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Objective:To analyze the distribution characteristics of plasma renin concentration (PRC) in patients with aldosterone-producing adenoma (APA) and its impact on diagnosis.Methods:In this retrospective case series, clinical data from 200 patients with APA (80 men and 120 women; mean age 45.6 years) in the First Affiliated Hospital of Chongqing Medical University from November 2013 to January 2022 were evaluated. PRC was determined by automated chemiluminescence immunoassay. The distribution characteristics of PRC were analyzed, and 8.2 mU/L was used as the low renin cutoff to evaluate whether renin was suppressed.Results:The median PRC was 1.6 mU/L (range, 0.4-41.5 mU/L). There were 116 patients with APA with PRC of ≤2 mU/L, 41 patients with 2<PRC≤4 mU/L. PRC was not suppressed (PRC>8.2 mU/L) in 8.0% (16/200) of the patients with APA. And PRC was not suppressed in 2.5% (5/200) of the patients with APA, resulting in a primary aldosteronism negative screening outcome.Conclusions:Although most patients with APA have low PRC, there are a small number (8%) of patients whose PRC has not been fully suppressed, which can lead to missed diagnoses during primary aldosteronism screening. While primary aldosteronism is highly suspected, further investigations are required to determine the diagnosis, even if PRC is not fully suppressed at screening.
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Objective To investigate the effect and mechanism of astragaloside Ⅳ(AS-Ⅳ) activating ROCK/JNK to regulate autophagy in improving isoproterenol (ISO) induced myocardial fibrosis (MF) in mice. Methods The mice were randomly divided into control operation group (Control group), ISO induced myocardial fibrosis group (MF group), AS-Ⅳ treatment group (AS-Ⅳ group) and combination group of astragaloside IV and Y-33075 (ROCK inhibitor) (astragaloside IV+Y-33075 group). After repeated administration for 30 days. The serum levels of LDH, BNP, CTGF in each group were detected. The cardiac function was detected by ultrasound. Myocardial structure and tissue fibrosis degree in each group were detected by Sirius Red and Masson staining. Oxidative stress (ROS) levels in myocardial tissue of each group were detected by DHE staining and the expression of ROCK, JNK, Atg5, Beclin 1, and LC3 Ⅰ/Ⅱ in myocardial tissue were detected by Western blotting. Results Compared with AS-Ⅳ group, the EF value of AS-Ⅳ+Y-33075 group decreased and the degree of myocardial fibrosis increased (P<0.05). The serum level of LDH, BNP, CTGF increased and the level of ROS in myocardial tissue increased while the expression of ROCK, JNK, Atg5, Beclin 1, LC3 Ⅰ/Ⅱ decreased (P<0.05). Y-33075 could block the protective effect of AS-Ⅳ on myocardial injury induced by MF and inhibit the regulation of AS-Ⅳ on ROCK and JNK. Conclusion AS-Ⅳ could attenuate myocardial fibrosis in mice by activating ROCK/JNK signal and promoting autophagy.
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Objective:To investigate the correlation between serum N-terminal pro-brain natriuretic peptide (NT-pro-BNP) and lipoprotein phospholipase A2 (Lp-PLA2) levels and the severity of coronary artery lesions in patients with acute coronary syndrome (ACS) complicated with type 2 diabetes mellitus (T2DM) .Methods:A total of 68 patients with ACS and T2DM who were admitted to our hospital from Jun. 2018 to Oct. 2020 were selected as the experimental group, and the control group was 52 patients with simple ACS. The serum NT-pro-BNP and Lp-PLA2 levels of the two groups of patients were detected, and the correlation between the serum NT-pro-BNP and Lp-PLA2 levels and the degree of coronary artery disease in patients with ACS complicated with T2DM was analyzed to screen for ACS complicated with T2DM. Influencing factors of moderate to severe coronary artery disease in diabetic patients were selected.Results:The serum levels of NT-pro-BNP[ (349.18±45.98 vs 235.68±26.37) ] ng/L and Lp-PLA2 [ (421.84±55.84 vs 318.62±36.69) ] ng/mL in the experimental group were higher than those in the control group ( P<0.05) . The levels of serum NT-pro-BNP [ (374.35±39.42 vs 320.88±35.41) ] ng/L and Lp-PLA2 [ (452.67±48.32 vs 387.16±40.45) ]ng/mL in the moderate-severe group were higher than those in the mild group ( P<0.05) . Serum NT-pro-BNP and Lp-PLA2 levels were positively correlated with the severity of coronary artery lesions in patients with ACS and T2DM ( r=-0.585, P=0.000; r=-0.595, P=0.000) . Serum NT-pro-BNP and Lp-PLA2 were risk factors for moderate to severe coronary artery disease in patients with ACS complicated with T2DM ( P<0.05) . Conclusion:Serum levels of NT-pro-BNP and Lp-PLA2 in patients with ACS complicated with type 2 diabetes mellitus are related to the degree of coronary artery disease.
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This study deeply analyzes the common problems of three military medical universities in the management of undergraduate extracurricular scientific research, such as lack of communication means, limited online resources, backward laboratory opening and low utilization rate of equipment. We have built a cloud platform management system for undergraduate extracurricular scientific research. This system firstly sets up a teaching resources storage module including videos, PPTs, documents, pictures, electronic materials, question bank, etc. Then four subsystems for different roles of students, mentors, experimental teaching staff and administrators are constructed. Finally, this system realizes independent experiments by students, real-time evaluation by mentors, instrument sharing and efficient management through the seamless connection with the user terminal equipment. And the study also makes evaluation on the present usage.
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Objective:To explore the genetic etiology and the value of early diagnosis of early onset epileptic encephalopathy (EOEE) with unknown etiology.Methods:A total of 60 children with EOEE of unknown etiology were prospectively enrolled in the outpatient and inpatient departments of Fujian Provincial Hospital from January 2018 to January 2021.Peripheral blood was collected prospectively for whole-exome sequencing and copy number variation (CNV) detection to analyze the clinical characteristics and genetic sequencing results of the children.Results:Twenty-four patients with EOEE-related pathogenic or suspected pathogenic mutations were detected, including infantile spasms (10 cases), Dravet syndrome (3 cases), pyridoxine-dependent epilepsy (1 case) and ohtahara syndrome (1 case), and unknown epileptic encephalopathy (9 cases). The onset age of EOEE-related patients ranged from 1 day to 11 months (median age was 4.2 months), the treatment age ranged from 2 days to 4 years (median age was 10 months), and the age of diagnosis was controlled within 1 month after treatment.There were 20 cases (33.3%) single gene variants and 4 cases (6.7%) CNV variants.A total of 13 genes were involved: KCNQ2, SCN1A, SCN8A, CACNA1E, CDKL5, PPP3CA, PCDH19, TSC1, TSC2, ZEB2, ALDH7A1, DCX and HNRNPU.The 4 CNV abnormalities were 17p13.3 deletion, 11q23.3q25 deletion, 1q36.31-p36.33 deletion, 1q43-1q44 deletion and Xp22.33 duplication, respectively.Totally, 20 mutations were new loci reported for the first time at home and abroad; 11q23.3q25 deletion that resulted in infantile spasm was first reported at home and abroad.Infantile spasm caused by ZEB2 mutation and epileptic encephalopathy caused by PPP3CA gene were both reported for the first time in China. Conclusions:Gene and CNV are important potential causes of children suffering from EOEE.When the etiology is unclear, the combination of whole-exome sequencing and CNV sequencing technology can improve the diagnosis level of genetic etiology of children with EOEE.The early genetic detection of these children can early diagnose and accurately treat epilepsy.
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Objective To investigate the efficacy and safety of domestic bortezomibˉbased chemotherapy for patients with multiple myeloma (MM). Methods The clinical data of 60 MM patients treated with domestic bortezomibˉbased chemotherapy regimen (the observation group) in the First Affiliated Hospital of Zhengzhou University from April 2018 to October 2018 were retrospectively analyzed, which were compared with 112 MM patients treated with original treatment regimen (the control group) at the same hospital from November 2010 to November 2014. According to the disease stage, the patients were divided into newly diagnosed MM (NDMM) group and relapsed refractory MM (RRMM) group, and efficacy and adverse reactions of domestic bortezomib were evaluated. Results The total response rate (ORR) of the observation group was 71.7% (43/60), severe complete response (sCR) + complete response (CR) rate was 16.7% (10/60), very good partial response (VGPR) rate was 18.3% (11/60), and partial response (PR) rate was 36.7% (22/60). The ORR of NDMM group (45 cases) and RRMM group (15 cases) was 82.2% (37/45) and 40.0% (6/15), respectively, and the difference was statistically significant (χ2＝ 9.877, P < 0.05). There was no significant difference between ISS stage Ⅰ+Ⅱ and stage Ⅲ [ORR: 75.7% (28/37) vs. 65.2% (15/23), respectively; χ2＝0.764, P >0.05]. ORR and CR rates in the NDMM group and RRMM group of the observation group and the control group were not statistically different (all P>0.05). In the treatment of bortezomibˉbased chemotherapy, the common adverse reaction was peripheral neuropathy, mostly belonging to grade 1-2. Other side effects included hematocytopenia, gastrointestinal events and herpes zoster, which could be alleviated or restored to normality after supportive treatments. One patient died of pulmonary infection, respiratory failure and septic shock during the intermittent period of chemotherapy. Conclusion ORR of domestic bortezomibˉbased chemotherapy in treatment of the patients with MM is high, and the incidence of adverse reactions shows no significant increase compared with original drugs.
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Objective To evaluate the risk factors for benign childhood epilepsy with centrotemporal spikes (BECT) complicated by electrical status epilepticus in sleep(ESES).Methods From January 2013 to January 2017,a total of 80 children diagnosed as BECT in pediatric neurology outpatient department of Provincial Clinical Medical College Affiliated to Fujian Medical University were enrolled.According to whether there was an attack of ESES or not,patients were divided into ESES group(38 cases) and non-ESES group(42 cases).In order to elucidate risk factors for BECT complicated by ESES,clinical data including age,gender,first seizure age,seizure frequency before treatment,types of seizure,therapeutic drug,recurrence of seizure after treatment,febrile seizure,status at birth,family history,brain MRI,discharge quantity,discharge location,and intelligence score were investigated by multivariate Logistic regression analysis.Results Compared with non-ESES patients,ESES patients were more likely to have recurrence of epilepsy after treatment (68.4％ vs 26.2％,P ＜ 0.001),and had worse intellectual development (＜ 90 scores;73.7％ vs 38.1％,P =0.001);while electroencephalogram showed more discharge in anterior location (47.4％ vs 21.4％,P =0.014) and bilateral distribution of brain (52.6％ vs 26.2％,P =0.015).However,the multivariate Logistic regression analysis showed that only recurrence of seizure after treatment was the risk factor for ESES in BECT patients(P=0.008,OR=4.039,95％CI:1.429-11.418).Conclusion Recurrence of seizure after treatment of BECT was a high risk factor for ESES.Controlling seizure and reducing ESES phenomenon could be beneficial to alleviate the intellectual impairment of patients with BECT.
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Objective To detect the infection and subtype distribution of human papillomavirus (HPV) in cervical epithelial cell line in the People's Hospital of Jinhua.Methods 26 kinds of HPV genotypes were detected by gene chip,and the infection states among all subtypes were analyzed.Results A total of 25 genotypes of HPV were identified in 984 female patients,with the positive rate of 36.89％.The top three common high-risk HPV,ranging from high to low according to positive rate were HPV-16,58 and 52.The positive rates of high-risk HPV,low-risk HPV and multiple infection rate were 25.91％,5.69％ and 5.28％,respectively.The positive rates of the age groups of 21-30 years,＞ 30-40 years and ＞ 40 years were 42.33 ％,35.23％ and 35.94％,respectively.There were significant differences among the three age groups in the detection rate of high-risk HPV,low-risk type and multiple infection rate(x2 =71.58,P ＜ 0.05).Conclusion HPV 16,58 and 52 are the main high-risk genotypes of the 984 women in our hospital.The genotyping of HPV has important significance in the prevention,treatment and etiology of cervical cancer,as well as in the study of HPV vaccine.
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Objective To analyze the clinical characteristics and prognostic factors of elderly patients with cytogenetically normal acute myeloid leukemia (CN-AML). Methods A total of 104 initial CN-AML patients were enrolled in this retrospective study. The clinical characteristics were collected and analyzed retrospectively. Factors affecting complete remission (CR) were analyzed by using chi square test. Univariate and multivariate analyses of prognostic factors were performed by using Kaplan-Meier and Cox hazard regression model respectively. Results After the first chemotherapy, 72 of 104 patients were able to be evaluated the efficacy, the CR rate was 38.9%(28/72) and total response rate was 55.6%(40/72). The white cell count<100 × 109/L and NPM1 mutation were related to a higher CR rate [59.4%(38/64) vs. 12.5%(1/8), 83.3%(10/12) vs. 36.4%(8/22), P<0.05]. Among 104 patients, the median overall survival (OS) was 6.9 months. Univariate analysis results demonstrated that age≥70 years, secondary AML, white cell count≥100×109/L, FLT3-ITD mutation, CD7 expression, achieving CR beyond 2 cycles of induction therapy and CCI score≥2 were influence factors on OS. In multivariable analysis, FLT3-ITD mutation (HR=7.61, 95%CI 1.80-32.11, P= 0.006) and achieving CR beyond 2 cycles of induction therapy (HR= 10.11, 95 % CI 2.38-43.03, P=0.002) were independent prognostic factors for OS in elderly patients with CN-AML. Conclusion The prognosis of elderly patients with CN-AML is the result of the combined effect of many factors, FLT3-ITD mutation and achieving CR beyond 2 cycles of induction therapy are independent prognostic factors in elderly patients with CN-AML.
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Objective To study the clinical efficacy of epirubicin combined with paclitaxel in the treatment of three negative breast cancer.Methods 100 patients with breast cancer who were treated in Shanxi Cancer Hospital from January 2014 to December 2016 were selected as the research object in this study.They were randomly divided into the control group and the experimental group, with each group having a total of 50 patients.The control group was treated with epirubicin, and the experimental group was treated with epirubicin combined with paclitaxel.The short-term remission rate, Karnofsky score and the incidence of adverse symptoms were compared between the experimental group and the control group.Results After treatment, the Karnofsky score of the experimental group was(89.76±10.12), and the Karnofsky score of the control group was(71.23±11.67).The Karnofsky score of the experimental group was significantly higher than that of the control group (P<0.05).In the experimental group, the number of short-term remission was 44 cases, the short-term remission rate was 88.0%, and the number of patients in the control group in the recent remission was in the number of cases, the short-term remission rate was 72.0%, and the number of patients in the control group was about 36.The results showed that the short-term remission rate of the experimental group was significantly higher than that of the control group, with statistical difference (P<0.05).After treatment, there was no significant difference between the control group and the experimental group in the incidence of complications, which was not statistically significant.Conclusion The clinical effect of doxorubicin plus paclitaxel in the treatment of three negative breast cancer, can improve the remission rate in a large extent, improve the quality of life of patients, with further clinical promotion and application significance.
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Objective To studythe efficacy of levosimendan in treating refractory heart failure complicating severe renal in sufficiency.Methods Sixty-seven cases of refractory heart failure complicating severe renal insufficiency in the internal medicine department of our hospital were randomly divided into the levosimendan treatment group(L group,n=33)and dopamine treatment group(D group,n=34).The changes of N-terminal pro-B-type natriuretic peptide(NT-pro-BNP),left ventricular ejection fraction (LVEF)and glomerular filtration rate(GFR)before treatment and on 1,3,7,30 d after treatment were compared between the two groups and analyzed.Results Before the treatment,there were no statistically significant differences in the baseline indicators between the two groups(P＞0.05).The group L:the NT-pro-BNP level on 1,3,7 d after treatment was decreased significantly(P＜ 0.05),LVEF on 3,7 d was significantly increased compared with th baseline(P＜0.05)and GFR on 1,3,7,30 d was significantly increased compared with the baseline(P＜0.05).The group D:the NT-pro-BNP level on 7 d of treatment was significantly decreased(P＜0.05),LVEF on 7 d of treatment was significantly increased compared with the baseline(P＜0.05),and no statistically significant changes were observed in GFR on 1,3,7,30 d(P＞0.05).After treatment,NT-pro-BNP,LVEF and GFR significant level values in the group L were better than those in the group D.Conclusion Levosimendan is superior to dopamine in improving heart and renal function for the patients with refractory heart failure complicating severe renal insufficiency.
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Mucosa-associated lymphoid tissue (MALT) lymphoma originates from outside of the lymph nodes, which is a kind of low-grade malignant lymphoma and the most type of marginal zone lymphoma (MZL).It accounts for about 30 ％-50 ％ of the indolent NHL.The onsets and therapies of MALT lymphoma are diverse.This article focuses on the recent therapeutic advances of MALT lymphoma.
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Objective To understand the prevalence and risk factors of Enterobius vermicularis among preschool children in kindergartens in Luohu District Shenzhen City. Methods A total of 489 children in 6 kindergartens were selected by the stratified sampling method and investigated for E. vermicularis infection by the cellophane anal swab technique. The information of sanitary condition of the kindergartens personal hygiene and family hygiene were investigated by questionnaire. Results The infection rate of E. vermicularis was 10.2% 50/489 . The single factor analysis indicated that the following factors might re?lated to the infection the different classes of kindergartens grades ground of bed room private toilet types of taps and beds bed management education levels of parents frequency of shower and washing anus and washing hands before meal and after WC. The multivariate Logistic analysis indicated that the bed management education level of mothers frequency of washing anus and private toilet were independent risk factors for E. vermicularis infection. Conclusion To control the infection of E. vermicularis the circumstance and management of kindergartens parents knowledge of E. vermicularis infection and chil?dren s healthy habit need improve.
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ObjectiveTo investigate the protective effect of tanshinoneⅡA on the expression of S100A1 protein after acute myocardial ischemia injury in rats.Methods Sixty Wistar rats were randomly divided into sham operation group, acute myocardial ischemia model group and tanshinoneⅡA pretreatment group by random number table. The acute myocardial ischemia model was established by thoracotomy and penetration of a thread and occlusion around the root part of the left anterior descending coronary artery, while the sham operation group was established only by thoracotomy and penetration of a thread around the root part of that artery but without occlusion; 3 days before the operation, in the tanshinoneⅡA pretreatment group, intraperitoneal injection of tanshinoneⅡA solution(at a dose of 1.5 mg/kg) was applied, while in the sham and acute myocardial ischemia groups, intraperitoneal injection of an equal volume of saline was given. Myocardial cell apoptosis was detected by the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling(TUNEL), the levels of serum superoxide dismutase (SOD), malondialdehyde(MDA), creatine kinase(CK), lactate dehydrogenase(LDH) and S100A1 protein were examined and the level of expression of S100A1 protein in myocardial tissue was assayed by immunohistochemical staining and Western Blot.Results Compared with the sham operation group, the myocardial cell apoptosis rate, the contents of MDA, CK, LDH, S100A1 and the level of S100A1 expression in myocardial ischemia group and tanshinoneⅡA pretreated group were significantly increased, while SOD activity was decreased obviously; compared with the myocardial ischemia model group, the myocardial cell apoptosis rate, the contents of MDA, CK, LDH, S100A1 and the level of S100A1 protein expression were significantly reduced〔apoptosis rate:(32.1±4.2)% vs.(72.4±5.4)%, MDA(μmol/L): 9.1±2.2 vs. 17.3±5.2, CK(U/L): 83.3±12.2 vs. 107.5±12.4, LDH (μmol·s-1·L-1): 84.0±16.4 vs. 114.4±16.0, S100A1(μg/L): 37.6±6.0 vs. 78.4±8.6,P<0.05 orP<0.01〕, while the activity of SOD was increased markedly in tanshinoneⅡA pretreated group(kU/L:72.8±10.2 vs. 49.6±8.8,P<0.01). TUNEL staining showed that in the myocardial ischemia model group and tanshinoneⅡA pretreated group, the myocardial cells represented positive staining(brown-yellow in color), irregular in shape with nuclear pyknosis, cell detachment from the surrounding tissue and other characteristics. And in sham operation group,the staining of majority of cells was negative. The results of immunohistochemistry showed that S100A1 protein staining was relatively deep in the myocardial ischemia model group and tanshinoneⅡA pretreated group, and in the latter group, the color of S100A1 protein positive staining was not as deep as that in the former group. Western Blot showed that the S100A1 protein expression in myocardial ischemia model group was 2.8 folds of that of the sham operation group, while the S100A1 protein expression in tanshinoneⅡA pretreated group was significantly decreased compared with that of myocardial ischemia model group(bothP<0.05),which was 1.5 folds of that of the sham operation group.ConclusionTanshinoneⅡA may play a role in inhibiting the expression of S100A1 protein to protect against acute myocardial ischemia injury, suggesting that this agent have a potential effect for treatment of myocardial ischemia.
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Objective To examine the association between one-hour plasma glucose (1-hPG) level during an oral glucose tolerance test (OGTT) and serum lipid profiles in individuals with NGT. Methods 6 402 individuals with NGT who underwent a 75 g OGTT were screened from four communities of Hefei suburban areas, aged over 40 years. Then 1 291 cases of NGT were randomly selected as the object of this research by random data table method. They were divided into NGT-1 group (1-h PG < 8.6 mmol/L, n = 597)and NGT-2 group(1-h PG≥8.6 mmol/L, n = 694). Pearson correlation analysis and multivariate linear regression analyses were performed to assess correlations between 1-h PG levels and lipid profiles. Results (1) The average values of body mass index were 24.3 kg/m2 in NGT-1 group, and 24.5 kg/m2 in NGT-2 group. (2) Compared with individuals in NGT-1 group , fasting plasma glucose , two-hour plasma glucose during OGTT , HbA1c , triglyceride (TG), and high-density lipoprotein-cholesterol(HDL-c) levels, TG/HDL-c ratios, and total cholesterol(TCH)/HDL-c ratios were significantly higher in individuals than in NGT-2 group. By contranst, body mass index, blood pressure , TCH and low-density lipoprotein-cholesterol levels were not significantly different between NGT-1 group and NGT-2 group. (3) The multiple linear regression analyses showed that 1 h PG levels positively correlated with TG in individuals in both NGT-1 group and NGT-2 group (P < 0.01). In addition, 1-h PG levels negatively correlated with HDL-c ratio in both groups (P < 0.01). Conclusion 1-h PG levels during OGTT in overweight individuals with NGT closely correlate with HDL-c and TG levels.