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Objective:To explore the clinical features of Mycoplasma pneumoniae(MP)infection in children, and provide data support for the prevention and control of MP.Methods:In this study , a retrospective analysis was used to collect clinical data with respiratory tract infection from January 2018 to February 2022 in the Shenyang Children′s Hospital, and analyze the distribution characteristics of MP positive rate, season, age, sex.Results:In this study, the positive rate of MP was 17.12% (20 299/118 598), in 2018, 2019, 2020 and 2021 were 22.92% (7 732/33 738), 15.76% (5 736/36 388), 9.81% (1 313/13 379) and 16.60% (4 954/29 849) respectively.The highest positive rates of MP in 2018 and 2019 were 27.72% (1 809/6 527) and 23.45% (1 519/6 478) in summer, respectively, 2020 was spring (19.13%, 216/1 129) and 2021 was autumn (20.09%, 1 665/8 287).The MP positive rates of infancy, early childhood, preschool age and school age were 5.89% (605/10 265), 14.35% (4 639/32 333), 18.51% (10 961/59 203) and 24.37% (4 094/16 798), and MP positive rate increased with age, the difference was statistically significant ( χ2=1 790.971, P<0.05).The positive rate of boys was 14.70% (9 586/65 206), while that of girls was 20.06% (10 713/53 392), the difference was statistically significant ( χ2=594.937, P<0.05). Conclusion:MP can occur all years round, mainly in summer and autumn.Girls are susceptible, especially common in school-age and pre-school children.Prevention and control measures should be taken as soon as possible for susceptible individuals to reduce the infection rate of MP.
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Case 1, a 63-year-old female patient presented with blisters and bullae arising in erythema all over the body with itching for 2 months. Two years ago, the patient underwent peri-intestinal lymph node dissection for the treatment of malignant melanoma of the rectum and anal canal, and received intravenous injection of toripalimab for preventive treatment for 1 year, and generalized skin lesions occurred 2 weeks after drug withdrawal. Direct immunofluorescence testing of erythema on the upper extremities showed that immunoglobulin G (IgG) was deposited along the basement membrane zone; salt-split indirect immunofluorescence testing of a serum sample showed liner deposition of IgG in the epidermis. Enzyme-linked immunosorbent assay (ELISA) revealed that the serum level of anti-BP180 antibodies was over 200 U/ml. The patient was diagnosed with bullous pemphigoid, but it was doubtful whether the disease was caused by PD-1 inhibitor toripalimab or not. Then, the patient received oral minocycline at a dose of 200 mg/d and prednisolone acetate at a dose of 20 mg/d, and topically applied halometasone cream all over the body. After half-a-month treatment, the blisters crusted over and the erythema darkened in color. Case 2, a 36-year-old female patient presented with generalized blisters and itching for more than 3 months. The skin lesions manifested as tense blisters, bullae, bloody bullae and crusts on the edematous erythema. The patient had a 3-year history of vaginal malignant melanoma, which was stage Ⅳ postoperative melanoma with local recurrence and lymph node metastasis nearby the right iliac vessels. After 2-year treatment with intravenous injection of toripalimab, generalized skin lesions occurred all over the body. Direct immunofluorescence testing of the erythema showed weakly positive staining for IgG, and linear deposition of IgG along the basement membrane zone; salt-split indirect immunofluorescence testing of a serum sample showed liner deposition of IgG in the epidermis. ELISA revealed that the serum level of anti-BP180 antibodies was over 200 U/ml. The case 2 was diagnosed with bullous pemphigoid, but it was also doubtful whether the disease was caused by PD-1 inhibitor toripalimab or not. Then, the case 2 was treated with oral doxycycline at a dose of 200 mg/d and oral prednisolone acetate at a dose of 40 mg/d. After 2-week treatment, the blisters completely crusted over and erythema darkened in color.
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Objective:To investigate the application value of pulse-indicated continuous cardiac output (PICCO) monitoring combined with critical care ultrasound-oriented convulsive therapy in the management of fluid intake in shock patients.Methods:Eighty-two patients with shock who received treatment in Shaoxing People's Hospital, China between May 2017 and May 2020 were included in this study. They were randomly assigned to undergo either PICCO monitoring (control group, n = 41) or PICCO monitoring combined with critical care ultrasound-oriented convulsive therapy (study group, n = 41). Fluid intake management-related indexes [24-hour total fluid intake, central venous pressure, mean arterial pressure, oxygenation index and lactic acid] and treatment outcome-related indexes (mechanical ventilation time, intensive care unit length of stay, 24-hour remission rate, 28-day mortality rate, sequential organ failure assessment score) were compared between control and study groups. Results:24-hour total fluid intake and lactic acid level in the study group were (2 516.98 ± 254.78) mL and (0.60 ± 0.05) mmol/L, respectively, which were significantly lower than those in the control group [(2 920.02 ± 295.33) mL, (1.34 ± 0.15) mmol/L, t = 16.573, 3.837, P < 0.01, P = 0.041). Central venous pressure, mean arterial pressure and oxygenation index in the study group were (13.381 ± 1.41) mmHg, (82.34 ± 8.22) mmHg and (224.06 ± 23.21) mmHg, respectively, which were significantly higher than those in the control group [(8.53 ± 0.85) mmHg, (70.92 ± 7.18) mmHg, (192.30 ± 19.70) mmHg, t = 5.152, 6.754, -2.498, all P < 0.05]. Mechanical ventilation time and intensive care unit length of stay in the study group were (7.54 ± 0.72) days and (11.46 ± 1.11) days, respectively, which were significantly shorter than those in the control group [(11.72 ± 1.13) days, (18.29 ± 1.73) days, t = 4.727, 5.224, both P < 0.05). 24-hour remission rate in the study group was significantly higher than that in the control group [85.37% (35/41) vs. 63.41% (26/41), χ2 = 5.185, P < 0.05]. 28-day mortality rate in the study group was significantly lower than that in the control group [7.32% (3/41) vs. 29.27% (12/41), χ2 = 6.608, P < 0.05]. Sequential organ failure assessment score in the study group was significantly lower than that in the control group [(6.86 ± 0.63) points vs. (11.05 ± 0.91) points, t = 4.814, P < 0.05]. Conclusion:PICCO monitoring combined with critical care ultrasound-oriented convulsive therapy exhibits an obvious effect in the management of fluid intake in shock patients, which can greatly reduce total fluid intake and remarkably improve treatment outcome-related indexes.
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Objective To evaluate the application of modified MELD score based on the estimated glomerular filtration rate (eGFR) in the prognosis of patients with liver failure.Methods Clinical data of 558 patients with liver failure admitted in the First Affiliated Hospital of Xinjiang Medical University from December 2001 to September 2017 were retrospectively analyzed.Among all patients,238 cases survived (survival group) and 320 died (fatal group) within 3 months.The eGFR was used in the modified model for end stage liver disease (MELD) instead of serum creatinine.Cox regression analyses were fitted with modified MELD or MELD scores by SAS 9.0 PHREG.The receiver operating characteristic (ROC) curve was generated and the values of modified MELD score and MELD score in predicting the prognosis of patients with liver failure in 3 months were compared.Kaplan-Meier method was used to analyze the survival rate of patients with liver failure.Results Cox regression analysis showed that total bilirubin,international normalized ratio (INR) and eGFR were independent prognostic factors for patients with liver failure.The fitted MELD modified score =4.07 × ln total bilirubin (mg/dL) + 12.99 × ln INR-8.32 × ln eGFR.The area under the ROC curve (AUC) of the modified MELD score and the MELD score were 0.814 and 0.757,respectively,and the sensitivity and specificity of the modified MELD score were 70.0％ and 71.4％,respectively.The predictive power of modified MELD scores in patients with liver failure was better than MELD score (Z =4.47,P ＜ 0.01).The 3-month survival rate of patients with modified MELD score ＜-15.38 was significantly higher than those with modified MELD score ≥-15.38 (x2 =99.20,P ＜ 0.01).Conclusions eGFR is an independent risk factor for the prognosis of patients with liver failure.The modified MELD score including eGFR and excluding etiological factors can be more effective and more accurate for prognosis of patients with liver failure.
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Objective@#To investigate the clinical features of brucellosis with thrombocytopenia.@*Methods@#The clinical data of patients with brucellosis complicated with thrombocytopenia (platelet count < 100 × 109/L) diagnosed by the Department of Infection Disease, the First Affiliated Hospital of Xinjiang Medical University from January 2012 to December 2018 were collected retrospectively, and the demographic characteristics, clinical characteristics, laboratory examinations, treatment and prognosis of the patients were analyzed.@*Results@#All the 21 patients were male and their age was (47.3 ± 12.2) years old, including 3 Uygur, 14 Han and 4 Kazak. Their occupation was dominated by farmers and herdsmen, a total of 16 patients; 11 patients had a history of close contact with cattle and sheep, 5 patients were engaged in slaughter and wool processing industries, and 5 patients were infected for unknown reason. All the 21 patients had fever, hyperhidrosis in 17 patients, fatigue in 16 patients, joint and muscle pain in 7 patients, and decreased body mass in 5 patients. Sheep Brucella blood culture were positive in 12 patients; serum tube agglutination test was positive in 16 patients, titer was 1∶200-1∶800; white blood cell count was normal [(4-10) × 109/L] in 3 patients, white blood cell count reduced in 18 patients. Sixteen patients were treated by orally taking rifampin capsules combined with doxycycline tablets, 3 patients were treated by orally taking baifule tablets combined with doxycycline tablets, and 2 patients were treated by orally taking baifule tablets combined with rifampin capsules; three patients with platelet count < 10 × 109/L were treated with glucocorticoid, gamma globulin and platelet transfusion. After 6 months of follow-up after treatment, 19 patients returned to normal platelet levels, and 2 patients had slightly lower platelet levels.@*Conclusions@#The main clinical features of brucellosis with thrombocytopenia are fever, hyperhidrosis, fatigue, joint and muscle pain, decreased body mass, and reduced white blood cell count. Their prognosis is better after treatment.
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Objective To investigate the clinical features of brucellosis with thrombocytopenia. Methods The clinical data of patients with brucellosis complicated with thrombocytopenia (platelet count < 100 × 109/L) diagnosed by the Department of Infection Disease, the First Affiliated Hospital of Xinjiang Medical University from January 2012 to December 2018 were collected retrospectively, and the demographic characteristics, clinical characteristics, laboratory examinations, treatment and prognosis of the patients were analyzed. Results All the 21 patients were male and their age was (47.3 ± 12.2) years old, including 3 Uygur, 14 Han and 4 Kazak. Their occupation was dominated by farmers and herdsmen, a total of 16 patients; 11 patients had a history of close contact with cattle and sheep, 5 patients were engaged in slaughter and wool processing industries, and 5 patients were infected for unknown reason. All the 21 patients had fever, hyperhidrosis in 17 patients, fatigue in 16 patients, joint and muscle pain in 7 patients, and decreased body mass in 5 patients. Sheep Brucella blood culture were positive in 12 patients; serum tube agglutination test was positive in 16 patients, titer was 1 : 200 - 1 : 800; white blood cell count was normal [(4 - 10) × 109/L] in 3 patients, white blood cell count reduced in 18 patients. Sixteen patients were treated by orally taking rifampin capsules combined with doxycycline tablets, 3 patients were treated by orally taking baifule tablets combined with doxycycline tablets, and 2 patients were treated by orally taking baifule tablets combined with rifampin capsules; three patients with platelet count < 10 × 109/L were treated with glucocorticoid, gamma globulin and platelet transfusion. After 6 months of follow-up after treatment, 19 patients returned to normal platelet levels, and 2 patients had slightly lower platelet levels. Conclusions The main clinical features of brucellosis with thrombocytopenia are fever, hyperhidrosis, fatigue, joint and muscle pain, decreased body mass, and reduced white blood cell count. Their prognosis is better after treatment.
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Objective To describe the Xinjiang region of tuberculous meningitis (TBM) (age ＞ 18 years of age) in patients with the clinical features,analysis of factors influencing the prognosis.Methods A retrospective of cases included in the data collection,describe the clinical characteristics,using the single factor and multiple factors Logistic regression analysis of factors influencing the prognosis.Results A total of 200 cases of TBM patients had the following characteristics:120 cases of male,female 80 cases;age 18 -75 (37.35 ±+ 14.24) years old;the course of the disease 3-270 (36.86 +43.86)days;and 179 cases of survival,21 cases of death,with a mortality of l0.5％.Single factor analysis showed that hydrocephalus,encephaledema,clinical staging,erythrocyte sedimentation rate,cerebro-spinal fluid (CSF)-protein had statistically significant difference between survival group and death group,respectively (P ＜ 0.05).The multi-factor Logistic regression analysis showed that encephaledema and erythrocyte sedimentation rate were independent factors to affect the prognosis of TBM (P ＜ 0.05).Conclusions Encephaledema and erythrocyte sedimentation rate are independent risk factors of poor prognosis in patients with TBM,early identify predictors,formulate corresponding clinical countermeasures,and can improve the prognosis of patients with tuberculous meningitis.
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Objective@#To investigate the curative effect of bone marrow mesenchymal stem cells (BMSCs) transplantation on the expression of stromal cell-derived growth factor (SDF-1 α) and vascular endothelial growth factor (VEGF) in rats with acute hepatic failure, and to compare the effects of two transplantation pathways.@*Methods@#Eighty-four rats with acute liver failure (ALF) induced by D-galactosamine combined with lipopolysaccharide were randomly divided into control group, tail vein and portal vein transplantation group. The latter two groups were injected allogenic BMSCs into the tail vein and portal vein. Blood samples and liver tissue samples were collected at 24, 72, 120, and 168h after transplantation to detect serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST). The improvement of liver function before and after BMSCs transplantation was compared. The expression of VEGF and SDF-1a in liver tissue was detected by immunofluorescence and Western blot. Data measurement between two groups was performed by analysis of variance and the correlation analysis was performed by Spearman’s rank correlation coefficient.@*Results@#Serum ALT and AST levels in the tail vein and portal vein transplantation group peaked at 24 h after transplantation, which were (134.60 ± 58.08 IU/L), (179.20 ± 86.68 IU/L), and (131.00 ± 54.47 IU/L), (173.50 ± 93.10 IU/L). In addition, 168h after transplantation it decreased to (46.10 ± 8.40 IU/L), (95.67 ± 13.80 IU/L) and (19.30 ± 1.30 IU/L), (54.30 ± 6.00 IU/L). After 120 and 168 hours of BMSCs transplantation, the levels of serum ALT and AST in tail vein and portal vein transplantation group were significantly higher than control group (F ≥ 12.51, P < 0.01). The results of western blot and immunofluorescence showed that the expression levels of SDF-1α and VEGF protein in the two BMSCs transplantation groups increased with the improvement of liver function, and the difference was statistically significant at 120 and 168 hours after transplantation (F ≥ 9.069, P < 0.05). There was no significant difference in the expression of SDF-1a and VEGF between the tail vein and portal vein transplantation groups (P > 0.05). Correlation analysis showed that the expression levels of SDF-1α and VEGF in liver tissues were positively correlated (r = 0.923, P < 0.05).@*Conclusion@#BMSCs transplantation can promote the secretion of VEGF for recovery of liver function to reduce the degree of inflammation and necrosis in rats with ALF.
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Objective@#To evaluate the efficacy and safety of ombitasvir/paritaprevir/ritonavir (OBV/PTV/r) 25/150/100 mg once daily and dasabuvir (DSV) 250 mg twice daily combined with ribavirin in adult patients of Mainland China with chronic HCV genotype 1b infection and compensated cirrhosis. @*Methods@#An open-label, multicenter, phase 3 clinical trial study was conducted in mainland China, Taiwan, and South Korea. Adult patients with compensated cirrhosis (Metavir score =F4) who were newly diagnosed and treated for hepatitis C virus genotype 1b infection with ombitasvir/paritaprevir/ritonavir and dasabuvir combined with ribavirin for 12 weeks were included. Assessed SVR rate of patients obtained at 12 and 24 weeks after drug withdrawal. Efficacy and safety were evaluated in patients who received at least one time study drugs. @*Results@#A total of 63 patients from mainland China were enrolled, 62 of whom (98.4%) had a baseline Child-Pugh score of 5 points. The overall rate of SVR12 and SVR24 in patients was 100% (95% CI: 94.3% to 100.0%). Most of the adverse events that occurred were mild. The incidence of common (≥10%) adverse events and laboratory abnormalities included elevated total bilirubin (36.5%), weakness (19.0%), elevated unconjugated bilirubin (19.0%) and conjugated bilirubin (17.5%), and anemia (14.3%). Three cases (4.8%) of patients experienced Grade ≥ 3 adverse events that were considered by the investigators to be unrelated to the study drug. None patients had adverse events leading to premature drug withdrawal. @*Conclusion@#Mainland Chinese patients with chronic HCV genotype 1b infection and compensated cirrhosis who were treated with OBV/PTV/r plus DSV combined with RBV for 12 weeks achieved 100 % SVR at 12 and 24 weeks after drug withdrawal. Tolerability and safety were good, and majority of adverse events were mild.
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Objective To analyze the clinical data of brucellosis, provide the references for brucellosis therapy. Methods The patients definitely diagnosed brucellosis at the First Affiliated Hospital of Xinjiang Medical University from 2005 to 2015 were assessed, data of clinical features, laboratory examination, complications, treatment and prognosis were analyzed. Results Of all 590 cases,the mean age was(44.24 ± 15.83)years old,the range was 3-75 years old,357(60.51%) cases had a history of raising and closely contacted with cattle and sheep, acute phase in 316(53.56%)cases,and chronic phase in 127(21.53%).The most common symptoms were fatigue in 537 (91.02%) cases, sweating in 520 (88.14%), fever in 513 (86.95%) and arthralgia in 478 (81.02%). Serum test tube agglutination test was positive in 583 (98.81%), blood culture was positive in 159 (33.97%,159/468).After patients receive antimicrobial treatment, body temperature decreased in 2 - 14 d. The overall recurrence rate was 5.98%(28/468),those patients with osteoarticular involvement even reached 23.22%(137/590).Doxycycline combined with rifampicin was the most common used antibiotics regimen, triple antibacterial drug program was recommended for patients with comorbidities. Conclusions The clinical manifestations of brucellosis is diversity, fatigue, sweaty, fever and arthralgia are the most common symptoms, and osteoarticular is the most frequently involved. Serum agglutination test is an important method in diagnosis of the disease, and combination of antibacterial drugs therapy is recommended.
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Objective To investigate the differentially expressed serum proteins in patients with liver cirrhosis complicated by portal vein thrombosis (PVT) . Methods Serum samples were collected from 45 patients with liver cirrhosis who were hospitalized in Infectious Disease Center, The First Affiliated Hospital of Xinjiang Medical University, from November 2015 to November 2016, and among these patients, 22 had PVT and 23 had no PVT. Isobaric tags for relative and absolute quantitation (i TRAQ) combined with chromatography and mass spectrometry were used to screen out the differentially expressed serum proteins, and a bioinformatics analysis was performed for the differentially expressed proteins. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. The Fisher's exact test was used to compare the distribution of GO terms or KEGG pathways in the target protein set or total protein set, in order to evaluate the significance level of protein enrichment of a GO term or KEGG pathway. Results A total of 800 proteins were screened out, among which 86 were differentially expressed, including 32 upregulated proteins (ratio ≥1. 2, P ＜ 0. 05) and 54 downregulated proteins (ratio ≤0. 83, P ＜ 0. 05) . Among these proteins, 14 were associated with cellular component, 22 were involved in biochemical processes, and 10 were associated with molecular function. The KEGG analysis showed that there were significant differences in 18 proteins in 5 metabolic and signaling pathways between the liver cirrhosis-PVT group and liver cirrhosis group. These 5 metabolic and signaling pathways were associated with fat digestion and absorption, platelet activation, metabolism of glyoxylic acid and dicarboxylic acid, osteoclast differentiation, and axon guidance. Conclusion i TRAQ combined with chromatography and mass spectrometry can effectively screen out the differentially expressed serum proteins, among which GP5, FGA, and FGG may be potential biological markers for PVT in patients with liver cirrhosis and are worthy of further research.
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Objective To investigate the clinical indicators which can predict esophageal varices in patients with primary biliary cirrhosis (PBC).Methods A total of 351 patients with PBC from the First Affiliated Hospital of Xinjiang Medical University from January 2013 to December 2016 were retrospectively analyzed, including 173 patients with esophageal varices and 178 patients without varicose veins.The alanine aminotransferase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), γ-glutamyl transpeptadase (γ-GT), total bilirubin (TBil), albumin (Alb), prothrombin time (PT), platelet (PLT), AST to ALT ratio (AAR), fibrosis index based on the 4 fator (FIB-4), AST to PLT ratio index (APRI) and Mayo scores were compared between two groups.Group t test or rank sum test was used to compare the two groups.Relation between the indicators mentioned above and esophageal varices were tested by univariate analysis.Multivariate unconditional Logistic regression was used to screen these indicators to independently predict esophageal varices in PBC patients.Results Age, PT, TBil, AAR, FIB-4, APRI and Mayo scores of PBC patients with esophageal varices were all higher than those of patients without esophageal varices ([60.3±10.6] years old vs [51.9±10.9] years old, [13.31±3.12] s vs [11.17±2.42] s, 28.06 [18.05, 60.06] mmol/L vs 15.39 [10.64, 33.63] μmol/L, 1.69±0.91 vs 1.23±0.95, 6.18 [4.05,9.16] vs 1.80 [1.10,2.74], 1.95 [1.12,3.08] vs 0.69 [0.38,1.57], 6.45±1.52 vs4.62±1.53, respectively).Whereas ALT, γ-GT, Alb and PLT levels were all lower than those without varicose veins (36.60 [19.88, 74.28] U/L vs 59.32 [23.58, 132.70] U/L, 71.00 [38.36, 165.38] U/L vs 125.00 [37.50, 336.21] U/L, [29.78±6.33] g/L vs [39.51±25.16] g/L, [103.43±52.84]×109/L vs [234.44±90.40]×109/L, respectively).The differences were all statistically significant (t=-7.25, t=-7.18, Z=-5.823, t=-4.60, Z=-8.427, Z=-12.661, t=-11.25, Z=-3.218, Z=2.987, t=4.94, t=16.63, respectively;all P11.95 s (OR=0.705, 95%CI: 0.569-0.874), TBil>17.19 μmol/L (OR=0.99, 95%CI: 0.982-0.999), FIB-4>3.02 (OR=0.868, 95% CI: 0.807-0.932) and Mayo score>4.88 (OR=6.053, 95%CI: 2.388-15.342) were independent clinical indicators for the prediction of esophageal varicose veins.Conclusions PLT, PT, TBil, FIB-4, and Mayo scores can be used as predictors of esophageal varices in patients with PBC.
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Objective To further clarify the pathogenesis of different types of Kaposi′s sarcoma (KS) by measuring the protein expressions of caspase-3 and E-cad in tumor tissues of Xinjiang Uygur patients with acqured immunodeficiency syndrome (AIDS)-Kaposi′s sarcoma (KS) and classical KS.Methods From July 2011 to October 2014, 38 patients with KS at the First Affiliated Hospital of Xinjiang Medical University and Urumqi Infectious Disease Hospital were enrolled, among whom 28 were male and 10 were female, and all of them were uygur.Immunohistochemical and Western blot methods were used to detect the expressions of caspase-3 and E-cad proteins in 22 cases of AIDS-KS patients and 16 cases of classic KS.The quantitative data of normal distribution were analyzed by t test, while count data were compared with χ2 test with R × C table.Results KS lesions in patients with classic KS were confined to the skin, without mucosal, lymph node or visceral involvement.Lesions in AIDS-KS patients were not only confined to the skin and superficial lymph nodes, but also oral mucosa involved in 12 cases and internal organs involved in 7 cases.Liver and lung involvement was more common.The CD4+T lymphocyte count in patients with AIDS-KS was (200.8±166)/μL.All 15 AIDS cases with CD4+ T cell count less than 200/μL developed opportunistic infections.CD4+ T lymphocyte count of patients with classic KS was (562.52±222.66)/μL and the 16 patients with CD4+T lymphocyte count greater than 350/μL had no opportunistic infections.The results of immunohistochemistry showed that the positive expression rate of caspase-3 protein in KS tissues in patients with AIDS-KS was 68.2%, in patients with classic KS was 100.0%, with significant difference between two groups (χ2=7.37, P=0.01).The positive expression rate of E-cad protein in KS tissues in patients with AIDS-KS was 72.7%, in patients with classic KS was 100.0%, with significant difference between two groups (χ2=5.18, P=0.03).Western blotting showed that the gray value of caspase-3 in the KS tissue of patients with AIDS-KS was 0.55±0.36, and that in patients with classic KS was 0.86±0.56, with significant difference between two groups (t=-2.070, P<0.05).The gray value of E-cad in the KS tissue of patients with AIDS-KS was 0.54±0.41, and that in patients with classic KS was 0.85±0.45, with significant difference between two groups (t=-2.060,P<0.05).Conclusions There are differences in the protein expressions of caspase-3 and E-cad in tumor tissues of patients with AIDS-KS and classical KS in Xinjiang Uygur patients with Kaposi's sarcoma, which may correlate with a faster progression and a higher mortality rate for AIDS-KS.
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Objective@#To investigate the clinical effect and safety of long-acting pegylated interferon-α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 μg/week) in the treatment of HBeAg-positive chronic hepatitis B (CHB) patients, with standard-dose Peg-IFN-α-2a as positive control.@*Methods@#This study was a multicenter, randomized, open-label, and positive-controlled phase III clinical trial. Eligible HBeAg-positive CHB patients were screened out and randomized to Peg-IFN-α-2b (Y shape, 40 kD) trial group and Peg-IFN-α-2a control group at a ratio of 2:1. The course of treatment was 48 weeks and the patients were followed up for 24 weeks after drug withdrawal. Plasma samples were collected at screening, baseline, and 12, 24, 36, 48, 60, and 72 weeks for centralized detection. COBAS® Ampliprep/COBAS® TaqMan® HBV Test was used to measure HBV DNA level by quantitative real-time PCR. Electrochemiluminescence immunoassay with Elecsys kit was used to measure HBV markers (HBsAg, anti-HBs, HBeAg, anti-HBe). Adverse events were recorded in detail. The primary outcome measure was HBeAg seroconversion rate after the 24-week follow-up, and non-inferiority was also tested. The difference in HBeAg seroconversion rate after treatment between the trial group and the control group and two-sided confidence interval (CI) were calculated, and non-inferiority was demonstrated if the lower limit of 95% CI was > -10%. The t-test, chi-square test, or rank sum test was used according to the types and features of data.@*Results@#A total of 855 HBeAg-positive CHB patients were enrolled and 820 of them received treatment (538 in the trial group and 282 in the control group). The data of the full analysis set showed that HBeAg seroconversion rate at week 72 was 27.32% in the trial group and 22.70% in the control group with a rate difference of 4.63% (95% CI -1.54% to 10.80%, P = 0.1493). The data of the per-protocol set showed that HBeAg seroconversion rate at week 72 was 30.75% in the trial group and 27.14% in the control group with a rate difference of 3.61% (95% CI -3.87% to 11.09%, P = 0.3436). 95% CI met the non-inferiority criteria, and the trial group was non-inferior to the control group. The two groups had similar incidence rates of adverse events, serious adverse events, and common adverse events.@*Conclusion@#In Peg-IFN-α regimen for HBeAg-positive CHB patients, the new drug Peg-IFN-α-2b (Y shape, 40 kD) has comparable effect and safety to the control drug Peg-IFN-α-2a.
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Objective@#To investigate the efficacy and safety of the new investigational drug pegylated interferon α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 µg/week) combined with ribavirin in the treatment of patients with genotype 1/6 chronic hepatitis C (CHC), with standard-dose Peg-IFN-α-2a combined with ribavirin as a positive control.@*Methods@#A multicenter, randomized, open-label, and positive-controlled phase III clinical trial was performed. Eligible patients with genotype 1/6 CHC were screened out and randomly divided into Peg-IFN-α-2b(Y shape, 40kD) group and Peg-IFN-α-2a group at a ratio of 2:1. The patients in both groups were given oral ribavirin for 48 weeks in addition and then followed up for 24 weeks after drug withdrawal. Abbott Real Time HCV Genotype II was used to determine HCV genotype, and Cobas TaqMan quantitative real-time PCR was used to measure HCV RNA level at 0, 4, 12, 24, 48, and 72 weeks. Adverse events were recorded in detail. The primary efficacy endpoint was sustained virological response (SVR), and a non-inferiority test was also performed.@*Results@#A total of 561 patients with genotype 1/6 CHC were enrolled, among whom 529 received treatment; 90.9% of these patients had genotype 1 CHC. The data of the full analysis set showed that SVR rate was 69.80% (95% CI 65.00%-74.60%) in the trial group and 74.16% (95% CI 67.73%-80.59%) in the control group (P = 0.297 0). The data of the per protocol set (PPS) showed that SVR rate was 80.63% (95% CI 76.04%-85.23%) in the trial group and 81.33% (95% CI 75.10%-87.57%) in the control group (P = 0.849 8), and the 95% CI of rate difference conformed to the non-inferiority standard. The analysis of the PPS population showed that of all subjects, 47.9% achieved rapid virologic response, with a positive predictive value of 93.8%. The incidence rate of adverse events was 96.30% in the trial group and 94.94% in the control group, and the incidence rate of serious adverse events was 5.13% in the trail group and 5.06% in the control group.@*Conclusion@#In the regimen of Peg-IFN-α combined with ribavirin for the treatment of genotype 1/6 CHC, the new investigational drug Peg-IFN-α-2b(Y shape, 40 kD) has comparable clinical effect and safety to the control drug Peg-IFN-α-2a.
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Objective To assess the prognostic value of APRI score and FIB-4 index for patients with chronic liver failure.Methods Clinical data of 426 patients with chronic liver failure admitted in the First Affiliated Hospital of Xinjiang Medical University from March 2005 to September 2014 were retrospectively analyzed.The MELD score,APRI score and FIB-4 index were calculated.Patients were divided into survival group and fatal group according to survival situation within 3 month after admission.Logistic regression was used to analyze the differences in all the indexes between the survival group and fatal group.Receiver operating characteristic (ROC) curve was used to assess the value of the above indexes in predicting the 3-month survival.Results Among 426 patients 244 died within three months after admission.Univariate analysis and multivariate Logistic regression showed that MELD score and FIB-4 index were statistically significant between the survival and fatal groups (Z =-4.783 and-4.104,x2 =26.31 and 11.34,both P ＜ 0.01).The area under the ROC curve of MELD score,APRI score and FIB-4 index was 0.635,0.511 and 0.616 for predicting 3-month survival,respectively.Compared with the APRI score,MELD score and FIB4 index were statistically different (x2 =13.669 and 6.341,P ＜ 0.05 or P ＜ 0.01).When MELD score ＞ 28,FIB-4 index ＞ 11.27,the patient has a high fatality rate and poor prognosis within three months.Conclusion FIB-4 index can be used to evaluate the short-term prognosis of patients with chronic liver failure,and the higher score of FIB-4 index predicts the worse prognosis.
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OBJECTIVE:To investigate the protective effect and mechanism of Wei medicine Cichorium glandulosum 95% eth-anol extract(CG-I)on immunological liver injury in mice,and provide reference for post-screening its effective site. METHODS:60 mice were randomly divided into blank control group(normal saline),model group(normal saline),positive control group(Di-ammonium glycyrrhizinate,100 mg/kg) and CG-I high-dose,medium-dose,low-dose groups (calculated by crude drugs as 200, 100,50 g/kg),10 in each group,intragastrically administrated once every day,for 10 d. After 1 h of last administration,except for blank control group,mice in other groups were intravenously injected Con-A in tail to induce immunological liver injury. After 8 h of modeling,tumor necrosis factor α(TNF-α),interferon γ(IFN-γ),interleukin 1β(IL-1β)contents in serum were detected;liver and spleen indexes were calculated. The pathological changes in liver tissue were observed,and aspartate aminotransferase(AST), alanine aminotransferase (ALT), glutathione S-transferase (GST), alkaline phosphatase (AKP), total superoxide dismutase (T-SOD),malondialdehyde(MDA)levels in liver tissue were detected. RESULTS:Compared with blank control group,TNF-α, IFN-γ,IL-1β contents in serum in model group were significantly increased;liver,spleen indexes and AST,ALT,GST,AKP, T-SOD levels in liver tissue were significantly increased;and MDA level in liver tissue was significantly reduced,with statistical significances(P<0.05 or P<0.01);liver of mice in model group was cluttered,showing swelling,necrosis and other diseases in liver cells. Compared with model group, except that AST, ALT,AKP levels in liver tissue in CG-I low-dose group and MDA, IFN-γ contents in serum in CG-I medium-dose, low-dose groups had no significant decrease, other indexes were significantly improved (P<0.05 or P<0.01);and patho-logical changes in liver tissue were relieved to varying degrees. CONCLUSIONS:CG-I shows protective effect on Con-A-in-duced immunological liver injury in mice,especially the high dose and medium dose. The mechanism may be associated with its an-ti-oxidation and anti-inflammatory effects.
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Objective To summarize the characteristics of liver injury due to brucellosis to provide reference for clinical diagnosis and treatment of brucellosis.Methods A total of 359 patients with brucellosis at the First affiliated Hospital of Xinjiang Medical University during 2010-2016 were enrolled, among them 113 (31.5%) developed liver injury.Alanine aminotransferase (ALT), aspartate transaminase (AST), γ-glutamyl transferase (γ-GT), serum albumin (Alb), alkaline phosphatase (ALP) and total bilirubin (TBil) were obtained before and after treatment.Ultrasound of upper abdomen was performed to observe the morphological changes of liver and spleen at admission.The routine blood test, erythrocyte sedimentation rate, C-reactive protein and other laboratory examinations were also performed.The data of patients before and after therapy were analyzed by t test.Results A total of 113 patients were included in this study.Eighty-eight (77.9%) were male.The mean age was (43.2±15.8) years old, among whom 81(71.7%) cases were between 31 and 60 years old.Seventy-one cases (62.8%) was in acute phase, and 42(37.2%) in chronic phase.The Han, Uighurs and Kazak nationalities accounted for 41.6%(47 patients),31.0%(35 patients) and 18.6%(21 cases), respectively.At admission, ALT level was (98.54±59.32) U/L before treatment, and decreased to (38.18±17.13) U/L after treatment, with statistically significant difference (t=6.627, P<0.05).AST levels before and after treatment were (93.17±59.19) U/L and (30.67±12.56) U/L, respectively, with significant difference (t=8.042, P<0.05).γ-GT levels before and after treatment were (162.27±48.19) U/L and (69.53±32.17) U/L, respectively, with statistically significant difference (t=8.271, P<0.05).Alb was (32.31±5.29) g/L before therapy, and increased to (38.00±4.27) g/L after therapy, with statistically significant difference (t=4.429, P<0.05).Conclusions Liver injury is common in patients with brucellosis.Elevation of transaminase is usually mild to moderate, accompanied by reduced ALB.For brucellosis patients with liver injury, antimicrobial treatment combined with liver protecting drugs could improve liver function effectively, and even within the normal range.
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Portal vein thrombosis (PVT) is a common complication in patients with liver cirrhosis. The development of PVT in patients with liver cirrhosis has not been taken seriously emphasis by clinicians, and there are few related studies. Up to now, no consensus has been reached on the diagnosis and treatment of liver cirrhosis complicated by PVT. In recent years, with the improvement in clinical diagnosis and treatment techniques and increasing knowledge of this disease, the influence of PVT on the course of disease in patients with liver cirrhosis has been taken seriously. This article investigates the development and progression, diagnosis, prevention, and related therapeutic methods of PVT in patients with liver cirrhosis.
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Liver cirrhosis is a common cause of portal vein thrombosis (PVT), and the patients with liver cirrhosis complicated by PVT tend to experience complications such as intractable ascites, upper gastrointestinal bleeding, and intestinal necrosis, which may lead to serious consequences and threaten the patient′s life. This article briefly overviews PVT and discusses the reasons and mechanisms of the development of PVT during liver cirrhosis, as well as the diagnosis and treatment of PVT and related controversial issues.