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Objective:To investigate the value of serum CD64, heparin binding protein (HBP) and procalcitonin (PCT) in early diagnosis of septic shock and its prognostic value.Methods:The clinical data of 40 children with sepsis (sepsis group) and 40 children with septic shock (septic shock group) in Children′s Hospital of Xuzhou Medical University from January 2018 to November 2021 were retrospectively analyzed. PCT was detected by chemiluminescence, HBP was detected by enzyme-linked immunosorbent assay, and CD 64 was detected by flow cytometry. All children were followed up within 1 month after discharge, and the occurrence of poor prognosis (including multiple organ failure and death) was recorded. The receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of serum CD 64, HBP and PCT for septic shock. Multivariate Logistic regression was used to analyze the independent risk factors for poor prognosis in children with septic shock. Results:The serum CD 64, HBP and PCT in septic shock group were significantly higher than those in sepsis group: 0.667 ± 0.120 vs. 0.501 ± 0.115, (116.46 ± 11.41) μg/L vs. (87.34 ± 23.49) μg/L and (11.41 ± 1.25) μg/L vs. (9.29 ± 1.31) μg/L respectively, and there were statistical differences ( P<0.05). ROC curve analysis result showed that the area under curve (AUC) of serum CD 64, HBP and PCT for predicting septic shock were 0.837, 0.894 and 0.880 respectively, and the optimal cut-off values were 0.586, 106.2 μg/L and 11.28 μg/L respectively; the AUC of serum CD 64, HBP and PCT combined detection for predicting septic shock was 0.914, with a sensitivity of 75.7%, specificity of 96.0%, and accuracy of 71.7%. According to the optimal cut-off values of serum CD 64, HBP and PCT, 40 children with septic shock were divided into high expression group and low expression group. The prognosis was good in 25 cases and bad in 15 cases. The incidence of poor prognosis in CD 64 high expression group, HBP high expression group and PCT high expression group was significantly higher than that in corresponding CD 64 low expression group, HBP low expression group and PCT low expression group: 56.52% (13/23) vs. 2/17, 10/17 vs. 21.74% (5/23) and 11/18 vs. 18.18% (4/22), and there was statistical difference ( P<0.01 or <0.05). Multivariate Logistics regression analysis result showed that serum CD64, HBP and PCT were independent risk factors for poor prognosis in children with septic shock ( OR = 0.818, 1.204 and 3.633; 95% CI 0.674 to 0.994, 1.022 to 1.419 and 1.090 to 12.108; P = 0.043, 0.026 and 0.036). Conclusions:The serum levels of CD 64, HBP and PCT in children with septic shock are significantly increased, which play an important role in the occurrence and development of septic shock, and which have predictive value for septic shock. The combined detection of the 3 indexes could be used to evaluate the prognosis, with a higher predictive value.
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Objective:To investigate the effect of slow intravenous infusion of low-dose mannitol on the hemodynamics of patients after cardiopulmonary bypass.Methods:Prospective, continuous inclusion of 62 patients after cardiac surgery under cardiopulmonary bypass. By random number method, they were divided into normal treatment group(group C) with 29 cases and mannitol treatment group(group M) with 33 cases. Group C was treated according to the postoperative routine treatment measures. On the basis of conventional treatment, group M received intravenous infusion of 20% mannitol injection 0.25 g/kg at 1、8、24 hours after operation, and the intravenous infusion time was 60 minutes each time. According to the hemodynamic changes during the two groups of treatment, the effect of slow intravenous infusion of low-dose mannitol on patients after cardiopulmonary bypass under cardiopulmonary bypass was analyzed.Results:In group M, CI and SVI were significantly increased after use of mannitol than before, with statistical significance( P<0.01). SVRI showed a downward trend, and the changes were statistically significant after use of mannitol( P<0.01). PAWP increased first and then decreased after operation, and the changes were statistically significant after mannitol use than before( P<0.05). RAP and MPAP had no significant changes after the first use of mannitol, but the changes after the latter two use mannitol were statistically significant than before( P<0.05). Repeated-measurement data analysis of variance was performed on the hemodynamic parameters of each group, and the results were all P<0.01. Conclusion:Postoperative slow intravenous infusion of low-dose mannitol optimizes hemodynamic status, increases stroke volume, reduces cardiac preload, improves systemic and pulmonary circulation resistance, and promotes recovery of postoperative cardiopulmonary function.
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OBJECTIVES@#The plateau environment is characterized by low oxygen partial pressure, leading to the reduction of oxygen carrying capacity in alveoli and the reduction of available oxygen in tissues, and thus causing tissue damage. Cilostazol is a phosphodiesterase III inhibitor that has been reported to increase the oxygen release of hemoglobin (Hb) in tissues. This study aims to explore the anti-hypoxic activity of cilostazol and its anti-hypoxic effect.@*METHODS@#A total of 40 male BALB/C mice were randomly divided into a low-dose cilostazol (6.5 mg/kg) group, a medium-dose (13 mg/kg) group, a high-dose (26 mg/kg) group, and a control group. The atmospheric airtight hypoxia experiment was used to investigate the anti-hypoxic activity of cilostazol and to screen the optimal dosage. Twenty-four male Wistar rats were randomly divided into a normoxia control group, a hypoxia model group, an acetazolamide (22.33 mg/kg) group, and a cilostazol (9 mg/kg) group. After 3 days of hypoxia in the 4 010 m high altitude, blood from the abdominal aorta was collected to determine blood gas indicators, the levels of IL-6 and TNF-α in plasma were determined by enzyme-linked immunosorbent assay, and the levels of malondialdehyde (MDA), superoxide dismutase (SOD), and glutataione (GSH) were measured. The degree of pathological damage for rat tissues was observed with HE staining.@*RESULTS@#Compared with the control group, the survival time of mice in the low, medium, and high dose group of cilostazol was significantly prolonged, and the survival time of mice in the medium dose group was the longest, with an extension rate at 29.34%, so the medium dose was the best dose. Compared with the hypoxia model group, the P50 (oxygen partial pressure at Hb oxygen saturation of 50%) value of rats in the cilostazol group was significantly increased by 1.03%; Hb and Hct were significantly reduced by 8.46% and 8.43%, and the levels of IL-6 and TNF-α in plasma were reduced by 50.65% and 30.77%. The MDA contents in heart, brain, lung, liver, and kidney tissues were reduced by 37.12%, 29.55%, 25.00%, 39.34%, and 21.47%, respectively. The SOD activities were increased by 94.93%, 9.14%, 9.42%, 13.29%, and 20.80%, respectively. The GSH contents were increased by 95.24%, 28.62%, 28.57%, 20.80%, and 44.00%, respectively. The results of HE staining showed that compared with the hypoxia model group, cilostazol significantly improved the damage of heart, lung, and kidney tissues in rats after hypoxia.@*CONCLUSIONS@#Cilostazol can significantly improve the oxidative stress and inflammatory reaction caused by rapid altitude hypoxia, and it has a significant protective effect on tissue damage caused by hypoxia, suggesting that it has obvious anti-hypoxic activity.
Subject(s)
Altitude Sickness , Animals , Cilostazol/therapeutic use , Hypoxia/drug therapy , Interleukin-6/pharmacology , Male , Mice , Mice, Inbred BALB C , Oxidative Stress , Oxygen , Rats , Rats, Wistar , Superoxide Dismutase/metabolism , Tumor Necrosis Factor-alpha/pharmacologyABSTRACT
Metformin is the most common first-line oral hypoglycemic drug ，but there are large individual differences in pharmacokinetic parameters and pharmacodynamics during clinical use. The dosage of some patients should be adjusted to achieve satisfactory therapeutic effect. Pharmacokinetic parameters of metformin are affected by many factors ，including respects of transporter gene polymorphism ，drug interaction ，intestinal flora ，plateau hypoxia and physiological function and so on. In order to guide the clinical individualized use of metformin ，this study reviews the research progress on the influencing factors of metformin pharmacokinetics.
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Objective:To construct tissue engineering small-caliber anti-calcifiction blood vessels with micron slow-release magnesium chloride.Methods:After decellularizing sheep carotid artery by combining Triton X-100+ deoxycholate sodium salt and DNA/RNA ribozyme, tissue engineering small-caliber vascular scaffold was made, HE staining of elastic fiber and collagen were carried out at the same time, and scanning electron microscope was used to observe the decellularization and the performance of vascular stent. The microemulsion anti-calcification slow-release microsphere particles loaded with magnesium chloride(MgCl 2) were prepared by double emulsion method, ultrasonic breaking, high speed stirring and evaporation method. Detected the particle size, encapsulation rate, drug loading(rate) of the sustained-release microspheres and measured the sustained-release curve. After the artificial small-caliber blood vessel was cross-linked with carbodiimide hydrochloride/succinic imine(EDC/NHS), freeze-drying technology was used to combine the micron slow-release microspheres loaded with MgCl 2 with the vascular scaffold. Observed the combination under the electron microscope, and tested the thickness and tensile strength of the specimen blood vessels. Results:After decellularization, the sheep carotid artery could remove all kinds of cells and maintain the original performance of the scaffold. The averaged particle size of micro-calcium-resistant slow-release microspheres loaded with MgCl 2 was(1.31±0.02)μm, which was relatively uniform. The encapsulation rate of microsphere particles was 82.79%, and the drug loading(rate) was 2.98%, which existed within 25 days slow release, the release rate reached 81.08%. The slow-release microsphere particles loaded with chlorinase could be effectively and tightly combined with small-caliber tissue engineering blood vessels. Conclusion:The slow-release microsphere particles loaded with magnesium chloride made of PLGA as a carrier have the effect of slow-release magnesium ions. It laid the foundation for the construction of anti-calcification tissue engineering small-caliber blood vessels.
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To analyze the lesion distribution situations and relationship of lesions detected by gastroscopy and colonoscopy in asymptomatic population in Beijing. Data of 1 663 patients who received gastroscopy and colonoscopy in the physical examination center of Peking Union Medical College Hospital and Beijing Hospital between January 2016 and December 2018 were analyzed retrospectively. Statistical analysis was conducted on the detection rate and relationship of different lesions based on the information of gender and ages. Gastroscopy data showed that chronic non-atrophic gastritis and chronic atrophic gastritis accounted for 1 240 (74.6%)and 423 (25.4%)cases respectively. Chronic atrophic gastritis was more common in population aged over 40. Other common diseases included erosions of gastric body and/or antrum, fundic gland polyps, reflux esophagitis, duodenitis, bile regurgitation and so on. Upper gastrointestinal tumors including esophagus cancer and gastric cancer were both early lesions. Colonoscopy results showed that colonic polyps were common lesions, among which there were 382 (23.0%)cases of colonic adenoma and 217 (13.0%)hyperplastic polyps. Incidence of colonic polyps increased with age. Colorectal cancer accounted for 0.7%. Colon diverticulum and melanosis coli were more common in population aged over 40. Colon adenoma was more common in male and melanosis coli was more common in female. The positive rate of HP was 32.2%. There was no positive relationship between HP infection and fundic gland polyps( P=0.329). There was no positive relationship between fundic gland polyps and colon adenomas as well as colorectal cancer( P=0.152, P=0.616). Gastroscopy and colonoscopy play important roles in different kinds of digestive diseases, especially in the early detection of tumors. More attention should be paid to the application of endoscopy in asymptomatic population.
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Objective:To explore the level of expression, clinical significance of receptor-interacting protein kinase-3(RIPK3) in the bronchoalveolar alveolar lavage fluid (BALF) of mycoplasma pneumoniae pneumonia(MPP) in children and the relationship between RIPK3 and various cytokines.Methods:Using a case-control study, 30 refractory mycoplasma pneumoniae pneumonia children treated in Children′s Hospital of Xuzhou Medical University from February 2019 to February 2021 were selected as the MRPP group, 35 mycoplasma pneumoniae pneumonia children as the RPP group.Meanwhile, 20 sex- and age-matched hospitalized children with bronchial foreign body were selected as the case-control group.In all subjects, protein levels of RIPK3 and mixed lineage kinase domain-like protein(MLKL) were determined by Western Blot.Meanwhile, levels of IL-6, IL-1β and TNF-α were determined by enzyme linked immuno sorbent assay(ELISA). Compare levels of different parameters between the three groups and analyze the correlation between levels of RIPK3 and MLKL, L-6, IL-1β, TNF-α in the BALF of MPP children using Spearman rank correlation analysis.Results:There were statistically significant differences in the levels of RIPK3, MLKL, IL-6, IL-1β and TNF-α in BALF between RMPP group, MPP group and control group (all P<0.001). Pairwise comparisons also showed statistical differences, and the RMPP group was the highest, followed by MPP group, and the control group was the lowest.The level of RIPK3 in BALF of MPP children was positively correlated with MLKL, IL-6, IL-1β and TNF-α ( r=0.711, 0.676, 0.725, 0.651, P<0.001). Linear regression analysis shows: MLKL=0.432×RIPK3. Conclusion:RIPK3 may be involved in the occurrence and development of MPP in children, and is closely related to cytokines such as IL-6, IL-1β and TNF-α.
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Objective:To evaluate the outcome of endoscopic submucosal dissection (ESD) of colorectal tumors, and to analyze the factors affecting the therapeutic efficacy of ESD.Methods:Clinical data of patients with colorectal tumors who were treated with ESD in Department of Gastroenterology in Beijing Hospital from November 2016 to December 2019 were reviewed. A total of 82 patients with pathologically confirmed colorectal adenoma or carcinoma of diameter ≥20 mm were included. The clinical features, ESD and pathological outcomes of the patients were analyzed.Results:All 82 lesions were single, with the mean diameter of 29.72±10.74 mm. Lesions were divided into the laterally spreading tumors (LST), mainly located in the ascending colon and ileocecal region (47.8%, 22 / 46) and the protruding colorectal tumors, mainly located in the left colon, 52.8% (19 / 36) of which were located in the sigmoid colon. The overall resection rate was 81.7%(67/82) and the curative resection rate was 72.0%(59/82). The incidences of bleeding and perforation were 2.4%(2/82) and 1.2%(1/82), respectively. The curative resection rates [91.4%(32/35), 63.6%(7/11) and 55.6%(20/36), P=0.003] and surgical operation rates [8.6%(3/35), 18.2%(2/11) and 36.1%(13/36), P=0.010] of LST-G, LST-NG and protruding colorectal tumors were significantly different. Multivariate regression analysis showed that protruding colorectal tumor ( OR=3.396, 95% CI: 1.014-11.374, P=0.047) and submucosal severe fibrosis (F2 type) ( OR=5.508, 95% CI: 2.216-13.692, P=0.001) were independent risk factors for non-curative ESD resection of colorectal tumors. Conclusion:ESD is effective and safe for colorectal tumors of diameter ≥ 20 mm. However, there are some differences in the rate of submucosal invasion and treatment outcome among different types of lesions. The risk factors for non-curative resection are protruding tumors and severe submucosal fibrosis.
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Objective:To investigate the predicting value of serum miR-195 and miR-599 for the outcome of patients with acute ischemic stroke (AIS).Methods:Patients with AIS admitted to Danzhou People's Hospital from January 2018 to July 2020 were enrolled prospectively. The modified Rankin Scale was used to evaluate the outcome of patients at 14 d after onset or when they were discharged from the hospital. A score of 0-2 was defined as a good outcome and a score of >2 were defined as a poor outcome. Multivariate logistic regression analysis was used to determine the independent risk factors for poor outcome of patients with AIS. Receiver operating characteristic (ROC) curve analysis was used to determine the predictive value of serum miR-195 and miR-599 for the poor outcome of patients with AIS. Results:A total of 158 patients with AIS were enrolled. Their age was (65.80±12.36) years old, 105 were males (66.46); 95 patients (60.1%) had a good outcome, and 63 patients (39.9%) had a poor outcome. The age, total cholesterol, triglycerides, low-density lipoprotein cholesterol, baseline National Institutes of Health Stroke Scale (NIHSS) score, serum miR-195 and miR-599 levels in the poor outcome group were significantly higher than those of the good outcome group ( P<0.05). Multivariate logistic regression analysis showed that age (odds ratio [ OR] 1.984, 95% confidence interval [ CI] 1.315-3.617; P=0.036), low-density lipoprotein cholesterol ( OR 2.108, 95% CI 1.406-4.103; P=0.013), baseline NIHSS score ( OR 2.584, 95% CI 1.675-4.505; P=0.005), serum miR-195 ( OR 3.927, 95% CI 2.615-8.227; P<0.001) and miR-599 ( OR 2.952, 95% CI 1.973-6.114; P<0.001) were the independent risk factors for the poor outcome of patients with AIS. ROC curve analysis showed that the area under the curve (0.938, 95% CI 0.882-0.997) of serum miR-195 combined with miR-599 for predicting poor outcome was significantly higher than that predicted alone, and its predictive sensitivity and specificity were 97.0% and 87.4% respectively. Conclusions:The higher levels of serum miR-195 and miR-599 are associated with the poor outcome of patients with AIS. The combination of the both had good predictive value for the poor outcome of patients with AIS.
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OBJECTIVE：To systematically evaluate the therapeutic efficacy and safety of Chinese patent medicine compound preparation combined with conventional therapy for psoriasis vulgaris ，and to provide evidence-based reference for clinical drug use. METHODS ：Retrieved from CNKI ，Wanfang database ，VIP，CBM，PubMed，the Cochrane Library and Web of Science ， RCTs about Chinese patent medicine compound preparation combined with conventional therapy versus conventional therapy in the treatment of psoriasis vulgaris were collected during the inception to Feb. 2020. After literature retrieval and data extraction ，the quality of the included studies was evaluated with risk bias assessment tool recommended by the Cochrane evaluation manual handbook 5.1. Bayesian network Meta-analysis was perfor med by using Stata 15.0 software，Addis 1.16.6 software and Markov Chain Monte Carlo method. RESULTS ：A total of 41 RCTs were included ，involving 4 122 patients. 5 kinds of interven- tion measures included Compound qingdai capsule ，Xiaoyin SF-010） granule， Keyin pill ，Yujin yinxie tablet and conventional therapy. Results of network Meta-analysis showed that in terms of improving the total effective rate ， compared with conventional therapy ，4 kinds of Chinese patent medicine compound preparations combined with conventional therapy could significantly improve the total effective rate （P＜0.05）；the results of network Meta-analysis were as follows ：Keyin pill combined with conventional therapy ＞Compound qingdai capsule combined with conventional therapy ＞Xiaoyin granule combined with conventional therapy ＞Yujin yinxie tablet combined with conventional therapy ＞conventional therapy. In terms of reducing psoriasis area and severity index （PASI）score after treatment ，compared with conventional therapy ，Keyin pill and Xiaoyin granule combined with conventional therapy could significantly reduce the PASI score （P＜0.05），while Compound qingdai capsule and Yujin yinxie tablet combined with conventional treatment had no significant difference （P＞0.05）；the results of network Meta-analysis showed that Xiaoyin granule combined with conventional therapy ＞Keyin pill combined with conventional therapy ＞ Compound qingdai capsule combined with conventional therapy ＞Yujin yinxie tablet combined with conventional therapy ＞ conventional therapy. In terms of reducing serum inflammatory factor level ，compared with conventional therapy ，Compound qingdai capsule and Xiaoyin granule combined with conventional therapy could significantly reduce the level of IL- 17（P＜0.05）， but Keyin pill and Yujin yinxie tablet combined with conventional therapy had no significant difference （P＞0.05）；the results of network Meta-analysis showed that Xiaoyin granule combined with conventional therapy ＞Compound qingdai capsule combined with conventional therapy ＞Yujin yinxie tablet combined with conventional therapy ＞Keyin pill combined with conventional therapy＞conventional therapy. In terms of safety ，there was no statistical significance in the incidence of ADR between 4 kinds of Chinese patent medicine combined with conventional therapy and conventional therapy （P＞0.05）；the results of network Meta-analysis showed that Compound qingdai capsule combined with conventional therapy ＞Xiaoyin granule combined with conventional therapy ＞Keyin pill combined with conventional therapy ＞conventional therapy ＞Yujin yinxie tablet combined with conventional therapy . CONCLUSIONS ：Compared with conventional therapy ，additional use of 4 kinds of Chinese patent medicine compound preparations can improve the curative effect of psoriasis vulgaris patients with blood heat syndrome ，and Keyin pill is the best ；Xiaoyin granule is the best in reducing the degree of skin lesions and serum inflammatory factors ；additional use of 4 kinds of Chinese patent medicine compound preparations show good safety ，and Compound qingdai capsule is the best.
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Objective:To investigate the predictive value of circulating miR-143 and miR-182 for the short-term clinical outcomes in patients with acute ischemic stroke (AIS).Methods:Patients with AIS admitted to Danzhou People's Hospital from January 2018 to June 2020 were included prospectively. The modified Rankin Scale was used to evaluate the short-term clinical outcome at 14 d after onset or at discharge. 0-2 was defined as good outcome, and >2 was defined as poor outcome. Multivariate logistic regression analysis was used to identify the independent risk factors for poor short-term clinical outcomes in patients with AIS. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of miR-143 and miR-182 for the short-term clinical outcomes in patients with AIS. Results:A total of 158 patients with AIS, aged 65.80±12.36 years, were enrolled, including 105 males (66.46%), 95 patients with good outcome (60.1%) and 63 with poor outcome (39.9%). The age, total cholesterol, triglyceride, low-density lipoprotein cholesterol, baseline National Institutes of Health Stroke Scale (NIHSS) score, serum miR-143 and miR-182 level in the poor outcome group were significantly higher than those in the good outcome group (all P<0.05). Multivariate logistic regression analysis showed that age (odds ratio [ OR] 1.984, 95% confidence interval [ CI] 1.315-3.617; P=0.036), low-density lipoprotein cholesterol ( OR 2.108, 95% CI 1.406-4.103; P=0.013), baseline NIHSS score ( OR 2.584, 95% CI 1.675-4.505; P=0.005), miR-143 ( OR 3.205, 95% CI 2.370-6.180; P<0.001) and miR-182 ( OR 2.802, 95% CI 1.905-5.516; P<0.001) were the independent risk factors for poor outcomes in patients with AIS. ROC curve analysis showed that the combined area under the curve of miR-143 and miR-182 to predict the poor outcome in patients with AIS was 0.935 (95% CI 0.873-0.992), the sensitivity and specificity were 96.5% and 87.0% respectively. Conclusions:The increase of serum miR-143 and miR-182 was closely associated with the poor short-term outcomes in patients with AIS. The combination of the two has a good predictive value for the poor short-term outcomes in patients with AIS.
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This study aimed to define the most consistent white matter microarchitecture pattern in Parkinson's disease (PD) reflected by fractional anisotropy (FA), addressing clinical profiles and methodology-related heterogeneity. Web-based publication databases were searched to conduct a meta-analysis of whole-brain diffusion tensor imaging studies comparing PD with healthy controls (HC) using the anisotropic effect size-signed differential mapping. A total of 808 patients with PD and 760 HC coming from 27 databases were finally included. Subgroup analyses were conducted considering heterogeneity with respect to medication status, disease stage, analysis methods, and the number of diffusion directions in acquisition. Compared with HC, patients with PD had decreased FA in the left middle cerebellar peduncle, corpus callosum (CC), left inferior fronto-occipital fasciculus, and right inferior longitudinal fasciculus. Most of the main results remained unchanged in subgroup meta-analyses of medicated patients, early stage patients, voxel-based analysis, and acquisition with 30 diffusion directions. The subgroup meta-analysis of medication-free patients showed FA decrease in the right olfactory cortex. The cerebellum and CC, associated with typical motor impairment, showed the most consistent FA decreases in PD. Medication status, analysis approaches, and the number of diffusion directions have an important impact on the findings, needing careful evaluation in future meta-analyses.
Subject(s)
Anisotropy , Brain/diagnostic imaging , Corpus Callosum , Diffusion Tensor Imaging , Humans , Parkinson Disease/diagnostic imaging , White Matter/diagnostic imagingABSTRACT
Bronchopulmonary dysplasia (BPD) is a common chronic respiratory complication in preterm infants without fully understand the mechanism or effective treatment, which could significantly affect the survival rate and prognosis of these infants. Studies have confirmed that epigenetic mechanisms, including histone modification, non-coding RNA and DNA methylation may play an essential role in the onset and development of BPD. And most related epigenetic changes are reversible, which might serve as a potential target for BPD treatment. Therefore, further studies on epigenetics will shed light on a better understanding of the pathogenesis, prevention, and treatment of BPD.
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Objective:To explore the correlation of Dermatophagoides pteronyssinus allergen components Ⅰ (Der p1 IgE) level and acute attack of childhood asthma.Methods:Using a case-control study, 52 asthmatic children treated in Children′s Hospital of Xuzhou Medical University from June to October in 2018 and June to October in 2019 were selected as the asthmatic group.In the same period, 52 healthy children with gender and age matched with asthma group were selected as control group.In addition, according to the grading standard of severity of asthma in children aged over 6 years, the asthma group was divided into mild moderate group ( n=33) and severe critical group ( n=19). The serum concentrations of Der p1 IgE were detected by enzyme-linked immunosorbent assay.The serum concentrations of Der p1 IgE in the two groups were compared.Logistic regression analysis was used to analyze the correlation between serum Der p1 IgE concentration and acute attack of asthma in children. Results:The Der p1 IgE concentration in asthmatic group was (409.63±51.50)×10 3 IU/L, which was significantly increased compared to the healthy case-control group(314.44±8.75)×10 3 IU/L.The difference was statistically significant ( t′=13.139, P<0.01). The Der p1 IgE concentrations in mild-moderate group and severe-critical group were (385.81±14.75)×10 3 IU/L and (451.00±65.45)×10 3 IU/L, respectively.The difference was statistically significant ( t′=4.279, P<0.01). Logistic regression result showed that peripheral serum Der p1 IgE level had a correlation with acute attack of childhood asthma (regression coefficien t=1.322, OR=3.596, 95% CI 2.874-8.957, P=0.003). Conclusion:The level of serum Der p1 IgE in children with acute exacerbation of asthma was higher than that of healthy children, suggesting that serum Der p1 IgE may be involved in the acute attack process of childhood asthma.
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Objective:To investigate the expressions of serum microRNA-24 (miR-24) and microRNA-29b (miR-29b) in elderly patients with acute ischemic stroke (AIS) and their neural function prognostic value.Methods:A prospective study was conducted. 170 elderly patients with AIS admitted to department of neurology of Danzhou People's Hospital from January 1st, 2017 to March 31st, 2019 were enrolled. According to modified Rankin scale (mRS) score, the patients were divided into good neural function prognosis group (mRS score ≤ 2, n = 105) and poor neural function prognosis group (mRS score > 2, n = 65). According to National Institutes of Health stroke scale (NIHSS) score, the patients were divided into mild group (NIHSS score < 5, n = 50), moderate group (NIHSS score 5-20, n = 76) and severe group (NIHSS score > 20, n = 44). Sixty-five healthy volunteers in the same period were enrolled as the control group. The expressions of serum miR-24 and miR-29b were determined by real-time fluorescent quantitative reverse transcription-polymerase chain reaction (RT-qPCR). Receiver operating characteristic (ROC) curve was plotted to analyze the value of serum expressions of miR-24 and miR-29b for predicting the poor neural function prognosis of elderly patients with AIS. Pearson correlation was used to analyze the correlation between the expressions of serum miR-24, miR-29b and NIHSS, mRS scores in elderly patients with AIS. Results:The expressions of serum miR-24 and miR-29b in the AIS group were significantly lower than those in the healthy control group [miR-24 (2 -ΔΔCt): 0.64±0.17 vs. 2.18±0.85, miR-29b (2 -ΔΔCt): 0.72±0.21 vs. 3.05±0.96, both P < 0.01]. The expressions of serum miR-24 and miR-29b in the poor neural function prognosis group were significantly lower than those in the good neural function prognosis group [miR-24 (2 -ΔΔCt): 0.20±0.05 vs. 1.16±0.48, miR-29b (2 -ΔΔCt): 0.18±0.03 vs. 1.41±0.56, both P < 0.01]. The expressions of serum miR-24 and miR-29b in the severe group were significantly lower than those in the mild and moderate groups [miR-24 (2 -ΔΔCt): 0.13±0.02 vs. 1.30±0.51, 0.56±0.14; miR-29b (2 -ΔΔCt): 0.09±0.01 vs. 1.52±0.60, 0.62±0.13; all P < 0.01], and they were significantly lower in the moderate group than those in the mild group (all P < 0.01). ROC curve analysis showed that the optimal cut-off values of serum miR-24 and miR-29b expressions for predicting poor neural function prognosis in elderly AIS patients were 0.53 and 0.48, respectively. The area under ROC curve (AUC) of the two combined prognoses was 0.920 [95% confidence interval (95% CI) was 0.861-0.982], and it was significantly higher than that of miR-24 (AUC was 0.802, 95% CI was 0.742-0.860) or miR-29b (AUC was 0.835, 95% CI was 0.778-0.890) alone ( Z values were 6.513 and 4.902, respectively, both P < 0.05), with sensitivity and specificity of 92.0% and 85.7%. Pearson correlation analysis showed that the expressions of serum miR-24 and miR-29b were negatively correlated with NIHSS score ( r values were -0.758 and -0.794, respectively) and mRS score ( r values were -0.817 and -0.860, respectively) in elderly AIS patients (all P < 0.01). Conclusion:The down-regulated expressions of serum miR-24 and miR-29b are correlated with the severity degree of neurological impairment and neural function prognosis of elderly AIS patients, and the two combined have certain value for predicting the neural function prognosis of elderly AIS patients.
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Objective:To investigate the effects of different concentrations of hydrogen peroxide (H 2O 2) on the expression of histone deacetylase-2(HDAC-2) and mitogen activated protein kinases phosphatases-1(MKP-1) in A549 cells. Methods:The experimental models of A549 cells were established by intervening of different concentrations of H 2O 2(0, 100, 200, 400, 600, 800 μmol/L)for 2 h, 4 h, 8 h, 12 h and 24 h, respectively.The survival rate of A549 cells was detected by thiazolyl blue(MTT) assay, and the apoptosis of A549 cells was tested by lactic dehydrogenase(LDH) assay.The expression of HDAC-2 and MKP-1 protein was detected by Western blot. Results:(1)MTT results showed that compared with the control group (H 2O 2 was 0 μmol/L), the survival rate of A549 cells was decreased with the increase of H 2O 2 concentration at 2 h, 4 h, 8 h, 12 h, 24 h and 48 h. (2)LDH results showed that, compared with the control group, the inhibition rate of A549 cells increased with the increase of H 2O 2 concentration at 2 h, 4 h, 8 h, 12 h, 24 h and 48 h. (3)The expression of HDAC-2 protein decreased ( F=14.588, P<0.01), and the expression of MKP-1 protein increased ( F=64.297, P<0.01) in a concentration-dependent manner with the increase of H 2O 2 concentration at 12 h after H 2O 2 treatment. Conclusions:H 2O 2 participates in oxidative stress injury of lung cells by regulating the expression of HDAC-2 and MKP-1.
ABSTRACT
The aim of this study was to investigate the clinical characteristics of neonates born to SARS-CoV-2 infected mothers and increase the current knowledge on the perinatal consequences of COVID-19. Nineteen neonates were admitted to Tongji Hospital from January 31 to February 29, 2020. Their mothers were clinically diagnosed or laboratory-confirmed with COVID-19. We prospectively collected and analyzed data of mothers and infants. There are 19 neonates included in the research. Among them, 10 mothers were confirmed COVID-19 by positive SARS-CoV-2 RT-PCR in throat swab, and 9 mothers were clinically diagnosed with COVID-19. Delivery occurred in an isolation room and neonates were immediately separated from the mothers and isolated for at least 14 days. No fetal distress was found. Gestational age of the neonates was 38.6 ± 1.5 weeks, and average birth weight was 3293 ± 425 g. SARS-CoV-2 RT-PCR in throat swab, urine, and feces of all neonates were negative. SARS-CoV-2 RT-PCR in breast milk and amniotic fluid was negative too. None of the neonates developed clinical, radiologic, hematologic, or biochemical evidence of COVID-19. No vertical transmission of SARS-CoV-2 and no perinatal complications in the third trimester were found in our study. The delivery should occur in isolation and neonates should be separated from the infected mothers and care givers.
Subject(s)
Adult , Betacoronavirus , Coronavirus Infections , Diagnostic Imaging , Female , Humans , Infant, Newborn , Infectious Disease Transmission, Vertical , Mothers , Pandemics , Pneumonia, Viral , Diagnostic Imaging , Pregnancy , Prospective Studies , Tomography, X-Ray ComputedABSTRACT
OBJECTIVES@#To explore the prescribing habits of doctors, and to provide basis for rational use of antibiotics in clinical practice via investigating and analyzing the applications of antibiotics in treatment of coronavirus disease 2019 (COVID-19) in the designated hospital.@*METHODS@#Specification, quantity, amount, defined daily dose system (DDDs), defined daily dose consumption (DDDc), antibiotics use density (AUD), composition, frequency of use, combined use of antibacterial drugs used in the hospital were analyzed between Feb. 2020 and Mar. 2020.@*RESULTS@#A total of 25 antibiotic drugs in 12 categories were used. The total cost for antibiotic drugs was 1 million 238 thousand yuan, in which quinolone accounts for 48%, the third generation cephalosporin/lactamase inhibitors accounts for 15.86%, antifungals accounts for 14.17%, oxazolidone accounts for 13.46%, and carbapenms account for 12.73%. The top three drugs of DDDs and AUD were moxifloxacin hydrochloride tablets, moxifloxacin hydrochloride and sodium chloride injection, cefoperazone sodium and sulbactam sodium for injection. The proportion of patients who had been used more than two kinds of antibiotics was 22.36%.@*CONCLUSIONS@#Broad-spectrum, high-potency antibiotics are used at the beginning of COVID-19 treatment. The varieties of antibiotics meet the requirements of the management of antibiotics, and the utilization rate of antibiotics and the cost proportion of antibiotics in COVID-19 patients are within a reasonable range.In the future, for the treatment of COVID-19, we should continue to summarize the experience, improve the strategies, and rationally apply antibiotics on the basis of guidelines.
Subject(s)
Anti-Bacterial Agents , Classification , Therapeutic Uses , Betacoronavirus , Coronavirus Infections , Drug Therapy , Humans , Pandemics , Pneumonia, Viral , Drug TherapyABSTRACT
Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has spread around the world. However, approaches to distinguish COVID-19 from pneumonia caused by other pathogens have not yet been reported. We retrospectively analyzed the clinical data of 97 children with probable COVID-19. A total of 13 (13.4%) patients were confirmed positive for SARS-CoV-2 infection by nucleic acid RT-PCR testing, and 41 (42.3%) patients were found to be infected with other pathogens. Notably, no pathogen was detected in 43 (44.3%) patients. Among all patients, 25 (25.8%) had familial cluster exposure history, and 52 (53.6%) had one or more coexisting conditions. Fifteen (15.5%) patients were admitted or transferred to the PICU. In the 11 confirmed COVID-19 cases, 5 (45.5%) and 7 (63.6%) were positive for IgM and IgG against SARS-CoV-2, respectively. In 22 patients with suspected COVID-19, 1 (4.5%) was positive for IgG but negative for IgM. The most frequently detected pathogen was Mycoplasma pneumonia (29, 29.9%). One patient with confirmed COVID-19 died. Our results strongly indicated that the detection of asymptomatic COVID-19 or coexisting conditions must be strengthened in pediatric patients. These cases may be difficult to diagnose as COVID-19 unless etiologic analysis is conducted. A serologic test can be a useful adjunctive diagnostic tool in cases where SARS-CoV-2 infection is highly suspected but the nucleic acid test is negative.
Subject(s)
Age Factors , COVID-19/diagnosis , COVID-19 Testing , Child , Child, Preschool , China , Female , Hospitalization , Humans , Infant , Male , Retrospective Studies , SARS-CoV-2/isolation & purification , Symptom AssessmentABSTRACT
Bronchopulmonary dysplasia (BPD) is a common chronic respiratory complication in preterm infants without fully understand the mechanism or effective treatment,which could significantly affect the survival rate and prognosis of these infants.Studies have confirmed that epigenetic mechanisms,including histone modification,non-coding RNA and DNA methylation may play an essential role in the onset and development of BPD.And most related epigenetic changes are reversible,which might serve as a potential target for BPD treatment.Therefore,further studies on epigenetics will shed light on a better understanding of the pathogenesis,prevention,and treatment of BPD.