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1.
Acta Pharmaceutica Sinica ; (12): 142-149, 2022.
Article in Chinese | WPRIM | ID: wpr-913179

ABSTRACT

Vaccination is an effective way to reduce the morbidity and mortality of infectious diseases. As a needle-free transcutaneous immunization (NF-TCI) vaccination technology, microneedles (MNs), composed of multiple micro-needles orderly attached to a substrate, can overcome the problems of low immune efficiency, poor compliance and waste of resources that exists in the conventional vaccination by injection, thus becoming a research hotspot in biomedicine. The microneedle vaccine can directly break through the stratum corneum barrier of the skin without touching nerves and blood vessels in the dermis, and effectively delivers the vaccine to the immune cells in the skin tissue to initiate the immune response of the body, thus triggering strong humoral and cellular immune processes. Vaccine delivery via the MNs system possesses the advantages of high safety, satisfying immune effect and practical economy, and shows great prospect in the prevention and treatment of infectious diseases and antineoplastic therapy. This article reviews the development background of MNs in transcutaneous immunization, the types of vaccine delivery, the factors affecting the immune effect, the problems to be solved and development direction in the future.

2.
Acta Pharmaceutica Sinica B ; (6): 2609-2644, 2021.
Article in English | WPRIM | ID: wpr-888876

ABSTRACT

Membrane-disruptive peptides/peptidomimetics (MDPs) are antimicrobials or anticarcinogens that present a general killing mechanism through the physical disruption of cell membranes, in contrast to conventional chemotherapeutic drugs, which act on precise targets such as DNA or specific enzymes. Owing to their rapid action, broad-spectrum activity, and mechanisms of action that potentially hinder the development of resistance, MDPs have been increasingly considered as future therapeutics in the drug-resistant era. Recently, growing experimental evidence has demonstrated that MDPs can also be utilized as adjuvants to enhance the therapeutic effects of other agents. In this review, we evaluate the literature around the broad-spectrum antimicrobial properties and anticancer activity of MDPs, and summarize the current development and mechanisms of MDPs alone or in combination with other agents. Notably, this review highlights recent advances in the design of various MDP-based drug delivery systems that can improve the therapeutic effect of MDPs, minimize side effects, and promote the co-delivery of multiple chemotherapeutics, for more efficient antimicrobial and anticancer therapy.

3.
Acta Pharmaceutica Sinica B ; (6): 2326-2343, 2021.
Article in English | WPRIM | ID: wpr-888865

ABSTRACT

Proteins and peptides have become a significant therapeutic modality for various diseases because of their high potency and specificity. However, the inherent properties of these drugs, such as large molecular weight, poor stability, and conformational flexibility, make them difficult to be formulated and delivered. Injection is the primary route for clinical administration of protein and peptide drugs, which usually leads to poor patient's compliance. As a portable, minimally invasive device, microneedles (MNs) can overcome the skin barrier and generate reversible microchannels for effective macromolecule permeation. In this review, we highlighted the recent advances in MNs-mediated transdermal delivery of protein and peptide drugs. Emphasis was given to the latest development in representative MNs design and fabrication. We also summarize the current application status of MNs-mediated transdermal protein and peptide delivery, especially in the field of infectious disease, diabetes, cancer, and other disease therapy. Finally, the current status of clinical translation and a perspective on future development are also provided.

4.
Article in Chinese | WPRIM | ID: wpr-883470

ABSTRACT

Objective:To investigate the influence of Covid-19 epidemic on the number of acute ischemic stroke patients with intravenous thrombolytic therapy in Dalian in 2020, the way to hospital, onset to door time (ODT), door to needle time(DNT), onset to needle time(ONT), and the National Institute of Health Stroke Scale (NIHSS) before and after intravenous thrombolytic therapy.Methods:This was a retrospective descriptive study on 13 map-participating hospitals in Dalian from August 2020 to December 2020. The number of acute ischemic stroke patients with intravenous thrombolytic therapy, ODT, DNT, ONT, modes of transport to hospital, the NIHSS score before and after intravenous thrombolytic therapy, etc were analyzed. Data were collected from August 1, 2020 to December 31, 2020, and compared with the baseline data from the same period in 2019.Results:SPSS 22.0 statistical software and Data Analysis ToolPak were used for statistical analysis of the obtained data, and T tests statistic was used for data analysis. In 2020,the number of acute ischemic stroke patients with intravenous thrombolytic therapy increased (681 cases vs 416 cases), and DNT increased [50 minutes vs 45 minutes P = 0.01]. In 2020, 83.55% of patients indicated self-visit as their main mode of transport to the hospital. In 2020, among the self-visit patients with NIHSS score<15 scores,the number of the patients with the NHISS score unchanged or decreased after intravenous thrombolytic therapy was more (562 scores vs. 535 scores, P<0.001), and the patients with NIHSS score ≥15 scores were more willing to call ambulances to hospital. Conclusions:During the Covid-19 epidemic period of 2020, the number of acute ischemic stroke patients receiving intravenous thrombolytic therapy increased, DNT increase; the patients withNIHSS score<15 scores are more willing to choose to visit the hospital using their own transportation and benefit from intravenous thrombolytic therapy. The patients with NIHSS ≥15 scores prefer to call ambulances to hospital.

5.
Article in Chinese | WPRIM | ID: wpr-883423

ABSTRACT

Objective:To analyze the correlation factors between peripapillary duodenal diverticulum (PDD) and choledochectasia by CT scan.Methods:The clinical data of 220 patients with duodenal diverticulum detected by multi-slice spiral CT scan and confirmed by gastrointestinal angiography or endoscopic retrograde cholangiopancreatography (ERCP) in Dahua Hospital, Xuhui District of Shanghai City were retrospectively analyzed. The correlation of the PDD, the contact of common bile duct (CBD), length of contact and exudation with choledochectasia in patients with PDD were analyzed.Results:A total of 236 duodenal diverticulum were found in 220 patients. Among them, there were 152 PDD, 41 diverticulum located superior to the duodenal papilla, 28 diverticulum located inferior to the duodenal papilla, 3 diverticulum located lateral to the duodenal papilla, and 12 diverticulumlocated in the horizontal portion. The incidence of choledochectasia in patients with PDD contacted with CBD was significantly higher than that in patients with PDD not contacted with CBD: 59.35% (73/123) vs. 37.93% (11/29), and there was statistical difference ( P<0.05); the incidence of choledochectasia in patients with contact length of PDD and CBD ≥1.5 cm was significantly higher than that in patients without contact of PDD and CBD and patients with contact length of PDD and CBD <1.5 cm: 82.43% (61/74) vs. 24.49% (12/49) and 37.93% (11/29), and there was statistical difference ( P<0.05); the incidence of choledochectasia in PDD patients with exudation was significantly higher than that in PDD patients without exudation: 10/11 vs. 52.48% (74/141), and there was statistical difference ( P<0.05). Conclusions:The patients with contact length of PDD and CBD ≥1.5 cm and patients with PDD combined with exudation could be prone to choledochectasia.

6.
Acta Pharmaceutica Sinica B ; (6): 1030-1046, 2021.
Article in English | WPRIM | ID: wpr-881183

ABSTRACT

When nanoparticles were introduced into the biological media, the protein corona would be formed, which endowed the nanoparticles with new bio-identities. Thus, controlling protein corona formation is critical to

7.
Article in Chinese | WPRIM | ID: wpr-879447

ABSTRACT

OBJECTIVE@#Using the method of finite element analysis, to compare the biomechanical properties between the plate deviating from the long axis of the cervical spine and the standard placement of the plate in the anterior cervical fusion surgery.@*METHODS@#A healthy female volunteer was selected and CT scan (C@*RESULTS@#The lower cervical spine (C@*CONCLUSION@#Little effect on the mechanical stability of the cervical spine was anticipated when the anterior cervical plate was not perfectly aligned with the long axis of the cervical spine. If the tilt of the plate in clinical surgery is less than 20°, there is no need to readjust the position of the plate.


Subject(s)
Biomechanical Phenomena , Cervical Vertebrae/surgery , Female , Finite Element Analysis , Humans , Range of Motion, Articular , Reproducibility of Results , Spinal Fusion
8.
Acta Pharmaceutica Sinica B ; (6): 3297-3309, 2021.
Article in English | WPRIM | ID: wpr-922795

ABSTRACT

Nanoparticles (NPs) have shown potential in cancer therapy, while a single administration conferring a satisfactory outcome is still unavailable. To address this issue, the dissolving microneedles (DMNs) were developed to locally deliver functionalized NPs with combined chemotherapy and photothermal therapy (PTT).

9.
Acta Pharmaceutica Sinica B ; (6): 2404-2416, 2020.
Article in English | WPRIM | ID: wpr-881120

ABSTRACT

Pulmonary drug delivery has attracted increasing attention in biomedicine, and porous particles can effectively enhance the aerosolization performance and bioavailability of drugs. However, the existing methods for preparing porous particles using porogens have several drawbacks, such as the inhomogeneous and uncontrollable pores, drug leakage, and high risk of fragmentation. In this study, a series of cyclodextrin-based metal-organic framework (CD-MOF) particles containing homogenous nanopores were delicately engineered without porogens. Compared with commercial inhalation carrier, CD-MOF showed excellent aerosolization performance because of the homogenous nanoporous structure. The great biocompatibility of CD-MOF in pulmonary delivery was also confirmed by a series of experiments, including cytotoxicity assay, hemolysis ratio test, lung function evaluation,

10.
Acta Pharmaceutica Sinica B ; (6): 2198-2211, 2020.
Article in English | WPRIM | ID: wpr-881106

ABSTRACT

Malignant tumor has become an urgent threat to global public healthcare. Because of the heterogeneity of tumor, single therapy presents great limitations while synergistic therapy is arousing much attention, which shows desperate need of intelligent carrier for co-delivery. A core‒shell dual metal-organic frameworks (MOFs) system was delicately designed in this study, which not only possessed the unique properties of both materials, but also provided two individual specific functional zones for co-drug delivery. Photosensitizer indocyanine green (ICG) and chemotherapeutic agent doxorubicin (DOX) were stepwisely encapsulated into the nanopores of MIL-88 core and ZIF-8 shell to construct a synergistic photothermal/photodynamic/chemotherapy nanoplatform. Except for efficient drug delivery, the MIL-88 could be functioned as a nanomotor to convert the excessive hydrogen peroxide at tumor microenvironment into adequate oxygen for photodynamic therapy. The DOX release from MIL-88-ICG@ZIF-8-DOX nanoparticles was triggered at tumor acidic microenvironment and further accelerated by near-infrared (NIR) light irradiation. The

11.
Chinese Journal of Radiology ; (12): 864-868, 2020.
Article in Chinese | WPRIM | ID: wpr-868350

ABSTRACT

Objective:To compare and analyze the calcification characteristics and diagnostic efficiency of different breast lesion types using digtal breast tomosynthesis (DBT) and full-field digital mammography (FFDM).Methods:Totally 1 263 patients who underwent both DBT and FFDM at the same time from January 2015 to December 2018 in Dahua Hospital, Xuhui district, Shanghai were analyzed retrospectively. Benign and malignant calcification should be confirmed by pathology or a follow-up of 24 months or more using mammography, and the results of DBT and FFDM were taken as a gold standard. The detection rate and diagnostic efficiency of different types of benign and malignant breast calcification with the two methods were compared and analyzed. The detection rate of morphology and distribution of malignant calcification were compared among groups.Results:There were 240 cases with non-dense breast including 56 cases with benign calcification and 13 cases with malignant calcification. Meanwhile, there were 1 023 cases with dense breast, including 356 cases with benign calcification and 63 cases with malignant calcification. In the cases of non-dense breast, the detection rates of benign calcification by DBT and FFDM were 22.9% (55/240) and 21.7% (52/240), whereas the rates of malignant calcification were 5.0% (12/240) and 4.6% (11/240), all without statistically significances(χ2=0.108, 0.046, P>0.05). No significant differences were observed in the morphology and distribution of malignant calcification detection rates ( P>0.05). In the cases of dense breast, the benign calcification detection rates by DBT and FFDM were 34.2% (350/1 023) and 31.9% (326/1 023), whereas the detection rates of malignant calcification were 6.0% (61/1 023) and 4.9% (50/1 023), all without statistically significances (χ2=1.273 and 1.153, P>0.05). DBT detected more cases of amorphous and cluster distribution of malignant calcification than FFDM, with statistically significant differences (χ2=12.921 and 11.667, P<0.05). The area under ROC curve of DBT and FFDM in diagnosis of non-dense breast were 0.993 and 0.992, and 0.987 and 0.964 in dense breast, respectively, with no significant differences ( Z= 0.136 and 1.391, P>0.05). Conclusions:Compared with FFDM, DBT shows no statistical difference in the diagnostic efficiency of breast calcification. However, it has certain advantages in detecting malignant, amorphous, and clustered calcification in dense breast. DBT has a potential to improve the accuracy of BI-RADS classification of breast calcification.

12.
Journal of Clinical Hepatology ; (12): 772-774, 2020.
Article in Chinese | WPRIM | ID: wpr-819185

ABSTRACT

ObjectiveTo investigate the condition of liver injury in different populations of patients with coronavirus disease 2019 (COVID-2019), and to further understand the pathogenic characteristics of COVID-2019. MethodsA total of 28 patients with COVID-2019 and liver injury who were admitted to the designated hospitals for COVID-2019 in Bozhou, China from February 1 to 12, 2020 were enrolled, and they were divided into male group(n=15) and female group(n=13) according to sex or young group(n=10) and middle-aged and elderly group(n=17) according to age. The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), and lactate dehydrogenase (LDH) were measured on admission. The Wilcoxon rank-sum test was used for comparison of continuous data between two groups, the Fisher exact test was used for comparison of categorical data between two groups. ResultsVarying degrees of liver injury were observed in the 28 patients. There were no significant differences in the levels of ALT, AST, GGT, ALP, and LDH between the male group and the female group and between the young group and the middle-aged and elderly group (all P>0.05). There was no significant difference in abnormal rate of ALT, AST, GGT and LDH between male group and female group (all P>0.05); There was no significant difference in abnormal rate of ALT, AST, GGT between the young group and the middle-aged and elderly group (all P>0.05); there was a significant difference in abnormal rate of LDH between the young group and the middle-aged and elderly group(P<0.05). ConclusionPatients with COVID-2019 may experience different degrees of liver injury with the development of the disease, middle-aged and elderly patients tend to develop liver injury.There was no significant correlation with gender and age in mild and general patients. Therefore, liver function should be monitored in patients with COVID-2019, and the treatment method should be selected carefully to prevent liver injury.

13.
Acta Pharmaceutica Sinica B ; (6): 1331-1346, 2020.
Article in English | WPRIM | ID: wpr-828804

ABSTRACT

An explicit illustration of pulmonary delivery processes (PDPs) was a prerequisite for the formulation design and optimization of carrier-based DPIs. However, the current evaluation approaches for DPIs could not provide precise investigation of each PDP separately, or the approaches merely used a simplified and idealized model. In the present study, a novel modular modified Sympatec HELOS (MMSH) was developed to fully investigate the mechanism of each PDP separately in real-time. An inhaler device, artificial throat and pre-separator were separately integrated with a Sympatec HELOS. The dispersion and fluidization, transportation, detachment and deposition processes of pulmonary delivery for model DPIs were explored under different flow rates. Moreover, time-sliced measurements were used to monitor the PDPs in real-time. The Next Generation Impactor (NGI) was applied to determine the aerosolization performance of the model DPIs. The release profiles of the drug particles, drug aggregations and carriers were obtained by MMSH in real-time. Each PDP of the DPIs was analyzed in detail. Moreover, a positive correlation was established between the total release amount of drug particles and the fine particle fraction (FPF) values ( = 0.9898). The innovative MMSH was successfully developed and was capable of illustrating the PDPs and the mechanism of carrier-based DPIs, providing a theoretical basis for the design and optimization of carrier-based DPIs.

14.
International Eye Science ; (12): 541-543, 2020.
Article in Chinese | WPRIM | ID: wpr-798296

ABSTRACT

@#AIM: To explore the effect of fundus laser combined with Qi Ming granule on diabetic retinopathy in stage Ⅲ.<p>METHODS: Fifty six patients with Ⅲ stage diabetic retinopathy who were treated in our hospital from December 2017 to June 2018 were divided into control group(28 cases)and observation group(28 cases)according to the treatment method. The control group was treated with panretinal photocoagulation. The observation group was treated with Qi Ming granule combined with retinal laser photocoagulation. The best-corrected visual acuity(BCVA), mean defect of visual field(MD), and central macular thickness(CMT)were examined before photocoagulation and 1mo, 3mo and 6mo after photocoagulation to compare the retinal function between the two groups.<p>RESULTS: The mean BCVA, MD and CMT values of the eyes in the PRP+ drug treatment group and the PRP treatment group were statistically significant(<i>P</i><0.05)at 1, 3, and 6mo after treatment. The mean BCVA, MD and CMT values between the two groups were statistically significant(<i>P</i><0.05)at 1 and 3mo after treatment. There was no significant difference at 6mo after treatment(<i>P</i>>0.05).<p>CONCLUSION: Qi Ming granule can alleviate the degree of laser photocoagulation damage to the retina, promote the rapid repair of laser damage, and reduce diabetic macular edema. It is worthy of popularization and application in the clinic.

15.
Chinese Journal of Cardiology ; (12): 814-819, 2019.
Article in Chinese | WPRIM | ID: wpr-796615

ABSTRACT

Objective@#To evaluate the feasibility and safety percutaneous pulmonary vein intervention in patients with severe pulmonary vein stenosis (PVS) caused by fibrosing mediastinitis(FM).@*Methods@#This retrospective analysis included 5 FM patients (2 male, 3 female, 54-77 years old) confirmed by clinical presentation and chest computed tomography (CT) scan from January to June 2018 who were from Gansu Provincial Hospital and Shanghai Chest Hospital. CT pulmonary angiography (CTPA) further revealed severe PVS caused by fibrotic tissue compression in mediastinum. After selective pulmonary vein angiography, gradually balloon angioplasty was used to expand the pulmonary vein and then stents were implanted in the pre-dilated stenotic pulmonary veins. Evaluation of therapeutic effect was made at 6 months after the procedure.@*Results@#All of 11 serious compression PVS were treated with stent implantation (diameter: 7-10 mm, length: 17-27 mm). After stenting, degree of pulmonary vein stenosis decreased from (83±16)% to (12±4)% (P<0.01). The minimal diameter of the stenotic pulmonary vein was significantly increased from (0.8±0.5)mm to (7.5±0.8)mm (P<0.01). Trans-stenotic gradient decreased from (27.0±15.1)mmHg (1 mmHg=0.133 kPa) to (2.50±0.58)mmHg (P<0.05). Mean pulmonary pressure measured by cardiac catheter decreased from (45.0±9.0)mmHg to (38.7±8.4)mmHg (P<0.05). One patient experienced cardiac arrest due to vagal nerve reflex during big sizing balloon stent dilation and recovered after cardiopulmonary resuscitation. There were no other serious procedure related complications. During the follow-up, severe stenosis at end of proximal stent was evidenced in 1 patient due to fibrotic compression, and another patient developed in-stent thrombosis due to discontinuation of prescribed anticoagulant.@*Conclusion@#Percutaneous intervention for severe pulmonary vein stenosis caused by FM is feasible and safe, and can improve hemodynamic caused by the compression of mediastinal vascular structures in these carefully selected patients.

16.
Acta Pharmaceutica Sinica ; (12): 29-35, 2019.
Article in Chinese | WPRIM | ID: wpr-778659

ABSTRACT

The aim of this study is to prepare porous γ-cyclodextrin metal-organic framework (CD-MOF) with good biocompatibility to improve the in vitro release properties of water-insoluble drugs. Different sizes of CD-MOF were obtained by controlling the self-assembly of γ-cyclodextrin and potassium ion and the rate of crystal growth. The poorly water-soluble diflunisal (DIF) was selected as the model drug and loaded into the interior of porous CD-MOF by the impregnation method. The DIF loaded CD-MOF (DIF-MOF) was characterized by scanning electron microscopy (SEM), powder X-ray diffraction (PXRD), nitrogen adsorption and desorption, Fourier infrared spectrometer and thermogravimetric analysis. In addition, in vitro cytotoxicity and solubilizing capability of CD-MOF were investigated. It revealed that the obtained CD-MOF was cubic-like with a narrow size distribution and high porosity. Negligible cytotoxicity was found after incubation with RAW264.7 cells. Compared with the pure CD-MOF carrier, the morphology and crystal form of DIF-MOF was not damaged during the drug loading process. Moreover, the solubility and release rate of water-insoluble DIF from the DIF-MOF were significantly increased.

17.
Article in English | WPRIM | ID: wpr-771427

ABSTRACT

OBJECTIVE@#To investigate whether Ershen Pill (ESP, ) could alleviate the symptom of Pi (Spleen)-Shen (Kidney) yang deficiency (PSYD)-induced diarrhea in rat model and explore its anti-diarrhea mechanism.@*METHODS@#Seventy-five Sprague-Dawley rats were divided into 5 groups by a random number table, including control, positive, model, low-dose (LD) and high-dose (HD) ESP groups, 15 rats in each group. All the rats, except those in the control group, were developed PSYD induced-diarrhea based on its pathology and etiology. The rats in positive, LD and HD ESP groups were treated with Shenling Baizhu Pill (), LD (1.05 g/kg) or HD (3.50 g/kg) ESP petroleum ether extract once a day for 2 weeks, respectively. Body weight change and diarrhea index were measured. The histology scores of the kidney were evaluated via hematoxylin and eosin (HE) staining. Aquaporin-3 (AQP3) expression in the colon was analyzed by immunofluorescence, quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and Western blot, respectively.@*RESULTS@#Compared with the model group, oral administration of LD and HD ESP prevented body weight loss and inhibited diarrhea after 2-week treatment (P<0.05). Kidney deterioration was impeded, and the histology score in LD and HD ESP groups were 8.2 and 10.5, respectively, which were both higher than those in the model group (P<0.05). In addition, ESP treatment alleviated rat colitis, and HD ESP significantly improved the AQP3 positive staining intensity in the colon tissue compared with the model group. The result from Western blot revealed that AQP3 protein synthesis in colon tissue of LD and HD ESP groups increased by 2.1- and 5.9-fold compared with the model group (P<0.05). qRT-PCR result showed that AQP3 gene expression in the HD ESP group was also up-regulated by 2.5-fold normalized to the model group (P<0.05).@*CONCLUSION@#ESP extract effectively alleviates the symptoms of PSYD and relieves PSYD-induced diarrhea by improving AQP3 synthesis in the colon.

18.
Journal of Experimental Hematology ; (6): 1056-1061, 2018.
Article in Chinese | WPRIM | ID: wpr-689529

ABSTRACT

<p><b>OBJECTIVE</b>To study the clinical characteristics and prognosis of patients with variant Ph chromosome-positive leukemia.</p><p><b>METHODS</b>The defection of morphology, cytogenetics, immunology and molecular biology was performed in 4 cares of variant Ph chromosome-positive leukemia, and the therepeuitics outcome of 4 patients was evaluated.</p><p><b>RESULTS</b>Among 4 cases of variant Ph+ leukemia, 3 cases were patients with CML, including 1 case in chronic phase and 2 cases in accelerated phase; and 1 cases was patient with adult B acute lymphoblasric leukemia(B-ALL).The defecfion of cytogenetics in 4 cases showed that 2 cases of CML displayed t(9; 22; 14) abnormality, 1 case of CML displayed t(5; 9; 22) abnormality, moreover, the BCR/ABL fution gane in 3 cases of CML all was e14a2 type, 1 cases of adult B-ALL disylayed t(9; 22; 17) abnormatlity, BCR/ABL fution gene of this case was e13a3 type, 4 patients all received treatment wire chemotherapeptic regimen contaiming methanesulfanate imatinib. As a result, 1 cases of adult B-ALL with e13a3 type BCR/ABL fusion gene positive relapsed after molecular biology remission for 4 months and died in the 10th month; and yet 3 cases of CML are still in molecular biology remission, the disease-free survival time of these 3 cases was 10, 19 and 27 months respectively.</p><p><b>CONCLUSION</b>The patients with variant Ph chromosome-positive leukemia will response to the first generation tyrosine kinase inhibitors, but the prognosis of patients with e13a3 type of BCR/ABL fusion gene remains to be further explored.</p>


Subject(s)
Fusion Proteins, bcr-abl , Humans , Imatinib Mesylate , Leukemia , Philadelphia Chromosome , Prognosis
19.
Journal of Experimental Hematology ; (6): 1072-1078, 2018.
Article in Chinese | WPRIM | ID: wpr-689526

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the clinical characteristics and outcome of parhents with EBV infection conbined with hemophagocytic syndrome and Hodgkin's lymphoma.</p><p><b>METHODS</b>The morphotogy of bone marrow cells was observed by bone marrow smear and light microscopy, the pathologic changes of bone marrow ware analyzed by bone marrow biopsy and immunohistochemistry methord, the pathologic changes of lymphonudes ware detected by immunohistochemical methord, the paticnts were treated with ABVD (epirubicin, bleomycin, vincristine and dacarbazine) chemotherapeutic regimen.</p><p><b>RESULTS</b>Fever complicatid with pancytopenia, obvious increase of ferritin and sCD25, hypofibrinogenemia, hemophogocytic phenomen of bone marrow, increase of EBV-DNA copy number ware observed, which all accorded with the criteria EBV righted hemophagocytic syndrome. The curative efficacy of amtiinfective treatmatnt was poor, After treatment with HLH-2004 regimen, the fever symptome and the laboratory indicaters such as whole blood cells, ferritin and fibrinogen all were recovered to normal levels. Left mandibular lymphadenctasis was confirmed as Hodgkin's lymphoma (mixed cell type) by pathological examination. The patient achieved complete molecular remission after 1 course chemotherapy with ABVD regimen. The level of EBV-DNA copy number were also decreased. As the reshlt, the patient's hemophagocytic syndrome had bean effectively controlled, and the Hodgkin's lymphoma is still in complete remission.</p><p><b>CONCLUSION</b>Epstein-Barr virus-ratated hemophagocytic syndrome and Hodgkin's lymphoma are rare, and their long-term prognosis needs to be further explored.</p>


Subject(s)
Epstein-Barr Virus Infections , Herpesvirus 4, Human , Hodgkin Disease , Humans , Lymphohistiocytosis, Hemophagocytic , Vincristine
20.
Article in Chinese | WPRIM | ID: wpr-694951

ABSTRACT

Objective To study the incidence of moderate and severe preoperative anxiety and its related risk factors in patients undergoing elective general anesthesia.Methods A total of 562 pa-tients undergoing selective anesthesia 225 males and 337 females,aged 18-85 years,ASA physical status Ⅰ-Ⅲ,were selected in the affiliated hospital of Xuzhou medical university.State-trait anxiety inventory (STAI)was used to assess the degree of preoperative anxiety and the patients were divided into mild anxiety group (SAI ≤ 37,n=294)and moderate and severe anxiety group (SAI > 37,n=268)according to SAI score.The factors related to preoperative anxiety such as age,gender,edu-cational background,marital status,history of previous surgery,presence of pain,preoperative diag-nosis of tumor and presence or absence of hypertension were collected.Results The incidence of moderate and severe preoperative anxiety in our study was 268 (47.7%).Logistic regression analysis showed that female (OR=1.846,95%C I 1.298-2.624),single (OR=2.208,95%C I 1.218-4.004) might be the risk factors of preoperative anxiety.Conclusion Females and single individuals may be independent risk factors for preoperative anxiety.

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