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1.
Article in Chinese | WPRIM | ID: wpr-875949

ABSTRACT

Objective To investigate the rate and the population distribution of subjects with indeterminate result of HIV antibody test and to understand the relationships between the western blot(WB)banding patterns and HIV infection through follow-up reexamination. Methods Samples with indeterminate results of HIV antibody test were collected by Jiading Center for Disease Control and Prevention from 2013 to 2017. They were used for analysis of the source, the distribution of Western blotting band pattern and the follow-up results. Results Among 698 samples required to be re-tested for confirmation of HIV infection, 151(21.63%)showed indeterminate WB test results. There were 18 types of WB band in 151 HIV antibody-indeterminate samples. The most common band types, accounting for 79.47%, were p24, gp160, and gp160p24. One hundred(among 151)subjects were followed up and the success follow-up rate was 50.00%. Among them, 28(56.00%)samples were still with indeterminate results of HIV antibody, 11(22.00% turned to be negative and 11(22.00%)turned to positive. The follow-up confirmatory tests showed that 67.86% of the samples with p24 band were still with indeterminate results and 40.00% of the samples with gp160 band became HIV antibody-negative. The samples with one of the three band patterns of gp160gp120p24, gp160p24p17 and gp160gp120p66p51 all became HIV antibody-positive. Conclusion The detection rate of indeterminate HIV antibody results varies in different populations. Positive conversion rates with different WB band patterns are different. Follow-up of the populations with specific WB band patterns should be strengthened to detect HIV infection cases as early as possible.

2.
Chinese Medical Journal ; (24): 1803-1811, 2021.
Article in English | WPRIM | ID: wpr-887602

ABSTRACT

BACKGROUND@#Acute heart failure (AHF) is the most common disease in emergency departments (EDs). However, clinical data exploring the outcomes of patients presenting AHF in EDs are limited, especially the long-term outcomes. The purposes of this study were to describe the long-term outcomes of patients with AHF in the EDs and further analyze their prognostic factors.@*METHODS@#This prospective, multicenter, cohort study consecutively enrolled 3335 patients with AHF who were admitted to EDs of 14 hospitals from Beijing between January 1, 2011 and September 23, 2012. Kaplan-Meier and Cox regression analysis were adopted to evaluate 5-year outcomes and associated predictors.@*RESULTS@#The 5-year mortality and cardiovascular death rates were 55.4% and 49.6%, respectively. The median overall survival was 34 months. Independent predictors of 5-year mortality were patient age (hazard ratio [HR]: 1.027, 95 confidence interval [CI]: 1.023-1.030), body mass index (BMI) (HR: 0.971, 95% CI: 0.958-0.983), fatigue (HR: 1.127, 95% CI: 1.009-1.258), ascites (HR: 1.190, 95% CI: 1.057-1.340), hepatic jugular reflux (HR: 1.339, 95% CI: 1.140-1.572), New York Heart Association (NYHA) class III to IV (HR: 1.511, 95% CI: 1.291-1.769), heart rate (HR: 1.003, 95% CI: 1.001-1.005), diastolic blood pressure (DBP) (HR: 0.996, 95% CI: 0.993-0.999), blood urea nitrogen (BUN) (HR: 1.014, 95% CI: 1.008-1.020), B-type natriuretic peptide (BNP)/N-terminal pro-B-type natriuretic peptide (NT-proBNP) level in the third (HR: 1.426, 95% CI: 1.220-1.668) or fourth quartile (HR: 1.437, 95% CI: 1.223-1.690), serum sodium (HR: 0.980, 95% CI: 0.972-0.988), serum albumin (HR: 0.981, 95% CI: 0.971-0.992), ischemic heart diseases (HR: 1.195, 95% CI: 1.073-1.331), primary cardiomyopathy (HR: 1.382, 95% CI: 1.183-1.614), diabetes (HR: 1.118, 95% CI: 1.010-1.237), stroke (HR: 1.252, 95% CI: 1.121-1.397), and the use of diuretics (HR: 0.714, 95% CI: 0.626-0.814), β-blockers (HR: 0.673, 95% CI: 0.588-0.769), angiotensin-converting enzyme inhibitors (ACEIs) (HR: 0.714, 95% CI: 0.604-0.845), angiotensin-II receptor blockers (ARBs) (HR: 0.790, 95% CI: 0.646-0.965), spironolactone (HR: 0.814, 95% CI: 0.663-0.999), calcium antagonists (HR: 0.624, 95% CI: 0.531-0.733), nitrates (HR: 0.715, 95% CI: 0.631-0.811), and digoxin (HR: 0.579, 95% CI: 0.465-0.721).@*CONCLUSIONS@#The results of our study demonstrate poor 5-year outcomes of patients presenting to EDs with AHF. Age, BMI, fatigue, ascites, hepatic jugular reflux, NYHA class III to IV, heart rate, DBP, BUN, BNP/NT-proBNP level in the third or fourth quartile, serum sodium, serum albumin, ischemic heart diseases, primary cardiomyopathy, diabetes, stroke, and the use of diuretics, β-blockers, ACEIs, ARBs, spironolactone, calcium antagonists, nitrates, and digoxin were independently associated with 5-year all-cause mortality.


Subject(s)
Angiotensin Receptor Antagonists , Angiotensin-Converting Enzyme Inhibitors , Beijing/epidemiology , Biomarkers , Cohort Studies , Emergency Service, Hospital , Follow-Up Studies , Heart Failure/mortality , Humans , Natriuretic Peptide, Brain , Peptide Fragments , Prognosis , Prospective Studies
3.
Article in Chinese | WPRIM | ID: wpr-885804

ABSTRACT

After decades of development, thymus minimally invasive surgery has derived a variety of surgical methods. In selected cases, it can achieve equivalent therapeutic effect as open surgery. Because mediastinal disease is rare compared with other chest diseases, there is a lack of large-scale comparative study among different surgical methods, and the choice of surgical approaches is mostly based on the experience and habit of the operator. The purpose of this review is to discuss the evolution of minimally invasive thymus surgery, summarize several kinds of minimally invasive thymus surgery approaches that are widely used in and abroad, and analyze the integration and improvement strategies of minimally invasive thymus surgery in China.

4.
Article in Chinese | WPRIM | ID: wpr-885577

ABSTRACT

Objective:To investigate the pathogenic gene locus and prenatal genetic diagnosis of 54 families with oculocutaneous albinism (OCA).Methods:This retrospective study enrolled 54 OCA probands and their families from Gansu Province Maternal and Child Health Care Hospital from May 2014 to May 2020. TYR gene variation screening was performed on the probands by Sanger sequencing. Those with negative results were analyzed by high-throughput sequencing, and further verification was performed on their parents by Sanger sequencing. Among the 54 families, 15 ml amniotic fluid were collected from 16 women at 18-21 gestational weeks in their subsequent pregnancy. Sanger sequencing combined with short tandem repeats sequence for linkage analysis were performed for genetic analysis. All data were analyzed using descriptive statistical analysis. Results:Out of the 54 OCA probands, 48 were diagnosed as OCA1, five were OCA2 and one was OCA4 based on the Sanger sequencing and high-throughput sequencing detection. A total of 26 different variation sites were involved in the 48 OCA1 probands, including 15 missense mutations, five nonsense mutations, three splicing mutations, and three frame-shift mutations, among which, c.929insC (29%, 28/96) was the most frequent mutation, followed by c.896G>A (11%, 11/96), c.832C>T (8%, 8/96) and c.703T>C (5%, 5/96). The diagnosis was confirmed in all 16 fetuses in the 16 families that underwent prenatal diagnosis. Five of them were affected and their mothers chose to terminate the pregnancies, the other 11 pregnancies continued to delivery, including seven heterozygous carriers and four fetuses without the same pathogenic allele as the proband. Maternal contamination was excluded in all prenatal samples using short tandem repeat for linkage analysis. All 11 children were in good health during telephone follow-up one month after birth. Postnatal validations were consistent with the prenatal tests.Conclusions:Genetic diagnosis could accurately identify various types of OCA and help to provide prenatal diagnosis and fertility consultation for subsequent pregnancies.

5.
Article in Chinese | WPRIM | ID: wpr-885542

ABSTRACT

Objective:To investigate the predictive value of cerebroplacental ratio (CPR) for adverse perinatal outcomes of induction of labor in prolonged pregnancy.Methods:This retrospective study recruited 315 singleton pregnant women who had induced labor due to prolonged pregnancy (≥41 gestational weeks) in the First Affiliated Hospital of Chongqing Medical University from January 1, 2019 to April 30, 2020. Based on the occurrence of adverse perinatal outcomes (emergency delivery due to persistent abnormal fetal heart rate monitoring, umbilical artery blood pH at birth <7.2, 5 min Apgar scores<7, transferring to neonatal intensive care unit after birth, chorioamnionitis and vaginal delivery converted to cesarean section), they were divided into two groups: case group ( n=76) and normal group ( n=239). Clinical features and umbilical artery blood flow, middle cerebral artery (MCA) flow and CPR measured in the last ultrasound scan before induction were compared between the two groups using student's t-test, Mann-Whitney U test and Chi-square test. Receiver operating characteristic (ROC) curve was used to analyze the predictive values of umbilical artery blood flow, MCA flow and CPR for the adverse perinatal outcomes. Multivariate logistic regression analysis was used to screen the meaningful predictors. Results:Compared with the normal group, the umbilical artery pulsatility index (PI) (0.9±0.1 vs 0.8±0.1, t=-5.458, P<0.001) and the percentage of abnormal CPR (<1.0) increased significantly [21.1%(16/76) vs 6.3%(15/239), χ2=14.190, P<0.001] in the case group, while the MCA-PI and CPR decreased significantly (1.1±0.2 vs 1.3±0.3, t=5.658, P<0.001; 1.2±0.3 vs 1.6±0.5, t=8.940, P<0.001). The areas under the ROC curves of umbilical artery PI, MCA-PI and CPR for predicting adverse perinatal outcomes were 0.71, 0.71 and 0.77, respectively. CPR had the highest sensitivity (0.74) compared with umbilical artery PI (0.68) and MCA-PI (0.71), but the specificity of them were similar (0.67, 0.66 and 0.66). Multivariate logistic regression analysis showed that only CPR was the independent risk factor for adverse perinatal outcomes ( OR=0.028, 95% CI: 0.010-0.080, P<0.001). Conclusions:As an indicator for early prediction of adverse perinatal outcomes of induction of labor in prolonged pregnancy, CPR was more sensitive but less specific.

6.
Article in Chinese | WPRIM | ID: wpr-881502

ABSTRACT

Neonicotinoid is a kind of neuroactive pesticide, and it has become the most widely used pesticide in the world. In recent years, neonicotinoid has been detected in the environment and food, suggesting that human can be exposed to this kind of pesticide through drinking water, ingestion and respiration, which poses potential health hazards to human. However, there is no comprehensive report on the pollution level of neonicotinoid pesticides in the environment and food and the impact on human health. In this paper, the pollution status, population exposure level and potential health risks of neonicotinoid pesticides in water, air and food were reviewed. We found that neonicotinoid residues are widespread in fruits and vegetables, of which imidacloprid has the highest detection rate. Except for a few samples with excessive neonicotinoid detection, the detection level in most samples did not exceed national food safety standards. A variety of neonicotinoid pesticides have been detected in the air, surface water, tap water and drinking water. External exposure studies in the population have shown that ingestion is the main route of exposure to neonicotinoid, and the external exposure level is much lower than its chronic reference dose. The internal exposure study mainly detected the concentration of neonicotinoid pesticides and their metabolites in urine. A variety of neonicotinoid pesticides and their metabolites are detected in urine, and the concentration range is ng/ml level. Internal exposure studies found that the detection rate of thiamethoxam and dinotefuran in urine is higher, and the detection rate of neonicotinoid in Asian countries is higher than that in European and American countries. Occupational exposure studies found that neonicotinoid exposure levels increased after pesticide spraying, and the exposure levels in rural areas where pesticides were commonly used were higher than those in neighboring urban areas. Animal experiments have found that neonicotinoid pesticides have reproductive toxicity, genetic toxicity, neurotoxicity, immunotoxicity, liver toxicity and nephrotoxicity to non-target organisms. Cell experiments suggest that neonicotinoid is an endocrine disruptor. The symptoms of acute exposure in humans are related to the exposure dose, route and physical condition of the exposed person, which ranges from mild symptoms (nausea, vomiting, headache and diarrhea) to death. Population epidemiological studies have shown that chronic exposure to neonicotinoid pesticides is associated with adverse health effects in humans such as neonatal tetralogy of Fallot, anencephaly, and adverse mental symptoms.

7.
Article in Chinese | WPRIM | ID: wpr-880178

ABSTRACT

OBJECTIVE@#To analyze and predict the effect of coronavirus infection on hematopoietic system and potential intervention drugs, and explore their significance for coronavirus disease 2019 (COVID-19).@*METHODS@#The gene expression omnibus (GEO) database was used to screen the whole genome expression data related with coronavirus infection. The R language package was used for differential expression analysis and KEGG/GO enrichment analysis. The core genes were screened by PPI network analysis using STRING online analysis website. Then the self-developed apparent precision therapy prediction platform (EpiMed) was used to analyze diseases, drugs and related target genes.@*RESULTS@#A database in accordance with the criteria was found, which was derived from SARS coronavirus. A total of 3606 differential genes were screened, including 2148 expression up-regulated genes and 1458 expression down-regulated genes. GO enrichment mainly related with viral infection, hematopoietic regulation, cell chemotaxis, platelet granule content secretion, immune activation, acute inflammation, etc. KEGG enrichment mainly related with hematopoietic function, coagulation cascade reaction, acute inflammation, immune reaction, etc. Ten core genes such as PTPRC, ICAM1, TIMP1, CXCR5, IL-1B, MYC, CR2, FSTL1, SOX1 and COL3A1 were screened by protein interaction network analysis. Ten drugs with potential intervention effects, including glucocorticoid, TNF-α inhibitor, salvia miltiorrhiza, sirolimus, licorice, red peony, famciclovir, cyclosporine A, houttuynia cordata, fluvastatin, etc. were screened by EpiMed plotform.@*CONCLUSION@#SARS coronavirus infection can affect the hematopoietic system by changing the expression of a series of genes. The potential intervention drugs screened on these grounds are of useful reference significance for the basic and clinical research of COVID-19.


Subject(s)
COVID-19 , Computational Biology , Follistatin-Related Proteins , Hematopoietic System , Humans , Pharmaceutical Preparations , SARS-CoV-2
8.
Article in Chinese | WPRIM | ID: wpr-880118

ABSTRACT

OBJECTIVE@#To test the anticoagulation functions, perform the genetic diagnosis and analyze the clinical characteristics in a family with combined heterozygous genetic variants of PROC and PROS1.@*METHODS@#Peripheral blood was collected from all the family members. Hematological phenotypes and activity of anticoagulant factors were analyzed. Target genes were amplified by PCR from DNA isolated from peripheral blood, and then were analyzed by Sanger DNA sequencing.@*RESULTS@#Many members in the family displayed the combined genetic variants in protein C and protein S, and six family members accompanied by deep venous thrombosis (DVT). The influences of genetic and secondary factors on the incidence of venous thrombosis in the family members were analyzed. The results showed that in this family, carriers of combined protein C and protein S gene defects had a higher incidence of VTE, but acquired factors still played a key role in the eventual thrombotic symptoms.@*CONCLUSION@#Venous thromboembolism (VTE) is a multifactorial disease, the combined genetic heterozygous mutations of protein C and S is an important genetic factor, and the clinical phenotype show a high heterogenicity, the secondary factors contribute to the VTE incidence.


Subject(s)
Heterozygote , Humans , Mutation , Protein C/genetics , Protein S/genetics , Risk Factors , Venous Thromboembolism , Venous Thrombosis/genetics
9.
Article in Chinese | WPRIM | ID: wpr-879864

ABSTRACT

OBJECTIVE@#To study the value of fecal calprotectin (FC) in the diagnosis of neonatal necrotizing enterocolitis (NEC) through a Meta analysis.@*METHODS@#Web of Science, Cochrane Library, PubMed, Embase, China National Knowledge Infrastructure, Weipu Periodical Database, Wanfang Data, Chinese Biomedical Literature Database were searched for related studies published up to May 2020, with manual search as supplementation. The QUADAS criteria were used to evaluate the quality of the articles included. Meta-DiSc 1.4 and Stata 15.0 software were used to perform the Meta analysis, including the evaluation of specificity, sensitivity, likelihood ratio, and diagnostic odds ratio. The sensitivity analysis and heterogeneity testing were performed, and the summary receiver operating characteristic (SROC) curve and Fagan diagram were plotted.@*RESULTS@#A total of 15 articles were enrolled, involving 1 719 neonates. Among these articles, 4 had low quality, 2 had high quality, and the rest had medium quality. There was high heterogeneity between studies, and there was no threshold effect or publication bias. The random effects model analysis showed that FC had a pooled specificity of 0.80 (95%@*CONCLUSIONS@#FC has high potential and efficiency in the early diagnosis of NEC. FC measurement can be used for the diagnosis of NEC, but it should be combined with clinical manifestations and other related laboratory examinations.


Subject(s)
China , Enterocolitis, Necrotizing/diagnosis , Feces , Humans , Infant, Newborn , Leukocyte L1 Antigen Complex , ROC Curve , Sensitivity and Specificity
10.
Article in Chinese | WPRIM | ID: wpr-879416

ABSTRACT

OBJECTIVE@#To retrospectively analyze the clinical efficacy of external fixation in the treatment of femoral neck fracture with two different pin layout.@*METHODS@#From April 2000 to April 2018, 140 cases of femoral neck fracture were treated with closed reduction and percutaneous pin external fixation, among them 121 cases were followed up for more than 1 year, including 31 cases in traditional group, 12 males and 19 females, aged 45 to 74(65.4±8.4) years;90 cases in modified group, 39 males and 51 females, aged 12 to 75 (64.5±7.8) years. In traditional group, the first needle was put on the femoral talus, the second and third needles were put under the tension line, and the three needles were not on the same line in the lateral phase; in modified group, the first needle was drilled into the lateralcortex of the femur, obliquely penetrating the distal and proximal end of the femoral talus fracture, and the other two needles were drilled into the medial cortex of the femoral neck and the femoral talus, respectively. The operation time, hospital stay, postoperative ambulation time, femoral neck shortening rate, fracture healing time, fracture healing rate and femoral head necrosis rate of the two groups were observed and compared. Harris hip function score was used one year after operation.@*RESULTS@#These 121 patients were followed-up, the follow up time of traditional group was 13 to 45(30.5±11.4) months;the follow-up time of modified group was 14 to 120(34.5±12.5) months. There was no significant difference in operation time, hospital stay and femoral head necrosis rate between two groups (@*CONCLUSION@#Compared with the traditional group, the modified group has the advantages of lower femoral neck shortening rate, shorter fracture healing time, higher fracture healing rate and higher Harris hip function score.


Subject(s)
Adolescent , Adult , Aged , Child , External Fixators , Female , Femoral Neck Fractures/surgery , Fracture Fixation , Fracture Fixation, Internal , Humans , Male , Middle Aged , Retrospective Studies , Treatment Outcome , Young Adult
11.
Article in Chinese | WPRIM | ID: wpr-879144

ABSTRACT

This paper aimed to explore the mechanism of the split components of Phytolaccae Radix by means of network pharmaco-logy. Based on the theoretical hypothesis of the nature and taste of traditional Chinese medicine, the chemical components of the separated components of Phytolaccae Radix were selected by using Traditional Chinese Medicine Systems Pharmacology Database(TCMSP) and Traditional Chinese Medicines IntegratedDatabase(TCMID) databases in combination with related literatures. Relevant target analysis was carried out based on PubChem and SwissTargetPrediction databases. Targets corresponding to disease were excavated based on GeneCards for each split component, corresponding potential targets were obtained through mapping the target set of target compounds to disease targets. GO biological process analysis and KEGG pathway enrichment analysis were performed on the mapped targets with the help of DAVID database. Based on Cytoscape software and the corresponding efficacy, the network diagram of "medicinal material-split components-compound-target-pathway" was constructed to explore the mechanism of different efficacy of the separated components of Cytoscape. And the target purgation and diuretic mapping was used as the target of the traditional efficacy of smoothening secretion for the first time. The study explored esculentoside component, fatty oil component and phenolic acid component, a total of 30 target compounds and 301 corresponding targets, involving 44 potential targets for "anti-inflammatory", 50 potential targets for "immunoregulation", 52 potential targets for "smoothening secretion", 28 potential targets for "antibacterial activity", 28 potential targets for "antiviral effect", and 29 potential targets for "antitumor effect". Topological analysis revealed 14 key gene targets such as MAPK8, MAPK14, EGFR and PTGS2. A total of 684 GO entries and 235 KEGG pathways were obtained through bioinformatics enrichment analysis, mainly involving TNF signaling pathway, NF-kappaB signaling pathway and MAPK signaling pathway. This study revealed the multi-component, multi-target, and multi-channel action mechanism of the split components of Phytolaccae Radix, which provided certain basis for the next step to clarify the split components of Phytolaccae Radix through the method of system biology, and injected new content and significance into the study of properties and flavors theory.


Subject(s)
Drugs, Chinese Herbal/pharmacology , Medicine, Chinese Traditional , Signal Transduction , Software
12.
Article in Chinese | WPRIM | ID: wpr-912891

ABSTRACT

Objective: To explore the clinical efficacy of muscle regions of meridians needling method for refractory facial paralysis affecting different locations.Methods: A total of 110 participants were randomized into an observation group and a control group, with 55 cases in each group. The observation group was treated with muscle regions of meridians needling method, and the control group was treated with conventional facial three-line needling method. The clinical efficacy was evaluated four weeks after the treatment. And the infrared imaging spectra of the two groups were examined. Results: The total effective rate of the observation group was higher than that of the control group (P<0.05), and its curative effect for refractory facial paralysis located above the geniculate ganglion was better than that of the control group (P<0.05). The color scale distribution of different disease locations in the two groups varied significantly (P<0.05), the higher the disease location, the higher the occurrence rate of cool zone and low temperature zone. After treatment, the reductions of the facial and periotic temperature difference between the healthy side and the affected side in the observation group were statistically different from those in the control group (P<0.05). Conclusion: Muscle regions of meridians needling method has a better effect than facial three-line needling method for refractory facial paralysis. It can promote the microcirculation of the affected side of the face, improve the blood and oxygen supply to local tissues, and thus promote the repair of the peripheral facial nerve.

13.
Article in Chinese | WPRIM | ID: wpr-910187

ABSTRACT

Objective:To investigate the feasibility, effectiveness and safety of indocyanine green (ICG) navigation in the surgical resection of abdominal wall endometriosis (AWE).Methods:Seven women undergoing surgery for AWE in First Affiliated Hospital of Sun Yat-sen University (from July 1, 2021 to October 1, 2021) were collected. After exposure of the focus, ICG were used intravenously (0.25 mg/kg) as fluorescent dye for the intraoperative evaluation of AWE vascularization. Resection of the AWE was guided by direct visualization of the focus under standard laparoscopy with a near-infrared (NIR) camera head. Surgical margin around the AWE (3, 6, 9 and 12 point) and the margin under the focus were obtained for postoperative pathological examination of endometriosis. Time from injection to fluorescence visualization, the proportion of fluorescence visualization, time of fully resection of AWE, side effects related to the use of ICG, perioperative complications as well as the pathological result of the surgical margins were recorded.Results:ICG fluorescence of the AWE were seen in 5 patients (5/7). The mean time from injection to fluorescence visualization was (46.7±9.8) s. The mean time of fully resection of AWE was (16.4±7.0) minutes. There were no side effects related to the use of ICG. The rate of class-A wound healing was 7/7. All of the surgical margins were confirmed endometriosis-negative by postoperative pathological examination.Conclusion:ICG fluorescence visualization could conduct accurate resection of AWE, which is clinically safe and effective.

14.
Chinese Medical Journal ; (24): 70-78, 2021.
Article in English | WPRIM | ID: wpr-921266

ABSTRACT

BACKGROUND@#Acquired immune deficiency syndrome (AIDS)-related non-Hodgkin lymphoma (AR-NHL) is a high-risk factor for morbidity and mortality in patients with AIDS. This study aimed to determine the prognostic factors associated with overall survival (OS) and to develop a prognostic nomogram incorporating computed tomography imaging features in patients with acquired immune deficiency syndrome-related non-Hodgkin lymphoma (AR-NHL).@*METHODS@#A total of 121 AR-NHL patients between July 2012 and November 2019 were retrospectively reviewed. Clinical and radiological independent predictors of OS were confirmed using multivariable Cox analysis. A prognostic nomogram was constructed based on the above clinical and radiological factors and then provided optimum accuracy in predicting OS. The predictive accuracy of the nomogram was determined by Harrell C-statistic. Kaplan-Meier survival analysis was used to determine median OS. The prognostic value of adjuvant therapy was evaluated in different subgroups.@*RESULTS@#In the multivariate Cox regression analysis, involvement of mediastinal or hilar lymph nodes, liver, necrosis in the lesions, the treatment with chemotherapy, and the CD4 ≤100 cells/μL were independent risk factors for poor OS (all P < 0.050). The predictive nomogram based on Cox regression has good discrimination (Harrell C-index = 0.716) and good calibration (Hosmer-Lemeshow test, P = 0.620) in high- and low-risk groups. Only patients in the high-risk group who received adjuvant chemotherapy had a significantly better survival outcome.@*CONCLUSION@#A survival-predicting nomogram was developed in this study, which was effective in assessing the survival outcomes of patients with AR-NHL. Notably, decision-making of chemotherapy regimens and more frequent follow-up should be considered in the high-risk group determined by this model.


Subject(s)
Acquired Immunodeficiency Syndrome , Humans , Lymphoma, Non-Hodgkin , Neoplasm Staging , Nomograms , Prognosis , Retrospective Studies
15.
Article in Chinese | WPRIM | ID: wpr-868041

ABSTRACT

Objective:To analyze the cerebroplacental blood flow distribution characteristics in monochorionic-diamniotic(MCDA) twin pregnancies with stageⅠ-Ⅱof twin-twin transfusion syndrome (TTTS), and investigate the predictive value of cerebroplacental ratio (CPR) in the stageⅡ of TTTS.Methods:The cerebroplacental blood flow distribution were analyzed retrospectively in 68 cases from June 2017 to June 2019 in the First Affiliated Hospital of Chongqing Medical University (34 cases for each stage) with TTTS, including the umbilical artery pulsatility index (UA-PI), middle cerebral artery peak systolic velocity (MCA-PSV), middle cerebral artery pulsatility index (MCA-PI), CPR, and their discordances(UA-PI disc, MCA-PSV disc, MCA-PI disc and CPR disc). Results:The differences of UA-PI, MCA-PI, and CPR between donors and recipients in TTTS Ⅱ were statistically significant (all P<0.05), the differences of UA-PI disc, MCA-PI disc and CPR disc between TTTS Ⅰ and TTTS Ⅱ were statistically significant (all P<0.05). Multivariate Logistic regression analyses showed that only CPR disc was independently associated with the stage Ⅱ of TTTS( P<0.05), and it had moderate predictive accuracy for the stage Ⅱ of TTTS with an area under the curve of 0.766, a sensitivity of 64.71% and a specificity of 82.35%( P<0.001). Conclusions:More cerebroplacental blood flow discordances are observed and CPR disc is closely related to stageⅡof TTTS.

16.
Article in Chinese | WPRIM | ID: wpr-867815

ABSTRACT

Objective To evaluate the minimally invasive treatment of calcaneal fractures of Sanders Ⅱ &Ⅲ by closed reduction or a sacral sinus arc-shaped minimally invasive incision under subtalar arthroscopy assisted by a self-designed cervical retractor and a self-designed reducer to expose and assist the reduction followed by internal fixation with hollow nails and Kirschner wires.Methods From June 2016 to February 2018,53 patients (60 feet) were treated at Department of Hand and Foot Surgery,Central Hospital of Linyi for closed intra-articular calcaneal fractures.Of them,24 (28 feet) received the minimally invasive treatment and 29 (32 feet) open surgery via the conventional lateral L-shaped incision.The 2 groups were compared in terms of B(o)hler angle,Gissane angle,and the width,length and height of the calcaneus before operation,one week after operation and at the final follow-up,as well as in terms of preoperative preparation time,operation time,surgical bleeding volume,incision complications,subtalar joint stiffness,and anklehindfoot score of the American Foot and Ankle Surgery Association (AOFAS).Results The 2 groups were comparable because there were no significant differences between them in the preoperative general data (P > 0.05).All the patients were followed up for 10 to 22 months (average,16 months).The B(o)hler angles,Gissane angles,and the widths,lengths and heights of the calcaneus after operation and at the final follow-up were significantly better than the preoperative values in the minimally invasive group (all P < 0.05).The preoperative preparation time (2.5 d ± 1.2 d) and operation time (62.6 min ± 6.3 min) in the minimally invasive group were significantly shorter than those (7.6 d ± 3.5 d and 85.9 min ± 9.7 min) in the conventional group (P < 0.05),the surgical bleeding volume in the former (30.5 mL ± 3.8 mL) was significantly smaller than that in the latter (80.9 mL ± 8.3 mL) (P < 0.05),and the rates of incision complications (0) and subtalar joint stiffness (10.7%) in the former were significantly lower than in the latter (9.4% and 43.7%) (P < 0.05).However,there was no significant difference between the 2 groups in the AOFAS anlle-hindfoot score (92.8 ± 5.9 versus 89.5 ± 7.5) (P > 0.05).Conclusion The minimally invasive treatment of calcaneal fractures of Sanders Ⅱ & Ⅲ by closed reduction or a sacral sinus arc-shaped minimally invasive incision under subtalar arthroscopy assisted by a self-designed cervical retractor and a self-designed reducer to expose and assist the reduction followed by internal fixation with hollow nails and Kirschner wires can lead to satisfactory clinical results,because this method shortens significantly the time for hospitalization and leads to less invasion,fewer complications,accurate reposition and reliable fixation.

17.
Journal of Chinese Physician ; (12): 84-86,90, 2020.
Article in Chinese | WPRIM | ID: wpr-867211

ABSTRACT

Objective To investigate the influence of metformin on glycolipid metabolism and sex hormone in patients with polycystic ovarian syndrome (PCOS).Methods 98 patients with PCOS were randomly divided into two groups,with 49 cases in each group.The control group were treated with clomifene,while the observation group were treated with clomifene combined metformin.The endometrial thickness and ovarian volume were observed in two groups before and after treatment.The changes of glycolipid metabolism and sex hormone indexes in two groups were analyzed before and after treatment.Results The endometrial thickness of observation group was significantly better than control group after treatment,while the sex hormone levels,ovarian volume and antral follicle count (AFC) were lower than control group (P < 0.05).The glycolipid metabolism indexes of total cholesterol (TC),triacylglycerol (TG),fasting blood glucose (FBG),fasting insulin (FIN) and homeostasis model assessment-insulin resistance (HOMA-IR) in observation group were significantly better than control group after treatment (P < 0.05).The rate of ovulation and pregnancy in observation group was significantly higher than control group after treatment (P < 0.05).Conclusions Clomifene combined metformin can significantly improve glycolipid metabolism and sex hormone of patients with PCOS.It is helpful in promoting ovulation and improving clinical pregnancy rate.

18.
Chinese Critical Care Medicine ; (12): 99-105, 2020.
Article in Chinese | WPRIM | ID: wpr-866769

ABSTRACT

Objective:To evaluate the diagnostic value of ultrasonic measurement of artery peak velocity variation (ΔVpeak) on predicting fluid responsiveness in critically ill patients.Methods:Databases of PubMed, Embase, Cochrane Library, SinoMed, Wanfang, CNKI and VIP were retrieved from the establishment of the database to November 2019. The retrieval literatures were about the research of ΔVpeak used to judge fluid responsiveness. According to the inclusion and exclusion criteria, the relevant literatures were screened by two researchers, and the data of the included literatures were extracted. The quality of literatures was evaluated by quality assessment of diagnostic accuracy studies (QUADAS). Meta Dics 1.4 software was used to analyze the literatures that met the quality standard by Meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio ( DOR) were calculated. The summary receiver operating characteristic (SROC) curve was drawn and the area under SROC curve (AUC) was calculated. The χ 2 test and Spearman correlation coefficient were used to analyze heterogeneity, and Deek test was used to analyze publication bias. Results:A total of 1 854 patients were enrolled in 31 studies, including 11 domestic studies and 20 foreign studies. Using 14 items of QUADAS to evaluate the quality of literatures, it was found that the enrolled literatures were all in Grade A, indicating that the overall quality of literatures was high. The scattered distribution of SROC curve was not "shoulder arm shape", and Spearman correlation coefficient was 0.062 ( P = 0.710), so there was no threshold effect. The heterogeneity test showed that I2 = 57.2% ( P = 0.001), indicating that there was a certain degree of heterogeneity among the studies, and the source of heterogeneity was non threshold effect. Meta regression analysis showed that the reason for heterogeneity was the method of volume load test [ DOR = 3.87, 95% confidence interval (95% CI) was 1.56-9.57, P = 0.004 8]. According to the results of heterogeneity analysis, there was no significant heterogeneity ( I2 = 10.6, P = 0.288 5) among the studies after removing the samples of the passive leg raising (PLR) instead of the volume expansion. A meta-analysis was done with random effects model. The results showed that the pooled DOR was 23.85 (95% CI was 17.57 to 32.37), pooled sensitivity was 0.82 (95% CI was 0.80 to 0.85), pooled specificity was 0.83 (95% CI was 0.80 to 0.85), pooled PLR was 4.17 (95% CI was 3.58 to 4.86), and pooled NLR was 0.22 (95% CI was 0.18 to 0.28). The AUC was 0.901 2 (95% CI was 0.88 to 0.93), and Q index was 0.832 5. The results of Deek funnel plot showed that there was no published bias in all the studies ( P = 0.19). Conclusions:Ultrasonic measurement of ΔVpeak has a high value in predicting fluid responsiveness. It is a reliable parameter for the evaluation of shock, critical illness and surgical operation population who need to monitor the fluid responsiveness.

19.
Article in Chinese | WPRIM | ID: wpr-873058

ABSTRACT

Objective:To investigate the mechanism of Jianpi Yangzheng recipe in inhibiting aerobic glycolysis by down-regulating the expression of pyruvate kinase isoenzyme M2 (PKM2) protein, in order to promote apoptosis and inhibite epithelial-mesenchymal transition(EMT)in HCT116 cells of colorectal cancer. Method:The effect of different concentrations of Jianpi Yangzheng recipe on HCT116 cell proliferation was detected by methylthiazolyldiphenyl-tetrazolium bromide(MTT)colorimetry. Flow cytometry was used to detect the effect of different concentrations of Jianpi Yangzheng recipe(2.0, 4.0, 8.0 g·L-1) on HCT116 cell apoptosis. The effect of Jianpi Yangzheng recipe(2.0, 4.0, 8.0 g·L-1) on the migration and invasion ability of HCT116 cells was observed by cell scratch and cell invasion assay (Transwell). The effect of different concentrations of Jianpi Yangzheng recipe(2.0, 4.0, 8.0 g·L-1) on glycolysis metabolism of HCT116 cells were detected by lactic acid (LD) test kit and glucose assay kit, respectively. Western blot was used to detect the expressions of apoptosis-related proteins, like B lymphocyte tumor-2 gene (Bcl-2), Bcl-2 related X protein (Bax) and EMT-related proteins, like epithelial cadherin (E-cadherin),neurogenic cadherin(N-cadherin), Vimentin, and PKM2, the key protein of glycolysis, in each group. Result:MTT assay showed that, compared with the blank group, HCT116 cells were treated with Jianpi Yangzheng recipe for 48 h. With the increase of drug concentration, the inhibitory effect of Jianpi Yangzheng recipe on the proliferation of HCT116 cells was also increased; and when the concentration was 4.0 g·L-1, the inhibition rate of HCT116 cells was about 53.87%. Therefore, 2.0,4.0,8.0 g·L-1 were selected as low, medium and high-dose groups for the study. The cell flow cytometry results indicated that, compared with the blank group, the low, medium and high-dose groups all significantly induced the apoptosis of HCT116 cells (P<0.05), and the effect in inducing apoptosis was more obvious with the increase of drug concentration (P<0.05). Cell scratch and Transwell showed that, compared with the blank group, all the groups had an inhibitory effect on migration and invasion of HCT116 cells (P<0.05), and the effect was more significant with the increase of drug concentration (P<0.05). The determination of lactic acid and glucose indicated that compared with the blank group, with the increase of drug concentration, the amount of lactic acid produced by cells in each group gradually decreased (P<0.05), while the glucose dosage also gradually decreased (P<0.05). Western blot showed that, compared with the blank group, the protein expressions of E-cadherin and Bax were up-regulated in groups with different concentrations, whereas the protein expressions of N-cadherin, Vimentin, Bcl-2 and PKM2 were down-regulated (P<0.05). Conclusion:Jianpi Yangzheng recipe can effectively induce the apoptosis of HCT116 cells and inhibit EMT in colorectal cancer. The possible mechanism may be related to the inhibition of aerobic glycolysis pathway of HCT116 cells by down-regulating PKM2 protein expression.

20.
Article in Chinese | WPRIM | ID: wpr-872765

ABSTRACT

Objective:To investigate the anti-tumor effect mechanism of atractylenolide Ⅱ by studying its effect on macrophage polarization. Method:Phorbol myristate acetate (PMA) was used to induce THP-1 cells differentiation into macrophages, and methylthiazolyldiphenyl-tetrazolium bromide(MTT)colorimetric assay was used to detect the effect of different concentrations of atractylenolide Ⅱ on macrophage growth at different time points to screen out the safe concentration of atractylenolide Ⅱ. The macrophages were treated with different concentrations of atractylenolide Ⅱ for 24 hours and then were co-cultured with gastric cancer cells. The survival of the two types of cells was observed under light microscope. The proliferation of gastric cancer cells was detected by MTT assay to determine the effective administration concentrations of atractylenolide Ⅱ. Cells were divided into blank group, model group, atractylenolide Ⅱ high dose group (200 mg·L-1), atractylenolide Ⅱ medium dose group (100 mg·L-1), and atractylenolide Ⅱ low dose group(50 mg·L-1). Wound healing assay was carried out to observe the effects of different concentrations of atractylenolide Ⅱ on the migration and morphology of gastric cancer cells. The expression levels of M1 and M2 macrophage surface markers CD86 and CD206 were detected by flow cytometry analysis(FCM). Quantitative polymerase chain reaction(Real-time PCR)and Western blot were used to detect M1, M2 macrophage-associated tumor necrosis factor (TNF) -α, human leukocyte antigen 2 (HLA-DRA), CD80, transforming growth factor (TGF)-β, interleukin (IL) -10 and IL-6 genes and protein expression. Western blot was used to detect intracellular phosphatidyl inositol kinase (PI3K) and p-PI3K protein expression in macrophages. Result:When the concentration of atractylenolide Ⅱ was 1, 10, 50, 100, 200 mg·L-1, it showed no inhibition on macrophage growth. As compared with the model group, macrophages treated with 50, 100, 200 mg·L-1 atractylenolide Ⅱ significantly inhibited tumor cell proliferation (P<0.01). As compared with the model group, the migration rate of tumor cells in the atractylenolide Ⅱ (200,100 mg·L-1) groups decreased (P<0.05). The expression levels of CD86 on M1 macrophage surfacen in the atractylenolide Ⅱ (200,100,50 mg·L-1) groups were increased(P<0.05,P<0.01), and the expression levels of CD206 on M2 macrophagen in the atractylenolide Ⅱ (200 mg·L-1) group were decreased (P<0.05). The expression levels of M1 macrophage-associated cytokines TNF-α, HLA-DRA, CD80 mRNA in the atractylenolide Ⅱ (200,100 mg·L-1) groups were increased(P<0.05,P<0.01), and TNF-α protein expression in the atractylenolide Ⅱ (200 mg·L-1) group was increased (P<0.05), M2 type macrophage-associated cytokine TGF-β mRNA expression levels in the atractylenolide Ⅱ (50 mg·L-1) group were decreased, and IL-10, IL-6 protein expression levels in the atractylenolide Ⅱ (200 mg·L-1) group were decreased (P<0.05,P<0.01). The expression levels of p-PI3K protein in the atractylenolide Ⅱ (200,100 mg·L-1) groups were also decreased(P<0.05,P<0.01). Conclusion:Atractylenolide Ⅱ could induce the polarization of macrophages to M1 type by reducing the expression of p-PI3K in macrophages and inhibiting the proliferation and migration of gastric cancer cells.

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