Objective To explore the protective effect of herbal medicine to tonify qi and strengthen the spleen on liver damage induced by antituberculotic according to the TCM theory "reinforce the earth to reduce the wood".Methods The 100 tuberculosis patients randomized into two groups,50 in each,all took antituberculosis drugs with the liver-protecting medicine,Tiopronin,and the herbal medicines to nourish qi and strengthen the spleen were administered to those in the treatment group.Incidence of liver damage and the changes of liver function including serum alanine aminotransferase(ALT),aspartate aminotransferase(AST) and total bilirubin(TBiL) were observed for four weeks.Results In the treatment group,the incidence of liver damage was significantly lower than that in the control group(P

AIM:To investigate the prevalence of demodex folliculorum in eyelashes of elderly patients with Meibomian gland dysfunction(MGD)and to find the correlation between the presence of demodex folliculorum and MGD.

METHODS: The study involved elderly patients(age≥40)who visited Department of Ophthalmology in Fujian Provincial Hospital for the Elderly between September 2017 and March 2018. Patients were divided into MGD group(137 patients 137 eyes)and non-MGD group(96 patients 96 eyes). The patients underwent eyelid examinations by slit lamp, lipid secretion of the Meibomian gland, fluorescein corneal staining(FL), tear film breakup time(BUT). At the same time underwent epilation of eyelashes, and the number of Demodex was counted. The positive rate of demodex was compared between the two groups, the relation of number of demodex with eyelid margin score, lipid secretion of the meibomian gland, FL score and BUT were evaluated.

RESULTS: The positive rate of demodex in MGD group was 89.1%, significantly higher than that of group non-MGD 74.0%(P<0.05). The number of demodex showed significant positive correlations with the eyelid margin(r=0.89, P<0.05), lipid secretion of the meibomian gland(r=0.67, P<0.05), FL(r=0.35, P<0.05)and BUT(r=-0.37, P<0.05). The mild infection rate of demodex mites in non-MGD(60.6%)was higher than MGD(37.7%, P<0.05).

CONCLUSION: There is a strong correlation between ocular moderate or severe demodex mites infection and MGD, suggesting that demodex folliculorum may play a pathogenic role in elderly patients with MGD.

[摘 要] 目的：制备并表征包载CPI-444并偶联CD8抗体的纳米微粒（CNP/αCD8），探讨其对CD8+ T细胞活化、增殖和抗肿瘤作用的影响。方法: 采用复乳溶剂蒸发法和EDC/NHS法制备包载腺苷受体A2A（A2AR）特异性拮抗剂CPI-444（C）或香豆素6（C6）荧光素的纳米微粒并分别在其表面偶联CD8抗体，制得CNP/αCD8和C6NP/αCD8。扫描电镜和NanoPlus粒度测定仪表征纳米微粒形态和粒径，液相色谱与串联质谱联用（LC-MS/MS）法和离心法测定纳米微粒的载药量和药物释放情况，荧光显微镜和流式细胞仪检测CD8+ T细胞内化C6NP/αCD8的情况，流式细胞仪、ELISA和LDH法检测CNP/αCD8对CD8+ T细胞增殖、活化、细胞毒活性和杀瘤能力的影响。结果: CNP/αCD8纳米微粒为圆形、粒径约150 nm，能有效包载CPI-444和偶联CD8抗体，药物包封率和CD8抗体偶联效率分别约为60%和53.4%；CNP/αCD8纳米微粒具有良好稳定性，能被CD8+ T细胞内化，抑制A2AR分子表达。生物学功能实验显示，CNP/αCD8增强CD8+ T细胞的增殖能力、促进T细胞活化、分泌细胞因子及产生颗粒酶B和穿孔素，并增强CD8+ T细胞杀伤肿瘤细胞的能力。结论: CNP/αCD8纳米微粒能显著增强CD8+ T细胞免疫效应功能，其增强CD8+ T细胞功能可能是通过抑制A2AR分子的表达起作用。

OBJECTIVETo detect the expression levels of Livin and Caspase-3 proteins in diffuse large B cell lymphoma (DLBCL), and to explore its correlation with clinicopathological characteristics, so as to provide a reference for clinical treatment and evaluation prognosis of DLBCL.

METHODSImmunohisto-chemical staining was performed to detect the expression of Livin and Caspase-3 in the samples from 51 DLBCL patients and 20 patients with reactive hyperplasia of lymph node (RHL). The relation between Livin and Caspase-3 with the factors influencing the prognosis of DLBCL was analyzed.

RESULTSLivinwas not expressed in the tissues of RHL, but its expression rates reached to 58.82%(30/51) in 51 cases of DLBCL(P<0.05). The expression rats of Caspase-3 in DLBCL and RHL were 25.49%(13/51) and 85.0%(17/20) respectively, and the difference was statistically significant(P<0.05). The expression level of Livin in DLBCL tissues was related with clinical stage and pathological type(P<0.01, P<0.01). The expression of Livin was not obviously related with sex, age and extranodal involvement. The expression level of Caspase-3 in DLBCL tissues was related with clinical stage (P<0.05). The expression of Caspase-3 was not obviously related with sex, age, pathological type and extranodal involvement. There was a negative correlation between Livin and Caspase-3 in DLBCL(γ=-0.333,P=0.017). Kaplan-meier survival analysis revealed that the expressions of Livin and Caspase-3 were related stalistically significantly with the patients prognosis (P<0.01, P<0.05).

CONCLUSIONOver-expression of Livin in DLBCL and DLBCL of non-GCB subtypes, and low-expression of Caspase-3 in DLBCL may play a significant role in clinical prognosis of DLBCL.

Objective To evaluate neuropsychiatric adverse effects of cycloserine therapy for multidrug resistant pulmonary tuberculosis (MDR-TB).Methods A total of 82 patients with MDR-TB who were enrolled in Global Fund Round Five MDR-TB Control Program were admitted in Center for Diagnosis and Treatment of Tuberculosis,Hangzhou Red Cross Hospital from May to December 2012.All patients received the standard treatment containing cycloserine for MDR-TB.The adverse reactions during the treatment were recorded,and symptom checklist-90 (SCL-90) scores at different time points were compared with t test.Results Adverse reactions were observed in 66 patients (66/82,80.5％) within 3 months after the initial treatment.Common adverse reactions included arthralgia (42.7％),gastrointestinal reactions (40.2％),central nervous system symptoms (22.0％) and electrolytes disturbance (17.1％).Nine patients had severe neuropsychiatric symptoms characterized by convulsions,depression,anxiety,schizophrenia and attempting suicide,6 of whom had used fluoroquinolones before the study.The above symptoms were relieved after stopping cycloserine or antitubercular agents,and cycloserine was replaced in the following treatment.The total SCL-90 score,depression and anxiety scores were significantly higher during onset of symptoms than those one month after the following treatment (t =2.241,2.301 and 5.659,P ＜ 0.05).Conclusion Cycloserine may induce severe neuropsychiatric adverse reactions in patients receiving standard treatment for MDR-TB.

BACKGROUNDAmyloid β (Aβ) has been established as a key factor for the pathological changes in the brains of patients with Alzheimer's disease (AD), and cellular senescence is closely associated with aging and cognitive impairment. However, it remains blurred whether, in the AD brains, Aβ accelerates the neuronal senescence and whether this senescence, in turn, impairs the cognitive function. This study aimed to explore the expression of senescence-associated genes in the hippocampal tissue from young to aged 5XFAD mice and their age-matched wild type (WT) mice to determine whether senescent neurons are present in the transgenic AD mouse model.

METHODSThe 5XFAD mice and age-matched wild type mice, both raised from 1 to 18 months, were enrolled in the study. The senescence-associated genes in the hippocampus were analyzed and differentially expressed genes (DEGs) were screened by quantitative real-time polymerase chain reaction. Cognitive performance of the mice was evaluated by Y-maze and Morris water maze tests. Oligomeric Aβ (oAβ) (1-42) was applied to culture primary neurons to simulate the in vivo manifestation. Aging-related proteins were detected by Western blotting analysis and immunofluorescence.

RESULTSIn 5XFAD mice, of all the DEGs, the senescence-associated marker p16 was most significantly increased, even at the early age. It was mainly localized in neurons, with a marginal expression in astrocytes (labeled as glutamine synthetase), nil expression in activated microglia (labeled as Iba1), and negatively correlated with the spatial cognitive impairments of 5XFAD mice. oAβ (1-42) induced the production of senescence-related protein p16, but not p53 in vitro, which was in line with the in vivo manifestation.

CONCLUSIONSoAβ-accelerated neuronal senescence may be associated with the cognitive impairment in 5XFAD mice. Senescence-associated marker p16 can serve as an indicator to estimate the cognitive prognosis for AD population.

Alzheimer Disease ; metabolism ; physiopathology ; Amyloid Precursor Protein Secretases ; genetics ; metabolism ; Amyloid beta-Peptides ; metabolism ; Amyloid beta-Protein Precursor ; metabolism ; Animals ; Aspartic Acid Endopeptidases ; genetics ; metabolism ; Brain ; metabolism ; physiopathology ; Cells, Cultured ; Cellular Senescence ; genetics ; physiology ; Cognition ; physiology ; Cognition Disorders ; metabolism ; physiopathology ; Disease Models, Animal ; Male ; Mice ; Mice, Inbred C57BL ; Mice, Transgenic ; Neurons ; metabolism ; pathology ; Real-Time Polymerase Chain Reaction

OBJECTIVETo explore molecular and genetic mechanism of 3 cases of para-Bombay blood group.

METHODSThe bood samples of proband and family members were selected to identify their blood groups with conventional serologic methods, and salivary components carrying the ABH antigens were detected. The coding regions of FUT1 as well as exon 6 and 7 of the ABO gene were amplified using polymerase chain reaction(PCR), and the FUT1 gene was directly sequenced.

RESULTSAll the 3 cases of proband were confirmed as para-Bombay blood group. Direct sequencing revealed h new2 (nt328G→A) and h1(nt 547 ΔAG) in FUT1 gene of the proband 1, and FUT1 genotype was h1/h new2. However, the genotypes of his parents were H/h1 and H/h new2, which were non-Bombay individuals. The FUT1 genotypes of proband 2 and 3 were h1h2 (nt 547 ΔAG) and h1h2 (nt 880 ΔTT), respectively.

CONCLUSIONThe technology of molecular biology can be used to detect the base deletion mutations in FUT1 gene, which contributes to the analysis of molecular and genetic mechanism of para-Bombay blood group.

OBJECTIVE: To analyze clinical response of the Rituximab-based chemotherapy and prognostic features in patients with primary gastric diffuse large B-cell lymphoma (PGDLBCL). METHODS: From June 2008 to December 2020, the data of 53 PGDLBCL patients were analyzed retrospectively. RESULTS: The median age was 46(25-77) years old in 53 patients including 35 males and 18 females. Stomachache is the most common symptom. The diagnosis were confirmed in 47 patients by endoscopic biopsy and 6 patients by surgery. Twenty-six patients had Ⅰ/Ⅱ1 stage (Lugano staging system) disease and 27 cases had II2/IV stage disease. All patients were treated with chemotherapy, including RCHOP (25/53) and R-DA-EPOCH (28/53). Complete remission rate was 79.2%（42/53）. The 3-year and 5-year overall survival (OS) rates were 77.4% and 69.8%. Univariate analysis showed that lactate dehydrogenase(LDH), Lugano stage and lesion size affected OS. Multivariate Cox regression analysis revealed that IPI score and Lugano stage were independent prognosis risk factors affecting OS. The patients in the R-DA-EPOCH group presented better survival outcomes than those in the RCHOP group with late stage (P_5-year OS=0.035). CONCLUSION Rituximab in combination with chemotherapy is the backbone of therapy for PGDLBCL. IPI score and Lugano stage are independent prognosis risk factors affecting OS of PGDLBCL. R-DA-EPOCH can be superior to R-CHOP as a first-line regimen in PGDLBCL patients with late stage.
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Cyclophosphamide/therapeutic use* ; Disease-Free Survival ; Doxorubicin/therapeutic use* ; Female ; Humans ; L-Lactate Dehydrogenase ; Lymphoma, Large B-Cell, Diffuse/pathology* ; Male ; Middle Aged ; Prednisone/therapeutic use* ; Prognosis ; Retrospective Studies ; Rituximab/therapeutic use* ; Vincristine/therapeutic use*

This study was aimed to investigate the effect of bortezomib combined with bisphosphonates on serum levels of DKK-1 and RANKL in multiple myeloma patients, and to evaluate its role in the therapy of osteolytic lesion. Fourty-three patients with newly diagnosed and relapsed myeloma were divided into 2 groups. Twenty-three patients were treated with bortezomib combined with bisphosphonates (A group) and 20 patients were treated with bisphosphonates combined with traditional chemotherapy (B group). Serum levels of DKK-1 and RANKL were measured by ELISA before and after 4 cycles of chemotherapy. The results indicated that serum DKK-1 level significantly decreased in patients of A group (43.2 µg/L before vs 30.4 µg/L after 4 cycles of chemotherapy), and so did for serum RANKL level in A group (0.83 pmmol/L before vs 0.45 pmmol/L after 4 cycles of chemotherapy). While there was no significant differences in DKK-1 and RANKL serum level before therapy between A and B groups, but there was significant differences in DKK-1 and RANKL levels after 4 cycles of chemotherapy (P < 0.05). It is concluded that bortezomib combined with bisphosphonates obviously reduce the serum levels of DKK-1 and RANKL, thus has beneficial effect on osteolytic lesion.
Adult ; Aged ; Boronic Acids ; administration & dosage ; therapeutic use ; Bortezomib ; Diphosphonates ; administration & dosage ; therapeutic use ; Drug Therapy, Combination ; Female ; Humans ; Intercellular Signaling Peptides and Proteins ; blood ; Male ; Middle Aged ; Multiple Myeloma ; blood ; drug therapy ; Pyrazines ; administration & dosage ; therapeutic use ; RANK Ligand ; blood

OBJECTIVETo explore the feasibility and clinical effect of posterior spinal canal decompression with pedicle screw fixation and reconstruction of anterior and middle vertebral column for thoracolumbar burst fractures complicated with nerve injury.

METHODSA total of 36 patients with thoracolumbar burst fractures treated from March 2011 to April 2016 were enrolled in the retrospective study. There were 20 males and 16 females, aged from 21 to 52 years old with an average of 37.6 years. All the fractures were located on a single segment, 8 cases of T11₁₁, 10 cases of T₁₂, 12 cases of L₁, 6 cases of L₂. According to thoracolumbar injury classification and severity score(TLICS) system, the score was 7 to 9 points, with an average of 7.4 points. According to the America Spine Injury Association(ASIA) grade, 4 cases were type A, 10 cases were type B, 14 cases were type C, 8 cases were type D. All the patients underwent posterior spinal canal decompression with pedicle screw fixation and reconstruction of anterior and middle vertebral column. The recovery of nerve function was evaluated by ASIA grading. The correction of kyphosis(Cobb angle), the volume change of injuried spinal canal, the change of anterior border height of injury vertebra which can be observed by X-rays;the internal fixation loosening and breakage and all the information of bone fusion were recorded.

RESULTSAll the operations were successful, the mean operative time and intraoperative blood loss were(2.8±0.3) h (2.1 to 3.5 h) and (880±120) ml(550 to 1 350 ml), respectively. All the incisions got primary healing. All the patients were followed up for 12 to 28 months with an average of 18.4 months. All the patients obtained satisfactory bone fusion. No pseudoarticulation formation was found, and there was no loosening, breakage of pedicle screws or displacement of titanium mesh. Neurological function was improved in different degree, except in one patient with grade A and another one with grade B. According to the ASIA grade, there were 1 case of type A, 1 case of type B, 7 cases of type C, 10 cases of type D and 17 cases of type E, postoperatively. At 3 days after operative, the anterior border height of injury vertebra, Cobb angle and the volume changes of injury spinal canal were obviously improved(<0.05), and there was no significant difference between postoperative at 3 days and final follow-up(>0.05).

CONCLUSIONSSpinal canal decompression with screw fixation and reconstruction of anterior and middle vertebral column through posterior midline approach is a safe and effective method in the treatment of thoracolumbar burst fractures with nerve injury, it is worthy to be popularized. It can complete the spinal canal decompression of 360 degree, reduction of fractures and reconstruction of vertebral three-column at the same time through a single posterior approach. The advantages includes less trauma, perfect decompression, good stability and etc.

Adult ; Bone Screws ; Decompression, Surgical ; Female ; Fracture Fixation, Internal ; Humans ; Lumbar Vertebrae ; injuries ; Male ; Middle Aged ; Retrospective Studies ; Spinal Canal ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries ; Treatment Outcome ; Young Adult