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1.
Frontiers of Medicine ; (4): 483-495, 2022.
Article in English | WPRIM | ID: wpr-939876

ABSTRACT

The pathological hallmarks of psoriasis involve alterations in T cell genes associated with transcriptional levels, which are determined by chromatin accessibility. However, to what extent these alterations in T cell transcriptional levels recapitulate the epigenetic features of psoriasis remains unknown. Here, we systematically profiled chromatin accessibility on Th1, Th2, Th1-17, Th17, and Treg cells and found that chromatin remodeling contributes significantly to the pathogenesis of the disease. The chromatin remodeling tendency of different subtypes of Th cells were relatively consistent. Next, we profiled chromatin accessibility and transcriptional dynamics on memory Th/Treg cells. In the memory Th cells, 803 increased and 545 decreased chromatin-accessible regions were identified. In the memory Treg cells, 713 increased and 1206 decreased chromatin-accessible regions were identified. A total of 54 and 53 genes were differentially expressed in the peaks associated with the memory Th and Treg cells. FOSL1, SPI1, ATF3, NFKB1, RUNX, ETV4, ERG, FLI1, and ETC1 were identified as regulators in the development of psoriasis. The transcriptional regulatory network showed that NFKB1 and RELA were highly connected and central to the network. NFKB1 regulated the genes of CCL3, CXCL2, and IL1RN. Our results provided candidate transcription factors and a foundational framework of the regulomes of the disease.


Subject(s)
Chromatin/genetics , Chromatin Assembly and Disassembly , Gene Regulatory Networks , Humans , Psoriasis/genetics , T-Lymphocytes, Regulatory
2.
Article in Chinese | WPRIM | ID: wpr-935340

ABSTRACT

Coronavirus disease 19 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 has spread all over the world. Streptococcus pneumoniae as a common pathogen of community-acquired pneumonia shares similar high-risk susceptible populations with COVID-19. Streptococcus pneumoniae co-infection is a key risk factor for severe COVID-19 and death. Pneumococcal vaccination has a beneficial impact on reducing the incidence and mortality of COVID-19. The vaccination rate of streptococcus pneumoniae is still low in China. Streptococcus pneumoniae vaccination may be one of effective strategies in the management of COVID-19 for high-risk population such as the elderly and those who have underlying chronic diseases.


Subject(s)
Aged , COVID-19 , Coinfection , Humans , Pneumococcal Infections/prevention & control , Streptococcus pneumoniae , Vaccination
3.
Article in Chinese | WPRIM | ID: wpr-933619

ABSTRACT

Objective:To compare carotid endarterectomy (CEA) and carotid artery stenting (CAS) in perioperative, medium and long term prognosis of patients with carotid artery stenosis.Methods:A retrospective analysis was performed on 1 329 cases of carotid artery stenosis treated at Department of Vascular Surgery, Beijing Anzhen Hospital from Jan 2011 to Aug 2020, as all cases being divided into CAS group and CEA group.Results:There were significant differences in age ( t=0.098, P=0.023) and drinking habits ( χ2=8.055, P=0.005) between the two groups. There were more unstable plaques in CEA group ( χ2=4.392, P=0.038), and more bilateral lesions in CAS group ( χ2=9.673, P=0.038). In perioperative period, there were more mannitol use in CEA group ( χ2=78.614, P<0.001), more incision/puncture site complications ( χ2=5.158, P=0.035), lung infection ( χ2=6.355, P=0.013), cerebral hyperperfusion syndrome (CHS) ( χ2=5.158, P=0.035) and extracranial nerve injury ( χ2=23.760, P<0.001) in CEA group than in CAS group, and more acute renal failure in CAS group ( χ2=10.393, P=0.001). There was no significant difference in survival rate and ischemic stroke, myocardial infarction, cerebral hemorrhage and renal insufficiency between the two groups (all P>0.05). The mean survival time of CAS group was 53.195 months (95% CI: 52.040-54.350), and 54.492 months (95% CI: 53.790-55.195) in CEA group ( P=0.051). Conclusions:Patients in CEA group had more unstable plaque and a lower perioperative stroke rate. CEA group had higher risk of CHS,while CAS was with lower postoperative lung infection rate and less wound local complications. There was no significant difference in long-term survival between the two groups.

4.
Article in Chinese | WPRIM | ID: wpr-932390

ABSTRACT

Objective:To evaluate the feasibility and applicability of using phospholipid-hybridization method for preparing biomimetic microbubbles (Bio-MBs) ultrasound contrast agents.Methods:Leukocyte biomimetic microbubbles (MB leu), platelet biomimetic microbubbles (MB pla) and erythrocyte biomimetic microbubbles (MB ery) were prepared by multiple steps: film-hydration, phospholipid-hybridization, mechanical oscillation. The size and zeta potential of Bio-MBs were measured by dynamic light scattering. A laser scanning confocal microscopy experiment was performed to confirm the presence of membrane proteins on the shell of Bio-MBs. The fluorescence of FITC-labeled typical membrane protein was evaluated using a flow cytometer. Sodium dodecyl sulfate polyacrylamide gel electrophoresis was used to characterize the membrane protein. Biosafety of Bio-MBs was evaluated by CCK-8 counting kit, blood and major organs. The contrast enhancement effect and stability were observed in vitro and in vivo. An in vivo fluorescence imaging system was performed to evaluate the distribution of Bio-MBs. The application value of biomimetic microbubbles was measured by ultrasound molecular imaging by using ischemia-reperfusion rat models and acute hepatitis rat models. Results:Bio-MBs with spherical shape distributed homogenously, without obvious aggregation. The membrane proteins were successfully integrated into the shell of Bio-MBs.The diameter of three Bio-MBs was similar to that of control microbubbles (MB con) ( P>0.05), three Bio-MBs had a lower zeta potential than MB con ( P<0.05). The Bio-MBs had an appreciable performance in vitro and in vivo biosafety. The Bio-MBs retained the main proteins inherited from cell membrane. Contrast enhanced ultrasound imaging in vitro and in vivo showed that the Bio-MBs had a stable imaging ability.MB leu and MB pla have good targeted imaging effect in two disease models. Conclusions:A series of Bio-MBs ultrasound contrast agents, which have high stability, biosafety and targeted imaging efficiency, were successfully prepared by using phospholipid-hybridization method. This fabrication method for obtaining Bio-MBs can be applied to different clinical scenarios with different cell types in the future.

5.
Article in Chinese | WPRIM | ID: wpr-928884

ABSTRACT

As an important auxiliary tool for amputees to gain abled limb functions, prosthetic limbs with decoration or feedforward control channel could not meet the needs. In order to enable the prosthesis to deliver the information, includes temperature, pressure, position, shape and so on, a variety of sensory feedback methods have been integrated into the prosthesis. According to the position of the feedback terminal on the human body, the perceptual feedback systems include invasive and noninvasive sensory feedback. This review presents the research progress of these perceptual feedback techniques, and summarizes the problems in the application in artificial limbs. Finally, the development trend of sensory feedback technology in prostheses is prospected.


Subject(s)
Amputees , Artificial Limbs , Feedback, Sensory , Humans , Prosthesis Design , Technology
6.
Chinese Journal of Urology ; (12): 375-380, 2021.
Article in Chinese | WPRIM | ID: wpr-885025

ABSTRACT

Objective:To evaluate the safety and effectiveness of Kangduo endoscopic surgical robot system for partial nephrectomy.Methods:Consecutive patients with stage T 1 renal tumor meeting the inclusion criteria from the Department of Urology, Peking University First Hospital from December 2020 to February 2021 were prospectively enrolled. All patients underwent partial nephrectomy with the Kangduo endoscopic surgical robot system after signing the informed consent. Clinical data including preoperative, perioperative and postoperative pathology and follow-up were collected. Results:Among the 26 patients, there were 16 males and 10 females, with a median age of 53(33-74) years, and a median body mass index of 25.99(20.90-32.91) kg/m 2. There were 12 cases of left kidney tumor and 14 cases of right kidney tumor. The median tumor diameter was 2.2(1.0-3.5) cm. The median time of warm ischemia was 17.7(7.1-29.2) minutes, and all of them were less than 30 minutes. The median docking time was 4.7(2.3-9.9) minutes, and the median time of robotic arm operation was 65.0 (37.0-155.0) minutes. The median National Aeronautics and Space Administration Task Load Index (NASA-TLX) score was 5.3 (2.0-28.0), and no instrument-related adverse events occurred intraoperatively. The median postoperative hospital stay was 4 (4-5) days. All tumor margins were negative on pathologic reports. No Clavien Ⅱ stage operative complications occurred in all patients during perioperative period and 1 month after the surgery. Conclusions:The partial nephrectomy using the kangduo endoscopic surgical robot system were completed successfully, and no instrument-related adverse events and complications occurred, showing that this surgical system used for partial nephrectomy is safe and effective.

7.
Article in Chinese | WPRIM | ID: wpr-910858

ABSTRACT

Objective:To analyze the etiological composition and changing trends in chronic kidney disease.Methods:CKD patients from our hospital were in cluded in the study from three separate periods, 173 patients from 1990-1991, 956 patients from 2009-2010, and 1440 patients from 2018-2019. The etiology of CKD in patients between the younger and middle-aged group and the elderly group were compared using the χ2 test, and the Bonferroni method was used to correct the pairwise comparisons.Results:The leading cause of CKD in 1990-1991, 2009-2010, and 2018-2019 was chronic glomerulonephritis (52%), chronic glomerulonephritis (35%), and diabetes (36%), respectively. The distribution of the etiologies was different signficantly among the three cohorts (χ2=74.375, P<0.001). Compared with 1990-1991, the percentage of CKD related to diabetes (χ2=14.847, P=0.001) and hypertension (χ2=12.279, P=0.002) significantly increased, while chronic glomerulonephritis showed a downward trend (χ2=19.976, P<0.001). Among the elderly CKD patients, the leading cause of CKD in the three cohorts was chronic glomerulonephritis (34%), diabetes (40%), and diabetes (43%), respectively. Conversely, diabetes and hypertension have become the predominant causes in 2009-2010 and 2018-2019. Although chronic glomerulonephritis remained the leading cause of CKD in the past 30 years, the percentage declined gradually among the younger and middle-aged patients with CKD. The percentage of CKD related to diabetes (χ2=31.345, P<0.001) and hypertension (χ2=15.485, P<0.001) significantly increased. In addition, in the 2018-2019 cohort, there were 494 patients with end-stage renal disease (ESRD), and the percentage of ESRD related to diabetes and hypertension were 48% and 37%, respectively. Conclusion:Diabetes and hypertension have become the predominant causes of CKD in Chinese elderly patients. Although chronic glomerulonephritis was the leading cause among the younger and middle-aged patients with CKD, the percentage declined gradually. Additionally, diabetes and hypertension were also the predominant causes of ESRD.

8.
Article in Chinese | WPRIM | ID: wpr-906152

ABSTRACT

Objective:To systematically analyze the chemical constituents of Qizhi Jiangtang capsules by ultra performance liquid chromatography-quadrupole-electrostatic field orbital trap high resolution mass spectrometry (UPLC-QE-Orbitrap-MS). Method:Analysis was conducted on a ACQUITY UPLC HSS T3 column (2.1 mm×100 mm, 1.8 μm) with acetonitrile (A)-water (B) as the mobile phase for gradient elution (0-13 min, 1%-25%A; 13-21 min, 25%-35%A; 21-28 min, 35%-85%A; 28-30 min, 85%-100%A; 30-32 min, 100%-1%A). The flow rate was 0.2 mL·min<sup>-1</sup>, the column temperature was 30 ℃, and the volume of sample injection was 3 μL. Electrospray ionization (ESI) was used to collect data in the negative and positive ion modes with the scanning range of <italic>m</italic>/<italic>z</italic> 100-1 500. Meanwhile, a variety of MS analytic methods were used, including comparing with the information of control substances, self-built compounds database and literature references, diagnostic ion filtering, Compound Discoverer 3.0 software, for identification of the chemical components. Result:Based on the above strategy, a total of 52 compounds were identified in Qizhi Jiangtang capsules, and the sources of these compounds were identified. Amino acids were mainly derived from Hirudo, phenylpropanoids were derived from Astragali Radix and Rehmanniae Radix, iridoid glycosides were derived from Rehmanniae Radix, coumarins and triterpenes were derived from Astragali Radix, flavonoids were from Astragali Radix and Polygonati Rhizoma. Conclusion:The established UPLC-QE-Orbitrap-MS analytical method can comprehensively and rapidly analyze and identify of the chemical constituents in Qizhi Jiangtang capsules. Many of the ingredients have been proved by modern pharmacological studies to have the effect of improving related symptoms of diabetes and its complications, reflecting the characteristics of synergistic action of multiple components in Qizhi Jiangtang capsules. This study can provide reference for the further research on the pharmacodynamic material basis and the quality control of Qizhi Jiangtang capsules.

9.
Article in Chinese | WPRIM | ID: wpr-930196

ABSTRACT

Objectives:To explore the value of heparin-binding protein (HBP) in the diagnosis and prognosis of patients with respiratory viral infections.Methods:The patients who were admitted to Emergency Department of Nanjing Hospital Affiliated to Nanjing Medical University from November 2018 to November 2020 were selected as the viral infection group, and the non-infected patients admitted in the same period as the non-viral infection group. Data of all patients’ general clinical information, peripheral white blood cell count (WBC), neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), procalcitonin (PCT), and HBP in 24 h were collected. The differences in various indicators were compared between the two groups of patients, the receiver operating characteristic (ROC) curves were drawn, and the diagnostic value of each indicator for patients with respiratory virus infection were evaluated. The prognostic indicators such as sequential organ failure assessment (SOFA) score, the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score within 24 h were recorded, and duration of ICU stay, antiviral treatment, ventilator and vasoactive agents to total length of hospital stay of patients in the viral infection group were calculated. The Spearman correlation analysis of HBP and the above indicators was performed to determine the prognostic value of HBP in patients with respiratory virus infections.Results:A total of 106 patients were included in the viral infection group, and 107 in the non-viral infection group. There were no significant differences in sex, age, and body mass index (BMI) between the two groups of patients (P>0.05). Compared with the non-viral infection group, the serum CRP and HBP of the viral infection group were significantly higher (P<0.05), while the WBC and NLR levels were significantly lower (P<0.05). There was no statistical difference in PCT between the two groups (P>0.05). HBP had the best diagnosis efficiency for respiratory viral infections, the areas under the ROC was 0.895, the optimal cut-off point was 13.625 μg/L, the sensitivity was 92.50% and the specificity was 76.60%. Correlation analysis showed that serum HBP levels within 24 h in the viral infection group were positively correlated with SOFA score and APACHEⅡ score in 24 h after admission (r = 0.756, P<0.05; r = 0.747, P<0.05). In the viral infection group, duration of ICU stay, antiviral treatment, and ventilator and vasoactive agents to total length of hospital stay were also positively correlated with serum HBP level (r = 0.873, 0.748, 0.830, and 0.794, P<0.05).Conclusions:HBP can be used as a favorable diagnostic indicator for patients with respiratory virus infections and has a good evaluation value for the prognosis.

10.
Chinese Medical Journal ; (24): 1967-1976, 2021.
Article in English | WPRIM | ID: wpr-887626

ABSTRACT

BACKGROUND@#Innovative coronavirus disease 2019 (COVID-19) vaccines, with elevated global manufacturing capacity, enhanced safety and efficacy, simplified dosing regimens, and distribution that is less cold chain-dependent, are still global imperatives for tackling the ongoing pandemic. A previous phase I trial indicated that the recombinant COVID-19 vaccine (V-01), which contains a fusion protein (IFN-PADRE-RBD-Fc dimer) as its antigen, is safe and well tolerated, capable of inducing rapid and robust immune responses, and warranted further testing in additional clinical trials. Herein, we aimed to assess the immunogenicity and safety of V-01, providing rationales of appropriate dose regimen for further efficacy study.@*METHODS@#A randomized, double-blind, placebo-controlled phase II clinical trial was initiated at the Gaozhou Municipal Centre for Disease Control and Prevention (Guangdong, China) in March 2021. Both younger (n = 440; 18-59 years of age) and older (n = 440; ≥60 years of age) adult participants in this trial were sequentially recruited into two distinct groups: two-dose regimen group in which participants were randomized either to follow a 10 or 25 μg of V-01 or placebo given intramuscularly 21 days apart (allocation ratio, 3:3:1, n = 120, 120, 40 for each regimen, respectively), or one-dose regimen groups in which participants were randomized either to receive a single injection of 50 μg of V-01 or placebo (allocation ratio, 3:1, n = 120, 40, respectively). The primary immunogenicity endpoints were the geometric mean titers of neutralizing antibodies against live severe acute respiratory syndrome coronavirus 2, and specific binding antibodies to the receptor binding domain (RBD). The primary safety endpoint evaluation was the frequencies and percentages of overall adverse events (AEs) within 30 days after full immunization.@*RESULTS@#V-01 provoked substantial immune responses in the two-dose group, achieving encouragingly high titers of neutralizing antibody and anti-RBD immunoglobulin, which peaked at day 35 (161.9 [95% confidence interval [CI]: 133.3-196.7] and 149.3 [95%CI: 123.9-179.9] in 10 and 25 μg V-01 group of younger adults, respectively; 111.6 [95%CI: 89.6-139.1] and 111.1 [95%CI: 89.2-138.4] in 10 and 25 μg V-01 group of older adults, respectively), and remained high at day 49 after a day-21 second dose; these levels significantly exceed those in convalescent serum from symptomatic COVID-19 patients (53.6, 95%CI: 31.3-91.7). Our preliminary data show that V-01 is safe and well tolerated, with reactogenicity predominantly being absent or mild in severity and only one vaccine-related grade 3 or worse AE being observed within 30 days. The older adult participants demonstrated a more favorable safety profile compared with those in the younger adult group: with AEs percentages of 19.2%, 25.8%, 17.5% in older adults vs. 34.2%, 23.3%, 26.7% in younger adults at the 10, 25 μg V-01 two-dose group, and 50 μg V-01 one-dose group, respectively.@*CONCLUSIONS@#The vaccine candidate V-01 appears to be safe and immunogenic. The preliminary findings support the advancement of the two-dose, 10 μg V-01 regimen to a phase III trial for a large-scale population-based evaluation of safety and efficacy.@*TRIAL REGISTRATION@#http://www.chictr.org.cn/index.aspx (No. ChiCTR2100045107, http://www.chictr.org.cn/showproj.aspx?proj=124702).


Subject(s)
Aged , Antibodies, Viral , COVID-19/therapy , COVID-19 Vaccines , Double-Blind Method , Humans , Immunization, Passive , Recombinant Fusion Proteins , SARS-CoV-2
11.
Chinese Journal of Geriatrics ; (12): 910-913, 2020.
Article in Chinese | WPRIM | ID: wpr-869485

ABSTRACT

Objective:To analyze the causes of puncture wound infections induced by the high pressure resistant injectable PICC catheter in patients undergoing hematopoietic stem cell transplantation and management measures.Methods:linical data of 75 patients undergoing hematopoietic stem cell transplantation who were treated with the high pressure resistant injectable PICC catheter in our hospital from Nov.2017 to Nov.2019 were retrospectively analyzed.According to whether there were puncture wound infections, patients were divided into the infection group(n=26)and the non-infection group(n=49). Bacterial culture results of the infection group were recorded, and the related factors for puncture wound infections caused by the injectable PICC catheter were analyzed.Effective strategies to prevent high-risk factors, treatment frequency, treatment effect and healing time for patients with different degrees of puncture wound infections were discussed.Results:There were 26 patients in the infection group.The proportions of bacteria types associated with PICC catheter-related infections, in descending order, were as follows: Staphylococcus aureus(46.51%), Klebsiella pneumoniae(30.77%), Corynebacterium(15.38%)and others(7.69%). Significant differences were found in materials used, season of tube placement, timing of dressing changes, duration of catheterization, success rate of first tube placement and condition of dressing films between the non-infection and infection groups( t=5.5, 4.9, 5.0, 13.6, 9.4 and 6.2, all P<0.05). Logistic multi-factor analysis showed that non-U-shaped fixation, delay in dressing changes, long duration of tube placement, low success rate of first tube placement, and loose dressing films were the high-risk factors for PICC catheter-related infections( OR=2.78, 2.42, 3.16, 2.66 and 2.32, all P<0.05). Compared with patients with moderate and mild infections, patients with severe infections had a higher frequency of treatment, a lower total effectiveness rate and a longer healing time( F=10.353, 8.775 and 12.341, all P<0.05). Conclusions:Materials, timing of dressing changes, catheterization time, success rate of first tube placement and condition of dressing films are the high-risk factors for puncture wound infections caused by high pressure resistant injectable PICC catheters in patients undergoing hematopoietic stem cell transplantation.Developing effective intervention strategies can help control the incidence of wound infections.

12.
Article in Chinese | WPRIM | ID: wpr-826647

ABSTRACT

OBJECTIVE@#To verify the efficacy of transcutaneous electrical acupoint stimulation (TEAS) on catheter related bladder discomfort after ureteroscopic lithotripsy.@*METHODS@#Sixty male patients with selective ureteroscopic lithotripsy under general anesthesia were randomly divided into a TEAS group (30 cases, one case dropped off) and a sham TEAS group (30 cases, 2 cases dropped off). Before anesthesia induction, the patients in the TEAS group were treated with TEAS at Guanyuan (CV 4), Zhongji (CV 3), Zusanli (ST 36) and Sanyinjiao (SP 6) for 30 min, with disperse-dense wave, frequency of 2 Hz/ 15 Hz and current intensity of 6 to 10 mA. The patients in the sham TEAS group were treated with the same TEAS device at the same acupoints, but no electrical stimulation was given. After 30 min, anesthesia induction started. The total dosages of propofol and remifentanil in the two groups were recorded, and the time of operation and anesthesia, the time of wake-up and the time of stay in postanesthesia care unit (PACU) were recorded. The postoperative recovery was evaluated 5 min (T) after wake-up, 1 h (T), 2 h (T) and 6 h (T) after the operation, including the severity of urinary tract irritation and visual analogue scale (VAS) score. The occurrence of adverse reactions was observed, such as nausea and vomiting, dizziness and headache.@*RESULTS@#The dosage of remifentanil in the TEAS group was significantly lower than that in the sham TEAS group (0.05). Compared with the sham TEAS group, the incidence of more-than-moderate urinary tract irritation symptoms in the TEAS group was reduced (<0.05), and the VAS scores 1 and 2 h after operation were reduced (<0.05).@*CONCLUSION@#The 30-min TEAS at Guanyuan (CV 4), Zhongji (CV 3), Zusanli (ST 36) and Sanyinjiao (SP 6) before anesthesia induction could significantly control the severity of postoperative urinary tract irritation in patients with ureteroscopic lithotripsy, reduce the dosage of anesthetic drugs and relieve postoperative pain.

13.
Article in Chinese | WPRIM | ID: wpr-826485

ABSTRACT

OBJECTIVE@#To explore the genetic basis of a patient with primary infertility due to loss of zona pellucida.@*METHODS@#The proband and his parents were subjected to whole exome sequencing. Candidate variants were validated by Sanger sequencing and bioinformatics analysis.@*RESULTS@#The proband was found to harbor compound heterozygous variants of the ZP1 gene in exon 5 c.874C>T(Gln292*) and exon 7 c.1127_1128delCT (p.Ala376GlyTer386), which were respectively inherited from her mother and father.@*CONCLUSION@#The compound heterozygous variant of ZP1 gene probably underlie the loss of zona pellucida in oocyte disease in the proband.

14.
Article in Chinese | WPRIM | ID: wpr-905379

ABSTRACT

Objective:To observe the effect of pelvic floor neuromuscular electrical stimulation (NMES) and sling exercise training (SET) on diastasis recti abdominis after parturition. Methods:From September to December, 2019, 90 patients with rectus abdominis separation > 2 cm and pelvic floor muscle strength above grade III were randomly divided into three groups, accepting simple pelvic floor NMES (group A), pelvic floor NMES and SET (group B), and simple SET (group C), respectively, for four weeks. The separation distance of rectus abdominis was measured before treatment, two weeks and four weeks after treatment, and four weeks follow-up. Results:The separation distance of rectus abdominis decreased in each group after treatment (F > 8.327, P < 0.01); and it was the least in group B (F > 8.327, P < 0.01), while the multiple comparison results showed that there was no significant difference between group A and group C (P > 0.05). Conclusion:Both pelvic floor NMES and SET can similarly relieve the diastasis recti abdominis after parturition, and it is more effective in combination.

15.
Journal of Clinical Hepatology ; (12): 977-979, 2020.
Article in Chinese | WPRIM | ID: wpr-821989

ABSTRACT

Functional cure of chronic hepatitis B (CHB) marks sustained virological inhibition and immunological control and is the ideal treatment goal recommended by the latest guidelines for the prevention and treatment of CHB in China and foreign countries. CHB patients can achieve virological inhibition with the help of long-term direct antiviral therapy, and only a small number of patients can achieve functional cure, suggesting that there is an urgent need for the combination of direct antiviral therapy and immunotherapy. At present, the best treatment strategy is targeted precise clearance of HBV-infected hepatocytes to reduce liver injury, which depends on HBV-specific immune cells in the liver. Therefore, restoring or enhancing the function of HBV-specific T cells and B cells is the key strategy for functional cure of CHB.

16.
China Pharmacy ; (12): 820-825, 2020.
Article in Chinese | WPRIM | ID: wpr-819094

ABSTRACT

OBJECTIVE:To establish HP LC ch aracteristic ch romatogram of different medicinal parts of Cirsium japonicum , and to compare the difference of chemical components in different medicinal parts of C. japonicum according to chemical identification method ,and to provide reference for quality control and evaluation of C. japonicum . METHODS :Medicinal material (overground part ),leaves,flower,main stem and lateral stem of C. japonicum were determined by HPLC. According to the TCM Chromatographic Fingerprint Similarity Evaluation System (2012A edition ),the chromatograms were matched to generate the HPLC characteristic chromatogram of each medicinal part. The differences of common characteristic peak area were analyzed according to variance analysis of single factor. The chromatographic peaks were identified by comparison of reference substance. Meanwhile,the chemical pattern recognition was performed to research the different medicinal parts of C. japonicum according to principal component analysis (PCA)and cluster analysis. RESULTS :HPLC characteristic chromatograms of medicinal material , leaves,flower,main stem and lateral stem from C. japonicum were established respectively ,and 15 common peaks were confirmed for medicinal material ,leaves and flower of C. japonicum ;11 common peaks were confirmed in chromatograms of main stem and lateral stem from C. japonicum (absence of No. 7,9,12,13 peak). The contents of chemical components were different greatly among different medicinal parts. No. 1,2,3,10,11 peaks were identified as neochlorogenic acid ,chlorogenic acid , cryptochlorogenic acid ,linarin and pectolinarin. Results of PCA and cluster analysis showed that chemical pattern recognition and clustering of the flower and stem of C. japonicum were distinct and can be clustered into one category respectively. However ,the leaves distribution of C. japonicum was relatively scattered ,so it was difficult to cluster . CONCLUSIONS :Established HPLC characteristic chromatogram-chemical pattern recognition can reflect the differences of different medicinal parts of C. japonicum integrally, comprehensively and truly , which has vital significance for origin indentification , quality control and overall evaluation of C. japonicum .

17.
Article in Chinese | WPRIM | ID: wpr-942046

ABSTRACT

OBJECTIVE@#Plasma free metanephrines (MNs) have been widely used as an initial test for pheochromocytoma and paraganglioma (PPGL). PPGL without MNs elevation has been reported on rare occasions. The objective of this study was to analyze the clinical profile of sporadic PPGL patients with normal MNs.@*METHODS@#In the study, 104 patients with sporadic PPGL diagnosed by histopathology in Peking University First Hospital from March 2015 to January 2020 were enrolled. All the patients had plasma MNs result, of whom, eight (7.69%) were with normal MNs. The reasons for their medical visits, clinical manifestations, the levels of plasma free MNs, 3-methoxytyramine (3-MT), catecholamines and chromogranin A (CgA), and the imaging findings were documented. Their preoperative diagnosis, perioperative medical management, and intraoperative blood pressure were analyzed. All the data mentioned above were compared with the MNs elevated group. The postoperative follow-up for MNs normal patients were applied.@*RESULTS@#For the eight PPGL patients with normal plasma MNs, the most common clinical symptoms were sweating (3/8), abdominal and back pain (3/8), headache (2/8), palpitations (2/8), and fatigue (2/8). There were no significant differences in plasma free 3-MT and catecholamines' diagnostic positive rate between the MNs normal group and MNs elevated group, but the rate for plasma CgA was significantly decreased in the MNs normal group (2/5 vs. 41/43, P=0.005). No significant difference was found for the incidence of typical findings by enhanced CT between the two groups. In these eight MNs normal patients, six were diagnosed with PPGL by the previous history of PPGL, typical symptoms and CT findings, or elevation of 3-MT, CgA levels or positive results of PET-CT; two patients were misdiagnosed as nonfunctioning adenoma or primary aldosteronism. All these MNs normal patients underwent preoperative management with alpha adrenergic receptor blockers, of whom, one had an average intraoperative arterial pressure < 60 mmHg during surgery. The median follow-up time for the eight patients was 1.5 (0.5-4.5) years. No evidence of new tumors was found on the enhanced CT scans. Two MNs normal patients' plasma 3-MT and (or) CgA decreased to normal.@*CONCLUSION@#For patients with adrenal or retroperitoneal tumors, typical symptoms or a previous history of PPGL, normal plasma MNs is not a sufficient exclusion for PPGL. Plasma 3-MT, catecholamine, CgA results and the imaging findings are helpful for the diagnosis of PPGL. We recommend patients with suspected MNs normal PPGL take alpha adrenergic receptor blockers as preoperative blockade, but should avoid overdose. Postoperative follow-up for patients with normal MNs should focus on the positive biochemical markers before surgery.


Subject(s)
Adrenal Gland Neoplasms , Humans , Metanephrine , Paraganglioma , Pheochromocytoma , Positron Emission Tomography Computed Tomography
18.
Chinese Journal of Cardiology ; (12): 641-647, 2020.
Article in Chinese | WPRIM | ID: wpr-941152

ABSTRACT

Objective: To investigate the safety and efficacy of regional transport to percutaneous coronary intervention(PCI) hospitals from non-PCI hospitals after thrombolysis in patients with acute ST-segment elevation myocardial infarction(STEMI) in northwest China. Methods: In this retrospective study, 1 062 STEMI patients who were transferred from non-PCI hospitals within 24 hours from symptom onset, during January 2015 and January 2019 in the First Hospital of Lanzhou University, were included. According to the treatment strategy, they were divided into two groups, namely intravenous thrombolysis combined with PCI group(n=240), and primary PCI group(n=822). Observation endpoint were in-hospital adverse cardiovascular and cerebrovascular events and bleeding events, Including all-cause death, ischemic stroke, malignant arrhythmia, intracranial hemorrhage and hemorrhage with hemoglobin decrease≥50 g/L. Results: A total of 1 062 STEMI patients were included(age was (61±12) years old), with 905 males (85.2%). The proportion of grade 0 TIMI blood flow in the primary PCI group before operation was significantly higher than that in the thrombolysis combined with PCI group(63.0%(518/822) vs. 36.3%(87/240), P<0.001). Compared with primary PCI group, the time from symptom onset to first medical contact(2.11(1.00, 4.00)hours vs.3.00(1.13, 7.07)hours, P<0.001) and reperfusion in thrombolysis combined with PCI group(3.07(1.83, 4.87)hours vs. 6.92(4.07, 11.15) hours, P<0.001) were significantly shorter. The proportion of all-cause death was significantly higher in the primary PCI group than that in the thrombolysis combined with PCI group (1.8%(15/822) vs. 0, P=0.03). There was no significant difference in hemorrhage, ischemic stroke and malignant arrhythmia between the two groups(all P>0.05). Conclusions: For STEMI patients initially hospitalized in non-PCI hospitals, regional transport combined with PCI is feasible and effective. It does not significantly increase the risk of bleeding and cardiovascular and cerebrovascular events, with shorter time from symptom onset to myocardial reperfusion.


Subject(s)
Aged , Angioplasty, Balloon, Coronary , China , Humans , Male , Middle Aged , Myocardial Infarction , Percutaneous Coronary Intervention , Retrospective Studies , ST Elevation Myocardial Infarction/therapy , Thrombolytic Therapy , Treatment Outcome
19.
Article in Chinese | WPRIM | ID: wpr-752712

ABSTRACT

Objective To analyze the relationship between fatigue and self- efficacy and empowerment in patients with rheumatoid arthritis. Methods A total of 219 cases of rheumatoid arthritis were investigated by general data questionnaire, Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire, Chinese Version of Patient Perception of Empowerment Scale and Chinese Version of Arthritis Self-efficacy Scale-8. SPSS 20.0 software was used for correlation analysis and AMOS software was used to construct structural equation model to test the mediating effect of self-efficacy between empowerment level and fatigue in patients with rheumatoid arthritis. Results There was a significant negative correlation between fatigue and empowerment level (r =-0.62, P <0.05), and a significant correlation between fatigue and self-efficacy (r=-0.81, P<0.05). Self-efficacy had a mediating effect on empowerment level and fatigue in patients with rheumatoid arthritis, and the mediating effect accounted for 96.41% of the total effect. Conclusions Self-efficacy has mediating effect between powerment level and fatigue in patients with rheumatoid arthritis.

20.
Article in Chinese | WPRIM | ID: wpr-754414

ABSTRACT

Objective: To identify risk factors for positive surgical margin after laparoscopic radical prostatectomy. Method: The study retrospectively analyzed the records of 177 patients with prostate cancer who eventually underwent laparoscopic radical prostatecto-my from January 2016 to December 2017 in Peking University First Hospital. Age, prostate volume, prostate-specific antigen (PSA) be-fore needle biopsy, number of positive cores, positive percentage of needle biopsy and biopsy, and postoperative Gleason scoreand pathological stage were analyzed. Results: The overall positive surgical margin rate was 32.2% (57/177). Age, prostate volume, PSA be-fore needle biopsy, positive percentage of biopsy, and postoperative Gleason score were not significantly different (P>0.05). The study demonstrated significant differences between the number of positive cores, positive percentage of needle biopsy, and pathological stage (P<0.05). Multiple logistic regression revealed that the pathological stage was an independent factor affecting the positive surgi-cal margin rate (odds ratio, 1.616; 95% confidence interval, 1.062-2.459). Conclusions: The number of positive cores, positive percent-age of needle biopsy, and pathological stage significantly correlated with a positive surgical margin. The postoperative pathological T stage is an independent factor affecting positive surgical margins.

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