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1.
Article in Chinese | WPRIM | ID: wpr-1029901

ABSTRACT

Objective:To compare the characteristics of cerebrospinal fluid (CSF) oligoclonal band electrophoresis examination results between patients with multiple sclerosis (MS) and Guillain-Barré syndrome (GBS), and to provide a basis for the differential diagnosis of the two types of neurological demyelinating diseases.Methods:Case analysis.The retrospective study method was used, and the patients who visited Beijing Tiantan Hospital, Capital Medical University from January 2020 to August 2023 were selected as the research subjects, including 70 MS patients[19 males and 51 females, aged 34 (28, 44) years] and 70 GBS patients [44 males and 26 females, aged 50 (36, 61) years]. The oligoclonal band electrophoresis and immunoglobulin G(IgG) index (IgG I) were performed on the clinical specimens from MS and GBS patients, and CSF routine, CSF biochemistry (glucose, chloride, protein), lactate, interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-α (TNF-α), antibodies to herpes simplex virus (HSV), cytomegalovirus (CMV), rubella virus (RV), toxoplasma gondii (TOX), Epstein-Barr virus (EBV), and coxsackievirus were detected simultaneously. The enumeration data were treated with the chi-square test. The measurement data didn′t accord with normal distribution, and were treated with the Mann-Whitney U test. Results:The positive rate of oligoclonal band (OCB) electrophoresis in MS and GBS patients were 80.00% (56/70) and 4.29% (3/70), respectively. The positive rate in MS patients was significantly higher than that in GBS patients (χ 2=82.289, P<0.001). The white blood cells count [5.50 (3.00, 11.00)/μl] and the level of chlorine [127 (125, 128) mmol/L] in CSF of MS patients was higher than that of GBS patients [3.50(2.00, 7.00)/μl, 126(124, 128) mmol/L] ( U=-2.245, P<0.05; U=-2.028, P<0.05), while the levels of CSF protein [33.40(27.61, 39.17)mg/L], glucose [3.59(3.36, 3.88) mmol/L], and lactate [1.55(1.40, 1.73) mmol/L] of MS patients were lower than those of GBS patients [6.71(43.78, 138.30) mg/L, 3.97(3.55, 4.54) mmol/L, 1.80(1.60, 2.00) mmol/L]( U=-6.747, P<0.001; U=-3.651, P<0.001; U=-4.531, P<0.001). The levels of IL-6 [3.36(2.34, 5.02) pg/ml], IL-8 [55.40(46.75, 66.40) pg/ml], and TNF-α [5.63(4.25, 6.63) pg/ml] in CSF of MS patients were lower than those of GBS patients [6.12(3.61, 11.73) pg/ml, 120.00(74.90, 187.80) pg/ml, 6.57(5.25, 8.03) pg/ml]( U=-3.463, P<0.05; U=-5.225, P<0.001; U=-2.785, P<0.05). The positive rates of CMV IgG, TOX IgG, and EBVCA IgG in CSF of MS patients were 36.36% (24/66), 0 and 0, respectively,and the positive rates of those of GBS patients were 85.71% (54/63), 30.16% (19/63), and 19.05% (12/63), respectively. The positive rates of CMV IgG, TOX IgG, and EBVCA IgG in CSF of MS patients were significantly lower than those of GBS patients (χ 2=32.839, P<0.001; χ 2=23.343, P<0.001; χ 2=13.861, P<0.001). Conclusions:The MS patients mainly showed the higher positive rates of OCB. The GBS patients showed elevated CSF protein levels but no significant increase in white blood cell count, namely albuminocytologic dissociation in CSF. Meanwhile, the GBS patients showed elevated levels of intrathecal immunity and inflammation indicators, and a higher positive rate of pathogen antibodies.

2.
Chinese Journal of Zoonoses ; (12): 70-75, 2024.
Article in Chinese | WPRIM | ID: wpr-1024891

ABSTRACT

Trichinosis is a global food-borne zoonotic parasitic disease caused by Trichinella spiralis(T.spiralis),which causes serious harm to animal production,and the public health safety of humans and animals.T.spiralis has a complex devel-opment history,and its entire life cycle is completed in the same host.To coexist with the host,it has evolved various immune escape mechanisms for avoiding immune clearance by the host,thus establishing long-term chronic infection.In this study,to aid in understanding the pathogenic mechanism of T.spiralis,the immune escape mechanism of Trichinella is discussed from three aspects:the molecular role of antigens in various stages,the immune regulatory effect on the host,and the formation of cysts to generate immune isolation.

3.
Article in Chinese | WPRIM | ID: wpr-1024987

ABSTRACT

In clinical practice, red blood cell infusion needs to be based on the patient′s hemoglobin level. However, different guidelines recommend different thresholds for red blood cell infusion and the timing of blood transfusion initiation is still controversial due to the presence of these different thresholds. Meanwhile, the use of allogeneic blood products carries a certain risk of transfusion-related infections or organ damage. Therefore, initiating red blood cell infusion requires more evidence. This review discusses some new methods, namely central venous oxygen saturation, arterial venous oxygen difference, near-infrared spectroscopy, and perioperative transfusion trigger score. It aims to help evaluate blood transfusion trigger and provide reference for doctors when making transfusion decisions.

4.
Article in Chinese | WPRIM | ID: wpr-973367

ABSTRACT

Objective To investigate the prevalence of ASCVD in adult with type 2 diabetes (T2DM) in Tianshui City and assess the incidence risk in the next 10 years, so as to provide a theoretical basis for the prevention and treatment of ASCVD. Methods A total of 904 T2DM patients aged 20~88 years admitted in the cardiology department of Tianshui Hospital from May 2018 to June 2022 were grouped according to physical index (BMI), blood pressure, triglyceride (TG) ,glycosylated hemoglobin (HbA1c) and serum levels of asprosin and the risk of ASCVD by China-PAR model. Results The prevalence of ASCVD in adults with T2DM was 36.06%, and there were significant differences in the prevalence of ASCVD between different gender, hypertension grade, BMI and serum albumin (P310 pg/mL (OR=2.873, 95% CI:2.332-4.103), grade 3 hypertension (OR=1.726, 95% CI:1.281-1.981) and BMI>24(OR>1.5). Conclusion The occurrence of ASCVD in T2DM patients is related to a variety of factors , it is very important to control the serum albumin , BMI , hypertension to reduce the incidence rate of ASCVD within 10 years.

5.
Zhonghua Bing Li Xue Za Zhi ; (12): 683-689, 2023.
Article in Chinese | WPRIM | ID: wpr-985758

ABSTRACT

Objective: To investigate the clinicopathological features, diagnosis and differential diagnosis of breast myofibroblastoma. Methods: The clinicopathological data and prognostic information of 15 patients with breast myofibroblastoma diagnosed at the Department of Pathology of the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China from 2014 to 2022 were collected. Their clinical characteristics, histological subtypes, immunophenotypes and molecular characteristics were analyzed. Results: There were 12 female and 3 male patients, ranging in age from 18 to 78 years, with a median and average age of 52 years. There were 6 cases in the left breast and 9 cases in the right breast, including 12 cases in outer upper quadrant, 2 cases in inner upper quadrant and 1 case in outer lower quadrant. Most of the cases showed a well-defined nodule grossly, including pushing growth under the microscope in 13 cases, being completely separated from the surrounding breast tissue in 1 case, and infiltrating growth in 1 case. Among them, 12 cases were classic subtype and composed of occasional spindle cells with varying intervals of collagen fiber bundles; eight cases had a small amount of fat; one case had focal cartilage differentiation; one case was epithelioid subtype, in which epithelioid tumor cells were scattered in single filing or small clusters; one case was schwannoma-like subtype, and the tumor cells were arranged in a significant palisade shape, resembling schwannoma, and one case was invasive leiomyoma-like subtype, in which the tumor cells had eosinophilic cytoplasm and were arranged in bundles, and infiltrating into the surrounding mammary lobules like leiomyoma. Immunohistochemical studies showed that the tumor cells expressed desmin (14/15) and CD34 (14/15), as well as ER (15/15) and PR (15/15). Three cases with histologic subtypes of epithelioid subtype, schwannoma-like subtype and infiltrating leiomyoma-like subtype showed RB1 negative immunohistochemistry. Then FISH was performed to detect RB1/13q14 gene deletion, and identified RB1 gene deletion in all three cases. Fifteen cases were followed up for 2-100 months, and no recurrence was noted. Conclusions: Myofibroblastoma is a rare benign mesenchymal tumor of the breast. In addition to the classic type, there are many histological variants, among which the epithelioid subtype is easily confused with invasive lobular carcinoma. The schwannoma-like subtype is similar to schwannoma, while the invasive subtype is easily misdiagnosed as fibromatosis-like or spindle cell metaplastic carcinoma. Therefore, it is important to recognize the various histological subtypes and clinicopathological features of the tumor for making correct pathological diagnosis and rational clinical treatment.


Subject(s)
Female , Humans , Male , Adolescent , Young Adult , Adult , Middle Aged , Aged , Antigens, CD34 , Biomarkers, Tumor/analysis , Leiomyoma/pathology , Neoplasms, Muscle Tissue/pathology , Neurilemmoma
6.
Zhonghua Bing Li Xue Za Zhi ; (12): 907-911, 2023.
Article in Chinese | WPRIM | ID: wpr-1012333

ABSTRACT

Objective: To investigate the efficacy of neoadjuvant therapy (NAT) on HER2-positive breast cancer and to analyze their clinicopathological features. Methods: A total of 480 cases of HER2-positive breast cancer who received neoadjuvant therapy (NAT), diagnosed at the Department of Pathology of Fudan University Shanghai Cancer Center from 2015 to 2020, were retrospectively identified. Clinicopathological parameters such as age, tumor size, molecular subtype, type of targeted therapy, Ki-67 proliferation index, ER and HER2 immunohistochemical expression, and HER2 amplification status were analyzed to correlate with the efficacy of NAT. Results: Among 480 patients with HER2-positive breast cancer, 209 achieved pathology complete response (pCR) after NAT, with a pCR rate of 43.5%. Of all the cases,457 patients received chemotherapy plus trastuzumab and 23 patients received chemotherapy with trastuzumab and pertuzumab. A total of 198 cases (43.3%) achieved pCR in patients with chemotherapy plus trastuzumab, and 11 cases (47.8%) achieved pCR in patients with chemotherapy plus trastuzumab and pertuzumab. The pCR rate in the latter group was higher, but there was no statistical significance. The results showed that the pCR rate of IHC-HER2 3+patients (49%) was significantly higher than that of IHC-HER2 2+patients (26.1%, P<0.001). The higher the mean HER2 copy number in the FISH assay, the higher the pCR rate was achieved. The expression level of ER was inversely correlated with the efficacy of NAT, and the pCR rate in the ER-positive group (28.2%) was significantly lower than that in the ER-negative group (55.8%, P<0.001). The pCR rate (29.1%) of patients with luminal B type was lower than that of HER2 overexpression type (55.8%, P<0.001). In addition, higher Ki-67 proliferation index was associated with higher pCR rate (P<0.001). The pCR rate was the highest in the tumor ≤2 cm group (57.7%), while the pCR rate in the tumor >5 cm group was the lowest (31.1%). The difference between the groups was significant (P=0.005). Conclusions: HER2 copy numbers, HER2 immunohistochemical expression level, molecular subtype, ER expression level and Ki-67 proliferation index are significantly associated with pCR after NAT. In addition, fluorescence in situ hybridization results, HER2/CEP17 ratio and tumor size could also significantly affect the efficacy of NAT.


Subject(s)
Humans , Female , China , In Situ Hybridization, Fluorescence , Ki-67 Antigen , Neoadjuvant Therapy , Retrospective Studies , Trastuzumab , Breast Neoplasms/drug therapy
7.
Zhonghua Bing Li Xue Za Zhi ; (12): 1210-1215, 2023.
Article in Chinese | WPRIM | ID: wpr-1012395

ABSTRACT

Objective: To identify BRAF V600E mutations in adult Wilms tumor (WT) with overlapping histologic features of metanephric adenoma (MA) and to investigate the clinicopathological features of adult WT. Methods: The clinical features of adult WT diagnosed at the Fudan University Shanghai Cancer Center, Shanghai, China from 2012 to 2021 were reviewed. HE-stained slides of all cases were reviewed by 2 expert pathologists. Representative tissues were selected for BRAF V600E immunohistochemical (IHC) staining and gene sequencing. Results: In adult WT with MA-like areas (cohort Ⅰ, n=6), 5 of the 6 cases were composed of epithelial-predominant and were positive for WT-1 and CD56, respectively, and all were positive for CD57. All 6 cases revealed highly variable Ki-67 indices, ranging from 1% in some areas to 60% in others. 5 of the 6 cases harbored a BRAF V600E mutation. All cases in cohort I were followed up for 23 to 71 months, and all survived. In classical adult WT without MA-like areas cohort (cohort Ⅱ, n=13), all 7 cases with available material were negative for BRAF by IHC and none of them had any BRAF mutation. Conclusions: BRAF V600E mutations are frequently present in adult WT with overlapping morphologically features of MA, but not in those without. More importantly, adult WTs with overlapping histologic features of MA may be an intermediate entity between typical MA and WT that may have a favorable prognosis and possible therapeutic targets.


Subject(s)
Adult , Humans , Proto-Oncogene Proteins B-raf/genetics , China , Wilms Tumor/genetics , Kidney Neoplasms/pathology , Mutation , Adenoma/genetics , Biomarkers, Tumor/genetics
8.
Article in Chinese | WPRIM | ID: wpr-996507

ABSTRACT

ObjectiveTo observe the effect of Danshen injection (DAN) on platelet (PLT)-induced metastasis of breast cancer cells in vitro. MethodThe 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was used to observe the effect of DAN on the growth of MDA-MB-231 cells in vitro. Oris™ migration assay was used to determine the effect of DAN (final mass concentrations 4, 8, 16 g·L-1) on PLT (1.5×1010 cells/L)-induced migration of breast cancer cells in vitro. The effect of DAN on PLT-induced cell invasion was detected by Transwell assay. Immunofluorescence and Western blot were used to detect the effect of DAN on the protein expression associated with PLT-induced epithelial-mesenchymal transition (EMT). In addition, enzyme-linked immune-sorbent assay (ELISA) was used to determine the effect of DAN (final mass concentrations 4, 8, 16, 32, 64 g·L-1) on the secretion of transforming growth factor-β1 (TGF-β1). Western blot was used to observe the effect of DAN on the expression of podoplanin (PDPN) protein in MDA-MB-231 cells induced by PLT. ResultCompared with the blank group, the DAN groups (32 and 64 g·L-1) showed decreased A570 (P<0.05, P<0.01), and there was no significant difference in A570 between DAN groups (4, 8, 16 g·L-1). Compared with the blank group, the PLT group showed increased cell migration and invasion, while DAN groups significantly inhibited PLT-induced cell migration and invasion. Compared with the blank group, the PLT group showed decreased expression of E-cadherin, while DAN could significantly reverse this effect of PLT. Compared with the blank group, the PLT group showed increased Slug and Snail protein expression (P<0.05, P<0.01), while DAN significantly reversed Snail protein expression induced by PLT (P<0.05, P<0.01). The content of TGF-β1 in the PLT group increased (P<0.01), while the secretion of TGF-β1 induced by PLT decreased in the DAN groups (16, 32, and 64 g·L-1) (P<0.05, P<0.01), and the secretion of TGF-β1 was not significantly affected in other DAN groups. PDPN protein expression in the PLT group increased (P<0.01), while DAN could significantly inhibit PLT-induced PDPN expression (P<0.01). ConclusionDAN can inhibit PLT-induced migration, invasion, and EMT of breast cancer cells. The mechanism may be related to the direct action between breast cancer cells and tumor cells by down-regulating PDPN expression and interfering with PLT and has nothing to do with the effect of TGF-β1 secretion of PLT.

9.
Chinese Pharmacological Bulletin ; (12): 731-738, 2023.
Article in Chinese | WPRIM | ID: wpr-1013906

ABSTRACT

Aim To study the ability of tetramethylpyrazine (TMP) on promoting neurogenesis in neural stem cell microenvironment after oxygen-glucose deprivation (OGD) injury in vitro. Methods Neural stem cells (NSCs), astrocytes (ACs) and cerebral microvascular endothelial cells (BMECs) were respectively extracted and separated to establish a co-culture system. The OGD modeling conditions were optimized by NSCs activity, and the concentration of TMP was optimized by Nissl staining. Then CCK-8 and Nestin

10.
Article in Chinese | WPRIM | ID: wpr-1024070

ABSTRACT

Objective To evaluate the effect of targeted monitoring and multi-modular improvement strategy on the prevention and control of catheter-associated urinary tract infection(CAUTI).Methods Patients with indwe-lling urinary catheter in a tertiary first-class hospital from January 2018 to December 2022 were selected as the re-search subjects.Targeted monitoring results and distribution of pathogenic bacteria in 5 consecutive years were ana-lyzed,and a multi-modular improvement strategy based on the targeted monitoring results was implemented.The occurrence of CAUTI before and after implementation,status and effectiveness of training in prevention and control measures were compared respectively.Results Before and after the implementation of the multi-modular improve-ment strategy,health care workers'compliance rate of hand hygiene,awareness rate of prevention and control measures,and implementation rate of prevention and control measures all increased significantly(all P<0.001).Targeted monitoring results showed that daily test rates of urine culture and routine urine from patients with in-dwelling catheters have been on the rise in 5 consecutive years(P<0.05).A total of 397 cases of CAUTI occurred in the past 5 years.Incidences of CAUTI in general intensive care unit(ICU)and surgical ICU showed decreasing trends in 5 consecutive years(all P<0.05).Incidence of CAUTI in general wards showed no statistically significant difference in 5 years(P=0.088).A total of 431 strains of pathogenic bacteria were detected,mainly Gram-negative bacteria.Daily incidence of multidrug-resistant organism infection in patients with indwelling catheters was 0.12‰.After the implementation of the multi-modular improvement strategy,incidence of CAUTI in all departments re-duced significantly(P<0.05).Conclusion Targeted monitoring can help identify departments with high-risk of CAUTI,multi-modular improvement strategy can raise the quality of prevention and control of CAUTI in all occa-sions,reduce the incidence of CAUTI,and is worthy of clinical promotion and application.

11.
Article in Chinese | WPRIM | ID: wpr-940423

ABSTRACT

ObjectiveTo investigate inhibitory effect of extracts from Veronica peregrina (EVP) on the osteoclastic bone metastasis induced by breast cancer cells. MethodBone metastasis model was established by injection of MDA-MB-231 cells, a human breast cancer cell line, into the left ventricle of BALB/c nude mice. The expression of human cytokeratin-19 (Ck-19) gene in mouse bone marrow was determined by nested polymerase chain reaction(PCR) to assess the bone metastasis of MDA-MB-231 cells. To assess the effects of EVP on the activation of bone marrow macrophages (BMMs), we counted the multinuclear cells and measured the secretion of Cathepsin K. Western blot was adopted to assess the effects of EVP on receptor activator of nuclear factor-κB (RANK), Runt-related transcription factor 2 ( Runx2 ), phosphorylated Runx2 (p-Runx2), and matrix metalloproteinase-9 (MMP-9) in BMMs. Gelatin zymography was employed to determine the activities of matrix metalloproteinases (MMPs). ResultCompared with that in the blank group, Ck-19 expression was down-regulated in EVP groups (P<0.05). The multinucleated cells increased when the BMMs were induced by soluble receptor activator of nuclear factor-κB ligand (sRANKL), which was inhibited by EVP (P<0.05). The level of cathepsin K in the supernatant of sRANKL group increased compared with that of the blank group, while EVP groups had lower cathepsin K levels than sRANKL group (P<0.05). Compared with the blank group, the sRANKL group showed up-regulated RANK expression, Runx2 phosphorylation, and MMP-9 expression (P<0.05), while the expression levels of RANK, p-Runx2, and MMP-9 were down-regulated when the cells were incubated with EVP (P<0.05). Furthermore, exposure of BMMs to sRANKL resulted in an increase in gelatin hydrolyzation compared with the blank group (P<0.01), which, however, was reversed in EVP groups (P<0.05). ConclusionEVP significantly inhibits bone marrow metastasis of MDA-MB-231 cells, which may be associated with the suppression of osteoclast activation by inhibiting Runx2 phosphorylation.

12.
Article in Chinese | WPRIM | ID: wpr-940842

ABSTRACT

ObjectiveTo explore the application law of compound prescriptions containing Coptidis Rhizoma to diabetes and its complications based on data mining. MethodA total of 288 records on formulas containing Coptidis Rhizoma in the treatment of diabetes and its complications and the corresponding syndromes and symptoms were retrieved from the medical records of modern physicians, with 218 on the treatment of diabetes and 70 on the treatment of diabetes complications. The Traditional Chinese Medicine Inheritance Computing Platform (V3.0) was used or data mining on the compositions of the formulas. Moreover, it was employed for the frequency statistics, formula analysis, symptom analysis, association rules analysis, network visualization, and cluster analysis. ResultThe 218 formulas containing Coptidis Rhizoma for the treatment of diabetes involved 190 Chinese medicinals. A total of 12 syndromes showed the occurrence frequency ≥ 6, and the one with the highest frequency was deficiency of both qi and yin, followed by the syndrome of excessive heat in lung and stomach, syndrome of Yin deficiency and effulgent fire, and syndrome of excessive heat and fluid consumption. The dose of Coptidis Rhizoma for the treatment of diabetes ranged from 1.5-30 g, and the most frequently used doses were 10, 6, and 5 g. The medicinal was frequently applied for the traditional Chinese medicine symptoms of dry stool, dry mouth and tongue, and swift digestion with rapid hungering. Moreover, 26 core medicinal pairs, 17 association rules, 3 diagrams on medicinal relationship, and 3 core combinations were yielded. The 70 formulas containing Coptidis Rhizoma for the treatment of diabetes complications involved 184 Chinese medicinals, and the top 3 complications were diabetic nephropathy, diabetic peripheral neuropathy, and diabetic gastroenteropathy. The dose of Coptidis Rhizoma in the treatment of diabetes complications fell in the range of 2-15 g, and 10, 6, and 5 g were most frequently used. ConclusionFormulas containing Coptidis Rhizoma for the treatment of diabetes and its complications mainly target the syndrome of dampness-heat transforming into fire and the syndrome of excessive heat damaging yin. This study can serve as a reference for standard use of Coptidis Rhizoma in the prevention and treatment of diabetes and its complications.

13.
Chinese Journal of Digestion ; (12): 247-252, 2022.
Article in Chinese | WPRIM | ID: wpr-934146

ABSTRACT

Objective:To study the clinical characteristics and endoscopic manifestations of patients with systemic amyloidosis involved in digestive tract.Methods:Clinical and endoscopic features, biopsy locations and positive rate of patients with systemic amyloidosis involved in digestive tract at Peking Union Medical College Hospital from December, 1991 to December, 2004 (1991 to 2004 diagnosed group, 18 cases) and from March 17th, 2009 to November 4th, 2020 (2009 to 2020 diagnosed group, 47 cases) were retrospectively analyzed and compared. Independent sample t test, Mann-Whitney U test and chi-square test were used for statistical analysis. Results:Among 47 patients in 2009 to 2020 diagnosed group, 41 were primary amyloid light chain (AL) amyloidosis, and the age of onset was older than that of 1991 to 2004 diagnosed group ((57.15±9.10) years old vs. (50.75±10.90) years old), and the time from disease onset to diagnosis was shorter than that of 1991 to 2004 diagnosed group ((13.48±11.72) months vs. (26.38±23.02) months), and the differences were statistically significant ( t=2.08 and -2.13, P=0.048 and 0.047). There was no significant difference in time from disease onset to diagnosis between patients with gastrointestinal manifestations at disease onset and patients without gastrointestinal manifestations at disease onset (10.5 months (6.0 months, 17.3 months) vs.14.0 months (5.8 months, 25.0 months), P>0.05). Among primary AL amyloidosis patients in 2009 to 2020 diagnosed group, weight loss was the most common clinical symptom, the proportion of patients was 87.8%(36/41); secondary was gastrointestinal bleeding, among which 18 patients (43.9%) were stool occult blood test positive and 4 patients (9.8%) were with melena or bloody stool. The endoscopic features of patients with biopsy-confirmed digestive tract involvemen vary, including mucosa hemorrhage and oozing of blood in 4 cases, fragile mucosa and easy to bleed in 3 cases, and 4 cases with bulged mucosa and all the 4 cases of biopsy at bulged mucosa was positive. Gingiva and tongue were the most common biopsy locations and the positive rate of biopsy was ≥60.0%. Rectal mucosa biopsy was performed in 15 patients and 6 were Congo red staining positive. Heart or kidney biopsy was performed in 3 and 6 patients, and the number of positive cases was 2 and 4, respectively. Conclusions:Weight loss and gastrointestinal bleeding are the common gastrointestinal symptoms of primary AL amyloidosis. The common endoscopic manifestations included mucosal bleeding, fragile and bulged mucosa. Biopsy at multiple locations according to experience may help earlier diagnosis and treatment.

14.
Chinese Journal of Digestion ; (12): 828-836, 2022.
Article in Chinese | WPRIM | ID: wpr-995419

ABSTRACT

Objective:To explore the influencing factors of hospitalization in patients with mild active Crohn′s disease or in clinical remission during long-term follow-up.Methods:This was a prospective cohort study. From August 5, 2013 to January 5, 2015, 123 patients with mild active Crohn′s disease or in clinical remission visited the Department of Gastroenterology, Peking Union Medical College Hospital were selected. The baseline information of all the patients were collected, including the general data such as age and gender, clinical data such as extra-intestinal manifestations, complications, efficacy of glucocorticoid usage, serum hypersensitive C-reactive protein (hsCRP), serum albumin, and the total score and the subscore in systemic symptoms of inflammatory bowel disease questionnaire (IBDQ). All the patients were followed up for a long time till May 31, 2022 or the date of hospitalization due to the disease. Receiver operating characteristic curve (ROC) was used to define the optimal cut-off values of hsCRP and serum albumin for hospitalization prediction. Multivariate Cox regression model was used to analyze the influencing factors of hospitalization.Results:The median age of 123 patients was 32.0 years old (25.0 years old, 49.0 years old), 32.5% (40/123) were female, and 71 cases (57.7%) were hospitalized because of disease, and the median follow-up time was 29.2 months (9.0 months, 57.9 months). ROC analysis showed that the optimal cut-off value of hsCRP and serum albumin in predicting hospitalization because of disease in patients with Crohn′s disease was 1.5 mg/L and 40 g/L (both P<0.001), respectively.Multivariate Cox regression model showed that the extra-intestinal manifestations ( HR=1.869, 95% confidence interval (95% CI) 1.014 to 3.443), complications ( HR=2.511, 95% CI 1.368 to 4.608), glucocorticoid dependence or refractory ( HR=1.958, 95% CI 1.128 to 3.396), serum hsCRP≥1.5 mg/L ( HR=2.116, 95% CI 1.111 to 4.029) and serum albumin≤40 g/L ( HR=3.040, 95% CI 1.716 to 5.386) were independent risk factors of hospitalization because of disease in patients with Crohn′s disease ( P=0.045, 0.003, 0.017, 0.023, and <0.001). However, IBDQ subscore in systemic symptoms ( HR=0.873, 95% CI 0.805 to 0.948) was an independent protective factor of hospitalization because of disease ( P=0.001). Conclusions:Patients with Crohn′s disease at remission stage or mild activity stage who have extra-intestinal manifestations, complications, glucocorticoid dependence or refractory, serum hsCRP≥1.5 mg/L or serum albumin≤40 g/L are at high risk of hospitalization because of disease, and should be given more active treatments and more frequent follow-up. Patients with higher IBDQ subscore in systemic symptoms are more likely to gain a long-term stable condition.

15.
Article in Chinese | WPRIM | ID: wpr-906269

ABSTRACT

Objective:To investigate the effect and mechanism of PAE<sub>2</sub>, a polypeptide of <italic>Periplaneta americana, </italic>in reversing multidrug resistance (MDR) for liver cancer <italic>in vivo</italic>. Method:Balb/c-nude mice were inoculated with HepG2 and HepG2/ADM cells under the armpits to establish animal models of liver cancer sensitive strains and animal models of MDR respectively. After successful modeling, the nude mice were randomly divided into normal group, HepG2 model group, HepG2/ADM model group, sorafenib group (positive drug control group, <italic>ig</italic> 30 mg·kg<sup>-1</sup>), HepG2/ADM+PAE<sub>2</sub> (<italic>iv</italic>) low, medium and high dose groups (50, 100, 200 mg·kg<sup>-1</sup>), HepG2/ADM+PAE<sub>2</sub> (<italic>ig</italic>) low, medium, and high dose groups (50, 100, 200 mg·kg<sup>-1</sup>), skim cream group (<italic>ig</italic> 200 mg·kg<sup>-1</sup>), and CⅡ-3 group (<italic>ig</italic> 200 mg·kg<sup>-1</sup>), all of which received corresponding drug treatment. The body weight and tumor volume of nude mice were measured and recorded every 2 days. The next day after the last administration, tumor tissues of nude mice were taken to record the tumor weight. The effect of <italic>P. americana </italic>polypeptide PAE<sub>2</sub> on permeability-glycoprotein(P-gp), lung resistance protein(LRP) , breast cancer resistance protein(BCRP), protein kinase C(PKC), glutathione S-transferase-π(GST-π), topo-isomerase typeⅡ(ToPoⅡ), multidurg resistance gene 1(MDR1)<sub> </sub>and Multidrug resistance-associated proteins(MRP1) of the protein level and gene level expression in tumor tissues were determined by immunohistochemistry (IHC) and real-time quantitative polymerase chain reaction (Real-time PCR). In addition, both oral and intravenous administration groups were set up at the same time for preliminary study on the basic pharmacokinetic characteristics of <italic>P. americana </italic>polypeptide PAE<sub>2</sub>. Result:After the successful modeling, the body weight of the nude mice was significantly lower than that in the normal mice(<italic>P</italic><0.05). After treatment with corresponding drugs, the body weight increased to a certain extent, but it was still not as good as the normal nude mice. In <italic>iv</italic> administration, the medium-dose <italic>P. americana </italic>polypeptide PAE<sub>2</sub> showed the best anti-tumor effect as compared with the model group (<italic>P</italic><0.05), while in oral administration, the anti-effect increased with the increase of the dose, so the high-dose group showed the best effect (<italic>P</italic><0.05). Preliminary crude extract CII-3 had no obvious anti-tumor effect, and skim cream showed a certain anti-tumor effect (<italic>P</italic><0.05). <italic>P. americana </italic>polypeptide PAE<sub>2</sub> had certain effects on MDR related proteins and enzymes<italic> in vivo</italic>, mainly by inhibiting the expression of LRP and BCRP in tumor tissues and affecting the expression of these related proteins and genes to different degrees to inhibit intracellular drugs outflow, thereby promoting tumor apoptosis, and the effect was superior to that of the <italic>P. americana</italic> crude extract CⅡ-3 and skim cream. Conclusion:<italic>P. americana</italic> polypeptide PAE<sub>2</sub> may reduce the drug efflux, promote intracellular drug accumulation and apoptosis by affecting the expression of related proteins and enzymes that mediate multidrug resistance, thereby exerting a reverse effect on HepG2/ADM cells Balb/c MDR in nude mice.

16.
Article in Chinese | WPRIM | ID: wpr-887135

ABSTRACT

Objective:To determine the epidemiological characteristics and incidence trends of sexually transmitted diseases (STD) in Mengla County of Yunnan Province, and provide evidence for future prevention and control of STD. Methods:STD case information from 2005 to 2017 was extracted from the National Notifiable Infectious Disease Report Information System. Data were collected by year and disease type,and the incidence rate, epidemic characteristics and suspicious contact history of STD were statistically analyzed. Results:A total of 1 251 STD cases were reported in Mengla county from 2005 to 2017, including 490 gonorrhea, 483 syphilis, 216 condyloma acuminatum, 16 genital chlamydial infection and 46 genital herpes. The average annual incidence of STD was 35.57/100 000. The majority of STD cases were 20-29 years old (n=541,43.25%), married (n=603,48.20%), Han people (n=638,50.10%), with education of middle school (n=536,42.85%), and occupation of farmers (n=702, 56.12%). The 42.61% of STD cases had non-marital sexual contact history, in which the proportion was significantly higher among male (55.05%) than female (28.98%). In addition, the proportion of non-marital sex among STD cases increased gradually by year and significantly differed. Conclusion:The epidemic status of STD in Mengla county is relatively low. However, STD incidence increased gradually by year, which warrants more and specific measures on the STD control and prevention.

17.
Article in Chinese | WPRIM | ID: wpr-942536

ABSTRACT

Objective: To investigate the sonographic features of primary thyroid lymphoma (PTL) and to evaluate the clinical significance of ultrasound-guided core needle biopsy (US-CNB) in PTL. Methods: A total of 24 patients with suspected PTL in Sir Run Run Shaw Hospital from January 2013 to June 2018 were analyzed retrospectively. All cases were confirmed by pathology, of them 23 patients received US-CNB and 1 patient chose operation without US-CNB, including 5 males and 19 females, aged from 39 to 75 years old. The effectiveness and safety of 23 patients with US-CNB were evaluated, and the sonographic features of 20 patients with PTL diagnosed by pathology were analyzed. Descriptive statistical methods were used in the study. Results: In the 23 patients with suspected PTL underwent US-CNB, 18 patients were diagnosed as PTL, 4 patients were respectively diagnosed as subacute thyroiditis, anaplastic carcinoma, Hashimoto's thyroiditis, and fibro thyroiditis, and the another patient was hard to diagnose by US-CNB and then was diagnosed as PTL by surgical biopsy. The success rate of US-CNB for diagnosis of PTL was 18/19, and no severe complications occurred in the patients with US-CNB. The other case was diagnosed as PTL by surgical biopsy without US-CNB. Sonographic features of 20 cases with PTL (18 cases diagnosed by US-CNB and 2 cases by surgery or surgery biopsy) were as follows: (1) Most nodules had irregular shapes and unsmooth margins; (2) Hypoechoic or markedly hypoechoic nodules with honeycombed or cord structures were observed in most cases; (3) Calcification was rare; (4) Multiple lesions were common; (5) Abundant intralesional vascularization was commonly observed; (6) Most cases had intensification of posterior acoustic enhancement; (7) Thyroid gland enlargement or with irregular shape; and (8) PTL often accompanied with lymph nodes enlargement in lateral neck or central region. Conclusion: PTL has certain sonographic features, with assistance of US-CNB, more accurate diagnosis of PTL can be obtained.


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Biopsy, Large-Core Needle , Image-Guided Biopsy , Lymphoma/diagnostic imaging , Retrospective Studies , Thyroid Gland , Thyroid Neoplasms/diagnostic imaging , Thyroid Nodule , Ultrasonography, Interventional
18.
Article in Chinese | WPRIM | ID: wpr-911191

ABSTRACT

The medical records of 11 pediatric patients undergoing resection of adrenal cortical carcinoma from January 2012 to January 2019 in our hospital were collected.Anesthesia management for resection of adrenal cortical carcinoma in children was analyzed and investigated.Anesthesia was induced by intravenously injecting atropine 0.01 mg/kg, dexamethasone 2-5 mg, propofol 2-3 mg/kg, sufentanil 0.3-0.5 μg/kg or fentanyl 1-2 μg/kg, rocuronium 0.5 mg/kg or cis-atracurium 0.1-0.2 mg/kg.Radial artery catheterization and femoral vein catheterization were performed under ultrasound guidance.Arterial blood pressure was continuously monitored.The esophageal thermometers probe was placed to continuously monitor body temperature.The catheter was placed to monitor urine volume.Intermittent positive pressure ventilation was performed after endotracheal intubation with the inspiratory oxygen fraction set 60%-100%, oxygen flow rate 2-3 L/min, tidal volume 7-10 ml/kg, ventilation frequency 20-26 times/min, inhalation/respiration ratio 1∶(1.5-2.0) and airway pressure 16-20 cmH 2O, and the end-tidal pressure of carbon dioxide was maintained at 35-45 mmHg.Anesthesia was maintained by inhaling 2%-4% sevoflurane and/or intravenously infusing propofol 0.10-0.15 mg·kg -1·min -1, and continuously infusing remifentanil 0.2-0.5 μg·kg -1·min -1.Hemodynamics was maintained within the normal range, and the bispectral index was maintained at 40-60 during the surgery.Before the tumor was completely removed, 5-10 mg/kg sodium hydrocortisone succinate was intravenously infused.At the end of the operation, sufentanil 0.75-1.00 μg·kg -1·d -1 or fentanyl 7.5-10.0 μg·kg -1·d -1 was continuously infused for postoperative analgesia until 48 h after operation.Operation was smoothly completed with stable anesthesia in all the pediatric patients.The tracheal tube was removed successfully after the operation.All children in this group were discharged from hospital and no death occurred.Anesthesia management for resection of adrenal cortical carcinoma required an appreciation of the clinical characteristics and perioperative pathophysiological changes.Paying attention to the changes in hormone levels during perioperative period and timely adjusting the children′s internal environment to maintain the stability of anesthesia and reduce the stress response were the keys to anesthesia management.

19.
Zhonghua Nei Ke Za Zhi ; (12): 253-256, 2020.
Article in Chinese | WPRIM | ID: wpr-870148

ABSTRACT

Diarrhea is a common digestive symptom. Here, we reported a case of young patient admitted with diarrhea caused by lead poisoning and cytomegalovirus infection. Through informative medical history and multi-disciplinary team discussion, Satoyoshi syndrome was finally diagnosed.

20.
Zhonghua Nei Ke Za Zhi ; (12): 253-256, 2020.
Article in Chinese | WPRIM | ID: wpr-799735

ABSTRACT

Diarrhea is a common digestive symptom. Here, we reported a case of young patient admitted with diarrhea caused by lead poisoning and cytomegalovirus infection. Through informative medical history and multi-disciplinary team discussion, Satoyoshi syndrome was finally diagnosed.

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