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2.
Zhonghua Shao Shang Za Zhi ; 37(8): 764-769, 2021 Aug 20.
Artículo en Chino | MEDLINE | ID: mdl-34404164

RESUMEN

Objective: To explore the value of using metagenomic next-generation sequencing (mNGS) technology to detect pathogens in patients with burns and patients with acute or chronic wounds. Methods: A retrospective observational study was conducted. From March 2019 to June 2020, 11 patients with burns and patients with acute or chronic wounds (including 10 males and 1 female, aged 23 to 85 years) in the Fourth Medical Center of PLA General Hospital met the inclusion criteria and were recruited. A total of 23 specimens were collected, including 6 whole blood specimens, 1 skin tissue specimen, 1 drained pus specimen, and 15 wound secretion swab specimens. Each specimen was divided into two parts, which were subjected for pathogen detection using microbial culture method and mNGS method, respectively. The number and types of pathogens detected by the 2 methods and the relative abundance detected by the mNGS method were recorded, and the consistency of the two methods were compared. Data were statistically analyzed with paired Wilcoxon rank sum test. Results: With the microbial culture method, no pathogen was detected in 5 of the 23 specimens, while 35 pathogens were detected in the remaining 18 specimens, belonging to 9 species of bacteria and 2 species of fungi. Five specimens had one pathogen while 9 specimens had 2 pathogens and 4 specimens had 3 pathogens detected in each specimen. With the mNGS method, no pathogen was detected in one of the 23 specimens, while 75 pathogens were detected in the remaining 22 specimens, belonging to 28 species of bacteria, 3 species of fungi, and 3 species of viruses. Eight specimens had one pathogen, 5 specimens had 2 pathogens, 2 specimens had 3 pathogens, 3 specimens had 4 pathogens, 2 specimens had 6 pathogens, and 1 specimen had 7 pathogens, and 1 specimen had 20 pathogens detected in each specimen. The number of pathogens detected in each specimen by microbial culture method was 2 (1, 2) types, which was significantly less than 2 (1, 4) types by mNGS method (Z=3.359, P<0.01). In 5 specimens, no bacteria were detected by microbial culture method but mNGS method detected bacteria in 2 specimens and virus in 2 different specimens. The mNGS method detected two or more types of bacteria in 13 specimens, the relative abundance of bacteria with the 1st relative abundance ranking ranged from 28.8% to 95.9% in each specimen. Of the 23 specimens detected by two detection methods, 7 specimens (30.4%) showed identical detection results, 5 specimens (21.7%) showed totally different detection results, and 11 specimens (47.8%) had partially consistent detection results. Conclusions: Compared with the traditional microbial culture method, the mNGS method has higher detection sensitivity and stronger capacity to detect pathogens, and can determine the relative abundance of pathogens in mixed infections. As a supplement to the culture method, the mNGS method is expected to play an important role in the diagnosis of infectious pathogens in burns and acute or chronic wounds.


Asunto(s)
Quemaduras , Metagenómica , Femenino , Secuenciación de Nucleótidos de Alto Rendimiento , Humanos , Masculino , Sensibilidad y Especificidad , Tecnología
3.
Fa Yi Xue Za Zhi ; 37(1): 21-25, 2021 Feb.
Artículo en Inglés, Chino | MEDLINE | ID: mdl-33780180

RESUMEN

ABSTRACT: Objective To study the heteroplasmy of the whole mitochondrial genome genotyping result of hair shaft samples using HID Ion GeneStudioTM S5 Sequencing System. Methods The buccal swabs and blood of 8 unrelated individuals, and hair shaft samples from different parts of the same individual were collected. Amplification of whole mitochondrial genome was performed using Precision ID mtDNA Whole Genome Panel. Analysis and detection of whole mitochondrial genome were carried out using the HID Ion GeneStudioTM S5 Sequencing System. Results The mitochondrial DNA sequences in temporal hair shaft samples from 2 individuals showed heteroplasmy, while whole mitochondrial genome genotyping results of buccal swabs, blood, and hair samples from the other 6 unrelated individuals were consistent. A total of 119 base variations were observed from the 8 unrelated individuals. The numbers of variable sites of the individuals were 29, 40, 38, 35, 13, 36, 40 and 35, respectively. Conclusion Sequence polymorphism can be fully understood using HID Ion GeneStudioTM S5 Sequencing system.


Asunto(s)
ADN Mitocondrial , Genoma Mitocondrial , ADN Mitocondrial/genética , Genoma Mitocondrial/genética , Heteroplasmia , Secuenciación de Nucleótidos de Alto Rendimiento , Humanos , Análisis de Secuencia de ADN
4.
Eur Rev Med Pharmacol Sci ; 25(3): 1387-1398, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33629309

RESUMEN

OBJECTIVE: The aim of the study was to summarize and update evidence on whether intra-operative ultrasonography (IOUS) guided breast conserving surgery (BCS) can be more effective than wire-guided or palpation-guided excision for both nonpalpable, as well as palpable breast cancers in achieving tumor free negative margins after lumpectomy for breast cancer. MATERIALS AND METHODS: Comprehensive searches were done systematically through PubMed, Scopus, CENTRAL (Cochrane Central Register of Controlled Trials) and Google scholar databases. Statistical analysis was done using STATA version 13.0. The primary outcome was proportion of patients that achieved tumor free resection margins after lumpectomy. Effect sizes were reported as pooled relative risks (RR). All estimates were reported with 95% confidence intervals (CI). RESULTS: A total of 20 RCTs with 2519 participants were included in the meta-analysis. Use of intra-operative ultrasonography was associated with 1.18 times higher chances [RR 1.18; 95% CI, 1.10-1.27] of attaining a tumor free margin for all breast cancers, 1.16 times higher chances [RR 1.16; 95% CI, 1.10-1.23] of attaining a tumor free margin for all palpable breast cancers and 1.20 times higher chances [RR 1.20; 95% CI, 1.05-1.38] of attaining a tumor free margin for all non-palpable breast, compared to wire guided or palpation guided localization. There was no evidence of publication bias. CONCLUSIONS: The findings support that intra-operative ultrasonography increases the chances of obtaining negative margins for tissue resected in breast conserving surgeries. The findings support the observations of previous reviews published in this aspect nearly half a decade back.


Asunto(s)
Neoplasias de la Mama/diagnóstico por imagen , Ultrasonografía Mamaria , Femenino , Humanos
5.
Zhonghua Fu Chan Ke Za Zhi ; 56(2): 108-113, 2021 Feb 25.
Artículo en Chino | MEDLINE | ID: mdl-33631882

RESUMEN

Objective: To investigate the clinical features of infertile women with non-classic 21-hydroxylase deficiency (21-OHD). Methods: The study enrolled 21 infertile women with non-classic 21-OHD in Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 2009 to December 2018. The clinical presentation, endocrine hormone, glucolipid metabolism and treatment outcome were retrospectively analyzed. The diagnosis of non-classic 21-OHD was comprehensively based on clinical and hormonal characteristics. Results: Among 21 cases, the age was (29.9±2.9) years, the mean age at menarche was (13.6±2.0) years, body mass index was (22.1±2.9) kg/m2, and 38% (8/21) had oligomenorrhea. Hirsutism was diagnosed in 3 cases (14%, 3/21). Clitoromegaly was seen in 14% (3/21) and polycystic ovarian morphology was found in 33% (7/21) of the patients. The mean serum level of basal progesterone was (11.3±21.0) nmol/L, with 48% (10/21) having high basal progesterone level; after therapy by glucocorticoid, the level of progesterone was (1.9±2.0) nmol/L. Serum 17-hydroxyprogesterone concentration was (66.4±123.6) nmol/L; after therapy by glucocorticoid, it was (2.4±1.8) nmol/L. In the study increased testosterone, androstenedione and dehydroepiandrosterone sulfate were present in 62% (13/21), 52% (11/21) and 43% (9/21), respectively; and 52% (11/21) of patients manifested androgen excess and basal progesterone elevation; androgen levels decreased after therapy by glucocorticoid. The pregnancy rate was 76% (16/21). Out of 19 pregnancies, 6/19 ended in spontaneous miscarriages. Conclusions: Infertile women with non-classic 21-OHD are characterized by hyperandrogenism and basal progesterone elevation, whereas gonad axis disorder is not apparent. After no response to conventional therapy, adult infertile women with non-classic 21-OHD could achieve a desirable pregnancy outcome with proper treatment of glucocorticoid.


Asunto(s)
Hiperplasia Suprarrenal Congénita/tratamiento farmacológico , Glucocorticoides/uso terapéutico , Infertilidad Femenina/etiología , 17-alfa-Hidroxiprogesterona/sangre , Adolescente , Hiperplasia Suprarrenal Congénita/sangre , Adulto , Femenino , Humanos , Infertilidad Femenina/sangre , Progesterona/sangre , Estudios Retrospectivos , Testosterona/sangre
6.
Zhonghua Shao Shang Za Zhi ; 36(7): 594-595, 2020 Jul 20.
Artículo en Chino | MEDLINE | ID: mdl-32842407

RESUMEN

From July 2018 to April 2019, 10 patients (8 males and 2 females, aged 5 to 53 years) who need skin grafting with 17 hands were admitted to the Fourth Medical Center of PLA General Hospital. The method of glove bandaging was used for wound hemostasis in skin grafting. After the initial hemostasis, sterile latex gloves were used as the inner cover of hand, and then pressure-wrapped with gauze. After 20 minutes, the gauze and gloves were removed in order from the near to the far, then thorough hemostasis was conducted again, and finally skin grafting was performed. The use of gloves as inner cover can avoid the adhesion of gauze fibers to the wound surface, so that it will not cause small blood vessels to re-bleed when the gauze is removed, therefore reducing the excessive use of electrocoagulation and secondary damage to the wound. As a result, blood loss can be reduced and hemostatic time can be shortened.


Asunto(s)
Mano , Trasplante de Piel , Adolescente , Adulto , Vendajes , Niño , Preescolar , Femenino , Hemostasis , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
7.
Eur Rev Med Pharmacol Sci ; 24(5): 2683-2691, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-32196619

RESUMEN

OBJECTIVE: Previous studies have shown that nucleus pulposus (NP) cell death plays an extremely important role in the progress of intervertebral disc degeneration (IVDD). This research aimed to investigate the protective effect of the MLKL inhibitor necrosulfonamide (NSA) on human NP cells. PATIENTS AND METHODS: We collected human NP tissues from the patients undergoing disc herniation operations and isolated NP cell from the samples. IL-1ß (10 ng/ml) was used to establish a NP cells degenerated model. We analyzed the expression of caspase 3, caspase 8, RIPK1, RIPK 3, and MLKL in different degree of degenerate disc tissues. Cell viability was analyzed by the Cell Counting Kit-8 (CCK-8) assay. The expression levels of collagen Ⅱ, ß-galactosidase (ß-gal), caspase 3, caspase 8, RIPK1, RIPK 3, and MLKL, several inflammatory and anti-oxidant enzymes of different NP cell treat groups were detected by Western blotting, immunofluorescence staining, or RT-PCR. Flow cytometry was used to measure the ROS level and cell apoptosis. RESULTS: The data showed that expression of caspase 3, caspase 8, RIPK1, RIPK 3, and MLKL markedly increased in severely degenerated disc tissues. IL-1ß promoted the cell death of NP cells, while NSA could reverse the effects of IL-1ß. We found that NAS increased the antioxidant SOD1, SOD2, CAT, and GPX3 expression and suppressed oxidative stress in the disc. Moreover, MMP3, MMP10, IL-6, and TNF-α were significantly suppressed by the NSA. CONCLUSIONS: These results suggest that NSA prevented NP degradation via inhibiting apoptosis and necroptosis of NP cells. Besides, the protective function of antagonizing cell death may owe to the inflammation and oxidative stress suppression.


Asunto(s)
Acrilamidas/farmacología , Apoptosis/efectos de los fármacos , Degeneración del Disco Intervertebral/prevención & control , Necroptosis/efectos de los fármacos , Núcleo Pulposo/efectos de los fármacos , Sulfonamidas/farmacología , Adulto , Anciano , Proliferación Celular/efectos de los fármacos , Células Cultivadas , Femenino , Humanos , Degeneración del Disco Intervertebral/diagnóstico , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Coloración y Etiquetado
8.
Zhonghua Yi Xue Za Zhi ; 99(41): 3227-3231, 2019 Nov 05.
Artículo en Chino | MEDLINE | ID: mdl-31694117

RESUMEN

Objective: To measure the levels of anti-interferon (IFN) -α2 antibody (IFN-α2-Ab) and anti-IFN-ω antibody(IFN-ω-Ab) and investigate their potential roles in patients with myasthenia gravis (MG). Methods: Radioimmunoprecipitationassay (RIPA) based on (125)I-labelled IFN-α2, -ω, acetylcholine receptor (AChR) and muscle-specific kinase (MuSK) were used to detect anti-IFN-α2-Ab, anti-IFN-ω-Ab, anti-AChR-Ab and anti-MuSK-Ab respectively in MG patients from Tianjin Medical University General Hospital, during the year of 2013. Relationship between IFN-α2-Ab and clinical characteristics in patients with MG were analyzed. Results: With the RIPA, anti-IFN-α2-Ab was positive in 11 (22%) patients with MG, among whom, 8 were thymoma associated MG (TAMG) and 3 were late onset MG (LOMG). The double positive one was among the LOMG who was a 76-year-old ocular MG patient. Serum anti-IFN-α2-Ab levels in different subgroups of MG had no significant difference (P>0.05). MG patients with anti-IFN-α2-Ab complicated with less other autoimmune disease. Serum anti-IFN-α2-Ab levels negatively correlated with QMG score in TAMG. Conclusions: MG patients with anti-IFN-α2-Ab complicate with less other autoimmune disease. The higher serum IFN-α2-Ab levels in TAMG, the slighter symptoms present.


Asunto(s)
Antivirales , Miastenia Gravis , Timoma , Neoplasias del Timo , Anciano , Autoanticuerpos , Humanos
9.
Zhonghua Yi Xue Za Zhi ; 99(34): 2696-2700, 2019 Sep 10.
Artículo en Chino | MEDLINE | ID: mdl-31505722

RESUMEN

Objective: To investigate the clinical features of lung natural killer (NK)/T cell lymphoma. Methods: The clinical data of patients with lung NK/T-cell lymphoma confirmed by pathology who were hospitalized due to lung shadow and initially treated as pneumonia from the First Affiliated Hospital of Zhengzhou University was collected from June 2013 to January 2019. The clinical manifestations, laboratory tests, chest CT findings, treatment procedures, outcomes, and misdiagnosis were retrospectively analyzed. Results: Among the 15 enrolled patients with lung NK/T-cell lymphoma, 5 were primary and the other 10 were secondary. There were 8 males and 7 females, aged 20-76 years. Fever presented in 14 cases, dyspnea was observed in 4 cases and 2 cases had cough. A total of 12 cases had leukopenia, 10 cases had mononuclear cell increase, 10 cases had liver dysfunction, 13 cases had elevated serum lactate dehydrogenase (LDH), and 2 cases of primary lung NK/T-cell lymphoma had increased pleural LDH and adenosine deaminase. Five cases of primary lung NK/T-cell lymphoma had multiple lung lesions, with diffuse multiple solid shadows, ground glass and patchy shadows, some with nodules; 10 cases of secondary lung NK/T-cell lymphoma showed nodular masses, some were accompanied by patchy shadows, and most patients had multiple lesions scattering in the lung. All the fifteen patients were misdiagnosed as pneumonia in the early stage, and then were diagnosed by percutaneous lung biopsy or transbronchial biopsy. Six patients underwent chemotherapy, of which 1 achieved complete response, 4 were in follow-up and 1 died of respiratory failure; 5 patients died of respiratory failure after diagnosis and 4 patients discharged and died within half a year. Conclusions: The lung NK/T-cell lymphoma are rare. The clinical manifestations and pulmonary imaging findings are indistinguishable from pulmonary inflammatory lesions. They are easily misdiagnosed as pneumonia. Early CT-guided percutaneous lung biopsy or transbronchial biopsy can improve the diagnostic accuracy.


Asunto(s)
Neoplasias Pulmonares , Linfoma de Células T , Neumonía , Adulto , Anciano , Errores Diagnósticos , Femenino , Humanos , Neoplasias Pulmonares/complicaciones , Linfoma de Células T/complicaciones , Masculino , Persona de Mediana Edad , Neumonía/etiología , Estudios Retrospectivos , Adulto Joven
10.
Artículo en Chino | MEDLINE | ID: mdl-31434370

RESUMEN

Objective: To analyse the mental state of patients with allergic rhinitis (AR) in Chengdu. Methods: One thousand five hundred and thirty-six AR patients from Sichuan Provincial Integrated Traditional Chinese and Western Medicine Hospital, West China Hospital of Sichuan University, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Sichuan People's Hospital, Sichuan Second Hospital of Traditional Chinese Medicine were selected from July 2013 to January 2018. Eight hundred and twenty-seven patients were screened into study group by inclusion and exclusion standards. The symptom check list 90 (SCL-90) was used to group and score the mental state of these patients according to nine classification criteria: gender, BMI, age, marital status, monthly salary, disease duration, living environment, education level and working environment. Then, the scores were compared within groups. Inter-group comparison was made between the study group and the Chinese norm, and the positive factors for psychological disorders were extracted. Four symptoms in the study group, i.e. nasal itching, sneezing, clear discharge and nasal congestion, were scored on the visual analogue scale (VAS). SPSS 19.0 software was used to carry out statistical analysis. Partial correlation analysis was performed between the positive factors and the symptom scores by multiple regression statistical method. Results: The total score of SCL-90 in the study group was 2.64±0.25, which was accorded with mild to moderate mental health impairment. There were 124 (15.0%) without mental health damage, 176 (21.3%) with mild damage, 474 (57.3%) with mild to moderate damage, 41 (5.0%) with moderate to severe damage and 12 (1.4%) with severe damage. The in-group comparison showed that the top three categories of different items were the living environment, gender and working environment. The scores of somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, psychosis, other (sleep, diet) and total average score of urban residents were higher than that of country residents (3.29±0.61 vs 2.65±0.50, 2.81±0.77 vs 2.05±0.38, 3.10±0.19 vs 2.49±0.67, 3.40±0.84 vs 2.49±0.70, 3.04±0.64 vs 2.33±0.51, 3.02±0.55 vs 2.40±0.77, 3.40±0.41 vs 2.52±0.77, 2.91±0.11 vs 2.29±0.40, Z value was 4.88, 5.25, 4.57, 5.91, 5.09, 4.63, 5.55, -4.55, respectively, all P<0.05). Women scored higher than man for somatization, interpersonal sensitivity, depression and others (2.66±0.51 vs 2.00±0.45, 3.37±0.47 vs 2.63±0.51, 3.44±0.57 vs 2.85±0.52, 3.47±0.36 vs 2.76±0.45, Z value was -5.10, -5.51, -4.86, -5.28, respectively, all P<0.05). The scores of somatization, interpersonal sensitivity, psychosis and other (sleep, diet) were higher in the indoor group than those in the outdoor group (3.49±0.64 vs 2.78±0.46, 3.33±0.30 vs 2.56±0.68, 3.28±0.60 vs 2.67±0.31, 3.50±0.85 vs 2.85±0.37, Z value was 5.31, 5.79, 4.89, 5.00, respectively, all P<0.05). The outdoor group scored higher on obsessive-compulsive symptoms, anxiety and hostility (3.44±0.40 vs 2.83±0.35, 3.40±0.50 vs 2.57±0.93, 3.34±0.88 vs 2.69±0.56, Z value was 4.96, 6.22, 5.08, respectively, all P<0.05). The inter-group comparison found that depression, anxiety, psychosis and other (sleep, diet) could be partially correlated with VAS scores as 4 positive factors. The results of partial correlation analysis showed that depression was positively correlated with sneezing and nasal runny discharge, anxiety was positively correlated with nasal itching and nasal obstruction, psychosis was positively correlated with nasal itching and sneezing, and other (sleep, diet) was positively correlated with nasal runny discharge and nasal obstruction. Conclusion: AR patients have mild to moderate mental health impairments, which are correlated with AR symptoms.


Asunto(s)
Trastornos Mentales/diagnóstico , Rinitis Alérgica/psicología , China , Femenino , Humanos , Masculino , Trastornos Mentales/etiología , Pruebas de Estado Mental y Demencia , Rinitis Alérgica/clasificación , Rinitis Alérgica/complicaciones , Rinitis Alérgica/diagnóstico
11.
Zhonghua Shao Shang Za Zhi ; 35(6): 446-450, 2019 Jun 20.
Artículo en Chino | MEDLINE | ID: mdl-31280538

RESUMEN

Objective: To observe the clinical effects of stage-Ⅱ Meek skin grafting on adipose tissue after tangential excision in patients with extensive deep burns, and to explore the functional mechanism. Methods: The medical records of 26 extensively burned patients who met the inclusion criteria and were admitted to the Department of Burns and Plastic Surgery of the Fourth Medical Center of PLA General Hospital from May 2015 to December 2017 were retrospectively analyzed. According to the treatment methods, 14 patients were enrolled in stage-Ⅰ skin grafting group (10 males and 4 females, aged 27 to 75 years), and 12 patients were enrolled in stage-Ⅱ skin grafting group (10 males and 2 females, aged 31 to 76 years). Patients in the 2 groups all underwent debridement of tangential excision, and their healthy adipose tissue was preserved. Meek skin grafting was performed just after tangential excision in patients in stage-Ⅰ skin grafting group. In patients in stage-Ⅱ skin grafting group, porcine acellular dermal matrix (ADM) was applied to cover the wound after tangential excision, and 3 days later, it was removed and Meek skin grafting was performed. The times of complement skin grafting and the wound basic healing time of patients in the 2 groups were observed and recorded. In the stage-Ⅱ skin grafting group, the adipose tissue of patients were taken from the wound center immediately after tangential excision and immediately after the removal of porcine ADM, for the observation of structure of the fault surface of adipose tissue through hematoxylin and eosin staining and microvessel density (MVD) through immunohistochemical staining. Data were processed with independent sample t test and Fisher's exact probability test. Results: (1) The times of complement skin grafting of patients in stage-Ⅱ skin grafting group was (1.83±0.17) times, which was obviously less than (3.36±0.63) times in stage-Ⅰ skin grafting group (t=2.19, P<0.05). The wound basic healing time of patients in stage-Ⅱ skin grafting group was (35.1±2.3) d, which was obviously shorter than (48.8±4.9) d in stage-Ⅰ skin grafting group (t=2.27, P<0.05). (2) Immediately after tangential excision, the intercellular substance was few between the adipose cells in adipose tissue of patients in stage-Ⅱ skin grafting group. Immediately after the removal of porcine ADM, there was regenerated granulation tissue in the intercellular space of adipose cells of adipose tissue of patients in stage-Ⅱ skin grafting group. Immediately after tangential excision, the MVD of adipose tissue of patients in stage-Ⅱ skin grafting group was 20.2±1.3 under per 400-time field, which was obviously less than 32.2±1.9 under per 400-time field immediately after the removal of porcine ADM (t=-5.38, P<0.01). Conclusions: Meek skin grafting on the adipose tissue in stage-Ⅱ surgery after tangential excision could reduce the times of complement skin grafting and shorten wound healing time of patients with extensive deep burns. The mechanism may be related to the improvement of the recipient condition of adipose tissue.


Asunto(s)
Tejido Adiposo , Quemaduras/cirugía , Trasplante de Piel , Adulto , Anciano , Animales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Porcinos , Cicatrización de Heridas
14.
Zhonghua Yi Xue Za Zhi ; 99(10): 775-777, 2019 Mar 12.
Artículo en Chino | MEDLINE | ID: mdl-30884634

RESUMEN

Objective: To analyze the clinical features of infective endocarditis with septic pulmonary embolism, and to improve the diagnosis and treatment of the disease. Methods: Retrospective analysis of clinical manifestations, blood culture, echocardiography, chest CT and diagnosis and treatment of 16 patients with infective endocarditis and septic pulmonary embolism in the First Affiliated Hospital of Zhengzhou University from January 2010 to June 2017 was carried out, and the clinical features of the disease were summarized. Results: Out of the 16 patients, 4 were males and 12 were females, aged (29.5±9.7) years old, 12 patients were with congenital heart disease. The main clinical manifestations were fever, cough, dyspnea, hemoptysis. There were 7 cases with positive blood culture, and 6 of them were Streptococcus. Echocardiography revealed cardiac vegetations, and all were from right heart. Chest CT was characterized by multiple pulmonary lesions, mainly characterized by multiple nodules and small patch shadows. All 16 patients were initially misdiagnosed as pneumonia. All patients were treated with antibiotics intravenously, 13 patients underwent cardiac surgery, 6 patients were cured, 8 patients improved, and 2 patients were discharged automatically. Conclusions: Infective endocarditis with septic pulmonary embolism is easily misdiagnosed. In patients with fever and multiple shadows in the lungs, the possibility of right heart infective endocarditis should be considered. The diagnosis can be confirmed once cardiac vegetations are found by echocardiography, and repeated echocardiographic examinations can be performed if necessary. The prognosis of patients treated with surgery as early as possible on the basis of anti-infection is good.


Asunto(s)
Endocarditis Bacteriana , Embolia Pulmonar , Adulto , Femenino , Cardiopatías Congénitas , Humanos , Masculino , Estudios Retrospectivos , Adulto Joven
15.
Andrology ; 7(3): 329-340, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-30811104

RESUMEN

BACKGROUND: Congenital absence of vas deferens (CAVD) is a major cause of obstructive azoospermia. Mutations in CFTR and ADGRG2 are responsible for this disease. However, until now the genetic spectrum of the CFTR and ADGRG2 genes in Chinese population and the reasons of the differences from Caucasian cohorts were not clear. OBJECTIVES: (i) To study the characteristic and functional consequences of CFTR and ADGRG2 mutations in Chinese CAVD patients. (ii) To describe the genetic spectrum of Chinese CAVD patients and explain the reasons of the differences from Caucasian cohorts and Chinese cystic fibrosis (CF) patients. MATERIALS AND METHODS: Patients were screened for mutations in CFTR by Sanger sequencing. Patients with only one or no mutations were further investigated by multiplex ligation-dependent probe amplification analysis and direct sequencing of ADGRG2 gene. Bioinformatic analysis and structural modeling of proteins were performed. RESULTS: A total of 28 mutations in CFTR were identified in 72 patients, of which five mutations were novel. Fifty-five patients (76.39%) had CFTR mutations but no indels, among which 80.00% CBAVD patients have at least one CFTR mutation and 66.67% CUAVD have at least one CFTR mutation. Two novel mutations (p.Lys818* and p.Arg1008Gln) in ADGRG2 were detected. These novel mutations were predicted to be damaging by bioinformatics and were absent or extremely low frequency among our controls and databases. The genetic spectrum of Chinese CAVD patients revealed that the most common mutations were c.1210-12T[5], p.Ile556Val and p.Gln1352His, the last two of which were predicted to reduce the domains' contacts and weaken adenosine triphosphate binding. DISCUSSION AND CONCLUSION: This study illustrates the significance of all exon sequencing in CFTR and ADGRG2. A picture of the genetic spectrum of Chinese CAVD patients and the most common mutations can be described, which are different from Caucasian cohorts and Chinese CF patients.


Asunto(s)
/genética , Enfermedades Urogenitales Masculinas/genética , Receptores Acoplados a Proteínas G/genética , Conducto Deferente/anomalías , Adulto , Regulador de Conductancia de Transmembrana de Fibrosis Quística/genética , Humanos , Enfermedades Urogenitales Masculinas/patología , Persona de Mediana Edad , Mutación , Fenotipo , Conducto Deferente/patología , Adulto Joven
16.
Zhonghua Xue Ye Xue Za Zhi ; 39(11): 917-920, 2018 Nov 14.
Artículo en Chino | MEDLINE | ID: mdl-30486588

RESUMEN

Objective: To explore the positive rate of intrinsic factor antibody (IFAb) and level of vitamin B(12) (VitB(12)) in normal physical examination population and the possible relation between IFAb, VitB12 and sex, age, number of RBC, HGB and MCV. Methods: A total of 1 427 people who came to Peking Union Medical Colleague Hospital (PUMCH) for physical examination were enrolled. There were 758 males with average age of (52.5±14.5) years-old and 669 females with average age of (50.3±14.3) year-old. Beckman DxI800 automatic biochemical-immune analyzer and corollary reagents were used to analyze the level of serum IFAb and VitB(12). The results in different sex, age were documented and their correlation with the value of whole blood cell count was tested later on. Results: Among the 1 427 normal subjects, 66 (4.63%) were positive for IFAb. The positive rate for IFAb in the population≥40 years-old was higher than those<40 years-old (5.66% vs 1.48%, χ(2)=7.46, P=0.006). The deficiency rate of VitB(12) in the population<40 years-old, 40-59 years-old and ≥60 years-old was 2.22%, 2.51% and 5.50%, respectively (χ(2)=8.55, P=0.014). There were no difference between people with different sex in the positive rate of IFAb (5.15% for males and 4.04% for females, χ(2)=0.99, P=0.320) or in the deficiency rate of VitB(1)2 (3.83% for males and 2.69% for females, χ(2)=1.44, P=0.230). The results of multiple linear regression showed that HGB level of IFAb positive subjects was 3.05 g/L lower on average than those of IFAb negative, but IFAb had no effect on both RBC and MCV. There was no correlation between VitB(1)2 deficiency and HGB, RBC and MCV. Conclusion: The positive rate of IFAb and deficiency rate of VitB(1)2 increase as age increases. But the presence of VitB(12) deficiency is later than the positive findings of IFAb. IFAb showed some effects on the level of HGB, which may compensate the limitations of VitB(12) detection to some extent. It is necessary to check the IFAb and level of VitB(12) in people with middle or old ages.


Asunto(s)
Examen Físico , Adulto , Anciano , Autoanticuerpos , Femenino , Humanos , Factor Intrinseco , Masculino , Persona de Mediana Edad , Vitamina B 12 , Vitaminas
18.
Zhonghua Shao Shang Za Zhi ; 34(10): 714-718, 2018 Oct 20.
Artículo en Chino | MEDLINE | ID: mdl-30369140

RESUMEN

Objective: To observe the effects of minimally invasive tangential excision in treating deep partial-thickness burn wounds on trunk and limbs in pediatric patients in the early stage post burn. Methods: Clinical data of 40 children with deep partial-thickness burn wounds on trunk and limbs, admitted to our burn ward from January 2016 to June 2017, conforming to the study criteria, were retrospectively analyzed. They were divided into conventional treatment group (CT, n=19) and minimally invasive tangential excision group (MITE, n=21) according to the different treatments. The patients in group CT were treated with eschar-reserving therapy firstly. When tangential excision was performed, the roller knife was used, and no necrotic tissue left on the wound bed was considered the proper depth of excision. Razor-thickness skin grafting was performed to cover the wound when adipose tissue exposed markedly after tangential excision. Dressing change was performed within 48 h after the operation and repeated every 2 days. Unhealed wounds were covered by razor-thickness skin grafting. The patients in group MITE were treated with tangential excision in the early stage post burn. The tangential excision was operated with electric dermatome, and the thickness was set at 0.1 mm to excise the surface of eschar until the sporadic punctate hemorrhage on wound surface was observed and some necrotic tissue was left on the wound bed. Porcine acellular dermal matrix was applied after tangential excision. The first dressing change was often performed about 1 week after the operation. Razor-thickness skin grafting was performed to cover the unhealed wounds. The length of wound healing, high fever, antibiotic usage, and hospital stay, times of later operation, and hospitalization expenses of patients in the 2 groups were recorded. The excisional eschar and wound bed tissue of patients in group MITE were harvested for pathological observation. Data were processed with t test and Fisher's exact probability test. Results: (1) There were no statistically significant differences in length of high fever and length of hospital stay and hospitalization expenses between patients in the 2 groups (t=-1.67, -1.93, 0.31, P>0.05). The lengths of wound healing [(24.8±2.5) d] and antibiotic usage [(4.4±0.7) d] of patients in group MITE were significantly shorter than those in group CT [(33.3±2.5) and (7.0±0.7) d, t=-2.44, -2.44, P<0.05], and times of later operation of patients in group MITE [(0.29±0.14) times] were significantly less than those in group CT [(0.79±0.21) times, t=-2.03, P<0.05]. (2) The thickness of the excisional eschar of patients in group MITE was about 150 µm. The eschar has epidermis and upper dermis. Some necrotic tissue was left on the wound bed. Conclusions: The treatment for pediatric deep partial-thickness burn wounds on trunk and limbs with minimally invasive tangential excision using electric dermatome in the early stage post burn can accelerate wound healing, shorten length of antibiotic usage, and reduce times of later operations.


Asunto(s)
Quemaduras/cirugía , Desbridamiento/métodos , Trasplante de Piel , Cicatrización de Heridas , Quemaduras/patología , Niño , Extremidades , Femenino , Humanos , Estudios Retrospectivos
19.
Fa Yi Xue Za Zhi ; 34(2): 161-164, 2018 04.
Artículo en Chino | MEDLINE | ID: mdl-29923383

RESUMEN

OBJECTIVES: To validate the analysis capability of RapidHIT™ 200 system for four kinds of routine forensic samples and the recyclable capability of template, template DNA and PCR products in the process of twice duplicate detection. METHODS: The buccal swabs underwent the test twice by RapidHIT™ 200 system, and the template DNA and PCR products that arose in the system were also tested for two times. After four kinds of routine forensic samples were detected by RapidHIT™ 200 system, the follow-up tests of the template, template DNA and PCR products that arose in the system were performed. RESULTS: The STR loci could be detected in the buccal swabs by the system for the first time. However, part of the STR loci lost during the second test. And the peak value obtained in the second test was significantly reduced than the one in the first time. The average STR loci detection rates of the template DNA and PCR products were both less than 50% in the second test, which were significantly reduced than that in the first test. In addition, the analysis capability of the system for the tissues and buccal swabs was better than that for the blood and cigarette butts. Compared with the first test, the STR loci detection rate of the tested items, template DNA and PCR products decreased with the numbers of tests. CONCLUSIONS: RapidHIT™ 200 system is more effective in retesting buccal swabs than other samples, whereas the items, DNA template, PCR products obtained in the first and second time cannot be directly used for the further application and study of forensic medicine.


Asunto(s)
Automatización , Genética Forense/instrumentación , Repeticiones de Microsatélite/genética , Moldes Genéticos , Genética Forense/métodos , Medicina Legal , Humanos , Mucosa Bucal/química , Reacción en Cadena de la Polimerasa , Reproducibilidad de los Resultados , Sensibilidad y Especificidad
20.
Eur Rev Med Pharmacol Sci ; 22(8): 2287-2296, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-29762851

RESUMEN

OBJECTIVE: To investigate the role of miR-198 and its target gene Toll-like receptor 4 (TLR4) of tumorigenesis of gastric cancer (GC). MATERIALS AND METHODS: The expression of miR-198 in GC cells was detected by quantitative polymerase chain reaction (qPCR). The proliferation, apoptosis, migration, and invasion of GC cells were detected by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT), flow cytometry, transwell chamber, and wound scratch assay. Bioinformatics analysis for the results of protein chip was performed to identify the target genes of miR-198. TLR4 was further confirmed to be the target gene of miR-198 by TLR4 luciferase reporter assay. RESULTS: miR-198 expression level in GC SGC-7901 cells significantly decreased compared with the normal cells. When the miR-198 was overexpressed, the proliferation, migration, and invasion of GC cells were significantly decreased, while the apoptosis was increased. The expression of TLR4 in SGC-7901 cells was significantly higher, while the expression of TLR4 in SGC-7901 cells transfected with miR-198 significantly lowered, which was consistent with the Western blot for TLR4. The luciferase reporter assay confirmed that TLR4 was the target genes of miR-198 in GC SGC7901 cells. CONCLUSIONS: miR-198 could induce apoptosis and inhibit the proliferation, migration, and invasion of GC cells through downregulating TLR4 expression.


Asunto(s)
Carcinogénesis/genética , Regulación hacia Abajo , Regulación Neoplásica de la Expresión Génica , MicroARNs/metabolismo , Neoplasias Gástricas/genética , Receptor Toll-Like 4/metabolismo , Apoptosis/genética , Línea Celular Tumoral , Movimiento Celular/genética , Proliferación Celular/genética , Transformación Celular Neoplásica/genética , Citometría de Flujo , Regulación Neoplásica de la Expresión Génica/genética , Humanos , MicroARNs/genética , Invasividad Neoplásica/genética , Receptor Toll-Like 4/biosíntesis , Regulación hacia Arriba
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