A retrospective clinical study of 121 cases and a prospective one of 21 cases of acute cholargitis of severe type(ACST)were carried out in order to probe the optimal time of emergency operation for those patients with ACST.The results indicated that the principle of clinical management for ACST is a combination of emergency operation and energetic active conservation therapy.Conservative treatment is practically qualified for the majority of ACST,especially,those cases with short history and a few complication.The survival prediction mathematical model reported previously is helpful to select the optimal time for an emergency operation.The regression value 0.40 of the model can be a reference of the predictive critical point for an operation.The mathematical model possesses more advantage than the traditional method.

The potential of cancer immunotherapy has been demonstrated recently using the chimeric antigen receptors-engineered (CAR) T cells, in which B cell haematological malignancies was successfully treated in clinical trials. However, challenges remain in the translation of the potential benefits into therapy of other types of cancer with similar efficacy and safety. Excessive activation of genetically-modified T cells may cause severe toxicities, such as cytokine storm, on-target toxicities, and tumor lysis syndrome. Genomic integration of viral vectors may cause genetic toxicities due to insertional mutagenesis of important genes. Strategies to overcome these toxicities are proposed and discussed, including the use of suicide genes, combinatorial antigen recognition, on-switch, non-viral vector and other innovative gene therapy strategies, to enhance safety of this promising immunotherapy.

OBJECTIVETo investigate the gene prevalence and spectrum of thalassemia in the women of childbearing age in quanzhou area.

METHODSVenous blood of the women were collected for study, all subjects were registered in each county of quanzhou area by using cluster sampling. Both the mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) were used for screening thalassemia．Genotyping of the screened positive samples was performed by gap single polymerase chain reaction (gap-PCR) and reverse dot blot (RDB) hybridization．Unknown positive samples were analyzed with DNA sequencing.

RESULTSOut of all 7 082 samples, Three hundred and eighty four were identified as thalassemia gene carriers with a carrying rate of 5.42 %. The α and β thalassemia were 3.21% and 2.15% respectively. -- /αα was the most common genotype with 68.72 % in mutation types of α thalassemia, In addition gene, 2 cases of --/αα and 1 case of αα/ααα were also detected. IVS-Ⅱ-654/N and CD41-42/N were the most common gentypes with 75.00 % in mutation types of β thalassemia gene, 5 cases were found to be α β compogite thalassemia.

CONCLUSIONThe carrying rate of thalassemia gene in quanzhou area is higher, and with the most common gentypes including -- /αα、IVSⅡ-654(C→T)/N and CD41-42(-TTCT)/N. The study results are beneficial for the screening of thalassemia in the genetic consultation and the prenatal gene diagnosis.

OBJECTIVE: To investigate the gene mutation types and gene carrying rate of common thalassemia in patients with thalassemia in Quanzhou, and to analyze its molecular epidemiological characteristics in Quanzhou. METHODS: 546 patients with thalassemia diagnosed at the first hospital of Quanzhou from January 2017 to October 2018 were collected and retrospectively analyzed for their types of mutations and carrier rates. RESULTS: Among the 4226 samples submitted, 546 positive samples were detected, the total carrying rate of the thalassaemia genes was 12.92%; the carrier rate of α-thalassemia was 8.16%; the carrier rate of β-thalassemia was 4.76%; There were more α-thalassemia missing patients than non-deleted patients. The Southeast Asian deletion type (-- /αα) was the most common one, with a composition ratio of 68.98%, which was followed by 22.61% (-α/αα), 2.61% (αα/αα), and 2.32% (αα/αα), 2.32% (αα/αα), 1.16% (-α/αα); 9 types of β-thalassemia gene mutations were detected. The most common three mutations were IVSII-654 (C→T, 42.29%), CD41-42 (-TTCT, 33.83%), CD17 (A→T, 12.94%). 2 cases of --/αα , 1 case of αα/ααα and 1 case of HKαα were detected. CONCLUSION This study shows that the gene carrying rate of thalassemia in Quanzhou is high and has diversity, which can provide some reference for the prevention and control of thalassemia in Quanzhou.
China ; Genotype ; Humans ; Mutation ; Retrospective Studies ; alpha-Thalassemia ; beta-Thalassemia

OBJECTIVE: To explore the genotypes and prenatal diagnosis of thalassemia in couples of childbearing age in Quanzhou, Fujian Province. METHODS: Blood routine and hemoglobin electrophoresis were performed for initial thalassemia screening in 76 328 couples in Quanzhou region from July 2017 to July 2020. The couples with positive initial screening results further underwent thalassemia gene test. Couples carrying homotypic thalassemia genes underwent prenatal diagnosis in the second trimester. RESULTS: Among 76 328 couples of childbearing age, 1 809 couples of positive initial thalassemia screening were identified, with the positive rate about 2.37%. Further results of genetic detection of the 1 809 couples showed that 985 cases were diagnosed as α- thalassemia, of which --^sea/αα was the most frequency, followed by -α^3.7/αα and αα^QS/αα; 296 cases were diagnosed as β-thalassemia, the most frequency mutations were 654M/N and 41-42M/N; 26 cases of compound α and β-thalassemia were detected. In addition, 3 rare cases of thalassemia were detected, including --^THAI/αα, SEA-HPFH, and -α^6.9/--^sea. Among them, 108 couples were confirmed as homologous thalassemia, with the detection rate about 5.97%, including 96 couples of homologous α-thalassemia, 9 couples of homologous β-thalassemia, and 3 couples with one had compound α- and β-thalassemia. Among them, 17 couples with homologous α-thalassemia underwent prenatal diagnosis in the second trimester, of which 1 case of Hb Bart's Hydrops Syndrome, 3 cases of HbH disease, 9 cases of silent thalassemia or α-thalassemia minor, and 4 cases of healthy fetuses were detected. Fetal chromosome karyotype analysis showed that 16 cases were normal and 1 case diagnosed as Down syndrome. CONCLUSION Thalassemia screening in pre-marital and pre-pregnancy, and prenatal diagnosis can effectively reduce the birth of children with thalassemia intermediate and thalassemia major. It is necessary to perform chromosome karyotype analysis at the same time as prenatal diagnosis of thalassemia gene in order to avoid fetus with abnormal chromosome.
Child ; China ; Female ; Genetic Testing ; Genotype ; Humans ; Pregnancy ; Prenatal Diagnosis ; alpha-Thalassemia/genetics* ; beta-Thalassemia/genetics*

OBJECTIVE: To understand the distribution of allergens in patients with allergic rhinitis (AR) in Quanzhou, for the diagnosis, prevention and treatment. METHOD: Twenty standardized allergen underwent skin prick testing (skin prick test, SPT) were used for 1236 patients with suspected AR patients in Quanzhou, and the different age, gender and severity in patients with allergen distribution differences of positive rate were analyzed. RESULT: The top 5 allergens with positive skin tests were D. pteronyssinus (66.7%), D. farinae (65.5%), Blattodea (32.8%), Sea crab (18.2%), and Sea lobster (16.8%). The positive rate of SPT in the minor groups and adult groups had significant difference (P < 0.05). Gender difference between the positive rate of SPT had no significant difference (P > 0.05). There was significant difference between the positive rate in patients with a family history and history of asthma and patients without above two history (P < 0.05). CONCLUSION Dust Mite, Blattodea, Sea crab. Sea lobster are the most important allergens in quanzhou. Different ages of the patients with SPT positive rates vary, a family history, history of asthma patients with positive rate is higher than patients without a family history of asthma history, high positive rate.
Adolescent ; Adult ; Aged ; Allergens ; analysis ; immunology ; Animals ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Rhinitis, Allergic ; Rhinitis, Allergic, Perennial ; diagnosis ; epidemiology ; immunology ; Skin Tests ; Young Adult

OBJECTIVE To systematically evaluate the efficacy and safety of glucagon-like peptide-1 receptor agonists(GLP-1RA) in the renal protection of type 2 diabetes(T2DM) patients, and provide evidence for clinic. METHODS Computer retrieval of PubMed, Embase, The Cochrane Library, Clinical Trials.gov, CNKI, WanFang Data and VIP databases, and manual retrieval of the included references. Randomized controlled trials(RCTs) for T2DM using GLP-1RA alone or GLP-1RA in combination with other conventional agents(experimental group) versus conventional treatment without GLP-1RA or placebo(control group). The search period spanned from the establishment of the database to January 30, 2022. Meta-analysis of the included data was performed using RevMan 5.4 statistical software. RESULTS A total of 7 studies were included, including 7 985 cases in experimental group and 6 633 cases in control group. Meta-analysis showed that the experimental group significantly reduced the incidence of renal complex endpoint events[Z=2.17, P=0.03, RR=0.79, 95%CI(0.64, 0.98)], urinary albumin creatinine ratio[Z=11.66, P<0.00001, MD=–23.74, 95%CI(–27.73, –19.74)], incidence of new macroalbuminuria[Z=5.79, P<0.000 01, MD=0.76, 95%CI(0.69, 0.83)], hemoglobin A1c[Z=12.76, P<0.000 01, MD=–0.94, 95%CI(–1.09, –0.80)] and estimated glomerular filtration rate[P=0.0007, Z=3.39, MD=–7.37, 95%CI(–11.63, –3.10)], the differences were statistically significant. One study showed that the experimental group could significantly reduce 24-hour urinary albumin excretion rate. However, there was no significant difference in the incidence of acute renal failure between the two groups[Z=0.63, P=0.53, MD=1.13, 95%CI(0.78, 1.63)]. In terms of safety, except the incidence of hypoglycemia, the incidence of adverse reactions in the experimental group was higher than that in the control group, including diarrhea, nausea, vomiting and loss of appetite, with statistically significant differences. CONCLUSION Existing research evidence shows that the common adverse reactions of GLP-1RA are gastrointestinal reactions and can be tolerated. Compared with placebo or conventional treatment without GLP-1RA, GLP-1RA may have a protective effect on the kidney of T2DM patients, and this conclusion needs to be further verified by RCTs.

Recombinant adenovirus-associated virus (rAAV) vectors mediated gene delivery system has been widely used in the treatments of cancer or other genetic diseases. It is considered to be one of the most promising vector owing to its non-pathogenicicity, low immune response, potential to integrate site-specif-ically, persistent and stable gene expression. However, it was limited in clinical applications because it is easy to be neutralized in serum and non-selection to the target site. Chemical modifications of rAAV have been studied to overcome those problems. This article reviewed the progress of chemical modifications of rAAV by various compounds and different modification methods, and predicted what the researches needed to do in the future.
Animals ; Chemical Phenomena ; Chemistry ; methods ; Dependovirus ; chemistry ; genetics ; metabolism ; Gene Transfer Techniques ; Genetic Vectors ; chemistry ; genetics ; metabolism ; Humans

This study investigated effects of Ginsenoside Ro (Ro) on interleukin-1β (IL-1β)-induced apoptosis and inflammation in rat chondrocytes. The rat chondrocytes were co-treated with IL-1β (10 ng·kg(-1)) and Ro (50, 100 and 200 μmol·L(-1)) for 48 h. Chondrocytes viability was detected by the MTT assay and Annexin V-FITC/PI dual staining assay. Caspase 3 activity was measured by using caspase 3 colorimetric assay kit. Apoptosis related proteins Bax, Bad, Bcl-xL, PCNA, p53 and phospho-p53, along with inflammation related protein MMP 3, MMP 9 and COX-2, and the expression of phospho-NF-κB p65 were assayed by western blotting analyses. Ro could improve IL-1β-induced chondrocytes viability. Ro could suppress IL-1β-induced apoptosis by inhibiting levels of Bax and Bad, decreasing p53 phosphorylation and promoting the expression of Bcl-xL and PCNA. Ro inhibited caspase 3 activity. IL-1β-induced inflammation and matrix degration were also alleviated by Ro with down-regulating the expression of MMP 3, MMP 9 and COX-2. Moreover, Ro inhibited NF-κB p65 phosphorylation induced by IL-1β. In conclusion, these results suggested Ro exerted anti-apoptosis and anti-inflammation in IL-1β-induced rat chondrocytes, which might be related to NF-κB signal pathway. Therefore, we propose that Ro might be a potential novel drug for the treatment of osteoarthritis.
Animals ; Anti-Inflammatory Agents ; pharmacology ; Apoptosis ; drug effects ; Apoptosis Regulatory Proteins ; drug effects ; metabolism ; Caspase 3 ; metabolism ; Cell Survival ; drug effects ; Chondrocytes ; cytology ; drug effects ; Cyclooxygenase 2 ; drug effects ; metabolism ; Down-Regulation ; drug effects ; Drug Evaluation, Preclinical ; Ginsenosides ; pharmacology ; Inflammation ; chemically induced ; drug therapy ; Interleukin-1beta ; antagonists & inhibitors ; pharmacology ; Matrix Metalloproteinase 3 ; drug effects ; metabolism ; Matrix Metalloproteinase 9 ; drug effects ; NF-kappa B ; antagonists & inhibitors ; drug effects ; metabolism ; Phosphorylation ; drug effects ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; drug effects

OBJECTIVE: To investigate the efficacy of single oblique lumbar interbody fusion(OLIF) with robot-assisted posterior internal fixation for the treatment of lumbar degenerative diseases. METHODS: The clinical data of 67 patients with lumbar degenerative diseases treated from September 2019 to December 2020 was retrospectively analyzed. According to different surgical methods, the patients were divided into traditional group and robot group. The traditional group received traditional OLIF with posterior fluoroscopy percutaneous nail fixation, and the robot group received OLIF with robot-assisted posterior internal fixation. There were 33 patients in traditional group, including 13 males and 20 females, aged from 44 to 82 years old with an average of (59.7±9.1) years; and 34 cases in robot group, including 7 males and 27 females, aged from 45 to 81 years old with an average of(61.6±8.8) years. The operation time, fluoroscopy time, intraoperative blood loss, postoperative out of bed time and hospital stay were recorded. The visual analogue scale (VAS) of low back pain and Oswestry Disability Index(ODI) were compared before operation and 3 days, 3 months after operation between two groups. The accuracy of nail placement was evaluated by postoperative CT scan. RESULTS: Both groups of patients successfully completed the operation and were followed up for more than 3 months. The operation time, fluoroscopy time, intraoperative blood loss, postoperative out of bed time and hospital stay in traditional group were(299.85±15.79) min, (62.58±10.83) min, (118.33±10.80) ml, (2.5±0.7) d, (9.67±2.13) d;and robot group was(248.53±14.22) min, (19.47±3.51) min, (115.74±9.86) ml, (2.3±0.6) d, (9.44±1.93) d, respectively. The symptoms of postoperative low back pain, lower limb pain and numbness were significantly improved in all patients. The operation time and fluoroscopy time in robot group were significantly less than those of traditional group. There was no significant difference in intraoperative blood loss, postoperative out of bed time, hospital stay, VAS and ODI before and after operation (P>0.05). The accuracy of nail placement in robot group was 98.8% (2/160), which was higher than 89.9% (16/158) in traditional group. CONCLUSION Treatment of lumbar degenerative diseases with single body position OLIF with robot-assisted posterior minimally invasive internal fixation has less operation time and fluoroscopy time, high nail placement accuracy and accurate surgical effect, which is worthy to be popularized in clinic.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Lumbar Vertebrae/surgery* ; Lumbosacral Region ; Male ; Middle Aged ; Retrospective Studies ; Robotics ; Spinal Fusion/methods* ; Treatment Outcome