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Hair follicle (HF), one of the skin appendages, has received a lot of attention to be a new target and pathway for drug delivery. The development of hair follicle targeted drug delivery system (HFTDDS) through percutaneous permeation is particularly important for skin diseases derived from HF such as acne, hair loss, and folliculitis for their on-site action. This review describes the structure and physiological function of HF, the microenvironment of HF, and factors affecting HF permeation. Multiple nanoformulations used to improve the HF permeation and technologies to characterize the HF permeation were introduced. The latest advance of HFTDDS based on nanoformulations were systematically summarized and analyzed in the treatment of acne and hair loss. Finally, the challenges of formulating HFTDDS were discussed. The review is expected to provide some ideas and references for developing delivery systems for treating skin diseases derived from HF.
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Objective:To investigate the significance of clinical factors combined with transvaginal ultrasound and contrast-enhanced ultrasound(CEUS) in guiding the choice of treatment plan for cesarean scar pregnancy(CSP).Methods:The clinical and transvaginal ultrasound and CEUS data of 120 patients with CSP from January 2016 to June 2021 in the First People′s Hospital of Foshan were retrospectively analyzed, and they were divided into ultrasound-guided curettage/ hysteroscopic group (Group A, 91 cases) and laparoscopic group (Group B, 29 cases) according to treatment option, and the differences in clinical and ultrasound factors between the two groups were compared, and to determine the relevant clinical and ultrasound indicators for the choice of treatment option.Results:There were statistical differences between the 2 groups in comparison of whether the gestational sac/mass protruded toward the plasma membrane, gestational sac/mass diameter, the main blood supply site of the gestational sac/mass, the site of the chorion/early placenta and scar thickness (all P<0.05). Logistic regression analysis indicated that CEUS showing major blood supply site of the gestational sac/mass ( OR=6.029, P=0.003) and uterine scar thickness ( OR=12.998, P=0.002) were independent risk factors for minimally invasive surgery for CSP. Conclusions:Ultrasound combined with clinical factors have a certain value in the selection of treatment options for CPS, and the thickness of the uterine scar and the main blood supply site of the gestational sac/mass showed in CEUS may be key factors affecting the minimally invasive surgical treatment of CSP.
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The clinical characteristics and gene variations of a family with mitochondrial myopathy and ataxia caused by MSTO1 gene mutation who visited Xiangya Hospital of Central South University in October 2019 were retrospectively analyzed.The proband was an 11-year-old female, who was found to have delayed motor and language development and dysarthria at the age of 1 year and 6 months.The 9-year-old younger brother of the proband had similar symptoms at the age of 1 year and 3 months.Both the proband and her younger brother had muscle weakness and ataxia.Their head magnetic resonance imaging showed cerebellar atrophy, and their electromyography showed neuroge-nic changes.Genetic testing revealed compound heterozygous mutations in MSTO1: c.1259delG; p.G420VfsX2 and c.571 C > T; p.R191X, which were inherited from their parents, respectively.The same site mutations were found in the younger brother.After 2 weeks of " cocktail therapy" , the symptoms of the children were alleviated, and their language and movement improved.
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@#In order to improve the poor solubility and low bioavailability of paeonol (Pae), paeonol-nanoemulsion (Pae-NE) was prepared, and its effect on uptake of human umbilical vein endothelial cells (HUVECs) was investigated.Pae-NE was prepared by phase inversion composition (PIC), the formulation of Pae-NE was optimized by single factor method and central composite design-response surface method (CCD), and the pharmaceutical properties were further characterized.Moreover, MTT was applied to evaluate the toxicity of Pae-NE on HUVECs, and the cellular uptake efficiency of Pae-NE was detected by fluorescence microscopy and flow cytometry.The results showed that the optimal formulation of Pae-NE was 20 mg of Pae, 55.1 mg of LCT, 144.9 mg of MCT, 600 mg of HS15, and 200 mg of 1,2 propylene glycol.The Pae-NE appearance was a light blue emulsion, and the average particle size is (25.69 ± 0.03) nm, with PDI of 0.182 ± 0.09, Zeta potential of -(4.01 ± 0.30) mV and good stability.The drug loading of Pae-NE was (1.967 ± 0.28) mg/mL and encapsulation rate of (99.36 ± 0.1)%.Pae-NE performed no significant effect on HUVECs growth in the Pae concentration range of 10-1-10-3 μg/mL.Moreover, NE as a drug delivery carrier significantly enhanced the uptake efficiency of Pae on HUVECs.In conclusion, Pae-NE preparation method was simple and stable, and promotes HUVECs uptake efficiency of Pae, suggesting that NE was a better dosage form reference for the lipid-soluble drug of Pae.
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Objective:To explore the effect of play-based communication and behavior intervention (PCBI) on internalizing and externalizing behaviors in children with autism spectrum disorder (ASD).Methods:From November 2018 to November 2021, 90 ASD children aged 8-30 months who registered in the Child Mental Health Research Center of the Affiliated Brain Hospital of Nanjing Medical University for PCBI ultra-early intervention training were selected and randomly assigned to the intervention group( n=60) and the waiting group( n=30) according to the ratio of 2∶1.Behavioral videos of free play between children and caregivers were collected before and after the 12-week intervention and the behavioral observation and analysis system (Observer XT) was used to code the parent-child interaction status and children's internalizing and externalizing behaviors.SPSS 23.0 statistical software were used and the data were analyzed by t-test, chi-square test, Pearson correlation analysis and multiple linear stepwise regression analysis. Results:After the intervention, the children in the intervention group had improved internalizing and externalizing behaviors (2.43±2.22, 1.88±1.91) compared with those before the intervention (4.82±3.37, 3.68±5.68), and the difference was statistically significant ( t=4.66, 2.60, both P<0.05). The children in the waiting group had no significant difference in internalizing and externalizing behaviors before (4.23±2.47, 4.00±2.18) and after intervention (4.37±2.57, 4.67±3.72) ( t=-0.23, -0.83, both P>0.05). After intervention, the children in the intervention group had fewer internalizing and externalizing behaviors than those in the waiting group, and the difference was statistically significant ( t=-3.70, -4.71, both P<0.05). The differences in internalizing behaviors (2.38±3.96, 1.80±5.37) and externalizing behaviors (1.80±5.37, -0.67±4.38) between the two groups before and after the intervention were statistically significant ( t=3.03, 2.18, both P<0.05). The results of multiple linear stepwise regression showed that the negative interaction of caregivers ( β=0.29, P<0.01) was a risk factor for internalizing behaviors.The negative interaction of children ( β=0.45, P<0.01) was a risk factor for externalizing behaviors, and the child's object status ( β=-0.30, P<0.01) and binary interaction ( β=-0.39, P<0.01) were protective factors for externalizing behaviors.In the intervention group, active child interaction, active caregiver interaction, and binary interaction increased after the intervention ( t=-6.77, -4.58, -7.72, all P<0.05), while the child's object status and the caregiver's negative interaction decreased ( t=3.37, 4.30, both P<0.05). Conclusion:The PCBI ultra-early intervention can effectively improve the internalizing and externalizing behaviors of ASD children.Improvements in internalizing behaviors may work by reducing negative caregiver interactions, and improvements in externalizing behaviors may work by increasing parent-child binary interactions.
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@#In this paper, the uncertainties of correction factors of fluconazole impurities determined by HPLC standard curve method were evaluated, and the main common factors affecting the accuracy of standard curve method were found, so as to improve the accuracy of the method.In this study, the corresponding fitting lines of fluconazole and its impurities A, B, C, D, F and I were established respectively, and the ratio of the slope of fitting lines of each impurity and its corresponding principal component was calculated as the correction factor of the impurity.Then on the basis of GUM method, the uncertainty of each impurity correction factor determined by standard curve method was evaluated according to the established uncertainty evaluation scheme of correction factor determination process.The correction factor and uncertainty of fluconazole impurities A, B, C, D, F and I were 1.068 ± 0.046, 0.102 ± 0.005, 0.0582 ± 0.0031, 1.382 ± 0.121, 0.802 ± 0.067 and 1.383 ± 0.119, respectively, and the coverage factor k was 2.Finally, the contribution rate of each uncertainty component was calculated.In the relative combined standard uncertainties urel(f) of fluconazole impurities A, B, C, D, F and I correction factors, the sum of contribution rate of slope uncertainty urel(K) of the linear equation of principal component and its impurity is more than 85%; in the slope uncertainties urel(K) of linear equation, the contribution rates of uncertainties of solution concentration in 8 of 12 data groups are more than 80%, and the contribution rates of uncertainties introduced by reference substance content in solution concentration are about 80%.It can be seen that the preparation of linear solution concentration is the most influential factor in the determination of impurity correction factor by standard curve method, followed by the linear fitting process.In the preparation process of linear solution concentration, the purity of reference substance is the most influential factor, followed by weighing and pipetting times.The conclusion can help the experimenters to better formulate experimental plans and ensure the accuracy of the results when doing similar work.
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Macrolide and corticosteroid resistance has been reported in patients with Mycoplasma pneumoniae (MP) pneumonia (MPP). MP clearance is difficult to achieve through antibiotic treatment in sensitive patients with severe MPP (SMPP). SMPP in children might progress to airway remodeling and even bronchiolitis/bronchitis obliterans. Therefore, identifying serum biomarkers that indicate MPP progression and exploring new targeted drugs for SMPP treatment require urgency. In this study, serum samples were collected from patients with general MPP (GMPP) and SMPP to conduct proteomics profiling. The Fc fragment of the IgG-binding protein (FCGBP) was identified as the most promising indicator of SMPP. Biological enrichment analysis indicated uncontrolled inflammation in SMPP. ELISA results proved that the FCGBP level in patients with SMPP was substantially higher than that in patients with GMPP. Furthermore, the FCGBP levels showed a decreasing trend in patients with GMPP but the opposite trend in patients with SMPP during disease progression. Connectivity map analyses identified 25 possible targeted drugs for SMPP treatment. Among them, a mechanistic target of rapamycin kinase (mTOR) inhibitor, which is a macrolide compound and a cell proliferation inhibitor, was the most promising candidate for targeting SMPP. To our knowledge, this study was the first proteomics-based characterization of patients with SMPP and GMPP.
Subject(s)
Child , Humans , Biomarkers , Carrier Proteins , Immunoglobulin Fc Fragments , Immunoglobulin G , Macrolides , Mycoplasma pneumoniae , Pneumonia, Mycoplasma/drug therapy , ProteomicsABSTRACT
@#To improve the standard of quality control of tazobactam and its preparations in China, national reference standard of tazobactam impurity A was developed. After tazobactam impurity A was synthesized, its structure was validated by infrared (IR), mass spectrometry (MS) and nuclear magnetic resonance (NMR), and its content uniformity and short-term stability were measured and investigated. Then, water content and residue on ignition of impurity A were determined, and its purity was determined using high performance liquid chromatography (HPLC) with 10 mmol/L ammonium acetate solution-acetonitrile (98∶2) as the mobile phase. Mass balance method was used to determine the content of the first batch of tazobactam impurity A national standard substance. Meanwhile, nuclear magnetic quantitative method was used to calculate the content, which was mutually verified with the mass balance method. The developed reference material of tazobactam impurity A is consistent with the maximum degradation impurity in tazobactam system applicability solution and the reference material of tazobactam related substance A contained in USP41. Within the 95% confidence range, the ratio of inter- and intra-bottle variance of impurity A after separation was 0.61 (< F0.05(11,12)), proving that the uniformity was satisfying. The contents of organic impurity, water content and inorganic impurity in impurity A were 0.90%, 1.24% and 0.25%, respectively. The content of impurity A was determined to be 97.6% by mass balance method, which was basically consistent with the result of nuclear magnetic quantitative method (97.1%). Under the condition of 25 °C, the area normalized purity of impurity A was 99.1% at 0, 3, 5 and 10 days, proving that the sample was stable at room temperature for 10 days. Finally the first batch of national standard substance of tazobactam impurity A was established successfully.
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The mammalian target of rapamycin (mTOR)-sterol regulatory element-binding proteins (SREBPs) signaling promotes lipogenesis. However, mTOR inhibitors also displayed a significant side effect of hyperlipidemia. Thus, it is essential to develop mTOR-specific inhibitors to inhibit lipogenesis. Here, we screened the endogenous inhibitors of mTOR, and identified that FKBP38 as a vital regulator of lipid metabolism. FKBP38 decreased the lipid content
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BACKGROUND@#The pathogenesis of osteosarcoma (OS) is still unclear, and it is still necessary to find new targets and drugs for anti-OS. This study aimed to investigate the role and mechanism of the anti-OS effects of miR-296-5p.@*METHODS@#We measured the expression of miR-296-5p in human OS cell lines and tissues. The effect of miR-296-5p and its target gene staphylococcal nuclease and tudor domain containing 1 on proliferation, migration, and invasion of human OS lines was examined. The Student's t test was used for statistical analysis.@*RESULTS@#We found that microRNA (miR)-296-5p was significantly downregulated in OS cell lines and tissues (control vs. OS, 1.802 ± 0.313 vs. 0.618 ± 0.235, t = 6.402, P < 0.01). Overexpression of miR-296-5p suppressed proliferation, migration, and invasion of OA cells. SND1 was identified as a target of miR-296-5p by bioinformatic analysis and dual-luciferase reporter assay. Overexpression of SND1 abrogated the effects induced by miR-296-5p upregulation (miRNA-296-5p vs. miRNA-296-5p + SND1, 0.294 ± 0.159 vs. 2.300 ± 0.277, t = 12.68, P = 0.003).@*CONCLUSION@#Our study indicates that miR-296-5p may function as a tumor suppressor by targeting SND1 in OS.
Subject(s)
Humans , Bone Neoplasms/genetics , Cell Line, Tumor , Cell Movement/genetics , Cell Proliferation/genetics , Endonucleases/genetics , Gene Expression Regulation, Neoplastic , Genes, Tumor Suppressor , MicroRNAs/genetics , Osteosarcoma/geneticsABSTRACT
With the in-depth study of related substances and the development of consistency evaluation of generic drugs, relative correction factors are gaining increasing attention. By analyzing the domestic and foreign literature on correction factors in recent years, this paper describes the correction factor component, the current measurement method and its application. The rules and key points of use of an impurity correction factor and its determination and application are described, and some problems in its determination and application are discussed, providing a reference and basis for the standardization of research on impurity correction factors in the future.
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OBJECTIVE:To optimize the p reparation technology of citronellol submicroemulsion. METHODS :The content of citronellol in Citronellol submicroemulsion was determined by HPLC. Citronellol submicroemulsion by high-speed shearing dispersion-high pressure homogenization method ,with centrifugation stability constant (ke) and particle size were used as evaluation indexes. Its formulation and preparation technology were optimized and validated. Drug-loading amount and encapsulation rate of the preparation were detected. RESULTS :The linear range of citronellol were 4-64 μg/mL(R 2=0.999 9). RSDs of precision ,stability(24 h)and reproducibility tests were all lower than 3%. The recoveries were 97.64%-101.97%(RSD= 2.28%,n=3),97.71%-99.50%(RSD=1.29%,n=3),96.87%-101.48%(RSD=2.86%,n=3). The optimal formulation included that total weight of soybean oil and medium chain triglycerides (1 ∶ 1,g/g)was 3.75 g,1.2% soybean phospholipid was 0.6 g, cholesterol was 0.06 g,citronellol was 1.25 g,0.6 % sodium oleate was 0.3 g,15-hydroxystearic acid polyethylene glycol ester was 0.75 g,poloxamer 188 was 0.75 g,water added to 50 mL. After prepared by optimal technology at 4 ℃ which contained shearing speed of 13 000 r/min,lasting for 5 min, primary emulsion was adjusted to pH 7 with dilute hydro- chloric acid ,and homogenized with 600 Bar high pressure for 1434412440@qq.com 5 min. The parameters of Citronellol submicroemulsion accor- ding to optimal formulation and technology contained mean particle size of (91.05±0.26)nm,PDI of (0.20±0.01), Zeta-potential of (-30.86±0.39)mV,average content of 649511230@qq.com citronellol(100.21±0.01)%,the drug-loading amount was (2.481 7 ± 0.000 7) mg/mL,the encapsulation rate was (99.27 ± 0.03)% . CONCLUSIONS :The optimal formulation and technology is stable and feasible.
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Objective:To investigate the protective effect of glycyrrhizic acid (GA) from tumor necrosis factor-α+actinomycetes ketone (TNF-α+CHX) induced apoptosis in rat small intestine crypt epithelial cell line (IEC-6) via AU rich element mRNA binding protein HuR mediated posttranscription of p21 and the potential mechanism. Method:The cultured IEC-6 cells were observed. The experiment was divided into blank group, GA (60 μmol·L-1) group, TNF-α+CHX group and GA+TNF-α+CHX group. Cytoplasmic and nuclear HuR were measured by Western blot. The interaction of HuR and p21 mRNA was detected by biotin pull down and RNA IP. Luciferase activity was measured after transfection with construct with p21 3'-UTR cloned into downstream of luciferase reporter. Cell apoptosis was detected by real-time dynamic cell analyzer, p21 and cysteine proteinas-3 precursor protein(proCaspase-3) association was analysised by CO-IP. Result:After GA treatment for 48 h, cytoplasmic HuR protein expression increased(P<0.05),the binding between HuR and p21 mRNA expression up regulated(P<0.05), luciferase activity increased(P<0.01), and p21 mRNA and protein expression also increased(P<0.05), while these results were abolished by HuR silencing with siRNA. GA enhanced p21 and procaspase3 interaction(P<0.05), and attenuated TNF-α+CHX induced apoptosis in IEC-6 cells. Conclusion:GA protected IEC-6 cells from TNF-α/CHX induced apoptosis via HuR mediated p21 posttranscription, which due to GA enhanced HuR binding to endogenous and recombinant p21 mRNA and increased p21 interaction with proCaspase3.
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Objective:To explore the significance of empathy and executive function indexes in the diagnosis and classification of autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD).Methods:According to DSM-Ⅴ diagnostic criteria, 33 children with ASD, 30 children with ADHD and 39 typical development (TD) children and adolescents were enrolled as the research subjects.The empathy and executive function characteristics were compared and analyzed in the subjects.Based on empathy and executive function indicators, the three groups of subjects were diagnosed and classified by machine learning method.Results:The total score of Griffith empathy measure parent ratings(GEM-PR)(ASD: (0.67±0.64), ADHD: (1.00±0.79), TD: (0.98±0.73)) and each factor score ( F=3.595-10.363, all P<0.05) and the total score of behavior rating inventory of executive function(BRIEF)(ASD: (62.79±7.45), ADHD: (59.47±8.77), TD: (49.08±7.91)) and each factor score of the three groups were different ( F=6.557-33.205, all P<0.01). Among them, the scores of empathy and executive function in ASD and ADHD groups were generally higher than those in TD children (all P<0.05). When combined with BRIEF scale and GEM scale, the classification accuracy of the three groups reached 62.75%. Conclusion:Both ASD and ADHD children have damages in empathy and executive function.Combining empathy and executive function indexes are more helpful for diagnosis and classification than single index.
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ObjectiveTo investigate the drug-resistant gene polymorphisms in Plasmodium falciparum imported from Equatorial Guinea to Shandong Province. MethodsFrom 2015 to 2016, blood samples were collected from imported P. falciparum malaria patients returning from Equatorial Guinea to Shandong Province, and genome DNA of the malaria parasite was extracted. The drug-resistant Pfcrt, Pfmdr1, Pfdhfr, Pfdhps, and K13 genes of P. falciparum were amplified using a PCR assay, followed by DNA sequencing, and the sequences were aligned. Results The target fragments of all 5 drug-resistant genes of P. falciparum were successfully amplified and sequenced. There were 72.8%, 18.6%, and 8.6% of P. falciparum parasites carrying the wild-, mutant-, and mixed-type Pfcrt gene, respectively, and all mutant haplotypes were CVIET (the underline indicates the mutation site). There were 20.0%, 61.4% and 18.6% of P. falciparum parasites carrying the wild-, mutant-, and mixed-type Pfmdr1 gene, respectively, and the mutant haplotypes mainly included YF and NF (the underlines indicate the mutation sites). There were 1.4%, 98.6%, and 0 of P. falciparum parasites carrying the wild-, mutant-, and mixed-type Pfdhfr gene, respectively, and AIRNI was the predominant mutant haplotype (the underline indicates the mutation site). There were 1.4%, 94.3%, and 4.3% of P. falciparum parasites carrying the wild-, mutant-, and mixed-type Pfdhps gene, respectively, and SGKAA was the predominant mutant haplotype (the underline indicates the mutation site). The complete drug-resistant IRNGE genotype consisted of 8.6% of the Pfdhfr and Pfdhps genes, and the K13 gene A578S mutation occurred in 1.4% of the parasite samples. Conclusions There are mutations in the Pfcrt, Pfmdr1, Pfdhfr, Pfdhps, and K13 genes of P. falciparum imported from Equatorial Guinea to Shandong Province, with a low frequency in the Pfcrt gene mutation and a high frequency in the Pfmdr1, Pfdhfr, and Pfdhps gene mutations, and the K13 gene A578S mutation is detected in the parasite samples.
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OBJECTIVE:To establish the fingerprint of crude/vinegar-processed Corydalis yanhusuo decoction pieces and their dispensing granules,and to determine the contents of five alkaloids (protopine,tetrahydropalmatine,corydaline,berberine hydrochloride,palmatine hydrochloride ). METHODS :HPLC method was adopted. The determination was performed on Agilent TC-C18 column with mobile phase consisted of 0.1% phosphoric acid solution-methanol (gradient elution )at the flow rate of 1.0 mL/min. The detection wavelength was set at 280 nm,and the column temperature was 30 ℃. The sample size was 10 μL. Using palmatine hydrochloride as reference , Similarity Evaluation System of TCM Chromatographic Fingerprint (2012 edition) was used to establish the fingerprint of 11 059) batches of C. yanhusuo decoction pieces ,7 batches of crude . yanhusuo dispensing granules , 12 batches of vinegar- processed C. yanhusuo decoction pieces and 11 batches of vinegar-processed C. yanhusuo dispensing granules. The same HPLC method was adopted to determine the contents of protopine, tetrahydropalmatine, corydaline, berberine hydrochloride and palmatine hydrochloride in 41 batches of crude/ vinegar-processed C. yanhusuo decoction pieces and their dispensing granules. RESULTS :There were 12 and 20 common peaks for crude C. yanhusuo decoction pieces and its dispensing granules ,and 14 and 16 common peaks for vinegar-processed C. yanhusuo decoction pieces and its dispensing granules. The similarity of each batch of same type were 0.529-0.981,0.342-0.985, 0.711-0.999,0.437-0.998,respectively. The linear range of protopine ,tetrahydropalmatine,corydaline,berberine hydrochloride and palmatine hydrochloride were 1.9-38.0,2.0-40.0,2.2-44.0,2.6-52.0,2.3-46.0 μg/mL(R2>0.999 0). The recoveries were 100.12%-100.98%(RSD=1.05%-1.90%,n=9). RSDs of precision ,reproducibility,stability(24 h)and durability tests were all lower than 2.0%. The average contents of five alkaloids in different batches of crude/vinegar-processed C. yanhusuo decoction pieces and its dispensing granules were 0.24-0.46,0.37-0.82,0.24-0.58,0.07-0.75,0.24-0.76 mg/g. RSDs were 12.27%-147.48%. CONCLUSIONS:The fingerprint of crude/vinegar-processed C. yanhusuo decoction pieces and its dispensing granules is established successfully. The similarities of fingerprint are different before and after processing with vinegar ,and the contents of five alkaloids in C. yanhusuo decoction pieces and its dispensing granules are greatly different.
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Congenital myasthenic syndrome (CMS) is a group of clinical and genetic heterogeneous diseases caused by impaired neuromuscular transmission due to genetic defects. At present, it has been reported that more than 30 genes can cause CMS. All CMS subtypes have the clinical features of fatigue and muscle weakness, but age of onset, symptoms, and treatment response vary with the molecular mechanisms underlying genetic defects. Pharmacotherapy and symptomatic/supportive treatment are the main methods for the treatment of CMS, and antisense oligonucleotide technology has been proven to be beneficial for CHRNA 1-related CMS in animals. Since CMS is a group of increasingly recognized clinical and genetic heterogeneous diseases, an understanding of the latest knowledge and research advances in its clinical features, genetic research, and treatment helps to give early diagnosis and treatment as well as gain a deeper understanding of the pathogenesis of CMS, so as to make new breakthroughs in the treatment of CMS.
Subject(s)
Animals , Humans , Mutation , Myasthenic Syndromes, Congenital , TherapeuticsABSTRACT
OBJECTIVE@#To conclude of the technical notes of percutaneous transforaminal endoscope-assisted lumbar interbody fusion (PT-Endo-LIF), and to investigate its safety and efficacy for treatment of degenerative lumbar disease.@*METHODS@#Twenty-four patients were treated by PT-Endo-LIF combined with posterior percutaneous pedicle screws fixation from October 2017 to April 2018. There were 16 males and 8 females, ranging in age from 39 to 72 years old, with a mean of (59.6±9.5) years old. There were 15 cases diagnosed with lumbar intervertebral disc herniation combined with degenerative disc, the other 9 cases were diagnosed as low level lumbar spondylolistheses w/o segmental instability. Single segmental fusion was performed for 22 cases(one for L₂,₃, 3 for L₃,₄ and 18 for L₄,₅) and 2 segmental fusion was performed for the other 2 cases (both for L₃,₄ and L₄,₅). PT-Endo-LIF was performed under local anesthesia with conscious sedation, followed by decompression through endoscopic technics. After that, end-plate preparation and autogenous bone and expandable cage implantation were performed. Finally, percutaneous screws and rod instrumentation were used. The visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate the clinical efficacy. The operation time, intraoperative bleeding volume, intraoperative and postoperative complications were recorded. All patients underwent X-ray, CT plain scan, three-dimensional reconstruction and MRI examination to evaluate the stability of the implants and fusion rate before 3 days and 1, 3, 6, 12 and 18 months after operation.@*RESULTS@#All patients were followed up, and the duration ranged from 12 to 18 months. The operation time of single-segment fusion was (192.3±22.7) min, and that of double-segment fusion was (272.5±24.7) min. The estimated intraoperative bleeding volume was less than 50 ml per segment, and no blood transfusion was performed in all patients. The VAS improved from preoperative 7.4±1.1 to postoperative 2.3±0.8 (=-19.65, <0.000 5). The ODI improved from preoperative (41.2±3.3)% to the final follow-up (12.3±2.5)%(=-35.76, <0.000 5). Postoperative complications occurred in 4 cases, and contralateral radicular symptoms occurred in 2 cases. After contralateral foraminoscopic decompression, the symptoms were completely alleviated. One case had neurological symptoms related to percutaneous screw placement, and the symptoms were alleviated after removal of the lateral screw rod internal fixation. The other cases had surgical incision infection and improved after debridement and suture. At the latest follow-up, no displacement or loosening of the fusion cage and screw rod system occurred in all patients, and 14 cases showed signs of fusion.@*CONCLUSIONS@#PT-Endo-LIF is a minimal invasive, safe and efficient surgical procedure for treatment of degenerative lumbar disease. Nevertheless, the long-term results still need to be confirmed by a multi-center and lagre sample follow-up study.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Follow-Up Studies , Intervertebral Disc Degeneration , Lumbar Vertebrae , Neuroendoscopy , Spinal Fusion , Treatment OutcomeABSTRACT
OBJECTIVE@#To investigate the correlation of IgG subclasses with blood cell parameters in the patients with autoimmune hemolytic anemia (AIHA).@*METHODS@#Thirty-four patients with AIHA (except C3d types) of immune complex type (IgG+C3d) and single IgG type, including 26 cases of primary AIHA and 8 cases of secondary AIHA from December 2010 to August 2016 in our hospital were selected and enrolled in AIHA group; 30 healthy persons were selected and enrolled in healthy control group. The levels of IgG subclasses in blood plasma were detected by double antibody sandwich ELISA in healthy persons and AIHA patients, at the same time. The levels of IgG subclasses in of RBC diffuse fluid were detected as well. The relation of IgG subclass level with some parameters of blood cells was analyzed in the hight of partial parameters of blood cells in patients. The independent sample test was used for comparison of data in 2 groups, the Spearman method was used for correlation analyziz.@*RESULTS@#The average value of IgG1-4 in AIHA group was higher than that in healthy control group, there was statisticad difference between 2 groups (IgG1: t=-4.88, P0.01) the ratio pf IgG1, IgG2 and IgG3 all had the statistical differences (IgG1: t=4.03, P<0.01; IgG2: t=7.38, P<0.01; IgG3: t=3.03, P<0.01). The spearmen analysis of corrclation of IgG subclass in blood plasma of patients with partial parameters of blood cells showed that the IgG4 positivety correlated with Hb level, the RBC count and HCT (Hb: r=0.358, P<0.05; RBC: r=0.426, P<0.05; HCT: r=0.363, P<0.05); the IgG1 and IgG2 negatively correlated with WBC count (IgG1: r=0.437, P<0.05; IgG2: r=-0.487, P<0.01); the IgG2 negatively correlated with count (r=-0.436, P<0.05). The comparison of IgG subclass ratio in plasma and RBC diffuse fluid of patients showed that in addition to IgG2 (t=1.544, P>0.05), the rest IgG1, 3 and 4 all had statistical differences (IgG1: t=6.528, P<0.01; IgG3: t=-9.488, P<0.05; IgG4: t=-9.434, P<0.05).@*CONCLUSIONS@#The AIHA relates with IgG1 and IgG3, the detection of IgG subclasses may have a certain significance for studying the diagnosis, treatment and pothogenesis of AIHA.
Subject(s)
Humans , Anemia, Hemolytic, Autoimmune , Blood Cells , Enzyme-Linked Immunosorbent Assay , Erythrocyte Count , Immunoglobulin GABSTRACT
T cells and T cell receptors (TCRs) play pivotal roles in adaptive immune responses against tumors. The development of next-generation sequencing technologies has enabled the analysis of the TCRβ repertoire usage. Given the scarce investigations on the TCR repertoire in lung cancer tissues, in this study, we analyzed TCRβ repertoires in lung cancer tissues and the matched distant non-tumor lung tissues (normal lung tissues) from 15 lung cancer patients. Based on our results, the general distribution of T cell clones was similar between cancer tissues and normal lung tissues; however, the proportion of highly expanded clones was significantly higher in normal lung tissues than in cancer tissues (0.021% ± 0.002% vs. 0.016% ± 0.001%, P = 0.0054, Wilcoxon signed rank test). In addition, a significantly higher TCR diversity was observed in cancer tissues than in normal lung tissues (431.37 ± 305.96 vs. 166.20 ± 101.58, P = 0.0075, Mann-Whitney U test). Moreover, younger patients had a significantly higher TCR diversity than older patients (640.7 ± 295.3 vs. 291.8 ± 233.6, P = 0.036, Mann-Whitney U test), and the higher TCR diversity in tumors was significantly associated with worse cancer outcomes. Thus, we provided a comprehensive comparison of the TCR repertoires between cancer tissues and matched normal lung tissues and demonstrated the presence of distinct T cell immune microenvironments in lung cancer patients.