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Isatis indigotica Fort. (Ban-Lan-Gen) is an herbal medicine prescribed for influenza treatment. However, its active components and mode of action remain mostly unknown. In the present study, erucic acid was isolated from Isatis indigotica Fort., and subsequently its underlying mechanism against influenza A virus (IAV) infection was investigated in vitro and in vivo. Our results demonstrated that erucic acid exhibited broad-spectrum antiviral activity against IAV resulting from reduction of viral polymerase transcription activity. Erucic acid was found to exert inhibitory effects on IAV or viral (v) RNA-induced pro-inflam-matory mediators as well as interferons (IFNs). The molecular mechanism by which erucic acid with antiviral and anti-inflammatory properties was attributed to inactivation of NF-kB and p38 MAPK signaling. Furthermore, the NF-kB and p38 MAPK inhibitory effect of erucic acid led to diminishing the transcriptional activity of interferon-stimulated gene factor 3 (ISGF-3), and thereby reducing IAV-triggered pro-inflammatory response amplification in IFN-β-sensitized cells. Additionally, IAV- or vRNA-triggered apoptosis of alveolar epithelial A549 cells was prevented by erucic acid. In vivo, erucic acid administration consistently displayed decreased lung viral load and viral antigens expression. Meanwhile, erucic acid markedly reduced CD8+cytotoxic T lymphocyte (CTL) recruitment, pro-apoptotic signaling, hyperactivity of multiple signaling pathways, and exacerbated immune inflammation in the lung, which resulted in decreased lung injury and mortality in mice with a mouse-adapted A/FM/1/47-MA(H1N1) strain infection. Our findings provided a mechanistic basis for the action of erucic acid against IAV-mediated inflammation and injury, suggesting that erucic acid may have a therapeutic potential in the treatment of influenza.
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Human infection with avian influenza A (H7N9) is easy to induce severe acute respiratory distress syndrome (ARDS), and traditional mechanical ventilation cannot correct hypoxemia, so patients may die from multiple organ failure (MOF) caused by persistent hypoxia. Extracorporeal membrane oxygenation (ECMO) can provide effective respiratory support and win time for the treatment of severe H7N9. The first case of severe H7N9 in Guangdong Province in 2018 was admitted to Zhongshan Hospital Affiliated to Sun Yat-sen University. The case was insult with severe ARDS caused by H7N9, the traditional mechanical ventilation could not correct hypoxemia, and the lung condition gradually improved with ECMO assistance. After 13 days of ECMO support, the patient was successfully weaned from ECMO and was transferred to a general ward after 55 days. After 102 days of rehabilitation, the patient was discharged from hospital and followed up for 2 months, who was in good health and had a good quality of life. This article states the diagnosis and treatment of severe H7N9 in details, providing experience for the treatment of severe H7N9 in the future.
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Objective To study the safety and effect of ultrasound guided minimally invasive rotary cutting for treatment of benign breast lesions. Methods A single-center, prospective, randomized, controlled study method was used, 84 patients with breast benign lesions were randomly divided into observation group and control group, 42 patients in each group. Patients in the observation group were treated with ultrasound guided minimally invasive rotary cutting, patients in control group were treated with traditional surgery. The intraoperative and postoperative related indicators were compared between two groups. Results The intraoperative blood loss, length of incision, operation time in breast benign unilateral single and unilateral and bilateral lesions in the observation group were significantly less than those in the control group, with statistically significant difference (P<0.01) . The healing time, postoperative pain score, complications in breast benign unilateral single and unilateral and bilateral lesions in observation group were less than those in the control group, with statistically significant difference (P<0.01) . And the postoperative satisfaction, and the excellent rate of beauty in breast benign unilateral single、unilateral and bilateral lesions were better than control group, with statistically significant difference (P<0.01) . There was no breast deformation in observation group after treatment, and there were 3 patients of breast deformation in the control group has 3 patients, accounting for 7.14%. Conclusion Ultrasound guided minimally invasive rotary cutting is significantly superior to the traditional treatment in security and effectiveness for treatment of breast benign lesions in one single and unilateral multiple and bilateral lesions.
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Objective To investigate the feasibility and the perioperative treatments of repairing atrial septal defects and bilateral lung transplantation in treatment of ASD with Eisenmenger's syndrome.Methods On May 24th,2016,one case of atrial septal defect with Eisenmenger's syndrome underwent repair for the atrial septal defect with bilateral sequential lung transplantation aided by extracorporeal circulation ECMO in Zhongshan People's Hospital.In strict accordance to the procedure,the lung was collected and preserved with the HTK solution.The operation went smoothly,the cold ischemic time for the right lung was 120 min and that for the left lung was 260 min.Postoperatively,Tacrolimus (FK506) + Mycophenolate Mofetil (MMF) + adrenal cortical hormone Sanlian immunosuppression was used.Results At 60th h post-operation the patient was hemodynamically stable,with good oxygenation after removal of the ECMO.At 7th day post-operation the patient was extubated.At 12th-20th day post-operation bacterial culture of the sputum was found to be positive and the patient was treated with the corresponding sensitive antibiotics and recovered.Cardiac ultrasound before discharge showed that there was no residual shunt.One month after discharge the cardiopulmonary function of the patient was quite good,chest X-ray showed that the bilateral transplanted lungs were clear and the patient's quality of life was much better.Conclusion Cardiac malformation repairs with bilateral lung transplantation is a feasible treatment for patients with end-stage Eisenmenger's syndrome with bi-directional shunts.The key to success is sufficient preoperative preparation,and a smooth operation with the timely and effective treatment of postoperative complications.
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Objective To study the lung protection of ambroxol in general thoracic surgery perioperation for the elderly.Methods Totally 130 hospitalized patients aged (65.1±4.3) years in our hospital during general thoracic surgery were randomly divided into two groups:ambroxol intervention(2 mg/kg,intravenous drip,once/d) and control groups (n=65 for each).The incidenceof pulmonary complications,changes of blood gas analysis before and after surgery and time of hospitalization were compared between the groups.Results The incidence of pulmonary complications was significantly lower in ambroxol intervention group than in control group (9.23％ vs.24.62％,P＜0.05).Blood gas analysis results before and after surgery were improved in ambroxol intervention group[PaO2:(61.32±8.65) mm Hg,(95.07±13.62)mm Hg; PaCO2:(44.15±5.52)mm Hg,(37.28±4.06)mm Hg] as compared with control group[PaO2:(62.11 ± 8.83) mm Hg,(80.37±10.46)mm Hg; PaCO2:(44.39±5.17) mm Hg,(40.73±4.51)mm Hg] (t=3.61,3.75,both P＜0.05).The time of hospitalization was shorter in ambroxol intervention group than in control group [(12.14±0.29) d vs.(15.85±0.62)d,t=3.41,P=0.036].Conclusions Perioperative use of ambroxol in general thoracic surgery in the elderly is worthy of clinical application because of reduction of pulmonary complications and shortness of hospital stay.
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Objective To investigate a new strategy of bone marrow transplantation (BMT) for donor-specific tolerance induction after heart transplantation. Methods Donor bone marrow cells (BMCs)were harvested simultaneously with donor cardiac graft using modified perfusion method (PM) ,then stored in a -80 ℃ refrigerator after filtration and centrifugation. Whole BMCs (IBM-BMT) (monocytes 1.2 ×107/kg,CD34+ cells 2.38× 105/kg) in host iliac bones were injected into the bone marrow cavity 40 days after heart transplantation. Preconditoning regimens that consisted of fludarabine, antithymoctye globin and total lymphoid irradiation were performed 3 days before BMT. Tacrolimus (Tac) was administrated intravenously after BMT or orally in conjunction with mycophenolate mofetil (MMF) 3 weeks later.Cyclosporine and MMF were orally administrated 6 weeks later. Donor chimerism was detected using short tandem repeats-polymerase chain reaction in monocytes from peripheral blood at the 2nd,4th, 8th or 12th week after BMT or BMCs at the 4th, 8th or 12th week after BMT. Intramyocardium electrocardiography examination or endomyocardial biopsy was performed weekly or monthly respectively. Mixed lymphocyte reactions (MLR) were performed 3 months after BMT. Results Donor chimerism in monocytes in peripheral blood or BMCs in iliac bones measured at the 1 st,2nd and 3rd month after BMT was 26.3%, 19.1%,4.8% ,and 46.3%, 24.4%, 7.6%, respectively. After 3-month follow-up, there was no rejection confirmed by endomyocardial biopsy or intramyocardium electrocardiography. Echocardiography revealed that the diastolic and systolic function of the cardiac graft was maintained well 3 months after BMT. MLR revealed donor-specific hyporesponsiveness while immunocompetence was preserved to third-party antigens. Conclusion These findings indicate that the two-stage BMT strategy is a safe and feasible method for the induction of donor-specific tolerance via stable mixed chimerism and needs to be further confirmed after a long-term observation.
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Objective To study the relation between coagulation-fibrinolysis and metastasis, hormone receptor and TNM stage of breast cancer. Methods The plasm levels of six coagulation-fibrinolysis indexes of 30 breast cancer patients were tested, which included activated partial thromboplastin time(APTT), fibrinogen(FIB), D-dimer(D-Di), tissue type plasminogen activator (t-PA)and plasminogen activator inhibitor-1(PAI-1). Statistic analysis of the relation between the changes of these indexes and metastasis, hormone receptor and breast cancer cell proliferation was performed. Results There were statistically significant differences between the malignant and benign breast disease in FiB(3.05±0.44)g/L vs(3.39±0.52)g/L(P＜0.05),D-Di(0.27±0.06)μg/ml vs(0.36±0.16)μg/ml(P＜0.05) and PAI-1(26.14±3.30)ng/ml vs(34.59±3.68)ng/ml (P＜0.01). The levels of plasma FIB (3.70±0.47)g/L and PAI-1 (37.36±2.71)ng/ml in metastasis group were higher than those in the non-metastasis group (P＜0.01). Significantly higher levels of PAI-1(36.40±3.57)ng/ml(P＜0.05)in expression of Ki67≥30% in the patients with lymph node involvement were seen. Conclusion Coagulation-fibrinolysis indexes were related to the proliferation, invasion, metastasis and clinical stage of breast cancer and it can serve as an important marker for predicting breast cancer's biological behavior and prognosis.
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Objective To evaluate the efficacy and toxicity of navebine(NVB) given by continuous infusion plus cisplatin combination therapy in the treatment of advanced breast cancer.Methods 60 patients with advanced breast cancer were enrolled in this study.The type of his to pathologyis invasive ductal carcinoma.19 patients had no previous chemotherapy but 21 cases received chemotherapy containing ADM.26 patients had ≥2 metasta-ticsites.All the patients received vinorelbine according to the following doses chedule:10mg bolus followed by 10mg by continuous infusion over 24 hours every 5 days every 3 weeks.Results 60 patients were evaluable for response.A total of 131 cycles were administered.The lverall response rate was 41.6%(3 patients achieved a complete response and 22 patients achieved a partial response).The median over all survival was 35 weeks and the median duration of response was 19 weeks.The dose limiting toxicity was marrow-suppression.Neutropenia was in 43% patients(31% was grade Ⅲ and Ⅳ).Thrombo-cytopenia and anemia were mild.Conclusion A highe rsponse is obtained in advanced breast cancer treated by continuous intravenous NVB infusion with tolerable toxicity and deserve further revaluation.
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Objective To study and compare the level of adiponectin in different functional status of thyroid,to assess the association of thyroid hormones and insulin resistance with adiponectin.Methods ELISA was used to examine the fasting plasma adiponectin in 56 hyperthyroidism,30 hypothyroidism and 44 normal control subjects.FT_3,FT_4,TSH, FPG,Fins and blood fat were measured.BMI and HOMA-IR were calculated.Results There were higher level of adiponectin in hyperthyroidism than hypothyroidism and normal control subjects.Fasting plasma adiponectin was posi- tively correlated with FT_4 (r=0.36,P