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1.
Journal of Clinical Hepatology ; (12): 314-317, 2021.
Article in Chinese | WPRIM | ID: wpr-873398

ABSTRACT

ObjectiveTo investigate the virologic response to direct-acting antiviral (DAA) therapy and the changes in liver stiffness measurement (LSM), fibrosis-4 (FIB-4), and aspartate aminotransferase-to-platelet ratio index (APRI) after treatment in chronic hepatitis C (CHC) patients with different alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels at baseline in a real-world setting. MethodsCHC patients who attended the outpatient service of Department of Infectious Diseases, Peking University First Hospital, from December 2017 to May 2020 were enrolled, and virologic response rate was calculated. The Wilcoxon rank-sum test was used to compare LSM, FIB-4, and APRI between groups at baseline and at 12 weeks after treatment, and the chi-square test was used for comparison of categorical data between groups. ResultsA total of 48 CHC patients were enrolled, among whom 33.3% had abnormal ALT or AST at baseline. Among these patients, the virologic response rate was 85.4% at week 4 of treatment and 100% at the end of treatment and at 12, 24, and 48 weeks after treatment, and there were significant changes from baseline to 12 weeks after treatment in LSM [6.1 (51-12.4) kPa vs 8.6 (5.7-16.9) kPa, Z=-1.676, P=0.043] and APRI [0.24(0.19-0.48) vs 0.42(0.23-1.17), Z=-2.050, P=0027]. From baseline to 12 weeks after treatment, the patients with abnormal ALT or AST at baseline had significant changes in LSM [89(5.6-13.1) kPa vs 14.4(8.0-28.2) kPa, Z=-1.679, P=0.047] and APRI [0.44(0.25-0.50) vs 1.29(0.99-2.09), Z=-3.427, P=0.001]. ConclusionCHC patients achieve a high sustained virologic response rate after DAA therapy, and the patients with abnormal ALT or AST at baseline tend to have more significant improvements in LSM and APRI than those without such abnormality.

2.
Article in Chinese | WPRIM | ID: wpr-885697

ABSTRACT

Objective:To evaluate the value of blood urea nitrogen (BUN)/creatinine (Cr) ratio for guiding the access route of double balloon enteroscopy (DBE) for small intestinal bleeding.Methods:The clinical information was collected from 105 patients who underwent DBE for suspected small intestinal bleeding at Air Force Medical Center from January 2015 to October 2019. Patients were divided into the elevated BUN/Cr group ( n=52) and the normal BUN/Cr group ( n=53), with a cut-off value of 81. Comparison was made for the detection rate of lesions between the oral route and anal route separately in the two groups using Chi-square test. Results:Among the 105 patients with suspected small intestinal bleeding, definite causes of bleeding were identified in 79 patients by DBE, and the overall lesion detection rate was 75.24% (79/105). In the elevated BUN/Cr group, the overall lesion detection rate was 76.92% (40/52), among which 79.49% (31/39) was through oral and 47.37% (9/19) through anal enteroscopy. In the normal BUN/Cr group, the overall lesion detection rate was 73.58% (39/53), and 63.64% (21/33) was transoral and 51.43% (18/35) transanal. The lesion detection rate of transoral enteroscopy in the elevated group was significantly higher than that in the normal group ( χ2=6.576, P=0.010). There was no significant difference in the lesion detection rate of transanal enteroscopy between the two groups ( χ2=2.230, P=0.135). Conclusion:For patients with active small intestinal bleeding (active bleeding within 48 hours), the BUN/Cr ratio higher than 81 may indicate that DBE should be performed firstly via oral route.

3.
Article in Chinese | WPRIM | ID: wpr-882749

ABSTRACT

Objective:To explore the clinical application value of group A Streptococcus (GAS) antigen rapid detection method in children suffering from GAS infection.Methods:A total of 44 733 children with suspected GAS infection who were admitted to the Outpatient and Inpatient Departments of Shenzhen Children′s Hospital from January 2015 to December 2019.Throat swab specimens from all children were collected, and BinaxNOW Strep A Test reagent was used for GAS antigen rapid detection.Among them, the throat swabs of 346 children were inoculated with blood culture medium for traditional bacterial culture, and then the GAS antigen rapid detection was tested.The sensitivity and specificity of the two methods were compared, and according to the result of the GAS antigen rapid detection, its age, gender and seasonal trends were analyzed.SPSS 19.0 software was applied for statistical analysis of the data.Results:Among the 346 children tested by both methods, the results of bacterial culture were adopted as the reference method, the sensitivity of the rapid detection method for GAS antigen was 89.41%(152/170 cases), and the specificity was 94.32%(166/176 cases) compared with culture methods.A total of 44 733 cases GAS antigen were tested in children in Shenzhen, of which 10 024 cases were positive, with the positive detection rate of 22.41%.The trend of GAS antigen rapid detection was consistent with the five-year trend, with the high positive rate of 3-8 years, of which 4-6 years of positive rate was the highest.The two seasonal peaks were evident each year, with peaks occurring in April-June, and November and January of next year.The detection rate ratio of male and female was 1.74∶1, and the gender difference was significant ( χ2=27.93, P<0.000 1). GAS antigen rapid detection rate in different clinical departments from high to low in order are as follows: dermatology outpatient (52.34%), emergency clinic (47.74%), internal medicine outpatient (37.36%), infectious disease area (19.71%), five-level disease area (10.27%), internal medicine area (8.63%), surgical areas (7.34%) and neonatal areas (0). Conclusions:GAS antigen rapid detection method and bacterial culture method have high coincidence rate, and high sensitivity and specificity, and can be popularized and applied in the diagnosis of GAS infectious diseases in children.GAS detection rate is higher in outpatient emergency department and dermatology clinics.There are obvious differences from seasonal and population (age and gender) in the positive detection of GAS antigen.No neonates were found.

4.
J Genet ; 2020 Jan; 99: 1-11
Article | IMSEAR | ID: sea-215553

ABSTRACT

The endangered medicinal plant Glehnia littoralis is one of the important natural source of furanocoumarin, which has been used as mucolytic, antitussive, antitumour and antibacterial. However, the genetic information of furanocoumarin biosynthesis in G. littoralis is scarce at present. The objective of this study was to mine the putative candidate genes involved in the biosynthesis pathway of furanocoumarin and provide references for gene identification, and functional genomics of G. littoralis. We carried out the transcriptome analysis of leaves and roots in G. littoralis, which provided a dataset for gene mining. Psoralen, imperatorin and isoimperatorin were detected in G. littoralis by high performance liquid chromatography analysis. Candidate key genes were mined based on the annotations and local BLAST with homologous sequences using BioEdit software. The relative expression of genes was analysed using quantitative real-time polymerase chain reaction. Further, the CYP450 genes were mined using phylogenetic analyses using MEGA 6.0 software. A total of 156,949 unigenes were generated, of which 9021 were differentially-expressed between leaves and roots. A total of 82 unigenes encoding eight enzymes in furanocoumarin biosynthetic pathway were first obtained. Seven genes that encoded key enzymes in the downstream furanocoumarin biosynthetic pathway and expressed more in roots than leaves were screened. Twenty-six candidate CYP450 unigenes expressed abundantly in roots and were chiefly concentrated in CYP71, CYP85 and CYP72 clans. Finally, we filtered 102 differentially expressed transcription factors (TFs) unigenes. The transcriptome of G. littoralis was characterized which would help to elucidate the furanocoumarin biosynthetic pathway in G. littoralis and provide an invaluable resource for further study of furanocoumarin.

5.
Article in Chinese | WPRIM | ID: wpr-864150

ABSTRACT

Congenital heart diseases of diminutive pulmonary blood are characterized by the decrease of pulmonary blood flow accompanied with pulmonary stenosis or atresia.Diminutive pulmonary blood leads to abnormal development of lung, the formation of major aorta pulmonary collateral arteries (MAPCAs) and a complex cardiac anatomy structure in children, thereby resulting in serious clinical symptoms, poor quality of life and even life-threatening conditions.Therefore, diminutive pulmonary blood is a thorny problem in the treatment of cardiac malformation.However, the etiology and pathogenesis of this disease have not been elucidated yet.The clinical treatment plan and time depend on the disease type and MAPCAs.In this paper, the etiology, pathogenesis, diagnosis and treatment progress of congenital heart diseases of diminutive pulmonary blood were reviewed.

6.
Article in Chinese | WPRIM | ID: wpr-864063

ABSTRACT

Objective:To explore the clinical characteristics and appropriate treatment of occult pneumococcal bacteremia (OPB) in children.Methods:The clinical characteristics, drug sensitivity and antibiotic use of 39 children with OPB who met the inclusion criteria in the Pediatric Internal Medicine Ward of Shenzhen Children′s Hospital from January 2013 to December 2018 were retrospectively analyzed.Results:The median age of onset in OPB in children was 2 years and 4 months, and 74.4% of children(29/39 cases) were between 6 months and 3 years.The average total fever duration was 3.69 days (1-14 days), and the average hospital stay was 6.74 days.Peripheral blood white blood cell count was >15×10 9/L in 89.7% (35/39 cases) of the children, C-reactive protein was increased in 76.9% (30/39 cases) of the children, and procalcitonin > 2 mg/L in 38.9% (14/36 cases) of the children.During hospita-lization, all the children received the treatment of intravenous antibiotics.The antibiotics used initially included Cefuroxime in 11 cases (28.2%), Amoxicillin sulbactam sodium in 10 cases (25.6%), Ceftriaxone sodium in 7 cases (17.9%) and Meloxicillin sulbactam in 6 cases (15.4%). The average fever clearance time after the antibiotic therapy was 1.4 days, and the average intravenous antibiotics treatment time was 6.2 days.The results indicated that the insensitivity rate of Penicillin was 46.2%, the insensitivity rate of Amoxicillin, Ceftriaxone and Cefotaxime were 22.2%, 10.3% and 17.9%, respectively, Erythromycin resistant rate was 100.0%, and no patient was resistant to Vancomycin and Linezolid. Conclusions:OPB occurs most frequently in infants aged from 6 months to 3 years old, with low drug resistance to Amoxicillin, Ceftriaxone and Cefotaxime.Children with complete immunity have shorter fever duration and good prognosis after antibiotic treatment.

7.
Journal of Clinical Hepatology ; (12): 2553-2556, 2020.
Article in Chinese | WPRIM | ID: wpr-829641

ABSTRACT

Since the development of direct-acting antivirals (DAAs) for hepatitis C virus(HCV), more than 95% of the patients with hepatitis C can be cured, but a very small proportion of patients still face treatment failure. There are many reasons for treatment failure, among which HCV genotype and resistance-associated substitutions (RASs) in virus genes show a certain impact. This article mainly introduces the RASs associated with the NS5B and NS5A gene fragments in genotype 2/3 HCV, summarizes the distribution of RASs, and compares the difference in the distribution of RASs between previously untreated chronic hepatitis C patients and patients with treatment failure.

8.
Article in Chinese | WPRIM | ID: wpr-803600

ABSTRACT

Objective@#To screen the risk factors of depression in patients with coronary heart disease(CHD) after percutaneous coronary intervention(PCI), and to construct a predictive model of depression in patients with CHD after PCI and to analyze its diagnostic efficacy.@*Methods@#A total of 3 048 patients with CHD who were treated in our hospital from April 2015 to January 2019 were selected as the study subjects. 967 patients with depression after PCI were selected as depression group. 967 patients without depression after PCI were randomly selected as CHD group according to 1:1 ratio. Univariate and multivariate logistic regression analysis were used to analyze the risk factors of depression in patients with CHD after PCI, and to construct a predictive model of depression in patients with CHD after PCI. The ROC curve was used to analyze the diagnostic efficacy of a predictive model of depression in patients with CHD after PCI.@*Results@#Of 3 048 patients with CHD, 967 (31.73%) suffered from depression after PCI. There were significant differences in age, sex, type D personality, smoking history, NYHA classification, number of stents implanted, solitary living, emergency PCI, Gensini score and education level between the two groups (P<0.05). Logistic regression analysis showed that age, type D personality, NYHA grade, solitude and education were risk factors for depression after PCI. The area under ROC curve of depression model after PCI in CHD patients was 0.961 (95% CI: 0.910-0.987), the sensitivity and specificity were 96.00% and 90.82% respectively.@*Conclusion@#The model constructed in this study can predict the risk of depression in patients with CHD after PCI and is more effective.

9.
Article in Chinese | WPRIM | ID: wpr-803441

ABSTRACT

Objective@#To explore the influence of psychological intervention before percutaneous coronary intervention (PCI) on mental stress, coping style and related factors of depression in patients with acute coronary syndrome (ACS).@*Methods@#281 patients with ACS who were treated in our hospital from March 2016 to August 2018 were selected as the study subjects. According to whether psychological intervention was given to ACS patients before PCI, they were divided into intervention group (n = 135) and control group (n = 146). SCL-90 was used to assess mental stress and MCMQ was used to assess coping styles. The changes of mental stress and coping style before and after operation were compared between the two groups. To investigate the incidence of depression in ACS patients after PCI and analyze the related factors affecting their depression.@*Results@#After PCI, the scores of somatization, obsessive-compulsive disorder, interpersonal sensitivity, depression, anxiety, hostility, fear, paranoia, psychosis and bedtime status were decreased in the SCL-90 scores of the intervention group and the control group (P<0.05). The reduction in the intervention group was more obvious, and the difference was statistically significant (P<0.05). After PCI, there was no significant difference in avoidance and yield between the two groups (P>0.05), and there was no significant difference between the two groups before PCI (P>0.05). After PCI, the face score of intervention group was higher than that of control group (P<0.05), and compared with pre-PCI, the difference was also statistically significant (P<0.05). Of the 281 patients with ACS, 84 (29.89%) had depression after PCI. In the intervention group, 26 patients (19.26%) suffered from depression, and 58 patients (39.73%) in the control group suffered from depression. The prevalence of depression in the two groups was statistically significant (P<0.05). Univariate and multivariate logistic analysis showed that the degree of coronary artery disease, education and psychological intervention before PCI were closely related to ACS patients with post-PCI complicated with depression.@*Conclusion@#Psychological intervention can improve the stress of ACS patients and reduce the negative response. At the same time, it can reduce the risk of depression after PCI.

10.
Article in Chinese | WPRIM | ID: wpr-746083

ABSTRACT

Objective To understand the epidemiological characteristics, genomic variations and macrolide resistance of Bordetella pertussis ( B. pertussis) strains circulating in Shenzhen with clinical data analysis, genotype profiling, phylogenetic analysis and antimicrobial susceptibility test. Methods Clinical data of patients with pertussis in Shenzhen Children's Hospital were collected from the electronic medical re-cord system. Genome sequences of 31 B. pertussis isolates were analyzed with next-generation sequencing and de novo assembled. Multilocus sequence typing (MLST) was performed to identify their sequences types. Sequence alignment by BLASTn was used to identify virulence genotypes and mutations in 23S rRNA gene. A phylogenetic tree was constructed to analyze the relationships among them. E-test was used to identify ma-crolide resistance. Results All of the 31 B. pertussis strains were identified as sequence type-2 (ST-2) by MLST with diverse virulence genotypes. Two were prn-deficient strains. Based on the phylogenetic tree, all of the isolates were distant from vaccine strains. Nineteen isolates were resistant to erythromycin with A2047G mutation in 23S rRNA. Conclusions The virulence genotypes of B. pertussis strains in Shenzhen were diverse with increasing non-vaccine genotypes. Macrolide-resistant strains were prevalent. This study might provide reference for improving the prevention, management and vaccination strategy of pertussis.

11.
Article in Chinese | WPRIM | ID: wpr-752998

ABSTRACT

Objective To explore the clinical efficacy of radical resection with individualized surgical approach for borderline resectable pancreatic head carcinoma.Methods The retrospective descriptive study was conducted.The clinicopathological data of 54 patients with borderline resectable pancreatic head carcinoma who underwent radical resection with individualized surgical approach in the West China Hospital of Sichuan University from January 2015 to January 2018 were collected.There were 37 males and 17 females,aged from 37 to 73 years,with a median age of 59 years.For venous type borderline resectable pancreatic head carcinoma,surgery for pancreatic head carcinoma and (or) pancreatic head and neck carcinoma was performed via inferior mesenteric vein,and surgery for pancreatic uncinate process carcinoma was performed via inferior colon artery.For arterial type borderline resectable pancreatic head carcinoma,surgery for pancreatic head carcinoma and (or) pancreatic head and neck carcinoma was performed via medial uncinate artery,and surgery for pancreatic uncinate process carcinoma was performed via left posterior artery.Observation indicators:(1) surgical situations;(2) postoperative complications;(3) postoperative pathological examination;(4) follow-up.Patients were followed up by outpatient examination or telephone interview once every 3 months to detect survival up to March 2019.Measurement data with normal distribution were represented by Mean ± SD.Measurement data with skewed distribution were represented by M (range),and count data were represented by absolute numbers or percentage.Kaplan-meier method was used to draw the survival curve and calculate the survival rate.Results (1) Surgical situations:all the 54 patients underwent expanded pancreatoduodenectomy combined with superior mesenteric vein/portal vein (SMV/PV) resection,including 15 via inferior mesenteric vein,20 via inferior colon artery,12 via medial uncinate artery,and 7 via left posterior artery.The operation time was (320± 83)minutes,and the volume of intraoperative blood loss was (865±512) mL.(2) Postoperative complications:of 54 cases,28 had postoperative complications,including 13 with grade 1 Clavien-Dindo complications,12 with grade 2 ClavienDindo complications,3 with grade 3 or above Clavien-Dindo complications.One of the 28 patients with postoperative complications died and 27 were improved after symptomatic and supportive treatment.(3) Postoperative pathological examination:of 54 patients,31 had R0 resection and 23 had R1 resection.In the 23 patients with R1 resection,5 underwent surgery via the inferior mesenteric vein (4 with involvement of pancreatic anterior surface,1 with involvement of both pancreatic anterior and posterior surface),9 underwent surgery via the inferior colon artery (2 with involvement of both pancreatic anterior and posterior surface,2 with involvement of superior mesenteric artery margin,2 with involvement of pancreatic posterior surface,2 with involvement of pancreatic anterior surface,1 with involvement of superior mesenteric artery margin and pancreatic posterior surface),5 underwent surgery via the medial uncinate process artery (2 with involvement of superior mesenteric artery margin,2 with involvement of both pancreatic anterior and posterior surface,1 with involvement of pancreatic neck transected margin),and 4 underwent surgery via the left posterior artery (3 with involvement of superior mesenteric artery margin,1 with involvement of both pancreatic anterior and posterior surface).Of 54 patients,16 had no positive lymph nodes,26 had 1-3 positive lymph nodes,and 12 had 4 or more positive lymph nodes.The tumor diameter was (3.20±0.14)cm.There were 48 of 54 patients with nerve infiltration,41 with superior mesenteric vein and/or portal vein infiltration,and 11 with vascular thrombus.There were 17 of 54 patients with high differentiation and medium differentiation,and 37 with low differentiation and undifferentiation.(4) Follow-up:54 patients were followed up for 1-42 months,with a median time of 19 months.The 1-,3-year overall survival rate was 78.0%,11.4%.Condusion As for the borderline resectable pancreatic head cancer,individualized and customized surgical approach according to the location of tumor and the relationship with blood vessels is helpful to standardize the radical resection and avoid R2 resection.

12.
Article in Chinese | WPRIM | ID: wpr-752776

ABSTRACT

Objective To explore the influence of psychological intervention before percutaneous coronary intervention (PCI) on mental stress, coping style and related factors of depression in patients with acute coronary syndrome (ACS). Methods 281 patients with ACS who were treated in our hospital from March 2016 to August 2018 were selected as the study subjects. According to whether psychological intervention was given to ACS patients before PCI, they were divided into intervention group (n=135) and control group (n=146). SCL-90 was used to assess mental stress and MCMQ was used to assess coping styles. The changes of mental stress and coping style before and after operation were compared between the two groups. To investigate the incidence of depression in ACS patients after PCI and analyze the related factors affecting their depression. Results After PCI, the scores of somatization, obsessive-compulsive disorder, interpersonal sensitivity, depression, anxiety, hostility, fear, paranoia, psychosis and bedtime status were decreased in the SCL-90 scores of the intervention group and the control group (P<0.05). The reduction in the intervention group was more obvious, and the difference was statistically significant (P<0.05). After PCI, there was no significant difference in avoidance and yield between the two groups (P >0.05), and there was no significant difference between the two groups before PCI (P> 0.05). After PCI, the face score of intervention group was higher than that of control group (P<0.05), and compared with pre-PCI, the difference was also statistically significant (P<0.05). Of the 281 patients with ACS, 84 (29.89%) had depression after PCI. In the intervention group, 26 patients (19.26%) suffered from depression, and 58 patients (39.73%) in the control group suffered from depression. The prevalence of depression in the two groups was statistically significant (P<0.05). Univariate and multivariate logistic analysis showed that the degree of coronary artery disease, education and psychological intervention before PCI were closely related to ACS patients with post-PCI complicated with depression. Conclusion Psychological intervention can improve the stress of ACS patients and reduce the negative response. At the same time, it can reduce the risk of depression after PCI.

13.
Article in Chinese | WPRIM | ID: wpr-823776

ABSTRACT

Objective To screen the risk factors of depression in patients with coronary heart disease(CHD) after percutaneous coronary intervention(PCI), and to construct a predictive model of depression in patients with CHD after PCI and to analyze its diagnostic efficacy. Methods A total of 3 048 patients with CHD who were treated in our hospital from April 2015 to January 2019 were selected as the study subjects. 967 patients with depression after PCI were selected as depression group. 967 patients without depression after PCI were randomly selected as CHD group according to 1:1 ratio. Univariate and multivariate logistic regression analysis were used to analyze the risk factors of depression in patients with CHD after PCI, and to construct a predictive model of depression in patients with CHD after PCI. The ROC curve was used to analyze the diagnostic efficacy of a predictive model of depression in patients with CHD after PCI. Results Of 3 048 patients with CHD, 967 (31.73% ) suffered from depression after PCI. There were significant differences in age, sex, type D personality, smoking history, NYHA classification, number of stents implanted, solitary living, emergency PCI, Gensini score and education level between the two groups (P<0.05). Logistic regression analysis showed that age, type D personality, NYHA grade, solitude and education were risk factors for depression after PCI. The area under ROC curve of depression model after PCI in CHD patients was 0.961 (95% CI: 0.910-0.987), the sensitivity and specificity were 96.00% and 90.82% respectively. Conclusion The model constructed in this study can predict the risk of depression in patients with CHD after PCI and is more effective.

14.
Journal of Chinese Physician ; (12): 360-363, 2018.
Article in Chinese | WPRIM | ID: wpr-705834

ABSTRACT

Objective Comparison of clinical and pathological features of Henoch-Sch(o)nlein purpura nephritis with different proportions of crescent.Methods Patients with Henoch Schonlein nephritis diagnosed by renal biopsy in our hospital from 2012 to 2017 (proportions of crescent < 50%)were enrolled and grouped according to the rate of crescent formation (A group:crescent formation rate < 10%;B group:10%-24%;C group:> 24%-50%),their epidemiological,clinical manifestations,laboratory examination,clinicopathological features were compared.Results There was no significant difference between the three groups in sex,age and incidence of diabetes(P > 0.05).The morbidity of hypertension in C group is higher than others (P < 0.05).There were no different in the incidence of hematemesis,abdominal pain,joint pain in the three groups (P >0.05),while the incidence of edema and gross hematuria was significantly higher in group C than others.There were more patients had Nephritic syndrome (38.8%) in C group than the other groups (P < 0.05).There was no significant difference in 24 h urinary protein,C-reactive protein (CRP),urine red blood cell,eosinophil granulocyte and immunoglobulin E (IgE) in the 3 groups.The levels of serum creatinine,blood urea nitrogen (BUN),and low density lipoprotein (LDL) increased significantly in group C,and the level of glomerular filtration rate (GFR) and albumin decreased significantly(P < 0.05).The tubulointerstitial lesions,mesangial cell proliferation and deposition of C1q levels,C group was significantly higher than the other two groups (P < 0.05).Conclusions In Henoch Sch(o)nlein purpura nephritis,with the increase of the proportion of the crescent body,the renal function and pathological changes of the kidney are gradually aggravated.Therefore,the crescent is important for the prognosis of Henoch Sch(o)nlein purpura nephritis.

15.
Journal of Chinese Physician ; (12): 42-45,49, 2018.
Article in Chinese | WPRIM | ID: wpr-705777

ABSTRACT

Objective To observe glomerular mesangial cells (GMCs) proliferation induced by IgA1 and the association with the expression of apoptosis-related proteins-B cell lymphoma-2 (Bcl-2),cysteine aspartic acid protease-3 (Caspase-3),cysteine aspartic acid protease-9 (Caspase-9) and with mitofusin 2 (Mfn2) in rat GMCs,to study the possible mechanism of valsartan inhibiting rat GMCs proliferation,and to provide a new direction for the mechanism of GMCs proliferation and intervention research in IgA nephrology (IgAN).Methods GMCs stimulated with IgA1 were cultured in vitro to detect cellproliferation with the cell counting kit-8 cell activity assay (CCK8).GMCs were divided into three groups:CG,TG and VG.The GMCs proliferation level was detected by the CCK8,using real-time PCR to detect Mfn2 expression and Western blotting to detect protein levels of Mfn2,Bcl-2,Caspase-3,and Caspase-9.Results Rat GMCs proliferated significantly after stimulation with IgA1,and IgA1 could obviously stimulate high expression of Bcl-2 in GMCs and down regulate the expression of Mfn2,Caspase-3,and Caspase-9.Valsartan could inhibit the proliferation of GMCs induced by IgA1 significantly,downregulate the expression of Bcl-2,and upregulate the expression of Mfn2,Caspase-3,and Caspase-9.Conclusions These results showed that the mechanism of action of valsartan in the treatment of lgAN is inhibiting the proliferation of GMCs.This mechanism may be associated with the regulation of apoptosis-related proteins,such as Mfn2,Bcl-2,Caspase-3,and Caspase-9.These findings may provide a new direction for the mechanism of GMCs proliferation and intervention research in IgAN.

16.
Chinese Critical Care Medicine ; (12): 613-615, 2018.
Article in Chinese | WPRIM | ID: wpr-703701

ABSTRACT

Objective To develop a washing tube for minimally invasive treatment of sinus cavity pressure ulcer, and to observe its clinical effect. Methods Using transparent non-toxic PU plastic to make sinus cavity flushing and drainage tube, and with rounded hemispherical blunt head for the entry of the sinus, the perforated tube in the sinus cavity was designed with perforated holes (3 rows, 5 for each row); the end of the tube is blocked with heparin cap. The invented sinus cavity flushing tube was used for clinical observation and its use effect was observed. When used, the sinus cavity flushing drainage tube must be placed in the deepest antrum. The wounds were covered with PU sponge. By the active aspiration drainage of the negative pressure with sterile isotonic flushing fluid, bacteria, liquefied necrotic tissue, purulent secretion, internal and external toxins produced by bacteria, and the harmful material such as exudate of inflammatory medium in the sinus cavity was thoroughly removed. Results When treating sinus cavity and mixed pressure ulcer, minimally invasive treatment using the developed sinus cavity flushing drainage tube for irrigation and negative pressure drainage can significantly reduce patients' iatrogenic trauma, observably reduce the pain of the patients, shorten the treatment cycle, improve the cure rate of sinus pressure ulcers, and achieve good clinical effect. The sinus cavity flushing drainage tube has no damage to soft tissue, with simple operation and easy tolerance of patients. It is low price and using disposable materials, which can avoid cross-infection; It can be used to treat oxygen negative pressure in sinus cavity, and it has therapeutic effect on the sinus cavity pressure sore infected by anaerobic bacteria. It can be made into different specifications, different models, and widely used in different professional fields. Conclusion The sinus cavity flushing drainage tube combined with negative pressure treatment is a new technique of mild and undamaged cleansing wound, which makes up for the deficiency of flap surgery, and it is a very ideal method for minimally invasive treatment for sinus and cavity pressure ulcers.

17.
Journal of Leukemia & Lymphoma ; (12): 750-753, 2018.
Article in Chinese | WPRIM | ID: wpr-732671

ABSTRACT

Objective To analyze the therapeutic effects of chemotherapy after chidamide pretreatment in 16 cases of high-risk and refractory lymphoid malignancy. Methods The efficacy and adverse reactions of 16 patients with high-risk and refractory lymphoid malignancy who received chidamide combined with chemotherapy after 3 days pretreatment of chidamide were analyzed. Results Sixteen patients included 6 males and 10 females, and the median age was 49.5 years old (23-88 years old). The median course of previous systemic chemotherapy was 4 (range 0-22). Among 14 patients who received induction chemotherapy, 7 patients achieved complete remission (CR), 7 patients achieved partial remission (PR). Fourteen patients had achieved clinical efficacy, and the overall response rate (ORR) was 100 %. After 2 cases had remission , the patients who entered this regimen for consolidation chemotherapy also had durable CR. The median follow-up time was 13 months (range 2-24 months) until December 2017. Nine cases had overall survival (OS), 7 cases died and 9 cases had progression-free survival. Common adverse effects of the chemotherapy included mild and controllable gastrointestinal reactions after chidamide. Conclusion Chemotherapy after chidamide pretreatment may improve the effect and prognosis of high-risk or refractory lymphoid malignancy.

18.
Article in Chinese | WPRIM | ID: wpr-618597

ABSTRACT

Objective To evaluate the accuracy of bispectral index (BIS)-guided closed-loop target controlled infusion (TCI) system in comparison with opened-loop manual TCI during anesthesia of biliary tract and pancreas surgeries.Methods Forty adult patients undergoing open surgery of biliary tract or pancreas under total intravenous anesthesia, including 17 males and 23 females, aged 18-75 years, falling into ASA physical status Ⅱ or Ⅲ, were randomly allocated into closed-loop group (group C, n=20) and opened-loop manual group (group M, n=20).In group M, the propofol effect-site concentration was adapted at the discretion of the anesthesiologist to reach and maintain a BIS as close as possible to 42-52.In the closed-loop TCI group, propofol was administered using the closed-loop anesthesia delivery system to reach and maintain atarget BIS of 42-52.The BIS values would be recorded automatically by the system at each second after it began to run.The anesthesia duration, unconsciousness time, endotracheal intubation time, recovery time and endotracheal extubation time were recorded.The total usage of propfol and remifentanil were calculated.The incidence rates of emergence agitation, postoperative nausea and vomiting and intraoperative awareness were recorded.The frequencies of vasoactive drug were recorded.MDAPE, Wobble, GS through BIS values were calculated.Results BIS was maintained within ±10% of target (excellent) for significantly longer time in group C (52.1±10.5)% than that in group M (37.6±5.8)% (P<0.05).BIS was maintained within ±(10%-20%) of target (good) for the same time in both groups.MDAPE in group C (10.1±2.2)% were significantly lower than those in group M (15.3±6.4)% (P<0.05).GS in group C (23.1±8.9)% was significantly lower than that in group M (33.5±15.8)%.The usages of propofol in group C ·kg-1·min-1 were similar to those in group M (0.12±0.03) mg·kg-1·min-1, and the usages of remifentanil in group C (0.12±0.03) μg·kg-1·min-1 were similar to those in group M (0.15±0.05) μg·kg-1·min-1.The frequencies of vasoactive drug were similar in both groups.There was one incidence of emergence agitation in groups M.Postoperative nausea and vomiting and intraoperative awareness didn't occur in both groups.Conclusion The depth of the anesthesia is maitained more appropriately and stable in the closed-loop group than that in manual administration group.

19.
Article in Chinese | WPRIM | ID: wpr-614175

ABSTRACT

Objective Taking medical cases in Lin Zheng Zhi Nan Yi An Shi as examples to analyze the network relationship between the syndromes and prescriptions through building a medical case model forecasting medication via artificial neural networks for the syndromes and prescriptions in medical cases. Methods The study screened medical cases in Lin Zheng Zhi Nan Yi An Shi, and standardized and entered the data with Python language programming. PyBrain module was used to build and train a network model. The MatPlotLib module drew the error curve and the predicted fit curve, and evaluated the sensitivity and specificity. NetworkX module realized the visual expression of the network relationship between the syndromes and prescriptions, and analyzed the medicine within the prescriptions and compatibility relationship and the relationship between the pathogenesis and pathology. Results The sensitivity of the constructed medical case network model was 96.15% and the specificity was 75.00%. The visual mapping of the network relationship between the syndromes and prescriptions and the analysis on single, single group, and multi-angle were realized. Conclusion Neural network is capable to simulate the relationship between syndromes and prescriptions of medical knowledge. The visual combination and manifestation of network can provide a feasible solution for the knowledge discovery in medical literature.

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Article in Chinese | WPRIM | ID: wpr-611753

ABSTRACT

Objective To establish the pipeline and evaluate the feasibility of high-throughput sequencing method used in the detection of severe pneumonia pathogens.Methods Clinical control study was used.Bronchi alveolar lavage fluids (BALF) samples from 76 patients with severe pneumonia (treatment group) and 18 patients with tracheal malacia (control group) and without clinical detected pathogens were collected during March 2015 to December 2016 in Shenzhen Children′s Hospital.The pathogens in the samples were detected using clinical tests and high-throughput sequencing respectively.The results of high-throughput sequencing were confirmed by real-time quantitative PCR and the high-throughput sequencing method used in the detection of severe pneumonia pathogens was evaluated.The χ2 test was used to analyze the correlation of detection rate between the high-throughput sequencing group and the non high-throughput sequencing group.Results The pipeline and method of high-throughput sequencing used in the severe pneumonia pathogens detection was established.The pipeline included sample collection, DNA extraction, library construction, sequencing, and bioinformatic analysis.In 76 cases of patients with severe pneumonia, the results of high-throughput sequencing in 66 cases of bronchoalveolar lavage fluid specimens were positive.The sensitivity was 86.84%, which was significantly higher than the total sensitivity of traditional clinical detection methods including bacterial culture, immunofluorescence and quantitative PCR(68.42%,52/76),χ2=7.426,P<0.001.A total of 13 pathogens were detected in 66 positive samples of high-throughput sequencing, including Mycoplasma pneumoniae, Streptococcus pneumoniae, Haemophilus influenzae and adenovirus, etc.Nine kinds of pathogens were detected in these samples through non-high-throughput sequencing.In the experimental group, the results obtained by clinical test and high-throughput (80.26%) were entirely consistent in 61 samples and not completely consistent in 15 samples (19.74%) specimens.These inconsistent results were mainly concentrated in the detection of adenovirus, Streptococcus pneumoniae and Haemophilus influenzae through high-throughput sequencing, whereas clinical cultures and immunofluorescence methods were not able to detect these pathogens.PCR validation showed that there was no significant difference between the results of high-throughput sequencing and the PCR tests (χ2=0.517,P=0.472), and the difference between the results of high-throughput sequencing and traditional clinical detection methods was statistically significant (χ2=11.671,P<0.001).Conclusion The method for the detection of severe pneumonia pathogens based on high-throughput sequencing is highly sensitive and can detect unknown pathogens, which is superior to those used in traditional clinical detection.

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