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AIM: To investigate the expression level of inflammatory factors of aqueous humor before trabeculectomy in binocular chronic primary angle-closure glaucoma(CPACG)and its correlation with postoperative filtration bleb and intraocular pressure.METHODS: A total of 15 cases(30 eyes)with binocular CPACG who admitted to the Affiliated Eye Hospital of Nanjing Medical University from September to December 2021 and received trabeculectomy were selected. The surgery interval between two eyes was 7d, and the preoperative expression levels of monocyte chemoattractant protein-1(MCP-1), interleukin-17(IL-17), transforming growth factor-β(TGF-β), and interferon-γ(IFN-γ)of the aqueous humor in both eyes were respectively detected by enzyme-linked immunosorbent assay(ELISA). Furthermore, the intraocular pressure(IOP)and the morphology of filtering blebs at 1mo after surgery were measured.RESULTS: The concentrations of MCP-1, IL-17, TGF-β, and IFN-γ in aqueous humor from the first eye before surgery were 330.4±46.2, 357.3±46.9, 2347.5±363.8 and 527.7±101.6pg/mL respectively, and those concentrations in aqueous humor from the fellow eye were 298.2±40.7, 309.1±53.5, 1938.3±426.0 and 628.2±104.9pg/mL respectively. The preoperative expression levels of inflammatory factors of aqueous humor in both eyes were statistically significant(P≤0.05). Furthermore, the expression levels of IL-17 and TGF-β in the aqueous humor of patients with CPACG correlated with IOP and the height of filtering blebs at 1mo after surgery(P<0.05).CONCLUSION: There may be changes in the expression levels of inflammatory factors of aqueous humor in the fellow eye after surgery of the first eye. Moreover, the preoperative expression level of IL-17 and TGF-β in aqueous humor possibly related to postoperative IOP and the height of filtering bleb.
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Hepatolenticular degeneration (HLD) is Wilson's disease, which is an autosomal recessive inherited disease caused by gene abnormality and copper transport disorder in liver cells. The pregnancy of HLD patients is safe. During pregnancy, the treatment of eliminating copper should be continued, the dosage of drugs should be reduced according to the condition, and regular monitoring should be done. HLD patients with satisfactory copper control had better pregnancy outcomes than untreated HLD patients. The treatment during pregnancy should be individualized, and perinatal care should be coordinated by obstetrics, hepatology, liver transplantation, genetic counseling, pharmacy, anesthesiology, pediatrics and other disciplines.
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Objective:To explore the perinatal management of patients with WD during pregnancy, and to determine its genetic etiology and the possibility of fetal morbidity using the genetic detection of amniotic fluid and umbilical cord blood.Method:In terms of fine management during the perinatal period, a case of K-F ring was found in the Ophthalmology Department of Beijing Friendship Hospital, Capital Medical University in March 2019 due to eye astringency and eye swelling, and the hepatology department further diagnosed WD for one artificial abortion. After the second pregnancy in October 2020, multidisciplinary consultation and standardized treatment during pregnancy including gynecology and obstetrics, liver disease center, anesthesiology department, gastroenterology department and nutrition department were carried out. The genomes of patients' venous blood, amniotic fluid and umbilical cord blood were extracted and analyzed for ATP7B gene variation by Sanger sequencing.Result:Through multi-disciplinary collaborative management, the patient gave birth successfully in the case of pregnancy complicated with liver cirrhosis, portal hypertension, splenomegaly with hyperfunction, thrombocytopenia, anemia, esophageal and gastric varices and other complications. The phenotype of the newborn was normal, and the Apgar score was 10-10-10. Sequencing results showed that the patient had ATP7B p.Arg778Leu and p.Val890Met, which were missense heterozygous variants reported in the mutation database, and ACMG was classified as pathogenic variants. The results of amniotic fluid and umbilical cord blood showed that the fetus had only p.Arg778Leu single heterozygous variation, and it was predicted that there would be no clinical phenotype of WD.Conclusion:Perinatal multidisciplinary collaborative management has important protective significance for the successful pregnancy of patients with WD. Genetic screening of amniotic fluid and umbilical cord blood is conducive to early detection of fetal WD.
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Cognitive behavior therapy(CBT) is one of the most widely used psychotherapy methods in the world.However, its origin in Western culture makes many researchers doubt whether it can be effectively applied to other cultural groups.The discussion on this issue is conducive to further adjusting CBT from an international perspective to better serve different cultural groups.This review focuses on the research progress of acculturation in CBT at home and abroad.Firstly, it discusses the necessity of acculturation and introduces the relevant major researchers in this field abroad, so as to explain how to carry out the work of acculturation.Then the effectiveness of current acculturation work is demonstrated, and the research progress of acculturation related to Chinese culture is introduced emphatically.In previous studies, most scholars supported the development of acculturation, and preliminary evidence has shown that CBT after acculturation has equal or even better effectiveness.Based on this, different researchers have put forward their own acculturation framework or adaptation suggestions.However, there are still many shortcomings in current research, which are mainly reflected in six aspects: few comparative studies, lack of unified framework, blank fields in some areas, shallow level of acculturation, unknown mechanism and lack of bottom-up research.Thus, this review is aimed to point out the urgency and necessity of CBT cultural adaptation in China, and put forward some suggestions and preliminary ideas for the further development of more culturally adaptable CBT in China, in order to better promote the application of CBT in China.
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Objective:To observe the effect of fluoride on growth and development of bone microstructure of rats condyle subchondral bone (RCSB).Methods:Forty two 3-week-old SD rats (half male and half female) were fed adaptively for 1 week, and 3 females and 3 males were sacrificed and recorded as 0 month. The remaining rats were randomly divided into control group ( n = 18) and fluoride exposed group ( n = 18) according to their body weight (55 - 70 g), half male and half female. The fluoride exposed group was fed with 150 mg/L sodium fluoride (NaF) aqueous solution, and the control group was fed with tap water. The two groups of experimental animals were sacrificed at 3, 5 and 7 month, respectively, 6 rats in each group, half male and half female. The right mandibular condyle was separated, and Micro CT scanning was performed to detect the microstructure parameters of RCSB. Results:In fluoride exposed group (3 month), bone surface/tissue volume (BS/TV), bone surface/bone volume (BS/BV), trabecular thickness (Tb.Th), trabecular number (Tb.N), structure model index (SMI), connectivity, connectivity density (Conn.D) and total porosity of female rats were significantly different from those of male rats ( t = - 5.10, - 5.58, 4.52, - 4.32, - 4.03, - 2.81, - 6.71, - 3.32, P < 0.05). There was no significant difference in each index between female and male rats in fluoride exposed group (5, 7 month, P > 0.05). Conclusion:In chronic fluorine exposure bone environment, the RCSB bone microarchitecture of male and female rats is different with time, showing the tendency of fluoride injury that the bone changes of female rats are slowed and the bone changes of male rats are active.
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Objective:To investigate the efficacy and safety of geritinib in the treatment of acute myeloid leukemia (AML) with FLT3 mutation.Methods:The clinical data of 5 AML patients with FLT3 mutation who were diagnosed in the University of Hong Kong-Shenzhen Hospital, Shenzhen People's Hospital, Shenzhen Second People's Hospital, Shenzhen University General Hospital from March 2020 to April 2021 were retrospectively analyzed. Relapsed patients concurrently received two- or three-drug chemotherapy combined with geritinib. Blood routine was checked once a week; liver function and renal function were checked once every 2 weeks during treatment. Bone marrow puncture was performed once every 1 to 3 months to monitor the bone marrow morphology, minimal residual disease (MRD) and FLT3 mutation expression levels. The efficacy, side effects, overall survival of these patients were analyzed after treatment with geritinib.Results:The white blood cell was increased in all the 5 patients at the initial diagnosis. FLT3 mutations analysis showed FLT3-internal tandem duplication (ITD) (3 cases) and FLT-3 tyrosine-kinase domain (TKD) (2 cases). Among 5 patients, 1 patient was relapse-free with maintenance therapy of oral geritinib after hematological stem cell transplantation (HSCT) for 60 days; among other 4 relapsed and refractory patients, 1 female patient after pregnancy relapsed after transplantation and then achieved complete remission followed by the maintenance therapy with geritinib after oral geritinib, 1 16-year-old patient achieved treatment outcome close to the complete remission after treatment with geritinib, 1 patient achieved complete remission after treatment with geritinib, and then underwent haplo-HSCT followed by the maintenance therapy with geritinib and the other 1 relapsed patient achieved complete remission after treatment with geritinib. After transplantation, 3 patients receiving maintenance treatment of geritinib did not relapse. The main side effects included anemia, decreased neutrophil count, rash, and increased aminotransferase. The median follow-up time of 5 patients was 15 months (6-20 months). All 5 cases survived until the last follow-up in November 2021 and 4 patients were disease-free.Conclusions:Relapsed and refractory AML patients with FLT3 mutation can achieve complete remission after treatment with geritinib and get a chance for transplantation. Geritinib may reduce the risk of recurrence after transplantation and improve survival rate. No serious side effects occur in geritinib treatment.
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Objective: To evaluate the short-term efficacy and perioperative safety of catheter-based intervention in patients with pulmonary vein stenosis caused by fibrosing mediastinitis (FM). Methods: It was a case series study. Consecutive patients with pulmonary vein stenosis caused by FM, who underwent percutaneous pulmonary vein angioplasty in Gansu Provincial Hospital from January 2018 to June 2020, were retrospective enrolled. The baseline characteristics, comorbidities, exercise capacity and hemodynamic data before and after treatment were compared, and the procedural related complications were evaluated. Results: A total of 30 patients ((64.3±7.1) years, 15 males) were included. Sixty-three pulmonary vein stenosis were treated by 32 percutaneous pulmonary vein angioplasty procedures. Forty-four stents were implanted in 41 pulmonary veins after balloon angioplasty, and the diameter of implanted stents was (8.3±1.2)mm. Balloon angioplasty was performed on 22 pulmonary vein stenosis, the mean balloon diameter was (4.2±2.1)mm. The pulmonary vein diameter increased from (2.6±1.3) to (6.6±2.6) mm (P<0.001) and the pressure gradient across the pulmonary vein stenotic segment reduced from 19 (12, 29) to 2 (0, 4) mmHg (1 mmHg=0.133 kPa) (P<0.001) immediately post procedure. The pulmonary vein flow grade was significantly improved compared with baseline (P<0.001). The most common operation related complications were lung injury (44.0% (11/25)) and hemoptysis (18.8% (6/32)), which did not need special treatment. During the 2.0 (1.3, 3.2) months follow-up, the WHO functional class was significantly improved (P<0.05), the 6-minute walking distance increased from (254.8±114.5) m to (342.8±72.4)m (P<0.05), the mean pulmonary arterial pressure decreased from (40.9±8.3) mmHg to (35.4±7.7) mmHg (P<0.01), 17 out of 19 patients with refractory pleural effusion experienced total remission during the follow-up period (P<0.001). CT pulmonary venography was repeated in 17 patients. The incidence of in-stent restenosis of pulmonary vein was 24.0% (6/25). Conclusions: Percutaneous pulmonary vein angioplasty is effective for the treatment of pulmonary vein stenosis caused by fibrosing mediastinitis. However, it's not so safe, procedural related complication should be paid attention to and the rate of in-stent restenosis is relative high during the short-term follow-up.
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Angioplasty, Balloon , Catheters , Humans , Male , Mediastinitis , Retrospective Studies , Sclerosis , Stenosis, Pulmonary Vein , Stents , Treatment OutcomeABSTRACT
Objective:To explore the clinical characteristics, causes, diagnosis and treatment of transplant renal artery stenosis after pediatric-to-adult kidney transplantation.Methods:Between July 2014 and March 2019, clinical data were retrospectively reviewed for 25 en-bloc and 27 single kidney transplant cases.Results:One en-bloc(4.0%)and two single kidney recipients(7.4%)were diagnosed as renal artery stenosis at Month 13-23 months post-transplantation.It was higher than the rate of stenosis in adult-to-adult transplant cases(1.1%)during the same period.As compared with recipients without stenosis, stenotic ones had younger pediatric donors( P<0.05)and yet similar body weight of donors as well as recipients( P>0.05). The inner diameters of stenonotic sites were(1.40-1.63)mm and predominant stenotic site was proximal renal artery rather than anastomotic site.The remaining parts of major renal arteries varied from 2.31 to 4.93 mm in diameter.It was normal in children with a corresponding age.All three cases responded well to percutaneous transluminal angioplasty and stenting. Conclusions:The cause of stenosis may be an undeveloped local artery diameter due to extensive tissue dissection around artery.Therefore cautious selections of infantile single renal graft for adult recipients and preserving surrounding tissue of renal artery assist in the prevention of graft arterial stenosis.
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A total of 33 pesticides have been banned from Chinese medicinal materials and decoction pieces(plants) according to Chinese Pharmacopoeia(2020 edition). According to the chemical structures, they are mainly divided into seven categories: organophosphorus compounds, organochlorines, carbamates, amidines, sulfonylureas, phenylpyrazoles, and ethers. These banned pesticides exhibit neurotoxicity, reproductive toxicity, immune system toxicity, teratogenicity, carcinogenesis, and mutagenesis, seriously damaging human and animal health. They affect not only the quality and safety of traditional Chinese medicines and resulting products, but also their competitiveness in the international market. Due to the numerous varieties of traditional Chinese medicines and their complex substrates, it is necessary to establish a universal and highly sensitive method for pesticide residue detection. This review systematically summarized the residual status, toxicity, and analytical methods of banned pesticides in traditional Chinese medicines, and forecasted the prospects of different analytical techniques, so as to provide reference for further safety and risk assessment of banned pesticide residues in traditional Chinese medicines, thus ensuring the safe production of traditional Chinese medicines.
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China , Drugs, Chinese Herbal/toxicity , Humans , Medicine, Chinese Traditional , Organophosphorus Compounds , Pesticide Residues/toxicity , Pesticides/analysisABSTRACT
Background A large number of studies on fluoride-induced systemic bone damage have been reported previously, but there is little understanding of the characteristics of fluoride accumulation in jawbone. Jawbone is homologous to the other bone tissues in the body, and is an indispensable and important frame structure in the oral cavity. Objective To study fluoride accumulation and its change trends in teeth, jawbone, and femur of SD rats with chronic drinking-water-borne fluorosis. Methods A total of 144 three-week-old SD rats, half male and half female, were randomly divided into two groups, a normal control group and a fluoride group. The rats in the normal controlgroup drank purified water disinfected and filtered from Guizhou, and the water contained 0.08 mg·kg−1 fluoride which was lower than the national water quality standard at 1 mg·kg−1. The rats in the fluoride group were fed with sodium fluoride (NaF) solution with a concentration of 150 mg·L−1. At 3, 5 and 7 months of the fluoride exposure, the levels of fluoride in urine, blood, teeth, jawbone, and femur were measured by fluoride ion electrode method. Results There was no sex difference in fluoride content in different biological samples of rats in the fluoride group and the normal control group (all P>0.05). After 3 months of fluoride exposure, the rats in the fluoride group showed dental fluorosis of grade II, and higher levels of fluoride ion in blood and urine than the normal control group (all P<0.05), indicating that the rat model of fluoride drinking-water-borne chronic fluorosis was successfully replicated. In the normal control group, the levels of fluoride in femur remained stable; at the end of 3 months, the levels of fluoride in jawbone and teeth were (1097.36±470.34) and (453.09±173.43) mg·kg−1 respectively, and at the end of 7 months, the levels of fluoride in jawbone and teeth were (2113.18±634.49) and (1604.80±160.43) mg·kg−1 respectively. Both jawbone and teeth showed a positive temporal effect of increasing fluoride accumulation (P<0.05). After continuous fluoride feeding, the fluoride levels in jawbone, teeth, and femur of rats in the fluoride group were (3145.02±765.82), (1550.20±77.73), and (3640.55±699.42) mg·kg−1 after 3 months, and (8420.36±1728.56), (4702.08±1417.06), and (6091.99±1384.97) mg·kg−1 after 7 months. The three kinds of hard tissues all showed a positive temporal effect of increasing fluoride accumulation (P<0.05), and the cumulative increas was large than that in the normal control group. Among them, jawbone fluorine increased most. At the end of 5 months, the levels of fluoride in jawbone, femur, and teeth were (6485.02±2141.98), (4914.99±1529.41), and (3365.21±1462.27) mg·kg−1 respectively, and the levels of fluoride in jawbone was much higher than those in femur and teeth (P<0.05). Conclusion Hard tissues such as bones and teeth are fluorine sensitive tissues. Compared with femur, jawbone showed significantly high fluoride accumulation, while teeth show relatively lagging fluoride accumulation.
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Objective:To understand the development trend of scientific research in major medical institutions in China from 2019 to 2021.Methods:The PubMedplus database was searched, and the distribution of papers, published journals and its′ influencing factors (IF) of top 30 domestic medical institutions from 2019 to 2021 were statistically analyzed.Results:From 2019 to 2021, 84 405 PubMed papers were published by the top 30 medical institutions, including 79 459 papers in English, accounted for 94.14%, and 4 946 papers in Chinese, accounted for 5.86%. Of them, 22 447, 29 540 and 32 430 papers were published in 2019, 2020 and 2021. 75 240 papers in English were indexed by SCI database (89.14% of total English papers). 17 729 papers (accounted for 21.00%) were published by the top 27 journals, Frontier in Oncology ranks first. 4 400 papers (5.85% of total) were published by the journals of impact factors greater than 10. The biggest portion of the papers, 26 550 papers (35.29% of total) were published by the journals of impactor factor from 3 to 5. Conclusions:The quantity and quality of papers published by major medical institutions in China have been greatly improved each year. The progress level of medical institutions is different, and their advantageous disciplines of medical institutions have been well reflected.
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Objectives:To investigate the epidemiological features and associated factors of chronic renal insufficiency (CRI) in Binhai county from Jiangsu province.Methods:This is a cross-sectional study including individuals aged≥18 years old and participating in health examinations of Binhai county from January to December 2018. Medical records were collected to analyze the epidemiology of CRI [estimated glomerular filtration rate <60 ml·min -1·(1.73 m 2) -1]. Multivariate logistic regression was used to analyze the associated influencing factors of CRI. Results:A total of 395 541 individuals residing in Binhai county were enrolled, with 190 258 males (48.1%) and age of (55.34±15.12) years old. The overall crude prevalence of CRI was 2.04% (8 065/395 541, 95% CI 2.00%-2.08%) in this adult population. Furthermore, the age- and gender-standardized overall prevalence of CRI was 1.22% (95% CI 1.18%-1.25%), with a rate of 1.47% (4 676/205 283, 95% CI 1.42%-1.52%) in women and a rate 0.95% (3 389/190 258, 95% CI 0.91%-1.00%) in men. There was a strong positive correlation between the risk of CRI and age (per 10-year increase, OR=2.449, 95% CI 2.402-2.497). Compared with individuals <30 years old, the OR of CRI in individuals aged 60-69, 70-79 and ≥80 years old were 3.827 (95% CI 3.010-4.864), 12.004 (95% CI 9.457-15.239) and 44.636 (95% CI 35.187-56.622) respectively. Females ( OR=1.142, 95% CI 1.083-1.203), increasing systolic blood pressure (per 10 mmHg increase, OR=1.062, 95% CI 1.048-1.076), increasing heart rate (per 10-beat/min increase, OR=1.071, 95% CI 1.044-1.098), elevating triglyceride (per 1.33 mmol/L increase, OR=1.140, 95% CI 1.119-1.162), elevating fasting blood glucose (5.6-6.9 mmol/L/<5.6 mmol/L, OR=1.158, 95% CI 1.086-1.233; ≥7 mmol/L/<5.6 mmol/L, OR=1.387, 95% CI 1.296-1.484) and central obesity ( OR=1.126, 95% CI 1.068-1.187) were independent risk factors for CRI. Conclusions:The age- and gender-adjusted prevalence of CRI in adults in Binhai county is 1.22%. Older age, females, central obesity, and high levels of triglyceride, systolic blood pressure, heart rate and fasting glucose are independent associated factors of CRI.
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From January to July 2017, 872 high-risk middle-aged and elderly patients of stroke who visited general practice clinics in 10 community health service centers in Shanghai were enrolled in the study. Cluster randomization was used to select 427 patients from 5 community centers as the intervention group, and 445 patients from other 5 community centers as the control group. The intervention group received health education and traditional Chinese exercise training on the basis of conventional treatment;while the control group received conventional treatment only. After 12 months of intervention physical examinations and related laboratory tests were performed,and the risk factors were compared between two groups before and after the intervention. The results showed that there were significant differences in the systolic and diastolic blood pressure,blood urea nitrogen (BUN),creatinine (Cr) and homocysteine before and after the intervention in both groups (all P<0.05); and compared the control group the improvement of above indicators was more marked in the intervention group. There was no significant difference in cholesterol, triglyceride, and low-density lipoprotein between the two groups before and after the intervention ( P>0.05). The health management with integrated traditional Chinese and western medicine can effectively control some risk factors of stroke for middle-aged and elderly people, which is beneficial for the prevention and control of stroke in the community.
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Objective:To explore the correlation between metabolic syndrome(MS)and early renal function injury in chronic kidney disease(CKD)in the healthy elderly subjects having passed through a healthy physical examination.Methods:These healthy elderly subjects aged ≥ 60 years in the Sichuan Provincial People's Hospital health management center from September 2017 to August 2018 were randomly selected to collect lifestyle information such as disease history and living habits, as well as health information such as height, weight, waist circumference, blood pressure, fasting blood lipid, blood glucose, creatinine, morning urine routine, urinary protein and urinary occult blood.The detection situation of MS and early renal function injury of chronic kidney disease, and the correlation of MS and its abnormal components with early renal function injury of CKD were analyzed.Results:A total of 2 975 subjects, aged from 60 to 92 years old, with mean age of(67.10±5.98)years old, were enrolled.The detection rate of MS and early renal function impairment in CKD was 32.34%(962/2 975)and 28.84%(858/2 975)respectively.The detection rate of early CKD renal function injury in MS patients was 37.63%(362/962), which was higher than that in non-MS patients(24.64%)(496/2 013)( χ2=53.52, P<0.001). The prevalences of CKD and albumin/creatinine ratio(ACR)in MS patients were significantly higher than those in non-MS patients[31.91%(307/962)versus 17.49%(352/2 013)]with the difference being statistically significant( χ2=78.56, P <0.001). Central obesity, elevated blood pressure and elevated blood glucose increased the risk of CKD( OR=1.44, 1.82 and 1.74 respectively, all P< 0.05). Along with the increase of number of metabolic abnormal components, the risk of CKD increased. Conclusions:MS is a risk factor for early renal function impairment in CKD.Early control and treatment of MS are of great significance in reducing the incidence rate of CKD and delaying CKD progression.
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Objective:To find out the hot-spot issues in the field of oral nursing.Methods:The bibliometric, classified statistics and CiteSpace visualized analysis methods were used to describe the current situation of papers publication in this field, the characteristics of core authors, highly cited papers and important burst terms and the co-occurrence map of key words by collecting oral nursing related papers of Web of Science published from January 1, 1999 to December 31, 2019.Results:A total of 1 645 literatures were obtained. It experienced growth of the total amount of the published articles and citation. The USA had the largest number of research papers and China ranked the thirteenth, 10 journals including British Dental Journal published 53.25% of the SCI papers about oral nursing. Most articles were published on journals with impact factor ranging 1-2. The de Baat C research team was the most influential. The articles of oral nursing research focused on the oral health, care, quality of life, prevention, health, prevalence, oral hygiene, oral care, nursing, children, risk and so on. The analysis of burst terms found that the frontiers of oral nursing research focus on oral care, quality of life, health and so on.Conclusion:The hot-spot directions of oral nursing research are family oral care solution of specific people and the help of teledentistry for oral health care.
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Vitamin D is a fat soluble steroid derivative, which is very important to maintain human normal physiological function. It plays an important role in embryogenesis, bone development and calcium homeostasis. Vitamin D deficiency is widespread in the world, and the prevalence of vitamin D deficiency during pregnancy is also significantly increased, accompanied by adverse maternal and neonatal outcomes, such as gestational diabetes mellitus, preeclampsia, premature delivery, and low birth weight. At present, there is no consensus on whether vitamin D supplementation is helpful to improve the prognosis of mothers and infants, and whether vitamin D is the etiology or marker of adverse pregnancy outcome. This paper reviews the latest research progress on the relationship between vitamin D level during pregnancy and maternal and infant outcomes.
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This study establishes a quantitative analysis of multi-components by single marker (QAMS) method for the simultaneous determination of gallic acid, sodium danshensu, protocatechuic acid, protocatechuic aldehyde, vanillin, rosmarinic acid, salvianolic acid B, eugenol, cryptotanshinone and tanshinone IIA in Guanxinshutong capsules (Bambusae Concretio Silicea, Salvia miltiorrhiza, clove, borneol, Bambusae Concretio Silicea) by HPLC. Sample was loaded onto an Agilent C18 (ZORBAX Extend-RP C18, 250 mm × 4.6 mm, 5 µm) column and eluted with methanol-0.4% aqueous formic acid solution as a flow phase gradient, flow speed 1.0 mL·min-1, detection wavelength 280 nm, column temperature 35 ℃ and sample intake of 5 µL. Using protocatechuic acid as the internal reference, a relative correction factor was calculated and the durability was investigated, and the content of 10 components was calculated by QAMS and external standard method (ESM). The results show that the specificity, linear relationship, precision, repeatability, and stability of the 10 components were good. The average recovery was 98.20%-103.47% and RSD was 1.26%-2.84%. The relative positive factors and contents of the other nine components were calculated as gallic acid (0.759, 227.381), sodium tanshinol (3.630, 3.283), protocatechualdehyde (0.185, 0.150), vanillin (0.532, 65.213), rosmarinic acid (4.240, 1.035), salvianolic acid B (3.245, 18.204), eugenol (1.729, 9.265), cryptotanshinone (0.691, 1.449), and tanshinone ⅡA (0.702, 1.939). The results of QAMS were consistent with ESM analysis, and the relative error was between -3% and 3%. This method is stable and reliable, and can be used for the determination of 10 components in Guanxinshutong capsules.
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OBJECTIVE@#To assess the efficacy and safety of mulberry twig alkaloids (Sangzhi alkaloids, SZ-A) for treatment of type 2 diabetes in a randomized, double-blind, placebo-controlled multicenter clinical trial.@*METHODS@#A total of 200 patients were randomized to receive SZ-A (n=100) or placebo (n=100) for 16 weeks. The data analysis system for electronic data capture clinical trial central randomization system was used for randomization and dispensing of drugs. The primary outcome was the change in glycosylated hemoglobin (HbA1c) level. The secondary outcome included the proportions of cases with HbA1c <7.0% and HbA1c <6.5%, fasting blood glucose (FBG), postprandial blood glucose (PBG), area under curve for the PBG (AUC0-2h), body weight, and body mass index (BMI). Adverse events (AEs), severe adverse events (SAEs), treatment-related adverse events (TAEs), gastrointestinal disorders (GDs), blood pressure, routine blood tests, and liver and kidney function were monitored.@*RESULTS@#Compared with baseline, the change of HbA1c at week 16 was -0.80% (95% CI: -0.98% to -0.62%) and -0.09% (95% CI: -0.27% to 0.09%) in SZ-A group and placebo group, respectively. The proportion of patients with HbA1c <7% and <6.5% was higher in the SZ-A group than in the placebo group (46.8% vs. 21.6% and 29.9% vs. 10.8%). The observed values and changes in FBG, 1 h-PBG, 2 h-PBG, and AUC0-2h differed significantly between groups (P<0.001), but differences were not significant in body weight and BMI (P>0.05). The incidence rates of AEs, TAEs, and GDs differed significantly between groups (P=0.010, P=0.005, and P=0.006, respectively), whereas the incidence rates of SAEs showed no significant differences between groups (P=1.000).@*CONCLUSION@#SZ-A are effective and safe for treatment of type 2 diabetes. The protocol was registered in http://www.chictr.org.cn/showproj.aspx?proj=60117 (ChiCTR2000038550).
Subject(s)
Alkaloids , Blood Glucose , Diabetes Mellitus, Type 2/drug therapy , Double-Blind Method , Glycated Hemoglobin , Humans , Hypoglycemic Agents/therapeutic use , Morus , Tablets/therapeutic use , Treatment OutcomeABSTRACT
OBJECTIVE@#To establish an immune gene prognostic model of acute myeloid leukemia (AML) and explore its correlation with immune cells in bone marrow microenvironment.@*METHODS@#Gene expression profile and clinical data of TCGA-AML were downloaded from TCGA database. Immune genes were screened by LASSO analysis to construct prognosis prediction model, and prediction accuracy of the model was quantified by receiver operating characteristic curve and area under the curve. Survival analysis was performed by Log-rank test. Enriched pathways in the different immune risk subtypes were evaluated from train cohort. The relationship between immune prediction model and bone marrow immune microenvironment was verified by flow cytometry in the real world.@*RESULTS@#Patients with low-risk score of immune gene model had better prognosis than those with high-risk score. Multivariate analysis showed that the immune gene risk model was an independent prognostic factor. The risk ratio for AML patients in the training concentration was HR=24.594 (95%CI: 6.180-97.878), and the AUC for 1-year, 3-year, and 5-year overall survival rate was 0.811, 0.815, and 0.837, respectively. In addition, enrichment analysis of differential gene sets indicated activation of immune-related pathways such as cytokines and chemokines as well as autoimmune disease-related pathways. At the same time, real world data showed that patients with high immune risk had lower numbers of CD8+T cells and B lymphocytes compared with low immune risk patients.@*CONCLUSION@#We constructed a stable prognostic model for AML, which can not only predict the prognosis of AML, but also reveal the dysregulation of immune microenvironment.
Subject(s)
Humans , Leukemia, Myeloid, Acute/genetics , Prognosis , ROC Curve , Risk Factors , Transcriptome , Tumor Microenvironment/geneticsABSTRACT
OBJECTIVE@#To explore the characteristics of infection in patients with myelodysplastic syndromes (MDS), risk factors of serious infection, and their correlation with curative effect.@*METHODS@#The clinical data of 92 newly diagnosed MDS patients with nosocomial infection from January 2016 to June 2020 in our hospital were retrospectively analyzed.@*RESULTS@#A total of 306 courses of treatment were completed in 92 newly diagnosed MDS patients. The infection rate was the highest in the first course of treatment (84.8%, 78/92), and then decreased gradually. The top three infection sites were lung, upper respiratory tract, and gastrointestinal tract. A total of 90 strains of pathogenic bacteria were detected, of which 33.4% (30/90) were gram-negative bacilli, 23.3% (21/90) were gram-positive cocci, 23.3% (21/90) were fungi, and 20.0% (18/90) were viruses. The serious infection rate among 92 patients with MDS was 22.8% (21/92). Multivariate analysis showed that neutrophil deficiency>7 days (OR=10.875, 95%CI: 2.747-43.051, P=0.001) was an independent risk factor for serious infection in MDS patients. Compared with non-severe infection group, the total effective rate of severe infection group was lower (90.9% vs 63.6%, χ2=4.393, P<0.05).@*CONCLUSION@#The infection rate of MDS patients is high in the first course of treatment, and the most common infection site is the lung. Gram-negative bacteria is the most common pathogen. MDS patients with neutrophil deficiency>7 days have a high risk of serious infection and poor efficacy.