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1.
Article in English | WPRIM | ID: wpr-888695

ABSTRACT

Pure red cell aplasia (PRCA) is a well-recognized complication of ABO major mismatched allogeneic hematopoietic stem cell transplantation (allo-HSCT), with a reported incidence of 10%-20% (Zhidong et al., 2012; Busca et al., 2018). It is clinically characterized by anemia, reticulocytopenia, and the absence of erythroblasts in a normal-appearing bone marrow biopsy (Shahan and Hildebrandt, 2015). The mechanism for PRCA has been presumed to be persistence of recipient isoagglutinins, produced by residual host B lymphocytes or plasma cells, which can interfere with the engraftment of donor erythroid cells (Zhidong et al., 2012). Several risk factors of PRCA at presentation are known, such as presence of anti-A isoagglutinins before transplantation, reduced intensity conditioning, absence of acute graft-versus-host disease (GVHD), sibling donors, and cyclosporin A (CsA) as GVHD prophylaxis (Hirokawa et al., 2013). PRCA is not considered to be a barrier to HSCT, as some patients can recover spontaneously or benefit from various approaches including high-dose steroids, erythropoietin (EPO), plasma exchange, immunoadsorption, donor lymphocyte infusion (DLI), treatment with rituximab, bortezomib, or daratumumab, and tapering or discontinuation of immunosuppression (Hirokawa et al., 2013; Bathini et al., 2019). However, there are still some patients who fail to respond even to aggressive treatment; they become red cell transfusion-dependent and iron-overloaded, and their life quality is impaired.

2.
Chinese Critical Care Medicine ; (12): 990-993, 2021.
Article in Chinese | WPRIM | ID: wpr-909440

ABSTRACT

Objective:To investigate the value of plasma syndecan-1 (SDC-1) combined with lung ultrasonography in evaluating the degree of extravascular lung water in patients with acute respiratory distress syndrome (ARDS).Methods:From July 2018 to July 2019, 50 patients with ARDS admitted to the department of intensive care unit of Wuxi People's Hospital Affiliated to Nanjing Medical University were enrolled. After admission, pulse indicator continuous cardiac output (PiCCO) catheter was established for all patients. PiCCO indexes, including extravascular lung water index (EVLWI) and pulmonary vascular permeability index (PVPI) were monitored by one doctor. Another doctor performed lung ultrasound examination, and calculated the sum of the number of B-lines under 10 ultrasound sections of upper blue point, lower blue point, diaphragm point, Plaps point and rear blue point of both lungs. Then the level of plasma SDC-1 was detected by enzyme linked immunosorbent assay (ELISA). Pearson correlation method was used to analyze the correlation between the number of ultrasonic B-lines, plasma SDC-1 level and EVLWI and PVPI. Taking 10 mL/kg EVLWI as the boundary value, the degree of pulmonary edema in patients with ARDS was divided into mild pulmonary edema and severe pulmonary edema. The receiver operator characteristic curve (ROC curve) was drawn, and the number of B-lines, SDC-1 and the predictive value of the combination of the above two indicators on the severity of pulmonary edema in patients with ARDS were analyzed.Results:The cardiac index (CI) and central venous pressure (CVP) of 50 patients with ARDS were (46.84±6.00) mL·s -1·m -2 and (8.12±1.80) mmHg (1 mmHg = 0.133 kPa), cardiogenic pulmonary edema was excluded. In 50 patients with ARDS, EVLWI was (10.82±2.92) mL/kg, PVPI was 3.02±0.69, the number of ultrasound B-lines was 40.90±13.05, and plasma SDC-1 was (568.25±118.14) μg/L. Pearson correlation analysis showed that the number of ultrasound B-lines in patients with ARDS was significantly positively correlated with EVLWI and PVPI ( r1 = 0.802, r2 = 0.799, both P < 0.01). Plasma SDC-1 was also positively correlated with EVLWI and PVPI ( r1 = 0.732, r2 = 0.576, both P < 0.01). ROC curve analysis showed that the number of B-lines and SDC-1 had good predictive value for the severity of pulmonary edema in patients with ARDS. The area under ROC curve (AUC) and 95% confidence interval (95% CI) were 0.891 (0.803-0.979) and 0.875 (0.772-0.978), respectively. When the cut-off of B-lines was 40.50, the sensitivity and specificity were 82.1% and 86.4%, respectively. When the cut-off of SDC-1 was 559.37 μg/L, the sensitivity and specificity were 85.7% and 81.8%, respectively. Combining the number of B-lines with SDC-1 could further improve the predictive value of pulmonary water in patients with ARDS. The AUC (95% CI) was 0.958 (0.890-1.000), and the sensitivity and specificity were 92.9% and 91.8%, respectively. Conclusions:The level of plasma SDC-1 and the number of pulmonary ultrasonic B-lines have a good correlation with the degree of extravascular lung water in patients with ARDS. The combined application of the two noninvasive indexes can be used to evaluate the degree of extravascular lung water in patients with ARDS.

3.
Article in Chinese | WPRIM | ID: wpr-906515

ABSTRACT

Objective:To observe the effect of modified Shengjiangsan on renal fibrosis in rats with membranous nephropathy (MN) and to explore the mechanism of its complications of renal fibrosis. Method:Rats were injected with cationized bovine serum albumin(C-BSA)in the tail vein to establish a rat model of membranous nephropathy. The normal group,model group,modified Shengjiangsan group (27.3 g·kg<sup>-1</sup>)and benazepril group(10 mg·kg<sup>-1</sup>)were established in this study. Each group was given corresponding dosage of the drug once a day for 4 weeks of continuous intervention. After the administration,we observed the pathological changes of rat kidneys by the technology of Masson staining, silverhexylamine iodate (PASM) staining, transmission electron microscopy (TEM), immunofluorescence technology (IF) was used to detect immunoglobulin(Ig)G deposition in rat kidneys. The levels of interleukin-1<italic>β</italic> (IL-1<italic>β</italic>), interleukin-6 (IL-6), tumor necrosis factor-<italic>α</italic> (TNF-<italic>α</italic>) in rat serum were detected by enzyme-linked immunosorbent assay (ELISA) method. Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) and immunohistochemistry (IHC) were used to detect the mRNA and protein expression levels of monocyte chemotactic protein 1 (MCP-1), intercellular adhesion molecule 1 (ICAM-1), nuclear factor kappa B (NF-<italic>κ</italic>B), Toll-like receptor 4 (TLR4), plasminogen activator inhibitor 1 (PAI-1), transforming growth factor-<italic>β</italic><sub>1</sub> (TGF-<italic>β</italic><sub>1</sub>), <italic>α</italic>-smooth muscle actin (<italic>α</italic>-SMΑ) and type Ⅳ Collagen (Collagen Ⅳ) in rat kidney tissues. Result:Compared with normal group, the kidney tissue of the model group was obviously fibrotic, the serum levels of IL-1<italic>β</italic>, IL-6, and TNF-<italic>α</italic> were significantly increased(<italic>P</italic><0.05), and the expressions of MCP-1, ICAM-1, NF-<italic>κ</italic>B, TLR4, PAI-1, TGF-<italic>β</italic><sub>1</sub>, <italic>α</italic>-SMA and Collagen Ⅳ mRNA and protein in kidney tissue were significantly increased(<italic>P</italic><0.05). Compared with model group, modified Shengjiangsan and benazepril significantly improved renal fibrosis in rats, reduced the levels of IL-1<italic>β</italic>, IL-6, and TNF-<italic>α</italic> in the serum of MN rats(<italic>P</italic><0.05), down-regulated MCP-1, ICAM-1, NF-<italic>κ</italic>B, TLR4, PAI-1, TGF-<italic>β</italic><sub>1</sub>, <italic>α</italic>-SMA and Collagen Ⅳ mRNA and protein expression in kidney tissue(<italic>P</italic><0.05). Conclusion:Modified Shengjiangsan can reduce the release and expression of inflammatory factors by down-regulating the TLR4/NF-<italic>κ</italic>B signaling pathway, inhibit renal fibrosis, and reduce renal damage in MN rats.

4.
Article in Chinese | WPRIM | ID: wpr-906427

ABSTRACT

Objective:To observe the effect of Yiqiyangyin Huoxuetongluo prescription on janus kinase 2/signal transducer and activator of transcription 3 (JAK2/STAT3) signaling pathway and cell apoptosis in rats with diabetic nephropathy (DN), and to explore the mechanism of its intervention in DN. Method:A total of 100 SD rats were randomly divided into an experimental group (<italic>n</italic>=80) and a normal group (<italic>n</italic>=20). The DN model was induced by high-sugar and high-fat diet combined with intraperitoneal injection of streptozotocin (STZ) in the experimental group, and confirmed by the pathological changes of kidney tissues in rats (three in each group) observed under light and electron microscopes. The model rats were randomly divided into a model group (normal saline, equal volume), low-, medium-, and high-dose (5.775, 11.550, and 23.100 g·kg<sup>-1</sup>) Yiqiyangyin Huoxuetongluo prescription groups, and an irbesartan group (irbesartan tablets, 0.016 g·kg<sup>-1</sup>). After drug intervention (<italic>i.g</italic>., once a day for 16 consecutive weeks), the 24-hour urine total protein (UTP), serum total cholesterol (TC), triglyceride (TG), creatinine (SCr), and blood urea nitrogen (BUN) levels of the rats were measured. Western blot was used to detect the protein expression of JAK2/STAT3 signaling pathway. Immunohistochemistry was used to determine the protein expression of B-cell lymphoma 2 (Bcl-2), Bcl-2-associated X protein (Bax), zonula occludens-1 (ZO-1), and actinin-4 in rat kidney tissues. Result:Compared with the normal group, the model group exhibited elevated UTP, serum TC, TG, BUN, and SCr levels (<italic>P</italic><0.05), severe pathological damage of rat kidney tissues, up-regulated expression of phospho-JAK2 (p-JAK2), phospho-STAT3 (p-STAT3), and Bax, increased renal cell apoptosis, and diminished expression of Bcl-2, ZO-1, and actinin-4 (<italic>P</italic><0.05). Compared with the model group, the Yiqiyangyin Huoxuetongluo prescription group and the irbesartan group showed dwindled UTP, serum TC, TG, BUN, and SCr levels (<italic>P</italic><0.05), relieved pathological damage of rat kidney tissues, down-regulated p-JAK2, p-STAT3, and Bax expression, and up-regulated expression of Bcl-2, ZO-1, and actinin-4 (<italic>P</italic><0.05). Conclusion:Yiqiyangyin Huoxuetongluo prescription can reduce renal cell apoptosis and improve the prognosis of DN by inhibiting the activation of JAK2/STAT3 signaling pathway.

5.
Article in Chinese | WPRIM | ID: wpr-906393

ABSTRACT

Objective:To observe the effects of Yishen Tongluo prescription (YTP) on autophagy-related proteins in rats with membranous nephropathy (MN) and explore its possible molecular mechanism in protecting the kidney. Method:Twenty of 80 Sprague-Dawley (SD) rats were randomly selected as the normal control, and the rest rats were pre-immunized and injected with cationized bovine serum albumin (C-BSA) through the tail vein to induce MN. The SD rats that were successfully modeled were randomized into the model group, benazepril hydrochloride group (10 mg·kg<sup>-1</sup>), and low- (6.61g·kg<sup>-1</sup>), medium- (13.22 g·kg<sup>-1</sup>), and high-dose (26.44 g·kg<sup>-1</sup>) YTP groups, and administered with the corresponding drugs by gavage, once a day, for four consecutive weeks. Then the changes in such quantitative indicators as plasma albumin (ALB), triglyceride (TG), total cholesterol (TC), serum creatinine (SCr), blood urea nitrogen (BUN), and 24-hour urinary total protein (UTP) were detected, followed by hematoxylin and eosin (HE) staining, Masson's trichrome staining, and periodic Schiff-methenamine (PASM) staining for observing the pathological changes in kidney under the transmission electron microscope (TEM). The deposition of immunoglobulin G (IgG) and complement 3 (C3) in the glomerulus was detected by fluorescence immunoassay. The expression levels of autophagy marker proteins Beclin-1, microtubule-associated protein light chain 3Ⅱ (LC3Ⅱ), and p62 were measured by immunohistochemistry (IHC), and those of related proteins in the adenosine monophosphate-activated protein kinase / mechanisic target of rapamycin/Unc-51-like kinase 1 (AMPK/mTOR/ULK1) signaling pathway were determined by Western blot assy. Result:Compared with the normal group, the model group exhibited significantly increased UTP (<italic>P</italic><0.01) and serum TG and TC (<italic>P</italic><0.01), decreased ALB (<italic>P</italic><0.01), disordered glomerular structure, enlarged volume, thickened basement membrane, vacuolated renal tubules, excessively deposited collagen fibers and fuchsinophilic proteins, extensively fused podocyte foot processes, and diffusely deposited IgG and C3 in glomerular capillary loops. Besides, the expression levels of Beclin-1, LC3II, and phosphorylated AMPK (p-AMPK) decreased (<italic>P</italic><0.01), while those of p62, phosphorylated mTOR (p-mTOR), and phosphorylated ULK1 (p-ULK1) increased (<italic>P</italic><0.01). The comparison with the model group revealed that the TG, TC, and UTP levels in the low-, medium-, and high-dose YTP groups and the benazepril hydrochloride group were reduced to varying degrees (<italic>P</italic><0.05, <italic>P</italic><0.01), whereas the ALB level was increased (<italic>P</italic><0.01). There was no statistically significant difference in SCr or BUN level. The pathological damages were alleviated. The expression levels of Beclin-1, LC3Ⅱ, and p-AMPK were up-regulated (<italic>P</italic><0.05, <italic>P</italic><0.01), while those of p62, p-mTOR, and p-ULK1 were down-regulated (<italic>P</italic><0.05, <italic>P</italic><0.01). Conclusion:YTP protects the kidney of rats with MN possibly by regulating related proteins in the AMPK/mTOR/ULK1 signaling pathway and activating the autophagy.

6.
Article in Chinese | WPRIM | ID: wpr-906051

ABSTRACT

Objective:To investigate the intervention effect of modified Shengjiangsan on hypoxia-inducible factor-1<italic>α </italic>(HIF-1<italic>α</italic>)/nicotinamide adenine dinucleotide phosphate oxidase 4 (NOX4) signaling pathway in membranous nephropathy (MN) rats and to explore its mechanism to reduce oxidative stress and apoptosis in renal tissues. Method:Cationized bovine serum albumin (C-BSA) was injected into the tail vein of rats to replicate the MN model. Rats were randomly divided into a model group, a modified Shengjiangsan group, and a benazepril group after modeling, and administered by gavage once a day accordingly. At the end of the 4<sup>th</sup> week, the 24-h urine total protein (UTP), urea nitrogen (BUN), and serum creatinine (SCr) levels of each group were detected. Enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of superoxide dismutase (SOD), malondialdehyde (MDA), and reactive oxygen species (ROS) in renal tissues of rats. In situ end labeling(TUNEL) staining was used to detect the cell apoptosis rate. The mRNA and protein expression levels of HIF-1<italic>α</italic> and NOX4 were detected by real-time fluorescence-based quantitative polymerase chain reaction(Real-time PCR)and Western blot, respectively. The immunohistochemistry method was used to detect the protein expression levels of B-cell lymphomas -2 (Bcl-2), B-cell lymphomas xl (Bcl-xl), Bcl-2 associated X protein (Bax), Bcl-2 cell death regulator antibody (Bim). Result:Compared with the normal group, the model group showed increased UTP (<italic>P</italic><0.05), decreased SOD, elevated MDA and ROS (<italic>P</italic><0.05), up-regulated mRNA and protein expression of HIF-1<italic>α</italic> and NOX4 (<italic>P</italic><0.05), enhanced protein expression of Bax and Bim, declining protein expression of Bcl-xl and Bcl-2 (<italic>P</italic><0.05), and increased cell apoptosis in renal tissues. Compared with the model group, the modified Shengjiangsan group and the benazepril group displayed declining UTP (<italic>P</italic><0.05), up-regulated SOD, decreased MDA and ROS (<italic>P</italic><0.05), down-regulated mRNA and protein expression of HIF-1<italic>α</italic> and NOX4 (<italic>P</italic><0.05), diminished protein expression of Bax and Bim, elevated protein expression of Bcl-xl and Bcl-2 (<italic>P</italic><0.05), and reduced cell apoptosis in renal tissues (<italic>P</italic><0.05). Conclusion:The protective effect of modified Shengjiangsan on the kidney is presumedly achieved by reducing the oxidative stress and apoptosis in renal tissues of MN rats via inhibiting the HIF-1<italic>α</italic>/NOX4 signaling pathway.

7.
Article in Chinese | WPRIM | ID: wpr-905852

ABSTRACT

Intestinal Peyer's patches (PPs) are local immune tissues of the intestine, which are considered to be the main induction site of the intestinal mucosal immune response, and closely related to immune-related refractory enteropathies, such as ulcerative colitis and Crohn's disease. In recent years, more and more scholars have tried to find a new breakthrough for treating refractory enteropathies with a limited efficacy of clinical interventions through in-depth study of the relationship between PPs and enteropathy. Traditional Chinese medicine (TCM) polysaccharides are considered to be a key component for immune regulation with TCM. Modern studies show that TCM polysaccharides have a significant positive intervention effect on the structure and function of PPs, with good development prospects. Based on this, this paper focuses on PPs and intestinal-related diseases, and systematically introduces the physiological structure of PPs and their drug delivery mechanism, and summarizes the interactions of PPs with effect on immune-related enteropathies, analyze of current studies and prospects of effect of TCM polysaccharides in intervening intestinal disease and its dysfunction by regulating PPs, with the aim to provide new strategies for basic studies and clinical treatment of immune-related refractory enteropathies from the perspective of PPs, and new ideas for basic studies and clinical studies on effect of TCM polysaccharides in intervening enteropathies.

8.
Article in Chinese | WPRIM | ID: wpr-905829

ABSTRACT

Objective:The purpose of this article was to observe the effect of modified Shengjiangsan on podocyte apoptosis in membranous nephropathy (MN) rats, to explore the molecular mechanism of its treatment of MN and to provide experimental basis for its clinical application. Method:The MN rat model was established by injection of cationic bovine serum albumin into the tail vein of rats. The successfully modeled rats were then randomly divided into model group (equal volume of normal saline), modified Shengjiangsan group (27.3 g·kg<sup>-1</sup>) and benazepril group (10 mg·kg<sup>-1</sup>), with corresponding drug dosage once a day for 4 weeks of continuous intervention. After drug administration, the 24-hour urine protein (UTP) was detected. Real time fluorescent quantitative polymerase chain reaction (Real-time PCR) and immunohistochemical (IHC) methods were used to detect Podocalyxin, Nephrin, Podocin, Synaptopodin mRNA and protein expression levels in rat kidney tissue. terninal-deoxynucleoitidyl transferase medsated nick and labeling (TUNEL) method was used to detect cell apoptosis rate in rat kidney tissue, and Western blot was used to detect Notch1, Hes1, B lymphoblastoma-2 (Bcl-2) associated X protein (Bax), and Bcl-2 protein expression levels in rat kidney tissue. Result:Compared with the normal group, UTP in the model group increased significantly, renal tissue cell apoptosis increased significantly, podocyte marker proteins podocalyxin, Nephrin, Podocin, Synaptopodin mRNA and protein expression levels decreased significantly, and Notch1, Hes1, Bax protein expression increased significantly, and Bcl-2 protein expression was significantly reduced(<italic>P</italic><0.05). Compared with the model group, UTP levels in MN rats were significantly reduced in modified Shengjiangsan and benazepril groups, with reduced rate of renal cell apoptosis, increased mRNA and protein expression levels of podocalyxin, Nephrin, Podocin, and Synaptopodin in renal tissue, decreased Notch1, Hes1, Bax protein expression, and increased Bcl-2 protein expression(<italic>P</italic><0.05). Conclusion:Modified Shengjiangsan can inhibit the Notch signaling pathway, reduce the apoptosis of rat kidney tissue podocytes, and reduce the kidney injury of MN rats.

9.
Chinese Acupuncture & Moxibustion ; (12): 1216-1220, 2021.
Article in Chinese | WPRIM | ID: wpr-921035

ABSTRACT

OBJECTIVE@#To compare the effect of moxibustion combined with basic treatment and simple basic treatment on the clinical symptoms, renal function and hypercoagulable state in patients with idiopathic membranous nephropathy (IMN) of low to medium risk with spleen-kidney deficiency and blood stasis.@*METHODS@#A total of 60 patients with IMN of low to medium risk with spleen-kidney deficiency and blood stasis were randomized into an observation group (30 cases, 2 cases dropped off) and a control group (30 cases, 1 case dropped off). In the control group, the conventional basic treatment of anti-hypertension, regulating blood lipid and anti-coagulation was adopted. On the basis of the control group, moxibustion was applied at Shenshu (BL 23), Pishu (BL 20), Guanyuan (CV 4), Zusanli (ST 36) and Sanyinjiao (SP 6) in the observation group, once a day, 5 days a week continuously with 2 day interval. The treatment of 6 months was required in the both groups. Before treatment and 3 and 6 months into treatment, the total TCM syndrome score, the renal function indexes (24-hour urinary protein quantity [UTP], albumin [ALB], urea nitrogen [BUN] and creatinine [Scr]), the blood coagulation indexes (fibrinogen [FIB], D-Dimer [D-D], p-selection and von Willebrand factor [vWF]), total cholesterol (TC) and triacylglycerol (TG) levels were observed, and the therapeutic efficacy was evaluated on 3 and 6 months into treatment in the two groups.@*RESULTS@#The effective rates of 3 and 6 months into treatment were 78.6% (22/28) and 89.3% (25/28) in the observation group, which were higher than 62.1% (18/29) and 75.9% (22/29) in the control group respectively (@*CONCLUSION@#Moxibustion combined with basic treatment can effectively improve the clinical symptoms, renal function and renal microcirculation in patients with idiopathic membranous nephropathy of low to medium risk with spleen-kidney deficiency and blood stasis, the therapeutic effect is superior to the simple basic treatment.


Subject(s)
Acupuncture Points , Acupuncture Therapy , Glomerulonephritis, Membranous , Humans , Kidney/physiology , Moxibustion , Spleen
10.
Article in Chinese | WPRIM | ID: wpr-912787

ABSTRACT

Objective:To understand the changes in the practice environment from the perspective of doctors in 136 tertiary public hospitals, and to provide evidence for formulating strategies and measures to improve the practice environment of doctors.Methods:The data was collected from five rounds of China Healthcare Improvement Evaluation Survey from December 2015 to March 2021. The sample size was 17 945, 19 774, 20 786, 23 289, and 22 836, with a total of 104 630. The self-designed questionnaire on four dimensions of doctor-patient relationship, workload, administrative logistics support and professional identity was performed.Results:From the 1st to the 5th survey, the approval ratio of " the administrative and logistics department of this hospital is highly efficient" showed the characteristics of " U-shaped distribution" , and the approval ratio of " approve or encourage children to continue to engage in medical work" increased from 13.38% to 23.91%.From the 2nd to the 5th survey, the percentage of doctors who experienced doctor-patient disputes dropped from 28.96% to 23.20%, and the percentage of doctors agreeing that the relationship between doctors and patients in this hospital was improving continued to increase from 33.20% to 60.45%.From the 3rd to the 5th survey, the proportion of doctors experiencing medical troubles dropped from 15.10% to 14.19%, and the recognition rate of " the cafeteria of this hospital provided medical staff with nutritious and delicious meals" increased from 36.25% to 47.52%, and the approval proportion of " my current work load is heavy" dropped from 61.55% to 45.24%. The results of the 5th survey showed that there were significant differences in the approval ratios of each dimension in different genders, job titles and hospital types( P<0.001). Conclusions:From the perspective of doctor-patient relationship, workload, administrative logistics support, and professional identity, the improvement of doctors′ practice environment is still insufficient. Hospital administrators should continue to focus on the improvement of the doctor-patient relationship, and take necessary measures to reduce doctors′ workload and improve doctors′ professional identity.

11.
Chinese Journal of Dermatology ; (12): 702-704, 2021.
Article in Chinese | WPRIM | ID: wpr-911509

ABSTRACT

Objective:To establish an in vivo diffusion model of Treponema pallidum (Tp) in New Zealand rabbits. Methods:A standard strain of Tp (Nichols strain) was recovered in the testes of New Zealand rabbits, and isolated and passaged continuously. The suspensions of the second-passage Tp were collected and inoculated onto the dorsal skin of New Zealand rabbits. After 21-day infection, the New Zealand rabbits were anesthetized and sacrificed, blood samples were collected, and skin tissues at the infection site as well as liver, spleen, testes and lymph nodes were aseptically resected. Real-time fluorescence-based quantitative PCR was performed to detect the spread of Tp in different tissues and organs.Results:On day 21 after infection with Tp, skin lesions such as indurations and ulcers were seen at all inoculated sites of New Zealand rabbits. Pathological examination showed a lot of inflammatory cells in the infected lesions, mainly including plasma cells, macrophages and lymphocytes. Real-time fluorescence-based quantitative PCR revealed a large number of Tp in tissues and organs, such as liver, spleen and testes.Conclusion:After inoculation with Tp in the dorsal skin of New Zealand rabbits, Tp could spread to the liver, spleen, testes and other tissues and organs through blood and lymph nodes, and the in vivo diffusion model of Tp strains in New Zealand rabbits was successfully constructed.

12.
Article in Chinese | WPRIM | ID: wpr-911241

ABSTRACT

Objective:To evaluate the superior effect of thoracic epidural block (TEB) used for analgesia in patients with severe acute pancreatitis (SAP).Methods:Fifty patients of both sexes, aged 18-64 yr, with SAP, with Japanese severity score (JSS) ≥3, onset time of SAP≤12 h, were divided into conventional analgesia group (group C) and TEB group.Sufentanil was intravenously infused for analgesia in group C. TEB was performed for analgesia in group TEB.In group C, sufentanil was intravenously infused at a rate of 0.2-0.3 μg·kg -1·h -1 after admission to hospital.In group TEB, an epidural catheter was placed at T 9, 10 interspace, and 0.66% lidocaine mixed with 0.33% ropivacaine was epidurally infused at a rate of 3-5 ml/h for 120 h after admission to hospital.Visual analog scale (VAS) score and intra-abdominal pressure (IAP) were recorded at 1, 24, 48, 72 and 120 h of analgesia.HR, respiratory rate (RR), oxygenation index, computed tomography severity index (CTSI), JSS and Ranson scores were recorded at 24, 72 and 120 h of analgesia, and the de-criticalization within 72 h following analgesia was evaluated. Results:Compared with group C, VAS score and IAP were significantly deceased at each time point ( P<0.05), the rate of de-criticalization (60%/90%) was increased ( P<0.05), and Ranson score, CTSI score and JSS score were decreased at 120 h of analgesia in group TEB ( P<0.05). Conclusion:TEB can not only produce good analgesic effect, but also improve the development of the disease, which has superior effect compared with routine analgesia when used for the treatment of SAP.

13.
Article in Chinese | WPRIM | ID: wpr-886645

ABSTRACT

Objective:To determine the awareness and knowledge of exposure to rabies of outpatients, and then provide strategies to reduce the occurrence of rabies in Huangpu district, Shanghai. Methods:A total of 293 patients attending the clinic due to exposure to rabies were selected to complete the questionnaire survey, including demographics, characteristics of exposure, and knowledge and awareness of rabies, using an application scanning. Results:The outpatients in this study were more likely to be women and aged 20-40 years. The exposed sites were mainly upper limbs, and injuries mainly caused by their own pets during playing. The knowledge of rabies, its harm and route of infection, as well as the time of vaccination against rabies and notes after vaccination have been well-documented. However, awareness of clinical manifestation of rabies and treatment after re-injury was lowest. There were significant difference in the clinical manifestation and incubation period of rabies across diverse occupations. There are multiple factors that affected the knowledge and awareness of exposure to rabies, in which the knowledge of rabies was strongly associated with the knowledge of treatment. The primary source of exposure was media, including the Internet, television and radio, WeChat and medical staff. Conclusion:The cognition of outpatients on exposure to rabies remains low. We should optimize the educational methods and implement various health education and promotion activities for rabies control and prevention to improve the knowledge and awareness of exposure to rabies.

14.
Article in Chinese | WPRIM | ID: wpr-885915

ABSTRACT

Objective:To investigate the multilocus sequence typing feature of the virulence-associated genes of Staphylococcus aureus(S. aureus) separated from the clinical specimens of a multi-center cohort children in Guangzhou area. Methods:A total number of 412 Staphylococcus aureus strains isolated from 2 059 non-repeated fecal specimens of children by three groups′ researchers in Guangzhou Women and Children′s Medical Center from August 2018 to November 2018. While collecting specimens, patient clinical information is also properly collected and preserved. After extracting the DNA of the strain, the virulence-associated genes were detected by polymerase chain reaction (PCR), including the staphylococcal enterotoxin (SE) genes ( sea, seb, sec, sed, see) and the Panton-Valentine leucocidin-encoding gene ( pvl).The multi-locus sequence typing (MLST) method was performed to reveal the MLST feature of these genes and the statistical difference were examined by the the χ 2 test. Results:Among the 412 isolates of S. aureus, 256 strains (256/412, 62.1%) contains at least one SE gene. Among the enterotoxin gens, the sec (125/412, 30.3%), seb(98/412, 23.8%)and sea (66/412, 16.0%)genes were the three most prevalent members of SEs. The frequency of pvl gene in Staphylococcus aureus was 18.7%(77/412).Among them, the frequency of Staphylococcus aureus sea gene isolated from patients with gastroenteritis (58/319, 18.2%) was significantly higher than that from the non-gastroenteritis group (8/93, 8.6%)(χ2=4.912, P=0.027). The frequency of Staphylococcus aureus pvl gene isolated from the patients with pneumonia (8/21, 38.1%) was greater than that from the non-pneumonia group (6/47, 12.8%)(χ2=4.252, P=0.039). In addition, the virulence-associated gene of S. aureus was closely related to the specific ST type, 82.4% (28/34) of ST6 carried sea gene, all ST338 and ST59 carried seb gene, 96% (48/50) ST45 carried sec gene, and the pvl gene carrying rate of ST338 was 5/5. Conclusions:The SEA toxin produced by ST6 Staphylococcus aureus may be closely related to the diagnosis of gastroenteritis in children. The frequency of pvl virulence gene in Staphylococcus aureus in children with community-acquired pneumonia was higher than that in the non-pneumonia group, and closely related to the CC59.

15.
Chinese Journal of Radiology ; (12): 282-287, 2021.
Article in Chinese | WPRIM | ID: wpr-884424

ABSTRACT

Objective:To investigate the value of ADC derived from DWI combined with texture analysis derived from T 2WI fat suppressed images in distinguishing benign and malignant soft tissue tumors. Methods:The MRI and DWI images of 94 patients with soft tissue tumors (44 cases with malignant and 50 cases with benign) confirmed by pathology were analyzed retrospectively in the First Affiliated Hospital of USTC West District. ADC values of solid components were measured at GE ADW4.6 workstation. The texture features were extracted by manually drawing the ROI on the maximum level of the T 2WI fat suppressed images; the ADC values and texture parameters between the two groups were statistically analyzed by SPSS17.0, and the multivariate logistic regression model were conducted to analyze and calculate the diagnostic performance. Results:ADC value of benign and malignant soft tissue tumors was (1.6±0.3)×10 -3 mm 2/s, (1.2±0.5)×10 -3 mm 2/s, respectively, and the difference was statistically significant( t=-5.382, P<0.05). Taking 1.28×10 -3 mm 2/s as the critical value, the area under curve (AUC) for the diagnosis of benign and malignant soft tissue tumors was 0.783, the sensitivity was 92.00%, and the specificity was 65.91%. Among the texture features, the AUC of frequency size, skewness, Inertia All Direction_offset7, Inverse Difference Moment angle0_offset1, Inverse Difference Moment angle0_offset7 and Haralick Correlation All Direction_offset4_SD distinguishing benign and malignant soft tissue tumors were 0.825, 0.739, 0.826, 0.816, 0.820 and 0.783, respectively. The AUC, sensitivity and specificity of the best predictive model distinguishing benign and malignant soft tissue tumors were 0.930, 88.00% and 86.36% respectively using multivariate logistic regression analysis. Conclusion:ADC combined with texture analysis is of great value in preoperative differentiation of benign and malignant soft tissue tumors.

16.
Article in Chinese | WPRIM | ID: wpr-883350

ABSTRACT

Objective:To investigate the effect of microRNA-146a (miR-146a) on apoptosis of human retinal microvascular endothelial cells (HRMECs) induced by high glucose and its possible molecular mechanism.Methods:HRMECs were cultured in vitro with 5.5 mmol/L D-glucose in the normal control group and 25 mmol/L D-glucose in the high glucose group for 48 hours, respectively.Normally cultured HRMECs were transfected by miR-146a mimics in the high glucose+ miR-146a mimics group or corresponding mimics control in the high glucose+ mimics control group by lipofection and cultured with 25 mmol/L D-glucose for 48 hours, respectively.Real-time fluorescent quantitative polymerase chain reaction (PCR) was performed to detect the expression level of miR-146a.MTT assay and flow cytometry were used to detect the activity and apoptosis of HRMECs, and Western blot was employed to detect the expression levels of apoptosis-associated protein B-cell lymphoma factor-2 (Bcl-2), Bcl-2 related X protein (Bax) and nuclear factor-κB (NF-κB) signaling-related proteins NF-κB p65 and p-NF-κB p65. Results:The relative expression levels of miR-146a were 1.00±0.10, 0.22±0.02, 0.21±0.02 and 0.88±0.09, and the cell viability was (100.00±10.06)%, (68.41±6.67)%, (67.91±6.74)% and (90.46±8.97)%, and the apoptosis rates were (3.11±1.02)%, (27.28±3.56)%, (27.44±4.03)% and (7.29±2.11)% in the normal control group, high glucose group, high glucose+ mimics control group and high glucose+ miR-146a mimics group, respectively.The relative expression levels of miR-146a and the cell viability were significantly lower, and the cell apoptosis rate was significantly higher in the high glucose group than those in the normal control group, with statistical significant differences (all at P<0.05). The relative expression levels of miR-146a and the cell viability were significantly higher, and the cell apoptosis rate was significantly lower in the high glucose+ miR-146a mimics group than those in the high glucose group and the high glucose+ mimics control group, and the differences were statistically significant (all at P<0.05). The relative expression levels of Bax and p-NF-κB p65 protein were significantly higher, the relative expression level of Bcl-2 protein was significantly lower in the high glucose group than those in the normal control group, showing statistically significant differences (all at P<0.05). The relative expression levels of Bax and p-NF-κB p65 protein were significantly lower, and the relative expression level of Bcl-2 protein was significantly higher in the high glucose+ miR-146a mimics group than those in the high glucose group and the high glucose+ mimics control group, and the differences were statistically significant (all at P>0.05). There was no significant difference in the relative expression of NF-κB p65 protein among the groups ( F=0.106, P=0.955). Conclusions:Overexpression of miR-146a may inhibit the apoptosis of HRMECs induced by high glucose, and its mechanism may be related to the inhibition of NF-κB signaling pathway activation.

17.
Article in Chinese | WPRIM | ID: wpr-882512

ABSTRACT

Objective:To explore the impact of the number of pathological lymph node metastasis areas on the prognosis of patients with thoracic esophageal squamous cell carcinoma (ESCC) after radical surgery.Methods:The clinicopathologic data of 153 patients with ESCC treated by radical surgery at the Department of Thoracic Surgery of the Affiliated Taixing People′s Hospital of Yangzhou University from January 2012 to December 2014 were retrospectively analyzed. Among these patients, 76 had no adjuvant therapy, and 77 received adjuvant radiotherapy or chemoradiotherapy after surgery. According to the lymph node classification criteria of American Thoracic Association and the number of pathological lymph node metastasis areas, the patients were divided into non-regional lymph node metastasis group ( n=68), oligo-regional lymph node metastasis group (1-2 regional lymph node metastasis, n=54) and multi-regional lymph node metastasis group (≥3 regional lymph node metastasis, n=31). Kaplan-Meier method was used to calculate survival rate and survival comparison was performed by log-rank test. The Cox proportional hazards model was used to analyze prognostic factors, receiver operating characteristic (ROC) curve was used to analyze the predictive value of the number of lymph node metastasis areas. Results:The median overall survival (OS) was 37.0 months for the 153 patients, and the 1-, 3- and 5-year OS rates were 97.4%, 51.0% and 30.7% respectively. In the non-regional lymph node metastasis group, the median OS was 46.0 months, and the 1-, 3- and 5-year OS rates were 97.1%, 58.8% and 39.7% separately. In the oligo-regional lymph node metastasis group, the median OS was 39.0 months, and the 1-, 3- and 5-year OS rates were 94.4%, 55.6% and 35.2% respectively. In the multi-regional lymph node metastasis group, the median OS was 26.0 months, and the 1-, 3- and 5-year OS rates were 98.1%, 25.8% and 3.2% separately. There was a statistically significant difference among the three groups ( χ2=18.257, P<0.001). Among the 76 patients without adjuvant treatment, the 1-, 3- and 5-year OS rates were 94.7%, 50.0% and 34.2% in patients with non-regional lymph node metastasis, 90.9%, 36.4% and 9.1% in patients with oligo-regional lymph node metastasis, 97.4%, 18.8% and 0 in patients with multi-regional lymph node metastasis, and there was a statistically significant difference ( χ2=8.201, P=0.017). Among the 77 patients with adjuvant therapy, the 1-, 3- and 5-year OS rates were 97.7%, 66.7% and 46.7% in patients with non-regional lymph node metastasis, 96.9%, 68.8% and 53.1% in patients with oligo-regional lymph node metastasis, 93.3%, 26.7% and 6.7% in patients with multi-regional lymph node metastasis, and there was a statistically significant difference ( χ2=18.083, P<0.001). Univariate analysis showed that age ( HR=1.534, 95% CI: 1.041-2.260, P=0.030), T stage ( HR=1.757, 95% CI: 1.197-2.579, P=0.004), N stage ( HR=1.548, 95% CI: 1.043-2.297, P=0.030), TNM stage ( HR=1.392, 95% CI: 1.114-2.459, P=0.015), adjuvant therapy ( HR=0.545, 95% CI: 0.370-0.803, P=0.002) and number of lymph node metastasis areas (multi-regional lymph node metastasis versus non-regional lymph node metastasis: HR=0.385, 95% CI: 0.238-0.624, P<0.001; multi-regional lymph node metastasis versus oligo-regional lymph node metastasis: HR=0.442, 95% CI: 0.269-0.726, P=0.001) were closely related to OS in patients with ESCC after operation. Multivariate analysis showed that T stage ( HR=1.699, 95% CI: 1.143-2.525, P=0.009), adjuvant therapy ( HR=0.577, 95% CI: 0.386-0.864, P=0.008) and number of lymph node metastasis areas (multi-regional lymph node metastasis versus non-regional lymph node metastasis: HR=0.553, 95% CI: 0.411-0.996, P=0.011; multi-regional lymph node metastasis versus oligo-regional lymph node metastasis: HR=0.550, 95% CI: 0.328-0.924, P=0.024) were independent prognostic factors for OS. The number of lymph node metastasis areas (AUC=0.648, 95% CI: 0.560-0.735, P=0.004) was better than the number of lymph node metastasis (AUC=0.595, 95% CI: 0.497-0.694, P=0.061) in predicting OS of patients with ESCC after radical surgery. Conclusion:The number of postoperative pathological lymph node metastasis areas in thoracic ESCC has important value in predicting survival prognosis, and adjuvant therapy can significantly improve the OS of patients with oligo-regional lymph node metastasis.

18.
Acta Pharmaceutica Sinica B ; (6): 394-405, 2021.
Article in English | WPRIM | ID: wpr-881143

ABSTRACT

Recent studies have shown that programmed cell death 4 (PDCD4) modulates distinct signal transduction pathways in different pathological conditions. Despite acute and chronic immune responses elicited by ischemia contributing to the functional deterioration of the kidney, the contributions and mechanisms of PDCD4 in acute kidney injury (AKI) have remained unclear. Using two murine AKI models including renal ischemia/reperfusion injury (IRI) and cisplatin-induced AKI, we found that PDCD4 deficiency markedly ameliorated renal dysfunction and inflammatory responses in AKI mice. Consistently, upregulation of PDCD4 was also confirmed in the kidneys from patients with biopsy confirmed acute tubular necrosis from a retrospective cohort study. Moreover, we found that overexpression of

19.
Article in Chinese | WPRIM | ID: wpr-878905

ABSTRACT

Rhei Radix et Rhizoma was first recorded in Shennong Ben Cao Jing, with a wide range of pharmacological activities. Autoimmune disease is a kind of disease that damages the tissue structure and function of immune cells and their components due to the impairment of immune tolerance function, including atherosclerosis, multiple sclerosis, gout, rheumatoid arthritis, autoimmune thyroiditis, ulcerative colitis, type 1 diabetes and IgA nephropathy. In recent years, clinical and experimental studies show that Rhei Radix et Rhizoma has potential therapeutic effects on autoimmune diseases. Under the guidance of the theory of traditional Chinese medicine, this paper reviews therapeutic and intervening effects of Rhei Radix et Rhizoma and its main active ingredient anthraquinone on autoimmune diseases. It also puts forward new study directions in view of the existing problems in studies of rhubarb and its anthraquinone, with the aim to provide reference for clinical treatment and scientific studies of effect of Rhei Radix et Rhizomaon autoimmune diseases.


Subject(s)
Animals , Anthraquinones , Autoimmune Diseases/drug therapy , Drugs, Chinese Herbal , Rheum , Rhizome
20.
Acta Pharmaceutica Sinica ; (12): 391-402, 2021.
Article in Chinese | WPRIM | ID: wpr-873787

ABSTRACT

Ulcerative colitis (UC) is a chronic non-specific inflammatory bowel disease, listed as a modern refractory disease by the World Health Organization, which is difficult to recover, whereas it is easy to be attacked repeatedly. UC pathogenesis is closely related to gut microbiota dysbiosis. The gut microbiota interacts with bile acids (BAs), short-chain fatty acids (SCFAs), tryptophan, and other metabolism, immune system, intestinal barrier, etc., which regulate each other and affect the occurrence and development of UC. The active ingredients of traditional Chinese medicine (TCM), single herb and its extracts, and formulae can effectively alleviate UC symptoms by regulating the diversity, structure, composition, and metabolites of gut microbiota. In this review, the TCM based on the regulation of gut microbiota in the treatment of UC and its related mechanism for nearly three years was summarized.

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