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BACKGROUND@#Immune checkpoint inhibitor associated pneumonia (CIP) is a serious side effect of immune checkpoint inhibitors. There is a consensus on the treatment of acute phase of CIP, but the treatment of pulmonary interstitial fibrosis after the acute phase is still a clinical problem to be solved.@*METHODS@#The diagnosis and treatment of a non-small cell lung cancer (NSCLC) patient with immune checkpoint inhibitor associated pneumonia in the Stereotactic Radiotherapy Department of Qingdao Central Hospital were retrospectively analyzed, and literatures were reviewed.@*RESULTS@#A 70-year-old male patient was diagnosed with Poorly differentiated squamous cell carcinoma of left lung with mediastinal lymph node metastasis T3N3M0 stage IIIc, EGFR/ALK/ROS1/RAF negative, PD-L1 (22c3) immunohistochemistry negative. After the progression of first-line chemotherapy, the patient was diagnosed as immune checkpoint inhibitor associated pneumonia grade 3 during second-line monotherapy with Nivolumab. After initial high-dose glucocorticoid pulse therapy, the lung computed tomography (CT) imaging and clinical symptoms of the patients were partially relieved, and then pirfenidone (300 mg tid) was given orally for more than 11 months. During the treatment of pirfenidone, the CT imaging and clinical symptoms of the patients were significantly improved, and there were no other adverse reactions except grade 1 nausea. During this period, chemotherapy and Anlotinib was given concurrently with pirfenidone and showed good safety profile.@*CONCLUSIONS@#This case report is the first report of pirfenidone in the treatment of CIP, which provides a new idea for the clinical practice and research of CIP treatment.
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Objective:To investigate the effect of adenosine deaminase acting on RNA 1 (ADAR1) on 5-serotonin-2c receptor in alleviating aggression in socially isolated mice.Methods:Sixty healthy male BALB / c mice aged 21 days were randomly divided into six groups: social isolation group, social control group, ADAR1 inducer social isolation group, ADAR1 inhibitor social isolation group, ADAR1 inducer social control group and ADAR1 inhibitor control group.The mice fed in single cage for 4 weeks were used as social isolation model while the mice fed in group were used as control group.ADAR1 inducer (5.0×10 4 U/kg) and inhibitor (10 mg/kg) were given intraperitoneally to mice in the ADAR1 inducer social isolation group and the ADAR1 inhibitor social isolation group respectively.The aggressive behavior of mice was evaluated by resident-intruder test.The expression of ADAR1 and 5-serotonin-2c receptors in the brain of mice was detected by immunohistochemistry and Western blot. Results:The attack latency of social isolation group was significantly lower than that of social control group ((43.15±6.99) s, (542.40±30.50) s; t=15.906, P<0.01), and the latency of attack ((256.70±29.49) s) in the ADAR1 inducer social isolation group was significantly higher than that in the social isolation group ( t=7.046, P<0.01). The latency of attack ((15.25±2.18)s) in the ADAR1 inhibitor social isolation group was significantly lower than that in the social isolation group ( t=3.809, P<0.01). The optical density of ADAR1 immunoreactive cells in the amygdala of the social isolation group mice was significantly lower than that in the corresponding brain area of the social control group (BLA: (0.038±0.002), (0.074±0.004); LaDL: (0.033±0.002), (0.060±0.002); LaVM: (0.045±0.003), (0.073±0.004); Lavl area: (0.044±0.003), (0.070±0.003); t=8.428, 9.037, 6.462, 5.698, all P<0.01). The optical density of ADAR1 immunoreactive positive cells in the amygdala (BLA: (0.060±0.003), LaDL: (0.042±0.002), LaVM: (0.056±0.004), Lavl: (0.054±0.003) in the ADAR1 inducer social isolation group was significantly higher than those in the corresponding brain area of the social isolation group mice ( t=6.055, 2.876, 2.312, 2.492; all P<0.05). The expression of ADAR1 protein and 5-serotonin-2c receptor protein in amygdala of social isolation group were significantly lower than those of social isolation group ( t=11.37, 12.65; P<0.01). The expression of ADAR1 protein and 5-serotonin-2c receptor protein in the amygdala of the ADAR1 inducer social isolation group were significantly higher than those of the social isolation group ( t=3.02, 4.401; P<0.05). Conclusion:ADAR1 inducer alleviates the aggressive behavior of social isolated BALB / c mice by enhancing the protein expression of 5-serotonin-2c receptor in the amygdala of social isolated BALB/c mice.
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OBJECTIVE：To investi gate the potential mechanism of couplet medicine of Cuscutae Semen-Lycii Fructus in the treatment of premature ovarian failure. METHODS ：Main active components and related targets of couplet medicine of Cuscutae Semen-Lycii Fructus in the treatment of premature ovarian failure were obtained from TCMSP ，GeneCards and OMIM database. The intersection genes between them were screened using Venn online tool. Cytoscape 3.7.0 software was adopted to establish the active ingredients-target network and the PPI network. GO and KEGG pathway enrichment analysis on intersection genes were carried out by DAVID database. Finally ，an active component-target-key pathway network was constructed. RESULTS ：Totally 42 active components ，231 and 1 913 targets for active components and disease were obtained from couplet medicine of Cuscutae Semen-Lycii Fructus. The components with high node degree included quercetin ，kaempferol，β-sitosterol，isorhamnetin，glycitein， stigmasterol and sesamin ，etc. There were 149 intersection genes between the active component targets and premature ovarian failure targets. PPI network contained 149 nodes and 2 970 edges，with an average node degree of 39.9 and an average medium of 0.005 4. The results of GO analysis showed that molecule function of the above-mentioned genes mainly involved protein binding ， enzyme binding ，etc. Biological process mainly included that positive regulatio n of transcription from RNA polymerase Ⅱ promoter，positive regulation of transcription DNA-templated ， Cell components mainly included nucleus ，cytoplasm，etc. Signaling pathway mainly involved cancer signaling pathway ， hepatitis B signling pathway ，PI3K/AKT signaling pathway ， MAPK signaling pathway ， etc. The results of active 617693370@qq.com component-target-key pathway network showed that active components of Cuscutae Semen and Lycii Fructus were flavonoids and alcohols ；key target included AKT 1，TP53， VEGFA，IL6，TNF，etc. Signaling pathway mainly involved cancer signaling pathway ，hepatitis B signaling pathway ，PI3K/AKT signaling pathway ，MAPK signaling pathway ，etc. CONCLUSIONS ：Through PI 3K/AKT signaling pathway and MAPK signaling pathway，the active components of couplet medicine of Cuscutae Semen-Lycii Fructus may act on AKT 1，TP53 and other targets ， and then play a therapeutic role on premature ovarian failure. The Potential active components stigmasterol ，sesamin and potential targets IL 6，TNF were found.
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HBeAg seroconversion is an important process during antiviral therapy for patients with HBeAg-positive chronic hepatitis B (CHB), while the first-line antiviral drugs, such as entecavir and tenofovir disoproxil fumarate, tend to have low HBeAg clearance rate and/or seroconversion rate, and at present, there is still a lack of effective radical treatment regimens. Latest studies have shown that fecal microbial transplantation (FMT) can induce HBeAg clearance in HBeAg-positive CHB patients receiving long-term antiviral therapy. This article reviews the research advances in the role of FMT in inducing HBeAg clearance in HBeAg-positive CHB patients and points out that FMT may become a new treatment regimen for HBeAg-positive CHB patients.
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Objective To explore the continuity nursing effect of WeChat platform on PICC patients with intermittent chemotherapy. Methods 150 patients with primary PICC intubation tumor were selected as the study object, and were divided into three groups according to the order of treatment, each group of 50 cases. The control group adopted the traditional health education mode; the observation group 1 pushed PICC catheter maintenance related content three times a week based on WeChat platform on the basis of routine health education, and the observation group 2 on the basis of routine health education pushed PICC catheter maintenance related content, collected questions three times and answered questions for everyone in the Weixin group. The PICC self-management ability and incidence of catheter-related complications of the three groups were compared after 3 months. Results The scores of PICC self-management ability in the three groups were (133.84±5.67), (142.36±8.62) and (148.76±6.52). There was significant difference in the scores of PICC self-management ability between the three groups (F=56.384, P<0.05). The incidence of catheter-related complications in the three groups were 14% (7/50), 4% (2/50) and 2% (1/50), respectively, and the difference was statistically significant (χ2=6.643, P<0.05) between the three groups. The incidence of catheter-related complications was statistically significant only in the control group compared with the observation group 2 (χ2=4.891, P<0.05). Conclusions Continuous nursing based on Weixin platform can improve the self-management ability of PICC catheterization patients during the intermittent period of chemotherapy. Continuous nursing based on Weixin group chat can reduce the incidence of catheter-related complications, which is worthy of wide clinical recommendation.
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Clinical studies have confirmed the FOLFIRINOX regimen (oxaliplatin + irinotecan + fluorouracil + leucovorin) is an effective regimen for advanced pancreatic cancer patients with good performance status.Current clinical studies on FOLFIRINOX regimen mainly include neoadjuvant therapy for unresectable and borderline resectable pancreatic cancer and first-line therapy for locally advanced pancreatic cancer and metastatic pancreatic cancer,which improved patient's surgical resection opportunities and survival.In addition,the toxicity,safety of FOLFIRINOX regimen and effective population selection for FOLFIRINOX regimen are also the problems concerned by researchers.
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Objective To investigate the related risk factors of complicated parapneumonic effusion (CPPE) in children. Method The clinical data of 88 children with parapneumonic effusion (PPE) were retrospectively analyzed from January 2013 to April 2015. According to the treatment effect of antibiotics, CPPE group and uncomplicated parapneumonic effusion (UPPE) group were divided. The univariate analysis of clinical and laboratory parameters was performed between two groups. Then the multifactor logistic regression was performed further. The receiver operator characteristic (ROC) curve was draw. Results The univariate analysis indicated that the risk factors were the formation of loculation and serum CD3+ and CD19+ levels (Z=2.030~7.457, P30%and the formation of loculation.
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Objective To explore the clinical characteristics of pleural effusion caused byMycoplasma pneumoniae in children.MethodsThe clinical data from children with pleural effusion caused byMycoplasma pneumoniae were retrospectively analyzed. Differences of clinical characteristics in children with pleural effusion caused byMycoplasma pneumoniae infection and non-Mycoplasma pneumoniae infection were compared. Moreover, multiple logistic regression analysis was performed on the factors that were identified to have statistical differences in single factor analysis. Receiver operating characteristic (ROC) curve was performed and the diagnostic boundary value of each factor and the diagnostic accuracy of the regression model were calculated.ResultsThere were statistical differences between children with pleural effusion caused byMycoplasma pneumoniae infection and by non-Mycoplasma pneumoniae infection in age, white blood cell count, lactic dehydrogenase (LDH), levels of IgA and IgM, and the proportion of multiple nuclei, glucose and lactic acid (LAC) in pleural effusion, pleural thickening, and formation of ifbrous separation (allP??3.92 years, serum IgM?>?1.29 g/L, LDH?>?367 U/L and pleural effusion LAC?
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Objective To identify the relevant factors for the loculation clinically in children with parapneumonic pleural effusion (PPE).Methods The clinical data of 172 children with PPE were retrospectively reviewed from January 2012 to March 2015 in Children's Hospital of Hebei Province.Based on the findings of chest ultrasound, the subjects were divided into 2 groups, the loculation group (78 cases) and the control group (94 cases).The comparison was made between the 2 groups in gender, age, course of disease and fever before admitting into hospital, the location of the effusion, white blood cells (WBC) and the percentage of neutrophils (N), blood platelet (PLT) ,lactate dehydrogenase (LDH),C-reactive protein (CRP), mycoplasma (MP), the routine and biochemical examination of pleural fluid, including white cell count (WBCp), the percentage of polymorphonuclear cell (PMN), lactate dehydrogenase (LDHp) ,glucose (GLU) ,adenosine deaminase (ADA) ,lactic acid (LAC) and C-reactive protein (CRPp).If the result of single factor regression showed P ＜ 0.01, the indicators were analyzed by the multifactor Logistic regression.The receiver operator characteristic (ROC) curve was drawn to evaluate the prediction ability of Logistic regression models.Results (1) The result of single factor regression indicated that the risk factors included age, WBC, PLT, LDH, MP, WBCp, PMN, GLU and LAC (all P ＜ 0.05).(2) The result of multifactor Logistic regression showed that the factors included PLT (OR =3.437,P =0.007), LDH (OR =0.306, P =0.006), GLU (OR =0.324, P =0.037), MP (OR =0.375 ,P =0.022) and LAC (OR =3.656, P =0.003).(3) The area under the ROC curve was 0.876, P =0.000,which indicated that the regression models had over medium diagnostic accuracy.Conclusions When PLT ＞ 434.5 × 109/L,LDH ＜400 U/L,non MP infection,GLU ＜6.11 mmol/L and LAC ＞3.83 mmol/L,it may indicate that the formation of loculation for the PPE children.
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Objective To describe the burden of caregivers of children with asthma,and to provide reference for the development of family care support program.Methods Qualitative research was used to carry out semi-structured interviews with 13 caregivers of children with asthma in the pediatric outpatient of the First Affiliated Hospital of Guangzhou Medical University.The data collected were analyzed with Colaizzi 7-step analysis method.Results The carcgiver burden was classified into 4 themes,including time and energy exhaustion,heavy economic burden,insufficient knowledge of care and negative emotions.Conclusions The burden of caregivers of children with asthma has a relatively great impact on the daily work and life,even the physical and mental health.Care workers should be concerned about the status of caregiver burden and provide targeted interventions,which could help caregiver adapt to their roles,maintain and promote the health of children patients and their families.
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Objective The difference of the equivalent IOL powers before and after LASIK was calculated by using the Haigis-L formula and Sirius ray-tracing respectively.And study the correlation be-tween the intraocular lens power and the myopic before laser in situ keratomileusis.Methods Ninety-one patients undergoing myopic laser in situ keratomileusis were enrolled, they were divided into 3 groups ac-cording to myopic diopter, group I (-1.00D~-3.00D) 13cases, group II( -3.25D and -6.00D)60 cases, group III(-6.25D~-10.0D)18 cases.The equivalent IOL power before and after LASIK will be calculated using Haigis-L formula and Sirius ray-tracing.The data were analyzed using SPSS20.0.Results 80.2%of the cases calculated using Haigis-L formula were within ±0.50D of the predicted refraction , 94.5%were within ±1.00D, and 100%within ±1.50D.also, within ±0.50D of the predicted refrac-tion 13cases(100%),51cases(85%),9cases(50%) in group I, II, III respectively.74.7% of the eyes calculated using Sirius ray-tracing were within ±0.50D of the predicted refraction , 89.0%were within ± 1.00D, and 100%within ±1.50D.within ±0.50D of the predicted refraction 12cases(92.3%),48cases (80%),8cases(44.4%) in group I, II, III respectively.Conclusions Sirius ray-tracing and Haigis-L formula can calculate IOL power accurately in eyes with prior myopic LASIK, with no need for preoperative data.and there is positive correlation between the intraocular lens power aberration and the myopic diopter before LASIK.
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Objective To analyze the risk factors of mucous plug caused byMycoplasma pneumoniae pneumonia (MPP) in children and guide clinical therapy to decrease the incidence of sequela caused by airway inlfammatory obstruc-tion.Methods We conducted a retrospective study of the clinical data of 116 children with MPP who received ifber broncho-scope from January 2012 to January 2014 admitted to the respiratory department of the Children's Hospital of Hebei provience. Based on the airway mucosal lesions seen through the bronchoscope, the subjects were divided into the mucous plug group (n=67) and the control group (n=49). Gender, age of onset, febrile course, pleural effusion, white blood cell counts, neutrophil ratio, C reactive protein (CRP), serum lactate dehydrogenase level (LDH), initial time of received macrolides and ifber bronchoscope were compared between the two groups. If the Results of single factor analysis showedP<0.05, the indicators were analyzed by the logistic regression analysis. The receiver operator characteristic (ROC) curve was drawn to evaluate the predictability of logistic regression model.Results The Results of single factor analysis showed that age of onset, febrile course, CRP, serum LDH, pleural effusion cases in the mucous plug group were higher than those in control group (P<0.05). The Results of the logis-tic regression analysis showed that older than three years (OR=7.45), febrile course more than 10 days (OR=4.01), the level of CRP and LDH higher than 40 mg/L (OR=5.41) and 350 U/L (OR=3.63) were respectively the risk factors of mucous plug caused by MPP in children. The area under the ROC curve is 0.846 (95%CI: 0.773-0.919,P=0.000).Conclusions MPP children with age older than three years, or with febrile course more than 10 days, or with the level of CRP and LDH higher than 40 mg/L and 350 U/L has the possibility of forming a mucous plug.
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Objective To investigate the expression and clinical significance of platelet glycoprotein CD62p,CD63 and neutrophil surface CD64 in sepsis.Methods Fifty-six children with sepsis from March 2010 to March 2013 in Communicable Disease Department of our hospital were divided into severe sepsis group(n =16) and general sepsis group (n =40),normal control group included 34 subjects from health check.CD62p,CD63 and CD64 were detected by flow cytometry in children with sepsis,and compared with normal control group.Results The levels of CD62p,CD63 and CD64 in severe sepsis group were higher than those of general sepsis group (P ＜ 0.01).The levels of CD62p,CD63 and CD64 in general sepsis group were higher than those of normal control group (P ＜ 0.01).Correlation analysis indicated that CD62p and CD63 were in positive correlation with CD64 in children with sepsis(r =0.817,0.796,P ＜0.001).The positive correlations of CD62p,CD63 and CD64 with pediatric critical illness score were also found(CD62p:r =0.883,P ＜0.001;CD63:r=0.862,P ＜0.001;CD64:r=0.805,P ＜0.001).Conclusion CD62p,CD63 and CD64 are closely related to the severity of infection and diseases,and may be used as immune parameters for the estimation of the clinical severity and the prognosis of acute and severe diseases.
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OBJECTIVE:To establish HPLC method for the determination the centent of tanshinone Ⅱ_A in danshen shuxin capsule.METHODS:The determination was performed on Shim-pack CLC-ODS column,the mobile phase consisted of methanol-water(15∶5),the detection wavelength of270nm,column temperature at40℃,a flow rate of1.5ml/min and.RE_ SULTS:The calibration curve of tanshinone Ⅱ_A is linear when its concentration range was with in 0.05125～0.25625?g/ml(r=0.9996,n=5),the average recovery was 99.05%(RSD=0.92%).CONCLUSION:This method is convenient in operation,precise,reliable in results,and it can be used as quality control for danshen shuxin capsule.
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The results of this study showed that no deficiency of the spleen or kidney were seen in the normal control group animal. About 1/3 of the anemic -rat control group revealed, earlier or later, spleen deficiency, without kidney deficiency. For the group of rats with iron deficiency, deficiency of the kidney appeared after 17 days, with many rats suffered from spleen deficiency, in which 43 % of the animals changed from deficiency of the spleen to deficiency of both spleen -kidney or kidney deficiency alone. The difference between the iron -deficiency group and animic control group of spleen deficiency was that the serum iron was markedly lower in the former group, whereas the serum iron in the deficiency of both the kidney and spleen - kidney rats was even lower than the spleen deficiency group. When deficiency of the kidney was induced by iron deficiency, the abnormality in the membranous protein of RBC is even more serious. Conclusion: Iron might be one of the crucial biochemical basis of the relations between the kidney and spleen.
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To study the effect of iron deficiency (ID)on crythrocyte membrane proteins, an investigation of the activity and site of Na+-K+-ATPase in crythrocyte membrane of rats with iron deficient anemia (IDA) was conducted. It was found that changes of the enzyme activity had various ciiaracteristics as ID course went on, and there was no difference in the numbers of 3H-ouabain binding sites (R0) between IDA rats and controls. In contrast to the controls, Na+-K+- ATPase activity of IDA rats showed no relation with R0, suggesting a primary association of the abnormalized activity of the enzyme with its molecular state in ID erythrocyte membrane which could be affected by the surroundings of cell metabolism and spatial structure.
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HBeAg seroconversion is an important process during antiviral therapy for patients with HBeAg-positive chronic hepatitis B (CHB), while the first-line antiviral drugs, such as entecavir and tenofovir disoproxil fumarate, tend to have low HBeAg clearance rate and/or seroconversion rate, and at present, there is still a lack of effective radical treatment regimens. Latest studies have shown that fecal microbial transplantation (FMT) can induce HBeAg clearance in HBeAg-positive CHB patients receiving long-term antiviral therapy. This article reviews the research advances in the role of FMT in inducing HBeAg clearance in HBeAg-positive CHB patients and points out that FMT may become a new treatment regimen for HBeAg-positive CHB patients.