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1.
Acta Pharmaceutica Sinica ; (12): 695-699, 2022.
Article in Chinese | WPRIM | ID: wpr-922878

ABSTRACT

Antibody-drug conjugates (ADCs) are widely used in cancer treatment. Human epidermal growth factor receptor-2 (HER2) is overexpressed in various types of solid tumors and is a validated therapeutic target for cancers. To develop a more effective therapy, we generated a novel anti-HER2 humanized monoclonal antibody MIL40 and MIL40 drug conjugates as novel cancer therapies. The MIL40 was conjugated with small molecule cytotoxic agents DM1 [emtansine, N2'-deacetyl-N2'-(3-mercapto-1-oxopropyl)-maytansine] or monomethylauristatin E (MMAE) to generate ADCs, which were evaluated for their in vitro and in vivo anti-cancer activities. Experimental results show that MIL40-DM1 and MIL40-MMAE can effectively identify and bind to HER2-positive tumor cells. The binding capabilities of MIL40-DM1 and MIL40-MMAE with HER2 extracellular domain (ECD) antigens were not different after conjugation with DM1 or MMAE. The ADCs showed potent cytotoxicity in HER2-positive ovarian cancer cells SKOV3, breast cancer cells SKBR3 and stomach cancer cells N87 in vitro. MIL40-DM1 can effectively inhibit the volume and weight growth of SKOV3 transplant tumors in mice. The mice in this study were used and treated by following the international guidelines for the care and use of laboratory animals, and approved by Animal Ethics Committee of Institute of Military Cognitive and Brain Sciences.

2.
Neuroscience Bulletin ; (6): 113-134, 2022.
Article in English | WPRIM | ID: wpr-922681

ABSTRACT

Mutations of the X-linked methyl-CpG-binding protein 2 (MECP2) gene in humans are responsible for most cases of Rett syndrome (RTT), an X-linked progressive neurological disorder. While genome-wide screens in clinical trials have revealed several putative RTT-associated mutations in MECP2, their causal relevance regarding the functional regulation of MeCP2 at the etiologic sites at the protein level requires more evidence. In this study, we demonstrated that MeCP2 was dynamically modified by O-linked-β-N-acetylglucosamine (O-GlcNAc) at threonine 203 (T203), an etiologic site in RTT patients. Disruption of the O-GlcNAcylation of MeCP2 specifically at T203 impaired dendrite development and spine maturation in cultured hippocampal neurons, and disrupted neuronal migration, dendritic spine morphogenesis, and caused dysfunction of synaptic transmission in the developing and juvenile mouse cerebral cortex. Mechanistically, genetic disruption of O-GlcNAcylation at T203 on MeCP2 decreased the neuronal activity-induced induction of Bdnf transcription. Our study highlights the critical role of MeCP2 T203 O-GlcNAcylation in neural development and synaptic transmission potentially via brain-derived neurotrophic factor.


Subject(s)
Animals , Humans , Methyl-CpG-Binding Protein 2/metabolism , Mice , Neurodevelopmental Disorders/genetics , Rett Syndrome/genetics , Synaptic Transmission , Threonine
3.
Article in English | WPRIM | ID: wpr-922581

ABSTRACT

The abnormality of platelet function plays an important role in the pathogenesis and evolution of blood stasis syndrome (BSS). The explanation of its mechanism is a key scientific issue in the study of cardiovascular and cerebrovascular diseases and treatment. System biology technology provides a good technical platform for further development of platelet multi-omics, which is conducive to the scientific interpretation of the biological mechanism of BSS. The article summarized the pathogenesis of platelets in BSS, the mechanism of action of blood activating and stasis resolving drugs, and the application of genomics, proteomics, and metabonomics in platelet research, and put forward the concept of "plateletomics in BSS". Through the combination and cross-validation of multi-omics technology, it mainly focuses on the clinical and basic research of cardiovascular and cerebrovascular diseases; through the interactive verification of multi-omics technology and system biology, it mainly focuses on the platelet function and secretion system. The article systematically explains the molecular biological mechanism of platelet activation, aggregation, release, and other stages in the formation and development of BSS, and provides a new research idea and method for clarifying the pathogenesis of BSS and the mechanism of action of blood activating and stasis resolving drugs.


Subject(s)
Blood Platelets , Hemostasis , Platelet Activation , Proteomics , Technology
4.
Article in English | WPRIM | ID: wpr-922536

ABSTRACT

BACKGROUND@#Functional constipation (FC) is one of the most prevalent functional gastrointestinal disorders. Dissatisfaction with medications prescribed to treat FC may lead patients to seek alternative treatments. Numerous systematic reviews (SRs) examining the use of acupuncture to treat FC have reported inconsistent results, and the quality of these studies has not been fully evaluated.@*OBJECTIVE@#In this overview, we evaluated and summarized clinical evidence on the effectiveness and safety of acupuncture for treating FC and evaluated the quality and bias of the SRs we reviewed.@*SEARCH STRATEGY@#The search strategy was structured by medical subject headings and search terms such as "acupuncture therapy" and "functional constipation." Electronic searches were conducted in eight databases from their inception to September 2020.@*INCLUSION CRITERIA@#SRs that investigated the effectiveness and safety of acupuncture for managing FC were included.@*DATA EXTRACTION AND ANALYSIS@#Two authors independently extracted information and appraised the methodology, reporting accuracy, quality of evidence, and risk of bias using the following critical appraisal tools: (1) A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2); (2) Risk of Bias in Systematic Reviews (ROBIS); (3) Preferred Reporting Items for Systematic Reviews and Meta-analyses for Acupuncture (PRISMA-A); and (4) the Grading of Recommendations, Assessment, Development and Evaluations (GRADE). A κ index was used to score the level of agreement between the 2 reviewers.@*RESULTS@#Thirteen SRs that examined the clinical utility of acupuncture for treating FC were identified. Using the AMSTAR 2 tool, we rated 92.3% (12/13) of the SRs as "critically low" confidence and one study as "low" confidence. Using the ROBIS criteria, 38.5% (5/13) of the SRs were considered to have "low risk" of bias. Based on PRISMA-A, 76.9% (10/13) of the SRs had over 70% compliance with reporting standards. The inter-rater agreement was good for AMSTAR 2, ROBIS, and PRISMA-A. Using the GRADE tool, we classified 22.5% (9/40) of the measured outcomes as "moderate" quality, 57.5% (23/40) as "low" quality, and 20.0% (8/40) as "very low" quality. The inter-rater agreement was moderate when using GRADE. Descriptive analyses indicated that acupuncture was more efficacious than sham acupuncture for improving weekly complete spontaneous bowel movements (CSBMs) and for raising the Bristol Stool Form Scale (BSFS) score. Acupuncture appeared to be superior to anti-constipation drugs for improving weekly spontaneous bowel movements, the total effective rate, and the Patient Assessment of Constipation Quality of Life score. Although ten SRs mentioned the occurrence of adverse events, serious adverse events were not associated with acupuncture treatment.@*CONCLUSION@#Acupuncture may be more efficacious than sham acupuncture for improving CSBMs and BSFS scores and may be superior to anti-constipation drugs for improving bowel movement frequency, as well as quality of life. Limitations to current studies and inconsistent evidence suggest a need for more rigorous and methodologically sound SRs to draw definitive conclusions.@*SYSTEMATIC REVIEW REGISTRATION@#PROSPERO CRD42020189173.


Subject(s)
Acupuncture Therapy , Constipation/therapy , Humans , Quality of Life , Systematic Reviews as Topic
5.
International Eye Science ; (12): 99-103, 2022.
Article in Chinese | WPRIM | ID: wpr-906740

ABSTRACT

@#AIM: To observe the efficacy of addition and subtraction of Buyang Huanwu decoction in the adjuvant treatment of non-proliferative diabetic retinopathy of Qi-Yin deficiency and blood stasis and its effects on traditional Chinese medicine(TCM)syndromes and visual function level. <p>METHODS: A total of 110 patients with non-proliferative diabetic retinopathy of Qi-Yin deficiency and blood stasis in our hospital between January 2017 and December 2019 were selected and divided into observation group(55 cases, 110 eyes)and control group(55 cases, 110 eyes). Patients in control group received conventional treatment according to the condition of patients with reference to relevant guidelines, and patients in observation group were combined with addition and subtraction of Buyang Huanwu decoction adjuvant therapy on this basis. The clinical efficacy after 3mo of treatment, and TCM syndromes scores, clinical indicators(macular edema score, macular retinal volume, macular foveal retinal thickness), visual function(best corrected visual acuity, average visual field sensitivity)and serum biochemical indicators \〖vascular endothelial growth factor(VEGF), hypoxia-inducible factor-1(HIF-1)\〗 before treatment and 3mo after treatment were compared between the two groups.<p>RESULTS: After 3mo of treatment, the total effective rate of treatment in observation group was significantly higher than that in control group(<i>P</i><0.05). After 3mo of treatment, the TCM syndromes scores in the two groups were decreased compared with those before treatment, and the scores in observation group were lower than those in control group(<i>P</i><0.05). After 3mo of treatment, the macular edema score, macular retinal volume and macular foveal retinal thickness in the two groups were reduced compared with those before treatment, and the indexes in observation group were smaller than those in control group(<i>P</i><0.05). After 3mo of treatment, the best corrected visual acuity and average visual field sensitivity in the two groups were improved compared with those before treatment, and the indexes in observation group were higher than those in control group(<i>P</i><0.05). After 3mo of treatment, the levels of serum VEGF and HIF-1 in the two groups were decreased compared with those before treatment, and the levels in observation group were lower than those in control group(<i>P</i><0.05). <p>CONCLUSION: Addition and subtraction of Buyang Huanwu decoction has an exact efficacy in the adjuvant treatment of non-proliferative diabetic retinopathy of Qi-Yin deficiency and blood stasis, and it can improve symptoms and promote visual function recovery by reducing the expressions of VEGF and HIF-1.

6.
Article in Chinese | WPRIM | ID: wpr-888467

ABSTRACT

OBJECTIVE@#To investigate the condition of enteral feeding and the incidence of feeding intolerance (FI) in extremely low birth weight (ELBW) infants with a gestational age (GA) of < 28 weeks versus ≥ 28 weeks.@*METHODS@#A retrospective analysis was performed for the ELBW infants who were admitted to the Department of Neonatology, The Third Affiliated Hospital of Guangzhou Medical University, from January 2018 to January 2020. According to GA, they were divided into two groups:GA < 28 weeks (@*RESULTS@#Among the 41 infants in the GA < 28 weeks group, 2 (5%) were small-for-gestational-age (SGA) infants, while among the 38 infants in the GA ≥ 28 weeks group, 24 (63%) were SGA infants. Compared with the GA ≥ 28 weeks group, the GA < 28 weeks group had significantly longer initial and final time to full enteral feeding (


Subject(s)
Birth Weight , Enteral Nutrition , Gestational Age , Humans , Infant , Infant, Extremely Low Birth Weight , Infant, Newborn , Infant, Premature , Retrospective Studies
7.
Article in Chinese | WPRIM | ID: wpr-888080

ABSTRACT

As a dangerous disease with rapid progression, endotoxemia is easy to induce the damage to multiple organs. However, its specific and efficient treatment methods are still lacking at present. Both Qingkailing Injection(QKLI) and Shengmai Injection(SMI) have been proved effective in anti-inflammation, anti-endotoxin and organ protection. In this study, carrageenan and endotoxin were injected successively into rats to establish an endotoxemia model. Different doses of QKLI and SMI were administered to the endotoxemia rats by intraperitoneal injection separately or in combination. Then the count of white blood cells, the number of platelets, the content of cytokines, biochemical indexes, organ coefficient and pathological changes of main organs in the rats were detected. The results showed that the rats in the model group had obvious symptoms of endotoxemia, i.e., leucopenia, thrombocytopenia, increase in cytokines(IL-6 and TNF-α) and biochemical indexes of liver and kidney function as well as pathological damage to liver, kidney and lung. QKLI alone can alleviate the above symptoms of endotoxemia and the organ injury. SMI alone is less effective in improving disseminated intravascular coagulation(DIC) and cytokine secretion complicated with endotoxemia, but capable of reducing the inflammation degree of the lung, liver and kidney. The combination of QKLI and SMI remarkably increased the number of platelets in the peripheral blood, improved the liver and kidney function and reduced inflammatory factors, with lung, liver, kidney and other organ structures protected well. Moreover, the improvement effect of the combination of QKLI and SMI was stronger than those of the two injections alone at fixed doses, indicative of a synergistic effect.


Subject(s)
Animals , Drug Combinations , Drugs, Chinese Herbal , Endotoxemia/drug therapy , Rats
8.
Chinese Medical Journal ; (24): 1593-1601, 2021.
Article in English | WPRIM | ID: wpr-887574

ABSTRACT

BACKGROUND@#Non-communicable chronic diseases have become the leading causes of disease burden worldwide. The trends and burden of "metabolic associated fatty liver disease" (MAFLD) are unknown. We aimed to investigate the cardiovascular and renal burdens in adults with MAFLD and non-alcoholic fatty liver disease (NAFLD).@*METHODS@#Nationally representative data were analyzed including data from 19,617 non-pregnant adults aged ≥20 years from the cross-sectional US National Health and Nutrition Examination Survey periods, 1999 to 2002, 2003 to 2006, 2007 to 2010, and 2011 to 2016. MAFLD was defined by the presence of hepatic steatosis plus general overweight/obesity, type 2 diabetes mellitus, or evidence of metabolic dysregulation.@*RESULTS@#The prevalence of MAFLD increased from 28.4% (95% confidence interval 26.3-30.6) in 1999 to 2002 to 35.8% (33.8-37.9) in 2011 to 2016. In 2011 to 2016, among adults with MAFLD, 49.0% (45.8-52.2) had hypertension, 57.8% (55.2-60.4) had dyslipidemia, 26.4% (23.9-28.9) had diabetes mellitus, 88.7% (87.0-80.1) had central obesity, and 18.5% (16.3-20.8) were current smokers. The 10-year cardiovascular risk ranged from 10.5% to 13.1%; 19.7% (17.6-21.9) had chronic kidney diseases (CKDs). Through the four periods, adults with MAFLD showed an increase in obesity; increase in treatment to lower blood pressure (BP), lipids, and hemoglobin A1c; and increase in goal achievements for BP and lipids but not in goal achievement for glycemic control in diabetes mellitus. Patients showed a decreasing 10-year cardiovascular risk over time but no change in the prevalence of CKDs, myocardial infarction, or stroke. Generally, although participants with NAFLD and those with MAFLD had a comparable prevalence of cardiovascular disease and CKD, the prevalence of MAFLD was significantly higher than that of NAFLD.@*CONCLUSIONS@#From 1999 to 2016, cardiovascular and renal risks and diseases have become highly prevalent in adults with MAFLD. The absolute cardiorenal burden may be greater for MAFLD than for NAFLD. These data call for early identification and risk stratification of MAFLD and close collaboration between endocrinologists and hepatologists.


Subject(s)
Adult , Cross-Sectional Studies , Diabetes Mellitus, Type 2 , Humans , Non-alcoholic Fatty Liver Disease/epidemiology , Nutrition Surveys , Prevalence
9.
Article in English | WPRIM | ID: wpr-887530

ABSTRACT

INTRODUCTION@#The aims of this study were to establish weight change, incidence of non-alcoholic fatty liver disease (NAFLD) and cardiovascular risk factors (CvRF) in liver transplant recipients (LTRs).@*METHODS@#Eighty-three patients whose mean (standard deviation [SD]) age was 55.6 (8.4) years (median follow-up 73 months) and who underwent their first liver transplantation (LT) at Singapore General Hospital between February 2006 and March 2017 were included in the study. Anthropometric, clinical and demographic data were collected retrospectively from patients' medical records. Diabetes mellitus (DM), hyperlipidaemia and hypertension were regarded as CvRF.@*RESULTS@#Compared to baseline, mean (SD) body weight decreased significantly at 1 month post-LT (60.8kg [11.9] versus 64.3kg [13.7], @*CONCLUSION@#CvRF increased significantly post-LT, and NAFLD occurred in 25.3% of LTRs. Body weight dropped drastically within the first month post-LT, which then returned to baseline level just before the end of first year. This novel finding suggests that nutritional intervention needs to be tailored and individualised, based on events and time from transplant. Although long-term obesity is a significant problem, aggressive oral or enteral nutritional supplements take precedence in the early and immediate post-LT period, while interventions targeted at metabolic syndrome become necessary after the first year.


Subject(s)
Cardiovascular Diseases/etiology , Heart Disease Risk Factors , Humans , Liver Transplantation , Middle Aged , Retrospective Studies , Risk Factors , Singapore/epidemiology
10.
Article in Chinese | WPRIM | ID: wpr-887148

ABSTRACT

Objective:To know the status of knowledge, attitude and behavior related to sexual and reproductive health in high school students in three regions of East China, and to provide a reference for adolescent reproductive health education. Methods:From August to October in 2019, 614 high school students were invited from 6 high schools in Jiading District and Yangpu District, Shanghai and Taicang City, Jiangsu to participate in this study. We conducted an anonymous self-questionnaire survey using structured questionnaires based on adolescent reproductive health knowledge and literacy. Results:The male to female ratio of all high school students in the study was 1∶1.25, and the average age was (16.1±0.9) years old. The score of pregnancy and abortion knowledge was the lowest among the reproductive health knowledge scores, and the differences among the three regions were statistically significant (P=0.002). Male high school students (P<0.001), students in the school with reproductive health education base (P=0.008) and students who wanted to obtain reproductive health education (P=0.002) were more acceptable to premarital sex. The high school students obtained adolescent health knowledge mainly through the internet or mobile phones, and had a demand for reproductive health related services. Conclusion:High school students in the three regions have a more open attitude towards premarital sex, but have a poor grasp of correct and efficient contraceptive knowledge. Responsible departments need to strengthen the health education of relevant knowledge, and at the same time to find new forms of education to effectively improve the level of adolescent reproductive health.

11.
Acta Pharmaceutica Sinica ; (12): 913-923, 2021.
Article in Chinese | WPRIM | ID: wpr-886971

ABSTRACT

Malignant tumors seriously endanger human life and health, and their treatment has always been a research focus of scientists all over the world. Natural flavonoids and their derivatives have a variety of biological activities, especially regarding antitumor growth, with unique biological activities. They can interfere with the growth cycle of tumor cells, change the mitochondrial membrane potential, promote apoptosis, and can reduce the immune escape of tumor cells and prevent tumor metastasis by improving human immunity. In the human body, they regulate the biological signal transduction, leading to the up-regulation of pro-apoptotic protein expression. They inhibit the growth of solid tumors by regulating the growth of vascular epithelial cells and blocking the formation of blood vessels in tumor tissue. Recent studies have shown that these compounds can play an important role in the treatment of various human tumors and are expected to be developed into new antitumor drugs. This review summarizes the recent research results on the antitumor mechanism of flavonoids and their ability to inhibit tumor growth.

12.
China Pharmacy ; (12): 2097-2102, 2021.
Article in Chinese | WPRIM | ID: wpr-886745

ABSTRACT

OBJECTIVE:To construct a calculation method which can accurately reflect the medical insurance fund expenditure of intervention scheme for cross-year survival patients ,and to provide reference for the research of medical insurance budget impact analysis(BIA). METHODS :Based on survival data of cohort model ,taking the patients diagnosed in each cycle in each year as a cohort,the number of per capita survival cycle of cohort patients in each state in the study year was calculated ,i.e. the average survival time ;on this basis ,the total cost of patients in all cohorts in the study year was calculated according to the number of people in each cohort and the per capita cost each cycle in each state. Taking the intervention scheme of a cancer as an example , the calculation was carried out by the established algorithm ,and the calculation results were compared with the results of several common algorithms ;at the same time ,the application suggestions were put forward for the expansion of the constructed algorithm in special cases. RESULTS & CONCLUSIONS :Compared with the several common algorithms ,the calculation process of the constructed algorithm is more in line with the process of medical insurance fund expenditure related to drug intervention scheme in the real world ,and it can flexibly adapt to the calculation needs in a variety of special situations. This algorithm can more accurately calculate the medical insurance fund expenditure of a intervention scheme in a specific year ,and to a certain extent solve the problem of inaccurate prediction of medical insurance fund expenditure due to insufficient consideration of cross-year survival patients or simple and rough calculation process. It can provide a more accurate method choice for the research of medical insurance BIA in China.

13.
Journal of Clinical Hepatology ; (12): 1894-1897., 2021.
Article in Chinese | WPRIM | ID: wpr-886345

ABSTRACT

ObjectiveTo investigate the association between perioperative immune status and postoperative infectious complications in elderly patients undergoing laparoscopic pancreaticoduodenectomy (LPD), as well as the effect of thymosin a1 on postoperative complications. MethodsRelated clinical data were collected from 43 elderly patients, aged 66-83 years, who underwent LPD in The Second Affiliated Hospital of Army Medical University, PLA from June 2014 to June 2018, and the patients were divided into combination group with 22 patients (with the application of thymosin a1 in the perioperative period) and control group with 21 patients (without the application of thymosin a1). Immune function parameters were observed before surgery and on days 3 and 7 after surgery, including serum levels of IgG, IgA, and IgM, peripheral blood neutrophil-lymphocyte ratio (NLR), changes in CD3+, CD4+, CD8+, and CD4+/CD8+ ratio, and the incidence rate of postoperative infectious complications (pulmonary infection, pancreatic leakage, and abdominal infection). In addition, the serum levels of C-reactive protein, interleukin-2 (IL-2), interleukin-10 (IL-10), tumor necrosis factor-α, and interferon-γ (IFN-γ) were measured before surgery and on days 3 and 7 after surgery. The t-test was used for comparison of continuous data between two groups; a repeated measures analysis of variance was used for comparison within each group at different time points, and the Duncan’s new multiple range test was used for further pairwise comparison. The chi-square test was used for comparison of categorical data between groups. ResultsCompared with the control group on days 3 and 7 after surgery, the combination group had significantly higher serum levels of IgG, IgA, IgM, CD3+, CD4+, CD8+, and CD4+/CD8+ ratio (all P<0.05) and a significantly lower NLR (P<0.05). From admission to day 7 after surgery, the control group had significant reductions in the serum levels of IgG, IgA, IgM, CD3+, CD4+, CD8+, and CD4+/CD8+ ratio (all P<0.05) and a significant increase in NLR (P<0.05). The combination group had significantly lower incidence rates of postoperative pulmonary infection and abdominal infection than the control group (χ2=1.44,1.65,all P<0.05). Compared with the control group on days 3 and 7 after surgery, the combination group had significant increases in the serum levels of IL-2, IL-10, and IFN-γ (all P<0.05). ConclusionSurgical trauma can further reduce the immune function of elderly patients, and the use of thymosin a1 during the perioperative period can enhance the immune function of patients and reduce the incidence rate of postoperative infectious complications.

14.
Article in Chinese | WPRIM | ID: wpr-885639

ABSTRACT

Objective:To analyze and evaluate the effect of OX40L as a potential adjuvant for H7N9 whole-virion inactivated vaccine (WIV).Methods:Fifty BALB/c mice were randomly divided into five groups and immunized intramuscularly with PBS (control group) and 1.5 μg WIV alone or in combination with 0.6, 1.8 or 3.0 μg Fc-fused OX40L (OX40L/Fc) adjuvant. Three weeks after immunization, IgG, IgG1 and IgG2 titers were measured by ELISA and hemagglutination inhibition (HI) assay. Moreover, the mice were challenged with 50×median lethal dose (LD 50) of homologous virus and the changes in mouse body weight and survival rate were recorded to evaluate the effects of OX40L. Flow cytometry was used to analyze the mechanism of OX40L as an adjuvant 7 d after immunization. Results:Compared with immunization with WIV alone, co-immunization of WIV with OX40L/Fc induced higher antigen-specific IgG in mice. The geometric mean titers (lgGMT) of antibodies induced by 0.6, 1.8 and 3.0 μg OX40L/Fc reached 3.79, 4.40 and 4.20, respectively. WIV combined with OX40L/Fc induced high levels of IgG1 and IgG2a without influencing Th1/Th2 balance. HI antibodies were also higher in WIV+ 1.8 μg OX40L/Fc and WIV+ 3.0 μg OX40L/Fc groups than in WIV group (6.25±0.50 and 5.70±0.97 vs 3.00±0.97, both P<0.05). WIV combined with 1.8 or 3.0 μg OX40L/Fc could protect 80% or 75% of mice against lethal challenge with H7N9 and result in less weight loss as compared with WIV alone. The most effective dose of OX40L/Fc was 1.8 μg. Flow cytometry showed that WIV (0.6, 1.8, 3.0 μg) in combination with OX40L/Fc enhanced the proliferation of T follicular helper cells (Tfh) through promoting the expression of CXCR5 and PD-1 as compared with WIV alone (all P<0.05). Conclusions:This study suggested that OX40L was beneficial to potent antibody responses induced by H7N9 WIV through promoting Tfh cell proliferation.

15.
Article in Chinese | WPRIM | ID: wpr-884346

ABSTRACT

Objective:To explore the effects of interpregnancy interval (IPI) on pregnancy outcomes of subsequent pregnancy.Methods:A multicenter retrospective study was conducted in 21 hospitals in China. Information of age, height, pre-pregnancy weight, IPI, history of diseases, complications of pregnancy, gestational age of delivery, delivery mode, and pregnancy outcomes of the participants were collected by consulting medical records of pregnant women who had two consecutive deliveries in the same hospital during 2011 to 2018. The participants were divided into 4 groups according to IPI:<18 months, 18-23 months, 24-59 months and ≥60 months. According to the WHO′s recommendation, with the IPI of 24-59 months group as a reference, to the effects of IPI on pregnancy outcomes of subsequent pregnancy were analyzed. Stratified analysis was further carried out based on age, history of gestational diabetes mellitus (GDM), macrosomia, and premature delivery, to explore the differences in the effects of IPI on pregnancy outcomes among women with different characteristics.Results:A total of 8 026 women were included in this study. There were 423, 623, 5 512 and 1 468 participants in <18 months group, 18-23 months group, 24-59 months group and ≥60 months group, respectively. (1) The age, pre-pregnancy body mass index (BMI), history of cesarean section, GDM, gestational hypertension and cesarean section delivery rate of <18 months group, 18-23 months group, 24-59 months group and ≥60 months group were gradually increased, and the differences were statistically significant ( P<0.05). (2) After adjusting for potential confounding factors, compared with women in the IPI of 24-59 months group, the risk of premature delivery, premature rupture of membranes, and oligohydramnios were increased by 42% ( OR=1.42, 95% CI: 1.07-1.88, P=0.015), 46% ( OR=1.46, 95% CI: 1.13-1.88, P=0.004), and 64% ( OR=1.64, 95% CI: 1.13-2.38, P=0.009) respectively for women in the IPI≥60 months group. No effects of IPI on other pregnancy outcomes were found in this study ( P>0.05). (3) After stratified by age and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of oligohydramnios for women with advanced age ( OR=2.87, 95% CI: 1.41-5.83, P=0.004); and <18 months could increase the risk of premature rupture of membranes for women under the age of 35 ( OR=1.59, 95% CI: 1.04-2.43, P=0.032). Both the risk of premature rupture of membranes ( OR=1.58, 95% CI: 1.18-2.13, P=0.002) and premature delivery ( OR=1.52, 95% CI: 1.07-2.17, P=0.020) were significantly increased in the IPI≥60 months group. After stratified by history of GDM and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would lead to an increased risk of postpartum hemorrhage for women with a history of GDM ( OR=5.34, 95% CI: 1.45-19.70, P=0.012) and an increased risk of premature rupture of membranes for women without a history of GDM ( OR=1.44, 95% CI: 1.10-1.90, P=0.009). After stratified by history of macrosomia and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months could increase the proportion of cesarean section for women with a history of macrosomia ( OR=4.11, 95% CI: 1.18-14.27, P=0.026) and the risk of premature rupture of membranes for women without a history of macrosomia ( OR=1.46, 95% CI: 1.12-1.89, P=0.005). After stratified by history of premature delivery and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of premature rupture of membranes for women without a history of premature delivery ( OR=1.47, 95% CI: 1.13-1.92, P=0.004). Conclusions:Both IPI≥60 months and <18 months would increase the risk of adverse pregnancy outcomes in the subsequent pregnancy. Healthcare education and consultation should be conducted for women of reproductive age to maintain an appropriate IPI when they plan to pregnant again, to reduce the risk of adverse pregnancy outcomes in the subsequent pregnancy.

16.
Article in Chinese | WPRIM | ID: wpr-884253

ABSTRACT

Objective:To evaluate the radiologic and clinical outcomes of supramalleolar dome osteotomy in the treatment of varus-type ankle arthritis.Methods:From June 2018 to December 2019, 13 patients with varus-type ankle arthritis underwent supramalleolar dome osteotomy at Department of Foot and Ankle Surgery, Beijing Jishuitan Hospital. Of them, 13 (5 males and 8 females) were included in the study. Their average age at surgery was 47.2 years (range, from 16 to 65 years). By the modified Takakura staging for arthritis, 3 cases were stage 2, 4 cases stage 3a and 6 cases stage 3b. Comparisons were made between preoperation and the last follow-up in ankle-hindfoot score of American Orthopedic Foot and Ankle Society (AOFAS), foot function index (FFI), visual analogue scale (VAS), Takakura staging, dorsal extension, plantar flexion, range of motion (ROM), tibial anterior surface angle (TAS), tibial lateral surface angle (TLS), and talar tilt (TT).Results:This cohort were followed up for 12 to 29 months (average, 17.2 months). At the last follow-up, AOFAS score (86.5±8.0), FFI (14.5±1.6), VAS score (1.5±1.0), Takakura staging (2.7±1.3), ROM (39.4°±8.0°), TAS (92.4°±6.0°), TT (3.7°±4.4°) were significantly improved than the preoperative values (68.3±14.4, 43.7±3.0, 4.2±1.4, 3.2±0.8, 43.3°±7.6°, 78.2°±8.3° and 7.0°±5.1°), and dorsal extension (10.9°±4.4°) was significantly smaller than the preoperative value (13.6°±5.1°) (all P<0.05). There were no significant differences between preoperation and the last follow-up in plantar flexion (29.7°±4.6° versus 28.5°±5.2°) or TLS (77.8°±4.5° versus 78.1°±5.3°) ( P>0.05). Conclusions:Supramalleolar dome osteotomy has shown promising short-term clinical efficacy in the treatment of varus-type ankle arthritis. It can significantly relieve pain, improve function, substantially correct deformity and retard progression of arthritis, but it may affect dorsal extension.

17.
Article in Chinese | WPRIM | ID: wpr-883826

ABSTRACT

Objective:To study the optimal pain control goal for preventing delirium in critical patients.Methods:A prospective cohort study were conducted. The patients admitted to general departments and transferred to the intensive care unit (ICU) due to critical illness in the First People's Hospital of Changde from January 2017 to November 2019 were enrolled. The General data of the patients were collected within 48 hours after admission. All patients admitted to the ICU were evaluated for pain level using the critical care pain observation tool (CPOT) every 8 hours by nurses, and confusion assessment method of ICU (CAM-ICU) was used to screen delirium patient every 8 hours by the leader of nursing team without knowing the pain level of the patients, until the subjects were transferred out of ICU. The receiver operating characteristic (ROC) curve was drawn, the area under ROC curve (AUC) and the optimal threshold were analyzed with delirium as the reference standard; according to the optimal threshold, multivariate Logistic regression analysis was used to evaluate the correlation between CPOT score and delirium.Results:During the study period, 575 patients were admitted to the participating departments and passed the preliminary screening according to the inclusion and exclusion criteria. During the study period, 34 patients were excluded due to incomplete data. Finally, a total of 541 patients were enrolled in the analysis, including 149 patients in delirium group and 392 patients in non-delirium group. There was no significant difference in gender, age, source of patients, education level, smoking history, drinking history, family mental history, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score or other general information between the two groups. There were 10.1% (15/149) of patients in the delirium group used opioids, which was significantly higher than 4.3% (17/392) in the non-delirium group, and the difference was statistically significant ( P < 0.05). The CPOT score in the delirium group was significantly higher than that in the non-delirium group (4.24±1.78 vs. 2.75±1.95, P < 0.01). The patients were subdivided into young group (< 40 years old), middle-aged group (40-65 years old) and old group (> 65 years old) according to age. The analysis results were consistent with the overall analysis results. ROC curve analysis showed that the AUC of CPOT score predicting delirium was 0.719; when the best threshold value of CPOT score was 2.5, the sensitivity was 91.3%, the specificity was 49.0%, the positive predictive value was 40.5% and the negative predictive value was 93.7%. Multivariate Logistic regression analysis showed that the risk of delirium in ICU patients with CPOT score ≥ 3 was 10.043 times higher than that in patients with CPOT score < 3 [odds ratio ( OR) = 10.043, 95% confidence interval (95% CI) was 5.498-18.345, P < 0.001]. When the gender, age, APACHEⅡ score, smoking history, drinking history, opioids usage were adjusted, the risk of delirium in patients with CPOT score ≥ 3 was 10.719 times higher than that in patients with CPOT score < 3 ( OR = 10.719, 95% CI was 5.689-20.196, P < 0.001). Conclusion:The best pain control goal for preventing the occurrence of delirium in ICU patients is a CPOT score of 3 or less.

18.
Article in Chinese | WPRIM | ID: wpr-883558

ABSTRACT

Objective:To compare the effect of Rain Classroom and traditional teaching model on the academic achievement of domestic medical undergraduates by Meta-analysis.Methods:All literature were retrieved from CNKI, Wanfang Med Online, VIP, and CBM databases, and the retrieval time limited from the establishment of the database to October 2019. Randomized controlled trials (RTCs) for the evaluation of the effects of Rain Classroom method in undergraduate medical education were selected. Literature were screened according to the established inclusion and exclusion criteria. Data was extracted and the quality of the literature was assessed using the Jadad scale. All analyses were performed by Stata 12.0 software.Results:A total of 3 662 medical undergraduates in 20 RCTs were included. Meta-analysis results showed that student's theoretical and practical scores of the Rain Classroom teaching group were significantly higher than those of the traditional teaching group (theoretical scores: WMD = 8.52, 95%CI = 7.30 -9.74, P < 0.001; practical scores: WMD = 8.95, 95%CI = 5.42 -12.49, P < 0.001). Conclusion:The Rain Classroom teaching method can effectively improve the theoretical and practical academic achievement among medical undergraduates and enhance the teaching effect. This study has also provided the evidence -based basis for the promotion and application of the Rain Classroom teaching method in medical undergraduate courses.

19.
Article in Chinese | WPRIM | ID: wpr-882816

ABSTRACT

Clinical data of a child with acquired immunodeficiency syndrome characterized by ischemic stroke who was admitted to the Pediatric Intensive Care Unit of Children′s Hospital Affiliated to Soochow University in January 2019 were retrospectively analyzed.The child is a 6 years and 4 months old boy with a history of thrombocytopenic purpura and recurrent respiratory infections.The main complaint was " the right limb weakness for more than 10 days" . The head magnetic resonance imaging (MRI) revealed extensive abnormal signals in the bilateral frontal and parietal lobes and the formation of softening foci in the left thalamus and outer capsule.Blood routine showed white blood cell 4.88×10 9/L, lymphocyte ratio 0.291, lymphocyte count 1.42×10 9/L, hemoglobin 99 g/L, and platelet 23×10 9/L.Lymphocyte subsets included CD3 + 84.1%, CD3 + CD4 + 0.2%, CD3 + CD8 + 61.4%, CD4 + /CD8 + 0, CD3 -CD 19+ 9.2%, CD3 -CD 16+ 56+ 6.1%, and CD 19+ CD 23+ 5.8%.Pretransfusion tests suggested human immunodeficiency virus (HIV) (+ ), and that other results were negative.Both parents of the child were infected with HIV.This paper demonstrates that neurological involvement is not rare in HIV infection, and stroke is the most common cause of clinical focal neurological deficits in HIV-infected children.Screening with MRI is recommended for high-risk children with neurologic symptoms or neurocognitive dysfunction.

20.
Article in Chinese | WPRIM | ID: wpr-882806

ABSTRACT

Objective:To study the pathogenic distribution of bronchoalveolar lavage fluid in children with severe pneumonia from Children′s Hospital Affiliated to Soochow University, and to investigate the drug resistance of major pathogenic bacteria.Methods:A total of 177 children with severe pneumonia undergoing fiberoptic bronchoscopy in Children′s Hospital Affiliated to Soochow University from January 2014 to December 2018 were enrolled.Their bronchoalveolar lavage fluid was collected for pathogen identification, pathogen culture and drug sensitivity analysis.The pathogens were detected by direct immunofluorescence quantitative PCR.Results:Of 177 cases enrolled, 100 children had at least one pathogen detected, and the positive rate was 58.13%.Among all the pathogens detected, Mycoplasma pneumonia (MP) had the highest detection rate, which was found in 41 cases.The top three bacteria detected included Streptococcus pneumoniae (9 cases, 10.59%), Staphylococcus aureus (8 cases, 9.41%), and Pseudomonas aeruginosa (6 cases, 7.06%). The top three viruses detected were cytomegalo virus (CMV) (14 cases, 33.33%), human bocavirus (HBoV) (10 cases, 23.81%), and respiratory syncytial virus (RSV) (8 cases, 19.05%). The drug sensitive test indicated that main kinds of Gram-negative bacteria had low resistance to quinolones, aminoglycosides, carbapenems, and enzymatic beta-lactams.Main kinds of Gram-positive bacteria had low resistance to Linezolid and vancomycin.The virus detection rate and MP detection rate in severe pneumonia children under 5 years old were about 30.00% and 20.00%, respectively.The MP detection rate in children above 5 years old exceeded 30.00%.The bacteria detection rates in children under and above 2 years old were over 20.00% and about 15.00%, respectively.Airway abnormalities were common in children with severe pneumonia, mainly including tracheobronchial malacia and stenosis. Conclusions:The most common pathogen of bronchoalveolar lavage fluid in severe pneumonia children under 5 years old in Suzhou is viruses.The bacteria detection rate is high in children under 2 years old.Common Gram-positive bacteria show high susceptibility to vancomycin and Linezolid. Pseudomonas aeruginosa is highly sensitive to quinolones, aminoglycosides, carbapenems, and enzymatic beta-lactams.Importance should be attached to the airway abnormalities in children, especially infants, with severe pneumonia.

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