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Objective:To investigate the risk factors of diabetes mellitus complicated by pulmonary tuberculosis.Methods:The clinical data of 83 patients with diabetes mellitus complicated by pulmonary tuberculosis who received treatment in Taiyuan Fourth People's Hospital from March 2020 to March 2022 were collected. These patients were divided into sensitive group ( n = 45) and resistant group ( n = 38 ) according to the results of drug sensitivity test. Univariate and multivariate non-conditional logistic regression was performed to analyze the influential factors of drug resistance. Results:Univariate logistic regression results revealed that there were significant differences in blood CD4 +T lymphocyte count ( χ2 = 11.73, P = 0.001) and diabetic complications ( χ2 = 4.94, P = 0.026). Multivariate non-conditional logistic regression analysis was performed taking whether blood CD4 +T lymphocyte count was lower than the average level and whether patients with diabetes mellitus had complications as independent variables, and taking whether drug resistance was a dependent variable. The results showed that the OR (95% CI) value of the decreased blood CD4 +T lymphocyte count was 4.909 (1.926-12.514). It is a risk factor for drug resistance of diabetes mellitus complicated by pulmonary tuberculosis. Conclusion:The decrease of blood CD4 +T lymphocyte count is a risk factor of drug resistance in diabetes mellitus complicated by pulmonary tuberculosis, and it should be intervened early in the clinic.
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Objective:To retrospectively assess early risk factor of persistent inflammation, immunosuppression and catabolism syndrome (PICS) in patients with severe polytrauma, in order to deepen the understanding of the pathological changes of chronic critical illness (CCI) after severe polytrauma.Methods:A total of 276 patients with severe polytrauma admitted to Department of Trauma Surgery of Tongji Hospital from March 2019 to December 2020 were enrolled. Inclusion criteria included patients who suffered severe polytrauma, and injury severity score (ISS) ≥27, age ≥18 years old, and had length of hospital stay >15 days. Exclusion criteria included previous medical history of malignancy, or immunological, consumptive, and metabolic diseases. The patient’s clinical characteristics, ISS scores, Glasgow coma scale (GCS), sequential organ failure assessment, APACHEⅡ scores, and nutrition and immune indexes on day 3 after injury were collected. The difference between the PICS group and N-PICS group were performed by Student’s t test, χ2 test or Mann-Whitney U test. The early risk factors were assessed in patients with PICS after severe polytrauma by logistic regression analysis. Results:According to the diagnostic criteria of PICS, all enrolled patients were divided into two groups: PICS group ( n=102) and N-PICS group (without PICS, n=174). Compared with the N-PICS group, patients in the PICS group were older and associated with more brain and chest injuries. On the third day after injury, serum levels of IL-6 and IL-10, and the ratio of Treg cells were significantly higher, the number and ratio of NK cells subset, and the ratio of activated T lymphocyte were significantly lower in the PICS group than in the N-PICS group ( P<0.05). Logistic regression analysis showed that the age>65 years old ( OR=2.375, 95% CI: 1.442-4.531), GCS ≤8 scores ( OR=3.431, 95% CI: 1.843-8.512), IL-10 >10 pg/mL ( OR=2.173, 95% CI: 1.751-5.614), the ratio of Treg cells >7% ( OR=3.871, 95% CI: 1.723-6.312), and the occurrence of traumatic brain and chest injuries ( OR=2.846, 95% CI: 1.522-5.361) were the early risk factors in patients with PICS after severe polytrauma. Conclusions:Age>65 years old, GCS score, IL-10, the ratio of Treg cells, and the occurrence of traumatic brain and chest injuries could be used as the early risk factors in patients with PICS after severe polytrauma. The discovery of early risk factors will help identify patients at high risk of PICS after severe polytrauma, and create the possibility for early intervention.
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Objective:To prospectively assess clinical characteristics, potential causes and prognosis in patients with persistent inflammation, immunosuppression and catabolism syndrome (PICS) after polytrauma.Methods:Totally 1 083 patients with polytrauma admitted to Department of Traumatic Surgery of Tongji Hospital from Janury 2019 to July 2020 were enrolled. Exclusion criteria included age<18 years old, length of hospital stay<15 days, previous medical history of malignancy, or immunological, consumptive, and metabolic diseases. According to the diagnostic criteria of PICS, all enrolled patients were divided into two groups: PICS group and N-PICS group (without PICS). The patient’s clinical characteristics, ISS score, GCS score, SOFA score, and prognosis were collected. The χ2 test or Student’s t test was uesd to compare the difference between the PICS group and N-PICS group. Results:The incidence of PICS in patients with polytrauma was 11.7% (127/1 083). The majority of PICS patients were middle-aged and elderly men, 68.5% with traumatic brain injury and 59% with thoracic injury. GCS score was significantly lower, while ISS, APACHE II and SOFA scores were significantly higher in the PICS group than in the N-PICS group ( P<0.01, P<0.05). Among PICS patients, 79.5% were treated with mechanical ventilation and 76.3% were associated with pulmonary infection, with a 28-day mortality of 5.5% and a 180-day mortality of 16.5%, which were siginifcantly different from those without PICS. Conclusions:PICS has a high incidence after polytrauma and is commonly seen in middle-aged and elderly male patients with severe polytrauma, especially accompanied by traumatic brain injury or/and thoracic injury. Patients with PICS after polytrauma have poor long-term prognosis, so early identification and intervention should be strengthened in clinical practice.
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Objective:To retrospectively assess the relationship between immune disorder and acute gastrointestinal injury (AGI) in patients after severe polytrauma.Methods:Totally 205 patients with severe polytrauma admitted to Tongji Hospital from April 2018 to October 2019 were enrolled as the observation group, and 23 healthy volunteers were served as the control group. According to the diagnostic criteria of AGI, all patients were divided into the AGI group (with AGI) or N-AGI group (without AGI), AGI patients were divided into the S-AGI group or L-AGI group according to the severity. The levels of cytokines and lymphocyte subset were evaluated at day 1, 7, and 14 after severe polytrauma. The differences between groups were statistically analyzed. The independent risk factors of AGI were analyzed by Logistic regression analyzed.Results:Totally 79.5% (163/205) of patients with severe polytrauma were accompanied by AGI. There were significant differences in the ratio of Tc, Th at day 1 after trauma, the levels of IL-6, TNF-α, IL-8, IL-10, the ratio of Ts, Th/Ts, Treg at day 7 after trauma, and the levels of IL-8, IL-10,the ratio of Ts, Th/Ts, Treg at day 14 after trauma between the AGI group and N-AGI group ( P<0.05). There were significant differences in the ratio of Tc, Th, the levels of IL-6, TNF-α at day 1 after trauma and the ratio of Ts, Th/Ts, Treg, the levels of IL-8, IL-10 at day 7 and 14 after trauma between the S-AGI group and L-AGI group ( P<0.05). Logistic regression analysis showed that Ts 7 d ( OR=2.018, 95% CI: 1.105-5.364, P=0.013), Treg 14 d ( OR=3.612, 95% CI: 1.375-8.476, P=0.006), IL-6 7 d ( OR=1.824, 95% CI: 1.011-5.835, P=0.024), IL-10 14 d ( OR=2.847, 95% CI: 1.241-6.216, P=0.014), TNF-α 7 d ( OR=1.754, 95% CI: 1.215-5.441, P=0.018) were independent risk factors in patients with AGI after severe polytrauma. Conclusions:AGI is more easily occurred in patients with the heavier immune disorders after severe polytrauma. AGI can also aggravate pre-existing immune disorders in patients after severe polytrauma.
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Objective:To retrospectively assess the occurrence and risk factors in patients with acute gastrointestinal injury (AGI) after polytrauma.Methods:Totally 430 patients with polytrauma admitted to Tongji Hospital from April 2018 to October 2019 were enrolled as the observation group. According to the diagnostic criteria of AGI, all patients were divided into the AGI group (with AGI) or N-AGI group (without AGI). The patients with abdominal injury or previously suffered from gastrointestinal disease were excluded. The patient's clinical characteristics lab tests results, and the first ISS, APACHEⅡ, SOFA and GCS scores were collected. The differences between different groups were statistically analyzed. The independent risk factors of AGI were analyzed by Logistic regression.Results:65.3% of patients with polytrauma were accompanied by AGI (281/430 cases).There were significant differences between the AGI group and N-AGI group in ISS, GCS, APACHE Ⅱ and SOFA score, PCT or IL-6 level, shock index and length of stay in ICU ( P<0.05). Logistic regression analysis showed that shock, ISS≥16, APACHE Ⅱ≥16, SOFA≥5, GCS≤8 and IL-6>50 pg/mL were the early independent risk factors in patients with ACI after polytrauma. Conclusion:The incidence of AGI in patients after polytrauma is higher, which is related to ischemia, hypoxia, abnormal blood coagulation and stress in the early stage after trauma.
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Objective To develop a multi-mode,detailed and sensitive object recognition method for learning and memory research,including novel object recognition task,object location recognition task,temporal order memory task and object context recognition task in animals based on their spontaneous behavior. Methods Two strains of mice(KM and ICR)and four patterns were used to establish the object recognition method and several relative factors,such as time of test phase,delay between test phase and familiar phase were investigated. Results It was stable and reasonable to set the time of familiar phase as 5 min,the interval between test phase and familiar phase as 10 min,and the time of test phase as 3-5 min,under the precondition of habituation for three days and selecting the appropriate object pairs. Conclusions Object recognition test including four patterns has been systematically established as a stable, reliable and normative way for the research of animal learning and memory and drug development.
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Objective To study the effects of different color light stimulus, duration of stimulus and day/night training on the incentive conditioned reflex of rats,and to provide a data basis for the methodology of incentive conditional reflection experiments. Methods Three experiments were included in this study. During the experiment 1, a total of 30 male 8-week-old Wistar rats were divided into three groups:red light stimulation group,yellow light stimulation group and blue light stimulation group. During the experiment 2, a total of 32 male 8-week-old Wistar rats were divided into three groups:the group I(with a light stimulation duration of 10 s), the group II(with a light stimulation duration of 30 s), and the group III(with a light stimulation duration of 60 s). During the experiment 3,a total of 16 male 8-week-old Wistar rats were randomly divided into two groups,of which the first group was trained at 9:00 a.m. every day, and the second group was trained at 21:00 every day. All the laboratory animals were given reward conditioned reflex training, and indicators such as the number of correct nose pokes,the number of incorrect nose pokes,the ratio of correct nose pokes and so on were counted and calculated. Results During the experiment 1,there was no significant difference in the numbers of correct nose pokes and incorrect nose pokes,movement distances and average speeds of the rats among the three groups. During the experiment 2,compared with the group with a light duration of 10 s,the rats in the groups with a light duration of 30 s or 60 s had a higher number of correct nose pokes(P< 0.05). Moreover,on the 13th and 14th days,the ratio of correct nose pokes of the group with a light duration of 30 s was significantly higher than that of the group with a light duration of 10 s(P< 0.001). During the experiment 3,there were no significant differences in the number of correct nose pokes and the nose poke accuracy of the rats between the two groups. Conclusions In the reward conditioned reflex test, red,yellow and blue light stimuli have similar reward prediction effect. When stimulated with the same light, the time of stimulation has an impact on the learning ability of the rats,and an appropriate extension of stimulation is beneficial to the formation of conditioned reflex in them. The day/night training has no effect on the learning and memory ability of the rats.
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Objective To investigate the relationship between different brain developmental stages and changes of cognitive function in rats. Methods 1-month, 2-month and 8-month-old rats were selected to imitate the juvenile, adolescent and adulthood, respectively, and their behavioral functions were compared. The reward operant conditioning and Morris water maze task were used to investigate the differences in exploration interest, executive and recognition ability, spatial learning and memory of the rats at different ages. Results In the reward operant conditioning and Morris water maze task, there was no significant difference in the cognitive function between 1-month and 2-month-old rats. In the reward conditioning phase, the nose pokes numbers of 8-month-old rats were significantly decreased compared with the 1-month-old rats (P＜ 0. 01). There was no significant difference in nose pokes accuracy. During the operant conditioning phase, the lever press numbers and accuracy of 8-month-old rats were significantly decreased ( P ＜ 0. 05 or P ＜ 0. 01) and the press latency was longer (P ＜ 0. 05). At the phase of visual identification, the press and reward numbers, and the visual identification index were significantly decreased ( P ＜ 0. 05 or P ＜ 0. 01). In the Morris water maze test, compared with the 1-month-old rats, the total swimming distance and escape latency of the 8-month-old rats were significantly increased (P＜ 0. 05), as well as average swimming speed ( P ＜ 0. 05 or P ＜ 0. 01) in spatial learning phage. In spatial memory phage, the swimming distance and time spent in the target quadrant were obviously decreased (P＜ 0. 01). Conclusions The cognitive functions of rats at different brain developmental stages are different. The juvenile and adolescent rats have similar cognitive functions, but 8-month-old adult rats appear decline in the exploration interest, executive and recognition ability, and spatial learning and memory function.
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Objective To investigate the effects of surgery combined with immunochemotherapy on peripheral blood T lymphocyte subsets and C -reactive protein ( CRP) in patients with single renal cell carcinoma.Methods From June 2015 to June 2017,ninety patients with single-renal clear cell carcinoma who underwent radical resection of kidney in the Fourth Affiliated Hospital of China Medical University were selected ,and they were confirmed by preoperative ultrasound,CT and MRI diagnosis of unilateral renal space -occupying lesions.All patients were treated with kidney cancer immunochemotherapy.The peripheral blood T lymphocyte subsets and the changes of CRP levels of the patients before and after operation and after immunochemotherapy were observed.Results The CRP level of peripheral blood before operation was (9.12 ±4.98)μg/L,which after operationwas (28.29 ±10.23)μg/L,which after immunochemotherapy was (2.34 ±0.97)μg/L,the CRP level of peripheral blood after operation was higher than that before operation ,and the CRP level after immunochemotherapy was lower than that before surgery ,the difference was statistically significant ( F ＝6.78, P ＜0.05).The CD+3, CD+3CD+8,CD+4/CD+8levels before operation were (59.78 ±5.50)%,(34.56 ±6.23)%,(1.05 ±0.58)%,respectively,which after operation were (68.91 ± 7.49)%,(33.60 ±7.59)%,(0.98 ±0.76)%,respectively,which after immunochemotherapy were (62.31 ± 5.90)%,(21.90 ±4.55)%,(1.90 ±0.34)%,respectively.The CD+3level after operation was significantly higher than that before operation and after immunochemotherapy ,and the CD +3CD+8levels after immunochemotherapy were significantly lower than that before and after operation , and the CD +4/CD+8level after immunochemotherapy was significantly higher than that before and after operation ,the differences were statistically significant (F＝6.98,8.12, 7.23,all P＜0.05).Conclusion The immunochemotherapy can improve the expression level of peripheral blood T lymphocyte subgroup and CRP in patients with single -renal clear cell carcinoma who underwent radical resection of kidney,which can provide a reasonable basis for diagnosis and treatment of renal carcinoma .
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Objective To investigate the clinicopathological characteristics, diagnosis and treatment of huge adrenal tumor.Methods Retrospectively analysed the clinical data of the 2 patients with huge adrenal tumor more than 10 cm in diameter, who were admitted in our hospital from September 2013 to January 2015.Clinical manifestations, treatment and prognosis were evaluated.Results Two patients were both suspected of adrenocortical carcinomas.Case 1 was a 28-year-old female.Laparoscopic surgery was performed at first but was conversed to open palliative adrenalectomy due to tumor rupture and bleeding.The postoperative pathology was adrenocortical carcinoma.The patient died of gastrointestinal bleeding caused by tumor metastasis 10 months later.Case 2 was a 39-year-old female, who underwent laparoscopic adrenolectomy with tumor excision completely.The postoperative pathology showed neoplasm of malignant potential, and no tumor recurred in 15 months follow-up.ConclusionsOpen surgery should be the priority if the diameter of adrenal tumor is more than 10 cm and diagnosis as suspicious of malignancy.Huge adrenocortical carcinoma is related to poor therapeutic response,and multimodality therapy may improve the prognosis.
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Objective To test the expression of serine/arginine rich splicing factor 1(SRSF1)and apoptosis inhibiting factor(Survivin) in prostate cancer,and study their correlation with the pathological features of prostate cancer,so as to put forward the new targets in the treatment of prostate cancer. Methods SRSF1 and Survivin protein was determined in 20 prostate tissue samples including prostate cancer(n=12)and benign prostat?ic hyperplasia(n=8)by immunohistochemical SP method. SRSF1 and Survivin was correlated to pathological features,and both the relevance was analyzed(no related reports at home and abroad). Results The positive expression rate of SRSF1 protein in prostate cancer tissue cells was 76.37± 5.06%,which was significantly higher than that of benign prostatic hyperplasia(11.30%±1.09%,P<0.05);the positive expression rate of Survivin protein in prostate cancer tissue cells was 86.93%±3.21%,which was significantly higher than that of benign prostatic hyperplasia(17.67%±1.99%, P<0.05);SRSF1 and Survivin protein expressed in prostate cancer organizations and were positively correlated to pathological Gleason grading, and there was significant correlation(P<0.05). Conclusion SRSF1 and Survivin protein were highly expressed in adenocarcinoma tissue,which were significantly increased than that of benign hyperplasia of prostate tissue. The positive expression SRSF1 and Survivin protein were positively cor?related to pathological Gleason grading.The expression of Survivin protein was elevated with the expression of SRSF1 protein in prostate cancer. These preliminary evidence indicated that SRSF1 may up?regulate the expression of Survivin,and thus promote the occurrence and development of prostate cancer.
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Objective To investigate the correlation between body mass index (BMI)and early graft function.Methods Clinical data of 133 recipients underwent renal allograft transplantation in the Department of Nephropathy of the First Affiliated Hospital of Xinjiang Medical University from November 2003 to November 2014 were retrospectively studied.According to BMI before transplantation,the recipients were divided into 3 groups:emaciation group (BMI < 18.5 kg/m2 ),normal weight group (BMI of 18.5-23.9 kg/m2 )and overweight group (BMI >23.9 kg/m2 ).The laboratory indexes [blood urea nitrogen (BUN),serum creatinine (Scr),hemoglobin,serum albumin,total cholesterol and triglyceride]and the incidence of delayed graft function at 1 week after transplantation were compared among three groups.The correlation between Scr and BMI was analyzed.Results There was significant difference in Scr level among three groups (P <0.05).In pairwise comparison,Scr level of the overweight group was higher than that of the normal weight group and the difference had statistical significance (Z =-3.408,P =0.01 ).The hemoglobin,serum albumin and total cholesterol of the three groups showed no difference with statistical significance (all in P >0.05).The Scr level of renal transplant recipients was positively correlated with BMI (r =0.187,P =0.031),and Scr level raised with the increase of BMI.Conclusions BMI influences the recovery of early graft function.To control body weight before transplantation is beneficial to improve graft function.
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Background and purpose:Laparoscopic partial nephrectomy has been one of the surgery options for patients with single renal carcinoma of T1 stage. Under the effect of some factors, intraoperative renal blood lfow clamping somtimes exceeds the safe limit of 30 minutes of warm ischemia time (WIT) for renal tissues, that might results in warm ischemia-reperfusion injury to severe extent. However, there still remains controversy about the depth of this warm ischemia-reperfusion injury. So this study aimed to evaluate the effects of longer WIT on ipsilateral residual renal tissues. Methods:Forty-four patients underwent retroperitoneal laparoscopic partial nephrectomy from Jan. 2012 to Jan. 2014. All of them were divided into observe group (WIT>30 min) and control group (WIT≤30 min). The differences of glomerular filtration rate (GFR) of operative kidney Pre- and post-operatively between two groups were analyzed. Results: The pre- and post-operative GFRs of operative kidney in observe group were 29.3-53.0 mL/min[(33.1±5.2) mL/min], 23.1-40.5 mL/min[(27.3±5.9) mL/min] respectively (P=0.054). The pre-and post-operative GFRs of operative kidney in control group were 27.4-49.6 mL/min[(32.3±4.1) mL/min], 23.8-44.4 mL/min[(29.1±5.0) mL/min], respectively (P=0.07). There was no statistically differences of the depth of the decrease of GFRs after surgery between the two groups (P=0.051). Conclusion: WIT of 30-60 min does not result in statistically signiifcant injury for ipsilateral residual renal function. However, it is still necessary to reserve more ipsilateral residual renal function through minimizing WIT under the premise of ensuring the safety of surgery.
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Objective To investigate the level of thyroid hormone in Xinjiang Uygur and Han old people with mild cognitive dysfunction (MCI),and to provide basis for early intervention of MCI.Methods Case control study was carried out among 5398 residents who was above 60 years old in Xinjiang,Han and Uyghur,from July 2008 to October 2010.According to the diagnosis of MCI by American Psychiatric Society and DSM-Ⅳ,314 patients were diagnosed with MCI matching 299 healthy people as control group.Serum T3 (triiodothyronine),T4 (thyroxine) and TSH (thyroid stimulating hormone) level was determined and compared between control group and MCI group with different nationalities and genders SPSS 17.0 statistical software was used to depict median and quartile of the data,two groups of distribution between the location of the median use Wilcoxon compares the rank of testing and analysis.Results (1) the level of serum T3 in MCI group was lower than that of the control group (1.26 μg/L vs.1.28 μg/L,Z=2.41,P＜0.05),serum TSH level of MCI group was 5.37 mIU/L higher than that of the control group (Z =4.13,P ＜ 0.05).(2) Male serum TSH level of MCI was 5.74 mIU/L higher than that of the control group (Z =5.09,P ＜ 0.05).Women serum T3 level of MCI was 1.29 μg/L lower than that of the control group 1.53 μg/L (Z =2.62,P ＜ 0.05).(3) Serum TSH level of MCI in Han nationality was 6.79 mIU/L higher than that of the control group (Z =4.95,P ＜ 0.05).Serum T3 level of MCI in Uygur nationality was 1.29 μg/L lower than those of the control group 1.39 μg/L (Z =2.58,P ＜0.05),and T4 level was 82.37 μg/L lower than that of the control group 92.71 μg/L (Z =4.28,P ＜ 0.05).(4) Uygur's T4 level was 82.3 μg/L,higher than the 42.12 μg/L in Han nationality (Z =9.83,P ＜ 0.05),level of TSH in Uygur with MCI was 6.79 lower than that of the Han nationality (Z =4.28,P ＜ 0.05).(5) The unconditional Logistic regression analysis showed hypertension,sugar metabolism disorders,hyperlipidemia,low level of T3 were independent risk factors for MCI (OR values were 2.014,2.466,2.096,0.470,respectively,95％ CI were 1.361-2.981,1.649-3.687,1.396-3.149,0.334-0.663,respectively,P ＜ 0.05).Conclusions (1) Thyroid hormone level in old people related to the occurrence of MCI ; (2)Aside recognized independent risk factors for MCI as hypertension,sugar metabolism disorders,hyperlipidemia,low T3 level may be one of the MCI independent risk factors.
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AIM: To investigate the mutation type in the IDUA gene of Liaoning district mucopolysaccharidosis I (MPS-I) patients. METHODS: The mutation type and polymorphism site in the IDUA gene of Liaoning district MPS-I patients were detected by PCR-RFLP, SSCP and DNA sequencing. RESULTS: ① There is a new mutation (1278-g-a) in the IDUA gene of Liaoning district MPS-I patients. ② There is no the common mutation (W402X and Q70X) of European patients and the common mutation (R89Q) of Japanese patients in the 10 families we studied. CONCLUSION: The mutation type in the IDUA gene of Liaoning district MPS-I patients is different from that of other countries and districts.