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1.
China Pharmacy ; (12): 179-184, 2022.
Article in Chinese | WPRIM | ID: wpr-913108

ABSTRACT

OBJECTIVE To optimize the e xtraction technology of Guizhi shaoyao zhimu decoction (GSZD). METHODS The contents of 9 components in GSZD were determined by HPLC ,such as ephedrine hydrochloride ,pseudoephedrine hydrochloride , mangiferin,paeoniflorin,liquiritin,5-O-methylvisammioside,glycyrrhizic acid ,cinnamic acid ,6-gingerol. On the basis of single factor experiment ,taking material-liquid ratio ,extraction times and extraction time as inspection factors ,taking the contents of above 9 components and the yield of dry extract as evaluation indicators ,the analytic hierarchy process and entropy weight method were used to determine the composite weight of each index and calculate the comprehensive score ;the extraction technology parameters of GSZD were optimized by Box-Behnken response surface method ,and the validation tests were conducted. RESULTS The composite weight of the contents of ephedrine hydrochloride ,pseudoephedrine hydrochloride ,mangiferin,paeoniflorin, glycyrrhizin,5-O-methylvisa- midol ,glycyrrhizinate,cinnamic acid ,6-gingerol and the yield of dry extract were respectively 0.12,0.10,0.05,0.12,0.14,0.06,0.13,0.15,0.10,0.03. The optimal extraction technology of GSZD is that the ratio of material to liquid is 1 ∶ 14(g/mL),extraction is 2 times,and the extraction time is 3.0 h;average comprehensive score of the 3 verification tests was 95.879,and RSD was 0.50%(n=3),the deviation from the predicted comprehensive score (94.328)was 1.64%. CONCLUSIONS In this study ,the optimal extraction technology of GSZD is determined.

2.
Article in Chinese | WPRIM | ID: wpr-943028

ABSTRACT

Objective: To analyzed perioperative safety of cytoreductive surgery (CRS) for patients with colorectal cancer peritoneal metastasis (CRPM) and to construct a predictive model for serious advese events (SAE). Methods: A descriptive case-series study was conducted to retrospectively collect the clinicopathological data and treatment status (operation time, number of organ resection, number of peritoneal resection, and blood loss, etc.) of 100 patients with peritoneal metastases from colorectal cancer or appendix mucinous adenocarcinoma who underwent CRS at the Sixth Affiliated Hospital of Sun Yat-sen University from January 2019 to August 2021. There were 53 males and 47 females. The median age was 52.0 (39.0-61.8) years old. Fifty-two patients had synchronous peritoneal metastasis and 48 had metachronous peritoneal metastasis. Fifty-two patients received preoperative neoadjuvant therapy. Primary tumor was located in the left colon, the right colon and the rectum in 43, 28 and 14 cases, respectively. Fifteen patients had appendix mucinous adenocarcinoma. Measures of skewed distribution are expressed as M (range). Perioperative safety was analyzed, perioperative grade III or higher was defined as SAE. Risk factors associated with the occurrence of SAEs were analyzed using multivariate logistic regression. A nomogram was plotted by R software to predict SAE, the efficacy of which was evaluated using the area under the ROC curve (AUC) and correction curves. Results: The median peritoneal cancer index (PCI) score was 16 (1-39). Sixty-eight (68.0%) patients achieved complete tumor reduction (tumor reduction score: 0-1). Sixty-two patients were treated with intraperitoneal hyperthermic perfusion chemotherapy (HIPEC). Twenty-one (21.0%) patients developed 37 SAEs of grade III-IV, including 2 cases of ureteral injury, 6 cases of perioperative massive hemorrhage or anemia, 7 cases of digestive system, 15 cases of respiratory system, 4 cases of cardiovascular system, 1 case of skin incision dehiscence, and 2 cases of abdominal infection. No grade V SAE was found. Multivariate logistic regression analysis showed that CEA (OR: 8.980, 95%CI: 1.428-56.457, P=0.019), PCI score (OR: 7.924, 95%CI: 1.486-42.259, P=0.015), intraoperative albumin infusion (OR: 48.959, 95%CI: 2.115-1133.289, P=0.015) and total volume of infusion (OR: 24.729, 95%CI: 3.956-154.562, P=0.001) were independent risk factors for perioperative SAE in CRS (all P<0.05). Based on the result of multivariate regression models, a predictive nomogram was constructed. Internal verification showed that the AUC of the nomogram was 0.926 (95%CI: 0.872-0.980), indicating good prediction accuracy and consistency. Conclusions: CRS is a safe and effective method to treat CRPM. Strict screening of patients and perioperative fluid management are important guarantees for reducing the morbidity of SAE.


Subject(s)
Adenocarcinoma, Mucinous/therapy , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Appendiceal Neoplasms/surgery , Colorectal Neoplasms/pathology , Combined Modality Therapy , Cytoreduction Surgical Procedures/methods , Female , Humans , Hyperthermia, Induced/methods , Male , Middle Aged , Peritoneal Neoplasms/secondary , Retrospective Studies , Survival Rate
3.
International Eye Science ; (12): 1658-1661, 2022.
Article in Chinese | WPRIM | ID: wpr-942836

ABSTRACT

Cataract is one of the most common causes of vision loss and even blindness in patients, and surgery is a proven and effective treatment option. Traditional cataract surgery for vision loss has increasingly given way to refractive cataract surgery as science and technology have progressed. There are also a variety of refractive intraocular lenses on the market place. Patients are increasingly accepting and recognizing multifocal intraocular lens(MIOL)as an alternative to traditional single focus intraocular lens(SIOL). Through classification and listing, the existing MIOL are discussed in this article, as well as the features of different types of MIOL and techniques for evaluating the clinical impacts of patients after surgery, so as to provide references for ophthalmologists.

4.
Article in Chinese | WPRIM | ID: wpr-942359

ABSTRACT

Objective To screen differentially expressed genes (DEGs) associated with chronic schistosomiasis japonica-induced hepatic fibrosis and analyze their functions. Methods The dataset of gene expression profiles of patients with chronic schistosomiasis japonica-induced hepatic fibrosis was downloaded from the Gene Expression Omnibus (GEO) database, and DEGs were screened using R package. The biological functions of DEGs were characterized using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses. In addition, the protein-protein interaction (PPI) network of DEGs was created to screen the hub genes. Results A total of 62 DEGs were identified, including 12 down-regulated genes and 50 up-regulated genes. GO enrichment analysis showed that DEGs were mainly enriched in 116 biological processes, including fatty acid, sulfur compound, acyl-coenzyme A and thioester metabolism; 19 cellular components, including mitochondrial matrix, outer mitochondrial membrane and organelle outer membrane; and 7 molecular functions, including insulin-like growth factor binding and oxidoreductase activity. KEGG pathway enrichment analysis that the DEGs were significantly enriched in phosphatidylinositol-3-kinase/serine/threonine protein kinase (PI3K/Akt), mitogen-activated protein kinase (MAPK), calcium metabolism and cyclic adenosine monophosphate (cAMP) signaling. PPI network analysis identified six hub genes involved in the development of chronic schistosomiasis japonica-induced hepatic fibrosis, including ACACA, ACSL1, GPAM, THRSP, PLIN1 and DGAT2, and ACSL1, ACACA and PLIN1 were the top 3 hub genes. Conclusions ACSL1, ACACA and PLIN1 may be the hub genes associated with the development of chronic schistosomiasis japonica-induced hepatic fibrosis, and abnormal lipid metabolism mediated by these DEGs may play an important role in the development of chronic schistosomiasis japonica-induced hepatic fibrosis.

5.
Article in Chinese | WPRIM | ID: wpr-942341

ABSTRACT

The method of scoping review was used to systematically search and sort out the clinical research of oral Chinese patent medicines for ischemic stroke,to understand the scope of relevant research and the distribution of evidence. Three medical catalogs were manually searched to obtain the oral Chinese patent medicines used for ischemic stroke,and 7 databases were retrieved to obtain the clinical research including these oral Chinese patent medicines. Then the clinical evidence results were visualized by description combined with chart analysis. A total of 68 oral Chinese patent medicines were retrieved,and 1 392 articles were included,with 367 published in core journals, involving 35 oral Chinese patent medicines. The research types included randomized controlled trials,cohort studies,case series,case reports,secondary studies,adverse drug reaction reports,pharmacoeconomic evaluations,drug interactions,consensus or guidelines,non-randomized intervention studies and cross-sectional studies,of which randomized controlled trials had the largest number (283, 77.1%),followed by secondary studies and case series (25, 6.7% for each). Among the 283 randomized controlled trials,there were 159 clinical studies in the acute phase of ischemic stroke,65 in the non-acute phase,and 59 in the unclear phase. Ten intervention control types and 20 outcome index types were summarized. Among them, the composite outcome index and surrogate outcome index were used 217 times (76.7%) and 245 times (86.6%), respectively,followed by the degree of neurological impairment (three scales). Future clinical research of oral Chinese patent medicines for ischemic stroke should clarify the stage of the disease,and the research design should specify the advantages of oral Chinese patent medicines intervening in ischemic stroke. Furthermore, publicly-recognized positive controls should be employed,and important clinical outcome indexes should be selected.

6.
Article in Chinese | WPRIM | ID: wpr-941034

ABSTRACT

OBJECTIVE@#To construct an adenovirus vector expressing artificial splicing factor capable of regulating alternative splicing of Yap1 in cardiomyocytes.@*METHODS@#The splicing factors with different sequences were constructed against Exon6 of YAP1 based on the sequence specificity of Pumilio1. The PCR fragment of the artificially synthesized PUF-SR or wild-type PUFSR was cloned into pAd-Track plasmid, and the recombinant plasmids were transformed into E. coli DH5α for plasmid amplification. The amplified plasmids were digested with Pac I and transfected into 293A cells for packaging to obtain the adenovirus vectors. Cultured neonatal rat cardiomyocytes were transfected with the adenoviral vectors, and alternative splicing of YAP1 was detected using quantitative and semi-quantitative PCR; Western blotting was performed to detect the signal of the fusion protein Flag.@*RESULTS@#The transfection efficiency of the adenovirus vectors was close to 100% in rat cardiomyocytes, and no fluorescent protein was detected in the cells with plasmid transfection. The results of Western blotting showed that both the negative control and Flag-SR-NLS-PUF targeting the YAPExon6XULIE sequence were capable of detecting the expression of the protein fused to Flag. The results of reverse transcription-PCR and PCR demonstrated that the artificial splicing factor constructed based on the 4th target sequence of YAP1 effectively regulated the splicing of YAP1 Exon6 in the cardiomyocytes (P < 0.05).@*CONCLUSION@#We successfully constructed adenovirus vectors capable of regulating YAP1 alternative splicing rat cardiomyocytes.


Subject(s)
Adenoviridae/metabolism , Alternative Splicing , Animals , Animals, Newborn , Escherichia coli/metabolism , Genetic Vectors , Myocytes, Cardiac/metabolism , Plasmids , RNA Splicing Factors/metabolism , Rats , Transfection
7.
Chinese Journal of Burns ; (6): 574-579, 2022.
Article in Chinese | WPRIM | ID: wpr-940963

ABSTRACT

Pyoderma gangrenosum (PG) is a rare chronic inflammatory non-infectious skin dermatosis, and there is no clear treatment guideline for this disease at home and abroad. There are a variety of clinical treatment methods for PG, including local therapy and systemic application of glucocorticoids, immunosuppressants, intravenous immuno- globulin, and biologics. Glucocorticoids are the first-line drugs commonly used in clinical practice, and immunosuppressants can be used alone or in combination with glucocorticoids. In recent years, more and more evidence has shown that biologics are a new trend in the treatment of PG, mainly including tumor necrosis factor α inhibitors, interleukin-1 (IL-1) inhibitors, IL-12/23 inhibitors, IL-17 inhibitors, rituximab, and small molecular inhibitors. This article summarizes the current status and latest progress in the treatment of PG, hoping to provide clinicians with ideas for the treatment of PG.


Subject(s)
Biological Products , Glucocorticoids , Humans , Immunosuppressive Agents , Immunotherapy , Interleukin Inhibitors , Pyoderma Gangrenosum/drug therapy
8.
Article in Chinese | WPRIM | ID: wpr-940320

ABSTRACT

Ephedrae Herba is a commonly used medicine for dispersing wind and cold, which has a long medicinal history. By referring to the herbal literature, medical books and prescription books, this paper intends to carry out herbal textual research on the name, origin, medicinal part, producing area, harvesting and processing methods of Ephedrae Herba in famous classical formulas, in order to provide the basis for the development of relevant famous classical formulas. According to textual research, the main base of ancient Ephedrae Herba was Ephedra sinica. The medicinal part is the herbaceous stems of Ephedrae Herba. Before the Northern and Southern dynasties, the origin of the records was Jindi and Hedong, which is now Shanxi province. In the Northern and Southern dynasties and later generations, the producing area expanded, and now it is mainly distributed in Hebei, Shanxi, Shaanxi, Inner Mongolia, Gansu, Liaoning and other places, among which Inner Mongolia is the main producing area. The harvesting and processing methods in the past dynasties are to harvest the stems in autumn, dry them in the shade or air to 70%-80% dry, and then dry them in the sun. The processing methods in the past dynasties mainly include removing the knots, wine-fried, honey-fried, processing with vinegar and so on, at present, only honey-fried is still in use. Based on the research results, it is suggested that Ephedrae Herba in famous classical formulas should be selected the dry herbaceous stems of E. sinica. If the processing requirements are not indicated, it is suggested to use raw products of Ephedrae Herba.

9.
Article in Chinese | WPRIM | ID: wpr-940319

ABSTRACT

In this paper, the name, classification, origin and other aspects of Schizonepetae Herba in the famous classical formulas were researched by referring to the related herbal literature, medical books and prescription books in the past dynasties. The results showed that Schizonepetae Herba first appeared in Shennong Bencaojing (《神农本草经》) as Jiasu, while Jingjie first appeared in Wupu Bencao (《吴普本草》), and the name of Jingjie was mainly used as the rectification of name in later generations. The name of Jiasu is mostly derived from its smell, and the name of Jingjie is mostly derived from its pronunciation. Schizonepeta tenuifolia has been highly praised in the past as a original material, and its genuine producing area is Jiangsu, Hebei and other places, medicinal part is whole herb with spike. In modern times, the quality of Schizonepetae Herba is best described as having thin stems, green spike, and aroma. In clinical application, the raw products of Schizonepetae Herba is mainly used, and the carbonisata is mainly used for hemostasis. Famous classical formulas of Huaihuasan and Danggui Yinzi are all made of Schizonepetae Spica, so it is recommended to use the dried panicle of S. tenuifolia. In Liangxue Dihuangtang, Schizonepetae Herba Carbonisata is used, therefore, it is suggested to adopt the processing method of Schizonepetae Herba Carbonisata in the 2020 edition of Chinese Pharmacopoeia.

10.
Frontiers of Medicine ; (4): 416-428, 2022.
Article in English | WPRIM | ID: wpr-939880

ABSTRACT

Abivertinib, a third-generation tyrosine kinase inhibitor, is originally designed to target epidermal growth factor receptor (EGFR)-activating mutations. Previous studies have shown that abivertinib has promising antitumor activity and a well-tolerated safety profile in patients with non-small-cell lung cancer. However, abivertinib also exhibited high inhibitory activity against Bruton's tyrosine kinase and Janus kinase 3. Given that these kinases play some roles in the progression of megakaryopoiesis, we speculate that abivertinib can affect megakaryocyte (MK) differentiation and platelet biogenesis. We treated cord blood CD34+ hematopoietic stem cells, Meg-01 cells, and C57BL/6 mice with abivertinib and observed megakaryopoiesis to determine the biological effect of abivertinib on MK differentiation and platelet biogenesis. Our in vitro results showed that abivertinib impaired the CFU-MK formation, proliferation of CD34+ HSC-derived MK progenitor cells, and differentiation and functions of MKs and inhibited Meg-01-derived MK differentiation. These results suggested that megakaryopoiesis was inhibited by abivertinib. We also demonstrated in vivo that abivertinib decreased the number of MKs in bone marrow and platelet counts in mice, which suggested that thrombopoiesis was also inhibited. Thus, these preclinical data collectively suggested that abivertinib could inhibit MK differentiation and platelet biogenesis and might be an agent for thrombocythemia.


Subject(s)
Acrylamides/pharmacology , Animals , Blood Platelets/drug effects , Cell Differentiation , Megakaryocytes/drug effects , Mice , Mice, Inbred C57BL , Piperazines/pharmacology , Pyrimidines/pharmacology
11.
Gut and Liver ; : 575-588, 2022.
Article in English | WPRIM | ID: wpr-937604

ABSTRACT

Background/Aims@#This study aimed to explore the effect of gut microbiota-regulated Kupffer cells (KCs) on colorectal cancer (CRC) liver metastasis. @*Methods@#A series of in vivo and in vitro researches were showed to demonstrate the gut microbiota and its possible mechanism in CRC liver metastasis. @*Results@#Fewer liver metastases were identified in the ampicillin-streptomycin-colistin and colistin groups. Increased proportions of Parabacteroides goldsteinii, Bacteroides vulgatus, Bacteroides thetaiotaomicron, and Bacteroides uniforms were observed in the colistin group. The significant expansion of KCs was identified in the ampicillin-streptomycin-colistin and colistin groups. B.vulgatus levels were positively correlated with KC levels. More liver metastases were observed in the vancomycin group. An increased abundance of Parabacteroides distasonis and Proteus mirabilis and an obvious reduction of KCs were noted in the vancomycin group. P. mirabilis levels were negatively related to KC levels. The number of liver metastatic nodules was increased in the P. mirabilis group and decreased in the B. vulgatus group. The number of KCs decreased in the P. mirabilis group and increased in the B. vulgatus group. In vitro, as P. mirabilis or B. vulgatus doses increased, there was an opposite effect on KC proliferation in dose- and time-dependent manners. P. mirabilis induced CT26 cell migration by controlling KC proliferation, whereas B. vulgatus prevented this migration. @*Conclusions@#An increased abundance of P. mirabilis and decreased amount of B. vulgatus play key roles in CRC liver metastasis, which might be related to KC reductions in the liver.

12.
Chinese Journal of Cardiology ; (12): 466-470, 2022.
Article in Chinese | WPRIM | ID: wpr-935171

ABSTRACT

Objective: To compare the efficacy and safety between indobufen and aspirin in the prevention of restenosis of bridge vessels at 1 year after off-pump coronary artery bypass grafting. Methods: This study was a prospective cohort study. We selected 152 patients who received coronary artery bypass grafting in Beijing Anzhen Hospital from December 2016 to December 2018. Patients were divided into the indobufen group and the aspirin group. Patients in the aspirin group were treated with aspirin and clopidogrel, and patients in the indobufen group were treated with indobufen and clopidogrel. During the 1-year follow-up, the rate of restenosis of saphenous vein bridge and internal mammary artery bridge, the rate of adverse cardiac events and adverse reactions were compared between the two groups. The levels of fibrinogen (FIB), D-dimer (D-D), thrombomodulin (TM) and thrombin-activatable fibrinolysis inhibitor (TAFI) were compared before and after antiplatelet therapy. Results: There were 76 cases in the indobufen group, including 57 males (75.0%), aged (60.3±6.6) years. There were 76 cases in the aspirin group, including 62 males (81.6%), aged (59.7±7.2) years. Baseline data were comparable between the two groups (P>0.05). During the follow-up, 3 cases were lost to follow up. Follow-up was completed in 74 patients in the indobufen group and 75 in the aspirin group. A total of 268 bridging vessels were grafted in the indobufen group and 272 in the aspirin group. One year after surgery, the patency rates of great saphenous vein bridge and internal mammary artery bridge were 94.5% (189/200) and 97.1% (66/68) in the indobuphen group, and 91.3% (189/207) and 96.9% (63/65) in the aspirin group, respectively. There was no significant difference in patency rate of great saphenous vein bridge and internal mammary artery bridge between the two groups (χ²=0.282, 0.345, P>0.05). The total incidence of adverse cardiac events was 5.4% (4/74) in the indobufen group and 6.7% (5/75) in the aspirin group (χ²=0.126, P>0.05). The overall incidence of gastrointestinal adverse reactions was significantly lower in the indobufen group than in the aspirin group (4.1% (3/74) vs. 13.3% (10/75), χ²=4.547, P<0.05). The levels of FIB, D-D, TM and TAFI in the two groups were lower than those before surgery (P<0.05), and there was no statistical significance between the two groups at baseline and post-operation (P>0.05). Conclusion: The efficacy of indobufen combined with clopidogrel in the prevention of 1-year restenosis after coronary artery bypass graft is similar to that of aspirin combined with clopidogrel, but the incidence of adverse reactions is lower, and the safety is higher in patients treated with indobufen combined with clopidogrel compared to aspirin combined with clopidogrel strategy.


Subject(s)
Aspirin/therapeutic use , Clopidogrel/therapeutic use , Coronary Artery Bypass/adverse effects , Drug Therapy, Combination , Humans , Isoindoles , Male , Phenylbutyrates , Platelet Aggregation Inhibitors/therapeutic use , Prospective Studies , Treatment Outcome
13.
Chinese Journal of Cardiology ; (12): 132-136, 2022.
Article in Chinese | WPRIM | ID: wpr-935116

ABSTRACT

Objective: To investigate whether atrial fibrillation (AF) before transcatheter aortic valve implantation (TAVI) will affect the prognosis of patients post TAVI. Methods: This is a single center retrospective study. A total of 115 patients with severe aortic stenosis (AS) who were admitted to General Hospital of Northern Theater Command from May 2016 to November 2020 and successfully received TAVI treatment were included. According to absence or accompaniment of AF pre-TAVI, they were divided into AF group (21 cases) and non-AF group (94 cases). The patients were followed up for postoperative antithrombotic treatment and the occurrence of the net adverse clinical and cerebrovascular events (NACCE) at 12 months post TAVI, including cardiogenic death, readmission to hospital for heart failure, nonfatal myocardial infarction, ischemic stroke and severe bleeding (BARC levels 3-5). Univariate logistic regression was used to analyze the related factors of NACCE. Results: Among the 115 selected patients, age was (73.8±6.9) years, there were 63 males. And 21 cases (18.2%) were diagnosed as AFbefore TAVI. In terms of postoperative antithrombotic therapy, 48.9% (46/94) of the patients in the non-AF group received monotherapy and 47.9% (45/94) received dual antiplatelet therapy. In the AF group, 47.6% (10/21) received anticoagulants and 33.3% (7/21) received dual antiplatelet therapy. The proportion of patients in the AF group taking non-vitamin K antagonist oral anticoagulants (NOAC) was higher than that in the non-AF group (38.1% (8/21) vs. 2.1% (2/94), P<0.001). Patients in both groups were followed up to 12 months after TAVI. During the 12 months follow-up, the incidence of NACCE after TAVI was 14.3% (3/21) in the AF group, which was numerically higher than that in the non-AF group (6.4% (6/94)), but the difference was not statistically significant (P=0.441). The incidence of severe bleeding was significantly higher in the AF group than in the non-AF group (9.5% (2/21) vs. 0, P=0.032). Univariate logistic regression analysis showed that hypertension was associated with the risk of NACCE (OR=8.308, P=0.050), while AF was not associated with the risk of NACCE (P=0.235). Conclusion: The incidence of severe bleeding after TAVI is higher in patients with AF than in patients without AF prior TAVI, and there is a trend of increased risk of NACCE post TAVI in AF patients.


Subject(s)
Aged , Aged, 80 and over , Anticoagulants , Aortic Valve , Aortic Valve Stenosis/surgery , Atrial Fibrillation/drug therapy , Follow-Up Studies , Humans , Male , Retrospective Studies , Risk Factors , Transcatheter Aortic Valve Replacement , Treatment Outcome
14.
Organ Transplantation ; (6): 495-2022.
Article in Chinese | WPRIM | ID: wpr-934771

ABSTRACT

Objective To evaluate the efficacy and safety of basiliximab (BAS) and antithymocyte globulin (ATG) in immune induction therapy in kidney transplantation by systematic review and Meta-analysis. Methods Prospective randomized controlled clinical trials screening and comparing BAS and ATG in immune induction therapy in kidney transplantation were systematically searched from global databases, screened and compared. The quality of clinical trials was evaluated by Jadad scoring system and data extraction was performed. The effects of BAS and ATG on the incidence of acute rejection, survival rate of kidney allografts, survival rate of recipients, incidence of delayed graft function, infection, cytomegalovirus infection, malignant tumor, leukopenia and thrombocytopenia at 1 year after kidney transplantation were analyzed. Results A total of 10 clinical trials in English consisting of 1 721 kidney transplant recipients were searched, including 883 cases in the ATG group and 838 cases in the BAS group. No significant differences were observed in the incidence of acute rejection, survival rate of kidney allografts, survival rate of recipients, incidence of delayed graft function, infection, cytomegalovirus infection and thrombocytopenia at postoperative 1 year between the ATG and BAS groups (all P > 0.05). The incidence of malignant tumor and leukopenia at postoperative 1 year in the ATG group were significantly higher than those in the BAS group (both P < 0.05). Conclusions The use of ATG and BAS for immune induction therapy in kidney transplantation yield equivalent efficacy at postoperative 1 year, but BAS is safer than ATG. Clinical trials related to stratified analyses of immune risk are urgently required to achieve individualized precision treatment.

15.
Article in Chinese | WPRIM | ID: wpr-934486

ABSTRACT

Objective:To evaluate the efficacy of combined fascia sheath suspension (CFS) and frontalis muscle flap suspension in the treatment of severe congenital blepharoptosis.Methods:We searched PubMed, EMbase, Cochrane Library, web of science and Chinese Hownet, Wanfang, VIP, CBM and other databases to collect randomized and non-randomized controlled trials comparing the efficacy of CFS and frontalis muscle flap suspension in the treatment of severe congenital ptosis, from the establishment of literature retrieval database to March 2020; two researchers used RevMan 5.3 software to select and exclude the literature, extract the data and evaluate the quality, set up appropriate effect index and conduct Meta-analysis.Results:Eleven studies included 661 patients, There were 312 cases in study group and 349 cases in control group. The results of Meta analysis showed that the OR of the two groups was 4.88 with 95% CI (2.69, 8.85); the OR of failure rate was 0.20, with 95% CI (0.11, 0.37); the OR of complications was 0.22, with 95% CI (0.14, 0.34). All three groups of data were statistically significant ( P<0.05). Conclusions:The available evidence shows that the combined fascia sheath suspension (CFS) is effective in the treatment of severe congenital blepharoptosis compared with frontalis muscle flap suspension, but the complications of CFS are lower and the satisfaction is higher; these findings have yet to be validated by more high-quality studies due to limitations in the quality and quantity of studies included.

16.
Article in Chinese | WPRIM | ID: wpr-934300

ABSTRACT

Uveal melanoma (UM) is an aggressive and lethal tumor in the eye. The complexity and heterogeneity of UM and its microenvironment leads to a lack of strategies for early prevention and treatment of metastases. Single-cell sequencing technologies provide critical insights into deciphering the complexity of intratumor heterogeneity and the microenvironment by enabling genomic, transcriptomic, and epigenetic analysis at the single-cell level. With the help of bioinformatics analysis combined with artificial intelligence algorithms, molecular indicator systems related to prognosis as well as therapeutic targets can be found, which can provide a basis for guiding the selection of clinical treatment plans. However, the single-cell sequencing technology also has certain limitations, such as high sample requirements, expensive and time-consuming sequencing. It is believed that with the improvement of science and technology and the update of analytical methods, these shortcomings can be gradually solved, and this rare tumor will eventually be overcome in the future, and the goal of long-term survival of UM patients will be achieved.

17.
Article in Chinese | WPRIM | ID: wpr-934299

ABSTRACT

Uveal melanoma (UM) is one of the most common primary intraocular malignancy in adults. The incidence of UM is lower in Asia than in Europe and the United States, however, the age of onset of UM patients in Asia is earlier than in the European and American populations. With the improvement of economic living standards in recent years, UM as a rare intraocular tumor has been gradually recognized by the public. In the past 10 years, the research of UM in China has been characterized by a large number and rapid development. Among them, the direction of molecular genetics represented by non-coding RNA, the frontier development of potential anticancer drugs for UM and Chinese traditional medicines are the research hotspots for scholars in China. In the past 10 years, China has made a relatively complete understanding and research progress on the pathogenesis, diagnosis and treatment of UM. On the other hand, compared with European and American countries, China still lacks in frontier research such as immunotherapy. With the further efforts of Chinese ophthalmology researchers and research teams, and with the further development of scientific research in my country, it is believed that the mechanism affecting tumors can be further elucidated, providing more possibilities for treatment and improving the prognosis of UM patients in China.

18.
Article in Chinese | WPRIM | ID: wpr-934294

ABSTRACT

Objective:To observe the different clinical response patterns of uveal melanoma (UM) patients after external scleral plaque radiotherapy (PRT), and to investigate the risk factors of secondary enucleation after treatment failure.Methods:A single-centre retrospective study. Demographic baseline characteristics and clinical data were collected from 465 UM patients treated with 125I external scleral PRT at Beijing Tongren Hospital from March 2011 to September 2017. Among them, 217 were male and 248 were female, tumor all occurred monocularly. The mean age of subjects was 46.7±12.1 years. Reasons for secondary enucleation included local tumor treatment failure, glaucoma, scleral necrosis and patient request. Tumor grading was based on the grading standards established by the American Joint Committee on Cancer (AJCC). The pattern of tumor response after PRT was classified as degenerated type, growth type, stable type or other types according to literature criteria. The median follow-up time after PRT was 59 months to observe tumor changes. Complete follow-up records of 3 or more color doppler ultrasound imaging (CDI) was available in 245 cases. A t-test was performed to compare the patient's age, intraocular pressure, best corrected visual acuity, tumor thickness and maximum basal diameter before treatment; a chi-square test was performed to compare the patient's gender, AJCC T classification of the tumor, whether the ciliary body was involved, presence of subretinal fluid, optic disc invasion and vitreous hemorrhage, tumor shape and location. Kaplan-Meier survival analysis was used to estimate the cumulative probability of secondary enucleation after extra-scleral PRT. Univariate and multivariate Cox proportional hazards regression analyses were used to evaluate the relationship between tumor characteristics and secondary enucleation after extra-scleral PRT. Results:Among 465 patients, eecondary enucleation was performed on 78 (16.8%, 78/465) patients during the follow-up period. The 1, 3 and 5 year secondary enucleation rates were 5.4%, 9.3% and 17.1 %, respectively. Eye preservation was successful in 387 cases (83.2%, 387/465). Patients treated by secondary enucleation had a larger maximum basal diameter of tumor, a higher proportion of irregular and diffuse morphology, a cumulative macular involved and a higher AJCC T classification, the difference was statistically significant ( P<0.05). There were 115, 76, 27, and 27 cases of degenerated type, stable type, growth type, and other type, respectively. The tumor thickness of the growth type and other types was significantly smaller than that of the degenerated type and the stable type, and the difference was statistically significant ( P<0.05). Univariate Cox analysis showed that the maximum basal diameter of the tumor ( HR=1.19), tumor thickness ( HR=1.08), AJCC T classification ( HR=1.90), growth type response pattern (relative to degenerated type response pattern) ( HR=4.20) was associated with failure of eye preservation ( P<0.05). In the multivariate Cox analysis, the largest tumor basal diameter ( HR=1.24) and the growth type response pattern (relative to the degenerated type response pattern) ( HR=4.59) were still associated with failure of eye preservation ( P<0.05). Conclusions:The tumor thickness of UM patients with growing and other response patterns after PRT is smaller before treatment; the maximum basal diameter of the tumor and the growing response pattern are independent risk factors for secondary enucleation.

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Article in Chinese | WPRIM | ID: wpr-934244

ABSTRACT

Objective:To explore the feasibility of applying quantitative flow ratio(QFR) to assess the degree of coronary artery functional stenosis before surgery, and to guide coronary artery bypass grafting(CABG) revascularization strategy.Methods:The study prospectively included a total of 154 patients who were electively treated with CABG in the 11th ward of the Department of Cardiac Surgery of Beijing Anzhen Hospital from January 2019 to September 2020, and their coronary angiography visually showed stenosis of the coronary artery to perform QFR analysis to know the diseased blood vessels. For functional stenosis, the surgeon was blinded to the results of QFR analysis before surgery. Collect its baseline data, perioperative data and recent clinical outcomes for summary analysis.Results:One year later, the coronary artery CTA showed that the occlusion rate of functionally significant disease(QFR<0.8) was 5.5%, and that of non-functionally significant disease(QFR≥0.8) was 15.6%. There was no difference in angina class or repeat interventions between patients with or without occluded bypass grafts.Conclusion:According to QFR analysis, coronary arteries with functional non-significant disease have a higher risk of grafts failure than those with functionally significant disease. For coronary arteries with negative QFR lesions, the risk of occlusion of arterial grafts is higher than that of venous. However, this finding is not significantly related to clinical prognosis, because patients with patency or occlusion of the grafts in non-significant lesions have not found excessive angina pectoris or repeated coronary interventions. QFR-guided selection of coronary surgery strategies is safe and feasible.

20.
Chinese Journal of Neurology ; (12): 341-348, 2022.
Article in Chinese | WPRIM | ID: wpr-933799

ABSTRACT

Objective:To analyze the clinical data and related literature of sporadic amyotrophic lateral sclerosis (sALS) caused by a new mutation of MATR3 gene.Methods:A sALS patient with MATR3 gene mutation who was admitted to the Department of Neurology, the First Medical Center of Chinese People′s Liberation Army General Hospital was collected. The examination of biochemistry, electromyography, cranial magnetic resonance imaging (MRI) and genetic tests, etc, were performed. Whole exon sequencing was performed to screen the disease-causing genes. Sanger sequencing was also performed to validate the mutation sites of the patient. Genetic harmfulness was predicted by multiple computational softwares, including SIFT Pred, Polyphen-2 HVAR Pred and MutationTaster Pred. Clinical characteristics of ALS induced by different MATR3 gene mutation sites were summarized by database retrieval.Results:The patient was a 69-year-old female, who began to show bulbar muscle weakness and then gradually developed to the facial muscles, including temporalis and masseter, and four limbs. In addition to the upper and lower motor neuron damage found in physical examination of the patient, the obvious facial muscle atrophy was also found in the patient. There was no family history of ALS in this patient. In terms of auxiliary examination, creatine kinase, rheumatism immunity and tumor markers were all normal. Cranial MRI showed no structural lesions and abnormal signals at the course of pyramidal tract. Electromyography suggested extensive neurogenic damage, decreased amplitude of repeated stimulation, abnormal measurement of blink reflex (BR) and skin sympathetic response (SSR). A heterozygous variant c.1472A>G (p.Y491C) of the MATR3 gene, which is a missense mutation, was detected in the patient. The variant was predicted as a harmful mutation by multiple computational softwares.Conclusions:A variant c.1472A>G (p.Y491C) of the MATR3 gene may be the pathogenic mutation of the patient. The patient not only has similar clinical manifestations to those of classic ALS, but also has facial muscle involvement. The electromyography shows abnormal SSR and BR.

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