Objective:To evaluate the efficacy of vitamin D supplementation for prevention of spontaneous bacterial peritonitis (SBP) in patients with decompensated liver cirrhosis of hepatitis B.Methods:A total of 172 patients with decompensated cirrhosis of hepatitis B admitted in Jinhua Hospital affiliated to Zhejiang University School of Medicine from January to December 2021 were randomly divided into two groups with 86 cases in each group. Patients in both groups received conventional antiviral and symptomatic treatment; while patients in the intervention group received additinal oral vitamin D drops (800 IU/d) for 6 months. After 6 months of treatment, the incidence of SBP and the serum biochemical indexes were compared between two groups. SPSS 21.0 statistical software was used for data analysis.Results:After 6 months of treatment, the incidence of SBP in the intervention group(5.81%, 5/86) was significantly lower than that in control group(30.23%, 26/86)( χ2=19.210, P<0.01). The serum 25-(OH)D level in intervention group was significantly higher than that in the control group ( t=13.425, P=0.018), while the levels of CRP, PCT and IL-6 in intervention group were significantly lower than those in control group ( t=17.312, 10.353 and 12.218, P<0.01 or <0.05). Conclusion:Vitamin D adjuvant therapy can increase serum 25-(OH)D level, decrease serum CRP, PCT and IL-6 levels, and effectively reduce the incidence of SBP in patients with decompensated cirrhosis of hepatitis B.

Objective To explore the expression of serine proteinase inhibitor family E member 1(SERPINE1)in colon cancer and its effect on the malignant biological behaviors of colon cancer cells.Methods starBase and TISIDB databases were used to analyze the expression of SERPINE1 in 471 patients with colon cancer and 41 paracancerous tissues,and the relationships of its differential expression with clinical stage and prognostic survival were analyzed.The cancer specimens and paracancerous tissues from 5 patients with colon cancer were collected in No.940 Hospital of Joint Logistic Support Force,and RT-qPCR and Western blotting were employed to detect the expression of SERPINE1 at mRNA and protein levels.After lentiviral vectors of SERPINE1 overexpression and interference were constructed and transfected into colon cancer RKO and LoVo cells.The experimental cells were assessed by RT-qPCR and Western blotting to verify the efficiency of overexpression and interference.Then cell proliferation,migration,invasion and apoptosis were evaluated by CCK-8 assay,clone formation test,Transwell test and Hoechst apoptotic nuclear staining,respectviely.Finally,Western blotting was applied to determine the effect of SERPINE1 on phosphatidyl-inositol 3-kinase(PI3K)/protein kinase B(AKT)signaling pathway.Results Database analysis showed that SERPINE1 was highly expressed,positively correlated with the clinical stage and negatively correlated with the overall survival in colon cancer patients(P＜0.05).Transfection of overexpression lentiviral vector resulted in enhanced cell proliferation,invasion and migration abilities while weakened apoptosis in RKO and LoVo cells.On the contrary,SERPINE1 interference reduced the abilities of cell proliferation,invasion and migration but improved cell apoptosis(P＜0.05).Western blotting showed that overexpression of SERPINE1 had no effect on the expression of PI3K and AKT,but increased the expression of p-PI3K and p-AKT,and SERPINE1 interference also had no change in PI3K and AKT expression and reduced the levels of their phosphorylation levels.Statistical differences were observed in relative quantitative analysis on the ratios of p-PI3K/PI3K and p-AKT/AKT(P＜0.05).Conclusion SERPINE1 is highly expressed,and correlated with clinical stage and prognosis of patients with colon cancer.Its overexpression promotes the proliferation,migration,invasion and inhibits apoptosis of colon cancer RKO and LoVo cells through PI3K/AKT signaling pathway.

OBJECTIVE: To analyze the roles of multidisciplinary team (MDT) in the diagnosis and treatment of suspected cases of coronavirus disease 2019 (COVID-19). METHODS: The clinical data of 48 patients with suspected COVID-19 admitted in Jinhua Municipal Central Hospital from January 21, 2020 to March 20, 2020 were retrospectively analyzed. RESULTS: In the 48 suspected cases, 18 were diagnosed with COVID-19, and 30 were excluded. Each of the confirmed cases were discussed among MDT for 2 to 12 times with an average of (4.7±3.2) times; while for non-COVID-19 patients were discussed for 2 to 4 times with an average of (2.3±0.6) times. With the guidance of MDT, one COVID-19 patient was transferred to designated provincial hospital after effective treatment; one patient complicated with acute cholecystitis underwent gallbladder puncture and drainage; and COVID-19 was excluded in a highly suspected patient after alveolar lavage fluid examination. Except one transferred patient, all 17 confirmed COVID-19 patients were cured and discharged. There was no cross-infection occurred in suspected patients during the hospitalization. There were no deaths and no medical staff infections. CONCLUSIONS The efficiency of diagnosis and treatment for suspected COVID-19 patients can be improved with MDT, particularly for complicated cases.
Betacoronavirus ; isolation & purification ; China ; Coronavirus Infections ; diagnosis ; therapy ; Humans ; Interdisciplinary Communication ; Pandemics ; Patient Care Team ; standards ; Pneumonia, Viral ; diagnosis ; therapy ; Retrospective Studies ; Treatment Outcome

OBJECTIVE: To analyze the roles of multidisciplinary team (MDT) in the diagnosis and treatment of suspected cases of corona virus disease 2019 (COVID-19). METHODS: The clinical data of 48 patients with suspected COVID-19 admitted in Jinhua Central Hospital from January 21, 2020 to March 20, 2020 were retrospectively analyzed. RESULTS: Of the 48 suspected cases, 18 were diagnosed with COVID-19, and 30 were excluded. Each of the confirmed cases were discussed among MDT for 2 to 12 times with an average of (4.7±3.2) times; while for non-COVID-19 patients were discussed for 2 to 4 times with an average of (2.3±0.6) times per case. With the guidance of MDT, one COVID-19 patient was transferred to designated provincial hospital after effective treatment; one patient complicated with acute cholecystitis underwent gallbladder puncture and drainage; and COVID-19 was excluded in a highly suspected patient after alveolar lavage fluid examination. Except one transferred patient, all 17 confirmed COVID-19 patients were cured and discharged; there was no cross-infection occurred in suspected patients during the hospitalization; there were no deaths and no medical staff infections. CONCLUSIONS The efficiency of diagnosis and treatment for suspected COVID-19 patients can be improved under MDT mode, particularly for complicated and refractory cases.
Betacoronavirus ; Coronavirus Infections ; complications ; diagnosis ; therapy ; Disease Management ; Humans ; Interdisciplinary Communication ; Pandemics ; Patient Care Team ; standards ; Pneumonia, Viral ; complications ; diagnosis ; therapy ; Retrospective Studies ; Treatment Outcome