Efficacy of duplizumab in the treatment of multiple type 2 inflammatory diseases / 中国医师杂志

Objective:To analyze the therapeutic effect of adding interleukin (IL)-4Rα monoclonal antibody (duplizumab) to patients with multiple types of inflammatory diseases.Methods:Six patients with multiple types of inflammatory diseases who started to use duplizumab from August 2020 were enrolled. The changes of airway inflammation, lung function, sinuses computed tomography (CT), Asthma Control Questionnaire-5 (ACQ-5), Sino-Nasal Outcome Test-22 (SNOT-22), Pennsylvania Smell Identification Test (UPSIT) and Numerical Rating Scale (NRS) score before and after duplizumab treatment were retrospectively analyzed. All patients were treated with doprilumab for more than 5 months.Results:4 of the 6 patients had both severe asthma and chronic sinusitis, and 2 patients had both severe asthma, chronic sinusitis and atopic dermatitis. After treatment, the pulmonary function of 6 patients was improved, the levels of sputum eosinophils, exhaled nitric oxide and total IgE were decreased (all P<0.05), and the scores of paranasal sinus CT, ACQ-5, SNOT-22 and UPSIT were significantly improved (all P<0.05). However, 3 patients had increased peripheral blood eosinophils during the treatment. Conclusions:Duplizumab is effective for a variety of type 2 inflammatory diseases without obvious adverse reactions, and the peripheral eosinophils may increase during the treatment.

Potential therapeutic effects of dipyridamole in the severely ill patients with COVID-19

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can cause acute respiratory distress syndrome, hypercoagulability, hypertension, and multiorgan dysfunction. Effective antivirals with safe clinical profile are urgently needed to improve the overall prognosis. In an analysis of a randomly collected cohort of 124 patients with COVID-19, we found that hypercoagulability as indicated by elevated concentrations of D-dimers was associated with disease severity. By virtual screening of a U.S. FDA approved drug library, we identified an anticoagulation agent dipyridamole (DIP) , which suppressed SARS-CoV-2 replication . In a proof-of-concept trial involving 31 patients with COVID-19, DIP supplementation was associated with significantly decreased concentrations of D-dimers ( < 0.05), increased lymphocyte and platelet recovery in the circulation, and markedly improved clinical outcomes in comparison to the control patients. In particular, all 8 of the DIP-treated severely ill patients showed remarkable improvement: 7 patients (87.5%) achieved clinical cure and were discharged from the hospitals while the remaining 1 patient (12.5%) was in clinical remission.

Clinical analysis of 30 cases of Castleman disease with different types of thoracic involvement / 中华血液学杂志

Objective@#To improve the clinical understanding of Castleman disease (CD) with different types of thoracic involvement, including their clinical features, radiological and pathological findings, diagnosis and current treatment strategies.@*Methods@#Retrospective analysis of 30 patients diagnosed with CD with thoracic involvement and hospitalized between June 2009 and May 2019 in The First Affiliated Hospital of Guangzhou Medical University was performed. Patients were divided into three groups for subsequent analysis based on the clinical data: CD with bronchiolitis obliterans (BO) , unicentric Castleman disease (UCD) without BO, and multicentric Castleman disease (MCD) without BO.@*Results@#Among the 30 patients, there were 5 (16.7%) patients diagnosed with BO, 18 (60.0%) patients had UCD without BO and 7 (23.3%) patients had MCD without BO. The average age of MCD without BO patients was significantly older than that of BO and UCD without BO patients[ (49.29±5.39) ys vs (27.20±3.76) ys and (37.17±2.87) ys; P=0.005 and 0.034, respectively) ]. Pulmonary symptoms were commonly seen in BO group (100%) and MCD without BO group (71.4%) . while no pulmonary symptoms were seen in UCD without BO group. Key abnormal laboratory findings were erythrocyte sedimentation rate (ESR) increase (40%in BO group and 57.1% in MCD without BO group) and hypoxia (60% in BO group and 28.6% in MCD without BO group) . Other abnormal laboratory findings seen in MCD without BO group included anemia and IgG increase (both 57.1%) . Notably, all patients in BO group had extremely severe mixed ventilation dysfunction in the lung function test. CT scan showed lung parenchyma involvement in BO group (100%) , in UCD without BO group (11.1%) featured by solitary pulmonary nodule and in MCD without BO group (57.1%) featured by diffuse lesions in bilateral lungs. The size of lymph nodes was significantly smaller in MCD without BO group comparing to that in BO group and UCD without BO group[short diameter (1.83±0.51) cm vs (4.73±1.63) cm and (3.62±0.26) cm; P=0.006 and 0.011, respectively]. All patients (100%) in the BO group had a pathological type of transparent vascular variant while the same pathological type accounts for 88.9% in UCD without BO patients. The predominantly pathological type (57.1%) was plasma cell variant in the MCD without BO group. Oral ulcers presented in all patients in BO group but were relieved after the mass resection and immunomodulatory therapy, but the pulmonary symptoms were still progressively aggravated. Thoracoscopic mass excision was the main treatment for UCD without BO patients while chemotherapy, immunomodulatory and targeted therapy were commonly used for MCD without BO treatment.@*Conclusion@#The age, clinical symptom, laboratory finding, lung function, imaging manifestation, pathology, treatment and prognosis were different among the three groups. This classification could improve clinical understanding of the disease.

Premature complex-induced chronic cough :case report and literature review / 中华全科医师杂志

The clinical presentation,chest image and electrocardiogram of 4 cases of premature complex-induced chronic cough admitted in the First Affiliated Hospital of Guangzhou Medical University from March 2008 to February 2009,were retrospectively analyzed.And other 6 cases of premature complex-induced chronic cough were retrieved for literature review.In total 10 patients,there were 3 males and 7 females aged 58(36-74) years,with a disease duration of 10.5 (3.0,264.0) months.The main clinical presentations were chronic dry cough with post-sternal thump and premature beats as shown by auscultation and 24 h-electrocardiogram examination.Cough was relieved after the premature beats were controlled with the treatment of arrhythmia drugs or radiofrequency ablation.Premature complex-induced cough is rare but it should be considered when the chief complaint of patients with premature beat is chronic cough.

Clinical application of intra-abdominal exposure instruments in laparoendoscopic single-port nephrectomy / 中华泌尿外科杂志

Objective To evaluate the feasibility and clinical efficacy of intra-abdominal exposure instruments in laparoendoscopic single-port nephrectomy(LESS-N).Method From February 2012 to July 2016,61 cases of LESS-N were performed in our center.There were 34 males and 27 females with a mean age of (60.3 ± 9.4) years old (ranging 36-72 years old).There were thirty-nine cases of renal tumors and twenty two cases of nonfunctioning kidney.The patients were divided into two groups.Group A included 39 cases that underwent conventional LESS-N (22 radical nephrectomy/17 simple nephrectomy).Group B included 22 cases that underwent intra-abdominal exposure instruments assisted LESS-N (17 radical nephrectomy/5 simple nephrectomy).The perioperative and postoperative data were collected and analyzed retrospectively.Results All the procedures of these two groups were completed successfully.In Group A,four patients were added one 5 cm additional trocar and two patients were converted to open surgery.No additional trocars or conversion to open surgery were needed in Group B.For LESS radical nephrectomy,there were no significant differences of mean tumor diameter (5.7cm vs.5.4 cm,P =0.65) between two groups.The average operative time was (95.1 ± 43.9) min in Group B which was lower than that in Group A (127.4 ± 61.9) min (P ＜ 0.01).The mean renal vascular processing time was declined from (25.4 ± 10.1)rmin in Group A to (18.8 ± 8.9)min in Group B (P ＜ 0.05).The mean estimated blood loss was (128.6 ± 51.1) ml in Group A and (98.7 ±-57.6) ml in Group B (P ＜ 0.05).No severe intraoperative and postoperative complications occurred in both group.Conclusions Intra-abdominal exposure instruments are feasible and effective for LESS-N.This system may shorten the operation time,reduce the amount of bleeding and improve surgical accuracy.

The application of low dose CT scan and quantitative analysis in airway remodeling and air trapping of asthma / 中华放射学杂志

Objective To explore airway remodeling and air trapping in asthmatic patients with low dose CT scanning and quantitative analysis. Methods 52 stable asthmatic patients in which 29 were severe and 23 were slight,and 20 healthy control cases were underwent low dose dual phase CT scanning. The LA/BSA, WA/BSA, TA/BSA, WA%and Pi10WA were analyzed as airway remolding indexes. The MLD of expiratory, VI-850 (%) of expiratory, MLD E/I, VI-850E-I (%) and VI-850/-950E-I (%) were analyzed as air-trapping indexes. One-Way ANOVA or H Kruskal-Wallis was used to analyze the above indicators. Results Airway remodeling indexes and LA/BSA were (9.6 ± 2.6), (11.0 ± 3.4) and (12.6 ± 3.0)mm2/m2 in severe asthmatics group, non-severe asthmatics group and healthy control group respectively, and there was significant difference between the three groups (F=5.60, P=0.006). WA%of each group was (65.1 ± 2.5)%, (63.3 ± 4.4)%and (62.0 ± 3.0)%, and there was significant difference between the three groups (F=5.53,P=0.006). The Pi10WA was (18.4±2.6), (17.7±3.1) and (16.4±1.4) mm2 respectively with significant difference between the three groups (F=3.59 ,P=0.033). Air-trapping indexes, MLD of expiratory of each group was-(771 ± 59),-(724 ± 43) and-(676 ± 60) HU respectively with significant difference (F=5.60, P=0.006). VI-850(%) of expiratory of each group was 30.79(30.45)%, 13.53(12.09)%and 2.85(6.87)%respectively with significant difference (H=17.20,P<0.001). Conclusions Low dose of CT scan and quantitative analysis can provide an objective and quantitative information for patients with airway disease of asthma, and both WA% and Pi10WA were objective indexes. The severe asthmatic patients were associated with obvious airway remodeling and air trapping compared with non-severe asthmatic patients.

PI3K signaling pathway in colorectal cancer / 国际肿瘤学杂志

Since the early symptoms are very hidden,most of patients with colorectal cancer (CRC)have occurred metastasis when diagnosed.Recently,chemotherapy combined with targeted therapy is the major therapeutic strategy for metastatic CRC and the high frequency activation of phosphatidylinositol 3-kinase (PI3K) signaling pathway has been validated sharing a close relationship with the development of CRC,contributing important values for the diagnosis and therapy of CRC.

Research progress of resveratrol on the prevention and treatment of colorectal cancer / 国际肿瘤学杂志

Recent studies show that resveratrol is characterized with its antioxidative and anti-inflammatory effects, and plays an important role in the prevention and treatment of colorectal cancer through modulating intracellular carbohydrate and ceramide metabolism, activating tumor suppressors such as activator of transcription 3 and peroxisome proliferators-activated receptor γ, down-regulating the expression of kirsten rat sarcoma viral oncogene and inhibiting the epithelial-to-mesenchymal transition process of cancer cells.In addition,resveratrol exhibits its broad application prospects in combination therapy.

An Intratracheal Challenge Murine Model of Asthma: Can Bronchial Inflammation Affect the Nose?

PURPOSE: Extensive data support the influence of the upper airway on lower airway inflammation and pathophysiology in allergic disease. However, few studies have focused on allergic inflammation in the nose after an isolated lower airway allergen challenge, a situation that can exist clinically when human subjects breathe primarily through the mouth, as occurs when nasally congested. This study used a mouse model to investigate whether upper airway inflammation and hyperresponsiveness were induced by an isolated lower airway allergen challenge. METHODS: BALB/c mice were sensitized by systemic intraperitoneal injection of ovalbumin/saline and challenged with intratracheal ovalbumin/saline. Inflammation in the nose and lungs was assessed by cytology and histology of nasal tissues and bronchoalveolar lavage fluid (BALF), while nasal airway resistance and response were measured over 3 days post-challenge. RESULTS: Intratracheal application of an allergen in anaesthetized mice resulted in exclusive deposition in the lower airway. Compared to control animals, ovalbumin-sensitized mice after challenge showed bronchial hyperreactivity and increased IL-5 in the serum BALF, as well as eosinophil infiltration in the lungs. However, nasal histology of the ovalbumin-sensitized mice showed no increase in eosinophil infiltration. The nasal lavage fluid revealed no increase in eosinophils or IL-5, and the nasal airway resistance did not increase after challenge either. CONCLUSIONS: In a mouse allergy model, exclusive allergen challenge of the lower airway can elicit a pulmonary and systemic allergic response, but does not induce upper airway inflammatory or physiological responses.

Establishment of a colorectal cancer SW620 cell line stably over-expressing Wilm's tumor on X chromosome using a recombinant lentivirus vector / 南方医科大学学报

<p><b>OBJECTIVE</b>To construct a recombinant lentivirus vector for Wilm's tumor on X chromosome (WTX) gene and establish a colorectal cancer SW620 cell line with stable WTX over-expression.</p><p><b>METHODS</b>The full length coding region of WTX gene was amplified with PCR, and the amplified fragment was cloned into the lentivirus vector GV387. The recombinant lentivirus vector was transfected in 293T cells for packaging the virus, which was then transfected into colorectal cancer SW620 cells. The stably transfected cells were selected with G418, and the cellular expressions of WTX mRNA and protein were detected using quantitative PCR and Western blotting.</p><p><b>RESULTS</b>The recombinant plasmid was successfully constructed as verified by sequence analysis. Quantitative PCR and Western blotting results showed that trasnfection with the recombinant lentivirus significantly increased the expression levels of WTX in SW620 cells.</p><p><b>CONCLUSION</b>We successfully established a colorectal cancer cell lines with stable over-expression of WTX, which provides an essential cell model for studying the role of WTX in the tumorigenesis and progression of colorectal cancer.</p>

Effects of Tiam1 overexpression on biological characters of human colorectal cancer cells / 实用医学杂志

Objective To explore the effect of Tiam1 overexpression on the biological behaviors of human colorectal cancer cells ( CRC ) . Methods The human CRC lines under the established stable overexpression of Tiam1 were studied. Cell morphology was detected before and after transfection by commassie blue staining and scanning electron microscope. The proliferation in vitro of CRC was tested by cell cycle, MTT and plate colony formation assay, the migration and invasion ability of CRC was tested by Transwell assay. The proliferation ability in vivo was studied by induced subcutaneous tumors of nude mice. Results Compared with HT29/mock cells, HT29/Tiam1 cells formed as spindle, the pseudopodia increased and elongated. The proportion in S phase of HT29/Tiam1 was higher (t=19.546, P=0.000), the proliferation ability enhanced (F=177.125, P=0.000), colonies formation ratio increased ( t = 3 . 222 , P = 0 . 032 ) . The number of HT29/Tiam1 cells acrossing the microporous membrane (t = 4.832, P=0.001)and Matrigel(t=3.779, P = 0.005)all raised. On the fifteenth day, the growth deference between the HT29/Tiam1cells and HT29/mock cells in nude mice in vivo occurred. Till the thirtieth day, the size of the tumors in HT29/Tiam1 cell group were 2.3 times as large as that in HT29/mock cell group (F=53.040, P=0.002). Conclusions Tiam1 stable overexpression can promote the proliferation, migration and invasion ability of CRC which indicates its important role in carcinogenesis and evolution of colorectal cancer. Tiam1 may represent a new therapeutic target for colorectal cancer.

Establishment of eosinophilic bronchitis mice model without airway hyperresponsiveness / 中国医师杂志

Objectiev To explore the use of different nebulizer to establish mice model that have airway eosinophilic inflam -mation without airway hyperresponsiveness .Methods Female BALB/c mice were obtained and divided randomly into 3 groups:eo-sinophilic airway inflammation group ( experimental group ) , asthma group, and control group .Mice were immunized with ovalbumin ( OVA) .The experiment group and asthma group were challenged with an aerosol of 1% w/v OVA using a PARI TIA and PARI LC STAR nebulizer on day 28, 29, 30, respectively.The control mice were received saline sensitization and challenge .Airway respon-siveness was measured .Cell different counts in bronchial alveolus lavage fluid ( BALF) were performed and a pathologist performed histopathological evaluation of the trachea and lung .Results Airway responsiveness in the experimental group was not significantly different compared with the normal saline ( NS) group but was significantly different compared with the asthma group .Eosinophils in BALF were increased significantly in experimental group compared with the NS group , and significant difference was observed between experimental group and asthma group .The intensity of airway inflammation in experimental group was milder than that in the asthma model .Conclusions We established an eosinophilic bronchitis mice model without hyperresponsiveness successfully .Our model es-tablished a foundation for the further research in airway hyperresponsiveness .

Promoter methylation of Wilms' tumor gene on the X- chromosome in gastric cancer / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the changes in methylation levels of the promoters of the tumor suppressor gene Wilms' tumor gene on the X-chromosome (WTX) and its possible role in gastric cancer.</p><p><b>METHODS</b>WTX promoter methylation levels were detected in 20 pairs of specimens of gastric cancer and matched normal tissues and in 3 gastric cancer cell lines (MGC803, SCG7901, and BGC823) using the Sequenom MassARRAY quantitative analysis system. The gastric cancer cell line BGC823 was treated with 5-aza-2'-deoxycytidine (5-aza-dC) for demethylation and the changes in the level of WTX promoter methylation were investigated.</p><p><b>RESULTS</b>WTX promoter methylation levels were very low and showed no significant differences among normal gastric tissues, gastric cancer tissues and the 3 gastric cancer cell lines. In BGC823 cells, treatment with 5-aza-dC did not obviously affect the promoter methylation levels of WTX.</p><p><b>CONCLUSION</b>High methylation levels of WTX promoters are rare in gastric cancer.</p>

Preliminary study on mobile platform-oriented echocardiogram data visualization for the evaluation of left ventricular diastolic function / 中华超声影像学杂志

Objective To research and develop the mobile platform-oriented echocardiogram data visualization technology for the evaluation of left ventricular diastolic function,and investigate its application value.Methods First,diagnostic algorithms for the evaluation of left ventricular diastolic function (based on recommendations from ASE & EAE guidelines) were programmed into a mobile application software package,using Adobe Flex builder 4.0 as a basic tool for data visualization.Second,the program was installed in the Apple iPad4 tablet computer,then debugged and improved according to feedback information from practical applications.Results The echocardiogram data visualization for the estimation of left ventricular filling pressures in patients with depressed ejection fraction(EF) or normal EF and grading diastolic function can be implemented in mobile platform device,and simultaneously with emergency bedside echocardiography.The evaluation process can be visually presented by using the graphics to show the algorithm framework,the animation to express the analysis step,the axis to indicate the direction of information,and the color to differentiate the degree of the diastolic dysfunction.Conclusions The mobile platform-oriented echocardiogram data visualization technology makes the evaluation of left ventricular diastolic function more convenient,efficient and fast,and shows its potential to become an important adjunct to evaluation of cardiac function in the context of mobile health.

Construction and application of computer-aided echocardiographic evaluation system for left ventricular diastolic function / 中华超声影像学杂志

ObjectiveTo build the computer-aided diagnosis system of left ventricular diastolic function for echocardiography,to make the evaluation process of left ventricular diastolic function for echocardiography more convenient,efficient,standardized and to obtain more accurate,practical,objective and reliable diagnostic results.MethodsFirst,the system was developed by the Macromedia Flash Professional referred to the newest guidelines and suggestions published by the American Society of Echocardiography(ASE) in 2009.Second,the program of left ventricular diastolic function in the computer- aided diagnosis system was designed,debugged and improved according to feedback information frompractical applications.ResultsThe diagnostic system can work simultaneously with echocardiography.If assessment parameters of the newest guidelines and suggestions,published by the American Society of Echocardiography in 2009,are imported to the system,then it can give the diagnosis of the change about the left ventricle filling pressures and score the left ventricular diastolic function quickly and automatically.The system will export standard report with both pictures and text.ConclusionsAccording to our experiment,the computer-aided diagnosis system is able to make the evaluation process of left ventricular diastolic function much more standardized and simplified,which guarantee the objectivity and reliability of the evaluation results.Consequently,it will be able to apply to clinical practice in the future.

Analysis on mental health status of the victims in Wenchuan earthquake / 中华创伤杂志

Objective To analysis the mental health status of the victims in Wenchuan earthquake. Methods Post-traumatic stress disorder checklist-civilian version (PCL-C), symptom checklist-90 (SCL-90) , Zung' s self-rating anxious scale/depressive scale (SAS/SDS) and simple coping style ques-tionnaires were use to investigate the mental health status of the victims that were transferred to Xinaiao Hospital, Third Military Medical University, one month after earthquake. Results (1) Compared with national ensemble, SCL-90 scores ranked the highest in aspects of somatization and anxiety (t = 3.733, P <0.01; t = 2.368, P < 0.05) but the score of paranoid ideation decreased significantly (t =-3.584, P<0.01), with score over 3 accounting for 20.7%. (2) The proportion of moderate anxiety and depres-sion was 21.7% and 26.0%, respectively. (3) The PCL-C total score was positively correlated with SCL-90 scores and SAS scores (r = 0.642, P < 0.01 ; r = 0.506, P < 0.05), but negatively with negative items in SCL-90(r =-0.681, P <0. 01). (4) Multiple linear regression analysis showed that 36. 6% of variation of PCL-C total score could be forecast by comhining SAS scores with positive copy scores. Conclusions One month after earthquake, more. than 20% of the victims transferred to Xinqiao Hospital have moderate mental health problem and need early mental intervention for improvement in physical and mental health.

Typing of Acinetobacter baumannii isolated from patients in intensive care unit with IRS-PCR / 第三军医大学学报

Objective To type Acinetobacter baumannii using infrequent restriction site PCR (IRS PCR). Methods Strain specific electrophoretic patterns from PCR products by amplifying DNA sequences flanking infrequent restriction sites of 15 strains of Acinetobacter baumannii were compared with the results of biotyping and antimicrobial susceptibility. Results The 15 bacteria were divided into 5 gene types with IRS PCR, but 3 with biotyping, and 4 with antimicrobial susceptibility. Conclusion IRS PCR method for typing Acinetobacter baumannii is of strong sensitivity, high recognition, good repeatability, convenient operation, and wide range of application.

A clinical study of A. baumannii infection patients treated with imipenem-cilastatin and ampicillin-sulbactam / 第三军医大学学报

Objective To compare treatment outcomes and antibiotic related costs of A. baumannii infection treated with imipenem cilastatin and ampicillin sulbactam and to provide evidence for clinical treatment of A. baumannii infection. Methods A prospective investigation was performed on 71 ICU A. baumannii infection patients treated with imipenem cilastatin and ampicillin sulbactam. The treatment outcomes and antibiotic related costs were also analyzed. Results There was no significant difference between the therapeutic efficacy of these two drugs within the same time limit. The antibiotic related costs of the patients treated with ampicillin sulbactam were significantly lower than those with imipenem cilastatin (2 113 Yuan vs 5 789 Yuan , P

Expression of Fas/FasL and their significance in the pathological tissues of SARS patients / 中国实用内科杂志

Objective To study the mechanisms and expressions of Fas/FasL in the lungs,spleens and lymph nodes of SARS patients.Methods The lungs,spleens and lymph nodes specimens of four autopsy cases and one control subject were studied with immunohistochemical mehod.Results Compared with normal tissues,apoptotic cells increased significantly in the spleens,lungs and lymph nodes of SARS patients.The apoptotic cells of lungs included alveolar epithelial ones,bronchial epithelial ones,monocytes/macrophages and lymphocytes.Apoptosis in the spleens and the lymph nodes was observed primarily in monocytes/macrophages and lymphocytes.Conclusion Over-expression of Fas/FasL is a general phenomenon in SARS,suggesting that Fas/FasL may play a key role in the pathogenesis of SARS.