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1.
Journal of Clinical Hepatology ; (12): 342-346, 2022.
Article in Chinese | WPRIM | ID: wpr-920882

ABSTRACT

Objective To investigate the effect of liver CD8 + T lymphocytes on co-cultured hepatic stellate cells (HSCs) after the application of Fuzheng Huayu prescription in a moues model of acute liver injury, as well as the mechanism of action of Fuzheng Huayu prescription in preventing liver fibrosis. Methods A total of 18 specific pathogen-free male C57BL/6NCrl Vr mice were randomly divided into normal group, model group, and Fuzheng Huayu prescription group, with 6 mice in each group. The mice in the Fuzheng Huayu prescription group were given Fuzheng Huayu prescription for 5 days in advance. At 12 hours before the experiment, 10% CCl 4 was injected intraperitoneally at a dose of 2 mL/kg body weight. Blood was collected from the main abdominal vein, and the serum was separated to measure the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Part of the liver was used for pathological observation. After the mice were pretreated with medication in vivo, flow cytometry was used for the sorting of mouse liver CD8 + T lymphocytes, which were then co-cultured with the mouse HSC cell line (JS 1) in a 96-well plate at a ratio of 2∶ 1, and after co-culture for 24 and 48 hours, qPCR was used to measure the changes in the mRNA expression of Col.I and α-SMA. An analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the SNK- q test or the least significant difference t -test was used for further comparison between two groups. Results The model group had significantly higher activities of ALT and AST than the normal group (both P < 0.000 1), and compared with the model group, the Fuzheng Huayu prescription group had a significantly lower degree of increase in ALT activity ( P < 0.001). HE staining showed that the Fuzheng Huayu prescription group had a significantly lower degree of hepatocyte degeneration and necrosis compared with the model group. Compared with the normal group, the total lymphocytes, CD45, CD4 - CD8 + T and CD8 + CD28 - T in the model group increased significantly, while the proportion of the above lymphocytes in the Fuzheng Huayu formula group decreased significantly compared with the model group ( P < 0.001). CD8 + T lymphocytes isolated from the liver of mice in each group were co-cultured with JS 1 for 48 hours, and compared with the control group (JS 1 cultured alone) and the normal group, the model group had a significant increase in the mRNA expression of α-SMA (both P < 0.01) and significantly higher mRNA expression of Col.I than the control group and the normal group (normal mouse liver CD8 + T lymphocytes co-cultured with JS 1) (both P < 0.001). The Fuzheng Huayu prescription group had significantly lower mRNA expression levels of α-SMA and Col.I than the model group (both P < 0.01). Conclusion Fuzheng Huayu prescription can indirectly inhibit activated HSCs by altering the functional phenotype of CD8 + T lymphocytes in mouse liver.

2.
Article in Chinese | WPRIM | ID: wpr-913058

ABSTRACT

Vaccination is one of the most effective intervention for the containment and elimination of infectious diseases. Recently, the world’s first malaria vaccine RTS, S/AS01 was approved by WHO for use among children living in moderately and highly malaria endemic areas of Africa, which brings a hope for the research and development of malaria vaccines. Here, we review the current status of malaria vaccines development and provide a perspective on the development of next-generation malaria vaccines, so as to provide insights into the successful development of malaria vaccines.

3.
Article in Chinese | WPRIM | ID: wpr-921540

ABSTRACT

Diabetic retinopathy(DR)is the major microvascular disease in diabetic patients,and it is also one of the main blinding eye diseases in the current population.The typical pathological change of DR in the eyes is vascular endothelial growth factor(VEGF)-mediated neovascularization induced by retinal ischemic stimulation.Therefore,anti-VEGF drugs have gradually become one of the mainstream methods to treat DR and DR-induced diseases such as diabetic macular edema.Recent studies have proved that anti-VEGF drugs have certain effects on ocular blood vessels and blood flow in patients with DR,while the specific mechanism has not been fully elucidated.This article summarizes the research progress on the effects of intravitreal injection of anti-VEGF drugs on the ocular blood vessels and blood flow in patients with DR.


Subject(s)
Angiogenesis Inhibitors/therapeutic use , Diabetes Mellitus , Diabetic Retinopathy/drug therapy , Humans , Intravitreal Injections , Macular Edema/drug therapy , Pharmaceutical Preparations , Vascular Endothelial Growth Factor A , Vascular Endothelial Growth Factors/therapeutic use
4.
Chinese Medical Journal ; (24): 2175-2185, 2021.
Article in English | WPRIM | ID: wpr-921109

ABSTRACT

BACKGROUND@#Macrophages are involved in the pathogenesis of idiopathic pulmonary fibrosis, partially by activating lung fibroblasts. However, how macrophages communicate with lung fibroblasts is largely unexplored. Exosomes can mediate intercellular communication, whereas its role in lung fibrogenesis is unclear. Here we aim to investigate whether exosomes can mediate the crosstalk between macrophages and lung fibroblasts and subsequently induce fibrosis.@*METHODS@#In vivo, bleomycin (BLM)-induced lung fibrosis model was established and macrophages infiltration was examined. The effects of GW4869, an exosomes inhibitor, on lung fibrosis were assessed. Moreover, macrophage exosomes were injected into mice to observe its pro-fibrotic effects. In vitro, exosomes derived from angiotensin II (Ang II)-stimulated macrophages were collected. Then, lung fibroblasts were treated with the exosomes. Twenty-four hours later, protein levels of α-collagen I, angiotensin II type 1 receptor (AT1R), transforming growth factor-β (TGF-β), and phospho-Smad2/3 (p-Smad2/3) in lung fibroblasts were examined. The Student's t test or analysis of variance were used for statistical analysis.@*RESULTS@#In vivo, BLM-treated mice showed enhanced infiltration of macrophages, increased fibrotic alterations, and higher levels of Ang II and AT1R. GW4869 attenuated BLM-induced pulmonary fibrosis. Mice with exosomes injection showed fibrotic features with higher levels of Ang II and AT1R, which was reversed by irbesartan. In vitro, we found that macrophages secreted a great number of exosomes. The exosomes were taken by fibroblasts and resulted in higher levels of AT1R (0.22 ± 0.02 vs. 0.07 ± 0.02, t = 8.66, P = 0.001), TGF-β (0.54 ± 0.05 vs. 0.09 ± 0.06, t = 10.00, P < 0.001), p-Smad2/3 (0.58 ± 0.06 vs. 0.07 ± 0.03, t = 12.86, P < 0.001) and α-collagen I (0.27 ± 0.02 vs. 0.16 ± 0.01, t = 7.01, P = 0.002), and increased Ang II secretion (62.27 ± 7.32 vs. 9.56 ± 1.68, t = 12.16, P < 0.001). Interestingly, Ang II increased the number of macrophage exosomes, and the protein levels of Alix (1.45 ± 0.15 vs. 1.00 ± 0.10, t = 4.32, P = 0.012), AT1R (4.05 ± 0.64 vs. 1.00 ± 0.09, t = 8.17, P = 0.001), and glyceraldehyde-3-phosphate dehydrogenase (2.13 ± 0.36 vs. 1.00 ± 0.10, t = 5.28, P = 0.006) were increased in exosomes secreted by the same number of macrophages, indicating a positive loop between Ang II and exosomes production.@*CONCLUSIONS@#Exosomes mediate intercellular communication between macrophages and fibroblasts plays an important role in BLM-induced pulmonary fibrosis.


Subject(s)
Angiotensin II , Animals , Bleomycin/toxicity , Exosomes , Fibroblasts , Lung , Macrophages , Mice , Mice, Inbred C57BL , Pulmonary Fibrosis/chemically induced , Receptor, Angiotensin, Type 1
5.
Article in Chinese | WPRIM | ID: wpr-912858

ABSTRACT

Objective: To observe the effects of acupuncture plus spinal manipulations on the physical functioning and levels of alkaline phosphatase (ALP), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and osteoprotegerin (OPG) in patients with ankylosing spondylitis (AS). Methods: A total of 128 AS cases were allocated into a control group and an observation group using random number table method, with 64 cases in each group. Patients in both groups took sulfasalazine and meloxicam. Patients in the observation group received additional acupuncture plus spinal manipulations. The efficacy, Bath AS functional index (BASFI), Bath AS disease activity index (BASDAI), and the levels of ALP, ESR, CRP and OPG were compared between the two groups after eight weeks of treatment. Results: After treatment, the symptom scores of traditional Chinese medicine in both groups were decreased (all P<0.05), and these scores in the observation group were significantly lower than in the control group (all P<0.05); the VAS, BASFI and BASDAI scores in both groups were decreased (all P<0.05), and these scores in the observation group were significantly lower than in the control group (all P<0.05); and the ALP, ESR, CRP and OPG levels in both groups were decreased (all P<0.05), and these levels in the observation group were significantly lower than in the control group (all P<0.05). The total efficacy rate was 92.2% in the observation group, versus 78.1% in the control group, presenting a statistical significance (P<0.05). Conclusion: Conventional medication combined with acupuncture and spinal manipulations can improve clinical symptoms, accelerate the recovery of physical functioning, and reduce the ALP, ESR, CRP and OPG levels.

6.
Article in Chinese | WPRIM | ID: wpr-912398

ABSTRACT

Beh?et uveitis (BU), one of the common manifestations of Beh?et syndrome, has a poor prognosis, high blinding rate, and severely impairs the quality of patients' life. The current treatment principle mainly induce and maintain inflammation remission by suppressing the immune response. The glucocorticoid combined with immunosuppressive therapy for the treatment of BU has disadvantages such as long medication time, severe adverse effects, and poor long-term prognosis, whereas biologics have gradually attracted attention about the treatment of BU because of their high efficacy, low toxicity, and good long-term prognosis. The biologics used to treat BU include tumor necrosis factor-α inhibitors, interferon-α, interleukin blockers, and lymphocyte targeting preparations. It is believed that with the progress of various studies and clinical trials, the stepwise application of biologics is promising, and it is hopeful to provide more accurate and effective treatment for patients with BU in the future.

7.
Article in Chinese | WPRIM | ID: wpr-912384

ABSTRACT

Retinitis pigmentosa (RP) is an inherited retinal disease characterized by degeneration of retinal pigment epithelial cells. Precision medicine is a new medical model that applies modern genetic technology, combining living environment, clinical data of patients, molecular imaging technology and bio-information technology to achieve accurate diagnosis and treatment, and establish personalized disease prevention and treatment model. At present, precise diagnosis of RP is mainly based on next-generation sequencing technology and preimplantation genetic diagnosis, while precise therapy is mainly reflected in gene therapy, stem cell transplantation and gene-stem cell therapy. Although the current research on precision medicine for RP has achieved remarkable results, there are still many problems in the application process that is needed close attention. For instance, the current gene therapy cannot completely treat dominant or advanced genetic diseases, the safety of gene editing technology has not been solved, the cells after stem cell transplantation cannot be effectively integrated with the host, gene sequencing has not been fully popularized, and the big data information platform is imperfect. It is believed that with the in-depth research of gene sequencing technology, regenerative medicine and the successful development of clinical trials, the precision medicine for RP will be gradually improved and is expected to be applied to improve the vision of patients with RP in the future.

8.
Article in Chinese | WPRIM | ID: wpr-912377

ABSTRACT

Objective:To preliminarily evaluate the feasibility of ultra-wide-angle fundus imaging (UWFI) to observe the Weiss ring (vitreous floats) and the effectiveness and safety of neodymium-doped yttrium aluminum garnet (Nd: YAG) laser ablation in the treatment of symptomatic Weiss ring.Methods:A retrospective clinical study. From March 2016 to December 2019, 80 eyes of 68 patients with symptomatic Weiss ring who were diagnosed and treated at Guangzhou Aier Eye Hospital were included in the study. Among them, there were 39 eyes in 32 males and 41 eyes in 36 females; the average age was 53.7±10.8 years old. All the affected eyes were examined by slit lamp microscope combined with 90 D front lens and UWFI. The position and shape of the vitreous floating objects by drawing pictures were recorded. All the affected eyes underwent Nd: YAG laser ablation treatment. Three months after treatment, a questionnaire survey was conducted on the patients to assess the improvement of subjective symptoms. Those with a total score of 10, 7-9, 3-6, and ≤2 points were defined as cured, significant improvement, partial improvement, and no improvement, respectively. The measurement software Gauge 1.0 was used to manually measure the long diameter, circumference and area of the vitreous float on the UWFI image. The diameter of the optic disc to 1 Unit (U) was set as a standardized reference value. Those who did not show UWFI and no floating objects were found on the front mirror were recorded as 0. The changes of vitreous floats before and after treatment were compared by Wilcoxon rank sum test; the changes in their size before and after treatment and the patients' subjective symptom improvement scores after treatment were analyzed by Spearman rank correlation.Results:After treatment, in 80 eyes, there were no vitreous floats in 59 eyes (73.8%, 59/80) on UWFI. Before treatment, the circumference of the vitreous float was 1.84 (1.07, 2.64) U, the long diameter was 1.17 (0.84, 1.66) U, and the area was 0.18 (0.08, 0.30) U2; after treatment, the circumference was 0.00 (0.00, 0.23) U, The long diameter is 0.00 (0.00, 0.23) U, and the area was 0.00 (0.00, 0.01) U2. There were statistically significant differences in the perimeter, diameter, and area of floating objects before and after treatment ( Z=-7.722, -7.560, -7.655; P<0.001). The results of the questionnaire survey showed that the patient's subjective symptoms were cured, significantly improved, and partially improved in 49 (61.3%, 49/80), 25 (31.2%, 25/80), and 6 (7.5%, 6/80) eyes, respectively. The results of correlation analysis showed that the degree of improvement of the patient's subjective symptoms was related to the circumference ( r=0.812), long diameter ( r=0.796), and area ( r=0.791) of the vitreous float on UWFI before and after treatment ( P<0.01). During the follow-up period, no complications such as increased intraocular pressure or decreased vision occurred. Conclusions:UWFI can objectively image the Weiss ring, and its size can be quantified relatively to the measurement software. Nd: YAG laser ablation treatment of symptomatic Weiss ring is safe and effective.

9.
Chinese Journal of Nephrology ; (12): 558-566, 2021.
Article in Chinese | WPRIM | ID: wpr-911883

ABSTRACT

Objective:To investigate the predictive value of abnormal heart rate circadian rhythm for all-cause mortality in stage 5 chronic kidney disease (CKD 5) patients.Methods:The retrospective study was performed in CKD 5 patients enrolled from the First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital) and the Affiliated BenQ Hospital of Nanjing Medical University from February, 2011 to December, 2019. A total of 159 healthy volunteers were enrolled as the healthy control group during the same period. The circadian rhythm of heart rate was monitored by 24-hour Holter. Related indices (including 24-hour, daytime and nighttime mean heart rate, night/day heart rate ratio, 24-hour maximum heart rate, 24-hour minimum heart rate and difference between maximum and minimum of 24-hour heart rate) were calculated. Non-dipping heart rate was defined as night/day heart rate ratio greater than 0.9. Cox regression model was used to analyze the risk factors of all-cause mortality in CKD 5 patients. Kaplan-Meier survival curve and Log-rank test were used to compare the differences of cumulative mortality between high ratio group (night/day heart rate ratio>0.91) and low ratio group (night/day heart rate ratio≤0.91). The nonlinear relationship between night/day heart rate ratio and all-cause mortality was analyzed by restricted cubic spline plot. Time-dependent receiver operating characteristic (ROC) curve was used to analyze the predictive value of night/day heart rate ratio for all-cause mortality in CKD 5 patients.Results:A total of 159 healthy volunteers and 221 CKD 5 patients were included in this study. There were 123 males (55.66%) and the age was (52.72±13.13) years old in CKD 5 patients. The total median follow-up time was 50.0 months. Compared with controls, 24-hour, nighttime mean heart rate, 24-hour minimum heart rate in CKD 5 patients were increased (all P<0.05), furthermore, the night/day heart rate ratio was higher [(0.91±0.09) vs (0.81±0.08), P<0.001], showing "non-dipping heart rate". However, the 24-hour maximum heart rate and the difference between maximum and minimum of 24-hour heart rate in CKD 5 patients were lower than controls (both P<0.05). Multivariate Cox regression analysis showed that the increased night/day heart rate ratio (per 0.1 increase, HR=1.557, 95% CI 1.073-2.258, P=0.020) was an independent influencing factor for all-cause mortality in CKD 5 patients. Kaplan-Meier survival curve analysis showed that the cumulative mortality of the high ratio group was significantly increased than that of the low ratio group (Log-rank test χ 2=7.232, P=0.007). From the restricted cubic spline plot, there was a linear effect between night/day heart rate ratio and all-cause mortality ( P=0.141), and when night/day heart rate ratio was above 0.91, the risk of all-cause mortality was significantly increased in CKD 5 patients. According to time-dependent ROC curve, the accuracy of night/day heart rate ratio in predicting all-cause mortality was 70.90% even when the survival time was up to 70.0 months. Conclusions:The circadian rhythm of heart rate in CKD 5 patients displays "non-dipping" state. High night/day heart rate ratio is an independent influencing factor for all-cause mortality in CKD 5 patients.

10.
Chinese Journal of Dermatology ; (12): 716-718, 2021.
Article in Chinese | WPRIM | ID: wpr-911513

ABSTRACT

A 24-year-old female patient presented with recurrent itchy annular erythema and scales on the trunk and extremities for 9 years. Histopathological study revealed hyperkeratosis with focal parakeratosis, neutrophil aggregation in the stratum corneum, blisters below the stratum corneum, and perivascular infiltration with lymphocytes, a small number of eosinophils and neutrophils in the superficial and middle dermis. Direct immunofluorescence assay showed negative staining for IgG, IgM, IgA and C3. Whole-exome sequencing of the SPINK5 gene showed a missense mutation c.2423C>T (p.T808I) in exon 25, and a splicing site mutation c.2965-1G>A in exon 31. The compound heterozygosity for the two mutations may be the cause of Netherton syndrome in the patient. Based on the clinical manifestations and genetic testing results, the patient was diagnosed with Netherton syndrome.

11.
Article in Chinese | WPRIM | ID: wpr-907943

ABSTRACT

Objective:To summarize the suspected cases of pertussis, to explore the pathogen, and to analyze the clinical features of pertussis.Methods:A retrospective study was conducted to analyze the clinical data of suspected pertussis cases who visited the Department of Infectious Diseases in the Children′s Hospital Affiliated to Capital Institute of Pediatrics from June 2015 to May 2019.Results:(1) The PCR test for respiratory secretions of Bacillus pertussis was completed in 400 cases, with 198 cases positive (49.5%). (2) Among the 198 cases, 158 cases with pertussis were less than 1 year old (79.8%), 113 cases had a clear history of close contact with cough patients (57.1%), and 162 cases were not vaccinated or did not complete full diphtheria and tetanus toxoids and pertussis(DTP) vaccination (81.8%). The incidence of spasmodic cough was 73.7%(146/198 cases); the duration from onset to diagnosis was (17.2±12.3) d; the incidence of cyanosis after cough was 31.3%(62/198 cases), cough with vomiting 17.7% (35/198 cases), inspiratory croup 12.1%(24/198 cases); other concomitant symptoms included wheezing, runny nose, fever, diarrhea, etc.(3) All the patients were divided into the pertussis group (198 cases), other pathogen group (104 cases), and unknown pathogen group (98 cases). Comparison of the clinical symptoms of the three groups showed the highest incidence of cyanosis after cough in pertussis group ( χ2=15.334, P<0.001), and the highest incidence of wheezing, dyspnea, fever, pulmonary rales and stridor in other pathogen group ( χ2=79.208, 38.214, 16.709, 44.794, 42.480, all P<0.001). The percentages of white blood cells, lymphocytes and platelets in the pertussis group were higher than those in the other two groups ( F=15.812, 18.198, 10.819, all P<0.001). Conclusions:Suspected cases of pertussis are infected with various pathogens.Improving the pertussis nucleic acid detection and respiratory virus detection can help to make a clear diagnosis.Pertussis is more common in infants under 1 year of age and in those who have not completed vaccination.The most prominent clinical symptom is spasmodic cough, and the incidence of cyanosis after cough is higher than that of patients infected with other pathogens.

12.
Article in Chinese | WPRIM | ID: wpr-877561

ABSTRACT

OBJECTIVE@#To compare the therapeutic effect between long-snake moxibustion combined with western medication and simple medication on diarrhea type irritable bowel syndrome (IBS-D) of spleen and kidney @*METHODS@#A total of 60 patients with IBS-D of spleen and kidney @*RESULTS@#Compared before treatment, the symptom scores of abdominal pain, defecation frequency, mucous stool and appetite reduction were decreased (@*CONCLUSION@#Long-snake moxibustion combined with western medication can effectively treat the IBS-D of spleen and kidney


Subject(s)
Acupuncture Points , Animals , Diarrhea/drug therapy , Humans , Irritable Bowel Syndrome/drug therapy , Kidney , Moxibustion , Quality of Life , Snakes , Spleen , Yang Deficiency/drug therapy
13.
China Pharmacy ; (12): 720-724, 2021.
Article in Chinese | WPRIM | ID: wpr-875654

ABSTRACT

OBJECTIVE:To study the efficacy and safety of sacubitril valsartan sodium tablets combined with Bailing capsules in the treatment of chronic left heart failure with renal insufficiency ,and to provide reference for clinical drug use. METHODS : Totally 96 patients with chronic left heart failure with renal insufficiency who sought medical care in our hospital from Nov. 2018 to Nov. 2019 were divided into group A ,B and C according to table of random numbers ,with 32 cases in each group. Group A received conventional heart failure treatment and and Bailing capsules (2 g each time ,3 times a day );group B received conventional heart failure treatment and Sacubitril valsartan sodium tablets (50 mg each time ,twice a day );group C was given with heart failure treatment and Sacubitril valsartan sodium tablets (50 mg each time ,twice a day )and Bailing capsules (2 g each time,3 times a day ). 3 groups received consecutive 6 months of treatment. Clinical response rates of 3 groups were compared. Left heart function indexes [left ventricular end systolic diameter (LVESD),left ventricular end-diastolic diameter (LVEDD),left ventricular ejection fraction (LVEF)] and serological indexes [interleukin 1(IL-1),IL-6,N terminal brain natriuretic peptide precursor,glomerular filtration rate (GFR)] were detected before and after treatment. The occurrence of ADR were observed and recorded. RESULTS :During this study ,a total of 6 patients fell off ,and eventually 90 patients completed the study ,including 29 cases in group A ,30 cases in group B and 31 cases in group C. Before treatment ,there was no statistical significance in left heart function indexes or serological indexes among 3 groups(P> 0.05). After 6 months of treatment ,clinical response rate of group C was significantly higher than those of group A and B 163.com (P<0.05). Compared with before treatment , LVEDD, LVESD and serological indexes of 3 groups were decreased significantly after treatment (P<0.05),while LVEF and GFR were increased significantly (P<0.05);the changes of above indexes (except for IL- 1 level in serum ) in group C were significantly better than group A and B ,the changes of above indexes in group B (except for GFR )were significantly better than group A (P<0.05). No significant ADR were observed in 3 groups. CONCLUSIONS :Sacubitril valsartan sodium tablets combined with Bailing capsules can significantly decrease the level of serum inflammation factors ,and improve cardiac and renal function in patients with chronic left heart failure with renal insufficiency ,with good safety.

14.
International Eye Science ; (12): 644-647, 2021.
Article in Chinese | WPRIM | ID: wpr-873861

ABSTRACT

@#Hirudo is highly effective in promoting blood circulation and removing blood stasis, a vital medicine for breaking blood and removing blood stasis in ophthalmopathy. Presently, Hirudo is commonly used in ophthalmology for age-related macular degeneration, diabetic retinopathy, cataract, retinal vein occlusion and other ophthalmic diseases, with the mechanism thereof possibly being related to anti-VEGF, improvement of microcirculation and anti-apoptosis. Further, although new functions have been found in Hirudo extract, such as transdifferentiation and inhibition of WERI-RB-1, these studies remain in the basic exploratory stage, and the specific molecular mechanism requires further verification. This paper concisely describes the application and research status of Hirudo and the extract thereof in ophthalmic diseases, so as to provide a new direction for further research on the treatment of ophthalmopathy using Hirudo and the extract thereof.

15.
Chinese Journal of Nephrology ; (12): 414-423, 2021.
Article in Chinese | WPRIM | ID: wpr-885504

ABSTRACT

Objective:To observe heart rate circadian rhythm in patients with chronic kidney disease (CKD) stage 5 and to analyze the effects of parathyroidectomy (PTX) on heart rate circadian rhythm in severe secondary hyperparathyroidism (SHPT) patients.Methods:A cross-sectional observation was performed in 213 patients with CKD stage 5 and 96 controls, and the patients were divided into those with severe SHPT (PTX group, n=70) and without severe SHPT (non-PTX group, n=143). Forty-six PTX patients were followed up prospectively. The baseline data were compared among these groups. Holter electrocardiogram was performed for each participant. Non-dipping heart rate was defined as night/day heart rate ratio greater than 0.9. Multiple linear regression analysis was used to analyze the related factors of heart rate circadian rhythm in patients with CKD stage 5. Results:The 24-hour, daytime and nighttime mean heart rate in patients with CKD stage 5 were all higher than those in controls, especially in PTX group (all P<0.05). The night/day heart rate ratios of controls and CKD stage 5 patients were (0.81±0.08) and (0.91±0.08) respectively ( P<0.01). Correlation analysis showed 24-hour and daytime or nighttime mean heart rate in patients with CKD stage 5 were positively correlated with serum levels of phosphorus and ln(alkaline phosphatase), while nighttime mean heart rate and night/day heart rate ratio were positively related with serum intact parathyroid hormone level. After adjusting with postoperative follow-up period (median time: 10.9 months), 24-hour and nighttime mean heart rate, and night/day heart rate ratio in PTX patients all decreased significantly (all P<0.01). Conclusions:Heart rate is increased and circadian rhythm is abnormal in patients with CKD stage 5, which are related with mineral and bone disorder. PTX significantly decreases 24-hour and nighttime mean heart rate in severe SHPT patients, and improves the heart rate circadian rhythm.

16.
Article in Chinese | WPRIM | ID: wpr-884268

ABSTRACT

Objective:To evaluate the diagnostic values of serum fibrinogen and D-dimer for periprosthetic joint infection (PJI).Methods:The medical records were retrospectively analyzed of the 175 patients who had undergone hip or knee revisions at Department of Joint Surgery, Affiliated Hospital to Qingdao University from August 2013 to June 2019. Of them, 59 were diagnosed as PJI (31 knees and 28 hips), including 33 males and 26 females with an age of (67.4±11.7) years and a body mass index (BMI) of (26.1±3.6) kg/m 2 while 116 as aseptic loosening (AL) (19 knees and 97 hips), including 67 males and 49 females with an age of (70.3±8.9) years and a BMI of (25.0±3.6) kg/m 2. The plasma levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fibrinogen and D-dimer in the 2 groups were recorded and analyzed. The receiver operating characteristic curve (ROC) was used to calculate the sensitivity and specificity of each indicator; the diagnostic value for each indicator was calculated according to the area under the curve (AUC). Results:There was no significant difference between the PJI and AL groups in gender, age or BMI ( P>0.05), but there was a significant difference in the joint type ( P<0.05). Compared with the AL group, the PJI group had significantly higher levels of CRP, ESR, fibrinogen and D-dimer ( P<0.05). The AUCs for CRP, ESR, fibrinogen and D-dimer were 0.830, 0.850, 0.848 and 0.664, respectively. By the Youden index, the optimal predictive cutoffs for CRP, ESR, fibrinogen and D-dimer were 8.06 mg/L, 17.60 mm/h, 3.73 g/L and 685.00 ng/mL, giving sensitivities of 79.2%, 85.4%, 81.3% and 64.6% and specificities of 85.7%, 76.2%, 79.8% and 61.9%. Conclusions:The diagnostic value of serum fibrinogen may be high for PJI, similar to that of CRP or ESR. However, D-dimer may be of limited value for diagnosis of PJI.

17.
Chinese Journal of Endemiology ; (12): 199-204, 2021.
Article in Chinese | WPRIM | ID: wpr-883693

ABSTRACT

Objective:To understand the levels of selenium and T-2 toxin in the historical critical disease area of Kashin-Beck disease in Aba State of Sichuan Province.Methods:From July 2018 to February 2019, in five cities (counties) of historical critical Kashin-Beck disease areas, namely, Ma'erkang, Rangtang, Aba, Ruo'ergai and Hongyuan, one township was selected, respectively, and then one village in the historical critical disease area and one village in non-disease area were selected from the selected townships. Hair samples from 30 children aged 6 to 12 years old were collected to test selenium content in each village. Staple food samples of 10 households were collected to test the selenium and T-2 toxin contents in each village. Ten soil samples were collected from each village to test the selenium content.Results:The medians selenium of children's hair in the diseased and non-diseased villages ( n= 180, 120) were 0.260 0 and 0.330 0 mg/kg, respectively, and the diseased village was lower than non-diseased village ( Z = - 6.319, P < 0.01). In Ma'erkang and Hongyuan, the medians selenium in the diseased villages were lower than those in non-diseased villages ( Z = - 3.327, - 4.939, P < 0.01), and there were no statistically significant differences between the diseased villages and non-diseased villages in Rangtang and Ruo'ergai ( P > 0.05). The medians selenium of staple food in the diseased and non-diseased villages ( n = 110, 70) were 0.005 8 and 0.018 0 mg/kg, respectively, and the diseased village was lower than non-diseased village ( Z = - 2.263, P < 0.05). In Ruo'ergai, the median selenium in the diseased village was lower than that in non-diseased village ( Z = - 2.306, P < 0.05), and there were no statistically significant differences between the diseased villages and non-diseased villages in Ma'erkang, Rangtang and Hongyuan ( P > 0.05). The T-2 toxin contents in staple food were all less than detection limit (1 μg/kg) in the diseased and non-diseased villages ( n = 103, 65). The soil selenium contents in the diseased and non-diseased villages ( n = 60, 40) were (0.045 3 ± 0.021 5) and (0.065 8 ± 0.045 4) mg/kg, respectively, and the diseased village was lower than non-diseased village ( t = 2.672, P < 0.05). The soil selenium content in the diseased village was lower than that in non-diseased village in Hongyuan ( t = 14.838, P < 0.01). There were no statistically significant differences in the soil selenium content between the diseased villages and non-diseased villages in Ma'erkang, Rangtang and Ruo'ergai ( P > 0.05). Conclusions:The overall selenium level of children's hair is at a medium level (0.25 - < 0.50 mg/kg) in the historical critical disease area of Aba State of Sichuan Province, the selenium levels of staple food and soil are at a deficiency level (< 0.025, < 0.125 mg/kg), and the diseased villages are lower than non-diseased villages. No T-2 toxin is detected in staple food.

18.
Article in Chinese | WPRIM | ID: wpr-882873

ABSTRACT

Objective:To investigate the characteristics of gonads, the incidence of gonadal tumors and the detection results of SRY gene and Y chromosome microdeletions in 45, X/46, XY chimeras. Methods:The medical records of 45, X/46, XY karyotype or its variant in Jiangxi Children′s Hospital from January 2013 to December 2019 were analyzed retrospectively and analyze the gonadal phenotype and oleculardetection of 45, X/46, YX karyotype.Results:Among the 30 patients with 45, X/46, XY karyotype or its variant, the age of treatment was under 18 years old, with 11 males and 19 females.Fourteen of the patients had undergone prophylactic gonadectomy.Six male cases of unilateral testis and contralateral striated gonads were detected.Pathological section suggested that the gonadal tissue contained testis and ovary in 3 cases, adrenal gland tissue with translocation in 2 cases, and bilateral striated gonad in 8 cases, and both sexes were female.Pathological section indicated that the gonad tissue contained both epididymis and ovary tissue in 1 case, and gonadoblastoma in 1 case.There were 1 case of ovarian dysplasia with granulomatous hyperplasia and 1 case with proliferative nevus cells (mixed nevus). No follicle was found in all patients with B-ultrasound and pathological sections.Among the 11 male children, 5 cases were positive by SRY gene detection.Seven cases by Y chromosome microdeletion detection displayed that 3 cases had partial Y chromosome deletion and 4 cases had no deletion; 10 cases among 19 cases of social gender female patients were detected by SRY gene detection and 9 cases were positive and 1 case was negative; 7 cases were detected by Y chromosome microdeletion and the results are 2 cases with Y chromosome partial deletion, 4 cases with Y chromosome no deletion and 1 case with Y chromosome whole deletion. Conclusions:Most patients with 45, X/46, XY chimera have abnormal gonadal tissue, which has the risk of gonadal tumor, especially among female patients.Most patients had positive SRY gene and had no or partial deletion of Y chromosome.In view of the increased risk of gonadal tumors in these patients, early prophylactic gonadectomy is recommended.

19.
Article in Chinese | WPRIM | ID: wpr-880164

ABSTRACT

OBJECTIVE@#To investigate the causes, treatment options and outcomes of immune thrombocytopenia (ITP) patients with splanchnic venous thrombosis (SVT).@*METHODS@#The clinical diagnosis, treatment and outcomes data of one 26-year-old male ITP patient with SVT as initial manifestation were collected. The possible causes and treatment options of the patients were discussed through literatures review.@*RESULTS@#The result of blood routine tests of the patient showed that Plt(17-38)×10@*CONCLUSION@#ITP combined with large scale of SVT is rare, and it is difficult to cure. It should be pay more attention to the possible thrombosis risk triggered by a transiently increased EOS in the blood stream. Promptly etiological treatment and the balance between anticoagulant therapy and bleeding risks should be taken in clinical practice.


Subject(s)
Aged, 80 and over , Anticoagulants/therapeutic use , Heparin, Low-Molecular-Weight , Humans , Male , Purpura, Thrombocytopenic, Idiopathic/complications , Splanchnic Circulation , Venous Thrombosis
20.
Article in Chinese | WPRIM | ID: wpr-879888

ABSTRACT

A boy, aged 3 years and 8 months, had recurrent thrombocytopenia with hemolytic anemia for more than 3 years. The physical examination showed no enlargement of the liver, spleen, and lymph nodes or finger deformities. Laboratory results showed a negative result of the direct antiglobulin test, normal coagulation function, and increases in bilirubin, lactate dehydrogenase and reticulocytes. The results of von Willebrand factor-cleaving protease ADAMTS13 activity assay showed extreme deficiency, and antibody assay showed negative ADAMTS13 inhibitory autoantibodies. Next-generation sequence showed compound heterozygous mutation in the


Subject(s)
ADAM Proteins/genetics , ADAMTS13 Protein , Anemia, Hemolytic , Autoantibodies , Child , Child, Preschool , Humans , Infant, Newborn , Male , Mutation , Purpura, Thrombotic Thrombocytopenic
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