Objective: To evaluate the clinical features of hepatic injury in the patients with Graves'disease. Methods: Clinical records of 22 Graves'disease patients with hepatic injury( group A) and 22 patients without hepatic injury( group B) were studied retrospectively. Results: In group A the ALT, AST, GGT and ALP increased significantly( P

OBJECTIVE To analysis the structures of the impurities in aciclovir tablets and the compulsory degradation samples by high performance liquid chromatography coupled with hybrid quadrupole orbitrap mass spectrometry technology (HPLC-Q-Exactive Orbitrap-MS). METHODS The HPLC separation was carried out on a Waters Xbridge BEH Shield RP18 (4.6 mm×250 mm, 5 μm) by the gradient elution with a mobile phase consisting of 10 mmol·L–1 ammonium formate solution (0.15% formic acid)(A) and 10 mmol·L–1 ammonium formate solution(0.15% formic acid)-acetonitrile(50∶50)(B), and the detection wavelength was 254 nm. The Q-Exactive Orbitrap-MS was used to determine the precise first-order molecular weight and second-order fragment ions of these impurities, and the structures were identified. RESULTS Aciclovir and its impurities were well separated, and 8 major impurities with content>0.1% were detected and identified in aciclovir tablets and the compulsory degradation samples. Among them, 4 were the impurities listed in the European Pharmacopeia 10.0, and the others were unknown impurities identified for the first time. CONCLUSION The LC-MS/MS method can effectively identify the impurities in aciclovir tablets, which is significant for the production process optimization and quality control.

Objective To understand the prevalence and epidemiological features of diabetes mellitus (DM ) in Nan′an district of Chongqing ,and to investigate the relationship between blood glucose with various factors of sex ,age and body mass index(BMI) to provide the basis for prevention and treatment of DM .Methods Take the local resident population as the investigation object ,By u-sing the epidemiological investigation method of random sampling ,the native permanent residents were taken as the respondents ,the epidemiological survey including the general conditions (gender ,age ,occupation and nationality ) ,height ,weight ,waist circumfer-ence ,waistline ,blood pressure ,heredity family history ,environmental factors ,personal dietary habits and social psychological factors was performed .Results Among 10 932 permanent residents ,DM was found in 447 cases ,the prevalence rate was 4 .09% ,in which the prevalence rate of females was significantly higher than that of males ;the prevalence rate of DM showed an upward trend with the age increase ;the incidence rate of DM in the obesity population was obviously higher than that in the normal population .The people with smoking history ,hypertension ,dyslipidemia have higher incidence rate than the common populations .Conclusion DM is a disease closely related with the factors of sex ,age ,obesity ,smoking ,hypertension and dyslipidemia .Early intervention control has important significance .

OBJECTIVETo explore relationship between effect of Lamivudine in the treatment of cirrhotic patients with uncompensated hepatitis B with hepatitis B virus (HBV)genotypes and HBV specific cytotoxic T lymphocytes (CTL).

METHODS80 cases of uncompensated cirrhotic hepatitis B (40 cases with genotype B and 40 with genotype C), HBV DNA positive, HBeAg positive and human leukocyte antigen (HLA)-A2 positive,were treated with Lamivudine 100 mg/d, one year later, its effect and relationship with HBV genotypes and HBV specific CTL were observed.

RESULTSHBV DNA turned negative:40 cases with genotype B turned negative (100%). In the 9th and 10th month of treatment, there was one case with genotype C had YMDD variation respectively and Adefovir dipivoxil was used for treatment, of the rest 38 cases, HBV DNA of 26 cases (68.42%) turned negative,HBV DNA negative rate of patients with genotype is lower than that of patients with genotype B, chi2 = 14.91, P < 0.01. HBeAg turned negative: 18 cases with genotype B (45%) turned negative, more than that of patients with genotype C (7 cases, 18.42%), chi2 = 6.32, P < 0.05. Peripheral blood HBV specific CTL level: before treatment, it was (0.33 +/- 0.03)% of patients with genotype B,higher than that of patients with genotype C [(0.11 +/- 0.02)%], t = 8.12, P < 0.001. 1 year after treatment: it was (0.44 +/- 0.04)% of patients with genotype B, higher than that before treatment, t = 4.01, P < 0.001, it was also higher than that of patients with genotype C 1 year after treatment [(0.23 +/- 0.03)%], t = 5.63, P < 0.01, alanine amino-transferase (ALT) returned to normal: 38 cases with genotype B (95%) returned to normal, more than that of patients with genotype C (28 cases, 73.68%), X2 = 6.79, P < 0.01.

CONCLUSIONEffect of Lamivudinein the treatment of cirrhotic patients with uncompensated hepatitis B is better in patients with genotype B than patients with genotype C, its mechanism may be related to lower level of HBV specific CTL in patients with genotype C than patients with genotype B.

Adult ; Aged ; Alanine Transaminase ; metabolism ; Antiviral Agents ; therapeutic use ; Female ; Genotype ; Hepatitis B ; drug therapy ; enzymology ; immunology ; virology ; Hepatitis B virus ; drug effects ; genetics ; isolation & purification ; Humans ; Lamivudine ; therapeutic use ; Liver Cirrhosis ; drug therapy ; enzymology ; immunology ; virology ; Male ; Middle Aged ; T-Lymphocytes, Cytotoxic ; immunology

Objective: To establish a nanometer magnetic particle chemiluminescence methodfor the detection of specific IgE antibodies to Tyrophagus putrefaciens allergen. Methods: According to the routine operation steps of chemiluminescence, chemiluminescence reaction system and suitable immune reaction conditions for detection of specific IgE of Tyrophagus putrescentiae allergen are established. Considering the performance of the chemiluminescence method established in this paper, the American Somerfly Phadia method wasused as the gold standard to evaluate the test performance of the established chemiluminescence method. Results: In thechemiluminescence reaction system, Luminol concentration in luminescent substrate A solution is 0.4 mg/ml, Urea hydrogen peroxidein luminescent substrate B solutionis 0.2 mg/ml.The sensitivity of this luminescent reaction system to horseradish peroxidase (HRP) is very high, the minimum detectable HRP is 0.01 ng/ml.In the immune response, the room temperature light-shielding reaction was detected for 5 min after the addition of substrates A and B, and the detection values were effective within 5-30 min. 37 ℃ is optimum luminescence reaction temperature. Choose the range of 0.35-100 IU/ml as the standard curve. According to the results of 120 clinical trials, using Phadia (immunofluorescence method) as the gold standard, the chemiluminescence method established in this study has significant significance for the detection of Tyrophagus putrescentiae allergen. Conclusion A nanometer magnetic particle chemiluminescence method was successfully established for the detection of specific IgE antibodies to Tyrophagus putrescentiae allergen.

【Objective】 To analyze the detection characteristics of a novel serum marker, hepatitis B core-associated antigen (HBcrAg), in the HBsAg-/HBV DNA+ blood donors in Wuxi. 【Methods】 A total of 37 previous HBsAg-/HBV DNA+ blood donors were followed up by telephone and their serum was obtained, and the serum of 22 HBsAg-/HBV DNA+ blood donors was detected by electrochemiluminescence and real-time PCR nucleic acid screening as the OBI group for HBcrAg enzyme-linked immunosorbent assay(ELISA). The serum of 20 healthy blood donors who underwent dual ELISA and one nucleic acid testing(NAT) was selected as the healthy control group, and the serum of 20 patients with chronic hepatitis B who were clinically diagnosed by Wuxi Fifth People's Hospital was selected as the experimental CHB group, and HBcrAg ELISA was detected respectively. The correlation analysis between HBcrAg and HBeAb, HBcAb, ALT and HBV DNA in the OBI group was performed. 【Results】 Thirty-seven blood samples were detected by chemiluminescence for HBsAg and NAT, and 22 HBsAg-/HBV DNA+ samples were detected in the OBI group, with a detection rate of 59.46%. The serum HBcrAg expression content (ng/mL) between the OBI group, the healthy control group and the CHB group were (0.92±0.13), (0.47±0.09) and (1.14±0.23), respectively, and the differences were statistically significant (P<0.05), the expression of HBcrAg in the OBI group and CHB group was higher than that in the healthy control group (P<0.05). There was no correlation between HBcrAg and HBeAb, HBcAb, ALT and HBV DNA indexes in the OBI group (P>0.05). 【Conclusion】 The expression of HBcrAg in the OBI group and CHB group was higher than that in the healthy control group, and the serum HBcrAg was not correlated with HBeAb, HBcAb, ALT and HBV DNA to a certain extent. HBcrAg has a good application prospect in screening HBsAg-/HBV DNA+ blood donors.

Objective:To investigate whether the therapeutic effect of Dahuang Mudan Tang on septic acute intestinal dysfunction in sepsis ratsis related to the regulation of expression of triggering receptor expressed on myeloid cells-1(TREM-1). Method:Totally 100 male SD rats were injected intraperitoneally with lipopolysaccharide (LPS) at a dose of 4.5 mg·kg^-1 to build sepsis model. The sepsis model rats were randomly divided into five groups:model group, glutamine group (3.75 g·kg^-1),low,medium, high-dose Dahuang Mudan Tang group(7.5,15,30 g·kg^-1),and another 10 normal rats were selected as normal group. Seven days later,2 mL suspension (100 mg lactulose and 50 mg mannitol) was orally administrated by gavage, and 24 h urinewas collected. The ratio of lactulose to mannitol in urine (L/M) was detected by HPLC with pulsed electrochemical detection (HPLC-PED).Serum citrulline concentrationsin blood and ileum were determined by HPLC.Enzyme linked immunesorbent assay (ELISA) was used to detect the concentrations of triggering receptor expressed on myeloid cells-1(TREM-1),tumor necrosis factor-α(TNF-α),intestinal fatty acid binding protein(iFABP) and D-lactic acid.Real-time PCR was used to detect the mRNA expressions of TREM-1,Toll-like receptors2(TLR2),Toll-like receptors 4(TLR4),myeloid cell differentiation protein(MyD88),nuclear transcription factor-κB(NF-κB).Electron microscopy was used to observe the pathological changes of intestinal mucosa injury. Result:Compared with normal group, the serum concentrations of TREM-1,TNF-α,iFABP, D-lactate; the ratio of lactulose to mannitol in urine (L/M)and the expressions of TREM-1,TLR2,TLR4,MyD88,NF-κB mRNA in model group were increased obviously(P<0.05,P<0.01); citrulline concentration was decreased obviously(P<0.05);the lengths of the villus and thicknesses of the mucosal layer were decreased obviously(P<0.05);the Chiu score was increased obviously(P<0.01).Compared with model group,the expressions of TREM-1,TLR2,TLR4,MyD88,NF-κB mRNA,and the serum concentrations of TREM-1 and TNF-α in all medication administration groups were decreased obviously(P<0.05), with no difference between these groups.Compared with model group, the serum concentrations of iFABP, D-lactate, L/M, the Chiu scorein glutamine group, medium-dose Dahuang Mudan Tang group and high-dose Dahuang Mudan Tang group were decreased obviously(P<0.05), lengths of villus and thicknesses of mucosal layers were increased obviously(P<0.05); and the citrulline concentrations were increased obviously(P<0.05). There was no difference between the three groups. Conclusion:Dahuang Mudan Tang can effectively treat SAID in rats, and its mechanism may be realized by regulating the expression of TREM-1 and relieving intestinal inflammation of intestinal tract.

Adult ; Cities ; Humans ; Middle Aged ; Proportional Hazards Models ; Quality of Life ; Risk Factors ; Silicosis

Objective To analyze the characteristics of postoperative hospital-acquired infections and drug sensitivity in lung transplant recipients over the past 5 years in a single center. Methods A total of 724 lung transplant recipients at Wuxi People's Hospital from January 2019 to December 2023 were selected. Based on the principles of hospital-acquired infection diagnosis, a retrospective analysis was conducted on the hospital infection situation and infection sites of lung transplant recipients, and an analysis of the distribution of hospital-acquired infection pathogens and their antimicrobial susceptibility test status was performed. Results Among the 724 lung transplant recipients, 275 cases of hospital-acquired infection occurred, with an infection rate of 38.0%. The case-time infection rate decreased from 54.2% in 2019 to 22.8% in 2023, showing a downward trend year by year (Z=30.98, P<0.001). The main infection site was the lower respiratory tract, accounting for 73.6%. The pathogens were mainly Gram-negative bacteria, with the top four being Acinetobacter baumannii (37.1%), Pseudomonas aeruginosa (17.3%), Klebsiella pneumoniae (13.7%), and Stenotrophomonas maltophilia (13.4%), with imipenem resistance rates of 89%, 53%, 58% and 100%, respectively. Gram-positive bacteria were mainly Staphylococcus aureus (3.6%), with a methicillin resistance rate of 67%. Conclusions Over the past 5 years, the hospital-acquired infections in lung transplant recipients have shown a downward trend, mainly involving lower respiratory tract infections, with the main pathogens being Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella pneumoniae, all of which have high resistance rates to imipenem.

Objective To investigate the seroprevalence of Toxoplasma gondii infection in patients with gynecological malignant tumors, so as to provide the evidence for the control of T. gondii infections in the patients with gynecological malignant tumors. Methods A total of 327 patients with gynecological malignant tumors were recruited, and 200 women with normal healthy examinations were served as controls. The serum anti-T. gondii IgG and IgM antibodies were detected by using ELISA, and the seroprevalence was compared between the patients and controls, and among various types of cancers. Results The overall seroprevalence of T. gondii was 26.91% (88/327) in the patients with gynecological malignant tumors, which was significantly higher than that (5.00%) in the healthy volunteers (χ² = 39.36, P<0.01) . The prevalence of anti-T. gondii IgG antibody in the cancer patients was significantly higher than that in the controls (26.30% vs. 5.00%; χ² = 37.79, P<0.01), while the prevalence of anti-T. gondii IgM antibody in the cancer patients was not significantly different from that in the controls (0.92% vs. 0; corrected χ² = 0.58, P > 0.01) . The positive rates of anti-T. gondii IgG antibody were 27.68%, 25.47% and 25.69% in ovarian cancer, cervical cancer, and breast cancer patients respectively, which were all significantly higher than those in the controls (χ² = 32.35, 27.32 and 28.00; all P values<0.01); however, there was no significant difference among the various types of cancer patients in the positive rates of anti-T. gondii IgG antibody (χ² = 0.17, P > 0.05) . In addition, the positive rates of anti-T. gondii IgM antibody were 1.79%, 0 and 0.92% in ovarian cancer, cervical cancer and breast cancer patients respectively, which was not significantly different from those in the controls (all P values > 0.05). Conclusions The seroprevalence of T. gondii infection is high in the patients with gynecological malignant tumors. It is suggested that the prevention and control of T. gondii infection should be strengthened in these patients.