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Objective:To treat the Crohn's disease(CD)patients with ustekinumab(UST),to eva-luate their clinical and endoscopic remission,and to evaluate their transmural response(TR)and trans-mural healing(TH)condition using intestinal ultrasonography(IUS).Methods:Retrospective analysis was made on patients diagnosed with CD in Peking University People's Hospital from January 2020 to Au-gust 2022,who were treated with UST for remission induction and maintenance therapy.All the patients were evaluated on both week 8 and week 16/20 after treatment,including clinical,biochemical indica-tors,colonoscopy and IUS examination.Results:A total of 13 patients were enrolled in this study,inclu-ding 11 males and 2 females.The minimum age was 23 years,the maximum age was 73 years and the mean age was 36.92 years.All the patients were in the active stage of disease before treatment,and the average Best Crohn's disease activity index(Best CDAI)score was 270.12±105.55.In week 8,the Best CDAI score of the patients decreased from 270.12±105.55 to 133.16±48.66(t=4.977,P＜0.001).Eight patients achieved clinical remission while 5 patients remained in the active stage.Nine patients underwent colonoscopy evaluation.The average simple endoscopic score for Crohn's disease(SES-CD)score decreased from 10.71±7.14 before treatment to 6.00±7.81(t=2.483,P=0.048)in week 16/20.Four patients achieved endoscopic remission while 5 patients did not.In week 8,5 pa-tients achieved TR,2 patients achieved TH,the other 6 patients did not get TR or TH.In week 16/20,6 patients achieved TR,3 patients achieved TH while the other 4 patients did not get TR or TH.There was no significant statistical difference in the TR effect of UST between small intestine and colon lesions(Fisher test,P＞0.999).The rate of UST transmural response in the patients who had had previous bio-logical agent therapy was lower than those with no previous biological agent therapy,but there was no sig-nificant statistical difference(Fisher test,P=0.491).Conclusion:After treatment of UST,the clinical and endoscopic conditions of the CD patients had been improved,and some patients could achieve clini-cal remission and endoscopic remission.UST had good TR and TH effects on CD.TR might appear in week 8,and the TR effect increased in week 16/20.There was no significant statistical difference in the TR effect between small intestine and colon lesions.TR effect of UST was better in the patients who had no previous biological agent therapy than those who had had other biological agents,but the result had no significant statistical difference.
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Objective To discover new-structure active molecules in order to provide candidate compounds for anti-radiation drug research.Methods Conformational fixation and functional group conversion strategies were used to modify the structure of Ex-RAD before substituted 2H-benzopyran-3-formylaniline compounds were designed and synthesized.The anti-radiation activities of the synthesized compounds were screened via irradiated cell survival models and the cytotoxicity of the active compounds was examined.Western blotting assay was used to investigate the effects of the optimal compound on the expressions of apoptosis related proteins in irradiated cells.The anti-radiation activity of the optimal compound was evaluated through irradiated mice models.Results Twenty-one target compounds were synthesized,eight of which were found to significantly improve the survival of irradiated cells.Four compounds were selected for re-screening and cytotoxicity evaluation.Compound D19 was determined as the optimal compound that could affect the expressions of apoptosis related proteins in irradiated AHH-1 cells by Western blotting assay.Compared with the radiation group,the 30-day survival rate of D19 treated mice irradiated with 8.6 Gy of whole-body radiation increased by 70%.D19 showed protective effect on the blood system of non-lethal dose irradiated mice.Conclusion The novel compound D19 has shown strong anti-radiation activity and deserves more research.
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Objective To analyze blood type unexpected antibody and disease characteristics of inpatients in a hospital,and provide a reference for optimizing precise transfusion schemes and improving clinical transfusion safety.Methods The data of unexpected antibody screening and identification in the General Hospital of Western Theater Command from January 2012 to December 2021 were collected,while information on these patient age,gender,blood transfusion history,pregnancy history and disease diagnosis were also collected.The positive rate,composition ratio and disease characteristics of unexpected antibodies were analyzed.Results The positive rate of unexpected antibody screening was 0.55%(1 736/315 456),in which females were higher than males(0.69%vs 0.44%,χ2=90.107,P＜0.05),patients with a history of blood transfusion or(and)pregnancy were higher than those without a history of blood transfusion or(and)pregnancy(75.69%vs 22.81%,χ2=971.098,P＜0.05),and patients aged 40～80 accounted for 72.93%(1 266/1 736).Patients diseases with unexpected antibody positive accounted for 80.41%(1 396/1 736),mainly including digestive system diseases,immune diseases of blood and hematopoietic organs,tumors,urogenital system diseases,circulatory system diseases,musculoskeletal system and connective tissue diseases.Moreover,91.88%(1 595/1 736)of the patients with anti-screening positive underwent antibody identification,in which the majority of unexpected antibodies were Rh blood group system[41.57%(663/1 595)],Lewis blood group system[11.22%(179/1 595)],and MNS blood group system[6.90%(110/1 595)].Antibody specificity was mainly characterized by anti-E[32.41%(517/1 595)],anti-Lea[10.47%(167/1 595)],and anti-M 6.08%(97/1 595).Other antibodies[35.8%(571/1 595)]were mainly no-detected specific antibodies.Conclusion The screening results of blood type unexpected antibodies and disease type analysis are of great significance for transfusion safety.Blood transfusion department should carry out precise blood transfusion matching with multiple antigens(RhCcDEe,Lea,M)for long-term transfusion patients,women,and patients with pregnancy or blood transfusion history,so as to reduce the incidence of unexpected antibodies and improve transfusion safety.
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Assisted reproductive technology(ART) faces challenges such as low embryo implantation rates due to uterine factors, and infertility caused by ovarian function suppression and abnormal semen. Platelet-rich plasma(PRP), which is rich in various bioactive substances, can play an anti-inflammatory role and promote cell proliferation, vascular regeneration and injury healing, and is now a hot topic in ART. This paper describes the relevant research on PRP in ART for clinical reference, aiming to standardize the application of PRP in ART and provide a new treatment for infertile couples.
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【Objective】 To analyze the clinical manifestations of delayed serological transfusion reactions (DSTR) after platelet transfusion in tumor patients, and to explore the transfusion strategy. 【Methods】 Clinical data and laboratory test results of patients with positive antibody screening were analyzed after platelet transfusion in our hospital from January 1, 2015 to June 30, 2023, and the incidence rate, clinical characteristics and transfusion strategy of patients with DSTR were analyzed. 【Results】 A total of 2 553 patients with 6 057 platelet transfusions were reviewed. Eight patients developed DSTR and received a total of 21 therapeutic amounts of platelets, and 5 patients were subsequently transfused with red blood cells. Rh system antibodies were detected in 7 cases (4 anti-E, 1 anti-c/E, 1 anti-C and 1 anti-c) and Kell system antibodies in 1 case. 【Conclusion】 Tumor patients may also develop DSTR after platelet transfusion. It is necessary to pay close attention to the antibody situation and perform matched transfusion when transfusing blood again.
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【Objective】 To investigate additional exclusion criteria for therapeutic apheresis erythrocytes and the possibility of adverse reactions by analyzing the occurrence of rare adverse reactions in two patients who underwent therapeutic erythrocytes apheresis. 【Methods】 Erythrocytes were harvested by apheresis from two patients with indications for therapeutic erythrocytes collection for preservation or discarding. 【Results】 One case experienced persistent atrial fibrillation and a gout attack after the collection, while another case experienced persistent hypotension during the collection and a subsequent reduction in haemoglobin levels after collection 【Conclusion】 To reduce the incidence of adverse reactions, it is essential to have strict exclusion criteria for therapeutic erythrocytes apheresis and to enhance the monitoring of whole collection process in patients with atrial fibrillation and gout.
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Objective To observe efficacy of Zishen Ankun Granules in treatment of mice with immune premature ovarian insufficiency(POI)and its influence on cytokines interleukin 2(IL2),interleukin 6(IL6)and transforming growth factor-β(TGF-β)Methods Screening female mice with regular estrus to establish immune POI mice model with zona pellucida 3(ZP3)as antigen.Low and high doses of Zishen Ankun Granules were set up for treatment,and estradiol valerate was used as a positive control.Observing the estrous cycle of mice by papanicolaou staining,observing the morphological changes of ovarian tissues by HE staining,and detecting serum estradiol(E2),follicle-stimulating hormone(FSH),anti mullerian hormone(AMH),IL2,IL6 and TGF-β levels by ELISA.Results Compared with the blank control group,the estrous cycle of model group was prolonged and disordered,inflammatory cell were infiltrated in the ovarian stroma,growth follicles were decreased,and atresia follicles were increased(P<0.05,P<0.01);serum E2,AMH and TGF-βlevels were decreased(P<0.01),serum FSH,IL2 and IL6 levels were increased(P<0.01).Compared with model group,the estrous cycle disorder and inflammatory cell infiltration were improved in each treatment group,in which the growing follicles increased in the high dose group of Zishen Ankun and the atretic follicles decreased in the estradiol valerate group(P<0.05);serum E2,AMH and TGF-βlevels were increased in Zishen Ankun high dose group and estradiol valerate group(P<0.05,P<0.01),Serum FSH and IL6 levels in Zishen Ankun high-dose group were decreased(P<0.05),Serum IL2 levels was decreased in each treatment group(P<0.05,P<0.01).Conclusion Zishen Ankun granules can improve the levels of serum reproductive hormone,IL2,IL6 and TGF-βin immune POI mice,reduce the inflammatory response of ovary,regulate immune disorders,improve the ovarian reserve capacity,and play a protective role on the ovary.
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Astrocytes constitute the most abundant cell type in the central nervous system.Under physi-ological conditions,astrocytes have a variety of functions,and play an important role in maintaining the homeostasis of the central nervous system.However,in response to insults such as injury,inflammation and hypoxia,astro-cytes undergo rapid changes in gene expression,morphology and function,and these responses collectively called as astrocyte reactivity.Activated astrocytes have been divided into neurotoxic phenotype(type A1)and neuropro-tective phenotype(type A2).Recent studies have shown that A1 astrocytes are widely involved in the occurrence and development of various central nervous system diseases.Therefore,targeted regulation of activated astrocytes by combining multiple techniques is expected to be a potential treatment for central nervous system diseases.Here,we review recent advances of A1 astrocytes,including the molecular mechanism of phenotypic transformation and its role in neurodegenerative and neuroinflammatory diseases.
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Objective:To explore the potential molecular targets and mechanism of Zeqi Decoction in the treatment of lung adenocarcinoma (LUAD) through bioinformatics and cell experiment.Methods:The active components of Zeqi Decoction were collected based on TCMSP database and literature search. Then R software was used to screen differentially expressed genes in LUAD from TCGA and GEO databases. The co-expression module was obtained through weighted gene co-expression network analysis (WGCNA), and the potential targets were obtained after matching and mapping with targets of Zeqi Decoction. Enrichment analysis of GO function and KEGG pathway of targets was conducted. The results were experimentally verified. The lung adenocarcinoma cell lines A549 and H1299 were divided into blank control group and Zeqi Decoction group according to random number table. The inhibition rate of cell proliferation was detected by cell proliferation test (CCK-8); the expression of leukocyte differentiation antigen 36 (CD36) in A549 and H1299 cells was detected by Western blot; the levels of low density lipoprotein receptor (LDLR) and IL-6 were detected by ELISA.Results:Totally 157 anti-lung adenocarcinoma active components and 18 potential targets were obtained, mainly including CD36, IL6, LDLR, etc. The main target of Zeqi Decoction in the treatment of lung adenocarcinoma was lipid metabolism. The results showed that Zeqi Decoction could effectively inhibit the activity of A549 and H1299 cells and the levels of CD36, LDLR and IL-6.Conclusion:Zeqi Decoction can inhibit the inflammatory response by down-regulating the protein expressions of CD36 and LDLR, thereby slowing the proliferation of cells.
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Objective:To investigate the safety and efficacy of FOLFOX (5-fluorouracil + calcium folinate + oxaliplatin) hepatic arterial infusion chemotherapy (FOLFOX-HAIC) combined with immune and targeted therapy as triple combination therapy for patients with single China Liver Cancer Staging (CNLC) Ⅰb hepatocellular carcinoma.Methods:A total of 20 patients with single CNLC Ⅰb hepatocellular carcinoma who received FOLFOX-HAIC combined with immune and targeted therapy as triple combination therapy in the First Affiliated Hospital of Guangxi Medical University from October 2021 to August 2022 were included. The clinical data of all patients was retrospectively analyzed. There were 18 males and 2 females, with the age of (55.1±9.9) years. Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and Modified Response Evaluation Criteria in Solid Tumors (mRECIST) were used to evaluate the efficacy of FOLFOX-HAIC combined with immune and targeted therapy, and the clinical safety of triple combination therapy was evaluated by common terminology criteria for adverse events 4.0.Results:According to RECIST 1.1, objective response rate of 20 patients was 70.0% (14/20) and disease control rate was 100.0% (20/20) after 2 cycles of treatment (one cycle of FOLFOX-HAIC plus programmed death-1 antibody). According to mRECIST, objective response rate was 90.0% (18/20) and the disease control rate was 100.0% (20/20) after 2 cycles of treatment. Following the treatment, 12 patients (60.0%) received liver tumor resection, and all of them achieved R 0 resection, 2 patients (10.0%) received radiotherapy, 3 patients (15.0%) stopped drug treatment for surgery, 2 patients (10.0%) refused surgery, and 1 patient (5.0%) died of multiple organ failure caused by immune hepatitis. According to pathological results, 3 patients (25.0%, 3/12) achieved pathological complete response, and 4 patients (33.3%, 4/12) achieved major pathological response. In the safety evaluation, the overall incidence of adverse events was 100.0% (20/20). Seven patients (35.0%) had grade 3 adverse events and 1 patient (5.0%) died of multiple organ failure due to immune hepatitis (grade 5). Grade 1-3 adverse events could be relieved after symptomatic treatment. Conclusion:The triple combination therapy of FOLFOX-HAIC combined with immune and targeted therapy is safe and has high objective response rate and disease control rate, which could be a new strategy for the neoadjuvant treatment of hepatocellular carcinoma.
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【Objective】 To retrospectively analyze the efficacy of low dose apheresis platelet prophylactic infusion and explore its feasibility. 【Methods】 A total of 392 inpatients with platelet transfusion in our hospital from November 2020 to September 2021 were selected. The conventional dose (1 therapeutic dose) of apheresis platelet transfusion was set as the control group, and the low dose (0.5 therapeutic dose) as the experimental group. Platelet count before and after infusion, platelet elevation value (△PLT) and 24 h platelet count correction increase index (CCI) were observed, and the efficacy of low-dose platelet infusion was analyzed by disease type and gender. 【Results】 The △PLT value and 24h CCI effective infusion rate in control group were higher than those in experimental group: (16±16) ×109 vs (7±10) ×109, 71.94% vs 60.46%, P<0.05. The △PLT value of the control group was about 1.2-3.5 times that of the experimental group, and the effective rate was about 1-1.4 times. In control group, the △PLT (×109) was AML (20±14) >AA (14±14) >ALL (13±12) >NHL (9±8) >MDS (7±6). In the experimental group, the △PLT (×109) was AA (11±18) >AML (8±8) >ALL (5±7) >NHL (5±7) >MDS (6±16). The 24h CCI was AML(163/188, 86.70%)>AA(23/32, 71.88%)>ALL(65/98, 66.33%)>MDS(9/17, 52.94%)>NHL(12/22, 51.55%) in the control group, and AML(133/188, 70.74%)>AA(19/32, 59.38%)>NHL(12/22, 51.55%)>ALL(47/98, 47.96%)>MDS(8/17, 47.06%) in the experimental group. The effective infusion rates of AML and ALL2 in the experimental groups were 70.74% (133/188) and 47.96% (47/98), respectively, significantly lower than 86.7% (163/188) and 66.33% (65/98) in the control group(P<0.05). No significant difference was noticed in the effective infusion rate between the experimental group and the control group for other diseases (P>0.05). 【Conclusion】 Low-dose apheresis platelet prophylactic infusion can alleviate the between supply shortage, with an effective infusion rate of 60.46% (236/392), which has certain clinical application value. Patients with AML, AA or ALL were recommended with low dose platelets, while patients with MDS and NHL were not recommended.
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【Objective】 To retrospectively analyze the safety and product quality of NGL XCF 3000 blood cell separator for collecting platelet-rich plasma (PRP) in 256 cases, so as to provide reference for safe collection and product quality control of PRP. 【Methods】 The data of 256 patients receiving PRP treatment in our hospital from June 2021 to June 2022 were statistically analyzed, and the differences in the collection time, circulating blood volume and the occurrence of adverse reactions to blood donation were analyzed when NGL XCF 3000 was used to collect autologous PRP among patients of different genders, ages and platelet counts. The differences in platelet content, red blood cell(RBC) contamination and white blood cell(WBC) residues in PRP products were analized. 【Results】 1) There were no significant differences in collection time, circulating blood volume and collection volume among patients of different genders, ages and platelet counts (P<0.05). 2) The contents of WBC, RBC and platelet were not significantly different between male and female patients after collection (P<0.05); 3) The WBC contents increased with the increase of age, and the WBC residue in the elder group[ 56 to78 years old, (0.64±0.41) ×109/L] was significantly higher than that in the younger group[group 1,18 to 40 years old, (0.50±0.35)×109/L], with significant difference was Statistically significant (P<0.05). 4) The residues of WBCs and RBCs in in low platelet group [group 1, (100-150)×109/L] were higher than those in other platelet count groups, and the difference was Statistically significant (P<0.05), and the platelet count in this product was significantly lower than that in other platelet count groups (P<0.05). Conclusion The NGL XCF 3000 blood cell separator is safe and stable for PRP collection in patients with different genders, ages and platelet counts of (100-450)×109/L, and the PRP products collected can meet clinical therapeutic needs.
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【Objective】 To retrospectively analyze the effect of AB platelet secondary compatible transfusion on the efficacy of matched platelet transfusion. 【Methods】 A total of 2 276 cases of platelet transfusion in our hospital were selected from November 2020 to September 2021, including 2 068 ABO matched platelet transfusions and 206 AB platelet secondary compatible transfusions. 117 cases were selected for the first occasion of AB platelet secondary compatible transfusion. The controls were matched transfusion receipts before given AB platelet secondary compatible transfusion, and the experimental group was given matched transfusion after AB platelet secondary compatible transfusion (take the first, second and third transfusion as group 1, 2 and 3, respectively). The platelet count(Plt), platelet elevation (△Plt) and 24 h Plt correction increase index (CCI) of patients before and after platelet transfusion were used as observation indexes to analyze the effect of AB type mis-matched platelet transfusion on the efficacy of matched platelet preventive transfusion by gender, blood type and disease type. 【Results】 Among the 2 276 platelet transfusions, and the △Plt of matched platelet transfusions was significantly higher than that of AB type secondary compatible transfusions, with the mean values at (14±15)×109/L and (11±14)×109/L(P<0.05). The △Plt of female patients was higher than that of male patients (15±16)×109/L vs (13±14)×109/L(P < 0.05). The △Plt values of MDS, NHL and MM were (9±14) ×109/L, (10±12) ×109/L and (8±11) ×109/L, respectively, which were significantly lower than the average value (P < 0.05). For 117 cases of AB platelet secondary compatible transfusion: the Δ Plt was significantly lower than that of the control group and the experimental group, respectively at (9±12) ×109/L, (13±13) ×109/L and (13±12) ×109/L(P<0.05). The effective rate of 24 h CCI was 52.14%, significantly lower than the control group and experimental group (71.59% vs 71.83%), P<0.05; no significant difference was noticed in △ Plt value and 24 h CCI between the experimental group and the control group(P>0.05). The △Plt of the experimental group 3 was significantly lower compared with the experimental group 1, (10±13) ×109/L vs (14±12) ×109/L, P<0.05, and the effective rate decreased from 73.12%(68/93)to 58.70%(27/46), P>0.05. No significant difference in △Plt and the number of effective 24 h CCI cases was found between the experimental group and the control group in terms of gender, blood type and disease type (P>0.05). 【Conclusion】 The △Plt and the effective rate of AB platelet secondary compatible transfusion were lower than those of matched platelet transfusions, and has no significant effect on short term(less than 10 days) matched platelet transfusion.
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【Objective】 To evaluate the detection and distribution characteristics of anti-P1 in tumor patients, so as to aid in blood screening and transfusion safety. 【Methods】 The clinical data of 112 658 tumor patients who underwent blood preparation and transfusion in our hospital from January 2014 to December 2021 were retrospectively analyzed, and column agglutination technique was used to perform transfusion compatibility test. 【Results】 A total of 1 079 (0.96%, 1 079/112 658) cases were detected with unexpected antibodies, of which 71 (6.58%, 71/1 079) were identified as anti-P1. In anti-P1 cases, 59.15% (42/71) were males; 60.56% had no pregnancy history (P<0.01); 29.58% (21/71), 52.11%(37/71), 12.68%(9/71) and 5.63%(4/71) of anti-P1 patients were with type A, B, O and AB, respectively. 57 cases of anti-P1 patients (80.28%) had difficulty in ABO blood group identification. The incidence of interfering in patients with type B was higher than that of other blood types (P<0.05), as the frequency of w+ in reverse blood typing was higher than other reactive patterns (P<0.05). The incidence of gastric tumor and brain space-occupying lesion in patients with anti-P1 was higher than that in patients with other alloantibodies, while the incidence of gynecological tumors was lower (P<0.05). 【Conclusion】 Anti-P1 affects the ABO blood group identification of tumor patients, and most of them had difficulty in ABO blood group identification. Compared with patients with other alloantibodies, patients with anti-P1 are more likely to be male and suffer from gastric and brain tumors, but less likely from gynecological tumors.
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Aim To observe the effect of epimedium on the proliferation and stem cell-like character expression of breast cancer cells, and investigate the relationship between the inhibition of stem cell-like character and miR-148a by epimedium, and its molecular mechanism. Methods After treatment with different concentrations of epimedium, cell viability and population dependence were detected by MTT assay and colony formation assay; the breast cancer stem cell-derived mammosphere formation was examined by Mammosphere assay; the expression levels of CD44,ALDH-1, Oct4,BMIl and EpCAM were detected by qPCR; the protein expression levels of EpCAM, SOX4, ZO-1, E-cadherin and vimentin were detected by Western blot; the protein localization of EpCAM was observed by im-munofluorescence assay; the effect of epimedium on migration was detected by wound healing assay. The miR-148a mimic was transfected into MDA-MB-231 cells, and the effects of epimedium on stem-like character expression of transfected MDA-MB-231 cells were observed. Results Epimedium significantly inhibited the proliferation and population dependence of MDA-MB-231 cells (P < 0.05 ), and reduced the breast cancer stem cell-derived mammosphere formation; compared with control group, epimedium significantly decreased mRNA levels of CD44, ALDH-1, Oct4, BMI1 and EpCAM (P <0.05) ,decreased protein contents of EpCAM, SOX4 and Vimentin (P < 0.05 ), up-regulated the protein expression of ZO-1 and e-cadherin ( P <0.05) ,and decreased the migration ability of MDA-MB-231 cells (P < 0.05). Epimedium up-regulated the expression of miR-148a in MDA-MB-231 cells (P <0.01). YYH + miR-148a mimic group significantly inhibited stem-like character expression and EMT process of breast cancer MDA-MB-231 cells compared with control group (P <0.05). Conclusions Epimedium can inhibit the proliferation of MDA-MB-231 cells, which may be related to the up-regulation of miR-148a, decrease of stem-like character expression of breast cancer cells,and inhibition of EMT.
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The study aims to investigate the mechanism of Fengshining fecal microbiota transplants in the intervention of rheumatoid arthritis by ultra-performance liquid chromatography-quadrupole/electrostatic field obitrap high-resolution mass spectrometry (UHPLC-Q-Exactive Orbitrap-MS). All animal welfare and experimental procedures followed the regulations of the Medical Ethics Committee of Shanxi University of Chinese medicine. The rats were randomly divided into normal group, model group, fecal microbiota transplantation group and Tripterygium wilfordii polyglycoside group, and the collagen induced arthritis (CIA) was established. The changes of body weight and metatarpodal lesions of rats were evaluated. The serum of rats in each group was analyzed by liquid chromatography-mass spectrometry and metagenomic technology for differential metabolites and microflora. The protein expression levels of Toll-like receptors (TLR4), myeloid differentiation factor 88 (MyD88) and nuclear factor of kappa B (NF-κB p65) were detected by Western blot. A total of 13 different metabolites, including arachidonic acid, docosahexaenoic acid, 13S-hydroxyoctadecanodienoic acid and L-phenylalanine were screened from serum. Three metabolic pathways, including phenylalanine, tyrosine and tryptophan biosynthesis, phenylalanine metabolism and arachidonic acid metabolism were identified through pathway enrichment. Metagenomic analysis showed that the abundance of g_Bacteroides, g_Prevotella and p_Actinobacteria in CIA group was higher. The abundance of c_Clostridia, g_Akkermansia and s_Akkermansia_muciniphila in fecal microbiota transplantation group is higher. The hierarchical cluster heat map showed that Akkermansia was negatively correlated with L-phenylalanine; while positively correlated with docosahexaenoic acid. Prevotella was positively correlated with L-phenylalanine. Fecal microbiota transplantation group could significantly inhibit the expression of TLR4, MyD88 and p65 proteins in the synovium of rats (P < 0.01). The anti-rheumatoid arthritis effects of fecal microbiota transplantation group is closely related to the intervention of the metabolism of phenylalanine and arachidonic acid, through Akkermansia, Prevotella and other microorganisms, inhibition the TLR4/MyD88/NF-κB pathway.
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Objective To systematically evaluate the qualitative studies on the care experience of caregivers for primary malignant bone tumors patients,in order to provide references for the construction of bone tumor support care system.Methods The Cochrane Library,PubMed,Embase,CNKI,Wanfang Database,VIP database,and China Biomedical Literature Database were searched by computer to collect qualitative studies on the care experience of caregivers of malignant bone tumors patients from the establishment of the databases to November 2022.The quality of the literature was evaluated using the Joanna Briggs Institute(JBI)Quality Evaluation Criteria for Quality Research in Evidence-Based Health Care Centers(2016),and the results were integrated by a pooled integration approach.Results A total of 12 studies were included;48 themes were extracted and summarized into 9 categories,which were combined into 3 integrated results.Integration result 1 is obvious physical and mental disturbance.Integration result 2 is multiple role maladaptation.Integration result 3 is positive growth after adjustment.Conclusion Caregivers of patients with malignant bone tumors have serious physical and mental burden and are eager for multiple support.It is suggested that medical staff pay attention to the multi-dimensional needs of patients,formulate personalized support strategies,help caregivers adapt and transform their roles,and promote the post-traumatic growth of caregivers.
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【Objective】 To explore the clinical application of a universal platelet product for emergency, which was prepared by suspending O-type apheresis platelet concentrate in AB-type fresh frozen plasma, so as to improve the platelet support ability in emergency and special treatment. 【Methods】 A retrospective analysis of 21 hematological patients, which was divided into 3 groups of platelet transfusion schemes: universal type, AB type and the same type, was performed to analyze the differences in PLT, dose, 24 h PPR, 24 h CCI, follow-up platelet transfusion units and interval, and adverse reactions to transfusion. 【Results】 1)There was no significant difference in PLT, MPV, PDW, K, MA and pH between the initial O-type apheresis platelets and the finished universal platelets (P>0.05). The titers of both anti-A and anti-B in the universal platelets were less than 2. 2) Twenty-one patients were transfused with universal platelet for 27 occasions[1~5 occasions per person; 1 (0.4, 1.0) dose per time]. No adverse reactions to transfusion occurred. 3)There was no significant difference in the effective rate of 24 h CCI and 24 h PPR between the three groups after transfusion(P>0.05). The time interval of the first subsequent platelet transfusion between the compatible group and the universal group was longer than that in the AB-type transfusion group, with significant difference(P0.05) among three groups. 【Conclusion】 In emergency, the application of this universal platelet product can make hematological patients get timely and effective treatment. Its accessibility and effectiveness can be elevated and the infusion interval can be prolonged by improving the preparation method and storage conditions. This product is not only expected to improve the platelet support capacity for patients with emergency and also those undergoing hematopoietic stem cell transplantation during the blood type conversion period, but also may be a practical method to alleviate the contradiction between platelet supply and demand.
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【Objective】 To analyze the safety of apheresis granulocyte(AG) collection from blood donors mobilized by G-CSF and apheresis granulocyte transfusion efficacy in patients. 【Methods】 The blood routine results, collection process and follow-up of blood donors mobilized by G-CSF before and after AG collection were collected to analyze the safety of AG collection, and the blood routine results, clinical symptom improvement and treatment outcome of patients before and after AG transfusion were collected to analyze the transfusion efficacy. 【Results】 A total of 27 blood donors donated 29 U AG, with collection time at (229±20)min, circulating blood volume at (9 890±1 107)mL, and the dosage of anticoagulant at (1 002±97)mL.Two blood donors had adverse reactions to blood donation, and the AG collection was carried out after treatment.After G-CSF mobilization, WBC increased significantly from (5.61±1.06) ×109/L to (22.85±5.23) ×109/L, while RBC, Hb, Hct and Plt showed no significant change.The blood routine returned to the level before G-CSF mobilization 1-2 days after blood donation.No physical discomfort occurred during the one week after blood donation.Four patients with granulocyte deficiency complicated with multidrug-resistant bacterial infection, who failed to respond to antibiotic treatment, were transfused with 29 U AG, with no adverse reactions and no obvious change in blood routine, but the infection symptoms were improved significantly judged from clinical manifestation, bacterial culture results, temperature monitoring and CT examination, suggesting that the AG infusion was effective.Among the 4 patients, 1 was cured and discharged, 1 gave up treatment, 1 died of sepsis, and 1 died of multiple organ failure. 【Conclusion】 It is safe to collect AG from blood donors mobilized by G-CSF through blood cell separator, and the AG products basically meet the national quality requirements and the treatment needs.Sustained high-dose AG transfusion has a significant effect on infection control in patients with agranulocytosis combined with refractory multidrug-resistant bacterial or fungal infection.
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【Objective】 To analyze the characteristics and influencing factors of blood transfusion in patients undergoing hepatectomy with hydatid hepatica, so as to provide perioperative blood security of these patients. 【Methods】 A retrospective analysis was performed on 40 hydatid hepatica patients who underwent hepatectomy from June 2011 to June 2021, and they were divided into the transfusion group (n=15) and the non-transfusion group (n=25). The difference in basic information, operative information, blood routine, coagulation function, biochemical parameters and thromboelastogram between the two groups were compared, and the characteristics of perioperative blood transfusion were analyzed. 【Results】 Fifteen(37.5%, 15/40) patients undergoing hepatectomy received blood transfusion, among which 2(5%, 5/40), 10(25%, 10/40) and 11(27.5%, 11/40) received preoperative, intraoperative and postoperative transfusion, respectively. The average transfusion of suspended red blood cells, plasma and cryoprecipitate were 4.77 U, 1 355 mL and 11.9 U respectively, without any adverse reactions of blood transfusion occurred. The operative time, intraoperative blood loss, the number of patients with tumor diameter ≥10 cm/ diameter <10 cm, the number of patients with cholecystectomy, postoperative PT, postoperative APTT and average hospital stay in the transfusion group were higher than those in the non-transfusion group(P<0.05), and the postoperative FIB was lower than those in the non-transfusion group(P<0.05). The blood test results showed that the WBC, AST, ALT and INR 24h after operation were significantly higher than those before operation (P<0.05), while RBC, Hb, ALP, FIB and Angle were significantly lower than those before operation(P<0.05). There were statistically significant differences in WBC, RBC, Hb, ALT, ALP and INR between preoperative and postoperative 3~5 days(P<0.05). The differences of WBC, AST, ALT and FIB 3~5 days after surgery were statistically significant compared with 24 hours after surgery(P<0.05). 【Conclusion】 The size of hepatic hydatid mass, cholecystectomy, intraoperative blood loss, operative time, postoperative PT, postoperative APTT and postoperative FIB were important factors affecting perioperative blood transfusion after hepatectomy, and the main transfusion components were plasma and cryoprecipitate.