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1.
Chinese Journal of Neurology ; (12): 219-227, 2021.
Article in Chinese | WPRIM | ID: wpr-885406

ABSTRACT

Objective:To summarize the clinical features and pathological changes of peripheral tissues from patients with neuronal intranuclear inclusion disease (NIID) diagnosed by genetic tests.Methods:Repeat-primed polymerase chain reaction was used to confirm the GGC repeated expansion in the 5′ untranslated region of the NOTCH2NLC gene in patients with suspected NIID who had visited the Department of Neurology of Peking University First Hospital from January 2018 to February 2020. The clinical data and pathological changes of peripheral tissues from patients with genetically diagnosed NIID were collected retrospectively and analysed. Immunostaining with anti-p62 and anti-ubiquitin antibody was performed on peripheral biopsy specimens.Results:Totally nine patients with NIID who had GGC repeated expansion in the NOTCH2NLC gene were found. Five patients were familial (from three faimilies), and four patients were sporadic. The age of onset was 36-61(51.33±7.12) years. The most common symptoms in this NIID group were episodic emotion and personality change (8/9), paroxysmal disturbance of consciousness (6/9) and intermitant head discomfort (6/9). Other symptoms included cognitive dysfunction, limb weakness, limb sensory disturbance, bladder dysfunction, ataxia, seizures and psychiatric symptoms. Brain magnetic resonance imaging showed high signals along the corticomedullary junction on diffusion-weighted image in eight out of nine patients. Skin biopsied samples from nine patients demonstrated the presence of eosinophilic intranuclear inclusions (IIs), appearing in the nucleus of fibroblasts, fat cells and ductal epithelial cells of sweat glands on hematoxylin-eosin staining. IIs were positive on anti-p62 and anti-ubiquitin immunostaining. Electron microscopy indicated the IIs were composed of a pile of filament materials without membrane. Muscle biopsies from two patients showed no obvious neurogenic or myogenic pathologic changes, except in one patient several rimmed vacuoles fibers were found. In one patient sural nerve biopsy showed severe demyelinating pathological changes. No IIs were found in the muscles and peripheral nerve tissue either by histological examination or by immunohistochemical staining with anti-p62 or anti-ubiquitin, while IIs were found by immunofluorescence staining with both anti-p62 and anti-ubiquitin in three patient′s tissue. Conclusions:The phenotype of this NIID patient group is adult-onset NIID, with episodic encephalopathy as the main clinical manifestation. Skin biopsy has high pathological diagnostic value for NIID. The immunofluorescence staining with anti-p62 and anti-ubiquitin is easier to detect the presence of IIs than histological staining and immumohistochemical staining.

2.
Article in Chinese | WPRIM | ID: wpr-885282

ABSTRACT

Objective:To evaluate salvage surgery in patients with early gastric cancer after noncurative endoscopic resection .Method:A total of 56 cases with early gastric cancer receiving salvage surgery after noncurative endoscopic resection were enrolled and the clinicopathological and follow-up information were analyzed to evaluate the necessity and safety of salvage surgery.Results:Among the 44(79%)patients with submucosal invasion, 38 (68%) were with SM2 (invasion submucosal invasion≥500 μm) according to the pathological results after endoscopic resection. 33 (59%)cases had positive margin. The rate of lymph node metastasis and positive residual tumor as found by salvage gastrectomy were 11% (6/56) and 25% (14/56) . In the multivariate analysis, deeper submucosal invasion resulted as independent risk factor for residual tumor( OR=1.001, 95% CI=1.000-1.002, P=0.036). Among the 12(21%)cases with postoperative complications, 3 (5%)underwent unplanned reoperations because of anastomotic or intra-abdominal bleeding. There was no difference in the number of retrieved lymph nodes and rate of postoperative complications between laparoscopic and open surgery(all P>0.05). Conclusion:For patients with the risk factors of lymph node metastasis after noncurative endoscopic resection, salvage surgery was necessary and laparoscopic approach was safe and feasible.

3.
Article in Chinese | WPRIM | ID: wpr-882387

ABSTRACT

Objective:To investigate the correlation between subclinical hypothyroidism (SCH) and clinical outcomes of patients with acute ischemic stroke.Methods:From July 2014 to October 2017, patients with acute ischemic stroke admitted to Jiangsu Shengze Hospital Affiliated to Nanjing Medical University were enrolled retrospectively. Their demographic and baseline clinical and laboratory data were collected. The modified Rankin Scale was used to evaluate the clinical outcome at 3 months after the onset of symptoms. Multivariate logistic regression analysis was used to determine the independent correlation between SCH and clinical outcome of patients with acute ischemic stroke. Results:A total of 200 patients with acute ischemic stroke were enrolled, including 107 males (53.5%) and 93 females (46.5%). Their age was 69.67±11.38 years. There were 45 patients (22.5%) with SCH, 160 (80.0%) with good outcomes, and 40 (20.0%) had poor outcomes. Univariate analysis showed that there were significant differences in the baseline National Institutes of Health Stroke Scale (NIHSS) score, stroke etiology classification and the proportion of patients with SCH between the poor outcome group and the good outcome group (all P<0.05). Multivariate logistic regression analysis showed that high NIHSS score (odds ratio 2.884, 95% confidence interval 2.005-4.147; P=0.001) and SCH (odds ratio 19.527, 95% confidence interval 2.334-163.386; P=0.006) were the independent risk factors for poor outcomes. Conclusion:High NIHSS score and SCH were associated with the poor outcomes at 3 months after the onset of acute ischemic stroke.

4.
Article in Chinese | WPRIM | ID: wpr-882010

ABSTRACT

Objective To explore the transmission chain of COVID-19 by serum antibody detection, and to provide scientific evidence for the prevention and control of the epidemic. Methods Field epidemiological investigation was used to determine the COVID-19 cases and their close contacts. The 2019-nCoV nucleic acid in throat swabs and anal swabs were examined by RT-PCR. Serum specimens were collected for anti-2019-nCoV IgM antibody detection and combined IgM/IgG detection. Results Case A had no confirmed exposure to COVID-19. However, case C and D had dinner and lived together with case A; they reported contact history and dinner history with other confirmed COVID-19 cases(H, L). Case A tested positive for 2019-nCoV nucleic acid, whereas case C and D were negative. Moreover, case A and C were IgM antibody positive, while case D was negative. Case A, C and D were all positive for combined IgM/IgG. In addition, case D had clinical symptom, while case C did not. Conclusion Serum antibody detection can be used as an effective supplement to the inference of transmission chain of COVID-19, which may facilitate determining the source of infection and improving the evidence.

5.
Acta Pharmaceutica Sinica B ; (6): 181-202, 2021.
Article in English | WPRIM | ID: wpr-881132

ABSTRACT

Urea transporters (UT) play a vital role in the mechanism of urine concentration and are recognized as novel targets for the development of salt-sparing diuretics. Thus, UT inhibitors are promising for development as novel diuretics. In the present study, a novel UT inhibitor with a diarylamide scaffold was discovered by high-throughput screening. Optimization of the inhibitor led to the identification of a promising preclinical candidate,

6.
Journal of Integrative Medicine ; (12): 144-157, 2021.
Article in English | WPRIM | ID: wpr-881007

ABSTRACT

OBJECTIVE@#The present study investigated how mild moxibustion treatment affects the intestinal microbiome and expression of NLRP3-related immune factors in a rat model of intestinal mucositis (IM) induced with 5-fluorouracil (5-Fu).@*METHODS@#Forty male Sprague-Dawley rats were randomly divided into control, chemotherapy, moxibustion and probiotics groups. The IM rat model was established by intraperitoneal injection of 5-Fu. Mild moxibustion treatment and intragastric probiotic administration were provided once daily for 15 days. Tissue morphology, serum levels of inflammatory factors and the expression levels of tight junction proteins, caspase-1, gasdermin D and NLRP3 were evaluated in colon tissue, through hematoxylin and eosin staining, electron microscopy, enzyme-linked immunosorbent assay, Western blotting, quantitative real-time reverse transcription polymerase chain reaction and immunofluorescence. Gut microbiome profiling was conducted through 16S rRNA amplicon sequencing.@*RESULTS@#Moxibustion and probiotic treatments significantly increased the expression levels of tight junction proteins, reduced cell apoptosis and the expression levels of caspase-1, gasdermin D and NLRP3; they also decreased the serum levels of tumor necrosis factor-α, interleukin (IL)-6, IL-1β and IL-18, while increasing serum levels of IL-10. Moxibustion and probiotic treatments also corrected the reduction in α-diversity and β-diversity in IM rats, greatly increased the proportion of the dominant bacterial genus Lactobacillus and reduced the abundance of the genera Roseburia and Escherichia in chemotherapy-treated rats to levels observed in healthy animals. We also found that these dominant genera were firmly correlated with the regulation of pyroptosis-associated proteins and inflammatory factors. Finally, moxibustion and probiotic treatments elicited similar effects in regulating intestinal host-microbial homeostasis and the expression of NLRP3 inflammasome-related factors.@*CONCLUSION@#Moxibustion exerts its therapeutic effect on IM by ameliorating mucosal damage and reducing inflammation. Moreover, moxibustion modulates the gut microbiota, likely via decreasing the expression levels of the NLRP3 inflammasome.

7.
Article in Chinese | WPRIM | ID: wpr-875950

ABSTRACT

Objective The present study was conducted to identify the Vibrio cholera type and to analyze its antibiotic resistance in an epidemic of cholera in Haiyan County in 2018, which would provide the references for prevention and control of cholera. Methods Stool samples of the patient and his close contacts as well as the food and environmental samples were collected for identification of the type of Vibrio cholerae and the toxin gene. The resistance of identified Vibrio cholerae to 20 different common antibiotics were tested. Results A total of 176 samples were collected, including 101 stool samples from the case and his close contacts, 35 environmental samples and 40 food samples. Among those samples, only one strain of V. cholerae, O139, was isolated from the patient's first feces sample. It was detected as a toxin gene of ctxA positive by real-time fluorescence PCR. Antibiotic resistance test showed that the strain was sensitive to norfloxacin, levofloxacin, ciprofloxacin, cefotaxime, cephalothin, ampicillin, and amoxicillin. It was 100% resistant to tetracycline, doxycycline, neomycin, kanamycin, streptomycin, and rifampicin. Conclusion V. cholerae O139 strain with ctxA is detected in an epidemic of cholera. Norfloxacin, levofluoxacin and some other antibiotics could be used for clinical treatment and prevention. It should pay attention to this strain of V. cholera regarding the multiple drug resistance and the change of antibiotic resistance.

8.
Chinese Journal of Endemiology ; (12): 525-528, 2020.
Article in Chinese | WPRIM | ID: wpr-866148

ABSTRACT

Objective:To analyze the results of external quality control network of iodine deficiency disorders (IDD) laboratories in Jiangxi Province in 2018, to summarize the total detection level and capability at all levels, and to provide reliable quality assurance for monitoring and prevention of IDD.Methods:In 2018, IDD laboratories of provincial, municipal and county-level in Jiangxi Province were examined for the external quality control of salt iodine, urinary iodine and water iodine. Among them, there were 1 provincial, 11 municipal and 30 county-level laboratories participated in salt iodine assessment; there were 1 provincial, 11 municipal and 100 county-level laboratories participated in urinary iodine assessment; and there were 1 provincial and 11 municipal laboratories participated in water iodine assessment. Salt iodine was determined by direct titration method (GB/T 13025.7-2012); urinary iodine was determined by As 3+-Ce 4+ catalytic spectrophotometry method (WS/T 107.1-2016) or inductively coupled plasma mass spectrometry method (WS/T 107.2-2016); water iodine was determined by the method in the range of 0 - 100 μg/L in "Study on the Method Suitable for the Detection of Water Iodine in Areas with Iodine Deficiency and High Iodine" recommended by national IDD reference laboratory. Urinary iodine was determined with Z score method, when│Z│≤ 2, it was qualified; when 2 <│Z│ < 3, it was basically qualified; when│Z│≥ 3, it was not qualified. Water iodine and salt iodine were determined by the method of reference value ± uncertainty, and the average value of the test results within this range was judged to be qualified; otherwise, it was judged to be unqualified. Results:In 2018, the feedback rates and qualified rates of salt iodine, urinary iodine and water iodine in 1 provincial and 11 municipal laboratories in Jiangxi Province were all 100.00%. Thirty county-level laboratories participated in the salt iodine assessment, and 1 of them failed. One hundred county-level laboratories participated in the urinary iodine assessment, and 3 of them failed.Conclusion:Laboratory testing technology of IDD continues to maintain at a high level in Jiangxi Province in 2018, and the detection ability of some county-level laboratories needs to be further improved.

9.
Article in Chinese | WPRIM | ID: wpr-865039

ABSTRACT

Objective:To investigate the influencing factors for anastomotic leakage after transabdominal transanal total mesorectal excision.Methods:The retrospective case-control study was conducted. The clinicopathological data of 50 patients with rectal cancer who were admitted to the Renji Hospital of Shanghai Jiaotong University School of Medicine from December 2017 to November 2018 were collected. There were 34 males and 16 females, aged (60±11)years, with a range from 31 to 84 years. All the patients underwent transabdominal transanal total mesorectal excision. Observation indicators: (1) anastomotic leakage after transabdominal transanal total mesorectal excision; (2) analysis of influencing factors for anastomotic leakage after transabdominal transanal total mesorectal excision; (3) effects of learning curve on anastomotic leakage after transabdominal transanal total mesorectal excision. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M (range). Count data were described as absolute numbers or percentages. Univariate analysis was conducted using the chi-square test, and multivariate analysis was conducted using the Logistic regression model. Results:(1) Anastomotic leakage after transabdominal transanal total mesorectal excision: of the 50 patients, 9 had postoperative anastomotic leakage, including 6 of grade A anastomotic leakage (2 patients receiving protective enterostomy), 2 of grade B anastomotic leakage, and 1 of grade C anastomotic leakage. Of the 9 patients with anastomotic leakage, there were 5 males and 4 females, aged 62 years (range, 40-75 years). The 9 patients had a body mass index of 27 kg/m 2 (range, 21-31 kg/m 2), and a distance from anastomosis to anal edge of 30 mm (range, 5-40 mm). (2) Analysis of influencing factors for anastomotic leakage after transabdominal transanal total mesorectal excision: results of univariate analysis showed that anastomotic method and protective stoma were related factors for anastomotic leakage after transabdominal transanal total mesorectal excision ( χ2=5.490, 5.456, P<0.05). Results of multivariate analysis showed that anastomotic method and protective stoma were not independent factors for anastomotic leakage after transabdominal transanal total mesorectal excision ( odds ratio=0.062, 0.460, 95% confidence interval: 0.009-1.119, 0.102-2.809, P>0.05). (3) Effects of learning curve on anastomotic leakage after transabdominal transanal total mesorectal excision: with the passing of learning curve and the use of protective stoma, 11 of the first 25 patients of learning cure underwent protective stoma and 6 had postoperative anastomotic leakage, while 20 of the last 25 patients of learning cure underwent protective stoma and 3 had postoperative anastomotic leakage. There was no significant difference in the postoperative anastomotic leakage between them ( χ2=1.220, P>0.05). Conclusion:Anastomotic method and protective stoma are related factors influencing anastomotic leakage after transabdominal transanal total mesorectal excision.

10.
Article in Chinese | WPRIM | ID: wpr-865028

ABSTRACT

Objective:To investigate the survival prognosis of patients with primary liver cancer and its influencing factors.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 3 106 patients with primary liver cancer who had health insurance for special illness in the Chongqing Malignant Tumor Treatment System from January 2000 to August 2018 were collected. There were 2 559 males and 547 females, aged (60±13)years, with a range from 19 to 95 years. Observation indicators: (1) demographic characteristics; (2) clinical treatment and pathological examination; (3) follow-up and survival; (4) analysis of prognostic factors. Follow-up using telephone interview, outpatient or inpatient reexamination was preformed to detect survival of patients. Follow-up was done once every 3 months within the first year and once a year thereafter up to December 2018. Measurement data with normal distribution were represented as Mean± SD. Measurement data with skewed distribution were represent as M (range). Count data were expressed as absolute numbers or percentages. Survival analysis was done after excluding missing data of follow-up. The survival rate was calculated and survival curve was drawn by Kaplan-Meier method. The prognostic factors were analyzed after excluding missing data of follow-up, pathological type, and TNM staging. The log-rank test was used for univariate analysis, and COX proportional hazard model was used for multivariate analysis. Results:(1) Demographic characteristics: of the 3 106 patients with primary liver cancer, the number of males and females (gender), cases with age < 30 years, from 30 to 44 years, from 45 to 59 years, from 60 to 74 years, ≥75 years, cases of Han nationality or other ethnic groups, cases being married or other status (marital status), cases with occupation as enterprise unit staff and (or) workers, public institution personnel and (or) civil servants, freelancers and (or) self-employed entrepreneurs, unemployed, company staff, and other professionals were 2 559, 547, 35, 362, 1 131, 1 163, 415, 3 053, 53, 2 896, 210, 880, 342, 130, 101, 124, and 1 529, respectively. (2) Clinical treatment and pathological examination: of the 3 106 patients with primary liver cancer, cases with hospitalization time < 10 days, from 10 to 19 days, from 20 to 29 days, ≥30 days, cases without surgery or with surgery, cases with hepatocellular carcinoma, cholangiocarcinoma, hybrid type and other pathological types, cases of stage Ⅰ, Ⅱ, Ⅲ, Ⅳ of TNM staging were respectively 771, 1 312, 661, 362, 915, 2 191, 836, 63, 24, 29, 28, 90, 624. There were 2 183 out of 3 106 patients without pathological data and 2 335 without TNM staging data. (3) Follow-up and survival: of the 3 106 patients with primary liver cancer, 2 561 were followed up for 3.0-96.0 months, with a median follow-up time of 27.6 months. The 2 561 patients had survived for 1.0-96.0 months, with a median survival time of 24.7 months. The 1-, 3-, 5-year survival rates were 63.2%, 42.3%, 29.5%, respectively. (4) Analysis of prognostic factors: results of univariate analysis showed that age, marital status, occupation, hospitalization time, surgical treatment, pathological types, and TNM staging were related factors for prognosis of patients ( χ2=31.820, 6.752, 39.100, 120.889, 226.700, 10.452, 48.602, P<0.05). Results of multivariate analysis showed that being married, hospitalization time no less than 30 days, surgical treatment were independent protective factors for prognosis ( hazard ratio=1.463, 0.572, 0.575, 95% confidence interval: 1.044-2.049, 0.413-0.793, 0.438-0.755, P<0.05), stage Ⅲ and Ⅳ of TNM staging were independent risk factors for prognosis of patients ( hazard ratio=3.941, 5.036, 95% confidence interval: 1.687-9.211, 2.237-11.335, P<0.05). Conclusions:Patients with primary liver cancer have poor prognosis. Being married, hospitalization time no less than 30 days, and surgical treatment are independent protective factors for prognosis, stage Ⅲ and Ⅳ of TNM staging are independent risk factors for prognosis.

11.
Article in Chinese | WPRIM | ID: wpr-862523

ABSTRACT

Objective To explore the differences in clinical symptoms and laboratory examination indexes between patients with HIV/AIDS infection complicated with tuberculosis (TB) and those with HIV/AIDS alone, so as to provide a reference for early identification and diagnosis of HIV/AIDS infection with TB. Methods A total of 206 patients with HIV/AIDS infection and TB who were admitted to Suining Central Hospital from January 2015 to April 2019 were selected as the study group. 86 patients with pure HIV/AIDS were selected as the disease control group. Data of clinical diagnosis and treatment as well as follow-up of the patients were retrospectively analyzed. The clinical symptoms, laboratory examination indexes and clinical treatment outcomes were compared between the two groups. Results The incidence rates of fever, emaciation, electrolyte imbalance, hypoproteinemia, cough and chest pain in the study group were significantly higher than those in the disease control group (P0.05). The positive rates of sputum smear acid fast stain, sputum mycobacterium tuberculosis culture and PPD test in the study group were significantly higher than those in the disease control group, while the CD3+ count, CD4+ count and CD4+/CD8+ were obviously lower than the disease control group (P0.05). The ROC curve suggested that the areas under the curve of CD3+, CD4+, CD4+/ CD8+ and the three combined indicators to evaluate HIV/AIDS infection combined with TB were 0.799, 0.841, 0.913, and 0.935, respectively. The hospitalization time in the study group was significantly longer than that in the disease control group. The proportion of discharged patients (improved) in the study group was significantly lower than that in the disease control group, while the proportion of discharged patients (not improved) was significantly higher than that in the disease control group (P<0.05). Conclusion Although the clinical symptoms of patients with HIV/AIDS infection combined with TB are similar to those of patients with HIV/AIDS alone, the main symptoms of the former are fever, emaciation and electrolyte imbalance. The detection of laboratory immune function indexes is of positive significance for improvement of the diagnostic sensitivity and accuracy of HIV/AIDS infection with TB.

12.
Protein & Cell ; (12): 339-351, 2020.
Article in English | WPRIM | ID: wpr-828762

ABSTRACT

Genome packaging is a fundamental process in a viral life cycle and a prime target of antiviral drugs. Herpesviruses use an ATP-driven packaging motor/terminase complex to translocate and cleave concatemeric dsDNA into procapsids but its molecular architecture and mechanism are unknown. We report atomic structures of a herpesvirus hexameric terminase complex in both the apo and ADP•BeF3-bound states. Each subunit of the hexameric ring comprises three components-the ATPase/terminase pUL15 and two regulator/fixer proteins, pUL28 and pUL33-unlike bacteriophage terminases. Distal to the nuclease domains, six ATPase domains form a central channel with conserved basic-patches conducive to DNA binding and trans-acting arginine fingers are essential to ATP hydrolysis and sequential DNA translocation. Rearrangement of the nuclease domains mediated by regulatory domains converts DNA translocation mode to cleavage mode. Our structures favor a sequential revolution model for DNA translocation and suggest mechanisms for concerted domain rearrangements leading to DNA cleavage.

13.
Protein & Cell ; (12): 339-351, 2020.
Article in English | WPRIM | ID: wpr-828598

ABSTRACT

Genome packaging is a fundamental process in a viral life cycle and a prime target of antiviral drugs. Herpesviruses use an ATP-driven packaging motor/terminase complex to translocate and cleave concatemeric dsDNA into procapsids but its molecular architecture and mechanism are unknown. We report atomic structures of a herpesvirus hexameric terminase complex in both the apo and ADP•BeF3-bound states. Each subunit of the hexameric ring comprises three components-the ATPase/terminase pUL15 and two regulator/fixer proteins, pUL28 and pUL33-unlike bacteriophage terminases. Distal to the nuclease domains, six ATPase domains form a central channel with conserved basic-patches conducive to DNA binding and trans-acting arginine fingers are essential to ATP hydrolysis and sequential DNA translocation. Rearrangement of the nuclease domains mediated by regulatory domains converts DNA translocation mode to cleavage mode. Our structures favor a sequential revolution model for DNA translocation and suggest mechanisms for concerted domain rearrangements leading to DNA cleavage.

14.
Article in Chinese | WPRIM | ID: wpr-821657

ABSTRACT

Objective To examine the effect of rational emotive therapy on negative emotions among advanced schistosomiasis patients with repeated hospitalizations. Methods A total of 97 advanced schistosomiasis patients with anxiety and depressive emotions that were hospitalized in Xiangyue Hospital of Hunan Institute of Schistosomiasis Control for three times or more were enrolled, and given rational emotive therapy for 4 weeks in addition to routine nursing care. The scores for anxiety, depression and quality of life were estimated in patients before and after the rational emotive therapy using the Self-Rating Anxiety Scale (SRS), the Self-Rating Depression Scale (SDS) and WHOQOL-BREF Form. Results The SAS and SDS scores were significantly lower 4 weeks following rational emotive therapy than before the intervention (SAS score, 45.40 ± 7.77 vs. 59.25 ± 9.29, t = 14.021, P < 0.01; 51.48 ± 8.01 vs. 63.93 ± 9.59, t = 12.991, P < 0.01). The percentages of patients with moderate and severe anxiety and depression were significantly lower 4 weeks following rational emotive therapy than before the intervention (P < 0.01), and the scores for each item in the quality of life were all significantly greater 4 weeks following rational emotive therapy than before the intervention (P < 0.01). Conclusion Rational emotive therapy may improve the negative emotions and the quality of life of advanced schistosomiasis patients with repeated hospitalizations.

15.
China Pharmacy ; (12): 1054-1061, 2020.
Article in Chinese | WPRIM | ID: wpr-821493

ABSTRACT

OBJECTIVE:To prepare Cheler ythrine (CHE) solid dispe rsion (SD),optimize the formulation technology , characterize its preparation and investigate its in vitro antioxidant activity. METHODS :The content of CHE in SD was determined by UV spectrophotometry. Based on single factor tests ,using the product yield as index ,using preparation method ,carrier material type,carrier material proportion (drug-carrier material mass ratio )as factors ,the formulation technology of SD was optimized by L(9 34)orthogonal test and validated. Based on solubility and accumulative dissolution determination ,the product was characterized with thermal analyssis ,X-ray diffraction and scanning electron microscope. Using ascorbic acid as positive control ,in vitro antioxidant activity of the product was determined by DPPH method. RESULTS :The linear range of CHE was 2.4-5.6 μg/mL; quantitation limit and detection limit were 0.066 9,0.022 1 μg/mL;RSDs of precision ,stability and reproducibility tests were all lower than 2%;recoveries were 97.50%-99.25%(RSD<1%, n=3). The optimal preparation technology included using PEG 6000 as carrier material ,carrier material ratio of 1 ∶ 3, prepared by solvent method. Three batches of CHE-PEG-SD were prepared. Verification test results showed that the 话:0539-80311889。E-mail:zhenshengao@163.com accumulative dissolution of CHE-PEG-SD was (61.72 ± 0.67)% at 15 min,and the yield was (99.04±0.83)%. The results of characterization showed that after CHE-PEG-SD prepared , its solubility (3.725 mg/mL)and accumulative dissolution (61.25%,15 min)were higher than CHE raw material [ 0.098 mg/mL, 6.24%(180 min)]. The endothermic peak and crystal absorption peak moved or even disappeared compared with raw material and the carrier material ,and CHE was uniformly dispersed in the carrier material as an amorphous state. Results of in vitro antioxidation test showed that different concentration of CHE-PEG-SD showed certain ability of DPPH free radical scavenging ,and the IC 50 was 0.124 mg/mL,higher than 0.041 mg/mL of ascorbic acid. CONCLUSIONS :Established content determination method is simple and accurate. The optimal SD formulation technology is stable and feasible. The solubility of prepared CHE-PEG-SD increases,and the dissolution in vitro increases,showing certain in vitro oxidation resistance.

16.
Chinese Medical Journal ; (24): 2787-2795, 2020.
Article in English | WPRIM | ID: wpr-877933

ABSTRACT

BACKGROUND@#Cryptococcal meningitis (CM) is one of the most common opportunistic infections caused by Cryptococcus neoformans in human immunodeficiency virus (HIV)-infected patients, and is complicated with significant morbidity and mortality. This study retrospectively analyzed the clinical features, characteristics, treatment, and outcomes of first-diagnosed HIV-associated CM after 2-years of follow-up.@*METHODS@#Data from all patients (n = 101) of HIV-associated CM hospitalized in Shanghai Public Health Clinical Center from September 2013 to December 2016 were collected and analyzed using logistic regression to identify clinical and microbiological factors associated with mortality.@*RESULTS@#Of the 101 patients, 86/99 (86.9%) of patients had CD4 count <50 cells/mm, 57/101 (56.4%) were diagnosed at ≥14 days from the onset to diagnosis, 42/99 (42.4%) had normal cerebrospinal fluid (CSF) cell counts and biochemical examination, 30/101 (29.7%) had concomitant Pneumocystis (carinii) jiroveci pneumonia (PCP) on admission and 37/92 (40.2%) were complicated with cryptococcal pneumonia, 50/74 (67.6%) had abnormalities shown on intracranial imaging, amongst whom 24/50 (48.0%) had more than one lesion. The median time to negative CSF Indian ink staining was 8.50 months (interquartile range, 3.25-12.00 months). Patients who initiated antiretroviral therapy (ART) before admission had a shorter time to negative CSF Indian ink compared with ART-naïve patients (7 vs. 12 months, χ = 15.53, P < 0.001). All-cause mortality at 2 weeks, 8 weeks, and 2 years was 10.1% (10/99), 18.9% (18/95), and 20.7% (19/92), respectively. Coinfection with PCP on admission (adjusted odds ratio [AOR], 3.933; 95% confidence interval [CI], 1.166-13.269, P = 0.027) and altered mental status (AOR, 9.574; 95% CI, 2.548-35.974, P = 0.001) were associated with higher mortality at 8 weeks.@*CONCLUSION@#This study described the clinical features and outcomes of first diagnosed HIV-associated CM with 2-year follow-up data. Altered mental status and coinfection with PCP predicted mortality in HIV-associated CM.


Subject(s)
China , HIV , HIV Infections/drug therapy , Humans , Meningitis, Cryptococcal/drug therapy , Retrospective Studies , Treatment Outcome
17.
Chinese Medical Journal ; (24): 2919-2927, 2020.
Article in English | WPRIM | ID: wpr-877929

ABSTRACT

BACKGROUND@#Albuvirtide is a once-weekly injectable human immunodeficiency virus (HIV)-1 fusion inhibitor. We present interim data for a phase 3 trial assessing the safety and efficacy of albuvirtide plus lopinavir-ritonavir in HIV-1-infected adults already treated with antiretroviral drugs.@*METHODS@#We carried out a 48-week, randomized, controlled, open-label non-inferiority trial at 12 sites in China. Adults on the World Health Organization (WHO)-recommended first-line treatment for >6 months with a plasma viral load >1000 copies/mL were enrolled and randomly assigned (1:1) to receive albuvirtide (once weekly) plus ritonavir-boosted lopinavir (ABT group) or the WHO-recommended second-line treatment (NRTI group). The primary endpoint was the proportion of patients with a plasma viral load below 50 copies/mL at 48 weeks. Non-inferiority was prespecified with a margin of 12%.@*RESULTS@#At the time of analysis, week 24 data were available for 83 and 92 patients, and week 48 data were available for 46 and 50 patients in the albuvirtide and NRTI groups, respectively. At 48 weeks, 80.4% of patients in the ABT group and 66.0% of those in the NRTI group had HIV-1 RNA levels below 50 copies/mL, meeting the criteria for non-inferiority. For the per-protocol population, the superiority of albuvirtide over NRTI was demonstrated. The frequency of grade 3 to 4 adverse events was similar in the two groups; the most common adverse events were diarrhea, upper respiratory tract infections, and grade 3 to 4 increases in triglyceride concentration. Renal function was significantly more impaired at 12 weeks in the patients of the NRTI group who received tenofovir disoproxil fumarate than in those of the ABT group.@*CONCLUSIONS@#The TALENT study is the first phase 3 trial of an injectable long-acting HIV drug. This interim analysis indicates that once-weekly albuvirtide in combination with ritonavir-boosted lopinavir is well tolerated and non-inferior to the WHO-recommended second-line regimen in patients with first-line treatment failure.@*TRIAL REGISTRATION@#ClinicalTrials.gov Identifier: NCT02369965; https://www.clinicaltrials.gov.Chinese Clinical Trial Registry No. ChiCTR-TRC-14004276; http://www.chictr.org.cn/enindex.aspx.


Subject(s)
Adult , Anti-HIV Agents/adverse effects , Antiretroviral Therapy, Highly Active , China , Drug Therapy, Combination , HIV Infections/drug therapy , HIV-1 , Humans , Maleimides , Peptides , Ritonavir/therapeutic use , Treatment Outcome , Viral Load
18.
Article in Chinese | WPRIM | ID: wpr-788954

ABSTRACT

Objective To investigate epidemic characteristics of a family aggregation COVID-19, and to provide scientific basis for prevention and control of family aggregation epidemic. Methods] Field epidemiological methods were used to investigate the cases and close contacts of a family aggregation COVID-19 in Y County, Chenzhou City, Hunan Province. Descriptive statistical analysis was used on epidemiological data . The 2019-nCoV nucleic acid was detected by real-time fluorescence quantitative RT-PCR. Results It was found that Ms. Deng was infected with COVID-19 and became the infectious source of the family aggregation epidemic , who had lived in Wuhan Hubei Province. Her boyfriend Mr. Cao became a second-generation case of COVID-19..Another two asymptomatic but infected persons were family members living with Ms.Deng . Conclusion COVID-19 easily spreads within families. The awareness of family members' protection, the education of new coronavirus pneumonia prevention and control in key groups should be strengthened to avoid the occurrence and spread of family aggregation epidemic.

19.
Journal of Medical Postgraduates ; (12): 178-183, 2020.
Article in Chinese | WPRIM | ID: wpr-818398

ABSTRACT

ObjectiveSurgical site infection (SSI)is a type of common hospital-acquired wounds. The purpose of this study is to understand its clinical characteristics and prognosis in order to provide evidence for taking appropriate measures.Methods132 wound patients who met the diagnostic criteria of surgical site infection in the wound care center in recent 3 years were enrolled. The patients were treated locally with nanosilver dressing combined with red light and infrared ray. Individualized nutritional recipes and activity prescriptions were given, and the skin was showered every other day to heal or last 2 months.Observation indicators: demographics and wound characteristics; changes of area and depth after14 days intervention; the posi-tive rate of bacteria before and after the intervention, and healing rate and healing time of 2 months were analyzed and compared.ResultsA total of 132 cases of SSI(52.27% superficial and 47.73% deep ) was identified. The average age was 48.33±16.90 years. The average age and gender of the two groups were similar (P>0.05).Peri-wound skin is contaminated in all cases. The mean onset time of SSIs was 19.82±5.64 days, and the median onset time was 20 days. The onset time and duration of deep SSIs were longer than that of superficial SSIs (P0.05), and the depth of deep SSIs was deeper than that of superficial SSIs (P<0.05).The positive rate of bacterial culture inthe deep SSI group (79.31%) was higher than that of the superficial SSI group (59.46%) (P<0.05). After 14 days treatment, the area was smaller, the depth was lower (P<0.05), and the positive rate of bacteria was significantly decreased in the two groups (P<0.05). The healing rate ofsuperficial SSI group (84.06%) was higher than that of deep SSI group (66.67%) (P<0.05) in two months, and the healing time of superficial SSI group was significantly shortened (35.46<11.12 days vs 41.08<11.33 days, P<0.05). Logistic regression analysis showed that negative bacterial culture before intervention increased the healing index (OR=0.190). Long-term use of antibiotics did not promote healing (OR=0.343).ConclusionSuperficial and deep SSIs are common types of SSIs. Gender and age are similar, and skin contamination may play a role in the development of SSI,which needs attention. Local and systemic interventions can effectively improve wound healing. Negative bacterial culture and proper use of antibiotics can improve the healingprobability.

20.
Chinese Medical Journal ; (24): 61-67, 2020.
Article in English | WPRIM | ID: wpr-781607

ABSTRACT

BACKGROUND@#Transcranial alternating current stimulation (tACS) offers a new approach for adult patients with major depressive disorder (MDD). The study is to evaluate the efficacy and safety of tACS treating MDD.@*METHODS@#This is an 8-week, double-blind, randomized, placebo-controlled study. Ninety-two drug-naive patients with MDD aged 18 to 65 years will receive 20 daily 40-min, 77.5-Hz, 15-mA sessions of active or sham tACS targeting the forehead and both mastoid areas on weekdays for 4 consecutive weeks (week 4), following a 4-week observation period (week 8). The primary outcome is the remission rate defined as the 17-item Hamilton depression rating scale (HDRS-17) score ≤7 at week 8. Secondary outcomes are the rates of response at weeks 4 and 8 and rate of remission at week 4 based on HDRS-17, the proportion of participants having improvement in the clinical global impression-improvement, the change in HDRS-17 score (range, 0-52, with higher scores indicating more depression) over the study, and variations of brain imaging and neurocognition from baseline to week 4. Safety will be assessed by vital signs at weeks 4 and 8, and adverse events will be collected during the entire study.@*DISCUSSION@#The tACS applied in this trial may have treatment effects on MDD with minimal side effects.@*TRIAL REGISTRATION@#Chinese Clinical Trial Registry, ChiCTR1800016479; http://www.chictr.org.cn/showproj.aspx?proj=22048.

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