Significance of molecular diagnostic technology in the diagnosis and treatment of inflammatory bowel disease in children / 中华实用儿科临床杂志

With the development of biological technology, molecular diagnosis has been increasingly applied in clinical practice and treatment.Inflammatory bowel disease (IBD) in children is a chronic intestinal inflammation caused by infection, immunity, environment and other factors in a specific genetic background.Children with IBD, especially early-onset and very early-onset IBD, can be considered a monogenic disease.Early identification of such children in clinical work and timely improvement of gene detection can identify the types of gene defects and reveal the inflammatory signal transduction pathways, providing a theoretical basis for the selection of treatment options.Moreover, drug-related pharmacogenetics in the treatment of IBD directly affects the organism′s response rate to drugs, thereby affecting the clinical remission and intestinal mucosal repair.Therefore, the understanding of the characteristics of drug immunogenicity of the Asian population, which can reduce the unnecessary waste of medical resources, the adverse drug reactions in children during the induction and maintenance of remission and complications and recurrence rate, is of great importance.

The expression change and clinical value analysis of serum hypersensitive C-reactive protein in patients with non-small cell lung cancer / 中国医师进修杂志

Objective:To investigate the level of hypersensitive C-reactive protein (hs-CRP) in serum of patients with non-small cell lung cancer (NSCLC), and to explore the relationship between hs-CRP level and clinical characteristics and prognosis.Methods:The clinical data of 96 patients with NSCLC (NSCLC group), 50 patients with benign lung disease (benign lung disease group) and 45 normal subjects (control group) from August 2015 to August 2019 were analyzed. The expression of hs-CRP in serum were detected by immunofluorescence immunoassay. The tumor markers carcino-embryonic antigen (CEA), carbohydrate antigen 125(CA125), cytokeratin-19 fragment antigen (Cyfra21-1), neuronspecific enolase (NSE)were measured using automatic biochemical immunoassay. The relationship between hs-CRP and age, gender, tumor pathological type, clinical stage, imaging relief in patients with NSCLC were analyzed. The sensitivity, specificity and accuracy of hs-CRP combined with CEA, CA125, Cyfra21-1 and NSE were calculated.Results:The levels of hs-CRP in NSCLC group and benign lung disease group were higher than that in control group [(14.9 ± 7.5), (26.4 ± 10.2) mg/L vs. (5.1 ± 1.3) mg/L], and the differences were statistically significant ( P<0.05 or <0.01); the level of hs-CRP in NSCLC group was lower than that in benign lung disease group [(14.9 ± 7.5) mg/L vs. (26.4 ± 10.2) mg/L], and the difference was statistically significant ( P<0.05). The levels of CEA, CA125, Cyfra21-1, NSE in NSCLC group were higher than that in benign lung disease group and control group, and there were significant differences ( P<0.01 or<0.05). In 96 patients with NSCLC, there was 49 patients with elevated hs-CRP (hs-CRP elevated group) and 47 patients with normal hs-CRP (hs-CRP normal group). Single factor analysis showed that the level of hs-CRP had no correlation with age, gender and tumor pathological type ( P>0.05), but had correlation with clinical stage ( P<0.05). After detecting the lesions by CT, the rate of solid tumors in hs-CRP elevated group was 66.0%, in hs-CRP normal group was 40.8%, and there was significant difference ( χ2 = 6.089, P<0.05).After followed up for 2 months in NSCLC patients, the disease control rate in hs-CRP elevated group was 59.6%, in hs-CRP normal group was 85.7%, and there was significant difference ( χ2 = 8.300, P<0.01). The ensitivity, specificity and accuracy of hs-CRP combined with CEA, CA125, Cyfra21-1 and NSE was 89.0%, 80.4% and 82.3%. Conclusions:Patients with NSCLC have high expression of hs-CRP, which is correlated with disease progression and clinical treatment. The indicator of hs-CRP combined with CEA, CA125, Cyfra21-1 and NSE may be important for diagnosis and prognosis of NSCLC.

A case of congenital bile acid synthesis disorder type 2 and literature review / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To summarize the clinical features, biochemical change and genetic mutations of a neonate with congenital bile acid synthesis disorder type 2.</p><p><b>METHODS</b>Clinical features, blood biochemical index, gene analysis and treatment of the patient were reviewed.</p><p><b>RESULTS</b>The patient presented with the symptoms of jaundice 3 days after birth but without skin itching. Pale stool was noted. Subsequently, he presented with hepatomegaly, blood coagulation disorders, left cochlear nerve damage, liver cirrhosis and remarkable growth retardation. Serum biochemistries showed that bilirubin and transaminase were elevated, while γ -GT and total bile acid was normal. Abdominal ultrasonography indicated decline of gallbladder contraction. Cholangiography showed normal extra- and intrahepatic bile ducts and patent biliary tract. Liver biopsy showed intrahepatic cholestasis. Gene testing has identified a homozygous mutation in AKR1D1 gene.</p><p><b>CONCLUSION</b>Congenital bile acid synthesis disorder should be suspected when a neonate has presented with jaundice, elevated bilirubin and transaminase, normal or reduced TBA and γ -GT. Genetic testing and urine mass spectrometry analysis can diagnose congenital bile acid synthesis disorder. Early therapy is crucial to patients with congenital bile acid synthesis disorder.</p>

Detection of neutrophil extracellular traps in patients with systemic lupus erythematosus / 中华风湿病学杂志

Objective To assay the level of neutrophil extracellular traps (NETs) in systemic lupus erythematosus (SLE) patients and healthy controls and compare the difference between SLE group and control group, and to analyze between the level of NETs and related laboratory parameters. Methods Forty-four females patients with SLE were recruited as research subjects, with 24 cases in the active stage and 20 in stable stage. Forty-two healthy female volunteers matched in age were enrolled as control subjects. The fluorescence intensity of NETs in neutrophils was detected by fluorospectrophotometry. The concentration of neutrophil elastase in plasma was quantitatively detected. Statistical analysis of the difference of level of NETs between the SLE group and control group was conducted. Then the correlation between the fluorescence intensity of NETs and erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), and anti-double-stranded DNA (dsDNA), and anti-histone, and anti-nucleosome, and systemic lupus erythematosus disease activity index (SLEDAI) was analyzed respectively. The same tests were conducted for the level of NE. The results of the two groups were compared using analysis of variance and the relevance was analyzed using Spearman correlation analysis. NETs morphosis was observated by immunoflurescence method, and the difference of NETs between SLE group and control group was analyzed. Results ① The fluorescence intensity of NETs was significantly increased in SLE group(241±139) than that in the control group (173±135), (t=2.31, P0.05] and NE concentration [(104±43) vs (96±48), t=0.50, P>0.05] between SLE active stage and stable stage was detected. ③ The fluorescence intensity of NETs in SLE patients was positively correlated with SLEDAI, but had no obvious correlation with anti-dsDNA, anti-histone, anti-nucleosome, CRP or ESR, respectively. ④Images under confocal microscope showed that more NETs generated by PMN from SLE patients than that from controls. Conclusion The generation of NETs is enhanced in female patients with SLE. And NETs may relate to disease activity. However, NETs may not induce the production of autoantibodies.

Effect of autologous platelet-rich gel on the treatment of diabetic foot ulcers / 西安交通大学学报(医学版)

Objective To evaluate the effectiveness of autologous platelet-rich gel (APG)in the repair of diabetic foot ulcers.Methods This study was a single-center,prospective,randomized controlled trial.A total of 60 patients with diabetic foot ulcers (Wagner grade 2 - 3 )were randomly divided into autologous APG group (treatment group)and recombinant bovine basic fibroblast growth factor gel group (control group).After 8 weeks, we compared wound healing rate and wound healing time at five levels (overall ulcer,superficial ulcer,sinus ulcer, Wagner 2 and Wagner 3)in the two groups.Results In APG treatment group and control group,the healing rate of overall sample ulcer (93.33% vs .63.33%,P =0.005),sinus ulcer (84.62% vs .36.36%,P =0.033),Wagner 3 (81.82% vs .30%,P =0.030)differed significantly,but did not significantly differ in superficial ulcer (100%vs .78.95%,P =0.106)or Wagner 2 (100% vs .80%,P =0.106).Ulcer healing time was 31 d vs .41.5 d,23 d vs .32 d,32 d vs .56 d,25 d vs .32 d,38 d vs .56 d,with significant difference between the two groups (P <0.05). Conclusion Autologous platelet-rich gel can effectively increase the curative rate of diabetic foot and shorten healing time.

The analysis on dynamic change and severity of IL-1 beta, TNF alpha, cox-2 detected by automatic enzyme immunoassay analyzer on patients with acute gout / 中国医学装备

Objective:To analyze dynamic change and severity of IL-1 beta, TNF alpha, COX-2 detected by automatic enzyme immunoassay analyzer on patients with acute gout.Methods: Ninety cases of acute gout patients selected according to the different degrees of severity, and were divided into three observed groups. Thirty health people were treated as the control group. IL-1β, TNF-α, COX-2 levels of dynamic change were recorded and compared within the four groups of patients.Results: The serum IL-1β, TNF-α, COX-2 levels in the 1st, 3rd, 7th, 10th day in the observation group 1 and group 2 in acute gout attacks were significantly higher than the control group; The serum levels of IL-1β, TNF-α, COX-2 levels in the 7th 10th day in observation group 1 in acute gout was significantly higher than observation group 2; The serum IL-1β, TNF-α,COX-2 levels in observation group 3 have not significant difference with control group 2; The serum IL-1β, TNF-α, COX-2 levels in observation group1,2,3 in acute gout attacks in the 14th days have not significant difference with control group.Conclusion: After analgesic drugs for the treatment of acute gout patients from 10 to 14 days, the inflammatory cytokines can be completely back to normal. The results provided important evidence for the introduction of analgesic drugs in patients with acute gout treatment.

Supra-molecular assembly and magnetic targeted slow-release effect of "dextran-magnetic layered double hydroxide-fluorouracil" drug delivery system / 药学学报

The drug-loading system of DMF (dextran - magnetic layered double hydroxide - fluorouracil) was synthesized by "co-precipitation intercalated assembly - dextran composite in situ - solvent conversion" technology. The crystal-phase characteristic and slow-release performance of DMF were investigated through X-ray diffraction (XRD), infrared spectrum (IR), transmission electron microscopy (TEM), thermogravimetry (TG) and in vitro release experiment. The targeted transshipment and slow-release effect of DMF system were evaluated by in vivo animal experiment. It was showed that the XRD of DMF matched with R-sixtetragonum type layered double hydroxide and Fd-3m cubic type ferrite. IR test demonstrated that the DMF system was a supra-molecular complex consisted of Dextran (DET), magnetic layered double hydroxide (MLDH) and fluorouracil (FU) components. The two-level supra-molecular MLDH-FU presented six-edge lozenge TEM morphology, with layered characteristics. DET on the surface of DMF was capable of protecting the layered structure of MLDH-FU, improving particle dispersion properties, and strengthening the slow-release performance of the drug delivery system. The drug release model of DMF at pH 7.35 of PBS in vitro fit to the zero-order kinetics equation C = 1.1716 x 10(-5) + 4.4626 x 10(-7) t. The drug delivery system DMF could transport drugs principally to in vivo target organs with a local effect, targeted specificity, and excellent circulation transshipment performance. The pharmacokinetic process of DMF presented multi-peak phenomenon with peak attenuation and cyclic growth. The peaks appeared at 0.25, 1, 3, 5 and 9 d separately after dosing intervention. The first peak process of DMF accorded with a pharmacokinetic equation of C(FU) = 14.34 e(-0.530t) + 36.04 e(-0.321t) + 24.18 e(-0.96t), and presented the characteristic of slow absorption and fast elimination. As for subsequent peak processes, half-life increased, bioavailability increased, and plasma clearance decreased. The highest peak value of DMF was 1/37 of original value of FU, and the relative bioavailability was 419% to original FU.

Application of humanistic nursing care for patients with esophageal cancer / 中国实用护理杂志

Objective To explore the humanistic care in the treatment of esophageal cancer patients, reducing surgery anxiety,fear,eliminate the negative psychology,reduce complications and promote early recovery.Methods We continuously strengthened the ideological education of nurses in our hospital and gave psychological preoperative care and enthusiastic postoperative care to 76 esophageal cancer patients since November 2008.then the nursing effect was observed.Results 74 cases(97.37%) surgery patients did not suffer a variety of complications due to emotional tension and fear,they kept quiet and stable vital signs during the operation.Postoperative follow-up showed 75 patients(98.68%) were satisfied with the service.Conclusions Application of humanistic care in patients with esophageal cancer throughout the nursing process can make patients feel the warmth of human caring,so as to reduce anxiety,fear and take the initiative with the operation.It is crucial for the entire success of the operation.