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Platelets not only have hemostatic function, but can also directly or indirectly recognize pathogenic microorganisms and the signals they produce to capture and destroy them through membrane receptors. They can collaborate with various components of the body's immune system by releasing of intraplatelet particulate matter, cytokines and chemokines to perform bactericidal functions. And it can also play a bactericidal role by swallowing pathogens, releasing antimicrobial proteins and chemokines and activating and enhancing other specialized anti-inflammatory cells bactericidal effect, such as leukocytes and so on. However, the bacteriostatic composition and bacteriostatic mechanism of platelets remain unclear, so attention should be paid to the immune mechanism and bacteriostatic effect of platelets.
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Plaquetas , Antibacterianos/farmacologia , Citocinas , Leucócitos , Material ParticuladoRESUMO
Objective:To compare the cost-effectiveness of hospitalized Chinese patients undergoing nucleic acid screening strategies for hepatitis B and hepatitis C, immunological screening strategy, and no screening strategy under different willingness to pay (WTP). The results might aid to decision-making for the optimal strategy.Methods:In this study, nucleic acid screening, immunological screening and no screening were used as screening strategies, and China′s GDP in 2021 (80 976 yuan) was used as the threshold of WTP to construct a Markov model. After introducing parameters related to the diagnosis and treatment of hepatitis B and C in inpatients, a cohort population of 100 000 inpatients was simulated by TreeAge Pro 2021 software, the total cost, total health effects, incremental cost-effectiveness ratio and average cost-effectiveness ratio of different screening strategies were calculated, and cost-effectiveness analysis was conducted. Univariate and probabilistic sensitivity analysis were used to assess the impact of parameter uncertainty on the final results.Results:Compared with the non-screening strategy, the incremental total cost of the hepatitis B immunological screening strategy for cohort patients was 11 049 536 yuan, and the incremental cost-effectiveness ratio was 24 762 yuan/quality-adjusted life years (QALY), while the total incremental cost of nucleic acid screening was 19 208 059 yuan, and the incremental cost-effectiveness ratio was 29 873 yuan/QALY; the incremental cost-effectiveness ratio of nucleic acid screening and immunological screening was 45 834 yuan/QALY. Compared with the non-screening strategy, the incremental cost-effectiveness ratio of hepatitis C immunological screening strategy was 5 731 yuan/QALY, the incremental cost-effectiveness ratio of nucleic acid screening strategy was 8 722 yuan/QALY, the incremental cost-effectiveness ratio of nucleic acid screening and immunological screening was 45 591 yuan/QALY. The results of probabilistic sensitivity analysis showed that when the cost of nucleic acid testing exceeded 214.53 yuan, it was not cost-effective to perform hepatitis B nucleic acid screening under the WTP as 1 fold GDP. When the cost of nucleic acid testing exceeded 132.18 yuan, it was not cost-effective to conduct hepatitis C screening under the WTP as 1 fold GDP.Conclusions:Nucleic acid screening strategy can achieve more cost-effectiveness and is worthy of vigorous promotion. Compared with no screening, both the nucleic acid and immunological screening strategies are cost-effective, and hepatitis nucleic acid screening is the optimal strategy for hospitalized patients.
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Objective:To evaluate the relationship between hemoglobin(Hb) level and the risk of diabetic retinopathy(DR) in patients with type 2 diabetes mellitus(T2DM).Methods:This study was a prospective cohort study. A total of 1 730 T2DM patients without DR, who received regular management at the Li′s Clinic in Taiwan, China starting from 2002, were selected as the study population. All patients underwent annual dilated fundus examination by professional ophthalmologists. General patient information and laboratory results were collected and analyzed. Based on the occurrence of DR during patient follow-up, patients were divided into the DR group and the non-DR(NDR) group. The impact of Hb levels on DR was explored using a generalized linear mixed model, and the relationship between Hb levels and DR was studied using Cox proportional hazards regression model.Results:After an average follow-up of 9.79 years, 481 patients with DR were detected. Compared with NDR group, DR group displayed a longer course of diabetes, higher rates of cataract, insulin use, and anemia, and higher systolic blood pressure, HbA 1C, and UACR as well as lower Hb. The results of the generalized linear mixed model showed a negative correlation between Hb and the occurrence of DR( β=-0.015, P<0.001). The Cox proportional hazards regression model showed that, after adjusting for confounding variables and based on quartiles of average Hb levels during follow-up, the risk of developing DR increased by 56.9% in the Q1 group(Hb≤127 g/L) compared to the Q4 group(Hb≥142 g/L). The cumulative risk plot showed that, after adjusting for confounding variables, the Q1 group had the highest cumulative risk of developing DR, and the difference was statistically significant( P<0.05). Conclusion:Hb was negatively correlated with DR, and the lower Hb levels were associated with the occurrence of DR, independent of other influencing factors.
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Dandy-Walker syndrome is one of the posterior fossa malformations, which is easily confused with arachnoid cyst or cerebellar dysplasia in clinical practice, leading to misdiagnosis. Dandy-Walker syndrome is easy to be combined with hydrocephalus, resulting in increased intracranial pressure, increased head circumference, growth retardation, spastic hemiplegia and other manifestations, and can also be accompanied by other nervous system malformations. On February 27, 2021, a child with Dandy-Walker syndrome with growth retardation as the primary manifestation was admitted to Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine. After multiple surgical treatment, the child's hydrocephalus was significantly improved. Through the analysis of the clinical data of the child's operation and the treatment of complications, it is helpful to improve the clinicians' understanding of the surgical treatment of the disease.
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Objective To investigate the value of S100β protein and electroencephalogram ( EEG) in cerebral function monitoring of critically ill children. Methods Sixty critically ill children admitted in our department from September 2014 to December 2016,were divided into 2 groups according to pediatric critical illness score ( PCIS) ,30 cases in critical group ( PCIS≤80 scores) and 30 cases of non critical group ( PCIS>80 scores) . Serum samples were collected from the 60 cases at 24 h,72 h and 1 week after admission, respectively. The serum S100β protein and EEG were dynamically monitored on 3 time points. ELISA was used to test the content of S100βprotein of collected samples. Results There was no statistically significant difference in gender and age between critical group and non critical group[ male/female:22/8 vs. 21/9;age:(3. 68 ± 1. 37)years vs. (2. 52 ± 0. 86)years,P>0. 05]. The glasgow score of critical group was lower than that of non critical group(8. 67 ± 1. 83 vs. 13. 05 ± 2. 94,P<0. 05). Serum S100βprotein contents of critical group were(112. 55 ± 29. 20)μg/L,(120. 86 ± 17. 10)μg/L,and (279. 82 ± 28. 80)μg/L) at 24 h,72 h and 1 week respectively, which were obviously higher than those of non cricical group [ ( 0. 51 ± 0. 06 )μg/L, (0. 32 ± 0. 03)μg/L,(0. 34 ± 0. 05)μg/L](P<0. 05). Meanwhile,the abnormal rate of EEG monitoring of critical group were 19 cases ( 63. 3％) , 18 cases ( 60. 0％) , 20 cases ( 66. 7％) at 24 hours, 72 hours and 1 week respectively,which were also obviously higher than those of non critical group [ 9 cases ( 30. 0％) , 7 cases(23. 3％),6 cases(20. 0％)](P<0. 05). Conclusion Both serum S100β protein and dynamically EEG monitoring contribute to detect the status of cerebral injury in early stage, with significant value in cerebral function monitoring of critically ill children.
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ObjectiveTo compare the efficacy and safety of oxaliplatin combined with tegafur and calcium folinate with FOLFOX4 regimens on patients with advanced gastric cancer.Methods120 patients with advanced gastric cancer were randomly divided into two groups. concluding 60 cases in observation group (modified group)treated with oxaliplatin combined with tegafur and leucovorin and 60 cases in control group (FOLFOX4 group)treated with oxaliplatin combined with calcium folinate and fluorouracil.Clinical efficacy was evaluated after 2 (3-6) cycles. ResultsThe clinical efficacy rates of observation group and control group were 63.3 ％ (38/60) and 41.7 ％ (25/60), respectively (x2 =5.647, P =0.028). The median progression-free survival and median overall survival of patients in observation group were 7.7 months and 11.6 months,respectively,and those in control group were 7.3 months and 10.1 months,respectively.The median progression-free survival(P =0.032)and median overall survival(P =0.005)were statistically significant differences.The increased ratio of Karnofsky score of patients in observation group was higher than that in control group(P =0.015).The incidence of myelosuppression in observation group was lower than that in control group (P =0.044). There was no significant difference between the two groups on other adverse reaction rates. ConclusionThe efficacy and safety of oxaliplatin plus tegafur and leucovorin in the treatment of advanced gastric cancer is superior to FOLFOX4 regimen, and worthy of clinical application.
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Objective. To observe the effect of chemotherapy on hepatic function of lymphoma patients with chronic HBV infection. Methods; We used ELISA to detect the serum markers, of HBV and liver function in 207 lymphoma patients and 207 patients with other types of cancer (except pdmary hepatocellular cacinoma). Results: The incidence of HBV infection was higher in lymphoma cancer cases than that in the controlled cases (19.8% vs 9.7%, P=0.004). The incidence of abnormal liver function was higher in lymphoma patients with positive HBsAg than in lymphoma patients without HBsAg (58.5% vs 27.7%, P=0.000). The incidence of ab-normal liver function in lymphoma patients with postive HBsAg was higher than that in patients with other types of cancer with positive HBsAg (58.5 vs 30.0%, P=0.036). The abnormal liver function in lymphoma patients after chemotherapy was associated with HBV infection (P=0.000) but not correlated with age, sex, histological subtype, immune subtype, stage, ECOG PS, and hormone administration. Conclusion: Lymphoma patients with HBV are more likely to have liver function damage after emotherapy.