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Objective To explore the clinical effect of Liuwei Dihuang decoction on thrombocytopenia(HIT)of liver and kidney yin deficiency in hemodialysis patients.Methods 84 hemodialysis patients with liver and kidney yin deficiency HIT were randomly divided into observation group and control group,with 42 cases in each group.The control group was treated with conventional western medicine,while the observation group was treated with Liuwei Dihuang decoction on the basis of the control group.The scores of liver and kidney yin deficiency syndrome before and after treatment and the curative effect of traditional Chinese medicine syndrome were compared between the two groups,and the platelet count(Plt),P-selectin level,HIT antibody before and after treatment,the platelet recovery time and clinical efficacy and adverse reactions of the two groups were also compared.Results After 1 month of treatment,the scores of liver and kidney yin deficiency syndrome in the two groups were both lower than those before treatment(P<0.05),which in the observation group was lower than that of the control group(P<0.05).The total effective rate of traditional Chinese medicine syndromes in the observation group(97.62%)was higher than that in the control group(P<0.05).After 14 d of treatment,the Plt of the two groups were both higher than those before treatment,while the levels of P-selectin and the positive rate of HIT antibody of the two groups were lower than those before treatment(P<0.05),and the Plt in the observation group was higher than that of the control group,the levels of P-selectin and the positive rate of HIT antibody in the observation group were lower than those in the control group(P<0.05).The platelet recovery time in the observation group was shorter than that in the control group(P<0.05),the total effective rate of clinical treatment in the observation group(95.24%)was higher than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups during treatment(P>0.05).Conclusion On the basis of conventional western medicine treatment,the addition of Liuwei Dihuang decoction to treat HIT of liver and kidney yin deficiency in hemodialysis patients can improve the clinical efficacy,reduce the clinical symptoms of patients,improve the level of Plt,shorten the recovery time of platelet,and reduce the level of P-selectin and the positive rate of HIT antibody,with good safety,which is worthy of clinical promotion.
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OBJECTIVE@#To explore the relationship between the level of soluble HLA-E (sHLA-E) molecules in plasma and gene polymorphism and leukemia in Shenzhen of China.@*METHODS@#Enzyme-linked immunosorbent assay was used to detect sHLA-E level in plasma of 103 leukemia patients and 113 healthy blood donors. PCR-SBT was used to identify the HLA-E genotype of 73 leukemia patients and 76 healthy blood donors.@*RESULTS@#The level of plasma sHLA-E of 103 leukemia patients was significantly higher than that of 113 healthy blood donors (P<0.001); And the level of plasma sHLA-E in 77 myeloid leukemia patients was also significantly higher (P<0.001). The percentage of patients with plasma sHLA-E concentration of 0-199 ng/ml in leukemia and myeloid leukemia patients was 37.86% and 32.47%, respectively, which was significantly lower than 53.98% of healthy donors, the difference was statistically significant (P<0.05, P<0.01); While, when the plasma sHLA-E concentration was more than 400 ng/ml, the percentage was 33.01% and 36.36%, respectively, which was significantly higher than 13.28% of healthy donors, the difference was also statistically significant (P=0.001, P<0.001). There was no significant difference in the level of plasma sHLA-E among different HLA-E genotypes (P>0.05), whether healthy blood donors or leukemia patients.@*CONCLUSION@#The level of plasma sHLA-E in patients with leukemia (especially myeloid leukemia) is significantly higher than that of healthy blood donors, but different HLA-E genotypes do not affect the level of plasma sHLA-E. A cut-off value for the concentration of plasma sHLA-E (recommended risk value >400 ng/ml) can be set to assess the risk of certain pre-leukemia patients.
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Humanos , Genotipo , Antígenos de Histocompatibilidad Clase I/genética , Leucemia/genética , Polimorfismo GenéticoRESUMEN
Objective To study the functional antibody and protection effect against pneumonia disease after inoculation with PPV23 in HIV-infected adults. Methods In 2015, 63 HIV-infected adults were randomly selected in Hongkou District of Shanghai, and blood samples were collected before and one month after the inoculation of PPV23.Functional antibodies against 4 serotypes (19F, 19A, 23F, 6B) of Streptococcus pneumoniae were detected by opsonophagocyitosis killing assay (OPA).The incidence of pneumonia after PPV23 inoculation was also determined. Results The GMT of OPA antibodies against 4 serotypes 1 month after inoculation with PPV23 was significantly higher than that before inoculation in HIV-infected subjects.After inoculation, the triple growth rates of OPA antibodies against 4 serotypes in HIV-infected subjects were 50%-91.67%.The protection rate against pneumonia was 100% in 2 years after PPV23 inoculation in HIV-infected subjects when compared with same group before inoculation as well as the control group.The HIV-infected patients who received highly active antiretroviral therapy (HAART) or had CD4 count of≥300/μL showed better response in production of OPA antibodies and obtained protection against community-acquired pneumonia (CAP) after receiving PPV23. Conclusion Routine vaccination of PPV23 is recommended for HIV-infected patients with good basic conditions.
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OBJECTIVE@#To observe the clinical effect of acupuncture by stages on secondary dysmenorrhea of adenomyosis through prospective case-series study.@*METHODS@#A total of 36 cases of adenomyosis patients with moderate-to-severe dysmenorrhea were treated with acupuncture by stages. The acupoints of Diji (SP 8), Sanyinjiao (SP 6), Ciliao (BL 32) and Shiqizhui (EX-B 8) were selected and acupuncture was given once a day during menstrual period; the acupoints of Guanyuan (CV 4), Zigong (EX-CA1), Sanyinjiao (SP 6) and Zusanli (ST 36) ect. were selected and acupuncture was given twice per week during non-menstrual period. All the treatment was given for three menstrual cycles. The visual analogue scale (VAS), Cox menstrual symptom scale (CMSS), Endometriosis Health Profile-5 (EHP-5) scores and the menstrual blood volume of pictorial blood loss assessment chart (PBAC) were observed before treatment and at the 1st, 2nd and 3rd menstrual cycle into treatment. Before treatment and at the 3rd menstrual cycle into treatment, the volume of uterus was measured by transvaginal ultrasound and the correlation among the quality of life, the severity of pain and symptoms was analyzed.@*RESULTS@#The VAS, CMSS and EHP-5 scores at the 1st, 2nd and 3rd menstrual cycle into treatment were lower than those before treatment (0.05). Compared before treatment, at the 1st, 2nd and 3rd menstrual cycle into treatment, the PBAC scores were reduced in patients with PBAC>100 points (<0.01). Compared between 2nd and 1st menstrual cycle into treatment, between 3rd and 2nd menstrual cycle into treatment, the VAS, CMSS scores were all decreased (<0.01, <0.05). There was a significant positive correlation between the severity score of CMSS and EHP-5 at the corresponding time points of the 1st, 2nd and 3rd menstrual cycle into treatment (<0.01).@*CONCLUSION@#The acupuncture by stages has significant analgesic effect in patients with secondary dysmenorrhea of adenomyosis, and has the advantages of relieving the menstruation-related symptoms, regulating menstrual blood volume and improving the quality of life.
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Objective To analyze functional antibody and protection effect against pneumonia after inoculation with 23-valent pneumococcal polysaccharide vaccine(PPV23)in healthy elderly. Methods In 2015, 48 healthy elderly people aged ≥60 years were randomly selected in Hongkou District of Shanghai, and their blood samples were collected before, and 1 month and 6 months after the inoculation of PPV23.Functional antibodies against 13 serotypes(1、3、4、5、6A、6B、7F、9V、14、18C、19A、19F、23F)of streptococcus pneumonia were determined by muti-specificity opsonophagocyitosis killing assay(MOPA).The incidence of community-acquired pneumonia(CAP)after PPV23 inoculation was also investigated. Results The GMT of OPA antibodies against 13 serotypes were higher 1 and 6 months after inoculation than that before inoculation.One month after the inoculation, OPA antibodies against 13 serotypes ≥2 times growth rate and ≥4 times growth rate were 64.58%-87.00% and 43.75%-75.00%, respectively.Six months after inoculation with PPV23, OPA antibodies against 13 serotypes ≥2 times growth rate and ≥4 times growth rate were 45.71%-82.86%, 40.00%-80.00%, respectively.There was no significant difference in the growth rate of OPA antibody between 6 months and 1 month after vaccination for most serotypes.Results of self-descriptive survey before and after the inoculation showed that the protection against CAP in healthy elderly people in the first and second years after PPV23 inoculation was 100.00% and 50.00%, respectively. Conclusion PPV23 has better immunogenicity and immune persistence after inoculation in healthy elderly people, and has better protective effect against CAP.
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Objective@#To explore potential serum biomarkers of children with Kashin-Beck Disease (KBD) and the metabolic pathways to which the biomarkers belong.@*Methods@#A two-stage metabolomic study was employed. The discovery cohort included 56 patients, 51 internal controls, and 50 external controls. The metabolites were determined by HPLC-(Q-TOF)-MS and confirmed by Human Metabolome Databases (HMDB) and Metlin databases. MetaboAnalyst 3.0 and the Kyoto Encyclopedia of Genes and Genomes (KEGG) database were used to analyze the metabolic pathways of the candidate metabolites. The use of HPLC-(Q-TRAP)-MS enabled quantitative detection of the target metabolites which were chosen using the discovery study and verified in another independent verification cohort of 31 patients, 41 internal controls, and 50 external controls.@*Results@#Eight candidate metabolites were identified out in the discovery study, namely kynurenic acid, N-α-acetylarginine, 6-hydroxymelatonin, sphinganine, ceramide, sphingosine-1P, spermidine, and glycine. These metabolites exist in sphingolipid, glutathione, and tryptophan metabolic pathways. In the second-stage study, five candidate metabolites were validated, including kynurenic acid, N-α-acetylarginine, sphinganine, spermidine, and sphingosine-1P. Except for spermidine, all substances exhibited low expression in the case group compared with the external control group, and the difference in levels of sphinganine, spermidine, and sphingosine-1P was statistically significant.@*Conclusion@#The direction of change of levels of sphinganine, spermidine, and sphingosine-1P in the two-stage study cohorts was completely consistent, and the differences were statistically significant. Therefore, these substances can be used as potential biomarkers of KBD. Furthermore, these results raise the possibility that sphingolipid metabolic pathways may be closely related to KBD.