1.Effects and safety of intra-articular injection of recombinant human tumor necrosis factor-α receptor Ⅱ :IgG Fc fusion protein in patients with refractory knee effusion
Chinese Journal of Primary Medicine and Pharmacy 2013;20(15):2313-2314
Objective To evaluate the clinical efficacy and safety of the intra-articular injection of recombinant human tumor necrosis factor-α receptor Ⅱ:IgG Fc fusion protein (rhTNFR:Fc) in inflammatory arthritis patients with refractory knee effusion.Methods Ten inflammatory arthritis patients presented with refractory knee effusion after treatment of intra-articular steroid injection were involved.They received intra-articular injection rhTNFR:Fc (12.5mg twice weekly).The clinical efficacy and safety were assessed the first and second week after injection.Results At 1 week and 2 weeks,the total effective rate was 60% and 70% respectively.Patients and physicians global assessment score (visual analogue scale VAS 0-100mm),joint tenderness and movement pain scale (VAS) were significantly improved.Knee circumference was reduced as compared with baseline (all P < 0.05).Conclusion Intra-artiular injection of rhTNFR:Fc in improving patients with refractory knee effusion is a worthwhile clinical treatment attempt.
2.Relationship between insulin sensitivity index and extent of coronary atherosclerosis in Uygur and Han nationality patients
Jie GAO ; Yukai WANG ; Liangzhen TU
Chinese Journal of cardiovascular Rehabilitation Medicine 2012;21(3):234-238
Objective: To explore the relationship between insulin sensitivity index (ISI)and extent of coronary atherosclerosis in Uygur and Han nationality patients. Methods: A total of 125 patients with coronary heart disease were enrolled, including 59 Uygur nationality patients and 66 Han nationality patients. There were 42 cases with stable angina pectoris, 52 cases with unstable angina pectoris, 31 cases with old myocardial infarction, 53 cases with type 2 diabetes and 35 cases with hypertension. Relevant medical history of patients [age, body mass index (BMI) etc.] was collected and laboratory examination (blood lipid, fasting blood glucose, fasting insulin etc.)were performed, and extent of coronary atherosclerosis was evaluated by coronary angiography in all patients. ISI was calculated and its relationship with extent of coronary atherosclerosis was analyzed. Results: In both nationality patients, ISI was negatively correlated with extent of coronary atherosclerosis (Han nationality: r=-0.71, P=0.03, Uygur nationality: r=-0.52, P=0.04). ISI was negatively correlated with BMI, glycosylated hemoglobin (HbA1c) and low density lipoprotein –cholesterol (LDL-C) (r=-0.45, -0.68, -0.55, P<0.05 all) in Han nationality patients; ISI was positively correlated with high density lipoprotein–cholesterol (HDL-C, r=0.67, P<0.01), and negatively correlated with HbA1c, LDL and lipoprotein a (r=-0.47, -0.35, -0.42, P<0.05) in Uygur nationality patients. Conclusion: Insulin resistance participates and promotes formation and development of coronary atherosclerotic plaques. Controlling weight, blood glucose and LDL-C levels etc. can decrease insulin resistance and prevent occurrence and development of coronary heart disease.
4.Effect of alteplase intra- arterial thrombolysis combined with continuous monitoring of transcranial Doppler in patients with acute cerebral infarction
Shaohui LUO ; Yukai WANG ; Pu DU ; Huahai FENG ; Xingzhen DENG
Chinese Journal of Postgraduates of Medicine 2016;39(12):1068-1071
Objective To observe the effect of alteplase intra-arterial thrombolysis combined with continuous monitoring of transcranial Doppler (TCD) in patients with acute cerebral infarction. Methods Fifty-four patients with acute cerebral infarction were divided into TCD group and control group by random digits table method. The patients of 2 groups were given alteplase intra-arterial thrombolysis, and the patients of TCD groups were combined with continuous monitoring of TCD. The degree of clinical neurologic impairment was evaluated by National Institutes of Health stroke scale (NIHSS) and Barthel index (BI). The condition of vascular recanalization was evaluated by the change of blood flow signal of TCD. CT was performed within 1 d after thrombolysis to detect intracranial hemorrhage and other adverse reaction. The degree of clinical neurologic impairment, blood vessel recanalization rate after thrombolysis and recanalization time and incidence of intracranial hemorrhage and other adverse reaction were compared between 2 groups. Results There were no statistical difference in NIHSS score before thrombolysis and 1 h after thrombolysis between 2 groups (P>0.05). The NIHSS scores 7 and 30 d after thrombolysis in TCD group were significantly lower than those in control group:(8.1 ± 4.9) scores vs. (12.1 ± 4.2) scores and (6.9 ± 3.1) scores vs. (10.9 ± 3.9) scores, there were statistical differences (P<0.05). The BI scores 7 and 30 d after thrombolysis in TCD group were significantly higher than those in control group: (78.5 ± 13.8) scores vs. (60.8 ± 12.4) scores and (82.6 ± 13.5) scores vs. (63.2 ± 12.9) scores, and there were statistical differences (P<0.05). The blood vessel recanalization rate 24 h after thrombolysis in TCD group was significantly higher than that in control group: 70.4% (19/27) vs. 44.4% (12/27), the recanalization time after thrombolysis was significantly shorter than that in control group: (36.4 ± 9.5) min vs. (58.5 ± 12.4) min, and there were statistical differences (P<0.05). No adverse reaction like intracranial hemorrhage and so on was found by CT detection within 1 d after thrombolysis in the 2 groups. Conclusions Alteplase intra-arterial thrombolysis combined with continuous monitoring of TCD in acute cerebral infarction has good curative effect, and no obvious adverse reaction.
5.The mechanism of electroacupuncture therapy after cerebral ischemic injury
Yukai WANG ; Li REN ; Mingna HUANG ; Chi LONG ; Haiying HUANG
Chinese Journal of Physical Medicine and Rehabilitation 2015;37(4):247-251
Objective To observe the operation of Nav1.6 voltage-gated sodium channels in rats with acute cerebral injury after electroacupuncture therapy and investigate the mechanism.Methods Male Sprague-Dawley rats were randomly divided into an ischemia control group (IC,n =48),an electroacupuncture group (ET,n =48),a nimodipine therapy group (NT,n =48) and a sham operation group (SO,n =24),and were treated accordingly.A model of acute cerebral ischemia was induced by occlusion of the right middle cerebral artery using the suture method.The expression of Nav1.6,the concentration of Ca2+ and infarct volume were observed at 6 h,1 d,2 d and 3 d after ischemia with the real-time quantitative fluorescence PCR,immunofluorescence and 2,3,5-triphenyl tetrazolium chloride methods,respectively.Results The Joshua score for neural function was zero in the sham operation group,and increased gradually in the three other groups 6 h and1 and 2 d after ischemia.The average Joshua score 3 d after ischemia was significantly lower than 1 d earlier in each group.In the ET group the expression of Nav1.6 was significantly upregulated at first,followed by a significant decrease.The concentration of Ca2+ behaved similarly.However,no significant changes were observed in the infarction volume percentage.At 3 d after ischemia the expression of Nav 1.6,the Joshua grades,the Ca2+ concentrations and the infarction volume percentage were all significantly lower in the ET group compared with the IC,NT and SO groups.Conclusion Electroacupuncture therapy after acute cerebral ischemia can inhibit the expression of Navl.6,reduced Na + inflow and calcium overload,and mitigate acute cerebral ischemic injury,at least in rats.The protective effect may be attributed to inhibiting the expression of Nav 1.6.
6.Correlation analysis on total lymphocyte count and CD4 count in HIV-infected patients: A retrospective evaluation.
Yuming, WANG ; Shuying LIANG ; Erman, YU ; Jinling, GUO ; Zizhao, LI ; Zhe, WANG ; Yukai, DU
Journal of Huazhong University of Science and Technology (Medical Sciences) 2011;31(5):712-6
CD4 count is the standard method for determining eligibility for highly active antiretroviral therapy (HAART) and monitoring HIV/AIDS disease progression, but it is not widely available in resource-limited settings. This study examined the correlation between total lymphocyte count (TLC) and CD4 count of HIV-infected patients before and after HAART, and assessed the thresholds of TLC for making decisions about the initiation and for monitoring HAART. A retrospective study was performed, and 665 HIV-infected patients with TLC and CD4 count from four counties (Shangcai, Queshan, Shenqiu and Weishi) were included in the study. Pearson correlation and receiver operating characteristic (ROC) were used. TLC and CD4 count after HAART was significantly increased as compared with pre-HAART (P<0.01). An overall positive correlation was noted between TLC and CD4 count (pre-HAART, r=0.73, P=0.0001; follow-up HAART, r=0.56, P=0.0001). The ROC curve between TLC and CD4 count showed that TLC ≤ 1200 cells/mm(3) could predict CD4 < 200 cells/mm(3) with a sensitivity of 71.12%, specificity of 66.35% at pre-HAART. After 12-month HAART, the optimum prediction for CD4 count < 200 cells/mm3 was a TLC ≤ 1300 cells/mm(3), with a sensitivity of 63.27%, and a specificity of 74.84%. Further finding indicated that TLC change was positively correlated to CD4 change (r=0.77, P=0.0001) at the time point of 12-month treatment, and the best prediction point of TLC change for CD4 increasing was 135 cells/mm(3). TLC and its change can be used as a surrogate marker for CD4 count and its change of HIV-infected individuals for making decisions about the initiation and for monitoring HAART in resource-limited settings.
7.Difference of AMI and coronary artery lesion between Uygur nationality and Han nationality in Xinjiang Dushanzi
Shuqiu QU ; Jianjun BAI ; Xinli ZHU ; Yukai WANG ; Yumei WANG ; Hongxia MIAO
Chongqing Medicine 2013;(33):4014-4016
Objective To discuss the clinical characteristics of acute myocardial infarction (AMI) and coronary artery lesion fea-tures for Uygur nationality and Han nationality in Xinjiang Dushanzi area .Methods The AMI patients during hospitalization from January 2005 to January 2012 were divide into two groups ,Group A(Uygur nationality ,n=40) and Group B(Han nationality ,n=130) ,and compared the aspects of risk factors ,morbidity situation and electrocardiogram changes etc ,carried out the coronary an-glography and analyzed the coronary artery lesion features of patients in two groups .Results The two groups of patients are male-dominated ,the AMI incidence of Uygur patients was higher than Han nationality before 60 years old(P<0 .01);More morbidities of Uygur nationality were related with the alcohol drinking (32 .5% ) ,mood disorders (40 .0% ) ,diabetes (52 .5% ) and hyperlipi-demia(72 .5% )(P<0 .01) ,and mainly coronary artery lesions were three blood vessels (P< 0 .05) .The Han nationality patients with high blood pressure have more proportion (P<0 .05) ,mainly coronary artery lesions were single blood vessel (P<0 .05) .No significant differences were observed after comparing the location of infarction and related infarction blood vessels of patients in two groups .Conclusion The onset age of Uygur AMI patients in Xinjiang Dushanzi area is younger ,and the coronary artery disease is worse .It is necessary to improve the lifestyles and change unhealthy eating habits and to carry out the active intervention in early stage .
8.Quantitative analysis of brain metabolites in systemic lupus erythematosus patients using multivoxel MR spectroscopy
Zhiyan ZHANG ; Yukai WANG ; Zhiwei SHEN ; Zhongxian YANG ; Li LI ; Xiaofang CHENG ; Dongxiao CHEN ; Renhua WU
Chinese Journal of Rheumatology 2016;(1):17-22
Objective To investigate the metabolite changes in systemic lupus erythematosus (SLE) patients with and without neuropsychiatric symptoms using magnetic resonance spectroscopy (MRS) and explore the associations between image findings and clinical variables. Methods Twenty-two SLE patients with neuropsychiatric symptoms (NPSLE), twenty-one SLE patients without neuropsychiatric symptoms (non-NPSLE) and twenty healthy controls (HCs) underwent routine MRI scan and multivoxel magnetic reson-ance spectroscopy (MVS). The absolute metabolite concentrations were measured bilaterally in the posterior cingulate gyrus (PCG), dorsal thalamus (DT), lentiform nucleus (LN) and posterior paratrigonal white matter (PWM) using LCModel and SAGE software. The relationships between metabolite con-centrations and cognitive function scores were analyzed by Spearman rank correlation. Single-factor Chi-square analysis and t-test were used for analysis. Results ① Compared to control subjects, NPSLE patients had significantly lower N-acetylaspartate (NAA) values in bilateral PCG and DT, with the mean differences of -1.504 [95% confidence interval ( CI) (-2.335, -0.672), P=0.001], -1.460 [95%CI (-2.349, -0.570), P=0.002], -1.259 [95%CI (-1.894, -0.625), P=0.000] and -1.022[95%CI (-1.688, -0.356), P=0.003] for RPCG, LPCG, RDT and LDT, respectively. The concentration of total creatinine were observed to decline in RPCG and RDT, with the mean differences of-1.094 [95%CI (-1.845, -0.342), P=0.003], -0.955 [95%CI (-1.630, -0.280), P=0.006], -1.259 [95%CI (-1.894,-0.625), P=0.006] respectively. Glutamine and glutamate-values decreased significantly in RDT [mean difference=-2.586, 95%CI (-4.139, -1.033), P=0.002]. ② Compared to non-NPSLE patients, NPSLE patients had a lower NAA level in LPCG [mean difference=-1.256, 95%CI (-2.146, -0.367), P=0.006]. Positive correlations between mini-mental state examination scores [RPCG: rs=0.312, P<0.05; LPCG: rs=0.355, P<0.01], Montreal cognitive assessment scores (RPCG: rs=0.362, P<0.01; LPCG: rs=0.285, P<0.05) and NAA values in bilateral PCG were detected. Conclusion Both NPSLE and non-NPSLE patients may have metabolite dysfun-ctions in different brain regions. The cognitive disorder in SLE patients may be interpreted by neuronic damage of PCG.
9.An experimental rabbit model of rhegmatogenous retinal detachment.
Qing, XIAO ; Shuiqing, ZENG ; Yukai, HUANG ; Jing, WANG ; Shaohua, LI ; Ying, ZHANG
Journal of Huazhong University of Science and Technology (Medical Sciences) 2004;24(2):181-4
An experimental model of rhegmatogenous retinal detachment (RRD) in rabbits was established to simulate the pathophysiologic condition of human RRD. 24 rabbits were randomly divided into 3 groups and underwent vitrectomy with a vitrector and/or retinotomy with a Charles flute needle, with 12 in group I (vitrectomy and retinotomy), 7 in group I (retinotomy) and 5 in group III (vitrectomy). All animals underwent follow-up examinations with direct and indirect ophthalmoscopy and fundus photography 12 h and day 1, 3, 5, 7, 10, 14, 21, and 28 after the procedure(s). Retinal changes were recorded. As a result, 10 RRDs were successfully established in group I. Direct and indirect ophthalmoscopy and fundus photography demonstrated typical features of RRD. No RRD developed in group II and III. It was concluded that the experimental rhegmatogenous retinal detachment produced in a rabbit model after vitrectomy with retinotomy in this study was a convenient and reliable one. This RRD model mimicked the typical pathophysiological changes in humans.
*Disease Models, Animal
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Random Allocation
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Retina/surgery
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*Retinal Detachment
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Vitrectomy
10.Abnormal glucose metabolism of patients with stroke in hospital in Foshan
Chengguo ZHANG ; Guanglun ZENG ; Guohua ZHANG ; Yan SHAO ; Shaohui LUO ; Tao LIU ; Yukai WANG ; Weiying PENG
Chinese Journal of Neurology 2008;41(12):824-826
Objective To investigate abnormal glucose metablism of patients with stroke in hospital in Foshan in order to design more reasonable diagnostic and treatment plans.Methods Our study was conducted in 557 patients with stroke who were in hospital in Neurology Department of the First Hospital of Foshan from June 2007 to April 2008 (all were consistent with diagnostic criteria of stroke).Sex,age,history of diabetes mellitus and smoking,height,weight,blood pressure,waist circumference,random blood glucose,fasting blood glucose and oral glucose tolerance test of all were recorded when they were in hospital Results All 368 individuals (66.1%) had abnormal blood glucose,including 185 cases (33.2%) of diabetes,183 cases (32.9%) of impaired glucose tolerance and 189 cases (33.9%) of normal sugar tolerance.Furthermore,about 89.1% (189/368) cases with impaired glucose regulation and 14.1% (26/185) cases of diabetes were misdiagnosed if they did not undergo oral glucose tolerance test.Conclusions Most of patients with stroke in Foshan have impaired glucose regulation,who have been diagnosed by oral glucose tolerance test,in favour of us to better design more reasonable diagnostic and treatment plans.