RESUMEN
Objective:To explore the predictive value of low-dose biphasic (inspiratory and expiratory) CT air trapping sign and semi-quantitative score in predicting abnormal blood gas parameters and progression to severe disease in COVID-19 patients.Methods:Patients with non-severe COVID-19 who were diagnosed by nucleic acid testing and hospitalized in designated hospitals in Wuxi City from January 23 to February 29, 2020 were prospectively and consecutively recruited. All patients received low-dose biphasic CT examination on admission and repeated CT examination at regular intervals during the course. On the inspiratory phase admission of the bipolar CT, the scope of the lesion was evaluated by semi-quantitative score, and the air trapping sign on bipolar CT was assessed. The differences of semi-quantitative score, the presence of the air trapping sign and other clinical factors were compared between the patients with abnormal and the normal blood gas index, as well as between the cases progressed to severe disease and cases without disease progression using the independent sample t-test or χ 2 test. The area under the curve (AUC) of receiver operating characteristic (ROC) and the comprehensive discriminant improvement index (IDI) were used to evaluate the predictive effectiveness of the semi-quantitative scores, air trapping sign, and combination of two factors in differentiating cases with abnormal and normal blood gas indexes, as well as in differentiating cases with and without disease progression to severe COVID-19 cases. Results:In total 51 non-severe COVID-19 cases were included, with 16 cases showed air trapping sign during the first biphasic CT examination on admission. During the course of the disease, there were 13 patients with abnormal blood gas index, and 9 cases displaying air trapping sign (9/13). All 7 cases with progression to severe cases showed air trapping sign (7/7). Patients with advanced age, air trapping sign and higher semi-quantitative score were found more likely to have abnormal blood gas index ( t=3.10, χ 2=9.38, t=3.34, P<0.05); patients with advanced age, underlying diseases, air trapping sign and higher semi-quantitative score were more likely to develop into severe disease ( t=2.68, χ 2=6.65, χ 2=4.25, t=4.33, P<0.05). The AUC of semi-quantitative score, air trapping sign and combination of two factors in distinguishing abnormal blood gas index from normal blood gas index was 0.803, 0.754 and 0.794 respectively. The AUC of semi-quantitative score, air trapping sign and combination of two factors in distinguishing cases with progression to severe cases from non-progression was 0.881, 0.898 and 0.932, respectively. Air trapping sign combined with semi-quantitative score significantly improved the prediction effectiveness of disease progression, compared with semi-quantitative score or air trapping sign (IDI=0.271, 0.117). Conclusion:Air trapping sign and semi-quantitative score might be used as effective indicators to predict the progression of COVID-19 cases, and the combination of these two factors might be more helpful to predict the disease progression.
RESUMEN
Objective:To evaluate the efficacy and safety of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines in patients with HIV-1 or chronic HBV infection through observing the dynamic changes in antibody responses to two-dose inactivated SARS-CoV-2 vaccines.Methods:This cohort study recruited 169 people (including 39 with HIV-1 infection, 36 with chronic HBV infection and 94 individuals without chronic diseases) who completed two doses (prime and boost) of inactivated SARS-CoV-2 vaccination from January to December 2021. The levels of SARS-CoV-2 IgM and IgG antibodies at 14 d, one month and two months after boosting and neutralizing antibodies at one month were detected by chemiluminescence immunoassay and competitive ELISA method.Results:The positive rates of antibodies against SARS-CoV-2 in the HIV-1 and HBV groups were higher at one month after booster immunization, but significantly decreases at two months. The double-negative rate of SARS-CoV-2 IgM and IgG antibodies was higher in the HIV-1 and HBV groups than in the control group. The single positive rate of IgG antibody at one month in the control group was 2.01-fold higher than that of the HIV-1 group and 3.17-fold higher than that of the HBV group. The single positive rate of IgG antibody in people aged 18-39 years in each group was higher than that in the 40-59 age group. The antibody persistence was better in the HBV group than in the HIV-1 group, and the levels of IgG antibody in the HBV group was higher than that in the HIV-1 group. The neutralizing capacity of serum antibodies was significantly lower in the HIV-1 group than in the other groups ( P<0.000 1). The inhibition rate of serum neutralizing antibodies in the HBV group was lower than that in the control group among people aged 18-39 years [(34.050±6.031)% vs (64.220±3.845)%, t=4.43, P<0.000 1]. SARS-CoV-2-specific antibody responses were induced in 73.08% (19/26) of the patients aged 18-39 years in the HIV-1 group and 80.00% (4/5) in the HBV group. Conclusions:There were differences in the antibody responses to inactivated SARS-CoV-2 vaccines between different age groups, and infectious diseases affected the positive rates of antibodies and the neutralizing capability against SARS-CoV-2.
RESUMEN
Objective To explore the 18F-FDG PET/CT features of sacral insufficiency fracture.Methods 18 F-FDG PET/CT imaging and clinical data of 8 patients with sacral insufficiency fracture were retrospectively analyzed.Results All 8 patients had different degrees of radioactivity uptake in sacra with the maximum standardized uptake value (SUVmax)from 2.7 to 7.2.Four patients had lesions in their left sacra,2 in the bilateral sacral wings and sacral promontories,1 in the bilateral sacral wings,and 1 in the left sacral wing and sacral promontory.There were 8 patients of longitudinal fractures in sacral wings,which of 6 patients involving S1-2 and 2 patients involving S3.Three patients had transverse fractures in sacral promontories,with 2 located at S2 and 1 at S3.The sacral bone density increased in 5 cases,and the density was not changed in 3 cases.Conclusion Sacral insufficiency fracture had specific 18F-FDG PET/CT characteristics.
RESUMEN
This study was aimed to establish the pharmacokinetics-pharmacodynamics (PK-PD) model of ginsenoside Rb1 following the intravenous administration of Shengmai injection in subjects with stable angina pectoris.A total of stable angina pectoris were selected and received Shengmai injection for 14 days.Plasma samples were collected at different time points.Plasma concentrations of ginsenoside Rb1 were determined by liquid chromatography-mass spectrometry (LC/MS).The concentration-time curves (AUC) were drawn,and then the PK parameters were calculated.The systolic pressure and diastolic pressure were monitored,and the combined PK-PD model was established based on the theory of effect compartment.The results showed that PK of ginsenoside Rb1 conformed to a mono-compartment model.The effect of Shengmai injection lagged behind the concentrations of ginsenoside Rb1 in plasma.The effect exhibited good correlation with ginsenoside Rb1 in effect compartment.The relationship between effect and plasma concentrations fits the Inhibitory Effect Imax model.It was concluded that the study successfully established the combined PK-PD model of ginsenoside Rb1 in subjects with angina pectoris.The model can efficiently evaluate the effective substance of Shengmai injection.
RESUMEN
This study was aimed to compare the pharmacokinetics (PK) of Shengmai injection and Shenmai injection with a single injection administration using a constant speed in subjects with stable angina pectoris.A total of 20 subjects with stable angina pectoris were divided into two groups.Each group was administered with Shengmai and Shenmai injection.The liquid chromatography-mass spectrometry (LC/MS) was adopted to determine concentrations of ginsenosides in plasma at different time points.PK parameters were calculated for comparison.The results showed that after a single intravenous infusion of Shengmai and Shenmai injection,the Cm.of ginsenoside Rg1,ginsenoside Re,ginsenoside Rb1 and ginsenoside Rc in Shenmai group were higher than those of the Shengmai group with statistical significance (P ≤0.05).There were differences on the T1/2 of ginsenoside Rg1,AUC0-144h and CL of ginsenoside Rc,as well as Tmax of ginsenoside Rd (P ≤ 0.05).However,there was no significant difference shown on other PK parameters.It was concluded that after a single Shengmai or Shenmai injection,there were PK differences of ginsenoside Rg1,ginsenoside Re,ginsenoside Rb1 and ginsenoside Rc in the human body.The clinical medication selection should be based on syndrome differentiation and treatment of patients.
RESUMEN
OBJECTIVE:To study the pharmacokinetics of the active ingredients of Shenmai injection,including ginsenoside Rg1 and ginsenoside Re,in normal Beagle dogs and those with myocardial ischemia. METHODS:6 Beagle dogs were given isopro-terenol hydrochloride (1.1 mg/kg) sc to establish the model of myocardial ischemia (model group). Another 6 Beagle dogs were given isometric normal saline (2.2 ml/kg) sc as controls group. The two groups of dogs respectively received corresponding drugs sc at 8:00 am and 13:00 pm on day 1 and at 8:00 am on day 2. Each group of dogs were given Shenmai injection(1.6 ml/kg)iv 1 h after administration on day 2,and such intravenous drip lasted for about 1 h. Blood was collected from each group 0,0.25, 0.5,0.75,1(the end of iv),1.5,2,3,4,6,8,12 and 24 h from the start of iv. Liquid chromatography-mass spectrometry was adopted to determine the concentrations of ginsenoside Rg1 and ginsenoside Re in blood,and WinNonlin 6.3 was used to calculate pharmacokinetic parameters for comparison. RESULTS:For ginsenoside Re in the dogs of the model group,t1/2 was(2.69±1.12) h,AUC0-24 h was(2 060.78±812.18)h·μg/L,Vz was(46.16±20.98)ml and CL was(9.02±4.45)ml/h;compared to the normal control group,AUC0-24 h was much greater and Vz and CL were significantly lower,showing a statistically significant difference(P0.05). CON-CLUSIONS:Myocardial ischemia may affect the removal of ginsenoside Re in Beagle dogs,but has no effect on the pharmacoki-netic process of ginsenoside Rg1.
RESUMEN
Objective To evaluate the importance of wide canal sign (increased anteroposterior diameter of the spinal canal at L5) in the MR diagnosis of lumbar isthmic spondylolisthesis.Methods One hundred cases of bilateral isthmic spondylolisthesis at L5 confirmed with conventional radiography and/or CT were randomly collected.Another age and sex matched 100 cases without spon-dylolisthesis were collected as control group.The sagittal canal diameters at the L1 and L5 levels were measured and analyzed for all 100 cases of bilateral isthmic spondylolisthesis and 100 control subjects.For each group,the sagittal canal ratio(defined as the maxi-mum anteroposterior diameter of the canal at L5 level divided by the diameter of the canal at L1 )was calculated and compared be-tween the two groups ,and anylyzed with ROC curve.Results The mean midline sagittal anteroposterior diameter was (22.3 ± 1.34)mm at L5 in patients with lumbar isthmic spondylolisthesis,and (18.8±1.57)mm in the control subjects.The sagittal canal ratio was 1.32 in the isthmic spondylolisthesis group and 1.12 in the control subjects,which was different significantly.ROC curve illustrated that the sagittal canal ratio 1.25 was a most meanful point with 88% sensitivity and 90% specificity.Conclusion The sag-ittal canal ratio at L5 is bigger than 1.25 meaning abnormally increased sagittal canal diameter (wide canal sign),which specifically indicates the presence of bilateral pars interarticularis defects.Using this sign can help to make correct MR diagnosis and differential diagnosis of isthmic spondylolisthesis .
RESUMEN
Objective To explore the association of ATP-binding cassette (ABC) efflux pump gene Rv1217c-Rv1218c and the drug resistance of Mycobacterium tuberculosis.Methods A total of 34 Mycobacterium tuberculosis clinical isolates including 24 drug-resistance isolates which were resistant to riffampicin,isoniazid,streptomycin or ethambutol and resistant to at least one second-line antituberculosis drug,and 10 drug-sensitive isolates were involved in this study.The RNA of isolated strains was extracted and then reverse transcribed. Gene expression was performed by real-time polymerase chain reaction (PCR) and data was analyzed by t test and Logistic regression analysis.Results The expressions of Rv1217c in rifampicin-resistant group (2.13 ± 1.89,t =3.44,P＜0.01),isoniazid-resistant group ( 1.84 ± 1.86,t =3.16,P＜ 0.05),streptomycin-resistant group ( 1.86 ±1.96,t=2.78,P＜0.05) and ethambutol-resistant groups (3.36±2.35,t=3.04,P＜0.05) were all higher than sensitive isolates (0.42 ± 0.31).The expressions of Rv1218c in rifampicin-resistant group (2.54±1.84,t=3.82,P＜0.01),isoniazid-resistant group (2.34± 1.84,t=3.72,P＜0.01),streptomycin-resistant group (2.15±1.86,t=3.01,P＜0.01) and ethambutol-resistant groups (3.78± 1.78,t=4.22,P＜0.01 ) were all higher than sensitive isolates (0.65 ± 0.42).The expressions of Rv1217c and Rv1218c in multidrug resistant group were 2.74±2.07 and 3.33± 1.77,respectively,which were both higher than polydrug resistant group (0.79 ± 0.47 and 1.03 ± 0.79,respectively; t =2.91,P＜0.05 ; t =3.84,P＜0.01,respectively).Logistic regression analysis found that high Rv1217c expression was positively correlated with rifampicin resistance and negatively correlated with isoniazid resistance (both P＜ 0.01 ),while high Rv1218c expression was negatively correlated with rifampicin resistance and positively correlated with isoniazid resistance (both P＜0.01 ).High expressions of two genes were both positively correlated with ethambutol resistance and multidrug resistance (both P＜0.01 ) and not statistically correlated with streptomycin resistance (P＞0.05).Conclusions The expressions of ABC efflux pump gene,Rv1217c-Rv1218c,are correlated with multiple drug resistance.The overexpression may contribute to the multidrug resistance of Mycobacterium tuberculosis.
RESUMEN
Objective To evaluate clinical and CT features of the 4 th lumbar vertebral spondylolisthesis (L 4DS ) as well as CT value in its diagnosis. Methods CT features of 36 cases of L 4DS were observed and interarticular distance (IAD) and facet joint angle (FJA) were measured and compared with control group.Results Patients with L 4DS mostly were over 40 years old. CT features included degenaration, spondylolisthesis and spinal canal stenosis. IAD and FJA were significantly narrowed. Conclusion CT axial scans combined with plain films,CTM and MPR clearly shows basic changes of L 4DS , providing useful details for clinical management. Narrow posterior vertebral part are important factors leading to L 4DS.
RESUMEN
Objective:To establish a new method to detect Amp C?-lactamase by PCR. Methods:The amp C and amp D gene fragments of E. cloacae were amplified by the amp C and amp D primers to detect Amp C ?-lactamase, especially the enduring and highly productive enzymes. Results:Totally 193 of 214 strains of E. cloacae were positive for amp C gene , implicating most strains of E. cloacae had the ability to produce the enzyme. Sixteen of the 193 strains (amp C positive) were negative for amp D genes, implicating these 16 strains could produce the enduring and highly productive enzymes. The results were confirmed by cefoxitin three-dimensional test. Conclusion:The new method to detect Amp C ?-lactamase, especially the enduring and highly productive enzymes,by amp C and amp D primers is a rapid and accurate method.