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1.
Journal of Clinical Hepatology ; (12): 1059-1064., 2021.
Article in Chinese | WPRIM | ID: wpr-876646

ABSTRACT

ObjectiveTo investigate the mechanism of gamma-chain (γC) cytokines in regulating the expression of T-cell immunoglobulin and mucin domain-containing molecule 3 (TIM-3) in CD8+ T cells of chronic hepatitis B (CHB) patients. MethodsA total of 23 CHB patients who attended Tangdu Hospital, Fourth Military Medical University, from January to May, 2017, were enrolled. Peripheral blood was collected from all patients, and Ficoll density gradient centrifugation was used to isolate peripheral blood mononuclear cells (PBMCs). PBMCs were stimulated with interleukin-7 (IL-7), interleukin-15 (IL-15), and interleukin-21, respectively, and then anti-γC antibody and/or anti-IL-7Rα, anti-IL-2Rβ, and anti-IL-21R were added to the culture solution. After 96 hours of culture, flow cytometry was used to measure the expression of TIM-3, interleukin-2 (IL-2), interleukin-10 (IL-10), and interferon-γ (IFNγ) and the phosphorylation level of signal transducer and activator of transcription (STAT) in CD8+ T cells. A one-way analysis of variance and the least significant difference t-test were used for comparison of continuous data. ResultsThe CD8+ T cells stimulated by IL-7 and IL-15 had a significantly higher percentage of TIM-3-positive CD8+ T cells than those without stimulation (t=9.966 and 9074, P<0.05), as well as significantly higher expression levels of IL-2, IL-10, and IFN-γ and phosphorylation levels of STAT-5 and STAT-1 (all P<0.05). Stimulation with anti-IL-7Rα and anti-γC antibody significantly reduced the elevated expression levels of TIM-3, IL-2, and IL-10 in the IL-7 stimulation group (t=5.537, 6.224, and 4.500, P<0.05). Stimulation with anti-IL-2Rβ alone or in combination with anti-γC antibody significantly reduced the expression levels of TIM-3 and IL-2 and the phosphorylation level of STAT-1 in the IL-15 stimulation group (P <0.05). ConclusionIL-7 and IL-15 can upregulate the expression of TIM-3 in CD8+ T cells of CHB patients, possibly via the γC receptor-mediated STAT-cytokine signaling pathway.

2.
Article in Chinese | WPRIM | ID: wpr-908246

ABSTRACT

Objective:To explore the effect of hand making combined with social skills training on the self-care ability and quality of life of patients with schizophrenia.Methods:According to random number table method, totally 120 patients with schizophrenia admitted to the Second People ′s Hospital of Chuzhou City, Anhui Province from January to December 2019 were divided into observation and control groups, which had 60 patients in each groups, 10 cases and 7 cases fell off respectively. The control group received antipsychotic medication and routine nursing, meanwhile the general recreational activities (circles, radio exercises, etc.) and physical therapy were also carried out in the department and rehabilitation physical therapy center. The observation group was given hand making and social skills training for 12 weeks on the basis of the control group. The self-care ability and quality of life of patients in the two groups were compared before intervention, 6 and 12 weeks after intervention. Results:Before intervention, there was no statistical significance in the scores of World Health Organization Quality of Life Scale (WHOQOL-BREF) and Activities of Daily Living (ADL) in 2 groups ( P>0.05). After 6 and 12 weeks of intervention, ADL scores in the observation group were (96.40±3.79) and (98.50±2.53) points, while those in the control group were (93.96±4.31) and (94.06±4.28) points. And the difference between the two groups was statistically significant ( t values were 3.38, 6.36, P<0.05). However, after 6 weeks of intervention, there was no significant difference in WHOQOL-BREF scores between the two groups ( P>0.05); after 12 weeks of intervention, the scores of WHOQOL-BREF in the domains of G1(patients′ self-rated quality of life), G4(patients′ satisfaction with self-rated health status), physiology, psychology, social relations and environment in the observation group were (3.76±1.14), (3.86±1.03), (14.83±2.56), (15.04±3.07), (14.72±3.67) (14.55±3.22) points. The scores of the control group were (3.00±0.83), (3.34±0.90), (12.79±2.06), (12.70±2.45), (12.70±3.06) and (12.64±2.42) points. And the difference between the two groups was statistically significant ( t values were from 2.73 to 4.47, P<0.01). Conclusions:Hand making combined with social skills training can improve the self-care ability and quality of life of patients with schizophrenia, and it is an effective means of treatment to help the patients with schizophrenia to achieve recovery, out of the hospital, back to society.

3.
Acta Pharmaceutica Sinica B ; (6): 3585-3594, 2021.
Article in English | WPRIM | ID: wpr-922426

ABSTRACT

The drug formulation design of self-emulsifying drug delivery systems (SEDDS) often requires numerous experiments, which are time- and money-consuming. This research aimed to rationally design the SEDDS formulation by the integrated computational and experimental approaches. 4495 SEDDS formulation datasets were collected to predict the pseudo-ternary phase diagram by the machine learning methods. Random forest (RF) showed the best prediction performance with 91.3% for accuracy, 92.0% for sensitivity and 90.7% for specificity in 5-fold cross-validation. The pseudo-ternary phase diagrams of meloxicam SEDDS were experimentally developed to validate the RF prediction model and achieved an excellent prediction accuracy (89.51%). The central composite design (CCD) was used to screen the best ratio of oil-surfactant-cosurfactant. Finally, molecular dynamic (MD) simulation was used to investigate the molecular interaction between excipients and drugs, which revealed the diffusion behavior in water and the role of cosurfactants. In conclusion, this research combined machine learning, central composite design, molecular modeling and experimental approaches for rational SEDDS formulation design. The integrated computer methodology can decrease traditional drug formulation design works and bring new ideas for future drug formulation design.

4.
Journal of Experimental Hematology ; (6): 1034-1038, 2021.
Article in Chinese | WPRIM | ID: wpr-888515

ABSTRACT

OBJECTIVE@#To study the effects of FLT3-ITD length on 32D cell proliferation, apoptosis and sensitivity to FLT3 inhibitor, so as to provide references for stepwise therapy of FLT3-ITD mutated acute myeloid leukemia patients.@*METHODS@#Three different FLT3-ITD mutants with same or adjacent insert sites were selected and constructed in an eukaryotic expression vector. FLT3-ITD mutants stably expressed 32D cell strains were selected with the help of lentivirus system and IL3 free cell culture medium. The proliferation and apoptosis of 32D cell strains after AC220 treatment were detected.@*RESULTS@#FLT3-ITD mutants (ITD1, ITD2 and ITD3) stably expressed 32D cell strains were constructed successfully. In the absence of IL3 factor, the proliferation number of ITD1, ITD2 and ITD3 cell strains were mounted up to 2.3 folds, 3.7 folds, and 4.3 folds after 48 hours, respectively. Under the exposure of FLT3 inhibitor AC220, the IC@*CONCLUSION@#FLT3-ITD mutant expressed cell strains with longer ITD show higher capacity of proliferation and higher tolerance to AC220 treatment.


Subject(s)
Apoptosis , Cell Proliferation , Humans , Leukemia, Myeloid, Acute/genetics , Mutation , Protein Kinase Inhibitors , Tandem Repeat Sequences , fms-Like Tyrosine Kinase 3/genetics
5.
Chinese Medical Journal ; (24): 1709-1719, 2021.
Article in English | WPRIM | ID: wpr-887652

ABSTRACT

BACKGROUND@#According to the amyloid, tau, neurodegeneration research framework classification, amyloid and tau positive (A+T+) mild cognitive impairment (MCI) individuals are defined as prodromal Alzheimer disease. This study was designed to compare the clinical and biomarker features between A+T+MCI individuals who progressed to progressive MCI (pMCI) and those who remained stable MCI (sMCI), and to identify relevant baseline clinical biomarker and features that could be used to predict progression to dementia within 2 years.@*METHODS@#We stratified 197 A+T+MCI individuals into pMCI (n = 64) and sMCI (n = 133) over 2 years. Demographics and cognitive assessment scores, cerebrospinal fluid (CSF), and neuroimaging biomarkers (18F-florbetapir positron emission tomography mean standardized uptake value ratios [SUVR] and structural magnetic resonance imaging [MRI]) were compared between pMCI and sMCI at baseline, 12- and 24-month follow-up. Logistic regression models then were used to evaluate clinical baseline and biomarker features that predicted dementia progression in A+T+MCI.@*RESULTS@#pMCI individuals had higher mean 18F-florbetapir SUVR, CSF total-tau (t-tau), and p-tau181P than those in sMCI individuals. pMCI individuals performed poorer in cognitive assessments, both global and domain specific (memory, executive, language, attention, and visuospatial skills) than sMCI. At baseline, there were significant differences in regions of interest of structural MRI between the two groups, including bilateral amygdala, hippocampus and entorhinal, bilateral inferior lateral ventricle, left superior and middle temporal, left posterior and caudal anterior cingulate (P < 0.05). Baseline CSF t-tau levels and cognitive scores of Montreal cognitive assessment, functional assessment questionnaire, and everyday cognition by the patient's study partner language domain could predict progression to dementia in A+T+MCI within 2 years.@*CONCLUSIONS@#In future clinical trials, specific CSF and cognitive measures that predict dementia progression in A+T+MCI might be useful risk factors for assessing the risk of dementia progression.


Subject(s)
Alzheimer Disease , Amyloid beta-Peptides , Biomarkers , Cognitive Dysfunction , Disease Progression , Humans , Peptide Fragments , Positron-Emission Tomography
6.
Chinese Journal of Urology ; (12): 381-384, 2021.
Article in Chinese | WPRIM | ID: wpr-885026

ABSTRACT

Objective:To investigate the safety and efficacy of domestic Kangduo robotic surgery system in adrenalectomy.Methods:This study summarized the clinical data of patients with adrenal adenoma who were operated by domestic kangduo robot from November 2020 to April 2021. This study was approved by the hospital ethics committee, and the clinical trials of medical devices were filed. Inclusion criteria: age 18-75 years old; all of them in accordance with the indication of adrenalectomy; tumor volume≤6 cm; agree to sign the informed consent, follow the doctor's advice and follow up regularly. Exclusion criteria: patients with ipsilateral upper abdominal surgery history; patients with severe uncontrolled disease or acute infection; patients with cardiovascular and cerebrovascular diseases, blood system diseases and immune system diseases that are not controlled and can not reach the operation standard; pregnant or lactating women. All patients underwent robot assisted adrenalectomy. The general information and perioperative data of the patients were summarized.Results:Five patients were included in this study, including 1 male and 4 female. The average age was 49 (34-61)years old. There were 2 cases on the left and 3 cases on the right. The average diameter of tumor was 2.2 (1.1-3.7) cm. All patients showed adenoma by CT examination. Two cases were diagnosed as primary aldosteronism, one as Cushing's syndrome, and two as nonfunctional adenoma. All the operations were successfully completed in 5 cases, including 4 cases via retroperitoneal approach and 1 case via peritoneal approach. The average docking time was 3.8 (3-6) min, the average operation time was 56.2 (21-92) min, and the average blood loss was 34 (20-50) ml. The postoperative pathology was adrenal cortical adenoma. The average postoperative hospital stay was 3.6 (3-5) days. No postoperative complications occurred in 5 cases. Two patients with primary aldosteronism had hypertension and hypokalemia before operation, and they needed oral antihypertensive drugs to control them. They did not need medication after operation, and their blood pressure and potassium were maintained at normal levels. All patients were followed up for average 1.5(0.5-5.0)months.Conclusions:Domestic robot assisted laparoscopic adrenalectomy has the advantages of few blood loss, short operation time, few complications. It’s a safe and effective operation, but the conclusion needs to be further verified by large sample and multi-center study.

7.
Chinese Journal of Urology ; (12): 246-251, 2021.
Article in Chinese | WPRIM | ID: wpr-884998

ABSTRACT

Objective:To present the learning curve of robotic assisted laparoscopic partial nephrectomy by a single surgeon.Methods:The clinical data of 100 patients with renal tumor who underwent robot assisted laparoscopic partial nephrectomy in Peking Union Medical College Hospital from February 2016 to April 2018 were retrospectively analyzed. There were 64 males and 36 females. The average age was 51.5(18-79) years. The average body mass index (BMI) was 24.9(19-31)kg/m 2. TNM stage was T 1N 0M 0, which indicated partial nephrectomy. The tumors were located on the left in 38 cases and on the right in 62 cases. The average maximum diameter of tumor was 3.9(1.0-6.7) cm, and the average R. E.N.A.L. score was 6.7(4-11). All operations were performed by a single surgeon. This group of operations were the first 100 robot cases for this surgeon. The mean machines docking time was 14(10-30) min, the mean operation time was 119.2(60-240) min, the mean warm ischemia time was 16.7(0-45) min, and the estimated mean blood loss was 105.2(30-500) ml. There was no conversion to open surgery or laparoscopic radical nephrectomy. No serious complications occurred (Dindo calvein grade ≥ grade Ⅲ). There were 1 case of lower extremity intramuscular venous thrombosis, 1 case of urinary fistula, 1 case of pulmonary infection and 1 case of peri-kidney hematoma after operation. All patients were cured after conservative treatment without further operation or intervention. Cumulative Sum (CUSUM) test was used to fit the learning curve of docking time and operation time, and to judge the three different learning stages of robot surgery according to the inflection of the curve (CUSUM stop rising, and CUSUM begin to decline). The characteristics of patients and perioperative data of different learning stages were compared. Result:According to the CUSUM, the learning curve of robot assisted laparoscopic partial nephrectomy was 19 cases. According to the inflection point of operation time learning curve, 100 cases could be divided into three stages, 1st-19th cases were learning stage, 20th-43rd cases were mastering stage and 44th-100th cases are proficient stage. There were no significant differences in age, gender, tumor side, intraoperative bleeding volume, postoperative pathological type, total cost of hospitalization and incidence of complications among the three stages ( P>0.05). The median BMI in the learning stage was significantly lower than that in the mastery stage and the proficiency stage (23 kg/m 2, 26 kg/m 2, 25 kg/m 2, P=0.02). The median docking time(20 min, 12 min, 12 min), median operation time (150 min, 120 min, 100 min) and median warm ischemia time (21 min, 18 min, 15 min)were gradually shortened in the learning stage, mastering stage and proficient stage ( P<0.001). The median length of postoperative hospital stay in mastering stage and proficient stage was shorter than that in learning stage (7 d, 6 d, 6 d, P=0.011). The median maximum diameter of tumor (3.7 cm, 3.9 cm, 4.0 cm)and median R. E.N.A.L. score (6, 7, 7)increased gradually in learning stage, mastering stage and proficient stage, but the difference was not statistically significant( P=0.75, P=0.16). Conclusions:The learning curve of robotic assisted laparoscopic partial nephrectomy for an experienced surgeon is about 19 cases. After the completion of the learning curve, the docking time, operation time, warm ischemia time and postoperative hospital stay of patients can be significantly shortened than the initial period, and more difficult renal tumor operations can be accomplished.

8.
Chinese Journal of Lung Cancer ; (12): 245-253, 2021.
Article in Chinese | WPRIM | ID: wpr-880251

ABSTRACT

BACKGROUND@#Lung cancer is one of the leading causes of cancer-related morbidity and mortality. Oncolytic virotherapy is an emerging therapeutic modality that utilizes replication-competent viruses to destroy cancers. As a powerful tool to kill tumor cells with excellent safety profile, attenuated measles virus of the Edmonston strain (MV-Edm) has been widely applied in the development of tumor therapy and preclinical trials. The aim of this study was to investigate the synergistic effect of nuclear factor kappa B (NF-κB) signaling pathway inhibitor and oncolytic measles virus vaccine against lung cancer and the involved mechanisms.@*METHODS@#Using Western blot to detect MV-Edm infection of A549 and H1299 were infected by MV-Edm alone or used the NF-κB pathway inhibitor PS1145/cell autophagy related siRNA, expression level of p-IκBα, IκBα, PARP and BAX were determined by western blot. Using flow cytometry to analysis the rate of apoptosis, and using MTT [3-(4,5)-dimethylthiahiazo(-z-y1)-3,5-di-phenytetrazoliumromide] method to detect the cell survival rate.@*RESULTS@#Inhibition of cell autophagy could obviously inhibit the MV-Edm infection induced the NF-κB pathway activation in A549 and H1299. In MV-Edm infected A549 and H1299, p-IκBα level increased and IκBα level decreased over infection time, compared with control group. Inhibition of the NF-κB pathway by PS1145 could promote the apoptosis of MV-Edm infected A549 and H1299 and amplify the tumor killing effect.@*CONCLUSIONS@#The combination of NF-κB signaling pathway inhibitor pS1145 and oncolytic measles virus vaccine strains can promote the apoptosis of human lung cancer cells A549 and H1299 and enhance their oncolytic effect.

9.
Chinese Medical Journal ; (24): E001-E001, 2020.
Article in English | WPRIM | ID: wpr-817253

ABSTRACT

Background: Human infections with zoonotic coronaviruses (CoVs), including severe acute respiratory syndrome (SARS)-CoV and Middle East respiratory syndrome (MERS)-CoV, have raised great public health concern globally. Here, we report a novel bat-origin CoV causing severe and fatal pneumonia in humans. Methods: We collected clinical data and bronchoalveolar lavage (BAL) specimens from five patients with severe pneumonia from Jin Yin-tan Hospital, Wuhan, Hubei province, China. Nucleic acids of the BAL were extracted and subjected to next-generation sequencing. Virus isolation was carried out, and maximum-likelihood phylogenetic trees were constructed. Results: Five patients hospitalized from December 18 to December 29, 2019 presented with fever, cough, and dyspnea accompanied by complications of acute respiratory distress syndrome. Chest radiography revealed diffuse opacities and consolidation. One of these patients died. Sequence results revealed the presence of a previously unknown β-CoV strain in all five patients, with 99.8–99.9% nucleotide identities among the isolates. These isolates showed 79.0% nucleotide identity with the sequence of SARS-CoV (GenBank NC_004718) and 51.8% identity with the sequence of MERS-CoV (GenBank NC_019843). The virus is phylogenetically closest to a bat SARS-like CoV (SL-ZC45, GenBank MG772933) with 87.6–87.7% nucleotide identity, but is in a separate clade. Moreover, these viruses have a single intact open reading frame gene 8, as a further indicator of bat-origin CoVs. However, the amino acid sequence of the tentative receptor-binding domain resembles that of SARS-CoV, indicating that these viruses might use the same receptor. Conclusion: A novel bat-borne CoV was identified that is associated with severe and fatal respiratory disease in humans.

10.
Chinese Medical Journal ; (24): 1015-1024, 2020.
Article in English | WPRIM | ID: wpr-827709

ABSTRACT

BACKGROUND@#Human infections with zoonotic coronaviruses (CoVs), including severe acute respiratory syndrome (SARS)-CoV and Middle East respiratory syndrome (MERS)-CoV, have raised great public health concern globally. Here, we report a novel bat-origin CoV causing severe and fatal pneumonia in humans.@*METHODS@#We collected clinical data and bronchoalveolar lavage (BAL) specimens from five patients with severe pneumonia from Wuhan Jinyintan Hospital, Hubei province, China. Nucleic acids of the BAL were extracted and subjected to next-generation sequencing. Virus isolation was carried out, and maximum-likelihood phylogenetic trees were constructed.@*RESULTS@#Five patients hospitalized from December 18 to December 29, 2019 presented with fever, cough, and dyspnea accompanied by complications of acute respiratory distress syndrome. Chest radiography revealed diffuse opacities and consolidation. One of these patients died. Sequence results revealed the presence of a previously unknown β-CoV strain in all five patients, with 99.8% to 99.9% nucleotide identities among the isolates. These isolates showed 79.0% nucleotide identity with the sequence of SARS-CoV (GenBank NC_004718) and 51.8% identity with the sequence of MERS-CoV (GenBank NC_019843). The virus is phylogenetically closest to a bat SARS-like CoV (SL-ZC45, GenBank MG772933) with 87.6% to 87.7% nucleotide identity, but is in a separate clade. Moreover, these viruses have a single intact open reading frame gene 8, as a further indicator of bat-origin CoVs. However, the amino acid sequence of the tentative receptor-binding domain resembles that of SARS-CoV, indicating that these viruses might use the same receptor.@*CONCLUSION@#A novel bat-borne CoV was identified that is associated with severe and fatal respiratory disease in humans.


Subject(s)
Adult , Aged , Betacoronavirus , Genetics , Coronavirus Infections , Diagnostic Imaging , Therapeutics , Virology , Female , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral , Diagnostic Imaging , Therapeutics , Virology , Tomography, X-Ray , Treatment Outcome
11.
Article in Chinese | WPRIM | ID: wpr-872732

ABSTRACT

Objective:To observe the efficacy of modified Chushi Huqianwan combined with core decompression on Ⅰ, Ⅱ stage osteonecrosis of femoral head due to hot and humid syndrome, and the effect on bone metabolism index [osteocalcin (BGP), bone morphogenetic protein-2 (BMP-2), bone isoenzyme alkaline phosphatase (BALP)], blood lipid [apolipoprotein A (ApoA), apolipoprotein B (ApoB), apolipoprotein C3 (ApoC3)], protein expression [matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9), tissue inhibitor of matrix metalloproteinase-2 (TIMP-2)]. Method:A total of 90 cases were divided into control group and observation group, with 45 cases in each group. The control group was given core decompression + Xianling Gubao, while the observation group was given core decompression + modified Chushi Huqianwan for 6 months. The hip harris score (HHS), lateral head index (LHI) and traditional Chinese medicine (TCM) syndrome were observed between two groups. The serum bone metabolic indices (BGP, BMP-2, BALP), blood lipid (ApoA, ApoB, ApoC3), protein expressions (MMP-2, MMP-9, TIMP-2) were detected between two groups. The clinical efficacy, adverse reaction and recurrence in 36-month follow-up were compared between two groups. Result:The total effective rate was 97.73% (43/44) in observation group, which was higher than 80.95% (34/42) in control group (χ2=5.915, P<0.05). The recurrence rate was 4.65% (2/43) in observation group, which was lower than 35.29% (12/34) in control group (χ2=5.317, P<0.05) during the 36-month follow-up. HHS and LHI in observation group were significantly higher than those in control group (P<0.05), and TCM syndrome score was significantly lower than that in control group (P<0.05). Compared with control group after treatment, BGP, BMP-2, BALP, MMP-2 and MMP-9 in observation group were significantly increased (P<0.05), whereas ApoA, ApoB, ApoC3, TIMP-2 were significantly decreased (P<0.05). No obvious adverse reactions were observed during the treatment. Conclusion:Modified Chushi Huqianwan combined with core decompression can significantly improve clinical symptoms, bone metabolism indexes, blood lipid and protein expressions of patients with Ⅰ, Ⅱ stage osteonecrosis of femoral head due to hot and humid syndrome.

12.
Article in Chinese | WPRIM | ID: wpr-871845

ABSTRACT

Objective:To observe the changes of blood flow density and perfusion density in the macula of non-diabetic peritoneal dialysis (PD) patients, and their correlation with blood pressure, total protein, albumin, prealbumin, serum creatinine, urea, and high-sensitivity C-reactive protein were preliminarily analyzed.Methods:A single-center, cross-sectional, clinical observational study. From January to December 2018, 63 eyes of 63 non-diabetic patients (non-diabetic PD group) and 75 eyes of normal healthy people (the normal control group) who underwent PD treatment at the PD Center of Peking University First Hospital were included in the study. All were monocular into the group. Among the 63 patients in the non-diabetic PD group, 24 were males and 39 were females. The duration of PD was 7 to 185 months, with the average duration of 67.87±48.36 months. There were 75 healthy persons in the normal control group. There was no significant difference in age ( t=-0.558), sex ratio ( χ2=0.492), axial length ( t=-1.197), and BCVA between the two groups ( P>0.05). OCT angiography was used to scan the macular area of 3 mm×3 mm and 6 mm×6 mm in the subject’s right eye. The blood flow density and perfusion density of superficial retinal capillaries in the macular area, as well as the area, circumference, and morphological index of the foveal avascular zone (FAZ) were measured. The blood flow density and perfusion density at different locations in the macular area of the two groups of eyes were compared by independent sample t test. The blood pressure, total protein, albumin, prealbumin, serum creatinine, urea, and high-sensitivity C-reactive protein was performed by Pearson correlation analysis. Results:Compared with the healthy control group, the blood flow density and perfusion density of superficial retinal capillaries in the macular area of the non-diabetic PD group decreased in different scanning ranges with the macular vessel 3×3 center ( t=-2.409), the macular vessel 3×3 macular ( t=-2.423), macular vessel 3×3 intact ( t=-2.759), macular vessel 6×6 intact ( t=-1.882), macular vessel 6×6 outer layer ( t=-2.188), macular perfusion 3×3 center ( t=-1.990), macular perfusion 3×3 complete ( t=-2.719), macular perfusion 6×6 complete ( t=-2.113), and macular perfusion 6×6 outer layer ( t=-2.205). The difference was statistically significant ( P<0.05). The comparison of the macular FAZ area of the two groups of eyes was statistically significant ( t=1.985, P <0.05). Correlation analysis showed that 3×3 macular blood vessels were intact and mean arterial pressure was positively correlated ( r=0.256, P=0.043). The macular blood vessels were 3×3 intact, macular perfusion was 3×3 intact, and macular blood was 6×6 intact, which the pre-white protein was positively correlated with ( r=0.468, 0.362, 0.333; P<0.001, P=0.004, 0.008). The macular vessel 3×3 was intact, the macular perfusion 6×6 was intact, which the hypersensitive C-reactive protein was negatively correlated with ( r=-0.370, -0.287, P=0.005, 0.030). Conclusion:The superficial retinal blood flow density and perfusion density in the macular area of non-diabetic PD patients are lower than those of normal healthy people.

13.
Article | WPRIM | ID: wpr-831057

ABSTRACT

Purpose@#This study aimed to investigate the potential systemic antitumor effects of stereotactic ablativeradiotherapy (SABR) and apatinib (a novel vascular endothelial growth factor receptor2 inhibitor) via reversing the immunosuppressive tumor microenvironment for lung carcinoma. @*Materials and Methods@#Lewis lung cancer cells were injected into C57BL/6 mice in the left hindlimb (primary tumor;irradiated) and in the right flank (secondary tumor; nonirradiated). When both tumors grewto the touchable size, mice were randomly divided into eight treatment groups. These groupsreceived normal saline or three distinct doses of apatinib (50 mg/kg, 150 mg/kg, and 200mg/kg) daily for 7 days, in combination with a single dose of 15 Gy radiotherapy or not tothe primary tumor. The further tumor growth/regression of mice were followed andobserved. @*Results@#For the single 15 Gy modality, tumor growth delay could only be observed at the primarytumor. When combining SABR and apatinib 200 mg/kg, significant retardation of both primaryand secondary tumor growth could be observed, indicated an abscopal effect wasinduced. Mechanism analysis suggested that programmed death-ligand 1 expressionincreased with SABR was counteract by additional apatinib therapy. Furthermore, whenapatinib was combined with SABR, the composition of immune cells could be changed.More importantly, this two-pronged approach evoked tumor antigen–specific immune responsesand the mice were resistant to another tumor rechallenge, finally, long-term survivalwas improved. @*Conclusion@#Our results suggested that the tumor microenvironment could be managed with apatinib,which was effective in eliciting an abscopal effect induced by SABR.

14.
Article in English | WPRIM | ID: wpr-829141

ABSTRACT

@#BACKGROUND: Automated external defibrillators (AEDs) enable laypeople to provide early defibrillations to patients undergoing cardiac arrest, but scant information is available on the general public’s ability to use AEDs. This study assessed the ability of laypeople to operate AEDs, the effect of a 15-minute training, and whether skills differed by age. METHODS: From May 1 to December 31, 2018, a prospective simulation study was conducted with 94 laypeople aged 18-65 years (32 aged 18-24 years, 34 aged 25-54 years, and 28 aged 55-65 years) with no prior AED training. The participants’ AED skills were assessed individually pre-training, post-training, and at a three-month follow-up using a simulated cardiac arrest scenario. The critical actions and time intervals were evaluated during the AED operating process. RESULTS: Only 14 (14.9%) participants (eight aged 18-24 years, four aged 25-54 years, and two aged 55-65 years) successfully delivered defibrillations before training. AED operation errors were more likely to occur among the participants aged 55-65 years than among other age groups. After training, the proportion of successful defibrillations increased significantly (18-24 years old: 25.0% vs. 71.9%, P<0.01; 25-54 years old: 11.8% vs. 70.6%, P<0.01; 55-65 years old: 7.1% vs. 67.9%, P<0.01). After three months, 26.1% of the participants aged 55-65 years successfully delivered defibrillations, which was significantly lower than that of participants aged 18-24 years (54.8%) and 25-54 years (64.3%) (P=0.02). There were no differences in time measures among three age groups in each test. CONCLUSIONS: The majority of untrained laypeople cannot effectively operate AEDs. More frequent training and refresher courses are crucial to improve AED skills.

15.
Article in Chinese | WPRIM | ID: wpr-851163

ABSTRACT

Objective To study the effects of Xianlu Qige Decoction combined with acupuncture on the improvement of cervical intervertebral disc symptoms (CIDS) and serum phosphorylation-P38 mitogen-activated protein kinase (p-P38MAPK). Methods A total of 156 patients with CIDS admitted to our hospital from April 2016 to September 2018 were enrolled. The patients were randomly divided into two groups, 78 cases for each. The control group was given conventional Western medicine treatment. The observation group was given the combination of Xianlu Qige Decoction and acupuncture. The acupuncture therapy was supervised, by comparing the total effective rate of the two groups before and after treatment. The Tianzhong Jingjiu cervical spondylosis symptom scale 20 points score, serum immunoinflammatory factors [immunoglobulin G (IgG), IgA, IgM, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-1, p-P38 MAPK pathway protein expression [vascular endothelial growth factor (VEGF), matrix metalloproteinase-3 p-P38MAPK, MMP-9], serum pain medium [nitrogen monoxide (NO), serotonin (5-HT), and prostaglandin E2 (PEG2)] levels were compared. Results The total effective rate of the experimental group was 94.87% higher than that of the control group of 76.92% (P < 0.001). After treatment the scores of symptoms, signs, work and life ability and hand function of the two groups were higher than those before treatment, and the scores of pain were lower than those before treatment (P < 0.05). After treatment, the scores of symptoms, signs, work and life ability and hand function in the experimental group were higher than those in the control group, and the scores of pain were lower than those in the control group (P < 0.001); the levels of IgG, IgA, IgM, TNF-α, IL-1 and IL-6 in the two groups were lower than those before treatment (P < 0.001); the levels of IgG, IgA, IgM, TNF-α, IL-1 and IL-6 in the experimental group were lower than those in the control group (P < 0.001). After treatment, the levels of vascular endothelial growth factor (VEGF) in both groups were lower than those before treatment, and the levels of MMP-3, p-P38MAPK and MMP-9 were higher than those before treatment (P < 0.001); after treatment, the levels of VEGF in the experimental group were lower than those in the control group, and the levels of MMP-3, p-P38MAPK and MMP-9 were higher than those in the control group (P < 0.001). After treatment, the levels of NO, PEG2 and 5-HT in the two groups were lower than those before treatment (P < 0.05); After treatment, the levels of NO, PEG2 and 5-HT in the experimental group were lower than those in the control group (P < 0.05). Conclusion Xianlu Qige Decoction combined with acupuncture in the treatment of CIDS can reduce the release of serum pain media, significantly improve the clinical symptoms such as pain, and inhibit the inflammatory response of body, and its curative effect is significant. The mechanism may be related to the regulation of p-P38MAPK signaling pathway.

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Chinese Journal of Orthopaedics ; (12): 755-765, 2019.
Article in Chinese | WPRIM | ID: wpr-755215

ABSTRACT

Objective To compare the clinical effects of endoscopic laminectomy with traditional hemilaminectomy for lumbar spinal stenosis. Methods From January 2016 to April 2017, 61 patients with lumbar spinal stenosis were treated surgi?cally. Percutaneous endoscopic laminectomy was performed in 32 patients (minimally invasive group), including 13 males and 19 females, aged 38-76 years, with an average age of 58.47±7.51 years. Twenty?nine patients (open group) underwent hemilaminecto?my, including 11 males and 18 females, aged 38-75 years, with an average age of 57.17±9.99 years. The operation time, bleeding, incision length, bedridden time and hospitalization time were recorded. Visual analogue scale(VAS), Oswestry disability index (ODI), dural sac cross?sectional area (DSCA), ventral intervertebral space height (VH), dorsal intervertebral space height (DH) and lumbar mobility (range of motion, ROM) were compared between the two groups. Results All of 61 patients were followed up for 14 to 27 months, with an average of 19.2±2.95 months. The operation time was 60.88±6.49 min in the minimally invasive group, and 52.07±9.45 min in the open group (t=4.277, P=0.000). The blood loss of minimally invasive group was 55.63±10.14 ml, and that of open group was 78.79±12.58 ml (t=7.952, P=0.000). The incision length of minimally invasive group was 23.31±4.56 mm, and open group 82.59±7.66 mm (t=12.047, P=0.000). Bed rest time was 21.97±6.42 h in minimally invasive group and 78.79± 12.58 h in open group (t=12.047, P=0.000). The hospitalization time of the minimally invasive group was 8.53±2.75 d and the open group 11.34±3.12 d (t=3.745, P=0.000). All these parameters had statistical significance (P<0.05). At the last follow?up, the VAS score of minimally invasive group was 1.06±0.56, and the open group was 1.14±0.74 (t=0.469,P=0.634). ROM of open group was 5.66±1.12 degree, and ROM of minimally invasive group was 5.56±1.13 degree (t=0.140, P=0.710), VH of minimally invasive group was 14.75±2.81 mm, and open group was 14.44±2.89 mm (t=0.181, P=0.672). There was no significant difference between the two groups for these parameters. At the last follow?up, ODI score was 13.25%±1.08% in the minimally invasive group and 14.28% ± 2.10% in open group (t=5.911, P=0.018). DSCA score was 108.56 ± 8.69 mm2 in the minimally invasive group, and 117.28±11.09 mm2 in open group (t=11.774, P=0.001). There were significant differences between the two groups for ODI and DS?CA. Conclusion Both endoscopic and open laminectomy have excellent clinical effects on lumbar spinal stenosis. Endoscop?ic laminectomy has the advantages of less local trauma, less damage to the stability of the lumbar spine and faster recovery. However, there's a higher technical requirement for endoscopic spine surgery.

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Chinese Journal of Rheumatology ; (12): 382-388, 2019.
Article in Chinese | WPRIM | ID: wpr-754905

ABSTRACT

Objective To investigate the levels of T helper cell 17 (Th17), Th17-related cytokines in-terleukin 17 (IL-17) and interleukin 23 (IL-23) and regulatory T cell (Treg) in relapsing remitting multiple sclerosis (RRMS). Methods In a case-control study, plasma was collected from RRMS patients (n=20) and healthy subjects as control group (n=20). The percentages of Th17 and Treg cells and the levels of IL-17 and IL-23 were tested. The levels of Th17, Treg, IL-17 and IL-23 of the two groups were compared. Patients were treated with methylprednisolone. The levels of Th17, Treg, IL-17 and IL-23 of multiple sclerosis (MS) patients b efore and after treatment were compared. Expanded disability status scale (EDSS) score and the number of Gd-enhancing lesions were evaluated in the case group. Statistical analysis was made by body mass index (IBM) statistical program for social sciences (SPSS) 17.0 software. Independent sample t test was conducted to compare the measurement data of the case group and the healthy control group, and enumeration data were compared by χ2 test; paired sample t test was performed to compare the data of the case group before and after treatment; Pearson correlation analysis was made forthe variables of the MS group before treatment. Results In the RRMS group, the percentage of Th17 cells in peripheral blood was significantly higher than the control group [(2.10±0.45)%vs (1.09±0.20)%](t=9.130, P<0.01), the levels of Th17-related cytokines IL-17 and IL-23 were remarkably higher than the control group (IL-17:t=19.843, P<0.01;IL-23:t=22.747, P<0.01), and the percentage of Treg cells was significantly lower than the control group [(1.33 ±0.30)%vs (2.52±0.30)%], (t=12.422, P<0.01). The levels of Th17 and IL-17 were positively associated with EDSS score (Th17: r=0.458, P<0.05; IL-17: r=0.480, P<0.05), there was no significant-correlation between the level of IL-23 and EDSS score (r=0.368, P>0.05), and Th17, IL-17 and IL-23 were positively correlated with the number of Gd-enhancing lesions (Th17: r=0.446, P<0.05; IL-17: r=0.544, P<0.05; IL-23: r=0.461, P<0.05). The levels of Th17, IL-17 and IL-23 in the RRMS group after the treatment with methylprednisolone were obviously decreased than before treatment (Th17: t=5.747, P<0.01; IL-17: t=9.967, P<0.01; IL-23: t=14.697, P<0.01), while that of Treg was apparently increased (t=10.050, P<0.01). Compared with the control group, the levels of Th17, IL-17 and IL-23 in the RRMS group after treatment were higher (Th17: t=6.889, P<0.01;IL-17:t=7.185, P<0.01;IL-23:t=13.284, P<0.01), and the percentage of Treg was lower (t=7.622, P<0.01). EDSS score of the RRMS group after treatment was remarkably decreased than before treatment(t=6.190, P<0.01), but the number of Gd-enhanced lesions after treatment was no significantiy changed (t=1.453, P>0.05). Conclusion Th17/Treg expression imbalance and Th17-related cytokines IL-17, IL-23 may participate in the pathological process of MS, and they might be therapeutic target for MS.

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Article in Chinese | WPRIM | ID: wpr-754874

ABSTRACT

Objective To evaluate Aptima HPV E6 and E7 mRNA assay (Aptima HPV) combined with Aptima HPV 16 and 18 or 45 (18/45) genotype assay (Aptima HPV-GT) as a means of cervical cancer opportunistic screening. Methods From October 2016 to October 2017, a total of 23 258 women aged 25-65 years were enrolled in the physical examination center and gynecological clinic of Huzhou Maternity and Child Health Care Hospital. All the women had Aptima HPV tested, further Aptima HPV-GT testing for positive women and liquid-based thin layer cytology Thinprep cytologic test (TCT). Women with Aptima HPV (+) or ≥low-grade squamous intraepithelial lesion (LSIL) or obvious clinical symptoms (including vaginal bleeding after intercourse and watery, bloody vaginal discharge) were referred for colposcopy and further biopsy with or without endocervical curettage (ECC) if indicated. Expression of Aptima HPV, HPV 16 and HPV 18/45 with different cytological diagnostic groups and histological diagnosis groups were compared respectively. Sensitivity, specificity, positive predictive value and negative predictive value of Aptima HPV detection and TCT in identifying histological diagnosis of high-grade squamous intraepithelial lesion (HSIL) or worse (HSIL+) were compared. Results (1) The positive rates of Aptima HPV, HPV 16 and HPV 18/45 were 14.00% (3 257/23 258), 1.85% (430/23 258) and 0.86% (199/23 258) respectively.The positive rates of Aptima HPV, HPV 16 and HPV 18/45 increased with cytology grading in squamous epithelium [negative for intraepithelial lesion or malignancy (NILM), atypical squamous cells of undetermined significance (ASCUS), LSIL, atypical squamous cell cannot exclude HSIL (ASC-H), HSIL and squamous cell carcinoma (SCC), all P=0.000)]. According to histology results, the positive rates of Aptima HPV, HPV 16 and HPV 18/45 increased with histology grading in squamous epithelium (normal cervical tissue, LSIL, HSIL and SCC, all P=0.000). The positive rate of Aptima HPV was significantly higher in HSIL+group than that in the LSIL or better (LSIL-) group [98.11% (311/317) vs 12.84% (2 946/22 941), P=0.000]. The positive rate of Aptima HPV-GT was significantly higher in HSIL+group than that in LSIL-group [58.36% (185/317) vs 1.91% (439/22 941), P=0.000]. (2) Compared with cytology, Aptima HPV resulted in significant higher sensitivity (98.11% vs 59.62%, P=0.000) and negative predictive value (99.97% vs 99.42%, P=0.000), significant lower specificity (87.16% vs 95.37%, P=0.000) and positive predictive value (9.55% vs 15.10%, P=0.000) when identified HSIL+. Conclusions Women with Aptima HPV positive, especially those with Aptima HPV-GT positive, are more likely to have histological diagnosis of HSIL+. Aptima HPV combined with Aptima HPV-GT is feasible as a means of cervical cancer opportunistic screening in tertiary hospitals.

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International Journal of Surgery ; (12): 542-548, 2019.
Article in Chinese | WPRIM | ID: wpr-751670

ABSTRACT

Objective To explore the relationship between gastrointestinal leakage after perioperative radical gastrectomy and perioperative factors.Methods The clinical data of 602 patients who underwent radical gastrectomy for gastric cancer in Beijing Friendship Hospital,Capital Medical University from January 2013 to December 2017 were retrospectively analyzed,including 420 male case and 182 female cases.Patients with postoperative gastrointestinal leakage of univariate and multivariate Logistic regression analysis.Results Of the 602 patients who underwent radical gastrectomy,44 (7.3%) had gastrointestinal leakage after operation,and the mean time was 9 (1 to 49) days.Univariate analysis showed that the incidence of digestive tract leakage after radical gastrectomy was age,body mass index (BMI) ≥ 24.0 kg/m2,previous drinking history,hypoproteinemia (<40 g/L),carcino-embryonic antigen positive,CA19-9 positive,tumor site,combined organ The differences between resection,postoperative pathological type,postoperative T stage,postoperative N stage,postoperative M stage,and postoperative TNM staging were statistically significant (P < 0.05).There was no significant difference between smoking,hypertension,diabetes,anemia and other factors (P > 0.05).Multivariate logistic analysis showed that the history of combined drinking,BMI≥24.0 kg/m2,and the tumor site is based on the gastric body as the standard distal stomach,carcino-embryonic antigen,hypoproteinemia (< 40 g/L) were relatively independent risk factors for digestive tract leakage after radical gastrectomy.Conclusions Age,BMI ≥24.0 kg/m2,previous drinking history,hypoproteinemia (< 40 g/L),carcino-embryonic antigen positive,CA19-9 positive,tumor site,combined organ resection,postoperative pathological type,postoperative T stage,postoperative N stage,postoperative M stage,postoperative TNM staging and other factors are risk factors for digestive tract leakage after radical gastrectomy,while previous drinking history,hypoproteinemia (< 40 g/L),BMI (≥ 24.0 kg/m2),carcino-embryonic ontigen,tumor's site is a relatively independent risk factor for digestive tract leakage after radical gastrectomy.Serum albumin and BMI levels need to be strictly controlled during the perioperative period,and the occurrence of postoperative digestive tract leakage is reduced in the case of effective alcohol withdrawal.

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Chinese Journal of Immunology ; (12): 213-219, 2019.
Article in Chinese | WPRIM | ID: wpr-744636

ABSTRACT

Objective: To study the expression of CD44 in pulmonary tuberculosis patients and explore the possible mechanisms. Methods: 236 patients suspected with pulmonary tuberculosis were selected and divided into pulmonary tuberculosis group ( n= 152) and non-pulmonary tuberculosis group ( n= 84), and 100 healthy people were randomly selected as healthy control group. The expression of CD44 was evaluated by qRT-PCR and ELISA in peripheral blood and pleural effusion from different patients. The CD44 levels at pre and post-treatment time points were determined by ELISA. The inducing factors of increased CD44 and the potentialroles played by CD44 in the pathogenesis of TB were also evaluated. We elucidated whether CD44 detection could combine with T-spot. TB to diagnose pulmonary tuberculosis rapidly and accurately. Results: The expression of CD44 in pulmonary tuberculosis patients was higher compared with the non-pulmonary tuberculosis patients and healthy people, and would be down-regulated after treatment for 3, 6 and 9 months. Besides, CD44 could not remove H37 Ra by the CFU assay, and could promote the expression of CCL-2, indicating that CCD4 promote the mobility the THP-1 via induction of CCL-2. Besides, TNF-α neutralizing antibody, added into the macrophages, could inhibit the expression of CD44, and functional TNF-α induced the expression of TNF-α. Conclusion: CD44 is highly expressed in pulmonary tuberculosis patients, which may be due to the high expression of TNF-α in pulmonary tuberculosis patients, stimulating macrophages to produce CD44, and it will provide a basis for clinical diagnosis of pulmonary tuberculosis.

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