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Glucocorticoids ; therapeutic use ; Humans ; Olfaction Disorders ; drug therapy ; Smell

Objective To investigate the effect of early low-glucocorticoid on hemodynamics and prognosis in the patients with septic shock.Methods Sixty patients with septic shock failing in active fluid resuscitation and vasoactive drugs in our hospital from June 2013 to August 2015 were selected and divided into the control group,early-hormone group and late-hormone group.MAP,HR,PO2/FIO2 and serum lactic acid levels were monitored in all selected patients before treatment and at 12,24,48 h after treatment.Apache Ⅱ,SOFA scores were assessed before treatment and on 1,3,7 d after treatment.The ventilation time,ICU stay time,hospital stay time and intravenous use time of vasoactive agents(VDNT) were recorded.Results The Apache Ⅱ scores and SOFA scores on 3,7 d after treatment in the early-hormone group were significantly decreased compared with the late-hormone group and control group (P＜0.05).MAP and HR at 24,48 h after treatment in the early-hormone group were significantly improved compared with the late-hormone group and control group (P＜0.05).The level of serum lactic acid at 12,24 h after treatment in the early-hormone group and late-hormone group were obviously lower than that in the control group,the levels of serum lactic acid at 12,24 h after treatment in the early-hormone group were obviously lower than those in the late-hormone group (P＜ 0.05).PO2/FIO2 at 12 h after treatment in the early-hormone group and late-hormone group were obviously better than that in the control group,and PO2/FIO2 at 12 h after treatment in the early-hormone group was obviously better than that in the late-hormone group(P＜0.05).The ventilation time,ICU stay time,hospital stay time and VDUT in the early-hormone group were significantly shortened compared with the late-hormone group and control group.The ventilation times,ICU stay time and VDUT in the latehormone group were significantly shortened compared with the control group (P＜0.05).Conclusion Early using low-dose glucocorticoid may restore hemodynamics more quickly,protects the organ function and improves the prognosis in the patients with septic shock.

OBJECTIVETo investigate the efficacy and safety of nebulizing glucocorticoid combined with olfactory training in the treatment of postviral olfactory dysfunction.METHODSPatients with postviral olfactory dysfunction were recruited in this study. All patients underwent T&T olfactory testing, sinonasal computer tomgraphy scanning, as well as magnetic resonance scanning of the olfactory pathway. Nebulizing glucocorticoid (pulmicort repulse) was inhaled once daily at the starting dose of 2 mg tapered to 1 mg after two weeks combined with olfactory training for 4 weeks. T&T olfactory testing were repeated after 4-week treatment.RESULTS Twenty four patients received teatment, with a mean age of 54 years old(range 37 to 81 years old), a mean olfactory dysfunction course of 2.20 months(range, 0.25-9 months). Of whom, 21 were anosmia, 3 were hyposmia. After teatment, complete recovery were achieved in 4 patients(16.7%), obvious improvement in 9 (37.5%), improvement in 5 (20.8%), no improvement in 6 (25.0%). No side effect and untoward effect were found.CONCLUSIONThe primmary outcomes suggest the efficacy and safety of nebulizing glucocorticoid combined with olfactory training in the treatment of postviral olfactory dysfunction.

CD4(+)CD25(+)CD127(dim/-) regulatory T cells (Tregs) have been implicated in suppressing T cell immune responses to hepatitis B virus (HBV), but the inhibition mechanism has not being clear yet. This study investigated the effects of soluble FGL2 (sFGL2) secreted by Tregs on immune suppression in chronic HBV-infected patients. We verified that sFGL2 protein and mRNA were highly expressed in Tregs. The separated Tregs by using magnetic beads from peripheral blood mononuclear cells (PBMCs) in 20 patients with chronic hepatitis B were co-cultured with PBMCs at a ratio of 1:3 with anti-CD3 stimulating antibody or FGL2 blocking antibody. The proliferation index of CD8(+)T cells after blocking FGL2 was higher than that in blank group (3.58±0.18 vs. 3.28±0.17, P=0.034) in 18 of 20 samples, and lower than that in CD3 stimulation group (3.82±0.19, P=0.026) in 16 of 20 samples. The IFN-γ secreted in the mixed culture in the absence of Tregs was higher than that in the culture in the presence of Tregs, but it could be abolished by FGL2 blocking antibody. These results suggest that sFGL2 protein secreted by Tregs suppresses the proliferation and function of CD8(+) T cells in chronic hepatitis B.

Objective To investigate the clinical features and diagnosis and treatment of acute fatty liver of pregnancy(AFLP). Methods A retrospective analysis was performed for the clinical data of 12 patients with AFLP who were diagnosed and treated in Department of Infec-tious Diseases,Tongji Hospital,Tongji Medical College of Huazhong University of Science and Technology,from April 2012 to March 2017, including general data,clinical manifestations,laboratory markers,imaging examinations,treatment,and prognosis. Results All 12 pa-tients developed AFLP in late pregnancy,and major clinical manifestations included gastrointestinal symptoms,liver failure,jaundice,and coagulation disorder. All patients were given multimodality therapy to protect the liver,improve coagulation,and reduce infection;11 pa-tients underwent cesarean section;6 underwent blood filtration;5 underwent plasma exchange. One patient died,resulting in a mortality rate of 8.3%;5 perinatal infants died,resulting in a mortality rate of 35.7%. Conclusion In patients with AFLP,early diagnosis,timely ter-mination of pregnancy,maximum symptomatic/supportive treatment,and control of infection,as well as the artificial liver support system,is the key to improving the prognosis of mothers and infants.

To obtain single chain variable fragment (scFv) and bivalent single chain variable fragment (bsFv) against transferrin receptor, up-stream and down-stream primers were designed according to the complementary sequences of FR1 region of variable heavy (VH) and FR4 of variable light (VL), respectively, which contained inter-linker G4S and the restriction endonuclease SfiI, AscI and NotI. Two pieces of scFv fragments were first amplified through PCR and then inserted into plasmid pAB1, which could express scFv protein once induced by IPTG in the host bacteria. To express scFv and bsFv, E. coli TG1 was cultured in LB broth and was induced by IPTG. The restriction enzyme digestion map and DNA sequencing demonstrated that scFv and bsFv genes were successfully inserted into the expression plasmid. SDS-PAGE and Western blotting revealed the protein band at 35kD and 60kD, which were consistent with the molecular weight of scFv and bsFv respectively. Flow cytometry showed that scFv and bsFv harbored the specific binding activity with TfR expressed in various tumor cells, and the avidity of bsFv was higher than that of the parent scFv.
Base Sequence ; Cloning, Molecular ; Escherichia coli/genetics ; Escherichia coli/metabolism ; Genetic Vectors/genetics ; Hep G2 Cells ; K562 Cells ; Molecular Sequence Data ; Receptors, Transferrin/*immunology ; Recombinant Fusion Proteins/biosynthesis ; Recombinant Fusion Proteins/genetics ; Single-Chain Antibodies/*biosynthesis ; Single-Chain Antibodies/genetics

This study was aimed to reveal the species characteristics of Chinese patent medicines for antitussive ef-fect and provide references for developing new drugs. This research targeted Chinese patent medicines for antitussive effect which were included in the Pharmacopoeia of the People's Republic of China and the New National Chinese Patent Medicines as well as those characterized by keywords such as cough cure, cough alleviating, antitussive effect, cough, persistent cough. The analysis was made on the species characteristics, such as the number of Chinese patent medicines for antitussive effect, license number, ethnomedicine patent medicines, drugs for children use, protection of varieties of traditional Chinese medicine, the number of drugs, the generic names of drug, and drug forms. The results showed that 684 Chinese patent medicines for antitussive effect collected in this research had ac-counted for 8.60% of the total 7 260 of Chinese patent medicines. A total of 7 450 license numbers were approved, and 33% of the Chinese patent medicines shares one license number. One Chinese patent medicine owns 16.6 li-cense numbers on average. Ethnomedicine patent medicines had 3 Tibetan prescriptions such as the Shiwuwei Chenxiang pill and 4 Mongolian prescriptions, such as the Siwei Tumuxiang powder. Drugs for children accounted for 14%, including 9 forms. The type of the generic names of drug reached 16 and most of them originate from abbrevia-tions of the main drug in prescription. The number of drugs in prescription ranges from 8 to 16. Chinese patent medicines for antitussive effect involved 16 forms, of which the proportion of the use of solid preparation was higher than the liquid preparation. It was concluded that Chinese patent medicines for antitussive effect were characterized by such advantages such as a variety of species, various forms, the reasonable number of drugs, considerable medicine retail market share and drug for children use which can meet the clinical needs, and meanwhile some prob-lems, such as a lack of criteria for the generic names of drug, the homogenization of fierce competition, and inade-quacy of ethnomedicine patent medicines.

OBJECTIVE: To study the expression of apoptosis related genes, Bcl-2, bax, and iNOS in the olfactory epithelium of mice infected with influenza virus, and to discuss how they regulate apoptosis of the olfactory sensory neurons. METHOD: The expression levels of apoptosis related genes were detected with semi-quantity RT-PCR. RESULT: (1) The expression levels of Bcl-2 mRNA remain relatively constant after virus inoculation; (2) The expression levels of bax mRNA increased massively, and decreased gradually; (3) The expression levels of iNOS mRNA increased significantly in a short period, and then fell down to the undetectable level gradually. CONCLUSION The apoptosis related genes, Bcl-2, bax, and iNOS may play important roles in regulation of apoptosis of olfactory sensory neurons of mice infected with influenza virus.
Animals ; Mice ; Mice, Inbred BALB C ; Nitric Oxide Synthase Type II ; metabolism ; Olfactory Mucosa ; metabolism ; Orthomyxoviridae ; Orthomyxoviridae Infections ; metabolism ; Proto-Oncogene Proteins ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; bcl-2-Associated X Protein ; metabolism

OBJECTIVE: To investigate the dynamic changes in the upper airway that cause the obstructive sleep apnea-hypopnea syndrome by measuring the variations of upper airway pressures in the palatal segment of oropharynx and in segment of laryngopharynx. METHOD: The two pressure sensors of the manometer: Apnea Graphs were positioned below uvula and upper esophagus. By comparing the difference between the two sites with the reference of outer atmospheric pressure and using two temperature sensors to determine the air flow through the nose and mouth, we got apnea and hypopnea index (AHI) of 21 patients of obstructive sleep apnea-hypopnea syndrome at the supine position and siding position and obtained the information about the site of upper airway collapse and obstruction. RESULT: 1. The AHI was (47.83 +/- 18.05) per hour for supine position, while (35.11 +/- 18.88) per hour for lateral position in the studying group. The difference between these two groups is statistically significant (P < 0.05). 2. The apnea events were mainly caused by the collapse and obstruction of palatal segment of oropharynx which constitute 84.48% of the obstruction. The collapse at the segment of laryngopharynx was responsible for 12.58% of the obstruction. CONCLUSION The upper airway pressure measurements could provide direct informations about the obstructive sleep apnea-hypopnea syndrome. These informations help choosing appropriate operation for apneic patients.
Adult ; Apnea ; physiopathology ; Humans ; Male ; Middle Aged ; Palate ; physiopathology ; Pressure ; Respiratory System ; physiopathology ; Sleep Apnea, Obstructive ; diagnosis ; physiopathology ; therapy ; Uvula ; physiopathology