ABSTRACT
Long non-coding RNA(lncRNA)is a type of non-protein-coding RNA with a length of at least 200 nucleotides.Ex-isting evidence shows that lncRNA affects the growth and development of humans and the occurrence of diseases through various mech-anisms,and plays an irreplaceable role in the differentiation and activation of immune cells and the development process of autoim-mune diseases.In recent years,lncRNA H19 has been found to play a unique regulatory function in pathological processes related to autoimmune diseases,such as inflammation and fibrosis.Therefore,the molecular mechanism involved in H19 is expected to become a potential target for the treatment of autoimmune diseases.In this review,we discussed the related mechanisms of H19 involved in the pathogenesis of autoimmune diseases based on the known functions of H19 and summarized the research results of H19 in several com-mon autoimmune diseases.
ABSTRACT
【Objective】 To discuss the effect of adding tranexamic acid(TXA) during surgery on blood loss and security during short segment lumbar spinal stenosis surgery. 【Methods】 One hundred and eight patients with lumbar spinal stenosis who were to undergo lumbar posterior fusion surgery were randomly divided into control group, TXA group and adding TXA group, with 36 patients in each group. In the control group, TXA was not used during surgery.The TXA group received intravenous infusion of 100 mL normal saline mixture containing 1 g of TXA 15 minutes before surgery after anesthesia. In adding TXA group, after the same operation in TXA group, 10 mg/kg(body weight) of TXA was infused 3 hours later. Total perioperative blood loss, dominant blood loss, hidden blood loss, intraoperative blood loss, postoperative drainage volume, and transfusion rate were recorded in the two groups. Hemoglobin (Hb), hematocrit(HCT), prothrombin time international standardized ratio (PT-INR), prothrombin time(PT), activated partial thromboplastin time(APTT), blood platelet count (BPC), D-dimer (D-D), fibringen(FIB), C-reactive protein (CRP), alanine aminotransferase (ALT), blood urea nitrogen (BUN) were measured 3 days before and after the surgery in the three groups. Postoperative adverse events were followed up. 【Results】 The total blood loss(mL) [(968.7±209.6) vs (1 369.8±276.3), (968.7±209.6) vs (1 273.9±250.2)], dominant blood loss(mL) [(590.5±164.3) vs (876.4±235.9), (590.5±164.3) vs (789.3±221.7)], intraoperative blood loss(mL) [(318.7±120.7) vs (457.8±146.6), (318.7±120.7) vs (423.9±162.3)] and postoperative drainage volume(mL) [1 day after surgery: (164.6±25.0) vs (262.3±51.7), (164.6±25.0) vs (219.8±37.1); 3 days after surgery: (107.2±18.6) vs (156.3±37.6), (107.2±18.6) vs (145.3±22.3)] of the adding TXA group were lower than those of the control group and TXA group (P0.05). Compared with the preoperative results, Hb, Hct and BPC in the three groups decreased (P0.05), and all of them were within the normal range. No serious adverse events such as deep vein thrombosis, pulmonary embolism, epilepsy, liver and kidney damage were found in all patients after postoperative follow-up. 【Conclusion】 Intraoperative addition of TXA can effectively reduce the amount of blood lost during short segment lumbar spinal stenosis surgery without increasing the risk of complications such as coagulation disorders, thrombosis, liver and kidney function damage.
ABSTRACT
With the wide application of phacoemulsification and intraocular lens implantation, many cataract patients have effectively recovered vision. Postoperative intraocular lens opacification is an important indicator for evaluating biocompatibility, as it affects the visual quality of patients. The manifestation and risk factors of opacification vary among different materials used for intraocular lenses. However, better visual quality after surgery is not determined by a single factor. The material of the intraocular lens and the patient's response to the intraocular lens are all factors that affect the postoperative visual quality. With the continuous advancement of technology, an increasing number of new materials are being applied in the field of intraocular lenses. Fully understanding the characteristics of intraocular lens materials, selecting suitable intraocular lens for patients and reducing complications caused by materials will be beneficial to patients. The characteristics of different intraocular lens materials and the risk factors of opacification after intraocular lens implantation were discussed in this paper.
ABSTRACT
BACKGROUND: Both hypoplastic left heart syndrome and ventriculo-coronary communication are extremely rare congenital cardiac conditions. CASE: The diagnosis of hypoplastic left heart syndrome combined with endocardial fibroelastosis and ventriculo-coronary communication was made in a pregnant woman at 24 weeks of gestation. Interestingly, unlike diastolic flow from the coronary artery to the left ventricle in typical ventriculo-coronary communication, this fetus showed a systolic flow from the left ventricle to the coronary artery. CONCLUSION: To the best of our knowledge, this is the first study to present only a systolic flow signal in hypoplastic left heart syndrome combined with ventriculo-coronary communication in prenatal ultrasonography.
Subject(s)
Endocardial Fibroelastosis , Heart Defects, Congenital , Hypoplastic Left Heart Syndrome , Pregnancy , Female , Humans , Hypoplastic Left Heart Syndrome/diagnostic imaging , Heart Ventricles/diagnostic imaging , Heart Ventricles/abnormalitiesABSTRACT
OBJECTIVE@#To analyze the 28-day survival status and influencing factors of adult patients with sepsis, providing reference for early diagnosis of sepsis prognosis and reducing sepsis mortality.@*METHODS@#A retrospective cohort study was conducted. A total of 160 adult patients with sepsis in the department of intensive care unit of the 940th Hospital of Joint Logistic Support Force of PLA from January 2021 to December 2022 were enrolled. The general information, laboratory examination results within 24 hours after admission, clinical treatment measures, and prognosis of patients were collected. Univariate analysis and binary multivariate Logistic regression were performed to screen the risk factors that might affect the short-term prognosis of patients with sepsis. Receiver operator characteristic curve (ROC curve) was plotted to analyze the predictive value of various risk factors on the short-term death risk of sepsis patients.@*RESULTS@#A total of 160 patients with sepsis were enrolled, of whom 91 survived in 28 days, and 69 died with a mortality of 43.12%. Compared with the survival group, the patients in the death group were older, more severe, had higher blood lactic acid (Lac) level, and had more complications such as hypertension and multiple organ dysfunction syndrome (MODS). A total of 22 related factors were statistically significant: age, acute physiology and chronic health evaluation II (APACHE II) score, sequential organ failure assessment (SOFA) score, length of hospital stay, Lac, interleukin-6 (IL-6), fibrinogen (FIB), international normalized ratio (INR), ratio of prothrombin time (PT) to healthy people, prothrombin activity (PTA), PT, thrombin time (TT), oxygenation index (PaO2/FiO2), aspartate aminotransferase (AST), ratio of AST to alanine amninotransferase (ALT), serum creatinine (SCr), blood urea nitrogen (BUN), site of infection, history of hypertension, concurrent MODS, implementation of continuous renal replacement therapy (CRRT), and treatment with vasoactive drugs. Combined with the results of the univariate analysis, variables that might affect the short-term prognosis of septic patients were included in the multivariate Logistic regression analysis. The results showed that APACHE II score ≥ 20 [odds ratio (OR) = 1.106, 95% confidence interval (95%CI) was 1.003-1.219], Lac ≥ 5 mmol/L (OR = 1.430, 95%CI was 1.041-1.964), combined with hypertension (OR = 13.879, 95%CI was 1.082-178.016), concurrent MODS (OR = 98.139, 95%CI was 18.252-527.672) was an independent risk factor for 28-day death in adult septic patients (all P < 0.05). ROC curve analysis showed that the combination of the four indicators including APACHE II score, Lac, combined with hypertension, concurrent MODS, had predictive value for short-term outcomes in patients with sepsis. The area under the ROC curve (AUC) was higher than that of the 4 indicators alone [AUC (95%CI): 0.952 (0.918-0.986) vs. 0.745 (0.670-0.820), 0.816 (0.748-0.883), 0.608 (0.518-0.699), 0.868 (0.810-0.927)], the sensitivity was 94.2%, and the specificity was 90.1%.@*CONCLUSIONS@#APACHE II score within 24 hours, Lac, combined with hypertension, and concurrent MODS are independent risk factors for short-term mortality in adult septic patients in ICU. The combination of these indicators can make meaningful early clinical judgments on the short-term prognosis of septic patients, thereby reducing the mortality.
Subject(s)
Adult , Humans , Retrospective Studies , ROC Curve , Sepsis/diagnosis , Prognosis , Intensive Care Units , Risk Factors , HypertensionABSTRACT
Objective:To study the expression of Toll like receptor 3 (TLR3) in human adenocarcinoma of the lung cells induced by respiratory syncytial virus (RSV) and its significance in the diagnosis of pneumonia in children.Methods:A549 cells were divided into RSV infection group [added 1 μg/ml Lipopolysaccharide (TLR3 agonist) transfected RSV virus after 150 μl intervention], Lipopolysaccharide stimulation group (added 1 μg/ml Lipopolysaccharide 150 μl intervention) and normal control group (normal culture). The mRNA expressions of tumor necrosis factor-α, interleukin 8, TLR3 protein and TLR3 in A549 Cells of different groups were compared. We prospectively selected 80 children with RSV infectious pneumonia admitted to Baoding Second Central Hospital from August 2019 to October 2021 as the RSV pneumonia group, and sixty children with common pneumonia were taken as the common pneumonia group, and 60 healthy children in our hospital were taken as the control group. The mRNA expression of serum TLR3 in different groups was compared, and the diagnostic efficacy of serum TLR3 in RSV pneumonia was evaluated by receiver operating characteristic.Results:There was a statistically significant difference in the expression of TLR3 protein among different groups of A549 cells ( P<0.001). The expression differences of TLR3 mRNA in different groups of A549 cells at different time points were statistically significant(all P<0.001). There was significant difference in the expression of tumor necrosis factor-α and interleukin 8 of A549 cells at different time points in different groups (all P<0.05). There was a statistically significant difference in the expression of serum TLR3 mRNA among the three groups of subjects ( F=155.237, P<0.001). The critical value for TLR3 gene diagnosis was 66.87, with corresponding sensitivity of 73.75%, specificity of 70.83%, and the area under curve (AUC) of 0.803(95% CI: 0.753-0.855). Conclusions:Respiratory syncytial virus induces human lung cancer cells and promotes disease progression through TLR3 expression; Serum TLR3 can be used for the diagnosis of RSV pneumonia.
ABSTRACT
The cisplatin-based concurrent chemoradiotherapy (CCRT) has been accepted as a standard treatment for most locally advanced cervical cancer. Compared with radiation therapy alone, CCRT can increase tumor control and survival rates, whereas it also can increase the incidence of acute hematological toxicity, which results in the treatment interruption or delay, and may even affect clinical efficacy and prognosis of patients. Therefore, how to reduce the incidence and severity of acute hematological toxicity induced by CCRT is a hot spot of clinical research. Previous studies have demonstrated that the occurrence of hematological toxicity is associated with the volume and dose of irradiated pelvic bone marrow. With the development of modern radiotherapy technology, precise radiotherapy technologies, such as intensity-modulated radiotherapy (IMRT) and image-guided radiotherapy (IGRT), not only guaranteed the enough dose for tumor, but also realized the protection of normal tissues. This article will focus on the feasibility of bone marrow sparing during CCRT for cervical cancer, and summarize the research progress in recent years.
ABSTRACT
ObjectiveTo explore the effect and toxicity change rule of Aconiti Lateralis Radix Praeparata(ALRP) and Zingiberis Rhizoma(ZR) before and after compatibility, and to reveal the compatibility connotation of them. MethodSixty SD rats were randomly divided into blank group, blank-ALRP group, blank-ALRP-ZR group, model group, model-ALRP group and model-ALRP-ZR group, the latter three groups were injected with adriamycin via tail vein to establish the model of heart failure, and the former three groups were injected with the same amount of physiological saline via tail vein. The effects of ALRP single decoction and ALRP-ZR mixed decoction on biochemical indexes and myocardial histopathological morphology of normal rats and model rats were compared. Metabolomics analysis was performed on rat serum samples, principal component analysis(PCA) and orthogonal partial least squares-discriminant analysis(OPLS-DA) were used to screen the differential metabolites between groups, and the differential metabolic pathways were analyzed. Combined with network pharmacology technology, the metabolites and their associated targets and pathways related to enhancing anti-heart failure efficacy and reducing cardiotoxicity were screened before and after the compatibility of ALRP and ZR, the screened representative pathways were verified by Western blot. ResultCompared with the blank group, the model group showed significant increases in the contents of brain natriuretic peptide(BNP), creatine kinase(CK), lactate dehydrogenase(LDH) and cardiac troponin(cTn)-T(P<0.01), the blank-ALRP group showed obvious increases in CK, LDH, and cTn-T contents(P<0.05, P<0.01), while the normal-ALRP-ZR group showed a significant increase in CK content(P<0.01). Compared with the blank-ALRP group, the blank-ALRP-ZR group showed a obvious decrease in LDH content(P<0.05), and pathological sections showed that both decoctions could lead to myocardial histopathological damage in normal rats. Compared with the model group, the model-ALRP-ZR group showed obvious decreases in BNP, CK, LDH and cTn-T contents(P<0.05, P<0.01), and the model-ALRP group showed obvious decreases in BNP, LDH and cTn-T contents(P<0.05, P<0.01). Compared with the model-ALRP group, the model-ALRP-ZR group showed a significant decrease in CK content(P<0.01), and both decoctions could improve the pathological morphology of myocardial tissue in the model rats. Metabolomics results showed that ALRP single decoction and ALRP-ZR mixed decoction could recover 422 and 459 metabolites in model rats, respectively. And the metabolic disruption of ALRP-ZR mixed decoction on normal rats was weaker than that of ALRP single decoction. The results of network pharmacological association analysis showed that in the aspect of ZR enhancing the anti-heart failure efficacy of ALRP, 3 metabolites such as deoxyuridylic acid were correlated to 56 metabolites, 82 targets and 13 pathways, including calcium signaling pathway, renin secretion, renin-angiotensin system, etc. In the aspect of ZR reducing the cardiotoxicity of ALRP, 3 metabolites such as tyrosol were associated with 24 metabolites, 55 targets and 14 pathways, including adrenergic signaling in cardiomyocytes and carbon metabolism and so on. Western blot results showed that the expression of angiotensin-converting enzyme(ACE), angiotensin-converting enzyme 2(ACE2) and angiotensin Ⅱ(Ang Ⅱ) in myocardial tissues of rats from the model group was significantly elevated by comparing with the blank group(P<0.01). Compared with the model group, the model-ALRP group and the model-ALRP-ZR group showed significantly decreased expression of ACE, ACE2 and Ang Ⅱ(P<0.01). Compared with the model-ALRP group, the expression of ACE2 and AngⅡ was significantly decreased in the model-ALRP-ZR group. Compared with the blank group, the expression of extracellular signal regulated kinase(ERK), protein kinase B(Akt) and cTn-I3 was significantly elevated in the blank-ALRP group and blank-ALRP-ZR group(P<0.01). Compared with the blank-ALRP group, the blank-ALRP-ZR group showed decreased expression of ERK, Akt and cTn-I3, but there was no statistical significance. ConclusionTo a certain extent, the combination of ALRP and ZR shows synergistic relationship under pathological state, and attenuated effect of compatibility under normal physiological state, and the pharmacodynamic characteristics and compatibility relationship of ALRP and ZR are closely related to the physiological state.
ABSTRACT
{L-End}Objective To explore the impact of workplace violence (WPV) on occupational burnout among healthcare workers. {L-End}Methods A total of 675 healthcare workers from an infectious disease hospital were selected as the study subjects using typical sampling method. The Workplace Violence in the Healthsector Country Case Studies Research Instruments: Survey Questionnaire and the Maslach Burnout Inventory 2-item were used to investigate the incidence of WPV and occupational burnout. {L-End}Results The incidence of WPV among the study subjects was 35.1%, with incidences of physical and psychological violence at 2.2% and 34.1%, respectively. The detection rates of emotional exhaustion, depersonalization, and occupational burnout were 25.9%, 12.6%, and 52.4%, respectively. The result of multifactorial logistic regression analysis showed that experiencing psychological violence, having a bachelor or master degree or higher, and having more concerns about WPV were influencing factors for emotional exhaustion (all P<0.05). Knowing the reporting process for violent incidents and having more concerns about WPV were influencing factors for depersonalization (all P<0.05). Being in a minority ethnic group, having a bachelor, a master degree or higher, experiencing psychological violence, and having more concerns about WPV were influencing factors for occupational burnout (all P<0.05). {L-End}Conclusion WPV increases the risk of occupational burnout among healthcare workers. Effective measures should be implemented to reduce the incidence of WPV, decrease the level of occupational burnout, and promote the overall well-being of healthcare workers.
ABSTRACT
OBJECTIVES: In IgG4-related disease, the relationship between pathological findings and relapse has not been well established. This study aimed to identify the clinical and pathological predictors of disease relapse in IgG4-RD. METHODS: Patients with newly diagnosed IgG4-RD (n = 71) were enrolled between January 2011 and April 2020; all cases were pathologically confirmed. The clinical and pathological features were recorded in a database at baseline and each follow-up visit. Patients were followed up at least once a month via outpatient clinic examinations and telephone calls. Univariate and multivariate Cox regression analyses and receiver operating curve (ROC) analysis were used to identify the predictors of disease relapse and to assess their predictive value. RESULTS: Over a median follow-up of 26 (range, 6-123) months, 3/71 (4.2%) patients died. Of the remaining 68 patients, 47 (69.1%) patients had achieved clinical remission and 21 (30.9%) had suffered relapse at the last follow-up. The independent predictors of relapse were IgG4 ≥ 6.5 g/L (HR = 2.84, 95% CI: 1.11-7.23), IgG ≥ 20.8 g/L (HR = 4.11, 95% CI: 1.53-11.06), IgG4-RD responder index (RI) ≥ 9 (HR = 3.82, 95% CI: 1.28-11.37), and severe IgG4+ plasma cell infiltration (HR = 6.32, 95% CI: 1.79-22.41). A prognostic score developed using three of the identified predictors (IgG ≥ 20.8 g/L, IgG4-RD RI ≥ 9, and severe IgG4+ plasma cell infiltration) showed good value for predicting impending relapse (AUC, 0.806). CONCLUSIONS: In patients with IgG4-RD, IgG4 ≥ 6.5 g/L, IgG ≥ 20.8 g/L, IgG4-RD responder index (RI) ≥ 9, and severe IgG4+ plasma cell infiltration are predictors of relapse.
Subject(s)
Immunoglobulin G4-Related Disease , Humans , Immunoglobulin G , Immunoglobulin G4-Related Disease/diagnosis , Recurrence , Retrospective StudiesABSTRACT
Objective:To explore the method of ultrasonography for detecting the fetal umbilical vein diameter, blood flow volume and normalized volume blood flow and establish normal reference ranges with umbilical vein diameter, blood flow volume and normalized blood flow and Z-scores for umbilical vein diameter and blood volume flow.Methods:This was a prospective study on 907 normal fetuses in the Second Xiangya Hospital, Central South University and Women and Children Healthcare Hospital of Zhuzhou from March 2019 to December 2020. The umbilical vein diameter (Duv), umbilical vein blood flow volume (Quv) and normalized volume blood flow (nQ = Quv/estimated fetal weight) of the free loop of umbilical vein (FUV) and fetal intra-abdominal umbilical vein (IUV) were collected. And the mean values and 90% confidence intervals of Duv, Quv and nQ in two segments of umbilical veins at different gestational ages were calculated. Regression analysis of Duv, Quv and nQ were performed with gestational age (GA), and the parameters of umbilical vein in different segments were compared. Finally, with gestational age (GA) as the independent variable, Z-scores of the Duv and Quv were built.Results:The mean values and 90% confidence intervals of Duv, Quv, and nQ in 858 (94.6%) normal fetal umbilical veins were successfully obtained. The Duv, Quv of the FUV and IUV increased as pregnancy progressed. The Quadratic curve of Duv and Linear curve of Quv were of the highest fitnesses, respectively( r=0.951, 0.941, 0.986, 0.982; all P<0.001). While nQ increased with GA followed by a decreased trend, and the Quadratic curve was the highest fitting curve of nQ( r=0.610, 0.611; all P<0.001). Duv-FUV was greater than Duv-IUV( P<0.001), nQ-FUV was bigger than Quv-IUV( P=0.001), and he difference was not statistically significant between Quv-FUV and Quv-IUV( P=0.133). Z-scores models of Duv and Quv were successfully established, and all Z-scores were Gaussian distribution. Conclusions:The normal ranges and Z-scores of umbilical vein parameters are useful to improve the evaluation of placental circulation and provide a strong basis for the monitoring of fetus-related diseases and the evaluation of pregnancy prognosis. The choice of FUV or IUV umbilical vein to evaluate placental circulation may depend on the actual situation in clinical application.
ABSTRACT
Objective:To investigate the effect of the methyltransferase inhibitor azacitidine (5-azaC) on the expression of homeobox A9 (HOXA9) gene in, as well as proliferation, invasion and migration of A375 cells.Methods:In vitro cultured A375 cells were treated with 5-azaC at various concentrations of 1, 5, 10 and 20 μmol/L, while routinely cultured A375 cells receiving no drug intervention served as control group. Methylation-specific PCR was performed to analyze methylation status of the HOXA9 gene promoter region after the treatment with different concentrations of 5-azaC, in order to screen the optimal concentration of 5-azaC for following experiments. Cell counting kit-8 (CCK8) assay was conducted to evaluate the proliferation of A375 cells, Transwell and wound healing assays were performed to estimate the invasion and migration of A375 cells, and real-time fluorescence-based quantitative PCR (qRT-PCR) and Western blot analysis were conducted to determine the mRNA and protein expression of HOXA9 in A375 cells after 5-azaC treatment. Two-independent-sample t test was used for comparisons between two groups. Results:Methylation was observed in the HOXA9 gene promoter region in A375 cells in the control group. After 5-azaC treatment, methylated and unmethylated states coexisted in the HOXA9 gene promoter region in A375 cells, and the higher the concentration of 5-azaC, the higher the degree of demethylation of the HOXA9 gene. Therefore, 20 μmol/L 5-azaC was selected to treat A375 cells for 72 hours, which served as 5-azaC treatment group in subsequent experiments. Compared with the control group, the 5-azaC treatment group showed significantly decreased cellular proliferative ability (72.46% ± 2.19% vs. 100%, t = 28.09, P < 0.001) , significantly decreased number of invasive cells (242.70 ± 29.19 vs. 466.00 ± 22.65, t = 10.47, P < 0.001) , significantly decreased migratory ability (27.56% ± 2.74% vs. 35.69% ± 2.50%, t = 3.79, P = 0.019) , significantly increased HOXA9 mRNA expression (1.73 ± 0.28 vs. 1.01 ± 0.15, t = 3.93, P = 0.017) , and significantly increased HOXA9 protein expression (0.62 ± 0.03 vs. 0.50 ± 0.01, t = 3.82, P = 0.019) . Conclusion:5-azaC can inhibit the proliferative, invasive and migratory ability of A375 melanoma cells, and one of the possible mechanisms underlying this process may be that 5-azaC reverses the methylation in the HOXA9 gene promoter region, activates HOXA9 gene expression, and participates in the regulation of biological behaviors of melanoma cells.
ABSTRACT
ObjectiveTo explore the effect of home visit based on empowerment education on psychotic symptoms, self-management ability and well-being of schizophrenia patients in home rehabilitation. MethodsA total of 87 cases of schizophrenia patients who met the diagnostic criteria of International Classification of Diseases, tenth edition (ICD-10) and were recovering at home in Caiba town, Yibin city from January to July 2021 were selected by random sampling method as research subjects. They were divided into experimental group (n=43) and control group (n=44) according to the random number table method. The two groups received routine family visits, and the experimental group received family visits based on empowerment education. The intervention cycle of the two groups was 6 months. Before and after the intervention, the severity of psychotic symptoms, self-management ability and well-being of the patients in the two groups were assessed with the Brief Psychiatric Rating Scale (BPRS), the Schizophrenia Self-Management Instrument Scale (SSMIS) and the Index of Well-Being Scale (IWB). ResultsAfter intervention, the intra group comparison showed that the BPRS score in the experimental group was lower than that before the intervention (t=4.550, P<0.01), the SSMIS scores in both groups were higher than those before intervention (t=-17.107, -6.367, P<0.01), and the IWB score in the experimental group was higher than that before intervention (t=-9.239, P<0.01). The comparison between groups showed that the BPRS score of the experimental group was lower than that of the control group, and the SSMIS and IWB scores were higher than those of the control group (t=-3.899, 10.564, 9.690, P<0.01). ConclusionThe implementation of family visit based on empowerment education may help to improve the psychotic symptoms of home rehabilitation schizophrenia, and improve their self-management ability and well-being.
ABSTRACT
OBJECTIVE: To compare the clinical outcomes of patients with active immunoglobulin G (IgG) 4 related disease (IgG4-RD) receiving tocilizumab versus those receiving cyclophosphamide (CYC). METHODS: This IgG4-RD registry study was a prospective cohort study conducted among patients with active IgG4-RD hospitalized at Zhongshan Hospital, Fudan University. Patients who were treated with tocilizumab or CYC along with glucocorticoids (GCs) were enrolled. All participants were followed up at the hospital clinic at 3 and 6 months after discharge. Primary clinical outcomes were measured via the IgG4-RD responder index (RI), complete response (CR), and partial response (PR), as well as side effects. RESULTS: From January 2015 to June 2020, 29 patients enrolled. Fourteen and 15 patients were treated with tocilizumab and CYC, respectively. At the 6-month follow-up, disease activity parameters including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), IgG4, and IgG4-RD RI, decreased significantly in both groups. At 6 months, tocilizumab demonstrated its superiority, with 50% of patients achieving CR in the Tocilizumab group versus 20% in the CYC group. However, no statistical significance was identified (p = 0.128). The GC dosage at 6 months was significantly lower in the tocilizumab group than in the CYC group [10 (9.4-15) mg/d versus 15 (15-15) mg/d, p = 0.025]. In the CYC group, two patients experienced lumbar vertebral compression fractures related to GCs. Other patients in both groups showed mild adverse effects. CONCLUSIONS: Tocilizumab could be a better steroid-sparing agent, with a comparable curative effect and tolerance, than CYC, in the treatment of IgG4-RD.
ABSTRACT
OBJECTIVES: Patients with IgG4-related disease (IgG4-RD) suffer high relapse rates during long-term treatment, but factors that predict relapse outcomes are not well established. In the present study, we aimed to identify predictive factors for treatment resistance and disease relapse in a Chinese IgG4-RD cohort. METHODS: This study enrolled 102 patients newly diagnosed with IgG4-RD. Disease prognosis was determined by evaluating disease activity and dosage of glucocorticoids. Predictive factors for refractory and relapsed disease were identified by univariate analysis and Cox regression. RESULTS: Among the 102 patients, 78 cases received medical treatment with regular follow-up (21 [6-111] months). During the follow-up period, 55 (70.5%) patients sustained clinical remission, and 23 (29.5%) patients suffered refractory or relapsed disease. The relapse rate of the patients with IgG4-RD was significantly higher among patients who stopped taking medicine than among those who continued treatment with glucocorticoids (GC) + immunosuppressor (IM). Serum TNF-α ≥ 13 pg/mL, sIL-2R ≥ 1010 U/mL, total cholesterol < 3.55 mmol/L, low-density lipoprotein < 2.0 mmol/L, IgG ≥ 20.2 g/L, and drug withdrawal were predictive factors for refractory and relapsed IgG4-RD. Multivariate Cox regression revealed that both sIL-2R and TNF-α were independent risk factors for refractory and relapsed disease. The combination of GC and IM treatment was an independent protective factor against refractory and relapsed IgG4-RD. CONCLUSIONS: High serum levels of sIL-2R and TNF-α may be informative risk factors for refractory and relapsed IgG4-RD. Our data suggest that a combination treatment of GC along with IM may be protective against refractory and relapsed IgG4-RD. Key Points ⢠High sIL-2R and TNF-α levels are informative risk factors for refractory and relapsed IgG4-related disease. ⢠Combination treatment of GC with IM protects against refractory and relapsed IgG4-related disease.
Subject(s)
Immunoglobulin G4-Related Disease , China , Cohort Studies , Humans , Immunoglobulin G , Immunoglobulin G4-Related Disease/drug therapy , Prognosis , Treatment OutcomeABSTRACT
Objective:To discuss the construction mode of regional scientific and technological achievements transformation medical alliance in prefecture-level cities by analyzing and summarizing the work experience and reflections in the construction of medical alliances with medical alliances.Methods:Through investigation of the status quo, empirical study and summary analysis, explore the feasibility and operating mechanisms of the construction of regional scientific and technological achievements in prefecture-level cities.Results:Develop operational management plans for the construction of medical alliance for the transformation of scientific and technological achievements, establish a regional medical innovation exchange and sharing platform in prefecture-level cities, share knowledge training on the transformation of scientific and technological achievements, set up a patent application sharing platform, multi-dimensional assistance in medical technological innovation and achievement transformation, and establish a regional medical alliance to support the transformation of scientific and technological achievements, which can effectively improve the scientific and technological innovation capacity of regional medical alliance hospitals.Conclusions:Establishing a tailored needs-based training model, building a medical innovation exchange platform, and establishing a grid map for the transformation of scientific and technological achievements of the regional medical consortium are effective ways for prefecture-level cities to transform scientific and technological achievements into medical consortia.
ABSTRACT
Macrolide antibiotics are a class of broad-spectrum antibiotics with the macrolide as core nucleus. Recently, antibiotic pollution has become an important environmental problem due to the irregular production and abuse of macrolide antibiotics. Microbial degradation is one of the most effective methods to deal with antibiotic pollution. This review summarizes the current status of environmental pollution caused by macrolide antibiotics, the degradation strains, the degradation enzymes, the degradation pathways and the microbial processes for degrading macrolide antibiotics. Moreover, the critical challenges on the biodegradation of macrolide antibiotics were also discussed.
Subject(s)
Anti-Bacterial Agents , Biodegradation, Environmental , MacrolidesABSTRACT
Objective:To investigate the role of peroxisome proliferator-activated receptor γ (PPARγ)/CD36 signaling pathway in macrophage lipid metabolism after Mycobacterium tuberculosis ( Mtb) infection. Methods:THP-1-derived macrophages were infected with Mtb. Four groups were included in this study, which were control group, Mtb infection group, Mtb+ rosiglitazone (ROZ, PPARγ agonist) group and Mtb+ GW9662 (PPARγ antagonist) group. Western blot and RT-PCR were used to detect the expression of PPARγ in macrophages at protein and mRNA levels, respectively. The lipids in cells were detected by oil red O staining. The concentrations of total cholesterol (TC), triglycerides (TG), low density lipoprotein (LDL-C) and high density lipoprotein (HDL-C) in the supernatant of cell culture were detected by automatic biochemical analyzer. The expression of CD36 was detected by immunohistochemistry. CCK-8 was used to detect the proliferation rate of macrophages. Results:Mtb infection significantly increased the expression of PPARγ in macrophages ( P<0.001), promoted intracellular lipid aggregation and CD36 expression and decreased the levels of TC, TG, LDL-C and HDL-C in the supernatant of cell culture ( P<0.001) and cell proliferation rate ( P<0.001). PPARγ agonist significantly enhanced the intracellular lipid accumulation and CD36 expression that were induced by Mtb infection and down-regulated the lipid level in the supernatant of cell culture and cell proliferation rate, while PPARγ antagonist reversed the above effects. Conclusions:PPARγ played a role in lipid metabolism in Mtb-infected macrophages through affecting CD36 expression.
ABSTRACT
Objective:To investigate the classification of patients with gout, and further analyze their clinical features.Methods:Outpatients with gout were enrolled from January 2018 to July 2019 in Depart-ment of Rheumatology, Zhongshan Hospital. Subjects were classified into four groups according to their 24-hour urinaryexcretion and fractional excretion of urate. Clinical features of different groups were analyzed using one-way Analysis of Variance (ANOVA), Kruskal-Wallis H test, or χ2 test. Results:Finally, 378 subjects were enrolled in this cross-sectional study. Among them, 186(49.2%) were renal underexcretion type, 100(26.5%) were combined type, 57(15.1%) were renal overload type, 35(9.3%) were the normal type. Renal underexcretion type was the main subtype in any age-stratified groups. With aging, the proportion of combined type decreased, while the normal type increased. Participants in the combined type were the youngest [(42±14) years of age] with the highest estimated glomerular filtration rate [(94±18) ml·min -1·1.73 m -2], while their serum urate levels were the highest [(554±104) μmol/L]. Subjects in the normal type were the oldest [(60±15) years of age] with the lowest estimated glomerular filtration rate [(71±19) mL·min -1·1.73 m -2], however, their serum urate concentrations were the lowest [(427±118) μmol/L], The difference was statistically significant (age, F=13.98; estimated glomerular filtration rate, F=16.11; urate, F=17.14; P<0.01). Prevalence of urolithiasis were similar among the four groups ( χ2 =2.00, P>0.05). Conclusion:The renal underexcretion type is the main type of gout. Young patients are more likely to suffer from combined type with the highest serum urate levels and the best renal function.
ABSTRACT
Objective:To evaluate the effect of down-regulation of RACK1 expression on growth and radiosensitivity of oral squamous cell carcinoma cells.Methods:The shRNA vector for RACK1 gene was constructed and transfected into HSC-3 cells by lipofectamine. The stably-transfected cell line was obtained by constructing G418. The expression levels of RACK1 mRNA and protein were detected by RT-PCR and Western blot. The cell proliferation was detected by CCK8 assay. Cell apoptosis was examined by flow cytometry. The invasive and metastatic capabilities of cancer cells were assessed by cell invasion assay in vitro.The effect of X-ray irradiation combined with down-regulation of RACK1 expression upon cell proliferation was assessed by clone formation assay. The xenograft tumor nude mouse model was established to observe the inhibitory effect of down-regulating RACK1 gene expression combined with X-ray irradiation on oral squamous cell carcinoma. Results:RT-PCR revealed that the expression level of RACK1 mRNA of transfected HSC-3 cells was significantly down-regulated ( P<0.05). Western blot showed that the expression level of RACK1 protein was significantly down-regulated ( P<0.05). CCK8 assay demonstrated that down-regulation of RACK1 expression could remarkably inhibit the growth of HSC-3 cells ( P<0.05). RACK1 gene shRNA interference combined with X-ray irradiation significantly enhanced the apoptosis rate of HSC-3 cells ( P<0.05). The number of invasion cells in vitro in the RACK1 silencing group was evidently decreased ( P<0.05). Clone formation assay showed that the survival fraction in the shRACK1 group was significantly lower than that in the control group. The sensitization enhancement ratio was 1.37(ratio of D 0 value). Xenograft tumor experiment in nude mice showed that tumor growth was significantly inhibited in the shRACK1 group, the tumor volume was significantly decreased and the tumor mass was significantly lower than those in the control group (all P<0.05). Conclusion:Down-regulating RACK1 expression can enhance the radiosensitivity of oral squamous cell carcinoma cells, providing novel thinking to improve the radiosensitivity of oral squamous cell carcinoma.