% confidence interval (CI): 1.01 to 1.30, P = 0.038)]. Carrier TA and GG haplotypes were conducive to chronic HCV infection (adjusted OR = 1.28, 95% CI: 1.08 to 1.53, P = 0.006; OR = 1.31, 95% CI: 1.03 to 1.66, P = 0.026).@*Conclusion@#The combinational effects of rs1061622 and rs1061624 in TNFRSF1B gene may increase the risk of HCV chronicity and infection.
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Objective@#To explore the relationship between the tumor necrosis factor receptor superfamily members 11A (TNFRSF11A) and 11B (TNFRSF11B) gene polymorphisms and the outcome of hepatitis C virus (HCV) infection.@*Methods@#In this case-control study, 749 cases of persistent HCV infection, 494 cases of spontaneous clearance and 1 486 control subjects were included from 2008 to 2016. TaqMan-MGB probe method was used to detect the genotype of TNFRSF11A rs1805034 and TNFRSF11B rs2073617. The genotypes distribution of the two single nucleotide polymorphisms (SNP) were analyzed in different populations.@*Results@#Co-dominant model showed that individuals carrying the rs2073617 CC genotype were prone to have chronic HCV infection, compared with individuals carrying the rs2073617 TT genotype (OR=1.517, 95%CI: 1.055-2.181, P=0.024). Recessive model results showed that individuals carrying rs2073617 CC genotype were more likely to develop chronic HCV infection compared with individuals carrying rs2073617 TT or TC genotype (OR=1.435, 95%CI: 1.033-1.996, P=0.032). Additive model showed that the risk for chronic HCV infection increased with the increase of the number of rs2073617 C alleles (OR=1.204, 95%CI: 1.013-1.431, P=0.035).@*Conclusion@#The genetic polymorphism of TNFRSF11B rs2073617 might be related with the chronicity of HCV infection.
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Objective To clone the murine Na+-K+-2Cl-cotransporter (Nkcc2) gene promoter and analyze 20-HETE regulation of the murine Nkcc2 gene transcriptional activity. Methods A fragment of the murine Nkcc2 gene promoter was analyzed using bioinformatics software AliBaba and TRANSFAC TESS. The murine Nkcc2 gene promoter fragment (-1 462 bp-+40 bp) was amplified by PCR using murine genomic DNA as a template and then cloned into a pGL3-Basic vector to generate a luciferase reporter construct. The recombinant reporter construct was transiently transfected into HEK293 T cells using Lipofectamine 2000 for 24 h. The transfected HEK293 T cells were treated with 20-HETE for 2 h followed by measurement of the luciferase activity using the Dual-Luciferase Reporter Assay system. Results A luciferase reporter construct containing the murine Nkcc2 gene promoter was successfully generated. The results showed that 20-HETE significantly reduced the transcriptional activity of the construct. Conclusion 20-HETE may reduce the expression of the murine Nkcc2 gene through transcriptional regulation.
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Objective:To investigate the treatment,clinical characteristics,and outcomes of patients with primary central nervous sys-tem lymphoma(PCNSL).Methods:A total of 75 patients histologically confirmed with PCNSL from November 2011 to November 2015 in the frist affiliated hospital of Zhengzhou Unversity were enrolled in this retrospective study.The clinical characteristics,treatment outcomes and prognostic factors of the patients were analyzed.The Kaplan-Meier method was used for univariate analysis of survival, with assessment of differences by the Log-rank test.Multivariate analysis was performed using the Cox proportional hazards model. Results:The median age at diagnosis of the 75 patients with PCNSL was 55 years(range:9-79 years),and a male-to-female ratio of 1.1:1 was observed.Major clinical characteristics observed in the patients were increased intracranial pressure and focal neurological defi-cits.All patients were diagnosed with diffuse large B-cell lymphoma(DLBCL).Of the 69 patients with follow-up data,the median pro-gression-free survival(PFS)of the chemotherapy combined with radiotherapy group(n=25),chemotherapy group(n=28),radiotherapy group(n=9)and surgery group(n=7)were 23.6(95% CI:16.0-31.3),6.4(1.0-11.8),9.8(4.7-14.9),and 5.0(4.9-5.2)months,respective-ly.The median overall survival(OS)of these four groups was 45.7(95% CI:44.2-47.2),11.0(7.1-15.0),16.1(15.3-17.0),and 6.9(1.9-12.0)months,respectively.All differences in PFS and OS between the groups were statistically significant(all P<0.01).No statistical dif-ferences were observed in the incidence of treatment-induced toxicity among these groups(P>0.05).Survival analysis showed that both age and Eastern Cooperative Oncology Group(ECOG)performance status were significantly associated with OS,and thus were in-dependent risk factors.Conclusions:PCNSL predominantly occurred in elderly people.Diffuse large B-cell lymphoma was the main type of PCNSL diagnosed.Increased intracranial pressure and focal neurological deficits were the major clinical characteristics of the patients.Age(60 years or younger),ECOG performance status score≤1,and the comprehensive treatment modality were significantly associated with improved OS.
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Objective To explore the relationship between aryl hydrocar-bon receptor (AhR),aryl hydrocarbon receptor nuclear translocator (ARNT),estradiol (E2),estrogen receptor (ER) and recurrent spontaneous abortion (RSA) through observing the level of serum AhR,ARNT,E2,and AhR,ARNT,ER in decidua and chorionic tissues of the patients with recurrent spontaneous abortion.Methods 64 cases of RSA patients who induced abortion at the Shanxi Dayi hospital from May 2015 to September2017 were chosen as RSA group,and 30 cases of healthy abortion women of the same period who had born full-term normal fetus were choosen as the normal group.The serum,villi and decidua of each case were collected during abortion.The level of AhR,ARNT,ER of both groupswere detected by enzyme-linked immunoscrbent assay (ELISA) method.The Serum E2 lever were detected by the method of chemical luminescence.The data of all the patients were analyzed.Results (1) The level of ARNT in peripheral blood of RSA group was significantly higher than that of normal group (P ＜ 0.05),and the levels of AhR and E2 in peripheral blood were not statistically significant between the two groups (P ＞ 0.05).The levels of AhR and ARNT in villi and decidua were significantly higher in RSA group than in normal group (P ＜ 0.05),while the expression of ER in villi and decidua was significantly lower in RSA group than in normal group (P ＜ 0.05).(2) There was no significant difference in the ratio of AhR/ARNT between the two groups (P ＞ 0.05);the ratio of AhR/ER and ARNT/ER in the villi and decidua of the RSA group was higher than that of the normal group (P ＜ 0.05).Conclusions Overexpression of AhR and ARNT and low expression of ER in villi and decidua tissues may be related to the occurrence of RSA.
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Objective To evaluate the efficacy,safety of rigid gas permeable contact lens (RGPCL) wearing for over 5 years in different degrees of keratoconus eyes.Methods A retrospective case study was performed.The clinical data of 217 eyes with different degree of keratoconus from 126 keratoconus patients who fitted with RGPCL in Beijing Tongren Hospital from 2000-2010 over 5 years were analyzed.The eyes were divided into mild keratoconus group (Ks≤45.0 D),moderate keratoconus group (45.0 D＜ Ks ＜ 52.0 D) and severe keratoconus group (Ks ≥52.0 D) according to the severity.Uncorrected visual acuity (UCVA,LogMAR),spectacle corrected visual acuity (SCVA) and RGP corrected visual acuity (RGPVA) was examined before RGPCL wearing and the end of followingup after RGPCL wearing.The refraction,corneal curvature,corneal astigmatism were measured with auto-refractomer/keratometer and keratoconus screening analysis system of computer-assisted corneal topography.Comparisons of the changes of corrected visual acuity and corneal parameters were assessed.Results The RGPVA was 0.09±0.17,0.05±0.07 and 0.07 ±0.07 in the mild,moderate and severe keratoconus group,respectively,showing a significant difference among the three groups (F=0.522,P=0.594);The △Ks was (2.25±5.42),(0.26±3.44) and (-4.52±3.44)D,and △Kf was (2.06±4.98),(1.02±3.41) and (-2.03±5.05)D,and the change value of corneal astigmatism was (0.19±2.87),(-0.78±2.84) and (-2.44±3.77)D in the mild,moderate and severe keratoconus group(all at P＜ 0.05),respectively,with the minimum amount of change in the severe keratoconus group.The variation of differential sector index (△DSI) was-0.33 ± 1.64,0.14±3.01 and-2.11 ±4.28;the variation of center/ surround index (△CSI) was-0.41 ± 1.07,0.03±2.22 and-2.49±4.15;the variation of standard deviation of power (△SDP) was-0.43 ±0.64,-0.02 ±0.89 and-1.67 ± 1.68;the variation of keratoconus prediction index (△KPI)was 0.00±0.07,0.03±0.09 and-0.05±0.11 in the mild,moderate and severe keratoconus group,respectively,and the reduced amount in above parameters was much more in the severe keratoconus group than that in the mild and moderate keratoconus group (all at P＜0.01).Mild conjunctivitis and corneal affection occurred in 12 eyes (5.5％)during the follow-up.Conclusions Long-term wearing RGPCL can improve the visual acuity and slow the tendency of corneal curvature increase in keratoconus eyes,and this procedure is safe and effective for the correction of different degree of keratoconus.
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Objective To investigate the clinical manifestations, treatment outcomes and prognosis factors of the patients with primary systemic anaplastic lymphoma kinase negative anaplastic large cell lymphoma (ALK-ALCL). Methods The clinical data of 32 patients histologically confirmed with ALK-ALCL from January 2011 to December 2017 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. Kaplan-Meier method, Log-rank test and Cox proportional hazards model were used for the survival analysis. Results There were 19 males and 13 females in 32 patients, and the median age of onset was 50 years old (14-78 years old). The proportion of the patients with B symptom, extranodal involved, stageⅢ-Ⅳ, International Prognostic Index (IPI) sore 2-3 were 34.4 % (11 cases), 53.1 % (17 cases), 59.4 % (19 cases) and 50.0 % (16 cases) respectively. Chemotherapy alone and chemotherapy plus radiotherapy were the main methods, and a few patients received surgery alone, surgery plus chemotherapy, chemotherapy plus autologous stem cell transplantation or palliative care. The efficacy of 28 cases could be evaluated. The objective effective rate was 85.7 % (24/28), the complete remission (CR) rate was 42.9 % (12/28), and the partial remission (PR) rate was 42.9 % (12/28). The median progression-free survival (PFS) time was 28 months (95 % CI 13-42 months) and the median overall survival (OS) time was 43 months (95 % CI 24-61 months). The anticipated 5-year OS rate was 36.6 % . Single factor analysis results revealed that patients who was female (χ2＝7.654, P＝0.006), with normal serum lactic dehydrogenase (LDH) level (χ2＝7.575, P＝0.006), normal serum β2microglobulin level (χ2＝4.770, P＝0.029) and without B symptom (χ2＝9.418, P＝0.002), IPI score 0-1 (χ2＝4.119, P＝0.042) had a better prognosis. Multivariate survival analysis indicated that symptoms B ( HR＝ 12.460, 95 % CI 2.645-58.708, P＝ 0.001) and IPI score ( HR＝7.521, 95 % CI 1.624-34.841, P＝0.010) were the independent factors for prognosis. Conclusion The prognosis of the patients with primary systemic ALK-ALCL is poor, especially for the worse prognosis of the patients with symptoms B and IPI sore 2-3.
ABSTRACT
Objective To discuss the influence of Yin yoga for Ⅰ, Ⅱ knee osteoarthritis patients'quality of life and anxiety. Methods Divided 98 patients of Joint department outpatient service with joint specializes into the experimental group and the control group by random number method, there were 49 cases in each group, two group patients all have routine drug therapy that according to the guidelines of diagnosis and treatment of knee osteoarthritis in 2015,and accept the routine health education of orthopaedic. On the basis of this, the experimental group accept Yin yoga exercise training by a professional yoga teacher and nurse, they also followed up the two group of patients for 1 year. And adopting health questionnaire (SF-36) to assess the patient's quality of life on the same day, which they see the doctor ,3 months, 6 months, 12 months, they also use Self-evaluation of the anxiety scale (SAS) to assess the patient's anxiety. Results SAS scores before and after the intervention of patients in the experimental group was (57.14 ± 5.92) and (37.92 ± 3.07) points respectively, the difference was statistically significant (t=15.64, P 0.05. Physiological function, physiological function, body pain, general health, energy, social function, emotional function, mental health of experimental group patients after 12 months intervention was (79.23 ± 9.15), (56.79 ± 13.20), (78.32 ± 10.15), (44.50 ± 11.92), (64.85 ± 9.72), (83.90 ± 11.61), (62.13 ± 18.72), (67.33 ± 8.50) points respectively, while in the control group was (70.22 ± 10.13), (32.12 ± 11.07), (60.14 ± 9.56), (39.40 ± 10.27), (48.66 ± 7.52), (67.62 ± 12.13), (43.23±14.89), (57.00±8.13) points respectively, the difference between the two groups was significant(t=3.18-15.54, P<0.05 or<0.01). Conclusions Yin yoga can improveⅠ,Ⅱknee osteoarthritis patients quality of life and all ease anxiety. The method is feasible.