False-positive HIV-1 nucleic acid testing results in patients with severe thalassemia after receiving cell and gene therapy / 中华检验医学杂志

A 11-year old female patient with severe thalassemia, receipt a lentivirus-based cell and gene therapy (CGT) therapy in Shenzhen Children′s Hosptial on July 27th, 2021. At the two follow-up visits after discharge, patient were continuously tested positive for HIV screening through HIV Ag/Ab Combo assay (chemiluminescence Immunoassay), and the viral load results of HIV-1 nucleic acid testing (NAT) were both>5 000 copies/ml. The patient can be diagnosed with HIV infection according to the National Guideline for Detection of HIV/AIDS(2020 Revised Edition). The thorough investigation findings and supplementary experiment results indicated that the false-positive HIV-1 NAT results was caused by cross-reactivity between the target sites detected by conventional HIV-1 NAT reagents and the lentiviral vectors fragments integrated into the genome of patient′s hematopoietic stem/progenitor cells. In conclusion, it is important for laboratories to select appropriate HIV-1 NAT testing platforms which won′t cause cross-reactivity for the testing of samples from patients who have been treated with HIV-derived vectors. It is also recommended to design and develop NAT testing platforms with multiple target regions labeled by different fluorescents for HIV NAT supplementation experiment to reduce the risk of false-positive diagnoses of HIV infection.

Effects of typical phthalate esters on lipid metabolism in rats and its potential mechanism / 环境与职业医学

Background Di(2-ethylhexyl)phthalate (DEHP) and dibutyl phthalate (DBP) are representative environmental endocrine disruptors of phthalate esters (PAEs). Some studies have shown that PAEs exposure may have an impact on lipid metabolism. Objective To investigate the effects of DEHP and/or DBP on lipid metabolism in rats and their possible mechanisms of action. Methods Thirty-six weaned healthy SD male rats, 3 weeks old, weighing 50-70 g, were divided into four groups, i.e., a corn oil control group, a DEHP (750 mg·kg−1) group, a DBP (500 mg·kg−1) group, and a DEHP+DBP (750 mg·kg−1+500 mg·kg−1) group. The rats were exposed to DEHP and/or DBP by oral gavage for 8 weeks, and weighed once a week. The rats were anesthetized 24 h after the last dose, and blood was taken from the apical part of the heart. Serum high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), total cholesterol (TC), and triglyceride (TG) were detected. Liver tissues and perigenital adipose tissues were collected, weighed, and one portion of the tissues was fixed in 10% neutral formalin for pathomorphological observation, and another portion was used for mRNA detection of lipid metabolism-related genes such as Janus kinase 3 (JAK3), signal transducer and activator of transcription 5b (STAT5b), and peroxisome proliferator-activated receptor γ (PPARγ). Results During the DEHP and/or DBP exposure period, the rats in all groups were free to eat and drink without death or injury observed. Compared with the control group: The body weight gain in the DEHP+DBP group was lower at all time points from the 2nd week onwards (P<0.05); the liver organ coefficients of the DEHP and the DEHP+DBP groups were higher (P<0.05); the serum LDL-C levels in the DEHP and the DBP groups were higher (P<0.05). Compared with the DEHP+DBP group: The body weight gains in the DEHP group at the 2nd, 4th, 5th, and 8th weeks were higher (P<0.05), and the body weight gains in the DBP group were higher at all time points except the 1st week (P<0.05); the liver organ coefficients in the DEHP group and the DBP group were lower (P<0.05); the serum TG level in the DEHP group was higher(P<0.05), and the serum LDL-C levels in the DEHP and the DBP groups were higher (P<0.05). The pathomorphological results of liver tissues showed that the hepatocytes in the DEHP, DBP, and DEHP+DBP groups were disordered with loss of cord-like arrangement, swelling (suggesting change of cell proliferation), and presented bilirubin pigmentation. The pathomorphological results of rat perigenital adipose tissues showed had irregular alignment, sizes, and arrangement of adipocyte in the DEHP, DBP, and DEHP+DBP groups. The results of rat liver lipid metabolism-related gene mRNA levels showed that the liver JAK3, STAT5b, and PPARγ mRNA levels in the DEHP, DBP, and DEHP+DBP groups were lower than those in the control group (P<0.05); the rat liver PPARγ mRNA levels in the DEHP and DBP groups were lower than those in the DEHP+DBP group (P<0.05). Conclusion DEHP and/or DBP can inhibit the increase of body weight to varying degrees, induce inflammatory damage to liver tissues, and cause abnormal lipid metabolism in rats, and the associated mechanism may be related to inhibiting the activation of JAK3/STAT5b/PPARγ signaling pathway in rat liver tissues.

Effects of midazolam on the agitation and wake time of the postoperative resuscitation in pediatric circumcision / 中国基层医药

Objective To explore the effect of midazolam on the agitation and wake time of the postoperative resuscitation in pediatric circumcision.Methods Clinical data of 170 cases of pediatric circumcision were retrospectively analyzed.They were divided into control group and observation group according to the anesthesia scheme ,85 cases in each group.The control group was anesthetized with sevoflurane compound ketamine ,and the observation group was given trifluorothane and ketamine combined with midazolam .The effects of the two groups were compared .Results The cardiac rhythm and the central arterial pressure at first 10min of operation in the observation group were (99.64 ±5.97) times/min,(65.81 ±5.63) mmHg,respectively,which in the control group were (122.38 ± 12.54)times/min,(86.49 ±12.35) mmHg,respectively,the differences between the two groups were statistically significant(t=8.749,9.438,all P<0.05).The total amount of ketamine,waking time,pain score,Watcha score, PAED score in the observation group were (42.33 ±5.85)mg,(5.56 ±2.03)min,(2.16 ±1.05)points,(1.65 ± 0.59)points,(5.23 ±1.04) points,respectively,which in the control group were (72.53 ±16.58) mg,(13.29 ± 4.66)min,(4.29 ±2.35) points,(2.84 ±1.46)points,(8.75 ±2.19)points,respectively,the differences between the two groups were statistically significant(t=11.698,8.239,7.763,6.997,8.168,all P<0.05).The incidence rates of respiratory inhibition ,fidgety,nausea and vomiting of the observation group were 1.18％,3.53％,3.53％, respectively,which of the control group were 9.41％,15.29％,16.47％,respectively,the differences between the two groups were statistically significant(χ2 =4.174,3.589,4.281,all P<0.05).Conclusion Application of midazolam in pediatric prepuce intraoperatively has little influence on the vital signs of children ,and can relieve postoperative awaken agitation , reduce the time of awakening and anesthesia complications , and it is worthy of popularizing in clinical application .

Levels of heme oxygenase-1 and carbon monoxide and its significance in the Mycoplasma pneumoniae infection in children / 重庆医学

Objective To explore the heme oxygenase-1 (HO-1) content of carbon monoxide (CO) levels and clinical significance of Mycoplasma pneumoniae infection in children.Methods 219 cases of mycoplasma pneumonia from October 2013 to June 2015 in our hospital were divided into two groups,which were non-asthmatic group (156 cases) and wheezing group (63 cases),and the wheezing group were divided into two groups according to the presence or absence of hypoxemia and mild asthmatic group (39 cases) and severe asthmatic group (24 cases).HO-1 content in the blood was measured by enzyme-linked immunosorbent assay,using dual-wavelength spectrophotometric determination of hemoglobin oxygen percentage of broken (COHb％),analysis of the differences between the groups.Results Children with blood COHb content wheezing group were (2.59 ± 0.40)％ and HO-1 levels were (1 813.24 ± 28.34)ng/L and non-respite group were significantly increased,it had significant differences between the two groups (P＜ 0.05).Group of children with severe wheezing COHb content were (3.63 ± 0.45)％ and HO-1 levels were (2 594.34±23.94)ng/L and mild wheezing group were significantly increased,it had significant differences between the two groups (P＜0.05).Positive correlation between blood COHb content and HO-1 levels were significantly (r=0.733,P＜0.05).Conclusion Mycoplasma pneumoniae infection in children with wheezing blood COHb content and HO-1 levels were significantly increased,and with wheezing exacerbation and showed an increasing trend,suggesting that CO and HO-1 may be involved in Mycoplasma pneumoniae infection in children in the pathogenesis of wheezing,should lead to clinical attention.

Establishment of a rat model of chronic heart failure by transverse aortic constriction and observation of its pathological process / 中国比较医学杂志

Objective To observe the pathological changes of heart failure caused by transverse aortic constriction in rats.Methods Partial thoracotomy was performed to the second rib and the transverse aortic constriction was performed between the innominate and left carotid arteries to establish a model of heart failure in 24 rats.The same operation was performed on another 8 rats, except for the ligation of the transverse aorta.Echocardiographic assessment, hemodynamic measurement, myocardial histopathological examination and NT-proBNP measurement were performed to the sham group at 12 weeks and model group at 4 weeks, 8 weeks, 12 weeks after the operation.Result At 4 weeks after the operation, NT-proBNP, EF, FS and -dp/dtmax of the model group was significantly increased and LVESV, +dp/dtmax of the model group were significantly decreased (P<0.05).At 8 weeks after the operation, EF and-dp/dtmax of the model group were increased and +dp/dtmax of the model group was significantly decreased (P<0.05).At 12 weeks after the operation, NT-proBNP, EF and +dp/dtmax of the model group were decreased, and LVESV, LVEDV and -dp/dtmax of the model group were increased (P<0.05).The cardiomyocytes became hypertrophic and lined up in disorder at 4 weeks after the operation.Pathologic examination of the myocardial tissue showed connective tissue proliferation and inflammatory cell infiltration at 8 weeks after the operation, and cardiomyocyte apoptosis and collagen fiber deposition at 12 weeks after the operation.Conclusions Transverse aortic constriction induces heart failure in rats.The pathological processes are compensatory hypertrophy at 4 weeks after the operation, initial reaction of decompensation at 8 weeks after the operation, and heart failure at 12 weeks after the operation.

Nursing of patients undergoing soft tissue defect repair using expanded flap after breast cancer surgery / 现代临床护理

Objective To summarize the experience in nursing the patients undergoing soft tissue defect repair using expanded flap after surgery of locally advanced breast cancer (LABC). Methods Thirteen LABC patients received neoadjuvant chemotherapy. Water balloon dilator was used to expand flap before the chemotherapy and expanded flap was used to repair the soft tissue defect after modified radical mastectomy . Skin preparation and psychological counseling were well prepared before operation . During therapy , more attention was paid to injection pot , abdominal wall flap and water injection and the nursing of the expanded flaps after repair . Results The water balloon dilator implantation for all patients was successful and soft tissues of chest wall defect were completely repaired . There wasn't flap necrosis or implantation metastasis in 0 . 5 to 2 years follow-up . Conclusion Expand flap can repair defect of chest wall after modified radical mastectomy . The nursing measures of perioperative nursing including implantation of expander , observation of the expanded flap variations during expanding of water sac and nursing of expanded flaps are important for the success of repair .

Nursing of patients undergoing modified radical mastectomy aided with laparoscopy / 现代临床护理

Objective To summarize the experience in nursing patients undergoing modified radical mastectomy aided with laparoscopy.Method The clinical data of eleven patients who underwent modified radical mastectomy aided with laparoscopy from April 2012 to October 2013 were reviewed to summarize nursing points.Result All the surgeries were successful,with 1 case developing with mild emphysema at the operation region and another case with edema.All the patients were discharged.Conclusion Comprehensive preoperative education,accurate perioperative coordination and careful postoperative nursing are important for the smooth manipulation of the surgeries and postoperative rehabilitation.

GC-MS analysis of volatile oils from fresh and processed typhonii rhizoma / 中国中药杂志

Typhonii Rhizoma is a toxic traditional Chinese medicine. Its toxic components remained unclear. To compare chemical composition of volatile oils from fresh and processed Typhonii Rhizoma qualitatively, volatile oils were obtained by stream distillation and analyzed by GC-MS. The data obtained from GC-MS were processed by principal component analysis. From the essential oils of fresh and processed Typhonii Rhizoma, 43 compounds and 34 compounds were identified respectively. The chemical composition and content in the two oils was different. In the two essential oils 15 identical components were detected. The chemical components and their contents in the essential oils are changing with the storage.

The effects of hypokalemia on the Na+ channel in cardiac tissue--a computer simulation study / 生物医学工程学杂志

In order to explore the reason why hypokalemia could increase the vulnerable window (VW) for unidirectional conduction block in Long QT Syndromes (LQTS), we observed the effect of hypokalemia on the spatial gradients of Na channel conductance (G(Na)) and gating factors by using the LR91 1-dimensional heterogeneous virtual cardiac ventricular tissue model quatitively. The computer simulation experiments were divided into two groups, namely control and LQTS groups. The action potential was elicited after the basic stimulus S1 (-70 microA/microF, 1.5 ms) was given 10 times with basic cycle length (BCL) 500, 1000 and 2000 ms. To test the VW in unit of time (VWtime), the S1-S2 programmed stimuli were used with shortening S1S2 interval at the decrement of 1 ms. At the same time, the spatial gradients of Na channel conductance (G(Na)) and gating factors, m, h, j, were investigated. The APD and ionic channel currents were also detected under the conditions of normal and lower concentration of K+ outside of cell. We found that hypokalemia, LQTS and slow pacing rate enhanced the spatial gradient of G(Na) by increasing the spatial gradient of inactive gating factors h x j. The results also showed that hypokalemia deduced the peak values of I(K) and I(K1), which prolonged the action potential duration and enlarged the repolarization dispersion in this 1-D tissue cable model. Possibly these are the important factors to cause the spatial gradient of h x j and G(Na). enlargement. These changes increase the incidence of unidirectional conduction block of VW, and are vital reasons to increase the possibility of ventricular arrhythmia generation.