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1.
Chinese Medical Journal ; (24): 2430-2437, 2021.
Article in English | WPRIM | ID: wpr-921177

ABSTRACT

BACKGROUND@#Circulating tumor DNA (ctDNA) is a promising biomarker for non-invasive epidermal growth factor receptor mutations (EGFRm) detection in lung cancer patients, but existing methods have limitations in sensitivity and availability. In this study, we used the ΔCt value (mutant cycle threshold [Ct] value-internal control Ct value) generated during the polymerase chain reaction (PCR) assay to convert super-amplification-refractory mutation system (superARMS) from a qualitative method to a semi-quantitative method named reformed-superARMS (R-superARMS), and evaluated its performance in detecting EGFRm in plasma ctDNA in patients with advanced lung adenocarcinoma.@*METHODS@#A total of 41 pairs of tissues and plasma samples were obtained from lung adenocarcinoma patients who had known EGFRm in tumor tissue and were previously untreated. EGFRm in ctDNA was identified by using superARMS. Through making use of ΔCt value generated during the detection process of superARMS, we indirectly transform this qualitative detection method into a semi-quantitative PCR detection method, named R-superARMS. Both qualitative and quantitative analyses of the data were performed. Kaplan-Meier analysis was performed to estimate the progression-free survival (PFS) and overall survival (OS). Fisher exact test was used for categorical variables.@*RESULTS@#The concordance rate of EGFRm in tumor tissues and matched plasma samples was 68.3% (28/41). At baseline, EGFRm-positive patients were divided into two groups according to the cut-off ΔCt value of EGFRm set at 8.11. A significant difference in the median OS (mOS) between the two groups was observed (EGFRm ΔCt ≤8.11 vs. >8.11: not reached vs. 11.0 months; log-rank P = 0.024). Patients were divided into mutation clearance (MC) group and mutation incomplete clearance (MIC) group according to whether the ΔCt value of EGFRm test turned negative after 1 month of treatment. We found that there was also a significant difference in mOS (not reached vs. 10.4 months; log-rank P = 0.021) between MC group and MIC group. Although there was no significant difference in PFS between the two groups, the two curves were separated and the PFS of MC group tended to be higher than the MIC group (not reached vs. 27.5 months; log-rank P = 0.088). Furthermore, EGFRm-positive patients were divided into two groups according to the cut-off of the changes in ΔCt value of EGFRm after 1 month of treatment, which was set at 4.89. A significant difference in the mOS between the two groups was observed (change value of ΔCt >4.89 vs. ≤4.89: not reached vs. 11.0 months; log-rank P = 0.014).@*CONCLUSIONS@#Detecting EGFRm in ctDNA using R-superARMS can identify patients who are more likely sensitive to targeted therapy, reflect the molecular load of patients, and predict the therapeutic efficacy and clinical outcomes of patients.


Subject(s)
Adenocarcinoma of Lung/genetics , Circulating Tumor DNA/genetics , ErbB Receptors/genetics , Humans , Lung Neoplasms/genetics , Mutation/genetics , Protein Kinase Inhibitors
2.
Article in Chinese | WPRIM | ID: wpr-912534

ABSTRACT

Objective:To investigate the expression pattern of TCR variable region subfamily (Vβ and Vδ) in patients with mature T-cell lymphoma (TCL), and to compare the diagnostic value of TCRVβ and TCRVδ analysis in TCL.Methods:The TCRVβ flow cytometry kit was used to detect the expression of Vβ subtypes of αβT cell in 199 patients with αβ TCL and 398 patients with non-TCL, who hospitalized in Jiangsu Provincial People Hospital from 2011 to 2020. Among them, 185 cases of αβ TCL and 355 cases of non-TCL also underwent TCRβ and TCRγ gene rearrangement detection. The TCRVδ based 10-color protocol was used to detect the expression of Vδ subtypes in 24 cases of γδTCL, 10 cases of normal controls, and 15 cases with reactively higher CD4 and CD8 double-negative ratio from 2017 to 2020, and 24 cases of γδTCL and 15 cases with reactively higher CD4 and CD8 double-negative ratio underwent TCRβ, TCRγ and TCRδ gene rearrangement detection. The diagnostic performance and degree of coincidence for detecting malignant clonality were compared between TCRVβ and TCRVδ analysis and the TCR gene scanning method.Results:In the 199 cases of αβ TCL, 182 cases (91.5%) showed restricted expression or the sum of the positive percentages of the subgroups was less than 30% for the 24 TCRVβ subtypes. Among them, the subfamily members with the highest incidence of clonal T lymphocytes were TCRVβ13.2 (12.6%, 23/182) and TCRVβ3 (8.2%,15/182); the TCRVβ subtypes showed nonclonal results in 99.0% (394/398) of non-TCL. All 24 cases of γδTCL (100%) showed abnormal distribution patterns of Vδ1 and Vδ2, of which 19 cases showed restricted expression of Vδ1, and the remaining 5 cases had negative expression of either Vδ1 or Vδ2, and the positive rate of Vδ1 cells was significantly higher than that of Vδ2 cells (79.9%±10.8% vs 0.7%±0.3%, P<0.001). Among the normal control and cases with reactively higher CD4 and CD8 double-negative ratio, the positive rate of Vδ2 cells was significantly higher than that of Vδ1 cells (73.7%±6.7% vs 15.6%±4.2%, P<0.001), and all cases (25/25) showed a normal distribution pattern. In terms of the diagnostic performance of TCL, there was no significant difference of sensitivity and specificity between TCR variable region subfamily detection by flow cytometry and TCR gene scanning technology (the sensitivity was 92.4% and 91.4% respectively; the specificity was 99.0% and 95.9% respectively, P=0.065), and the coincidence rate of the two diagnostic methods is high (Kappa=0.809, P<0.001). Conclusion:Detection of TCR variable region subfamily by flow cytometry could quickly and effectively diagnose mature TCL.

3.
Article in Chinese | WPRIM | ID: wpr-912406

ABSTRACT

Objective:To observe the incidence of diabetic iridopathy and optic disc neovascularization in the contralateral eyes of proliferative diabetic retinopathy (PDR) with proliferative diabetic iridopathy (PDI).Methods:A retrospective case-control study. From February 2014 to May 2020, 72 eyes of 36 patients with PDR and PDI who underwent iris fluorescein angiography (IFA) combined with fluorescein fundus angiography(FFA) at the Henan Eye Institute were enrolled in the study. Among them, there were 34 eyes in 17 males and 38 eyes in 19 females; the average age was 62.3±4.7 years. All patients underwent best corrected visual acuity(BCVA), intraocular pressure, IFA combined with FFA examination. The BCVA examination was performed using the international standard visual acuity chart, which was converted into logarithm of the minimum angle of resolution BCVA for statistic analysis. According to PDI staging, patients were divided into early rubeosis iridis(RI) group and neovascular glaucoma (NVG) group, with 28 and 8 cases respectively. Compared with NVG group, RI group had better BCVA and intraocular pressure, and the difference was statistically significant( t=6.433, 10.619; P=0.000, 0.011). The incidence of PDI and the incidence of binocular optic disc neovascularization in the two groups were compared, and Fisher's exact probability method was used for comparison. Results:The results of the IFA examination showed that in the RI group, the pupil border and the iris surface of the iris of the affected eyes had strong neovascular bud-like or patchy fluorescence; the pupil border and the middle of the iris of the patients in the NVG stage had strong neovascular cluster-like fluorescence. Among the contralateral eyes in the RI group, 6 eyes (21.4%, 6/28) were with PDI (stage RI), 21 eyes (75.0%, 21/28) were with non-PDI (NPDI), and 1 eye (1/ 28, 3.6%) were absence of diabetic iris disease. Among the contralateral eyes in the NVG group, there were 5 eyes with PDI (62.5%, 5/8), including 4 eyes with RI stage, 1 eye with NVG stage (12.5%, 1/8); 3 eyes with NPDI. The image of IFA in patients with NPDI early showed as punctate fluorescence in the local small blood vessels of the iris itself. The incidence of PDI in the contralateral eye of the RI group was lower than that of the NVG group, and the difference was statistically significant ( P=0.040). The results of FFA examination showed that 9 (32.1%, 9/28) and 8 (28.6%, 8/28) eyes of the affected eye and the contralateral eye in the RI group were combined with optic disc neovascularization. In NVG group, there were seperately 6 eyes (75.0%, 6/8) in the affected eyes and the contralateral eyes with optic disc neovascularization. The differences in the incidence of optic disc neovascularization between the two groups of the affected eyes and the contralateral eye were statistically significant ( P=0.046, 0.040). Conclusion:The incidence of PDI and optic disc neovascularization in the contralateral eye of PDR and PDI, RI is lower than that of NVG.

4.
Article in Chinese | WPRIM | ID: wpr-912392

ABSTRACT

Objective:To observe the short-term effects of intravitreal injection of aflibercept (IVA) for initial treatment and dressing change on exudative age-related macular degeneration (eAMD).Methods:A retrospective clinical study. From June 2018 to February 2021, forty-nine eAMD eyes of 38 patients who underwent IVA treatment in Department of Ophthalmology of Central Theater Command Hospital of People’s Liberation Army were included in the study. Among them, there were 24 males with 29 eyes and 14 females with 20 eyes; the average age was 66.82±8.71 years. All affected eyes were treated with IVA. The initial loading dose was 2.0 mg, which was injected once a month for 3 consecutive months, followed by monthly review and treatment as needed. Of the 49 eyes, 26 eyes were initially treated (initial treatment group), they were diagnosed within 3 months of the first onset and followed by IVA treatment, and no intraocular drugs and surgery were performed from the onset to the first diagnosis. Twenty-three eyes were treated with drug exchange therapy (dressing change group), they received intravitreal injection of ranibizumab and/or conbercept more than 4 times 6 months before the replacement therapy, during which there was persistent interlaminar cystoid edema and/or subretinal fluid (SRF) in the macular area and no improvement in pigment epithelial detachment (PED). Before IVA treatment, there were no statistically significant differences in the best corrected visual acuity (BCVA), foveal thickness (CMT), PED height (PEDH), and PED volume (PEDV) of the two groups of eyes before IVA treatment ( P>0.05). The same equipment and methods as before treatment were used for related examinations, and the changes of BCVA, CMT, PEDH, PEDV and complications of the two groups of eyes were recorded in 1, 3, and 6 months after treatment. The comparison of BCVA, CMT, PEDH, and PEDV between the two groups were used repeated measures analysis of variance. Results:Six months after treatment, the number of IVA injections in the eyes of the initial treatment group and dressing change group were 4.15±0.73 and 4.39±0.72 times, respectively, and the difference was not statistically significant ( t=-1.141, P=0.260). The BCVA, CMT, PEDH, and PEDV of the the initial treatment group ( F=5.345, 22.995, 6.764, 5.425) and the dressing change group ( F=12.519, 15.576, 8.843, 9.406) were significantly improved compared before treatment with 1, 3, and 6 months. All were statistically significant ( P<0.05). There was no significant difference in BCVA, CMT, PEDH, and PEDV between the initial treatment group and the dressing group at each time point after treatment ( F=1.741, 0.069, 0.876, 3.455; P>0.05). During the follow-up period, none of the affected eyes had complications such as persistent intraocular pressure increase, endophthalmitis, and retinal pigment epithelial tear. Conclusions:IVA can improve eyesight of patients with eAMD and reduce CMT, PEDH, and PEDV. The initial treatment and dressing change have the same effect.

5.
Chinese Journal of Trauma ; (12): 968-972, 2021.
Article in Chinese | WPRIM | ID: wpr-909964

ABSTRACT

The osteoporotic fracture is characterized by a high disability rate,poor internal fixation strength,delayed bone healing,etc.,which greatly affects elderly health,so accelerating fracture healing is the key point of therapeutic strategies. Current researches mainly concentrate in bone formation acceleration and resorption inhibition,but the outcomes turn out to be unsatisfactory under the coupling of osteoblasts and osteoclasts. The accumulation of yellow adipose tissue in the medullary cavity is often arisen in patients with osteoporotic fractures,but its role and mechanism in bone metabolism remain unclear. Bone marrow adipocytes are differentiated from mesenchymal stromal cells and possess unique metabolic and secretory functions involving in energy metabolism,maintenance of hematopoietic microenvironment and regulation of bone metabolism balance. However,the role of bone marrow adipose tissue(BMAT)in osteoporotic fracture healing requires more elucidation. In this study,the authors discuss the key role and molecular mechanism of BMAT in the regulation of bone metabolism and homeostasis,aiming to provid new ideas and targets for the promotion of osteoporotic fracture healing.

6.
Chinese Journal of Trauma ; (12): 481-487, 2021.
Article in Chinese | WPRIM | ID: wpr-909894

ABSTRACT

The osteoporotic fracture, also known as fragility fracture, occurs due to osteoporosis. With the acceleration of aging in China, the incidence of osteoporotic fracture increases rapidly, which causes significant changes in the spectrum of orthopedic trauma. The osteoporotic fracture has both the commonness and particularity of fracture, which poses challenges to orthopedic surgeons. Meanwhile, the fast improvement of interdisciplinary research and the advancement of basic research in bone metabolism have brought many opportunities to facilitate the treatment of osteoporotic fracture. The authors intend to illustrate the challenges and solutions during the treatment of osteoporotic fracture by elaborating the awareness, fracture assessment, drug development, implant design, postoperative rehabilitation and refracture prevention to establish an improved protocol for the therapy.

7.
Chinese Journal of Trauma ; (12): 101-106, 2021.
Article in Chinese | WPRIM | ID: wpr-909839

ABSTRACT

Osteoporotic fractures have become major social problems threatening the health of the elderly population in China. Compared with conventional fractures, low bone mass, bone defect and retarded healing issues of osteoporotic fractures contribute to the difficulty in treatment and rehabilitation. Addressing major concerns in clinical settings, the "three in one" bone repair strategy focuses on anti-osteoporosis therapies, appropriate bone graft and fracture healing promotion. The authors summarize misunderstandings in diagnosis and treatment of osteoporotic fractures and repair strategies, expecting to improve prognosis and clinically standardize the treatments for osteoporotic fractures, to further improve therapeutic effect and living quality of the patients.

8.
Clinical Medicine of China ; (12): 503-508, 2021.
Article in Chinese | WPRIM | ID: wpr-909785

ABSTRACT

Objective:To explore the effect of the implantation of absorbable stents on the prognosis of patients with inferior knee artery balloon dilatation.Methods:From March 2018 to January 2021, twenty-five patients with drug absorbable stent implantation after inferior knee artery balloon dilatation (stent group) and 25 patients without absorbable stent implantation after inferior knee artery balloon dilatation (control group) were included in Qingdao Haici Medical Group Affiliated to Qingdao University. The improvement of symptoms, ankle brachial index, Rutherford classification and claudication distance before and after operation were compared. The symptoms, ankle brachial index, Rutherford grade, claudication distance and patency rate of the two groups were compared 6 months after operation. The preoperative and postoperative data were analyzed by independent sample t-test, and the patency rate was analyzed by χ 2 test. Results:The ankle brachial index in the stent group and the control group on the first day after operation was significantly higher than that before operation (0.18±0.11 vs. 0.85±0.15, t=18.5, P<0.05, 0.22±0.15 vs. 0.87±0.10, t=20.8, P<0.05), and the Rutherford classification decreased significantly (4.66±0.21 vs. 2.1±0.11, t=9.2, P<0.05, 4.58±0.33 vs. 2.3±0.22, t=12.9, P<0.05), the limp distance increased significantly ((27±8) m vs. (300±43) m, t=20.8, P<0.05, (42±14) m vs. (320±18) m, t=32.6, P<0.05). There was no significant difference in preoperative ankle brachial index, postoperative ankle brachial index, Rutherford grade and claudication distance between the two groups ( P>0.05). Six months after operation, the ankle brachial index (0.72±0.03 and 0.54±0.12; t=10.2, P<0.05), Rutherford classification ((1.72±0.17) and (3.23±0.22); t=12.8, P<0.05) and claudication distance ((580.00±137.00) m and (267.00±54.00) m; t=8.2, P<0.05) in the stent group and the control group were significantly better than those in the control group. The patency rate of stent group at 6 months was 68% (17/25), which was better than that of ordinary balloon dilatation group by 56% (14/25). Conclusion:Implantation of drug absorbable stents can significantly improve the prognosis of patients undergoing arterial balloon dilatation.

9.
Article in Chinese | WPRIM | ID: wpr-907597

ABSTRACT

Objective:To explore the safety and efficacy of EAC [etoposide+ cytarabine+ cyclophosphamide (CTX)] mobilization scheme for mobilizing stem cells in patients with lymphoma undergoing autologous hematopoietic stem cell transplantation (ASCT).Methods:A total of 36 patients with lymphoma who had collected peripheral blood stem cells through EAC or CTX+ granulocyte colony stimulating factor (G-CSF) mobilization scheme in Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from June 2018 to March 2020 were retrospectively analyzed. Among them, 16 patients used EAC mobilization (EAC group), and 20 patients used CTX (CTX group). When white blood cells≤1.0×10 9/L, G-CSF (10 μg/kg per day) was given subcutaneously in two doses. The changes of hematology indexes, the number of collected cells, adverse reactions during mobilization collection and hematopoietic reconstitution after ASCT were observed. Results:The peripheral blood stem cells were collected on 5 d (3-8 d) after EAC+ G-CSF mobilization and 7 d (4-12 d) after CTX+ G-CSF mobilization. The success rates of collection in the EAC group and CTX group were 100% (16/16) and 75.0% (15/20) respectively, the high-quality collection rates were 87.5% (14/16) and 25.0% (5/20) respectively, and there were statistically significant differences ( P=0.041; P<0.001). The median of CD34 + cells of the two groups was 13.67×10 6/kg and 3.45×10 6/kg respectively, the median of mononuclear cells was 7.16×10 8/kg and 5.09×10 8/kg respectively, the median of CD34 + cells/mononuclear cells was 1.44% and 0.67% respectively, and there were statistically significant differences ( Z=-4.219, P<0.001; Z=-2.118, P=0.034; Z=-3.104, P=0.002). In the EAC group and CTX group, the incidences of grade 3 and above granulocytopenia were 100% (16/16) and 90.0% (18/20) respectively, the incidences of grade 3 and above hemoglobin reduction were 43.8% (7/16) and 25.0% (5/20) respectively, the incidences of grade 3 and above thrombocytopenia were 87.5% (14/16) and 65.0% (13/20) respectively, and there were no statistically significant differences ( P=0.492; P=0.298; P=0.245). There were no significant differences in the incidences of infection, adverse reactions of digestive system or other adverse reactions between the two groups (all P>0.05). All patients accepted improved Bucy scheme before ASCT. The median implantation time of neutrophils and platelets was 9.0 d and 10.5 d in the EAC group, which was 12.0 d and 13.5 d in the CTX group, and there were statistically significant differences ( Z=-4.698, P<0.001; Z=-3.757, P<0.001). Conclusion:EAC mobilization scheme can significantly increase the number of hematopoietic stem cell. This scheme has a high success rate of high-quality collection and the adverse reactions are within the controllable range. It provides a high-quality mobilization scheme for hematopoietic stem cell mobilization and collection, which is worthy of clinical promotion and application.

10.
Article in Chinese | WPRIM | ID: wpr-907391

ABSTRACT

Diabetes is an important risk factor for ischemic stroke. The glycated hemoglobin (HbA1c) level reflects the mean blood glucose level in the past 8-12 weeks. It is a detection index of abnormal glucose metabolism and chronic hyperglycemia. Some studies have shown that high HbA1c is associated with the poor outcomes of patients with acute ischemic stroke, including patients treated with intravenous thrombolysis and endovascular mechanical thrombectomy. This article reviews the relationship between HbA1c and the outcomes of patients with acute ischemic stroke.

11.
Article in Chinese | WPRIM | ID: wpr-906338

ABSTRACT

Objective:To study the extraction method and characteristics of vesicle-like nanoparticles (VLNs) in Astragali Radix decoction, and to explore the mechanism of the VLNs in reducing blood glucose by regulating the gut microbiota of db/db diabetic mice. Method:Ultracentrifugation and size exclusion chromatography were used to enrich VLNs from Astragali Radix decoction, and the morphology, particle size and concentration of the VLNs were analyzed by transmission electron microscope and nanoparticle tracking analyzer. The db/db diabetic mice were randomly divided into model group, Astragali Radix VLNs high-, medium- and low-dose (21.1, 10.6, 5.3 g·kg<sup>-1</sup>) groups and metformin group (0.25 g·kg<sup>-1</sup>) according to their blood glucose levels. There were 7 mice in each group, and another 7 C57BL/6 mice were set as the normal group. The mice were given intragastrically for 3 weeks (once a day), and the changes of fasting blood glucose were observed every week. Hematoxylin-eosin (HE) staining was used to observe the pathological morphology of liver and pancreas of diabetic mice. The feces of mice were collected for 16S rRNA diversity detection of intestinal microbes. Result:The size of the nanoparticles obtained by the two methods was about 200 nm. Astragali Radix VLNs extracted by ultracentrifugation had a typical saucer-like shape with the concentration of 3.0×10<sup>11</sup> particles·mL<sup>-1</sup>. The morphology of Astragali Radix VLNs obtained by size exclusion chromatography was relatively poor with the concentration of 2.2×10<sup>11</sup> particles·mL<sup>-1</sup>. After 3 weeks of administration, compared with the model group, Astragali Radix VLNs high-, medium- and low-dose groups could significantly reduce the fasting blood glucose of diabetic mice (<italic>P</italic><0.05, <italic>P</italic><0.01). The VLNs could improve the gut microbiota dysbiosis, significantly decrease the ratio of Firmicutes/Bacteroidota, and increase the relative abundance of beneficial bacteria and reduce the relative abundance of harmful bacteria. Conclusion:Astragali Radix VLNs may reduce the blood glucose of db/db diabetic mice by adjusting the ratio of Firmicutes/Bacteroidota in the intestinal flora.

12.
Article in Chinese | WPRIM | ID: wpr-905875

ABSTRACT

Objective:The biological mechanism of <italic>Codonopsis pilosula</italic> adaptation to drought was explored by determining the root metabolome of <italic>C. pilosula</italic> during harvesting. Method:Non-targeted metabonomics LC-MS was used to screen differential metabolites by multivariate statistical analysis,univariate statistical analysis and metabolic pathway enrichment analysis. Result:①There were 274 metabolites in LD vs CK group,142 of which were up-regulated and 132 of which were down-regulated. There were 284 metabolites with significant difference in MD vs CK group,of which 157 were up-regulated and 127 were down-regulated. There were 317 metabolites with significant difference in SD vs CK group,of which 133 were up-regulated and 184 were down-regulated. ②Differential metabolites were annotated into kyoto Encyclopedia of Gene and Genomes (KEGG) database and 82 differential metabolic pathways were obtained,among which sphingolipids metabolism was significantly enriched (<italic>P</italic><0.01).Metabolism of arginine and proline,tryptophan,alanine,galactose,nicotinic acid and nicotinamide,cysteine and methionine,arachidonic acid,linolenic acid and glycerides were significantly enriched in different metabolite pathways (<italic>P</italic><0.05). ③The metabolites of the three comparison groups before and after enrichment were classified and analyzed. It was found that they were mainly concentrated in fatty acyls group,carboxylic acid and derivatives,and organ oxygen compounds,followed by sphingolipids,indoles and derivatives,organonitrogen compounds,glycerophospholipids,pyridines and derivatives,peptidomimetics,glycerolipids and so on.In the drought stress of <italic>C. codonopsis</italic>,carbohydrate related metabolites were mainly up-regulated,lipid related metabolites were mainly down-regulated,and all other metabolites were up-regulated. Conclusion:The changes of metabolites in the roots of <italic>C. pilosula</italic> under drought stress were elucidated. carbohydrate and lipid-related metabolites were the main products of <italic>C. pilosula</italic> under drought stress,and these metabolites may be the main reason to improve the ability of <italic>C. pilosula</italic> to resist drought,which laid a foundation for further study on the mechanism of <italic>C. pilosula</italic> to resist drought.

13.
Article in Chinese | WPRIM | ID: wpr-905215

ABSTRACT

Objective:To analyze the clinical features related to erectile dysfunction for male patients with spinal cord injury. Methods:From December, 2019 to January, 2021, 28 male patients with spinal cord injury were detected the stiffness and periactivity index of penises during night sleep using RigiScan. The patients were grouped as presence or absence of bulbocavernous reflex, anal autonomic contraction, anal tactile sensation and anal pressure sensation, to compare the stiffness and periactivity index between the groups. Results:The stiffness and periactivity indexes were more in patients presenting bulbocavernosus reflex, anal autonomic contraction, anal tactile sensation and anal deep pressure sensation (|t| > 2.19, P < 0.05). Conclusion:Bulbocavernous reflex, anal autonomic contraction, anal tactile and anal deep pressure response may predict penile erectile function after spinal cord injury.

14.
Asian Nursing Research ; : 8-14, 2021.
Article in English | WPRIM | ID: wpr-897190

ABSTRACT

Purpose@#Symptom experience after liver transplantation (LT) provides healthcare professionals with important information about the benefits and limitations of LT from patients’ perspective. This study aims to explore the multidimensional symptom experience and analyze related predictive factors in LT recipients. @*Methods@#This cross-sectional study evaluated the occurrence, frequency, intensity, and level of distress of 40 symptoms in 265 LT recipients. Stepwise multiple regression analysis was performed to analyze the influencing factors of symptom experience. @*Results@#The analysis of patient-reported data indicated that the ten most common symptoms were fatigue (42.3%), frequent sleep interruptions (38.9%), difficulty falling asleep (35.9%), decreased memory (34.0%), dreaminess (29.8%), itch (28.7%), muscular weakness (26.4%), shortness of breath (25.3%), anxiety (24.5%), and hand tremor (21.9%). Patients were classified into four groups according to survival time (1-month, 2–6-month, 7–12-month, and >1-year groups) after LT, and the most common symptom was fatigue in the one-month and 2–6-month groups, difficulty falling asleep in the 7–12-month group, and decreased memory in the >1-year group. Type of the primary caregiver, complications, concerns about the decreased ability to perform household and outdoor activities, and concerns about being a burden to the family were predictors of symptoms burden. @*Conclusion@#LT recipients experienced complicated symptoms. In clinical practice, it is critical to integrate physicians, nurses, and social workers as a medical team to help LT recipients develop suitable coping strategies that can potentially address patients’ concerns, increase the sense of confidence, and improve symptom outcomes.

15.
Asian Nursing Research ; : 8-14, 2021.
Article in English | WPRIM | ID: wpr-889486

ABSTRACT

Purpose@#Symptom experience after liver transplantation (LT) provides healthcare professionals with important information about the benefits and limitations of LT from patients’ perspective. This study aims to explore the multidimensional symptom experience and analyze related predictive factors in LT recipients. @*Methods@#This cross-sectional study evaluated the occurrence, frequency, intensity, and level of distress of 40 symptoms in 265 LT recipients. Stepwise multiple regression analysis was performed to analyze the influencing factors of symptom experience. @*Results@#The analysis of patient-reported data indicated that the ten most common symptoms were fatigue (42.3%), frequent sleep interruptions (38.9%), difficulty falling asleep (35.9%), decreased memory (34.0%), dreaminess (29.8%), itch (28.7%), muscular weakness (26.4%), shortness of breath (25.3%), anxiety (24.5%), and hand tremor (21.9%). Patients were classified into four groups according to survival time (1-month, 2–6-month, 7–12-month, and >1-year groups) after LT, and the most common symptom was fatigue in the one-month and 2–6-month groups, difficulty falling asleep in the 7–12-month group, and decreased memory in the >1-year group. Type of the primary caregiver, complications, concerns about the decreased ability to perform household and outdoor activities, and concerns about being a burden to the family were predictors of symptoms burden. @*Conclusion@#LT recipients experienced complicated symptoms. In clinical practice, it is critical to integrate physicians, nurses, and social workers as a medical team to help LT recipients develop suitable coping strategies that can potentially address patients’ concerns, increase the sense of confidence, and improve symptom outcomes.

16.
Asian Journal of Andrology ; (6): 510-515, 2021.
Article in English | WPRIM | ID: wpr-888453

ABSTRACT

There are many unknown genetic factors that lead to infertility in nonobstructive azoospermia men. Here, we performed whole-exome sequencing in blood samples obtained from 40 azoospermia patients with meiotic arrest and found a novel c.151_154del (p.D51fs) frame-shift mutation in exon 3 of the testis expressed 11 (TEX11) gene in one patient. Sanger sequencing analysis of the patient and 288 fertile men was performed to validate the mutation. Immunohistochemical analysis showed TEX11 expression in late-pachytene spermatocytes and in round spermatids in fertile human testes. In contrast, testes of the patient with TEX11 mutation underwent meiotic arrest and lacked TEX11 expression. Western blotting of human embryonic kidney (HEK293) cells transfected with a vector for the p.D51fs TEX11 variant detected no TEX11 expression. In conclusion, we identified a novel frame-shift mutation in the TEX11 gene in an azoospermia patient, emphasizing that this gene should be included in genetic screening panels for the clinical evaluation of azoospermia patients.

17.
Article in Chinese | WPRIM | ID: wpr-887145

ABSTRACT

Objective:To analyze the household smoking behavior of smokers in rural Taizhou City of Zhejiang Province, and to provide the basis for the intervention measures to reduce children's second-hand smoke (SHS) exposure. Methods:The investigation started in May 2018. A total of 418 smoking families in Luqiao and Linhai were included. Field face-to-face questionnaire survey was conducted and cotinine level in children's urine was measured. Kernel density estimation was used for curve fitting. The results were analyzed by Wilcoxon rank sum test and chi square test. Results:The age distribution of smokers in the family was bimodal. The younger smoker group was mainly the parents. The older group was mainly the other relatives such as grandfather. The age started smoking in the parent group was younger than that in relative group, but the average number of cigarettes smoked per day in relative group was higher than that in parent group (P<0.05). The parent group had higher proportion than the relative group in having family smoking regulations or agreeing not to smoke in the room in the presence of children (P<0.001).The proportion of the parent group who has heard about third hand smoke and electronic cigarette was higher than that of the relative group (P<0.001).The detection rates of cotinine in urine of children were 91.05% and 86.96% in parent group and relative group, respectively. The urine cotinine level of the children in the parent group was higher than that in the grandfather group (P=0.049). Conclusion:Children are more exposed to SHS when the smoker in the household are parents. In order to reduce children's SHS exposure, we should pay more attention to educate the parents with a family based tobacco control program.

18.
Article in Chinese | WPRIM | ID: wpr-887137

ABSTRACT

Objective:To examine the survival status and explore factors related to death among human immunodeficiency virus (HIV) infected patients receiving antiretroviral therapy (ART) in Taizhou City during 2006‒2019. Methods:A retrospective cohort study was conducted to analyze the data on HIV-infected patients receiving ART in Taizhou during 2006‒2019. Kaplan-Meier (K-M) method was used to calculate the cumulative survival rate and cumulative treatment success rate. Cox regression model was used to determine survival status and factors associated with ART. Results:A total of 2 904 HIV-infected patients was included. The cumulative survival rate after 1, 3, 5, and 8 years of ART were 96.9%, 94.9%, 93.1% and 92.1%, respectively, and the cumulative treatment response rate were 91.3%, 85.3%, 81.8% and 73.8%, respectively. Compared with aged 18-30 years old, baseline CD4+T cell >350 count/μL, normal hemoglobin level, effective ART, no clinical symptom at baseline, and homosexual transmission, we found that aged 51-60 years old(HR=4.94,95%CI:1.66-14.69), aged over 60 years old(HR=9.14,95%CI:3.14-26.63), anemia at baseline(HR=2.24,95%CI:1.55-3.23), baseline CD4+T cell <200 count/μL(HR=4.35,95%CI:2.14-8.86), ART failure (HR=3.90,95%CI:2.73-5.58), heterosexual transmission(HR=1.92,95%CI:1.15-3.20), and signs of symptom at baseline(HR=1.68,95%CI:1.16-2.41) were risk factors of HIV-related death. Conclusion:The effect of ART in Taizhou City is confirmed with a high cumulative survival rate and treatment success. We should pay additional attention to senior HIV-infected patients with anemia at baseline and intensively monitor the effect of ART. Interventions such as “treat after discover” are supposed to be implemented more widely to further reduce HIV-related mortality.

19.
Article in Chinese | WPRIM | ID: wpr-886640

ABSTRACT

Objective:To determine the prevalence of AIDS/HIV, sexual behavior, knowledge, and access to HIV-related services among college students in Taizhou from 2016 through 2018, and provide scientific evidence for developing targeted strategies and measures. Methods:Based on the National HIV/AIDS Sentinel Surveillance, a cross-sectional survey was conducted annually among college students in three sentinels by a multi-stage cluster sampling across Taizhou, using questionnaire and laboratory examination. Results:A total of 4 185 college students were surveyed during 2016–2018, in which the proportion of reporting sexual behavior was 7.7%, with 58.4% using condom at. Sexual behavior, with fixed sexual partners, casual partners, commercial partners, and homosexual partners accounted for 68.7%, 23%, 4.0%, and 4.0%, respectively. Sexual experience and sexual behavior with fixed partners were statistically different among colleges and gender, which was much higher in male and vocational schools. The awareness rate of HIV/AIDS knowledge was 65.8%; 3.6% was found to have HIV voluntary counseling and testing, in which 7.8% had sexual behavior, indicating an upward trend over years. No college student tested positive for HIV from 2016 to 2018, and only one tested positive for anti-syphilis antibody and one positive for anti-hepatitis C antibody. Conclusions:Young male and vocational students in Taizhou are likely to have more sexual behavior and lower awareness on HIV/AIDS. College students have at-risk sexual behavior, insufficient awareness of HIV/AIDS, which may facilitate high risk of infection. It warrants further strengthening HIV/AIDS health education.

20.
Article in Chinese | WPRIM | ID: wpr-884774

ABSTRACT

Objective:To investigate the diagnostic value of 11C-Pittsburgh compound B (PIB) in patients with mild cognitive impairment (MCI) and Alzheimer′s disease (AD) and explore the factors that may affect the binding of 11C-PIB. Methods:From January 2017 to December 2019, the 11C-PIB uptake of 6 patients with normal cognitive (NC; 3 males, 3 females, age: (64.5±12.3) years), 11 patients with MCI (4 males, 7 females, age: (64.5±9.8) years) and 21 patients with AD (7 males, 14 females, age: (68.1±9.1) years) from Daping Hospital, Army Medical University were retrospectively analyzed. Regional 11C-PIB binding was assessed by using standardized uptake value ratio (SUVR) and visual reading of 11C-PIB scan. Clinical data, including age, gender, education level, cognitive impairment, neuropsychological scale score, vascular risk factors (VRF), apolipoprotein E (ApoE) gene, were collected and differences among groups were analyzed by using one-way analysis of variance, least significant difference t test or Fisher exact test. Factors that affected the 11C-PIB binding were analyzed by multiple linear regression. Results:SUVR of cerebral lobe among NC, MCI and AD groups were significantly different (range of mean SUVR: 1.16-1.26, 1.19-1.35 and 1.40-1.61; F values: 5.331-9.279, all P<0.05). For positive PIB patients, SUVR of posterior cingulate and precuneus were increased in MCI group compared with NC group (1.20±0.15 vs 1.50±0.12, 1.18±0.15 vs 1.59±0.13; F values: 6.389 and 10.668, t values: -2.33 and -3.10, both P<0.05), and there were no significant differences in all lobes between MCI and AD group ( t values: from -1.29 to -0.51, all P>0.05). Visual analysis showed that the positive rates of PIB in frontal lobe (85.7%(18/21)), posterior cingulate (85.7%(18/21)), precuneus (81.0%(17/21)), temporal lobe (81.0%(17/21)) and occipital lobe (47.6%(10/21)) in AD were higher than those in MCI (4/11, 4/11, 4/11, 3/11 and 1/11, respectively; all P<0.05). Multiple linear regression showed that the degree of cognitive impairment were independent risk factors for SUVR of all lobes ( b values: 0.377-0.536, all P<0.05). The ApoE ε4 gene was independent risk factor for SUVR of precuneus ( b=0.290, P<0.05). Conclusion:11C-PIB is helpful for clinical diagnosis of MCI and AD patients and the degree of cognitive impairment and ApoE ε4 gene may be independent risk factors for increasing 11C-PIB binding.

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