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OBJECTIVE To explore the antidepressant effect and potential mechanism of icariside Ⅱ （ICSⅡ） based on the GABAergic nervous system. METHODS The male Kunming mice were randomly divided into a control group （group C， 10 mice） and a modeling group （50 mice）. The depression model was induced by chronic unpredictable mild stress （CUMS） method in the modeling group. After 21 days of stimulation， the rats of modeling group were randomly divided into depression model group （NS group）， positive control group [ECS group， oxalate escitalopram 15 mg/（kg·d）] and ICSⅡ low-dose， medium-dose and high-dose groups [ICSⅡ-L group， ICSⅡ-M group， ICSⅡ-H group； ICSⅡ 10， 20， 30 mg/（kg·d）]， with 10 mice in each group. Administration groups were given relevant medicine intragastrically， once a day， for 14 consecutive days. The sugar water preference rate， total exercise distance， immobility time in tail suspension and forced swimming experiments were detected in each group. The morphology of neurons and Nissl bodies in the hippocampal CA3 region were observed； the contents of γ-aminobutyric acid （GABA） and glutamic acid （Glu）， GABA/Glu ratio， and the expressions of GABAergic nervous system-related proteins （GABA A receptor α1， GABA B receptor 1， vesicular GABA transporter， glutamate decarboxylase 67， GABA membranal transporter 3） were detected in hippocampus. RESULTS Compared with group C， the sugar water preference rate and the total exercise distance significantly reduced in NS group， while the values of immobility time in the tail suspension test and forced swimming test were significantly prolonged （P＜0.05）. The morphology of neurons in the CA3 area of the hippocampus was irregular and the Nissl bodies were reduced， with a significant decrease in the number of structurally intact neurons （P＜0.05）； the content of Glu was significantly increased， while the content of GABA， GABA/Glu ratio， and the expressions of GABAergic nervous system-related proteins were significantly decreased （P＜0.05）. Compared with NS group， depression behavior in each administration group was improved， and the above indexes were mostly reversed （P＜0.05）. CONCLUSIONS ICSⅡ can improve depression behavior of depression model mice. The mechanisms may be associated with regulating the balance of GABA and Glu， increasing the synthesis， transport and release of GABA， and regulating the expressions of GABA-related receptors， so as to improve GABAergic nervous system.
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Objective:To establish time-resolved fluorescence immunochromatographic assay (TFICA) for rapid and quantitative detection of mycoplasma pneumoniae (MP) immunoglobulin (Ig)M and IgG.Methods:Based on capillary effect and europium nanospheres, rapid TFICA for MP-IgM and IgG detections were developed with the optimized parameters (coupling rates of antigens or antibodies to microspheres, dilution of labeled nanospheres, fixture concentrations on test line and serum dilutions). The methodological performances were estimated such as sensitivity, specificity, stability. By testing 55 healthy control samples, the reference values of TFICA were obtained. The reliability was evaluated by Kappa test from detecting sera of 88 cases (33 patients and 55 healthy controls) using TFICA and commercial kits by chemiluminescence immunoassays (CLA). Results:After screening the assay conditions, the mass ratios of mouse anti-human IgG and MP antigen with nanospheres were 1∶20 and 1∶100 respectively; the work dilutions of nanobeads conjugated with anti-human IgG and MP antigen were 1∶200 and 1∶100 respectively; the spraying concentrations of MP antigen and goat anti-human IgM were 0.5 and 1.0 g/L on the test line respectively, and the working dilutions of serum sample were both 1∶300. In the MP-IgM and IgG detections, the linear working ranges were (0.78-70.00)×10 3 relative unit (RU)/L and (0.17-200.00)×10 3 RU/L, while the sensitivities of the assays were 0.78×10 3 and 0.17×10 3 RU/L, respectively. No cross reactions were found with antithyroid peroxidase antibody, anticardiolipin antibody or thyroglobulin antibody. In these MP-IgM and IgG assays, the relative standard deviations were 3.7%-14.8% and 2.9%-14.0%, the average reduction rates of fluorescence were 13.7% and 14.2% respectively after incubation at 37 ℃ for 5 d. The reference values of MP-IgM and IgG were 3.33×10 3 and 2.61×10 3 RU/L, while the Kappa values between TFICA and CLA were 0.79 and 0.76, respectively. Conclusion:TFICA is a simple, sensitive, specific and quantitative method for detecting MP-IgM and IgG antibodies, and may show great promise for future clinical use.
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Objective:To investigate the dynamic changes of mitochondrial fission and fusion in the heart of cardiac arrest (CA) rats after return of spontaneous circulation (ROSC), and to explore the role of mitochondrial fission and fusion in the myocardial injury after ROSC.Methods:Healthy male SD rats were randomly random number assigned into the post-resuscitation (PR) 4 h ( n=12), PR 24 h ( n=12), PR 72 h ( n=12), and sham groups ( n=6). The rat CA model was induced by asphyxia, and cardiopulmonary resuscitation (CPR) was performed 6 min after CA. The protein expressions of mitochondrial Drp1, Fis1, Mfn1, and Opa1 were determined by Western blot in each group at 4, 24 and 72 h after ROSC. The mRNA expressions of Drp1, Fis1, Mfn1, and Opa1 were determined by RT-PCR. Myocardial ATP content and mitochondrial respiratory function were measured. The histopathologic changes of myocardial tissue were observed under light microscope. One-way analysis of variance (ANOVA) was use to compare quantitative data, and LSD- t test was used for comparison between groups. Results:Compared with the sham group, the protein and mRNA expressions of Drp1 and Fis1 were increased (all P<0.05) and the protein and mRNA expressions of Mfn1 and Opa1 were decreased (all P<0.05) in the PR 4 h and PR 24 h groups. However, there were no statistical differences in the protein and mRNA expressions of Drp1, Fis1, Mfn1, and Opa1 in the PR 72 h group compared with the sham group (all P>0.05). Compared with the sham group, the levels of ATP content [(4.53±0.76) nmol/g protein vs. (8.57±0.44) nmol/g protein and (5.58±0.58) nmol/g protein vs. (8.57±0.44) nmol/g protein] and mitochondrial respiratory control rate [(2.47±0.38) vs. (3.45±0.32) and (2.97±0.24) vs. (3.45±0.32)] were obviously decreased in the PR 4 h and PR 24 h groups (all P<0.05). There were no statistically significant differences in the ATP content [(7.73±0.95) nmol/g protein vs. (8.57±0.44) nmol/g protein] and mitochondrial respiratory control ratio [(3.39±0.34) vs. (3.45±0.32)] between the PR 72 h group and the sham group (all P>0.05). The pathological damage of myocardial tissue was obvious in the PR 4 h group, and was improved significantly in the PR 72 h group. Conclusions:The imbalance of mitochondrial fission and fusion is probably involved in the pathological process of myocardial injury after ROSC, which may be related to mitochondrial dysfunction.
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The IMbrave 150 study opened the door of immunotherapy combined with targeted therapy, and then the data of ORIENTAL-32, a Phase Ⅲ clinical trial for Chinese patients, was released, which confirmed the efficacy of immunotherapy combined with targeted therapy, especially significant survival benefits in Chinese patients. At present, there are many ongoing studies on PD-1/PD-L1 inhibitors combined with small-molecule tyrosine kinase inhibitors, and their corresponding early data provide a considerable objective response rate, which provides an opportunity for conversion therapy/sequential therapy for hepatocellular carcinoma in different stages and courses, as well as a basis for further exploration of neoadjuvant/adjuvant therapy. Combined immunotherapy has entered the era of version 3.0, in which reasonable local therapy can be implemented at different stages in combination with targeted drugs. However, there are still no accurate predictive indicators for efficacy, and it requires comprehensive consideration of the features such as the natural course of the disease, clinicopathological parameters, genomics, and radiomics. Compared with single-drug immunotherapy or single-drug targeted therapy, immunotherapy combined with targeted therapy had a relatively complex spectrum of adverse reactions and difficult identification of correlation, and whole-process management, comprehensive judgment, and timely treatment should be performed within the framework of multidisciplinary team.
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Objective:To compare the curative effect of hematoma removal and minimally invasive puncture drainage in hypertensive intracerebral hemorrhage (HICH) under neuroendoscope.Methods:The clinical data of 118 patients with HICH admitted to our hospital from February 2017 to November 2019 were retrospectively analyzed. According to the different surgical methods, the patients were divided into group A ( n=59, minimally invasive puncture and drainage) and group B ( n=59, neuroendoscopic hematoma removal). The perioperative indexes, complications and neurological function indexes [neuron specific enolase (NSE), neurotrophic factor (NGF), substance P (SP)], inflammatory factor index [interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)] and related scale scores [National Institutes of Health Stroke Scale (NIHSS), modified Barthel Index (mBI)] were compared between the two groups. Results:The operation time, cerebrospinal fluid recovery time, hematoma removal time and hospitalization time of group B were shorter than those of group A ( P<0.05). On the 7th day after operation, the NSE, SP, IL-6, TNF-α in the two groups were decreased, and the levels of NSE, SP, IL-6 and TNF-α in group B were lower than those in group A ( P<0.05); on the 7th day after operation, the levels of NGF in two groups were increased, and those in group B were higher than those in group A ( P<0.05). 6 months after operation, the NIHSS decreased and mBI increased in both groups ( P<0.05), and NIHSS in group B was lower than that in group A, but mBI was higher than that in group A ( P<0.05). There was no difference in the incidence of complications between the two groups ( P>0.05). Conclusions:Compared with minimally invasive puncture and drainage, neuroendoscope hematoma removal for HICH patients can effectively improve perioperative indicators, reduce neurological damage and body inflammatory stimulation, and improve the self-care ability of patients, which is safe and reliable.
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Objective@#To establish patient derived xenograft (PDX) model of malignant peritoneal mesothelioma (MPM), and to identify the key characteristics of tumor biology of the model, so as to provide an experiment platform for studying the pathologic mechanisms and new therapeutic strategies for MPM.@*Methods@#Surgically excised MPM tumor tissues were inoculated subcutaneously in BALB/c-nu/nu mice for 3 stable passages. In the 4th passage, the subcutaneous tumors were harvested under aseptic conditions, cleaned and made into MPM tumor cell homogenate. Four nude mice (two males and two females) were selected and one male and one female nude mouse were inoculated in the abdominal cavity at the dose of 100 μL, others were inoculated at a dose of 200 μL. The PDX model of MPM was established. The changes of body mass in nude mice were measured regularly, the extent of abdominal and pelvic tumors was judged by experimental peritoneal cancer index (ePCI) score, and the pathologic characteristics of tumors were analyzed.@*Results@#The subcutaneous and abdominal animal models of MPM were successfully established. The subcutaneous tumor model grew into tumor on the 20th day, followed by a slow growth stage between the 20th and 29th day, then a rapid growth stage between the 30th and 57th day. According to the dose of tumor cells (100, 200 μL) and timing (14th and 69th days after grafting), the abdominal tumor model successfully simulated the early and late clinical stages of MPM. The HE staining results of the MPM nude mice model showed that the tumor was epithelial mesothelioma and invaded most of the organs, including liver, spleen, pancreas, mesentery. Immunohistochemical staining for calretinin, cytokeratin 5/6, WT1 and Ki-67 were positive. Whole-genome exon sequencing identified 26 and 36 high frequency gene mutations in tumors derived from the PDX model and clinical sample from patients, including 21 common gene mutations.@*Conclusions@#The PDX model of MPM is established. The model is characterized by highly malignant tumor with rapid growth and high invasiveness.
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Objective:To evaluate the clinical efficacy and safety of cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS+HIPEC) for patients with advanced ovarian cancer as the first-line surgical treatment.Methods:The ovarian cancer patients with completed clinical data diagnosed as stage Ⅲ C-Ⅳ according to Federation International of Gynecology and Obstetrics (FIGO) who underwent CRS+HIPEC as the first-line treatment from December 2007 to November 2019 in Beijing Shijitan Hospital were retrospectively analyzed. Survival status was analyzed by using Kaplan-Meier method, and prognostic factors were analyzed by using Cox multivariate regression model. The primary endpoints were median overall survival (mOS) time and median progress-free survival (mPFS) time, and the secondary endpoint was safety in perioperative period. Results:Of 100 patients with advanced ovarian cancer, the median follow-up time was 18.4 months, and 75 (75.0%) patients were alive and 25 (25.0%) patients died, of which the mOS time was 87.6 months (95% CI 72.1-103.1 months), and 1-, 2-, 3-, 4- and 5-year survival rate was 94.1%, 77.2%, 68.2%,64.2% and 64.2%, respectively. Univariate analysis showed that the patients with age≤58 years old ( P = 0.023), Karnofsky≥80 scores ( P = 0.026), ascites ≤1 000 ml ( P = 0.041), peritoneal carcinomatosis index (PCI) score <19 ( P = 0.044) and completeness of cytoreduction (CC) score 0-1 ( P = 0.001) had better prognosis. Multivariate analysis showed that CC score 0-1 was independent prognostic factor, the mortality risk of resectable patients with CC score 2-3 was 3.2 times higher than that in patients with CC score 0-1 ( HR = 3.2, 95% CI 1.4-7.6, P = 0.008), and mPFS time was 23.3 months (95% CI 0-50.7 months) for patients with CC score 0-1. Grade Ⅲ-Ⅳ adverse event rate during perioperative period and mortality rate was 4.0% (4/100) and 2.0% (2/100), respectively. Conclusion:CRS+HIPEC could improve the survival of advanced ovarian cancer patients with good safety.
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Objective:To investigate the serum complement C1q level in patients with polymyositis/dermatomyositis (PM/DM) and its clinical significance.Methods:Thirty patients with PM/DM admitted to the Department of Endocrinology in Shuguang Hospital from January 2016 to December 2018 were selected as the case group. Thirty healthy people for physical examination in the same period in Shuguang Hospital were selected as the control group. The levels of complement C1q and creatine kinase (CK) in the serum of all the subjects were detected. Meanwhile, the levels of anti-Jo-1 antibody(Jo-1) , antineutrophil cytoplasmic antibodies (ANCA) and anti-ribonuclear protien antibody (RNP) in PM/DM patients were detected. The levels of complement C1q and CK in the serum of PM/DM patients with different clinical symptoms and antibody expression were compared. The working characteristics (ROC curve) were used to determine the diagnostic efficacy of complement C1q and CK for PM/DM.Results:Compared with the control group, the levels of complement C1q [(241.26±26.10) mg/L vs (125.04±11.87)mg/L] and CK[(561.03±29.48)mU/ml vs (161.74±15.86)mU/ml] in serum of patients with PM and DM were higher ( t=22.201, P=0.026; t=65.331, P=0.012) , but there was no significant difference in the levels of complement C1q [(254.63±29.24) mg/L vs (240.18±25.72) mg/L] and CK[(557.19±50.10)mU/ml vs (585.42±63.64)mU/ml] between PM and DM( t=1.427, P=0.165; t=1.358, P=0.185). The serum complement C1q and CK in patients with myalgia, limb muscle weakness, Reynolds phenomenon, arthralgia, Yang rash, interstitial lung disease, Gottron sign, V sign, dysphagia and other organ-accumulated patients were increased( P<0.05). The levels of complement C1q[(189.25±24.20) mg/L vs (352.19±30.22) mg/L; (207.31±16.29)mg/L vs (298.16±34.29) mg/L] and CK[(524.56±51.32) mU/ml vs (752.56±49.61)mU/ml; (497.36±54.28) mU/ml vs (651.22±58.26)mU/ml] in patients with serum of Jo-1 or ANCA positive were lower than those of negative patients (χ 2=8.536, P=0.019;χ 2=7.694, P=0.037 and χ 2=12.696, P=0.027; χ 2=10.763, P=0.046). The levels of complement C1q [(316.00±34.82) mg/L vs (225.46±41.38) mg/L] and CK[(624.18±26.10)mU/ml vs (468.25±24.27)mU/ml] in serum of RNP positive patients were higher than those of negative patients (χ 2=6.712, P=0.041; χ 2=11.751, P=0.038). The ROC curves of complement C1q and CK in diagnosis of PM/DM were 0.842 and 0.783 respectively, and the Jordan index was 0.811 and 0.534 respectively, which had certain value for diagnosis of PM/DM, but that of the complement C1q level was higher than that of CK ( P<0.05). The sensitivity and specificity of complement C1q were 88.95% and 92.10% respectively with 231.820 mg/L as the critical value, which was higher than that of CK (68.42% and 85.00%)( P<0.05). Conclusions:The expression of complement C1q in serum of PM/DM patients is increased, which is related to the clinical symptoms and antibody levels of PM/DM patients. It may be involved in the progression of PM/DM disease.
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To establish patient derived xenograft (PDX) model of malignant peritoneal mesothelioma (MPM), and to identify the key characteristics of tumor biology of the model, so as to provide an experiment platform for studying the pathologic mechanisms and new therapeutic strategies for MPM. Surgically excised MPM tumor tissues were inoculated subcutaneously in BALB/c-nu/nu mice for 3 stable passages. In the 4th passage, the subcutaneous tumors were harvested under aseptic conditions, cleaned and made into MPM tumor cell homogenate. Four nude mice (two males and two females) were selected and one male and one female nude mouse were inoculated in the abdominal cavity at the dose of 100 μL, others were inoculated at a dose of 200 μL. The PDX model of MPM was established. The changes of body mass in nude mice were measured regularly, the extent of abdominal and pelvic tumors was judged by experimental peritoneal cancer index (ePCI) score, and the pathologic characteristics of tumors were analyzed. The subcutaneous and abdominal animal models of MPM were successfully established. The subcutaneous tumor model grew into tumor on the 20th day, followed by a slow growth stage between the 20th and 29th day, then a rapid growth stage between the 30th and 57th day. According to the dose of tumor cells (100, 200 μL) and timing (14th and 69th days after grafting), the abdominal tumor model successfully simulated the early and late clinical stages of MPM. The HE staining results of the MPM nude mice model showed that the tumor was epithelial mesothelioma and invaded most of the organs, including liver, spleen, pancreas, mesentery. Immunohistochemical staining for calretinin, cytokeratin 5/6, WT1 and Ki-67 were positive. Whole-genome exon sequencing identified 26 and 36 high frequency gene mutations in tumors derived from the PDX model and clinical sample from patients, including 21 common gene mutations. The PDX model of MPM is established. The model is characterized by highly malignant tumor with rapid growth and high invasiveness.
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The identification and diagnosis of coronavirus disease 2019 (COVID-19) is of great significance in the treatment of COVID-19. Based on Diagnosis and Treatment Protocol for COVID-19 (Trial Version 5) issued on February 8, 2020 by the National Health Commission, there is no fungal pneumonia among the disease listed in the identification and diagnosis item. Thus, we reported a case of patient with AIDS associated with pneumocystis carinii severe pneumonia admitted to Shanghai Fourth People′s Hospital affiliated to Tongji University School of Medicine in January, 2020, which was helpful in improving the identification and diagnosis of COVID-19.
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Objective@#To establish the patient derived xenograft (PDX) model of pseudomyxoma peritonei (PMP), and identify the key characteristics of tumor biology of this model, in order to provide a reliable model for studying the pathological mechanisms and new therapeutic strategies of PMP.@*Methods@#PMP tumor tissue was obtained from surgery and cut into pieces after washing. Then tumor pieces were implanted subcutaneously in BAL B/c-nu mice for 6 stable passages. In the 7th passage, tumor tissue was implanted orthotopically into abdomen. Subcutaneous tumor and orthotopic tumor were then homogenized to make tumor cell suspension, implanted into abdomen of 10 BAL B/c-nu mice through midline laparotomy, 100 μl for each. The key experimental parameters including body weight changes in the observation period, experimental peritoneal cancer index (ePCI) score at the autopsy, histopathological and immunohistochemical characteristics, and gene expression profiles by high-throughput whole-genome exon sequencing were detected and recorded.@*Results@#The successful rate of established orthotopic PDX model of human PMP was 100% (10/10). The animals showed smooth body weight increases after tumor inoculation until day 27, then the body weight began to decrease steadily. Widespread tumor dissemination of PMP tumor through the whole abdomen was found by autopsy, including the diaphragm, liver, spleen, stomach, kidney, parietal peritoneum, bowel and mesenterium. Gelatinous ascites was also observed in abdominopelvic cavity. The ePCI score ranged from 5 to 9, with a 8 of median ePCI. Histopathological studies showed peritoneal mucinous carcinomatosis accompanied with signet ring cells (PMCA-S), obvious tumor cell atypia and parenchymal invasion.Immunohistochemistry showed the expressions of MUC1, MUC2, MUC5AC, CEA, CA199, CK20, CDX-2 and Ki-67 were positive, MUC6, CK7 and p53 were negative. Whole-exome sequencing identified that the most significant genetic alteration is the exon10 missense mutation c. 1621A>C of KIT gene, the mutation abundance was 89.7%.@*Conclusion@#PDX model of PMCA-S is successfully established, which displays the characters of high-degree malignancy, high proliferation and strong aggressiveness.
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Objective To explore the feasibility of using bispectral index (BIS)value to assess the degree of acute brain injury (ABI) and study the correlation between Glasgow Coma Scale (GCS)scores and BIS values in ABI patients. Method A prospective and double-blinded study was conducted to assess GCS scores and BIS values in 330 patients with ABI from January 2013 till July 2017. Mean BIS values (BISMEAN) in mild, moderate and severe group of ABI were calculated. Linear regression between BIS values and GCS scores was constructed. Receiver operating characteristic(ROC) curves to predict non-mild ABI (GCS score less than 13) and severe ABI (GCS score less than 9) were plotted respectively. Results BISMEAN were significantly different among mild, moderate and severe ABI group (75.46±12.94、64.30±12.56、50.37±16.90 respectively, P＜0.01). There were a significant positive correlations between GCS scores and BIS values (R2=0.446, F=264.374, P＜0.01). Regression equation was BIS=2.96 GCS+33.77. ROC curve to predict non-mild ABI demonstrated that area under the curve (AUC)was equal to 0.835 and the optimal cut-off point (BIS value) corresponding with the maximum of sensitivity+specificity was 72.7(sensitivity=0.689, specificity=0.840); ROC curve to predict severe ABI demonstrated that AUC was equal to 0.846 and the optimal cut-off point (BIS value) corresponding with the maximum of sensitivity + specificity was 65.8 (sensitivity=0.721, specificity=0.861). Conclusion BIS values significantly correlate with GCS scores in ABI patients, indicating the feasiblity of using BIS value to assess the degree of ABI. Furthermore, continuous and real-time BIS monitoring can assess degree of ABI better than BIS value.
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Objective To observe the clinical effect of water-assisted liposuction system using in the breast augmentation surgery.Methods From 2015 to 2017,we received 30 new patients who were diagnosed as small breast disease.The water-assisted liposuction system (Body-jetTM) was used to harvest autologous fat,and then autologous fat grafting was preformed in the breast augmentation surgery.The follow-up was conducted one year after operation to observe the change of breast size,fat survival rate,and the occurrence of postoperative complications.Results There was no any serious complication happened in all the 30 cases.The breasts got a good shape and soft feeling after long-term follow up.Conclusions The application of body-jetTM water-assisted liposuction system is safe;the survival rate of autologous fat transplantation is high,and the clinical effect is satisfactory.
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Objective To analysis the frequency and mutational patterns of HBV(hepatitis B virus) S protein in the different phases of chronic hepatitis B patients, exploring the clinical implication of these mutations in CHB. Methods The difference of S protein mutation rates and mutation site among each groups were analyzed by cases-comparison. 112 cases of chronic hepatitis B patients in Shanghai Shu-guang hospital were enrolled in this study; they were divided into four groups, immune-tolerance group [IT, 36 cases, male 20 cases,female 16 cases,age 28.00 (25.00,30.75)years], immune-clearance group [IC, 28 cases, male 17 cases,female 11 cases,age 29.00 (25.25,31.75) years], low-replication group [LR, 25 cases, male 17 cases,female 8 cases,age 39.00 (35.00,45.50) years], reactivation group [RE, 23 cases, male 15 cases,female 8 cases, age 43.00 (36.00, 48.00) years]. DNA sequencing was used to detection HBV S protein gene mutation. Difference between categorical variables were analyzed using Chi-square test, Non-parametric test (kruskal-wallis H and Mann-Whitney U) was used for non-normal distribution data. Results Naturally occurring MHR (major hydrophilic region) variants was 16.67％ (6/36 cases) in IT group, preferentially within"a"determinant in the first loop, compared with IC (21.43％,6/28 cases), LR (20.00％,5/25 cases) and RE (34.78％,8/23 cases), there was no statistics Significance (χ2=2.814, P=0.421), while variant frequencies outside the MHR were 11.11％ (4/36 cases) and 14.29％ (4/28 cases) in IT and IC group, viral diversity gradually increased during LR phase with 24.00％(6/25 cases) of mutation frequency, and peak at RE phase (52.17％, 12/23 cases) with a statistics significance (χ2=15.041, P=0.002). Conclusion Amino acid substitutions is not only the consequence of the pressure of host immunity, it may be a probably cause of disease reactivation.
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OBJECTIVE@#To quantify the relationship between cerebral blood flow velocity and peripheral blood pressure during hypotension period, aiming to predict the brain hypotension before symptomatic occurrence.@*METHODS@#Twenty vasovagal syncope (VVS) patients who had a previous clinical history were selected in groups and 20 pair-matched control subjects underwent 70° tilt-up test. The subjects remained supine for 30 minutes before recordings when Doppler probes, electrodes and Finapres device were prepared. After continuous baseline recordings for 10 min, the subjects underwent head up tilt (HUT) test (70°), and were standing upright for 30 minutes or until syncope was imminent. For ethical reasons, the subjects were turned back to supine position immediately after SBP dropped to ≥20 mmHg, when their consciousness persisted. The point of syncope was synchronized for all the subjects by the point SBP reached the minima. Their beat-to-beat blood pressures (BP) were recorded continuously and bilateral middle cerebral artery (MCA) flow velocities were obtained with two 2 MHz Doppler probes from a transcranial Doppler ultrasonography (TCD) system. A nonlinear dynamic method--multimodal pressure flow (MMPF) analysis was introduced to access cerebral autoregulation during different time intervals. We introduced a new indicator--syncope index (SI), which was extracted from blood flow velocity (BFV) signal to evaluate the variation of cerebral vascular tension, and could reflect the deepness of dicrotic notch in BFV signal.@*RESULTS@#Compared with the syncope index of the baseline value at the beginning of the tilt test, SI in VVS group showed significantly lower when the VVS occurred (0.16±0.10 vs.0.27±0.10,P<0.01),while there was no significant difference in syncope index between the control group at the end of the tilt test and the baseline value at the beginning of the tilt test. For those VVS patients, pulse index and resistance index had no significant change. Syncope index decreased significantly 3 minutes before the point of syncope (0.23±0.07 vs.0.29±0.07,P<0.01).@*CONCLUSION@#Dynamic regulation is exhausted when vasovagal syncope occurred. Tension decrease of small vessels could have some relationship with loss of the cerebral autoregulation capability. The proposed syncope index could be a useful parameter in predicting syncope of VVS patients since it decreased significantly up to 3 minutes earlier from the point of syncope.
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Humans , Blood Pressure , Heart Rate , Nonlinear Dynamics , Syncope , Syncope, Vasovagal , Tilt-Table TestABSTRACT
Type Ⅰallergy is one type of allergic reaction mediated by IgE antibody .Simple, rapid and accurate allergen detection method can be used to identify the allergen of patients , which is of great significance for the prevention , diagnosis and treatment of allergic diseases . In this article , different techniques for in vitro diagnosis of allergen specific IgE antibodies in type Ⅰ allergic reactions were described , important factors affecting in vitro diagnosis of allergens were analyzed , and the future development trend of in vitro diagnosis of allergen specific IgE antibodies were prospected .In order to help clinicians to select more suitable in vitro detection methods in the process of in vitro diagnosis of type Ⅰallergy and to better understand the internal relationship between the allergen specific IgE detection report and clinical symptoms.
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Objective To investigate the advantages and continuous optimization of laboratory automation system through analysis and assessment of the core data and performance after the application of open assembly line.Methods Collect the data of biochemical and immunoassay in Shuguang Hospital attached to Shanghai University of Traditional Chinese Medicine from April to October 2017.( 1 ) Cost analysis of the assembly line schemes;(2) Analysis of workflow before and after the application of assembly line;(3) Analysis of the volume of samples collecting before and after the application of assembly line ;(4) Analysis of TAT data before and after the application of assembly line; ( 5 ) Analysis of staffs allocation before and after the application of assembly line; (6) Analysis of samples rechecking before and after the application of assembly line .Results (1) Open assembly line costs least on hardware (8 million) and site among various projects;(2) Inspection process is greatly simplified after the application of assembly line;(3) The samples′volume of biochemical and immunoassay inspection were reduced by 31.85％;(4) The items′test cycle decreases after the application of assembly line , the average TAT is reduced by 32 minutes;(5) Staffs for samples pretreatment can be reduced by 50％after the application of assembly line , and the quantity of operators does not change;(6) The number of re-check samples increase except the gray zone and critical values , which ensures the reliability of the results .Conclusion To analyze the core data and to evaluate the performance , the laboratory improve on detection cycle ,staffs,and test efficiency.
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Objective To set up a time-resolved fluoroimmunoassay (TRFIA) method for human epidermal growth factor receptor 2 (HER2) detection and to evaluate its performance.Methods Each well of the 96-microwell plate was coated with monoclonal antibody of HER2(H7) and another monoclonal antibody of HER2(E5) was labeled by Eu3+.The sensitivity,stability,specificity,measurement range and reference value of this method were tested.The correlation between chemiluminescence (CLIA) method and TRFIA method was analyzed.Results The sensitivity of HER2-TRFIA method was 0.214 ng/ml.The measurement range was 0.214-1 000 ng/ml.The mean within-run CV and mean between-run CV were 3.48％ and 4.13％,respectively.HER2-TRFIA method had no cross-reaction with HER1 and its reference range was 0-13.20 ng/ml.The correlation coefficient between TRFIA and CLIA was 0.997.The same batch of reagents were found to be stable for more than 6 months at 4 ℃.Conclusions HER2-TRFIA method has high sensitivity,specificity,stability and wide detecting range.It might be suitable for clinical use.
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Objective To develop a time-resolved fluorescent microspheres immunochromatographic assay (TRFMIA) for detection of alphafetoprotein (AFP) and carcinoembryonic antigen (CEA) in human serum and to evaluate its performance.Methods The Eu-time-resolved fluorescent polystyrene particles conjugated with monoclonal antibody AC18# for AFP and AE03# for CEA were used as fluorescent labels.The monoclonal antibody AC17# for AFP,AE05# for CEA and goat anti-rabbit antibody were immobilized on the nitrocellulose membrane as the test lines and control line.Several performances indicators were measured,including linear range,detection limit,and specificity.AFP and CEA were measured by the new method and the results were compared with those obtained by time-resolved fluoroimmunoassay (TRFIA) and electro-chemiluminescence immunoassay (ECLIA) using linear correlation analysis.Results The measurement ranges of AFP were 0.07-1 000.00 kU/L with the intra-and inter-assay CV of 5.93％ and 11.07％,and those of CEA were 0.12-500.O0 μg/L with the intra-and inter-assay CV of 7.53％ and 12.13％ respectively.The average recovery rate of AFP and CEA was 92.77％ and 94.73％,respectively.Measurements obtained by TRFMIA had strong correlation coefficients ranging from 0.93 to 0.97 when compared with those obtained by TRFIA and ECLIA.Conclusion TRFMIA,which can simultaneously detect AFP and CEA,has been successfully established.
ABSTRACT
Objective To investigate the antimicrobial characteristics of shigella flexneri and to analyze the correlation between acquired resistance genes and mobile genetic elements.Methods 139 strains of shigella flexneri collected from each district of Centers for Disease Control and Prevention in Shanghai from 2010 to 2014 were recovered.The K-B method was used to determine the susceptibility of the strains to 13 antibiotics.And then 17 kinds of acquired resistance genes to β-lactams, sulfonamides, aminoglycosides and 7 kinds of genetic markers of mobile genetic elements were analyzed by PCR.Index cluster analysis was performed to explore the correlation between them.Results Among 139 strains of Shigella flexneri,3 kinds of genetic markers of mobile genetic elements,ISEcp1,intI1 and trbC,3 kinds of acquired β-lactam-resistance genes,CTX-M,OXA and TEM,2 kinds of acquired aminoglycoside-resistance genes,ant(3")-I and aac(6′)-Ib, 1 kind of overlapping gene of quaternary ammonium disinfectant and sulfonamides, qacEΔ1-sull and 1 kind of sulfamethoxazole/trimethoprim-resistant gene, dfrA1 were detected.The resistence genes,OXA,ant(3")-I and drfA1 were highly related with each other,which were mediated by Class 1 integron.TEM,qacEΔl-sull and aac(6′)-Ib were highly related with each other,which were mediated by trbC.Conclusion Acquired multidrug resistance gene transfer mediated by a variety of mobile genetic elements may have largely contributed to the spreading of resistant strains of Shigella.