Effects of vaccination status on the disease severity of patients with coronavirus disease 2019 / 中华危重病急救医学

Objective:To evaluate the effect of 2019 novel coronavirus inactivated vaccine on the disease severity of patients with Delta variant of coronavirus disease 2019.Methods:A retrospective analysis was performed on 704 patients with coronavirus disease 2019 infected with Delta variant who were older than 18 years old and admitted in the coronavirus disease 2019 designated hospital of Yangzhou (Subei Hospital New Area Branch) from July 2021 to September 2021. They were divided into severe (severe, critical) group and non-severe (light, ordinary) group according to the clinical characteristics of patients. According to the vaccination status, they were divided into 0-dose group, 1-dose group and 2-dose group. We evaluated the effects of vaccination on the severity of the disease and the production of antibodies, and analyzed the influencing factors leading to the severe group of coronavirus disease 2019.Results:The proportion of severe group in the 2-dose vaccinated group was significantly lower than that in the 1-dose vaccinated group and 0-dose vaccinated group [3.02% (7/232) vs. 9.48% (22/232), 15.83% (38/240), P < 0.05]. The time from onset to admission (day: 1.97±1.66 vs. 2.66±2.70), age (years: 45.3±12.2 vs. 63.6±17.0), direct bilirubin [DBil (μmol/L): 3.70±1.83 vs. 5.30±5.13], lactate dehydrogenase [LDH (U/L): 240.69±74.29 vs. 256.30±85.18], creatinine [SCr (μmol/L): 63.38±19.86 vs. 70.23±25.43], interleukin-6 [IL-6 (ng/L): 7.32 (1.54, 17.40) vs. 18.38 (8.83, 33.43)], creatine kinase [CK (U/L): 66.00 (43.00, 99.75) vs. 78.00 (54.50, 144.00)] and D-dimer [mg/L: 0.30 (0.08, 0.49) vs. 0.41 (0.23, 0.69)] of patients in the 2-dose group were significantly lower than those in the 0-dose group (all P < 0.05), while platelet [PLT (×10 9/L): 176.69±60.25 vs. 149.25±59.07], white blood cell count [WBC (×10 9/L): 5.43±1.77 vs. 5.03±1.88] and lymphocyte [LYM (×10 9/L): 1.34±0.88 vs. 1.17±0.50] were significantly higher than those in the 0-dose group (all P < 0.05). The titer of immunoglobulin G (IgG) in the 2-dose group was significantly higher than those in the 1-dose group and 0-dose group on the 10th day after admission [U/L: 130.94 (92.23, 326.31), 113.18 (17.62, 136.20), 117.85 (33.52, 156.73), both P < 0.05], and higher than 0-dose group on the 16th day [U/L: 156.12 (120.32, 167.76) vs. 126.52 (61.34, 149.57), P < 0.05]. The proportion of complete 2-dose vaccination [10.45% (7/67) vs. 35.32% (225/637)], LYM (×10 9/L: 1.09±0.32 vs. 1.25±0.56) and PLT (×10 9/L: 138.55±68.03 vs. 166.93±59.70) in the severe group were significantly lower than those in the non-severe group ( P < 0.05), while the time from onset to admission (day: 3.01±2.99 vs. 2.25±2.09), the length of hospital stay (day: 28±18 vs. 16±6), male proportion [77.61% (52/67) vs. 34.54% (220/637)], age (years: 69.13±12.63 vs. 52.28±16.53), DBil [μmol/L: 4.20 (3.18, 6.65) vs. 3.60 (2.80, 4.90], LDH (U/L: 310.61±98.33 vs. 238.19±72.14), SCr (μmol/L: 85.67±38.25 vs. 65.98±18.57), C-reactive protein [CRP (μmol/L): 28.12 (11.32, 42.23) vs. 8.49 (2.61, 17.58)], IL-6 [ng/L: 38.38 (24.67, 81.50) vs. 11.40 (4.60, 22.07)], CK [U/L: 140.00 (66.00, 274.00) vs. 72.80 (53.00, 11.00)] and the D-dimer [mg/L: 0.46 (0.29, 0.67) vs. 0.35 (0.19, 0.57)] in the severe group were significantly higher than those in the non-severe group (all P < 0.05). Multivariate regression analysis showed that the odds ratio ( OR) of severe group was 0.430 ( P = 0.010) in the 1-dose group and the 2-dose group compared with the 0-dose group. However, the risk of severe group was 0.381-fold in the 2-dose group compared with the 0-dose group [ OR = 0.381, 95% confidence interval (95% CI) was 0.121-1.199] which was not statistically significant, when the age was included in the regression analysis ( P > 0.05). PLT ( OR = 0.992, 95% CI was 0.986-0.998) were protective factors, but older than 60 years old ( OR = 3.681, 95% CI was 1.637-8.278), CK ( OR = 1.001, 95% CI was 1.000-1.001), IL-6 ( OR = 1.006, 95% CI was 1.002-1.010), SCr ( OR = 1.020, 95% CI was 1.007-1.033) were risk factors for severe group (all P < 0.05). Conclusions:Compared with the 0-dose vaccinated patients, the coronavirus disease 2019 patients infected with delta variant and fully vaccinated with 2-dose 2019 novel coronavirus inactivated vaccine had lower level of IL-6, SCr, CK and D-dimer, and higher PLT, LYM and IgG titer, who were not easy to develop into the severe condition.

Ambulatory blood pressure monitoring in children suffering from orthostatic hypertension.

BACKGROUND: It is particularly important to utilize appropriate blood pressure measurement methods to evaluate the changes of orthostatic hypertension (OHT) for children, and this study was designed to analyze the blood pressure type in OHT children with 24 h semiautomatic ambulatory blood pressure monitoring. METHODS: Children who were diagnosed by head-up tilt table test as OHT patients (OHT group) and treated or hospitalized in the syncope specialist outpatient unit of the Second Xiangya Hospital of Central South University mainly for syncope or pre-syncope with unknown causes during the October, 2009 to September, 2013 were recruited in the study. Healthy children that came to the hospital for physical examination at the same time period according to age and sex were matched as control group. Semiautomatic ambulatory blood pressure monitoring of every child was recorded. The differences of daytime systolic (diastolic) pressure and night systolic (diastolic) pressure were calculated, and the average systolic pressure and diastolic pressure of the entire day, daytime and night were also calculated, respectively. RESULTS: There were 23 boys and 17 girls in OHT group, aging (11.5 ± 1.9) years. There were 22 boys and 18 girls in the control group, aged (10.6 ± 2.4) years. The difference of daytime systolic pressure and night systolic pressure of the control group was higher than that of OHT group, while the average systolic pressure of the whole day, the average diastolic pressure of the whole day, the daytime average systolic pressure, the daytime average diastolic pressure, the night average systolic pressure and the night average diastolic pressure were higher than that of the control group (P > 0.05). The difference of daytime diastolic pressure and night diastolic pressure of the control group was higher than that of OHT group (P > 0.05). Most children of the OTH group had non-dipper blood pressure type (72.5%), while most children of the control group had a dipper blood pressure type (55.0%). In addition, the time domain SDNN and SDANN in the OHT group were higher than those in the control group (P < 0.01). And, the indicators including TP, ULF, VLF, and LF/HF were higher in the OHT group, when compared with control group (P < 0.01). Besides, in terms of subgroup analysis within the OHT group, the age difference between boys and girls was not statistically significant (P > 0.05). When compared with grils, the time domain SDNN increased (P = 0.003), and the frequency index TP, ULF, and VLF increased in boy group (P < 0.05). CONCLUSION: OHT Children's autonomic nervous system showed dysfunction, and differences of systolic blood pressure between day and night were much lower than those of healthy children, and the main blood type was non-dipper blood pressure with circadian rhythm disappearing.

Study on the role of GPR30 in the proliferation of Non-small cell lung cancer / 重庆医学

Objective To evaluate the expression of GPR30 and Ki-67 in Non-small cell lung cancer(NSCLC) and the relationship between them.The clinicopathological features of GPR30 in NSCLC were also analyzed.The molecular mechanism that estrogen mediated the proliferation of H1299 by activating GPR30 was further studied.Methods The expression of GPR30 and Ki-67 in 80 cases of specimens of NSCLC after surgery was examined using immunohistochemistry method.After 17-β-estradiol(E2) or G-1 added,H1299 cells were counted and the cell cycle distribution was analyzed by flow cytometry.Finally,the activated ERK1/2 and the expression of cyclin D1 and p16 after G-1 treatment in H1299 cells were examined through western blotting.Results Expressions of GPR30 was more in stage Ⅲ or low differentiation tissues or adenocarcinoma (P＜0.05).A positive correlation between GPR30 and Ki-67 was further disclosed (r=0.502,P=0.000).The proliferation of H1299 cells was promoted and more cells entered S-p hase after E2 or G-1 treatment for 3 days,which could be inhibited after G-15 or U0126 pre-treatment for 2 hours.We further discovered that the activated ERK1/2 and cyclin D1 expression increased after G-1 treatment,which was blocked after G-15 or U0126 pre-treatment for 2 hours.The change of p16 was on the opposite.Conclusion A positive correlation existed between GPR30 and Ki-67.GPR30-EGFR-MAPKs signaling transduction pathway was involved in the estrogen-induced proliferation of NSCLC cells.Blocking GPR30 signaling pathway may be a promising new strategy for NSCLC treatments.

Analysis of 56 cases of ADR Induced by Irinotecan in Advanced Malignant Cancer Patients of Our Hospital / 中国药房

OBJECTIVE:To explore the characteristics and regularities of the adverse drug reactions(ADRs)induced by irino-tecan,in order to provide reference for clinical application. METHODS:In retrospective study,56 cases of irinotecan-induced ADR collected from our hospital during Jun. 2011-Jan.2015 were analyzed statistically in respects of gender,age,disease types, ECOG score,medication,organs/systems involved in ADR,clinical manifestations,outcome,etc. RESULTS:All 56 patients suf-fered from ADR,among which the percentage of hematopoietic system accounted for the highest(100%),and followed by diges-tive system;the grade Ⅰ-Ⅱ ADRs accounted for 87.20%,the grade Ⅲ-Ⅳ ADRs accounted for 12.80%. 64.50% of ADRs oc-curred within 1 week. In respect of conversion,85.71%(48/56)of the patients recovered with supportive care and continued che-motherapy,the remaining 8 cases had to reduce the dose of chemotherapy and then recovered. CONCLUSIONS:With regular dose,irinotecan is well tolerated. Since ADRs induced by irinotecan are slight,all the ADRs are well managed. It is important to enhance follow-up observations of patients to prevent some serious ADRs.

Expression of GPR30,HRG1 and HER2 in breast cancer and their relationship with lymphatic metastasis / 重庆医学

Objective To explore the expression of GPR30,HRG1 and HER2 including the activation status of HER2 (phosphorylated HER2)in invasive ductal breast cancers and their relationship with lymphatic metastasis.Methods The expres-sion of GPR30,HRG1,HER2 and pHER2 in 72 cases of specimens of invasive ductal breast cancers were examined by immunohis-tochemistry method.Results A moderate correlation between GPR30 and HRG1 was disclosed (r=0.597,P =0.000).There was strong correlation between pHER2 and GPR30 or HRG1(r=0.742,P =0.000;r=0.615,P =0.000).The expression of GPR30 and pHER2 in the lymphatic metastasis group was remarkably higher than in the group without lymphatic metastasis(P <0.05). Conclusion The interaction between GPR30 and HRG1 HER2 signal transduction pathways might be involved in the lymphatic metastasis in breast cancer.Blocking both of GPR30 and HRG1 signaling pathway could be a promising new strategy for breast cancer treatments.

The clinical application of intramyocardium electrocardiography after heart transplantation( Report of 5 cases) / 中国医师杂志

Objective To evaluate intra-myocardial electrocardiography(IMEG) for rejection monitoring in transplanted heart.Methods The electrode was anchored in the transplanted right ventricular wall during operation in all patients,and the electrode was connected to the permanent pacemaker to monitor the change of QRS wave in IMEG after the operation.Results The average of R wave amplitude was not decreased after operation in 4 patients who were alive with good quality of life.1 patient died of acute renal failure 8 days after operation.Conclusion IMEG can be used for long time monitoring the rejection after non invasive heart transplantation and reduce the need of endomyocardial biopsy(EMB).

Clinical significance of multiple tumor marker protein chip in monitoring the recurrence,progression and metastasis of lung cancer / 中国肺癌杂志

<p><b>BACKGROUND</b>According to the report of the 11th World Conference on Lung Cancer, lung cancer is the leading cause of cancer related death. So there is important clinical significance to monitor the patients with lung cancer through different ways. The aim of this study is to investigate the clinical significance of multiple tumor marker protein chip in monitoring the recurrence, progression and metastasis of lung cancer.</p><p><b>METHODS</b>Forty-four patients were selected, who were detected at least 4 times with tumor mar-ker protein chip. Based on efficacy and status, patients were classified as six grades. Correlation of expression level of each tumor marker with grade of efficacy and status was analyzed. And the discriminant functions for recurrence, progression and metastasis of lung cancer were established.</p><p><b>RESULTS</b>Grade of efficacy and status was closely related to CA199, CEA, CA242, AFP and CA125 in adenocarcinoma (AC), to CA125 in squamous cell carcinoma (SqCa), and to CA199 and CA125 in small cell lung cancer (SCLC). Based on the discriminant functions, accuracy rate of efficacy and status judgement was 89.4%, 80.4%, 78.3% and 66.7% for female AC, male AC, SqCa and SCLC respectively.</p><p><b>CONCLUSIONS</b>There is important clinical significance of multiple tumor marker protein chip in monitoring the recurrence, progression and metastasis of lung cancer (especially adenocarcinoma).</p>

The role of P53, Bax, Bcl-2 expression and cell apoptosis in the formation and development of acute radiation-induced skin ulcers / 军事医学科学院院刊

Objective:To study the expression of P53, Bax, Bcl-2 proteins and the role of cell apoptosis in the formation and development of acute radiation-induced skin ulcers.Methods:A rat model which was locally irradiated with 60 Co γ-rays was used, and the pathological changes were observed for 40 days. Immunohistochemistry and TUNEL assay were performed which enabled the detection of P53, Bax, Bcl-2 and cell apoptosis during the formation and development of radiation skin ulcers.Results: Skin ulcers were found on day 14 after irradiation, and enlarged and deepened gradually during the observation period. P53 was over expressed during days 11 to 40 after irradiation and was localized in vascular endotheliocytes and smooth muscle cells. Bax was moderately positive during days 14 to 21 and weakly positive during days 28 to 35, and was localized in vascular endotheliocytes, some fibroblasts and proliferating keratinocytes. Bcl-2 was weakly positive during days 1 to 11 after irradiation, and was located in keratinocytes, hair follicular cells and some vascular endotheliocytes. Bcl-2 was negative during days 11 to 40.The rate of cell apoptosis, especially of vascular endotheliocytes,wash igher than that in the early process of normal wound healing. Conclusions:After irradiation,the increased expression of the apoptosis-inducing protein P53, Bax and the decreased expression of the apoptosis-inhibiting protein Bcl-2 might be associated with the high rate of apoptotic events, and play important roles in the formation and development of radiation skin ulcers.

Intracoronary Doppler Flow Reserve Versus Dipyridamole Emission Computed Tomographic 201T1 or 99mTc-Sestamibi Myocardial Imaging / 复旦学报（医学版）

PurposeTo compare measures of coronary flow reserve by an intracoronary Doppler guide wire with results of dipyridamole emission computed tomographic 201T1/ 99m Tc-sestamibi myocardial imaging(SPECT).MethodsThe coronary blood flow velocity were measured by Cardiometrics Flomap Ⅱ and 0. 014 or 0. 018 inches Doppler flowire in 27 patients (55 arteries) with coronary angiography. 8 patients (19 arteries )without underlying diseases of coronary microvascular lesions were studied as the normal control. The proximal and distal average peak velocity (APV), diastolic/systolic velocity ratio (DSVR), CFR and proximal/distal velocity ratio (P/DVR) were measured. The results were compared with that of SPECT before angiography. ResultsAccording to the CFR measured by Doppler fiowire, the arteries were divided into two groups:Group A, consisted of 33 arteries with CFR > 2.0. Group B consistedof 22 arteries with CFR≤2.0. CFR of group A was significantly higher than that of group B (P< 10 - 7). Among 22 arteries with abnormal CFR, SPECT could detect 16. Among 33 arteries with normal CFR, all arteries except 2 showed normal SPECT. With intracoronary Doppler flowire as reference, the sensitivity and specificity of dipyridamole SPECT were 72.73 % and 93.94 %. With results of dipyridamole SPECT as reference, the sensitivity and specificity of intracoronary Doppler CFR were 88.89% and 83.78%. Their conformability rate was 85.45%.Conclusions In evaluating coronary reserve function, results of dipyridamole SPECT was rather conformable to measures of intracoronary Doppler CFR, but they cannot be replaced each other.

Joint report of the Jilin 192Ir radiation accident : A clinical study on a case of moderate degree bone marrow form of acute radiation sickness with extremely severe local radiation injury

After the medical handling of a patient exposed to extremely uneven total body irradiation from an 192ir source (the activity was 2.765 TBq) on January 5, 1996 in Jilin City in order to afford new experience and information for similar case in the future. The authors emphasize the early amputation as the key to success, the importance of rhG-CSF effect and the significance of rational nutrition for the support of the patient, who had total body irradiation, massive local radiation injury and extensive surgical intervention to sustain. The document describe the accident, early clinical manifestation and posterior clinical manifestations (peripheral blood changes and bone marrow examination), evolution of local radiation injury; the assay of myocardial and musculature enzymes; assay of hemopoietic activity in the patient's sera and the treatment

Role of intracellular calcium in proliferation inhibition of MCF-7 cells induced by HMG-CoA reductase inhibitor / 第三军医大学学报

Objective To study the effects of HMG CoA reductase inhibitor, lovastatin (LOV), on the proliferation of human breast cancer cell MCF 7 and the role of intracellular calcium concentration ([Ca 2+ ]i) in this event. Methods After treated with LOV at the dosages of 4, 8 and 16 ?mol/L for 1-3 d respectively, the proliferation of MCF 7 cells was examined with MTT, and the distributions of cell cycles with FCM assay. Meanwhile, the change of [Ca 2+ ]i of MCF 7 cells was observed with laser scanning confocal microscopy, and the expression of plasma membrane calcium ATPase isoform 1 (PMCA1) mRNA with RT PCR. Results Lovastatin, inhibited the proliferation of MCF 7 cells and arrested MCF 7 cells in the G 0/G 1 phase of cell cycle, in a dose and time dependent manner. However, apoptosis of LOV treated MCF 7 cells was not obvious. Simultaneously, LOV increased [Ca 2+ ]i of MCF 7 cells, but didn't change the expression of PMCA1 mRNA. Conclusion The results suggest that LOV has the capabilities of inhibiting the proliferation of MCF 7 cells and arresting them in G 0/G 1 phase. These effects of LOV maybe correlate with LOV changing the function of PMCA1and increasing [Ca 2+ ]i of MCF 7 cells.

Application of ~(18)F-FDG hybrid PET/CT imaging in clinical staging of non-small cell lung cancer / 解放军医学杂志

Objective To investigate the application of ~(18)F-fluorodeoxyglucose hybrid PET/CT (~(18)F-FDG hPET/CT) imaging in clinical staging of non-small cell lung cancer (NSCLC). Methods Seventy two consecutive patients with NSCLC undergoing ~(18)F-FDG hPET/CT before radiotherapy were analyzed. The results were compared with previous CT scan and conventional clinical staging. The patients were followed-up for at least 6 months. Results Among the 72 patients, the staging grade was changed in 27 patients due to the result of ~(18)F-FDG hPET/CT in whom with 20 patients having their grade raised and 7 lowered. Radical treatment was changed to palliative treatment in view of a raise of staging grade. Because of distant metastasis was detected by ~(18)F-FDG hPET/CT imaging, 14 patients received palliative treatment. Compared with CT, 47 more lymph nodes and 26 distant metastases were found with ~(18)F-FDG hPET/CT imaging, and the patients in question received radiotherapy and palliative treatment accordingly. Conclusion ~(18)F-FDG hPET/CT imaging, by changing the clinical staging in 37.5% (27/72) NSCLC patients, has impact on treatment strategy and treatment planning of radiotherapy in NSCLC patients. Patients were frequently spared unnecessary treatment, and management was more appropriately targeted.

CLINICAL ANALYSIS OF 154 CASES OF RADIATION INJURY OF SKIN / 解放军医学杂志

This paper deals with 154 cases of radiation injury of skin, of which 57 cases were acute and 97 cases chronic. The injury was variously produced by linear accelerator, 60Co, X-ray, and B-ray. The injury doses varied from 10Gy to 40Gy in most cases, and the maximum dose was 180Gy. 41 cases (26.6%) were treated conservatively, and 113 cases (73.4%) with operative intervention. The overall curative rate was 87.7%. The diagnosis, clinical characteristics and treatment of radiation injury of skin were discussed. Surgical excision of injured skin and underlining tissues as much as possible, and repair with grafts of skin and other tissues are emphasized.