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1.
China Pharmacy ; (12): 101-106, 2024.
Article in Chinese | WPRIM | ID: wpr-1005222

ABSTRACT

OBJECTIVE To provide reference for the adjustment of antibiotic treatment regimens, identification of adverse reactions, and individualized pharmaceutical care for melioidosis sepsis (MS). METHODS Clinical pharmacists participated in the intensive and eradicating therapeutic processes for an MS patient by using blood concentration and gene detection. Based on the literature, antibiotic treatment regimens of MS were adjusted by determining the blood concentrations of β-lactam and trimethoprim/ sulfamethoxazole (TMP/SMZ) and calculating PK/PD parameters. The causes of adverse drug reactions were analyzed and addressed by detecting drug-related gene polymorphisms through high-throughput sequencing. RESULTS Clinical pharmacists used blood concentration and genetic testing methods to propose adjustments to imipenem-cilastatin sodium dosage and analyze the causes of various adverse drug reactions. PK/PD targets were calculated by measuring the blood concentrations of β-lactam and TMP/SMZ. Clinical pharmacists explained to clinical doctors the compliance status of patients with melioidosis in sepsis and non- sepsis stages through reviewing guidelines and literature; the results of blood concentration and genetic test were used to analyze the correlation of neurotoxicity of MS patients with B14) IMP cmin, and it was found that nephrotoxicity was not related to the cmax of TMP/SMZ, but to the patient’s water intake. After whole-process antibiotic treatment, the patient’s condition improved and was discharged, and the adverse reactions were effectively treated. CONCLUSIONS Clinical pharmacists use blood concentration and genetic tests to assist clinicians in formulating MS treatment regimens, and provide whole-course pharmaceutical care for a MS patient. This method has improved the safety and effectiveness of clinical drug therapy.

2.
Sichuan Mental Health ; (6): 46-51, 2024.
Article in Chinese | WPRIM | ID: wpr-1012556

ABSTRACT

BackgroundBariatric surgery has emerged as an important tool in the management of obesity. Some patients undergoing bariatric surgery are prone to develop emotional abnormalities and have abnormally elevated concentrations of inflammatory factors level in peripheral blood, whereas current domestic research focusing on the impact of preoperative emotional states and peripheral blood inflammatory factors level on weight loss effect remains limited. ObjectiveTo explore the correlation of preoperative emotional abnormalities with the effectiveness of bariatric surgery in obese patients, and to provide theoretical basis for improving the clinical efficacy of bariatric surgery. MethodsEighty-one obese patients scheduled for bariatric surgery at gastrointestinal surgery Department of West China Hospital, Sichuan University from December 30, 2022 to June 30, 2023 were enrolled and assessed using Hamilton Depression Scale-17 item (HAMD-17) and Hamilton Anxiety Scale (HAMA). Patients who scored 7 or above on HAMD-17 or HAMA or had a history of previous depression or anxiety diagnoses were classified into emotional abnormality group (n=34), and samples who scored less than 7 on HAMD-17 and HAMA and were free of history of previous depression and anxiety diagnoses were set as non-emotional abnormality group (n=47). The data were collected by the self made questionnaire. Patients were subjected to complete the assessment of Beck Scale for Suicide Ideation-Chinese Version (BSI-CV), Eating Disorder Inventory (EDI) and Pittsburgh Sleep Quality Index (PSQI). Laboratory tests including peripheral blood C-reactive protein (CRP) and interleukin-6 (IL-6). Body weight and height assessed in the early morning after an overnight fasting period were recorded in all participants at 1- and 6-month after surgery through outpatient clinic visits or telephone follow-up. Pearson correlation coefficient was used to examine relationship among body mass index (BMI), preoperative emotional states and peripheral blood inflammation mediators. ResultsAmong 81 obese patients, 62 completed the study, including 27 cases in emotional abnormality group and 35 cases in non-emotional abnormality group. Emotional abnormality group scored higher on BSI-CV (current), BSI-CV (worst), EDI and PSQI, and detected higher levels of CRP and IL-6 compared with non-emotional abnormality group (Z=2.677, 2.975, t=3.573, 4.035, 1.990, 2.799, P<0.05 or 0.01). For BMI, there was no significant group effect and time×group interaction effect (P>0.05), but a significant time effect (F=227.740, P<0.01). Within emotional abnormality group, BMI at the baseline, 1- and 6-month after surgery showed a positive correlation with IL-6 level (r=0.419, 0.510, 0.559, P<0.05 or 0.01), BMI at 6-month after surgery was positively correlated with HAMD-17 total score (r=0.390, P<0.05), and ΔBMI% at 6-month after surgery was negatively correlated with HAMD-17 total score (r=-0.421, P<0.05). Within non-emotional abnormality group, baseline BMI was positively correlated with IL-6 level (r=0.338, P<0.01). ConclusionThe short-term effect of bariatric surgery may be comparable in obese patients with or without emotional abnormalities, while it cannot be ruled out whether the outcome of bariatric surgery is related to the severity of preoperative depression.

3.
Sichuan Mental Health ; (6): 26-32, 2024.
Article in Chinese | WPRIM | ID: wpr-1012553

ABSTRACT

BackgroundThere exist differences in the subjective and objective cognitive functions of patients with depressive disorder, ane there are limited research on influencing factors of such phenomenon currently. ObjectiveTo explore the differences in subjective and objective cognitive function in patients with depressive disorder as well as influencing factors, and to provide references for further understanding of cognitive impairment in patients with depressive disorder. MethodsA total of 77 patients with depressive disorder who received outpatient or inpatient treatment in the Fourth People's Hospital of Chengdu from January 13, 2022 to December 11, 2023 were selected for the study. These patients also met the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders, fifth edition(DSM-5). Various tools were employed to assess patients in this study: Montgomery-Asberg Depression Rating Scale (MADRS) for the depressive symptoms, Perceived Deficits Questionnaire for Depression (PDQ-D) and Chinese Version of Brief Neurocognitive Test Battery (C-BCT) for the subjective and objective cognitive function, Sheehan Disability Scale (SDS) for the social function, and Clinical Global Impression-Severity of Illness(CGI-SI) for the severity of patient's condition. Pearson correlation analysis was used to examine the correlation of subjective and objective cognitive function and their differences with age, years of education, MADRS total score, SDS total score, and CGI-SI score. Multiple linear regression was used to explore the influencing factors of the differences between subjective and objective cognitive function. ResultsThere was a statistically significant difference in the total PDQ-D scores and the difference of subjective and objective cognitive function (D value) between depressive patients with and without medication (t=-4.228, -2.392, P<0.05 or 0.01). There was no statistically significant correlation in subjective and objective cognitive function in patients with depressive disorder (r=-0.148, P>0.05). Negative correlations can be observed between the PDQ-D total score and age or years of education (r=-0.333, -0.369, P<0.01). The PDQ-D total score was positively correlated with MADRS total score, SDS total score and CGI-SI score (r=0.487, 0.637, 0.434, P<0.01). D value was negatively correlated with age and years of education (r=-0.411, -0.362, P<0.01), while positively correlated with MADRS total score, SDS total score and CGI-SI score (r=0.259, 0.468, 0.299, P<0.05 or 0.01). Age (β=-0.328, P<0.01) and SDS total score (β=0.409, P<0.01) were two predictive factors for D value. ConclusionThe difference between subjective and objective cognitive function among patients with depressive disorder is related to several factors including age, years of education, severity of symptoms and impairment of social function. [Funded by Surface Project of National Natural Science Foundation of China (number, 62173069); Technological Innovation 2030-Major Project of "Brain Science and Brain-Like Research" (number, 2022ZD0211700); Key R&D Support Program and Major Application Demonstration Project of Chengdu Science and Technology Bureau (number, 2022-YF09-00023-SN)]

4.
Chinese Journal of Epidemiology ; (12): 1037-1045, 2023.
Article in Chinese | WPRIM | ID: wpr-985630

ABSTRACT

Objective: To understand the health examination rate and its changing trend in adults in China from 2010 to 2018, identify the main factors affecting the health examination rate and provide data support for decision making of health intervention. Methods: Data from China Chronic Disease and Risk Factor Surveillance in 2010, 2013, 2015 and 2018 were used. After complex weighting of the data, the rates of health examination, its changing trends and reasons for receiving health examination in adults were analyzed. Average annual percent change (AAPC) was used to describe the changing trend. Anderson model was used as the analysis framework. Multivariate logistic regression model was used to identify the influencing factors for the health examination rate. Results: From 2010 to 2018, the health examination rate in adults increased from 28.2% (95%CI: 24.8%-31.6%) to 41.0% (95%CI: 38.9%-43.1%, P for trend <0.001), the AAPC was 5.47%, the annual average increase was more obvious in those with lower education level and lower income level and in those living in rural area and in western China. In 2018, people received health examination mainly due to providing without charge by community (36.7%) and working unit (28.5%). The results of multivariate analysis showed that being women, age ≥45 years, education level of junior high school or above, living in urban areas, medical insurance, annual income ≥24 000 RMB, suffering from multiple chronic diseases, non-smoking, drinking, adequate physical activity were positive factors for receiving health examination. Conclusion: The rate of health examination in adults increased in China during 2010-2018, and the main reason for receiving health examination is free of charge.


Subject(s)
Humans , Adult , Female , Middle Aged , Male , Rural Population , Risk Factors , China/epidemiology , Schools , Chronic Disease
5.
Chinese Journal of Cardiology ; (12): 716-721, 2023.
Article in Chinese | WPRIM | ID: wpr-984709

ABSTRACT

Objective: To identify and analyze 3D architecture of the mutational sites of susceptible genes in a pedigree with familial hypercholesterolemia-like phenotype (FHLP). Methods: This is a case series study. A pedigree with suspected familial hypercholesterolemia was surveyed. The proband admitted in Beijing Anzhen Hospital in April 2019. Whole-exome sequencing was performed to determine the mutational sites of susceptible genes in the proband. Polymerase chain reaction (PCR) sequencing was used to verify the pathogenic variant on proband's relatives. The structural and functional changes of the proteins were analyzed and predicted by Discovery Studio 4.0 and PyMol 2.0. Results: The patients in the pedigree showed abnormal lipid profiles, especially elevated levels of total cholesterol(TC). The genetic screening detected the c.1330C>T SNP in the exon 8 of lipase C (LIPC) gene, this mutation leads to an amino acid substitution from arginine to cysteine at position 444 (Arg444Cys), in the proband and proband's father and brother. In this family, members with this mutation exhibited elevated TC, whereas lipid profile was normal from the proband's mother without this mutation. This finding indicated that LIPC: c.1330C>T mutation might be the mutational sites of susceptible genes. The analysis showed that Arg444Cys predominantly affected the ligand-binding property of the protein, but had a limited impact on catalytic function. Conclusion: LIPC: c.1330C>T is a new mutational site of susceptible genes in this FHLP pedigree.


Subject(s)
Humans , Male , Hyperlipoproteinemia Type II/genetics , Lipase/genetics , Lipids , Mutation , Pedigree , Phenotype , Proteins
6.
Chinese Journal of Hematology ; (12): 366-372, 2023.
Article in Chinese | WPRIM | ID: wpr-984631

ABSTRACT

Objective: To investigate the effect of the AML1-ETO (AE) fusion gene on the biological function of U937 leukemia cells by establishing a leukemia cell model that induces AE fusion gene expression. Methods: The doxycycline (Dox) -dependent expression of the AE fusion gene in the U937 cell line (U937-AE) were established using a lentivirus vector system. The Cell Counting Kit 8 methods, including the PI and sidanilide induction, were used to detect cell proliferation, cell cycle-induced differentiation assays, respectively. The effect of the AE fusion gene on the biological function of U937-AE cells was preliminarily explored using transcriptome sequencing and metabonomic sequencing. Results: ①The Dox-dependent Tet-on regulatory system was successfully constructed to regulate the stable AE fusion gene expression in U937-AE cells. ②Cell proliferation slowed down and the cell proliferation rate with AE expression (3.47±0.07) was lower than AE non-expression (3.86 ± 0.05) after inducing the AE fusion gene expression for 24 h (P<0.05). The proportion of cells in the G(0)/G(1) phase in the cell cycle increased, with AE expression [ (63.45±3.10) %) ] was higher than AE non-expression [ (41.36± 9.56) %] (P<0.05). The proportion of cells expressing CD13 and CD14 decreased with the expression of AE. The AE negative group is significantly higher than the AE positive group (P<0.05). ③The enrichment analysis of the transcriptome sequencing gene set revealed significantly enriched quiescence, nuclear factor kappa-light-chain-enhancer of activated B cells, interferon-α/γ, and other inflammatory response and immune regulation signals after AE expression. ④Disorder of fatty acid metabolism of U937-AE cells occurred under the influence of AE. The concentration of the medium and short-chain fatty acid acylcarnitine metabolites decreased in cells with AE expressing, propionyl L-carnitine, wherein those with AE expression (0.46±0.13) were lower than those with AE non-expression (1.00±0.27) (P<0.05). The metabolite concentration of some long-chain fatty acid acylcarnitine increased in cells with AE expressing tetradecanoyl carnitine, wherein those with AE expression (1.26±0.01) were higher than those with AE non-expression (1.00±0.05) (P<0.05) . Conclusion: This study successfully established a leukemia cell model that can induce AE expression. The AE expression blocked the cell cycle and inhibited cell differentiation. The gene sets related to the inflammatory reactions was significantly enriched in U937-AE cells that express AE, and fatty acid metabolism was disordered.


Subject(s)
Humans , U937 Cells , RUNX1 Translocation Partner 1 Protein , Leukemia/genetics , Core Binding Factor Alpha 2 Subunit/genetics , Oncogene Proteins, Fusion/genetics , Leukemia, Myeloid, Acute/genetics
7.
Journal of Peking University(Health Sciences) ; (6): 915-922, 2023.
Article in Chinese | WPRIM | ID: wpr-1010149

ABSTRACT

OBJECTIVE@#To observe the diurnal difference of acute gout attacks in men, and provide reference for accurate clinical prevention and treatment.@*METHODS@#Using a single-center, cross-sectional study design, the patients diagnosed with gout in the outpatient department of Rheumatology and Immuno-logy of PLA Joint Logistic Support Force No.980 Hospital from October 2021 to April 2022 were selected. The information about the patient's current/last acute gout attacks (less than 2 weeks from visit), date and time of attacks, joint symptoms and signs, medication use, and relevant biochemical tests on the day of visit was recorded. The diurnal time difference of acute gout attacks in male patients was analyzed, and univariate comparison and multivariate Logistic regression analyses were conducted to compare the diurnal difference of acute gout attacks with clinical characteristics and biochemical indicators.@*RESULTS@#A total of 100 male gout patients were included, and 100 acute attacks were recorded. Diurnal distribution of acute gout attacks: morning (6:00~11:59, 18, 18%), afternoon (12:00~17:59, 11, 11%), the first half of the night (18:00~23:59, 22, 22%), the second half of the night (0:00~05:59, 49, 49%); During the day (included morning and afternoon, 29, 29%) and at night (included the first half of the night and the second half of the night, 71, 71%). The rate of acute gout attack was significantly higher at night than in the day (about 2.5 ∶1). No matter the first or recurrent gout, no matter the duration of the disease, the number of acute gout attacks had the difference of less in the day and more in the night. Serum urate (SU) level was higher in the patients with nocturnal attack than in those with daytime attack (P=0.044). Comorbidities were significantly different in the day-night ratio of the number of acute gout attack (P=0.028). Multiple Logistic regression analysis showed that SU level (OR=1.005, 95%CI: 1.001-1.009) and comorbidities (OR=3.812, 95%CI: 1.443-10.144) were the correlative factors of nocturnal acute gout attacks.@*CONCLUSION@#No matter the first or recurrent gout, no matter the duration of the disease, it has a diurnal variation characterized by multiple attacks at night, increased SU level and comorbidities are correlative factors for nocturnal acute attack of gout.


Subject(s)
Humans , Male , Cross-Sectional Studies , Gout/drug therapy , Arthritis, Gouty , Gout Suppressants/therapeutic use , Comorbidity
8.
Journal of Experimental Hematology ; (6): 1516-1522, 2023.
Article in Chinese | WPRIM | ID: wpr-1010002

ABSTRACT

OBJECTIVE@#To analyze factors associated with intestinal acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation(allo-HSCT) in children and to develop a prediction model for intestinal aGVHD after allo-HSCT in children.@*METHODS@#The clinical data of 62 children who underwent allo-HSCT at the Department of Hematology of the People's Hospital of Xinjiang Uygur Autonomous Region from February 2018 to September 2021 were retrospectively analyzed. Intestinal aGVHD was evaluated according to the Mount Sinai Acute GVHD International Consortium (MAGIC) grading criteria, the variables were screened by LASSO (least absolute shrinkage and selection operator) regression analysis with 10-fold cross-validation, and developed a model for predicting intestinal aGVHD after allo-HSCT in children.@*RESULTS@#A total of 33 (53.2%) of the 62 children developed intestinal aGVHD, of which 25 were degree II and 8 were degree III-IV. The results of screening variables by 10-fold cross-validated LASSO regression showed that the significant variables included ethnic minorities (OR =7.229; 95%CI: 2.337-22.354), platelet (PLT) (OR =0.971; 95%CI: 0.932-0.993), uric acid (UA) (OR =0.971; 95%CI: 0.935-0.988), C-reactive protein (CRP) (OR =1.217; 95%CI: 1.053-1.545), and viral infection (OR =10; 95%CI: 3.021-32.668), and these variables were independently associated with intestinal aGVHD in children (all P <0.05). A prediction model was constructed based on above variables. The area under the receiver operating characteristic (ROC) curve (AUC) of the model was calculated, and the AUC value was 0.985 (0.966-1), the Brier score was 0.055. The evaluation showed that the model has a high degree of discrimination and calibration.@*CONCLUSION@#Ethnic minorities, low PLT, low UA, high CRP, and viral infections are independently associated with intestinal aGVHD in children, and early attention should be paid to these high-risk children.


Subject(s)
Humans , Child , Retrospective Studies , Hematopoietic Stem Cell Transplantation/adverse effects , Graft vs Host Disease/diagnosis , Risk Factors , C-Reactive Protein , Acute Disease
9.
Journal of Experimental Hematology ; (6): 1462-1468, 2023.
Article in Chinese | WPRIM | ID: wpr-1009997

ABSTRACT

OBJECTIVE@#To evaluate the expression level of melatonin and its effects on immune function in aplastic anemia (AA) patients.@*METHODS@#The enzyme-linked immunosorbent assay (ELISA) was used to detect the plasma levels of melatonin in AA patients, and the correlation between melatonin levels and laboratory indexs was analyzed. The activation, proliferation, and apoptosis of T cells from AA patients were analyzed by flow cytometry with or without melatonin in vitro.@*RESULTS@#The plasma levels of melatonin in AA patients were significantly lower compared with healthy controls (HC) (12.23 pg/ml vs 20.04 pg/ml, P < 0.01), while the plasma melatonin levels of AA patients in remission group after immunosuppressive therapy (IST) were significantly higher than those in non-remission group (29.16 pg/ml vs 11.73 pg/ml, P =0.04). Moreover, the melatonin levels were positively correlated with platelets (r =0.49), the absolute reticulocyte count (r =0.45), and the percentage of neutrophils (r =0.43). Meanwhile, there was a negative correlation between melatonin levels and the percentages of lymphocytes (r =-0.45). The expressions of CD25 and CD69 in both CD4+ and CD8+ T cells from AA patients were remarkably inhibited by melatonin in vitro (all P < 0.05). When cultured with melatonin, the proliferation rates of both CD4+ and CD8+ T cells from AA patients were markedly suppressed (P =0.01 andP < 0.01).@*CONCLUSION@#The plasma levels of melatonin were decreased in AA patients, which might play an important role in the mechanism of immunological abnormalities. The hyperimmune status of AA patients could be partially ameliorated by melatonin in vitro.


Subject(s)
Humans , Anemia, Aplastic , CD8-Positive T-Lymphocytes , Melatonin , Blood Cell Count
10.
Chinese Journal of Contemporary Pediatrics ; (12): 1253-1258, 2023.
Article in Chinese | WPRIM | ID: wpr-1009877

ABSTRACT

OBJECTIVES@#To investigate the clinical application of metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF) in the etiological diagnosis and treatment of refractory pneumonia (RTP) in children.@*METHODS@#A retrospective analysis was performed on 160 children with RTP who were admitted to the Department of Pediatric Internal Medicine, Maternal and Child Health Hospital of Inner Mongolia Autonomous Region, from January 2020 to March 2023. According to whether mNGS was performed, they were divided into two groups: mNGS (n=80) and traditional testing (n=80). All children received the tests of inflammatory markers and pathogen tests after admission. Traditional pathogenicity tests included microbial culture (sputum specimen collected by suction tube), nucleic acid detection of respiratory pathogens, and serological test (mycoplasma, tuberculosis, and fungi). For the mNGS group, BALF specimens were collected after bronchoscopy and were sent to the laboratory for mNGS and microbial culture. The two groups were analyzed and compared in terms of the detection of pathogens and treatment.@*RESULTS@#Compared with the traditional testing group, the mNGS group had a significantly higher detection rate of pathogens (92% vs 58%, P<0.05), with more types of pathogens and a higher diagnostic rate of mixed infections. Compared with the traditional testing group, the mNGS group had a significantly higher treatment response rate and a significantly lower incidence rate of complications during hospitalization (P<0.05). Treatment was adjusted for 68 children in the mNGS group according to the results of mNGS, with a treatment response rate of 96% (65/68) after adjustment.@*CONCLUSIONS@#Compared with traditional pathogen tests, BALF mNGS can significantly improve the detection rate of pathogens and find some rare pathogens. In clinical practice, when encountering bottlenecks during the diagnosis and treatment of children with RTP, it is advisable to promptly perform the mNGS to identify the pathogens.


Subject(s)
Humans , Child , Bronchoalveolar Lavage Fluid , Retrospective Studies , Pneumonia/therapy , High-Throughput Nucleotide Sequencing , Bronchoscopy , Sensitivity and Specificity
11.
Chinese Journal of Nephrology ; (12): 305-311, 2023.
Article in Chinese | WPRIM | ID: wpr-994979

ABSTRACT

In recent years, with the development of metabolic reprogramming research, people have changed their understanding of the biological effects of immune cells. Under the stimulation of inflammatory response, immune cells re-regulate their metabolism and bioenergetics, provide energy and substrates for cell survival, and initiate immune effect functions. Nod-like receptor protein 3 (NLRP3) inflammasome, as an important component of the innate immune system, has been shown to sense metabolites such as uric acid and cholesterol crystals, and can be inhibited by metabolites such as ketones. It is also regulated by mitochondrial reactive oxygen species and glycolytic components (such as hexokinase). Recent studies have shown that a variety of metabolic pathways converge as effective regulators of NLRP3 inflammasome. The paper reviews the metabolic regulatory pathways and specificity of NLRP3 inflammasome activation, and its role in renal diseases.

12.
Chinese Journal of Neurology ; (12): 434-437, 2023.
Article in Chinese | WPRIM | ID: wpr-994850

ABSTRACT

Combined central and peripheral demyelination (CCPD) is a rare autoimmune disease and its action mechanism remains unknown. This article described a case of CCPD with anti-neurofascin 155 IgG4 antibodies after varicella-zoster virus (VZV) infection who was recovered after steroids and intravenous immunoglobulin treatments. The clinical characteristics of this patient were summarized and the possible pathogenesis was discussed, so as to provide information of CCPD after VZV infection for clinicians.

13.
Chinese Journal of Dermatology ; (12): 64-66, 2023.
Article in Chinese | WPRIM | ID: wpr-994440

ABSTRACT

Objective:To evaluate clinical efficacy of bipedicled scrotal flaps combined with keystone-design perforator island flaps in repairing postoperative large-area defects in male patients with extramammary Paget′s disease of the perineum.Methods:Clinical data were collected from 6 male patients with extramammary Paget′s disease of the perineum in Dermatology Hospital of Jiangxi Province from February 2018 to March 2019, and analyzed retrospectively. These patients were aged from 70 to 84 years (median, 77.5 years) , skin lesions involved the mons pubis, penis and scrotum, and the area of postoperative skin defects varied from 18 to 133 cm 2 (median, 96 cm 2) in size. In all the patients, mons pubis defects after tumor resection were repaired with abdominal keystone-design perforator island flaps, and scrotal and penile defects were repaired with bipedicled scrotal flaps using the remaining scrotal tissues. These patients were followed up at 1 and 3 months after surgery and every 3 months thereafter. Results:All the 6 patients were followed up for 3 - 36 months, with an average of 10 months. All flaps survived with a good color and texture match, and favorable function and appearance were achieved in both the donor and recipient sites.Conclusions:The bipedicled scrotal flaps combined with keystone-design perforator island flaps can repair postoperative large-area defects in male patients with extramammary Paget′s disease of the perineum. Moreover, the operation is simple, and good blood supply can be achieved.

14.
Chinese Journal of Nuclear Medicine and Molecular Imaging ; (6): 91-96, 2023.
Article in Chinese | WPRIM | ID: wpr-993563

ABSTRACT

Objective:To investigate the predictive values of 18F-FDG PET/CT image feature and metabolic parameters for the malignant potential of gastrointestinal stromal tumor (GIST). Methods:From March 2014 to June 2020, the 18F-FDG PET/CT imaging and surgical pathological data of 35 patients with GIST (27 males, 8 females; age 44-84 years) from Union Hospital, Tongji Medical College, Huazhong University of Science and Technology and Zhongnan Hospital of Wuhan University were analyzed retrospectively. Patients were divided into ring-shaped uptake group and other uptake patterns group according to 18F-FDG PET/CT image feature. Fisher′s exact test was used to analyze the differences of tumor necrosis and National Institutes of Health (NIH) risk classification (short for NIH classification) between different image feature groups. Mann-Whitney U test was used to analyze the differences of SUV max , metabolic parameters at different thresholds (2.5, 40%, 50%) of SUV max (metabolic tumor volume (MTV; MTV 2.5, MTV 40%, MTV 50%) and total lesion glycolysis (TLG; TLG 2.5, TLG 40%, TLG 50%)) between different clinicopathological features (lesion location, tumor diameter, mitotic count, Ki-67, necrosis, image feature, NIH classification) groups. Spearman rank correlation analysis was used to explore the correlation between clinicopathological features and metabolic parameters. ROC curve analysis was used to distinguish NIH classification of different metabolic parameters. Delong test was used to compared differences between different AUCs. Results:Of 35 GIST patients, 11(31.4%) were ring-shaped uptake and 24(68.6%) were other uptake patterns, and the differences of necrosis (7/11 vs 12.5%(3/24); P=0.004) and NIH classification (11/11 vs 25.0%(6/24); P<0.001) between the two groups were significant. There were significant differences of metabolic parameters between different groups of tumor diameter, mitotic count, necrosis, image feature, NIH classification ( z values: from -4.70 to -2.09, all P<0.05), while there were no significant differences of Ki-67 ( z values: from -0.83 to -0.71, all P>0.05). Metabolic parameters were correlated with mitotic count, tumor diameter, necrosis, image feature and NIH classification ( rs values: 0.36-0.81, all P<0.05), while was not correlated with Ki-67 ( rs values: 0.12-0.14, all P>0.05). The differences of AUCs between SUV max and MTV 2.5, TLG 2.5, TLG 40%, TLG 50%were significant (0.752, 0.856, 0.856, 0.882, 0.886; z values: 1.96-2.12, all P<0.05). Conclusions:The NIH classification of GIST with ring-shaped uptake on 18F-FDG PET/CT is higher and more prone to necrosis. The 18F-FDG PET/CT metabolic parameters based on different thresholds of SUV max have certain significance for the prediction of NIH classification of GIST, and may be superior to SUV max.

15.
Chinese Journal of Lung Cancer ; (12): 38-45, 2023.
Article in Chinese | WPRIM | ID: wpr-971177

ABSTRACT

The occurence and development of tumors is a complicated process, which not only depends on the mutation or deletion of genes, but also is affected by epigenetic regulation. Accumulating evidences have shown that epigenetic modifications play fundamental roles in transcriptional regulation, heterochromatin formation, X chromosome inactivation, DNA damage response and tumor development. SET domain containing lysine methyltransferase 7 (SETD7) was initially identified as an important lysine methyltransferase, which methylated histone and non-histone proteins. These modifications play fundamental roles. Once this modification disorders, it can directly lead to cell abnormalities and cause many diseases. Studies have shown that SETD7 is related to the occurence and development of various tumors, but the methylation sites of SETD7 and its regulatory mechanism have not been fully elucidated. This article summarizes the research progress of the role of SETD7 on histone and non-histone methylation modification in tumors and the molecular mechanism, in order to provide new therapeutic targets for tumor pathogenesis and diagnosis.
.


Subject(s)
Humans , Epigenesis, Genetic , Histone-Lysine N-Methyltransferase/metabolism , Lysine/metabolism , Lung Neoplasms/genetics , Histones/metabolism
16.
Chinese Journal of Internal Medicine ; (12): 384-392, 2023.
Article in Chinese | WPRIM | ID: wpr-985936

ABSTRACT

Objective: To investigate the quality of life and associated factors in patients with coronary heart disease (CHD) in China. Methods: A cross-sectional study of 25 provinces and cities in China was performed from June to September 2020. A questionnaire was used to collect the socio-demographic and clinical information of patients with CHD, while the European Five-dimensional Quality of Life Scale (EQ-5D) was used to assess the quality of life. Multiple linear regression model was performed to analyze the associated factors. Results: The median age of the 1 075 responders was 60 (52, 67) years, and 797 (74.1%) were men. The EQ-5D and EQ-VAS indices were 0.7 (0.5, 0.8) and 60.0 (40.0, 80.0). Among the five dimensions in the quality of life scale, the frequency of anxiety/depression was the highest (59.8%), while problems in self-care was the lowest (35.8%). In the multiple linear regression model, female, increasing age, obesity, comorbidity(ies), anxiety/depression, social media channels, and receiving the CABG therapy were associated with the lower EQ-5D index (all P<0.05). In addition, increasing age, obesity, comorbidity (ies), depression, anxiety and depression, social media channels, and receiving the CABG therapy were associated with lower EQ-VAS index (all P<0.05). Conclusion: Over half of the patients with CHD in China have a low quality of life, which is related to gender, age, obesity, treatment pathway, the presence or absence of comorbidity (ies), and psychological state. In addition to managing the adverse effects of traditional socio-demographic factors on the quality of life, clinical practices should pay attention to the psychological state of patients. Moreover, establishing a WeChat group for doctor-patient communication could improve the quality of life of CHD patients.


Subject(s)
Male , Humans , Female , Quality of Life/psychology , Self Report , Cross-Sectional Studies , Coronary Disease , Surveys and Questionnaires , Obesity
17.
Chinese Journal of Pediatrics ; (12): 351-356, 2023.
Article in Chinese | WPRIM | ID: wpr-985875

ABSTRACT

Objective: To evaluate the therapeutic efficacy of hematopoietic stem cell transplantation (HSCT) for Wiskott-Aldrich syndrome (WAS), and to analyze the factors related to the outcomes. Methods: The clinical data of 60 children with WAS received HSCT in Shanghai Children's Medical Center from January 2006 to December 2020 were retrospectively analyzed. All cases were treated with a myeloablative conditioning regimen with busulfan and cyclophosphamide, and a graft-versus-host disease (GVHD) prevention regimen based on cyclosporine and methotrexate. Implantation, GVHD, transplant-related complications, immune reconstitution and survival rate were observed. Survival analysis was performed by Kaplan-Meier method, and Log-Rank method was used for univariate comparison. Results: The 60 male patients had main clinical features as infection and bleeding. The age at diagnosis was 0.4 (0.3, 0.8) years, and the age at transplantation was 1.1 (0.6, 2.1) years. There were 20 cases of human leukocyte antigen matched transplantation and 40 mismatched transplantation; 35 patients received peripheral blood HSCT, and 25 cord blood HSCT. All cases were fully implanted. The incidence of acute GVHD (aGVHD) was 48% (29/60) and only 2 (7%) developed aGVHD of grade Ⅲ; the incidence of chronic GVHD (cGVHD) was 23% (13/56), and all cases were limited. The incidence of CMV and EBV infection was 35% (21/60) and 33% (20/60) respectively; and 7 patients developed CMV retinitis. The incidence of sinus obstruction syndrome was 8% (5/60), of whom 2 patients died. There were 7 cases (12%) of autoimmune hemocytopenia after transplantation. Natural killer cells were the earliest to recover after transplantation, and B cells and CD4+T cells returned to normal at about 180 days post HSCT. The 5-year overall survival rate (OS) of this group was 93% (95%CI 86%-99%), and the event free survial rate (EFS) was 87% (95%CI 78%-95%). EFS of non-CMV reactivation group is higher than that of CMV reactivation group (95% (37/39) vs.71% (15/21), χ2=5.22, P=0.022). Conclusions: The therapeutic efficacy of HSCT for WAS is satisfying, and the early application of HSCT in typical cases can achieve better outcome. CMV infection is the main factor affecting disease-free survival rate, which can be improved by strengthening the management of complications.


Subject(s)
Humans , Male , Child , Retrospective Studies , Wiskott-Aldrich Syndrome/therapy , China , Hematopoietic Stem Cell Transplantation/methods , Graft vs Host Disease/prevention & control , Transplantation Conditioning
18.
Chinese Journal of Obstetrics and Gynecology ; (12): 536-545, 2023.
Article in Chinese | WPRIM | ID: wpr-985674

ABSTRACT

Objective: To evaluate the efficacy and safety of Nocardia rubra cell wall skeleton (Nr-CWS) in the treatment of persistent cervical high-risk human papillomavirus (HR-HPV) infection. Methods: A randomized, double blind, multi-center trial was conducted. A total of 688 patients with clinically and pathologically confirmed HR-HPV infection of the cervix diagnosed in 13 hispital nationwide were recruited and divided into: (1) patients with simple HR-HPV infection lasting for 12 months or more; (2) patients with cervical intraepithelial neoplasia (CIN) Ⅰ and HR-HPV infection lasting for 12 months or more; (3) patients with the same HR-HPV subtype with no CINⅡ and more lesions after treatment with CINⅡ or CIN Ⅲ (CINⅡ/CIN Ⅲ). All participants were randomly divided into the test group and the control group at a ratio of 2∶1. The test group was locally treated with Nr-CWS freeze-dried powder and the control group was treated with freeze-dried powder without Nr-CWS. The efficacy and negative conversion rate of various subtypes of HR-HPV were evaluated at 1, 4, 8, and 12 months after treatment. The safety indicators of initial diagnosis and treatment were observed. Results: (1) This study included 555 patients with HR-HPV infection in the cervix (included 368 in the test group and 187 in the control group), with an age of (44.1±10.0) years. The baseline characteristics of the two groups of subjects, including age, proportion of Han people, weight, composition of HR-HPV subtypes, and proportion of each subgroup, were compared with no statistically significant differences (all P>0.05). (2) After 12 months of treatment, the effective rates of the test group and the control group were 91.0% (335/368) and 44.9% (84/187), respectively. The difference between the two groups was statistically significant (χ2=142.520, P<0.001). After 12 months of treatment, the negative conversion rates of HPV 16, 18, 52, and 58 infection in the test group were 79.2% (84/106), 73.3% (22/30), 83.1% (54/65), and 77.4% (48/62), respectively. The control group were 21.6% (11/51), 1/9, 35.1% (13/37), and 20.0% (8/40), respectively. The differences between the two groups were statistically significant (all P<0.001). (3) There were no statistically significant differences in vital signs (body weight, body temperature, respiration, pulse rate, systolic blood pressure, diastolic blood pressure, etc.) and laboratory routine indicators (blood cell analysis, urine routine examination) between the test group and the control group before treatment and at 1, 4, 8, and 12 months after treatment (all P>0.05); there was no statistically significant difference in the incidence of adverse reactions related to the investigational drug between the two groups of subjects [8.7% (32/368) vs 8.0% (15/187), respectively; χ2=0.073, P=0.787]. Conclusion: External use of Nr-CWS has good efficacy and safety in the treatment of high-risk HPV persistent infection in the cervix.


Subject(s)
Female , Humans , Adult , Middle Aged , Cervix Uteri/pathology , Uterine Cervical Neoplasms/pathology , Papillomavirus Infections/diagnosis , Cell Wall Skeleton , Persistent Infection , Powders , Uterine Cervical Dysplasia/pathology , Immunotherapy , Papillomaviridae
19.
Chinese Journal of Epidemiology ; (12): 1054-1062, 2023.
Article in Chinese | WPRIM | ID: wpr-985632

ABSTRACT

Objective: To assess the cardiovascular health status of adults in China by using the "Life's Essential 8" score, and provide reference for the development and improvement of cardiovascular disease prevention and control policies and measures. Methods: Chronic Disease and Nutrition Surveillance was conducted in 298 counties/districts in 2015 in 31 provinces (autonomous regions, municipalities) across China, multi-stage stratified cluster random sampling was used to select 45 households in each village or neighborhood, and 20 households were further selected to conduct dietary surveys. In this study, a total of 70 093 adults aged ≥20 years who completed the dietary survey and had complete information were included, their cardiovascular health status were assessed by using the "Life's Essential 8" score, a cardiovascular health scoring standard released by the American Heart Association in 2022. All results were adjusted using complex design-based sampling weights to achieve a better estimate of the population. Results: In 2015, the overall cardiovascular health score of Chinese adults aged ≥20 years was 73.3±12.6, the score was significantly higher in women (77.9±11.6) than in men (68.7±11.8), and higher in urban area (74.5±12.8) than in rural area (71.9±12.2), the differences were significant (P<0.001). It was estimated that about 0.25% (95%CI: 0.16%-0.33%) of adults in China had cardiovascular health score of 100, and 33.0% (95%CI: 31.6%-34.3%), 63.2% (95%CI: 62.1%-64.3%), and 3.9% (95%CI: 3.5%-4.2%) of adults had high, moderate and low cardiovascular health scores, respectively. The proportion of those with high cardiovascular health scores was relatively low in men, those with low education level, those with low income, those living in rural areas, and those living in southwest China (P<0.001). Of the eight factors, diet had the lowest mean score (46.0, 95%CI: 44.7-47.3), followed by blood pressure (59.4, 95%CI: 58.2-60.6) and tobacco exposure (61.4, 95%CI: 60.6-62.2). Conclusions: The cardiovascular health status of two-thirds of adult population in China needs to be improved. Diet, tobacco exposure, and blood pressure are the factors affecting the cardiovascular health of Chinese population, to which close attention needs to be paid, and men, rural residents, and those with lower socioeconomic status are key groups in cardiovascular health promotion.


Subject(s)
Adult , Female , Humans , Male , Young Adult , Asian People , Cardiovascular Diseases/prevention & control , China/epidemiology , Diet , East Asian People , Health Status , Risk Factors , United States , Health Status Indicators
20.
Chinese Journal of Schistosomiasis Control ; (6): 68-72, 2023.
Article in Chinese | WPRIM | ID: wpr-965530

ABSTRACT

Objective To investigate the prevalence and risk factors of hookworm infections among vegetable growers in Anhui Province, so as to provide the evidence for formulating the control strategy and interventions for hookworm human infections.. Methods A total of 1 179 vegetable growers were randomly sampled from 7 counties in Anhui province according to the natural ecological function areas in 2018 and 2019, and the basic features and risk factors of hookworm infections were collected from all subjects using a self-designed questionnaire, including living environment, vegetable planting and fertilization, type of household crops, animal feeding, hygiene and labor habits. In addition, stool samples were collected from all participants, and each stool sample was subjected to twice tests with the Kato-Katz technique. The risk factors of hookworm infections were identified among vegetable growers with the Bayesian log-binomial regression model. Results The prevalence of hookworm infection was 3.90% among the 1 179 vegetable growers. The prevalence of hookworm infection was 10.07% (15/149) among unemployed subjects, 5.32% (31/583) among farmers, and 0 among full-time vegetable growers (0/377) and subjects with other occupations (0/70), and there was a significant difference among subjects in terms of occupation (χ2=36.37, P < 0.01). Bayesian log-binomial regression analysis showed that fertilization with human feces [relative risk (RR)=18.25, 95% confidence interval (CI): (4.31, 77.17)], barefoot labor in vegetable fields [RR=2.86, 95% CI: (1.43, 5.70)], and living in plain ecological areas along the middle and lower reaches of the Yangtze River [RR=4.19, 95% CI: (1.19, 14.81)] were independent risk factors of hookworm infections among vegetable growers. Stratified analysis showed that fertilization with human feces, barefoot labor in vegetable fields, drinking well water or mountain spring, and living in plain ecological areas along the middle and lower reaches of the Yangtze River were independent risk factors of hookw, orm infection among farmers, and living in plain ecological areas along the middle and lower reaches of the Yangtze River and growing rice were independent risk factors of hookw, orm infection among unemployed individuals. Conclusions The prevalence of hookworm infection is high among vegetable growers in Anhui Province, and fertilization with human feces, barefoot labor in vegetable fields and living in plain ecological areas along the middle and lower reaches of the Yangtze River are risk factors of hookw, orm infections among vegetable growers.

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