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ObjectiveTo understand the presence of virulence genes， molecular typing characteristics， and antibiotic sensitivity of enteroaggregative Escherichia coli （EAEC） in children with diarrhea in Shanghai， so as to provide a scientific basis for EAEC monitoring and standardized treatment of EAEC infection. MethodsEAEC strains isolated from children （≤5 years old） with diarrhea in six districts of Shanghai were collected as the study subjects. EAEC virulence genes were detected by real-time fluorescence quantitative PCR， molecular typing was performed by pulsed-field gel electrophoresis （PFGE）， and drug susceptibility tests were conducted using the microbroth dilution method. χ2 test and two independent samples t-test were used to compare the differences in virulence genes and antibiotic resistance between suburban and urban EAEC strains. ResultsFrom 2019 to 2021， the overall detection rates of gene aggR， pic and astA of 59 EAEC were 30.5%， 50.8%， and 57.6%， respectively. There was no significant difference in the detection rates of virulence genes between suburban and urban EAEC strains （P>0.05）. PFGE analysis revealed that only two EAEC strains belonged to the same PFGE pattern and were collected from the same hospital， and the overall PFGE patterns were polymorphic. EAEC showed susceptibility to imipenem and colistin E， and the resistance rates to sulfamethoxazole （SXT）， ampicillin （AMP）， nalidixic acid （NAL）， and tetracycline （93.1%， 79.3%， 63.8%， and 58.6%， respectively） were higher than 50.0%. The antibiotic resistance rates of cefazolin （CFZ）， cefotaxime （CTX）， and ciprofloxacin （CIP） were significantly different between EAEC strains from suburban and urban areas （P<0.05）. A total of 47 strains exhibited multi-drug resistance， with the most common resistance spectrum being AMP-SXT-NAL. There was no statistically significant difference in the number of multidrug-resistant EAEC strains between suburban and urban areas （P>0.05）. ConclusionThe EAEC virulence gene assemblages in children with diarrhea in the six districts of Shanghai are diverse， and the molecular typing patterns are relatively scattered， indicating possible cross-infection of homologous strains. Multi-drug resistance in EAEC strains is relatively common， and there is a statistically significant difference in the resistance rates of CFZ， CTX and CIP between urban and suburban EAEC strains. Attention should be given to standardizing the use of clinical antibiotics to effectively control the dissemination of multidrug-resistant EAEC strains.
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The clinical data of a case of compound oxidative phosphorylation deficiency type 10 (COXPD10) caused by a new site mutation of MTO1 gene in the Department of Pediatrics, Affiliated Hospital of Southwest Medical University on December 29, 2020 were retrospectively analyzed.The patient was a 2 months and 19 days old boy of Han nationality.The main clinical manifestations were shortness of breath, hyperlactic acidemia, hyperammonemia and brain damage.Cardiac hypertrophy was not obvious.Heterozygous mutations at c. 344delA and c. 1055C>T sites in the MTO1 gene have not been reported in domestic and foreign literature.COXPD10 caused by MTO1 gene mutations may result in diversified clinical manifestations due to inconsistent mutation sites.For hyperlactic acidemia with unknown predisposing factors, early genetic examination should be conducted to confirm the possibility of COXPD10.
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【Objective】 To learn more about the role of therapeutic plasma exchange in the management of cytokines release syndrome(CRS) after chimeric antigen receptor T(CAR-T) infusion by reviewing and analyzing the diagnosis and treatment of one case. 【Methods】 The diagnosis and treatment of lymphoma patients with CAR-T infusion related CRS were described, and case analysis was carried out by searching PubMed, Elsevier, Wiley, CNKI, and other databases for relevant guidelines, clinical trials, and case reports. 【Results】 The patient was diagnosed with follicular cell lymphoma. Progressive disease(PD) was assessed after multiple courses of treatment, and anti-CD19/20 CAR-T cell therapy was administered.The patient developed a high fever and chills, secondary dyspnea and hypotension at night on the day of infusion, and the inflammatory factors such as C-reactive protein(CRP) and interleukin-6(IL-6) increased sharply, suggesting the occurrence of cytokines release syndrome(CRS). After the patient was given symptomatic antipyretic, broad-spectrum anti-infection, tumor necrosis factor(TNF) antibody and three occasions of plasma exchange, the clinical manifestations of CRS gradually relieved. Three months after discharge, the patient was in complete response(CR). 【Conclusion】 CAR-T-associated CRS is a serious cellular immunotherapy-related toxicity that can result in multiple organ failure or even death in patients. Therapeutic plasma exchange may be a potential treatment for some patients with severe CRS.
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Objective:To investigate the antimicrobial resistance characteristics of carbapenem-resistant Enterobacteriaceae （CRE） isolated from outpatients with diarrhea in Shanghai， and provide support for surveillance， prevention and control of CRE. Methods:A total of 800 fecal swabs of the outpatients with diarrhea were collected from 23 sentinel hospitals for diarrhea pathogen surveillance in Shanghai from January 2018 to December 2019. The drug-resistant strains were isolated using MacConkey plates containing 1 μg/μL meropenem. The collected strains were identified preliminarily by the VITEK-2 Compact system and VITEK mass spectrometry. The minimum inhibitory concentration （MIC） of the strain was determined by the broth microdilution method. The multi-locus sequence typing （MLST） method and pulsed-field gel electrophoresis （PFGE） were used to analyze the homology of drug-resistant strains. The transferability of the resistance gene was investigated by a junction experiment. High-throughput sequencing was used to characterize the isolates. Results:Seven non-repetitive CRE isolates were multi-drug resistant carbapenem-resistant Escherichia coli （CREC） strains that produce New Delhi metallo-β-lactamase （NDM） with resistance to several commonly used antibiotics in clinical therapy. The molecular typing results showed that the CRE strains had different sequence types， and diverse PFGE patterns. The stains were all positive for blaNDM genes， including blaNDM-5 and blaNDM-13， with blaNDM-5 as the main type. The carbapenem-resistant genes could be transferred to EC600 by conjugation. Conclusion:The intestinal carbapenem-resistant strains in this study are all NDM-producing Escherichia coli. The isolates carried blaNDM and other resistance genes. The MLST analysis showed that they belonged to different cloning types. Antimicrobial resistance genes could be horizontally transferred to EC600 by conjugation.
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OBJECTIVE@#To compare clinical effect of intramedullary nailing through suprapatellar, infrapatellar and paracpatellar approach in treating tibial shaft fracture.@*METHODS@#From June 2012 to June 2018, 36 patients with tibial shaft fracture were treated with intramedullary nails, and were divided into three groups according to surgical approach. Twleve patients were through suprapatellar approach, including 7 males and 5 females aged from 25 to 53 years old with an average of (37.8±11.4) years old;and 4 patients were type A, 4 patients were type B, and 4 patients were type C according to AO classification. Ten patients were through infrapatellar approach, including 6 males and 4 females aged from 19 to 56 years old with an average of (35.6±10.0) years old;and 3 patients were type A, 4 patients were type B, and 3 patients were type C according to AO classification. Forteen patients were through paracpatellar approach, including 8 males and 6 females aged from 21 to 58 years old with an average of (36.6±10.0) years old;and 4 patients were type A, 6 patients were type B, and 4 patients were type C according to AO classification. Operation time, intraoperative blood loss, fluoroscopy times, fracture healing time and complications among three groups were observed, and knee joint functions were evaluated by Lysholm score.@*RESULTS@#All patients were followed up from 12 to 18 months with an average of (15.0±3.0) months. There were no difference in intraoperative blood loss and fracture healing time among three groups (@*CONCLUSION@#intramedullary nailing through suprapatellar for the treatment of tibial shaft fracture is benefit for fracture healing and recovery of knee joint function, while infrapatellar and paracpatellar approach have advantages in exposure of insertion point. We should select approach reasonably according to our experience.
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Adult , Female , Humans , Male , Middle Aged , Young Adult , Bone Nails , Diaphyses , Fracture Fixation, Intramedullary , Tibia , Tibial Fractures/surgery , Treatment OutcomeABSTRACT
【Objective】 To evaluate common laboratory items in a large-dose blood loss model in vitro using thromboelastogram (TEG), to provide a reasonable infusion solution for clinical massive transfusions. 【Methods】 On March 2nd, 2017, eight healthy blood donors who participated in voluntary blood donation in the Department of Blood Transfusion Medicine of the First Medical Center of the PLA General Hospital were selected to undergo phlebotomy, and an in vitro dilution model of massive blood loss was established based on the previous research, namely Model 1 (M1, given massive transfusion protocol) and Model 2 (M2, given packed red blood cells and plasma) were established. Then blood routine, routine coagulation function, clotting factor activity, TEG of each model were tested. 【Results】 The platelet count in the M1 model was 61.00±10.24 (×109/L), and reduced to 28.83±10.36(×109/L) in M2 (P<0.01). The MA value (mm) of two groups detected by TEG was 29.35±2.37 vs 20.53± 2.76 (P<0.01). In M1 and M2 model, The activities of primary clotting factors respectively decreased to about 40% and 30% to original in M1 and M2. The R value of TEG prolonged to (6.32±0.85) min and (7.27±0.63) min respectively, still within the normal range(baseline 4.97±1.04). The fibrinogen concentration in the M1 and M2 model decreased to (1.10±0.08) g/L and (0.81±0.10) g/L(P<0.01), which had the same variation tendency to Alpha angle of TEG (25.65±4.95 vs 16.63±3.94, P>0.05). 【Conclusion】 MTP with blood components supplemented such as platelet and cryoprecipitate in time has effectively improved the Plt and Fib in vitro large-dose blood loss/transfusion model.
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Objective To evaluate the visual improvement of therapeutic plasma exchange (TPE) for refractory optic neuritis (ON) patients in acute phase.Methods Seventy-five affected eyes from 44 refractory ON patients with severe visual defect or resistance to high-dose intravenous methylprednisolone (IVMP) therapy,who were admitted to The Chinese PLA General Hospital between January 2015 and August 2016,were recruited and received TPE therapy.Among these patients,11 were male and 33 were female;the average age was 39.1 ± 13.9;31 patients had two affected eyes,13 patients had one affected eye.The course of the disease on the group of patients were more than 2 weeks,and the visual acuity worsened for more than 10 days and continued to deteriorate.TPE treatment was performed on all of the patients.BCVA was recorded before and 24 h after treatment,and the visual function was scored using visual outcome scale (VOS).At the same time,the adverse reactions of TPE treatment were observed.The paired t-test was used to compare the VOS before and after treatment.The correlation between VOS before and after treatment was analyzed by Linear-by-Linear correlation analysis.Results Among 75 affected eyes,the post-therapy VOS 3.89 ±2.13 was significantly improved from pre-therapy VOS 5.56± 1.69 (t=6.77,P＜0.001).Forty-eight of 75 eyes were improved at lease 1 score of VOS,the overall rate of visual improvement was 64.0％.Especially among the eyes with initial vision of light perception,an improved rate of 82.4％ was presented.75.0％ in those eyes with initial vision of count fingers and 67.7％ in no light perception.Linear-by-Linear correlation analysis showed a significant linear correlation between the scores of VOS before and after TPE treatment (r=0.398,P=0.01).During the course of TPE treatment,5 patients had mild adverse reactions such as low calcium reaction and allergic reaction and were well controlled after treatment.Conclusion Using TPE to treat refractory ON in acute phased can improve the visual function of patients.
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Objective@#To understand the seasonality and etiological characteristics of infectious diarrhea in adults from Shanghai.@*Methods@#Adult patients with diarrhea who had visited the enteric disease clinics in 22 hospitals that carrying on the Diarrhea Comprehensive Surveillance sentinel programs in Shanghai during 2014-2017, were surveyed. Stool specimens were collected according to the different intervals of sampling and detected for 12 bacteria and 5 viruses. Concentration ratio and circular distribution method were used for data analysis.@*Results@#From 2014 to 2017, a total of 9 573 stool specimens were collected from the targeted diarrhea patients ≥18 years old (n=96 067), through the Shanghai Diarrhea Comprehensive Surveillance program. The positive rate of detection was 46.44%. Seasonal peaks of infectious diarrhea were both seen in summer (bacteria peak, diarrheagenic Escherichia coli and Vibrio parahaemolyticus, etc.) and in winter (virus peak, Norovirus, etc.). Both bacterial and viral infections presented seasonal concentration (Raleigh’s test P<0.001) but more obvious with bacterial infection. Viral infection accounted for 60.19% of the cause of infectious diarrhea. The top five predominant pathogens appeared as Norovirus, Rotavirus, diarrheagenic Escherichia coli, Vibrio parahaemolyticus, and Salmonella spp..@*Conclusions@#Among the adult outpatients with infectious diarrhea in Shanghai, obvious seasonality was seen, with peaks in both summer and winter. Viral infection with Norovirus in particular, appeared as the predominant source of infection. Active, continuous and comprehensive diarrhea-related surveillance programs would be able to monitor the changing dynamic of pathogen spectrum, and lead to the adoption of targeted preventive measures.
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Objective The level of lactic acid in blood can reflect the degree of ischemia and hypoxia of brain tissue and cerebral perfusion pressure. The aim of this paper is to explore the value of blood lactate and lactate clearance in evaluating the survival rate and neurological outcome of patients with craniocerebral trauma. Methods The clinical data of 497 craniocerebral trauma patients admitted to our hospital from September 2017 to July 2018 were collected and retrospectively analyzed. Patients were divided into groups with different 6 h lactate clearance rates and admission lactate levels, and the differences in mortality and outcome of neurological function in each group were compared. Results The serum admission lactate levels、serum lactate levels at 6 hours, 28-day mortality and 28-day poor nerve function prognosis rate of patients with different 6h lactate clearance rates were statistically significant differences(P < 0. 05). The efficacy of 6h lactic acid to predict the mortality rate of patients was better than that of admission lactic acid and 6h lactate clearance rate (Z=3.71、Z=3.95,P<0.05). However, in predicting the neurological function of patients, the lactate clearance rate is not better than blood lactate level at any time(Z=1.30，Z=0.81，P>0.05). Conclusion 6h lactic acid has the best ability to judge the mortality of patients while lactic acid clearance rate is not better than the blood lactate level at any time in predicting the neurological function of patients.
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A family of transcription factors known as Id proteins, or inhibitor of DNA binding and differentiation, is capable of regulating cell proliferation, survival and differentiation, and is often upregulated in multiple types of tumors. Due to their ability to promote self-renewal, Id proteins have been considered as oncogenes, and potential therapeutic targets in cancer models. On the contrary, certain Id proteins are reported to act as tumor suppressors in the development of Burkitt's lymphoma in humans, and hepatosplenic and innate-like T cell lymphomas in mice. The contexts and mechanisms by which Id proteins can serve in such contradictory roles to determine tumor outcomes are still not well understood. In this review, we explore the roles of Id proteins in lymphocyte development and tumorigenesis, particularly with respect to inhibition of their canonical DNA binding partners known as E proteins. Transcriptional regulation by E proteins, and their antagonism by Id proteins, act as gatekeepers to ensure appropriate lymphocyte development at key checkpoints. We re-examine the derailment of these regulatory mechanisms in lymphocytes that facilitate tumor development. These mechanistic insights can allow better appreciation of the context-dependent roles of Id proteins in cancers and improve considerations for therapy.
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Carcinogenesis , Metabolism , Cell Physiological Phenomena , Inhibitor of Differentiation Protein 1 , Metabolism , Lymphocytes , Physiology , Transcription Factors , Tumor Suppressor Proteins , MetabolismABSTRACT
Objective:To analyze the dietary and nutritional status of the tube feeding elderly in nursing home.Methods:Self-designed questionnaire was used to analyze the basic information and dietary intake,and the Mini Nutritional Assessment (MNA) questionnaire was used to evaluate the nutritional status of the tube feeding elderly.Results:The median MNA score was 13,the incidence of malnutrition was 71.1％,the average dietary energy intake was low,and it was significantly lower in the malnutrition group and having potential nutritional risk group than that in the well-nourished group.There was no significant difference in dietary protein intake among these three groups.Dietary Vitamin A,riboflavin,Vitamin C,potassium,calcium,magnesium,iron,Selenium and dietary fiber intake were less than 60％ of the recommended intake,and dietary vitamin E and sodium intake were more than 200％ of the recommended intake.Conclusions:The malnutrition prevalence rate of the tube feeding elderly in nursing home is high,dietary intake is not reasonable.It is urgent for the nutritional support group to carry out health education in nursing home and improve the overall health level of the tube feeding staff.
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Objective To explore the relationship of two loci (rs2293152, rs9579700) gene polymorphisms of signal transduction and transcription factor-3 (STAT3) with susceptibility to Henoch-Scho. .nlein purpura (HSP) and HSP nephritis (HSPN). Methods From September 2013 to September 2015, 180 children with HSP (group HSP) and 205 healthy children (control group) were enrolled in this study. Single nucleotide polymorphism (SNP) of intron 11 rs2293152C/G and intron 23 rs957970C/T of STAT3 gene was detected by sequence specific primer polymerase chain reaction (SSP-PCR). Results The frequency of CC genotype in STAT3 gene intron 11 rs2293152 in HSP group (26.1％) was significantly higher than that in control group (8.8％), and the frequency of allele gene of rs2293152C in HSP group (48.6％) was significantly higher than that in control group (32.7％) (P=0.013, 0.025). There were no differences in distribution of genotype and allele in rs957970C/T loci of intron 23 of STAT3 gene between two groups (P>0.05). The frequencies of genotype and allele of the two loci of STAT3 gene were no difference between HSPN and non HSPN groups (P>0.05). Conclusions The allele gene C of intron 11 rs2293152C/G of STAT3 gene may be a susceptible gene of HSP, while there was no association of 23 rs957970C/T polymorphism to HSP and there was no association of the two loci polymorphisms to HSPN.
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Objective To discuss the discovery of stent graft mis-deployed into false lumen during aortic dissection treatment and re-deployment.Methods Retrospective analysis of the data of deployment of the stent-graft into the false lumen in the initial treatment of aortic dissection between January 2013 to December 2017.Of the five cases,there were three males and two females,range from 28 to 52 year old.Two patients,suffered from acute Stanford type A aortic dissection,with aortic surgical replacement and circulatory elephant trunk technique,displayed the visceral ischemia and internal environment disorder postoperatively.An emergency CT angiography showed that the deployed stent-graft was in the false lumen.Another two cases with sub-acute Stanford type B aortic dissection underwent TEVAR.The stent-grafts were put in the false lumen intra-operatively,one patient with pregnancy-induced hypertension suffered from acute Stanford type B aortic dissection.An emergency endovascular repair was set under general anesthesia to deal with this problem.New stent-graft was utilized to correct the blood flow into true lumen via flap fenestration or secondary intimal tear.Results The successful rate of this operation was 100％.Time of surgery spanned from 45 minutes to 120 minutes,and blood loss was estimated to be from 50 ml to 100 ml.Five stent grafts were placed with 160 mm length and 6 mm taper and one was 120 mm length and 10 mm taper.Patients were observed in ICU for three days and discharged from hospital after seven days.No complications such as paraplegia,visceral ischemia,etc occurred.Postoperative aortic CTA one month later showed no complications,such as endoleak,etc.The stents were in ideal position,with fluent blood flow of aorta and major visceral artery.Conclusions Deployment of the stent-graft in the false lumen is a rare and critical complication in the treatment of aortic dissection.In addition to clinical manifestations and laboratory tests,aortic CTA could identify this complication quickly and accurately.Endovascular repair was recommended as primary treatment of choice,which could re-direct the blood flow into true lumen via flap fenestration or secondary intimal tear technology quickly and effectively.
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@#The facial nerve is the longest nerve shaped the bone tube, which has many turnings and narrow path. About 7% to 10% of patients with temporal bone fracture have facial paralysis. Most of the patients showed loss of frontal lines, inability to close eyes, and deflection of the teeth. Facial nerve decompression has been an effective way to relieve the symptoms and restore facial nerve functions. However, the issue of surgical indications, timing of surgery, and scope of decompression still need further research.
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Objective@#To compare thulium laser vaporization of the prostate (TLVP) and transurethral resection of the prostate (TURP) in the treatment of benign prostate hyperplasia (BPH) analyze the risk factors for postoperative urethral stricture.@*METHODS@#From June 2015 to June 2016, 210 BPH patients in our hospital underwent TURP (n = 126) or TLVP (n = 84). We followed up the patients for 6 months, compared the effects of the two surgical strategies and analyzed the risk factors for postoperative urethral stricture by multivariate logistic regression analysis.@*RESULTS@#Compared with TURP, TLVP achieved significantly shorter time of operation (［78.6 ± 27.5］ vs ［53.2 ± 21.6］ min, P <0.01), postoperative bladder irrigation (［31.5 ± 2.9］ vs ［26.1 ± 3.7］ h, P <0.01), urethral catheterization (［5.3 ± 1.7］ vs ［3.7 ± 1.5］ d, P <0.01) and postoperative hospitalization (［7.9 ± 2.1］ vs ［5.5 ± 1.4］ d, P <0.01) as well as lower urinary leukocyte count at 6 months after surgery (［32.1 ± 12.6］ vs ［24.9 ± 11.7］ /μl, P <0.01) and incidence rate of postoperative complications (11.9% ［15/126］ vs 3.6% ［3/84］, P <0.05), particularly that of urethral stricture (7.9% ［10/126］ vs 1.2% ［1/84］, P <0.05). Logistic regression analysis showed that the preoperative urinary leukocyte count, postoperative urethral catheterization time, and surgical method were independent risk factors for postoperative urethral stricture.@*CONCLUSIONS@#TLVP, in comparison with TURP, has the advantages of definite effect, fast recovery, high safety and low incidence of postoperative urethral stricture. The main risk factors for postoperative urethral stricture include preoperative urinary tract infection, postoperative urethral catheterization time and surgical method.
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Humans , Male , Laser Therapy , Methods , Operative Time , Postoperative Complications , Prostatic Hyperplasia , General Surgery , Quality of Life , Regression Analysis , Risk Factors , Thulium , Therapeutic Uses , Transurethral Resection of Prostate , Treatment Outcome , Urethral Stricture , Urinary Catheterization , Urinary Tract InfectionsABSTRACT
Objective@#To analyze the pathogen spectrum and epidemiological characters of infectious diarrhea cases in Shanghai from July 2013 to June 2015.@*Methods@#From July 2013 to June 2015, using multi-stage sampling to select 22 hospitals as adult diarrhea surveillance sentinels, and 3 district central hospitals together with Shanghai municipal children's hospital as children diarrhea surveillance sentinels. A total of 6 267 diarrhea cases were sampled. The demographic characters, main clinical manifestations and signs of cases were investigated, and stool specimens were collected to conduct the bacteria culture and virus nucleic acid detection. The difference of positive rate of bacteria and virus in different seasons, and age difference of relevant pathogens were compared.@*Results@#Among 6 267 cases, 3 262 (52.05%) were male, and most of them were in 50-69 years group (1 999 cases, 31.90%) and 30-49 years group (1 691 cases, 26.98%). Totally, 2 783 positive specimens were detected out of 6 267 specimens with the positive rate being 44.41%. A total of 7 kinds of bacteria and 5 kinds of viruses were detected. The positive rate for bacterium was 12.61%(790 cases), mainly being vibrio parahaemolyticus (256 cases), diarrheagenic E.coli (239 cases) and salmonella (209 cases). The positive rate for virus was 31.80% (1 993 cases), mainly being norovirus (1 172 cases) and rotavirus (546 cases). The positive rates of viruses in winter of 2013 and 2014 were 57.89%(429 cases) and 62.14%(522 cases) respectively, higher than those of bacterium in the same periods which were 2.43% (18 cases) and 2.86% (24 cases) respectively. The positive rates of bacterium in summer of 2013, 2014 and 2015 were 14.56% (97 cases), 25.29%(258 cases) and 21.21% (49 cases), also higher than those of viruses in the same periods which were 7.51% (50 cases), 8.43%(86 cases) and 11.69% (27 cases) respectively, all of the above differences were statistically significant (P<0.05). The cases of 50-69 years group had the highest positive rate of pathogen, which was 47.57% (951/1 999). Secondly was those of 30-49 years group with 47.13% (797/1 691). Positive rate of pathogen for cases of 0-2 years group was 35.74% (213/596).@*Conclusion@#The pathogen spectrumes of infectious diarrhea in Shanghai are mainly vibrio parahaemolyticus, diarrheagenic E.coli, salmonella, norovirus and rotavirus. The summer and winter season peak was obvious. Specific etiological surveillance and control strategies should be strengthened aiming at focus groups including children and the elderly in different seasons.
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Plasma exchange (PE) is a therapeutic blood component replacement method. The blood of patients is first separated into plasma and blood cell components using a blood cell separator in vitro, the plasma containing harmful pathogenic substances is then discarded and replaced with the same volume of exchange solution. Finally the separated blood cells together with the exchange solution are returned back to the blood circulation of patients. By reducing the circulating antibodies, abnormal plasma proteins or cytokines and other pathogenic molecules, PE can block the disease process. PE has a good therapeutic effect on neuromyelitis optica-related optic neuritis (NMO-ON), which shows resistant to glucocorticoid therapy for the first onset. The American Society for Apheresis guideline evaluates PE for acute optic neuritis as a recommended grade 1B, type II indication. In the implementation of PE treatment for NMO-ON and other diseases, indications and contraindications should be strictly adhered to the guideline, treatment procedures and protocols should be optimized, common adverse events and its prevention and management should be known and alerted. It is important to conduct multi-center clinical cooperation and a high standard clinical randomized controlled study, to find out the optimal time window, the best protocol, and the associated factors for the efficacy and prognosis of PE in NMO-ON.
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Plasma exchange (PE) is a therapeutic blood component replacement method. The blood of patients is first separated into plasma and blood cell components using a blood cell separator in vitro, the plasma containing harmful pathogenic substances is then discarded and replaced with the same volume of exchange solution. Finally the separated blood cells together with the exchange solution are returned back to the blood circulation of patients. By reducing the circulating antibodies, abnormal plasma proteins or cytokines and other pathogenic molecules, PE can block the disease process. PE has a good therapeutic effect on neuromyelitis optica-related optic neuritis (NMO-ON), which shows resistant to glucocorticoid therapy for the first onset. The American Society for Apheresis guideline evaluates PE for acute optic neuritis as a recommended grade 1B, type II indication. In the implementation of PE treatment for NMO-ON and other diseases, indications and contraindications should be strictly adhered to the guideline, treatment procedures and protocols should be optimized, common adverse events and its prevention and management should be known and alerted. It is important to conduct multi-center clinical cooperation and a high standard clinical randomized controlled study, to find out the optimal time window, the best protocol, and the associated factors for the efficacy and prognosis of PE in NMO-ON.
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AIM: To explore the effect of Bu Shen Yang Xue Ming Mu (BSYXMM) Formula on hydroquinone-induced oxidative stress injury in ARPE-19 cells.METHODS: The oxidative injury model of ARPE-19 cell was induced by exposure to various concentrations of hydroquinone (HQ) to determine the optimal concentration.Intestinal absorption solutions of BSYXMM Formula were prepared.Effect of intestinal absorption solutions of BSYXMM Formula on the cell viability was detected by CCK-8 assay,and the percentage of apoptotic cells was measured by TUNEL assay.The levels of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in ARPE-19 cells were detected by means of chemical colorimetry.RESULTS: It was found that ARPE-19 cell viability significantly decreased when the concentration of HQ was higher than 90μmol/L.Compared with the model group,1% and 2% intestinal absorption solutions in the pre-treatment group could significantly alleviate HQ-induced injury (P<0.01) and 0.5% and 5% intestinal absorption solutions in the pre-treatment group could alleviate the injury in certain degree(P<0.05).While in the treatment group 1% and 2% intestinal absorption solutions could alleviate the injury to some extent (P<0.05).TUNEL results showed that the apoptosis rate decreased significantly in the pre-treatment group (P<0.01)and to some extent in the treatment group (P<0.05)compared with the model group.It was shown that both levels of SOD and GSH-Px in pre-treatment group and treatment group were markedly higher than that of model group(P<0.05),and pre-treatment group had more significant effect (P<0.01,P<0.05).CONCLUSION: BSYXMM Formula could protect against HQ-induced oxidative stress injury in ARPE-19 cells,which may be related with the increasing of antioxidant enzyme in the cells.
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<p><b>INTRODUCTION</b>This study aimed to describe the knowledge, attitudes and practices of young women regarding human papillomavirus (HPV) vaccination.</p><p><b>METHODS</b>We conducted a descriptive, cross-sectional, questionnaire-based study among female students at a tertiary institute in Singapore.</p><p><b>RESULTS</b>A total of 255 questionnaires were completed and formed the basis of the analysis. 244 (95.7%) of the total participants were of the age group 15-22 years. 252 (98.8%) participants were unmarried and 240 (94.1%) had never had sexual intercourse. Only 25 (9.8%) women had received vaccination. Among the unvaccinated participants, 96 (41.7%) had no intention to receive HPV vaccination and 62 of them cited lack of information as a major barrier to HPV vaccination. Knowledge of cervical cancer and HPV vaccination was also assessed and graded via a point system, with a maximum score of 14. Knowledge was found to be low, with a median score of 7. There was a significant association between HPV vaccination uptake and the source from which they first heard about the vaccine (p = 0.007). Vaccinated respondents tended to first hear about it from their relatives and friends, as compared to unvaccinated respondents (60.0% vs. 27.0%).</p><p><b>CONCLUSION</b>There is poor uptake of HPV vaccination amongst Singapore's susceptible youth as well as poor knowledge of cervical cancer and HPV vaccination. Public health education regarding cervical cancer and HPV vaccination is still needed and has to be targeted at not only respondents, but also their family and friends.</p>