1.Glucocorticoids+cyclophosphamide+tacrolimus capsules in type Ⅲ+Ⅴ and Ⅳ+Ⅴ lupus nephritis
Xuelian WU ; Zhongwei YE ; Xiaoyuan MAO ; Lu YANG ; Ying ZHU ; Xiaochun ZHU
Chinese Journal of Biochemical Pharmaceutics 2017;37(1):188-190
Objective To explore the efficacy and safety of glucocorticoids+cyclophosphamide+tacrolimus capsules (GC+CTX+FK506) in the treatment of patients with type Ⅲ+V and Ⅳ+Vlupus nephritis. Methods The 31 cases with first diagnosis as systemic lupus erythematosus (SLE) with type Ⅲ+V and Ⅳ+Vlupus nephritis (LN) were selected, then divided into group A (CTX+GC) with 16 cases and group B (FK506+CTX+GC) with 15 cases. The group A received CTX+GC during treatment, group B received GC+CTX+FK506 for the first three months, and received FK506+GC for the last three months. The patients were followed up once monthly to observe the efficacy and safety,the efficacy was analysed after 6 months. Results After treatment, the total efficacy in group B was significantly higher than group A (86.7%vs.50.0%, P<0.05). The 24 h urine protein of group B was lower than group A(P<0.05). The plasma albumin of group B was higher than group A (P<0.05). After treatment, the systemic lupus erythematosus disease activity index (SLEDAI) in two groups were lower and C3 level was higher than those pre-treatment(P<0.05), but there was no significant difference in above indicators between two groups. There was one case menelipsis in group A, and one case with transient increasing of creatinine. Conclusion The FK506+CTX+GC could reduce urine protein sifnificantly compared with CTX+GC without serious adverse reaction.
2.Expression of bone sialoprotein in prostate cancer and its clinical significance
Qicong ZHU ; Gaocai MAO ; Yang LYU ; Yahui WANG ; Lin YANG ; Shuyong YU
Cancer Research and Clinic 2015;(9):602-604,608
Objective To investigate the expression of bone sialoprotein (BSP) in prostate cancer and its clinical significance. Methods Prostate cancer tissues of different pathological grades (68 cases) and benign prostatic hyperplasia tissues (22 cases) were selected. SP method was used to detect the expression of BSP. Serum total prostate-specific antigen (tPSA) levels of prostate cancer were detected by electrochemiluminescence immunoassay before the operation. Results Compared with no or low expression in the adjacent normal glandular tissues, the detectable levels of BSP were examined in most of the prostate cancer tissues. The expression rate of BSP in prostate cancer tissues was higher than that in benign prostatic hyperplasia tissues [76.47%(52/68) vs 13.64%(3/22),χ2=27.614, P<0.001]. The expression rates of BSP in well differentiated, moderately differentiated and poorly differentiated tissues according to cell differentiating degree (Gleason system) were 75.0 % (12/16), 77.5 % (31/40) and 75.0 % (9/12) respectively. There was no significant difference in various pathological grading (χ2=0.057, P=0.972). The expression rates of BSP in pathological stage pT2, pT3 and pT4 tissues were 62.16%(23/37), 95.24%(20/21) and 90.0%(9/10) respectively. A statistically significant association was found between BSP expression and pathological stage (χ2=9.338, P=0.009). Serum tPSA level of prostate cancer group with BSP expression was higher than that with no BSP expression [(69.06±25.52)μg/L vs (38.00±21.64)μg/L, F=19.355, P<0.001]. Conclusion The high expression of BSP in prostate cancer has a relationship with pathological stage and serum tPSA level, it may play an important role in the biological behaviour of prostate cancer.
3.Effect of early goal directed sedation on cerebral oxygen metabolism in patients with acute brain injury
Guirong YANG ; Changchun YANG ; Gengsheng MAO ; Jie ZHANG ; Huiya HOU ; Haiyan ZHU
Chinese Critical Care Medicine 2021;33(1):79-83
Objective:To observe the effect of early goal directed sedation (EGDS) on cerebral oxygen metabolism in patients with acute brain injury.Methods:A prospective cohort study was conducted. A total of 108 patients with acute brain injury admitted to the intensive care unit (ICU) of the Third Medical Center of the PLA General Hospital from January 2015 to December 2019 were enrolled. According to the patient's condition, dexmedetomidine contraindication and tolerance, and combined with the wishes of patients' families, they were divided into EGDS group and on-demand sedation group. Routine treatments such as surgery, mechanical ventilation, dehydration and reduction of intracranial pressure with mannitol, hemostasis or antiplatelets therapy were given according to the patient's condition. All patients were continuously given sufentanil by intravenous infusion for analgesia. Patients in the EGDS group were sedated by continuously intravenous infusion of dexmedetomidine (0.2-0.7 μg·kg -1·min -1) for 72 consecutive hours. Patients in the on-demand sedation group received intravenous bolus of propofol (0.5-1.0 mg/kg) when treatments were interfered due to agitation. Hemodynamic indexes [heart rate (HR), mean arterial pressure (MAP), cerebral perfusion pressure (CPP), intracranial pressure (ICP)], sedation indexes [bispectral index (BIS)], severity indexes [acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, Glasgow coma score (GCS)] and cerebral oxygen metabolism indexes [jugular venous blood lactate (Lac), jugular venous oxygen saturation (SjvO 2), cerebral arterial oxygen content (CaO 2), cerebral extraction rate of oxygen (CERO 2), cerebral arteriovenous blood oxygen content difference (a-vDO 2)] were compared between the two groups before sedation and at 24, 48 and 72 hours of sedation. Results:① Among the 108 patients, 3 patients with cerebral hemorrhage received secondary surgery or had worsening of cerebral hernia were excluded. 105 patients were enrolled in the study, including 54 patients in the EGDS group and 51 patients in the on-demand sedation group. There were no statistically significant differences in gender, age, type of craniocerebral injury, GCS score, proportion of mechanical ventilation and operation ratio between the two groups. ② Compared with before sedation, Lac, CERO 2 and a-vDO 2 of both groups gradually reduced over time of sedation while SjvO 2 and CaO 2 were gradually higher. Those changes were more quickly in the EGDS group, Lac, SjO 2, CERO 2 and a-vDO 2 significantly improved at 24 hours of sedation compared with those before sedation. Above indexes at 72 hours of sedation in the EGDS group were obviously better than those in the on-demand sedation group [Lac (mmol/L): 1.81±0.31 vs. 2.19±0.12, SjvO 2: 0.714±0.125 vs. 0.683±0.132, CaO 2 (mL/L): 201.21±15.25 vs. 179.65±14.07, CERO 2: (27.87±3.66)% vs. (33.00±2.58)%, a-vDO 2 (mL/L): 44.32±5.68 vs. 48.57±8.22, all P < 0.05]. ③ Compared with before sedation, HR, MAP and ICP decreased in the two groups over time while CPP, BIS and GCS score showed increasing trend, especially more quickly in the EGDS group, HR at 24 hours of sedation, MAP, CPP, BIS and GCS score at 48 hours significantly improved as compared with those before sedation. Hemodynamics and sedation related parameters and GCS score at 72 hours of sedation in the EGDS group were significantly better than those in the on-demand sedation group [HR (bpm): 70.69±7.80 vs. 79.85±9.77, MAP (mmHg, 1 mmHg = 0.133 kPa): 84.23±8.76 vs. 89.97±9.48, ICP (mmHg): 14.23±8.76 vs. 15.97±9.48, BIS: 60.56±24.58 vs. 56.86±33.44, GCS score: 8.06±3.63 vs. 7.86±2.98, all P < 0.05]. The APACHE Ⅱ scores were significantly reduced at 72 hours of sedation in both groups as compared with those before sedation, while there was no statistical difference between the two groups. Conclusion:Compared with the on-demand sedation, EGDS could reduce cerebral oxygen metabolism, improve the coma degree, and reduce the severity of the disease in patients with acute brain injury.
4.Research of dendritic cells pulsed with HPV peptide inducing specific CTL in vitro
Hong PU ; Yang SHI ; Yinghua LU ; Chenyao ZHU ; Yurong MAO ; Zhenyu ZHANG ; Hongzhen SHI
Chinese Journal of Microbiology and Immunology 2012;32(5):468-472
Objective To explore the potential of autologous dendritic cells (DC) pulsed with HLA-A201-binding peptide E613-21(KLPDLCTEL) and E786-94(TLGIVCPI)in inducing specific T cells respouse in vitro.Methods Cervical carcinoma patients with positive HLA-A201 were enrolled and their monocytes isolated and induced into dendritic cells and pulsed with HLA-A201-binding peptide E613-21 and E786-94.PBLs were primed by DCs every week for thee times.The cytokine level of supernatant of CTLs was tested by ELISA.The percentage of special CTLs was tested by flow cytometry.The specific killing effect of CTLs was tested by MTT.Results the numbers of DCs of eleven cervical carcinoma patients were (10.79±0.88) ×106(100 ml peripheral blood).CDllc+HLA-DR+(97.15±2.41)%,CD80+(84.28+5.39)%,CD83 +(85.17±5.06) %,CD86 + (97.74+0.87) %.Proliferation index of PBLs primed by DCs three times was 15.4± 1.5.Cytokine levels including IL-2,IL-12,IFN-γ and TNF-α were obviously higher than nonpriming PBLs[(2551.9+195.3) pg/ml,(554.9±64.0) pg/ml,(2416.9±281.7) pg/ml,(632.4 +71.1)pg/ml,respectively] (P<0.05),but IL-10 was no significant difference between priming CTLs and nonpriming CTLs.The average percentage of special CTLs was obviously higher than control group[(6.32±1.54)%,P<0.05].The killing effect of CTLs was obviously higher than control group(P<0.05).Conclusion Dendritic cells pulsed with peptide E613-21 and E786-94 can induce special CTLs in vitro and stimulate CTLs secret cytokines.This will provide science basis for research of therapeutic HPV vaccine.
5.Standardized early medical care of Lushan earthquake victims in army hospitals
Hao ZHU ; Jihong ZHOU ; Renyi YANG ; Wei XIAO ; Zhiyou MAO ; Xianyun QIN
Chinese Journal of Trauma 2013;29(8):679-681
Objective To summarize the experiences with early treatment of the wounded associated with 4 · 20 Lushan earthquake in army hospitals.Methods Emergency response programs were started and tent hospitals were set up.According to the basic principle of wartime wound treatment regulation,emergency triage,emergency medical care,transferring,specialized treatment and evacuation were performed for the wounded in this earthquake.Results After the earthquake,the emergency rescue programs were started in the hospital.Twenty minutes later,emergence medical team with full equipment were set out for the epicenter and the tent hospitals were set up.A total of 181 earthquake cases were admitted within two weeks,of which 68 (37.6%) were transferred from the scene of earthquake and 113 (62.4%) were transferred after the primary treatment (including cases evacuating from other hospitals).Forty-nine surgeries had been done,including 30 emergence ones.Thirty-four cases (including 14 severe wounded) were evacuated to superior hospitals as their vital signs turned stable.There was no death or surgical wound infection.Conclusions Peacetime complete emergence programs and materials reserves,unified and well-organized command as well as normative grading treatment system in army hospitals assure the standardized medical care with high efficiency and high quality for earthquake victims.However,more researches are needed over diagnosis methods and standards for wound severity,equipment improvement and standards for casualty evacuation.
6.Role of cannabinoid receptor 2 selective antagonist in titanium particles-induced inflammatory osteolysis
Dechun GENG ; Yaozeng XU ; Huilin YANG ; Xuesong ZHU ; Genlin WANG ; Haiqing MAO
Chinese Journal of Trauma 2011;27(9):839-843
ObjectiveTo explore the therapeutic effect of selective antagonist-AM630 of cannabionid receptor 2 (CB2) in treatment of the titanium particles-induced inflammatory osteolysis.MethodsForty-five female BALB/c mice, 6-8 weeks old, were involved in the study, of which 15 mice were used as skull donors and the rest experimental animals were randomly divided into three groups, ie, black group, control group and treatment group, 10 mice per group.The mice model with air-pouch osteolysis induced by the titanium particles were established.The mice in the treatment group were injected with CB2 selective antagonist-AM630 (200 μg · kg-1 · d-1) intraperitoneally from two days before establishment of the air-pouch osteolysis model to two weeks after establishment of the model.Then, the mice were sacrificed and the pouch tissues were collected for molecular and histological analyses.The pouch membrane thickness and cell infiltration were tested by using computerized image analysis system and HE staining respectively.Osteoclast-like cells in the pouch membrane were determined by using tartrate-resistant acid phosphatase (TRAP) staining.Quantitative real-time polymerase chain reaction (RT-PCR) was employed to detect the mRNA levels of CB2, IL-1 β, TNF-α, receptor activator of NF-κB ligand (RANKL)and receptor activator of NF-κB (RANK).ResultsThere exhibited apparent erythematous and oedematous changes in the control group, which was mitigated around the bone implants with AM630 treatment.Quantitative image analysis of the histological sections revealed significant difference of the pouch membrane thickness among three groups, (192.2 ± 19.4)μm in control group, (88.5 ± 14.7) μm in blank group and (122.1 ± 15.2) μm in treatment group (F = 101.74, P < 0.05).Intensive TRAP staining was identified much in the control group but markedly reduced after AM630 treatment in the pouch tissues.RT-PCR showed that titanium particle stimulation could enhance the expressions of CB2, IL-1 β, TNF-α, RANKL and RANK gene in the air pouch tissues.However, the mRNA levels of these genes were markedly reduced after AM630 treatment, with statistical difference compared with control group (P < 0.05).ConclusionsCB2 selective antagonist AM630 can inhibit the process of titanium particlesstimulated inflammatory reaction and osteoclast activation.Therefore, CB2 represents a new suitable therapeutic candidate for the prevention and treatment of aseptic loosening of the artificial joint.
7.Effect of neural stem cell transplantation on neurological function of cerebral hemorrhage rats
Qingzhu AN ; Wei ZHU ; Yang WANG ; Ying MAO ; Rong ZHANG ; Liangfu ZHOU
Chinese Journal of Tissue Engineering Research 2008;12(12):2364-2368
BACKGROUND: Exogenous neural stem cells (NSCs) can repair nerve and promote recovery of neurofunction following cerebral hemorrhage.OBJECTIVE: To observe the growth and development of NSCs in vitro, to evaluate the survival, migration and differentiation of transplanted NSCs surrounding hematoma and the possible recovery function of NSCs, and to investigate the repairing effect of NSCs on damaged neurofunction in cerebral hemorrhage model rats.DESIGN: Completely randomized grouping design and controlled animal study,SETTING: Department of Neurosurgery, Huashan Hospital, Fudan University.MATERIALS: Eighteen adult healthy male SD rats weighing 280-320 g were provided by Shanghai Animal Center of Chinese Science Academy. BrdU was provided by Neomarkers Company; rat-anti-glial fibrillary acidic protein (GFAP) and rabbit-anti-microtubule-associated protein-2 (MAP-2) by Chemicon Company.METHODS: This study was performed at the Laboratory of Anatomy and Histology & Embryology, Shanghai Medical College,Fudan University from February to December 2006. The NSCs was isolated, cultured, and evaluated from hippocampus of day E14fetal SD rats. Eighteen rats were randomly divided into control group, PBS group and NSC transplantation group. Cerebralhemorrhage rat models were established via injection of autoiogous arterial blood in caudate nucleus. Thirty minutes after model establishment, 5 μ L NSC suspension with the concentration of 2×1011 L-1 was transplanted at four points surrounding hematoma cavity in the NSC transplantation group. Transplantation of PBS and NSCs was the same as autoblood transplantation. Thirty minutes after model establishment, injuries at the four points were performed, and nothing was injected in the control group.MAIN OUTCOME MEASURES: Neurofunction was evaluated with forward limb scale and turning scale just soon after transplantation and at 1, 3, 5, 14, and 28 days after transplantation. Brain was colleted by anesthesia 28 days after model establishment.Differentiation of transplanted NSCs was detected through testing GFAP, MAP-2, and BrdU by using immunohistochemistry.RESULTS: ①Neurofunction scores: There was no significant difference 5 days after model establishment (P>0.05). However, the scores were significantly improved in the NSC transplantation group 14-28 days after model establishment (P<0.05).②lmmunofluorescent double labeling: Apoptosis ceils around hemotoma in the NSC transplantation group were less than those in the PBS group. BrdU and MAP-2 or GFAP-positive ceils were observed in cerebral tissue sections, and this suggested that NSCs could survive, migrate and differentiate in host brain and differentiate into neurons or astrocytes.CONCLUSION: NSC Transplantation contributes to the recovery of neurofunction in cerebral hemorrhage rats through differentiation into neurons or astrocytes.
8.Integration of judicial expertise into basic medicaleducation improves the growing up of excellent medical doctors
Liqin MA ; Zhengrong MAO ; Huiqin PENG ; Keqing ZHU ; Dongmei LI ; Wei ZHANG ; Hongxi HUANG ; Shuiyou YANG
Basic & Clinical Medicine 2017;37(5):734-737
Through the addition of discussion course associated with judicial expertise during the pre medical education, integration of true and typical forensic pathological cases into basic medical theory and experimental education, further addition of optional course of forensic medicine,and guiding the medical students applying the scientifically training projects about forensic pathology, students may improve their learning interesting and clinical thought, and are made early warning and increase the abilities of preventing and dealing with the suddenly medical tangles in the future, at the same time, the medical teachers also increase their professional levels and teaching qualities.These benefit the growing up of high quality medical doctors, decrease and even prevent the happening of medical tangles.
9.Influence of total progressively motile sperm count after treatment on outcomes of intrauterine insemination with husband′s sperm
Juan ZHU ; Yuanhua HUANG ; Weiying LU ; Yi ZHANG ; Wei HUANG ; Jilong MAO ; Yanlin MA ; Zaijia YANG
Chongqing Medicine 2017;46(20):2758-2760
Objective To investigate the influence of total progressively motile sperm count(TPMSC) after treatment on clinical outcomes of intrauterine insemination(IUI) with the husband′s sperm in ovulation-promoting cycles.Methods The clinical data in 4179 cases undergoing IUI with the husband′s sperm in ovulation-promoting cycles were retrospectively analyzed.The correlation between clinical pregnancy rate and TPMSC was analyzed.Results Among all the clinical data,TPMSC was to 100×106 in occasional live sperm.TPMSC<0.15×106 was in 15 cases,1 case had pregnancy (live sperm was occasionally seen on IUI day after sperm processing).Ten cases of TPMSC >60×106 had no pregnancy.A total of 4 154 cases of TPMSC (0.15-60.00)×106 were analyzed.The female age,duration of infertility,number of follicles and endometrial thickness(EDM) had no statistical differences among various groups.The clinical pregnancy rate was 13.5%(576/4 154),the group with the highest clinical pregnancy rate was (5.00-<10.00)×106.But there was no statistically significant difference in clinical pregnancy rate among groups(P=0.133).Conclusion Performing IUI in PMSC (0.15-60.00)×106 after processing can get preferable pregnancy rates.
10.Comparison between combined clostridium butyricum and bifidobacterium living powders and saccha-romyces boulardii for prevention of antibiotic-associated diarrhea in children:a randomized,controlled clinical trial
Lingfen XU ; Zhu GUAN ; Yang WANG ; Liyun WANG ; Xiaoli GUO ; Yunqing ZHAO ; Zhiqin MAO
Chinese Pediatric Emergency Medicine 2015;22(4):257-261
Objective To evaluate the protection of combined clostridium butyricum and bifidobac-terium living powders for antibiotic-associated diarrhea ( AAD ) with all kinds of infections in hospitalized children,and to compare the therapeutic effect with saccharomyces boulardii. Methods This study was a prospective,randomized case-control clinical trial which collected the data of the hospitalized children with all kinds of infections in Pediactric Department of Shengjing Hospital of China Medical University between May 2011 to May 2012. A total of 552 cases were enrolled and 480 cases completed the study. A total of 240 chil-dren were in experimental group,80 cases received combined clostridium butyricum and bifidobacterium liv-ing powders 840 mg per time,twice a day and the other 160 cases received saccharomyces boulardii 250 mg per time,twice a day,for one week; the control group took none of probiltics. Two groups received routine antibiotic therapy. Everyday′s defecate frequency was recorded, the traits of excrement according to bristol stool assessment scale were evaluated,the incidence of diarrhea and drug related adverse reactions were coun-ted. Results During the studied 7 days,the AAD incidence was 4. 2%(10/240) in experimental group and 20. 4%(49/240) in control group,there was significant difference between two groups. The risk of AAD in experimental group decreased 58. 5%. Compared to saccharomyces boulardii,combined clostridium butyricum and bifidobacterium living powders decreased 38. 2% (RR=0. 728, 95%CI 0. 257~0. 784, P=0. 009). Compared to control group,the average defecate frequency decreased in experimental group,diarrhea duration contracted,there was statistic difference between two groups ( P<0. 01 ) . No drug related adverse reactions happened during the trial. Conclusion Both combined clostridium butyricum and bifidobacterium living powders and saccharomyces boulardii could effectively reduce the risk of AAD in hospitalized children with bacterial infection,relieve diarrhea symptoms,short the duration of diarrhea,and did not find the adverse reac-tions. Combined clostridium butyricum and bifidobacterium living powders and saccharomyces boulardii had the same protective effect for AAD of northern China children.