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Objective:To evaluate the relationship between silent information regulator 2 homologue 3 (SIRT3) and mitochondrial function in mice with endotoxin-induced lung injury.Methods:Twenty clean-grade healthy adult male wild C57BL/6 (SIRT3 + /+ ) mice, 20 SIRT3 knockout (SIRT3 -/-) mice, weighing 20-25 g, aged 6-8 weeks, were studied.SIRT3 + /+ mice and SIRT3 -/- mice were divided into 4 groups ( n=5 each) according to the random number table method: blank control group (group C, group SIRT3 -/-C), endotoxin-induced lung injury group (group L, group SIRT3 -/-L), endotoxin-induced lung injury plus resveratrol group (group L+ R, group SIRT3 -/-L+ R), and resveratrol group (group R, group SIRT3 -/-R). Resveratrol 15 mg/kg was intraperitoneally injected once a day for 7 consecutive days in L+ R, R, SIRT3 -/-L+ R and SIRT3 -/-R groups, while the equal volume of normal saline was injected in the rest groups.Lipopolysaccharid 15 mg/kg was injected via the tail vein to develop a mouse model of endotoxin-induced lung injury at 30 min after resveratrol injection on 7th day, in L+ R and SIRT3 -/-L+ R groups and at the corresponding time points in L and SIRT3 -/-L groups, while the equal volume of normal saline was injected in the other groups.Blood samples were collected from the orbital venous plexus at 12 h after injection of normal saline or lipopolysaccharid for determination of serum total oxidation state (TOS) and total antioxidant state (TAS) levels by the xylenol orange method and ABTS colorimetric method, and the oxidative stress index (OSI) was calculated.After the mice were sacrificed, the lung tissues were taken for microscopic examination of the pathological changes which were scored and for determination of the mitochondrial membrane potential (MMP) (by JC-1 method), cellular oxygen consumption rate (OCR) (by the specific fluorescent probe method), and expression of SIRT3 (by Western blot). Results:Compared with group C or group SIRT3 -/-C, the lung injury score, serum TOS concentration and OSI were significantly increased, TAS concentration, MMP and OCR were decreased, and SIRT3 expression was down-regulated in L, L+ R, SIRT3 -/-L and SIRT3 -/-L+ R groups ( P<0.05). Compared with group L, the lung injury score, serum TOS concentration and OSI were significantly decreased, TAS concentration, MMP and OCR were increased, and SIRT3 expression was up-regulated in group L+ R, and lung injury score, serum TOS concentration and OSI were significantly increased, TAS concentration, MMP and OCR were decreased, and SIRT3 expression was down-regulated in group SIRT3 -/-L ( P<0.05). Compared with group L+ R, the lung injury score, serum TOS concentration and OSI were significantly increased, the TAS concentration, MMP and OCR were decreased, and the expression of SIRT3 was down-regulated in group SIRT3 -/- L+ R ( P<0.05). There was no significant difference in the indicators mentioned above between group SIRT3 -/-L+ R and group SIRT3 -/-L ( P>0.05). Conclusions:Down-regulation of SIRT3 expression can lead to impaired mitochondrial function, which is involved in the pathophysiological mechanism of endotoxin-induced lung injury.
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Objective:To investigate the serum level and significance of complement factor B (CFB) and complement factor D (CFD) in patients with type 2 diabetes mellitus (T2DM) and diabetic peripheral neuropathy (DPN).Methods:From October 2019 to October 2020, 110 patients with T2DM in the endocrinology department of Affiliated Hospital of Jining Medical College were divided into DPN group ( n=60) and simple T2DM group ( n=50) according to whether or not DPN was combined. In addition, 52 cases of physical examination population in the physical examination center in the same period were selected as the normal control group ( n=52). The serum levels of CFB, CFD and tumor necrosis factor-α (TNF-α) were measured by enzyme linked immunosorbent assay (ELISA). The correlation between CFB, CFD and clinical indexes was analyzed, and the influencing factors of DPN were analyzed by logistic regression. Results:The serum levels of CFB and CFD in DPN group were higher than those in T2DM group and normal control group [CFB: (845.43±101.10)μg/ml vs (792.19±116.59)μg/ml, (739.20±123.43)μg/ml, P<0.05], [CFD: (491.71±41.03)mg/L vs (467.58±45.16)mg/L, (445.16±50.47)mg/L, P<0. 05]. Pearson correlation analysis showed that the serum level of CFB was positively correlated with glycosylated hemoglobin (HbA 1c), fasting plasma glucose (FPG) and TNF-α (all P<0.05) and negatively correlated with triiodothyronine (FT3) and total bilirubin (TBIL) (all P<0.05). Serum CFD level was positively correlated with systolic blood pressure, HbA 1c, FPG and TNF-α (all P<0.05), but negatively correlated with FT3 and TBIL (all P<0.05). Logistic regression analysis showed that CFB and CFD were still influential factors for the occurrence and development of DPN after excluding confounding factors such as systolic blood pressure, HbA 1c, FPG, FT3, DBIL, TBIL and TNF-α. Conclusions:(1) Serum CFB and CFD levels were significantly increased in DPN patients, suggesting that CFB and CFD may be involved in the occurrence and development of DPN. (2) Serum TNF-α level was significantly increased in DPN patients, confirming the role of TNF-α in the pathogenesis of DPN.
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Objective:To observe the clinical effect of electroacupuncture combined with Qingyi Xianxiong Decoction on the treatment of acute respiratory distress syndrome (ARDS) caused by severe acute pancreatitis (SAP).Methods:From February 2021 to April 2022, 120 patients with ARDS caused by SAP who were admitted to the department of critical care medicine of Tianjin Nankai Hospital and whose syndrome differentiation belonged to the syndrome of knot chest were selected. They were randomly divided into pure traditional Chinese medicine group and acupuncture medicine group, with 60 cases in each group. The pure traditional Chinese medicine group was received Qingyi Xianxiong Decoction on the basis of conventional western medicine treatment, and the acupuncture medicine group was received electric acupuncture treatment on the basis of the pure traditional Chinese medicine group. The two groups continued to be treated for 7 days. The primary outcome was the ventilator-free days within 28 days after admission to the intensive care unit (ICU), and the secondary outcome measures were mechanical ventilation time, the length of ICU stay, total lenth of hospital stay, time of intra-abdominal pressure recovery, scores of organ function, oxygenation index (PaO 2/FiO 2), serum inflammatory factors, blood amylase, urine amylase, etc. Results:Compared with the pure traditional Chinese medicine group, the ventilator-free days in the acupuncture medicine group within 28 days after admission to the ICU were significantly longer [day: 22.10±2.29 vs. 20.97±2.31, P < 0.05, odds ratio ( OR) = 1.24, 95% confidence interval (95% CI) was 1.053-1.460, P < 0.05]. The time of mechanical ventilation, the length of ICU stay, total length of hospital stay, and recovery time of intra-abdominal pressure were significantly shortened [mechanical ventilation time (days): 5.90±2.29 vs. 7.03±2.31, the length of ICU stay (days): 8.07±1.89 vs. 12.08±2.23, total length of hospital stay (days): 19.55±6.82 vs. 22.28±5.19, recovery time of intra-abdominal pressure (days): 6.05±1.81 vs. 8.45±1.76, all P < 0.05]. The Murray score and bedside index for severity in acute pancreatitis (BISAP) score of the two groups after 7 days of treatment were significantly lower than those before treatment, while PaO 2/FiO 2 was significantly higher than those before treatment, and the Murray score of the acupuncture medicine group after 7 days of treatment was significantly lower than that of the pure traditional Chinese medicine group [score: 0.50 (0.33, 0.75) vs. 1.00 (1.00, 1.33), P < 0.05], PaO 2/FiO 2 was significantly higher than that in the pure traditional Chinese medicine group [mmHg (1 mmHg ≈ 0.133 kPa): 390.75±27.73 vs. 330.02±42.34, P < 0.05]. With the prolongation of treatment time, the levels of inflammatory factors such as tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP), serum amylase and urine amylase in both groups after treatment continued to decrease, and the levels of the inflammatory factors in the acupuncture medicine group after 7 days of treatment were significantly lower than those in the pure traditional Chinese medicine group [TNF-α (ng/L): 38.20±10.00 vs. 45.35±5.09, IL-6 (ng/L): 0.95±0.44 vs. 7.42±1.39, CRP (mg/L): 8.55±2.79 vs. 36.20±13.97, all P < 0.05]. Subgroup analysis showed that biliary system disease was a risk factor for the duration of mechanical ventilation ≥ 7 days in the treatment of ARDS with acupuncture and medicine ( OR = 2.728, 95% CI was 1.293-5.754). Conclusion:Compared with the pure traditional Chinese medicine, acupuncture combined can better reduce the clinical symptoms of patients with ARDS caused by SAP, promote the recovery of patients, and reduce systemic inflammatory reaction, which is worthy of clinical promotion.
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The clinical data of patients with severe acute pancreatitis complicated with intraabdominal hypertension or abdominal compartment syndrome admitted to our Department of Critical Care Medicine from January 1, 2018 to October 1, 2021 were collected and analyzed.Patients were divided into a conventional treatment group and conventional treatment plus IV infusion of cisatracurium besilate group (muscle relaxation group). A prediction model of treatment propensity score was developed for paired screening, with 31 cases in each group.The conventional treatment group adopted conventional basic treatment methods such as gastrointestinal decompression, spasmolysis and analgesia, fluid therapy, inhibition of gastric acid, suppression of parenzyme, nutritional support, mechanical ventilation, and enemata.In muscle relaxation group, cisatracurium besilate was intravenously infused on the basis of routine treatment with the initial dose of 0.15 mg/kg given to facilitate endotracheal intubation, followed by continuous intravenous infusion at 1-3 μg·kg -1·min -1, and the dose was adjusted according to the patient′s basic vital signs and clinical effects.The primary outcome was survival rate.Secondary outcome measures were changes in intraabdominal pressure, oxygenation index, the number of defecation, volume of defecation, and urination volume before treatment and on 7, 14 and 20 days of treatment.and the recovery time of bowel sounds, length of mechanical ventilation, time of intensive care unit treatment, and total hospitalization costs.Compared with conventional treatment group, the survival rate was significantly increased, the intraabdominal pressure was decreased on 7, 14 and 20 days of therapy, the oxygenation index was increased, the number of defecation and volume of defecation were increased on 7 and 14 days of therapy, urinary volume was increased before treatment and on day 7 of therapy, the recovery time of intestinal sound was significantly shortened ( P<0.05), and no significant change was found in urinary volume on days 14 and 20 of therapy, length of ventilation, time of intensive care unit treatment, and total hospitalization costs in muscle relaxation group ( P>0.05). In conclusion, cisatracurium besilate can improve oxygenation, promote the recovery of intestinal function and improve the survival rate when used to assist the treatment in the patients with severe acute pancreatitis complicated with intraabdominal hypertension.
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OBJECTIVE@#To explore the feasibility of surgical treatment for cancer patients complicated with corona virus disease 2019 (COVID-19).@*METHODS@#The management and clinical outcome of a sigmoid cancer patient with COVID-19 were analyzed.@*RESULTS@#The inflammation indicators and fever of this patient were effectively controlled and the lung lesions remained stable after active anti-viral treatment, then the radical colorectomy was performed after the viral negative conversion for twice.@*CONCLUSIONS@#The case indicates that it may feasible to undergo radical tumor surgery for cancer patients with COVID-19 after the virus nucleic acid testing turns negative and more studies are needed to confirm this conclusion.
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Humans , Antiviral Agents , Therapeutic Uses , Betacoronavirus , Clinical Laboratory Techniques , Colonic Neoplasms , General Surgery , Virology , Coronavirus Infections , Diagnosis , Drug Therapy , Fever , Nucleic Acid Amplification Techniques , Pandemics , Pneumonia, Viral , Diagnosis , Drug TherapyABSTRACT
OBJECTIVE@#To explore the feasibility of radical resection for cancer patients complicated with coronavirus disease 2019 (COVID-19).@*METHODS@#The management and clinical outcome of a sigmoid cancer patient with COVID-19 were analyzed.@*RESULTS@#The inflammation indicators and fever of this patient were effectively controlled and the lung lesions remained stable after active anti-viral treatment, then the radical colorectomy was performed after the viral negative conversion for twice.@*CONCLUSIONS@#The case indicates that radical resection can be performed in SARS-CoV-2 patients with twice-negative SARS-CoV-2 nucleic acid testing results.
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Humans , Betacoronavirus , Colonic Neoplasms , General Surgery , Coronavirus Infections , Therapeutics , Disease Management , Pandemics , Pneumonia, Viral , Therapeutics , Treatment OutcomeABSTRACT
Objective@#To evaluate the histocompatibility and clearance of chlorpyrifos and its metabolite of activated charcoal and adsorption resin by in vitro study.@*Methods@#Venous blood from volunteers were incubation with activated charcoal or adsorbent resins, cytometry parameters and plasma components were detected for evaluation the histocompatibility of adsorbents. Venous blood from volunteers mixed with chlorpyrifos and its metabolite were incubation with activated charcoal or adsorbent resins, plasma concentration of chlorpyrifos and its metabolite were detected for evaluation the efficacy of adsorbents.@*Results@#Incubation tests show that the absorbents reduce the blood platelet (F=3.671, P<0.05) , serum glucose (F=10.564, P<0.05) , albumin (F=5.239, P<0.05) , uric acid (F=7.175, P<0.05) , creatinine (F=23.673, P<0.05) , T3 (F=11.161, P<0.05) and free T3 (F=10.256, P<0.05) . However, other cytometry parameters and plasma components were not influenced. Both activated charcoal and adsorbent resins could reduce the plasma concentration of chlorpyrifos (F=798.110, P<0.01) and its metabolite (F=1495.212, P<0.05) .@*Conclusion@#In vitro test show that both activated charcoal and adsorbent resins could clear chlorpyrifos and its metabolite, however, could not influence main cytometry parameters and plasma components, the histocompatibility of adsorbents are satisfactory.
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Objective To evaluate the effect of dexmedetomidine on mitochondrial dynamics in mice with endotoxin-induced acute lung injury (ALI).Methods Thirty clean-grade healthy adult male C57BL/6 mice,weighing 20-25 g,aged 2 months,were divided into 3 groups (n=10 each) using a random number table method:control group (group C),endotoxin-induced ALI group (group LPS) and endotoxin-induced ALI plus dexmedetomidine group (group LPS+DEX).In LPS and LPS+DEX groups,lipopolysaccharide (LPS) 10 mg/kg was injected via the caudal vein to establish the model of endotoxin-induced ALI.In group LPS+DEX,dexmedetomidine 50 μg/kg was intraperitoneally injected at 30 min before injection of LPS,while the equal volume of normal saline was given instead in C and LPS groups.The mice were sacrificed at 6 h after LPS administration,and lung tissues were obtained for examination of the pathological changes (with a light microscope) which were scored and for determination of the level of reactive oxygen species (ROS) and expression of mitochondrial fusion proteins mitofusin 1 (Mfn1),Mfn2,optic atrophy 1 (OPA1),dynamin-related protein 1 (Drp1) and fission protein 1 (Fis1) (using Western blot).Results Compared with group C,the lung injury scores and ROS level in lung tissues were significantly increased,the expression of Mfn1,Mfn2 and OPA1 was down-regulated,and the expression of Drp1 and Fis1 was up-regulated in LPS and LPS+DEX groups (P＜0.05).Compared with group LPS,the lung injury scores and ROS level in lung tissues were significantly decreased,the expression of Mfn1,Mfn2 and OPA1 was up-regulated,and the expression of Drp1 and Fis1 was down-regulated in group LPS+DEX (P＜ 0.05).Conclusion Dexmedetomidine can reduce endotoxin-induced ALI through maintaining the mitochondrial fusion-fission balance in mice.
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Objective@#To evaluate the effect of dexmedetomidine on mitochondrial dynamics in mice with endotoxin-induced acute lung injury (ALI).@*Methods@#Thirty clean-grade healthy adult male C57BL/6 mice, weighing 20-25 g, aged 2 months, were divided into 3 groups (n=10 each) using a random number table method: control group (group C), endotoxin-induced ALI group (group LPS) and endotoxin-induced ALI plus dexmedetomidine group (group LPS+ DEX). In LPS and LPS+ DEX groups, lipopolysaccharide (LPS) 10 mg/kg was injected via the caudal vein to establish the model of endotoxin-induced ALI.In group LPS+ DEX, dexmedetomidine 50 μg/kg was intraperitoneally injected at 30 min before injection of LPS, while the equal volume of normal saline was given instead in C and LPS groups.The mice were sacrificed at 6 h after LPS administration, and lung tissues were obtained for examination of the pathological changes (with a light microscope) which were scored and for determination of the level of reactive oxygen species (ROS) and expression of mitochondrial fusion proteins mitofusin 1 (Mfn1), Mfn2, optic atrophy 1 (OPA1), dynamin-related protein 1 (Drp1) and fission protein 1 (Fis1)(using Western blot).@*Results@#Compared with group C, the lung injury scores and ROS level in lung tissues were significantly increased, the expression of Mfn1, Mfn2 and OPA1 was down-regulated, and the expression of Drp1 and Fis1 was up-regulated in LPS and LPS+ DEX groups (P<0.05). Compared with group LPS, the lung injury scores and ROS level in lung tissues were significantly decreased, the expression of Mfn1, Mfn2 and OPA1 was up-regulated, and the expression of Drp1 and Fis1 was down-regulated in group LPS+ DEX (P<0.05).@*Conclusion@#Dexmedetomidine can reduce endotoxin-induced ALI through maintaining the mitochondrial fusion-fission balance in mice.
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BACKGROUND/AIMS: Microvascular invasion (MVI) is an established risk factor for hepatocellular carcinoma (HCC). However, prediction models that specifically focus on the individual prognoses of HCC patients with MVI is lacking. METHODS: A total of 385 HCC patients with MVI were randomly assigned to training and validation cohorts in a 2:1 ratio. The outcomes were disease-free survival (DFS) and overall survival (OS). Prognostic nomograms were established based on the results of multivariate analyses. The concordance index (C-index), calibration plots and Kaplan-Meier curves were employed to evaluate the accuracy, calibration and discriminatory ability of the models. RESULTS: The independent risk factors for both DFS and OS included age, tumor size, tumor number, the presence of gross vascular invasion, and the presence of Glisson's capsule invasion. The platelet-to-lymphocyte ratio was another risk factor for OS. On the basis of these predictors, two nomograms for DFS and OS were constructed. The C-index values of the nomograms for DFS and OS were 0.712 (95% confidence interval [CI], 0.679 to 0.745; p<0.001) and 0.698 (95% CI, 0.657 to 0.739; p<0.001), respectively, in the training cohort and 0.704 (95% CI, 0.650 to 0.708; p<0.001) and 0.673 (95% CI, 0.607 to 0.739; p<0.001), respectively, in the validation cohort. The calibration curves showed optimal agreement between the predicted and observed survival rates. The Kaplan-Meier curves suggested that these two nomograms had satisfactory discriminatory abilities. CONCLUSIONS: These novel predictive models have satisfactory accuracy and discriminatory abilities in predicting the prognosis of HCC patients with MVI after hepatectomy.
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Humans , Calibration , Carcinoma, Hepatocellular , Cohort Studies , Disease-Free Survival , Hepatectomy , Multivariate Analysis , Nomograms , Prognosis , Risk Factors , Survival RateABSTRACT
Objective To evaluate the role of endogenous heme oxygenase-1/carbon monoxide ( HO-1/CO) signaling pathway in endoplasmic reticulum stress during endotoxin-induced acute lung injury ( ALI) in rats. Methods Forty healthy clean-grade male Sprague-Dawley rats, aged 8 weeks, weighing 190-210 g, were divided into 4 groups ( n=10 each) using a random number table method: control group (group C), ALI group, ALI plus ZnPP-IX group (group AZ), and ALI plus vehicle sodium bicarbonate group ( group AV) . ALI was induced by intravenously injecting lipopolysaccharide 5 mg/kg in anesthetized rats. At 30 min before establishing the model, ZnPP-IX 10μmol/kg (diluted to 1 ml in 50 mmol/L sodium bicarbonate) was intraperitoneally injected in group AZ, and 50 mmol/L sodium bicarbonate 1 ml was intra-peritoneally injected in group AV. After injecting lipopolysaccharide for 6 h, blood samples were collected from the common carotid artery for determination of plasma CO concentration, the rats were then sacrificed, and lungs were removed for microscopic examination of the pathological changes which were scored and for determination of CO level, wet to dry weight ratio ( W/D ratio) , cell apoptosis ( by TUNEL) , and expres-sion of heme oxygenase-1 ( HO-1) , glucose-regulated protein 78 ( GRP78) , phosphorylated protein kinase R-like endoplasmie reticulum kinase (p-PERK), phosphorylated eukaryotic translation initiation factor 2 alpha ( p-elF2 ) , CCAAT/enhancer-binding protein homologous protein ( CHOP ) and caspase-12 in lung tissues ( by Western blot) . Apoptosis index ( AI) was calculated. Results Compared with group C, the lung injury scores, W/D ratio, AI and CO levels in plasma and lung tissues were significantly increased, and the expression of HO-1, GRP78, p-PERK, p-elF2, CHOP and caspase-12 was up-regulated in the other three groups ( P＜0. 05) . Compared with group ALI, lung injury scores, W/D ratio and AI were sig-nificantly increased, CO levels in plasma and lung tissues were decreased, the expression of HO-1 was down-regulated, and the expression of GRP78, p-PERK, p-elF2, CHOP and caspase-12 was up-regula-ted in group AZ (P＜0. 05), and no significant change was found in the parameters mentioned above in group AV ( P＞0. 05) . Conclusion HO-1/CO signaling pathway produces endogenous protection possibly through inhibiting endoplasmic reticulum stress during endotoxin-induced ALI in rats.
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Objective To investigate the effect of family factors on the prognosis of patients with epilepsy and the relationship between family factors and clinical characteristics of epilepsy.Methods Data were collected from 107 patients definitely diagnosed with epilepsy who were treated by antiepileptic drugs for at least two years.All the patients were divided into good or poor prognosis group according to whether achieving at least one year free of seizures.The clinical and family data were colleeted.The questionnaire Family Adaptability and Cohesion Evaluation Scale-Ⅱ-Chinese Version containing 30 items was used for patients and the Epilepsy Knowledge Questionnaire containing 34 questions for primary caregiver.We compared the clinical and family factors between the two groups to identify the predictors of poor control of seizures with univariate and multiple Logistic regression,and observed the relationship between family factors and clinical features such as course,type of seizure,seizure frequency,etc,with Pearson correlation analysis.Results Patients with poor prognosis were more likely to have interictal epileptiform discharges (IEDs),multidrug treatment and pre-treatment seizure frequency of more than once monthly (84.6％ (44/52) vs 50.9 ％ (28/55),x2 =13.797,P =0.000;63.5 ％ (33/52) vs 34.5 ％ (19/55),x2 =8.947,P =0.003;38.5％ (20/52) vs 5.5％ (3/55),x2 =17.257,P =0.000).Family in rural area,unbalanced family type,number of family members were much more in poor prognosis group than in good prognosis group (51.9％ (27/52) vs 25.5 ％ (14/55),x2 =7.923,P =0.005;80.8 ％ (42/52) vs 49.1％ (27/55),x2 =11.712,P=0.000;4.1 ± 1.1 vs 3.6 ±0.8,t=2.631,P=0.010).And average family income,education level of father,the level of epilepsy knowledge of primary caregiver were significantly lower in poor prognosis group than in good prognosis group (19/20/13 vs 11/17/27,x2 =7.198,P =0.027;15/30/7 vs 4/34/17,x2 =10.709,P =0.005;36/11/5 vs 15/25/15,x2 =19.022,P =0.000).Multiple Logistic regression analysis demonstrated that IEDs (OR =12.332,95％ CI 2.756-55.190,P =0.001),pretreatment seizure frequency of more than once monthly (OR =8.401,95％ CI 1.573-44.884,P =0.013)were clinical risk factors of unfavorable prognosis;more family members (OR =3.021,95％ CI 1.554-5.870,P =0.001),poor epilepsy knowledge of primary caregiver (OR =3.392,95％ CI 1.304-8.821,P=0.012) and unbalanced family type (OR=4.794,95％ CI 1.217-18.894,P=0.025) were independent family risk factors of poor prognosis.The level of epilepsy knowledge of primary caregiver was inversely associated with duration (r =-0.237,P =0.014).Conclusions The prognosis of epilepsy is not only affected by clinical factors,but also by family factors.More family members,poor epilepsy knowledge of primary caregiver and unbalanced family type are independent risk factors of unfavorable prognosis.The poorer epilepsy knowledge the primary caregivers have,the longer duration the disease has.
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Objective To compare the efficacy and safety of simeprevir-based (SMV) or telaprevir-based (TVR) triple therapy [SMV + Pegylated interferon alfa (PegIFNα) and ribavirin (RBV) versus TVR + PegIFNαand RBV] in patients with hepatitis C virus (HCV) genotype 1 infection .Methods A systematic literature searching was conducted in multiple online databases to identify relevant studies .The sustained virologic response rate at 12 (SVR12) and 24 weeks (SVR24) after end of the treatment were used as the efficacy endpoints .The rate of treatment related adverse events (AEs) ,discontinuation due to AEs and overall treatment discontinuation were used as safety endpoints . Patients were divided into multiple subgroups according to the previous treatment history to further compare the efficacy of the two treatment regimen .Statistical analyses were performed using the RevMan 5 .3 software .The Jajad score scale and the Newcastle-Ottawa scale were employed to evaluate the quality of included studies .Results A total of 5 clinical studies including 1666 HCV genotype 1 patients were included in this study .The pooled results showed that SVR12 rates in SMV group and TVR group were 67 .6％ and 68 .3％ , respectively .There was no significant difference in overall SVR12 rate between SMV and TVR groups (OR=0 .95 ,95％ CI:0 .76 -1 .18 , P=0 .65) .There was no significant heterogeneity among studies (P=0 .84 ,I2 = 0％ ) .For SVR24 rate ,the average SVR24 rate in SMV group was 78％ ,which was lower than that in TVR group of 84％ .However ,there was no significant difference in overall SVR24 rate between SMV and TVR groups (OR=0 .71 ,95％ CI:0 .42-1 .20 ,P=0 .20) .Meanwhile ,there was no significant heterogeneity among studies (P= 0 .69 ,I2 = 0％ ) .The subgroup analysis also showed that there was no significant difference in efficacy between SMV and TVR-based triple therapy for treatment-native patients ,prior partial response ,relapse ,and prior null response patients (all P>0 .05) .However , the pooled analysis indicated that both SMV-based and TVR-based triple therapies were most effective for the treatment-naive patients(SMV :85 .7％ ,TVR :85 .6％ ) .For the safety endpoints ,the incidence rate of anemia was significant lower in SMV group compared to TVR group (OR=0 .30 ,P<0 .001) .For the rate of overall treatment discontinuation ,there was no statistically significant difference between SMV and TVR group (OR=0 .48 ,P=0 .12) .Conclusions This meta-analysis suggests that the efficacy of SMV-based triple therapy is non-inferior to TVR-based triple therapy .However ,the SMV-based triple therapy is more tolerable and has a lower incident rate of anemia and discontinuation due to AEs compared to TVR-based triple therapy .
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Alcoholic liver fibrosis is a series of pathological changes caused by excessive intrahepatic deposition of fibrous connective tissue due to hepatocyte inflammation and necrosis caused by excessive drinking. Laboratory markers help with the differentiation of alcoholic liver disease,and a combination of these markers and examination of liver fibrosis can be used for the diagnosis of alcoholic liver fibrosis. Liver biopsy remains the gold standard for the diagnosis of liver fibrosis,but its clinical application is limited by its invasiveness. Therefore,more and more new serum molecular markers with a diagnostic value have been identified in recent years,and great breakthroughs have been made. In addition,a noninvasive diagnostic and predictive model based on various biochemical parameters and imaging findings also brings new hope to the diagnosis and treatment of liver fibrosis. This article reviews the recent research advances in the noninvasive diagnosis of al-coholic liver fibrosis by serum markers.
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Objective To observe the clinical efficacy of decitabine combined with half dose CAG regimen in patients with relapsed/refractory acute myeloid leukemia (AML).Methods Clinical data of 8 patients with relapsed/refractory AML who took the therapeutic regimen with decitabine combined with half dose CAG regimen in the Third People's Hospital of Datong from January 2015 to January 2017 were collected.The clinical efficacy and adverse effects were observed.Results After one course treatment by decitabine combined with half dose CAG regimen,3 patients achieved complete remission,and 2 patients achieved partial remission.The major adverse reactions were myelosuppression and infection,8 patients appeared grade Ⅲ-Ⅳ myelosuppression,5 patients appeared infection,2 patients appeared grade Ⅰ abnormality of liver and no treatment-related death occurred.Conclusion Decitabine combined with half dose CAG regimen is effective for relapsed/refractory AML,and this regimen is worthy of further study.
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ObjectiveTo explore the diagnostic value of serum YKL-40 for liver fibrosis stage, and to provide a reference for noninvasive diagnosis of liver fibrosis in patients with chronic liver disease. MethodsWe searched PubMed, EMBASE, the Cochrane Library, Web of Science, and CNKI for studies on the clinical value of YKL-40 in the diagnosis of liver fibrosis or cirrhosis. The quality of studies was evaluated using the QUADAS-2 tool to assess the risk of bias. Comprehensive quantitative evaluation of the included studies was performed using Stata 12.0. The source of heterogeneity was analyzed, and the forest plot and summary receiver operating curve (SROC) were generated. ResultsA total of nine studies involving 1592 patients were included in the meta-analysis; six studies were conducted on significant fibrosis (≥F2), and seven studies were conducted on progressive fibrosis (≥F3). In the diagnosis of significant fibrosis (≥F2), YKL-40 had pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, odds ratio, and area under the SROC (AUC) of 078 (95% confidence interval ［CI］: 0.69-0.85), 0.53 (95%CI: 0.33-0.72), 1.7 (95%CI: 1.0-2.7), 0.41 (95%CI: 0.21-0.76), 4 (95%CI: 1-13), and 0.76 (95%CI:0.72-0.80), respectively. In the diagnosis of progressive fibrosis (≥F3), YKL-40 had pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, odds ratio, and AUC of 0.83 (95%CI: 0.76-089), 0.72 (95%CI: 0.62-0.80), 3.0 (95%CI: 2.0-4.4), 0.23 (95%CI: 0.14-0.37), 13 (95%CI: 5-30), and 0.85 (95%CI: 082-0.88), respectively. ConclusionThe diagnostic value of serum YKL-40 for significant and progressive liver fibrosis is limited, so it may not be a new, effective serum marker for the staging of liver fibrosis.
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OBJECTIVE: To explore the potential association between occupational medicamentosa-like dermatitis induced by trichloroethylene( OMDT) and past infection,reactivation and recent infection of human herpesvirus 6( HHV6) and human cytomegalovirus( HCMV). METHODS: Twenty OMDT patients were recruited as case group by using judgment sampling method. Twenty healthy workers occupationally exposed to trichloroethylene for more than half a year were randomly selected as exposure group. Twenty healthy people with no exposure history to trichloroethylene were randomly selected as control group. The enzyme linked immunosorbent assay was used to qualitatively determine the titer of HHV6 and HCMV immunoglobulin( Ig) G,Ig M antibodies from serum samples of these subjects. The polymerase chain reaction was used to qualitatively detect HHV6 and HCMV DNA from whole blood DNA samples of these subjects. The differences of previous infection rate,reactivation rate and recent infection rate of HHV6 and HCMV among these three groups of patients with different clinical types of OMDT were analyzed. RESULTS: The prevalence of HHV6 and HCMV infection in the case group was higher than that in the control group,and the difference was statistically significant( 65. 5% vs 20. 0%,75. 0% vs15. 0%,P < 0. 017). The reactivation rate of HHV6 and HCMV in the case group was higher than that in the control group,but the difference was not statistically significant( P > 0. 017). The recent infection rate of HHV6 and HCMV in the case group was not significantly different from that in the control group( P > 0. 017). There was no significant difference in the past infection rate,reactivation rate and recent infection rate of HHV6 and HCMV between the exposure group and the control group( P > 0. 05),meanwhile in different clinical types of OMDT patients( P > 0. 05). CONCLUSION: OMDT may be associated with past infection of HHV6 and HCMV.
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Objective To investigate the current status of posttraumatic growth among digestive system cancer patient' families, and explore correlation of posttraumatic growth with social support, coping style in digestive system cancer patient' s families. Methods The Posttraumatic Growth Inventory, Perceived Social Support Scale and Simplified Coping Style Questionnaire were used to survey the 280 digestive system cancer patient' s families. Results The mean posttraumatic growth total score in families of the patients with digestive system cancer was (46.03 ± 15.83) points. The highest score was found for appreciation of life, the lowest was spiritual change. Meanwhile, posttraumatic growth was significantly correlated with perceived social support. The correlation coefficient was 0.730 (P<0.01). In the coping style, there was a positive correlation between positive coping style and post-traumatic growth. The correlation coefficient was 0.644, (P<0.01). While except personal relationship and mental change dimensions, there was a negative correlation between the post-traumatic growth with the negative coping style. The correlation coefficient was-0.155 (P<0.05). Conclusions Family of patients with digestive system cancer also experience posttraumatic growth when their loved ones are diagnosed with cancer, but the posttraumatic growth was at the lower level. Social support and positive coping are the positive factors of post traumatic growth, and negative coping is the negative influencing factor.
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Objective To investigate the current status of posttraumatic growth among digestive system cancer patient' families, and explore correlation of posttraumatic growth with social support, coping style in digestive system cancer patient' s families. Methods The Posttraumatic Growth Inventory, Perceived Social Support Scale and Simplified Coping Style Questionnaire were used to survey the 280 digestive system cancer patient' s families. Results The mean posttraumatic growth total score in families of the patients with digestive system cancer was (46.03 ± 15.83) points. The highest score was found for appreciation of life, the lowest was spiritual change. Meanwhile, posttraumatic growth was significantly correlated with perceived social support. The correlation coefficient was 0.730 (P<0.01). In the coping style, there was a positive correlation between positive coping style and post-traumatic growth. The correlation coefficient was 0.644, (P<0.01). While except personal relationship and mental change dimensions, there was a negative correlation between the post-traumatic growth with the negative coping style. The correlation coefficient was-0.155 (P<0.05). Conclusions Family of patients with digestive system cancer also experience posttraumatic growth when their loved ones are diagnosed with cancer, but the posttraumatic growth was at the lower level. Social support and positive coping are the positive factors of post traumatic growth, and negative coping is the negative influencing factor.
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Objective To establish a method for the isolation and identification of platelets.Methods 10 healthy volunteers were selected to collect the EDTA anticoagulant venous blood of 3 tubes,each tube was 2 ml,which was divided into the whole blood cell tube,platelet rich plasma (control group),and stepped centrifugal platelet extract (experiment group).Platelet was isolated by simple centrifugation method(PRP) and stepped centrifugal method.The two groups were full blood count and analyzed by microscopic morphology and platelet activity test.Leukocyte specific HGB gene and platelet mitochondrial ND1 gene content was analyzed by real time PCR.Results Platelets were extracted and detected in control group and experimental group.Platelets were found and white blood cells and red blood cells were not remained in experimental group.Platelets and sporadic white blood cells were found in control group.The platelet pick up rate of experiment group was significantly higher than control group,the difference was statistically significant.Experimental gene content HGB of experiment group was significantly lower than control group,the difference was statistically significant (t=-3.281,-2.865,P＜0.05).ND1 gene content of experiment group higher than the control group,the difference was not statistically significant.There was no significant difference for platelet activity test between experimental group and control group (t=-0.046,-0.799,P＞ 0.05).Conclusion A isolation and identification method of stepped centrifugal platelet was established.The method can be used for the study of platelet gene and the functional analysis of platelets.