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Objective:To retrospectively analyze the independent risk factors of complicated appendicitis(CA)in children under five years old and establish a clinical prediction model, and to evaluate the clinical application of this model.Methods:A retrospective analysis was performed on children under five years old who underwent appendectomy at Children′s Hospital of Shanghai Jiao Tong University School of Medicine from January 2018 to December 2021.The children were divided into CA group and uncomplicated appendicitis group according to whether there was sign of perforation or gangrene in appendiceal tissue after operation.The differences in clinical features and preoperative laboratory test results between two groups were compared.The independent risk factors of CA were identified and a clinical prediction model was established.The clinical prediction model was verified by receiver operating characteristic curve.Results:A total of 140 children were enrolled in this study, including 84 cases in the CA group and 56 cases in uncomplicated appendicitis group.Univariate and binary Logistic regression analysis showed that the duration of symptoms>23.5 h( OR=6.650, 95% CI 2.469-17.912, P<0.05), abdominal muscle tension( OR=3.082, 95% CI 1.190-7.979, P<0.05) and C-reactive protein>41 mg/L ( OR=3.287, 95% CI 1.274-8.480, P<0.05) were independent risk factors for CA( P<0.05). The clinical prediction model of CA was constructed by the above mentioned three independent risk factors.The area under the receiver operating characteristic curve of the clinical prediction model was 0.881(95% CI 0.825-0.936), the sensitivity was 77.4%, the specificity was 87.5%, the positive predictive value was 91.3% and the negative predictive value was 70.0%. Conclusion:Acute appendicitis in children under five years old is more likely to progress to CA if the duration of symptoms>23.5 h, the level of C-reactive protein is increased, and the abdominal muscle tension is accompanied.The clinical prediction model of CA constructed by common clinical information in pediatric clinics has good prediction efficiency, which provides a simple and feasible reference method for clinicians to distinguish CA from uncomplicated appendicitis.
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In recent years, immunotherapy has made a breakthrough in the field of non-small cell lung cancer, reshaping the pattern of lung cancer treatment. However, with the wide application of immunotherapy in clinical practice, immune-related adverse events have attracted increasing attention. Immune pneumonia, as one of the immune-related toxic side effects of greatest concern, affects the treatment process and curative effect and can be a threat to life in serious cases. Given that immune pneumonia has a complicated pathogenesis and diverse clinical manifestations, strengthening the understanding of immune pneumonia is urgently needed. The treatment of immune pneumonia is limited, and additional therapeutic medicines are still awaiting exploration. Therefore, this paper summarizes the progress of the research on immune pneumonia in the treatment of non-small cell lung cancer.
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OBJECTIVE@#To analyze variation of ISL1 gene and explore its functional characteristics in relation with congenital heart defect (CHD).@*METHODS@#Clinical data and peripheral blood samples of 194 CHD patients and 232 healthy controls were collected for the extraction of genomic DNA. The coding exons and flanking intronic regions of the ISL1 gene were sequenced. Expression plasmid for the wild-type ISL1 gene ISL1-pcDNA3.1 was constructed, and the corresponding variants were obtained by site-specific mutagenesis. The gene expression plasmid was transfected into CHO cells with liposome, and the functional characteristics of ISL1 variant were studied by double luciferase reporter gene analysis.@*RESULTS@#A novel variant of the ISL1 gene c.499C>T (p.Q167X) was detected in a patient with sporadic CHD. Functional study showed that the variant has lost its transcriptional activation function for the MEF2C promoter.@*CONCLUSION@#A novel variant of the ISL1 gene related to CHD has been identified. The defect of ISL1 gene may underlay the pathogenesis for a proportion of CHD.
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In this paper, absorption and pharmacokinetic study of Radix Rehmanniae was studied by liquid chromatography coupled with mass spectrometry method after oral administration to rats. By comparing the chromatograms of ultraviolet, full scan, extracted ion and selective reaction monitoring (SRM) of standard solution, Radix Rehmanniae, blank plasma and rat plasma post drug administration, catalpol and ajugol were found to be the main compounds absorbed from Radix Rehmanniae. Plasma concentrations of aucubin, dihydrocatalpol, rehmannioside A (or rehmannioside B/ melittoside) and rehmannioside D were very low. Quantitative method for catalpol and aucubin and semi-quantitative method for other compounds in rat plasma were established. The pharmacokinetic study of those absorbed components was conducted after oral administration of 6 g x kg(-1) Radix Rehmanniae water extract to rats. Cmax, t(1/2) and AUC(0-infinity) of catalpol and ajugol were (2349.05 +/- 1438.34) and (104.25 +/- 82.05) ng x mL(-1), (0.86 +/- 0.32) and (0.96 +/- 0.37) h, (4407.58 +/- 2734.89) and (226.66 +/- 188.38) ng x h x mL(-1), respectively. tmax was at 1.00 h for catalpol and ajugol. Both catalpol and ajugol were absorbed and excreted rapidly.
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objective To study the pharmacokinetics of lignans components in Shengmai granule in volunteers and in mice. Methods After oral administration of Shengmai granule (3.6 g/person) for the volunteers and ig administration of the drug (4.7 g/kg) for the mice, the plasma was collected at different time points. The lignans components in Shengmai granule and in the plasma were analyzed by HPLC to monitor the changes of plasma concentration of schisandrind. Pharmacokinetic parameters were calculated from the plasma concentration- time data with the 3P97 software package. Results After oral administration of Shengmai granule by volunteers and mice, schisandrin and some new components in plasma were detected. The new components may be the metabolites of schisandrin. The main pharmacokinetic parameters of schisandrin in mice and in volunteers were as follows: T1/2ka was 0.03 and 0.04 hour, T1/2ke 0.88 and 0.86 hour, Vd 19.12 and 1.73 L? kg- 1, CL 15.06 and 1.46 L? h- 1? kg- 1, Cmax 1.196 and 0.098 mg? L- 1, Tpeak0.21 and 0.50 h, AUC0- ∞ 1.096 and 0.137 mg? h? L- 1, respectively. Conclusion Schisandrin in Shengmai granule can be absorbed in the volunteers and mice after oral administration. It can be absorbed and eliminated rapidly, and can be transformed into the metabolite. The pharmacokinetics of plasma Schizandrin complies with linear kinetic course.
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AIM: To study the pharmacokinetics of flavonoids in mice after ig administration of Xiexin Decoction (Radix et Rhizoma rhei, Rhizoma coptidis, Radix Scutellariae). METHODS: Mice were given a single ig dose of Xiexin Decoction 4.5, 9.0 or 18.0 g/kg. Flavonoids in plasma were analysed by HPLC and plasma concentration of baibalin was determined. Pharmacokinetic parameters were calculated from the plasma concentration-time data with the DAS software package. RESULTS: After ig administration of Xiexin Decoction in mice, baicalin, baicalein and another flavonoid were detected in plasma and baicalin concentration was the highest of the three kinds of flavonoids in plasma. After a single ig dose of Xiexin Decoction 4.5, 9.0 or 18.0 g/kg, the pharmacokinetic parameters of baicalin were as follows:T_ 1/2 =2.77、5.69、6.20 h,AUC_ 0-∞ =9.09、23.49、39.57 ?g?h/mL,CL= 12.52 、 6.962 、 11.50 L?h/kg,V_d= 50.11 、 79.56 、 102.95 L/kg,C_ max1 =1.89、3.32、4.79 ?g/mL(T_ p1 = 0.08 h ), C_ max2 =1.46、2.57、4.16 ?g/mL(T_ p2 =3 h), respectively. CONCLUSION: Three kinds of flavonoids can be absorbed after ig administration of Xiexin Decoction in mice, of which baicalin is the major component.