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1.
Article in Chinese | WPRIM | ID: wpr-936364

ABSTRACT

OBJECTIVE@#To investigate the relationship between AML1-ETO (AE) fusion gene and intracellular N6-methyladenosine (m6A) modification pattern in t(8;21) acute myeloid leukemia (AML).@*METHODS@#RNA m6A sequencing was performed in SKNO-1 and AE knockdown SKNO-1 (SKNO-1 siAE) cells using RNA-protein co-immunoprecipitation and high-throughput sequencing (methylated RNA immunoprecipitation sequencing, MeRIP-Seq) to analyze the changes in m6A modification of the entire transcriptome. Transcriptome sequencing (RNA-seq) was performed using high-throughput sequencing. The differentially modified mRNAs were further functionally annotated by Gene Ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. The changes in m6A-related enzyme expressions were detected using real-time PCR.@*RESULTS@#A total of 26 441 genes were identified in AE knockdown AML cells and AE-expressing cells, containing 72 036 m6A peaks. AE knockdown caused a reduction of the number of intracellular m6A peaks from 37 042 to 34 994, among which 1278 m6A peaks were significantly elevated and 1225 were significantly decreased; 1316 genes with newly emerged m6A modification were detected and 1830 genes lost m6A modification after AE knockdown. The differential peaks were mainly enriched in pathways involving cancer and human T-lymphocytic leukemia virus I. RNA-seq results showed that 2483 genes were up-regulated and 3913 genes were down-regulated after AE knockdown. The combined analysis of MeRIP-Seq and RNA-Seq results revealed relatively high expression levels of m6A-modified genes as compared with the genes without m6A modification (SKNO-1: 0.6116±1.263 vs 2.010±1.655, P < 0.0001; SKNO-1 siAE: 0.5528±1.257 vs 2.067±1.686, P < 0.0001). The m6A modified genes located in the 3'UTR or 5 'UTR had significantly higher expression levels than those located in exonic regions (SKNO-1: 2.177± 1.633 vs 1.333 ± 1.470 vs 2.449 ± 1.651, P < 0.0001; SKNO-1 siAE: 2.304 ± 1.671 vs 1.336 ± 1.522 vs 2.394 ± 1.649, P < 0.05). Analysis of RNA-seq data identified 3 m6A-related enzymes that showed significantly elevated mRNA expression after AE knockdown, namely WTAP, METTL14, and ALKBH5 (P < 0.05), but the results of real-time PCR showed that the expressions of WTAP and ALKBH5 were significantly increased while the expression of METTL14 was lowered after AE knockdown (P < 0.05).@*CONCLUSION@#AE knockdown results in differential expressions of m6A-associated enzymes, suggesting that the AE fusion gene regulates the expression of one or more m6A-associated enzymes to control cellular methylation levels.


Subject(s)
Adenosine/analogs & derivatives , Humans , Leukemia, Myeloid, Acute/genetics , RNA, Messenger/metabolism , Transcriptome
2.
Article in Chinese | WPRIM | ID: wpr-928706

ABSTRACT

OBJECTIVE@#To analyze the kinetic characteristics of lymphocyte subsets and myeloid-derived suppressor cell (MDSC) in patients who newly diagnosed intermediate- to high-risk aGVHD and treated with steroids-ruxolitinib as the first line therapy from a single-arm, open clinical trial (NCT04061876).@*METHODS@#We prospectively observed the efficacy of 23 patients having intermediate- to high-risk aGVHD and treated with steroids-ruxolitinib as the first line therapy. The kinetic characteristics of lymphocyte subsets and MDSC were monitored, and then we compared them in steroids-ruxolitinib group (n=23), free-aGVHD group (n=20) and steroids group (n=23).@*RESULTS@#Of the 23 patients, the CR rate was 78.26% (18/23) on day 28 after first-line treatment with steroids-ruxolitinib. On day 28 after treatment, patients had lower level of CD4+CD29+ T cells (P=0.08) than that of pre-treatment, whereas levels of other lymphocyte subsets in this study were higher than that of pre-treatment; CD4+CD29+ T cells in CR patients decreased, compared with refractory aGVHD patients. On day 28 of treatment, CD8+CD28- T cells (P=0.03) significantly increased in patients with aGVHD than that in patients without aGVHD, so did CD8+CD28- T / CD8+CD28+ T cell ratio (P=0.03). Compared with patients without aGVHD, patients with aGVHD had lower level of G-MDSC, especially on day 14 after allo-HSCT (P=0.04). Compared with pre-treatment, M-MDSC was higher in CR patients on day 3 and 7 post-treatment (P3=0.01, P7=0.03), e-MDSC was higher on day 28 post-treatment (P=0.01). Moreover, compared with CR patients, M-MDSC was lower in refractory aGVHD patients on day 3 post-treatment (P=0.01) and e-MDSC was lower on day 28 post-treatment (P=0.01). Compared with steroids group, MDSC in steroids-ruxolitinib group was higher, with the most significant difference in M-MDSC (P3=0.0351; P7=0.0142; P14=0.0369).@*CONCLUSION@#We found that patients newly diagnosed intermediate- to high-risk aGVHD receiving first-line therapy with steroids-ruxolitinib achieved high response rate. Moreover, the novel first-line therapy has a small impact on the immune reconstitution of patients after allo-HSCT. Elevated MDSC might predict a better response in aGVHD patients receiving this novel first-line therapy. M-MDSC responded earlier to steroids-ruxolitinib than e-MDSC, G-MDSC.


Subject(s)
Graft vs Host Disease , Hematopoietic Stem Cell Transplantation , Humans , Kinetics , Myeloid-Derived Suppressor Cells , Nitriles , Pyrazoles , Pyrimidines , Retrospective Studies , Steroids
3.
Journal of Preventive Medicine ; (12): 227-231, 2022.
Article in Chinese | WPRIM | ID: wpr-920757

ABSTRACT

Objective@#To analyze the trends in incidence and mortality of Alzheimer's disease (AD) in Zhejiang Province from 2003 to 2017, so as to provide the evidence for the development of AD prevention and control strategies. @* Methods@#The data pertaining to the incidence and mortality of AD in China from 2003 to 2017 were collected from the Global Burden Disease Study, and standardized to the data of the Sixth National Population Census in China in 2010. The trends in incidence and mortality of AD were analyzed using annual percent change (APC) and average annual percent change ( AAPC ) in Zhejiang Province from 2003 to 2017. @*Results@#The incidence of AD increased from 96.05/105 in 2003 to 140.96/105 in 2017 in Zhejiang Province, with AAPC of 2.776% ( P<0.05 ), and the greatest APC ( 3.419% ) was found during the period between 2003 and 2005 ( P<0.05 ). The standardized incidence of AD increased 102.06/105 in 2003 to 106.09/105 in 2017 in Zhejiang Province, with AAPC of 0.274% ( P<0.05 ), and the greatest APC ( 1.177% ) was measured during the period between 2003 and 2005 ( P<0.05). The mortality of AD increased from 24.60/105 in 2003 to 41.44/105 in 2017 in Zhejiang Province, with AAPC of 3.862% ( P<0.05 ), and the greatest APC (4.667%) was found during the period between 2005 and 2011 ( P<0.05 ). The standardized mortality of AD increased 26.83/105 in 2003 to 27.16/105 in 2017 in Zhejiang Province, with AAPC of 0.142% ( P>0.05 ), and the greatest APC ( 1.048% ) was measured during the period between 2005 and 2012 ( P<0.05 ).@*Conclusion@#Both the incidence and mortality of AD appeared a tendency towards a rise in Zhejiang Province from 2003 to 2017.

4.
Article in Chinese | WPRIM | ID: wpr-941000

ABSTRACT

OBJECTIVE@#To compare the effects of artificial liver treatment with double plasma molecular adsorption system(DPMAS) mode and traditional plasma exchange (PE) mode on platelets in patients, and to evaluate the clinical efficacy of recombinent human thrombopoietin (rhTPO) in the treatment of thrombocytopenia.@*METHODS@#A total of fifteen patients undergoing artificial liver with DPMAS model admitted to the Fifth Affiliated Hospital of Guangzhou Medical University from January 2018 to November 2020 were selected and included in the DPMAS group, and another 15 patients receiving PE were selected and included in the PE group. The improvement of clinical symptoms, such as fatigue, jaundice, oliguria, edema, etc. before and after artificial liver treatment was compared between the two groups, and the trend of blood routine (especially platelet), coagulation function and other indexes before and after treatment were compared between the two groups. The use of rhTPO and the number of platelets were recorded during treatment.@*RESULTS@#The improvement rate of clinical symptoms in DPMAS group was 86.67%, which was higher than that in PE group, but the difference was not statistically significant (P>0.05). There was no statistical significance in the outcome of the two groups within 90 days (P>0.05). There was no significant difference in white blood cell (WBC) and hemoglobin (HB) between the two groups after treatment (P>0.05). However, the level of platelet(PLT) in DPMAS group was significantly lower than that before treatment (P < 0.05), and was significantly lower than that in PE group (P < 0.05). After treatment, the international normalized ratio (INR) level in PE group was significantly improved (P < 0.05), but there was no significant difference in the INR level in DPMAS group (P>0.05). The patients in the DPMAS group received an average of (8.2±3.1) doses of rhTPO and (1.5±0.3) IU of platelet transfusions during hospitalization. In DMPAS group, platelets increased significantly after infusion of terbium.@*CONCLUSION@#Compared with PE mode, the artificial liver with DPMAS mode can reduce platelet levels in patients, but the application of rhTPO can stimulate platelet regeneration and increase platelet levels in the patients, thereby reducing the risk of bleeding due to platelet hypoplasia.


Subject(s)
Blood Platelets , Humans , Liver, Artificial , Plasma Exchange , Recombinant Proteins , Thrombocytopenia/therapy , Thrombopoietin
5.
Article in Chinese | WPRIM | ID: wpr-940288

ABSTRACT

ObjectiveTo explore the effect of Gelsemium elegans combined with Mussaenda pubescens on efflux transporter breast cancer resistance protein (BCRP) and cytochrome P450 3A11 (CYP3A11) and their attenuation mechanism, and to investigate whether the nuclear receptors were involved in such regulation by intervening it with nuclear receptor activators. MethodC57BL/6 mice were divided into the blank group, G. elegans (GE, 0.25 g·kg-1)group, GE + M. pubescens (MP) (0.25 g·kg-1+10 g·kg-1) group, GE + pregnane X receptor (PXR) activator (rifampicin)(GE + Rif,0.25 g·kg-1+50 mg·kg-1) group, GE + MP + Rif (0.25 g·kg-1+10 g·kg-1+50 mg·kg-1) group, GE + constitutive androstane receptor (CAR) activator (1,4-Bis [2-(3,5-Dichloropyridyloxy)] benzene, TCPOBOP)(GE + TCP, 0.25 g·kg-1+0.5 mg·kg-1) group, and GE + MP + TCP (0.25 g·kg-1+10 g·kg-1+0.5 mg·kg-1) group. The medication lasted for 14 successive days. One hour after the last administration, the mice were sacrificed by cervical dislocation and the liver tissue was harvested. The left liver tissue was stained with hematoxylin- eosin (HE) for observing the pathological changes. The right liver tissue was used for BCRP and CYP3A11 mRNA and protein expression detection by real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) and Western blot. ResultThe survival rates of mice in the GE + Rif group, GE group, and GE + MP group were 25% (the lowest), 40%, and 80%, respectively, and no death was observed in the other groups. Compared with the obvious lesions in the liver cells of the GE group, the pathological changes in liver cells of the GE + MP group were alleviated, while those in the GE + Rif group were worsened. Compared with the GE + Rif group, the GE + MP + Rif group exhibited relieved pathological changes in liver cells. Both the GE + TCP group and the GE + MP + TCP group showed mild liver lesions. The comparison with the GE + MP group revealed that the pathological changes in the GE + MP + TCP group were slightly relieved. Compared with the blank group, the expression of BCRP protein and mRNA in GE group were significantly decreased (P<0.05,P<0.01).The expression of CYP3A11 protein in GE group were significantly decreased (P<0.01). Compared with the GE group, the GE + MP group displayed remarkably up-regulated BCRP protein and mRNA expression (P<0.05,P<0.01) and CYP3A11 protein expression (P<0.05), but slightly up-regulated CYP3A11 mRNA expression. Compared with the GE group, the GE + Rif group exhibited down-regulated BCRP protein expression (P < 0.05). The protein and mRNA expression levels of BCRP were lower in the GE + MP + Rif group than in the GE + MP group (P<0.05,P<0.01). The PXR activator rifampicin regulated BCRP before and after the combination of G. elegans with M. pubescens. The CYP3A11 protein and mRNA expression levels in the GE + TCP group were higher than those in the GE group (P<0.05,P<0.01). Compared with the GE + MP group, the GE + MP + TCP group showed up-regulated CYP3A11 protein and mRNA expression (P<0.05,P<0.01). CAR activator TCPOBOP also had a regulatory effect on CYP3A11 before and after the compatibility of G. elegans with M. pubescens. ConclusionThe attenuated toxin after the combination of G. elegans with M. pubescens is closely related to the efflux transporter BCRP and the drug-metabolizing enzyme CYP3A11.

6.
Article in English | WPRIM | ID: wpr-939911

ABSTRACT

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease. It is known that aucubin (AU) exerts anti-inflammatory activity, but its effects and mechanisms in RA are unclear. This study investigated the anti-inflammatory effects and mechanisms of AU in vivo and in vitro. Human fibroblast-like synoviocyte cells from patients with RA (HFLS-RA), RAW264.7 cells, and MC3T3-E1 cells were used to evaluate the effects of AU on migration, invasion, apoptosis, osteoclast differentiation and production. Immunofluorescence was used to observe nuclear translocation of nuclear factor (NF)-κB, the double luciferase reporter gene method was used to observe NF-κB-p65 activity in AU-treated MC3T3-E1 cells. RT-qPCR was used to measure expression of bone metabolism and inflammation-related genes, and western blot was used to measure bone metabolism and NF-κB protein expression levels. Collagen-induced arthritis (CIA) rat model was used for pharmacodynamics study. Arthritis indexes were measured in the ankle and knee, histological staining and Micro-computed tomography were performed on the ankle joints. Also, inflammatory factor gene expression and the levels of NF-κB-related proteins were detected as in vitro. AU effectively inhibited HFLS-RA cell migration and invasion, promoted apoptosis, and inhibited RAW264.7 cell differentiation into osteoclasts, as well as inhibited NF-κB-p65 activity in MC3T3-E1 cells. Notably, AU significantly reduced the gene expression levels of three cell-related inflammatory factors and bone metabolism factors, effectively inhibited the expression of p-Iκκα β, p-IκBα, and p-p65 proteins. In vivo, AU relieved joint inflammation, reduced related inflammatory factors, and inhibited NF-κB signaling. It could be used to treat RA-related synovial inflammation and bone destruction through the NF-κB pathway.


Subject(s)
Animals , Anti-Inflammatory Agents/therapeutic use , Arthritis, Experimental , Arthritis, Rheumatoid/drug therapy , Cells, Cultured , Humans , Inflammation/pathology , Iridoid Glucosides , NF-kappa B/metabolism , Rats , X-Ray Microtomography
7.
Article in Chinese | WPRIM | ID: wpr-939697

ABSTRACT

OBJECTIVE@#To analysis the specific protein markers of essential thrombocythemia (ET) based on proteomics technology, to explore and verify the differential protein related to platelet activation.@*METHODS@#Blood samples were obtained from ET patients and healthy people and a certain protein mass spectrometry was detected using label-free quantitative technology. The proteins relative abundance increased or down-regulated by 1.3 times in the disease group compared with the control group, and the protein abundance in the two groups t test P<0.05 were defined as differential proteins. Bioinformatics analysis of the differential proteins was performed using GO and KEGG. The difference in the average protein abundance between the two groups was analyzed by t test and P<0.05 was considered statistically significant. Differential proteins were selected for verification by parallel reaction monitoring (PRM) technology.@*RESULTS@#A total of 140 differential proteins were found, of which 72 were up-regulated and 68 were down-regulated. KEGG enrichment showed that the differential protein expression was related to the platelet activation pathway. The differential proteins related to platelet activation were GPV, COL1A2, GP1bα, COL1A1 and GPVI. Among them, the expressions of GPV, GP1bα and GPVI were up-regulated, and the expressions of COL1A2 and COL1A1 were down-regulated. PRM verification of COL1A1, GP1bα, GPVI and GPV was consistent with LFP proteomics testing.@*CONCLUSION@#Differential proteins in ET patients are related to platelet activation pathway activation.Differential proteins such as GPV, GPVI, COL1A1 and GP1bα can be used as new targets related to ET platelet activation.


Subject(s)
Blood Platelets/metabolism , Humans , Platelet Activation , Platelet Membrane Glycoproteins/metabolism , Technology , Thrombocythemia, Essential
8.
Acta Pharmaceutica Sinica ; (12): 2352-2363, 2022.
Article in Chinese | WPRIM | ID: wpr-937036

ABSTRACT

Using the concepts and methods of epigenetics and metabolomics, to investigate the overall action molecular mechanism of Chrysanthemi indici C (CIC), the anti-hepatitis B virus (HBV) active extracts from Flos chrysanthemi indici. The inhibitory effects of CIC on proliferation and hepatitis B surface antigen (HBsAg), hepatitis B envelope antigen (HBeAg) and HBV-DNA of HepG2.2.15 cells were detected by CCK-8 and antigen kit. The DNA methyltransferases (DNMTs)/ten-eleven-translocation-2 (TET2) equilibrium was detected by ELISA. Illumina 850K methylation chip, pyrosequencing and qPCR were used to determine the action pathway and target of CIC by GO and KEGG analysis. Cell metabolites were extracted with 80% methanol, and the changes of differential metabolites, differential metabolic pathways and cell microenvironment were detected by LC-MS and other metabolomics methods. The results showed that CIC could inhibit the proliferation, HBsAg, HBeAg and HBV-DNA of HepG2.2.15 cells obviously, down-regulate DNA methyltransferase 1 (DNMT1), DNA methyltransferase 3a (DNMT3a) and DNA methyltransferase 3b (DNMT3b), up-regulate TET2, and restore the balance of DNMTs/TET2. The action targets of CIC were phospholipase C gamma 2 (PLCG2), phosphoinositide-3-kinase regulatory subunit 3 (PIK3R3), 1-acylglycerol-3-phosphate O-acyltransferase 2 (AGPAT2), 5-hydroxytryptamine receptor 2B (HTR2B), nerve growth factor (NGF), mainly involved in lipid metabolism, inflammation mediated regulation of transient receptor potential (TRP), phospholipase D signaling and advanced glycation end product-receptor for AGE (AGE-RAGE) signaling in diabetic complications pathways. CIC could significantly affect fatty acid metabolism and had great influence on phenolic acid, alkaloid and lipid metabolites in cell microenvironment. These results suggest that the action mechanism of CIC may be the synergistic action of multiple pathways and multiple targets, including related inflammatory pathways, immune pathways and lipid metabolism, through regulating epigenetic expression balance and restoring the balance of cell microenvironment.

9.
Chinese Journal of Epidemiology ; (12): 702-708, 2022.
Article in Chinese | WPRIM | ID: wpr-935447

ABSTRACT

Objective: We aim to evaluate the morbidity and mortality of cancer attributable to human papillomavirus (HPV) infection in China in 2016. Methods: Based on the cancer incidence and mortality rates, national population data, and population attributable fraction (PAF) in China, we calculated the number of incidence and death cases attributed to HPV infection in different areas, age groups, and gender in China in 2016. The standardized incidence and mortality rates for cancer attributed to HPV infection were calculated by using Segi's population. Results: In 2016, a total of 124 772 new cancer cases (6.32 per 100 000) were attributed to HPV infection in China, including 117 118 cases in women and 7 654 cases in men. Of these cancers, cervical cancer was the most common one, followed by anal cancer, oropharyngeal cancer, penile cancer, vaginal cancer, laryngeal cancer, oral cancer, and vulvar cancer. A total of 41 282 (2.03 per 100 000) deaths were attributed to HPV infection, of which 37 417 occurred in women and 3 865 in men. Most deaths were caused by cervical cancer, followed by anal cancer, oropharyngeal cancer, penile cancer, laryngeal cancer, vaginal cancer, oral cancer, and vulvar cancer. The incidence and mortality rates of cervical cancer increased rapidly with age, peaked in age group 50-54 years, then decreased obviously. The morbidity and mortality rates of non-cervical cancer increased with age. The cancer case and death numbers in rural areas (57 089 cases and 19 485 deaths) were lower than those in urban areas (67 683 cases and 21 797 deaths). However, the age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) of cervical cancer were higher in rural areas than in urban areas. There were no significant differences in ASIR and ASMR of non-cervical cancers between urban areas and rural areas. Conclusions: The incidence of cancers attributed to HPV infection in China was lower than the global average, but the number of incidences accounted largely, furthermore there is an increasing trend of morbidity and mortality. The preventions and controls of cervical cancer and male anal cancer are essential to contain the increases in cancer cases and deaths attributed to HPV infection.


Subject(s)
China/epidemiology , Female , Humans , Incidence , Laryngeal Neoplasms , Male , Middle Aged , Mouth Neoplasms , Oropharyngeal Neoplasms/epidemiology , Papillomavirus Infections/epidemiology , Penile Neoplasms/epidemiology , Registries , Uterine Cervical Neoplasms/epidemiology , Vaginal Neoplasms , Vulvar Neoplasms
10.
Journal of Preventive Medicine ; (12): 681-686, 2022.
Article in Chinese | WPRIM | ID: wpr-934882

ABSTRACT

Objective@#To investigation the correlation between sleep duration and hypertension among adults in Zhejiang Province, and to provide scientific evidence for the prevention and control of hypertension.@*Methods@#Permanent residents at age of 18 years and older were enrolled from 10 surveillance sites for risk factors of chronic diseases included in the 2018 China Chronic Diseases and Risk Factors Surveillance Program. Subjects' demographic characteristics, smoking, alcohol consumption, sleep duration and development of hypertension were collected, and following complex weighting calculations, the association between sleep duration and hypertension were examined using a multivariable logistic regression model.@*Results@#Totally 5 770 adults were included, including 2 952 men (50.72%) and 3 178 women (49.28%), and the prevalence of hypertension was 29.39% (2 702 cases). There were 712 (8.37%), 1 077 (18.77%), 1 582 (28.68%), 1 717 (34.60%) and 682 adults (9.57%) with sleep duration of <6 h/d, 6 to 7 h/d, 7 to 8 h/d, 8 to 9 h/d and 9 h/d and longer, respectively. Taking the sleep duration of 7 to 8 h/d as a reference, multivariable logistic regression analysis identified a significant association between sleep duration of <6 h/d and the risk of hypertension (OR=1.709, 95%CI: 1.184-2.466), a significant association between sleep duration of 9 h/d and longer and the risk of hypertension (OR=1.369, 95%CI: 1.006-1.862) in men, significant associations between sleep duration of <6 h/d (OR=2.174, 95%CI: 1.528-3.093) and 6 to 7 h/d (OR=1.412, 95%CI: 1.078-1.850) and the risk of hypertension in women, and significant associations between sleep duration of <6 h/d (OR=3.095, 95%CI: 1.025-9.347) and 6 to 7 h/d (OR=2.046, 95%CI: 1.156-3.622) and the risk of hypertension in residents at ages of 18 to 44 years.@*Conclusions@#Short sleep duration may increase the risk of hypertension among adults at ages of 18 to 44 years in Zhejiang Province. Short sleep duration may increase the risk of hypertension in women and long sleep duration may increase the risk of hypertension in men.

11.
Chinese Journal of Nephrology ; (12): 100-106, 2022.
Article in Chinese | WPRIM | ID: wpr-933847

ABSTRACT

Objective:To investigate the effect of usage of transthoracic echocardiography(TTE) on the prognosis of patients after acute kidney injury (AKI) in intensive care unit (ICU).Methods:The clinical data of patients with AKI in the Medical Information Mart for Intensive Care (MIMIC-Ⅲ v1.4) database was collected retrospectively, and the patients were divided into TTE group (with TTE within 24 hours of AKI diagnosis) and No-TTE group (without TTE examination or first TTE examination was more than 24 hours after AKI diagnosis). Propensity score matching (PSM) was utilized to balance the baseline variables between the two groups and Cox regression analysis was used to evaluate the independent risk factors for 28-day all-cause mortality (the primary outcome). Moreover, after PSM, the effects of TTE usage on the second outcomes (including the volumes of intravenous fluid and urine output in the first, second and third 24-hour after the diagnosis of AKI; the total number of mechanical ventilation-free days, renal replacement therapy-free days and vasopressor-free days within 28 days after ICU admission; use of diuretics after the diagnosis of AKI; reduction in serum creatinine within 48 hours after the diagnosis of AKI; and the length of ICU stay and hospital stay) were also evaluated.Results:Among 23 945 eligible AKI patients, 3 365 patients (14.1%) patients received TTE within 24 hours after the diagnosis of AKI and finally there were 3 361 patients in TTE group and No-TTE group included in this study after PSM based on the ratio of 1∶1. After PSM, all variables in the two groups were well balanced (standardized mean difference<0.1, respectively). Before and after PSM, patients in TTE group had lower 28-day all-cause mortality compared with patients in No-TTE group (10.76% vs 13.04%, χ2=13.535, P<0.001; 10.65% vs 18.80%, χ2=88.932, P<0.001), and Kaplan-Meier survival curves also revealed that patients in the TTE group had higher cumulative survival rate compared with patients in No-TTE group (Log-rank χ2=15.438, P<0.001; Log-rank χ2=75.360, P<0.001, respectively). Multivariate Cox regression analysis showed that TTE was an independent influencing factor for 28-day all-cause mortality before and after PSM ( HR=0.80, 95% CI 0.73-0.89, P<0.001; HR=0.58, 95% CI 0.51-0.65, P<0.001). And all subgroup analyses showed the similar results. Compared with patients in the No-TTE group, patients in the TTE group had higher volume of intravenous fluid on the first day and the second day after the diagnosis of AKI (both P<0.01). Patients in the TTE group had higher volume of urine output on the first day and the third day after the diagnosis of AKI (both P<0.01). The patients in the TTE group had a significantly lower duration of vasopressor-free and mechanical ventilation-free (both P<0.01). The usage of diuretic was significantly higher in the TTE group compared with that in the No-TTE group (54.1% vs 44.2%, χ2=65.609, P<0.001). With respect to serum creatinine, the reduction in serum creatinine within 48 hours after the diagnosis of AKI was higher in the TTE group than that in the No-TTE group [36.6(23.0, 97.2) μmol/L vs 30.1(14.2, 61.9) μmol/L, Z=-9.549, P<0.001]. Moreover, TTE group had shorter ICU stay than that in the No-TTE group [5.03(3.40, 8.90) d vs 5.37(3.77, 10.00) d, Z=-6.589, P<0.001]. There were no significant difference between the two groups in other secondary outcomes (all P>0.05). Conclusions:Timely TTE utilization after AKI incident is associated with better clinical outcomes for ICU patients.

12.
Chinese Journal of Neurology ; (12): 35-40, 2022.
Article in Chinese | WPRIM | ID: wpr-933753

ABSTRACT

Objective:To analyze the feasibility and clinical efficacy of reperfusion-expanding-thrombectomy-stenting (RETS) technique in the endovascular treatment of acute carotid artery tandem lesion.Methods:The general clinical data of 88 patients with carotid artery tandem lesion who received emergency endovascular treatment from January 2018 to December 2020 in Department of Neurology, Linyi People′s Hospital were reviewed, the Modified Rankin Scale (mRS) was used as the evaluation standard for the prognosis of patients at 90 days after endovascular treatment, and the clinical data were analyzed, including the recanalization (modified thrombolysis in cerebral infarction ≥2b), perioperative complications and 90-day prognosis, and good prognosis was defined as a mRS score of 0-2.Results:A total of 88 patients with tandem carotid artery disease were included,48 of whom were treated with RETS technique, 40 were treated with anterograde approach. Compared with antegrade recanalization, RETS technique had significant differences in the time from puncture to recanalization [(72.06±17.29) min vs (98.88±26.09) min, t=-5.56, P<0.001] and the primary recanalization rate [35/48(73.0%) vs 21/40(52.5%),χ2=3.93 ,P=0.047], with statistically significant difference. There was no significant difference in clinical prognosis and surgical complications between the two methods (all P>0.05). Conclusions:RETS technique can shorten the operation time and increase the primary recanalization rate. RETS technique is safe and feasible for the treatment of carotid tandem lesions.

13.
Article in Chinese | WPRIM | ID: wpr-933407

ABSTRACT

Objective:To report embryonic testicular regression syndrome(ETRS) caused by DHX37 heterozygous variant for the first time in China and summarize the clinical manifestations of ETRS as to improve the understanding of doctors for this disease.Methods:The clinical data and whole exome sequencing results of five cases of ETRS from Shenzhen Children′s Hospital were collected. The reported cases of DHX37 heterozygous variant were reviewed.Results:Five patients with ETRS visited the doctors at the age of 2 months to 5 years and 5 months. Three patients raised as males came to hospital due to virilition and 2 female patients visited a doctor due to clitoral hypertrophy. No uterus was detected by ultrasound in all patients. The gonadal pathologies from 4 cases displayed no testicular tissue or gonadal dysgenesis, complicated with gonadoblastoma in one case. The genetic testing revealed that the heterozygous variant(c.923G>A, p. R308Q) in DHX37 was found in 2 cases, without variant in other 3 cases. According to the review, ETRS and 46, XY gonadal dysgenesis due to DHX37 herozygous variant was firstly reported in 2019. A total of 40 cases, including 21 cases of ETRS, presented with the virilition or female phenotype, with the disappearance of testicular tissue as the main pathologies. There is no report in China.Conclusion:The article summarized the clinical manifestations and whole exome sequencing results of 5 patients with ETRS, among which two cases were caused by DHX37 variants and one was complicated with gonadoblastoma.

14.
Chinese Journal of Urology ; (12): 266-271, 2022.
Article in Chinese | WPRIM | ID: wpr-933210

ABSTRACT

Objective:To compare the efficacy and safety of transurethral thulium laser enucleation of prostate for benign prostatic hyperplasia (BPH) with laser controller and sheath.Methods:The clinical data of 128 BPH patients who underwent transurethral thulium laser enucleation of prostate (THuLEP) in our hospital from January to June 2020 were retrospectively analyzed. Prostatic enucleation by laser controller was performed in 66 patients (LC-THuLEP group). The prostatic urethral mucosa was cut into Ω shape at 0.5 cm in front of the verumontanum to expose the prostate capsule, and then the fiber was retracted into the laser controller. Push the gland directly between the prostate gland and the prostate surgical capsule and expand along the capsule by the laser controller. In case of bleeding or prostate adhesive cord, the fiber was extended to coagulate or cut off, and the prostate was eventually en bloc removed. THuLEP by sheath was performed in 62 cases (THuLEP group). The ages of patients in LC-THuLEP group and THuLEP group were (71.00±8.72) years and (70.32±7.80) years, respectively. The prostate volumes were (74.80±40.88) ml and (73.14±36.31) ml, respectively. Prostate specific antigen (PSA) was (4.67±4.99) ng/ml and (4.89±4.59) ng/ml, International Prostate Symptom Score (IPSS) was (19.48±5.30) points and (18.50±5.05) points, respectively. The quality of life (QOL) scores were (4.17 ± 0.78) points and (4.18± 0.67) points, the maximum urine flow rate (Q max) was (9.82± 2.58) ml /s and (9.98± 2.91) ml/s, respectively. Postvoid residual (PVR) was (60.20±39.19) ml and (61.11±52.83) ml, respectively. The international index of erectile function (IIEF-5) score was (5.58±4.50) and (5.60±4.16), respectively.There was no significant difference in preoperative baseline data between 2 groups ( P>0.05). The operation time, the reduced level of hemoglobin, the weight of removed tissue, The time to postoperative bladder irrigation, the time to indwelling catheter and complications were compared between the two groups. IPSS, QOL score, Q max, PVR, and complications were compared between the two groups at 1, 3 and 6 months after surgery, while IIEF-5 score were compared only at 6 months after surgery. Results:The operative time of LC-THuLEP group and THuLEP group was (71.85±25.68) min and (80.65±29.64) min, respectively, and the decrease of postoperative hemoglobin was (6.42±9.89) g/L and (9.47±10.79) g/L, respectively, the weight of the removed tissue was (56.73±31.21) g and (48.11±24.50) g, respectively, and the time to postoperative bladder irrigation was (14.73±2.71) h and (16.06±2.71) h, respectively, the time to indwelling catheter was (4.41±1.92)d and (4.31±1.66)d, respectively, with no statistically significant differences between the two groups. IPSS scores of LC-THuLEP group were (6.52±2.46) points, (5.83±2.43) points and (5.30±2.49) points at 1, 3 and 6 months after surgery, respectively. QOL scores were (2.36±0.85) points, (2.27±1.02) points and (1.98±0.77) points, Q max were (22.89±2.41) ml/s, (23.61±2.62) ml/s and (23.83±3.53) ml/s, respectively. In THuLEP group, IPSS were (7.60±1.89) points, (6.86±1.81) points and (6.44±1.78) points at 1, 3 and 6 months after surgery, and QOL scores were (2.68±0.67) points, (2.74±1.01) points and (2.35±0.68) points, respectively. Q max were (21.31±2.52) ml/s, (22.13±2.51) ml/s and (22.11±2.49) ml/s, respectively. Those indexes (except Qmax at 6 months)were better in LC-ThuLEP group than THuLEP group, and the differences were statistically significant ( P<0.05). PVR of LC-THuLEP group were (15.95±12.31) ml, (14.83±12.19) ml and (13.67±15.03) ml, respectively, PVR of THuLEP group were (21.89±21.14) ml, (20.03±21.51) ml and (19.69±21.19) ml, respectively, and there were no significant differences. There was no bladder injury, severe bleeding, blood transfusion or secondary operation. The incidence of urinary incontinence 1 month after surgery was 6.1% (4/66) in the LC-THuLEP group and 19.4% (12/62) in the THuLEP group, the difference was statistically significant ( P<0.05). There was no significant difference at 3 months (3/66 vs. 4/62) and 6 months (1/66 vs. 2/62) after surgery ( P>0.05). There were no significant differences in the incidence of epididymitis, urethral stricture and bladder neck contracture between the two groups ( P>0.05). Conclusion:Compared by sheath, THuLEP by laser controller could be a safe and effective surgical method with better curative effect and lower complication rate.

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Chinese Journal of Geriatrics ; (12): 406-410, 2022.
Article in Chinese | WPRIM | ID: wpr-933095

ABSTRACT

Objective:The aim of this study was to explore the associations of muscle size and density with handgrip strength(HGS)and the Timed Up and Go(TUG)test.Methods:Totally 301 participants living in the Xinjiekou community near Beijing Jishuitan Hospital were recruited for CT imaging of the hip and a 1-cm slice of the mid-thigh.The cross-sectional area and density of the gluteus maximus and the mid-thigh muscles were estimated by the Osirix viewer based on CT images.HGS and TUG were also performed in these subjects.Logistic regression analysis was used to evaluate the correlations of muscle density and size with TUG and grip strength.Results:In women, after adjustment for age and BMI, the density of the gluteus maximus was negatively correlated with TUG( P trend=0.0366), while the size of the gluteus maximus and the mid-thigh muscles was not correlated with TUG.In men, the density or size of these muscles was not correlated with TUG.After adjustment for age and BMI, the density of the gluteus maximus was positively correlated with grip strength( P trend=0.0334)and the size of the mid-thigh muscles was also positively correlated with grip strength( P trend=0.0155)in men, but they were not correlated with grip strength in women. Conclusions:There were sex differences in the relationship between muscle size or density and grip strength or timed up and go.The density of the gluteus maximus is associated with muscle strength and physical performance while the size of the mid-thigh muscles is correlated with muscle strength.

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Article in Chinese | WPRIM | ID: wpr-932760

ABSTRACT

Objective:To investigate the clinical value of drug-eluting beads transcatheter arterial chemoembolization (DEB-TACE) in preoperative liver transplantation application of hepatocellular carcinoma beyond Milan standard.Methods:A total of 100 patients with hepatocellular carcinoma who were underwent liver transplantation exceeding Milan criteria were retrospectively analyzed from April 2013 to March 2019 at the Tianjin First Central Hospital. Of 72 males and 28 females were included, aged (50.3±7.8) years. Fifty patients who received preoperative DEB-TACE treatment were included in the DEB-TACE group. According to the tumor necrosis rate after liver transplantation, they were further divided into group A (complete tumor necrosis), group B (50%≤ tumor necrosis rate <100%) and group C (tumor necrosis rate <50%). Fifty patients with hepatocellular carcinoma who did not receive any preoperative treatment were included in the control group. DEB-TACE complications were analyzed. Their survival and recurrence were followed up. Survival analysis was performed by Kaplan-Meier method and survival rates were compared by log-rank test.Results:In the DEB-TACE group, the technical success rate of interventions was 100%(50/50) and 1 to 4(1.8±1.2) interventions were received. Post-DEB-TACE complications, included post-embolization syndrome in 18 cases (36.0%). Cumulative survival rates at 1, 2 and 3 years after liver transplantation in the DEB-TACE group were 96.0%, 90.0%, and 76.0%, respectively, which were better than the control group with 94.0%, 78.0%, and 54.0%. The differences were statistically significant (χ 2=6.62, P=0.015). The cumulative survival rates at 1, 2 and 3 years after liver transplantation for patients in group A+ B ( n=30) were 100.0%, 96.7% and 93.3% respectively, which were better than 94.0%, 78.0% and 54.0% for the control group, with statistically significant differences (χ 2=6.99, P=0.012). The cumulative survival rates after liver transplantation for group C compared with the control group were not statistically significant (χ 2=0.56, P=0.130). The results of the comparison of cumulative recurrence-free survival rates were consistent with the comparison of cumulative survival rates. Conclusion:In patients with liver cancer exceeding Milan criteria, DEB-TACE before liver transplantation is beneficial in improving the prognosis of patients.

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Article in Chinese | WPRIM | ID: wpr-932738

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Objective:To evaluate the safety and efficacy of irreversible electroporation ablation for liver cancer.Methods:A retrospective study was conducted on 21 patients who underwent irreversible electroporation ablation for liver cancer from September 2018 to August 2019. There were 17 males and 4 females, with a median age of 57.9 (48, 69) years old. Complications were graded according to the Clavien Dindo complication grading system. Tumor response was evaluated by the improved evaluation standard of solid tumor efficacy. Clinical data such as tumor size and operation time were recorded. Tumor recurrence and survival outcomes were followed-up until August 27, 2020.Results:All patients had well-compensated cirrhosis (Child-Pugh A 20 cases, Child-Pugh B 1 case). There was no persistent deterioration of liver function after ablation. The diameter of tumor ranged from 10 to 56 mm, with 7 patients having a tumor diameter over 3 cm. Each of the 21 patients received only once irreversible electroporation ablation and the technical success rate was 100%. The operation time was 2.3 (1.5, 3.5) h. All complications were Clavien Dindo grade Ⅰ, which included pain, fever and brachial plexus strain. Imaging examination 4 weeks after treatment showed a complete remission rate of 85.7% (18/21), a partial remission rate of 9.5% (2/21), a stable disease rate of 0(0/21), and a progressive disease rate of 4.8% (1/21). The objective remission rate was 95.2% (20/21). Overall recurrence rates were 9.5% (2/21) at 3 months and 23.8% (5/21) at 12 months. AFP at 3 and 12 months after treatment were (28.0±7.3) and (29.0±8.1) ng/ml, respectively, which were significantly lower than that before treatment (278.0±41.2) ng/ml ( t3m=-3.57, t12m=-4.12, P<0.05). Conclusion:Irreversible electroporation ablation was safe and effective in treating malignant liver tumors.

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Article in Chinese | WPRIM | ID: wpr-931915

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Objective:To explore the characteristics of sleep disorders in patients with Parkinson's disease (PD) and its correlation with homocysteine.Methods:Totally 75 PD patients hospitalized in the department of neurology from January 2017 to June 2021 were selected and divided into sleep disorder group ( n=39) and non-sleep disorder group ( n=36)according to polysomnography, Parkinson's disease sleep scale(PDSS) and Epworth sleepiness scale(ESS). The basic clinical data, hematological examination results, scale evaluation data and polysomnography monitoring data of the above patients were collected during hospitalization to analyze the sleep characteristics of patients with Parkinson's disease and its correlation with homocysteine.SPSS 26.0 statistical analysis software was used for t test, Mann-Whitney U test, Pearson analysis, Spearman analysis and multivariate Logistic analysis. Results:The sleep efficiency (56.82±19.07)%, N2 phase ratio(48.67±17.70)%, N3 phase ratio(9.20%(19.00%)) and the leg movement micro-arousal index(0(1.20)) in the sleep disorder group were lower than those in the non-sleep disorder group (sleep efficiency (82.15±5.55)%, N2 phase ratio(57.02±2.80)%, N3 phase ratio(20.01%(3.93%)), the leg movement micro-arousal index(1.15(1.80)). The differences were statistically significant ( t/ Z=-6.087, -2.905, -3.773, -3.683, all P<0.05). The proportion of AHI (0.90(14.60)), N1 stage (19.50%(15.70%)), and periodic limb index (0(24.80)) in sleep disorder group were higher than those in non-sleep disorder group (AHI (0.60(0.30)), N1 stage (12.15%(3.15%)), and periodic limb index (0(0)). The difference was statistically significant ( Z=2.154, 5.250, 3.559, all P<0.05). The homocysteine (15.80(3.90) μmol/L), NMSS-insomnia correlation score (3.00(5.00)), MDS-UPDRS-Ⅰ(7.00 (10.00)), MDS-UPDRS-Ⅲ (23.00 (16.00)) in the sleep disorder group were higher than those in the non-sleep disorder group (homocysteine (14.10 (4.20)μmol/L), NMSS-insomnia correlation score (0(1.00)), MDS-UPDRS-Ⅰ(3.00 (2.00)), MDS-UPDRS-Ⅲ (17.00 (4.00)), and the differences were statistically significant( Z=2.557, 4.487, 2.952, 2.180, all P<0.05). The NMSS-olfactory correlation scores (2.00(4.00)) and PDSS (99.00 (40.00)) were lower than those in the non-sleep disorder group (NMSS-olfactory correlation scores (4.50 (7.00)) and PDSS (122.00 (28.00)), and the differences were statistically significant ( Z=2.450, 4.126, both P<0.05). Hcy was positively correlated with sleep disorder in PD patients ( r=0.297, P<0.05). Binariate logistic regression analysis showed that elevated homocysteine level might be a risk factor for sleep disorder in PD patients ( β=0.193, OR=1.213, 95% CI=1.029-1.430). Conclusion:Parkinson's disease patients with sleep disorder have the characteristics of sleep structure disorder, often accompanied by more serious motor disorders, and the olfactory function impairment is relatively mild. Elevated homocysteine levels may be a risk factor for sleep disorder in Parkinson's disease.

19.
Article in Chinese | WPRIM | ID: wpr-931367

ABSTRACT

Introducing the multidisciplinary cooperation model into the clinical teaching of residents has gradually been paid attention to, and the relevant multi-disciplinary teaching teams participate in and formulate teaching plan. The Department of Urology of the Peking University Third Hospital carries out multidisciplinary cooperative teaching of residents based on network platform to improve residents' autonomous learning ability and teaching effect. This model has certain advantages in mobilizing students' subjective initiative and cultivating learning interest. It is of great significance for the training of urology residents.

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Article in Chinese | WPRIM | ID: wpr-931059

ABSTRACT

Objective:To compare the accuracy and stability between corneal topography-guided femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) and small incision lenticule extraction (SMILE) for myopic astigmatism by vector analysis.Methods:A non-randomized controlled clinical trial was performed.One hundred and twenty patients (214 eyes) with myopic astigmatism who underwent the FS-LASIK or SMILE in Henan Eye Hospital from January 2020 to July 2020 were enrolled.The patients were divided into FS-LASIK group (58 cases, 105 eyes) and SMILE group (62 cases, 109 eyes) according to different surgeries.The visual acuity, refraction, intraocular pressure and corneal topography were examined before and 1 week, 1 month and 3 months after operation.The results of vector analysis between the two groups were compared, including target induced astigmatism vector (TIA), surgically induced astigmatism vector (SIA), magnitude of error (ME), angle of error (|AE|), difference vector (|DV|), correction index (CI), and index of success (IOS) 3 months after operation.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Henan Eye Hospital (No.HNEECKY-2020[25]). Written informed consent was obtained from each patient before operation.Results:Three months after surgery, no astigmatism was found in 11 eyes (10.5%), and with the rule (WTR) astigmatism was in 23 eyes (21.9%), and against the rule (ATR) and oblique astigmatism were in 71 eyes (67.6%) in FS-LASIK group.In SMILE group, no astigmatism was detected in 35 eyes (32.1%), and WTR astigmatism was in 58 eyes (53.2%), and ATR and oblique astigmatism were in 16 eyes (14.7%), showing a statistically significant difference between them ( χ2 =48.20, P<0.05). The postoperative SIA, |AE|, |DV|, CI and IOS values in the SMILE group were lower than those in the FS-LASIK group, showing statistically significant differences between them (all at P<0.05). The ME was -0.20 (-0.37, 0.00)D in FS-LASIK group and 0.20 (0.00, 0.25)D in SMILE group.Within 3 months after operation, there was no significant difference in ME among different time points in the FS-LASIK group (all at P>0.05) and in spherical equivalent (SE) among different time points in the SMILE group (all at P>0.05). There was significant difference in the results of vector analysis among different time points in the two groups (all at P<0.05). Conclusions:Both FS-LASIK and SMILE are effective in the correction of myopic astigmatism.Astigmatism is slightly overcorrected by FS-LASIK and slightly undercorrected by SMILE.The axial error is smaller and the SE is more stable after SMILE within 3 months postoperatively.

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