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OBJEC TIVE To investigate the status and clinical characteristics of adverse drug reactions （ADRs）induced by sintilimab in order to provide references for clinical rational drug use. METHODS The cases of ADR induced by sintilimab were retrieved from the databases of PubMed ，Embase，CNKI，VIP and Wanfang. RESULTS A total of 32 literature were included ， involving 33 patients among which there were 25 males（75.76％）and 8 females（24.24％）. The incidence of ADRs was higher in patients aged over 40 years（81.82％）. The dose of sintilimab was the drug instructions recommended dose （200 mg）for 30 patients and 100 mg for a patient. The earliest ADR occurred 1 h after the first medication ，the latest ADR occurred after 14 cycles of sintilimab. The 27 cases suffered from ADR cases （81.82％）within 4 months after medication ，and no reports of ADR occurred after 12 months of medication. The major manifestations of ADR were myocarditis ，diabetes mellitus ，checkpoint inhibitor pneumonitis（CIP），cytokine release syndrome （CRS）and hypothyroid myopathy （HM），etc. CRS and HM belonged to ADRs not recorded in the drug instructions. The 29 cases of recovery and 4 deaths occurred after symptomatic treatment. CONCLUSIONS ADR caused by sintilimab often occurs within 4 months after treatment ，and it is high in males and patients over 40 years old. In clinical application of sintilimab ，attention should be paid to the occurrence of myocarditis ，diabetes mellitus ，CIP，as well as CRS and HM not recorded in the drug instructions.
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Objective:To investigate the influence of preoperative thyroid dysfunction on the 30-day postoperative mortality and complications in elderly patients with hip fracture.Methods:A retrospective analysis was conducted of the 349 elderly patients with hip fracture who had been admitted to Department of Orthopedic Trauma, Beijing Luhe Hospital Affiliated to Capital Medical University from January 2018 to December 2019. They were 108 males and 241 females, with an average age of 76.3 years (from 60 to 104 years). There were 190 femoral intertrochanteric fractures and 159 femoral neck fractures. By the preoperative level of thyroid function, the patients were divided into a normal function group of 290 cases and a dysfunction group of 59 cases. The 2 groups were compared in terms of hospital stay, mortality and incidence of complications within 30 days postoperation.Results:In this cohort, the rate of 30-day postoperative mortality was 3.4%(12/349) and the incidence of 30-day postoperative complications 14.6%(51/349). The 2 groups were comparable because there was no significant difference between them in the preoperative general data except for the preoperative comorbidity of coronary heart disease ( P>0.05). In the dysfunction group, the hospital stay averaged (10.2±6.9) d, the rate of 30-d postoperative mortality 1.7%(1/59) and the incidence of 30-day postoperative complications 16.9%(10/59), which were insignificantly different from those in the normal function group [(10.7±7.5) d, 3.8%(11/290) and 14.1%(41/290), respectively] ( P> 0.05). Conclusion:Since preoperative thyroid dysfunction does not affect the 30-day postoperative mortality and postoperative complications in the elderly patients with hip fracture but no definite thyroid disease, routine thyroid function screening is not recommended for them.
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Objective@#To investigate the correlation between serum asymmetric dimethylarginine (ADMA) and cystatin C (CysC) in degenerative calcific aortic valvular disease and its clinical application value.@*Methods@#One hundred and eighty patients with degenerative calcific aortic valvular disease who were treated in Beijing Luhe Hospital Affiliated to Capital Medical University from June 2016 to June 2018 were selected as the study subjects, and another 82 healthy subjects from the same hospital in the same period were selected as the control group. Serum ADMA and CysC levels were detected by enzyme-linked immunosorbent assay and latex-enhanced immunoturbidimetric assay. Risk factors of degenerative calcific aortic valvular disease were analyzed by Logistic regression analysis. Evaluation of the diagnostic efficacy of serum ADMA and CysC for degenerative calcific aortic valvular disease was used by receiver operating characteristic curve.@*Results@#There were no significant differences in the general data between the two groups in terms of age, gender, body mass index, drinking history, smoking history, and history of hypertension (P>0.05). The systolic blood pressure(SBP), diastolic blood pressure (DBP), heart rate (HR), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterin(LDL-C), CysC and ADMA levels of the study group were significantly higher than those of the control group [(131.51 ± 19.09) mmHg (1 mmHg=0.133 kPa) vs. (126.48 ± 16.68) mmHg, (91.11 ± 16.35) mmHg vs. (86.89 ± 10.71) mmHg, (74.39 ± 15.22) beats/min vs. (70.09 ± 13.01) beats/min, (4.51 ± 1.12) mmol/L vs. (4.15 ± 0.92) mmol/L, (1.91 ± 0.63) mmol/L vs. (1.60 ± 0.65) mmol/L, (2.59 ± 1.13) mmol/L vs. (2.27 ± 0.85) mmol/L, (1.01 ± 0.22) mg/L vs. (0.79 ± 0.16) mg/L, (20.17 ± 6.38) ng/L vs. (11.88 ± 4.22) ng/L], and left ventricular ejection fraction (LVEF), high density lipoprotein cholesterin (HDL-C) levels were significantly lower than those of the control group [(56.45 ± 9.21)%vs. (60.87 ± 10.02)%, (1.56 ± 0.63) mmol/L vs. (1.76 ± 0.62) mmol/L], there were significant differences (P<0.05). Logistic multivariate regression analysis showed that serum CysC and ADMA were independent risk factors for degenerative calcific aortic valvular disease (P<0.05). Receiver operator characteristic (ROC) curve analysis showed that area under curve (AUC) of serum CysC for degenerative valvular heart disease was 0.785, with a sensitivity of 71.67%, and a specificity of 73.17%. The AUC of serum ADMA for degenerative valvular heart disease was 0.862, with a sensitivity of 71.67%, and a specificity of 87.80%. The AUC of serum CysC combined with ADMA in the diagnosis of degenerative valvular heart disease was 0.910, with a sensitivity of 85.56%, and a specificity of 84.15%, which was significantly higher than the two alone (Z=4.897 and 3.335, P<0.05).@*Conclusions@#Serum ADMA is positively correlated with CysC in patients with degenerative valvular heart disease, and can be used as diagnostic serum markers for degenerative calcific aortic valvular disease. It has clinical reference value for improving the diagnosis of degenerative calcific aortic valvular disease.
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Objective To investigate the correlation between serum asymmetric dimethylarginine (ADMA) and cystatin C (CysC) in degenerative calcific aortic valvular disease and its clinical application value.Methods One hundred and eighty patients with degenerative calcific aortic valvular disease who were treated in Beijing Luhe Hospital Affiliated to Capital Medical University from June 2016 to June 2018 were selected as the study subjects,and another 82 healthy subjects from the same hospital in the same period were selected as the control group.Serum ADMA and CysC levels were detected by enzyme-linked immunosorbent assay and latex-enhanced immunoturbidimetric assay.Risk factors of degenerative calcific aortic valvular disease were analyzed by Logistic regression analysis.Evaluation of the diagnostic efficacy of serum ADMA and CysC for degenerative calcific aortic valvular disease was used by receiver operating characteristic curve.Results There were no significant differences in the general data between the two groups in terms of age,gender,body mass index,drinking history,smoking history,and history of hypertension (P＞ 0.05).The systolic blood pressure(SBP),diastolic blood pressure (DBP),heart rate (HR),total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterin(LDL-C),CysC and ADMA levels of the study group were significantly higher than those of the control group [(131.51 ± 19.09) mmHg (1 mmHg=0.133 kPa) vs.(126.48 ± 16.68) mmHg,(91.11 ± 16.35) mmHg vs.(86.89 ± 10.71) mmHg,(74.39 ± 15.22) beats/min vs.(70.09 ± 13.01)beats/min,(4.51 ± 1.12) mmol/L vs.(4.15 ± 0.92) mmol/L,(1.91 ± 0.63) mmol/L vs.(1.60 ± 0.65) mmol/L,(2.59 ± 1.13) mmol/L vs.(2.27 ± 0.85) mmol/L,(1.01 ± 0.22) mg/L vs.(0.79 ± 0.16) mg/L,(20.17 ± 6.38)ng/L vs.(11.88 ± 4.22) ng/L],and left ventricular ejection fraction (LVEF),high density lipoprotein cholesterin (HDL-C) levels were significantly lower than those of the control group [(56.45 ± 9.21)％vs.(60.87 ± 10.02)％,(1.56 ± 0.63) mmol/L vs.(1.76 ± 0.62) mmol/L],there were significant differences (P ＜ 0.05).Logistic multivariate regression analysis showed that serum CysC and ADMA were independent risk factors for degenerative calcific aortic valvular disease (P ＜ 0.05).Receiver operator characteristic (ROC) curve analysis showed that area under curve (AUC) of serum CysC for degenerative valvular heart disease was 0.785,with a sensitivity of 71.67％,and a specificity of 73.17％.The AUC of serum ADMA for degenerative valvular heart disease was 0.862,with a sensitivity of 71.67％,and a specificity of 87.80％.The AUC of serum CysC combined with ADMA in the diagnosis of degenerative valvular heart disease was 0.910,with a sensitivity of 85.56％,and a specificity of 84.15％,which was significantly higher than the two alone (Z =4.897 and 3.335,P ＜ 0.05).Conclusions Serum ADMA is positively correlated with CysC in patients with degenerative valvular heart disease,and can be used as diagnostic serum markers for degenerative calcific aortic valvular disease.It has clinical reference value for improving the diagnosis of degenerative calcific aortic valvular disease.
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Sixty four pregnancy women with mildly raised TSH level (2.5-4.5 mU/L) in the 1st trimester were divided into two groups:only the thyroid function was monitored in study Ⅰ group (n =32),while levothyroxine therapy was given in study Ⅱ group (n =32);45 normal pregnant women with TSH level ＜2.5 mU/L served as control group.Serum unconjugated estriol(uE3) and placenta growth factor (PlGF) levels in 3rd trimester were measured in all subjects.The incidence of adverse events in control group,study groups Ⅰ and Ⅱ were 22.2％,40.6％ and 31.3％,respectively (P ＞0.05).The serum levels of uE3 (7.34 μg/L) and PlGF (76.3 ng/L) were elevated in study group Ⅱ;and the uE3 level was close to that in the control group (6.61 μg/L),while PlGF level was lower than that in the control group (169.1 ng/L).When TPO antibody was positive,the uE3 level in the study group Ⅰ (logarithmic value 0.37 ±0.31) was lower than those in other two groups (logarithmic value 0.81 ± 0.37,0.56 ± 0.27),while there was no significant difference in PlGF levels among three groups.The results suggest that levothyroxine may improve placental function to some extent and TPO antibody might be one of the regulators in the expression of uE3.
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Objective To find out the expression relation between TP53 and NOTCH1,and to explore their effects in head and neck squamous cell carcinoma.Methods Obtained the differentially expressed genes data of head and neck squamous cell carcinoma from 279 samples in TCGA database.Analyzed the co-expression relation between TP53 and NOTCH1 through Pearson and Spearman method.Cbioportal was used to analyze their co-expressed genes.Establish the co-expression network of TP53 and NOTCH1 with String database.The pathway and function of co-expression network was identified through KEGG and DAVID database respectively.Results Among the 279 samples,TP53 and NOTCH1 was co-expressed in head and neck squamous cell carcinoma.(Pearson score =0.45;Spearman score =0.41) There were 182 interaction pairs of TP53 and NOTCH1 related co-expressed gene according to the String database.(Pearson and Spearman score ＞ 0.3)These genes were enriched in some pathways such as T cell receptor signaling pathway,cell cycle,cell adhesion molecules and so on.These genes were enriched in some tumor related function including immune response,regulation of transposition,regulation of apoptotic process,cell cycle,regulation of GTPase activity and so on.Conclusion TP53 and NOTCH1 was co-expressed.Through establishing co-expressed network of TP53 and NOTCH1 and bioinformatics analysis,their function and signaling pathway were explored.The data generated from this study could provide a new reference in mechanism research of head and neck squamous cell carcinoma.
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Objective To explore the clinical efficacy and safety of cyclosporin A combined with glucocorti-costeroid in the treatment of juvenile uveitis.Methods 66 juvenile uveitis patients(93 eyes)were selected.Accord-ing to the conditions,the patients were treated by oral administration of cyclosporin A,2-5mg·kg -1 ·d -1 ,twice per day,combined with prednisone,0.5-1mg·kg -1 ·d -1 ,taken in the morning.After 4-6 months treatment,the inflam-mation control and visual acuity improvement were observed,and before and after treatment liver and kidney function, blood glucose,blood pressure,white blood cell counts were checked.Adverse reactions in patients were recorded with regular follow-up.Results After 4-6 months treatment,heal inflammation 78 eyes,accounted for 83.87%;improved 9 eyes,accounted for 9.68%;no respond in 6 eyes,accounted for 6.45%;the total effective rate was 93.55%.Visual acuity was obviously improved in 50 eyes,improved in 27 eyes and no response in 16 eyes;the total effective rate was 82.79%;56 eyes were removed from residual standard.In the stage of therapy,6 patients had liver and kidney dys-function,6 patients had blood abnormalities,and 3 patients had low blood sugar,all were controlled by symptomatic treatment in the normal range,and no systemic progression.Conclusion Cyclosporin A combined with glucocortico-steroid applied in juvenile uveitis improved the results with obvious clinical effect and fewer systemic side effect.
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Aim To understand the hemostatic effect of a non-polysaccharide fraction of Bletilla striata ( BS-80EE) and to clarify its mechanism of action .Methods The non-polysaccharide fraction ( BS-80 EE ) was prepared by passing the 95%ethanol extract of Bletilla striata through a D101 macroporous resin column elu-ted first with water and then with 80%ethanol.Bleed-ing time ( BT ) and clotting time ( CT ) of heparinized mice were employed as indicators for evaluating the he-mostatic effect of BS-80EE.The mechanism of action was investigated through observing the effect of BS-80 EE on platelet aggregation induced by adenosine diphosphate ( ADP) in rats with nephelometry and tes-ting the effect of BS-80EE on the thrombin time(TT), prothrombin time(PT), activated partial thromboplas-tin time(APTT), fibrinogen(FIB), P-selectin(P-S), thrombin-antithrombin complex ( TAT ) , D-dimer ( D-D) and plasminogen activator inhibitor-1 ( PAI-1 ) . Results BS-80 EE significantly shortened the CT and BT( P<0.01 or 0.05 ) of heparin mice in a dose-de-pendent manner; groups of all doses significantly re-duced the rat TT ( P <0.01 or 0.05 ) , and the high-dose group significantly increased the FIB content ( P<0.05); the mid-dose group and high-dose groups of BS-80EE significantly increased the contents of P-S, TAT and PAI-1 , while reduced the D-D production in rats ( P <0.01 ); although dose-dependent reductions of APTT and PT were observed for each treatment-group, no significance was observed .Conclusion BS-80EE possess pronounced hemostatic effect by promo-ting platelet aggregation and coagulation .