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1.
Chinese Journal of Nephrology ; (12): 705-711, 2021.
Article in Chinese | WPRIM | ID: wpr-911893

ABSTRACT

Objective:To evaluate the efficacy and safety of rituximab in the treatment of adult primary focal segmental glomerulosclerosis (FSGS).Methods:Adult FSGS patients treated with rituximab in the First Affiliated Hospital of Zhejiang University College of Medicine were retrospectively enrolled. One or two doses of rituximab (375 mg/m 2) were used aiming to achieve B cell depletion (defined as<5 B cells per microliter in peripheral blood) and the interval between the two doses was 2 weeks. The evaluated major outcomes were remission and relapse of nephropathy, and the secondary outcome measures were adverse events and renal outcomes. Results:A total of 14 patients (9 males) were enrolled, among whom 7 cases were steroid-dependent nephrotic syndrome (SDNS) or frequently relapsing nephrotic syndrome (FRNS), 6 cases were steroid-resistant nephrotic syndrome (SRNS) and one patient was new onset FSGS with contraindication to steroid. After treatment with rituximab, 7 patients with SDNS/FRNS achieved complete remission. At 6 months, the daily oral steroid dose reduced significantly compared with the baseline [(33.3±5.2) mg/d vs (6.7±6.6) mg/d, P<0.01]; while one patient still received tacrolimus 1.0 mg/d, the other 6 patients stopped using immunosuppressants; and the total number of relapse/total follow-up months decreased from 0.257 times/month to 0.058 times/month after the use of rituximab. For the other 6 SRNS patients and one patient with contraindication to steroid, three SRNS patients achieved partial remission and one patient with contraindication to steroid achieved complete remission at 34.50(20.25, 95.25) days after use of rituximab, and the other 3 SRNS patients failed to achieve remission, of whom one patient developed end stage renal disease at 23 months. Conclusions:Rituximab may reduce the risk of relapse and help steroid or immunosuppressant-tapering in adult steroid-dependent/frequently relapsing idiopathic FSGS. However, it is not effective in SRNS patients.

2.
Chinese Journal of Nephrology ; (12): 655-661, 2021.
Article in Chinese | WPRIM | ID: wpr-911891

ABSTRACT

Objective:To analyze the prognostic factor of arteriovenous fistula (AVF) maturation and provide the theoretical basis for the hemodialysis patients' AVF surgery.Methods:Retrospective investigation was conducted on patients that underwent AVF surgery in Wuhan Central Hospital from January 2017 to June 2019 as study subjects to investigate the prognostic factor of AVF maturation. The general information, hematological indicators, preoperative and postoperative ultrasound data of patients were recorded. Patients were divided into mature group and immature group according to the physical examination status, functional status and postoperative color doppler ultrasound data after AVF surgery, and the differences between the two groups were compared. Logistic regression analysis was used to analyze the prognostic factors of AVF maturation, and receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of each factor for AVF maturation.Results:A total of 164 patients were included, including 110 patients in the mature group and 54 patients in the immature group. There were statistically significant differences between the two groups in surgical vein diameter, surgical artery diameter, brachial artery flow, cardiac ejection fractions, systolic blood pressure, diastolic blood pressure and history of diabetes (all P<0.05), while there were no statistically significant differences in other indicators such as gender, age, etc. Logistic regression analysis showed that preoperative surgical artery diameter (every increase by 0.1 mm, OR=1.402, 95% CI 1.159-1.697, P=0.001), surgical vein diameter (every increase by 0.1 mm, OR=1.341, 95% CI 1.176-1.528, P<0.001), cardiac ejection fraction (every increase by 5%, OR=1.184, 95% CI 1.087-1.289, P<0.001), systolic blood pressure (every increase by 10 mmHg, OR=1.407, 95% CI 1.103-1.796, P=0.006), brachial artery flow (every increase by 10 ml/min, OR=1.047, 95% CI 1.004-1.091, P=0.034) and history of diabetes ( OR=0.271, 95% CI 0.103-0.715, P=0.008) were the independent influencing factors for AVF maturation. ROC curve showed that preoperative surgical artery diameter ( AUC=0.728, 95% CI 0.643-0.839, P<0.001), surgical vein diameter ( AUC=0.762, 95% CI 0.686-0.839, P<0.001), cardiac ejection fraction ( AUC=0.711, 95% CI 0.626-0.796, P<0.001) were the important indicators for predicting AVF maturation. Conclusions:Preoperative surgical artery diameter, surgical vein diameter, cardiac ejection fraction and diabetes mellitus are the prognostic factors of AVF maturation. In preoperative vascular assessment, attention should be paid to the diameter of target arteries and veins, as well as to the cardiac function and diabetes mellitus of patients.

3.
Article in Chinese | WPRIM | ID: wpr-910031

ABSTRACT

Objective:To explore the correlations of α-melanocyte stimulating hormone ( α-MSH) levels in serum and synovial fluid with progression of primary knee osteoarthritis (KOA). Methods:A retrospective analysis was conducted of the 96 patients who had been diagnosed as primary KOA at Department of Orthopedics, The First Hospital of Huizhou from October 2018 to October 2019. Radiographic severity of KOA was determined by Kellgren-Lawrence (K-L) grades; α-MSH levels were measured by enzyme-linked immunosorbent assay (ELISA). Levels of pro-inflammatory cytokine interleukin-1 β (IL-1 β) and matrix metalloproteinase-3 (MMP-3) were also detected. Another 64 patients with patellar dislocation, matched in age and gender, were enrolled as controls. The Numeric Pain Scale (NPS) and revised Oxford Knee Score (OKS) were employed to evaluate their symptomatic severity. Receiver operating characteristics (ROC) curve was used to compare α-MSH, IL-1 β and MMP-3 with regard to their diagnostic values in the K-L grading. Results:There were no statistically significant difference in age, gender and body mass index between the 2 groups, showing they were comparable ( P> 0.05). The α-MSH levels in synovial fluid were significantly lower in the KOA patients than in the controls [(16.9±3.8) pg/mL versus (18.8±2.7) pg/mL] ( P<0.001); there were no significant differences between the KOA patients and the controls in the serum α-MSH levels [(24.9±1.8) pg/mL versus (24.8±1.7) pg/mL] ( P>0.05). The α-MSH levels in synovial fluid were negatively correlated with K-L grades ( r=-0.382, P<0.001) and negatively correlated with NPS ( r=-0.382, P<0.001) but positively correlated with OKS ( r=0.339, P<0.001). Moreover, the α-MSH levels in synovial fluid were negatively correlated with the IL-1 β levels in synovial fluid ( r=-0.483, P<0.001) and with the MMP-3 levels in synovial fluid ( r=-0.336, P< 0.001). Conclusions:The level of serum α-MSH may not be correlated with the progression of KOA but the synovial fluid α-MSH is negatively correlated with the progression of KOA. Therefore, the expression level of α-MSH in joint synovial fluid can be used as a potential biomarker for assessment of severity of knee osteoarthritis.

5.
Journal of Experimental Hematology ; (6): 1837-1844, 2021.
Article in Chinese | WPRIM | ID: wpr-922344

ABSTRACT

OBJECTIVE@#To explore the effects of serum free light chain (sFLC) and monoclonal protein (MP) on the efficacy and prognosis of patients with multiple myeloma relapse, and investigate the clinical value of light chain escape (LCE).@*METHODS@#The relationship between sFLC/MP levels and clinical features and outcomes in 71 patients with multiple myeloma after relapse were retrospective analyzed. The patients were divided into MO group, MLC group and LCE group according to different levels of sFLC/MP after relapse. Then the clinical indicators, efficacy, survival after relapse (SAR) and overall survival (OS) of the patients in each group were compared. Meanwhile a paired sample t test was used to analyze the relevant indicators of the patients before and after relapse in LCE group.@*RESULTS@#There were significant differences in ISS stage, the levels of Hb, PLT, ALB, SFLC/MP and the proportion of myeloplasma cells afte relapse (P<0.05). The initial treatment effect of the patients in MO group was better than those in the other groups, and the LCE group was the worst (P<0.05). Comparison of relevant indicators between the patients before and after relapse in LCE group showed that the levels of MP, Hb and PLT decreased significantly, while sFLC, LDH and Cr increased significantly (P<0.05). Multivariate analysis showed that MO was the independent risk factor affecting SAR, while MO and LCE were the independent risk factors affecting OS (P<0.05) of the patients.The average SAR of the patients in MO, MLC and LCE group was 41, 28.6 and 23.5 months (P=0.002), and the average OS was 79.6, 57.9 and 41 months (P<0.001), respectively. The patients in MO group showed longer SAR and OS, while the LCE group was the shortest.@*CONCLUSION@#After relapse, patients only with elevated MP levels have a better curative effect and prognosis, while only with elevated sFLC levels have poor curative effects and prognosis, which suggesting that sFLC/MP levels can be used as a good indicator for predicting the prognosis of multiple myeloma patients.The appearance of LCE indicates disease progression, poor prognosis and early relapse.


Subject(s)
Humans , Immunoglobulin Light Chains , Multiple Myeloma , Prognosis , Recurrence , Retrospective Studies
6.
Article in Chinese | WPRIM | ID: wpr-876163

ABSTRACT

Objective:To understand the trend of Helicobacter pylori (Hp) resistance to clarithromycin and levofloxacin and to provide guidance for Hp eradication therapy. Methods:From January 2014 to December 2018, a total of 66 515 patients with gastrointestinal symptoms were enrolled in the First People's Hospital of Wenling. The patients were divided into the following groups: childhood (0 to 6 years old); juvenile (7 to 17 years old); youth (18 to 40 years old),middle age (41 to 65 years old),and old age (≥66 years old). All patients received gastroscopy, gastric mucosal biopsy, Hp culture and drug sensitivity test of clarithromycin and levofloxacin. Results:The Hp positive rate showed a significant downward trend in 2016, 2017 and 2018 (χ2=14.317, 47.079, 88.054, all P<0.05). The average resistance rate of Hp to clarithromycin from 2014 to 2018 was 22.72% (4 732/20 831) showing an increasing trend, but the increase was slower after 2017. The average resistance rate to levofloxacin was 30.55% (6 364/20 831), and the overall trend showed a sharp rise from 2015 to 2017 (χ2=38.383, 49.569, both P<0.05), and a significant decline was detected after 2017 (χ2=18.841, P<0.05). The resistance rate of Hp to levofloxacin in patients increased with age. The clarithromycin resistance rate first decreased and then increased with age, and the resistance rate in old age (32.52%, 763/2 346) was higher than that in youth (22.09%, 1 086/4 916) and middle age patients (21.21%, 2 854/13 458), and the differences were significant (χ2=991.071, 144.968, both P<0.05). The resistance rate of Hp rose from 12.73% (14/110) in juvenile to 43.31% (1 016/2 346) in old age (χ2=228.867, P<0.05). Conclusion:In recent years, the positive rate of Hp infection in Wenling area has a decreasing trend. Although the resistance rate of Hp to clarithromycin and levofloxacin has been rising slowly or decreasing, it is still at a high level. In the selection of Hp eradication program, the differences between patients in different age groups should be considered with particular attention on the minors.

7.
Article in English | WPRIM | ID: wpr-888778

ABSTRACT

Two new lignan glucosides, tinsinlignans A and B (1 and 2), two new oxyneolignans, tinsinlignans C and D (3 and 4), along with one known analogue (5), were isolated from the stems of Tinospora sinensis. The structures of the new compounds were elucidated based on analysis of spectroscopic data, and the absolute configuration of 1 was determined through electronic circular dichroism (ECD) calculation based on the time-dependent density functional theory (TD-DFT). Compounds 1-4 were evaluated for their inhibitory effects on nitric oxide (NO) production induced by lipopolysaccharide (LPS) in murine RAW264.7 macrophage cells and compounds 1 and 2 exhibited moderate inhibitory activities with IC


Subject(s)
Animals , Glucosides/pharmacology , Lignans/pharmacology , Lipopolysaccharides , Mice , Molecular Structure , Nitric Oxide , Phytochemicals/pharmacology , Tinospora/chemistry
8.
Chinese Journal of Neurology ; (12): 43-47, 2021.
Article in Chinese | WPRIM | ID: wpr-885399

ABSTRACT

Neuronal intranuclear inclusion disease (NIID) is a slowly progressive neurodegenerative disease characterized by eosinophilic hyaline intranuclear inclusions in the central and peripheral nervous system, and also in the visceral organs. Although in recent years skin biopsy is useful for the antemortem diagnosis of this disease, it is often misdiagnosed due to its highly variable clinical manifestations. A case of NIID is reported here. The patient had a long course of disease, mainly presenting as dysfunction of autonomic nervous system. No significant cognitive impairment was found. Thus, a new idea is provided for the diagnosis of this disease.

9.
Article in Chinese | WPRIM | ID: wpr-880147

ABSTRACT

OBJECTIVE@#To explore the influence of controlling nutritional status (CONUT) score on the prognosis of newly diagnosed patients with multiple myeloma (MM).@*METHODS@#The clinical data 119 patients with MM who were diagnosed according to the international myeloma diagnostic criteria in Lanzhou University Second Hospital from April 2010 to October 2018 were collected and retrospectively analyzed. The relationship between clinical indexes, including age, sex, MM type, absolute lymphocyte count (ALC), absolute neutrophil count (ANC), absolute monocyte count (AMC), hemoglobin (Hb), platelet (PLT), β@*RESULTS@#Compared with high-scoring group, low-scoring group had a better OS [median OS was 43.3 months and 127.67 months, respectively, 95% confidence interval (CI): 57.065-78.345, P=0.038]. At the same time, the low-scoring group also had higher level of ALC, ANC, AMC, Hb, PLT, ALB, and CHO but lower of GLO. Multivariate survival analysis showed that age (HR=1.027, 95%CI: 1.000-1.054, P=0.048), AMC (HR=11.284, 95%CI: 22.968-42.897, P<0.001), CONUT score (HR=1.198, 95%CI: 1.036-1.385, P=0.015), M protein (non-IgG/IgG type) type (HR=0.503, 95%CI: 0.259-0.977, P=0.043) were independent factors affecting the prognosis of MM patients.@*CONCLUSION@#The CONUT score as an immune-nutrition score is a convenient and easy-to-obtain index to effectively predict the prognosis of MM patients.


Subject(s)
Humans , Lymphocyte Count , Multiple Myeloma/diagnosis , Nutritional Status , Prognosis , Retrospective Studies
10.
Article in Chinese | WPRIM | ID: wpr-906571

ABSTRACT

@#In recent years, the number of interventions for valvular heart disease has been increasing day by day, and it has become a hot topic in the field of cardiovascular surgery. Given the aging global population and trends in the prevalence of valvular disease and the broadening of indications for transcatheter aortic valve replacement (TAVR), a breakthrough of 130 000 TAVR procedures is expected by 2026. In the new technology development period, the development potential and technical advantages of heart valve interventional therapy should be faced squarely. This paper focuses on key issues such as comparison of outcomes after TAVR versus surgical aortic valve replacement (SAVR), prosthetic valve endocarditis after TAVR, and broadening of indications for TAVR, as well as recommendations on how surgeons face the era of TAVR. We hope that this article will help and attract the attention of cardiac surgeons.

11.
Article in Chinese | WPRIM | ID: wpr-905074

ABSTRACT

Objective:To discuss clinical effect of addition and subtraction therapy of Ditantang combined with Taohong Siwutang to cerebral infarction and syndrome of phlegm and blood stasis blocking collaterals during early recovery, and to study protection to brain nerve. Method:One hundred and fifty-two patients were randomly divided into control group (76 cases) and observation group (76 cases) by random number table, 71 patients in control group completed the therapy (5 patients were falling off, missing visit or eliminated), and 70 patients in observation group completed the therapy. Both groups' patients got comprehensive rehabilitation measures. Patients in control group got Zhongfeng Huichun pills, 1.5 g/time, 3 times/day. Patients in observation group got addition and subtraction therapy of Ditantang combined with Taohong Siwutang in the morning and at night, 1 dose/day. The treatment was continued for 12 weeks. Before and after treatment, scores of degree of neurological deficit, Barthel (BI) index, Fugl-Meyer scale (FMA), modified Rankin scale (MRS) and syndrome of phlegm and blood stasis blocking collaterals were graded. And levels of malondialdehyde (MDA), glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), advanced oxidation protein products (AOPP), vascular endothelial growth factor (VEGF), brain-derived neurotrophic factor (BDNF) and neuron specific enolase (NSE). And cerebral hemodynamics were detected, and peak flow velocity (VS), vascular resistance index (RI), pulsatility index (PI) and cerebrovascular reserve function (CVR) were recorded. Safety was evaluated. Result:After the 6th week and 12th week of treatment, scores of degree of neurological deficit, BI, FMA, MRS, syndrome of phlegm and blood stasis blocking collaterals, AOPP, MDA, NSE, RI and PI were lower than those in control group (P<0.01), levels of SOD, GSH-Px, BDNF, VEGF, Vs and CVR were higher than those in control group (P<0.01). The clinical effect was better than which in control group (Z=2.109, P<0.05). Besides, there was no adverse reaction caused by Ditantang combined with Taohong Siwutang. Conclusion:Ditantang combined with Taohong Siwutang can ameliarate the hemodynamics, reduce the lipid peroxidation damage, regulate the neurovascular repair factor, so it can promote the repair of nerve tissue and function, clinically reduce the degree of nerve function defect, improve the ability of daily life and exercise when it used to cerebral infarction and syndrome of phlegm and blood stasis blocking collaterals during early recovery, and it is good for clinical effect and safe using.

12.
Journal of Medical Postgraduates ; (12): 174-177, 2020.
Article in Chinese | WPRIM | ID: wpr-818397

ABSTRACT

ObjectiveReconstruction of oral and maxillofacial defects following resection of oral and maxillofacial malignant tumors is required to restore the patient's appearance and oral function. The aim of this study was to evaluate the application and value ofsoleus perforator flap from the lateral leg in repair of oral and maxillofacial defects.MethodsIn this retrospective study, ten patients with oral and maxil-lofacial malignancies who were admitted to the Department of Oral and Maxillofacial Surgery in Fuyang People's Hospital during the period from May 2015 to March 2019 were enrolled. The effect of soleus perforator flap from the lateral leg was ana-lyzed.At 1 month and 3 months after surgery, the recovery of oral function and donor sites, quality of life and surgical satisfaction were followed.ResultsAllpatients underwent operation successfully without skin flap necrosis or serious complications.At 3 months after surgery,voice function and swallowing func-tion were level 3. The scar hyperplasia was 1 case,donor itching1 case and paresthesia or dysfunction 0 case.Compared with those at 1 month after surgery, the scores at 3 months after surgery were increased using the University of Washington Quality of Life (UW-QOL) questionnaire(P<0.05). At 1 month and 3 months after sur-gery,patient satisfaction rateswere 80.00% and 90.00%, respectively.ConclusionThe soleus perforator flap from the lateral leg isideal for repairing oral and maxillofacial defects. The postoperative recovery of oral functio-nand donor sites is goodwith high quality of life and surgical satisfaction.

13.
Article in Chinese | WPRIM | ID: wpr-873499

ABSTRACT

@#Objective To understand the distribution and epidemic characteristics of common pathogens of pneumonia among hospitalized children in Suzhou. Methods Nasopharyngeal secretions were collected from hospitalized children with clinical pneumonia admitted to the respiratory department of Children's Hospital Affiliated to Suzhou University from April 2011 to March 2018 to detect common viral and bacterial pathogens of children's pneumonia. Results The total positive rate of pathogens was 75. 6% in the 4 765 clinical pneumonia cases. The positive rate of bacterial pathogens was 57. 4%. Streptococcus pneumoniae ( SP) was the highest,followed by Haemophilus influenzae ( H. i) ; The positive rate of viral pathogens was 44. 1%. Respiratory syncytial virus ( RSV) was the highest,followed by Bocavirus ( BoV) . The mixed infection rate of bacteria and virus was 25. 9%,and the most common types were RSV and SP,BoV and Streptococcus viride ( SV) . Conclusions SP,H.i,RSV and BoV are the main pathogens of clinical pneumonia in children. There are statistical differences in different age groups and seasons of hospitalized children's pneumonia in Suzhou. The mixed infection rate of bacteria and virus is high.

14.
Article in Chinese | WPRIM | ID: wpr-873012

ABSTRACT

Objective:To study the effect of Yupingfeng San (YPFS) on the expressions of GATA binding protein 3 (GATA3) and forkhead transcription factor3 (Foxp3) in ovalbumin (OVA)-induced lung tissue of allergic rhinitis (AR) mice, and explore the mechanism of YPFS on AR. Method:The allergic rhinitismice model was established by intraperitoneally injecting with OVA and Al (OH)3, and challenged with OVA intranasally. The mice were divided into four groups: normal,model,chloretadine(3 mg·kg-1) and YPFS(6.5 g·kg-1) group, the corresponding drugs were orally administrated for three weeks. At the end of administration,the infiltration of inflammatory cells, such as mast cells, eosinophils and neutrophils in nasal mucosa, were observed by htoxylin eosin (HE) staining. The serum concentrations of OVA-specific IgE and cytokines [interleukin-4(IL-4), IL-5 and γ-interferon (INF-γ)] were determined by enzyme-linked immune sorbent assay (ELISA). The expressions of GATA3 and Foxp3 proteins in nasal mucosa tissue were detected by Western blot. Result:The AR mice had such symptoms as scratching, sneezing and running nose. Nasal mucosa section by HE staining showed significant desquamation of AR mouse nasal mucosa cilia, obvious tissue stromal edema, telangiectasia, and a large number of eosinophilic cells, lymphocytes, plasma cells infiltration. YPFS obviously improved nasal symptoms of allergic rhinitis mice. Nasal mucosa epithelial structure was complete and arranged evenly, with no obvious tissue clearance edema and vasodilation, and inflammatory cell infiltration was significantly reduced. Compared with normal group, the levels of OVA specific IgE, IL-4 and IL-5 in peripheral blood of AR model group were significantly higher(P<0.01), and the INF-γ level was significantly lower (P<0.01). Compared with AR model group, the administration of chloretadine and YPFS can significantly reduce the level of OVA specific IgE and IL-4, IL-5, and increase the level of INF-γ in AR mice peripheral blood (P<0.05, P<0.01). Western blot results showed that compared with normal group, GATA3 protein expression was significantly increased, while Foxp3 protein expression was significantly decreased in AR model group (P<0.05, P<0.01). Compared with AR model group, YPFS inhibited GATA3, and promoted Foxp3 protein expression (P<0.01). Conclusion:YPFS has an effect in alleviating OVA-induced allergic rhinitis.YPFS may modulate the immune response by regulating the balance of Th2/Treg cells.

15.
Article in Chinese | WPRIM | ID: wpr-872179

ABSTRACT

Objective:To investigate the risk factors on androgenetic alopecia (AGA) of primary healthcare staffs.Methods:Primary healthcare staffs were investigated by a questionnaire.Results:A total of 934 healthcare staffs (550 males and 384 females) were surveyed, of which 238 cases were diagnosed as AGA. 68.8% of AGA patients had poor mental health self-assessment; 52.94% of AGA patients had a family history; the prevalence in the people who usually had the night shift was 26.03%, which was higher than that in the people who had no night shift.Conclusions:The prevalence of AGA in healthcare staffs is higher than the national average, which might be related to working pressure, mental status, night shifts, genetic and alcohol drinking.

16.
Article in Chinese | WPRIM | ID: wpr-872178

ABSTRACT

Objective:To study the clinical efficacy of nanocrystalline needles combined with 5% minoxidil tincture in the treatment of androgenetic alopecia of male.Methods:A total of 60 patients with androgenetic alopecia were randomly divided into treatment group and control group, with 30 patients in each group. The control group was treated with 5% minoxidil tincture 2 times a day. On the basis of the control group, the treatment group was treated with nanocrystalline needles combined with 5% minoxidil tincture for 10 minutes 2 times a week. The clinical effects of different treatments were compared after six months.Results:There was a significant difference in overall response rate between the treatment group and the control group (80.00% vs. 53.30%, P<0.05). The improvement of the each clinical features of image by dermoscopy in patients with hair loss disease included more than 20% of hair diameter diminish, vellus hair increased, partly acomia and yellow dot sign had a significant difference between the treatment group and the control group ( P<0.05). Conclusion:Nanocrystalline needles combined with 5% minoxidil tincture has a good clinical effect in the treatment of androgenetic alopecia.

17.
Article in Chinese | WPRIM | ID: wpr-870195

ABSTRACT

Objective:To explore the predictive value of complement and coagulation indicators in sepsis related acute kidney injury (AKI).Methods:Clinical data of 217 patients with sepsis admitted to the Department of Internal Medicine and Intensive Care Unit of Affiliated Hospital of Jiangnan University from January 2018 to June 2019 were retrospectively analyzed. All patients were divided into sepsis with AKI group and without AKI group. Laboratory indicators of all patients were collected, including complement C 3, complement C 4, activated partial thrombin time (APTT), prothrombin time (PT), international normalized ratio (INR), D-dimer, procalcitonin(PCT), etc. logistic regression analysis was used to explore the risk factors of sepsis related AKI. Receiver operating characteristic curve (ROC) was used to evaluate the predictive value of independent risk factors. Results:Among 217 patients, 120 patients developed sepsis related AKI and 97 patients didn′t. PCT, lactic acid, PT, APTT, INR and D-dimer in AKI patients were significantly higher than those without AKI ( P<0.01). Complement C 3 and complement C 4 were significantly lower in AKI group ( P<0.01). Multivariate logistic regression analysis suggested that blood pressure<90/60 mmHg (1 mmHg=0.133 kPa)( OR=3.705, 95% CI 1.536-8.934, P=0.004), increased lactic acid ( OR=1.479, 95% CI 1.089-2.008, P=0.012), decreased complement C 3 ( OR=0.027, 95% CI 0.005-0.152, P<0.001) and prolonged APTT ( OR=1.090, 95% CI 1.047-1.137, P<0.001)were independent risk factors predicting AKI. The area under the ROC curve (AUC) of these multivariates were 0.741 (95% CI 0.675-0.807), 0.798 (95% CI 0.732-0.864), 0.712 (95% CI 0.643-0.781) and 0.716 (95% CI 0.648-0.783) respectively. The relevant sensitivity was 57.5%, 80.8%, 87.5%, 59.2%, and the specificity was 90.7%, 75.3%, 51.5%, 77.3%, respectively. The AUC of the combined four indicators was 0.880 (95 %CI 0.835-0.926) with the sensitivity 75.0% and the specificity 90.7%. Conclusion:The low level of complement C 3 and prolonged APTT predict sepsis related AKI, and the predictive value can be enhanced if hypotension and hyperlactacidemia are added.

18.
Article in Chinese | WPRIM | ID: wpr-867881

ABSTRACT

Objective:To investigate the correlation of mRNA and protein levels of Ghrelin in shoulder tissue and synovial fluid with severity of rotator cuff tear(RCT) and frozen shoulder(FS).Methods:Recruited for this study were 66 RCT and 66 FS patients who had been definitely diagnosed at Department of Orthopedics, The First Hospital of Huizhou from January 2018 to September 2019. Another 60 patients with rotator instability were recruited as a control group. After the severity of RCT was evaluated by ultrasonographic images, the RCT group was further divided into 3 subgroups according to the severity of RCT: a massive full thickness tear (MFTT) subgroup, a non massive full thickness tear (MFTT) subgroup, and a partial thickness tear (PTT) subgroup. The FS group was conventionally divided into 31 cases of acute phase and 35 cases of adhesive phase. Samples of subacromial bursa and shoulder joint bursa tissues and shoulder joint synovial fluid were collected. The expression of Ghrelin mRNA was detected by RT-PCR and the expression of Ghrelin protein in joint synovial fluid was detected by ELISA. The symptoms and functions of shoulder joint were evaluated by visual analogue scale (VAS) and Constant-Murley functional score.Results:There were no significant differences in gender or age between the RCT, FS and control groups, showing compatibility ( P>0.05).The expression of Ghrelin mRNA in subacromial synovial capsule and shoulder joint capsule and the expression of Ghrelin protein in shoulder synovial fluid in the RCT and FS groups were significantly lower than those in the control group ( P<0.05).The expression of Ghrelin mRNA in subacromial synovial capsule and shoulder joint capsule and the expression of Ghrelin protein in shoulder synovial fluid in the PTT subgroup were the highest, followed sequentially by NMFTT and MFTT subgroups, with significant differences between subgroups ( P<0.05). For FS patients, the expression levels of Ghrelin mRNA and protein in the acute phase were significantly lower than in the adhesive phase ( P<0.05). The relative expression of Ghrelin mRNA in joint capsule and the expression of Ghrelin protein in shoulder synovial fluid were negatively correlated with VAS scores and IL-6 levels (all P<0.05), and positively correlated with the Constant-Murley scores (all P<0.05). Conclusions:The expression of Ghrelin in shoulder tissue and synovial fluid is negatively correlated with the progress of rotator cuff tear and frozen shoulder.Local supplementation of Ghrelin may be a potential therapy for rotator cuff tear and frozen shoulder.

19.
Chinese Medical Journal ; (24): 2803-2807, 2020.
Article in English | WPRIM | ID: wpr-877935

ABSTRACT

BACKGROUND@#Allogeneic natural killer (NK) cell immunotherapy is recognized as a promising anti-tumor strategy, but whether it plays a role in poor CD4 recovery among human immunodeficiency virus type 1 (HIV-1) infected patients is unknown. This study aimed to investigate the safety and effectiveness of allogeneic NK cells immunotherapy on HIV-1 immunological non-responders (INRs) receiving antiretroviral therapy (ART).@*METHODS@#From February to April 2018, a prospective, randomized, controlled, open-label clinical trial, which enrolled 20 HIV-1 INRs following specific inclusion criteria, was conducted at Nankai University Second People's Hospital. Participants were randomly allocated (simple randomization 1:1) to either the combined treatment (NK + ART) group (n = 10) or the control (ART) group (n = 10). The allogenic highly activated NK cells from killer cell immunoglobulin-like receptor (KIR)/human leukocyte antigen (HLA)-Cw mismatched healthy donor were prepared (10 cells in each injection) and intravenously infused to each recruited patient of NK+ART group in three courses. Key immune parameters (CD4 count, CD8 count, CD4/CD8 ratio), laboratory tests (count of blood cells, biochemistry panel) and symptoms at baseline and at month 1, 3, 6, 9, 12, and 24 were measured/collected to analyze the safety and efficacy of the therapy. Comparisons were between the seven time-points of both groups using repeated measurement analysis of variance (ANOVA) test. Generalized estimating equations (GEE) model was performed to evaluate the overall effect of the NK+ART group vs. the ART group.@*RESULTS@#From baseline to 24 months, we noted a mean CD4 count augmentation (139 to 243 cells/μL) in the NK + ART group and (144 to 176 cells/μL) in the ART group (difference, 67; 95% CI, 10 to 124; P = 0.024). Our estimations revealed that NK+ART group could improve CD4 level (β = 54.59, P = 0.006) and CD8 level (β = 322.47, P = 0.010) on average among the six measurements compared with the ART group. Only two (2/10, 20%) participants in the NK+ART group developed a transient mild fever after the first course.@*CONCLUSIONS@#This preliminary study informs that HIV-1 INRs, allogenic NK cells immunotherapy is safe and could significantly improve CD4 recovery but not CD4/CD8 ratio. The practical effects, however, need long-term follow-up observations. Further study on the potential underlying mechanism is warranted. REGISTRATION INFO:: www.chictr.org.cn/showproj.aspx?proj=34912 (No. ChiCTR1900020634).


Subject(s)
CD4 Lymphocyte Count , HIV Infections/therapy , HIV-1 , Hematopoietic Stem Cell Transplantation , Humans , Immunotherapy , Killer Cells, Natural , Prospective Studies , Viral Load
20.
Article in Chinese | WPRIM | ID: wpr-905420

ABSTRACT

Objective:To observe the effect of comprehensive treatments on autism spectrum disorders (ASD). Methods:From October, 2017 to October, 2019, 60 children with ASD were divided into control group (n = 30) and treatment group (n = 30) randomly. The control group received rehabilitation training and special education, while the treatment group received acupuncture, massage and Chinese Medicine, in addition, for twelve weeks. The scores of Austin Behavior Checklist (ABC) and Autism Treatment Evaluation Checklist (ATEC) were compared before and after treatment. Results:Before treatment, there was no significant difference in the scores of ABC and ATEC between two groups (t < 1.426, P > 0.05). After treatment, the scores of ABC and ATEC significantly decreased in both groups (t > 5.46, P < 0.001), and were better in the treatment group than in the control group (|t| > 3.304, P < 0.01). Conclusion:Traditional Chinese Medicine combined with rehabilitation training and special education is effective on ASD, which is superior to rehabilitation training and special education.

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