ABSTRACT
AIM:To explore the effect of intravitreal injection FasL inhibitors on corneal apoptosis, Fas, FasL expression, Treg numbers in blood and lymph nodes and rejection index in rats after corneal transplantation.METHODS:A total of 24 SD rats(24 eyes)who received penetrating keratoplasty were randomly divided into two groups: PBS group received intravitreal injection of PBS(12 rats, 12 eyes)and FasL inhibitor group(12 rats, 12 eyes). Rejection index was recorded every week and blood samples and lymph node were collected at 1, 3 and 5wk after surgery to analyze the proportions of Treg. Corneal tissue was collected for detecting the expression of Fas and FasL and number of apoptosis.RESULTS: The expression of Fas, FasL in FasL inhibitor group decreased significantly compared with the PBS group(all P<0.05); Corneal cell apoptosis significantly decreased in FasL inhibitor group, and it was the lowest at 5wk after surgery; Treg numbers in blood and lymph nodes significantly increased in FasL inhibitor group at 3wk after surgery(all P<0.05); rejection index of corneal transplantation in the FasL inhibitor group was significantly lower than that of PBS group(all P<0.05).CONCLUSION:Intravitreal injection of FasL inhibitors after corneal transplantation could reduce the apoptosis in all layers of cornea, increase the number of Tregs in blood and lymph nodes, and alleviate rejection.
ABSTRACT
To maintain the precision and stability of the efficacy of classical formulas, this study compared the origins and specifications of Bupleuri Radix and revealed the precise application regularity of Bupleurum chinense(Beichaihu) and Bupleurum scorzonerifolium(Nanchaihu) in classical formulas. The efficacy and indications of formulas with Bupleuri Radix as the sovereign drug in the Treatise on Cold Damage and Miscellaneous Diseases(Shang Han Za Bing Lun) were investigated. The difference in the efficacy of Bupleuri Radix as well as the differences in the chemical composition, and liver-protecting and lipid-lowering effects of the decoctions of Beichaihu and Nanchaihu were analyzed with LC-MS technology based on the CCl_4-induced liver injury model in mice and sodium oleate-induced HepG2 hyperlipidemia cell model. The results showed that seven classical formulas with Bupleuri Radix as the sovereign drug in the Treatise on Cold Damage and Miscellaneous Diseases were mainly used in the treatment of digestive, metabolic, immune, circulatory, and other diseases. Bupleuri Radix mainly played the functions of protecting the liver, benefiting the gallbladder, and lowering the lipid, and had different focuses in different formulas. There were 14 differential components in the decoctions of Beichaihu and Nanchaihu, and the chemical structures of 11 components were identified, including 10 saponins and one flavonoid. The results of the liver-protecting efficacy experiment showed that compared with the Nanchaihu decoction, Beichaihu decoction could reduce the serum aspartate aminotransferase(AST) activity in liver injury model mice(P<0.01). The results of the lipid-lowering efficacy experiment proved that Beichaihu and Nanchaihu decoctions both showed highly significant differences in lowering the total cholesterol(TC) and triglyceride(TG) content in HepG2 cells(P<0.01), and Nanchaihu decoction was superior to Beichaihu decoction in lowering the lipid. The results of this study preliminarily proved that there were differences in chemical composition, and liver-protecting and lipid-lowering effects of Beichaihu and Nanchaihu decoctions, indicating that it was necessary to determine the precise origin of Bupleuri Radix in the clinical formulation of traditional Chinese medicine. The study provides a scientific basis for both precise clinical medication and purpose-based accurate quality evaluation of traditional Chinese medicine in clinical application.
Subject(s)
Animals , Mice , Liver , Aspartate Aminotransferases , BupleurumABSTRACT
Background@#and Purpose We aimed to determine the clinical features of Miller Fisher syndrome (MFS) in southern China and compare them with those presenting in other countries. @*Methods@#We collected the medical records of patients diagnosed with MFS during 2013–2016.We analyzed the age, sex, onset season, precursor events, clinical symptoms and signs, findings of nerve conduction studies (NCS), cerebrospinal fluid (CSF), therapeutic remedies, nadir time, and length of hospital stay of patients with MFS in southern China. We concurrently compared the differences between urban and rural areas and between patients with incomplete ophthalmoplegia (IO) and complete ophthalmoplegia (CO). @*Results@#The study enrolled 72 patients: 36 from rural areas and 36 from urban areas, and 50 males and 22 females. The mean age at onset was 47.72 years, and 30 (41.7%) and 21 (29.2%) patients developed MFS in spring and winter, respectively. The typical triad of ophthalmoplegia, ataxia, and areflexia was observed in 50 (69.4%) patients. A history of upper respiratory tract infection 1 week before onset was found in 52.8% of the patients, while 5.6% experienced gastrointestinal infections and 48 (73.8%) exhibited albuminocytological dissociation in the CSF study. Only 26 (36.1%) patients presented abnormalities in NCS. Moreover, restricted outward eyeball movement presented in 83.5% of the patients with classic MFS and acute ophthalmoplegia, and bilateral symmetrical ophthalmoplegia presented in 64.2%. With the exception of the higher proportion of NCS abnormalities in urban areas (47.2% vs. 25.0%), urban and rural differences were insignificant regarding sex ratio, age at onset, high-incidence season, precursor events, disease characteristics, and albuminocytological dissociation in the CSF. Furthermore, patients with CO were older than those with IO (64.53±7.69 vs. 43.19±14.40 years [mean±standard deviation], p<0.001). @*Conclusions@#The patients with MFS were mostly male and middle-aged, and most presented in winter and (especially) spring. More than half of the patients had clear precursor events, most of which were classic MFS with the typical triad. More than 70% of the patients presented albuminocytological dissociation in the CSF. NCS abnormalities were uncommon in MFS. The age at onset was lower in patients with IO than in patients with CO; bilateral symmetrical extraocular muscle paralysis was the most common symptom, and the external rectus was the most frequently involved muscle.
ABSTRACT
Objective:To analyze the relationship between mesenteric fat or creeping fat and bowel stricture or penetrating disease of Crohn's disease (CD).Methods:Clinical data of 101 CD patients undergoing bowel surgery at Department of General Surgery in our hospital between Mar 2021 and Dec 2021 were retrospectively analyzed. The characteristics of mesenteric fat, creeping fat, luminal cross-section diameter, and the intestinal stricture index were analyzed. The Spearman correlation analysis was used to evaluate the correlation between disease behavior and mesenteric fat score or creeping fat score.Results:Totally 101 CD patients were enrolled, with 68 stricturing diseases and 33 penetrating diseases. CD patients with stricturing diseases had higher score of mesenteric disease activity index (4.6±1.9 vs. 3.7±2.0, t=2.212, P=0.029) and creeping fat index (4.2±2.0 vs. 2.9±1.6, t=3.154, P=0.002) than those in patients with penetrating diseases. The mesenteric fat and creeping fat score positively correlated with the intestinal stricture index, C-reactive protein, and fecal calprotectin, and negatively correlated with minimum luminal cross-section diameter. Conclusion:The higher score of mesenteric fat and creeping fat were observed in CD patients with stricturing disease, which were associated with intestinal stricture index and inflammation status.
ABSTRACT
This study summarizes the construction background, rules and regulations and institutional settings of the MOOC and Micro-course Club in the Second Hospital of Jilin University, discusses the means of teacher training for clinical teachers, and shows the application effect of the club. At the same time, the related problems encountered in the process of club construction are summarized and reflected. The construction of MOOC and micro-course clubs is conducive to improving the information-based teaching level of clinical teachers, and also provides new inspiration and ideas for the construction of medical clubs.
ABSTRACT
OBJECTIVE To provide information service support for research on proteolysis targeting chimera （PROTAC） in China and provide reference for technical development and patent layout of relevant drug research and development institutions. METHODS The patent analysis method was used to search the patent applications related to PROTAC technology that had been applied to China National Intellectual Property Administration and had been issued before Feb. 2022， using the HimmPat patent database as the search platform. The patent application trend， technology life cycle， main applicants， technology source countries， technology themes， improvement routes and other patent data were analyzed. RESULTS & CONCLUSIONS A total of 133 patents were included in this study. The patent application for PROTAC technology started relatively late in China， with the number of applicants increasing from 2 in 2015 to 30 in 2020， and the number of applications increasing from 2 in 2015 to 38 in 2020. Both the annual patent application volume and the number of applicants were in a period of rapid growth， but the average annual application volume of a single applicant was still less than 2， indicating that research in this field was still in the early stage of technology development； the number of applications from Arvinas， Hisco， and Hinova Pharmaceutical Inc. ranked among the top. Although the number of domestic applications led that of foreign applications in China， the average number of simple peer applications and the average number of simple peer countries in domestic patent applications was only 1.5， which was far lower than that of foreign applications in China， reflecting that there was still room for improvement in the “quality” level of domestic applications. The initial improvements in PROTAC technology mainly focused on the selection of E3 ligands， targets and ligands， and then new improvements such as new PROTAC development， linker design and matching methods emerged， indicating that the patent applicant had started a multi-track layout in the early stages of the development of PROTAC technology. It is suggested that the research and development of PROTAC drugs in China should focus on improving the oral bioavailability and biosafety of PROTAC drugs， overcoming potential drug resistance， and exploring rational design and evaluation methods.
ABSTRACT
Objective:To analyze the factors influencing prognosis of intrahepatic cholangiocarcinoma (ICC) after surgical resection.Methods:The clinical data of patients diagnosed with ICC and who underwent surgical resection from December 2015 to December 2019 at the Fifth Medical Center of PLA General Hospital were retrospectively analyzed. Of 39 patients who were included in this study, there were 23 males and 16 females, with age of (54.1±7.2) years old. The body mass index, hepatitis B virus infection status, tumor diameter, degree of differentiation, microvascular tumor thrombus, lymph node metastasis, and serum levels of carbohydrate antigen 19-9 (CA19-9) were analyzed as risk factors affecting postoperative recurrence and survival.Results:The median times to recurrence were significantly better in patients with a tumour length <5 cm (11 vs. 5 months), patients without microvascular tumor thrombus (54 vs. 6 months) and patients without lymph node metastasis (8 vs. 5 months) (all P<0.05). The median survival of patients with CA19-9≥100 U/ml was significantly shorter than that of patients with CA19-9<100 U/ml, (9 vs. 27 months, P<0.05). Tumor diameter>5 cm, microvascular tumor thrombus, lymph node metastasis, and CA19-9 ≥100 U/ml are risk factors affecting the recurrence time after ICC resection, CA19-9 ≥100 U/ml is a risk factor affecting survival time after ICC resection. Conclusion:Tumor diameter, microvascular tumor thrombus, lymph node metastasis and CA19-9 can be used to estimate the risk of ICC recurrence, and CA19-9 level can be used to estimate postoperative survival of ICC patients after resection.
ABSTRACT
Background/Aims@#Complementary and alternative medicine (CAM) is prevalent in East Asia. However, information on CAM in East Asian patients with inflammatory bowel disease (IBD) is scarce. We aimed to profile the prevalence and pattern of CAM use among East Asian IBD patients and to identify factors associated with CAM use. We also compared physicians’ perspectives on CAM. @*Methods@#Patients with IBD from China, Japan, and South Korea were invited to complete questionnaires on CAM use. Patient demographic and clinical data were collected. Logistic regression analysis was applied for predictors of CAM use. Physicians from each country were asked about their opinion on CAM services or products. @*Results@#Overall, 905 patients with IBD participated in this study (China 232, Japan 255, and South Korea 418). Approximately 8.6% of patients with IBD used CAM services for their disease, while 29.7% of patients sought at least 1 kind of CAM product. Current active disease and Chinese or South Korean nationality over Japanese were independent predictors of CAM use. Chinese doctors were more likely to consider CAM helpful for patients with IBD than were Japanese and South Korean doctors. @*Conclusions@#In 8.6% and 29.7% of East Asian patients with IBD used CAM services and products, respectively, which does not differ from the prevalence in their Western counterparts. There is a significant gap regarding CAM usage among different Asian countries, not only from the patients’ perspective but also from the physicians’ point of view.
ABSTRACT
Objective:To analyze the risk factors for postoperative surgical site infections (SSIs) in patients with Crohn's disease (CD).Methods:This retrospective observational study included CD patients undergoing bowel resection between July 2015 and July 2018. The prevalence and risk factors of SSIs were evaluated. The microbiological evaluation from patients with SSIs was performed by bacterial culture and drug sensitivity test.Results:There were 66 patients suffering SSIs, with 41 incisional SSIs and 32 organ/space SSIs. Multivariate analysis identified the preoperative infliximab therapy ( OR 2.338,95% CI 1.192-4.587, P=0.013), laparoscopic surgery ( OR 0.460,95% CI 0.226-0.936, P=0.013), and preoperative white blood cell ( OR 2.008,95% CI 1.018-3.961, P=0.044) as independent factors for SSIs. Fifty-nine strains of pathogenic bacteria were detected in 66 cases of CD combined with SSIs, including 36 strains of gram-negative bacteria, 5 strains of gram-positive bacteria, and 2 strains of fungi. Escherichia coli and Klebsiella pneumoniae were main G - bacteria, with high resistance to common used antibiotics. Enterococcus faecalis and Enterococcus faecium were main G -. 62.1% of the SSIs grew extended-spectrum β-lactamase (ESBL)-producing pathogens in their bacteria cultures and 37.9% grew non-ESBL microbes. Conclusion:The incidence of SSIs was higher in CD patients. Preoperative infliximab therapy, preoperative white blood cell, and laparoscopic surgery were predictors of SSIs.
ABSTRACT
Background/Aims@#Risk of venous thrombosis is increased in patients with inflammatory bowel disease (IBD); data on Asian IBD patients is limited and status quo of thrombosis screening and prophylaxis are unknown. Therefore, we aimed to investigate the incidence, screening, prophylaxis, and risk factors for venous thrombosis among Asian IBD patients. @*Methods@#Medical files of patients with Crohn’s disease (CD) and ulcerative colitis (UC) from 17 hospitals across China between 2011 and 2016 were reviewed for venous thrombosis, use of screening and prophylaxis. A case-control study was performed among hospitalized patients with venous thrombosis and their age-, sex-matched IBD controls hospitalized around the same period; disease characteristics and known provoking factors of venous thrombosis were recorded. Risk factors were analyzed in both univariate and logistic regression analyses. @*Results@#A total of 8,459 IBD patients were followed for 12,373 person-year. Forty-six patients (0.54%) had venous thrombosis, yielding an incidence of 37.18 per 10,000 person-year. Incidence increased with age, especially among CD. Less than 20% of patients received screening tests and 35 patients (0.41%) received prophylaxis. Severe disease flare was an independent risk factor for venous thrombosis (odds ratio [95% confidence interval]: CD, 9.342 [1.813– 48.137]; UC, 5.198 [1.268–21.305]); past use of steroids and extensive involvement were 2 additional risk factors in CD and UC, respectively. @*Conclusions@#Incidence of venous thrombosis in China was 37.18 per 10,000 person-year (0.54%). Use of screening and prophylaxis were rare. Severe disease flare was an independent risk factor for thrombosis among hospitalized patients.
ABSTRACT
Background/Aims@#Risk of venous thrombosis is increased in patients with inflammatory bowel disease (IBD); data on Asian IBD patients is limited and status quo of thrombosis screening and prophylaxis are unknown. Therefore, we aimed to investigate the incidence, screening, prophylaxis, and risk factors for venous thrombosis among Asian IBD patients. @*Methods@#Medical files of patients with Crohn’s disease (CD) and ulcerative colitis (UC) from 17 hospitals across China between 2011 and 2016 were reviewed for venous thrombosis, use of screening and prophylaxis. A case-control study was performed among hospitalized patients with venous thrombosis and their age-, sex-matched IBD controls hospitalized around the same period; disease characteristics and known provoking factors of venous thrombosis were recorded. Risk factors were analyzed in both univariate and logistic regression analyses. @*Results@#A total of 8,459 IBD patients were followed for 12,373 person-year. Forty-six patients (0.54%) had venous thrombosis, yielding an incidence of 37.18 per 10,000 person-year. Incidence increased with age, especially among CD. Less than 20% of patients received screening tests and 35 patients (0.41%) received prophylaxis. Severe disease flare was an independent risk factor for venous thrombosis (odds ratio [95% confidence interval]: CD, 9.342 [1.813– 48.137]; UC, 5.198 [1.268–21.305]); past use of steroids and extensive involvement were 2 additional risk factors in CD and UC, respectively. @*Conclusions@#Incidence of venous thrombosis in China was 37.18 per 10,000 person-year (0.54%). Use of screening and prophylaxis were rare. Severe disease flare was an independent risk factor for thrombosis among hospitalized patients.
ABSTRACT
The current study aims to rapidly and comprehensively profile the chemical composition of Cistanche salsa using direct infusion coupled with MS/MS~(ALL)(DI-MS/MS~(ALL)). The C. salsa extract was directly imported into electrospray ionization(ESI) source of quadrupole time-of-flight(Q-TOF) mass spectrometer with an infusion pump at a flow rate of 10 μL·min~(-1). Acquisition program was applied under negative ionization polarity to collect one MS~1 spectrum(m/z 50-1 200), followed by 1 150 MS~2 spectra with precursor isolation window(m/z 1) amongst mass range m/z 50-1 200. After each MS~2 spectrum was matched to its precursor ion, putative identification was conducted through matching mass spectral data with literature and database. A total of 31 components were identified from C. salsa, including 9 phenylethanoid glycosides, 2 iridoids, 4 saccharides, 9 organic acids, and 7 other compounds, similar to those from C. tubulosa and C. deserticola. In conclusion, DI-MS/MS~(ALL), a facile and reliable analytical tool, can be employed for qualitative analysis of chemical constituents in C. salsa. The research offers a promising strategy to achieve rapid chemome profiling of herbal medicine and provides an alternative source of Cistanches Herba.
Subject(s)
Chromatography, High Pressure Liquid , Cistanche , Drugs, Chinese Herbal , Glycosides , Plants, Medicinal , Tandem Mass SpectrometryABSTRACT
Objectives:To assess bowel function and quality of life in patients with ulcerative colitis (UC)after ileal pouch anal anastomosis (IPAA).Methods:Clinical data of 37 UC patients after IPAA between 2014 and 2017 were retrospectively analyzed at Sir Run Run Shaw Hospital School of Medicine Zhejiang University. The IBDQ and Bowel Function questionnaire were used for analyzing correlation between clinical variables and quality of life or bowel function.Results:Laparoscopic operation was performed in 12 cases at stage 2 and 25 cases at stage 3. Postoperative defecation of stage 3 patients were better than that of stage 2 ( t=6.72, P<0.05). The number of daily defecation in age >45-year-old group was more than that in <45-year-old ( t=3.49, P<0.05), and the rate of evening stool seepage in the older group was higher than in the younger group( t=5.28, P<0.05). The total score of intestinal symptoms of IBDQ in patients of pouchitis was lower than that without pouchitis ( r=0.330, P<0.05). The total score in age >45 in terms of systemic symptoms ( r=0.349, P<0.05) and emotional function ( r=0.379, P<0.05) was higher than age <45. Conclusions:Outcomes of UC patients after IPAA are satisfactory, bowel function and quality of life is related with age, and stage of IPAA affect postoperative defecation.
ABSTRACT
Objective@#To investigate the changes of school absenteeism among students received Nutrition Improvement Program for Rural Compulsory Education Student (NIPCES), and to provide basic data for further nutritional health improvement for rural students.@*Methods@#Among 699 NIPCES monitored counties among 22 provinces across western and central China, 10%-30% of elementary and junior high schools were randomly selected as monitoring schools within each stratification according to the food supply pattern (school canteen, company and mix) in each county, school absenteeism information were collected and analyzed from 2012 to 2017.@*Results@#The total rate of student absenteeism was 26.0 per 10 000. From 2012 to 2016, it dropped from 30.8 per 10 000 to 23.4 per 10 000 year by year, but it increased again in 2017(28.2 per 10 000). The rate of school absenteeism in the western region (29.4 per 10 000) was higher than that in the central region (21.5 per 10 000); The sick leave rate (15.0 per 10 000) of primary school students was higher than that of junior high school students (13.4 per 10 000), and the rate of personal leave absences (16.9 per 10 000) of junior high school students was higher than that of elementary school students(9.9 per 10 000); the absentees rate in mixed-food supply schools (28.5 per 10 000) was higher than that in canteen food supply schools(26.4 per 10 000), the latter was higher than that of company food supply schools(25.0 per 10 000). The rate of sick leave absenteeism was highest in December(18.4 per 10 000), and the rate of personal leave absenteeism in June was highest(14.6 per 10 000).@*Conclusion@#The rate of school absenteeism among students in the NIPCES area showed an overall downward trend year by year. The absentee rate of students varies by regions, grade, food supply patterns and school locations.
ABSTRACT
Objective:To investigate the clinical characteristics, diagnosis and treatment of neurological diseases combined with COVID-19.Methods:The data of five patients of neurological diseases combined with COVID-19 (including two suspected cases) in the Department of Neurology, Renmin Hospital of Wuhan University from January 1, 2020 to February 24, 2020 were retrospectively collected. The epidemiology, clinical manifestations, laboratory and radiologic characteristics, diagnosis, treatment and outcomes of these cases were described and analyzed.Results:Among the five patients, three were confirmed cases and two were suspected cases with a history of indirect contact with confirmed cases of COVID-19. The age of these patients was (76.4±9.3) years. Neurological diseases included cerebral infarction in two cases, cerebral hemorrhage, Guillain-Barre syndrome and Alzheimer′s disease each in one case. There were one acute case and one chronic case, and three patients were in the sequelae stage of acute diseases. One patient had an open airway as a result of Guillain-Barre syndrome. There were four cases of limb paralysis, half of whom were hemiplegic and quadriplegic respectively. The initial symptom was fever in all cases, and they showed a decrease in lymphocyte count. Four patients with chest computed tomographic scans showed bilateral lung lesions, of whom two cases showed multiple lung patches and ground glass shadows. Tests for 2019 novel coronavirus nucleic acid were positive in three patients and negative in two. The time from onset of COVID-19 to diagnosis was (6.6±5.6) d. As of February 24, two patients died and the remaining were still hospitalized.Conclusions:Neurological diseases, especially in elderly patients with limb paralysis, open airways and stroke, can be complicated by COVID-19, of which the prognosis is poor. Neurologists need to identify this situation early and pay attention to strengthening protection.
ABSTRACT
Objective To assess the safety of infliximab (IFX) treatment in patients with Crohn's disease(CD).Methods From January 2009 to May 2018,at inflammatory bowel disease (IBD) center of Sir Run Run Shaw Hospital,School of Medicine,Zhejiang University,486 CD patients received the treatment of IFX were enrolled and their clinical data were collected.Univariate and multivariate regression of binary logistic were performed for statistical analysis.Results The median follow-up duration was 31.1 months (12.0 months to 40.0 months).The median duration of IFX therapy was 13.0 months (7.0 months to 21.0 months).Among 486 patients,98 (20.16％) patients reported adverse effects,and 12 (2.47％) patients discontinued the therapy because of adverse effects.Acute infusion reaction was the most common adverse effect in CD patients who received IFX treatment accounting for 41.84％ (41/98) of all the adverse effects,and the incidence was 8.44％.Thirty-nine patients had mild and moderate infusion reaction,and all improved after symptomatic treatment (eight patients discontinued IFX therapy because of recurrent infusion reaction).Two patients developed severe infusion reaction as allergic shock,and both relieved after emergency rescue.Four patients developed late-phase allergic reactions.Among 486 patients,39 (8.02％) patients had infections,including infections of Clostridium difficile,cytomegalovirus,herpeszoster virus,Mycobacterium tuberculosis,and other opportunistic pathogens.There was no cases of infection related death.Thirty-six patients continued with IFX treatment after infection controlled.Among 486 patients,14 (2.88％) patients had severe infection,and all the cases improved after anti-infection treatment.Twenty-seven CD patients with hepatitis B virus (HBV) infection received anti-viral treatments,no active HBV infection was observed.Colon adenocarcinoma was found in one patient under colonoscopy at 22 months after discontinuation of IFX therapy.There were six patients with the history of benign tumors,and no evidence of recurrence,progress or malignancy during treatment.In terms of other rare adverse effects in 486 patients,there were eight (1.64％) patients with liver function injury,two (0.41％) patients with anemia,one (0.21％) patient with peripheral neuropathy,and four (0.82％) patients with skin lesion.Prolonged duration of IFX therapy,without combination of immune-suppressors and with increased baseline body mass index (BMI) were the risk factors of acute infusion reactions.Prolonged duration of IFX therapy and with low baseline albumin level were the risk factors of infections.Conclusions IFX is generally safe as the treatment for CD patients,and its adverse effects can be clinically controlled.Screening before therapy and monitoring during therapy may reduce the risks of adverse effects.
ABSTRACT
AIM:To study the relativity between reject reaction from donation after cardiac death (DCD) and corneal endothelial cell source of corneal graft after penetrating keratoplasty.METHODS:Totally 28 cases of corneal graft rejection after penetrating keratoplasty with cardiac death donor cornea were analyzed using corneal endothelial microscope at less than 1mo,2-3mo,4-6mo,7-12mo after operation.RESULTS:Coefficient variation of corneal endothelial cell of the 28 cases at less than 1 mo,2-3mo,4-6mo and 7-12mo were 38.23％,49.56％,57.18％,65.04％.Corneal endothelial cell density were 2071.15 ± 311.47,1771.33 ± 348.18,1626.59±353.92,1553.14±307.31.The coefficient variation of corneal endothelial cells was positively correlated with rejection (r =0.95,P ＜ 0.05).The postoperative corneal endothelial cell density was negatively correlated with rejection (r=-0.93,P＜0.05).CONCLUSION:The corneal endothelial cell coefficient variation increased gradually and the corneal endothelial cell density decreased gradually after DCD corneal allograft rejection.Corneal endothelial cell coefficient variation and corneal endothelial cell density can be used as indicators of early detection of postoperative rejection.
ABSTRACT
Objective@#In most countries, nearly 6% of the adults are suffering from chronic obstructive pulmonary disease (COPD), which puts a huge economic burden on the society. Moreover, COPD has been considered as an independent risk factor for pulmonary embolism (PE). In this review, we summarized the existing evidence that demonstrates the associations between COPD exacerbation and PE from various aspects, including epidemiology, pathophysiological changes, risk factors, clinical features, management, and prognosis.@*Data Sources@#We searched the terms "chronic obstructive pulmonary disease," "pulmonary embolism," "exacerbations," and "thromboembolic" in PubMed database and collected the results up to April 2018. The language was limited to English.@*Study Selection@#We thoroughly examined the titles and abstracts of all studies that met our search strategy. The data from prospective studies, meta-analyses, retrospective studies, and recent reviews were selected for preparing this review.@*Results@#The prevalence of PE in patients with COPD exacerbation varied a lot among different studies, mainly due to the variations in race, sample size, study design, research setting, and enrollment criteria. Overall, whites and African Americans showed significantly higher prevalence of PE than Asian people, and the hospitalized patients showed higher prevalence of PE compared to those who were evaluated in emergency department. PE is easily overlooked in patients with COPD exacerbation due to the similar clinical symptoms. However, several factors have been identified to contribute to the increased risk of PE during COPD exacerbation. Obesity and lower limb asymmetry were described as independent predictors for PE. Moreover, due to the high risk of PE, thromboprophylaxis has been used as an important treatment for hospitalized patients with COPD exacerbation.@*Conclusions@#According to the previous studies, COPD patients with PE experienced an increased risk of death and prolonged length of hospital stay. Therefore, the thromboembolic risk in patients with acute exacerbation of COPD, especially in the hospitalized patients, should carefully be evaluated.
Subject(s)
Adult , Humans , Acute Disease , Disease Progression , Prevalence , Prospective Studies , Pulmonary Disease, Chronic Obstructive , Pulmonary Embolism , Retrospective StudiesABSTRACT
Objective To evaluate the optical quality in patients with meibomian gland dysfunction (MGD) by using double-pass optical quality analysis system (OQAS-Ⅱ) for offering the reference data for clinical practices.Methods A total of 50 patients with a diagnosis of MGD,who were divided into MGD with dry eye disease (DED) group (n =22) and MGD without DED group (n =28) according to the results of tear film break-up time (BUT) and Schirmer I test (SIT),and another 25 healthy subjects were enrolled in this study.Then several parameters,including modulation transfer function cutoff (MTF cutoff),Strehl ratio (SR) and objective scattering index (OSI),were measured to evaluate the optical quality by using OQAS-Ⅱ.Additional clinical examination,including meibomian gland and tear film assessment were per formed and compared between the three groups.In addition,a correlation analysis was conducted among OSI,MTF cutoff,SR,BUT,SIT and meibomian gland assessment.Results Statistical differences were approached in MTF cutoff,SR,OSI of the three groups (all P ＜ 0.05).The MTF cutoff and SR in MGD without DED group were significantly lower than those in the control group [(31.36 + 1.83) c · deg-1 vs.(35.87 ± 1.59)c·deg-1,(0.21 +0.02) vs.(0.23 ±0.03)],but the OSI got higher [(0.57+ 0.06) vs.(0.45 ±± 0.06)] (all P ＜ 0.05).The SR and MTF cutoff in MGD patients with DED was significantly lower than those in MGD patients without DED [(27.87 ±± 3.08),c·deg-1 vs.(31.36±±1.83)c· deg-1,(0.16 ±±0.02) vs.(0.21 ± 0.02)],but OSIgot significantly higher [(0.72 ± 0.10) vs.(O.57 ± 0.06)] (all P ＜ 0.05).Among the three groups,OSI,MTF cutoff and SR showed no significant correlation with BUT,SIT and meibomian gland assessment (all P ＞ 0.05).Conclusion There is changes in visual quality parameters in MGD patients by OQAS-Ⅱ,and MGD with DED patients has significant changes than MGD patients without DED.
ABSTRACT
Objective To analyze the infection among nursing staff after occupational exposure to human immunodeficiency virus(HIV)and status of HIV-infected nursing staff,provide basis for prevention of HIV infection among nursing staff.Methods Nurses who sustained HIV occupational exposure in a hospital between January 2004 and June 2015,nurses with positive anti-HIV and admitted to this hospital,consulted in outpatient department,as well as consulted outside this hospital between January 2001 and December 2015 were and analyzed,HIV infection status among nurse's mate was also analyzed.Results 76 nurses who sustained HIV occupational exposure didn't infect with HIV after received standard treatment and follow-up.Among 13 nurses infected with HIV,3 might be with occupational exposure infection previously,5 were with blood transfusion-related infection in the 1990s,4 were with sexually transmitted infection(including 2 male nurses who had sex with man,MSM),1 case with infection of unknown transmission route;secondary transmission occurred in 2 cases;9 nurses are still alive.The infected nurses have received effective antiretroviral treatment and then work at the logistic or administrative department.Conclusion Nurses often suffer from occupational exposure to HIV,occupational exposure infection may occur in the absence of the implementation of standardized management,implementation of standardized management is essential to avoid the occupational exposure of HIV.Sexual transmission(including MSM)has become an important transmission route for HIV infection among nurses.