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1.
Artigo em Chinês | MEDLINE | ID: mdl-34624954

RESUMO

In order to improve the clinical attention to the poisoning of chlorfenapyr, the diagnosis and treatment strategy of chlorfenapyr poisoning were discussed. This paper collected 4 cases of chlorfenapyr in the emergency department of the Second Hospital of Hebei Medical University and 4 cases of literature review, summarized the clinical characteristics of pesticide poisoning cases containing chlorfenapyr in China, and summarized and analyzed the clinical data of the cases. Seven of the 8 patients died from poisoning by chlorfenapyr. Exposure to chlorfenapyr through respiratory tract and digestive tract showed high mortality. Fever, hyperhidrosis, elevated muscle enzymes and progressive central nerve damage were its prominent clinical characteristics. Most of the initial symptoms of exposure were not serious. Some patients, especially those with low exposure dose, had a relatively stable stage with or without clinical diagnosis and treatment. In case of sweating, obvious fever and disturbance of consciousness, the condition would deteriorate rapidly, respiratory and circulatory failure and eventually die. With the increase of production capacity and market launch, people have more opportunities to be exposed to chlorfenapyr. It is urgent to strengthen the basic and clinical research of chlorfenapyr poisoning; Attention should be paid to the observation and treatment in the initial stable stage of poisoning, which can be used as a reference for the treatment of oxidative phosphoric acid dissolving coupling agent (sodium pentachlorophenol) poisoning.


Assuntos
Inseticidas , Piretrinas , China/epidemiologia , Humanos
2.
Lett Appl Microbiol ; 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34597432

RESUMO

An engineered Pichia pastoris GS115 with a FIP-glu gene was mutated using ultraviolet (UV) radiation, and a high-throughput screening method was established for screening of high-yield strains. Meanwhile, a preliminary study was conducted to determine the bioactivity of the rFIP-glu. Based on OD600 value and the mortality of engineered P. pastoris GS115, the best UV irradiation time was determined. Bradford method and SDS-PAGE method were employed to analyze the concentration and yield of rFIP-glu. Melanoma B16 cells were employed to evaluate the biological activities of rFIP-glu in vitro. Results showed that the protein yield of the best mutant #4-336 screened from 3680 mutant strains increased from 242 to 469 µg ml-1 . In vitro assays of biological activity indicated that rFIP-glu had significant toxicity and possessed the ability to affect melanin content and enhance tyrosinase activity in B16 cells. In conclusion, an effective high-throughput screening approach was established for screening mutant strains. The screened mutant possesses a good ability to enhance the production of rFIP-glu, and recombinant proteins display a better biological activity on melanoma B16 cells. The engineered P. pastoris mutant seems promising as a potential source for industrial production of rFIP-glu and should be a candidate industrial strain for further study.

3.
Zhonghua Yu Fang Yi Xue Za Zhi ; 55(9): 1145-1148, 2021 Sep 06.
Artigo em Chinês | MEDLINE | ID: mdl-34619935

RESUMO

To construct and develop the home self-sampling processes of cervical human papillomavirus (HPV) detection and evaluate its application effect. An integrated HPV self-sampling detection platform is scheduled to include three terminals: a user terminal, a detection terminal and a medical terminal. It covers a wide range of functions of self-sampling kit acquisition of user, sample logistics tracking, inspection services, report query, medical consultation, health management, and follow-up tracking. A total of 8 053 users applied for self-sampling kits and all completed online user information registration from January to November 2020. The average age of users ranged from 17 to 84 with a median age of 42 years old. Registered users of the platform were distributed in Jiangsu, Jiangxi, Hebei, Shanxi, Shanghai, Ningxia, Anhui, Zhejiang, Inner Mongolia, Beijing and Xinjiang. 8 045 users completed self-sampling with a kit return rate of 99.9%. Six users lost the kits during the express delivery, and 2 users had the kits contaminated due to improper application; The amount of exfoliated cells collected from 8 045 cases in the sample kits were all within the endogenous internal standard of the nucleic acid kit, and the qualified rate of kits was 100%. The proportion of test report issued by the detection platform within 3 d accounts for 96.93% (7 799/8 054). Among the 763 positive users, 742 completed 6-month reexamination, with a reexamination rate of 97.25%. Unfortunately, 21 cases were lost to follow-up. Taken together, HPV home-based self-sampling is simple, convenient and efficient in use. It can expand the coverage of cervical cancer screening and may help promote HPV screening.


Assuntos
Alphapapillomavirus , Infecções por Papillomavirus , Neoplasias do Colo do Útero , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , China , Detecção Precoce de Câncer , Feminino , Humanos , Pessoa de Meia-Idade , Papillomaviridae , Infecções por Papillomavirus/diagnóstico , Neoplasias do Colo do Útero/diagnóstico , Adulto Jovem
4.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 56(9): 909-913, 2021 Sep 09.
Artigo em Chinês | MEDLINE | ID: mdl-34496541

RESUMO

Objective: To investigate the changes of occlusal delay time, percentage of occlusal force and patients' subjective satisfaction of masticatory function for single implant crown in one year after the application of space reserved occlusion design. To provide data support and suggestions for clinical occlusion design. Methods: Patients who had received single posterior dental implant restoration in Department of Prosthodontics, Capital Medical University School of Stomatology from January 2019 to December 2019 were selected. At 0.5, 3, 6 and 12 months after restoration, the T-scan Ⅲ occlusal analyzer was used to detect and record the initial occlusal contact time of the natural tooth and implanted single crown, the occlusal force percentage of single implant prosthesis and corresponding tooth on the contralateral side (control teeth) on the contralateral side (control teeth) were also recorded. Subjective satisfaction with the masticatory function of the implants was recorded using visual analogue scale (VAS). The changes of occlusal delay time (the difference of the initial occlusal time between implant restoration and the natural teeth), percentage of occlusal force and patients' subjective feeling with time were analyzed. All data were analyzed by repeated measurement analysis of variance, bilatteral P<0.01 was considered statistically significant. Results: A total of 48 patients aged (36.8±8.4) years (23 males, 25 females, aged 23-50 years) were recruited. The occlusal delay time at 0.5 months was 0.15 (0.08, 0.20) s, at 3 months was 0.11 (0.06, 0.16) s, at 6 months was 0.07 (0.03, 0.13) s and at 12 months was 0.06 (0.03, 0.10) s. The occlusal delay time was shortened at every two time points, and the occlusal force percentage of the implant crown increased significantly. The percentage of occlusal force of implant prosthesis at 0.5 months was (7.7±4.8)%, at 3 months was (10.6±5.9)%, at 6 months was (12.3±6.2)% and at 12 months was (13.2±6.7)%. The most significant change was during the period of 0.5-3 months. At 0.5 months, the occlusal force of implant prosthesis was significantly lower than that of control teeth (14.3±6.5)% (P<0.01). The VAS score at 0.5 months was (7.06±1.64) and was (8.71±0.74) at 12 months. The score was increased and the difference was statistically significant from 3 month to 12 month (P<0.01). Conclusions: The change of occlusal force percentage of single posterior dental implant is most obvious within 3 months after restoration. The occlusal condition should be reexamined and adjust occlusal after 3 months of implant restoration as appropriate.


Assuntos
Implantes Dentários , Prótese Dentária Fixada por Implante , Força de Mordida , Coroas , Oclusão Dentária , Feminino , Humanos , Masculino
6.
Zhonghua Xue Ye Xue Za Zhi ; 42(8): 654-659, 2021 Aug 14.
Artigo em Chinês | MEDLINE | ID: mdl-34547871

RESUMO

Objective: To retrospectively analyze hemogram and bone marrow characteristics of pediatric patients infected with parvovirus B19 (HPV-B19) after hematopoietic reconstitution following allo-hematopoietic stem cell transplantation. Methods: The clinical course of nine patients with HPV-B19 infection, including hemogram and bone marrow smear analysis during infection, were retrospectively analyzed. Results: Despite the hematological heterogeneity, all patients exhibited reduced hemoglobin levels accompanied by reticulocytes. The proportion and absolute count of reticulocytes decreased by 90.4% (24.7% -98.7% ) and 90.7% (18.6% -99.0% ) , respectively, in one week. Additionally, five patients manifested a decline in neutrophil granulocyte count in peripheral blood whereas granulocytic hypoplasia was not observed in bone marrow. Furthermore, six patients exhibited megakaryocytic hypoplasia in bone marrow, including five patients with decreased platelet counts in peripheral blood. Importantly, only some patients exhibited erythroid hypoplasia although all patients exhibited a decline in hemoglobin in peripheral blood. Erythroid hypoplasia in bone marrow was present in five patients. Conclusion: There was heterogeneity in hemogram and bone marrow smear characteristics among pediatric patients infected with HPV-B19 following allo-hematopoietic stem cell transplantation. Anemia accompanied by decreased reticulocyte count should prompt screening for HPV-B19 in these patients.


Assuntos
Eritema Infeccioso , Transplante de Células-Tronco Hematopoéticas , Infecções por Parvoviridae , Parvovirus B19 Humano , Criança , Humanos , Estudos Retrospectivos
7.
Zhonghua Nei Ke Za Zhi ; 60(10): 875-879, 2021 Oct 01.
Artigo em Chinês | MEDLINE | ID: mdl-34551475

RESUMO

Objective: To investigate the pathogen distribution and antimicrobial resistance among lower respiratory tract infections in patients with hematological malignancies. Methods: Sputum samples were collected from 967 patients with hematological malignancies and lower respiratory tract infections in Department of Hematology,the Second Hospital of Shanxi Medical University from January 2017 to July 2020. The pathogens and drug sensitivity reports were carried out by automatic bacterial identification instruments. WHONET 5.6 and SPSS 20.0 softwares were used for statistical analysis. Results: A total of 961 strains of pathogens were isolated, 516 (53.7%) pathogens were Gram-negative bacteria, mainly 118 strains of Klebsiella pneumonia (12.3%), 68 strains of Pseudomonas aeruginosa (7.1%), 67 strains of Acinetobacter baumannii (7.0%),52 strains of Stenotrophomonas maltophilia (5.4%), 43 strains of Escherichia coli (4.5%), and 42 strains of Enterbacter cloacae (4.4%). There were 171 (17.8%) strains of Gram-positive bacteria and 274 (28.5%) fungi. The drug resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannii to carbapenem were 22.1%-31.3%. Stenotrophomonas maltophilia was sensitive to levofloxacin, compound sulfamethoxazole and minocycline. The antimicrobial resistance rates of these three enterobacteria to carbapenems, cefoperazone/sulbactam, piperacillin/tazobactam were low (<10%). The resistant Gram-positive bacteria to ticoplanin, vancomycin and linazolamide were not detected. Conclusion: The major pathogens related to lower respiratory tract infections in patients with hematological malignancies are gram-negative bacteria in our centre. Different pathogens appear different characteristics of antimicrobial resistance.


Assuntos
Infecção Hospitalar , Neoplasias Hematológicas , Infecções Respiratórias , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Infecção Hospitalar/tratamento farmacológico , Farmacorresistência Bacteriana , Bactérias Gram-Negativas , Neoplasias Hematológicas/complicações , Humanos , Testes de Sensibilidade Microbiana , Infecções Respiratórias/tratamento farmacológico , Infecções Respiratórias/epidemiologia
9.
Lett Appl Microbiol ; 2021 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-34586634

RESUMO

Vibrio parahaemolyticus, a kind of biofilm-forming foodborne bacterium, presents formidable challenges to the effectiveness of antimicrobial agents. Increasingly, the safety of chemical antimicrobials has aroused the widespread attention of the public. The development of the novel nature antimicrobial agents has become critical for controlling biofilm-related pollution and infections. In this paper, we investigated the antibacterial activity of Lactobacillus paracasei L10, and evaluated the inhibition and eradication effects of the cell-free supernatant (CFS) of the strain on V. parahaemolyticus biofilms in detail. We found that the CFS exhibited marked antibacterial activity against all tested pathogenic bacteria. In co-cultural assay, L. paracasei L10 could notably reduce cell viability in both plankton and biofilm of V. parahaemolyticus and this antagonism effect in biofilm was greater than that in planktonic state. Meanwhile, the growth of V. parahaemolyticus was completely inhibited when 6% (v/v) of the CFS was added, and the supernatant also showed a concentration-dependent manner to inhibit and eradicate the biofilms of V. parahaemolyticus while decreased the metabolic activity of the biofilm in the same way. Moreover, the fluorescence microscopic and confocal laser scanning microscopy images confirmed the anti-biofilm activity of the CFS. This study elucidates that L. paracasei L10 displays a significant anti-biofilm effect on V. parahaemolyticus and the mechanism of its antagonism merits further study, which provides theoretical support for further development and application of L. paracasei L10 as anti-biofilm agents.

11.
Br Poult Sci ; : 1-10, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34406094

RESUMO

1. The role of melanoma differentiation-associated protein 5 (MDA5) in infectious bursal disease virus (IBDV)-induced autophagy was studied in chicken embryos.2. Chicken embryo fibroblasts (CEF) were used as the research model and small interfering RNA (siRNA), western blot, indirect enzyme-linked immunosorbent assay (ELISA), real-time fluorescence quantitative polymerase chain reaction (PCR) and transmission electron microscopy were used to detect autophagy, IBDV replication, CEF damage, and activation of both MDA5 and its signalling pathway.3. The results showed that CEF infected with IBDV activated the intracellular MDA5 signalling pathway and caused autophagy via inactivation of the AKT/mTOR pathway. While autophagy promotes IBDV proliferation, MDA5 weakens IBDV-induced CEF autophagy thus inhibiting IBDV replication and protecting CEF cells.4. The results indicated that chMDA5 can be activated by IBDV and attenuate CEF autophagy caused by IBDV infection, thereby inhibiting IBDV replication. This study provided a foundation for further exploring the relationship between viruses, autophagy and the pathogenic mechanism of the MDA5 pathway involved in IBDV.

12.
Zhonghua Wai Ke Za Zhi ; 59(9): 799-803, 2021 Sep 01.
Artigo em Chinês | MEDLINE | ID: mdl-34404180

RESUMO

In the past,treatment of acute ilio-femoral deep vein thrombosis (IFDVT) was mainly based on anticoagulation alone,but 30%-50% of patients will develop post-thrombotic syndrome,causing a serious medical burden.Thrombus removal technology such as catheter-directed thrombolysis and percutaneous mechanical thrombectomy can effectively remove blood clots and compensate for the deficiencies of simple anticoagulation,which is expected to improve the prognosis of such disease,but the current evidence is insufficient,and other treatments such as filter implantation and compression therapy are also controversial.This article summarizes the treatment strategies and the latest progress of acute IFDVT,hoping to help the treatment of this type of disease.

14.
J Physiol Pharmacol ; 72(2)2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34374656

RESUMO

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system (CNS). There is currently no satisfactory treatment for this disease. Pin1 is the only known peptidyl-prolyl cis/trans isomerase (PPIase) that is involved in many cellular processes, including immune responses. Numerous studies have shown that juglone effectively inhibits Pin1 activity. However, the effect of Pin1 inhibitor juglone on autoimmune diseases such as multiple sclerosis (MS) and its animal model, experimental autoimmune encephalomyelitis (EAE), remain incomplete. So the present study aimed to explore the therapeutic effects of the Pin1 inhibitor juglone on EAE. EAE was induced in C57BL/6 mice with myelin oligodendrocyte glycoprotein (MOG)35-55 and treatment with juglone. The health status of EAE was observed and inflammation explored using pathological analysis. The impact of juglone on immune cells was further examined using intracellular staining and flow cytometry. The results demonstrated that juglone ameliorates EAE and reduces inflammation and demyelination in the CNS. The study also found that juglone suppresses pathogenic Th1 and Th17 cells and the expression of CD83 and MHCII on dendritic cells in EAE. In addition, juglone ameliorates EAE. Pin1 inhibitors therefore hold great promise for autoimmune disease and MS therapy.

15.
Zhonghua Yi Xue Za Zhi ; 101(31): 2478-2484, 2021 Aug 17.
Artigo em Chinês | MEDLINE | ID: mdl-34399563

RESUMO

Objective: To characterize the antibiotic resistance and virulence in a carbapenem-resistant Klebsiella pneumoniae (CRKP). Methods: A CRKP (designated K. pneumoniae C35) was isolated from a stool sample. The minimal inhibitory concentrations of antimicrobial agents were determined using the broth microdilution method. Whole-genome sequencing and genome analysis were performed to identify the antibiotic resistance and virulence genes. The genetic relationship among K. pneumoniae C35 and other CRKP isolates from our hospital was analyzed by single nucleotide polymorphism (SNP) typing of core genomes. Conjugation experiments were carried out by filter mating to evaluate the transferability and efficiency of resistance genes. The virulence phenotype was determined by Galleria mellonella infection model. Results: K. pneumoniae C35 exhibited resistance to the majority of tested antibiotics, especially carbapenems, sulbactam, and polymyxins. SNP typing showed that K. pneumoniae C35 shared a high degree of sequence homology with several CRKP isolates from different wards. This ST11 CRKP carried 13 resistance genes, including blaKPC-2, blaCTX-M-199, mcr-1, and tet(A) variant. blaKPC-2 gene was located on an IncFⅡ plasmid with>69 800 bp in size, blaCTX-M-199 and mcr-1 genes were located on an IncI2 plasmid (>64 800 bp), and tet(A) variant was located on an unknown Inc-type plasmid (83 628bp). All these three plasmids were conjugative. K. pneumoniae C35 was found to harbor rmpA, rmpA2, and iucABCD aerobactin-related genes, and was considered to be classic carbapenem-resistant hypervirulent K. pneumoniae (CR-hvKP). The virulence potential of this strain was confirmed in a Galleria mellonella infection model. The survival rate of the larvae injected with strain C35 at 48 h after infection was significantly lower than that of negative control strain (16.7% vs 80.0%). Conclusion: Multiple conjugative plasmids are identified in a faecal CR-hvKP. The IncI2 plasmid co-carrying both blaCTX-M-199 and mcr-1 genes is firstly identified in CR-hvKP. The emergence of such strain should be alerted and active surveillance is warranted.


Assuntos
Infecções por Klebsiella , Klebsiella pneumoniae , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Proteínas de Bactérias/genética , Carbapenêmicos/farmacologia , Resistência Microbiana a Medicamentos , Humanos , Infecções por Klebsiella/tratamento farmacológico , Klebsiella pneumoniae/genética , Tipagem de Sequências Multilocus , Plasmídeos/genética , Virulência/genética , beta-Lactamases
16.
Zhonghua Xue Ye Xue Za Zhi ; 42(6): 474-479, 2021 Jun 14.
Artigo em Chinês | MEDLINE | ID: mdl-34384153

RESUMO

Objective: To evaluate the efficacy of syngeneic hematopoietic stem cell transplantation in the treatment of aplastic anemia. Methods: The clinic data of 11 patients with aplastic anemia undergoing syngeneic HSCT were retrospectively analyzed. Results: Among all of the 11 patients with AA, 4 males and 7 females were determined, with a median age of 22 (7-44) years old. All of the 11 patients achieved engraftment after the first transplantation: neutrophils engraftment occurred after a median of 10 days (range 8-23) , and platelet engraftment occurred after a median of 11 days (range 8-28) . Eight patients achieved long-term stable engraftment: three patients had graft failure, and two of them underwent secondary transplantation (1 case achieved long-term stable engraftment, but graft failure occurred again after hematopoietic reconstruction in another case) . The median follow-up time was 53 (5-135) months. All of the 11 patients survived, and the blood routine of 9 patients was normal for a long time. Conclusion: Syngeneic hematopoietic stem cell transplantation has a good long-term survival rate in the treatment of aplastic anemia, and graft failure is still the most significant problem.


Assuntos
Anemia Aplástica , Doença Enxerto-Hospedeiro , Transplante de Células-Tronco Hematopoéticas , Adulto , Anemia Aplástica/terapia , Feminino , Humanos , Masculino , Estudos Retrospectivos , Condicionamento Pré-Transplante , Adulto Jovem
18.
Zhonghua Er Ke Za Zhi ; 59(7): 570-575, 2021 Jul 02.
Artigo em Chinês | MEDLINE | ID: mdl-34405639

RESUMO

Objective: To explore the genetic etiologies of newborn deaths. Methods: A total of 98 newborns who were recruited to the Neonatal Genome Project of the Children's Hospital of Fudan University and died in the hospital from January 2018 to August 2020 were enrolled in this study. The genetic information and the interventions based on the genetic findings were retrospectively analyzed. T-test, Mann-Whitney U test, Chi square test and Fisher's exact probability test were used to compare the demographic features and clinical characteristics between the patients with or without a genetic finding. Results: Among 98 newborns (55 males and 43 females), there were 63 preterm and 35 term infants, with a gestational age of (33±5) weeks, a birth weight of (2 107±975) g and the age at death of 12 (2,34) days. Sixteen (16%)patients were identified with genetic variants, including 11 with single nucleotide variants, 4 with copy number variants and 1 with both single nucleotide variant and copy number variant. The detected single nucleotide variants were spanning 12 genes, among which 3 were multiple disorders-related, 2 metabolic disorder-related, 2 hematological disorder-related, 2 respiratory disorder-related, 2 cardiovascular disorder-related and 1 skeletal disorder-related. The patients with a positive genetic finding had significant differences in the birth weight ((2 605±940) vs. (2 009±957) g, t=2.283, P=0.025), the gestational age ((36±5) vs. (33±5) weeks, t=2.131, P=0.036), the age at death ((37 (5, 69) vs. 11 (2, 29) days, Ζ=-2.245, P=0.025) and the history of asphyxia at birth (1/16 vs. 46% (38/82), P=0.002)when compared to those without a genetic finding. In addition, the genetic etiology rates of patients who were born term or with a birth weight ≥ 2 000 g were significantly higher than those who were born preterm (29% (10/35) vs. 10% (6/63), P=0.022) or with a birth weight<2 000 g (25% (13/51) vs. 7% (3/46), χ2=5.016,P=0.025), respectively. Six cases were medically actionable based on the genetic findings and the treatments included special diet, applying specific medicine, hematopoietic stem cell transplantation and lung transplantation. Conclusions: Genetic etiologies are not rare in newborn deaths and mainly associated with metabolic disorder, multi-system disorders, hematological disorder, respiratory disorder, cardiovascular disorder and skeletal disorder. Some findings are medically actionable, based on which the specific treatments could be scheduled timely. A genetic etiology should be investigated in newborn deaths especially in those who are term birth or with a birth weight ≥2 000 g or without a history of asphyxia at birth.


Assuntos
Estudos Retrospectivos , Peso ao Nascer , Feminino , Idade Gestacional , Humanos , Lactente , Recém-Nascido , Masculino , Fatores de Risco
19.
Zhonghua Er Ke Za Zhi ; 59(8): 672-677, 2021 Aug 02.
Artigo em Chinês | MEDLINE | ID: mdl-34333920

RESUMO

Objective: To investigate the association between genotype and clinical phenotype in children with primary hemophagocytic lymphohistiocytosis (HLH). Methods: Clinical data of 38 children with primary HLH at Beijing Children's Hospital from November 2015 to October 2020 were analyzed retrospectively. According to whether destructive mutation site, familial HLH (FHL) or non-familial HLH, degranulation pathway and non-degranulation pathway were detected in them, these patients were divided into different groups. Clinical characteristics, laboratory tests and functional tests were analyzed in different groups. Wilcoxon test or chi-square test were used for comparison between groups. Results: Among 38 cases, there were 23 males and 15 females. The age of onset was 2.5 (0.1-13.7) years. PRF1 (13/38, 34%) and UNC13D (12/38, 32%) gene mutations had the highest detectable rate. Correlation analysis between genotypes and phenotypes suggested that patients in destructive mutation sites group (n=25) had a younger age of onset than that in non-destructive mutation sites group (n=13) (1.0 (0.1-9.0) vs. 4.0 (0.4-13.4) years, Z=-2.711, P=0.005). The incidence of central nervous system involvement and convulsion was higher in patients in familial HLH group (n=26) than that in non-familial HLH group (n=12)(62% (16/26) vs. 2/12, χ²=6.631, P=0.015; 54% (14/26) vs. 2/12, χ²=4.656, P=0.040). The levels of soluble CD25, bilirubin, interferon γ (IFN-γ) and interleukin 10 (IL-10) were higher in degranulation pathway impairment group than that in the non-degranulation pathway impairment group (38 444 (2 393-44 000) vs.15 304 (1 620-36 937) ng/L,Z=2.634,P=0.008; 23.5 (6.3-126.4) vs. 6.0 (3.6-31.0) µmol/L, Z=2.992, P=0.003; 20.7 (0-248.7) vs. 11.9 (2.6-21.0) ng/L, Z=2.156, P=0.031; 20.7 (4.3-2 500.0) vs. 11.8 (4.0-88.0) ng/L, Z=2.210, P=0.027). However, the levels of neutrophils, ferritin and lactate dehydrogenase (LDH) in degranulation pathway impairment group were lower in the non-degranulation pathway impairment group (0.5 (0.1-8.0)×109 vs. 1.0 (0.9-2.3)×109/L, Z=-3.197, P=0.001; 1 133 (78-10 452) vs. 3 048 (630-37 900) µg/L, Z=-2.407, P=0.016; 410 (188-1 254) vs. 599 (389-3 147) U/L, Z=-2.489, P=0.013). Conclusions: PRF1 and UNC13D gene mutations are most common in primary HLH. Patients with destructive gene mutations have a younger age of onset. Patients with familial HLH are more likely to have central nervous system involvement and convulsions. The levels of sCD25, bilirubin, IFN-γ and IL-10 are higher in the degranulation pathway patients.


Assuntos
Linfo-Histiocitose Hemofagocítica , Adolescente , Criança , Pré-Escolar , Feminino , Genótipo , Humanos , Lactente , Linfo-Histiocitose Hemofagocítica/genética , Masculino , Proteínas de Membrana , Mutação , Fenótipo , Estudos Retrospectivos
20.
Eur Rev Med Pharmacol Sci ; 25(14): 4693-4701, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34337717

RESUMO

OBJECTIVE: The rapid onset of pediatric sepsis and the short optimal time for resuscitation pose a severe threat to children's health in the ICU. Timely diagnosis and intervention are essential to curing sepsis, but there is a lack of research on the prediction of sepsis at shorter time intervals. This study proposes a predictive model towards real-time diagnosis of sepsis to help reduce the time to first antibiotic treatment. PATIENTS AND METHODS: The dataset used in this paper was obtained from the pediatric intensive care unit of Shanghai Children's Medical Center and consisted of the initial examination records of patients admitted to the hospital. The data included six groups of laboratory tests: medical history, physical examination, blood gas analysis, routine blood tests, serological tests, and coagulation tests. We divided the admission examination into three stages and proposed a sepsis prediction model towards real-time diagnosis based on local information to shorten waiting time for treatment. The model extracts homogeneous features from patient groups in real-time using a graph neural network and uses the deep forest to learn from homogeneous features and laboratory data to give a comprehensive prediction at the current stage. Discriminative features of each stage are used as augmented information for the next phase, finally achieving self-optimization of global judgment, assisting in pre-allocation of medical resources and providing timely medical assistance to sepsis patients. RESULTS: Based on the first stage, second stage, and full test, the AUCs of our model were 93.63%, 96.73%, and 97.58%, respectively, and the F1-scores were 77.35%, 85.71%, and 86.48%, respectively. The models gave relatively accurate predictions at each stage. CONCLUSIONS: The prediction model toward a real-time diagnosis of sepsis shows more accurate predictions at each stage compared to other control methods. When the first two stages of data are obtained as input, the model accuracy is close to using complete test data, which can help compress the time to diagnosis to about an hour after the test and significantly reduce waiting time.

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