Objective To investigate the effect and safety of Mycobacterium vaccae vaccine ( M. vaccae vaccine) on diabetes patients complicated with pulmonary tuberculosis. Methods A total of 76 diabetes patients complicated with pulmonary tuberculosis were randomized into immunotherapy group (M, n =38) and control group (C, n =38). Administration of routine anti diabetic drugs and diet treatment were conducted in both groups. In addition, patients in group M were treat with additional M. vaccae vaccine for 3 months, but those in group C were not. Results At the end of the treatment, no side effects of M. vaccae vaccine were found in group M, but immunological function of T cells was significantly improved. Compared with those in group C, CD3 and CD4 in group M were significantly higher ( P

Sepsis is an inflammatory disorder syndrome caused by the infection of pathogenic microorganisms, which organ dysfunction due to the dysregulated response of the body to the infection. Sepsis is a dangerous disease with a high fatality rate. The liver, an important organ involved in human biological transformation, energy metabolism, and cytokine production. Its role in sepsis is like a "double-edged sword" because the liver acts as not only an important defense line of the body against microorganisms but also a common target of inflammatory disorders and damage, making it one of the most vulnerable organs in sepsis. The liver contributes to pathogen clearance through immune responses, but the resulting inflammatory reactions can also lead to tissue and organ damage. Sepsis liver injury is an independent risk factor for poor prognosis in sepsis patients, and preventing its occurrence and promoting early recovery can partially inhibit disease progression and reduce mortality rates. However, the pathogenesis of sepsis liver injury is not yet fully understood, and there is a lack of early and effective means of diagnosis and treatment. In-depth research on its pathogenesis will provide a better understanding of its occurrence and development, further supporting the theoretical basis for the treatment of sepsis liver injury and identifying some new targets for sepsis treatment, ultimately reducing the mortality of sepsis.

Objective:This study aimed to analyze and compare the prognosis and the prognostic factors of combined small cell lung cancer (CSCLC) and pure small cell lung cancer (PSCLC) retrospectively. Methods:The clinicopathological characteristics of the 343 small cell lung cancer patients who were diagnosed in Tianjin Medical University Cancer Institute and Hospital between January 2006 and December 2012 were collected and reviewed. Survival analysis was performed and prognostic factors were assessed. Results:The median OS (overall survival) and PFS (progression free survival) of CSCLC were 31 and 21 months, respectively, and the median OS and PFS of PSCLC were 15 and 9 months, respectively. The Kaplan-Meier survival curves revealed that the prognosis of CSCLC was significantly better compared with that of PSCLC. COX analysis showed that disease stage, pathology, and therapy were indepen-dent prognostic factors of small cell lung cancer. Univariate analysis indicated that the small cell lung cancer group benefited from the surgery, particularly the CSCLC. NLR , therapy, and disease stage influenced the prognosis of PSCLC, and disease stage and therapy in-fluenced the prognosis of CSCLC. Multivariate analysis revealed that disease stage and therapy were independent risk factors of CSCLC in regard to OS. Conclusion:The prognosis of CSCLC was better compared with that of PSCLC. Limited-stage small cell lung cancer should undergo surgery, particularly the CSCLC.

Objective To explore the relationship between serum cccDNA and liver damage in the patients with chronic HBV infection.Methods Serum cccDNA,ALT of 156 patients with chronic HBV infection were measured,and pathology of liver tissue in 85 patients was detected.Results The positive rate of Serum cccDNA and ALT had no significant difference(P＞0.05).Between pathology light,medium and severe group,S0_(～1) and S_(2～4) group,G_(0～1) and G_(2～4) group the serum cccDNA mean was significantly different(P＜0.01).The positive rate of serum cccDNA was significantly different between the group of NAASC and ASC,CH,LC,HCC,and the group of ALT ≤40u/Land 40～80,80～400,≥400u/L(P＜0.01).Conclusion Serum cccDNA and liver inflammation,fibrosis and ALT had no relevance,serum cccDNA with at a low level may be non-active,but should be excluded from serious liver diseases.

Objective To analyze the difference of dosimetry and evaluate clinical efficacy and acute toxicity reaction between RapidArc and fixed gantry angle dynamic intensity modulated radiotherapy (IMRT) in advanced cervical carcinoma.Methods A total of 43 patients with locally advanced cervical cancer were studied,including 22 patients treated with RapidArc and 21 patients with IMRT.All plans were prescribed 50.4 Gy in 28 fractions.The conformity index and homogeneity index of the targets,the monitor units(MUs) and delivery time were compared.Incidence of acute intestinal and bladder side effects and rates of efficacy were calculated.Results The conformity index of RapidArc was better compared to IMRT.The V40 and V50 of bladder and V30,V40 and V50 of rectum planned by RapidArc was significantly lower than that by IMRT(t =-2.386,-2.397,P ＜0.05;t =-5.525,-2.883,-2.686,P ＜0.05).The mean dose of femoral head planned by RapidArc was also significantly lower (t =-2.395,P ＜ 0.05).For RapidArc,mean MU and treatment time were reduced by 53.15％,and 62.14％,respectively.There was no difference in the incidence of acute intestinal and bladder toxicity and rates of complete remission and efficacy between the two groups.Conclusions In dosimetric analysis,RapidArc showed advantage in protecting organs at risk and reducing treatment time in radical radiotherapy for locally advanced cervical carcinoma.

OBJECTIVE: To analyze the clinical symptom and parental origin of patients with MECP2 duplication syndrome in order to provide a basis for genetic counseling and prenatal diagnosis. METHODS: Clinical symptoms of four patients who were diagnosed with MECP2 duplication syndrome by copy number variation sequencing (CNV-Seq) were reviewed. The maternal origin of the duplications were verified. RESULTS: All patients were males, and CNV-Seq revealed that they have all harbored a duplication in the Xq28 region spanning 0.32 ~ 0.86 Mb, which were derived from asymptomatic mothers. The clinical symptoms of three patients with three copies included delayed speech, intellectual disability, and muscular hypotonia, while the patient with four copies had died at 6 months after birth, with clinical symptoms including recurrent infections, seizures, and spasticity. CONCLUSION The four cases of MECP2 duplication syndrome have shown complete penetrance and have all derived from asymptomatic mothers. As a stable and reliable method, CNV-Seq can accurately detect the MECP2 duplication syndrome.
Chromosomes, Human, X ; DNA Copy Number Variations ; Gene Duplication ; Humans ; Male ; Mental Retardation, X-Linked ; Methyl-CpG-Binding Protein 2/genetics* ; Phenotype

OBJECTIVE: To analyze the prenatal diagnosis, parental verification and pregnancy outcome of 6 fetuses with 22q11.2 microdeletion syndrome. METHODS: Copy number variation sequencing (CNV-seq)and chromosomal microarray analysis (CMA) were carried out for the fetuses. RESULTS: The fetuses were found to harbor 2.54-3.2 Mb microdeletions of the 22q11.2 region, among which one was maternally inherited and one was paternally inherited. Two parents opted to continue with the pregnancy, and 4 chose induced labor. One fetus was found to have tetralogy of Fallot, while two carrier parents and one fetus appeared to have normal phenotype. CONCLUSION 22q11.2 microdeletions identified upon prenatal diagnosis should be treated carefully, with ultrasonic scan and parental verification taken into account.
DNA Copy Number Variations ; Female ; Fetus ; Humans ; Microarray Analysis ; Pregnancy ; Pregnancy Outcome ; Prenatal Diagnosis ; Ultrasonography, Prenatal

OBJECTIVE: To explore the clinical characteristics and genetic etiology of a child with Aicardi-Goutières syndrome 3 (AGS3). METHODS: Trio whole exome sequencing was carried out for the child and his parents, and candidate variants were verified by Sanger sequencing. To further clarify their pathogenicity, the crystal structure of the variants was simulated and analyzed, and the plasmid of variants was expressed in vitro. A literature search was also carried out to summarize the phenotypic and genetic characteristics of AGS3. RESULTS: The child was found to harbor novel compound heterozygous variants of the RNASEH2C gene, namely c.434G>T (p.Arg145Leu) and c.494G>C (p.Ter165Ser), which were inherited from his mother and father, respectively. Analysis of protein crystal structure suggested that the c.434G>T (p.Arg145Leu) variant may affect the stability of local structure, and in vitro experiments showed that this variant can lead to protein degradation. The c.494G>C (p.Ter165Ser) variant has destroyed the stop codon, resulting in prolonged variant. CONCLUSION The novel compound heterozygous variants of the RNASEH2C gene probably underlay the AGS3 in this child, which has enriched the phenotypic and mutational spectrum of this disorder.
Humans ; Child ; Mutation ; Autoimmune Diseases of the Nervous System/genetics* ; Nervous System Malformations/genetics*

Objective To explore the effect and safety of ice compress combined with early walking training on postoperative rehabilitation in patients with total hip arthroplasty (THA) without drainage. Methods Totally 84 THA patients from Zhejiang Provincial People′s Hospital were recruited in this study during April 2015 to March 2016 by using purposive sampling method. According to the random number table (i.e. hospital ID),the participants were divided into the intervention group (n=42) and the control group (n=42). Patients in the control group received drainage tubes after THA,and started walking training after removing the tubes. However,patients in the intervention group didn′t receive drainage tubes after THA but received ice compress,and started walking training within 24 hours after surgery. The postoperative complications,the pain, swelling degree,hemoglobin change,time of recoving independent walking,activities of daily living (ADL),and average inpatient days of patients in two groups were observed and compared.Results The pain scores within 24 hours and 25-48 hours after surgery for the intervention group were (2.38±1.13) and (1.90±1.06),which were lower than the scores [(3.26±1.38) and (2.41±1.0)] for the control group (t=3.283,2.487;P<0.05). But the pain scores 49-72 hours after surgery had no statistical differences between two groups (t=-1.185;P>0.05). Similarly,there were no differences between two groups in wound swelling and hemoglobin change (t=-1.221,-0.294;P>0.05). The ADL scores one week and two weeks after THA surgery for the intervention group were (70.12±9.96) and (75.00±7.89),which were higher than the scores [(64.52±9.9) and (70.21±9.3)] for the control group (t=2.577,2.588;P<0.05). While the ADL scores that one month after surgery had no statistical differences between two groups (t=-1.185,P>0.05). The time of recoving independent walking in the control group was longer than that in the intervention group [(3.71±1.59) d vs (5.20±2.03) d;t= -3.848;P<0.05]. The average hospitalization time in the intervention group was shorter than that in the control group [(9.29±4.03) d vs (11.07±3.28) d;(t=2.283;P<0.05)]. No complications (e.g. dislocation,infection,and symptomatic deep venous thrombosis) were observed after three months′ follow-up.Conclusions The ice compress combined with early walking training is beneficial for postoperative rehabilitation in THA patients without drainage. It can improve patients′ independent walking function and self-care ability and can accelerate the rehabilitation process.

Objective:To systematically evaluate the real experience of living related organ transplantation donors from relatives and provide evidence-based basis for medical and nursing staff to develop personalized intervention measures.Methods:Qualitative study on the real experience of living related organ transplantation donors from relatives was searched on PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure, WanFang Data, VIP, and Biology Medicine disc. The search period was from database establishment to August 31, 2022. The article was evaluated using the quality evaluation criteria for qualitative study of the Australian Joanna Briggs Institute (JBI) Evidence-Based Healthcare Center. We converged the results and performed Meta-synthesis.Results:A total of 15 articles were included, 32 research results were extracted, and summarized and integrated into 13 new categories. A total of 5 integration results were synthesized, including the motivation to donate, the pressure and challenges faced before transplantation, the physical and mental discomfort caused by donation, the positive impact of donation, and the desire for support and needs from various aspects.Conclusions:Donors of living related organ transplantation have multiple psychological experiences during the process of organ donation. Nurses should dynamically assess the pressure and challenges faced by donors, provide diverse support to meet their needs, help donors actively respond, and improve their quality of life.