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1.
Zhonghua Yi Xue Za Zhi ; 99(41): 3221-3226, 2019 Nov 05.
Artigo em Chinês | MEDLINE | ID: mdl-31694116

RESUMO

Objective: To determine the factors affecting distribution and magnitude of antibody detection value in myasthenia gravis (MG). Methods: A total of 406 MG patients diagnosed at Department of Neurology, Peking University First Hospital from May 2015 to November 2017 were included.All of them exhibited muscle fatigue with decreased response in repetitive nerve stimulation test. There were 200 males and 206 females whose ages ranged from 2 to 85 years old. According to clinical classification of MG recommended by Myasthenia Gravis Foundation of America (MGFA), patients assigned to class I to class V included 200,140, 46, 15 and 5 cases, respectively. There were 33 cases of thymic hyperplasia and 63 cases of thymoma confirmed by radiological or pathological findings. Quantile plots and quantile regression model were used to determine the effects of age, gender and MGFA classification, thymus disease on acetylcholine receptors (AChR)antibody, acetylcholinesterase (AChE) antibody, Titin antibody, ryanodine receptor (RyR) antibody and muscle-specific tyrosine kinase (MuSK) antibody detection values detected by enzyme-linked immunosorbent assay (ELISA). Results: MGFA classification had effects on distribution of AChR antibody level. There was a positive correlation between age and AChR antibody level(P<0.05). Negative correlation was found between age and AChE, Titin and RyR antibody level (P<0.05). No significant correlation was shown between any factors and MuSK antibody level(P≥0.05). MGFA classification had a positive correlation with AChR antibody level (P<0.05) and no correlation with other antibody levels (P>0.05). Gender and thymus disease had no correlation with any tested antibody levels (P>0.05). Conclusion: MGFA classification has significant effects on distribution of AChR antibody level. Age and MGFA classification have positive correlation with AChR antibody level.


Assuntos
Miastenia Gravis , Timoma , Hiperplasia do Timo , Neoplasias do Timo , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Autoanticorpos , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
2.
Zhonghua Nei Ke Za Zhi ; 58(12): 899-904, 2019 Dec 01.
Artigo em Chinês | MEDLINE | ID: mdl-31775453

RESUMO

Objective: To analyze the diagnostic value of skeletal muscle biopsy in patients with rhabdomyolysis. Methods: Clinical and pathological data of 26 patients with rhabdomyolysis from January 2002 to December 2018 undergoing muscle biopsy were collected. Results: Eighteen males and 8 females were finally recruited with median age of 6-73 (37.3±19.6) years. The average time from onset to biopsy was 44 days (median course was 30 days). All patients had acute manifestations with muscle pain and/or weakness. Serum creatine kinase was between 1 648-92 660 U/L. Muscle biopsies showed nonspecific changes in 12 cases (a few with type 2 muscle fiber atrophy, slight deposition of lipid droplets), 10 cases with necrotizing myopathy (muscle fiber necrosis and regeneration). Toxic neurogenic damages were seen in 2 cases (type 1 and type 2 angular atrophic muscle fibers with group change), lipid storage disease in 1 case (lipid droplets deposit significantly) and idiopathic inflammatory myopathy in 1 case (muscle fiber necrosis and regeneration, with lymphocyte infiltration). The etiology of non-specific pathological changes included short-term strenuous exercise in 6 patients, poisoning in two, chronic kidney disease in one, viral infection in one, hypothyroidism in one and unknown reason in one. As to patients with necrotizing myopathy, seven were poisoning or drug-related, one with hyperthyroidism, two with unknown reason. Conclusions: Among the numerous causes of rhabdomyolysis, exercise usually links nonspecific skeletal muscle changes and poisoning or drug-related disorders are commonly associated with necrotic myopathy. Rhabdomyolysis induced by primary myopathy is rare.


Assuntos
Músculo Esquelético/patologia , Rabdomiólise/patologia , Adolescente , Adulto , Idoso , Biópsia , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Musculares/diagnóstico , Miosite/patologia , Adulto Jovem
3.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi ; 37(10): 732-736, 2019 Oct 20.
Artigo em Chinês | MEDLINE | ID: mdl-31726502

RESUMO

Objective: To observe the changes of extracellular histones and pulmonary microvascular endothelial cells, and study the activating role of extracellular histones to pulmonary microvascular endothelial cells in the pathogenesis of acute respiratory distress syndrome (ARDS) . Methods: The correlation of the severity of acute lung injury with extracellular histones and pulmonary endothelial damage was studied through mice model, and acute lung injury was produced by aspiration of different concentrations of hydrochloric acid (0.01、0.1、0.3 and 0.5 mol/L, 2 ml/kg). Tumor necrosis factor-α (TNF-α), soluble thrombomodulin (sTM) and lung pathological change were measured. The pro-inflammatory role of extracellular histones was tested by injecting calf thymus histones (CTH) or specific anti-H4 antibody through tail vein. The direct activating role of extracellular histones to pulmonary microvascular endothelial cells was studied through pulmonary endothelial model. Results: The extracellular histones in plasma were increased obviously 6h after aspiration of different concentrations of hydrochloric acid in mice. A positive correlation was seen between extracellular histones and concentrations of aspirated hydrochloric acid (r=0.9180, P<0.05). The sTM in plasma also showed a positive correlation with concentrations of aspirated hydrochloric acid (r=0.8701, P<0.05). Merely administering CTH could not only increase TNF-α and sTM in plasma but also cause obvious lung injury, while specific anti-H4 antibody could relieve the inflammation and lung damage caused by CTH. Extracellular histones could directly damage pulmonary endothelial cells to release sTM in pulmonary endothelial model in vitro, while anti-H4 antibody could protect the endothelial cells. Conclusion: Extracellular histones are the key endogenic inflammatory mediators during the pathogenesis of ARDS caused by aspiration of hydrochloric acid, which could promote inflammation by directly activating pulmonary endothelial cells.


Assuntos
Lesão Pulmonar Aguda/patologia , Células Endoteliais/citologia , Histonas/sangue , Síndrome do Desconforto Respiratório do Adulto/patologia , Lesão Pulmonar Aguda/induzido quimicamente , Animais , Células Endoteliais/patologia , Ácido Clorídrico , Inflamação , Pulmão , Camundongos , Síndrome do Desconforto Respiratório do Adulto/induzido quimicamente , Trombomodulina/sangue , Fator de Necrose Tumoral alfa/sangue
4.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(10): 1043-1048, 2019 Oct 06.
Artigo em Chinês | MEDLINE | ID: mdl-31607053

RESUMO

Objectives: To understand the status of studies about influenza economic burden in mainland China and summarize their major results. Methods: The words of influenza, flu, cost, economic, burden, effectiveness, benefit, utility, China, and Chinese, were used as search keywords. Journal papers published during 2000-2018 were searched from Chinese electronic databases (CNKI and Wanfang) and English electronic databases (PubMed, Web of science, EconLit and Cochrane Library). The language of literature was restricted to Chinese and English. A total of 23 effective documents were included, and the descriptive characteristics, research indexes and methods included in the literature were analyzed. The monetary unit used in this review is Chinese Yuan (CNY). Results: The 23 study sites were mainly in the relatively developed and populous regions. The total cost per capita of laboratory-confirmed influenza,of all age-group was reported in 6 literatures, and only 4 literatures reported it in out-patients (range: 768.0-999.9 CNY), Only one study reported this indicator in inpatients (9 832.0 CNY). One literature reported the total cost per capita of influenza-like illness,, which was 205.1 CNY. And one literature reported that the direct medical cost of inpatients per capita in children under 5 years of age was 6 072.0 CNY while two literature reported this index for the elderly over 60 years of age, ranging from 14 250.0 to 19 349.1 CNY. Four articles reported the economic burden of influenza in urban and rural areas, one of which showed that the related expenses of urban influenza inpatients accounted for 31% of the average annual income, while which for the rural flow was 113%. Conclusion: The average economic burden of lab-confirmed influenza case is higher than that of influenza-like illness, and there are differences in outpatient indirect expenses and inpatients direct medical expenses. The direct medical burden for the hospitalized 60-years-and-beyond influenza case group is heavier thar other age group. By region, the influenza associated individual economic burden in rural area is higher than that of urban area..


Assuntos
Efeitos Psicossociais da Doença , Influenza Humana/epidemiologia , Idoso , Criança , Pré-Escolar , China/epidemiologia , Humanos , Renda , Pessoa de Meia-Idade , População Rural
5.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(6): 627-632, 2019 Jun 10.
Artigo em Chinês | MEDLINE | ID: mdl-31238609

RESUMO

Objective: To understand the characteristics relating to the etiology and complications of hand, foot and mouth disease (HFMD) based on data from the pilot National Sentinel Surveillance (NSS) program so as to explore the feasibility, advantages and disadvantages of the NSS. Methods: Data were extracted from the NSS system, conducted in 11 provinces of China from November 2015 to October 2016. Characteristics regarding the etiology, complications of HFMD and factors related to the positive rates of HFMD specimens were analyzed under the logistic regression method by SPSS 20.0 software. Results: A total of 4 783 specimens were collected, including 3 390 from mild, 1 390 from severe and 3 from death cases. The overall positive rate was 81.43% (3 895/4 783). Other enteroviruses (non EV71/Cox A16 enteroviruses) appeared the major serotype (52.68%, 1 482/2 813) for mild infection of the disease while EV71 was for the severe cases (65.31%, 706/1 081). The serotype spectrum revealed by the pilot NSS was almost identical with the existing surveillance system. Other enteroviruses tended to infect younger children (χ(2)=130.17, P<0.001) than EV71 and Cox A16, in China. The multivariate logistic regression results showed that higher positive rate was associated with specimens which were collected from males, at children' hospitals, in peak seasons, timely and in stools. The positive rates presented downwarding trends with the extension of the onset-sampling interval (χ(2)=14.47, P<0.001 in stool specimen; χ(2)=31.99, P<0.001 in throat swab; χ(2)=24.26, P<0.001 in anal swab). Aseptic meningitis, non-brainstem encephalitis and brainstem encephalitis appeared the top three complications of both EV71-associated and other enteroviruses-associated severe HFMD cases. Conclusions: Factors as gender, season/place/timeliness of specimen collection, and types of hospital all appeared independently influenced the positive rates. NSS seemed feasible to be used as an alternative or supplement tool to the existing surveillance program in China.


Assuntos
Infecções por Enterovirus/virologia , Doença de Mão, Pé e Boca/complicações , Doença de Mão, Pé e Boca/etiologia , Vigilância de Evento Sentinela , Criança , China , Enterovirus Humano A/classificação , Enterovirus Humano A/isolamento & purificação , Doença de Mão, Pé e Boca/diagnóstico , Humanos , Lactente , Masculino
6.
Zhonghua Wai Ke Za Zhi ; 57(4): 282-287, 2019 Apr 01.
Artigo em Chinês | MEDLINE | ID: mdl-30929374

RESUMO

Objective: To explore the selection method and technology of laparoscopic surgery for gallbladder stones and common bile duct stones(GCBDS). Methods: Data was collected from 318 in-patients of GCBDS at Department of General Surgery,Xuanwu Hospital of Capital Medical University from January 2013 to December 2017, and 298 in-patients acceptedlaparoscopic cholecystectomy(LC) and choledocholithotomy were recruited into final analysis.There were 138 males and 160 females,aged (60.4±18.6)years (range:25-89 years).Retrospective analysis was done on method distribution,effect and safety of laproscopic surgery.Comparisons of basic characters and therapeutic effects were performed betweenlaparoscopic common bile duct exploration (LCBDE) combined with primary closure and T tube drainage(TTD). Results: Among therecruited in-patients,LC combined with common bile duct exploration was performed in 7 cases(2.3%, 7/298), LC combined with LCBDE was performed in 291 cases(97.7%,291/298).There were 133 cases (45.7%,133/291) who treated by LCBDE combined with TTD and 158 cases(54.3%,158/291) who treated by LCBDE combined with primary closure.In LCBDE combined with primary closure group,18 cases (11.4%,18/158)had intraoperative biliary manometry.All patients were followed up for 6 months at least and there no death.Postoperative complications rate was 10.0% (29/291).There were no significant differences in sex ratio,age,American Society of Anesthesiologists score,concomitant diseases and previous abdominal surgery history between LCBDE combined with primary closure and LCBDE combined with TTD group.Patients in LCBDE combined with primary closure group were accompanied with less acute cholangitis than TTD group (43.3% vs.76.7%; χ(2)=9.061, P=0.002).There were no significant differences in the diameter of common bile duct, the number of stones, hospitalization expenses and the incidence of complications between the two groups(all P>0.05).LCBDE combined with primary closure had shorter operation time ((134.2±28.3)minutes vs.(148.3±19.6)minutes; t=-1.830, P=0.011)and post-operative hospitalization time ((5.6±2.6)days vs. (7.2±2.4)days; t=-1.847,P=0.014).Bile duct leakage rate was higher in primary closure group(6.3% vs.0.8%, χ(2)=3.934, P=0.047) and TTD group had higher residual stones rate(6.8% vs.1.3%; χ(2)=6.008, P=0.014). Conclusion: Strategy for treating GCBDS by laparoscopic surgery should be considered preoperative evaluation and intraoperative exploration to select appropriate minimally invasive surgical methods and techniques.


Assuntos
Laparoscopia , Adulto , Idoso , Idoso de 80 Anos ou mais , Coledocolitíase , Ducto Colédoco , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
7.
J Biol Regul Homeost Agents ; 33(1): 73-80, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30734549

RESUMO

This study aimed to investigate the effect of T cell subsets with different proportions on renal function and blood lipids in patients with preeclampsia (PE). Ninety pregnant women were included in this experiment and classified into 3 groups: group A (30 with severe PE), group B (30 with mild PE) and group C (30 healthy pregnant women). Clinical characteristics were examined. The ratio of T cell subsets in the three groups was detected by flow cytometry. The relationship between PE and T cell subsets was determined. The results showed that no significant difference was found in age or gestational age (P>0.05). The number of CD4+ T cells (CD4 is mainly expressed in helper T cells, referred to as TH) in group A increased significantly compared with group B and group C (P less than 0.05), while the number of CD8+ T cells (CD8+ T cell, also known as cytotoxic T cell (CTL) in group A decreased noticeably in comparison to group C (P less than 0.05). The ratio of CD4+ cell number to CD8+ cell number (TH/CTL) in group A was elevated significantly compared with group B and group C (P less than 0.05). The uric acid (UA) concentration of group A was noticeably elevated compared to group C (P less than 0.05), which differed insignificantly between group B and C (P>0.05). Glomerular filtration rate (GFR) of group A was obviously impaired in comparison to group B and group C (P less than 0.05), which differed insignificantly between group B and C (P>0.05). Total cholesterol (TC) concentrations in group A, C and B were examined. TC concentrations in the former two groups were slightly higher compared to the latter (P less than 0.05), and those in the former two groups were also higher than the normal range (P less than 0.05). Mean triglyceride (TG) concentrations in all 3 groups were above the normal range, and those in group A and B were significantly higher compared to group C (P less than 0.05). TG concentrations differed insignificantly between group B and C (P>0.05). Serum TG, UA and TC in PE patients were positively related to TH/CTL (P less than 0.05). In conclusion, PE is related to T cell subsets, and T cell subsets are closely related to kidney injury and dyslipidemia.


Assuntos
Rim/imunologia , Lipídeos/sangue , Pré-Eclâmpsia/imunologia , Subpopulações de Linfócitos T/imunologia , Relação CD4-CD8 , Linfócitos T CD4-Positivos , Linfócitos T CD8-Positivos , Estudos de Casos e Controles , Feminino , Taxa de Filtração Glomerular , Humanos , Gravidez
8.
Zhonghua Liu Xing Bing Xue Za Zhi ; 39(11): 1413-1425, 2018 Nov 10.
Artigo em Chinês | MEDLINE | ID: mdl-30462947

RESUMO

Seasonal influenza vaccination is the most effective way to prevent influenza virus infection and its complications. Currently, China has licensed trivalent (IIV3) and quadrivalent inactivated influenza vaccine (IIV4), including split-virus influenza vaccine and subunit vaccine. In most parts of China, influenza vaccine is a category Ⅱ vaccine, which means influenza vaccination is voluntary, and recipients need to pay for it. To strengthen the technical guidance for prevention and control of influenza and the operational research on influenza vaccination in China, the National Immunization Advisory Committee (NIAC), Influenza Vaccine Technical Working Group (TWG), updated the 2014 technical guidelines and compiled the "Technical guidelines for seasonal influenza vaccination in China (2018-2019)" , based on most recent existing scientific evidences. The main updates include: epidemiology and disease burden of influenza, types of influenza vaccines, northern hemisphere influenza vaccination composition for the 2018-2019 season, and, IIV3 and IIV4 vaccines'major immune responses, durability of immunity, immunogenicity, vaccine efficacy, effectiveness, safety, cost-effectiveness and cost-benefit. The recommendations include: Points of Vaccination clinics (PoVs) should provide influenza vaccination to all persons aged 6 months and above who are willing to be vaccinated and do not have contraindications. No preferential recommendation is made for any influenza vaccine product for persons who can accept ≥1 licensed, recommended, and appropriate products. To decrease the risk of severe infections and complications due to influenza virus infection among high risk groups, the recommendations prioritize seasonal influenza vaccination for children aged 6-60 months, adults ≥60 years of age, persons with specific chronic diseases, healthcare workers, the family members and caregivers of infants <6 months of age, and pregnant women or women who plan to pregnant during the influenza season. Children aged 6 months to 8 years old require 2 doses of influenza vaccine administered a minimum of 4 weeks apart during their first season of vaccination for optimal protection. If they were vaccinated in previous influenza season, 1 dose is recommended. People ≥ 9 years old require 1 dose of influenza vaccine. It is recommended that people receive their influenza vaccination by the end of October. Influenza vaccination should be offered as soon as the vaccination is available. Influenza vaccination should continue to be available for those unable to be vaccinated before the end of October during the whole season. Influenza vaccine is also recommended for use in pregnant women during any trimester. These guidelines are intended for CDC members who are working on influenza control and prevention, PoVs members, healthcare workers from the departments of pediatrics, internal medicine, and infectious diseases, and members of maternity and child care institutions at all levels.


Assuntos
Guias como Assunto , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Estações do Ano , Adulto , Criança , Pré-Escolar , China , Feminino , Humanos , Lactente , Gravidez , Vacinação
9.
Zhonghua Yu Fang Yi Xue Za Zhi ; 52(11): 1101-1114, 2018 Nov 06.
Artigo em Chinês | MEDLINE | ID: mdl-30419692

RESUMO

Seasonal influenza vaccination is the most effective way to prevent influenza virus infection and complications from infection. Currently, China has licensed trivalent inactivated influenza vaccine (IIV3) and quadrivalent inactivated influenza vaccine (IIV4), including split-virus influenza vaccine and subunit vaccine. Except for a few major cities, influenza vaccine is a category Ⅱ vaccine, which means influenza vaccination is voluntary, and recipients must pay for it. To strengthen the technical guidance for prevention and control of influenza and operational research on influenza vaccination in China, the National Immunization Advisory Committee (NIAC) Influenza Vaccine Technical Working Group (TWG), updated the 2014 technical guidelines and compiled the "Technical guidelines for seasonal influenza vaccination in China (2018-2019)" . The main updates in this version include: epidemiology, disease burden, types of influenza vaccines, northern hemisphere influenza vaccination composition for the 2018-2019 season, IIV3 and IIV4 immune response, durability of immunity, immunogenicity, vaccine efficacy, effectiveness, safety, cost-effectiveness and cost-benefit. The influenza vaccine TWG provided the recommendations for influenza vaccination for the 2018-2019 influenza season based on existing scientific evidence. The recommendations described in this report include the following: Points of Vaccination clinics (PoVs) should provide influenza vaccination to all persons aged 6 months and above who are willing to be vaccinated and do not have contraindications. No preferential recommendation is made for one influenza vaccine product over another for persons for whom more than one licensed, recommended, and appropriate product is available. To decrease the risk of severe infections and complications due to influenza virus infection among high risk groups, the recommendations prioritize seasonal influenza vaccination for children aged 6-59 months, adults ≥60 years of age, persons with specific chronic diseases, healthcare workers, the family members and caregivers of infants <6 months of age, and pregnant women or women who plan to become pregnant during the influenza season. Children aged 6 months through 8 years require 2 doses of influenza vaccine administered a minimum of 4 weeks apart during their first season of vaccination for optimal protection. If they were vaccinated in 2017-2018 influenza season or a prior season, 1 dose is recommended. People more than 8 years old require 1 dose of influenza vaccine. It is recommended that people receive their influenza vaccination by the end of October. Influenza vaccination should be offered as soon as the vaccination is available. For the people unable to be vaccinated before the end of October, influenza vaccination will continue to be offered for the whole season. Influenza vaccine is also recommended for use in pregnant women during any trimester. These guidelines are intended for use by staff members of the Centers for Disease Control and Prevention at all levels who work on influenza control and prevention, PoVs staff members, healthcare workers from the departments of pediatrics, internal medicine, and infectious diseases, and staff members of maternity and child care institutions at all levels.


Assuntos
Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Criança , Pré-Escolar , China , Feminino , Humanos , Lactente , Pessoa de Meia-Idade , Gravidez , Estações do Ano
10.
Zhonghua Liu Xing Bing Xue Za Zhi ; 39(8): 1045-1050, 2018 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-30180426

RESUMO

Influenza can be prevented through annual appropriate vaccination against the virus concerned. In China, influenza vaccine is categorized as "Class Ⅱ" infectious diseases which the cost is paid out of the user's pockets. The annual coverage of influenza vaccination had been 2%-3%. The main reasons for the low coverage would include the following factors: lacking awareness on both the disease and vaccine, poor accessibility of vaccination service, and the cost of vaccination. To reduce the health and economic burden associated with influenza, comprehensive policies should be improved, targeting the coverage of seasonal influenza vaccination. These items would include: ① Different financing reimbursement schemes and mechanisms to improve the aspiration on vaccination and on the vaccine coverage in high-risk groups, as young children, elderly, people with underlying medical conditions; ② to ameliorate equality of vaccination services; ③ to improve knowledge of the health care workers (HCWs) and the public on influenza and related vaccines; ④ to improve clinical and preventive medical practice and vaccination among HCWs through revising clinical guidelines, pathway and consensus of experts; ⑤ to provide more convenient, accessible and normative vaccination service system; ⑥ to strengthen research and development as well as marketing on novel influenza vaccines; ⑦ to revise items regarding the contraindication for influenza vaccine on pregnancy women, stated in the Chinese Pharmacopoeia.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde , Promoção da Saúde/métodos , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Vacinação , Idoso , Conscientização , Criança , China , Custos e Análise de Custo , Feminino , Humanos , Vacinas contra Influenza/economia , Masculino , Gravidez
11.
Artigo em Chinês | MEDLINE | ID: mdl-29495169

RESUMO

Objective: In order to explore the role of heparan sulfate (HS) during the pathogenesis of acute respiratory distress syndrome (ARDS) , the protective effect of HS and its fragments against extracellular histones was compared. Methods: Calf thymus histones (CTH) were injected via femoral vein to induce ARDS in rats. HS, HS fragments or saline was intraperitoneally injected (10mg/kg, Q6h, 24h) to test the protective effect against CTH. The ratio of wet/dry lung weight, protein content in bronchoalveolar lavage fluid (BALF) , total leukocyte and neutrophil count in BALF were measured. Results: After CTH injection, the ratio of wet/dry lung weight (5.7±0.95) was much higher than the saline control group (3.1±0.15). The protein content (0.47±0.086mg/ml) , total leukocyte[ (97.4±15.6l) ×10(4)/ml] and neutrophil (18±3.4/LPF) in BALF were obviously increased compared with the saline control group. The intervention of HS evidently decreased ratio of wet/dry lung weight (4.2±0.41) , protein content[ (0.26±0.019) mg/ml], leukocyte[ (61.3±5.74) ×10(4)/ml] and neutrophil (12±1.8/LPF) in BALF. HS fragments also decreased ratio of wet/dry lung weight, protein content, leukocyte and neutrophil count in BALF though the strength was much less than HS. Conclusion: HS and its fragments could provide protection against extracellular histones during the pathogenesis of ARDS. For the protective effect full length HS was much better than HS fragments.


Assuntos
Heparitina Sulfato , Histonas/metabolismo , Neutrófilos , Síndrome do Desconforto Respiratório do Adulto/etiologia , Animais , Líquido da Lavagem Broncoalveolar , Contagem de Leucócitos , Pulmão , Ratos
12.
Zhonghua Liu Xing Bing Xue Za Zhi ; 38(6): 754-758, 2017 Jun 10.
Artigo em Chinês | MEDLINE | ID: mdl-28647977

RESUMO

Objective: Through analyzing the surveillance data on typhoid fever and paratyphoid fever in 2015 to understand the related epidemiological features and most possible clustering areas of high incidence. Methods: Individual data was collected from the passive surveillance program and analyzed by descriptive statistic method. Characteristics on seasonal, regional and distribution of the diseases were described. Spatial-temporal clustering characteristics were estimated, under the retrospective space-time method. Results: A total of 8 850 typhoid fever cases were reported from the surveillance system, with incidence rate as 0.65/100 000. The number of paratyphoid fever cases was 2 794, with incidence rate as 0.21/100 000. Both cases of typhoid fever and paratyphoid fever occurred all year round, with high epidemic season from May to October. Most cases involved farmers (39.68%), children (15.89%) and students (12.01%). Children under 5 years showed the highest incidence rate. Retrospective space-time analysis for provinces with high incidence rates would include Yunnan, Guangxi, Guizhou, Hunan and Guangdong, indicating the first and second class clusters were mainly distributed near the bordering adjacent districts and counties among the provinces. Conclusion: In 2015, the prevalence rates of typhoid fever and paratyphoid fever were low, however with regional high prevalence areas. Cross regional transmission existed among provinces with high incidence rates which might be responsible for the clusters to appear in these areas.


Assuntos
Febre Paratifoide/epidemiologia , Febre Tifoide/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Criança , Pré-Escolar , China/epidemiologia , Epidemias , Fazendeiros , Feminino , Humanos , Incidência , Lactente , Masculino , Pessoa de Meia-Idade , Febre Paratifoide/etnologia , Febre Paratifoide/microbiologia , Vigilância da População , Estudos Retrospectivos , Estações do Ano , Análise Espaço-Temporal , Estudantes , Febre Tifoide/etnologia , Febre Tifoide/microbiologia
13.
Zhonghua Liu Xing Bing Xue Za Zhi ; 38(6): 759-762, 2017 Jun 10.
Artigo em Chinês | MEDLINE | ID: mdl-28647978

RESUMO

Objective: To investigate the clinical severity, etiological classification and risk factors of severe cases with hand, foot and mouth disease (HFMD). Methods: A total of 1 489 records on severe and fatal HFMD cases reported to the national pilot surveillance system of HFMD were used to analyze the demographic, medical treatment, etiological classification of the cases. Treatment outcome related risk factors were also studied with multi-variable stepwise logistic regression method. Results: Seven out of the 1 489 severe HFMD cases died of this disease. A total of 960 (72.9%) were under three years old and 62.9% were male and most of the cases (937, 62.9%) resided in rural areas. Among all the cases, 494 (33.2%) went to seek the first medical assistance at the institutions of village or township level. Durations between disease onset and first medical attendance, being diagnosed as the disease or diagnosed as severe cases were 0(0-1) d, 1 (0-2) d and 2 (1-4) d, respectively. In total, 773 (51.9%) of the severe HFMD cases were diagnosed as with aseptic meningitis, 260 (17.5%) with brainstem encephalitis, 377 (25.3%) with non-brainstem encephalitis, 6 (0.4%) with encephalomyelitis, 1 (0.1%) with acute flaccid paralysis, 4 (0.3%) with pulmonary hemorrhage/pulmonary edema and 68 (4.6%) with cardiopulmonary failure. Of the etiologically diagnosed 1 217 severe and fatal HFMD cases, 642 (52.8%) were with EV71, other enterovirus 261 (21.5%), Cox A16 36 (3.0%), 1 (0.1%) with both EV71 and Cox A16. However, 277 (22.8%) showed negative on any pathogenic virus. Complication (Z=3.15, P=0.002) and duration between onset and diagnosed as severe cases (Z=3.95, P<0.001) were shown as key factors related to treatment outcomes. Conclusions: Most severe HFMD cases appeared in boys, especially living in the rural areas. Frequently seen complications would include aseptic meningitis, non-brainstem encephalitis and brainstem encephalitis. EV71 was the dominant etiology for severe and fatal cases. Early diagnosis and complication control were crucial, related to the treatment outcome of HFMD.


Assuntos
Infecções por Enterovirus/epidemiologia , Doença de Mão, Pé e Boca/epidemiologia , Vigilância da População , Pré-Escolar , China/epidemiologia , Enterovirus , Enterovirus Humano A , Infecções por Enterovirus/etnologia , Feminino , Doença de Mão, Pé e Boca/etnologia , Humanos , Lactente , Masculino , Meningite Asséptica , Fatores de Risco
14.
Zhonghua Liu Xing Bing Xue Za Zhi ; 38(4): 462-466, 2017 Apr 10.
Artigo em Chinês | MEDLINE | ID: mdl-28468063

RESUMO

Objective: To evaluate the health related quality of life (HRQoL) for severe hand, foot and mouth disease (HFMD) patients with different complications. Methods: A national telephone interview under the EQ-5D proxy2 questionnaire (EQ-SD and EQ-VAS), was conducted to obtain the HRQoL of lab-confirmed severe HFMD patients, aged between six months and five-year-olds from the national communicable disease surveillance system from January 1, 2012 to December 31, 2013. Results: A total of 685 severe HFMD cases were included in the study. A total of 456 (66.6%) of them were males with 75.8% of them younger than three years old. A total of 337 (49.2%) and 407 (59.4%) of the participants reported that they had problems in mobility or daily activities. A total of 569 (83.1%) and 616 (89.9%) of the cases reported having problems in pain/discomfort or anxiety/depression. The average EQ-5D and EQ-VAS scores were 0.58±0.23 and 53.6±25.7, both were positively associated with the duration of illness. Mean quality adjusted life years loss during the HFMD episode for the severe patients was (15.45±13.75) years/1 000 persons. The QALY losses for severe patients with each of below complication were: respiratory diseases (11.17±8.83) years/1 000 persons, aseptic meningitis (13.56±11.99) years/1 000 persons, encephalitis/brainstem encephalitis/acute flaccid paralysis (AFP) (15.31±12.63) years/1 000 persons, Myocarditis (17.28±18.16) years/1 000 persons, pulmonary hemorrhage/pulmonary edema (17.34±14.98) years/1 000 persons, cardiopulmonary failure (25.47±20.53) years/1 000 persons. Among patients with lab confirmed Entero virus A71 (EV71) (16.51±14.48) years/1 000 persons, the QALY loss was seen higher than Coxsackie virus A16 (Cox A16) (13.02±11.45) years/1 000 persons and other Enter virus (14.74±14.22) years/1 000 persons (Z=11.83, P=0.003). Conclusion: The HRQoL loss for severe HFMD patients substantially increased under complications exacerbation and related to the duration of illness.


Assuntos
Doença de Mão, Pé e Boca/psicologia , Nível de Saúde , Qualidade de Vida , Adolescente , China/epidemiologia , Feminino , Doença de Mão, Pé e Boca/epidemiologia , Humanos , Masculino , Anos de Vida Ajustados por Qualidade de Vida , Índice de Gravidade de Doença , Adulto Jovem
15.
Zhonghua Yu Fang Yi Xue Za Zhi ; 51(1): 87-92, 2017 Jan 06.
Artigo em Chinês | MEDLINE | ID: mdl-28056277

RESUMO

Objective: To estimate the direct medical cost of severe hand, foot and mouth disease (HFMD) in patients aged less than five years. Methods: A stratified sampling method was used to collect data on severe HFMD cases reported in the National HFMD surveillance database between Jan 1, 2012, and Dec 31, 2013. The sampling was referenced with the national aetiologic distribution of Enterovirus A71 (EV-A71), Coxsackievirus A16 (CV-A16) and other Enteroviruses (OEV) for severe HFMD cases and the included cases were distributed among seven geographic regions (Northeast, North China, Northwest, Central China, Southwest, East China and South China). A nationwide telephone interview using a structured questionnaire was conducted to obtain the direct medical cost and any complications that occurred in patients during the outbreak of laboratory-confirmed HFMD. After excluding the cases who could not recall their medical expenses or complications, a total of 685 cases were included in the analysis. Kruskal-Wallis H test was used to analyze the differences among patients who reported different complications. Multiple linear regression with bootstrap analysis of 500 replicates was used to explore the factors that influenced the direct medical costs. Results: Of 685 patients analyzed, 456 (66.6%) were male and 229 (33.4%) were female. The direct medical costs P50 (P25, P75) were 14 250 (10 301, 20 600) Yuan. In total, 127 (18.5%) patients were diagnosed with severe HFMD patients with respiratory disease, 38 (5.5%) patients were diagnosed with aseptic meningitis, and 378 (55.2%) with encephalitis/brainstem encephalitis/acute flaccid paralysis. Furthermore, 53 (18.5%) patients were diagnosed with myocarditis, 39 (5.7%) with pulmonary hemorrhage/pulmonary edema and 50 (7.3%) with cardiopulmonary failure. The median (interquartile range) direct medical costs were 12 360 (7 313, 16 480) Yuan for severe HFMD patients with respiratory disease, 13 803 (9 064, 19 930) Yuan for aseptic meningitis, 14 438 (11 000, 20 015) Yuan for encephalitis/brainstem encephalitis/acute flaccid paralysis, 14 800 (8 500, 21 218) Yuan for myocarditis, 20 600 (12 500, 31 130) Yuan for pulmonary hemorrhage/pulmonary edema, and 20 043 (12 772, 28 840) Yuan for cardiopulmonary failure (H=17.70, P<0.001). The results of multiple linear regression with bootstrap analysis revealed that the direct medical cost for severe HFMD patients from Central China was 7 881 (95% CI: 3 814-11 949) Yuan higher than that of North China; severe HFMD patients diagnosed with OEV had direct medical costs of 1 987 (95%CI: 206-3 769) Yuan less those associated with EV-A71; severe HFMD patients whose duration of illness was ≥21 d had 20 480 (95% CI: 10 985- 29 974) Yuan higher direct medical costs those whose illness lasted ≤5 d; the direct medical costs for severe HFMD patients with pulmonary hemorrhage/pulmonary edema and cardiopulmonary failure were 7 874 (95%CI: 3 723-12 026) and 9 855 (95% CI: 328- 19 382) Yuan higher, respectively, than that associated with respiratory disease. Conclusion: The direct medical costs associated with severe HFMD were found to be substantial. The total cost was affected by the duration of the illness and the severity of any complications.


Assuntos
Doença de Mão, Pé e Boca/economia , Custos de Cuidados de Saúde , Pré-Escolar , China/epidemiologia , Efeitos Psicossociais da Doença , Surtos de Doenças , Enterovirus/isolamento & purificação , Infecções por Enterovirus , Feminino , Doença de Mão, Pé e Boca/diagnóstico , Doença de Mão, Pé e Boca/tratamento farmacológico , Custos de Cuidados de Saúde/estatística & dados numéricos , Humanos , Lactente , Masculino
16.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi ; 35(11): 807-811, 2017 Nov 20.
Artigo em Chinês | MEDLINE | ID: mdl-29316749

RESUMO

Objective: To investigate the effect of baicalin on the changes in hemorheology and its mechanism during the development of Acute Respiratory Distress Syndrome(ARDS) induced by oleic acid (OA) in rats. Methods: Rats were randomized into 3 groups: control, ARDS (OA induction, 0.12 mg/kg) and ba-icalin-treated group (300 mg/kg). The blood samples were collected at 30 min, 1, 2, 3, 6, 12 and 6 h after OA injection. The whole blood viscosity, plasma viscosity, Maximum erythrocyte deformability index (DImax) were detected. Meanwhile, blood gas analysis and Routine blood test were also performed. Results: The level of arte-rial oxygen partial pressure and oxygenation index decreased (P<0.01 vs. control) and oxygenation index (178 mm Hg, 1 mm Hg=0.133 kPa) reached the diagnostic standard of ARDS at 2 h in ARDS group. In baicalin-treated group, the level of arterial oxygen partial pressure and oxygenation index increased versus the ARDS group. The platelet count (PLT) decreased in baicalin-treated and ARDS groups. Compared with the ARDS group, the level of PLT increased significantly in baicalin-treated group at 30min, 1, 2, and 3 h. Hematocrit (HCT) increased in baicalin-treated and ARDS groups. Compared with the ARDS group, the level of HCT de-creased significantly in baicalin-treated group at 2, 3, 6 and 12 h. Meanwhile, all the index of hemorheology improved in baicalin-treated group. Conclusion: Baicalin may improve hypoxemia of ARDS induced by OA in rats. It may be due to the Improvement of microcirculation of lung.


Assuntos
Flavonoides/uso terapêutico , Hemorreologia/efeitos dos fármacos , Síndrome do Desconforto Respiratório do Adulto/induzido quimicamente , Síndrome do Desconforto Respiratório do Adulto/tratamento farmacológico , Animais , Pulmão , Ácido Oleico/efeitos adversos , Ratos
17.
Beijing Da Xue Xue Bao Yi Xue Ban ; 48(5): 830-834, 2016 10 18.
Artigo em Chinês | MEDLINE | ID: mdl-27752165

RESUMO

OBJECTIVE: To describe a method based on analysis of the histogram of intensity values produced from the magnetic resonance imaging (MRI) for quantifying the degree of fatty infiltration. METHODS: The study included 25 patients with dystrophinopathy. All the subjects underwent muscle MRI test at thigh level. The histogram M values of 250 muscles adjusted for subcutaneous fat, representing the degree of fatty infiltration, were compared with the expert visual reading using the modified Mercuri scale. RESULTS: There was a significant positive correlation between the histogram M values and the scores of visual reading (r=0.854, P<0.001). The distinct pattern of muscle involvement detected in the patients with dystrophinopathy in our study of histogram M values was similar to that of visual reading and results in literature. The histogram M values had stronger correlations with the clinical data than the scores of visual reading as follows: the correlations with age (r=0.730, P<0.001) and (r=0.753, P<0.001); with strength of knee extensor (r=-0.468, P=0.024) and (r=-0.460, P=0.027) respectively. Meanwhile, the histogram M values analysis had better repeatability than visual reading with the interclass correlation coefficient was 0.998 (95% CI: 0.997-0.998, P<0.001) and 0.958 (95% CI: 0.946-0.967, P<0.001) respectively. CONCLUSION: Histogram M values analysis of MRI with the advantages of repeatability and objectivity can be used to evaluate the degree of muscle fatty infiltration.


Assuntos
Tecido Adiposo Branco/diagnóstico por imagem , Bioestatística/métodos , Imagem por Ressonância Magnética/métodos , Imagem por Ressonância Magnética/estatística & dados numéricos , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/patologia , Distrofias Musculares/diagnóstico por imagem , Distrofias Musculares/patologia , Coxa da Perna/diagnóstico por imagem , Fatores Etários , Distrofina/deficiência , Distrofina/genética , Humanos , Força Muscular/fisiologia , Distrofias Musculares/congênito
18.
Beijing Da Xue Xue Bao Yi Xue Ban ; 48(5): 846-849, 2016 10 18.
Artigo em Chinês | MEDLINE | ID: mdl-27752168

RESUMO

OBJECTIVE: To report thigh muscle magnetic resonance imaging (MRI) tests of four Chinese patients with dystrophinopathy with edema changes in adductor longus muscles that mimics adductor enthesopathy. METHODS: Four boys, who were from four unrelated families and aged from 5 to 11 years, were investigated because of the clinical manifestations including myalgia or muscle weakness or the incidental findings of elevated serum creatine kinase levels, and were diagnosed with dystrophinopathy by gene test of Duchenne muscular dystrophy (DMD). Their creatine kinase levels were increased from 4 087 IU/L to 32 700 IU/L (Normal range: 75-175 IU/L). The muscle biopsy of three patients all demonstrated a dystrophic pattern including necrosis, regeneration, hypertrophy, atrophy and connective tissue proliferation, with different proportions of dystrophin-negative muscle fibers. The gene test of DMD showed an out-frame deletion of exons in three of the four patients, involving either exons 45 or exons 49-52 deletion or exon 62 duplication, and c.2665 C>T with nonsense mutation in the other one. Muscle MRI tests of the bilateral thighs were performed with T1 weighed sequence and slow tau inversion recovery sequence. The degree of fatty infiltration changes was scored. RESULTS: MRI of the thigh muscles showed mild to severe fatty infiltration changes in T1 weighed sequence with the total scores from 2 to 13.The most severe fatty infiltration changes were in the long head of biceps femoris and adductor magnus. Obvious hyperintensities appeared mainly in the adductor longus muscles on slow tau inversion recovery (STIR) images in all the patients without any abnormal signals in the attachment of the ligament, indicating edema changes of the adductor longus muscles which mimiced adductor enthesopathy. Two of the four patients presented with edema changes in the bilateral adductor longus muscles, while the other two were with only unilateral changes. Furthermore, other thigh muscles, including adductor magnus, semitendinosus, sartorius and rectus femoris muscles, could also have mild edema changes in two of the four patients. CONCLUSION: Dystrophinopathy can manifest as edema changes in the adductor longus muscles in thigh muscle MRI tests, which is a typical lesion in adductor enthesopathy. The adductor longus muscles in the dystrophinopathy patients may be easy to be impaired due to traction injury during sports.


Assuntos
Tecido Adiposo/diagnóstico por imagem , Edema/diagnóstico por imagem , Edema/etiologia , Entesopatia/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/patologia , Distrofia Muscular de Duchenne/diagnóstico por imagem , Distrofia Muscular de Duchenne/patologia , Coxa da Perna/diagnóstico por imagem , Tecido Adiposo/patologia , Biópsia , Criança , Pré-Escolar , Diagnóstico Diferencial , Éxons/genética , Humanos , Masculino , Distrofia Muscular de Duchenne/genética , Mutação/genética
19.
Chem Commun (Camb) ; 51(7): 1367-70, 2015 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-25487177

RESUMO

A facile fabrication of flower-shaped porphyrin Janus colloids with oriented arrangement was demonstrated based on the interfacial assembly and water droplet template. The as-fabricated colloidal crystals from flower-shaped Janus particles show a special optical signal produced from the hierarchical structures.


Assuntos
Nanopartículas/química , Nanotecnologia/métodos , Porfirinas/química , Coloides , Modelos Moleculares , Conformação Molecular
20.
Reprod Domest Anim ; 45(6): e323-31, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20113446

RESUMO

The aims of this study were (i) to establish a goat mammary gland epithelial (GMGE) cell line, and (ii) to determine if these GMGE cells could be maintained long-term in culture by continuous subculturing following transfection with a reporter gene, enhanced green fluorescence protein (EGFP). Primary culture of GMGE cells was achieved by outgrowth of migrating cells from the fragments of the mammary gland tissue of a lactating goat. The passage 16 GMGE cells were transfected with EGFP gene using lipofection. The expression of Cell keratins of epithelial cells in GMGE cells was test by immunofluorescence. Βeta-Casein gene mRNA was test for GMGE cells by RT-PCR. The results showed that when grown at low density on a plastic substratum, the GMGE cells formed islands, and when grown to confluency, the cells formed a monolayer and aggregated with the characteristic cobble-stone morphology of epithelial cells. GMGE cells could form dome-like structure which looked like nipple, and the lumen-like structures formed among the cells. Several blister-like structures appeared in the appearance of the cells. The GMGE cells contained different cell types, majority of the cells were short shuttle-like or polygon which were beehive-like. A part of cells were round and flat, a small number of cells were elongated. Some of the GMGE cells contained milk drops. The cell nuclei were round which had 2-4 obvious cores. The expression of Cell keratins demonstrated the property of epithelial cells in GMGE cells by immunofluorescence. The GMGE cells could express transcript encoding a Βeta-Casein protein. EGFP gene was successfully transferred into the GMGE cells, and the transfected cells could be maintained long-term in culture by continuous subculturing. In conclusion, we have established a EGFP gene transfected GMGE (ET-GMGE) cell line and maintained it long-term in culture by continuous subculturing.


Assuntos
Células Epiteliais/metabolismo , Cabras/anatomia & histologia , Proteínas de Fluorescência Verde/metabolismo , Glândulas Mamárias Animais/citologia , Animais , Caseínas , Linhagem Celular , Células Epiteliais/citologia , Feminino , Regulação da Expressão Gênica/fisiologia , Proteínas de Fluorescência Verde/genética , Glândulas Mamárias Animais/metabolismo , Reação em Cadeia da Polimerase Via Transcriptase Reversa
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