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1.
Article in Chinese | WPRIM | ID: wpr-884175

ABSTRACT

Objective:To explore the value of improved sequential organ failure assessment (ISOFA) in predicting the prognosis of Klebsiella pneumoniae sepsis. Methods:The clinical data of 379 patients with Klebsiella pneumoniae sepsis admitted to the First Hospital of Jilin University from January 1, 2018 to June 30, 2019 were retrospectively analyzed.They were divided into survival group and death group according to the 28-day prognosis, and the age, gender, C-reactive protein, procalcitonin, grade of bacterial resistance, and the occurrence of septic shock of the two groups were compared.Statistical analysis was conducted by using independent sample t test, Mann-Whitney U test and chi-square test. Risk factors for the prognosis of the disease was analyzed by logistic regression analysis.The correlation between ISOFA and other scoring system including Charlson′s weighted index of comorbidities (WIC), national early warning system (NEWS), acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), simplified acute physiology scoreⅡ (SAPSⅡ), mortality in emergency department sepsis score (MEDS), sequential organ failure assessment (SOFA), acute gastrointestinal injury (AGI) was determined by Spearman correlation coefficient.The area under the receiver operating characteristic curve (AUROC) was used to compare the evaluation value of each scoring system for the prognosis of Klebsiella pneumoniae sepsis. The clinical significance of ISOFA risk stratification was evaluated by Kaplan-Meier survival curve. Results:Among the 379 patients with Klebsiella pneumoniae sepsis, 278 were in the survival group and 101 were in the death group.The differences of age, gender, the occurrence of septic shock, grade of bacterial resistance, C-reactive protein, procalcitonin, WIC, NEWS, APACHEⅡ, SAPSⅡ, MEDS, SOFA, AGI and ISOFA score between the two groups were all statistically significant ( t=-3.218; χ2=6.781, 24.374 and 27.208, respectively; Z=-3.689, -5.022, -4.396, -4.697, -7.438, -6.348, -6.358, -8.676, -6.680 and -11.658, respectively; all P<0.01). The calculation method of ISOFA was obtained by single factor analysis: ISOFA=SOFA+ 1.5×AGI.Multivariate logistic regression suggested that ISOFA, gender, SOFA, procalcitonin, C-reactive protein, and bacterial resistance were independent risk factors for the prognosis of the disease. The Spearman correlation coefficients of ISOFA and WIC, NEWS, APACHEⅡ, SAPSⅡ, MEDS and SOFA were 0.327, 0.371, 0.614, 0.564, 0.578 and 0.847, respectively. The AUROC and its 95% confidence interval for WIC, NEWS, MEDS, SAPSⅡ, APACHEⅡ, SOFA alone, SOFA plus AGI, and ISOFA to predict the prognosis of Klebsiella pneumoniae sepsis were 0.646 (0.584-0.708), 0.657 (0.597-0.716), 0.712 (0.654-0.771), 0.713 (0.653-0.773), 0.749 (0.693-0.806), 0.788 (0.737-0.838), 0.872 (0.826-0.917) and 0.891 (0.845-0.937), respectively.The results showed that ISOFA had the best predictive effect.The Kaplan-Meier survival curve suggested that there were statistical differences in survival rate among ISOFA low-risk level, medium-risk level, and high-risk level (all P<0.01). Conclusion:ISOFA has important clinical significance in predicting the prognosis of Klebsiella pneumoniae sepsis.

2.
Protein & Cell ; (12): 194-212, 2021.
Article in English | WPRIM | ID: wpr-880909

ABSTRACT

Fibrotic remodeling is an adverse consequence of immune response-driven phenotypic modulation of cardiac cells following myocardial infarction (MI). MicroRNA-146b (miR-146b) is an active regulator of immunomodulation, but its function in the cardiac inflammatory cascade and its clinical implication in fibrotic remodeling following MI remain largely unknown. Herein, miR-146b-5p was found to be upregulated in the infarcted myocardium of mice and the serum of myocardial ischemia patients. Gain- and loss-of-function experiments demonstrated that miR-146b-5p was a hypoxia-induced regulator that governed the pro-fibrotic phenotype transition of cardiac cells. Overexpression of miR-146b-5p activated fibroblast proliferation, migration, and fibroblast-to-myofibroblast transition, impaired endothelial cell function and stress survival, and disturbed macrophage paracrine signaling. Interestingly, the opposite effects were observed when miR-146b-5p expression was inhibited. Luciferase assays and rescue studies demonstrated that the miR-146b-5p target genes mediating the above phenotypic modulations included interleukin 1 receptor associated kinase 1 (IRAK1) and carcinoembryonic antigen related cell adhesion molecule 1 (CEACAM1). Local delivery of a miR-146b-5p antagomir significantly reduced fibrosis and cell death, and upregulated capillary and reparative macrophages in the infarcted myocardium to restore cardiac remodeling and function in both mouse and porcine MI models. Local inhibition of miR-146b-5p may represent a novel therapeutic approach to treat cardiac fibrotic remodeling and dysfunction following MI.

3.
Article in Chinese | WPRIM | ID: wpr-880035

ABSTRACT

METHODS@#From January 2005 to December 2013, 83 patients with refractory/recurrent CD20@*RESULTS@#All the patient achieved complete response. The median follow.up time was 39 months. Both the two groups collected peripheral blood stem cells successfully, and had no difference in hematopoietic reconstitution time. Three patients in treatment group and six patients in control group relapsed and the three year overall survival and EFS in treatment group was significantly higher than that in control group, that is(93.0% vs 73.1%, P=0.037) and (89.5% vs 65.4%, P=0.034), respectively. Subgroup analysis showed that: compared with the treatment group in which using R in the whole courses(before and after transplantation, and collection of stem cells) was superior to the control group in both OS and EFS, with the OS 97% vs 87.5% (P>0.05) and EFS 97% vs 76.2% (P=0.05) respectively. While stratified by the different courses of rituximab, the OS was 88.9% (1-2 courses, 9 cases), 93.1% (3-4 courses, 29 cases), 94.7%(more than 5 courses,19 cases), and EFS was 77.8%, 89.7% and 94.7%, respectively.@*CONCLUSION@#For the patients with refractory/recurrent CD20


Subject(s)
Antineoplastic Combined Chemotherapy Protocols , Disease-Free Survival , Hematopoietic Stem Cell Transplantation , Hodgkin Disease , Humans , Lymphoma, Non-Hodgkin/drug therapy , Rituximab/therapeutic use , Transplantation, Autologous , Treatment Outcome
4.
Chinese Journal of Orthopaedics ; (12): 802-810, 2020.
Article in Chinese | WPRIM | ID: wpr-869027

ABSTRACT

Objective:To explore the role of BMP7 in inducing the differentiation of BMSCs into neurons in vitro.Methods:BMSCs were isolated and cultured by whole bone marrow adherence method. Adipogenic induction and osteogenic differentiation were used to test the multi-directional differentiation ability of BMSCs. BMSCs were randomly divided into control group and BMP7 groups (25 ng/ml, 50 ng/ml, 75 ng/ml and 100 ng/ml). The effect of BMP7 on the proliferation of rat BMSCs was measured by MTT assay. BMP7 induced morphological changes in rat BMSCS under an inverted phase contrast microscope. The relative expression levels of NF200, SYN1, MAP2 and GFAP mRNA in induced cells were measured by qRT-PCR. Immunofluorescence was used to measure the expression of NSE protein.Results:Rat BMSCs showed lipid droplets in the cytoplasm after adipogenic induction, and oil red O staining was positive; rat BMSCs showed opaque mineral nodules after osteogenic induction, and alizarin red stained was positive. At 2 d, 3 d, 4 d, 5 d, and 6 d after induction, the cell absorbance values of each group were statistically different ( P < 0.05). On the 6th day of induction, the absorbance values of the control group, 25 ng/ml BMP7 group, 50 ng/ml BMP7 group, 75 ng/ml BMP7 group and 100 ng/ml BMP7 group were 0.370±0.003, 0.399±0.003, 0.404±0.003, 0.410±0.003, 0.397±0.001, respectively. Cells absorbance value of 75 ng/ml BMP7 group was significantly higher than the other groups ( P< 0.05). The 75 ng/ml BMP7 group had the most significant changes in cell morphology, similar to neurons in cell morphology. The relative expression of NF200, SYN1, MAP2, and GFAP mRNA of 75 ng/ml BMP7 group (5.47±0.59, 1.48±0.38, 2.86±1.65, 4.41±0.13) was significantly higher than that of the control group ( P< 0.05). The positive rate of NSE immunofluorescence staining in the 75 ng/ml BMP7 group was higher than that in the control group (32.94%±1.62% vs 0). Conclusion:BMP7 has the ability to induce the differentiation of rat BMSCs into neurons in vitro.

5.
Article in Chinese | WPRIM | ID: wpr-866717

ABSTRACT

Objective:To investigate the clinical efficacy and safety of postpyloric feeding in elderly patients with severe disease.Methods:From March 2017 to December 2019, 66 elderly severe patients hospitalized in Taishan Sanatorium of Shandong Province were selected in the study.The patients were divided into control group and observation group according the random digital table method, with 33 cases in each group.The control group received routine nasogastric tube feeding nutrition support, while the observation group received post pylorus feeding nutrition support.The feeding time of both two groups was 14 days.The nutritional status, improvement and complications of the two groups were observed.Results:On the 14th day after feeding, the total serum protein(TP), albumin(ALB), transferrin(TF), prealbumin(PA) in the observation group were (62.75±4.22)g/L, (35.38±2.63)g/L, (2.09±0.13)g/L, (221.52±26.62)g/L, respectively, which were higher than those in the control group [(54.53±4.16)g/L, (32.34±2.83)g/L, (1.85±0.10)g/L, (197.85±25.73)g/L]( t=7.969, 4.520, 8.406, 3.673, all P<0.05). On the 3rd, 7th and 14th day after feeding, the ApacheⅡ scores of the observation group were (14.04±2.17)points, (10.95±2.21)points, (8.95±2.21)points, respectively, which were significantly lower than those of the control group [(15.98±2.45)points, (13.75±2.25)points, (10.75±2.25)points]( t=3.405, 5.100, 3.279, all P<0.05). The incidences of vomiting, gastric retention, dominant aspiration and aspiration pneumonia in the observation group were 3.03%(1/33), 12.12%(4/33), 0.00%(0/33), 12.12%(4/33) , respectively, which were significantly lower than those in the control group [18.18%(6/33), 33.33%(11/33), 12.12%(4/33), 33.33%(11/33)](χ 2=3.995, 4.227, 4.258, 4.227, all P<0.05). Conclusion:Postpyloric feeding used in elderly patients with severe illness can improve the nutritional status and condition of patients, and reduce the incidence of complications such as gastric retention and aspiration pneumonia.It has high efficacy and safety.

6.
Article in Chinese | WPRIM | ID: wpr-865845

ABSTRACT

Objective:To explore the effect of artificial intelligence teaching-picture system in training the bone marrow cell morphological reading ability of clinical medical students.Methods:A total of 110 five-year undergraduate students were divided into experimental group (artificial intelligence picture teaching method) and control group (traditional teaching method) in the bone marrow cell morphology reading ability training. On the basis of multimedia teaching, the experimental group was given the teaching by using the bone marrow cell morphology picture storage and transmission system for retrieval, learning and computer adaptive test. Then objective evaluation of image recognition ability and questionnaire were used to compare the teaching effect.Results:The image recognition ability was significantly better in the experimental group than in the control group [(89.6±5.7) vs. (81.4±4.9), P<0.01]. Furthermore, the experimental group showed more obvious advantages in cell morphology recognition [(74.7±4.0) vs. (68.7±4.9)] and diagnosis of hematological diseases [(14.9±3.0) vs. (12.9±2.4)] than the control group (both P<0.01). Questionnaire survey showed that the students expressed their affirmation and support for the artificial intelligence teaching-picture system in the bone marrow cell morphological reading ability training. Conclusion:The application of artificial intelligence teaching-picture system can greatly improve the teaching effect, mobilize students' learning enthusiasm and expand learning resources, which is worthy of further promotion and application.

7.
Journal of Integrative Medicine ; (12): 229-241, 2020.
Article in English | WPRIM | ID: wpr-829101

ABSTRACT

OBJECTIVE@#Lung-toxin Dispelling Formula No. 1, referred to as Respiratory Detox Shot (RDS), was developed based on a classical prescription of traditional Chinese medicine (TCM) and the theoretical understanding of herbal properties within TCM. Therapeutic benefits of using RDS for both disease control and prevention, in the effort to contain the coronavirus disease 2019 (COVID-19), have been shown. However, the biochemically active constituents of RDS and their mechanisms of action are still unclear. The goal of the present study is to clarify the material foundation and action mechanism of RDS.@*METHODS@#To conduct an analysis of RDS, an integrative analytical platform was constructed, including target prediction, protein-protein interaction (PPI) network, and cluster analysis; further, the hub genes involved in the disease-related pathways were identified, and the their corresponding compounds were used for in vitro validation of molecular docking predictions. The presence of these validated compounds was also measured in samples of the RDS formula to quantify the abundance of the biochemically active constituents. In our network pharmacological study, a total of 26 bioinformatic programs and databases were used, and six networks, covering the entire Zang-fu viscera, were constructed to comprehensively analyze the intricate connections among the compounds-targets-disease pathways-meridians of RDS.@*RESULTS@#For all 1071 known chemical constituents of the nine ingredients in RDS, identified from established TCM databases, 157 passed drug-likeness screening and led to 339 predicted targets in the constituent-target network. Forty-two hub genes with core regulatory effects were extracted from the PPI network, and 134 compounds and 29 crucial disease pathways were implicated in the target-constituent-disease network. Twelve disease pathways attributed to the Lung-Large Intestine meridians, with six and five attributed to the Kidney-Urinary Bladder and Stomach-Spleen meridians, respectively. One-hundred and eighteen candidate constituents showed a high binding affinity with SARS-coronavirus-2 3-chymotrypsin-like protease (3CL), as indicated by molecular docking using computational pattern recognition. The in vitro activity of 22 chemical constituents of RDS was validated using the 3CL inhibition assay. Finally, using liquid chromatography mass spectrometry in data-independent analysis mode, the presence of seven out of these 22 constituents was confirmed and validated in an aqueous decoction of RDS, using reference standards in both non-targeted and targeted approaches.@*CONCLUSION@#RDS acts primarily in the Lung-Large Intestine, Kidney-Urinary Bladder and Stomach-Spleen meridians, with other Zang-fu viscera strategically covered by all nine ingredients. In the context of TCM meridian theory, the multiple components and targets of RDS contribute to RDS's dual effects of health-strengthening and pathogen-eliminating. This results in general therapeutic effects for early COVID-19 control and prevention.


Subject(s)
Antiviral Agents , Chemistry , Therapeutic Uses , Betacoronavirus , Chemistry , Coronavirus Infections , Drug Therapy , Virology , Cysteine Endopeptidases , Chemistry , Drugs, Chinese Herbal , Chemistry , Therapeutic Uses , Humans , Mass Spectrometry , Medicine, Chinese Traditional , Molecular Docking Simulation , Pandemics , Pneumonia, Viral , Drug Therapy , Virology , Protein Interaction Maps , Viral Nonstructural Proteins , Chemistry
8.
Article in Chinese | WPRIM | ID: wpr-872950

ABSTRACT

Objective::To investigate the effect of betulic acid(BA) on steatosis LO2 cells. Method::LO2 cells were intervened with BA at different gradient concentrations (0, 10, 20, 40, 80, 160, 250 μmol·L-1) for 24 hours. methyl thiazolyl tetrazolium(MTT) staining was used to observed cell viability to determine the final concentration of BA. The cells were divided into control, model, dimethylsulfoxide (DMSO) and BA groups, as well as BA groups intervened with low, middle and high concentrations. First, model, DMSO and BA group's cells were cultured in 10% Lipid Mix 1 medium for 24 hours to establish a nonalcoholic fatty liver model. Then, DMSO group and low, medium and high-concentration groups were separately cultured with 0.1%DMSO medium and 20, 40, 80 μmol·L-1 BA medium for 24 hours. And control and model groups were cultured in drug-free medium for 24 hours. Oil red O staining and Nile red staining were used to observe the intracellular lipid droplets. Immunofluorescence was used to detect the protein expression of inducible nitric oxide synthase (iNOS). Western blot was used to detect the protein expression levels of receptor for advanced glycation end-products (RAGE), nuclear factor κB p65 (NF-κB p55) and iNOS. Result::BA within the concentration of 80 μmol·L-1 had no significant toxicity on LO2 cells. Compared with control group, the intracellular lipid droplets were significantly increased in the model group, and the expressions of oxidative stress-related proteins RAGE, NF-κB p65 and iNOS also increased significantly(P<0.05). Compared with model group, the intracellular lipid droplets in DMSO group were similar to those in model group, with no significant difference in the three protein expressions between the two groups. However, the intracellular lipid droplets deposition in the BA group was significantly decreased. And the expressions of RAGE, NF-κB p65 and iNOS proteins in high-concentration BA group were significantly decreased(P<0.05, P<0.01). Conclusion::BA can significantly improve the intracellular fat deposition in LO2 cells, which was probably related to the inhibition of the expressions of oxidative stress-related proteins RAGE, NF-κB p65 and iNOS.

9.
Article in Chinese | WPRIM | ID: wpr-872408

ABSTRACT

Objective: To observe the effects of moxibustion at Shenshu (BL 23), Zusanli (ST 36) and Shenque (CV 8) on the energy metabolism and endocrine metabolism indicators of rats undergoing one-time exhaustive swimming, and to explore the differences between moxibustion at different points in the effects on anti-exercise fatigue. Methods: Forty-eight male SPF rats were randomly divided into a blank group, a model group, a non-meridian and non-acupoint group, a Shenshu (BL 23) group, a Zusanli (ST 36) group, and a Shenque (CV 8) group using random number table method, with eight rats in each group. Except for the blank group, rats in the other groups were subjected to replicating the one-time exhaustive model using the weight-bearing swimming experiment. Except for the model group, the other model rats received mild moxibustion immediately after swimming. Rats in the non-meridian and non-acupoint group received mild moxibustion at bilateral subcostal non-meridian and non-acupoint points, those in the Shenshu (BL 23) group received mild moxibustion at bilateral Shenshu (BL 23), those in the Zusanli (ST 36) group received mild moxibustion at bilateral Zusanli (ST 36), and those in the Shenque (CV 8) group received mild moxibustion at Shenque (CV 8) for 15 min. Four hours after the exhaustive swimming, femoral artery blood was collected to detect blood lactate (BLA), lactate dehydrogenase (LDH), creatine kinase (CK), creatinine (CRE), blood urea nitrogen (BUN), cortisol (C) and testosterone (T) levels, and calculate the T/C ratio. Results: Compared with the blank group, rat's serum levels of BLA, LDH, CK, BUN and C in the model group and the non-meridian and non-acupoint group were increased, and serum levels of CRE and T, and T/C ratios were decreased (P<0.01 or P<0.05); compared with the model group and the non-meridian and non-acupoint group, the serum levels of BLA, LDH, CK, BUN and C in the Shenshu (BL 23) group, Zusanli (ST 36) group and Shenque (CV 8) group were decreased, and the serum CRE and T levels, and the T/C ratios were increased (all P<0.01); compared with the Shenshu (BL 23) group, the serum CK level was decreased in the Shenque (CV 8) group (P<0.01), the serum levels of T and C were decreased in the Zusanli (ST 36) group and Shenque (CV 8) group (P<0.01 or P<0.05), and the T/C ratio was increased in the Shenque (CV 8) group (P<0.01); compared with the Zusanli (ST 36) group, the serum CK and BUN levels were decreased (P<0.01, P<0.05), and the T/C ratio was increased in the Shenque (CV 8) group (P<0.05). Conclusion: Moxibustion at Shenshu (BL 23), Zusanli (ST 36) and Shenque (CV 8) shows different anti-fatigue effects by regulating the energy metabolism and endocrine metabolism in rats undergoing one-time exhaustive swimming. Moxibustion at Shenshu (BL 23) is better in promoting energy synthesis. Moxibustion at Shenque (CV 8) is more effective in regulating synthesis and decomposition of the skeletal muscle proteins.

10.
Chinese Journal of Hematology ; (12): 16-22, 2020.
Article in Chinese | WPRIM | ID: wpr-799072

ABSTRACT

Objective@#To probe the prognostic value of consolidation chemotherapy in non-favorable acute myeloid leukemia (AML) patients who were candidates for allogeneic hematopoietic stem cell transplantation (allo-HSCT) with first complete remission (CR1) and negative minimal residual disease (MRD-) .@*Methods@#A retrospective analysis was conducted on 155 patients with non-favorable AML who received allo-HSCT in CR1/MRD- from January 2010 to March 2019. The survival data were compared between patients who received and those not received pre-transplant consolidation chemotherapy.@*Results@#A total of 102 patients received pre-transplant consolidation chemotherapy (consolidation group) , and 53 cases directly proceeded to allo-HSCT when CR1/MRD- was achieved (nonconsolidation group) . The median ages were 39 (18-56) years old and 38 (19-67) years old, respectively. Five-year post-transplant overall survival [ (59.3±7.5) % vs (62.2±6.9) %, P=0.919] and relapse-free survival [ (53.0±8.9) % vs (61.6±7.0) %, P=0.936] were not significantly different between the two groups (consolidation vs nonconsolidation) . There was a weak relationship between consolidation therapy and cumulative incidence of relapse [consolidation: (21.9±5.4) % vs nonconsolidation: (18.3±6.0) %, P=0.942], as well as non-relapse mortality [consolidation: (22.4±4.3) % vs nonconsolidation: (28.4±6.5) %,P=0.464]. Multivariate analysis indicated that pre-transplant consolidation and the consolidation courses (< 2 vs ≥2 courses) did not have an impact on allo-HSCT outcomes.@*Conclusion@#Allo-HSCT for candidate patients without further consolidation when CR1/MRD- was attained was feasible.

11.
Article in Chinese | WPRIM | ID: wpr-870092

ABSTRACT

Objective:To analyze the correlation between hyperuricemia and obesity in young college students.Methods:A total of 19 673 students receiving enrolment physical examinations in Nanjing University from 2018 to 2019 were included in the study. The subjects were divided into underweight, normal, overweight, and obesity groups according to their body mass index. Fasting blood were taken to detect alanine aminotransferase (ALT), serum uric acid, urea nitrogen, and creatinine. The differences between serum uric acid and metabolic parameters among different groups as well as the correlation between body mass index and hyperuricemia were analyzed by using multivariate linear regression and logistic regression analysis.Results:The prevalence of hyperuricemia was 32.35% for the college students, while for the males it reached up to 57.30% that was significantly higher than female ones (6.51%, P<0.01). With the increasing of body mass index, the prevalence of hyperuricemia increased significantly( Ptrend<0.01), as well as serum uric acid in both male and female students ( Ptrend<0.01). Serum uric acid was positively correlated with body mass index in both genders( P<0.01). The odds ratio ( OR) and 95% confidence interval( CI) for overweight, obesity, and underweight body mass index groups were 2.30(95% CI 1.99-2.66), 4.35(95% CI 3.22-5.89), and 0.70(95% CI 0.60-0.82), respectively, compared to the normal body mass index group by adjusting possible factors such as gender, age, ALT, urea nitrogen, creatinine, as well asestimated glomerular filtration rate. Conclusion:The prevalence of hyperuricemia in young students is high. Obesity seems to be an independent risk factor of hyperuricemia.

12.
Article in Chinese | WPRIM | ID: wpr-856404

ABSTRACT

The 8th World International Symposium on the Diabetic Foot (ISDF) Conference which was sponsored by the International Working Group on Diabetic Foot (IWGDF) was held in the Hague between May 22nd and May 25th, 2019. The conference issued the 2019 IWGDF guidelines on the prevention and management of diabetic foot disease. The update to the 2015 edition of the guidelines involves the following 6 chapters: prevention of foot ulcers in patients with diabetes; offloading foot ulcers in patients with diabetes; diagnosis, prognosis, and management of peripheral arterial disease in patients with a foot ulcer and diabetes; diagnosis and treatment of foot infection in patients with diabetes; interventions to enhance healing of foot ulcers in patients with diabetes; classification of diabetic foot ulcers. This guideline has been changed more than the previous edition. In this paper, the guidelines will be interpreted to provide cutting-edge information for domestic diabetic foot researchers.

13.
Article in Chinese | WPRIM | ID: wpr-818122

ABSTRACT

Objective The prevalence of nonalcoholic fatty liver disease(NAFLD) is increasing in middle-aged and older people. This article aimed to analyze the relationship between thyroid hormone and NAFLD in euthyroid middle-aged and older people.Methods We retrospectively analyzed 589 euthyroid patients aged 40 years or older who were hospitalized in our department from January 2015 to December 2017. According to the Results of abdominal ultrasound, they were divided into NAFLD group (n=217) and non-NAFLD group (n=372). We compared the differences of general data between two groups and analyzed the association of thyroid hormones(FT3, TSH) with metabolic indexes and the risk of NAFLD.Results TSH and FT3 in NAFLD group were significantly higher than those in non-NAFLD group (respectively 2.18±1.01 mIU/L versus 1.74±0.77 mIU/L, P<0.001; 4.54±0.72 pmol/L vs 4.05±0.83 pmol/L, P<0.001). After adjusting for age and sex, TSH was positively correlated with BMI, abdominal circumference, and LDL (r, P respectively were 0.117, 0.005; 0.136, 0.001; 0.086, 0.037). FT3 was positively correlated with LDL (r=0.098, P=0.017), and negatively correlated with FPG and HbA1c (r, P respectively were -0.161, <0.001; -0.139, 0.001). With the increase of TSH and FT3 quartiles, the risk of NAFLD showed a significantly increasing trend (P<0.01). Logistic regression analysis showed that abdominal circumference, BMI, ALT, TG, TSH, and FT3 were independent risk factors of NAFLD. Conclusion TSH and FT3 are risk factors of NAFLD in euthyroid middle-aged and older people, which can be used as a good serological indicator of NAFLD.

14.
Article in Chinese | WPRIM | ID: wpr-773506

ABSTRACT

OBJECTIVE@#To observe the therapeutic effect of tetramethylpyrazine on immune-mediated bone marrow failure (BMF) induced by different doses of X-ray exposure in C57 mice.@*METHODS@#C57BL6 mice were randomized into 4 groups, including a blank control group and 3 X-ray exposure groups with X-ray exposure at low (5.0 Gy), moderate (5.75 Gy), and high (6.5 Gy) doses. After total body irradiation with 0.98 Gy/min X-ray. The mice as recipient received injections of 4×10 lymphocytes from DBA/2 mice via the tail vein within 4 h. The survival rate of the recipient mice, peripheral blood cell counts, bone marrow nucleated cell count, and bone marrow pathology were examined at 14 days after the exposure. In the subsequent experiment, C57 mice were exposed to 5.0 Gy X-ray and treated with intraperitoneal injection of tetramethylpyrazine at the low (5 mg/mL), moderate (10 mg/mL), or high (20 mg/mL) doses (12 mice in each group) for 14 consecutive days, and the changes in BMF were observed.@*RESULTS@#X-ray exposure, especially at the high dose, resulted in significantly lowered survival rate in the mouse models of BMF at 14 days. As the X-ray dose increased, the mice showed significantly reduced peripheral blood counts of red blood cells, white blood cells, platelets and lowered bone marrow nucleated cell counts with obvious bone marrow congestion and reduction of nucleated cells ( < 0.05 or 0.001). In the mice exposed to 5.0 Gy X-ray, tetramethylpyrazine at the high dose most obviously increased bone marrow nucleated cells ( < 0.01) and red blood cells ( < 0.001), and even at the low dose, tetramethylpyrazine significantly increased the counts of white blood cells ( < 0.05) and platelets ( < 0.01) following the exposure. Tetramethylpyrazine dose-dependently alleviated bone marrow hyperemia, increased bone marrow nucleated cell counts, and lowered Fas protein expression in the bone marrow.@*CONCLUSIONS@#X-ray irradiation at 5.0 Gy is suitable for establish mouse models of immune-mediated BMF. Tetramethylpyrazine promotes bone marrow repair by regulating Fas cell apoptosis signals, which further expands the traditional Chinese medicine theory of "removing blood stasis to create new."


Subject(s)
Animals , Bone Marrow , Mice , Mice, Inbred C57BL , Mice, Inbred DBA , Pyrazines , Whole-Body Irradiation
15.
Chinese Journal of Hematology ; (12): 625-632, 2019.
Article in Chinese | WPRIM | ID: wpr-805794

ABSTRACT

Objective@#To compare the difference of efficacy between traditional Hyper-CVAD/MA regimen and the adolescents inspired chemotherapy regimen, CH ALL-01, in treatment of adult Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) .@*Methods@#In this study we retrospectively analyzed 158 Ph+ ALL patients receiving Hyper-CVAD/MA regimen (n=63) or CHALL-01 regimen (n=95) in our center and Changzheng hospital from January 2007 to December 2017, excluding patients with chronic myeloid leukemia in blast crisis. Tyrosine kinase inhibitor (TKI) was administered during induction and consolidation chemotherapy. Patients who underwent hematopoietic stem cell transplantation received TKI as maintenance therapy.@*Results@#Of them, 91.1% (144/158) patients achieved complete remission (CR) after 1-2 courses of induction. CR rate was 90.5% (57/63) for patients in Hyper-CVAD/MA group and 91.6% (87/95) for patients in CHALL-01 group. There was no difference in CR rates between the two groups (χ2=0.057, P=0.811) . The last follow-up was June 2018. A cohort of 134 CR patients could be used for further analysis, among them, 53 patients received Hyper-CVAD/MA regimen and other 81 patients received CHALL-01 regimen. The molecular remission rates were significantly higher in CHALL-01 group (complete molecular response: 44.4%vs 22.6%; major molecular response: 9.9% vs 18.9%) (χ2=7.216, P=0.027) . For the patients in Hyper-CVAD/MA group, the 4-year overall survival (OS) was 44.81% (95%CI: 30.80%-57.86%) and the 4-year disease free survival (DFS) was 37.95% (95%CI: 24.87%-50.93%) . For patients received CHALL-01 regimen, the 4-year OS was 55.63% (95%CI: 39.07%-69.36%) (P=0.037) and 4 year DFS was 49.06% (95%CI: 34.24%-62.29%) (P=0.015) , while there was no significant difference in 4 year cumulative incidence of relapse (CIR) (P=0.328) or cumulative incidence of nonrelapse mortality (CI-NRM) (P=0.138) . The rate of pulmonary infection was lower in patients received CHALL-01 regimen compared with patients received Hyper-CVAD regimen (43.4% vs 67.9%, χ2=7.908, P=0.005) .@*Conclusions@#Outcome with CHALL-01 regimen appeared better than that with the Hyper-CVAD/MA regimen in Ph+ ALL, which has lower incidence of pulmonary infection, higher molecular remission rate and better OS and DFS.

16.
Article in Chinese | WPRIM | ID: wpr-803408

ABSTRACT

Objective@#To investigate the effect of resilience on fear of cancer recurrence in breast cancer patients and to find the specific role of perceived social support between them.@*Methods@#From April 2018 to January 2019, we invited 456 breast cancer patients hospitalized in the Department of Breast surgery in Qilu Hospital of Shandong University in Jinan to participate in the study and to finish a questionnaire survey which including the general information questionnaire, Chinese version of the Fear of Progression Questionnaire-Short Form, The Connor-Davidson Resilience Scale and Perceived Social Support Scale.@*Results@#The average score of fear of cancer recurrence in breast cancer patients was (41.5±7.7), and 85.99% (313/364) of the patients′ score was clinically significant (total score ≥ 34). Resilience could negatively predict the fear of cancer recurrence (β=-0.240 P < 0.01). Perceived social support is the moderation between resilience and fear of cancer recurrence (β=-0.179, P<0.01).@*Conclusions@#The level of resilience could affect the level of fear of cancer recurrence in breast cancer patients, and the increase in the level of perceived social support could enhance the effect of resilience on the fear of cancer recurrence, thus further reducing the level of patient′s fear of recurrence.

17.
Chinese Journal of Hematology ; (12): 990-995, 2019.
Article in Chinese | WPRIM | ID: wpr-800484

ABSTRACT

Objective@#To investigate the relationship between donor chimerism and relapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT) .@*Methods@#The clinical data of 105 patients with acute myeloid leukemia (AML) who underwent allo-HSCT and recurrence-free survival>90 days from January 2010 to January 2019 were retrospectively analyzed. The bone marrow samples were collected at 15, 30, 60, 90, 180, 270, 360 days after transplantation. Donor chimerism was detected by single nucleotide polymorphism (SNP) -PCR.@*Results@#Of the 105 patients, 43 cases were male and 62 cases were female, with a median age of 38 (16-60) years. Till April 2019, the median follow-up was 843 (94-3 261) days. Ninety days after transplantation, 18 cases relapsed, 33 cases died, and 72 cases survived. The 3-year overall survival (OS) rate was (66.8±5.1) %, and the recurrence-free survival (RFS) rate was (65.1±5.0) %. Pre-transplant disease status, pre-transplant minimal residual disease (MRD) , and 90 day post-transplantation chimerism were independent risk factors related to RFS. The risk of recurrence was significantly increased in patients with a donor chimerism rate ≤97.24% at 90 days after transplantation[HR=6.921 (95%CI 2.669-17.950) , P<0.001], which was considered as a sign of early relapse.@*Conclusion@#SNP-PCR is an applicable method for detecting donor chimerism in patients after allo-HSCT. Chimerism rate equal or less than 97.24% at 90 days after transplantation predicts a higher risk of relapse.

18.
Article in Chinese | WPRIM | ID: wpr-797805

ABSTRACT

Objective@#To investigate the clinical application value of symmetrical three-hole laparoscopic sleeve gastrectomy (LSG).@*Methods@#The retrospective and descriptive study was conducted. The clinical data of 232 patients with obesity who were admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from April 2017 to December 2018 were collected. There were 40 males and 192 females, aged (32±8)years, with a range of 17-63 years. All the 232 patients underwent symmetrical three-hole LSG. Observation indicators: (1) surgical and postoperative conditions; (2) complications; (3) follow-up. Follow-up was conducted by telephone interview and WeChat to collect the patient satisfaction with cosmetic effects of wounds at 3 months after surgery up to March 2019. Measurement data with normal distribution were expressed as Mean±SD. Count data were expressed as absolute numbers or percentages.@*Results@#(1) Surgical and postoperative conditions: of the 232 patients, 230 underwent symmetrical three-hole LSG successfully, without conversion to open surgery. Two patients had one puncture hole added due to spleen bleeding to help pull the omentum to stop bleeding, and no spleen hemorrhage recurred after improving the surgical procedure. Of the 232 patients, the operation time, volume of intraoperative blood loss, and duration of postoperative hospital stay were (115±7)minutes, (10±5)mL, and (3.0±0.8)days. (2) Complications: of the 232 patients, 10 had postoperative complications of fat liquefaction in the umbilical incision, and were cured after repeated dressing changes. All patients had no serious complications such as gastrointestinal bleeding, abdominal bleeding, or gastric fistula. (3) Follow-up: of the 232 patients, 230 undergoing successful symmetrical three-hole LSG were followed up for 3 months. Of the 230 patients, 3 were dissatisfied with the cosmetic effects of wounds, 12 were satisfied, and 215 were very satisfied. The satisfaction rate was 98.70%(227/230).@*Conclusion@#Symmetrical three-hole LSG is safe and feasible, with a good cosmetic effects of wounds.

19.
Article in Chinese | WPRIM | ID: wpr-796644

ABSTRACT

Objective@#To evaluate the efficacy and safety of bevacizumab in the treatment of radiation brain necrosis, and to provide guidance for rational clinical application.@*Methods@#A retrospective analysis was made of 14 patients with radiation brain necrosis who had failed to receive mannitol and hormone treatment or had been treated for the first time. All the patients were divided into two groups according to different treatment regimens (5.0 mg/kg repeated every 14 d and 7.5 mg/kg repeated every 21 d). The changes of enhanced lesions in MRI T1W1 phase and edema in T2W1 phase were compared separately in the two groups. The clinical symptoms, changes of KPS score and adverse drug reactions were recorded.@*Results@#Totally 14 patients completed at least two cycles of treatment. After two cycles of treatment, the KPS scores of both groups were improved. The KPS scores of 5.0 mg/kg group were increased by 31.66 points on average compared with those before treatment. The KPS scores of 7.5 mg/kg group were increased by 27.50 points on average compared with those before treatment. The volume of CRN lesions were decreased(46.0±9.4)%(t=6.57, P<0.05) and the volume of edema lesions decreased(68.9±8.9)%(t=3.32, P<0.05) in 5.0 mg/kg group. In 7.5 mg/kg group, these two parameters were reduced by(53.9±10.7)%(t=7.89, P<0.05 and (77.1±14.3)%(t=4.22, P<0.05), respectively. There was no significant difference in the reduction of the mean volume of CRN lesions and the volume of edema area between the two groups (P>0.05). In this study, the incidence of adverse events in the 5.0 mg/kg group was similar to that in the 7.5 mg/kg group, with no significant difference(P>0.05).@*Conclusions@#Bevacizumab can significantly improve the clinical symptoms and quality of life of patients with radiation brain necrosis. The safety of 5.0 mg/kg treatment regimen repeated every 14 d is similar to that of 7.5 mg/kg treatment regimen repeated every 21 d, which can be used for reference in the treatment of CRN.

20.
Article in Chinese | WPRIM | ID: wpr-796418

ABSTRACT

The clinical research model based on evidence - based medicine (EBM) can effectively improve students' learning initiative, cultivate their abilities to obtain information and solve problems, and strengthen their scientific and innovative thinking in clinical research. Moreover, the EBM-based clinical research model can also help supervisors to update knowledge system and maintain strong clinical innovative thinking and research ability. The EBM - based clinical research model was applied in the cultivation of postgraduate students in hematology, and through topic selection, new technique application, ethical number acquisition, registration of clinical research number, case enrollment, and statistical analysis, postgraduates can master the methods and process of clinical research, which lays a solid foundation for future research.

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