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Objective:To investigate the diagnosis and clinical characteristics of five elderly patients with Chlamydia psittaci-caused severe pneumonia.Methods:Through retrospective analysis, diagnosis and treatment process and clinical characteristics of five elderly inpatients with severe pneumonia caused by Chlamydia psittaci were summarized in the Department of Critical Care Medicine, Quanzhou First Hospital East Street Branch Area, affiliated to Fujian Medical University between January to June 2021.Results:Five patients with severe pneumonia caused by Chlamydia psittaci were aged from 64 to 74 years, with various underlying diseases such as coronary heart disease, chronic heart failure, chronic obstructive pulmonary disease, etc.All patients had an established history of poultry exposure.These cases had high fever, cough, spitting, and dyspnea as the main clinical manifestations.Some of them also had systemic symptoms or weakness of the limbs as the prodromal symptoms.The disease progressed rapidly, with severe respiratory failure, acute kidney injury, and shock appearing soon, accompanied by different degrees of muscle injury, and damage to the heart, liver, blood coagulation, and immune systems at the same time.Laboratory examination showed that levels of inflammatory indicators were increased: at 3, 5, 7 d after admission, the level of C reactive protein was 214.6(153.9-256.3)mg/L, 199.2(115.8-333.8)mg/L, 151.0(11.19-173.7)mg/L, respectively; and interleukin 6 level was 1 241.0(912.1-6822.0)ng/L, 779.1(451.2-7122.0)ng/L, 631.2(7.0-4 321.0)ng/L, respectively.And monitoring results of nutritional index indicated a high metabolic state.The imaging examinations showed that consolidation and ground-glass shadows spreaded to both lungs, may accompany the miliary and nodular shadows, and may also involve pleural which caused pleural effusion.After the clinical use of metagenomic next-generation sequencing(mNGS), mNGS has been confirmed as an important method for the diagnosis of Chlamydia psittaci infection.The disease course and prognosis were related to the severity of the disease, advanced age, underlying diseases, and timely diagnosis and effective treatment.Conclusions:The progression of Chlamydia psittaci pneumonia to severe disease may be related to advanced age, more basic diseases such as chronic cardiopulmonary disease, smoking, and timely diagnosis and treatment.Generally, laboratory and imaging examinations have no diagnostic specificity, but mNGS is of great significance for early diagnosis, transition to target treatment and improvement of prognosis.
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Objective To evaluate the effect of nimodipine on the activity of calcineurin (CaN) in the hippocampus of aged rats.Methods Sixty healthy male Sprague-Dawley rats,aged 18 months,weighing 550-650 g,were divided into 2 groups (n=30 each) using a random number table:surgery group (group S) and nimodipine group (group N).Nimodipine 1 mg/kg was intraperitoneally injected in group N,while the cqual volume of normal saline was given instead in group S,and 30 min later exploratory laparotomy was performed.Ten rats in each group were randomly selected on 1 day before operation and 3 and 7 days after operation,and Morris water maze test was performed.After the end of Morris water maze test,10 rats were selected and sacrificed,brains were removed,and hippocampi were isolated for detection of apoptosis in hippocampal neurons (by flow cytometry) and expression of CaN,phosphor-BAD (p-BAD) and caspase-3 in hippocampal tissues (by Western blot).Apoptotic rate was calculated.Results Compared with the value at 1 day before operation,the escape latency was significantly prolonged,the frequency of crossing the original platform was decreased,the time of staying at the platform quadrant was shortcned,apoptotic rate was increased,and the expression of CaN,p-BAD and caspase-3 in hippocampal tissues was up-regulated at each time point after operation in group S (P＜0.05).Compared with group S,the escape latency was significantly shortened,the frequency of crossing the original platform was increased,the time of staying at the platform quadrant was prolonged,apoptotic rate was decreased,and the expression of CaN,p-BAD and caspase-3 in hippocampal tissues was down-regulated at each time point after operation in group N (P＜0.05).Conclusion The mechanism by which nimodipine inhibits apoptosis in hippocampal neurons and reduces postoperative cognitive dysfunction may be related to inhibition of CaN activation in aged rats.
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<p><b>OBJECTIVE</b>To investigate the distribution and clonality of T cell receptor (TCR) V beta repertoire in patients with acute monoblastic leukemia (AML-M5).</p><p><b>METHODS</b>Expression of the TCR V beta repertoire was analyzed using reverse transcription-polymerase chain reaction (RT-PCR), which amplified the complementarity determining region 3 of 24 TCR V beta genes in peripheral blood from 9 cases with acute myclogenous leukemia subtype 5 or acute monoblastic leukemia (AML-M5). PCR products were further studied by genescan analysis to identify T cell clonality.</p><p><b>RESULTS</b>Expression of 1-10 V beta subfamilies was found in samples from 9 patients. Genescan analysis showed that some V beta subfamily products from 8 of 9 cases contained an oligoclonal peak. Oligoclonal T cells of the V beta 2 subfamily could be found in 6 patients with AML-M5.</p><p><b>CONCLUSIONS</b>T cell clonality expansion was found in AML-M5 cases and were tendentious in the V beta 2 subfamily, suggesting a the specific immune response for leukemia cell (M5) associated antigen and may display antileukemia activity.</p>
Subject(s)
Humans , Complementarity Determining Regions , Genetics , Genes, T-Cell Receptor beta , Leukemia, Monocytic, Acute , Allergy and Immunology , Reverse Transcriptase Polymerase Chain Reaction , T-Lymphocytes , Allergy and ImmunologyABSTRACT
Objective To investigate the features of digital subtraction angiography(DSA) of meningioma and the application of therapy in preoperative embolization.Methods DSA in 36 cases with meningioma proved pathologically was performed.Of them,22 cases which the blood supply of tumor was mostly by external carotid artery were undergone external carotid artery embolization and surgical incision 3~10 days after embolization.Results Among 36 cases,the blood supply of tumor was only from external carotid artery in 9 cases,both of external and internal carotid artery supply in 25,and only internal carotid artery in 2.Among 22 cases undergone embolization of supplying artery the tumor stain absolutely disappeared in 16,evidently decreased in 6.22 cases undergone surgical incision after embolization,the tumors were wholly resected,average bleeding 150~500 ml during surgery.Conclusion The blood supply of meningioma can be only by external or internal carotid artery,or both.Preoperative cerebral angiographies and embolization are beneficial for the total resection of meningioma and reduction of bleeding during surery.
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The applications of allogeneic bone marrow transplantation (allo-BMT) are limited by the high risk of relapse with primary malignancy. The newly adaptive immunotherapy with donor lymphocyte infusions (DLI) can induce an effective graft-versus-leukemia (GVL) reaction leading to molecular remission and prolonged disease free survival in the majority of patients with relapse of CML and some other hematologic malignancies. Little is known about the mechanisms and the kinetics of GVL, however, increasing evidences show that in the case of existence of chimerism the mature donor T lymphocytes are activated by the specific leukocyte artigen presented in the surface of host antigen presenting cells (APC), resulting in exclusively elimination of leukocyte. Undesired side-effects are the development of graft-versus-host disease (GVHD) and the occurrence of pancytopenia in some patients. Infusions with selective T lymphocytes and G-CSF-mobilized peripheral blood stem cells (PBSC) are the promising treatment of DLI for more patients.
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AIM: To investigate clonal expansion and specific cytotoxicity of TCR V? subfamily T cells from acute myelogenous leukemia M_ 2a subtype (AML-M_ 2a)patients and normal individuals induced by AML-M_ 2a cells, respectively. METHODS: Complementarity determining region 3(CDR3) of TCR ? with variable region genes was amplified in autologous or allogeneic T cells from mixed lymphocyte and tumor culture (MLTC) using RT-PCR. The positive products were further analyzed to identify the clonality of T cells by genescan. The specific cytotoxicity of T cells was analyzed by MTT. RESULTS: T cells from both M_ 2a patients and normal individuals after MLTC showed high response to M_ 2a cells with 4-17 TCR V? subfamily dominant utilization, one or two clonal expansion of T cells were identified in some predominant TCR V? subfamilies. Difference of distribution and clonal expansion of TCR V? subfamily T cells were related to source of T cells and the phase during MLTC. Compared with LAK cell, most of T cells from MLTC were CD3+CD8+T cells with higher and more specific cytoxicity to the induced cells, M_ 2a cells, but not HL60 or K562 cell line. CONCLUSION: Clonal expansion of TCR V? subfamily T cells stimulated selectively by M_ 2a cells may be a specific immune response of autologous and allogeneic T cells to M_ 2a cells associated antigen. The T cells induced by M_ 2a cells have the ability of specific cytoxicity to the AML-M_ 2a cells.
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Objective To investigate the value of imaging diagnosis of endomyocardial fibrosis(EMF).Methods Imaging findings of 28 cases of EMF were restrospectively analyzed.Results There were three types:right ventricle type(n=21),left ventricle type(n=1),and dual ventricle type(n=6).The misdiagnostic rate of EMF by X-ray plain films was high(18/28). On angiography and MRI right ventricle type presented as shortened,deformed inflow-tract,obliteration of apex and dilated outflow-tract,marked tricuspid valve regurgitation(TR) and enlarged right atrium,even dilated superior vena cava,left ventricle type presented as narrowiug and deformed inflow-tract,small and deformed left ventride,even no markedly volume changes in relaxation or contraction,obtuse cardiac apex and mitral regurgitation.Dual ventricle type owned manifestations in the two types mentioned above,but predominated by right ventricle type. Conclusion In diagnosis of EMF X-ray plain films are of less value while MRI and cardioangiography are significant,MRI is a valuable non-invasive method,it can substitutd for cardioangiography as the first choice in diagnosing EMF.