1.The effect of albumin on (1, 3)-β-D-glucan for diagnosis of invasive fungal infections
Shiquan HAN ; Xiaolei SU ; Rui ZHAO ; Kaiyu FANG
Chinese Critical Care Medicine 2015;(8):672-676
ObjectiveTo explore the diagnostic value of plasma (1, 3)-β-D-glucan test (G test) in diagnosis of invasive fungal infections (IFI) and the influence of albumin on G test.Methods A prospective observational study was conducted. 267 patients admitted to medical intensive care unit (MICU) of Dalian Municipal Central Hospital from January 21st, 2012 to October 31st, 2014 were enrolled. According to IFI guideline, the patients were divided into without IFI group (n= 35), possible IFI group (n = 70), hypotheticle IFI group (n = 145) and proven IFI group (n = 17). G test was examined routinely using microbiology kinetic rapid reader MB-80.The different threshold values were calculated on G test. The difference among G tests, fungal culture and clinical diagnosis were compared. The results of G test ahead of and post albumin administration in each group were compared, and the value of G test for diagnosis of IFI during albumin infusion was evaluated.Results When the cut-off value was 20 ng/L for IFI diagnosis, higher sensitivity (79.8%), specificity (87.9%), and Youden index (67.7%) were found. The positive rates of G test, fungal culture and clinical diagnosis of IFI were 57.7% (154/267), 60.7% (162/267) and 54.3%(145/267) respectively, without showing significant differences (allP> 0.05). The result of G test (ng/L) was not obviously changed after albumin administration compared with that before in without IFI, possible IFI, hypotheticle IFI, and proven IFI groups (without IFI group: 11.25±2.33 vs. 10.99±1.07,t= -1.723,P= 0.085; possible IFI group: 53.14±5.53 vs. 49.22±8.11,t= -0.395,P= 0.693; hypotheticle IFI group: 90.30±9.38 vs. 85.41±10.11, t= 710.500,P= 0.860; proven IFI group: 100.98±19.24 vs. 103.21±17.66,t= 653.000,P= 0.449). Prior to the administration of albumin, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and Youden index were 79.8%, 87.9%, 45.6%, 96.7%, 67.7%, respectively. However, after the administration of albumin, they were 81.5%, 85.7%, 44.8%, 96.5%, and 67.2%, respectively, without significant difference.Conclusions G test is method for early diagnosis of IFI. The sensitivity and specificity are higher with 20 ng/L as the critical value. The result of G test is not interfered by albumin administration.
2.Clinical feature of pulmonary manifestation in mixed connective tissue disease:analysis of 112 patients
Kaiyu HAN ; Jianing LI ; You SUN ; Fuzhen L
Chinese Journal of Practical Internal Medicine 2001;0(09):-
Objective To study the clinical manifestations,diagnosis,treatments and prognosis of the pulmonary change in mixed connective tissue disease(MCTD).Methods From January 1996 to June 2008,112 patients with definite MCTD in Second Affiliated Hospital of Harbin Medical University were retrospectively studied,and the clinical feature about pulmanary manifestations,echocardiography feature,radiology features and treatments were reviewed and analyzed.44 patients were followed up.Results 48(5 male)had pulmonary manifestation.The median age of onset of symptoms was 39 years and the median duration of disease was three years.The most common manifestation was pleural effusion and(or)pachynsis pleurae(21 cases,18.8%).16 patients(14.3%) had interstitial lung disease,and 8 cases(7.1%)had pulmonary hypertension.The cardinal symptom was short breath.Thirteen patients(11.6%)had dyspnea,4 cases(3.6%)had chest pain,and 4 cases(3.6%)had cough.Reductions of pulmonary function or abnormalities of ultrasonographic image were noted in 25(52.1%)of 48 patients with pulmonary involvement of MCTD who had not any complaint of respiratory symptoms.Six patients had reductions in diffusing capacity of the lung for carbon monoxide(DLCO),17 patients had pulmonary abnormality on chest X ray or CT,and two patients had pulmonary hypertension on doppler echocardiography.Conclusion Pulmonary involment of MCTD may contribute to prognosis seriously.DLCO was the most sensitive parameter.Pulmonary hypertension was the most common cause of death.
3.Effect of cordyceps sinensis compound on immunological rejection of human-pig skin grafting
Daiwei CHENG ; Yong ZOU ; Shuguang WU ; Xueqin ZENG ; Wenjie HAN ; Kaiyu NIE ; Chaoliang WANG ; Erchan XIAO
Chinese Journal of Pathophysiology 1986;0(02):-
AIM:To investigate the effect of compound of cordyceps sinensis(CS) and tripterygium hypoglaucum on survival time of the heterologous human-pig graft skin.METHODS: CS solution were used to hatch the skin graft and CS was used locally.Ciclosporin A(CsA) and normal saline solution(NS) were used in control.Besides,skin HE staining was detected and CD4,CD8,IL-2 and IL-10 were also examined before and after operation.RESULTS: The survival time of the graft skin treated with CS was(21.20?3.19) days,while the control group treated with NS was(10.17?1.94) days(P
4.Genome cloning of human bocavirus (HBoV1) and analysis of viral promoter activity.
Jingjing LI ; Bin SUN ; Jinfeng OUYANG ; Ying CHEN ; Hu HAN ; Kaiyu LIU ; Yi LI
Chinese Journal of Biotechnology 2011;27(6):909-916
Human bocavirus (HBoV) is a recently discovered parvovirus, which is suspected to be an etiologic agent of respiratory disease and gastrointestinal disease in human. In the present study, we screened 941 nasopharyngeal aspirates collected from hospitalized children with lower respiratory tract infections from October 9, 2007 to March 20, 2009 in the Children's Hospital of Hubei Province. Our results showed that 33 of 941 samples (3.51%) were detected positive for HBoV. To obtain a full-length HBoV clone, three segments which covered the nearly full-length genome were amplified by PCR from HBoV positive samples separately and cloned into pBluescript SK II vector, and the resulting plasmid was designated as pWHL-1 (GenBank Acession No. GU139423). We constructed the both EGFP and luciferase reporter gene vectors under the control of the HBoV unique promoter, respectively. Our data demonstrated that the HBoV promoter exhibited very high activity in all mammalian cells tested by fluorescent microscopy observation of the EGFP and luciferase activity assay and its strength was 4-5 fold higher compared to that of the CMV promoter. This work provided an excellent tool for further study of the mechanism of transcription and expression of the viral genome.
Base Sequence
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Child, Preschool
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Cloning, Molecular
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Female
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Genome, Viral
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genetics
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Human bocavirus
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genetics
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isolation & purification
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Humans
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Infant
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Male
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Molecular Sequence Data
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Pneumonia
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virology
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Promoter Regions, Genetic
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genetics
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Sequence Analysis, DNA
5.Short-term efficacy of primary treatment and dressing change with aflibercept for exudative age-related macular degeneration
Kaiyu DENG ; Ya YE ; Xiaoli HUANG ; Zhen HUANG ; Yun HAN ; Ming YAN ; Xiao CHEN ; Yanping SONG
Chinese Journal of Ocular Fundus Diseases 2021;37(9):687-692
Objective:To observe the short-term effects of intravitreal injection of aflibercept (IVA) for initial treatment and dressing change on exudative age-related macular degeneration (eAMD).Methods:A retrospective clinical study. From June 2018 to February 2021, forty-nine eAMD eyes of 38 patients who underwent IVA treatment in Department of Ophthalmology of Central Theater Command Hospital of People’s Liberation Army were included in the study. Among them, there were 24 males with 29 eyes and 14 females with 20 eyes; the average age was 66.82±8.71 years. All affected eyes were treated with IVA. The initial loading dose was 2.0 mg, which was injected once a month for 3 consecutive months, followed by monthly review and treatment as needed. Of the 49 eyes, 26 eyes were initially treated (initial treatment group), they were diagnosed within 3 months of the first onset and followed by IVA treatment, and no intraocular drugs and surgery were performed from the onset to the first diagnosis. Twenty-three eyes were treated with drug exchange therapy (dressing change group), they received intravitreal injection of ranibizumab and/or conbercept more than 4 times 6 months before the replacement therapy, during which there was persistent interlaminar cystoid edema and/or subretinal fluid (SRF) in the macular area and no improvement in pigment epithelial detachment (PED). Before IVA treatment, there were no statistically significant differences in the best corrected visual acuity (BCVA), foveal thickness (CMT), PED height (PEDH), and PED volume (PEDV) of the two groups of eyes before IVA treatment ( P>0.05). The same equipment and methods as before treatment were used for related examinations, and the changes of BCVA, CMT, PEDH, PEDV and complications of the two groups of eyes were recorded in 1, 3, and 6 months after treatment. The comparison of BCVA, CMT, PEDH, and PEDV between the two groups were used repeated measures analysis of variance. Results:Six months after treatment, the number of IVA injections in the eyes of the initial treatment group and dressing change group were 4.15±0.73 and 4.39±0.72 times, respectively, and the difference was not statistically significant ( t=-1.141, P=0.260). The BCVA, CMT, PEDH, and PEDV of the the initial treatment group ( F=5.345, 22.995, 6.764, 5.425) and the dressing change group ( F=12.519, 15.576, 8.843, 9.406) were significantly improved compared before treatment with 1, 3, and 6 months. All were statistically significant ( P<0.05). There was no significant difference in BCVA, CMT, PEDH, and PEDV between the initial treatment group and the dressing group at each time point after treatment ( F=1.741, 0.069, 0.876, 3.455; P>0.05). During the follow-up period, none of the affected eyes had complications such as persistent intraocular pressure increase, endophthalmitis, and retinal pigment epithelial tear. Conclusions:IVA can improve eyesight of patients with eAMD and reduce CMT, PEDH, and PEDV. The initial treatment and dressing change have the same effect.
6.The effect of aflibercept in the treatment of exudative age-related macular degeneration combined with retinal pigment epithelial detachment
Kaiyu DENG ; Zhen HUANG ; Xiaoli HUANG ; Hong JI ; Yun HAN ; Yanping SONG
Chinese Journal of Ocular Fundus Diseases 2020;36(10):764-771
Objective:To observe the efficacy of intravitreal injection of aflibercept (IVA) in the treatment of exudative age-related macular degeneration (wAMD) combined with RPE detachment (PED).Methods:A retrospective case study. From June 2018 to June 2019, 32 eyes (overall group) of 27 wAMD patients with PED were included in the study. All eyes were treated with IVA. The initial loading dose was 2.0 mg, which was injected once a month for 2 consecutive months and and then use a PRN regimen after evaluation. According to the maximum height of PED (PEDH) 2 months after treatment, the overall group was divided into the response group and the partial response group, with 20 (62.50%) and 12 (37.50%) eyes respectively. The response group: PEDH decreased by ≥25% compared with before treatment. The partial response: PEDH decreased by <25%. The macular fovea was scanned with the 3D-OCT 2000 instrument from Topcon (Japan). PEDH, PED area (PEDA), PED volume (PEDV), and macular foveal retinal thickness (CMT) were measured. There was no significant difference in BCVA, CMT, PEDH, PEDA, and PEDV of the eyes in the response group and the partial response group ( t=-0.791, -0.488, -0.900, -1.130, -0.400; P=0.435, 0.630, 0.380, 0.270, 0.690). The changes of BCVA, PEDH, PEDA, PEDV, CMT in each group were observed before treatment and 1, 2, 4, and 6 months after treatment. The comparison of BCVA and PED-related indicators and CMT before and after treatment were performed by repeated measures analysis of variance. Results:Compared with before treatment, the BCVA, CMT, PEDH, PEDA and PEDV of the eyes in the overall group, the response group, and the partial response group were obviously improved after treatment. Among them, there were statistically significant differences in all indicators of the overall group and the response group ( FBCVA=5.871, 3.798; P=0.001, 0.019. FCMT=24.526, 14.109; P=0.000, 0.001. FPEDH=12.569, 12.091; P=0.000, 0.000. FPEDA=7.534, 6.286; P=0.000, 0.000. FPEDV=5.139, 4.104; P=0.004, 0.014); there was no statistically significant difference in PED-related indicators in the partial response group ( FPEDH=3.210, P=0.054; FPEDA=1.913, P=0.183; FPEDV=3.500, P=0.051), the difference between BCVA and CMT was statistically significant ( FBCVA=3.033, P=0.027; FCMT=11.140, P=0.001). Two months after treatment, the eye number of PEDH reduction rate <25%, 25%-<50%, 50%-<75%, and ≥75% were 12 (37.50%), 8 (25.00%), 9 (28.13%), and 3 (9.38%) in the overall group, respectively. And PED in one eye (3.13%) was completely eliminated. Six months after treatment, the proportion was 13 (40.23%), 5 (15.63%), 7 (21.88%) and 7 (21.88%), respectively, among which 4 eyes (12.50%) with PED were completely resolved. Conclusions:Aflibercept treatment of wAMD combined with PED can restore its anatomical indicators and improve visual function of patients in a short time; the efficacy of PED in the PRN stage is related to the efficacy of the loading dose stage.