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1.
Frontiers of Medicine ; (4): 403-415, 2022.
Article in English | WPRIM | ID: wpr-939874

ABSTRACT

The morbidity and mortality of myeloproliferative neoplasms (MPNs) are primarily caused by arterial and venous complications, progression to myelofibrosis, and transformation to acute leukemia. However, identifying molecular-based biomarkers for risk stratification of patients with MPNs remains a challenge. We have previously shown that interferon regulatory factor-8 (IRF8) and IRF4 serve as tumor suppressors in myeloid cells. In this study, we evaluated the expression of IRF4 and IRF8 and the JAK2V617F mutant allele burden in patients with MPNs. Patients with decreased IRF4 expression were correlated with a more developed MPN phenotype in myelofibrosis (MF) and secondary AML (sAML) transformed from MPNs versus essential thrombocythemia (ET). Negative correlations between the JAK2V617F allele burden and the expression of IRF8 (P < 0.05) and IRF4 (P < 0.001) and between white blood cell (WBC) count and IRF4 expression (P < 0.05) were found in ET patients. IRF8 expression was negatively correlated with the JAK2V617F allele burden (P < 0.05) in polycythemia vera patients. Complete response (CR), partial response (PR), and no response (NR) were observed in 67.5%,10%, and 22.5% of ET patients treated with hydroxyurea (HU), respectively, in 12 months. At 3 months, patients in the CR group showed high IRF4 and IRF8 expression compared with patients in the PR and NR groups. In the 12-month therapy period, low IRF4 and IRF8 expression were independently associated with the unfavorable response to HU and high WBC count. Our data indicate that the expression of IRF4 and IRF8 was associated with the MPN phenotype, which may serve as biomarkers for the response to HU in ET.


Subject(s)
Biomarkers , Humans , Hydroxyurea/therapeutic use , Interferon Regulatory Factors/genetics , Janus Kinase 2/genetics , Leukemia, Myeloid, Acute/genetics , Mutation , Phenotype , Primary Myelofibrosis/genetics , Thrombocythemia, Essential/genetics
2.
Acta Pharmaceutica Sinica B ; (6): 1240-1253, 2022.
Article in English | WPRIM | ID: wpr-929364

ABSTRACT

The mammalian target of rapamycin (mTOR) pathway is abnormally activated in lung cancer. However, the anti-lung cancer effect of mTOR inhibitors as monotherapy is modest. Here, we identified that ginsenoside Rh2, an active component of Panax ginseng C. A. Mey., enhanced the anti-cancer effect of the mTOR inhibitor everolimus both in vitro and in vivo. Moreover, ginsenoside Rh2 alleviated the hepatic fat accumulation caused by everolimus in xenograft nude mice models. The combination of everolimus and ginsenoside Rh2 (labeled Eve-Rh2) induced caspase-independent cell death and cytoplasmic vacuolation in lung cancer cells, indicating that Eve-Rh2 prevented tumor progression by triggering paraptosis. Eve-Rh2 up-regulated the expression of c-MYC in cancer cells as well as tumor tissues. The increased c-MYC mediated the accumulation of tribbles homolog 3 (TRIB3)/P62+ aggresomes and consequently triggered paraptosis, bypassing the classical c-MYC/MAX pathway. Our study offers a potential effective and safe strategy for the treatment of lung cancer. Moreover, we have identified a new mechanism of TRIB3/P62+ aggresomes-triggered paraptosis and revealed a unique function of c-MYC.

3.
Article in English | WPRIM | ID: wpr-888798

ABSTRACT

Seven alkaloids including five undescribed ones (1a/1b, 2, 3 and 5) were obtained from the leaves of Isatis indigotica Fortune. Their structures were established by extensive spectroscopic analyses. The absolute configurations of compounds 1a, 1b, 3 and 5 were determined by comparison of the experimental and calculated electronic circular dichroism (ECD) spectra. Subsequently, the neuroprotective effects of all the isolates against H

4.
Article in Chinese | WPRIM | ID: wpr-931885

ABSTRACT

Objective:To estimate the mental symptoms in malignant tumor patients undergoing chemotherapy using DSM-5 cross cutting symptom measure.Methods:A total of 314 patients who undergoing chemotherapy in oncology department of Zhongshan Hospital, Fudan University who met all standards were chosen. The DSM-5 cross cutting symptom measure Level 1 Scale was used to assess the mental symptoms of the patients. SPSS 25.0 software was used for χ 2 test, Pearson correlation analysis and multiple regression analysis. Results:The most common symptoms in the patients were depressive symptoms(85/314, 27.1%), somatic symptoms (79/314, 25.2%), manic symptoms (78/314, 24.5% ) and anxiety symptoms (76/314, 24.3%). The proportion of anxiety symptoms in malignant tumor patients who were taken care of by other personnel(26/64, 40.6%) was significantly higher than that in patients who were taken care of by immediate relatives(50/250, 20.0%)(χ 2=12.23, P<0.05). Patients with unstable working conditions were more likely to have depressive symptoms (χ 2=7.64, P<0.05). There was a significant negative correlation between the patients' understanding of the disease and their scores of depressive symptoms, somatic symptoms, manic symptoms, anxiety symptoms and the total score of mental symptoms( r= -0.26, -0.15, -0.12, -0.25, -0.22, all P<0.05). In addition, the total score of mental symptoms of malignant tumor patients was significantly positively correlated with family burden and family status( r=0.11, 0.11, both P<0.05), and negatively correlated with patients' education ( r=-0.13, P<0.05). Multiple regression analysis showed that the degree of understanding of the disease( β=-0.203) and family status( β=0.197) were the influencing factors of mental symptoms of inpatients malignant tumors undergoing chemotherapy in general hospital ( F=13.653, P<0.001). Conclusion:Malignant tumor patients undergoing chemotherapy may have a variety of mental symptoms. The high incidence mainly includes depressive symptoms, somatic symptoms, manic symptoms and anxiety symptoms. The understanding of the patients to the disease and family situation are the main influencing factors.

5.
Article in Chinese | WPRIM | ID: wpr-942591

ABSTRACT

Objective: To explore the classification and reconstruction strategy of defects in lateral face region after operation of malignant tumors. Methods: Eighteen cases with the reconstruction of complicated defects after resection of tumors in the region of lateral face from January 2015 to January 2018 in Hunan Cancer Hospital were retrospectively reviewed. There were 14 males and 4 females, aged from 32 to 68 years. According to the presence or absence of bony scaffold, complicated defects were divided into two main categories: soft tissue perforating defects and soft tissue defects combined with bony scaffold defects. All soft tissue perforating defects in 5 cases were repaired with free anterolateral femoral flaps. Among 13 cases with soft tissue plus bony scaffold defects, 3 were repaired with free fibular flaps, 6 with free fibular flaps combined with free anterolateral femoral flaps, and 4 with chimeric deep circumflex iliac artery perforator flaps combined with anterolateral femoral flaps. Results: All flaps survived well. Two patients complicated with fistula in floor of mouth, but the wound healed after dressing change. Transoral feeding was resumed within 2 weeks after surgery in all patients. One year follow-up evaluation showed that 14 cases had symmetrical face and 10 cases had mouth opening more than 3 transverse fingers. After 36-50 months of follow-up, 6 patients died, with an overall 3-year survival rate of 66.7%. Conclusion: The classification of defects with or without bony stent loss is conducive to the overall repair design, the recovery of facial contour stent, the effective fill of dead space and the maintain of residual occlusal relationship. Good reconstruction results require a multi flap combination of osteocutaneous and soft tissue flaps.


Subject(s)
Facial Neoplasms , Female , Free Tissue Flaps , Humans , Male , Perforator Flap , Reconstructive Surgical Procedures , Retrospective Studies , Skin Transplantation , Soft Tissue Injuries/surgery , Thigh/surgery
6.
Article in Chinese | WPRIM | ID: wpr-942401

ABSTRACT

Objective: To study the efficacy and patient comfort of absorbable hemostatic powder after endoscopic sinus surgery (ESS). Methods: A total of 21 (17 males, 4 females) patients with an average age of 42(ranging from 18 to 65) underwent bilateral ESS for chronic rhinosinusitis(CRS) in Beijing Tongren Hospital, Capital Medical University between October 2015 and July 2019 were enrolled to compare the effect of absorbable hemostasis powder with Nasopore using an intrapatient control design. A randomized controlled trial was conducted in the left and right nasal cavities of the same patient. If hemostatic powder was applied in the experiment nasal cavity, the Nasopore was applied in the control nasal cavity. The mean preoperative sinus computed tomography (CT) score was 6.25. All patients competed for symptom diaries using a visual analog scale (VAS, score out of 10) at baseline, through 1, 7, 14 and 30 days. Outcomes including bleeding, facial pain, nasal obstruction, nasal discharges using VAS were recorded separately for both sides. Postoperative endoscopic scores were also investigated. SPSS 22 and Graphpad prism 8.0 statistical softwares were used for the analysis. Paired t-test or nonparametric test was used between the test side and the control side. The difference was statistically significant (P<0.05). Results: The bleeding score and total nasal symptom VAS scores at postoperative days (POD) 1, 7, 14 and 30 were not significantly different(t=1.341, 0.552, 0.631, 0.158, all P>0.05;t=0.944, 1.471, 1.612, 2.251, all P>0.05). There was no significant difference between absorbable hemostasis powder and Nasopore side on POD 1, 7, 14 and 30 in terms of each nasal symptom VAS scores(all P>0.05). On POD 1, 7 and 14, the packing material degeneration scores of the absorbable hemostasis powder side were significantly lower than those of the Nasopore side [(1.33±0.21)vs(2.00±0.00),(0.38±0.18) vs (1.95±0.22), 0 vs (1.80±0.13), all P<0.01]. There were significant differences between absorbable hemostasis powder and Nasopore side on POD 1, 7, 14 and 30 in terms of endoscopic scores (edema, crusting, discharges, scar, polyps and material degeneration, t=3.07, 7.00, 6.41, 2.69, all P<0.05). Conclusions: The absorbable hemostasis powder and Nasopore has similar postoperative hemostasis effect. The absorbable hemostasis powder is rapidly cleared and without negative effects on mucosal wound healing 14 days postoperatively.

7.
Chinese Critical Care Medicine ; (12): 478-482, 2021.
Article in Chinese | WPRIM | ID: wpr-883910

ABSTRACT

Objective:To evaluate the assistant role of manifestations under tracheoscopy in the diagnosis of invasive pulmonary aspergillosis (IPA) in severe patients.Methods:A retrospective study was conducted. The patients with suspected IPA admitted to intensive care unit (ICU) of Affiliated Hospital of Binzhou Medical College from January 2015 to December 2019 were enrolled. The diagnosis, clinical diagnosis and suspected diagnosis were made according to the grading criteria of Guidelines for the diagnosis and treatment of invasive fungal infection in severe patients (2007). Those who met the criteria were enrolled in the IPA group, and those who did not meet the criteria or other pathogens were enrolled in the non-IPA group. The general data of the patients were collected, and the changes of tracheal and bronchial mucosa under tracheal microscope before and after treatment were recorded, as well as the results of galactomannan (GM) test and aetiology culture of bronchoalveolar lavage fluid (BALF). The baseline, bronchoscopy and pulmonary CT manifestations and their dynamic changes were compared in each group. Results:A total of 142 patients with suspected IPA were finally enrolled. Among them, 12 were pathologically proven IPA, 77 were probable IPA, 22 were possible IPA, and 31 were undefined IPA. Of the 142 patients, 60 had typical manifestations of mucosal injury under bronchoscopy, including 7 proven IPA patients (58.3%), 52 probable IPA patients (67.5%), and 1 possible IPA patient (4.5%), but none undefined IPA patient. The patients undergoing lung CT scan were 12 proven IPA patients (100%), 73 probable IPA patients (94.8%), and 21 possible IPA patients (95.5%), respectively. Most of the Chest CT showed patchy or strip density increasing and other non-specific manifestations. There were 3 proven IPA patients (25.0%), 7 probable IPA patients (9.0%), and 0 possible IPA patient (0%) who had typical IPA CT manifestations (halo sign and cavity or crescent sign). Among the patients of proven IPA and probable IPA (89 cases), there were a total of 35 cases with endoscopic airway mucosal injury and tracheoscopy reexamination ≥ 3 times. All the 35 patients received anti-aspergillus treatment, among which 16 survived and 19 died. Among the 16 patients who survived, the microscopic appearance of mucosal injury was gradually reduced and the clinical manifestations were gradually improved. Of the 19 patients who died, 16 had deteriorated endoscopic airway mucosal injury.Conclusions:The specific manifestations of severe patients with bronchial mucosal injury are of great significance in the diagnosis of IPA. In the case of severe patients who cannot receive pathological examination or chest CT in time, dynamic observation of the changes of airway mucosal injury is a simple auxiliary method to discover the changes of patients' condition in time, evaluate the effect of antifungal therapy and the prognosis of IPA.

8.
Article in Chinese | WPRIM | ID: wpr-883778

ABSTRACT

Objective:To investigate the expression levels of matrix metalloproteinase-9 (MMP-9), procalcitonin (PCT), soluble triggering receptor expressed on myeloid cells (sTREM-1) and soluble cell differentiation 14 (sCD14) in pregnant women with premature rupture of membranes (PROM) and their predictive value for chorioamnionitis.Methods:A total of 132 pregnant women with PROM who received treatment in Tengzhou Central People's Hospital from January 2016 to June 2017 were included in the study group. These women were assigned to pre-term PROM group (gestational age < 37 weeks, n = 58) and full-term PROM group (gestational age > 37 weeks, n = 74). A total of 106 concurrent full-term healthy pregnant women were included in the control group. Pregnant women in the PROM group were also assigned into an infection group ( n = 51) and a non-infection group ( n = 81). Serum levels of MMP-9, PCT, sTREM-1 and sCD14 were compared between study and control groups, and their value in the diagnosis of PROM complicated with chorioamnionitis was analyzed. Results:The expression levels of MMP-9 [(271.42 ± 34.16) ng/L], PCT [(54.57 ± 8.16) pg/mL], sTREM-1 [(0.51 ± 0.11) ng/mL] and sCD14 [(60.23 ± 9.49) ng/mL] in the study group were significantly higher than those in the control group [(54.97 ± 10.08) ng/L, (26.04 ± 1.98) pg/mL, (0.19 ± 0.04) ng/mL, (42.04 ± 10.33) ng/mL, t = 27.064, 13.767, 14.831, -13.342, all P < 0.01). The expression levels of MMP-9 [(314.05 ± 45.37) ng/L], PCT [(0.61 ± 0.18) ng/mL], sTREM-1 [(63.12 ± 10.12) pg/mL] and sCD14 [(68.07 ± 11.05) ng/mL] in the pre-term PROM group were significantly higher than those in the full-term PROM group [(238.01 ± 40.45) ng/L, (47.87 ± 8.90) pg/mL, (0.43 ± 0.14) ng/mL, (54.09 ± 10.33) ng/mL, t = 9.103, 8.862, -10.538, 6.494, all P < 0.05). The expression levels of MMP-9 [(343.74 ± 43.74) ng/L], PCT [(69.88 ± 8.83) pg/mL], sTREM-1 [(0.67 ± 0.16) ng/mL], sCD14 [(70.41 ± 8.89) ng/mL] in the infection group were significantly higher than those in the non-infection group [(230.09 ± 49.82) ng/L, (45.82 ± 11.04) pg/mL, (0.42 ± 0.19) ng/mL and (54.41 ± 12.42) ng/mL, t = 23.655, 12.014, 9.382, 11.306, all P < 0.01]. The sensitivity (94.23%), specificity (93.75%), positive predictive value (92.45%) and negative predictive value (96.20%) of combined detection of these indexes in the diagnosis of PROM complicated by chorioamnionitis were significantly higher than those of other indexes detected alone (all P < 0.05). Conclusion:Combined detection of serum levels of MMP-9, PCT, sTREM-1 and sCD14 can be used as an effective auxiliary index for the diagnosis of early premature rupture of membranes complicated with chorioamnionitis.

9.
Chinese Journal of Urology ; (12): 414-422, 2021.
Article in Chinese | WPRIM | ID: wpr-911043

ABSTRACT

Objective:To assess the efficacy and safety of 100 units of botulinum toxin A (BTX-A) intradetrusor injection in patients with overactive bladder.Methods:From April 2016 to December 2018, 17 tertiary hospitals were selected to participate in this prospective, multicenter, randomized, double-blind, placebo-controlled study. Two phases of study were conducted: the primary phase and the extended phase. This study enrolled patients aged 18 to 75 years who had been inadequately managed by anticholinergic therapy (insufficient efficacy or intolerable side effects) and had spontaneous voiding with overactive bladder. Exclusion criteria included patients with severe cardiac, renal and hepatic disorders, patients with previous botulinum toxin treatment for 6 months or allergic to BTX-A, patients with urinary tract infections, patients with urinary stones, urinary tract tumors, diabetes mellitus, and bleeding tendency. Eligible patients were randomly assigned to BTX-A group and placebo control group in a ratio of 2∶1. Two groups of patients received 20 intradetrusor injections of BTX-A 100U or placebo at the depth of the submucosal muscle layer respectively under cystoscope, including 5 injections at the base of the bladder, 3 injections to the bladder triangle, 5 injections each to the left and right walls and 2 injections to the top, sparing the bladder neck. As a placebo control group, patients received same volume of placebo containing no BTX-A and only adjuvant freeze-dried preparations for injection with the same method. A combination of gelatin, sucrose, and dextran served as adjuvants. Average micturition times per 24 hours, urinary incontinence (UI) episodes per day, average micturition volume per day, OAB symptom score(OABSS), and quality of life (QOL) score were recorded at baseline and the 2nd, 6th and 12th week after treatment. The primary efficacy endpoint was the change from baseline in the average micturition times per 24 hours at the 6th week after treatment. The secondary efficacy endpoints included the change from baseline in the average micturition times per 24 hours at 2nd and 12th week, as well as the change from baseline in the OABSS, QOL score, average frequency of urgency and UI episodes per day, urgency score, average micturition volume per day at 2nd, 6th and 12th week after treatment. Patients were followed for 12 weeks to assess adverse events (AEs). After assessed at week 12, if the micturition times has decreased less than 50% compared to baseline and the patient is willing to receive retreatment, then patients could enter the extended trial phase. In that phase, patients in both groups were injected with 100 units BTX-A from 12th week onwards and then followed up the same indicators for 12 weeks.Results:216 patients were enrolled in this trial (144 cases in the BTX-A group and 72 cases in the placebo control group). Baseline characteristics such as age (47.75±14.20 in the BTX-A group and 46.39±15.55 in the control group), sex (25 male/117 female in the BTX-A group and 10/61 in the control group), and disease duration (0.51 years in the BTX-A group and 0.60 years in the control group) were balanced between the two groups( P>0.05). A marked reduction from baseline in average micturition times per 24 hours was observed in all treatment groups at the 6th week and the reduction of the two groups was statistically different ( P<0.001 and P=0.008 respectively). Compared with the baseline, the average micturition times per 24 hours at the 6th week decreased from baseline by 2.40(0.70, 4.60)times for the BTX-A group and 0.70(-1.00, 3.30) times for the placebo control group respectively, and the difference between the two groups was considered to be statistically significant ( P=0.003). The change rates of average micturition times per 24 hours from baseline at the 6th week of the two groups were (16±22)% and (8±25)% respectively, and the difference between the two groups was statistically significant ( P=0.014). Compared with the baseline, the average micturition times per 24 hours at 2nd and 12th week decreased by 2.00(0.00, 4.00)and 3.30(0.60, 5.03)for the BTX-A group, 1.00(-1.00, 3.00)and 1.70(-1.45, 3.85)for the placebo control group respectively. The difference between two groups was considered to be statistically significant ( P=0.038 and P=0.012); the changes of average urgency times per day for the BTX-A group and the control group at the 2nd, 6th and 12th week were 2.00(0.00, 4.30)and 2.40(0.30, 5.00), 3.00(0.30, 5.70)and 0.70(-1.30, 2.70), 0.70(-1.30, 3.00) and 1.35(-1.15, 3.50), respectively. There were significant differences between two groups at the 2nd, 6th and 12th week, ( P=0.010, P=0.003 and P=0.025, respectively). The OABSS of the BTX-A group and the control group at the 6th week decreased by 1.00(0.00, 4.00)and 0.50(-1.00, 2.00) compared with the baseline, and the difference between the two groups was statistically significant ( P=0.003). 47 cases of BTX-A group and 34 cases of placebo control group entered the extended trial phase, and 40 and 28 cases completed the extended trial phase, respectively. The average micturition volume per 24 hours changed by -16.60(-41.60, -0.60)ml and -6.40(-22.40, 13.30)ml, (-35.67±54.41)ml and(-1.76±48.69)ml, (-36.14±41.51)ml and (-9.28±44.59)ml, (-35.85±43.35)ml and(-10.41±40.29)ml for two groups at the 12th, 14th, 18th and 24th week, and the difference between two groups was statistically significant at each follow-up time ( P=0.01, 0.006, 0.012 and 0.016, respectively). There was no significant difference in other parameters( P>0.05). However, adverse reactions after intradetrusor injection included increased residual urine volume (27 in the BTX-A group and 3 in the control group), dysuria (21 in the BTX-A group and 6 in the control group), urinary infection (19 in the BTX-A group and 6 in the control group), bladder neck obstruction (3 in the BTX-A group and 0 in the control group), hematuria (3 in the BTX-A group and 1 in the control group), elevated alanine aminotransferase (3 in the BTX-A group and 0 in the control group), etc. During the follow-up period, there was no significant difference in the other adverse events between two groups except the increase of residual urine volume( P<0.05). In the primary trial phase, among the 27 cases with increased residual urine volume in BTA group, only 1 case (3.70%) with PVR more than 300 ml; the PVR of 3 patients in the placebo group was less than 100 ml. The increase of residual urine volume caused by the injection could be improved or disappeared with the passage of time. Conclusions:Intradetrusor injection of Chinese BTX-A improved the average micturition times per 24 hours, the average daily urgent micturition times, OABSS, and average micturition volume per time, and reduced the adverse effects in patients with overactive bladder.Chinese BTX-A at dose of 100U demonstrated durable efficacy and safety in the management of overactive bladder.

10.
Article in Chinese | WPRIM | ID: wpr-873230

ABSTRACT

Objective:To investigate the effective substance of the choleretic effect of Gardeniae Fructus,and analyze the relationships between its choleretic effect and the HPLC fingerprint chromatogram. Method:HPLC method was applied to establish the fingerprint chromatography of 8 batches of Gardeniae Fructus at different harvest periods. The flow,the content of bile acid,bilirubin and cholesterol in bile were tested,and then the principal component analysis was used to comprehensively evaluate the total choleretic effects of Gardeniae Fructus. After the relationships between the relative peak area of the common peaks and the choleretic effects were explored using grey relationship analysis method,the spectrum-effect relationship of Gardeniae Fructus was established. Result:The order of the contribution of the chemical components to the choleretic effect at the common peaks was as follow(r>0.8):P9>P14>P26>P4>P30>P6>P1>P10>P5>P24. Among all peaks,the full wavelength scanning results implied that the peaks 9,14 and 4 might be iridoids, and the peaks 26,30 and 24 might be crocins. By comparing with the standard substances,the peak 9 was finally identified as geniposide. Conclusion:The choleretic effect of Gardeniae Fructus may be the results of multiple components and pathways,and the main components in Gardeniae Fructus with the choleretic effect was from geniposide. In conclusion,these results provide a reference for investigating the material basis of choleretic effect of Gardeniae Fructus.

11.
Article in Chinese | WPRIM | ID: wpr-872858

ABSTRACT

Coronavirus disease-2019 (COVID-19) belongs to the epidemic diseases of traditional Chinese medicine (TCM), which is infected by the air with disease and the initial stage of the disease is in upper energizer. TCM holds that the nose is the orifice of the lung and the gateway of the breath. WU Shang-xian, the famous external doctor in Qing dynasty, discussed in Liyue Pianwen that "for the disease in upper energizer, the most effective method is to use the medicine powder via nasal administration and sneeze to disperse". For thousands of years, ancient Chinese medical practitioners had explored and developed the TCM nasal administration method in the struggle against epidemics. Qingkailing is the basic formula for heat-clearing and detoxifying, and researches have clarified its therapeutic effect on upper respiratory tract infections. Therefore, based on TCM nasal administration, this article took Qingkailing as an example to study the feasibility of its nasal preparations for the treatment of COVID-19. On the one hand, it is helpful for the rapid development of Qingkailing nasal preparations for COVID-19. On the other hand, it can broaden the new thinking of TCM in treating epidemic diseases, and give full play to the advantages of TCM in treating epidemic diseases.

12.
Article in Chinese | WPRIM | ID: wpr-870557

ABSTRACT

Objective:To explore the clinicopathologic features and renal prognosis of patients with post-transplant membranous nephropathy (MN).Methods:Patients with allograft biopsy-proven MN were reviewed retrospectively and divided into unknown etiology group (A, n=12) and recurrent membranous nephropathy (rMN) group (B, n=7). Their clinicopathological data and renal prognosis were assessed and compared.Results:No differences existed in the proportion of living-related donor or post-transplant allograft function. Group B had recurrence at 16.4 months after transplantation and it was significantly shorter than group A. Allograft impairment manifested as proteinuria, nephrotic syndrome and/or renal insufficiency in both groups. The positive rate of serum anti-PLA2R antibody and renal PLA2R staining was significantly higher in group B than that in group A. Similarly, the intensity of IgG4 subtype staining was also stronger in group B than that in group A. The 5-year cumulative renal survival rates from end-stage renal disease (ESRD) were 77.8% and 66.7% in groups A and B respectively. No significant inter-group difference existed in renal prognosis.Conclusions:Anti-PLA2R antibody plays an important role in the recurrence of rMN after renal allografting. PLA2R staining is useful for detecting primary disease and its sensitivity is higher than that of serum anti-PLA2R antibody. Rituximab is an effective treatment for post-transplant MN. Follow-up studies with a larger sample size are required for further verification.

13.
Article in Chinese | WPRIM | ID: wpr-869805

ABSTRACT

Objective:To identify the risk factors for mortality after laparotomy for hemorrhage in the patients with bleeding after liver transplantation.Methods:The patients who underwent re-laparotomy for hemorrhage after liver transplantation, aged>18 yr, from June 2005 to June 2013, were selected.The preoperative clinical characteristics of patients, time of liver transplantation, mode of operation, intraoperative massive hemorrhage, intraoperative use of vasoactive drugs, atropine, lidocaine and immunosuppressive agents, and postoperative tracheotomy and renal failure were collected.Patients were divided into survival group (group S) and death group (group D) according to the survival outcome at 3 months after surgery.Factors of which P values were less than 0.05 would enter the multiple logistic regression analysis to stratify the risk factors for mortality of patients with bleeding after liver transplantation. Results:A total of 128 patients were included in this study , with 117 cases in group S and 11 cases in group D. Postoperative renal failure was the independent risk factor for mortality of patients with bleeding after liver transplantation, and OR value (95% confidence interval) was 11.307 (1.992-64.188) ( P<0.05). The area under the curve of postoperative renal failure (95% confidence interval) was 0.849 (0.712-0.986), and the sensitivity and specificity were 81.8% and 12.0%, respectively. Conclusion:Postoperative renal failure is an independent risk factor for mortality after laparotomy for hemorrhage in the patients with bleeding after liver transplantation.

14.
Article in Chinese | WPRIM | ID: wpr-827998

ABSTRACT

This research is to establish an HPLC method for determination of geniposidic acid, genipin-1-β-D-gentiobioside, geniposide, p-trans-coumaroylgenipin gentiobioside, chlorogenic acid, crocin-Ⅰ, crocin-Ⅱ and crocin-Ⅲ in Gardeniae Fructus at different harvest time. The detection wavelength was 238, 320 and 440 nm. Principal component analysis(PCA), correlation analysis, regression analysis and partial least squares(PLS) analysis were used to explore the relationship of color and content of eight components in Gardeniae Fructus. The result showed that the trend of the eight components in Gardeniae Fructus at harvest time in different three years was varied similarly. According to the variation of eight components at different harvest time, the mature and immaturate Gardeniae Fructus were discriminated. The content of crocin-Ⅰwas correlated positively with a~* of color significance. The redder color of Gardeniae Fructus showed the higher value of a~* and content of crocin-Ⅰ, indicating the better quality of Gardeniae Fructus. This method provided reference for justifying the color and quality of Gardeniae Fructus and scientific evidence for "assessing quality by distinguishing color".


Subject(s)
Chlorogenic Acid , Chromatography, High Pressure Liquid , Drugs, Chinese Herbal , Fruit , Gardenia
15.
Chinese Medical Journal ; (24): 1390-1396, 2020.
Article in English | WPRIM | ID: wpr-827665

ABSTRACT

BACKGROUND@#Critical patients with the coronavirus disease 2019 (COVID-19), even those whose nucleic acid test results had turned negative and those receiving maximal medical support, have been noted to progress to irreversible fatal respiratory failure. Lung transplantation (LT) as the sole therapy for end-stage pulmonary fibrosis related to acute respiratory distress syndrome has been considered as the ultimate rescue therapy for these patients.@*METHODS@#From February 10 to March 10, 2020, three male patients were urgently assessed and listed for transplantation. After conducting a full ethical review and after obtaining assent from the family of the patients, we performed three LT procedures for COVID-19 patients with illness durations of more than one month and extremely high sequential organ failure assessment scores.@*RESULTS@#Two of the three recipients survived post-LT and started participating in a rehabilitation program. Pearls of the LT team collaboration and perioperative logistics were summarized and continually improved. The pathological results of the explanted lungs were concordant with the critical clinical manifestation, and provided insight towards better understanding of the disease. Government health affair systems, virology detection tools, and modern communication technology all play key roles towards the survival of the patients and their rehabilitation.@*CONCLUSIONS@#LT can be performed in end-stage patients with respiratory failure due to COVID-19-related pulmonary fibrosis. If confirmed positive-turned-negative virology status without organ dysfunction that could contraindicate LT, LT provided the final option for these patients to avoid certain death, with proper protection of transplant surgeons and medical staffs. By ensuring instant seamless care for both patients and medical teams, the goal of reducing the mortality rate and salvaging the lives of patients with COVID-19 can be attained.


Subject(s)
Aged , Betacoronavirus , Coronavirus Infections , Mortality , Extracorporeal Membrane Oxygenation , Humans , Lung Transplantation , Methods , Male , Middle Aged , Pandemics , Pneumonia, Viral , Mortality , Pulmonary Fibrosis , Mortality , General Surgery , Respiratory Distress Syndrome , Mortality , General Surgery
16.
Journal of Chinese Physician ; (12): 886-890,895, 2020.
Article in Chinese | WPRIM | ID: wpr-867333

ABSTRACT

Objective:To investigate the clinical effect of ozone combined with sodium hyaluronate injection in the treatment of knee osteoarthritis and its effect on inflammatory factors and hemorheology in patients.Methods:146 patients with knee osteoarthritis who received treatment in our hospital from October 2016 to February 2019 were selected and divided into observation group and control group according to the random number table method, 73 cases in each group.In the experimental group, intra-articular injection of sodium hyaluronate combined with ozone was used, while in the control group, glucosamine hydrochloride tablets were routinely taken and intra-articular injection of sodium hyaluronate was performed. Patients in both groups were treated once a week for 5 consecutive weeks for a course of treatment. General data of patients in the two groups were analyzed, and the efficacy, visual analogue scale (VAS) score and hospital for special surgery knee score (HSS) before and after treatment, levels of inflammatory factors and changes in hemorheology indexes were compared between the two groups.Results:There was no significant difference in general data between the two groups ( P>0.05). Before treatment, there was no significant difference in VAS score and HSS score between the two groups ( P>0.05). After treatment, VAS score and HSS score in the two groups were significantly decreased and increased respectively ( P<0.05). Compared with the control group, VAS score was significantly decreased and HSS score was significantly increased in the observation group after treatment ( P<0.05). The total effective rate in the observation group was higher than that in the control group, and the difference between the two groups was statistically significant ( P<0.05). Before treatment, there was no significant difference in the levels of inflammatory factors vascular endothelial growth factor (VEGF), tumor necrosis factor (TNF-α), interleukin (IL)-1β, IL-6, hypersensitive C-reactive protein (hs-CRP) and matrix metalloproteinase (MMP)-13 in the articular fluid between the two groups ( P>0.05). After treatment, the above indexs in the observation group were significantly lower than those in the control group ( P<0.05). After treatment, the levels of inflammatory cytokines in the articular fluid of the two groups were lower than before ( P<0.05). There was no significant difference in hemorheology indexes between the two groups before treatment ( P>0.05), and the two groups were significantly improved after treatment, and the degree of improvement in the observation group was significantly better than that in the control group ( P<0.05). Conclusions:Ozone combined with sodium hyaluronate intra-articular injection is more effective in the treatment of knee osteoarthritis, which can effectively reduce the level of inflammatory factors and inflammatory response, improve hemorheology, and then reduce the pain of patients, improve the knee joint function.

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Chinese Critical Care Medicine ; (12): 933-937, 2020.
Article in Chinese | WPRIM | ID: wpr-866942

ABSTRACT

Objective:To explore the value of high mobility group box 1 (HMGB1), von Willebrand factor (vWF) and other cytokines in predicting the severity and prognosis of sepsis patients.Methods:Patients with sepsis and septic shock who ≥18 years old and met the Sepsis-3 diagnostic criteria admitted to the department of critical care medicine of Binzhou Medical University Hospital from January to June 2019 were taken as the research objects. The healthy individuals for regular health examination in the same period were taken as the control. The basic information, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) and sequential organ failure assessment (SOFA) scores were recorded. The venous blood was taken within 24 hours after the patients were diagnosed. The levels of HMGB1, vWF, tumour necrosis factor-α (TNF-α), interleukin-10 (IL-10), soluble thrombomodulin (sTM), vascular endothelial growth factor receptor 2 (VEGFR-2), angiopoetin-2 (Ang-2) and other cytokines in serum were determined by enzyme linked immunosorbent assay (ELISA). Differences among patients with sepsis, septic shock, healthy physical examinees, and patients who died in 28-day and those who survived, were compared. Spearman rank correlation method was used to analyze the correlation among each cytokine and APACHEⅡ, SOFA scores. The receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of cytokines on the prognosis of patients with sepsis/septic shock. Logistic regression was used to analyze the risk factors of 28-day death.Results:Eleven patients with sepsis, 25 patients with septic shock and 30 healthy individuals were enrolled. Among the patients with sepsis/septic shock, 15 died in 28-day and 21 survived. The serum levels of TNF-α, IL-10, HMGB1, vWF, sTM and VEGFR-2 in patients with sepsis were significantly higher than those in the healthy control group. The levels of TNF-α, IL-10, HMGB1, vWF, sTM in septic shock group were higher than those in the sepsis group, while the Ang-2 level decreased significantly. The serum levels of TNF-α, IL-10, HMGB1, vWF and sTM in the death group were higher than those in the survival group, while Ang-2 was lower than the survival group. Spearman correlation analysis showed that HMGB1, TNF-α, sTM, IL-10, vWF were positively correlated with APACHEⅡ score when patients with sepsis/septic shock were enrolled ( r values were 0.652, 0.666, 0.445, 0.430 and 0.355, respectively, all P < 0.05), and HMGB1, TNF-α also positively correlated with SOFA score ( r values were 0.433, 0.479, both P < 0.05). Ang-2 was negatively correlated with APACHEⅡ and SOFA scores ( r values were -0.519, -0.440, both P < 0.05). ROC curve analysis showed that the predictive value of HMGB1, vWF, IL-10, sTM for 28-day death in patients with sepsis/septic shock were higher than the APACHEⅡ score [the area under ROC curve (AUC) and 95% confidence interval (95% CI): 0.946 (0.870-1.000), 0.902 (0.790-1.000), 0.877 (0.745-1.000), 0.868 (0.734-1.000) vs. 0.846 (0.700-0.991)]. Logistic regression analysis showed that APACHEⅡ score, vWF, sTM, and IL-10 were independent risk factors for 28-day death in patients with sepsis/septic shock (β values were 4.731, 0.407, -7.058, -0.887, all P < 0.05). Conclusion:HMGB1, vWF, IL-10, sTM and other cytokines all can be used to evaluate the severity and prognosis of sepsis patients.

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Chinese Medical Journal ; (24): 2150-2156, 2019.
Article in English | WPRIM | ID: wpr-774633

ABSTRACT

BACKGROUND@#The association between peripheral leukocyte count and bleeding events in nonvalvular atrial fibrillation (NVAF) patients treated with dabigatran remains unclear. This study aimed to explore the association between leukocyte count and bleeding events after excluding other confounders in NVAF patients taking dabigatran.@*METHODS@#A total of 851 NVAF patients treated with dabigatran (110 mg bid) were recruited from 12 centers in China from February 2015 to December 2017. Follow-up was completed by May 2018. The exposure and outcome variables were leukocyte count measured at baseline and the number of bleeding events within the subsequent 6 months. Multivariate Cox proportional hazards models were constructed to analyze independent associations, and a Cox proportional hazards regression with cubic spline functions and smooth curve fitting (penalized spline method) was used to address nonlinearity between leukocyte count and bleeding. The inflection point was calculated using a recursive algorithm, and then a two-piecewise Cox proportional hazards model for both sides of the inflection point was constructed.@*RESULTS@#During 6-month follow-up, 87 participants occurred bleeding events. For every 1 × 10/L increase in leukocyte count, the risk of bleeding increased by 11% (hazard ratio [HR]: 1.11, 95% confidence interval [CI]: 0.99-1.25). The smooth curve showed nonlinear relationship between leukocyte count and bleeding events. The inflection point of the leukocyte count was 6.75 × 10/L. For leukocyte counts < 6.75 × 10/L, the HR (95% CI) was 0.88 (0.69-1.13), and for leukocyte counts ≥ 6.75 × 10/L, the HR (95% CI) was 1.28 (1.09-1.51).@*CONCLUSION@#This study found a J-shaped association between baseline leukocyte count and risk of bleeding in NVAF patients treated with dabigatran.@*CLINICAL TRIAL REGISTRATION@#NCT02414035, https://clinicaltrials.gov.

19.
Article in Chinese | WPRIM | ID: wpr-774213

ABSTRACT

Zinc oxide quantum dots (ZnO QDs) were synthesized by gel-sol method and employed as the transdermal aloesin (Alo) carriers. ZnO QDs were surface-functionalized with amino using aminopropyltriethoxysilane (APTES). Alo was covalently bonded on the surface of ZnO QDs via N,N'-carbonyldiimidazole to obtain Alo NPs, which were characterized by transmission electron microscope (TEM), dynamic light scattering (DLS), Fourier transform infrared spectroscopy (FTIR) and thermal gravimetric analyzer (TGA). TEM images showed that ZnO QDs were analogously sphere and monodisperse with a reasonably narrow size distribution, of which was around 4 nm. The size of Alo NPs increased to around 8 nm due to the surface modification. The intense bands at around 3 400 cm and 1 200 cm in the FTIR spectrum of Alo NPs from the vibration of -OH indicated the linkage of Alo on the surface of ZnO QDs. The results of TGA analysis showed that the mass ratio of ZnO QDs and Alo were 39.27% and 35.14%, respectively. The penetration of Alo NPs was much higher than raw Alo according to the passive penetration experiments with Franz-type diffusion cells instrument using full-thickness cavy skin, which manifested the improvement of the penetration for Alo delivered by ZnO QDs. The pH-controlled drug release behavior was investigated. At pH 7.4, only a small amount of Alo (1.45% ± 0.21%) had been released after 2 h. In contrast, as incubation at pH 5.0 of which pH was similar to endosomal environment, Alo was released very fast (87.63% ± 0.46% in 2 h) from Alo NPs, confirming that Alo NPs could response to the pH and realize the intracellular drug release. The inhibitory effect of Alo NPs on tyrosinase was in a dose dependent manner. When the concentration of Alo NPs was 12.5 μg/mL, the inhibition rate was up to 40.32% ± 1.57%. All the results show that the Alo NPs hold a great potential in transdermal tyrosinase inhibition.


Subject(s)
Administration, Cutaneous , Animals , Chromones , Drug Delivery Systems , Glucosides , Guinea Pigs , Monophenol Monooxygenase , Metabolism , Nanoparticles , Quantum Dots , Zinc Oxide
20.
Article in Chinese | WPRIM | ID: wpr-777934

ABSTRACT

Objective To explore influencing factors of the elderly's frailty. Methods Eight communities were randomly selected from Dalang Town, Dongguan City, and all the eligible elderly people were investigated using the self-developed frailty index. Univariate analysis was performed using the 2 test, and multivariate analysis was performed by ordinal multi-class Logistic regression. Results Univariate analysis showed that there were significant differences in the distribution of frailty conditions among different demographic characteristics, family relationships, economic situation and lifestyle (all P<0.05). Multivariate analysis showed that younger age (OR=0.13, P<0.001), male (OR=0.65, P=0.012), and daily exercise (OR=0.76, P=0.049) were protective factors for frailty of the elderly. Illiterate (OR=2.42, P<0.001), fewer times to see children per month (OR=1.82, P=0.035), pension funds as the main economic source (OR=1.59, P<0.001), low level of physical activity (OR=2.18, P<0.001) and none social participation (OR=1.41, P=0.004) were risk factors of frailty. Conclusion Age, gender, education level, times to see children per month, economic source, exercise frequency, physical activity level and social participation are the influencing factors of frailty of the elderly.

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