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Objective:To evaluate clinical efficacy and safety of dupilumab in the treatment of moderate and severe atopic dermatitis (AD) in the elderly.Methods:An observational study was conducted, and a total of 42 elderly patients with moderate to severe AD were collected from Department of Dermatology, the First Affiliated Hospital of Soochow University from September 2021 to June 2022. These patients all received subcutaneous injection of dupilumab at an initial dose of 600 mg, followed by every-2-week injections at a dose of 300 mg, and the total course of treatment was 16 weeks. Clinical indicators, including eczema area and severity index (EASI) , numerical rating scale (NRS) , dermatology life quality index (DLQI) and investigator′s global assessment (IGA) , were recorded at weeks 0, 4, 8, 12 and 16, and the proportion of patients achieving more than 50% (EASI-50) and 75% (EASI-75) improvement in EASI scores were calculated; related laboratory indicators, including total serum immunoglobulin E (IgE) levels and eosinophil counts, were recorded at weeks 0, 4 and 16. During the treatment, adverse events were recorded. Statistical analysis was carried out by using chi-square test, one-way analysis of variance and t test with SPSS27 and GraphPad Prism 9.0 software. Results:Among the 42 patients, there were 25 males (59.5%) and 17 females (40.5%) , and their age was 71.82 ± 16.81 years. Among them, 17 patients (40.5%) presented with generalized eczema phenotype, 15 (35.7%) with flexor eczema phenotype, and 10 (23.8%) with prurigo nodularis phenotype. At weeks 4 and 16 after start of the treatment, the mean EASI score significantly decreased by 38.4% and 73.3% respectively, the mean NRS score significantly decreased by 53.0% and 77.4% respectively, and the mean DLQI score significantly decreased by 58.2% and 93.8% respectively compared with the corresponding scores before the treatment ( P < 0.05 or 0.001) . At weeks 4 and 16, the proportions of patients achieving an IGA score of 0 or 1 were 11.9% and 61.9% respectively, the proportions of patients achieving EASI-50 were 11.9% and 76.2% respectively, and the proportions of patients achieving EASI-75 were 2.4% and 57.1% respectively. Compared with the baseline levels, the mean total serum IgE level decreased by 23.1% and 38.2% at weeks 4 and 16 respectively ( P = 0.274, 0.395, respectively) , and the mean eosinophil count decreased by 24.4% and 37.5% at weeks 4 and 16 respectively ( P = 0.059, 0.735, respectively) . During the treatment, mild adverse events occurred in 6 (14.3%) patients, including conjunctivitis (3 cases) , fungal infection of the head and face (2 cases) , and psoriasiform dermatitis (1 case) , which subsided after symptomatic treatment. Conclusion:Dupilumab exhibited a rapid onset and marked efficacy in the treatment of moderate and severe AD in the elderly, with few and mild adverse events; however, some patients had not achieved EASI-50 or EASI-75 after 16-week treatment, and maintenance treatment was required.
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Objective To assess the predictive effect of myocardial injury biomarkers (proBNP, CK-MB, and cTnI) on the severity of acute pancreatitis (AP). Methods The records of 246 patients diagnosed with acute pancreatitis who were treated at Ruijin Hospital Emergency Department from January 2015 to December 2016 were retrospectively analyzed. According to the revised 2012 Atlanta guidelines, these patients were divided into the mild acute pancreatitis (MAP, n=47), moderately severe acute pancreatitis (MSAP, n=151) and severe acute pancreatitis (SAP, n=48) groups. The highest plasma levels of troponin I (cTnI), creatine kinase (CK)-MB, N-terminal B-type brain natriuretic peptide (NT-proBNP), C-reactive protein (CRP), and procalcitonin (PCT) were recorded for comparison within 72 h after admission. The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) score, sequential organ failure assessment (SOFA), bedside index for severity in acute pancreatitis (BISAP) and Balthazar computed tomography severity index (CTSI) were calculated at admission within 72 h. Whether there is an occurrence of organ dysfunction, and the organ types and persist time of organ dysfunction were recorded. The analysis of variance, SNK-q test and paired samples t test were used for the statistical analysis. Results The levels of proBNP, CK-MB, and cTnI were significantly higher in the SAP group than in the non-SAP group. The receiver operating characteristic (ROC) curve demonstrated cTnI had the maximum predictive power (AUC=0.872), while proBNP had the least predictive ability (AUC=0.763). The established model, which is to explore whether the myocardial injury markers had the predictive value, showed that the combination of myocardial injury indicators (CK-MB, cTnI) and traditional indicators had higher predictive value for SAP than traditional indicators alone (AUC=0.966 vs. AUC=0.945, P=0.04). Conclusions The elevated markers of myocardial injury had certain predictive value for severe acute pancreatitis.
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Objective To compare the one year efficacy of intravitreal injection with ranibizumb for macular edema (ME) secondary to ischemic and non-ischemic central retinal vein occlusion (CRVO).Methods A total of 88 patients (88 eyes) with ME secondary to CRVO were enrolled in this retrospective study.The best corrected visual acuity (BCVA) was detected by the Early Treatment Diabetic Retinopathy Study Chart.The optical coherence tomography was used to measure the foveal retinal thickness (CRT) and macular edema volume.The patients were divided into non-ischemic group and ischemic group,44 eyes of 44 patients in each group.There was no significant differences in age (t=0.650,P=0.517) and gender (x2=0.436,P=0.509) between the two groups.Compared with the ischemic group,the CRT was significantly decreased in the non-ischemic group (t=-2.291,P=0.024),and the edema volume in the macular area was significantly reduced (t=-2.342,P=0.022).All eyes were treated with continuous intravitreal injection of ranibizumab three times,and repeated injections were performed as needed.The patients without obvious ME regression after treatment were combined with triamcinolone acetonide injection.The patients with peripheral retinal non-perfusion area were combined with peripheral retinal laser photocoagulation.The follow-up was 1 year.The number of injections was counted.The changes of BCVA,CRT and edema volume in the macular area were compared between the two groups.Results During the 1-year follow-up period,88 eyes were injected 1 to 10 times,with the mean of 4.51 ±2.33.The number of injections in the ischemic group and non-ischemic group were 4.55± 1.59 and 4.48 ± 2.91,respectively.There was no significant difference in the average number of injections between the two groups (t=0.136,P=0.892).The number of acetonide injections and laser treatment in the ischemic group was significantly higher than that in the non-ischemic group (t=3.729,9.512;P＜0.001).At the last follow-up,compared with the ischemic group,the BCVA was increased (t=8.128),the CRT was decreased (t=-7.029) and the edema volume in the macular area was decreased (t=-7.213) in the non-ischemic group (P＜ 0.001).Conclusion Compared with ME secondary to ischemic CRVO,intravitreal injection of ranibizumab for ME secondary to non-ischemic CRVO has the better outcome of vision improvement and edema regression as well as less fiequent of acetonide injections and laser treatment.
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Objective To investigate the epidemic factors of human brucellosis in Qiqihar from 2008 to 2014 so as to provide a scientific basis for prevention and control of the disease.Methods Descriptive epidemiologic method was used to analyze the monitoring results of human brucellosis in Qiqihar between 2008 and 2014.Indexes observed were:the incidence rate,the distribution of gender,age,occupation,area and time.Results From 2008 to 2014,there were a total of 15 003 cases of brucellosis covering all counties.The average incidence rate was 38.85/100 000.The average incidence rate of Meilisi Daur District was the highest,178.93/100 000.Cases occurred year around and peaked in March-July.The average incidence rate of male and female brucellosis was 57.53/100 000 and 19.35/100 000,respectively,and male patients were more than female (x2 =3 658.973,P ＜ 0.05).Most patients were in the 41-50 years old age group,and the number of patients was 4 386.The major occupation was farmer (herdsmen),which acount for 93.96％ (14 097/15 003).Conclusions Qiqihar is the epidemic area of brucellosis and has a higher incidence.Governments should pay nore attention to the epidemic of brucellosis.Health education and intervention measure for high-risk population should be strengthened and the professional team should be reinforced so as to reduce the incidence of brucellosis.
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BACKGROUND:Primary human lung epithelial cel s are difficult to be isolated and cultured in vitro, which is characterized as limited sources, low cel viability, slow proliferation capacity, and lacking of differentiation capability. OBJECTIVE:To establish an air-liquid interface model of lung epithelium by in vitro proliferation of human bronchiolar epithelial cel s, which is used for research on function of lung epithelial cel s. METHODS:Primary human bronchiolar epithelial cel s were isolated using Pronase and DNase I combined digestive methods, and then proliferated using medium containing ROCK kinase inhibitor. The proliferated cel s were used for establishment of the air-liquid interface epithelium model. Cel differentiation was identified using scanning electron microscope, phase contrast microscope and immunofluorescent staining. RESULTS AND CONCLUSION:The primary human bronchiolar epithelial cel s could be expanded successful y using medium containing ROCK kinase inhibitor, and the basal cel marker Cytokeratin14 was preferential y expressed in the proliferated cel population, indicating that these basal cel s might be the main subpopulation of human lung epithelial stem cel s. Subsequently, the proliferated cel s under the air-liquid interface could differentiate into ciliated cel s and non-ciliated column cel s. The results suggest that the proliferation and differentiation of human bronchiolar epithelial cel s were maintained in the presence of ROCK kinase inhibitor, and the air-liquid interface could promote the differentiation of human bronchiolar epithelial cel s.
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Objective:To study the effects of ascorbic acid on BMP-2 mRNA expression of osteoblast cell sheets.Methods:Rat os-teoblasts were primaryly cultured and identified;osteoblast cell sheets were built by physical scraping method in vitro;the osteoblast cell sheets were cultured with 1 5,50 and 85 mg/L ascorbic acid for 1 and 2 weeks respectively,and the expression of BMP-2 mRNA of the cell sheets was detected by RT-qPCR.Results:The obtained cells were conformed to be osteoblasts.The osteoblast cell sheets could be rolled into tube in vitro.The expression of BMP-2 mRNA of osteoblast cell sheets in experiment group,whether in week one or week two was higher than that in control group,50 mg/L group showed the highest expression(first week P 0.05);the expression of any group in week two was higher than that in week one(P <0.05).Conclusion:Ascorbic acid may pro-mote the expression of BMP-2 mRNA in osteoblast cell sheets.
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Bacterial cellulose (BC) is a high-purity nanometer cellulose secreted by some bacteria. Compared with plant cellulose, it possesses an array of unique properties, including high crystallinity, high water content, good bio-compatibility, high mechanical strength and an ultra-fine fiber network. BC is prosperous as a new type of biomedical material, which has medical applications such as wound dressing, artificial skin, artificial blood vessels and tissue engineering scaffolds. There are, however, some problems to be solved on the large-scale application of BC, such as the high cost, low yield, and poor mechanical stability and so on.
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Bacteria , Chemistry , Bandages , Biocompatible Materials , Cellulose , Chemistry , Nanostructures , Chemistry , Skin, Artificial , Tissue Engineering , Tissue ScaffoldsABSTRACT
<p><b>OBJECTIVE</b>To investigate effectiveness and safety of combined treatment with glucosamine hydrochloride orally and hyaluronate intraarticularly in patients with temporomandibular joint osteoarthritis.</p><p><b>METHODS</b>Twenty eight participants who were diagnosed as temporomandibular joint osteoarthritis were randomly allocated to intervention and control groups (n = 14). The former received oral glucosamine hydrochloride (each day 1.44 g) and the latter placebo for four weeks. Both groups received intraarticular injection of hyaluronate for upper and inferior compartment, once a week for four weeks. Maximal mouth opening, pain on opening, deviation at the end of opening were measured at baseline and each week of follow up, quality of life was measured by using the instrument of oral health impact profile-14 (OHIP-14) at baseline and the fourth week. Intention-to-treat analysis was adopted for data analysis.</p><p><b>RESULTS</b>All participants except two in control group adhered to the follow-up. Parameters on baseline were balanced between the two groups. Maximal mouth opening was significantly increased in intervention group compared with control group (P = 0.03) and decrease was found for pain on opening (P = 0.02). No statistical difference was detected between the two groups on deviation (P = 0.67). The intervention group didn't show advantages compared with placebo on quality of life assessed by OHIP-14 (P = 0.77). No serious adverse drug events were detected in both groups.</p><p><b>CONCLUSION</b>The glucosamine hydrochloride plus double joint cavity injection of hyaluronate is safe and may reduce pain scores and improve opening in patients with temporomandibular joint osteoarthritis.</p>
Subject(s)
Female , Humans , Male , Middle Aged , Glucosamine , Hyaluronic Acid , Injections, Intra-Articular , Osteoarthritis , Quality of Life , Temporomandibular JointABSTRACT
<p><b>OBJECTIVE</b>To assess the efficacy and safety of hyaluronate sodium (HS) for internal derangement of temporomandibular joint by means of systematic review on relevant randomized controlled trials.</p><p><b>METHODS</b>After identifing the study question of the efficacy and safety of HS for internal derangement of temporomandibular joint, Medline, Cochrane Controlled Trials Register, EMBASE, OPEN SIGLE and CBM were searched electronically till October 3rd 2010. Hand-searching covering 19 dental journals in Chinese were also performed. Risk of bias assessment, with Cochrane Collaboration's tool, and data extraction of included studies were conducted by two reviewers in duplicate. Meta analysis was done with Revman 5.0.23 and the quality of evidence was evaluated by GRADE.</p><p><b>RESULTS</b>10 randomized controlled trials met the eligibility criteria and were included. All these studies had unclear risk of bias. When compared with negative control, HS showed a significant advantage on maximal mouth opening in short and long-term (P < 0.05), and clinical overall assessment in short-term (P < 0.05), but its effect on pain control and long-term effect on clinical overall assessment had no extra benefit (P > 0.05). Additionally, when compared with glucocorticoids, the participants who received HS injection would get a better clinical overall assessment in short-term and less adverse drug reactions (P < 0.05), but presented a similar temporomandibular joint pain relief and maximal mouth opening (P > 0.05).</p><p><b>CONCLUSION</b>To a certain extent, HS had good efficacy and better safety than controls when treating internal derangement of temporomandibular joint. However, as the quality of some included studies were limited, more randomized controlled trials are needed to reinforce the conclusion.</p>
