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Objective:To understand the diagnostic value of tuberculosis (TB) pathogenic detection methods (TPDM) in pathological tissue for TB.Methods:A retrospective study was conducted with 190 pathological specimens from different tissues suspected with TB from Third People′s Hospital of Shenzhen during May 2016 and May 2019. Specimens were divided into four groups according to histomorphology: group one, necrotizing granulomatous inflammation (109 cases); group two, non-necrotic granulomatous inflammation (20 cases); group three, non-granulomatous inflammation (45 cases); group four, non-tuberculous lesions (16 cases). The positive rates of each TPDM among specimens from four groups were compared. The positive rates of all TPDM for specimens from group one were compared. Meanwhile, the influence of antituberculosis treatment course on the TPDM was analyzed. Chi-square test or Fisher′s exact test was used for statistical analysis.Results:The positive rates of Ziehl-Neelsen acid-fast staining among the four groups were 17.4%(19/109), 5.0%(1/20), 4.4%(2/45) and 0(0/16), respectively. The positive rates of Mycobacterium tuberculosis (MTB) complex culture were 32.0%(32/100), 4/19, 4.8%(2/42) and 0(0/16), respectively. The positive rates of Mycobacterium tuberculosis/rifampin resistance real-time quantitative nucleic acid amplification detection system (Xpert MTB/RIF) were 74.3%(81/109), 15.0%(3/20), 13.3%(6/45) and 0(0/16), respectively. The positive rates of fluorescent quantitative polymerase chain reaction (FQ-PCR) were 63.0%(58/92), 0(0/15), 2.6%(1/38) and 0(0/10), respectively. The positive rates of simultaneous amplification and testing (SAT) were 32.4%(24/74), 0(0/10), 0(0/15) and 0(0/10), respectively. The differences of each TPDM among four groups were all statistically significant (all P<0.05). The positive rate of Xpert MTB/RIF in group one specimens was significantly higher than those of acid-fast staining, MTB culture and SAT ( χ2=71.016, 37.162 and 35.679, respectively, all P<0.01), while the difference was not statistically significant when compared with FQ-PCR ( χ2=2.517, P=0.112). The positive rate of combined TPDM (85.3%(93/109)) was significantly higher than Xpert MTB/RIF(74.3%(81/109)) ( χ2=4.100, P=0.043). The positive rates of acid-fast staining group 1A (anti-tuberculosis treatment course was less than one month) and group 1B (anti-tuberculosis treatment course was longer than one month) were 14.3%(7/49) and 20.0% (12/60), respectively ( χ2=0.612, P=0.434); those of MTB culture were 48.9% (22/45) and 18.2% (10/55), respectively ( χ2=10.721, P=0.001); those of Xpert MTB/RIF were 69.4%(34/49) and 78.3%(47/60), respectively ( χ2=1.131, P=0.287); those of FQ-PCR were 55.0%(22/40) and 69.2%(36/52), respectively ( χ2=1.965, P=0.161); those of SAT were 43.3%(13/30) and 25.0%(11/44), respectively ( χ2=2.736, P=0.098). Conclusions:The results of TPDM correlate closely with the typical histomorphological features of tuberculosis. Xpert MTB/RIF possesses significantly higher sensitivity than any other single TPDM, and is not attenuated by early anti-tuberculosis treatment. Combined TPDM could significantly improve the sensitivity of TB pathogenic detection, which is suggested to be applied when the tissue specimen is sufficient.
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OBJECTIVE：To establish the method for determining protein binding rate of dipeptidyl peptidase- 4 inhibitor LGT- 6 in different species of plasma ，and to compare their difference. METHODS ：By equilibrium dialysis ，LGT-6（3，30，300，3 000 nmol/L）was equilibrated in rat ，monkey and human plasma （i. e. internal dialysis solution ）for 48 h，using phosphate buffer as the external dialysis solution. The concentration of LGT- 6 in internal and external dialysis solution was determined by UPLC-MS/MS using tolbutamide as internal standard ，and the plasma protein binding rate was calculated. The determination was performed on ACQUITY UPLC HSS T 3 column with water （containing 0.01％ formic acid ）-acetonitrile（containing 0.01％ formic acid ）as mobile phase at the flow rate of 0.6 mL/min. The column temperature was 40 ℃，and the sample size was 2 μL. The ion source was electrospray ion source ，and the multiple ion monitoring mode was used to carry out positive ionization scanning. The ion pairs for quantitative analysis were m/z 487.0→434.3（LGT-6），m/z 271.1→172.0（internal standard ），respectively. RESULTS ：At the concentrations of 3，30，300，and 3 000 nmol/L，the protein binding rates of LGT- 6 in rat plasma were （96.25±0.97）％，（84.16± 1.24）％，（78.25±0.61）％，（66.63±0.95）％；the protein protein binding rates in monkey plasma were （98.54±0.58）％，（87.27± 1.01）％，（79.35±0.86）％，（66.69±0.54）％；the protein binding rates in human plasma were （99.40±1.03）％，（84.48± 1.15）％，（77.62±0.77）％，（66.93±0.48）％. At the same concentration ，the protein binding rates of LGT- 6 in rat ，monkey and human plasma had no significant difference （P＞0.05）. In the same species of plasma ，there were significant differences in the plasma protein binding rates of different concentration of LGT-6 among those groups （P＜0.05），and it decreased with 才〔2016〕4015） the increase of drug concentration. CONCLUSIONS ： The method for the determination of plasma protein binding rate of LGT-6 is successfully established. The data revealed that the protein binding rate of LGT- 6 is concentration-dependent ， there was no obvious spec ies difference on protein binding rates of LGT- 6 in rat ，monkey and human plasma under the same concentration.
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OBJECTIVE：To establish the metho d for the concentration det ermination of foretinib derivative LWK- 126 in liver microsomes，and to study its metabolism stability in liver microsomes of rats ，Beagle dogs and human. METHODS ：In the in vitro incubation system of liver microsomes ，LWK-126 was dissolved in liver microsomal incubation systems of rats ，Beagle dog and human initiated by reduced nicotinamide adenine dinucleotide phosphate solution. After incubation in water at 37 ℃ for 0，5，10，20， 30 and 60 min，the reaction was terminated with acetonitrile containing internal standard （1 μg/mL tolbutamide）. UPLC-MS/MS method was applied to determine the concentration of LWK- 126 in the incubation systems. The determination was performed on Waters BEH C 18 column with mobile phase consisted of water （containing 0.1％ formic acid ）-acetonitrile（containing 0.1％ formic acid）by gradient elution at the flow rate of 0.4 mL/min. The column temperature was 30 ℃，and the sample size was 2 μL. The mass spectral analysis was performed in a positive electrospray ionization mode ，and the full MS experiment was run with the selective reaction monitoring mode with a scanning range of m/z 50→1 200. Taking the concentration of LWK- 126 at 0 min as reference，the remaining percentage and the enzyme kinetic parameters were calculated. RESULTS ：The linear range of LWK- 126 was 0.05-15 μg/mL（R 2＝0.999 2）；the lower limit of quantification was 0.05 μg/mL，and the lowest detection limit was 0.01 μg/mL. The precision，accuracy，extraction recovery and matrix effect all met the analysis requirements of biological samples. The remaining percentage of LWK- 126 in liver microsomes of human ，rats and Beagle dogs for 60 min were （33.17±4.52）％，（3.14± 6.73）％，（1.38±5.85）％；t1/2 of them were 33.15，11.76，5.62 min；the clearance rates were 38.45，118.81，245.76 μL（/ min·mg）， respectively. CONCLUSIONS ：The method for the content ； determination of LWK- 126 in liver microsomes is established successfully. The order of metabolic stability of LWK- 126 in 〔2016〕4015） liver microsomes of different species is human ＞rats＞Beagle dogs.
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OBJECTIVE:To evaluate the pharmacoeconomics of pantoprazole vs. ranitidine in the treatment of gastricesophagitis reflux disease(GERD). METHODS:Retrieved from PubMed,EMBase,The Cochrane Library,CNKI,VIP and Wanfang database, RCTs about pantoprazole vs. ranitidine in the treatment of GERD were selected until Sept. 2014. Two reviewers independently screened literature in accordance with the inclusion and exclusion criteria,and extracted the data of included studies. Stata 12.0 soft-ware was used to estimate therapeutic efficacy index and cost,and cost-effectiveness analysis was performed with the decision tree model. RESULTS:A total of 7 RCTs were included,involving 1 389 patients. Cost-effectiveness analysis showed that for gradeⅠ-Ⅲ(by Savary-Miller standard)GERD,cost-effectiveness ratios of ranitidine were all lower than those of pantoprazole(gradeⅠ:18.86 vs. 57.93;gradeⅡorⅢ:35.58 vs. 146.13);gradeⅠ,Ⅱ,Ⅲincremental cost-effectiveness ratio(ICER)were 335.53,349.85,349.85. Sensitivity analysis supported this conclusion. CONCLUSIONS:Ranitidine is more economic therapy plan for gradeⅠ-Ⅲ GERD, but its ICER fluctuates greatly. Individual therapy plan should be formulated according to disease condition and economic condition.
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Objective To systematically review the effectiveness and safety of pantoprazole ( PAN ) vs. ranitidine (RAN) for patients with gastroesophageal reflux disease (GERD). Methods PubMed,Medline,EMbase,The Cochrane Library and three Chinese literature databases (CNKI,VIP and Wan fang) were retrieveed.Randomized controlled trials (RCTs) which compared the clinical outcomes of PAN group vs. RAN group for GERD were included. Two reviewers independently screened literatures in accordance with the inclusion and exclusion criteria, extracted the data and assessed the methodological quality of included studies.Then,meta-analysis was performed using RevMan 5.2 software. Results A total of 8 RCTs involving 1 590 patients were included.The results of meta-analysis showed that the PAN group was significantly superior to RAN group in terms of the healing rates and the relief rates of chief symptom for GERD of gradeⅠ-Ⅲ. While there was no significant difference in the incidence of adverse events between the two groups [GradeⅠ,RR=1.17,95%CI (0.80,1.70),P=0.43;GradeⅡorⅢ, RR=0.76,95%CI (0.43,1.36);P=0.36]. Conclusion Current evidence indicates that,pantoprazole is more effective than ranitidine for GERD of grade Ⅰ-Ⅲ,but both treatments are safe and well tolerated.
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Objective To investigate the clinical efifcacy of biifco combined with triple therapy for eradication of Helicobacter pylori. Methods 84 cases with Helicobacter pylori infection were selected as the observation objects, and were randomly divided into treatment group and control group, 42 cases in each group. Control group used standard triple (omeprazole, amoxicillin, clarithromycin) oral;treatment group took biifco on the basis of control group use. Hp eradication rate, gastrointestinal symptoms and the incidence of adverse reaction in two groups after treatment were compared. Results Hp eradication rate in treatment group was 92.9%, higher than 75.0%in control group, the difference was statistically signiifcant(P<0.05);the incidence of adverse reaction in treatment group was 2.4%, signiifcantly lower than 10.0%in control group, the difference was statistically signiifcant (P<0.05);the total symptom relief rate in treatment group was 90.5%, signiifcantly higher than 75.0%in control group, the difference was statistically signiifcant(P<0.05). Conclusion The eradication rate of biifco combined with triple therapy for Helicobacter pylori is high and signiifcant, which can effectively reduce adverse gastrointestinal reactions.
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In recent years,targeted drug delivery system as one of the hottest areas in pharmaceutical research has received more and more attention.However,the targeted anti-tumor drug delivery system has many shortcomings including low targeted efficiency which limit its clinical application.Elevating tumor targeting efficiency has become the bottleneck of nano-drug development and clinical application.Therefore,it is urgent to design and develop novel targeted drug delivery vehicle.Recent studies showed that mesenchymal stem cells (MSCs) have characters of tumor tropism and migration,which make them as ideal targeted anti-tumor drug delivery carriers for the treatment of solid and metastatic tumors.This paper reviews the progress in using MSCs as targeted anti-tumor drug delivery carrier,recapitulates the problems and challenges of the system,and proposes a solution for these problems.
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Objective To investigate the predictive factors of long-term outcome of cerebral venous sinus thrombosis (CVST).Methods The clinical data of 26 patients with CVST were analyzed retrospectively.The clinical outcome was assessed with the modified Rankin Scale (mRS) at 6 months after symptom onset.Univariate and multivariate analysis were used to determine the independent predictors of the long-term poor outcome.Results The mRS scores for 26 patients with CVST:0 to 1 in 19 cases,2 in 2 cases,3 to 5 in 3 cases,and 6 in 2 cases.19.2％ of patients had poor outcome (mRS score,≥3),and the mortality rate was 7.7％.The survivors did not have any recurrence within 6 months.Univariate analysis showed that disturbance of consciousness,papilloedema,cerebral edema,and cerebral deep venous thrombosis were the possible risk factors for poor outcome,while headache was the main clinical manifestation,which was negatively correlated with the poor prognosis.Multivariate regression analysis showed that disturbance of consciousness was an independent predictor of poor outcome in patients with CVST (odds ratio,48.0,95％ confidence interval 2.311 to 997.176,P =0.012).Conclusions The long-term outcome of the patients was better,disturbance of consciousness was an independent predictor of poor outcome at 6 months after the onset.
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Objective To investigate the appearance and characteristics of hepatic tuberculosis lesions on low mechanical index contrast-enhanced ultrasound. Methods Eight patients with hepatic tuberculosis lesions were studied with conventional ultrasound and contrast-enhanced ultrasound. Lesions,distribution.size,echogenieity,blood flow,enhancement phase,enhancement patterns and intensity were studied. ResuIts Fifteen lesions were found in eight patients. On conventional ultrasound,mean size of the lesions was(21.7±10.7)mm×(30.3±22.4)mm,and 66.7%(10/15)lesions located under liver capdule,and 33.3%(5/15)were in hepatic parenchyma.All lesions were hypoechoic except the largest one (50 mm x 102 mm)which demonstrated heterogeneous.Doppler signals were not demonstrated in all 15 lesions.After administration of SonoVue,satisfied image data were obtained in 13 lesions for aterial phase,and 15 lesions for portal venous phase and parenchyma phase.84.6%(11/13)of the lesions demonstrated hyperenhancing on aterial phase,mean enhancing start time was(8.6±1.6)s,ranging from 5 s to 10 s.and mean enhancing end time was(25.6±2.8)s,ranging from 20 s to 29 s. Of 13 lesions,6 lesions demonstrated circle periphery hyper-enchanCement,5 lesions demonstrated whole hyper-enchancement,and 2 lesions appeared hypoenhancement on arterial phase. All lesions demonstrated either hypoenhancing or non-enhancement on portal venous phase and parenchyma phase. Conclusions Low mechanical index contrast-enhanced ultrasound can reveal the blood flow status of hepatic tuberculous lesions and will facilitate the diagnosis of hepatic tuberculosis.
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<p><b>OBJECTIVE</b>To study the gene mutation and streptomycin, isoniazid or rifampicin resistance of Mycobacterium isolated from silico-tuberculosis patient's sputum so as to find a more effective therapy for this disease.</p><p><b>METHODS</b>Mycobacteria tuberculosis were separated from 96 coal worker with silico-tuberculosis firstly. Then rpsL, KatG and rpoB fragments of genome were copied with PCR and compared their SSCP profiles with standard strains.</p><p><b>RESULTS</b>67 strains of streptomycin, isoniazid or rifampicin resistant Mycobacteria tuberculosis were found in routine drug resistance test, with the percentages of 80.5% (54/67), 58.2% (39/67) respectively. PCR-SSCP showed that out of 67 drug-resistant strains, 66(98.5%) of rpsL, 47(70.1%) of rpoB and 42(62.7%) of KatG appeared abnormal.</p><p><b>CONCLUSION</b>Most of the resistant strains appeared gene mutation. The mution rates were higher than the results from routine drug resistance test.</p>
Subject(s)
Humans , Coal , Drug Resistance, Bacterial , Mutation , Mycobacterium tuberculosis , Genetics , Polymerase Chain Reaction , Polymorphism, Single-Stranded Conformational , Silicotuberculosis , Microbiology , Sputum , MicrobiologyABSTRACT
With the development of technology,automatic management system Controlled by co mputer is necessary in hospitals Building a bank of mycobacterium and their gen ome is a great step to this aim It can make it easier to get the mycobacterium data than before,furthermore,it is helpful for further research for doctors to m ake a new treatment plan for the patients
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The authors observed the development of the organ of Corti in the temporal bones of 64 human fetuses of various fetal ages by means of comparing celloid sections with surface preparations. The organ of Corti just begins to appear in the second month. Most rapid development occurs in the period from the third to the fifth month. Afterwards, the principal structure of the organ of Corti tends to be stable with no further major changes, except for the differentiation and maturation of the intracellular components. In the fifth month, the major part of the higher columnar epithelial cells on the inner Side of the tunnel begins to degenerate and disintegrate before the formation of the inner spiral sulcus. But a few epithelial cells turn into large wandering cells. The authors discussed the characteristics, function and possible transformation of the wandering cells and compared them with essentially similar cells that appear in the developing central nervous system.