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OBJECTIVE@#To analyze the clinical characteristics of bloodstream infection (BSI) in patients treated by hematopoietic stem cell transplantation (HSCT).@*METHODS@#The clinical characteristics, distribution of pathogenic bacteria causing BSI and drug sensitivity of 910 patients treated by HSCT in our department from January 2013 to June 2020 were retrospectively analyzed.@*RESULTS@#Among 910 HSCT patients, 111 patients were diagnosed as BSI within 100 days after transplantation, and 98 patients showed BSI during the period of agranulocytosis. Multivariate analysis showed that the usage of anti-thymocyte globulin (ATG), long duration of agranulocytosis and low infusion volume of mononuclear cell (MNC) were the independent risk factors affecting BSI after HSCT. Among 121 pathogenic bacteria isolated, 76 Gram-negative (G-) bacteria (62.8%), 40 Gram-positive (G+) bacteria (33.0%), and 5 fungi (4.1%) were detected out. The top three pathogens were Escherichia coli, Staphylococcus epidermidis and Pseudomonas aeruginosa. The drug-resistance rates of Escherichia coli and Klebsiella pneumoniae to carbapenems was 14.3% and 7.7%, respectively, and Pseudomonas aeruginosa was 66.7%. The susceptibility of G+ bacteria to vancomycin, linezolid and teicoplanin was 97.5%, 100% and 100%, respectively. The crude mortality rate of the patients with BSI at 100 days after HSCT was significantly higher than that of patients without BSI (P<0.001).@*CONCLUSION@#The usage of ATG, long duration of agranulocytosis and low infusion volume of MNC are independent risk factors for BSI after HSCT. The pathogens after HSCT are mainly G- bacteria. Pseudomonas aeruginosa is highly resistant to carbapenems. Key words ;
Subject(s)
Humans , Bacteremia/epidemiology , Bacteria , Hematopoietic Stem Cell Transplantation , Retrospective Studies , SepsisABSTRACT
The goal of this study was to investigate the clinical application of free/total prostate-specific antigen (F/T PSA) ratio, considering the new broad serum total PSA (T-PSA) "gray zone" of 2.0-25.0 ng ml-1 in differential diagnosis of prostate cancer (PCa) and benign prostate diseases (BPD) in men over 50 years in Western China. A total of 1655 patients were included, 528 with PCa and 1127 with BPD. Serum T-PSA, free PSA (F-PSA), and F/T PSA ratio were analyzed. Receiver operating characteristic curves were used to assess the efficiency of PSA and F/T PSA ratio. There were 47.4% of cancer patients with T-PSA of 2.0-25.0 ng ml-1. When T-PSA was 2.0-4.0 ng ml-1, 4.0-10.0 ng ml-1, and 10.0-25.0 ng ml-1, the area under the curve (AUC) of F/T PSA ratio was 0.749, 0.769, and 0.761, respectively. The best AUC of F/T PSA ratio was 0.811 when T-PSA was 2.0-25.0 ng ml-1, with a specificity of 0.732, a sensitivity of 0.788, and an optimal cutoff value of 15.5%. The AUC of F/T PSA ratio in different age groups (50-59 years, 60-69 years, 70-79 years, and ≥80 years) was 0.767, 0.806, 0.815, and 0.833, respectively, and the best sensitivity (0.857) and specificity (0.802) were observed in patients over 80 years. The T-PSA trend was in accordance with the Gleason score, tumor node metastasis (TNM) stage, and American Joint Committee on Cancer prognosis group. Therefore, the F/T PSA ratio can facilitate the differential diagnosis of PCa and BPD in the broad T-PSA "gray zone". Serum T-PSA can be a Gleason score and prognostic indicator.
Subject(s)
Humans , Male , Middle Aged , Area Under Curve , Prostate-Specific Antigen , Prostatic Neoplasms/pathology , ROC Curve , Sensitivity and SpecificityABSTRACT
OBJECTIVE@#To investigate the clinical characteristics, etiology and drug susceptibility of bacterial bloodstream infections in acute leukemia(AL) patients.@*METHODS@#Clinical data, etiology and drug susceptibility of acute leukemia patients with bacterial bloodstream infections from April 2009 to April 2018 were retrospectively analyzed.@*RESULTS@#A total of 376 strains were isolated, 76.9% was Gram-negative bacterial and 23.1% was Gram-positive bacteria. Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumoniae were listed as the top three of Gram-negative bacteria. The susceptibility of Escherichia coli to the tigacycline, imipenem and meropenem was 100.0%, 98.2% and 98.1%, respectively. The susceptibility of Klebsiella pneumoniae to the tigacycline, imipenem and meropenem were 100.0%, 98.3% and 94.4%, respectively. The adjustment rate for initial use of carbopenems was 3.8%, while the adjustment rate for initial use of noncarbopenems was 74.3% in patients with main Gram-negative bacterial blood stream infection. The susceptibility of Gram-positive bacteria to glycopeptide antibiotics, linezolid and tigacycline was 100.0%.@*CONCLUSION@#Gram-negative bacteria is the majority type of bacteria in AL patients with bacteria blood stream infections. The susceptibility of Gram-negative bacteria to the carbapenems is high, and the treatment adjustment rate is obviously low. The glycopeptide, linezolid and tigacycline are effective for Gram-positive bacteria infections..
Subject(s)
Humans , Bacteremia , Gram-Negative Bacteria , Gram-Positive Bacteria , Microbial Sensitivity Tests , Retrospective StudiesABSTRACT
Objective:To study the acute toxicity in mice and cytotoxicity of the impuritiy(3-amino-2-piperidinone hydrochloride) in ornithine. Methods:The mice were given the impurity by intravenous injection.The acute toxicity was observed and LD50in mice was calculated by Bliss method. According to the result of LD50,the mice were given the impurity respectively at high,medium and low dose. The changes of general condition and body weight were recorded,and the blood biochemical indices and histomorphology of organs and tissues were observed after 14 days. The cytotoxicity was measured on fibroblasts(L929) cells. Results:The LD50and 95% con-fidence limit of the impurity (intragastric administration) was 758.49-848.08 mg·kg-1.All the detected indices of the three groups (660,330 and 170 mg·kg-1) including general condition,weight change,biochemical indices,organ morphological and histological change were all within the normal ranges. The impurity significantly decreased the viability of L929 cells. The NOAEL value was 660 mg·kg-1in mice. Conclusion:The impurity has certain toxicity to mice and cells. The data can provide experimental basis for the quality standard establishment for ornithine and the safety improvement in clinic use.
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At present,transplantation has been the predominant way to solve most of the end-stage diseases,ensued by the use of immunosuppressive drugs.Since the immunosuppressive drugs have narrow therapeutic index,the blood drug concentration is needed to mornior.Pharmacogenetics is one subject which focuses on the interaction between gene and the metabolism of the drug,providing great help for designing the regime of achieving the target drug concentration.Meanwhile,it facilitates the realization of individual therapy.This review thus focuses on the latest advancement on the pharmacogenetics of those immunosupprressants,hoping to provide help for the treatment.
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Objective To analyze blood-CSF barrier and cerebrospinal intrathecal IgG synthesis in patients of multiple sclerosis, and explore the Protis software, IgG index and IgG synthesis rate in the and evaluation for cerebrospinal intrathecal IgG synthesis and blood-CSF barrier dysfunction. Methods 134 patients with neurological diseases were divided into threes groups, including multiple sclerosis group (34 cases), disease control group(80 cases) and control group(20 cases). IgG and ALB concentration of CSF and blood was detected by BN-Ⅱ. The oligoclonal IgG was detected by immunofixation electrophoresis. The relationship between Protis software results and IgG index or IgG synthesis rate was calculated and analyzed. Results The function of blood-brain barrier was almost normal in multiple sclerosis group,QALB was 4.5×10-3[(3.1-7.6)×10-3], there was no significance compared with control group (D=5.25, P>0.05). there were 31 patients with oligaclonal bands in cerebrospinal fluids in multiple sclerosis group (34 patients) with the positive rate of 91.2%. In multiple sclerosis group the intrethecal IgGIF, IgG index and IgG synthesis rate of 24 hours were 31.25% (11.65%-71.45 %), 0.93% (0.80%-1.04%), 24.25 mg/24 h(15.25-46.15 mg/24 h) ,the results were all higher than that in control group (D=175.5, 112.5,103.4,P<0.05). And in multiple sclerosis group there was no significant difference among the intrethecal IgGIF, IgG index and IgG synthesis rate of 24 hours, the positive rate of oligaclonal bands (P>0.05). In disease control group(80 patients) QALB Was 35.2×10-3[(18.5-55.5)×10-3] ,the result was significantly higher than control group (D=102.7, P<0.05), the oligaclonal bands were all negative, IgG index and IgG synthesis rate of 24 hours were 0.75(0.69-0.82) ,44.29 mg/24 h(20.35-65.98 mg/24 h) were both higher than control group(D=85.6,98.5,P<0.05). In disease control group the positive rate of intrathecal IgGIF, IgG index and IgG synthesis rate of 24 hours were 0 (0/80), 40.0% (32/80), 72.5% (58/80) respectively, IgG index and its positive rate both increased alone with the lesion degree of blood-brain barrier increasing (P<0.05). And there was similar trend in the IgG synthesis rate of 24 hours. There were significant correlations among intrathecal IgGIF, IgG index and IgG synthesis rate of 24 hours in multiple sclerosis group (r=0.788, 0.695 ,P<0.05). However there was no correlation among intrathecal IgGIF, IgG index and IgG synthesis rate of 24 hours in disease control group (r=0.000,P>0.05). Conclusions The Protis software can be used to analyze the intrathecal IgGIF and reflect the actual status of intrathecal IgG synthesis more accurately. Protis software has great application value for clinical diagnosis for nervous system disease.
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<p><b>BACKGROUND</b>Cytotoxic lymphocytes play an important role in anti-tumor immune. CD₃+CD₅₆+NKT cells, which are a new type of cytotoxic cells, are mainly focused on anti-tumor effect in hematologic malignancy, however its cytotoxic effects on solid tumor are not clear. The aim of this study is to explore the clinical expression and significance of peripheral CD₃+CD₅₆+NKT cells and CD₃-CD₅₆+NK cells in patients with solid malignant tumors.</p><p><b>METHODS</b>Peripheral T cell subsets and CD₃+CD₅₆+NKT cells and CD₃-CD₅₆+NK cells in 118 patients with malignant tumors (55 lung cancers and 63 breast cancers) and 46 healthy volunteers were analysed by flow cytometer.</p><p><b>RESULTS</b>Compared with healthy control, both peripheral CD₃+T lymphocytes and CD₃+CD₄+ T lymphocytes in patients with lung cancer or breast cancer significantly decreased, but CD₃+CD₈+T lymphocytes only increased significantly in patients with lung cancer (P < 0.01). Further analysis of CD₃+CD₅₆+NKT cells and CD₃-CD₅₆+NK cells indicated that there was difference between lung cancer group and breast cancer group. In patients with lung cancer CD₃+CD₈+T cells and CD₃+CD₅₆+NKT cells increased significantly, and in patients with breast cancer CD₃+CD₅₆+NKT cells and CD₃-CD₅₆+NK cells increased obviously.</p><p><b>CONCLUSIONS</b>In patients with lung cancer or breast cancer, CD₃+CD₅₆+NKT cells play the important role in anti-tumor effects, however, the anti-tumor effects of CD₃+CD₈+CTL and CD₃-CD₅₆+ NK cells were different.</p>