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Objective@#To analyze the epidemiological and clinical characteristics of pulmonary tuberculosis patients complicated by diabetes mellitus (PTB-DM), so as to provide insights into PTB-DM control.@*Methods@#The data pertaining to PTB cases in Quzhou City from 2016 to 2020 were extracted from Tuberculosis Information Management System of Chinese Disease Prevention and Control Information System. The demographic features, diagnosis and treatment of PTB-DM patients were descriptively analyzed, and compared with PTB patients.@*Results@#The incidence of PTB-DM was 6.79/105 to 9.27/105 in Quzhou City from 2016 to 2020, with an annual increase rate of 8.09%. Among all PTB-DM patients, there were 674 men (76.94%), 620 cases at ages of 60 years and older (70.78%), 564 cases living in urban areas (64.38%), 619 farmers (70.66%), 537 cases with delay in healthcare-seeking (61.30%), 802 treatment-naïve cases (91.55%), 547 cases positive for pathogenic tests (62.44%), 11 cases with rifampicin resistance (1.26%), 695 cases with negative conversion of sputum smears 2 months post-treatment (79.34%), and 783 cases with successful treatment (89.38%). The proportions of men, ages of 60 years and older, living in urban areas, farmers, delay in healthcare-seeking, positive pathogenic tests and rifampicin resistance were significantly higher among PTB-DM patients than among PTB patients, and the negative conversion rate of sputum smears 2 months post-treatment was significantly lower among PTB-DM patients than among PTB patients (all P<0.05).@*Conclusions@#The incidence of PTB-DM increased year by year in Quzhou City from 2016 to 2020, and PTB-DM cases were predominantly found among elderly men. The proportion of delay in healthcare-seeking, positive pathogenic tests and rifampicin resistance was higher among PTB-DM patients than among PTB patients.
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Background Paraquat (PQ) is one of the most widely used herbicides in the world and a risk factor for Parkinson's disease (PD), but the mechanisms underlying PD are poorly understood. Single-cell RNA sequencing (scRNA-seq) technology can study cellular heterogeneity at genetic level, providing insights into the pathogenesis of PQ-induced PD. Objective To analyze the brain cell grouping of PQ-infected mice and the biological processes involved in the subpopulation of PD-like changes cells by scRNA-seq, and to provide clues for revealing potential mechanisms of PQ-induced PD-like changes in mouse brains. Methods Six male 6-week-old C57BL/6 mice were randomly divided into a control group and an experimental group, three mice in each group, and were intraperitoneally injected with 0 (saline) and 10.0 mg·kg−1 PD respectively, once every two days, for 10 consecutive injections for modeling. After infection, mouse brains were taken and scRNA-seq was performed. Cell segmentation was performed according to gene expression characteristics of different cell types, PD-related cell subsets were screened by bioinformatics tools, and gene ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), gene set enrichment analysis (GSEA), protein interaction network analysis, and transcription factor prediction were performed on their characteristic genes. Finally, GO and KEGG analyses were performed on the differential genes of PD-associated cell subsets between the PQ-treated group and the control group, and the biological processes in which these genes may participate were analyzed. Results The sequencing data met quality control standards, a total of 55779 cells were obtained, and all cell dimensionality reduction analysis results showed that they could be further divided into 37 clusters, including 5 major cell types. Based on the KEGG analysis of the top 20 characteristic genes of each subpopulation, the specifically expressed Cluster 33 subpopulation (dopaminergic neurons) was screened and found to be significantly associated with PD. The results of GO analysis showed that the biological function of this subpopulation mainly enriched neurotransmitter transport and regulation. The results of GSEA analysis showed that the tyrosine metabolic pathway and the ligand-receptor interaction pathway of neural activity in brain tissues were significantly enriched. The analysis of transcriptional regulatory networks showed that 39 transcription factors were expressed differently. The metabolic pathway of the dopamine neuronal subset, endocytosis, Ras-associated protein 1 (Rap1) signaling pathway, and mitogen-activated protein kinase (MAPK) signaling pathway were all affected by PQ exposure, according to further analysis of its effects on this subpopulation. The GO analysis showed that differential genes were involved in biological processes such as ion transport and synaptic assembly regulation, and were involved in the cellular component formation of cytoplasm and synapses. Conclusion This study has initially mapped the transcriptome of single cells in the mouse brain after PQ exposure, and screened out the specific expression of Cluster 33 subgroup (dopaminergic neurons), which is significantly correlated with PD, and its biological function changes may be one of the mechanisms of PD-like changes in the mouse brain induced by PQ.
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Vigabatrin-associated brain abnormalities on magnetic resonance imaging (VABAM) is a relatively rare side effect of vigabatrin, most of which are asymptomatic. However, there will be extremely rare cases with hyperkinetic disorders, myoclonus, tremor, and acute encephalopathy under certain circumstances. VABAM is often underappreciated by physicians and its accurate incidence remains unclear. A female infant who was diagnosed with infantile spasms and required adrenocorticotropic hormone therapy accompanied by various antiseizure medicines was reported. Unfortunately, she became lethargic and her spasm deteriorated gradually after vigabatrin exposure. Her brain magnetic resonance imaging revealed abnormal signals bilaterally in the dorsal midbrain, thalamus, and rostral part of the pallidum. She had a seizure amelioration and became lively as a result of vigabatrin withdrawal. In the meanwhile, magnetic resonance imaging returned to normal. Attempts were made to discover the risk factors of VABAM and potential pathogenesis. Further understanding of the disease should contribute to decreasing misdiagnosis and making precise decisions.
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OBJECTIVE：To ex plore the effects of solamargine on the growth and apoptosis of human hepatocarcinoma cells HepG2 and its underlying mechanism. METHODS ：The effects of 0（blank group ）-12 μmol/L solamargine treatment of 24，48 h on survival rate of HepG 2 cells were investigated. The effects of 0（blank group ），6 μmol/L solamargine treatment of 10 days on cell clone formation were also investigated. The effects of 0（blank group ），4，6，8 μmol/L solamargine for 24 h on the apoptotic rate of cells，mRNA expression of Bcl- 2，Bax and caspase- 3， protein expression of Bcl- 2 and cleaved caspase- 3 as well as ratio of p-AMPKα to AMPKα were all tested. The effects of AMPK inhibitor as compound C on the protein expression of AMPKα and Bcl- 2 in cells were investigated after treated with 6 μmol/L solamargine for 24 h. RESULTS ：Compared with 020-39318678。E-mail：wujingjing6028@gzucm.edu.cn blank group ，1-12 μ mol/L solamargine for 24，48 h could significantly decrease the survival rates of cells （P＜0.05）in a concentration-dependent manner ；IC50 of them were 8.310 and 7.996 μmol/L，respectively；the rate of cell clone formation was decreased significantly after treated with 6 μmol/L solamargine for 10 days（P＜0.05）. The apoptotic rate of HepG 2 cells，mRNA expression of Bax and caspase- 3，protein expression of cleaved caspase-3（except for 8 μmol/L）as well as ratio of p-AMPKα to AMPKα（except for 8 μmol/L）were all increased significantly after treated with 6，8 μmol/L solamargine（P＜0.05）；mRNA and protein expression of Bcl- 2 were decreased significantly （P＜ 0.05）；the changes of some indexes were in a concentration-dependent manner. The compound C could inhibit protein expression of AMPKα，and reverse the inhibitory effect of solamargine on Bcl- 2 protein. CONCLUSIONS ：Solamargine can inhibit the proliferation of HepG 2 cells and induce apoptosis ，the mechanism of which may be associated with activating AMPK signaling pathway.
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Objective:To evaluate the effects of ultrasound-guided quadratus lumborum block (QLB) on acute pain after total hip arthroplasty.Methods:A retrospective study was conducted of the 36 patients with hip osteoarthritis who had undergone selective one-side total hip arthroplasty under total intravenous anesthesia (TIVA) from January 2019 to January 2020. According to whether additional QLB was used or not they were divided into 2 equal groups ( n=18). The control group of 10 males and 8 females with an age of 60.5±9.4 years used mere TIVA while the QLB group of 7 males and 11 females with an age of 53.6±12.7 years used TIVA plus QLB. All patients accepted patient-controlled intravenous analgesia (PCIA) postoperatively. The 2 groups were compared in terms of visual analogue scale (VAS) at rest and during exercise and IL-6 level at 24 h postoperation, consumption of opioids and postoperative incidence of nausea and vomiting. Results:There were no significant differences between the 2 groups in their preoperative general data, indicating they were compatible ( P>0.05). The VAS scores at rest and during exercise in the QLB group (0.3 ± 0.5 and 0.8 ± 0.6) were significantly lower than in the control group (2.1 ± 0.7 and 2.7 ± 0.5), the IL-6 level in the former[40.9 (30.5, 56.3) pg/mL] was significantly lower than in the latter[165.0 (82.5, 276.5) pg/mL], the intraoperative total consumptions of sufentanil[6 (6, 7) μg] and remifentanil[1,370 (1,200, 1,485) μg] in the former were significantly lower than in the latter[35 (30, 40) μg and 1, 910 (1, 805, 2, 000) μg], and the postoperative incidenceof nausea and vomiting[27.8%(5/18)] in the former was significantly lower than in the latter[77.8%(14/18)] (all P<0.05). Conclusions:Ultrasound-guided quadratus lumborum block can effectively relieve acute pain in patients after total hip arthroplasty. It can suppress stress-related inflammatory factors, reduce consumption of opioids and incidence of postoperative nausea and vomiting.
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OBJECTIVE: To compare the effects of different anesthetics and blood sampling methods on blood routine test results in experimental animals. METHODS: A total of 42 specific pathogen free( SPF) male Sprague Dawley( SD) rats and 59 SPF male Kunming( KM) mice were randomly divided into 4 groups( control group,ether group,chloral hydrate group and pentobarbital sodium group). Ether group animals were treated with ether inhalation anesthesia; animals in chloral hydrate group and pentobarbital sodium group were injected intraperitoneally with chloral hydrate or pentobarbital sodium. The control group received no anesthesia treatment. Blood samples were collected by different ways: orbital venous plexus,abdominal aorta or eyeball enucleation. White blood cell( WBC) count,red blood cell( RBC) count,platelet(PLT) count,hemoglobin(Hb) level and hematocrit(HCT) in blood samples were analyzed. RESULTS: The RBC count,Hb level and HCT of SD rats in pentobarbital sodium group were significantly lower than those in control group( P <0. 05). The HCT of SD rats in ether group was lower than that in control group( P < 0. 05). The WBC count of orbital venous plexus of KM mice was lower than that taken by eyeball enucleation in control group( P < 0. 05),but the WBC count of orbital venous plexus was higher than that taken by eyeball enucleation in chloral hydrate group( P < 0. 05). The RBC count,Hb level,HCT of KM mice in pentobarbital sodium group were significantly lower than those in control group(P < 0. 05). CONCLUSION: The anesthetic can affect the blood routine test results of experimental animals. Different blood sampling methods have effects on blood routine test results of KM mice.
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OBJECTIVE: To investigate the effects of subacute systemic inhalation exposure of 1,2-dichloroethane(1,2-DCE) on learning and memory in NIH mice. METHODS: Forty-five specific pathogen free healthy 7-week-old NIH mice were randomly divided into control,low-dose and high-dose groups with 5 female mice and 10 male mice in each group. The mice were exposed to 1,2-DCE at dosages of 0. 00,100. 00 and 350. 00 mg/m3 for 6 hours per day for consecutive 28 days by dynamic systemic inhalation. The neurobehavioral tests of mice were performed before and after the first to fourth weeks of exposure using the Morris water maze test. RESULTS: There was no significant difference in body weight and swimming speed among the three groups of mice( P > 0. 05). The navigation experiment results showed that the escape latency of mice in both low-and high-dose groups were longer than that of the control group at the same time point(P < 0. 05) during 1-4 weeks after exposure. In the control group,the escape latency was shorter than that of the same group before exposure( P < 0. 05). The escape latency of high-dose group prolonged with the increase of exposure time,and in the 4 th week the escape latency was significantly higher than that of the same group before exposure( P < 0. 05).The experiment results of space exploration indicated that the first time of crossing platform in low-and high-dose groups were longer than that of the control group at the second to the fourth week( P < 0. 05). The target quadrant retention time and the number of crossing the platform in the low-and high-dose groups were lower than those in the control group( P <0. 05). CONCLUSION: Subacute inhalation exposure of 1,2-DCE can impair the learning and memory ability of NIH mice.The high-dose exposure may reduce learning ability in mice in a time-effect manner.
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Objective:To explore the application effect of diversified teaching methods in the Pharmacy Intravenous Admixture Services (PIVAS),thus to improve the quality of nursing teaching in PIVAS.Methods:Intemship students from PIVAS in a top three hospital in Xi’an from July to December 2015 and July to December 2016 were randomly divided into control group with 42 cases and experimental group with 40 cases.The control group used conventional teaching method and the experimental group adopted the diversified teaching method.the practical work of the students in the two groups was compared.Results:After intervention,the experimental group had marked improvement in the drug configuration error,the mastery of aseptic technology,the passing rate of theoretical achievement and operational achievement,significantly higher than that of the control group (P ＜ 0.01);the frequency of labels and warehousing errors of the experimental group was significantly lower than that of the control group (P ＜0.01).Conclusion:The application of diversified teaching methods in PIVAS is very important at several dimensions:helping students to be familiar with the work of PIVAS as soon as possible,reducing the occurrence of errors,improving the nursing teaching level of PIVAS and ensuring the quality of dispensing fluid.
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OBJECTIVE:To reduce the incidence of irrational medical orders for parenteral nutrition,and promote the rational use of parenteral nutrition. METHODS:The medical orders for parenteral nutrition of the first quarter of 2016 in general surgery de-partment of our hospital were collected,and the number and types of its irrational medical orders were summed up. Then FO-CUS-PDCA(Find-organize-clarify-understand-select-plan-do-check-act)cycle management was adopted to analyze and improve the existing problems in issuing medical orders for parenteral nutrition. The improved(the third quarter of 2016)medical orders for par-enteral nutrition were collected,the number and types of its irrational medical orders were summed up,and management effect was evaluated. RESULTS:Establishing nutrition support group,strengthening the training and communication of medical staff,adding prescription evaluation module for parenteral nutrition in hospital information system and a number of measures had made the inci-dence of irrational medical orders for parenteral nutrition in general surgery department declined from 48.25%(1433/2970)before improvement to 5.67%(120/2118)after improvement. The incidences of cation excess,inappropriate selection of drugs and inap-propriate compatibility in irrational types were 0. CONCLUSIONS:FOCUS-PDCA cycle management can reduce the irrational rate of medical orders for parenteral nutrition and promote the rational use of parenteral nutrition in hospital.
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Objective To study the clinical efficacy of low dose thyroxine combined with irbesartan hydrochlorothiazide in the treatment of elderly patients with severe heart failure.Methods 100 cases of elderly patients with severe heart failure treated in our hospital from January 2013 to December 2016 were selected as the research object in this study.They were randomly divided into control group and experimental group, with 50 cases in each group.Patients in the control group were treated with conventional therapy, while the experimental group was treated with low dose thyroxine combined with irbesartan and hydrochlorothiazide.The clinical efficacy of the two group were compared and analyzed.Results After the corresponding treatment, the total effective rate of the experimental group was 88.0%,significantly higher than that of the control group(70.0%), the difference was statistically significant(P<0.05).After treatment, the experimental group of patients with left ventricular ejection fraction index, four triiodothyronine and three triiodothyronine levels were significantly higher than those before treatment, the control group of patients with left ventricular ejection fraction were significantly higher than before treatment, the difference was statistically significant(P<0.05).Conclusion Low dose thyroxine combined with irbesartan hydrochlorothiazide in the treatment of elderly patients with severe heart failure has better clinical effect, can improve the therapeutic effect in a certain extent, with further clinical promotion and application significance.
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Subcritical butane technology was employed for the separation of abamectin on the fresh tea leaves surface.Under the conditions of solid-liquid ratio of 1∶10 (m/V), the experiment was designed via the response surface methodology and conducted at different temperature, various separation time and discrepant cycle number.Besides, the activity of the polyphenol oxidase (PPO) relating to the quality of the tea was determined and compared.At the same time, scanning electron microscopy (SEM) was used to observe the surface structure of fresh tea leaves before and after treatment, and the effect on physiological characteristics of the leaves by subcritical butane treatment was analyzed.The experimental results showed that the subcritical butane extraction could effectively isolate the abamectin, making the physical structure basically remained and the polyphenol oxidase activity preserved as well.Through the analysis by Design Expert software, the optimal processing parameters of separating abamectin were as follows: 45℃, 30 min, 1 cycle, and solid-liquid ratio of 1∶10 (m/V).Under the optimal conditions, the separation efficiency was over 91% and the relative PPO activity was 25.73%.The structure of fresh tea leaves changed insignificantly before and after the butane processing.This study suggested that the subcritical butane extraction technology could effectively remove pesticide residues in tea, thus provided a certain scientific basis for application of subcritical fluid removal of pesticide residue in natural plants.
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In order to improve the staff′s ability to combine professional level and moral quality in pharmacy in-travenous admixture services and implement it in nursing practice, this paper discussed the common ethical issues and its importance in pharmacy intravenous admixture services. It analyzed the problems, found the causes out, put forward the countermeasures, and thus to promote the further development of pharmacy intravenous admixture serv-ices and offer high quality clinical services, avoid medical disputes, and provide safer pharmacy service to patients.
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OBJECTIVE To evaluate the long-term toxicity of fully human anti-human tumor necrosis factor-α monoclonal antibody(anti-hTNF-α FHMA)for injection in cynomolgus monkeys. METHODS Forty cynomolgus monkeys were randomly divided into 5 groups (4 males and 4 females in each group):negative control group,adalimumab 10 mg·kg-1 group,anti-hTNF-αFHMA 2,10 and 50 mg·kg-1 groups. Cynomolgus monkeys in each group were injected sc once a week for 5 consecutive times, followed by 4 weeks of recovery. During the test,general clinical observation,body mass,body temperature,electrocardiogram(ECG),hematology,coagulation function,blood biochemistry,urine, ophthalmology,immune index,and pathological changes in organs and tissues were observed. At the same time,plasma drug concentrations were detected and the toxicokinetics parameters were analyzed. RESULTS No significant toxicological changes related to drugs were observed in general clinical observation,body mass,body temperature,ECG,ophthalmic examination,blood cell counts,coagu?lation function,blood biochemistry,urine analysis,lymphocyte subsets,cytokines,serum immuno?globulin,serum complement. Neutralizing anti-drug antibody(ADA)could be detected in adalimumab group and anti-hTNF-αFHMA groups. Anti-hTNF-αFHMA showed linear dynamic characteristics in cyno?molgus monkeys. At the same dose(10 mg·kg-1),anti-hTNF-αFHMA had similar immunogenicity and kinetics characteristics to adalimumab. CONCLUSION The level of anti-hTNF-α FHMA at which no adverse effect was observed was 50 mg · kg-1,which is equivalent to 75 times clinical dosage of quasi (0.67 mg·kg-1),which suggests that anti-hTNF-αFHMA be safe in clinical use.
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Objective To research the impact of various PEEP parameters of mechanical ventilation on liver mor-phology and function and on hemodynamics. Methods Fifty patients of respiratory failure due to COPD using mechanical ventilation was observed by prospective, exoterical and self-control methods after their condition were stabilized. The varia-tion of abdominal pressure was measured with different PEEP of 0 cmH2O, 5 cmH2O and 10 cmH2O with mechanical ventila-tion, and measured when patients breathe autonomously with tracheostomy tube. The changes of liver morphology, hepatic por-tal vein diameter, hemodynamics and liver function were also measured on above circumstances. Results With PEEP value increases:the abdominal pressure (IAP) rise (P＜0.01) while liver morphology, function and hepatic portal did not change markedly evidently (P>0.05). By contrast, blood flow of hepatic portal vein reduced with PEEP increase (P＜0.05). Conclu-sion Higher PEEP values on mechanical ventilation will causes abdominal pressure increases and low blood flow of hepatic portal , but not obvious impact on portal vein diameter and liver function.
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Objective To explore the bone marrow stromal cells,anti-late antigen-4 (VLA-4) antibody (aVLA-4),cytarabine (Ara-C) on the proliferation and apoptosis of leukemia HL-60 cells.Methods The experiment was divided into five groups:HL-60 cells were cultured alone (control group),HL-60 cells and stromal cells group (stromal cells group),HL-60 cells + stromal cells + aVLA-4 (antibody group),HL-60 cells + stromal cells + Ara-C group (drug group),HL-60 cells + stromal cells + aVLA-4 + Ara-C group (antibody +drug group).Cell proliferation or inhibition rate was detected by CCK-8 method,the HL-60 cells apoptosis was detected by flow cytometry.The expression of anti-apoptotic gene bcl-2 in HL-60 cells was determined by Western blot.Results After 24 h and 48 h,treatment,the number of the stromal cells group HL-60 cells were higher than that of the control group with significant difference cultured [(7.2±0.3)×1O5/ml vs (5.3±0.4)×105/ml,(8.4±0.2)×105/ml vs (6.8±0.3)×105/m1,P ＜ 0.001],while the HL-60 cell proliferation inhibition rate [(24.3±2.1) ％,(37.0±2.6) ％,(65.6±3.8) ％] and apoptosis rate [(5.7±0.6) ％,(8.0±0.5) ％,(10.4±0.9) ％,(16.5±0.7) ％] of antibody group,drug group,antibody + drug group were higher than the control group with a difference of statistically significant (P ＜ 0.05),and the increase of antibody + drug group was most obvious.With the decreasing of the bcl-2 protein expression,which was most the decrease of antibody + drug group was most obvious.Conclusion Bone marrow stromal cells can stimulate the proliferation of leukemia cells,aVLA-4 interference the interaction between stromal cells and leukemia cells can enhance the chemosensitivity of leukemia cells to Ara-C.
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Objective To observe the clinical efficacy and adverse reaction of the combination of fiudarabine,cytarabine and granulocytecolony-stimulating factor (G-CSF) (FLAG regime) therapy for refractory and relapsed acute leukemia in children. Methods From 2004 to date, a total of 9 patients with relapsed and refractory acute leukemia patients in our hospital accepted the treatment, in 9 cases 8 cases were AML,1cases were ALL; in 9 cases 5 cases were refractory acute leukemia, 4 cases were recurrent acute leukemia.Results Among the 9 cases,6 cases with 1 cycles of chemotherapy achieved complete remission (CR),CR rate was 66.7 ％ (6/9); partial remission (PR) rate was 22.2 ％ (2/9),total efficiency (CR+PR) was 88.9 ％.In 6 CR patients 2 underwent hematopoietic stem cell transplantation, are disease-free survival; this regimen' s main adverse reactions were infection,bone marrow depression and gastrointestinal reaction.Conclusion The remission rate of FLAG regimen in the treatment of children with refractory and relapsed acute leukemia is relatively high, adverse reactions were tolerable; the FLAG program is a choice for the treatment of children with refractory and relapsed acute leukemia,which provides the opportunity for subsequent hematopoietic stem cell transplantation.