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1.
Article in Chinese | WPRIM | ID: wpr-920739

ABSTRACT

Objective To analyze the dynamic changes of schistosomiasis in Poyang County of Jiangxi Province from 2004 to 2020, so as to provide insight into the development of the schistosomiasis elimination strategy. Methods Schistosomiasis control data were captured from Poyang County from 2004 to 2020, and the epidemiological data of schistosomiasis were collected from national schistosomiasis surveillance sites in Poyang County from 2005 to 2020. The endemic status of schistosomiasis was analyzed in Poyang County from 2004 to 2020, and a Joinpoint regression analysis was performed to investigate the trends of schistosomiasis in Poyang County from 2004 to 2020. Results The sero-prevalence and egg-prevalence of human Schistosoma japonicum infections reduced from 24.39% (24 976/102 397) and 4.53% (259/5 721) in 2004 to 5.37% (2 421/45 100) [annual percent change (APC) = average annual percent change (AAPC) = −8.64%] and 0 (0/3 963) in 2020 (APC = AAPC = −32.07%) in Poyang County, and the trends were both significant (both P < 0.01). The sero-prevalence of S. japonicum infections reduced from 1.21% (294/24 332) in bovines in 2013 to 0.58% (35/5 999) in 2020 in Poyang County, with one turning point (AAPC = −8.20%, P > 0.05). There were no townships or villages with emerging snail habitats in Poyang County from 2004 to 2020, and there were three turning points of trend in the proportion of snail areas detected in total snail areas (AAPC = −2.30%, P > 0.01). The sero-prevalence and adjusted prevalence of S. japonicum infections reduced from 60.82% (742/1 220) and 10.16% (124/1 220) in local residents in 2005 to 5.73% (70/1 221) and 0 in 2020 in national schistosomiasis surveillance sites of Poyang County, and the trends for sero-prevalence (APC = AAPC = 17.47%, P < 0.01) and adjusted prevalence of S. japonicum infections (APC = AAPC = −44.92%, P < 0.01) were both statistically significant. S. japonicum infections were identified in 10 (2005) and 2 local livestock (2007), with prevalence of 10.00% (10/100) and 13.33% (2/15), respectively, and S. japonicum infections were detected in snails in 2008 and 2009; however, no positive samples of mixed O. hupensis were detected by loop-mediated isothermal amplification. Conclusions The endemic situation of schistosomiasis control had remarkably reduced in Poyang County from 2004 to 2020; however, there are still challenges for consolidating schistosomiasis control achievements and even elimination of schistosomiasis.

2.
China Pharmacy ; (12): 602-610, 2022.
Article in Chinese | WPRIM | ID: wpr-920732

ABSTRACT

OBJECTIVE To study the triterpenoid saponins from Anemone rivularis var. flore-minore and their antitumor activities. METHODS The n-butanol extract of 70% ethanol extract from rhizome of the plant was separated. The triterpenoid saponins were separated and purified by normal silica gel column chromatography ,reversed phase ODS column chromatography , Sephadex LH- 20 gel column chromatography and semi-preparation high performance liquid chromatography. The structures of these saponins were identified by spectral analysis (NMR and MS )and physical and chemical properties. MTT assay was used to test the proliferation inhibitory activity of the compounds against five kinds of human tumor cells (HL-60 cells,A549 cells,HepG2 cells,HeLa cells and U 87MG cells ). The apoptosis inducing effect of compound 7 on U 87MG cells was evaluated by flow cytometric Annexin V-FITC/PI staining test. RESULTS:Sixteen triterpenoid saponins were obtained and identified as 3 β-O-β-D-xylopyranosyl-(1→2)-α-L-arabinopyranosyl-oleanolic acid-28-O-α-L-rhamnopyranosyl- (1→4) -β-D-glucopyranosyl-(1→6)-β-D-glucopyranoside(1),3β-O-L-arabinopyranosyl oleanolic acid- 28-O-β-D-glucopyranoside(2),saponin B (3), 163.com oleanolic acid- 3β-O-β-D-glucopyranosyl-(1→2)-α-L-arabino- pyranoside(4),HN-saponin F (5),clematoside S (6),prosapogenin CP 4(7),cussonside B (8),pulsatilla saponin C (9), clemastanoside D (10),3 β-O-β-D-glucopyranosyl-(1→2)-β-L-arabinopyranosyl-hederagenin-28-O-β-D-glucopyranoside(11), ciwujianoside C 3(12),ciwujianoside A 1(13),huzhangoside D (14),kalopanaxsaponin B (15)and hederacolchiside E (16). Compounds 3,4,6-9 displayed inhibitory activities on the proliferation of tumor cells to different extent ,and compound 7 had the strongest activity ;compound 7 induced the apoptosis of U 87MG cell so as to inhibit the proliferation of cancer cells in a time-dependent manner. CONCLUSIONS The obtained 16 saponins are all identified as oleanolane-type ,among which compound 1 is a new compound. The monodesmosidic saponins ,the sugar chain of which attached at C- 3 and a free carboxyl at C- 28, possess stronger antitumor activity than others.

3.
China Pharmacy ; (12): 473-480, 2022.
Article in Chinese | WPRIM | ID: wpr-920465

ABSTRACT

OBJECTIVE To study in vitro inhibitory effects of realgar nanoparticles on breast cancer stem cells. METHODS Human breast cancer MCF- 7 parent cells were selected as subjects and cultured by serum-free culture to obtain breast cancer stem cells. Using adriamycin (1 mg/L)as positive control ,same concentration of water-processed realgar as reference ,the effects of realgar nanoparticles on the proliferation of MCF- 7 parent cells and stem cells were detected by CCK- 8 method. The effects of realgar nanoparticles on the formation of mammosphere ,the ability of differentiation ,migration and invasion ,the proportion of CD44+/CD24- subgroup in breast cancer stem cells were detected by mammosphere formation and differentiation experiment , scratch experiment ,Transwell invasion experiment and flow cytometry. Western blot assay was used to detect the expression of proteins related to epithelial mesenchymal transformation pathway (E-cadherin and vimentin ) in breast cancer stem cells. RESULTS The survival rates of MCF- 7 parent cells and stem cells (except for breast cancer stem cells in both 1 mg/mL groups )in 1,5,10,40,60,80 mg/L groups of water-processed realgar and realgar nanoparticles were significantly lower than blank control group(P<0.01). The number of mammosphere (>20 stem cells )in 1,2.5,5,10 mg/L groups of water-processed realgar and realgar nanoparticles was significantly lower than blank control group (P<0.01);the volume of mammosphere decreased and the differentiated adherent cells decreased ;the healing rate of wound ,relative invasion rate (except for water-processed realgar 1 mg/L group)and the proportion of CD 44+/CD24- subgroup were significantly lower than blank control group (P<0.01). The expressions of E-cadherin in 2.5,10 mg/L groups of water-processed realgar and realgar nanoparticles was significantly higher than blank control group ,and the expressions of vimentin was significantly lower than those in blank control group (P<0.01). The above effects of realgar nanoparticles were generally better than those of water-processed realgar with the same mass concentration (P< 0.01). CONCLUSIONS Compared with water-processed realgar with the same mass concentration ,realgar nanoparti cles can significantly inhibit the proliferation of breast cancer stem cells, the formulation and differential ability of mammo- sphere,and reduce the proportion of CD 44+/CD24- subgroup. The effect may be associated with the inhibition of migration and invasion of breast cancer stem cells by inhibiting the expression of proteins related to epithelial mesenchymal transformation pathway.

4.
Article in Chinese | WPRIM | ID: wpr-912535

ABSTRACT

Objective:To seek indicators or models for predicting the risk of deep vein thrombosis (DVT) after traumatic lower extremity fractures.Methods:A nested case-control study was conducted on 424 patients with traumatic lower extremity fractures in Beijing Jishuitan Hospital from May 2019 to December 2019. Patients with traumatic lower extremity fractures of the hip, femoral shaft, distal femoral, patella, tibial plateau, tibiofibular shaft, ankle or foot were 18 or older. Trauma patients were examined by venogram before surgery. 56 of 424 patients with traumatic lower limb fractures were diagnosed with preoperative DVT. Then, those with no evidence of DVT were paired by age, gender and fracture sites to those with DVT. Laboratory parameters included conventional coagulation tests and thrombotic biomarkers, such as D-dimer, plasmin-ɑ2-plasmin inhibitor complex (PIC), tissue plasminogen activator-plasminogen activator inhibitor complex (tPAIC), and Caprini score was calculated. Univariate analysis was used to distinguish statistically significant variables between trauma patients with and without DVT. Then logistic regression analysis was applied to identify independent risk factors for post-traumatic DVT. The receiver-operating characteristic (ROC) curve analysis was employed to assess the efficacy of indicators in predicting the risk of DVT after traumatic lower extremity fractures.Results:The levels of tPAIC and Caprini score in patients with DVT after traumatic lower limb fractures were significantly higher than those in non-DVT patients ( P values of 0.036 and 0.016, respectively). D-dimer, PIC, and Caprini score were independent risk factors for preoperative DVT after traumatic lower limb fractures. Thus, we defined the Predicting Index as 0.098×D-dimer (mg/L FEU)+(-0.564) ×PIC (μg/ml)+0.233×Caprini score, and found that the area under the ROC curve for the Predicting Index was 0.721. Conclusions:Predicting Index, calculated by D-dimer, PIC and Caprini score, can comprehensively encompass the changes of risk factors between patients with and without DVT after traumatic lower limb fractures, and can well predict the risk of DVT after traumatic lower extremity fractures.

5.
Clinical Medicine of China ; (12): 327-332, 2021.
Article in Chinese | WPRIM | ID: wpr-909752

ABSTRACT

Objective:To explore the influence of symptom group of stroke patients with exercise disorder on acute stress disorder.Methods:Patients with stroke and motor impairment hospitalized in the Department of Neurology and surgery of North China University of technology from October 2018 to August 2019 were selected as the research objects.The general information of patients, brain injury subscale (BIS) and Stanford acute stress reaction questionnaire (SARSQ) were investigated by questionnaire.Results:A total of 324 patients with stroke and motor disorders were investigated.The demographic characteristics of education, age, degree of motor function, number of combined dysfunction and Activity Of Daily Living Scale(ADL) grade had effects on acute stress disorder, and the differences were statistically significant( P<0.05). The score of acute stress disorder in stroke patients with motor disorders was (99.60±13.69 ) points.From the highest to the lowest symptom group, the scores were obsessive symptom (11.35±2.71), depression (7.44±1.86), hostility (7.23±2.26), somatization (3.69±1.42) and psychosis (2.81±1.09). The results of correlation analysis showed that somatization, depression, obsessiveness, hostility and psychosis were positively correlated with the total score of acute stress disorder and the scores of each dimension ( r=0.164, 0.355, 0.329, 0.298, 0.279, all P<0.05), the symptoms were also positively correlated with all the dimensions of acute stress disorder(all P<0.05). Multiple linear regression analysis showed that age(Regression coefficient=7.682, 95% CI: 4.930-10.435, P<0.001), the number of combined dysfunction(Regression coefficient=3.937, 95% CI: 0.268-7.605, P=0.036), depression(Regression coefficient=1.662, 95% CI: 0.727-2.597, P=0.001) had influence on ASD of stroke patients. Conclusion:The level of acute stress disorder in stroke patients with motor impairment is on the high side, and the characteristics of symptom group are obvious, which has a positive correlation with acute stress disorder.Medical staff should pay attention to the characteristics of symptom group and acute stress reaction level of stroke patients with motor impairment, so as to provide targeted intervention strategies to avoid disease recurrence and improve the quality of life.

6.
China Pharmacy ; (12): 2785-2789, 2021.
Article in Chinese | WPRIM | ID: wpr-904784

ABSTRACT

OBJECTIVE:To explore the role of clinical pharmacists in the diagnosis and tre atment of immune checkpoint inhibitor related adrenocortical insufficiency ,so as to provide reference for the diagnosis and treatment of similar cases. METHODS:A lung squamous carcinoma patient with tumor immunotherapy ,who received long-term intravenous infusion of Pembrolizumab injection ,was hospitalized for more than 10 days due to fatigue and poor appetite. The clinical pharmacists consulted the literature and evaluated the correlation of ADR on the basis of patient ’s physical examination results (plasma cortisol 16.41 nmol/L at 8:00 in the morning on the second day of admission ,adrenocorticotropic hormone 8.39 pg/mL,serum electrolyte sodium 126.00 mmol/L,chlorine 88.00 mmol/L,etc.)and medication history (receiving the treatment with immune checkpoint inhibitors). The clinical pharmacists assisted the doctor to confirm that the patient was adrenocortical insufficiency ,and the correlation with pembrolizumab was “very likely ”. On the basis of discontinuation of pembrolizumab ,it was recommended to take Hydrocortisone tablets orally (20 mg at 8:00 in the morning and 10 mg at 4:00 in the afternoon )for glucocorticoid physiological dose substitution therapy. Before treatment ,the patient and his families should be educated on the use of drugs ,pharmaceutical care should be implemented to evaluate the glucocorticoid doseand efficacy during treatment ,and medication education was carried out at discharge. RESULTS :The doctor adopted theli_xyan suggestions of the clinical pharmacist. On the 5th day after @126.com administration,the symptoms of adrenocortical insufficiency were significantly impro ved,and the patient was discharged with medicine. CONCLUSIONS :During the treatment of the patient , the clinical pharmacist gave full play to his pharmaceutical expertise ,assisted the doctor to formulate an appropriate medication plan,and carried out medication education for the patient and his family members ,so as to ensure the effectiveness and safety of the patient ’s medication. It is suggested that the baseline examination of patients should be improved before immune checkpoint inhibitor treatment ,including physical examination and plasma cortisol level at 8:00 in the morning ;the frequency of monitoring plasma cortisol level and serum electrolyte level at 8:00 in the morning. should be increased during medication ;the patients should be followed up for at least 1 year after withdrawal ,so as to early detect and treat immune checkpoint inhibitor related adrenocortical dysfunction.

7.
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
8.
Acta Pharmaceutica Sinica B ; (6): 2585-2604, 2021.
Article in English | WPRIM | ID: wpr-888873

ABSTRACT

Invasive fungal infections (IFIs) represent a growing public concern for clinicians to manage in many medical settings, with substantial associated morbidities and mortalities. Among many current therapeutic options for the treatment of IFIs, amphotericin B (AmB) is the most frequently used drug. AmB is considered as a first-line drug in the clinic that has strong antifungal activity and less resistance. In this review, we summarized the most promising research efforts on nanocarriers for AmB delivery and highlighted their efficacy and safety for treating IFIs. We have also discussed the mechanism of actions of AmB, rationale for treating IFIs, and recent advances in formulating AmB for clinical use. Finally, this review discusses some practical considerations and provides recommendations for future studies in applying AmB for combating IFIs.

9.
Journal of Experimental Hematology ; (6): 1295-1300, 2021.
Article in Chinese | WPRIM | ID: wpr-888555

ABSTRACT

OBJECTIVE@#To investigate the clinical characteristic of coagulation, possible causes and countermeasures of patients with severe corona virus disease 2019 (COVID-19).@*METHODS@#The clinical data of the 142 patients diagnosed as COVID-19 at Wuhan Third Hospital in Wuhan, China, from February 10 to February 16, 2020 were collected and analyzed retrospective. Among the patients, 17 cases of dead patients were divided into observe group, and 125 cases of cured patients were divided into control group. The clinical characteristics, laboratory tests, influencing factors, anticoagulant therapy, embolization and bleeding events of the two groups were observed.@*RESULTS@#The average hospital stay time in 142 patients was 22 d. For the 17 dead patients in the observe group, the average hospital stay time was 9.9 d, and the D-dimer, prothrombin time, WBC count and Padua score of the patients in the observe group were significantly higher as compared with the patients in the control group. PT(OR=1.064, 95%CI 1.012-1.119) and D-D(OR=1.045, 95%CI 1.027-1.064) were the independent risk factors that causing the death of COVID-19 patients. Among the patients, 36(25.4%) patients received low-molecular-weight heparin for anticoagulant therapy, with the average course of 9.6 d. The cumulative incidence of the embolism of the patients in the observe group was 7(41.2%), while 2(11.8%) patients developed to deep vein thrombosis (DVT) and pulmonary embolism (PE), 3 (17.6%) patients occurred acute cerebral infarction and 2 (11.8%) patients occurred acute myocardial infarction. 3 (17.6%) dead patients revealed dominant disseminated intravascular coagulation (DIC).@*CONCLUSION@#Most patients with severe COVID-19 shows a variety of risk factors for thrombus, and those with coagulation dysfunction shows a high dead rate and rapid disease progression. Therefore, coagulation indicators should be dynamically monitored, and mechanical and drug prevention should be actively carried out.


Subject(s)
Anticoagulants , COVID-19 , Disseminated Intravascular Coagulation , Humans , Retrospective Studies , SARS-CoV-2
10.
Journal of Experimental Hematology ; (6): 1181-1186, 2021.
Article in Chinese | WPRIM | ID: wpr-888536

ABSTRACT

OBJECTIVE@#To investigate the prognostic value of metabolic parameters of @*METHODS@#The clinical data of 58 patients with DLBCL who were examined by @*RESULTS@#The SUV@*CONCLUSION@#MTV and TLG are independent risk factors for OS and PFS in patients with DLBCL, which may be valuable for prognosis of patients with DLBCL.


Subject(s)
Fluorodeoxyglucose F18 , Humans , Lymphoma, Large B-Cell, Diffuse , Positron Emission Tomography Computed Tomography , Positron-Emission Tomography , Prognosis , Retrospective Studies
11.
Article in Chinese | WPRIM | ID: wpr-888171

ABSTRACT

Astragali Radix is a traditional Chinese herbal medicine with a long history, which has the functions of tonifying Qi and promoting urination and granulation. Astragalosides are the main effective components of Astragali Radix, and more than 40 triterpenoid saponins have been obtained from Astragalus membranaceus and its related plants, mainly including astragalosides Ⅰ-Ⅷ, isoastragalosides Ⅰ, Ⅱ, and Ⅳ, acetylastragalosides, and soyasaponins. Astragalosides have a wide range of biological activities, such as immunomodulation, antioxidation, and neuroprotection. Nervous system diseases seriously affect people's quality of life, threaten human physical and mental health, and impose a burden on families and society. As natural drugs, astragalosides have good preventive and therapeutic effects on central nervous system diseases. This paper reviews the main pharmacological effects and mechanisms of astragalosides in the treatment of multiple sclerosis, Parkinson's disease, Alzheimer's disease, and cerebral ischemic stroke and proposes the research prospects and potential problems, aiming to provide reference for the clinical application and basic research of astragalosides.


Subject(s)
Astragalus Plant , Astragalus propinquus , Drugs, Chinese Herbal , Humans , Nervous System Diseases , Quality of Life , Saponins/pharmacology
12.
Article in Chinese | WPRIM | ID: wpr-888077

ABSTRACT

This study aimed to explore the effects of galangin on energy metabolism and autophagy in gastric cancer MGC803 cells and the underlying mechanism. Cell counting kit-8(CCK-8) was used to detect the effects of galangin at different concentrations on via-bility of MGC803 cells after 48 h intervention. Western blot was carried out to measure the effects of galangin on expression of proteins related to autophagy, nuclear factor-κB(NF-κB) pathway and energy metabolism, followed by the determination of its effects on mRNA expression of energy metabolism-related proteins by Real-time quantitative PCR(qPCR). The impact of galangin on autophagy was explored using AutophagyGreen dye reagent, with autophagosomes and lysosomes observed under the transmission electron microscope(TEM). Nude mice transplanted with gastric cancer MGC803 cells via subcutaneous injection were randomly divided into the following three groups: control(0.5% sodium carboxymethyl cellulose, once a day), 5-fluorouracil(5-FU, 50 mg·kg~(-1), twice a week), and galangin(120 mg·kg~(-1), once a day) groups. The body weight and tumor volume were measured once every three days with a vernier caliper at the same time point by the same person. After 21-d treatment, the tumor tissue was isolated and weighed for the calculation of the tumor-suppressing rate. The comparison with the control group revealed that galangin inhibited the viability of MGC803 cells, up-regulated the protein expression of microtuble-associated protein 1 light chain 3 B(LC3 B) Ⅱ, inhibited the phosphorylation of NF-κB pathway-related proteins, and promoted the formation of autophagosomes in MGC803 cells. However, it did not obviously affect the expression of energy metabolism-related proteins. Furthermore, galangin at 120 mg·kg~(-1) significantly reduced the tumor weight and volume in mice, enhanced LC3 BⅡ protein expression, and inhibited the phosphorylation of NF-κB pathway-related proteins. All these have suggested that galangin inhibited the growth of gastric cancer MGC803 cells both in vivo and in vitro, possibly by inhibiting the NF-κB pathway and enhancing autophagy.


Subject(s)
Animals , Autophagy , Flavonoids , Mice , Mice, Nude , NF-kappa B/genetics , Signal Transduction , Stomach Neoplasms/genetics
13.
Chinese Medical Journal ; (24): 1687-1694, 2021.
Article in English | WPRIM | ID: wpr-887650

ABSTRACT

BACKGROUND@#Computed tomography images are easy to misjudge because of their complexity, especially images of solitary pulmonary nodules, of which diagnosis as benign or malignant is extremely important in lung cancer treatment. Therefore, there is an urgent need for a more effective strategy in lung cancer diagnosis. In our study, we aimed to externally validate and revise the Mayo model, and a new model was established.@*METHODS@#A total of 1450 patients from three centers with solitary pulmonary nodules who underwent surgery were included in the study and were divided into training, internal validation, and external validation sets (n = 849, 365, and 236, respectively). External verification and recalibration of the Mayo model and establishment of new logistic regression model were performed on the training set. Overall performance of each model was evaluated using area under receiver operating characteristic curve (AUC). Finally, the model validation was completed on the validation data set.@*RESULTS@#The AUC of the Mayo model on the training set was 0.653 (95% confidence interval [CI]: 0.613-0.694). After re-estimation of the coefficients of all covariates included in the original Mayo model, the revised Mayo model achieved an AUC of 0.671 (95% CI: 0.635-0.706). We then developed a new model that achieved a higher AUC of 0.891 (95% CI: 0.865-0.917). It had an AUC of 0.888 (95% CI: 0.842-0.934) on the internal validation set, which was significantly higher than that of the revised Mayo model (AUC: 0.577, 95% CI: 0.509-0.646) and the Mayo model (AUC: 0.609, 95% CI, 0.544-0.675) (P < 0.001). The AUC of the new model was 0.876 (95% CI: 0.831-0.920) on the external verification set, which was higher than the corresponding value of the Mayo model (AUC: 0.705, 95% CI: 0.639-0.772) and revised Mayo model (AUC: 0.706, 95% CI: 0.640-0.772) (P < 0.001). Then the prediction model was presented as a nomogram, which is easier to generalize.@*CONCLUSIONS@#After external verification and recalibration of the Mayo model, the results show that they are not suitable for the prediction of malignant pulmonary nodules in the Chinese population. Therefore, a new model was established by a backward stepwise process. The new model was constructed to rapidly discriminate benign from malignant pulmonary nodules, which could achieve accurate diagnosis of potential patients with lung cancer.


Subject(s)
Humans , Lung , Lung Neoplasms/diagnostic imaging , Multiple Pulmonary Nodules , Risk Assessment , Solitary Pulmonary Nodule/diagnostic imaging , Tomography, X-Ray Computed
14.
Article in Chinese | WPRIM | ID: wpr-886821

ABSTRACT

Objective To determine the genotype and clustering characteristics of multidrug-resistant (MDR) mycobacterium tuberculosis in Wuhan City. Methods A total of 149 mycobacterium tuberculosis strains from MDR tuberculosis (MDR-TB) patients were genotyped by DTM-PCR, mycobacterial interspersed repetitive unit–variable number tandem repeat typing (MIRU-VNTR) and sequencing of drug-resistant associated genes. The Hunter-Gaston discriminatory index (HGDI), clustering rate and recent minimum estimated infection rate were calculated. Results The cumulative HGDI of all MIRU loci was 0.9944. Gene locus with the highest HGDI(0.6467)was QUB11b. Combing MIRU-VNTR and DTM-PCR, 111 unique genotypes and 11 clustered genotypes(38 strains)from 149 isolates were identified. The clustering rate was 25.50%, and the recent minimum infection rate was estimated to be 18.12%. After further genotyping by sequencing of drug-resistant associated genes, the results showed that 17 (44.74%) strains in each cluster shared the same mutation sites, while the other strains had different mutation sites. Conclusion The combination of DTM-PCR, 24 locus MIRU-VNTR typing and drug resistance gene sequencing demonstrates a relatively high discriminatory power, which is suitable for the genotyping of multi drug resistant mycobacterium tuberculosis in Wuhan. The epidemic of MDR-TB in Wuhan is mainly caused by reactivation, and the recent transmission rate is not high.

15.
Article in Chinese | WPRIM | ID: wpr-885718

ABSTRACT

Objective:To compare the efficacy of three approaches of parallel-style bilateral metal stenting in the management of unresectable malignant hilar biliary obstruction.Methods:Data of 118 patients with unresectable malignant hilar biliary obstruction (Bismuth type Ⅱ-Ⅳ) treated by endoscopic bilateral metal stenting in Oriental Hepatobiliary Surgery Hospital from January 2012 to February 2019 were retrospectively studied. According to the method of stent placement, patients were divided into three groups, both stents crossing the main duodenal papilla (long long-stent by stent, LL-SBS) group (53 cases), one stent crossing the papilla (long short-SBS, LS-SBS) group (53 cases) and no stent crossing the papilla (short short-SBS, SS-SBS) group (12 cases). The main outcomes, clinical success rate, stent patency, success rate of re-intervention of both intrahepatic systems and overall survival, were compared among the three groups.Results:There were no significant differences in clinical success rate [96.2% (51/53), 98.1% (52/53), and 91.7% (11/12)], median stent patency [9.2 (8.0-10.3) months, 11.6 (6.8-16.4) months, and 8.1 (3.7-12.5) months] or overall survival time [6.7 (4.6-8.8) months, 7.6 (5.7-9.4) months, and 7.1 (0.7-13.6) months] among the three groups (all P>0.05). The success rate of endoscopic re-intervention of both intrahepatic systems was 12/13, 0/10, and 1/5 in LL-SBS, LS-SBS and SS-SBS groups, respectively ( P<0.001). Conclusion:Parallel-style bilateral metal stenting is an effective endoscopic modality in the treatment of malignant hilar biliary obstruction, and LL-SBS may improve the success rate of endoscopic re-intervention to both intrahepatic systems.

16.
Article in Chinese | WPRIM | ID: wpr-885708

ABSTRACT

Objective:To investigate the feasibility and efficacy of endoscopic placement of transpapillary parallel-style bilateral metal stents for malignant hilar biliary stricture.Methods:A total of 55 patients with malignant hilar biliary stricture (Bismuth Ⅱ-Ⅳ) were treated with an improved endoscopic drainage technique (endoscopic transpapillary parallel-style bilateral metal stenting) from January 2012 to December 2018 in Shanghai Oriental Hepatobiliary Surgery Hospital. The technical success rate, clinical success rate, incidence of complications, success rate of endoscopic re-intervention, stent patency and overall survival were analyzed.Results:The technical success rate of endoscopic placement of bilateral metal stents was 96.4% (53/55), the clinical success rate was 96.2% (51/53), and the early complication incidence was 13.2% (7/53). The median stent patency was 9.2 months (95% CI: 8.0-10.3 months), the success rate of endoscopic re-intervention of bilateral biliary systems was 92.3% (12/13), and the median overall survival was 6.7 months (95% CI: 4.7-8.8 months). Conclusion:This modified technique of bilateral metal stent placement is safe and effective for malignant hilar biliary stricture that is unsuitable for surgery.

17.
Article in Chinese | WPRIM | ID: wpr-885695

ABSTRACT

Objective:To compare the efficacy of bilateral and unilateral metallic stenting in the treatment of unresectable malignant hilar biliary obstruction.Methods:From January 2012 to December 2018, a total of 300 patients with malignant hilar biliary obstruction (Bismuth type Ⅱ-Ⅳ) were treated with endoscopic metallic stenting in Oriental Hepatobiliary Surgery Hospital. Ninety-four patients with bilateral metallic stenting (bilateral metallic stent group) and 94 patients with unilateral metallic stenting (unilateral metallic stent group) were matched and analyzed by propensity score matching. The clinical success rate, the total number of interventions, the stent patency and overall survival time were compared between the two groups.Results:The clinical success rate in the bilateral metallic stent group was significantly higher than that of the unilateral metallic stent group [98.9% (93/94) VS 78.7% (74/94), χ2=19.352, P<0.001], and the mean number of intervention in the bilateral metallic stent group was significantly less than that of the unilateral metallic stent group (1.2±0.5 times VS 1.7±0.9 times, t=-4.345, P<0.001). The stent patency time in the bilateral metallic stent group was significantly longer than that of the other group [10.0 (8.0, 12.1) months VS 5.7 (5.2, 6.3) months, χ2=19.789, P<0.001]. The median survival time of patients in the bilateral group was numerically longer than that in the unilateral group, but did not reach statistical significance [7.6 (6.3, 8.9) months VS 4.6 (3.7, 5.7) months, χ2=3.628, P=0.057]. Conclusion:Endoscopic bilateral metallic stenting is superior to unilateral metallic stenting in the clinical management of malignant hilar biliary obstruction unsuitable for surgery.

18.
Chinese Journal of Neurology ; (12): 409-417, 2021.
Article in Chinese | WPRIM | ID: wpr-885437

ABSTRACT

Anti-glutamic acid decarboxylase antibody-associated encephalitis is a kind of autoimmune encephalitis mediated by anti-glutamic acid decarboxylase antibody, which belongs to anti-neuronal intracellular synaptic protein antibody-associated encephalitis. Clinical manifestations include stiff-person syndrome, cerebellar ataxia, limbic encephalitis, seizures, etc., often associated with a variety of autoimmune diseases, rarely associated with tumors. Detection of anti-glutamic acid decarboxylase antibody is crucial for clinical diagnosis. Immunotherapy helps to relieve symptoms and improve prognosis. The incidence of this disease is low, and there are few reports at home and abroad. This paper intends to review the research on this encephalitis, hoping to improve the clinicians′ understanding and the level of diagnosis and treatment of the disease.

19.
Chinese Journal of Neurology ; (12): 362-367, 2021.
Article in Chinese | WPRIM | ID: wpr-885429

ABSTRACT

Objective:To analyze the sleep quality and sleep structure of patients with obstructive sleep apnea hypopnea syndrome (OSAHS) complicated with patent foramen ovale (PFO), and to study the effect of PFO on the sleep structure of OSAHS.Methods:Fifty-six patients with OSAHS complicated with PFO, 64 patients with simple OSAHS and 62 controls were collected from December 2018 to March 2020 in Centre of Sleep Disorders, the Second Affiliated Hospital of Zhengzhou University. Pittsburgh Sleep Quality Index and polysomnography were used to compare the sleep quality and sleep structure of the three groups.Results:Compared with the control group [6/62(9.68%)], OSAHS complicated with PFO group [54/56(96.43%)] and simple OSAHS group [53/64(82.81%)] had higher incidence of poor sleep quality (χ2=112.08, P<0.0l). Furthermore, compared with the control group, the OSAHS complicated with PFO group and simple OSAHS group showed reduced sleep efficiency [PSQI total score was 0.5 (0, 1), 2 (1, 3) and 2 (1, 2) respectively, H=74.549, P<0.01] and reduced proportions of rapid eye movement (REM; 20.45%±3.49%, 12.19%±5.95% and 15.11%±7.21%,respectively, F=21.17, P<0.01) and slow wave sleep (N3; 21.24%±4.12%, 14.15%±6.08%, 17.68%±6.35%, respectively, F=29.51, P<0.01); the N1 (4.47%±2.40%, 9.50%±5.34%, 9.55%±4.61%, respectively, F=30.07, P<0.05) and N2 sleep (53.88%±4.35%, 64.09%±7.49%, 58.14%±6.67% , respectively, F=46.21, P<0.05) were prolonged; the inocturnal lowest oxyhemoglobin saturation (SpO 2) level was lower, mean SpO 2 reduction at night was higher [3.00% (0, 4.00%),6.00% (5.00%, 8.75%) and 4.00% (4.00%, 5.00%), respectively, H=72.24, P<0.05], and periodic leg movement index [16.30(4.80, 32.82), 33.30(9.26, 54.80) and 23.10(8.38, 31.83),respectively, H=17.86, P<0.05], arousal index [11.60(7.73, 17.55), 23.90(14.03, 30.45) and 15.6(11.23, 20.78), respectively, H=22.80, P<0.05] and sleep apnea and hypopnea index (AHI; 1.60±1.38, 23.90±7.27 and 16.24±4.22,respectively, F=136.97, P<0.05) increased. Compared with the simple OSAHS group, the incidence of poor sleep quality was higher, the proportions of slow wave sleep (N3, F=29.51, P=0.047) and REM ( F=21.17, P=0.012) were decreased, N2 sleep ( F=46.21, P=0.000) was prolonged, mean SpO 2 reduction at night ( Z=54.28, P=0.000), wake after sleep onset [116.00(89.88, 143.00) min vs 135.00(118.50, 168.38) min, Z=25.71, P=0.023], arousal times [14.00(8.25, 8.00) vs 17.50(9.00,23.00),respectively, Z=19.68, P=0.041], microarousal ( Z=23.57, P=0.044), and AHI ( F=136.97, P=0.000) were increased in the OSAHS complicated with PFO group. Conclusions:OSAHS complicated with PFO patients had poor sleep quality and high incidence of sleep disorders. They had sleep disorder at night, which was characterized by the decrease of REM sleep and slow wave sleep, the prolongation of N2, the decrease of nocturnal SpO 2 and the increase of awakening times, and the increase of arousal times and AHI. PFO can aggravate the sleep disorder of OSAHS.

20.
Chinese Journal of Geriatrics ; (12): 650-653, 2021.
Article in Chinese | WPRIM | ID: wpr-884941

ABSTRACT

Objective:To investigate the effects of aerobic exercise on blood glucose and insulin levels in chronic intermittent hypoxic(CIH)rats and the underlying mechanisms, and to provide new insights for the prevention and treatment of diabetes caused by CIH.Methods:SD rats were randomly divided into the blank control group, CIH control group and CIH exercise group.After adaptive feeding, a rat model of CIH was established.The CIH exercise group received non-weight bearing exercise training through swimming.After 4 weeks, all rats were sacrificed and levels of total antioxidant capacity(T-AOC), reactive oxygen species(ROS), malondialdehyde(MDA), fasting blood glucose(FPG)and fasting insulin(FINS)were measured.Results:Compared with the blank control group and CIH control group, levels of ROS, MDA, FPG, T-AOC, FINS and FPG were significantly different in the CIH exercise group( F=4.60, 5.03, 4.87, 4.52 and 6.42, P=0.021, 0.015, 0.017, 0.022 and 0.006). Compared with the blank control group, levels of ROS, MDA, FPG and FINS increased and levels of T-AOC declined in the CIH control and exercise groups(all P<0.05). Compared with the CIH control group, levels of ROS, MDA, FPG and FINS decreased and T-AOC levels increased in the CIH exercise group(all P<0.05). Conclusions:CIH increases blood glucose and insulin levels by activating the oxidative stress response.Aerobic exercise can reduce the impact of oxidative stress on blood glucose and insulin levels.

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