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1.
Retina ; 44(6): 982-990, 2024 Jun 01.
Article in English | MEDLINE | ID: mdl-38767849

ABSTRACT

PURPOSE: To evaluate macular sensitivity using microperimetry in patients with proliferate diabetic retinopathy following vitrectomy and to investigate the relationship between the sensitivity and foveal microstructures with optical coherence tomography/angiography. METHODS: Eighty-four eyes of 84 patients with proliferative diabetic retinopathy, who were indicated for vitrectomy, had no intraocular surgery history 3 months preoperatively, and were able to ensure fundus examination after the vitrectomy, were included. A logMAR best-corrected visual acuity, macular sensitivity of microperimetry, macular retinal thickness, and macular vessel perfusion using optical coherence tomography/angiography were examined at 1 week, 1 month, and 3 months postoperatively. RESULTS: The logMAR best-corrected visual acuity and mean macular sensitivity of patients with proliferative diabetic retinopathy improved postoperatively (P < 0.05). There was a significant correlation between best-corrected visual acuity and mean sensitivity (P < 0.05). Postoperative mean macular sensitivity was significantly correlated with outer retinal thickness in the 0 to 6 mm macular area (P < 0.05) and also significantly correlated with deep capillary plexus perfusion (P < 0.05). Fixation stability and mean macular sensitivity did not show any correlation with glycated hemoglobin, triglyceride, serum total cholesterol, carbamide, and creatinine and duration of diabetes mellitus (P > 0.05). CONCLUSION: Postoperative mean macular sensitivity was significantly correlated with outer retinal thickness and deep capillary plexus perfusion for patients with proliferative diabetic retinopathy. The authors found that the visual performance of patients can be evaluated by the outer retinal thickness and deep capillary plexus perfusion, so optical coherence tomography/angiography examination can be an important prognostic factor for visual performance in patients.Clinical Trial Registration: This trial is registered with the Chinese Clinical Trial Registry (http://www.chictr.org.cn; Registration No.: ChiCTR2100043399).


Subject(s)
Diabetic Retinopathy , Fluorescein Angiography , Macula Lutea , Tomography, Optical Coherence , Visual Acuity , Visual Field Tests , Vitrectomy , Humans , Diabetic Retinopathy/physiopathology , Diabetic Retinopathy/surgery , Diabetic Retinopathy/diagnosis , Vitrectomy/methods , Male , Female , Tomography, Optical Coherence/methods , Visual Acuity/physiology , Middle Aged , Visual Field Tests/methods , Fluorescein Angiography/methods , Macula Lutea/blood supply , Macula Lutea/diagnostic imaging , Aged , Adult , Visual Fields/physiology , Retinal Vessels/physiopathology , Retinal Vessels/diagnostic imaging , Postoperative Period
2.
BMC Ophthalmol ; 24(1): 193, 2024 Apr 25.
Article in English | MEDLINE | ID: mdl-38664679

ABSTRACT

BACKGROUND: We aimed to investigate the anatomical features of optical coherence tomography (OCT) and vitreous cytokine levels as predictors of outcomes of combined phacovitrectomy with intravitreal dexamethasone (DEX) implants for idiopathic epiretinal membrane (iERM) treatment. METHODS: A prospective, single-masked, randomized, controlled clinical trial included 48 eyes. They were randomly assigned in a 1:1 ratio to undergo the DEX group (combined phacovitrectomy with ERM peeling and Ozurdex implantation) and control group (phacovitrectomy only). Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were assessed at 1 d, 1 week, 1 month, and 3 months. The structural features of OCT before surgery were analysed for stratified analysis. Baseline soluble CD14 (sCD14) and sCD163 levels in the vitreous fluid were measured using ELISA. RESULTS: BCVA and CMT were not significantly different in the DEX and control groups. Eyes with hyperreflective foci (HRF) at baseline achieved better BCVA (Ptime*group=0.746; Pgroup=0.043, Wald χ²=7.869) and lower CMT (Ptime*group = 0.079; Pgroup = 0.001, Wald χ²=6.774) responses to DEX during follow-up. In all patients, the mean vitreous level of sCD163 in eyes with HRF was significantly higher than that in eyes without HRF (P = 0.036, Z=-2.093) at baseline. In the DEX group, higher sCD163 predicted greater reduction in CMT from baseline to 1 month (r = 0.470, P = 0.049). CONCLUSIONS: We found that intraoperative DEX implantation did not have beneficial effects on BCVA and CMT over a 3-month period in all patients with iERM, implying that the use of DEX for all iERM is not recommended. In contrast, for those with HRF on OCT responded better to DEX implants at the 3-month follow-up and thier vitreous fluid expressed higher levels of sCD163 at baseline. These data support the hypothesis that DEX implants may be particularly effective in treating cases where ERM is secondary to inflammation. TRIAL REGISTRATION: The trail has been registered at Chinese Clinical Trail Registry( https://www.chictr.org.cn ) on 2021/03/12 (ChiCTR2100044228). And all patients in the article were enrolled after registration.


Subject(s)
Biomarkers , Dexamethasone , Aged , Female , Humans , Male , Middle Aged , Biomarkers/metabolism , Dexamethasone/administration & dosage , Dexamethasone/therapeutic use , Drug Implants , Epiretinal Membrane/surgery , Epiretinal Membrane/metabolism , Glucocorticoids/administration & dosage , Glucocorticoids/therapeutic use , Intravitreal Injections , Phacoemulsification , Prospective Studies , Single-Blind Method , Tomography, Optical Coherence/methods , Visual Acuity , Vitrectomy/methods , Vitreous Body/metabolism , Vitreous Body/diagnostic imaging
3.
Diabetes Metab Syndr Obes ; 17: 1199-1213, 2024.
Article in English | MEDLINE | ID: mdl-38476345

ABSTRACT

Purpose: To investigate the 3-months outcomes of patients who underwent intraoperative intravitreal injection of Ozurdex for proliferative diabetic retinopathy (PDR). Methods: This is a prospective randomized controlled clinical trial (ChiCTR2100043399). Seventy-one patients with PDR who had indications for surgery without intravitreal injection history within 3 months preoperatively were enrolled. Patients were randomly divided into three groups based on the medicine injected intraoperatively: Ozurdex, Conbercept, and Control group. The primary outcome is the best-corrected visual acuity (BCVA) within 3 months postoperatively. The secondary outcomes include the intraocular pressure (IOP), mean sensitivity, central retinal thickness and vessels perfusion. Results: The BCVA and the mean sensitivity improved in the three groups (F = 130.8, P < 0.0001; F = 34.18, P < 0.0001), but there was no statistical difference among the three groups (F = 0.858, P = 0.552; F = 0.964, P = 0.452). The IOP was no significant differences among the three groups within 3 months postoperatively (F = 0.881, P = 0.533). Compared with the other two groups, central retinal thickness (CRT) and outer retinal layer (ORL) thickness decreased significantly in patients of the Ozurdex group (F = 3.037, P = 0.008; F = 2.626, P = 0.018), especially in the diabetic macular edema (DME) patients (F = 2.761, P = 0.0164; F = 2.572, P = 0.0240). In macular region, superficial vascular plexus (SVP), intermediate capillary plexus (ICP) and deep capillary plexus (DCP) perfusion were not shown statistical difference at 3 months postoperatively in the all three groups compared with 1 day postoperatively (P > 0.05). Conclusion: Compared with the other two groups, anatomical outcomes was improved significantly in Ozurdex group for DR patients. Ozurdex may help to improve the visual acuity and visual sensitivity, and there is no significant difference in the change of IOP and microvascular improvement. Clinical Trial Registration: This trial is registered with the Chinese Clinical Trial Registry (http://www.chictr.org.cn, registration number ChiCTR2100043399).

6.
Mol Ther Methods Clin Dev ; 23: 633-643, 2021 Dec 10.
Article in English | MEDLINE | ID: mdl-34901308

ABSTRACT

Our previous clinical study achieved complete remission (CR) rates of >90% following chimeric antigen receptor T cells targeting CD19 (CART19) treatment of refractory/relapsed B cell acute lymphoblastic leukemia (r/r B-ALL); however, the influence of the leukemia burden in peripheral blood (PB) blasts remains unclear. Here, we retrospectively analyzed 143 patients treated with CART19 (including 36 patients with PB blasts) to evaluate the effect of peripheral leukemia burden at the time of apheresis. One hundred seventeen patients with high disease burdens achieved 91.5% CR or incomplete count recovery CR and 86.3% minimal residual disease-negative CR, and 26 patients with low disease burdens obtained 96.2% MRD- CR. Collectively, 9 of 36 (25%) patients with PB blasts and 2 of 107 (1.87%) patients without PB blasts did not respond to CART19 therapy. The leukemia burden in PB negatively influenced ex vivo cell characteristics, including the transduction efficiency of CD3+ T cells and their fold expansion, and in vivo cell dynamics, including peak CART19 proportion and absolute count, fold expansion, and persistence duration. Further studies showed that these patients had higher programmed death-1 expression in CART19 products. Our data imply that PB blasts negatively affected CART19 production and the clinical efficacy of CART19 therapy in patients with r/r B-ALL.

7.
FASEB J ; 35(5): e21535, 2021 05.
Article in English | MEDLINE | ID: mdl-33817835

ABSTRACT

Thymic epithelial cells (TECs) are indispensable for T cell development, T cell receptor (TCR) repertoire selection, and specific lineage differentiation. Medullary thymic epithelial cells (mTECs), which account for the majority of TECs in adults, are critical for thymocyte selection and self-tolerance. CD74 is a nonpolymorphic transmembrane glycoprotein of major histocompatibility complex class II (MHCII) that is expressed in TECs. However, the exact role of CD74 in regulating the development of mTEC is poorly defined. In this research, we found that loss of CD74 resulted in a significant diminution in the medulla, a selective reduction in the cell number of mature mTECs expressing CD80 molecules, which eventually led to impaired thymic CD4+ T cell development. Moreover, RNA-sequence analysis showed that CD74 deficiency obviously downregulated the canonical nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) signaling pathway in mTECs. Our results suggest that CD74 positively controls mTEC cellularity and maturation partially by activating the canonical NF-κB signaling pathway.


Subject(s)
Antigens, Differentiation, B-Lymphocyte/physiology , Cell Differentiation , Epithelial Cells/pathology , Gene Expression Regulation , Histocompatibility Antigens Class II/physiology , Lymphocyte Activation/immunology , NF-kappa B/metabolism , Thymus Gland/pathology , Animals , Epithelial Cells/immunology , Epithelial Cells/metabolism , Mice , Mice, Inbred C57BL , Mice, Knockout , NF-kappa B/genetics , Signal Transduction , Thymus Gland/immunology , Thymus Gland/metabolism
8.
Int J Infect Dis ; 105: 769-775, 2021 Apr.
Article in English | MEDLINE | ID: mdl-33618006

ABSTRACT

OBJECTIVES: To describe epidemiological trends and spatial distributions of HIV/AIDS among older adults (aged ≥50) in Sichuan Province, China during 2008-19, and provide scientific reference for HIV/AIDS prevention, intervention and treatment. METHODS: Data on HIV/AIDS cases reported in 2008-19 was extracted from the Case Report System. The Cochran-Armitage trend test was used to determine epidemic trends. Spatial autocorrelation and space-time analysis were conducted with ArcGIS10.6 and ArcGIS Pro2.4, respectively. RESULTS: A total of 77854 HIV/AIDS cases among older adults were included in the study. Newly reported cases increased from 320 in 2008 to 22189 in 2019, and the reported incidence rate (number of new reported cases/older adult population) rose from 0.001% to 0.077%. Infections through heterosexual transmission increased from 65.3% to 98.2% of total cases in older adults in this period. Spatial analysis at the county-level showed significant clustering throughout Sichuan, with the main hot spots concentrated in the southeast. Spatiotemporal analysis indicated that most of the southeastern counties/districts were Consecutive Hot Spots. CONCLUSIONS: Older adults have become a key population in the HIV/AIDS epidemic in Sichuan; comprehensive prevention and intervention measures targeted to older adults are urgently needed to control the spread of HIV/AIDS.


Subject(s)
Acquired Immunodeficiency Syndrome/epidemiology , HIV Infections/epidemiology , Acquired Immunodeficiency Syndrome/prevention & control , Aged , China/epidemiology , Epidemics , Female , HIV Infections/prevention & control , Humans , Incidence , Male , Middle Aged , Prevalence , Spatial Analysis , Spatio-Temporal Analysis
9.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 51(2): 131-138, 2020 Mar.
Article in Chinese | MEDLINE | ID: mdl-32220177

ABSTRACT

This review summarizes the ongoing researches regarding etiology, epidemiology, transmission dynamics, treatment, and prevention and control strategies of the coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with comparison to severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV) and pandemic H1N1 virus. SARS-CoV-2 may be originated from bats, and the patients and asymptomatic carriers are the source of epidemic infection. The virus can be transmitted human-to-human through droplets and close contact, and people at all ages are susceptible to this virus. The main clinical symptoms of the patients are fever and cough, accompanied with leukocytopenia and lymphocytopenia. Effective drugs have been not yet available thus far. In terms of the prevention and control strategies, vaccine development as the primary prevention should be accelerated. Regarding the secondary prevention, ongoing efforts of the infected patients and close contacts quarantine, mask wearing promotion, regular disinfection in public places should be continued. Meanwhile, rapid detection kit for serological monitoring of the virus in general population is expected so as to achieve early detection, early diagnosis, early isolation and early treatment. In addition, public health education on this disease and prevention should be enhanced so as to mitigate panic and mobilize the public to jointly combat the epidemic.


Subject(s)
Betacoronavirus , Coronavirus Infections , Pandemics , Pneumonia, Viral , Asymptomatic Diseases , Betacoronavirus/pathogenicity , COVID-19 , COVID-19 Testing , COVID-19 Vaccines , Clinical Laboratory Techniques , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Cough/etiology , Early Diagnosis , Fever/etiology , Humans , Influenza A Virus, H1N1 Subtype , Leukopenia/etiology , Lymphopenia/etiology , Middle East Respiratory Syndrome Coronavirus , Pandemics/prevention & control , Pneumonia, Viral/complications , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Severe acute respiratory syndrome-related coronavirus , SARS-CoV-2 , Secondary Prevention , Viral Vaccines
10.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 50(4): 551-555, 2019 Jul.
Article in Chinese | MEDLINE | ID: mdl-31642234

ABSTRACT

OBJECTIVE: To investigate the status and influencing factors of the knowledge and behavior related to brucellosis among occupational workers in Jianyang city, and to provide basic information for developing regional specific strategies for brucellosis prevention and control. METHODS: With multistage cluster random sampling, occupational workers aged ≥18 yr. who had been in contact with sheep and their products were interviewed through a questionnaire about demographic characteristic, knowledge, and behavior related to brucellosis. The knowledge and practice scores were described as frequency and percentage, and the awareness rate of knowledge about brucellosis was calculated. Unconditional logistic regression model was used to analyze the influencing factors of knowledge and behavior related to brucellosis. RESULTS: In total, 378 workers were recruited. The minority (25.1%) of the workers had heard of brucellosis, and the awareness rate of brucellosis was 22.0%. Occupational protective behaviors were poor, and the scoring rates of wearing protective clothes, mask and gloves were 58.7%, 76.5%, 71.7% respectively. The results of multivariate logistic regression analysis revealed that the awareness rate of knowledge about brucellosis decreased with age, while the low educational level was found to be associated with low awareness of knowledge about brucellosis, and occupation type had association with the awareness rate of knowledge. Besides, the awareness of knowledge about brucellosis was a protective factor and occupation type were associated with the behavior related to brucellosis. CONCLUSIONS: The knowledge and behavior related to brucellosis are poor among occupational workers in Jianyang. It is necessary to continuously implement targeted health education and health promotion programs in this region, and the people with low education level and livestock farmers should be paid special attention to.


Subject(s)
Brucellosis , Health Knowledge, Attitudes, Practice , Occupational Exposure/prevention & control , Animals , Humans , Logistic Models , Sheep , Surveys and Questionnaires
11.
Medicine (Baltimore) ; 98(24): e15923, 2019 Jun.
Article in English | MEDLINE | ID: mdl-31192928

ABSTRACT

This study aims to analyze the influence of comprehensive nursing intervention on the postoperative pain, complications, and psychological pressure of otolaryngology patients.A total of 300 otolaryngology patients in our hospital from February 2016 to October 2017 were selected and randomly divided into 2 groups using the random number table: control group (n = 150), patients were given routine nursing; experimental group (n = 150), patients were given comprehensive nursing intervention. Postoperative pain, complications, and psychological pressure between the 2 groups were analyzed.Residual pain in the experimental group at 3 months after the operation was lower than that in the control group (P < .05). The postoperative complications in the experimental group was lower than that in the control group (P < .05). The acute psychological pressure score and the psychological pressure self-test score in the experimental group were both lower than that in the control group (P < .05).Comprehensive nursing intervention for otolaryngology patients was associated to relieving pain after the operation and psychological pressure of patients in the short and long term. Besides, comprehensive nursing intervention for otolaryngology patients was associated with a lower risk of complications.


Subject(s)
Pain Management/methods , Pain, Postoperative/nursing , Pain, Postoperative/psychology , Adult , Aged , Female , Humans , Inpatients , Male , Middle Aged , Nurse's Role , Nursing Assessment , Otolaryngology
12.
Differentiation ; 107: 42-49, 2019.
Article in English | MEDLINE | ID: mdl-31238242

ABSTRACT

Functional mature T cells are generated in the thymus. Thymic epithelial cells (TECs) provide the essential microenvironment for T cell development and maturation. According to their function and localization, TECs are roughly divided into cortical TECs (cTECs) and medullary TECs (mTECs), which are responsible for positive and negative selection, respectively. This review summarizes the current understanding of TEC biology, the identification of fetal and adult bipotent TEC progenitors, and the signaling pathways that control the development and maturation of TECs. The understanding of the ontogeny, differentiation, maturation and function of cTECs lags behind that of mTECs. Better understanding TEC biology will provide clues about TEC development and the applications of thymus engineering.


Subject(s)
Epithelial Cells/cytology , Thymocytes/cytology , Thymus Gland/cytology , Cell Differentiation , Signal Transduction , T-Lymphocytes/cytology , Tissue Engineering
13.
Infect Genet Evol ; 67: 44-50, 2019 01.
Article in English | MEDLINE | ID: mdl-30347249

ABSTRACT

Enterovirus 71 is the main pathogen that causes severe and fatal hand-foot-mouth-disease (HFMD) cases. As the enterovirus virus mutation has implications for pathogenesis, vaccine development, antiviral therapy, and epidemiological disease management of the virus. In this study, we investigated the variations of enterovirus 71 in thermal adaption, using the method of adaptive laboratory evolution. The sibling virus strains were isolated from a 2-year-old severe case of HFMD (#100) and her symptomless close contact (#101). Both strains were cultured in Vero cells by serial passage of 36 generations at the temperatures of 28.0 °C, 33.0 °C and 39.5 °C to construct adaptive lineages. According to the comparative analysis of phenotypes between adapted strains and parental strains, differences in growth rate were observed in the sibling lineages and a larger plaque was found mainly in the hot adapted strains for lineage #101. Two sets of adaptive strains from six time points (parental, 12th 17th, 31st, 35th passage and endpoint) were sequenced and analyzed by both Sanger sequencing and Next Generation Sequencing. Several variations in most coding genes and one reverse mutation in 5'UTR was observed, along with the identity of 99.8% for complete genome for both lineages. Notably, thermal specific non-synonymous mutations were found in the gene of VP1\VP3\3A\2C\3C. Moreover, the concurrent mutations A292G, A434G and A355C/T of sibling lineages in VP1 showed quantificational trace with distinguishing patterns for different temperatures, which were suspected to be the thermo-sensitive mutation hotspots. These results highlight the possible rules of thermal adaption in enterovirus 71, produce a novel picture of genome evolution of the virus, and shed light on viral variation and evolution.


Subject(s)
Adaptation, Biological , Enterovirus A, Human/classification , Enterovirus A, Human/genetics , Temperature , 5' Untranslated Regions , Animals , Biological Evolution , Cells, Cultured , Chlorocebus aethiops , Enterovirus Infections/virology , Genome, Viral , Humans , Sequence Analysis, DNA , Vero Cells , Viral Plaque Assay , Virus Replication
14.
International Eye Science ; (12): 753-756, 2019.
Article in Chinese | WPRIM (Western Pacific) | ID: wpr-735195

ABSTRACT

@#AIM: To analyze the application effects of femtosecond laser assisted cataract surgery(FLACS)in patients with hard nuclear cataract.<p>METHODS: The clinical data of each 42 cases(eyes)in patients with hard nuclear cataract who underwent FLACS(observation group)and traditional phacoemulsification(control group)were retrospectively analyzed. The operation conditions and postoperative recovery were recorded in the two groups.<p>RESULTS: The mean ultrasound power, actual phacoemulsification time and effective phacoemulsification time and corneal edema degree at 3d after operation in observation group were lower than those in control group(<i>P</i><0.05). The changes of postoperative corrected distance visual acuity(CDVA), uncorrected distance visual acuity(UCDVA)and corneal endothelial cell loss rate showed 3d after operation>1wk after operation>1mo after operation, and the changes in observation group were greater than those in control group(<i>P</i><0.05). The corneal endothelial cell density in observation group at each time point after operation was higher than that in control group(<i>P</i><0.05).<p>CONCLUSION: FLACS has significant effects on hard nuclear cataract.

15.
Autophagy ; 14(3): 505-517, 2018.
Article in English | MEDLINE | ID: mdl-29099279

ABSTRACT

Thymic epithelial cells (TECs) are critical for the establishment and maintenance of appropriate microenvironment for the positive and negative selection of thymocytes and the induction of central immune tolerance. Yet, little about the molecular regulatory network on TEC development and function is understood. Here, we demonstrate that MTOR (mechanistic target of rapamycin [serine/threonine kinase]) is essential for proper development and functional maturation of TECs. Pharmacological inhibition of MTOR activity by rapamycin (RPM) causes severe thymic atrophy and reduction of TECs. TEC-specific deletion of Mtor causes the severe reduction of mTECs, the blockage of thymocyte differentiation and output, the reduced generation of thymic regulatory T (Treg) cells and the impaired expression of tissue-restricted antigens (TRAs) including Fabp2, Ins1, Tff3 and Chrna1 molecules. Importantly, specific deletion of Mtor in TECs causes autoimmune diseases characterized by enhanced tissue immune cell infiltration and the presence of autoreactive antibodies. Mechanistically, Mtor deletion causes overdegradation of CTNNB1/Beta-Catenin due to excessive autophagy and the attenuation of WNT (wingless-type MMTV integration site family) signaling in TECs. Selective inhibition of autophagy significantly rescued the poor mTEC development caused by Mtor deficiency. Altogether, MTOR is essential for TEC development and maturation by regulating proliferation and WNT signaling activity through autophagy. The present study also implies that long-term usage of RPM might increase the risk of autoimmunity by impairing TEC maturation and function.


Subject(s)
Autophagy/immunology , Cell Differentiation/immunology , Epithelial Cells/metabolism , TOR Serine-Threonine Kinases/metabolism , Thymocytes/immunology , Animals , Lymphocyte Activation/immunology , Mice, Transgenic , Signal Transduction/immunology , T-Lymphocytes, Regulatory/metabolism
16.
J Crit Care ; 30(5): 1101-6, 2015 Oct.
Article in English | MEDLINE | ID: mdl-26260916

ABSTRACT

Pharmacists are integral members of the multidisciplinary team for critically ill patients. Multiple nonrandomized controlled studies have evaluated the outcomes of pharmacist interventions in the intensive care unit (ICU). This systematic review focuses on controlled clinical trials evaluating the effect of pharmacist intervention on medication errors (MEs) in ICU settings. Two independent reviewers searched Medline, Embase, and Cochrane databases. The inclusion criteria were nonrandomized controlled studies that evaluated the effect of pharmacist services vs no intervention on ME rates in ICU settings. Four studies were included in the meta-analysis. Results suggest that pharmacist intervention has no significant contribution to reducing general MEs, although pharmacist intervention may significantly reduce preventable adverse drug events and prescribing errors. This meta-analysis highlights the need for high-quality studies to examine the effect of the critical care pharmacist.


Subject(s)
Critical Illness/therapy , Medication Errors/prevention & control , Pharmacists , Practice Patterns, Physicians' , Controlled Clinical Trials as Topic , Critical Care , Humans , Intensive Care Units , Observational Studies as Topic
17.
Am J Reprod Immunol ; 73(6): 522-35, 2015 Jun.
Article in English | MEDLINE | ID: mdl-25640465

ABSTRACT

PROBLEM: Maternal immune activation (MIA) is a risk factor for autism and schizophrenia. However, how MIA affects offspring immune function remains unknown. METHOD OF STUDY: To investigate the effect of MIA on the offspring, pregnant C57BL/6J mice were given an intraperitoneal injection of 50 µg/kg lipopolysaccharide (LPS) on gestational day 12.5. RESULTS: Adult LPS-treated offspring were hyper-reactive to LPS, and enhanced tumor necrosis factor-α production was observed. CD4+ T cells from LPS offspring had an elevated percentage of interferon (IFN)-γ(+) CD4+ T cells and interleukin (IL)-17A+ CD4+ T cells in the spleen, IL-17A+ CD4+ T cells in the liver, and CD4+ Foxp3+ T cells in the spleen. LPS offspring CD4+ T cells showed increased proliferation and an enhanced survival rate. DNA microarray analysis of resting LPS offspring CD4+ T cells identified eight up-regulated genes, most of which encoded transcription factors. Quantitative liquid chromatography-mass spectrometry identified 18 up-regulated proteins in resting LPS offspring CD4+ T cells and five up-regulated proteins in activated LPS offspring CD4+ T cells, most of which participated in the PANTHER Gene Ontology metabolic process. CONCLUSIONS: Our results showed that MIA to LPS up-regulated proteins involved in metabolic process in CD4+ T cells from LPS offspring that might contribute to the hyperactivated immune response of adult LPS offspring.


Subject(s)
CD4-Positive T-Lymphocytes/immunology , Lipopolysaccharides/toxicity , Maternal Exposure/adverse effects , Prenatal Exposure Delayed Effects/chemically induced , Prenatal Exposure Delayed Effects/immunology , Animals , Autistic Disorder/immunology , Autistic Disorder/pathology , CD4-Positive T-Lymphocytes/pathology , Female , Interferon-gamma/immunology , Interleukin-17/immunology , Mice , Pregnancy , Prenatal Exposure Delayed Effects/pathology
19.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 26(6): 425-30, 2014 Jun.
Article in Chinese | MEDLINE | ID: mdl-24912643

ABSTRACT

OBJECTIVE: To systematically review the efficacy and safety of erythromycin on enteral nutrition (EN) tolerance in adult critical care patients. METHODS: Databases including PubMed, EMbase, the Cochrane Library, CNKI and Wangfang data were retrieved up to June, 2013 to collect the randomized controlled trial (RCT) concerning erythromycin in improving EN tolerance or increasing the successful rate of postpyloric EN tube as compared with other treatments. Two reviewers independently screened the literature, extracted the data, and assessed the quality of methodology. Then Meta-analysis was performed using RevMan 5.2 software. RESULTS: A total of 16 RCTs were included. Ten RCTs involving 668 patients were included for evaluating erythromycin in improving EN tolerance. Six RCTs involving 353 patients were included for evaluating erythromycin to increase the successful rate of postpyloric EN tube. The result of Meta-analysis showed that compared with placebo, erythromycin could significantly improve the successful rate of postpyloric EN tube placement [relative risk (RR)=1.82, 95% confidence interval (95%CI) 1.40-2.37, P<0.000 01], while there was no significant difference between erythromycin and metoclopramide (RR=1.04, 95%CI 0.79-1.36, P=0.799). In patients who needed early EN, compared with placebo or blank control, erythromycin had higher successful gastric feeding rate over 5 days (RR=1.89, 95%CI 1.19-3.00, P=0.007). In patients who failed EN, compared with metoclopramide, erythromycin could significantly increase the successful gastric EN rate for 24 hours (RR=1.30, 95%CI 1.02-1.66, P=0.03), 72 hours (RR=1.57, 95%CI 1.15-2.14, P=0.005) and 144 hours (RR=2.04, 95%CI 1.23-3.37, P=0.006). The median time of EN intolerance was postponed in erythromycin group than that in metoclopramide group. Adverse reactions were reported in 5 studies. There was no statistic difference except for the higher diarrhea rate in the combination treatment group compared with erythromycin group. CONCLUSIONS: Postpyloric EN tube placement rate can be improved by erythromycin, which could be a choice of substitute for bedside intubation without fluoroscopy or endoscopic assistance. Based on the evidence, we recommended that intravenous erythromycin in a small dose of approximately 3 mg/kg weight as an option for EN intolerance in critical patients.


Subject(s)
Enteral Nutrition , Erythromycin/therapeutic use , Adult , Critical Care , Humans , Randomized Controlled Trials as Topic
20.
Asian Pac J Cancer Prev ; 14(11): 6673-80, 2014 Jan.
Article in English | MEDLINE | ID: mdl-24377587

ABSTRACT

OBJECTIVE: Insulin resistance (IR) is an established risk factor for colorectal cancer (CRC). Given that CRC and IR physiologically overlap and the calpain-10 gene (CAPN10) is a candidate for IR, we explored the association between CAPN10 and CRC risk. METHODS: Blood samples of 400 case-control pairs were genotyped, and the lifestyle and dietary habits of these pairs were recorded and collected. Unconditional logistic regression (LR) was used to assess the effects of CAPN10 SNP43 and SNP19, and environmental factors. Both generalized multifactor dimensionality reduction (GMDR) and the classification and regression tree (CART) were used to test gene-environment interactions for CRC risk. RESULTS: The GA+AA genotype of SNP43 and the Del/Ins+Ins/Ins genotype of SNP19 were marginally related to CRC risk (GA+AA: OR = 1.35, 95% CI = 0.92-1.99; Del/Ins+Ins/ Ins: OR = 1.31, 95% CI = 0.84-2.04). Notably, a high-order interaction was consistently identified by GMDR and CART analyses. In GMDR, the four-factor interaction model of SNP43, SNP19, red meat consumption, and smoked meat consumption was the best model, with a maximum cross-validation consistency of 10/10 and testing balance accuracy of 0.61 (P < 0.01). In LR, subjects with high red and smoked meat consumption and two risk genotypes had a 6.17-fold CRC risk (95% CI = 2.44-15.6) relative to that of subjects with low red and smoked meat consumption and null risk genotypes. In CART, individuals with high smoked and red meat consumption, SNP19 Del/Ins+Ins/Ins, and SNP43 GA+AA had higher CRC risk (OR = 4.56, 95%CI = 1.94-10.75) than those with low smoked and red meat consumption. CONCLUSIONS: Though the single loci of CAPN10 SNP43 and SNP19 are not enough to significantly increase the CRC susceptibility, the combination of SNP43, SNP19, red meat consumption, and smoked meat consumption is associated with elevated risk.


Subject(s)
Calpain/genetics , Colorectal Neoplasms/genetics , Polymorphism, Single Nucleotide/genetics , Adult , Aged , Aged, 80 and over , Case-Control Studies , DNA/analysis , DNA/genetics , Feeding Behavior , Female , Gene-Environment Interaction , Genotype , Humans , Male , Meat , Middle Aged , Polymerase Chain Reaction , Prognosis , Risk Factors
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