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ObjectiveTo compare the efficacy between the Mycob.T scanner system and manual microscopy for detecting acid-fast bacilli in sputum specimens. MethodsBetween January and November 2020， a total of 1 519 sputum samples from suspected primary tuberculosis patients from 5 designated tuberculosis hospitals in Shanghai were examined by Smear and BACTEC MGIT 960 liquid culture （liquid culture） methods. Each specimen was subiected to 2 direct smear slides. One slide was stained by Z-N method and examined with manual microscopic method. Another slide was stained and scanned by the Mycob.T system. The efficacy of manual microscopy and the Mycob.T scanner system for detecting acid-fast bacilli in sputum specimens was compared based on the result of liquid culture. Results of the repetitive scanning by the Mycob.T scanner system and the recheck of the manual microscopy were analyzed. ResultsThe average positive rate by the Mycob.T scanner system was 14.4% （219/1 519） while the average positive rate by manual microscopy was 16.3% （248/1 519）. No significant difference was observed （χ2=2.13， P=0.145）. Based on liquid culture confirmation results， the sensitivity of manual microscopy （60.36%） was higher than that of the Mycob.T scanner system （52.94%）， and the difference is statistically significant （χ2=4.38， P=0.036）. Both methods had high specificity （98.94%）. The concordance of the Mycob.T scanner system and manual microscopy was 95.46%， with the kappa value of 0.826. The results of repeatability test of the Mycob.T scanner system and the recheck results of the manual microscopy showed that the coincidence rate of scanning by the Mycob.T scanner system was 99.5% （436/438）， and the recheck coincidence rate by the manual microscopy was 98.6% （432/438）. ConclusionThe Mycob.T scanner system have high specificity for detecting acid-fast bacilli in sputum samples and good consistency with the results of manual microscopy. Compared with manual microscopic examination， the Mycob.T scanner system can greatly alleviate the work intensity.
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Objective:To explore the value of "conceive, design, implement, and operation" (CDIO) combined with cluster training mode in clinical teaching of cardiopulmonary resuscitation (CPR).Methods:A total of 108 interns of General Hospital of Southern Theater Command from January 2019 to November 2020 were included in the study, and they were randomly divided into control group ( n=54) and observation group ( n=54). The control group used the cluster training mode for CPR teaching, and the observation group used CDIO combined with the cluster training mode for CPR teaching. The theoretical performance, operation performance, comprehensive ability, chest compression quality and CPR time of the two groups of interns were compared, and the scores of post competency and satisfaction of the two groups of interns were evaluated. SPSS 22.0 was used for t test and chi-square test. Results:The scores of theory, operation and comprehensive ability in the observation group were higher than those in the control group. Compared with those before training, the compression depth, compression frequency and chest rebound rate of the observation group were higher than those of the control group. The observation group found that the patients' unconscious judgment of pulse free time, the time from the occurrence of ventricular fibrillation to the start of automated external defibrillator (AED), and the time to complete AED were lower than those in the control group. The five dimensions of practical ability, critical thinking ability, coordination ability, career development ability, psychological characteristics and the total score of post competency in the observation group were higher than those in the control group ( P < 0.05). The satisfaction of the observation group with the teaching teacher, practice content, practice form and practice effect was higher than that of the control group ( P<0.05). Conclusion:The application of CDIO combined with cluster training in clinical CPR teaching can improve the interns' theoretical performance, operational performance and comprehensive ability, improve the quality of external chest compression and CPR time, make the interns have good communication ability and post competency, and finally improve the interns' satisfaction.
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ObjectiveTo study the correlation between the appearance color of the sample powder and the contents of five non-sugar components of wine-processed Polygonatum kingianum rhizoma during processing， and determine the feasibility of color quantitative value for judging the processing end point of the wine-processed products， and to screen steroidal saponins and flavonoids as markers for the control of the wine-processed products during processing. MethodThe changes of apparent color of the sample powder at different time points of the wine-processed products were measured by colorimeter， and the total color value （E*ab），the total color difference value （ΔE*ab） were calculated. The contents of protodioscin， pseudoprotodioscin， dioscin， diosgenin and narcissoside in the wine-processed products （No. S0-S10） after processing for 0， 5， 10， 14， 16， 18， 20， 22， 24， 26， 28 h were determined simultaneously by ultra-high performance liquid chromatography-tandem mass spectrometry （UHPLC-MS/MS）. Cluster analysis （HCA）， principal component analysis （PCA）， partial least squares discriminant analysis （PLS-DA） and Pearson correlation analysis were used to analyze the chromaticity value of the sample powder and the content of the five components. ResultDuring processing of wine-processed P. kingianum rhizoma， E*ab of the sample powder showed a decreasing trend and the apparent color changed from light yellow to lacquer black. The contents of the five components showed an obvious dynamic change trend with time， and showed different laws. HCA results showed that the processing process of the wine-processed products could be divided into three stages， namely， the early stage （samples S0-S1）， the middle stage （samples S2-S4） and the late stage （samples S5-S10）. PCA results showed that there were significant differences in color and contents of five components between the initial sample and the processing samples， and the difference between samples S8 and S9 was the smallest. PLS-DA results showed that the variable importance in the projection （VIP） values of b*， the contents of pseudoprotodioscin， narcissoside， diosgenin and protodioscin were >1. Pearson correlation analysis showed that the contents of protodioscin， diosgenin and narcissoside had a significant positive correlation with E*ab （P<0.01）， the content of diosgenin had a significant negative correlation with E*ab （P<0.01）， while the content of pseudoprotodioscin had no linear correlation with E*ab. ConclusionIn the process of wine-processed P. kingianum rhizoma， there is a certain linear correlation between color quantitative value and chemical composition， and the processing end point can be determined objectively. It can be considered that protodioscin can be used as a marker for the control of the wine-processed products.
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Objective:To investigate the clinical effect of thoracoumbilical flap combined with random abdominal flap in repair of large-area soft tissue defects of calf in children.Methods:The clinical data of 16 children with large-area soft tissue defects of calf treated with thoracoumbilical flap combined with abdominal random flap from January 2004 to December 2007 in PLA Trauma Orthopaedic Research Institute, 80th Group Military Hospital of the PLA were retrospectively analysed. There were 7 boys and 9 girls aged 8 to 14(11.3 in average) years old. Six cases were crushed by heavy objects, 6 crushed by wheels, 3 by thermal press and 1 by machine strangulation. After thorough debridement, the wound area ranged from 16.0 cm×9.0 cm to 38.0 cm×15.0 cm. Four cases were treated after 3-10 hours of injury by emergency surgery. Twelve cases received surgeries 0-11 days after hospital admission and wound being stabilised. Doppler ultrasound was used to locate the perforating vessels according to the location, size and shape of the wound. Thoracoumbilical flap combined with abdominal random flap were designed and harvested to repair the wound. The sizes of flaps were 18.0 cm×11.0 cm-40.0 cm×16.0 cm. All patients entered follow-up at the outpatient clinic or through WeChat interviews. The appearance, texture of the flap and limb recovery were checked and recorded.Results:After surgery, all of 16 flaps survived, of which 12 flaps had phase-one healing, 3 flaps had small area of necrosis at the edge, which healed after repeated dressing changes and 1 flap developed vascular comproise, and survived after surgical exploration. The donor sites healed in phase-one. All 16 children had 6 months to16 years of follow-up, with an average of 20.7 months. The colour of the flaps was normal with soft texture. The motor function of calf was satisfactory. According to Punor functional evaluation criteria, 12 cases were in excellent and 4 in good.Conclusion:The thoracoumbilical flap combined with abdominal random flap features a reasonable design, strong blood supply and repair of a large area. It is a reliable method for repairing large area soft tissue defects in the calf of children.
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Objective:The purpose of this study was to develop a risk score for predicting upper gastrointestinal hemorrhage(UGIH)in acute ischemic stroke(AIS)patients following intravenous thrombolysis.Methods:A retrospective analysis of 203 elderly AIS patients treated with intravenous thrombolysis was conducted in this study.Patients were divided into an UGIH group and a non-NUGIH group, with 40 in the former group and 163 in the latter group.Baseline data at admission were collected to predict UGIH after intravenous thrombolysis.Logistic regression analysis was used to examine independent risk factors affecting UGIH.The score was developed according to regression coefficients.The area under the receiver operating characteristic curve(AUROC)was used to evaluate the sensitivity and specificity of the risk score.The maximum value of the Youden index was used to determine the cutoff value for predicting UGIH.Results:Univariate analysis showed smoking( χ2=4.825, P=0.037), age( χ2=16.927, P<0.001), atrial fibrillation( χ2=14.176, P<0.001), NIHSS score( χ2=29.075, P<0.001), nasogastric intubation( χ2=47.339, P<0.001)and antiplatelet therapy( χ2=56.585, P<0.001)were associated with UGIH.Multivariate analysis found that NIHSS score( OR=2.902, 95% CI: 1.053-8.003)and nasogastric intubation( OR=6.300, 95% CI: 2.281-17.404)were independent risk factors affecting UGIH.The scoring system was named N2, and the total score was 3 points.The N2 scoring system had a good predictive ability(AUROC: 0.828, 95% CI: 0.758-0.899). The cut-off value was 2, the sensitivity was 0.775, and the specificity was 0.791.AIS patients with an N2 score ≥2 were at risk of UGIH after intravenous thrombolysis. Conclusions:The N2 score may be a valid predictive model for AIS patients at high-risk for UGIH after intravenous thrombolysis.Patients with an N2 score≥2 need preventive measures against UGIH.
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Objective:To investigate impacts of a deep learning image reconstruction (DLIR) algorithm on image quality of lower extremity CTA with low kVp and reverse flow direction scanning.Methods:From January 2021 to March 2021, fifty patients with suspected lower extremities diseases and received lower extremity CTA with low kVp and reverse flow direction scanning in Union Hospital affiliated to Fujian Medical University were retrospectively collected in this study. Six groups of CT images were reconstructed at the thickness of 0.625 mm using two algorithms including ASIR-V of three blending ratios (ASIR-V 20%, ASIR-V 50% and ASIR-V 80%) and DLIR of three strengths (DLIR-H, DLIR-M and DLIR-L). Regions of interest (ROIs) were placed on proximal abdominal aorta (AA), distal AA, left and right common iliac arteries, left and right femoral arteries (upper segment), left and right superficial femoral arteries (middle segment), left and right popliteal arteries. The CT value and SD value were measured for each group; the signal-noise ratio (SNR) and contrast-noise ratio (CNR) were calculated. The lower extremity CTA was divided into four segments, and the subjective evaluation was independently performed on noise and sharpness using 4 points scales by two radiologists. One-way analysis of variance was utilized to evaluate the differences in subjective scoring and objective parameters among the six groups.Results:For all arteries segments, with the increase of blending ratios for ASIR-V and reconstruction strength of DLIR, the SD values were reduced while SNR and CNR were increased (all P<0.05). Among the six groups, DLIR-H and ASIR-V80% images had lowest SD as well as highest SNR and CNR (all P<0.05). In comparison to ASIR-V20% and ASIR-V50% images, DLIR-H images showed lower SD, higher SNR and CNR values (all P<0.05). There were no statistical differences between ASIR-V80% and DLIR-H images in SD, SNR and CNR values (all P>0.05). Subjective scoring results showed that the DLIR-H images displayed the best noise performance for the entire lower extremity arteries from AA to the foot artery, and the sharpness scores of DLIR-H images were also significantly higher than ASIR-V80% (all P<0.05). Conclusion:DLIR can significantly reduce the image noise and improve the image quality in CTA for abdominal aorta to lower extremity arteries. DLIR-H showed the greatest noise reduction ability and the best effect balancing noise and sharpness, providing highest image quality.
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Background@#Enterotoxigenic Escherichia coli (ETEC) infection is a primary cause of livestock diarrhea. Therefore, effective vaccines are needed to reduce the incidence of ETEC infection. @*Objectives@#Our study aimed to develop a multivalent ETEC vaccine targeting major virulence factors of ETEC, including enterotoxins and fimbriae. @*Methods@#SLS (STa-LTB-STb) recombinant enterotoxin and fimbriae proteins (F4, F5, F6, F18, and F41) were prepared to develop a multivalent vaccine. A total of 65 mice were immunized subcutaneously by vaccines and phosphate-buffered saline (PBS). The levels of specific immunoglobulin G (IgG) and pro-inflammatory cytokines were determined at 0, 7, 14 and 21 days post-vaccination (dpv). A challenge test with a lethal dose of ETEC was performed, and the survival rate of the mice in each group was recorded. Feces and intestine washes were collected to measure the concentrations of secretory immunoglobulin A (sIgA). @*Results@#Anti-SLS and anti-fimbriae-specific IgG in serums of antigen-vaccinated mice were significantly higher than those of the control group. Immunization with the SLS enterotoxin and multivalent vaccine increased interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) concentrations. Compared to diarrheal symptoms and 100% death of mice in the control group, mice inoculated with the multivalent vaccine showed an 80% survival rate without any symptom of diarrhea, while SLS and fimbriae vaccinated groups showed 60 and 70% survival rates, respectively. @*Conclusions@#Both SLS and fimbriae proteins can serve as vaccine antigens, and the combination of these two antigens can elicit stronger immune responses. The results suggest that the multivalent vaccine can be successfully used for preventing ETEC in important livestock.
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Objective:To investigate the effects of human umbilical cord-derived mesenchymal stem cells (hUC-MSC) and their conditioned medium on proliferation, migration and apoptosis of human non-small cell lung cancer (NSCLC) polyploid A549 cells.Methods:A549 cells in logarithmic phase were selected. After induction treatment with 1 μmol/L docetaxel for 24 h, DMEM/F12 medium with 10% fetal bovine serum was used to culture the cells for 3 d, finally the polyploid A549 cells model was successfully established. After finishing the separation and culture of hUC-MSC, hUC-MSC conditioned medium was prepared. Normally cultured polyploid A549 cells were treated as the control group, conditioned medium cultured polyploid A549 cells were treated as the conditioned medium group. hUC-MSC was co-cultured with polyploid A549 cells, and the ratio of the total number of cells was 2:1 and 5:1, respectively, which were recorded as MSC 1 group and MSC 2 group. Cells in each group were continually cultured for 48 h or 72 h. Proliferation and apoptosis of polyploid A549 cells in each group were detected by using flow cytometry, cell migration ability was detected by using Transwell assay, and the expressions of migration and apoptosis-related proteins were detected by using Western blotting.Results:Polyploid A549 cells model was successfully established and hUC-MSC was cultured separately. The result of cell proliferation detected by flow cytometry showed that at 48 h, the mean fluorescence intensity of the control group, conditioned medium group, MSC 1 group and MSC 2 group was 1 695±305, 2 020±85, 1 259±35 and 1 356±33, respectively, and the difference was statistically significant ( F = 14.00, P < 0.05); at 72 h, the mean fluorescence intensity of the control group, conditioned medium group, MSC 1 group and MSC 2 group was 1 052±77, 1 309±24, 864±201 and 1 103±237, respectively, and the difference was statistically significant ( F = 3.90, P > 0.05). The result of Transwell assay showed that at 48 h, the number of cell migration in the control group, conditioned medium group, MSC 1 group and MSC 2 group was 52±9, 57±12, 68±8 and 75±11, respectively, and the difference was statistically significant( F = 32.16, P < 0.05); the number of cell migration in each experimental group was all higher than that in the control group (all P < 0.05). The percentage of apoptotic cells in the control group, conditioned medium group, MSC 1 group and MSC 2 group was (15.53±4.27)%, (13.77±1.75)%, (3.60±0.50)% and (2.33±0.06)%, respectively, and the difference was statistically significant ( F = 182.36, P < 0.05); there was no statistically significant difference between the control group and conditioned medium group ( P > 0.05); there were statistically significant differences between MSC 1 group and the control group, MSC 2 group and the control group (both P < 0.05). Western blotting results showed that compared with the control group, the expression of migration-related protein matrix metallopeptidase 9 (MMP-9) was increased, the expression of pro-apoptotic protein bax was reduced, the expression of anti-apoptotic protein bcl-xL was increased in conditioned medium group, MSC 1 group and MSC 2 group. Conclusions:hUC-MSC can improve the migration and anti-apoptotic ability of polyploid A549 cells, suggesting that hUC-MSC may affect the survival of tumor cells during the process of chemotherapy damage and repair.
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Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is an extracorporeal circulation technique that provides circulatory and oxygenation support, and it is currently used in the treatment of cardiogenic shock (CS), pulmonary embolism, cardiac arrest (CA), and other diseases. However, this technology is still associated with high complications and mortality. The use of predictive scores for risk stratification before VA-ECMO will be helpful to screen the optimal benefiting population, make optimal clinical decisions, and allocate medical resources reasonably. At present, there are few reports about predictive scores for VA-ECMO. This article systematically reviewed the predictive performance of various scoring tools [the survival after venoarterial ECMO (SAVE) score, prediction of cardiogenic shock outcome for acute myocardial infarction (AMI) patients salvaged by VA-ECMO (ENCOURAGE) score, model for end-stage liver disease (MELD-Ⅺ) score, post-cardiotomy extracorporeal membrane oxygenation (PC-ECMO) score, the predicting mortality in patients undergoing VA-ECMO after coronary artery bypass grafting (REMEMBER) score, predictors of mortality with VA-ECMO for acute massive pulmonary embolism, extracorporeal cardiopulmonary resuscitation (ECPR) score, the hypothermia outcome prediction after extracorporeal life support (HOPE) score] for patients receiving VA-ECMO to provide reference for clinical treatment.
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Objective:To explore the clinical efficacy and safety of the camrelizumab combined with apatinib and chemotherapy as second-line or later therapy in human epidermal growth factor receptor-2 (HER-2) negative advanced gastric cancer.Methods:A total of 66 patients with HER-2 negative advanced gastric cancer and first-line treatment failure in Shandong Cancer Hospital Affiliated to Shandong First Medical University from March 2018 to September 2021 were selected. They were divided into study group ( n=22) and control group ( n=44) according to the different treatment regimens. The patients in the study group were treated with camrelizumab combined with apatinib and chemotherapy, and the patients in the control group were treated with chemotherapy alone. The short-term efficacy, progression-free survival (PFS) , overall survival (OS) and the occurrence of adverse reactions were compared, and Cox regression analysis was used to analyze the influencing factors of prognosis. Results:After at least 2-4 cycles of treatment, the ORR in the study group and the control group were 9.1% (2/22) and 0 (0/44) respectively, with no statistically significant difference ( P=0.108) . DCR in the two groups were 77.3% (17/22) and 45.5% (20/44) respectively, with a statistically significant difference ( χ2=6.03, P=0.014) . The study group didn’t reach median OS and the median OS in the control group was 11.7 months, with no statistically significant difference ( χ2=1.59, P=0.207) . The study group didn’t reach median PFS and the median PFS in the control group was 3.2 months, with a statistically significant difference ( χ2=10.13, P=0.001) . Multivariate Cox regression analysis showed that treatment method was an independent influencing factor for PFS in patients with HER-2 negative advanced gastric cancer ( HR=0.33, 95% CI: 0.15-0.75, P=0.008) . In terms of adverse reactions, there was a statistically significant difference in the incidence of elevated alanine aminotransferase between the study group and the control group [31.8% (7/22) vs. 6.8% (3/44) , χ2=5.32, P=0.021]. There were no adverse-related deaths in both groups. Conclusion:Compared with chemotherapy alone, camrelizumab combined with apatinib and chemotherapy as a second-line or later therapy in HER-2 negative advanced gastric cancer can prolong PFS and improve DCR, but the incidence of elevated alanine aminotransferase increases significantly.
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The COVID-19 pandemic caused by the novel SARS-CoV-2 virus has caused havoc across the entire world. Even though several COVID-19 vaccines are currently in distribution worldwide, with others in the pipeline, treatment modalities lag behind. Accordingly, researchers have been working hard to understand the nature of the virus, its mutant strains, and the pathogenesis of the disease in order to uncover possible drug targets and effective therapeutic agents. As the research continues, we now know the genome structure, epidemiological and clinical features, and pathogenic mechanism of SARS-CoV-2. Here, we summarized the potential therapeutic targets involved in the life cycle of the virus. On the basis of these targets, small-molecule prophylactic and therapeutic agents have been or are being developed for prevention and treatment of SARS-CoV-2 infection.
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Purpose@#The purpose of this study was to optimize a peptide (nABP284) that binds to programmed cell death protein 1 (PD-1) by a computer-based protocol in order to increase its affinity. Then, this study aimed to determine the inhibitory effects of this peptide on cancer immune escape by coculturing improving cytokine-induced killer (ICIK) cells with cancer cells. @*Materials and Methods@#nABP284 that binds to PD-1 was identified by phage display technology in our previous study. AutoDock and PyMOL were used to optimize the sequence of nABP284 to design a new peptide (nABPD1). Immunofluorescence was used to demonstrate that the peptides bound to PD-1. Surface plasmon resonance was used to measure the binding affinity of the peptides. The blocking effect of the peptides on PD-1 was evaluated by a neutralization experiment with human recombinant programmed death-ligand 1 (PD-L1) protein. The inhibition of activated lymphocytes by cancer cells was simulated by coculturing of human acute T lymphocytic leukemia cells (Jurkat T cells) with human tongue squamous cell carcinoma cells (Cal27 cells). The anticancer activities were determined by coculturing ICIK cells with Cal27 cells in vitro. @*Results@#A high-affinity peptide (nABPD1, KD=11.9 nM) for PD-1 was obtained by optimizing the nABP284 peptide (KD=11.8 μM). nABPD1 showed better efficacy than nABP284 in terms of increasing the secretion of interkeulin-2 by Jurkat T cells and enhancing the in vitro antitumor activity of ICIK cells. @*Conclusion@#nABPD1 possesses higher affinity for PD-1 than nABP284, which significantly enhances its ability to block the PD-1/PD-L1 interaction and to increase ICIK cell-mediated antitumor activity by armoring ICIK cells.
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OBJECTIVE To study the protective effects o f valproic acid on cardiac and cerebral injury in rats subjected to severe scalding combined with seawater immersion injury with delayed fluid replacement. METHODS The rats were divided into scalding+delayed fluid replacement group （group S ），scalding+seawater immersion+delayed fluid replacement group （group SS ）， scalding+seawater immersion+valproic acid+delayed fluid replacement group （group SSV ）according to random number table ，with 60 rats in each group. All groups were subjected to 35％total body surface area third-degree full-thickness scalding with boiled water. Group SS and group SSV were immersed in artificial ；seawater（30 min）immediately after scalding ，and group SSV was subcutaneously injected with valproic acid 300 mg/kg immediately after out of water. Sodium lactate Ringer ’s 0314-2279277。E-mail：125467374@qq.com injection was injected intravenously within 30 minutes according to 1/2 Parkland formula at 2 h after scalding in each group for delayed fluid replacement. The death time of rats was recorded ，and the average survival time and 24 h survival rate of rats in each group were calculat ed. Mean arterial pressure （MAP），heart rate （HR），respiration rate （RR），rectal temperature （RT），arterial blood pH ，arterial partial pressure of oxygen （PaO2），arterial blood partial pressure of carbon dioxide （PaCO2），HCO3－，creatine kinase MB isoenzyme （CK-MB）and neuron specific enolase （NSE）were detected before scalding ，at 0，2，5 h after scalding. The pathological changes of cardiac and cerebral tissue were observed. RESULTS The 24 h survival rate of group SS （55％）was significantly lower than that of group S （90％）， while that of group SSV （75％）was increased significantly ，compared with group SS （P＜0.05）. Compared with group S ，the levels of MAP ，RT，HR，pH，PaO2 and HCO 3－ in group SS were significantly lowered ，while the levels of CK-MB and NSE were increased significantly at 0，2，5 h after scalding ；the levels of PaCO 2 were increased significantly at 2，5 h after scalding ， while the levels of RR were decreased significantly at 0，2 h after scalding （P＜0.05）. Compared with group SS ，the levels of MAP，RT，HR，pH，PaO2 and HCO 3－ in group SSV were significantly increased ，while the levels of PaCO 2，CK-MB and NSE were decreased significantly at 2，5 h after scalding ；the level of RR was increased significantly at 2 h after scalding （P＜0.05）. At 2，5 h after scalding ，cardiac and cerebral injury of rats in group SS were aggravated significantly than that in group S ；cardiac and cerebral injury of rats in group SSV were relieved significantly than that in group SS. CONCLUSIONS After severe scalding combined seawater immersion injury ，hypodermic injection of sodium valproate could protect cardiac and cerebral function of rats ， improve vital signs and blood gas index ，prolong survival time and improve survival rate in rats.
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ObjectiveTo explore the effect of Youguiwan on the rats with adriamycin-induced nephrotic syndrome （NS） and its mechanism. MethodSD rats were randomly divided into a normal group， a model group， three Youguiwan low， medium， and high-dose groups， and a prednisone group. Rats in the model group were intravenously injected with adriamycin in the tail vein to induce the NS model. Rats in the Youguiwan low， medium， and high-dose groups were given 2.8， 5.6， 11.2 g·kg-1·d-1 of crude drugs， respectively， and rats in the prednisone group were given 6.3 mg·kg-1·d-1 of prednisone acetate. Each administration group was given continuous medicine for 6 weeks， and the normal group and model group were given an equal volume of normal saline. Bicinchoninic acid （BCA） assay was used to detect 24 h urine protein （24 h UP）. Automatic biochemical analyzer was used to detect serum urea nitrogen （BUN）， creatinine （SCr）， albumin （ALB）， total cholesterol （TC）， and triglyceride （TG） levels. Hematoxylin-eosin （HE） staining was used to observe renal tissue morphology， and kit was used to detect serum advanced oxidized protein products （AOPPs） and reactive oxygen species （ROS）. Western blot was used to detect the receptor of advanced glycation endproducts （RAGE） of renal tissue， nuclear factor-κB （NF-κB） phosphorylation levels， Wnt， and β-catenin protein expression. ResultAs compared with the normal group， 24 h UP， serum BUN， SCr， TC， TG， AOPPs， and ROS levels in the model group increased significantly （P<0.01）， whereas ALB decreased （P<0.01）. There were typical pathological injuries in the renal tissue， and the expressions of RAGE， phosphorylation（p）-NF-κB， Wnt1， and β-catenin protein were significantly increased （P<0.01）. As compared with the model group， the 24 h UP， serum BUN， SCr， TC， TG， AOPPs， and ROS levels of rats in the Youguiwan low， medium， and high-dose groups significantly reduced （P<0.01）， and ALB significantly increased （P<0.01）. The renal tissue damage was reduced， and the expressions of RAGE， p-NF-κB， Wnt1， and β-catenin protein were significantly decreased （P<0.01） in a dose-dependent manner. ConclusionYouguiwan improves the kidney injury of rats with adriamycin-induced NS. The mechanism may be related to the reduction of AOPPs level， inhibition of RAGE/ROS/NF-κB axis， and activation of Wnt/β-catenin signal.
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A retrospective analysis of 7 patients of multiple myeloma (MM) with initial manifestation of bleeding and coagulation abnormalities were performed. Clinical manifestations, laboratory and imaging examinations were collected. The activity of coagulation factors was measured before the treatment. Single factor X deficiency was seen in one patient. Two cases had factor Ⅶ deficiency, while four other patients had multiple factor deficiency. The time from onset of symptoms to diagnosis ranged from 2 to 10 months. After anti-MM treatment started and plasma or coagulation factors were transfused, the prolonged coagulation time returned to normal from 28-84 days. Most of these patients presented large, deep and multiple sites of hematoma, which caused concerns of bone marrow puncture and may direct to other differential diagnoses. This is helpful to improve physicians′ understanding of the special clinical characteristics in MM patients.
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Objective:To explore the hope level and influencing factors of infertile patients with first or repeated in vitro fertilization-embryo transfer (IVF-ET).Methods:Female patients receiving IVF-ET treatment during January to June, 2019 in reproductive Medicine Center, Ruijin Hospital, Shanghai Jiaotong University School of medicine, were enrolled in this study. All patients were divided into first and repeated cycles (≥2 cycles), then a questionnaire survey was conducted. The questionnaire included demographic information, Herth hope index (HHI) scale, Locke-Wallace short marital-adjustment test scale and social support rating scale. Multiple linear regression was used to analyze the associated influencing factors of hope level.Results:A total of 251 IVF-ET patients were recruited in the study, including 142 (56.6%) in the first cycle and 109 (43.4%) in the repeated cycle. The HHI score of the repeated cycle was significantly lower than that of the first cycle [(32.0±3.3) vs (36.0±3.1) points] ( P<0.001). Multiple linear regression analysis indicated that repeated IVF-ET was independently negatively correlated with HHI, with a standardized coefficient β of -0.406 ( P<0.001). While living in a city ( P=0.013), high monthly income ( P=0.026), high degree short marital-adjustment test ( P=0.006) and social support rating ( P=0.002) were independently positively correlated with HHI. Conclusions:Repeated IVF-ET treatment patients have a significantly lower HHI score. The residence, monthly income, marital-adjustment, and social support are significantly associated with hope level.
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Objective To investigate the health literacy level and its influencing factors of patients with chronic heart failure (CHF) in Shaanxi, and to analyze the mediating effect of income level on health literacy. Methods From June 2019 to June 2020, 236 patients with CHF who were hospitalized in the Department of Cardiovascular Medicine of Xi'an North Hospital were enrolled in the study. The demographic and clinical characteristics questionnaire, and the heart failure-specific health literacy scale (HFS-HL) were used to collect data. The health literacy levels of patients with different characteristics were analyzed and compared. Logistic regression was used to analyze the factors affecting health literacy levels, Pearson correlation analysis was used to analyze the correlation between income level and health literacy, and Bootstrap test was used to analyze the mediating effect between income level and health literacy. Results Each dimension score and total score of HFS-HL scale of patients with different age, gender, place of residence, education level, family income per capita and NYHA cardiac function classification showed significant difference (P<0.05). Age, education level, family income per capita level and NYHA cardiac function classification were the influencing factors of CHF patients' health literacy (P<0.05). The level of family income per capita was significantly positively correlated with functional health literacy, interactive health literacy, critical health literacy and overall health literacy (P<0.05). The mediating effect value of family income per capita level was 0.134 (95% CI: 0.113-0.158), and the mediating effect was statistically significant (P<0.05). Conclusion The overall health literacy level of CHF patients in Shaanxi needs to be improved. The health literacy interventions for the elderly and people with low level of education, low family income, and poor heart function should be strengthened. At the same time, attention should be paid to the mediating effect of income level.
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ObjectiveTo investigate the change in the activity of glucosylceramide synthase, the key enzyme in glycosphingolipid metabolism and synthesis, in Huh7 cells infected by hepatitis B virus (HBV) in vitro. MethodsBlood samples were collected from nine previously untreated patients with acute hepatitis B who attended Department of Infectious Diseases, The First Hospital of Lanzhou University, from June to August, 2019, and the blood samples collected from seven healthy individuals who underwent physical examination were established as control. Huh7 cells were inoculated with the high-copy HBV particles (＞9.9×107 IU/ml) in the serum of patients with HBV infection (infection group), and Huh7 cells co-cultured with the serum of healthy individuals were established as control group. The expression levels of HBsAg and HBV DNA in the cytoplasm of HBV-infected Huh7 cells were measured, and the correlation between GCS activity and virus was analyzed. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t-test was used for further comparison between two groups, and a Pearson correlation analysis was performed. ResultsCompared with the control group, the infection group had a significant reduction in the number of cells, an increase in cell volume, and cell membrane fragmentation. The infection group had a significant increase in the expression of HBsAg in cytoplasm at 4 hours, 8 hours, 2 days, and 5 days after infection (P＜0.05); the expression level of HBV DNA tended to increase significantly from 4 hours after infection to 8 hours, 2 days, and 5 days after infection (16.67±11.55 IU/ml vs 112.01±25.94 IU/ml/328.01±10350 IU/ml/101.60±49.84 IU/ml, P＜0.001), with the highest level at 2 days after infection. During HBV infection, the activity of GCS gradually increased with the increase in viral replication from 4 hours after infection (126.21±9.59 IU/ml) and reached a peak at 2 days after infection (226.53±36.27 IU/ml), with a significant difference between the infection group and the control group at 2 days after infection (226.53±36.27 IU/ml vs 136.50±1544 IU/ml, t=3.956, P=0.016 7). The activity of GCS was positively correlated with HBV DNA level (r=0.576 8, P=0047 1). ConclusionHuh7 cells are successfully infected with the high-copy HBV particles in the serum of patients with HBV infection, which mimics the characteristics of HBV infection in vitro to a certain degree. The activity of GCS may be associated with HBV infection, suggesting that glycosphingolipid synthesis and metabolism may be closely associated with HBV.
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Objective:To investigate the changes of intestinal flora and serum amino acid levels in elderly patients with Parkinson's disease(PD)at different stages, and to provide evidence for diagnosis, prevention and treatment of PD.Methods:A total of 140 elderly PD patients diagnosed and treated in our hospital from January 2018 to August 2019 were enrolled and divided into PD course <5 years group(n=70)and PD course≥5 years group(n=70). Ninety subjects without PD confirmed by medical examination in our hospital were included as the control group.Real-time fluorescence quantitative PCR of 16S rDNA gene was used to detect levels of Bifidobacterium, Lactobacillus, Clostridium prasus, Enterococcus, Enterobacter, Prevotella copri and Akkermansia muciniphila bacteria in the gut, and the high-performance liquid chromatography was used to detect the serum amino acids in the three groups.Results:Compared with the control group, the levels of Bifidobacterium, Lactobacillus, Clostridium prasalis and Prevotella copri in the intestines were decreased and Enterobacter level was increased in PD course <5 years group and PD course≥5 year group( F=20.863, 32.251, 23.166, 24.683 and 10.136, all P<0.001). The serum levels of methionine, tryptophan, lysine and glutamate in PD course <5 years and PD course≥5 year group were decreased as compared with the control group( F=5.858, 5.877, 4.183 and 25.462, all P<0.05). Spearman correlation analysis showed that serum glutamate level was positively correlated with Clostridium prastia in the intestine( r=0.647, P=0.002)and negatively correlated with Prevotella copri( r=-0.559, P=0.010). Multivariate Logistic regression analysis showed that the protective factors in the intestines of elderly PD patients were Bifidobacterium( OR=0.186, 95% CI: 0.054-0.637, P=0.007), Lactobacillus( OR=0.283, 95% CI: 0.098-0.816, P=0.020), Clostridium prastia( OR=0.232, 95% CI: 0.063-0.851, P=0.028), and Prevotella copri( OR=0.222, 95% CI: 0.058-0.851, P=0.028), and the risk factor was Enterobacter( OR=5.119, 95% CI: 1.406-18.636, P=0.013). Conclusions:The decreases of Bifidobacterium, Lactobacillus, Clostridium, Prevotella copri and Enterobacter levels in the intestinal tract of PD patients, and the decrease of serum glutamate level may be correlated to the progression of PD.
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Objective:To analyze the clinical characteristics that affect the early outcomes of the elderly patients with transient ischemic attack(TIA) and provide the guidance for the prediction of disease recurrence.Methods:From January 2016 to December 2019, 315 TIA patients over 60 years old based on the time-clinical definition who were admitted to the department of neurology in Beijing Shijitan Hospital were divided into recurrence cerebrovascular events group(RCVEs group) and non-recurrence cerebrovascular events group(non-RCVEs group) according to the recurrence at 1 month after onset. The clinical characteristics of the two groups were compared by Logsitic regression analysis.Results:There were 29 cases in the RCVEs group and 286 cases in the non-RCVEs group. Compared to the non-RCVEs group, patients in RCVEs group were more likely have higher prevalence of hypertension history(14/15, 83/203), moderate or severe intracranial artery stenosis(21/8, 132/154), carotid stenosis(22/7, 107/179), DWI positive, motor symptoms, carotid artery stenting and higher times of TIA episodes(2(2, 3), 2(1, 2)), fasting blood glucose and glycosylated hemoglobin levels(8.86(8.17, 9.56)mmol/L, 5.82(5.27, 6.33)mmol/L). Logistic regression analysis showed that patients in RCVEs group had a DWI positive( B=1.634, OR=5.124, 95% CI: 2.898-9.059, P=0.000) and higher prevalence of moderate to severe stenosis of carotid artery( B=0.572, OR=1.773, 95% CI: 1.050-2.993, P=0.032). Conclusion:DWI positive and moderate to severe carotid stenosis may influence the early poor prognosis in patients with TIA.