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1.
Journal of Clinical Hepatology ; (12): 1191-1195, 2024.
Article in Chinese | WPRIM | ID: wpr-1032269

ABSTRACT

ObjectiveTo investigate the efficacy and safety of artificial liver support therapy with an Evanure-4A selective membrane plasma separator and its influence on platelet count in the treatment of patients with acute-on-chronic liver failure (ACLF) patients with different platelet counts. MethodsA total of 302 patients with ACLF who were hospitalized in Department of Hepatology, Chengdu Public Health Clinical Medical Center, from January 2021 to May 2023, were enrolled, and according to the platelet count (PLT), they were divided into group A (25×109/L — 50×109/L) with 101 patients, group B (51×109/L — 80×109/L) with 98 patients, and group C (81×109/L — 100×109/L) with 103 patients. In addition to medical treatment, all patients received different modes of artificial liver support therapy based on their conditions, including plasma perfusion combined with plasma exchange, double plasma molecular adsorption combined with plasma exchange, and bilirubin system adsorption combined with plasma exchange. The paired t-test was used for comparison of continuous data before and after treatment in each group; an analysis of variance was used for comparison between multiple groups, and the SNK-q test was used for further comparison between two groups; the chi-square test was used for comparison of categorical data between multiple groups. ResultsOf all 302 patients, 268 (88.74%) achieved varying degrees of improvement in clinical symptoms after artificial liver support therapy. After treatment, all three groups had varying degrees of reductions in alanine aminotransferase (t=14.755, 21.614, and 15.965, all P<0.001), aspartate aminotransferase (t=11.491, 19.301, and 13.919, all P<0.001), total bilirubin (t=19.182, 17.486, and 21.75, all P<0.001), and international normalized ratio (INR) (t=3.497, 3.327, and 4.358, all P<0.05). After artificial liver support therapy with an Evanure-4A selective membrane plasma separator, PLT in group A decreased from (37.73±6.27)×109/L before treatment to (36.59±7.96)×109/L after treatment, PLT in group B decreased from (66.97±7.64)×109/L before treatment to (62.59±7.37)×109/L after treatment, and PLT in group C decreased from (93.82±5.38)×109/L before treatment to (85.99±12.49)×109/L after treatment; groups B and C had significant reductions in PLT after treatment (t=12.993 and 8.240, both P<0.001), but there was no significant difference in group A (P>0.05). There was no significant difference in the incidence rate of adverse reactions during artificial liver support therapy between the three groups (P>0.05). ConclusionArtificial liver support therapy can improve liver function and INR in patients with ACLF. The use of Evaure-4A selective membrane plasma separator during artificial liver support therapy has little influence on platelets, and it is safe in the treatment of ACLF patients with a significantly lower level of platelets.

2.
Article in Chinese | WPRIM | ID: wpr-1024089

ABSTRACT

Objective To analyze the characteristics and influencing factors of healthcare-associated bloodstream infection(HA-BSI)of carbapenem-resistant Enterobacterales(CRE).Methods Retrospective nested case-control study was adopted.Fifty-six patients with CRE HA-BSI in a tertiary general hospital from January 2020 to Decem-ber 2022 were selected as the CRE group.With a 1:1 ratio,56 patients with carbapenem-sensitive Enterobacterales(CSE)BSI during the same period was selected as the CSE group.Distribution of infection strains and departments was analyzed,and the relevant factors for CRE BSI were analyzed by univariate and multivariate logistic regression analyses.Results The distribution of CRE BSI was mainly in intensive care unit(ICU,n=23,41.07%)and de-partment of hematology(n=17,30.36%).The main infection strains were Klebsiella pneumoniae(n=32,57.14%)and Escherichia coli(n=16,28.57%).Univariate analysis showed that malignant tumor,hospitalization history within 60 days,stay in ICU for>48 hours before infection,mechanical ventilation,indwelling central venous cathe-ter,combined use of at least two kinds of antimicrobial agents,and duration of antimicrobial use ≥10 days were all related to CRE BSI(all P<0.05).Multivariate logistic regression analysis found that stay in ICU>48 hours before infection and duration of antimicrobial use ≥10 days before infection were independent risk factors for CRE HA-BSI(P<0.05).Conclusion Clinical departments,especially ICU,should pay attention to the epidemiological history of patients,identify patients with high-risk factors for CRE BSI as early as possible,use antimicrobial agents ratio-nally and standardize invasive procedure,so as to reduce the occurrence of CRE HA-BSI.

3.
Chinese Journal of Rheumatology ; (12): 160-166, 2021.
Article in Chinese | WPRIM | ID: wpr-884383

ABSTRACT

Objective:To analyze the clinical characteristics of anti-cyclic citrullinated peptide (CCP) antibody-negative rheumatoid arthritis (RA) patients.Methods:To retrospectively analyze the medical records of RA patients hospitalized in the department of rheumatology and immunity of Peking University Third Hospital from January 2013 to December 2018, we collected the baseline characteristics, joint manifestations, extra-articular manifestations, and laboratory parameters of RA patients, and compared the differences between anti-CCP antibody-negative patients and anti-CCP antibody-positive patients by U test and chi-square test. Results:A total of 486 RA patients were included in this study, including 153 anti-CCP antibody-negative patients (31.5%) and 333 anti-CCP antibody-positive patients (68.5%). Compared with anti-CCP antibody-positive group, anti-CCP antibody-negative group had shorter disease course ( U=-4.750, P<0.01) and the pro-portion of morning stiffness, shoulder or elbow joint involvement, and hand arthritis ( P<0.05) was lower, while the incidence of phlebothrombosis of leg ( χ2=4.100, P=0.043) was higher, as well as thrombocytosis ( U=-2.179, P=0.029) and elevation of CRP ( U=-2.154, P=0.03). Subgroup analysis based on RF showed that CCP RF + group had higher percentage of women ( P=0.042) and higher incidence of interstitial lung disease ( χ2=5.652, P=0.017) and secondary Sj?gren's syndrome ( χ2=11.211, P=0.001), compared with CCP RF - group. Conclusion:anti-CCP antibody-negative-patients have similar clinical char-acteristics with anti-CCP antibody-positive group, but the involvement of shoulder or elbow joint and hand arthritis are less common in anti-CCP antibody-negative group. Meanwhile the incidence of phlebothrombosis of leg is higher, and the level of platelet(PLT) and C-reactive protein (CRP) is higher, suggesting that anti-CCP antibody-negative RA may have more vident inflammatory response.

4.
Beijing Da Xue Xue Bao ; (6): 1023-1028, 2020.
Article in Chinese | WPRIM | ID: wpr-942111

ABSTRACT

OBJECTIVE@#To analyse the clinical and laboratory characteristics of antinuclear antibody (ANA) positive rheumatoid arthritis (RA) patients.@*METHODS@#The clinical and laboratory data of 428 RA cases from Department of of Rheumatology and Immunology Peking University Third Hospital from Jan 2013 to Dec 2018 were collected and used to analyse characters between ANA positive group and ANA negative group. T test was used for the quantitative data in accordance with normal distribution. Wilcoxon rank sum test was used for the quantitative data of non normal distribution. The qualitative data were analyzed by chi square test. But while 1≤theoretical frequency < 5, chi square test of corrected four grid table was used. And Fisher exact probability method was used when theoretical frequency < 1.@*RESULTS@#The number of ANA positive group was 231 (54%). The female rate was obviously higher in ANA positive group (82.7% vs. 63.5%, χ2=20.355, P < 0.01). The rate of metatarsophalangeal joints (MTPJs) involvement was lower in ANA positive group (22.1%) than in ANA negative group (33.0) (χ2=6.414, P < 0.05). The incidence of secondary Sjögren's syndrome (sSS) was much higher in ANA positive group(19.5% vs. 4.1%, χ2=23.300, P < 0.01). The positivity of rheumatoid factor (RF), as well as the positivity of anti-cyclic citrullinated peptide(CCP) antibody was much higher in ANA positive group (77.1% vs. 53.8%, χ2=25.743, P < 0.01, 74.9% vs. 59.4%, χ2=11.694, P < 0.01, respectively). The levels of immunoglobulin G (IgG) and immunoglobulin M (IgM) of ANA positive group were higher [(15.1±5.1) g/L vs. (13.8±5.3) g/L, t=2.359, P < 0.05, 1.25 (0.92) g/L vs. 1.05 (0.65) g/L, Z=-3.449, P < 0.01, respectively]. But the levels of hemoglobin (Hb) and platelet (PLT) was lower in ANA positive group[(109.64±17.98) vs. (114.47±18.48) g/L, t=-2.734, P < 0.01; (266.4×109±104.6×109) vs. (295.9×109±100.1×109) /L, t=-2.970, P < 0.01, respectively].@*CONCLUSION@#The incidence of sSS was obviously higher in ANA positive group than in ANA negative group. Serum IgG of ANA positive group was higher, but Hb and PLT were lower.


Subject(s)
Female , Humans , Antibodies, Antinuclear , Arthritis, Rheumatoid/epidemiology , Autoantibodies , Laboratories , Peptides, Cyclic , Rheumatoid Factor
5.
Journal of Clinical Hepatology ; (12): 187-190, 2019.
Article in Chinese | WPRIM | ID: wpr-778920

ABSTRACT

Liver cirrhosis is common in clinical practice and is the common clinical outcome of various chronic liver diseases including chronic hepatitis C virus (HCV) infection. Before the development of direct-acting antiviral agents (DAAs), anti-HCV therapy based on pegylated interferon (PEG-IFN.) and ribavirin (RBV) has a poor clinical effect due to the presence of liver cirrhosis, and decompensated liver cirrhosis itself is an absolute contraindication for PEG-IFN treatment. DAAs have gradually become the first-line drug for HCV infection, and many studies have shown that DAAs have good clinical effects and tolerability in the treatment of cirrhotic patients with HCV infection. On the one hand, DAAs have better clinical effect and safety than PEG-IFN/RBV in patients with compensated liver cirrhosis; on the other hand, patients with decompensated liver cirrhosis are tolerant to DAAs, and although they have a lower proportion of patients with sustained virologic response than normal patients, they can still benefit from DAAs from many aspects. This article reviews the latest research advances in DAAs in patients with HCV-related liver cirrhosis, in order to provide a reference for clinical diagnosis and treatment.

6.
Article in Chinese | WPRIM | ID: wpr-705293

ABSTRACT

OBEJECTIVE Gecko has been clinically used in China for many years. It has been proved that the gecko polypeptide mixture(GPM)extracted from gecko could inhibit the growth of multiple types of tumor cells.In order to investigate the possible anti-tumor molecular mechanisms of GPM,we used RNA-seq technology to identify the differentially expressed genes of human hepatocellular carci-noma(HCC)HepG2 cells treated with or without GPM.METHODS The HepG2 cells were treated with different concentration of GPM(0,0.1,0.2,0.3,0.4 mg·mL-1)for 6 h,12 h and 24 h,respectively.MTT assay was used to detect the viability of HepG2 cells. DAPI fluorescence staining was performed to observe nucleus morphological changes of HepG2 cells.Western blot analysis was applied to observe the expres-sion of apoptosis- related proteins and endoplasmic reticulum stress (ERs)-related proteins in HepG2 cells.Flow cytometry was also applied to detect reactive oxygen species(ROS)generation.In this report, we showed that GPM could induce HepG2 cells apoptosis and influence HepG2 cells proliferation in a dose-dependent manner.We applied many analysis methods,including differentially expressed genes analysis,Gene Ontology(GO)enrichment analysis,KEGG pathway enrichment analysis,protein-protein interaction network analysis to screen out possible molecular mechanisms.RESULTS ER-nucleus signaling pathway, cellular response to stress and apoptotic processes were identified the potential anti-cancer molecular biological process of GPM.GPM may also induce apoptosis in HepG2 cells via endoplasmic reticulum stress pathway. The GPM could induce ROS generation and up-regulate ERs-related proteins. CONCLUSION The present study revealed the potential anti-tumor mechanism of GPM.

7.
Tianjin Medical Journal ; (12): 379-382, 2015.
Article in Chinese | WPRIM | ID: wpr-465607

ABSTRACT

Objective To investigate the incidence and risk factors of human papillomavirus type 16 (HPV16) infec?tion among women through health screenings in Tianjin urban area. Methods A total of 2 000 women from Tianjin urban area were recruited for this study, and potential risk factors were investigated by questionnaire as well as by collecting cervi?cal exfoliated cells from the participants. HPV type was examined using polymerase chain reaction and pyrosequencing tech?nology, then the risk factors of HPV16 infection were examined by chi square test and the multiple factor logistic regression analysis. Results Among those 2 000 women who received health screenings, a total of 271 cases were HPV positive (13.55%). HPV16 accounts for the most common human papillomavirus types (39.5%, 107/271) while HPV58 account for 15.13%(41/271)and HPV18 account for 9.59% (26/271). Factors related to HPV16 infection were investigated include smoking history, initial age of sex (>25 years old or not) , number of pregnancies (≥2 or not), number of sexual partners (≥2 or not) and contraception measures (condom or other ways) with χ2=6.268,8.540,4.951,7.123,6.053,5.019, respectively. (P < 0.05). Age, alcohol intake, education level and previous gynecologial examination did not differ significantly among HPV16 positive patients compared to those with negative HPV. Multiple factor Logistic regression model analysis showed that the independent factors were smoking history and initial age for sex(≤25 years old)(P<0.05). Conclusion HPV16 is the most common type of cervical infection among women in Tianjin urban area. Changing inappropriate sexual behavior and smoking cessation are effective measures to prevent HPV16 infection and reduce incidence of cervical cancer.

8.
Article in Chinese | WPRIM | ID: wpr-602828

ABSTRACT

Objective To study the asymmetric dimethylarginine(ADMA) concentrations in plasma of acute coronary syndrome (ACS) and its various subgroups ,and analyze the relationship between ADMA and traditional risk factors of ACS .Methods 101 ACS patients were enrolled in the study ,which were divided into several subgroups according to clinical diagnosis ,ECG and coro‐nary angiography .ACS group were divided into unstable angina(UA) group(n=70) and acute myocardial infarction(AMI) group (n=31) ,then AMI group was divided into non‐ST segment elevation myocardial infarction(NSTEMI) group(n=19) and ST seg‐ment elevation myocardial infarction (STEMI) group(n=12) .The control group(n= 40) were recruited in the study during the same period ,who showed normal coronary arteries in coronary angiography .All the patients received coronary attery angiography . The plasma ADMA concentration was measured by using enzyme‐linked immunosorbent assay (ELISA) ,and serum contents of lip‐id(TC ,TG ,HDL‐C ,LDL‐C) ,C‐reactive protein(CRP) ,troponin were detected by automatic biochemic analysis apparatus .Results Compared with the control group ,plasma ADMA concentration of ACS group increased ,the difference was statistically significant (P<0 .05) .The concentrations of ADMA in AMI group and UA group were higher than those in control group ,and the difference was statistically significant(P< 0 .05) .The concentrations of ADMA in AMI group were significantly higher than those in UA group(P<0 .05) .Plasma ADMA negatively correlated with HDL‐C concentrations(r= -0 .222 ,P<0 .05) ,positively correlated with LDL‐C concentration(r=0 .357 ,P<0 .05) ,and positively correlated with CRP(r=0 .619 ,P<0 .05) .Conclusion The occur‐rence of ACS and some of its related risk factors are correlated with plasma ADMA concentration .

9.
Article in Chinese | WPRIM | ID: wpr-453593

ABSTRACT

Objective To investigate the type of gene mutation and its distribution in patients with thalassemia in Chongqing ,in order to guide prenatal and postnatal care .Methods PCR and membrane hybridization technology for α-thalassemia andβ-thalasse-mia gene detection .Results From September 2012 to September 2013 ,349 thalassemia patients were detected ,including 125 α-thalassemia patients and 211β-thalassemia patients .Based on genotypes ,gene deletions were the most common type of gene muta-tion of α-thalassemia patients .Southeast Asia deletion - -SEA/αα(accounted for 73 .60 % ) and the right deletion -3 .7/αα(ac-counted for 19 .20% ) were the major types of gene deletion .Forβ-thalassemia patinets ,the hot spots of mutation were CD17(A→T) ,CD41-42(-TCTT) and IVS-Ⅱ-654(C→ T) ,which accounted for 29 .38% ,28 .91% and 27 .49% respectively .α-thalassemia combined with β-thalassemia mutations were detected in 13 patients .Conclusion Studing the gene mutation types of thalassemia and its distribution provides valuable information for genetic counseling and clinical therapy in Chongqing .

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