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Objective:To compare the efficacy of the combination of abidol, lopinavir/ritonavir plus recombinant interferon α-2b (rIFNα-2b) and the combination of lopinavir/ritonavir plus rIFNα-2b for patients with COVID-19 in Zhejiang province.Methods:A multicenter prospective study was carried out to compare the efficacy of triple combination antiviral therapy and dual combination antiviral therapy in 15 medical institutions of Zhejiang province during January 22 to February 16, 2020. All patients were treated with rIFNα-2b (5 million U, 2 times/d) aerosol inhalation, in addition 196 patients were treated with abidol (200 mg, 3 times/d) + lopinavir/ritonavir (2 tablets, 1 time/12 h) (triple combination group) and 41 patients were treated with lopinavir/ritonavir (2 tablets, 1 time/12 h) (dual combination group). The patients who received triple combination antiviral therapy were further divided into three subgroups: <48 h, 3-5 d and >5 d according the time from the symptom onset to medication starting. The therapeutic efficacy was compared between triple combination group and dual combination group, and compared among 3 subgroups of patients receiving triple combination antiviral therapy. SPSS 17.0 software was used to analyze the data.Results:The virus nucleic acid-negative conversion time in respiratory tract specimens was (12.2±4.7) d in the triple combination group, which was shorter than that in the dual combination group [(15.0±5.0) d] ( t=6.159, P<0.01). The length of hospital stay in the triple combination group [12.0 (9.0, 17.0) d] was also shorter than that in the dual combination group [15.0 (10.0, 18.0) d] ( H=2.073, P<0.05). Compared with the antiviral treatment which was started within after the symptom onset of in the triple combination group, the time from the symptom onset to the viral negative conversion was 13.0 (10.0, 17.0), 17.0 (13.0, 22.0) and 21.0 (18.0, 24.0) d in subgroups of 48 h, 3-5 d and >5 d, respectively ( Z=32.983, P<0.01), while the time from antiviral therapy to viral negative conversion was (11.8±3.9), (13.5±5.1) and (11.2±4.3) d, respectively( Z=6.722, P<0.05). Conclusions:The triple combination antiviral therapy of abidol, lopinavir/litonavir and rIFNα-2b shows shorter viral shedding time and shorter hospitalization time, compared with the dual combination antiviral therapy; and the earlier starting triple combination antiviral therapy will result in better antiviral efficacy.
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Objective:To systematically analyze the clinical features of severe fever with thrombocytopenia syndrome (SFTS) and to provide evidence for the prevention and treatment of SFTS.Methods:Relevant studies of SFTS from six databases, including China National Knowledge Infrastructure, Wanfang Database, Chongqing VIP, PubMed, Cochrane Library and Embase from January 2009 to May 2019 were systematically searched and identified. The literatures were screened and the data of patients′ epidemiology, clinical manifestations, laboratory examinations and prognosis were obtained. Revman 5.2 software was used for meta analysis.Results:Sixty-eight Chinese literatures and fourteen English literatures encompassing 6 780 patients with SFTS were included in the final analysis. Of these patients, 845 cases (12.46%) died. SFTS mostly occurred in mountainous and hilly areas, and farmers (3 637 cases) were the usual victims. The onset season was mostly in summer and the peak was from May to August each year. There were 1 434 patients had a clear history of tick bites, and 21 cases were human-to-human transmitted.There were 6 071 cases (89.54%) presented with fever, 5 407 cases (79.75%) presented with fatigue, 3 140 cases (46.31%) presented with muscle soreness, and 2 300 cases (33.92%) presented with chills.Using random effects model for meta analysis, the levels of creatine kinase (CK) (mean difference ( MD)=500.40, 95% confidence interval ( CI) 380.51-620.28, P<0.01) and lactic acid dehydrogenase (LDH)( MD=442.81, 95% CI 152.85-732.78, P=0.003) in severe patients were both higher than those in mild patients, and the difference were both statistically significant. The risk of death increased in patients aged>60 years( MD=8.19, 95% CI 4.03-12.36, P<0.01). The levels of CK( MD=530.92, 95% CI 29.27-1 032.56, P=0.040), LDH( MD=609.28, 95% CI 80.25-1 138.31, P=0.020), urea nitrogen ( MD=4.67, 95% CI 3.05-6.30, P<0.01) and creatinine ( MD=43.05, 95% CI 23.49-62.62, P<0.01) of patients in the death group were all higher than those in the survival group. The differences were all statistically significant. Conclusions:During the course of SFTS, the patients may show impaired blood system, heart, liver and kidney functions with high mortality. Clinicians should timely monitor the changes of blood routine, myocardial enzyme spectrum, liver and kidney functions and other indicators, so as to find cardiovascular and other system complications as early as possible. Timely treatment could not only reduce liver, heart and other organ injuries, but also reduce mortality.
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Objective@#Comparing the benefit of Abidor, lopinavir/ritonavir and recombinant interferon α-2b triple combination antiviral therapy and lopinavir/ritonavir and interferon dual combination antiviral therapy to hospitalized novel coronavirus pneumonia 2019 in Zhejiang province.@*Methods@#A multi-center prospective study was carried out to compare the effect of triple combination antiviral therapy with dual combination antiviral therapy in 15 medical institutions of Zhejiang Province. All patients were treated with recombinant interferon α-2b (5 million U, 2 times/d) aerosol inhalation. 196 patients were treated with abidol (200 mg, 3 times/d) + lopinavir / ritonavir (2 tablets, 1 time/12 h) as the triple combination antiviral treatment group. 41 patients were treated with lopinavir / ritonavir (2 tablets, 1 time/12 h) as the dual combination antiviral treatment group. The patients who received triple combination antiviral therapy were divided into three groups: within 48 hours, 3-5 days and > 5 days after the symptom onset. To explore the therapeutic effects of triple combination antiviral drugs and dual combination antiviral drugs, as well as triple combination antiviral drugs with different antiviral initiate time. SPSS17.0 software was used to analyze the data.@*Results@#The time of virus nucleic acid turning negative was (12.2 ± 4.7) days in the triple combination antiviral drug group, which was shorter than that in the dual combination antiviral drug group [(15.0 ± 5.0) days] (t = 6.159, P < 0.01 ). The length of hospital stay [12 (9, 17) d] in the triple combination antiviral drug group was also shorter than that in the dual combination antiviral drug group [15 (10, 18) d] (H = 2.073, P < 0.05). Comparing the antiviral treatment which was started within 48 hours, 3-5 days and > 5 days after the symptom onset of triple combination antiviral drug group, the time from the symptom onset to the negative of viral shedding was 13 (10,16.8), 17 (13,22) and 21 (18-24) days respectively (Z = 32.983, P < 0.01), and the time from antiviral therapy to the negative of viral shedding was (11.8±3.9) , (13.5±5.1) and (11.2±4.3) d. The differences among the three groups were statistically significant (Z=32.983 and 6.722, P<0.01 or<0.05).@*Conclusions@#The triple combination antiviral therapy of Abidor, Lopinavir/Litonavir and recombinant interferon α-2b showed shorter viral shedding time and hospitalization time compared with the dual combination antiviral therapy. The earlier the time to initiate triple antiviral treatment, the shorter the time of virus shedding.
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Objective@#To analyze the prevalence of severe fever with thrombocytopenia syndrome virus(SFTSV)infection in Zhoushan island of Zhejiang province and the duration of serum positive IgG antibody in patients infected with SFTSV.@*Methods@#One thousand one hundred and twenty-two healthy people from Zhoushan island of Zhejiang province were recruited for cross-sectional study in August 2019, including 641 from non-epidemic areas and 481 from epidemic areas. The serum SFTSV-IgG antibody was detected by enzyme-linked immunosorbent assay (ELISA), and the positive rates of SFTSV-IgG antibody were compared between people from the epidemic areas and non epidemic areas. Meanwhile, the antibody titer of SFTSV-IgG in 19 patients confirmed between July 2011 and June 2018 was detected by indirect ELISA. SPSS 17.0 software was used to analyze data.@*Results@#The positive rate of SFTSV-IgG antibody was 1.5% (7/481) in the epidemic area, which was higher than that in the non-epidemic area (0/641) (χ2=7.187, P<0.01). The positive rates of SFTSV-IgG antibody in 2019 were lower than those in the epidemic area (11.7%) and non-epidemic area (2.5%) in 2013 (χ2=22.556 and 10.352, both P<0.01). The serum SFTSV-IgG antibody of 18 patients with previous infection was still positive, and the longest one lasted for 8 years.@*Conclusions@#There is a SFTSV latent infection in population from epidemic area of Zhoushan island. The SFTSV-IgG antibody can last for a long time in patients with SFTS and it may have certain protective effect.
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Objective@#To investigate the clinical value of blood routine tests (RT) and coagulation function in differential diagnosis of mild and severe patients infected with bunyamwera virus.@*Methods@#Twenty-five mild patients and 25 severe patients infected with bunyamwera virus were selected and their blood RT and coagulation function tests were performed.@*Results@#The earliest prothrombin time (PT-early) and activated partial thromboplastin time(APTT-early) were significantly lower than those of severe patients(t=-2.43, P<0.05; t=-2.53, P<0.05). The lowest values of white blood cells (WBC-low) of mild patients were significantly higher than those of severe patients (t=5.66, P<0.01). The highest value of D-dimer (DD-high) of mild patients were significantly lower than that of severe patients (z=1.35, P<0.05). When mild patients values were set as outcome variable, AUC of APTT-early was the highest (AUC=0.713, P<0.05). When values of severe patients were set as outcome variable, AUC of DD-high was the highest (AUC=0.874, P<0.01).@*Conclusions@#APTT-early and DD-high are suitable for differential diagnosis of mild and severe patients infected with bunyamwera virus.
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Objective@#To study serum HCV antibody (anti-HCV) with geographic distribution characteristics in Zhejiang Province.@*Methods@#A stratified random cluster sampling method was used. Serum samples of the surveyed population were collected from selected hospitals, anti-HCV antibodies were examined, then hepatitis C infection rates among different genders, regions and age groups were analyzed. The anti-HCV rate was compared using the χ 2 test.@*Results@#The average anti-HCV positive rate in Zhejiang Province was 0.24% [95% confidence interval (CI): 0.16% ~ 0.32%]. The antibody positive rate in the plain area was 0.32% (95% CI: 0.19% ~ 0.45%), which was significantly higher than the coastal islands 0.05%(95% CI: 0.00% ~ 0.12%, χ 2 = 7.638, P < 0.05). There was no significant difference between plain area and hilly area 0.22% (95% CI: 0.03% - 0.41%). There was no statistically significant difference in anti-HCV positive rates between males and females (χ 2 = 2.238, P = 0.135). The highest positive rate of anti-HCV (0.93%) was in the population aged 56-60 years and the lowest in the population aged less than 20 years. Anti-HCV positive rate of all age groups in 2017 was lower than that of 2006 seroepidemiological study of hepatitis C.@*Conclusion@#Zhejiang Province is a region with low anti-HCV positive rate and the disease prevalence further reduced than 10 years ago. The positive rate of anti-HCV in plain areas is higher than islands. Middle-aged and elderly people are the age group with high prevalence, and the anti-HCV positive rate in people under 20 years old is exceptionally low. Gender differences in anti-HCV positive rate have little effect.
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Objective To analyze the clinical features and risk factors for mortality of patients with severe fever with thrombocytopenia syndrome (SFTS) in Zhoushan, the eastern coastal of China with high incidence of severe fever with thrambocytopenia syndrome bunyavirus infection, to provide reference for reducing the mortality rate of SFTS.Methods Clinical data of 107 cases of SFTS from Zhoushan Hospital during June 2011 to June 2016 were retrospectively analyzed.According to the prognosis, patients were divided into survival group and death group.The clinical features and the laboratory results were analyzed with a case-control method to analyze the prognostic factors.Normal distribution data were compared with the independent t test.Kolmogorov-Smirnov Z test were used in data with skewness distribution.Categorical data were analyze by chi-square test.The related risk factors were analyzed with the receiver-operating characteristic (ROC) curve and multivariate unconditioned logistics regression analysis.Results Seventeen cases among 107 STFs patients died, yielding the mortality rate of 15.9%.The proportion of patients suffering from two or more underlying diseases, with disorders of consciousness, activated partial thromboplastin time (APTT), the level of creatine kinase (CK), lactate dehydrogenase (LDH) as well as sepsis-related or sequential organ failure assessment (SOFA) score in death group were all significantly higher than those in the survival group (all P73.45 s, SOFA scores >9 were the independent risk factors for mortality of SFTS (OR=6.947, 8.459 and 11.770, respectively, all P<0.05).Conclusion Ca2+, APTT and SOFA score are the independent risk factors for prognosis of SFTS, which provide reference for prognostic evaluation of SFTS.
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Objective To assess the morphological characteristics of bone marrow in patients of severe fever with thrombocytopenia syndrome ( SFTS) and its value in diagnosis.Methods The bone marrow morphology was retrospectively reviewed in 28 laboratory confirmed patients with SFTS from Zhoushan Hospital during January 2012 and December 2015.The correlation between bone marrow -derived macrophage and peripheral blood cells was analyzed with t test.Results All patients presented leukocytopenia and thrombocytopenia.Poor bone marrow hematopoietic function was observed in 23 patients (82%) showing granulocyte, erythrocyte and megakaryocyte hypoplasia , but no pathological hematopoietic disorder was observed.Eighteen patients (64%) had various degrees of increased amount of macrophage in the bone marrow; peripheral white blood cell count and platelets in patients with macrophage ≥0.5% were lower than those with macrophage <0.5%, and the difference was of statistical significance (t =3.836 and 4.499, P<0.01).Conclusion SFTS patients have characteristic bone marrow morphology , and bone marrow examination is beneficial for differentiation of SFTS from blood lymphatic system diseases and other virus infection.
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Objective To investigate the protective effect of magnesium isoglycyrrhizinate on the liver of hepatic arterial chemoembolization.Methods 68 patients with hepatic arterial chemoembolization were selected as research subjects,they were divided into magnesium isoglycyrrhizinate group and control group.All patients were routinely given hepatoprotective drug treatment from seven days before surgery until three days after surgery,magnesium isoglycyrrhizinate group was given magnesium isoglycyrrhizinate treatment on the basis of hepatoprotective treatment. Detected and compared the alanine aminotransferase,aspartate aminotransferase,total bilirubin,total protein,albumin and cholinesterase levels before and after liver cancer before and after surgery.Results The alanine aminotrans-ferase,aspartate aminotransferase levels at 3 days after surgery[(60.2 ±25.8)and (71.5 ±29.6)IU /L]were higher than before surgery in the control group[(34.7 ±18.6)and (49.5 ±20.4)IU /L](t =7.264 and 5.974,all P 0.05).The alanine aminotransferase,aspartate amin-otransferase and total bilirubin levels before surgery in magnesium isoglycyrrhizinate group had no differences with the control group (P >0.05).The alanine aminotransferase,aspartate aminotransferase levels at 3 days after surgery in the magnesium isoglycyrrhizinate group[(44.8 ±22.8)and (57.3 ±24.8)IU /L]were higher than those in the control group[(60.2 ±25.8)and (71.5 ±29.6)IU /L](t =6.385 and 7.358,all P 0.05).The albumin and cholinesterase levels at 3 days after surgery in the magnesium isoglycyrrhizinate group[(28.4 ±4.7)g/L,(8.0 ±4.8)kU /L]were lower than those of control group [(29.3 ±3.5 )g/L,(6.9 ±4.3)kU /L](t =8.436 and 6.947,all P <0.05 ).The incidence rates of adverse reactions of the magnesium isoglycyrrhizinate group (upper abdominal pain incidence rate was 35.3%,fever incidence rate was 29.4%,nausea and vomiting incidence rate was 52.9%)were lower than those of the control group(55.9%,88.2%,76.5%)(χ2 =7.246,6.472,6.274,all P <0.05).Conclusion Hepatic arterial chemoem-bolization has some damage to liver function of liver cancer patients.Magnesium isoglycyrrhizinate can reduce liver damage,improve liver synthetic function,and has a protective effect on liver.
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<p><b>OBJECTIVE</b>To explore the effect of the cytoplasmic DNA sensor DAI on replication of hepatitis B virus (HBV) and its possible mechanism.</p><p><b>METHODS</b>The hepatocyte-derived cell line HepG2 was co-transfected with DAI siRNA and the HBV1.3 replicative plasmid PHY106, and the cells were divided into two experimental groups. Six hours later, total RNA was extracted from the first group of cells and expression of IFIT1 and IL-6 were detected by real-time RT-PCR. The second group of cells was incubated for 4 days, after which the cell supernatant was collected and the HBV surface antigen (HBsAg) and envelope antigen (HBeAg) were detected by ELISA. In addition, HBV core particles were extracted and applied to southern blot assay to detect the intracellular HBV replication intermediates (rcDNA, dlDNA and ssDNA). Next, the HepG2 cells were triple transfected with siRNA targeting the type I interferon pathway molecule TBK1 and DAI simultaneously and HBV1.3, after which HBV viral proteins were detected. Two-group comparisons were made using the independent sample t-test, and more-than-2-group comparisons were made using ANOVA.</p><p><b>RESULTS</b>DAI gene expression was down-regulated in response to DAI siRNA transfection. Cells with down-regulated DAI showed inhibited HBV replication (in a dose-dependent manner), accompanied by reduced levels of HBsAg (0.0195+/-0.0050 vs.</p><p><b>CONTROL</b>0.3150+/-0.0200, P less than 0.05, t = 14.77) and HBeAg (0.0140+/-0.0040 vs.</p><p><b>CONTROL</b>0.01235+/-0.0135, P less than 0.05, t = 7.777). No effect of down-regulated DAI was observed for the expression of IFIT1 of IL-6. siRNA-mediated down-regulation of TBK1 and DAI simultaneously led to reduced expression of HBsAg and HBeAg.</p><p><b>CONCLUSION</b>Down-regulation of DAI gene expression inhibited HBV replication and HBV protein expression, but the underlying mechanism was not related to the type I interferon or NF-kB signaling pathway.</p>
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Humans , Carrier Proteins , Metabolism , DNA-Binding Proteins , Genetics , Metabolism , Down-Regulation , Gene Expression Regulation , Hep G2 Cells , Hepatitis B Surface Antigens , Hepatitis B e Antigens , Hepatitis B virus , Physiology , Interleukin-6 , Metabolism , NF-kappa B , Metabolism , Plasmids , RNA, Small Interfering , Genetics , Signal Transduction , Transfection , Virus ReplicationABSTRACT
Objective To observe the biochemical indicators and lifestyles of patients with non-alcoholic fatty liver disease (NAFLD),and analyse the risk factors of induced NAFLD.Methods A total of 258 in-and out-patients of NAFLD were included in the present study,the control group consisted of 213 examinationers with nonfatty liver disease.All samples were being blood biochemical indicator detection and lifestyle survey.Results Some blood biochemical index of NAFLD patients such as TC(5.48 ± 1.10) mmol/L,TG(2.31 ± 1.25) mmol/L,ALT (51.35 ± 26.18) U/L,AST (42.37 ± 28.32) U/L,FPG (5.62 ± 3.24) mmol/L,GGT (58.47 ± 43.25) U/L and UA (398.51 ± 96.85) μmol/L were higher than those of the control group (t =3.423,5.250,7.402,4.348,3.326,6.683,3.891,all P ＜ 0.01) ; and the incidence of hyperlipidemia,hypertension (21.71％),diabetes (22.09％),BMI(26.85 ± 3.45) or metabolic syndrome (44.57％) etc.Those indexes in NAFLD patients were significantly higher than those in the control group (x2 =8.14,10.55,58.48,t =10.73,all P ＜ 0.01).By multivariable Logistic regression analysis,TG,WI,BMI,HOMA-IR,lack of exercise,high-fat diet were independent risk factors for NAFLD (all P ＜ 0.05).Conclusion Patients with NAFLD is closely correlated to metabolic abnormalities,reasonable diet and a healthy lifestyle is an effective way of prevention and treatment of this disease.
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Objective To analyze the characteristics of lymphocyte subsets and interleukin-2 re-ceptor (CD25) in patients with severe fever with thrombocytopenia syndrome (SFTS) in Zhoushan island. Methods Automated blood analyzer , automatic biochemical analyzer and flow cytometry were used to meas-ure hematological parameters , biochemical parameters and lymphocyte subsets in patients with SFTS before and after treatment .The dynamic changes and correlation analysis were statistically analyzed .Results The counts of white blood cells (WBCs), platelets, total T cells and CD4+T cells in patients with SFTS before treatment were significantly lower than those in healthy subjects .The counts of WBCs and platelets were sig-nificantly increased after ten days of treatment , and the level of CD25+cells was higher than that in control group, but the level of total T cells and CD 4+T cells were still lower than those in healthy subjects ( P<0.05).Patients died of SFTS had significantly lower counts of total T cells , CD4+T cells, CD8+T cells and CD25+cells than cured patients (P<0.05).The level of CD25+cells and B cells were positively correlated with WBC level (P<0.05).Platelet level was positively correlated with the percentage of CD 4+T cells (P<0.05).The level of alanine aminotransferase and creatine kinase were positively correlated with the number of CD3+T and CD8+T cells (P<0.05).Conclusion SFTS virus infection affected the percentage of body′s immune cells, especially the level of CD4+T cells.The imbalanced immune system was correlated with the counts of WBCs , platelets and various enzymes in serum and it might be one of the factors causing extensive damage of multiple organs and tissues .
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Objective To review pulmonary CT imaging features and their correlations with the changes on clinical indexes in patients infected with severe fever with thrombocytopenia syndrome bunyavirus (novel bunyavirus).Methods Clinical data and pulmonary CT findings of 19 patients infected with the novel bunyavirus in Zhoushan Hospital and Daishan Hospital of Zhejiang Province during May 2011 and August 2012 were collected.Infection of the novel bunyavirus was confirmed by Zhejiang Provincial Center for Disease Control and Prevention (CDC).All patients received high resolution CT scanning at initial period,critical period and recovery period.And the changes on WBC,platelet (PLT) and lymphocytes (mainly CD4 + T lymphocytes) were observed.Repeated measures analysis of variance and least significant difference (LSD) were performed,and correlation between the changes on clinical parameters and pulmonary imaging was studied.Results In pulmonary CT images,13 out of 19 cases presented groundglass shadow,5 cases presented consolidation shadow,3 cases presented retisculation,5 cases presented pleural thickening and adhesion,and 3 cases presented mediastinal lymphadenopathy.Sixteen patients presented the involvement of bilateral lungs and 3 patients unilateral.Pleural effusion was observed in 11 cases.There were significant differences in WBC,PLT and CD4+T count among initial,critical and recovery periods in 15 patients with obvious lung lesions (F =20.21,28.37 and 32.92,P ＜0.01).And the above indexes dropped to the lowest points during critical period,which were (1.6 ± 0.6) x 109/L,(26.0 ±9.1) x 109/L and (100.0 ± 66.2) x 106/L,respectively.After treatment,pulmonary CT scan showed that the foci were completely absorbed and no sequelae were observed.Conclusion The changes on pulmonary CT imaging are correlated with those of clinical indexes in novel bunyavirus infection,and the prognosis is good if patients receive the appropriate treatment in the early stage.
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ObjectiveTo investigate the protective effects and mechanism of ursodeoxycholic acid (UDCA) on α-naphthylisothi (ANIT)-induced cholestatic liver injury in rats.MethodsA total of 48 Sprague-Dawley (SD) rats were selected.Fouty-two rats were gavaged with ANIT (100 mg/kg) to induce acute liver injury,six rats were sacrificed 24 hours after the liver injury and the rats left were evenly divided into control group which were gavaged with saline and UDCA group which were gavaged with UDCA (20 mg/kg).Six rats were sacrificed at 48 hours,72 hours and 96 hours after modeling.The six untreated rats were set as blank control group.Serum and liver tissues of all rats were kept after sacrificed.Serum levels of alanine transaminase (ALT),aspartate transaminase (AST),total bilirubin (TBil) and total bile acid (TBA) were tested,interleukin-10 (IL-10),interleukin-6 (IL-6),and tumor necrosis factor-α (TNF-α) were detected by enzyme linked immunosorbent assay (ELISA).The expression of multidrug resistance associated protein2 (Mrp2) at mRNA level in liver tissue was measured by quantitative real-time polymerase chain reaction (qRT-PCR) and the inflammatory reaction activity of liver tissues was inspected with Haematoidin-Eosin (HE)staining under microscope.ResultsAt 48 hours after liver injury modeling,serum TBil (143.80± 12.08) μmol/L vs.(178.50±15.19) μmol/L,TBA (13.15±3.81) μmol/L vs.(21.68±7.93)mol/L,IL-10 (44.13±3.68,37.15±6.25 ng/L),IL-6(50.80±2.09,57.32±4.63 ng/L) and TNF-α (17.53±0.84) ng/L vs,(19.10±1.64) ng/L of UDCA group and control group were compared,and the differences were statistically significant (P ＜ 0.01 or P＜ 0.05).At 72 hours after liver injury modeling,serum ALT (721.67±97.54) U/L vs.(929.50±148.29) U/L and IL-10 (54.68±6.79)ng/L vs.(43.85±4.08) ng/L of UDCA group and control group were compared,and the differences were statistically significant (P＜0.01 or P＜0.05).At 96 hours after liver injury modeling,serum ALT (156.83±14.99) U/L vs.(250.67±42.29) U/L,AST (143.67±27.45) U/L vs.(206.00±63.94) U/L and TBil (23.53±5.08) μmol/L vs.(34.02±9.98) μmol/L of UDCA group and control group were compared,and the differences were statistically significant (P＜0.01 or P＜0.05).The differences of Mrp2 expression at mRNA level in liver tissues between UDCA group and control group at 48 hours (0.77 ± 0.21,0.46 ± 0.25),72 hours (2.27 ±0.84,1.10 ±0.38) and 96 hours (3.64±0.54,2.75±0.69) after liver injury modeling were statistically significant (P＜0.01 or P＜0.05).ConclusionThe mechanism of the protective effects of UDCA on ANIT-induced liver injury may be related with the regulation of serum cytokines and liver Mrp2 expression.
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ObjectiveTo investigate the clinical characteristics,epidemiology of patients with severe fever with thrombocytopenia syndrome bunyavirus (SFTSV) infection and genetic sequences of SFTSV.MethodsClinical data of five cases of severe fever with thrombocytopenia syndrome (SFTS)from Zhoushan Hospital during May 2011 to July 2011 were retrospectively analyzed.SFTSV gene was amplified by polymerase chain reaction (PCR).CD3+ CD4+ and CD3+ CD8+T lymphocytes were detected by flow cytometry (FCM).The sequences of isolated SFTSV strains were compared with those in GenBank. ResultsThe symptoms of continuous high fever,sore muscles,enlarged superficial lymph nodes,abdominal pain,diarrhea with gastrointestinal hemorrhage were observed.The white blood cells,platelets and CD3+ CD4+ T lymphocytes were progressive decreased in acute phase with the minimum of (0.97-2.00) × 109/L,(12-42) × 109/L and 7.52％-20.39％,respectively.The SFTSV was isolated from the sera of two patients.The sequences were compared with SFTSV sequences in GenBank.The homology of RNA-dependent RNA polymerase gene was 96％ compared with BX-2010,L-WWG,LN3,JS4,SD4,HN6 and AH12; the glycoprotein gene was 94％ ; N protein gene was 95％ compared with JS4,SD4 and LN4.The homology of the above three genes between two isolates was 99％.ConclusionsOur results suggest that SFTSV is sporadic in Zhejiang Province which is probably from native epidemic focus.SFTS is progressive and severe with acute onset.Multiple organ dysfunction is common in severe eases.
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Background: Hereditary ataxia is a group of hereditary diseases that are characterized by chronic progressive uncoordinated gait and are frequently associated with cerebellar atrophy.Objectives: To investigate evidence-based diagnosis of hereditary ataxia by retrospective analysis of the diagnostic process in one Chinese family.Methods: Clinical records of 15 ataxia patients from one Chinese family with 46 family members were retrospectively reviewed and a tentative diagnosis was made based on clinical manifestations, signs and symptoms, mode of inheritance, and progression. Since hereditary ataxia is a group of heterogeneous diseases having various subtypes and overlapping symptoms, we adopted a stepwise evaluation to achieve a tentative diagnosis. To confirm the diagnosis, we performed polymerase chain reaction (PCR) specific for the suspected causative gene of spinocerebellar ataxia (SCA) subtype 3 (SCA3).Results: Through analysis of hereditary and clinical characteristics of family histories of the patients, we suspected that the family might suffer from SCA, especially, SCA3. The PCR assay for SCA3 showed that, five of the ten samples analyzed had a CAG trinucleotide expansion of the SCA3 gene, and four of the five members developed ataxia. The remaining one, a seven-year-old girl, showed no symptoms or signs except for uvula deviation. No clinical symptoms were found in five other members with negative PCR results. Thus, based on both clinical findings and laboratory results, we further confirmed that the family suffered from SCA3.Conclusion: Hereditary ataxias are disorders sharing overlapping symptoms. Comprehensive analysis of medical and family records together with genetic diagnosis improves diagnostic efficiency of hereditary ataxia and aides in family counseling.Keywords: Cerebellar ataxia, diagnosis, heredity, PCR
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ObjectiveTo explore and establish pre-hospital scoring system (respiration, pulse,motor and burn, RPMB) for evaluation of coal mine gas explosion injury. MethodsAfter analysis of characteristics of blast injury caused by coal mine gas explosion, a new pre-hospital scoring system,RPMB, for evaluation of blast injury was established on the basis of pre-hospital evaluation of coal mine injuries (respiration, pulse and motor, RPM). From January 2003 to December 2009, 251 patients with blast injury caused by coal mine gas explosion were collected in this study for a retrospective study. ISS≥16 points was set as the gold standard for severe wound. All the injuries were assessed by RPMB, RMP,pre-hospital index (PHI) and trauma triage rule (TTR). The consistency and detection rate of severe wounds were compared. The sensitivity and specificity were also calculated. ResultsOf 251 patients,41 patients were evaluated as severe, with high consistency rate between AIS-ISS and RPMB (kappa =0.985). The sensitivity of RPMB, RPM, PHI and TTR was 97.6％, 26.8％ , 22.0％ and 17.1％ respectively and the specificity of those was 88. 1 ％ , 97.6％ , 87.6％ and 95.7％ respectively. ConclusionRPMB is a simple and easy scoring method, with high detection rate of severe wound and potential of clinical applications.
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Objective To investigate the correlation of serum total bile acid (TBA) levels with the inflammation grades of liver tissue in chronic liver diseases.Methods Cyclophorase assay was used to detect the serum TBA levels in 172 patients with various chronic liver diseases,and the inflammation grades of liver tissue were determined by liver biopsy.The correlation between serum TBA levels and the inflammation grades of liver tissue was evaluated using SPSS 12.0 software.Results Serum TBA level was positively correlated with the inflammation grade of liver tissue ( r =0.275,P ＜ 0.01 ).The inflammation grade reached G2 when serum TBA was 20 μmol/L.Conclusion Serum TBA level may be useful for evaluating the inflammation grade of liver tissue in chronic liver diseases.
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<p><b>OBJECTIVES</b>To investigate patients with acute lymphoblastic leukemia (ALL) for TEL/AML1 fusion, BCR/ABL fusion, MLL gene rearrangements, and numerical changes of chromosomes 4, 10, 17 and 21 by fluorescence in situ hybridization (FISH) and to determine the relationship and the significance of those findings.</p><p><b>METHODS</b>Fifty-one American patients (34 men and 17 women) were included in this study. Of them there were 41 patients with pro-B cell type ALL, 9 with B cell type ALL and 1 with T cell type ALL. Chromosome metaphases of each sample were prepared according to standard protocols. Fluorescence in situ hybridization was performed using commercially available DNA probes, including whole chromosome painting probes, locus specific probes, specific chromosome centromere probes and dual color/multiple color translocation fusion probes. The digital image analysis was carried out using Cytovision and Quips FISH programs.</p><p><b>RESULTS</b>An overall incidence of chromosomal anomalies, including t (9;22), MLL gene rearrangements, t (12;21), and numerical chromosomal anomalies of chromosomes 4, 10, 17 and 21 was found in 33 patients (65%). Thirty-one of them were pediatric patients and two adults. The t (12;21) was the commonest chromosomal anomaly detected in this population; 14 out of the 45 pediatric patients (31%) were positive for TEL/AML1 fusion, among which three had an additional derivative 21 [t (12;21)], four had a deletion of 12p and two had an extra copy of chromosome 21. All 14 patients with positive TEL/AML1 fusion had ALL pre-B cell or B-cell lineage according to standard immunotyping. The percentage of cells with fusion signals ranged from 20% to 80%. All fourteen patients positive for TEL/AML1 gene fusion were mosaic. Three out of the 14 patients positive for the TEL/AML1 gene fusion were originally reported to be culture failures and none of the remaining eleven samples had been found to have chromosome 12 abnormalities by conventional cytogenetic techniques. All pediatric patients with pre-T or T cell lineage and the six adults were negative for TEL/AML1 fusion. One patient had double Philadelphia chromosomes, three had a rearrangement or a deletion of the MLL gene, one had t (4;11) and two had a deletion of the MLL. One of the patients with an MLL deletion also had a large ring of chromosome 21, and r (21) was caused by AML1 gene tandemly duplicated at least five times. The second case with the MLL deletion was also unique, the patient had a t (12;21) as well. A total of 20 patients had numerical changes (gain or loss) of chromosomes 4, 10, 17 and 21. Eight patients were found to have trisomies of three or four different chromosomes. Interestingly, seven of these patients did not have TEL/AML1, BCR/ABL or the MLL gene rearrangement; one did have the TEL/AML1 gene fusion. Eleven patients with pro-B cell or B cell type ALL (9 children with ALL, 2 adults with ALL) had numerical changes of chromosome 21 (gain 1 or 2 chromosome 21), among them, 10 patients had no structural alteration of chromosome 21, and one was combined by t (12; 21). Four patients had a monosomy of chromosome 17 and three out of these patients with monosomy 17 also had a fusion signal of TEL/AML1.</p><p><b>CONCLUSIONS</b>FISH plays an important role in detecting chromosome changes, especially in some cryptic chromosome translocations and patients with culture failures. This study found a trend towards a division between patients who had structural changes such as t (12;21) or a ring chromosome 21 and those who had numerical changes of chromosome 21 as well as the patients with TEL/AML1 fusion and patients with the coexistence of numerical chromosomal changes of chromosomes 4, 10 and 17. In our opinion there are two separate mechanisms which lead to the development or progression of leukemia.</p>