ABSTRACT
Objective:To survey the status quo of hospice care service in community health service centers in Shanghai.Methods:A questionnaire survey was conducted to investigate the situation of hospice care services from January 2021 to December 2021 in 16 community health service centers selected by stratified sampling from 16 districts in Shanghai.Results:Among 16 community health service centers, 13 provided inpatient hospice care services, 16 provide home hospice care and 14 provided outpatient hospice care services; and totally 1 935 (77.93%), 158 (6.36%) and 390 (15.71%) patients received palliative care, respectively. In centers providing inpatient hospice care service, the average bed number was 12 (10, 20); the annual number of patients was 58 (29, 137); the average length of hospital stay was (29.55±11.18) days; and the bed occupancy rate was (55.51±30.02)%, which in urban districts was significantly higher than that in rural districts ((74.76±19.33)% vs.(39.00±28.32)%; t=2.61, P=0.024). The number of patients receiving home hospice care in each center was 10 (3, 19) and the average duration of home service was (66.97±29.41) days. The proportion of physician fee of inpatient hospice care and that of home hospice care were (8.61±5.27)% and (6.25±3.11)%, respectively. While the proportion of medication expenses of inpatient hospice care and that of home hospice care were (35.60±16.13)% and(49.58±9.16)%, respectively. The outpatient hospice service were opened 2.0 (1.0, 4.0) days a week in 14 centers and 95 (58, 199) patients received services. Inpatient services were mainly provided for the patients with non-malignant chronic diseases (53.23%, 1 030/1 935), while home hospice care (89.87%, 142/158) and outpatient hospice care (83.85%, 327/390) mainly provided service for malignant patients. Conclusion:There is still room for improvement about the hospice care services delivered by community health service centers in Shanghai:discrepancy of utilization of hospice care services between urban districts and rural districts, low utilization of home and outpatient hospice care services, unreasonable cost composition in inpatient and home hospice care services.
ABSTRACT
Pain is one of the most frightening and unbearable symptoms in cancer patients, approximately 80% of patients with advanced cancer have pain, and a systematic review shows that the prevalence of breakthrough cancer pain (BTcP) was 59.2%. Breakthrough pain often has a significant negative effect on quality of life of patients, which is related to a direct effect (suffering) and an indirect effect (interference with activities of daily living). Clinical management of BTcP is still not satisfactory despite the availability of various effective pain relief agents. The purpose of this review is to summarize the current situation of the management of BTcP at home and abroad, and to discuss the factors that hinder the management of BTcP.
ABSTRACT
Objective:To investigate the work stress and its influencing factors among hospice care physicians and nurses in medical institutions in Shanghai.Methods:It was a cross-sectional study. The study was carried out between December 2021 and January 2022. By use of multistage random sampling, 256 hospice care physicians and nurses were selected from community healthcare centers, secondary and tertiary hospitals in Shanghai to attend a WeChat-based survey using a self-designed questionnaire. The chi-square test was used to compare the differences in prevalence of work stress and stressors among all subjects with different characteristics. Binary logistic regression analysis was used to explore the major determinants associated with work stress. And the sources of work stress and the expepectd decompression countermeasures were investigated.Results:A total of 256 valid questionnaires were collected with a recovery rate of 100.0%. The median of work stress score was 7.5 (6.0, 9.0). Logistic regression analysis showed that those aged>40 years old and working for ≥5 years in hospice care service had higher level of work stress ( OR=3.78, 2.04; P=0.007, 0.039), and those with monthly income>10 000 RMB Yuan had lower level of work stress ( OR=0.34, P=0.005). The top three stressors were the death of patients (88.3%, 226/256), low income (78.1%, 200/256), difficulty in promotion (67.2%, 172/256). The top three way that doctors and nurses desired to reduce work stress were to increase income (88.3%, 226/256) and optimize performance appraisal target (78.1%, 200/256) and promotion mechanism (66.0%, 169/256). Conclusions:In general, the work stress among hospice care physicians and nurses is at a high level in Shanghai and the stressors are widely distributed. Age, monthly salary and years of working in hospice care unit are independent factors of work stress. Improving salary, optimizing performance appraisal target and promotion mechanism are the most desired strategies to reduce work stress among hospice care physicians and nurses.
ABSTRACT
Objective:To investigate the effects of mixed probiotics on food allergy and the underlying mechanism.Methods:BALB/c mice on the 15 th day of pregnancy were randomly (random number table method) classified into the control group, food allergy model group and mixed probiotics group.Mice in the food allergy model and mixed pro-biotics group were subjected to ovalbumin (OVA) sensitization after birth, and those in the mixed probiotics group were then given probiotic solution by gavage from day 21 to day 35.Mice in control group were similarly given 9 g/L saline.Twenty-four hours after the last OVA sensitization, intestinal histopathological sections were prepared to observe intestinal pathological changes.Blood smears were prepared to detect eosinophil count.In addition, serum samples were collected to measure cytokine levels and OVA specific antibodies.The number of dendritic cells (DCs) and regulatory T cells (Tregs) in mouse mesenteric lymph nodes was calculated.Differences among 3 groups were compared by the One- Way ANOVA or Kruskal- Wallis H test. Results:Compared with those of food allergy model group, diarrhea score, the ratio of eosinophils and serum levels of interleukin(IL)-4, IL-5, IL-13, mast cell protease 1 (MCPT-1), and OVA specific antibodies IgE and IgG were significantly lower in mixed probiotics group[(2.00±0.71) points vs.(3.22±0.97) points, (2.28±1.61)% vs.(10.99±2.26)%, (413.68±22.81) ng/L vs.(708.78±27.66) ng/L, (36.64±3.74) ng/L vs.(46.05±4.95) ng/L, (201.37±65.61) ng/L vs.(495.22±96.66) ng/L, (31 924.15±1 177.77) ng/L vs.(36 175.77±618.29) ng/L, (9.10±8.08) ng/L vs.(19.69±0.84) ng/L, (30.50±8.81) ng/L vs.(190.32±6.40) ng/L], while IL-10 level was significantly higher[(164.12±3.88) ng/L vs.(123.90±7.31) ng/L] ( t=3.37, 8.72, 16.07, 3.90, 7.40, 7.95, 3.91, 44.00 and 7.76, respectively, all P<0.01). Compared with those of food allergy model group, programmed cell death ligand 1 (PD-L1) level on the surface of CD 103+ DCs and CD 103+ CD 80-CD 40-DCs, the proportion of Tregs in CD4 + T cells, and the level of programmed cell death 1 (PD-1) on the surface of Tregs were significantly higher in mixed probiotics group[(75.59±0.45)% vs.(45.60±4.73)%, (67.56±1.87)% vs.(37.12±6.07)%, (8.24±0.69)% vs.(6.20±0.66)%, (11.25±3.12)% vs.(4.08±2.33)%]( t=7.88, 4.48, 3.63 and 3.71, all P<0.01). Conclusions:Mixed probiotics can alleviate the symptoms of food allergy and inflammatory response of young rats through mediating Tregs via the PD-1/PD-L1 pathway.
ABSTRACT
Gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN) is a rare heterogeneous tumor. The heterogeneity in pathology, differentiation, grade and clinical stages results in different prognosis and treatment strategy. Patients with recurrent or metastatic NEN have limited treatment options and poor prognosis.Programmed cell death 1(PD-1) blockade has played indispensable roles in management of cancers recently.Immunotherapy is being explored in NENs in the world with emerging clinical trials. The results of the trials provide evidence and guidance in the application of NEC.The article analizes and summarizes of the findings of major investigations in this field.
ABSTRACT
Objective:To explore the effect of combining hyperbaric oxygen (HBO) therapy with cognition training for persons with vascular cognitive impairment (VCI).Methods:Forty-two persons with VCI were randomly divided into a control group of 19 and a research group of 23. In addition to basic treatment, the control group was given hyperbaric oxygen therapy once a day, 5 days per week for 4 weeks, while the research group received cognition training along with the hyperbaric oxygen therapy. Each person′s cognition was assessed using the Simple Mental Status Scale (MMSE) before and after the four-week treatment. Meanwhile, 3ml of venous blood was collected before eating in the morning to test the plasma levels of Klotho protein and homocysteine using enzyme-linked immunosorbent assays.Results:After the treatment the average MMSE score had improved significantly in both group, with the improvement in the research group′s average significantly greater than that in the control group. The average plasma levels of Klotho protein and homocysteine had also improved significantly more in the research group. In the control group, the only significant improvement was in the average homocysteine level.Conclusions:Hyperbaric oxygen therapy can be an effective supplement to cognition training for persons with vascular cognitive impairment.
ABSTRACT
Objective@#To analyze epidemiological characteristics of campus bullying among primary and middle school students in central China to explore its relation with mental health problems, and to provide a reference for the campus bullying prevention.@*Methods@#Stratified cluster sampling method was used to select primary and middle school 10 581 students from Anyang, Nanyang and Xinxiang cities of Henan Province, Middle School Students Mental Health Scale and the Self designed Scale of Adolescent Bullying Behavior were used to analyze the relationship between mental health problems with campus bullying behavior.@*Results@#The total report rate of bullying penetrator was 12.5% among students in the three cities. Among primary and middle school students with mental health problems such as hostility, interpersonal stress, academic pressure and emotional imbalance, the detection rate of bullying behavior was 24.2%, 20.3%, 19.4% and 20.1%, respectively. The results of multivariate analysis showed that hostility symptoms ( OR =3.78, 95% CI =1.71-8.32), interpersonal stress ( OR =3.50, 95% CI = 1.62 -7.57), academic pressure ( OR = 1.62 , 95% CI =1.21-2.16) and emotional imbalance ( OR =2.80, 95% CI =1.41-5.56) showed a significant impact on campus bullying ( P <0.05).@*Conclusion@#Mental health problems of primary and middle school students are closely related to the occurrence of bullying behavior. It is necessary to pay attention to the mental health education of bullies and intervene bullying behaviors from the source.
ABSTRACT
Objective:To investigate the effect of combining aerobic exercise with hyperbaric oxygen therapy on the cognition and oxidative stress of patients with post-stroke cognitive impairment (PSCI).Methods:Forty-five PSCI patients were divided randomly into a hyperbaric oxygen therapy (HBO) group (of 21) and a combination group (of 24). Both groups received HBO therapy, but the combination group also performed 30min of aerobic exercise using a cycle ergometer 5 times a week for 8 weeks. The HBO therapy involved 20min for pressurization, 20min of decompression, 60min of pressurized oxygen inhalation and 10min of air inhalation. The treatment pressure was 0.2MPa (2.0ATA). Before and after the intervention, cognitive functioning was measured using the mini-mental state examination (MMSE) and the Montreal cognitive assement (MoCA). The Barthel index quantified ability in the activities of daily living. Serum glutathione (GSH) and malondialdehyde (MDA) were measured spectrophotometrically.Results:The average MMSE scores of both groups had improved significantly after the treatment, with significantly better improvement in the combination group. After the treatment, the average MoCA score of the combination group had improved significantly while that of the HBO group had not. The average Barthel index scores of both groups improved significantly and there was no significant difference between them after the treatment. The average serum GSH increased after the treatment in the combination group, and the increase was weakly positively correlated with the increase in MMSE scores. The average MDA content of the HBO group decreased after the treatment, and the decrease was positively correlated to the increase in the MMSE scores, but again weakly.Conclusions:Aerobic exercise combined with hyperbaric oxygen therapy can effectively improve cognition among PSCI patients. Increases in serum GSH and decreases in serum MDA are weakly positively correlated with cognitive functioning.
ABSTRACT
Objective:To investigate the effect of Suhuang Zhike Capsule on airway inflammation in patients with acute episode of allergic rhinitis and asthma syndrome.Methods:Eighty patients with allergic rhinitis and asthma syndrome were admitted to North China University of Science and Technology Affiliated Hospital from June 2016 to September 2017.A prospective cohort study was carried out and randomly divided into treatment group and control group with 40 patients in each group.The control group was treated with conventional anti-inflammatory, expectorant and antiasthmatic therapy, while the treatment group was treated with Suhuang Zhike Capsule.The changes of nasal symptoms and asthma clinical symptoms in the two groups were compared before and after treatment, and the changes of nitric oxide in exhaled air, eosinophils in blood and induced sputum were measured.Results:Compared with the control group, there was no significant difference in the number of eosinophils in the exhaled nitric oxide, eosinophil count in blood and induced sputum before treatment in the treatment group ((161.45±4.67)×10 -9 vs.(163.12±4.56)×10 -9, (1.59±0.53)×10 9/L vs.(1.60±0.51)×10 9/L, (1.11±0.06)×10 9/L vs.(1.18±0.09)×10 9/L; t values were 0.10, 0.44, 1.75, respectively, all P>0.05). After treatment, the exhaled nitric oxide, eosinophil count in blood and induced sputum in the treatment group were significantly lower than those before treatment((30.86±5.54)×10 -9 vs. (161.45±4.67)×10 -9; (0.32±0.05)×10 9/L vs. (1.59±0.53)×10 9/L; (0.06±0.02)×10 9/L vs. (1.11±0.06)×10 9/L, t values were 91.32, 41.63, 51.77, respectively, all P<0.01). In the treatment group, the effective rate of nasal symptom control was 85.0% (34/40) significantly higher than 62.5% (25/40) in the control group (χ 2=5.23, P<0.05), and the effective rate of asthma clinical symptom control was significantly higher than that in the control group(90.0%(36/40), 72.5%(29/40), χ 2=4.02, P<0.05). Conclusion:Suhuang Zhike capsule can obviously improve the airway inflammatory response of patients with allergic rhinitis asthma syndrome in the acute attack stage, and the combination of conventional treatment plan is helpful to improve the curative effect.
ABSTRACT
Objective:To select the animal model more consistent with the pathophysiology of abdominal compartment syndrome (ACS) through the comparative study of the methods of multiple water sacs superimposed compression and gas perfusion.Methods:Ten experimental pigs were randomly divided into two groups ( n = 5): the "constant volume model" (constant volume model group) and the "constant pressure model" (constant pressure model group) of intra-abdominal hypertension. The models were prepared by the method of water sac superposition and pressurization, and artificial pneumoperitoneum respectively. The abdominal pressures of both groups were 25 mmHg (1 mmHg = 0.133 kPa) and observed for 4 hours. The pressure was measured once an hour for 4 hours and the pressure-time curves of the two groups were drawn respectively. The experimental animals were sacrificed 4 hours after modeling. The heart and lung were harvested, and the histopathological changes were observed by hematoxylin-eosin (HE) staining. Results:Two groups of experimental pigs were successfully modeled. The abdominal pressure gradually increased at 0, 1, 2, 3, 4 hours after operation in the constant volume model group (mmHg: 25.0±0, 27.1±0.2, 29.4±0.1, 30.9±0.2, 33.1±0.1), and there was a positive correlation between the abdominal pressure and time (functional equation: Y1 = 25.102 0+1.996 0 X1; R2 = 0.996 2, P = 0.000 1). The abdominal pressure value in the constant pressure model group at 0, 1, 2, 3, 4 hours were maintained 25 mmHg, and there was no linear correlation between the abdominal pressure and time (functional equation: Y2 = 25). HE staining showed that in the constant volume model group, the myocardial fibers were accompanied with hyaline degeneration, significantly reduced transverse lines, part of myocardial fiber atrophy, and visible nuclear aggregation; hemorrhage, chronic inflammatory cell infiltration and inflammatory exudation were found in the lung tissues. In the constant pressure model group, partial atrophy of myocardial fiber, partial hypertrophy, focal hyaline degeneration, disappearance of local striae, hyaline degeneration of myocardial fiber, dilation and congestion of intermyocardial artery were observed. Slight hyperplasia of alveolar epithelium in some areas, heart failure cells, dilation and congestion of bronchi and trachea artery, a large number of red blood cells and uniform light staining substances in lumen were found. Conclusion:After the model was made by the method of multiple water sacs, the pressure of the abdominal cavity continued to increase with the development of the disease, which was in line with the clinical pathological changes of ACS, and was more suitable for making the animal model of the intra-abdominal hypertension.
ABSTRACT
Objective:To understand the status of life quality, resilience and disability acceptance of burn patients, and to explore the impact of mental resilience and disability acceptance on the quality of life.Methods:Connor-Davidson Resilience Scale (CD-RISC), Acceptance of Disability Scale (ADS) and Burn Specific Health Scale-Brief (BSHS-B) were used to carry out questionnaire survey for a total of 315 burned patients who were in rehabilitation phase.Results:For burned patients, the total score of resilience was 57.12±14.34, the total score of disability acceptance was 78.20 ±9.99, and the total score of quality of life was 128.29 ±37.26. The correlation analysis showed that the total score of resilience was positively correlated with quality of life for burned patients ( r value was 0.646, P<0.01); the total score of disability acceptance was positively correlated with the total score of quality of life for burned patients ( r value was 0.846, P < 0.01). Multiple stepwise regression showed that the total score of disability acceptance, severity of burn, sleep state, ability and endurance of negative emotions were the main predictors of the quality of life for burned patients. Conclusions:Great attention should be paid to the quality of life of burned patients, and psychological problems of high-risk patients should be found as soon as possible and reasonable intervention should be given to improve the resilience and disability acceptance of patients, so as to improve their quality of life.
ABSTRACT
Objective To analyze the drug consumption in medical service for Dominica and Dominican in Harmonious Mission -2018, and provide reference for future drug supply services in similar countries. Methods Data of the drugs used during the medical service of the two countries were extracted from the computer system, which were summarized and analyzed. Results Ranking first in drug consumption in medical service for Dominica and Dominican was external drugs. Chinese traditional medicines were very popular in both two countries. There were great similarities and unique characteristics in the drug consumption during medical service between the two countries, orthopedic drugs, digestive system drugs, ophthalmic drugs and dermatological drugs were frequently used drugs. Conclusion The drug consumption in medical service was closely associated with the national conditions. Therefore, in order to prepare medicines reasonably in future overseas medical service, disease distribution of the country which would be visited and drug consumption in the similar country which had been visited before should be concerned.
ABSTRACT
Objective Through the statistics of drug consumption in the task of Harmonious Mission -2018, sort out the process of medication supply of overseas medical services, analyze and evaluate the medication supply services. Methods Count the types and quantities of medicines consumed by marine hospitals in the Harmonious Mission-2018, analyze whether the preparation of medicines is sufficient, effective, and economically reasonable, and find way to improve the process of medicine supply in overseas medical services. Results Statistics on the consumption of drugs in the Harmonious Mission-2018 show that the number of drugs consumed accounted for 68.21% of the total kinds of medicine carried, that the total amount of drugs consumed accounted for 40.61% of the total costs of medicine carried, and that the total number of boxes of drugs consumed (the number of the smallest packages) accounted for 21.72% of the total number of boxes of medicine carried. Conclusion The medicine support services in the Harmonious Mission-2018 was sufficient and effective. But, the workflow and the processes of the services still need to be further improved.
ABSTRACT
Objective To investigate the potential therapeutic effect of luteolin on sepsis-induced ALI and the underlying mechanisms.Methods Total of 50 mice were randomly(random number) divided into five groups:a sham control group,a sepsis-induced ALI group,and three sepsis groups pre-treated with 20,40,and 80 mg/kg body weight luteolin.Mice in the treatment groups were pre-treated with luteolin at the respective oral dose two days before ALI induction.The lungs were isolated for histopathological examinations,and the bronchoalveolar lavage fluid (BALF) was collected for biochemical analyses.Results Luteolin significantly attenuated sepsis-induced ALI.Additionally,luteolin treatment decreased protein and inflammatory cytokine concentration and the number of infiltrated inflammatory cells in BALF compared with that in the non-treated sepsis mice.Pulmonary myeloperoxidase (MPO) activity was lower in the luteolin-pre-treated sepsis groups than in the sepsis group.The mechanism underlying the protective effect of luteolin on sepsis is related to the up-regulation of certain antioxidation genes,including inducible nitric oxide synthase (iNOS),cyclooxygenase-2 (COX-2),superoxide dismutases (SODs),and heme oxygenase 1 (HO-1),and the reduction of inflammatory responses through blockage of the activation of the nuclear factor (NF)-κB pathway.Conclusions Luteolin pre-treatment inhibits sepsis-induced ALI through its anti-inflammatory and antioxidative activity,suggesting that luteolin may be a potential therapeutic agent for sepsis-induced ALI.
ABSTRACT
Objective To study the effect of estrogen on proliferation of astrocytes in hippocampus of mice following middle cerebral artery occlusion(MCAO).Methods One hundred and eight Kunming mice were randomly divided into estrogen group(n=54)and saline group(n=54).The animals in two groups underwent right MCAO with tissue samples taken at 3,6,12,24,48and 72h after MCAO.The ischemic site was detected and the ischemic size was measured with TTC staining,the damage of neurons in hippocampus was assayed with HE staining,the expression of GFAP in hippocampal astrocytes was detected with immunohistochemical staining.Results The cerebral infarction size was significantly smaller in estrogen group than in saline group at different time points after MCAO(P＜0.05,P＜0.01)especially at 12hafter MCAO(31.50％±3.36％vs 54.50％±5.68％,P=0.019).The damage of hippocampal neurons aggregated with the prolonged ischemia time in two groups and was milder in estrogen group than in saline group at the same time points.The expression level of GFAP positive cells in bilateral hippocampal areas was higher when the ischemia time was prolonged and was significantly higher in ischemic hippocampus of estrogen group than in that of control group except at 6hin CA3ischemic area(P＜0.05).Conclusion Estrogen can protect mice against focal cerebral ischemia,stimulate the genesis of astrocyte synapses,alleviate neuronal damage after ischemia,and can thus reduce the size of cerebral infarction.
ABSTRACT
Objective To summarize the clinical and pathologic characteristics of patients with RosaiDorfman disease (RDD) mimicking immunoglobulin (Ig) G4-related disease (IgG4-RD).Methods Retrospectively analyze the clinical manifestations,laboratory tests,pathologic features,treatment and prognosis of RDD patients whose clinical presentations mimicked IgG4-RD in Peking Union Medical College Hospital during January 2015 to June 2017.Results Six RDD patients mimicking IgG4-RD were described,which accounted for 1.5％ of the 450 registered IgG4-RD patients.All patients were male,with the median age of 53 year and the median disease duration of 12 months.All patients had extra-nodal involvements,of which the locations included spinal cord (3/6),intracranial (2/6),skin (2/6) and liver (1/6).Increased serum IgG4 (＞1 350 mg/L) was found in 4 cases (1 360-6 410 mg/L).Seven specimens were obtained from these patients.The number of IgG4-positive plasma cells was found to be more than 50 per HPF in 3 cases,30 per HPF in 1 case.The IgG4/IgG ratio was 40％ in 2 specimens,between 10％ and 30％ in 2 specimens and 10％ in 2 specimens.All patients were treated by glucocorticoids and 4 of them were treated with combined cyclophosphamide.Five patients got partial remission by these treatments while 1 patient withdrew from further follow up.Conclusion RDD is one of the mimics of IgG4-RD.There are several differences in lab tests and pathologic features between RDD and IgG4-RD.Before the IgG4-RD is diagnosed,RDD should be excluded by specific pathologic manifestations at the first place.
ABSTRACT
Objective To investigate the influence of supplemental probiotics on the changes of immunity and microecology in asthmatic children. Methods One hundred and seventy?six asthmatic children treated in the Affiliated Hospital of North China University of Science and Technology from October 2015 to October 2016 were selected in the study and were randomly divided into two groups, 88 cases in each group. Patients in the control group were given routine treatment, and the observation group was treated with routine treatment combined with probiotics. The changes in immune index and microecological index before and after the treatment were compared between the two groups. Results After treatment, the observation showed CD3+ was(65. 8±2. 6)％,CD4+was(39. 2±1. 3)％,CD8+ was(24. 5±1. 0)％,CD4+/CD8+ was(1. 6±0. 2),NK cells was(15.2±0.4)％,Th1/ Th2 was(5.7±1.3),interferon γ was(56.3±1.8)ng/L,bifidobacterium was (9. 3±0. 7)lgCFU/g,lactobacillus was(9. 5±0. 6)lgCFU/g,yeast was(6. 6±0. 8)lgCFU/g,compared with those before treatment ((52. 5±1. 7)％,(23. 6±0. 8)％,(19. 7±0. 9)％,(1. 2±0. 1),(12. 8±0. 3)％,(3. 4±0. 7), (44.0±1.5)ng/L,(4.2±1.1)lgCFU/g,(4.9±0.4)lgCFU/g,(3.7±0.4)lgCFU/g),the differences were statistically significant ( t= 5. 533, 9. 957, 5. 436, 6. 332, 4. 875, 9. 764, 5. 727, 15. 143, 12. 387, 10. 837, P<0. 05). After treatment,in the control group,CD3+ was(60. 1±3. 4)％,CD4+ was(30. 7±1. 2)％,CD8+ was (21.9±1.1)％,CD4+/ CD8+ was(1.4±0.3),NK cells was(14.0±0.3)％,Th1/ Th2 was(4.6±0.9), interferon γ was ( 50. 2 ± 1. 4 ) ng/L, bifidobacterium was ( 7. 6 ± 0. 8 ) lgCFU/g, lactobacillus was ( 8. 1 ± 0. 7 ) lgCFU/g, yeast was ( 4. 9 ± 0. 8 ) lgCFU/g, compared with those before treatment ( ( 52. 4 ± 2. 0 )％, ( 23. 8 ±0. 7)％,(19. 8±0. 6)％,(1. 2±0. 2),(12. 7±0. 2)％,(3. 5±1. 1),(44. 1±1. 3)ng/L,(4. 3±0. 9)lgCFU/g, (5.0±0.5)lgCFU/g,(3.8±0.6)lgCFU/g),the differences were statistically significant(t=4.469,5.899, 4. 061,4. 667,4. 023,6. 143,4. 363,10. 674,9. 201,5. 894,P<0. 05) . The above indexes in observation group were higher than those in the control group ( t=3. 948, 3. 162, 4. 187, 4. 428, 3. 857, 5. 391, 4. 202, 5. 236, 4. 728,6. 469,P<0. 05). After treatment,the observation group showed IgE(139. 4±21. 0)was kU/L,IL?4(30. 2 ±1. 7)was ng/L,IL?10 was(6. 3±0. 8)ng/L,escherichia coli was(4. 8±0. 6)lgCFU/g,streptococcus was(6. 1 ±0.9)lgCFU/g,bacillus was(4.6±0.2)lgCFU/g,staphylococcus was(1.9±0.3)lgCFU/g,enterococcus was (5.2±0.4)lgCFU/g,compared with those before treatment((381.2±49.6)kU/L,(59.4±3.5)ng/L,(13.9 ±1.1)ng/L,(7.1±0.5)lgCFU/g,(8.4±0.6)lgCFU/g,(8.0±0.6)lgCFU/g,(4.0±0.8)lgCFU/g,(7.4 ±0. 8)lgCFU/g),while the differences were statictically significant (t=22. 231,12. 667,15. 063,7. 791,6. 770, 10. 392,16. 523,7. 232,P<0. 05). After treatment,in control group showed IgE was (230. 8±31. 7) kU/L,IL?4 was (41. 3±2. 3)ng/L,IL?10 was (9. 8±0. 7)ng/L,escherichia coli was (5. 9±0. 7)lgCFU/g,streptococcus was (7. 2±1. 0)lgCFU/g,bacillus was (6. 4±0. 8)lgCFU/g,staphylococcus was(2. 7±0. 7)lgCFU/g,enterococcus was (6.1±0.6)lgCFU/g,compared with those before treatment((387.9±54.3)kU/L,(59.6±3.4)ng/L, (13. 7±1. 2)ng/L,(7. 0±0. 4)lgCFU/g,(8. 3±0. 5)lgCFU/g,(8. 1±0. 7)lgCFU/g,(4. 1±1. 0)lgCFU/g,(7. 3 ± 0. 7 ) lgCFU/g ) , while there were significant differences ( t= 9. 826, 7. 390, 6. 979, 4. 864, 4. 527, 5. 656、8. 185,4. 967,P<0. 05). The above indexes in observation group were lower than those in the control group(t=9. 618,6. 713,8. 556,5. 290,4. 803,6. 913,7. 215,4. 731,P<0. 05) . The intestinal flora time was ( 5. 6 ± 1) d,hospitalization time was (10. 2 ± 1. 3) d,hospitalization expenses (3527. 1 ± 403. 2) RMB in the observation group,compared with (10. 7±1. 8)d,(14. 6±2. 1)d,(4689. 4±526. 7)RMB in the control group,the differences between the two groups were statistically significant ( t= 12. 107, 7. 314, 6. 295, P<0. 05 ) . Conclusion Probiotic supplement can improve immune status and microecology status in asthmatic children,which is worthy of clinical use.
ABSTRACT
At present, glucocorticoids are the first-line drugs for the treatment of type 1 autoimmune pancreatitis, which is also known as IgG4-related autoimmune pancreatitis. Combined treatment with immunosuppressant and glucocorticoids helps to reduce the dose of glucocorticoids and maintain long-term remission. There are no high-quality evidence-based prospective studies of immunosuppressant in the treatment of IgG4-related disease. No uniform standards have been developed in China and the rest of the world, and the treatment of this disease mainly draws experience from other autoimmune diseases. This article introduces the application of conventional drugs (including azathioprine, mycophenolate mofetil, cyclophosphamide, methotrexate, leflunomide, and cyclosporine) and biological therapy (for example, rituximab targeting B lymphocytes) in the treatment of autoimmune pancreatitis.
ABSTRACT
Objective To observe the effect of edaravone (ED) on cognition function and expression of Nogo-A in prefrontal cortex neuron of rats with serious intermittent hypoxia.Methods Ninety-six adult male Wistar rats were randomly divided into normal control group, chronic intermittent hypoxia (CIH) model group and ED group, 32 rats in each group. The rat model of CIH was reproduced in a low oxygen box at 08:00-15:00 every day: alternatively, different flow rates of nitrogen and compressed air were given, 120 seconds being one cycle, maintaining the oxygen concentration at 5%-21% in the low oxygen chamber; the normalcontrol group was continuously under the circumstance fulfilled with compressed air. The rat in ED group was given intravenous injection of 3 mg/kg ED in a tail vein at 07:00 daily. After modeling for 7, 14, 21, 28 days, the learning and memory functions of rats were assessed with the Morris water maze test, and the reactive oxygen species (ROS) content in the rat prefrontal lobe tissue was detected; the level of Nogo-A protein expression in the rat prefrontal cortex was examined by immunohistochemical method .Results ① Rat learning results: in CIH model group, with the time prolongation escaping latency period was gradually longer, since 14 days after the modeling, the difference was statistically significant compared with that in normal control group, while the learning time in ED group was obviously shorter than that in the CIH model group (seconds: 14 days was 26.97±3.35 vs. 34.95±3.36, 21 days was 32.78±4.59 vs. 46.72±4.11, 28 days was 41.39±3.84 vs. 57.35±3.72, allP < 0.05). ② Rat memory results: the rats in CIH model group, with the time prolongation crossing the target quadrant time was gradually shorter, since 14 days after the modeling, the difference was statistically significant compared with that of the normal control group, while the memory time in the ED group was obviously longer than that of the model group (seconds: 14 days was 42.72±3.35 vs. 39.88±3.56, 21 days was 40.48±4.62 vs. 28.72±3.93, 28 days was 31.13±3.46 vs. 22.79±3.24, allP < 0.05). ③ ROS content: with the time prolongation, ROS content was gradually increased in CIH model group, but the ROS content in ED group was significantly lower than that in CIH model group at various time points (MU/L: 7 days was 13.27±0.23 vs. 17.68±0.51, 14 days was 15.51±0.28 vs. 20.41±0.65, 21 days was 20.29±0.44 vs. 23.86±0.35, 28 days was 24.46±0.53 vs. 30.43±0.85, allP < 0.05). ④ Protein expression of Nogo-A: with the time prolongation, the protein expression of Nogo-A was gradually increased in CIH model group, they reached the peak on the 14th day, the expression of Nogo-A [absorbance (A) value] in ED group were significantly lower than that in CIH model group at each time point (×103: 7 days was 4.80±0.70 vs. 5.99±0.62, 14 days was 5.89±0.90 vs. 7.42±0.66, 21 days was 4.92±0.64 vs. 5.90±0.37, 28 days was 3.59±0.59 vs. 4.27±0.40, allP < 0.05).Conclusions The mechanism of ED has a valid therapeutic effect on the cognitive dysfunction induced by serious intermittent hypoxia in rats, ED can remove oxygen free radicals and inhibit the protein expression of Nogo-A in the prefrontal cortex, so ED can alleviate the damage of cognitive function in rats with CIH.
ABSTRACT
Objective To analyze the clinical characteristics of IgG4-related disease (IgG4-RD)so as to improve the understanding of IgG4-RD in China.Methods IgG4-RD patients were recruited from Peking Union Medical College Hospital between January 2011 and January 2016.All patients were followedup for more than 6 months.The demographic characteristics,symptoms,organ involvements,laboratory examinations and treatment efficacy were evaluated and analyzed.Results A total of 346 patients were finally enrolled,including 230 males (66.5％) and 116 females (33.5％).The mean age of disease onset was (53.8 ± 14.2) years old.The mostly common involved organs were lymph nodes (56.4％) and submandibular glands (52.6％).Other affected organs and manifestations included:swelling of the lacrimal glands (46.5％),autoimmune pancreatitis (38.4％),pulmonary involvement (28.0％),sclerosing cholangitis (25.4％),naso-sinusitis (23.4％),parotid gland swelling (21.7％),retroperitoneal fibrosis (19.9％),large arteries involvement (9.5％),kidney involvement (obstructive nephropathy caused by retroperitoneal fibrosis was excluded) (6.9％),skin lesions (6.4％).Rare features consisted of thyroid glands,pituitary glands,gastrointestinal tract,pachymeningitis,pericardium,sclerosing mediastinitis and orchitis.The majority of patients had multi-organ involvement,such as 74.3％ patients with 3 and more,18.2％ and 7.5％ patients with 2 and single organ involvement respectively.The average IgG4-RD responder index (IgG4-RD RI) was 13.21 ±5.70.History of allergy was found in 172 (49.7％) patients.As to the laboratory tests,elevated serum IgG4 levels were confirmed in 285 (94.1％) patients,which was positively correlated with IgG4-RD RI.There were 33.5％ patients receiving monotherapy of glucocorticoid,52.6％ treated with glucocorticoids combined with immunosuppressive agents,4.9％ patients with immunosuppressant only,and 9.0％ patients with mild disease not receiving medication.The majority (336,97.1％) patients improved the above regimens.Conclusion IgG4-RD is a systemic fibro-inflammatory disease with multiple organ involvement.The mostly common involved organs include lymph node,submandibular glands,and pancreas.Glucocorticoids and immunosuppressive agents were effective for IgG4-RD.