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BACKGROUND: Thyroid dysfunction plays an important role in the pathology of diabetes-associated cognitive dysfunction (DACD). However, thyroid hormone (TH) signaling and action changes in DACD brains remain unknown. This study evaluated the alternations in TH signaling and action in the brains of DACD mice, and explored the beneficial effects of levothyroxine (L-T4) treatment. METHODS: KK-Ay mice, serving as a spontaneous type-2 diabetes mellitus model, underwent intragastric administration of 10 ng/g and 20 ng/g of L-T4 solution or normal saline for 8 weeks. Age-matched C57BL/6J mice were used as normal controls. Cognitive and memory functions were examined through the open field and Morris water maze tests. Hippocampal TH signaling and pathogenic status were evaluated. The potential signaling pathways involved in the neuroprotective action of L-T4 were investigated through RNA sequencing and further verified through quantitative real-time PCR (qPCR), Western blotting (WB), immunofluorescence (IF), and fluorescent multiplex immunohistochemistry (mIHC) in vivo and vitro. RESULTS: The expressions of hippocampal TH transporters (Mct8 and Oatp1c1), Dio2, and TH receptor were up-regulated, while Dio3 as well as the TH positive-regulated genes MBP, Enpp2 and Klf9 were down-regulated in DACD mice. Exogenous L-T4 partially alleviated cognitive and memory dysfunction and restored hippocampal neuronal activity by optimizing TH signaling. RNA sequencing provided insights into the role of type-I interferon (IFN-I) signaling and necroptosis on the amelioration of hippocampal damage following L-T4 treatment. WB and qPCR further confirmed that the levels of key proteins for IFN-I signaling and necroptosis (p-STAT1, p-STAT2, IRF9, ZBP1, p-RIP3, and p-MLKL) were increased, but largely returned following L-T4 administration in vivo and T3 treatment in vitro. IF and mIHC revealed that IRF9 and p-MLKL co-localized in neurons, but not in astrocytes or microglia, of the hippocampus in DACD mice. The diabetes mellitus group had an increased number of IRF9+p-MLKL+NeuN+ cells, which decreased after L-T4 treatment. The elevated IFN-I signaling-mediated necroptosis in HT22 cells was also decreased by T3. CONCLUSION: We demonstrated abnormal hippocampal TH signaling and action in DACD. Promoting TH action with exogenous L-T4 ameliorated hippocampal impairment through inhibiting IFN-I signaling-induced necroptosis.
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Background: Nuclear protein in testis (NUT) carcinoma (NC) is a rare, highly aggressive neoplasm, usually accompanying with NUTM1 (NUT midline carcinoma family member 1) gene fusions. Primary thyroid NC is clinically rare and to date there is no established treatment guideline available for NC. We report a case of histopathologically confirmed thyroid NC and provide reference for diagnosis and treatment. Case Description: We presented a 32-year-old female admitted to hospital with "painful neck swelling and progressive dysphagia". Preoperative ultrasound-guided core needle aspiration biopsy suggested a poorly differentiated tumor. Considering the tumor was totally unresected on computed tomography (CT) scan, a partial thyroidectomy was performed to obtain sufficient tissue for a clear diagnosis. Histopathological specimens showed features of sudden keratosis. Strong immunoreactivity with NUT was detected by immunohistochemistry (IHC) and thus confirmed the diagnosis of NC. CK5/6, P40 and P63 were partially positive exclusively in keratosis area. Next-generation sequencing (NGS) and RNA sequencing results revealed a NSD3-NUTM1 fusion. The patient was treated with a combined regimen of radiotherapy of 70 Gy, chemotherapy with paclitaxel (albumin-bound), immunotherapy with nivolumab, targeted therapy with anlotinib and BET inhibitor NHWD-870, but the patient died 7 months after diagnosis. Conclusions: Thyroid NC is a rare and distinct pathological subset of NUT carcinoma with a higher rate of NSD3-NUTM1 fusion. In the clinical diagnosis process, we recommended performing NUT IHC for poorly differentiated thyroid tumors. Gene rearrangement detection is also helpful for diagnosis and treatment. At present, surgery and radiation are still first choices for NC, and advances in targeted immunotherapy such as bromodomain and end motif inhibitors (BETi) may bring better treatment options to patients.
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MXene emerges as a premier candidate for electromagnetic shielding owing to its unique properties as a novel two-dimensional material. Its exceptional electrical conductivity, chemical reactivity, surface tunability, and facile processing render it highly suitable for diverse electromagnetic shielding applications. The research status of MXene and MXene-based electromagnetic shielding materials is systematically discussed in this paper. First, the research status of MXene as a single-component electromagnetic shielding material is briefly introduced. Subsequently, the research status of composite structures constructed by MXene with polymers, carbon derivatives, and ferrites is introduced in detail. Furthermore, the research progress of MXene-based ternary and quaternary composite electromagnetic shielding materials is further focused. Finally, the application of MXene-based composite electromagnetic shielding materials is prospected. A deeper understanding of MXene's electromagnetic shielding properties is facilitated by this paper, providing the direction for the future development of two-dimensional materials in the design and processing of electromagnetic shielding materials.
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Microalgae-based biotechnology holds significant potential for addressing dual challenges of phosphorus removal and recovery from wastewater; however, the removal mechanism and metabolic adaptation of microalgae to dissolved organic phosphorus (DOP) are still unclear. This study investigated the removal mechanisms and metabolomic responses of the Chlorella pyrenoidosa to different DOP forms, including adenosine triphosphate (ATP), glucose-6-phosphate (G-6-P), and ß-glycerophosphate (ß-GP). The results showed C. pyrenoidosa could efficiently take up above 96% DOP through direct transport and post-hydrolysis pathways. The uptake of inorganic phosphorus (IP) followed pseudo first order kinetic model, while DOP followed pseudo second order kinetic model. Metabolite profiling revealed substantial alterations in central carbon metabolism depending on the DOP source. G-6-P upregulated glycolytic and TCA cycle intermediates, reflecting enhanced carbohydrates, amino acids and nucleotides biosynthesis. In contrast, ATP down-regulated carbohydrate and purine metabolism, inhibiting sustainable growth of microalgae. This study offers theoretical support for phosphorus-containing wastewater treatment using microalgae.
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Trifosfato de Adenosina , Chlorella , Fósforo , Chlorella/metabolismo , Fósforo/metabolismo , Trifosfato de Adenosina/metabolismo , Microalgas/metabolismo , Cinética , Glucose-6-Fosfato/metabolismoRESUMO
INTRODUCTION: T cells play a critical role in inflammatory diseases. The aim of the present study was to investigate the effects of Majie cataplasm (MJC) on asthma and to propose a possible mechanism involved in this process. METHODS: Airway inflammation, infiltration of inflammatory cells, levels of interleukin (IL)-4, IL-10, IL-17, and interferon (IFN)-γ, levels of Th2, Treg, Th17, and Th1 cells, and the expressions of IL-4, IL-10, IL-17, IFN-γ, GATA binding protein 3 (GATA-3), Foxp3, RAR-related orphan receptor gamma (RORγt), and T-bet were detected. RESULT: MJC treatment reduced lung airway resistance and inflammatory infiltration in lung tissues. MJC treatment also reduced the numbers of eosinophils and neutrophils in the blood and bronchoalveolar lavage fluid (BALF). The levels of IL-4 and IL-17 in the blood, BALF, and lungs were suppressed by MJC, and IFN-γ and IL-10 were increased. Furthermore, MJC suppressed the percentage of Th2 and Th17 and increased the percentage of Th1 and Treg in spleen cells. In addition, MJC can inhibit asthma by increasing expressions of IFN-γ, IL-10, T-bet, and Foxp3, as well as decreasing expressions of IL-4, IL-17, GATA-3, and RORγt. CONCLUSION: MJC may improve airway hyperresponsiveness and inflammation by regulating Th1/Th2/Treg/Th17 balance in ovalbumin-induced rats. And MJC may be a new source of anti-asthma drugs.
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BACKGROUND: Carcinosarcoma of the gallbladder is a rare malignant tumor with a very poor prognosis. To date, only approximately 100 patients have been reported in the English literature. The prognosis of this tumor type is poor, the preoperative diagnosis is difficult, and there is a possibility of a misdiagnosis. We present an unsuccessful case of carcinosarcoma of the gallbladder with a preoperative misdiagnosis and rapid early postoperative recurrence. Therefore, we have a deeper understanding of the poor prognosis of gallbladder carcinosarcoma (GBC) patients. CASE SUMMARY: The patient is a 65-year-old male. He was admitted to the hospital because of right upper abdomen distending pain and discomfort for half a month. Abdominal magnetic resonance imaging revealed a polycystic mass in the right lobe of the liver and the fossa of the gallbladder. After admission, the patient was diagnosed with a liver abscess, which was treated by abscess puncture drainage. Obviously, this treatment was unsuccessful. Hepatectomy and cholecystectomy were performed one month after the puncture. Postoperative pathologic examination revealed carcinosarcoma of the gallbladder, and the resected specimen contained two tumor components. One month after surgery, the patient's tumor recurred in situ and started to compress the duodenum, resulting in duodenal obstruction and bleeding. The treatment was not effective. The patient died of gastrointestinal hemorrhage and hypovolemic shock. CONCLUSION: Carcinosarcoma of the gallbladder is a rare malignant tumor that is easily misdiagnosed preoperatively and has a poor prognosis.
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BACKGROUND: The association between obesity and depression may partly depend on the contextual metabolic health. The effect of change in metabolic health status over time on subsequent depression risk remains unclear. We aimed to assess the prospective association between metabolic health and its change over time and the risk of depression across body mass index (BMI) categories. METHODS: Based on a nationally representative cohort, we included participants enrolled at the wave 2 (2004-2005) of the English Longitudinal Study of Ageing and with follow-up for depression at wave 8 (2016-2017). Participants were cross-classified by BMI categories and metabolic health (defined by the absence of hypertension, diabetes, and hypercholesterolemia) at baseline or its change over time (during waves 3-6). Logistic regression model was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the risk of depression at follow-up stratified by BMI category and metabolic health status with adjustment for potential confounders. RESULTS: The risk of depression was increased for participants with metabolically healthy obesity compared with healthy nonobese participants, and the risk was highest for those with metabolically unhealthy obesity (OR 1.62, 95% CI 1.18-2.20). Particularly hypertension and diabetes contribute most to the increased risk. The majority of metabolically healthy participants converted to unhealthy metabolic phenotype (50.1% of those with obesity over 8 years), which was associated with an increased risk of depression. Participants who maintained metabolically healthy obesity were still at higher risk (1.99, 1.33-2.72), with the highest risk observed for those with stable unhealthy metabolic phenotypes. CONCLUSIONS: Obesity remains a risk factor for depression, independent of whether other metabolic risk factors are present or whether participants convert to unhealthy metabolic phenotypes over time. Long-term maintenance of metabolic health and healthy body weight may be beneficial for the population mental well-being.
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Diabetes Mellitus , Hipertensão , Obesidade Metabolicamente Benigna , Humanos , Adiposidade , Obesidade Metabolicamente Benigna/epidemiologia , Obesidade Metabolicamente Benigna/complicações , Estudos Longitudinais , Depressão/epidemiologia , Obesidade/epidemiologia , Fatores de Risco , Hipertensão/epidemiologia , Hipertensão/complicações , Fenótipo , Índice de Massa CorporalRESUMO
OBJECTIVE: Aim to establish a multimodal model for predicting severe acute pancreatitis (SAP) using machine learning (ML) and deep learning (DL). METHODS: In this multicentre retrospective study, patients diagnosed with acute pancreatitis at admission were enrolled from January 2017 to December 2021. Clinical information within 24 h and CT scans within 72 h of admission were collected. First, we trained Model α based on clinical features selected by least absolute shrinkage and selection operator analysis. Second, radiomics features were extracted from 3D-CT scans and Model ß was developed on the features after dimensionality reduction using principal component analysis. Third, Model γ was trained on 2D-CT images. Lastly, a multimodal model, namely PrismSAP, was constructed based on aforementioned features in the training set. The predictive accuracy of PrismSAP was verified in the validation and internal test sets and further validated in the external test set. Model performance was evaluated using area under the curve (AUC), accuracy, sensitivity, specificity, recall, precision and F1-score. RESULTS: A total of 1,221 eligible patients were randomly split into a training set (n = 864), a validation set (n = 209) and an internal test set (n = 148). Data of 266 patients were for external testing. In the external test set, PrismSAP performed best with the highest AUC of 0.916 (0.873-0.960) among all models [Model α: 0.709 (0.618-0.800); Model ß: 0.749 (0.675-0.824); Model γ: 0.687 (0.592-0.782); MCTSI: 0.778 (0.698-0.857); RANSON: 0.642 (0.559-0.725); BISAP: 0.751 (0.668-0.833); SABP: 0.710 (0.621-0.798)]. CONCLUSION: The proposed multimodal model outperformed any single-modality models and traditional scoring systems.
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Aprendizado Profundo , Pancreatite , Humanos , Doença Aguda , Pancreatite/diagnóstico por imagem , Radiômica , Estudos RetrospectivosRESUMO
The hydrogen oxidation reaction is an important process in anion exchange membrane fuel cells with alkaline solutions. The pursuit of efficient catalysts for alkaline hydrogen oxidation has attracted considerable attention. In this study, we present a precursor route for the synthesis of a new Ir-based catalyst (Ir-Ni/NiO/C), in which Ir nanoclusters were immobilized on the generated Ni/NiO/C support derived from a metal-organic framework. The small size of Ir clusters facilitates the exposure of catalytically active sites. The electronic interplay between the Ir nanoclusters and the Ni/NiO/C support optimized the hydrogen binding energy (HBE) and hydroxide binding energy (OHBE) on the surface, which is unattainable on the contrasting Ir-C, Ir-Ni/C, and Ir-NiO/C products. The optimized catalyst shows excellent mass activity for alkaline hydrogen oxidation, which is 3.1 times that of the Pt/C catalyst. This study presents a promising pathway for the development of advanced HOR catalysts.
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A novel fluorescent probe N'-(2-hydroxybenzylidene)-indole-3-formylhydrazine (JHK) was designed and synthesized based on the condensation reaction of indole-3-formylhydrazine and salicylaldehyde. The probe JHK solution could highly selectively recognize Al3+ by the obvious fluorescence enhancement (288-fold) after adding Al3+. And the probe solution with Al3+ had a very high fluorescence quantum yield (89.29 %). The detection limit was calculated to be 1.135 nM, which was significantly lower than many reported detection limits, indicating that the probe JHK had pretty good sensitivity. The ratio of JHK to Al3+ (1:1) and the sensing mechanism were determined by Job's plot, 1H NMR spectra, FTIR spectra, ESI-MS and Gaussian calculation. The probe solution and medium-speed filter paper were successfully used to make test papers for more convenient detection of Al3+. Furthermore, the probe JHK had been successfully applied to the detection of Al3+ in real water, zebrafish and living cells.
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Corantes Fluorescentes , Hidrazinas , Peixe-Zebra , Animais , Corantes Fluorescentes/química , Limite de Detecção , Imagem Óptica , Indóis , Espectrometria de Fluorescência/métodosRESUMO
Constructing atom-clusters (ACs) with in situ modulation of coordination environment and simultaneously hollowing carbon support are critical yet challenging for improving electrocatalytic efficiency of atomically dispersed catalysts (ADCs). Herein, a general diffusion-controlled strategy based on spatial confining and Kirkendall effect is proposed to construct metallic ACs in N,P,S triply-doped hollow carbon matrix (MACs /NPS-HC, M=Mn, Fe, Co, Ni, Cu). Thereinto, FeACs /NPS-HC with the best catalytic activity for oxygen reduction reaction (ORR) is thoroughly investigated. Unlike the benchmark sample of symmetrical N-surrounded iron single-atoms in N-doped carbon (FeSAs /N-C), FeACs /NPS-HC comprises bi-/tri-atomic Fe centers with engineered S/N coordination. Theoretical calculation reveals that proper Fe gathering and coordination modulation could mildly delocalize the electron distribution and optimize the free energy pathways of ORR. In addition, the triple doping and hollow structure of carbon matrix could further regulate the local environment and allow sufficient exposure of active sites, resulting in more enhanced ORR kinetics on FeACs /NPS-HC. The zinc-air battery assembled with FeACs /NPS-HC as cathodic catalyst exhibits all-round superiority to Pt/C and most Fe-based ADCs. This work provides an exemplary method for establishing atomic-cluster catalysts with engineered S-dominated coordination and hollowed carbon matrix, which paves a new avenue for the fabrication and optimization of advanced ADCs.
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Abstract Objectives: To screen the COL1A1 and COL1A2 gene mutation sites in a family with type I osteogenesis imperfecta (OI)/hearing loss and analyze the characteristics and recovery of hearing loss in patients with osteogenesis imperfecta. Methods: The basic clinical data of Ol proband and her parents were collected, and the COL1A1 and COL1A2 genes were detected in peripheral blood by PCR amplification and generation Sanger sequencing. Literature of stapedial surgery in patients with osteogenesis imperfecta was collected. Results: The heterozygous mutation of the 26 exon c.1922_1923 ins C in the Ol progenitor COL1A1 gene led to the amino acid frameshift mutation of p.Pro 601FS, which was not detected in the phenotypic parents. The homozygous of exon 28 c.1782>G in COL1A2 was detected in the proband and her parents, resulting in changes in the protein p.Pro 549Ala. Conclusion: The clinical symptoms of the Ol proband is caused by heterozygous mutation of the 26 exon c.1922_1923 ins C in COL1A1 gene. Stapedial surgery can provide short-term and long-term hearing benefits for Ol patients with hearing loss. Level of evidence: Level 4.
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RNA-guided protease activity was recently discovered in the type III-E CRISPR-Cas systems (Craspase), providing a novel platform for engineering a protein probe instead of the commonly used nucleic acid probe in nucleic acid detection assays. Here, by adapting a fluorescence readout technique using the affinity- and fluorescent protein dual-tagged Csx30 protein substrate, we have established an assay monitoring Csx30 cleavage by target ssRNA-activated Craspase. Four Craspase-based nucleic acid detection systems for genes from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), norovirus, and the influenza virus (IFV) were reconstituted with demonstrated specificity. The assay could reliably detect target ssRNAs at concentrations down to 25â pM, which could be further improved approximately 15 000-fold (ca. 2â fM) by incorporating a recombinase polymerase isothermal preamplification step. Importantly, the species-specific substrate cleavage specificity of Craspase enabled multiplexed diagnosis, as demonstrated by the reconstituted composite systems for simultaneous detection of two genes from the same virus (SARS-CoV-2, spike and nsp12) or two types of viruses (SARS-CoV-2 and IFV). The assay could be further expanded by diversifying the fluorescent tags in the substrate and including Craspase systems from various species, thus potentially providing an easily adaptable platform for clinical diagnosis.
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Bioensaio , Sistemas CRISPR-Cas , Sistemas CRISPR-Cas/genética , Corantes , RNA , SARS-CoV-2/genética , Peptídeo Hidrolases , Técnicas de Amplificação de Ácido NucleicoRESUMO
OBJECTIVES: To screen the COL1A1 and COL1A2 gene mutation sites in a family with type I osteogenesis imperfecta (OI)/hearing loss and analyze the characteristics and recovery of hearing loss in patients with osteogenesis imperfecta. METHODS: The basic clinical data of OI proband and her parents were collected, and the COL1A1 and COL1A2 genes were detected in peripheral blood by PCR amplification and generation Sanger sequencing. Literature of stapedial surgery in patients with osteogenesis imperfecta was collected. RESULTS: The heterozygous mutation of the 26 exon c.1922_1923 ins C in the OI progenitor COL1A1 gene led to the amino acid frameshift mutation of p.Pro 601FS, which was not detected in the phenotypic parents. The homozygous of exon 28 c.1782>G in COL1A2 was detected in the proband and her parents, resulting in changes in the protein p.Pro 549Ala. CONCLUSION: The clinical symptoms of the OI proband is caused by heterozygous mutation of the 26 exon c.1922_1923 ins C in COL1A1 gene. Stapedial surgery can provide short-term and long-term hearing benefits for OI patients with hearing loss. LEVEL OF EVIDENCE: Level 4.
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Surdez , Perda Auditiva , Osteogênese Imperfeita , Feminino , Humanos , Cadeia alfa 1 do Colágeno Tipo I , Perda Auditiva/genética , Mutação , Osteogênese Imperfeita/complicações , Osteogênese Imperfeita/genéticaRESUMO
The crucial role of plasmid-encoded protein Pgp3 in Chlamydia pathogenesis has been demonstrated in various animal models. Previous studies have revealed that the Pgp3-deficient C. muridarum mutant fails to induce hydrosalpinx after vaginal inoculation in mice. Structural analysis of C. trachomatis Pgp3 trimer has indicated that Trp234 may play a critical role in trimeric crystal packing interactions and that Tyr197 is involved at predominant cation-binding sites. In this study, we constructed C. muridarum transformants harboring Pgp3, Trp234, or Tyr197 point mutations (Pgp3W234A and Pgp3Y197A). C3H/HeJ mice infected with Pgp3W234A mutant failed to induce severe hydrosalpinx in the oviduct tissue, which largely phenocopied the full-length Pgp3-deficient C. muridarum. The Pgp3Y197A variant induced an intermediate severity of pathology. The attenuated pathogenicity caused by the Pgp3W234A mutant may be due to its decreased survival in the lower genital tracts of mice, reduced ascension to the oviduct, and milder induction of inflammatory cell infiltration in the oviduct tissue. Thus, our results point to an important amino acid residue involved in Pgp3 virulence, providing a potential therapeutic target for chlamydial infection.
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BACKGROUND: Invasive fungal otitis media is clinically rare. The clinical features are often atypical in the early stages of the disease, and delayed treatment results in poor outcomes. METHODS: In this study, we report 2 patients with invasive fungal otitis media with diabetes. The early diagnosis was confirmed by comprehensive methods such as laboratory tests and imaging examinations, and the condition was significantly improved by antifungal drugs and surgical treatment. RESULTS: By reviewing the literature, we found that invasive fungal infections confined to the middle ear and mastoid were rarely reported, and the diagnosis and treatment were still controversial. CONCLUSION: In this article, we summarized and evaluated the different diagnoses and treatment methods so as to better diagnose and improve the cure rate in the early stage of invasive fungal infection of the middle ear.
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Diabetes Mellitus , Otite Média , Humanos , Antifúngicos/uso terapêutico , Diabetes Mellitus/tratamento farmacológico , Orelha Média , Processo Mastoide/cirurgia , Otite Média/cirurgiaRESUMO
The development of hydrogen-oxygen fuel cells with an alkaline electrolyte was highly limited by the sluggish kinetics of the hydrogen oxidation reaction (HOR). Here, with a pyrolysis-reduction route, a new RuNi-based electrocatalyst was prepared, which presents an ultrathin nanowire-like structure. In alkaline media, this catalyst shows an excellent catalytic performance with an exchange current density of 1.10 mA cm-2disk for hydrogen oxidation. The exchange current density and mass activity of this catalyst are much higher than those of its single-metal counterparts and even the commercial Pt/C catalyst containing 20% Pt. Such a remarkable catalytic activity can be explained by the interaction between Ru and Ni; the incorporation of Ni may induce an electronic effect on the optimization of the Ru-Had strength and provide a functional surface that can absorb OH species, thus boosting the catalytic activity. These findings may cast a new light on the exploration of low-cost but high-efficiency catalysts for fuel cells.
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WHAT IS KNOWN AND OBJECTIVE: Pain is the main symptom of herpes zoster (HZ), whilst postherpetic neuralgia (PHN) is a long-term unbearable pain, which seriously affects the quality of life of patients and is also the most intractable problem for clinicians. Early antiviral treatment is considered as a key measure to reduce acute pain and PHN. Nevertheless, most patients still have long-term pain after 7 days of antiviral treatment, and some patients will develop PHN. This study aimed to investigate whether prolonged duration of antiviral therapy could reduce HZ acute pain and the occurrence of PHN. METHODS: The outpatient data of HZ patients over 50 years old who visited the Dermatology Department from January 2016 to May 2018 were retrospectively analysed. According to the different courses of treatment of famciclovir (FCV), the patients were divided into 7-day FCV group and 14-day FCV group. The numerical rating scale (NRS) score at the first visit and on the 7th, 14th and 21st days after the start of treatment, the adverse drug reactions and the incidence of PHN were compared between the two groups. RESULTS: A total of 219 patients were involved in the analysis. For acute pain control, the 14-day FCV group was better than the 7-day FCV group. For patients with mild initial pain, there was no significant difference in NRS between the two treatments. For patients with moderate-to-severe initial pain, the NRS in the 14-day FCV group was significantly lower than that of the 7-day FCV group on the 14th and 21st days after starting treatment. PHN occurred in patients with moderate-to-severe initial pain, and the incidence was significantly lower in the 14-day FCV group than in the 7-day FCV group. There was no significant difference in the number of adverse reactions between the two groups. WHAT IS NEW AND CONCLUSION: Compared with the traditional 7-day antiviral therapy, the 14-day course of FCV can reduce the acute pain and the incidence of PHN in elderly patients with HZ, especially in patients with moderate to severe initial pain. Prolonging the course of medication did not increase the side effects.
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Dor Aguda , Herpes Zoster , Neuralgia Pós-Herpética , Humanos , Idoso , Pessoa de Meia-Idade , Neuralgia Pós-Herpética/tratamento farmacológico , Famciclovir/uso terapêutico , Incidência , Qualidade de Vida , Dor Aguda/tratamento farmacológico , Estudos Retrospectivos , Herpes Zoster/tratamento farmacológico , Antivirais/efeitos adversosRESUMO
RATIONALE: Although coronavirus disease 2019 (COVID-19) remains a global threat, administering effective and safe vaccines is currently the most promising strategy to curb the ongoing pandemic and decrease the number of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. However, there remains some uncertainty regarding the safety of vaccines for patients with kidney disease. PATIENT CONCERNS: A 58-year-old man presented at our institution with gross hematuria 48 hours after receiving his first dose of the CoronaVac (Sinovac) vaccine. DIAGNOSES: Analysis of a renal biopsy sample led to the diagnosis of crescentic immunoglobulin A nephropathy (IgAN), which we considered an adverse event of receiving the CoronaVac vaccine in China. INTERVENTIONS: The patient's serum creatinine and albumin levels were 1.20 mg/dL and 31.3 g/L, respectively; as such, he was administered a diuretic. His serum creatinine level had risen to 7.45 mg/dL 1 month later, and he developed high blood pressure. The patient then received conventional doses of hormone therapy but developed recurrent fever, which led to the suspicion of active tuberculosis (which he had a history of) and suspension of the hormone therapy. OUTCOMES: The patient's renal function deteriorated further, and he ultimately underwent dialysis. LESSONS: The patient's course of events of apparent IgAN exacerbation should prompt nephrologists to closely follow patients with glomerular disease after they receive a COVID-19 vaccine, especially if persistent gross hematuria occurs.