1.Exploring the Mechanism of LUO's Neiyi Prescription for the Treatment of Endometriosis Based on the HIF1A/EZH2/ANTXR2 Pathway
Fangli PEI ; Jinjin JIA ; Xiaoxin CHEN ; Shuhong LIN ; Zengxian LIN ; Lizheng WU ; Cheng ZENG
Traditional Chinese Drug Research & Clinical Pharmacology 2024;35(7):993-1000
Objective To investigate the intervention effect and mechanism of LUO's Neiyi Prescription on the proliferation and angiogenesis of eutopic endometrium in rats with endometriosis(EMs)based on hypoxia-inducible factor 1A(HIF1A)/enhancer of zeste homolog 2(EZH2)/anthrax toxin receptor 2(ANTXR2)signaling pathway.Methods SD rats were randomly divided into sham operation group,model group,Danazol group(4.2 g·kg-1),low-dose LUO's Neiyi Prescription group and high-dose LUO's Neiyi Prescription group(15.74,31.48 g·kg-1),eight rats in each group.The rat model of EMs with qi stagnation and blood stasis syndrome was constructed by autologous endometrial transplantation combined with multi-factor intervention.Intragastric administration was given once a day for 28 consecutive days.The pathological changes of endometrial tissue were observed by HE staining.The expression levels of proliferating cell protein 67(Ki67)and platelet endothelial cell adhesion molecule 1(CD31)in endometrial tissue were detected by immunohistochemistry.The mRNA and protein expression levels of HIF1A,EZH2 and ANTXR2 in endometrial tissues were detected by qRT-PCR and Western Blot.The expression levels of YAP1,CD44 and β-catenin in endometrial tissues were detected by Western Blot.Results Compared with the sham operation group,the epithelial cells of the eutopic endometrium of the model group were thickened,the interstitial cells were arranged disorderly,and the inflammatory cells increased.The expression levels of Ki67 and CD31 in endometrial tissues were significantly increased(P<0.01),the mRNA and protein expression levels of HIF1A and ANTXR2 were significantly increased(P<0.01),while the mRNA and protein expression levels of EZH2 were significantly decreased(P<0.01),and the protein expression levels of YAP1,CD44 and β-catenin were significantly increased(P<0.01).Compared with the model group,the epithelial layer of the eutopic endometrial tissue of the rats in each administration group became thinner,the interstitial disorder and inflammatory infiltration were improved,and the levels of Ki67 and CD31 in the eutopic endometrial tissue were significantly decreased(P<0.01).The mRNA and protein expression levels of HIF1A and ANTXR2 in the endometrium of rats in the Danazol group and the high-dose LUO's Neiyi Prescription group were significantly decreased(P<0.05,P<0.01),and the mRNA and protein expression levels of EZH2 were significantly increased(P<0.05,P<0.01).The protein expression levels of YAP1,CD44 and β-catenin in endometrial tissue of rats in each administration group were significantly decreased(P<0.05,P<0.01).Conclusion LUO's Neiyi Prescription can play a role in the treatment of EMs by inhibiting the proliferation and angiogenesis of eutopic endometrial cells,and its mechanism may be related to the inhibition of HIF1A/EZH2/ANTXR2 signaling pathway.
2.Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients (version 2024)
Yao LU ; Yang LI ; Leiying ZHANG ; Hao TANG ; Huidan JING ; Yaoli WANG ; Xiangzhi JIA ; Li BA ; Maohong BIAN ; Dan CAI ; Hui CAI ; Xiaohong CAI ; Zhanshan ZHA ; Bingyu CHEN ; Daqing CHEN ; Feng CHEN ; Guoan CHEN ; Haiming CHEN ; Jing CHEN ; Min CHEN ; Qing CHEN ; Shu CHEN ; Xi CHEN ; Jinfeng CHENG ; Xiaoling CHU ; Hongwang CUI ; Xin CUI ; Zhen DA ; Ying DAI ; Surong DENG ; Weiqun DONG ; Weimin FAN ; Ke FENG ; Danhui FU ; Yongshui FU ; Qi FU ; Xuemei FU ; Jia GAN ; Xinyu GAN ; Wei GAO ; Huaizheng GONG ; Rong GUI ; Geng GUO ; Ning HAN ; Yiwen HAO ; Wubing HE ; Qiang HONG ; Ruiqin HOU ; Wei HOU ; Jie HU ; Peiyang HU ; Xi HU ; Xiaoyu HU ; Guangbin HUANG ; Jie HUANG ; Xiangyan HUANG ; Yuanshuai HUANG ; Shouyong HUN ; Xuebing JIANG ; Ping JIN ; Dong LAI ; Aiping LE ; Hongmei LI ; Bijuan LI ; Cuiying LI ; Daihong LI ; Haihong LI ; He LI ; Hui LI ; Jianping LI ; Ning LI ; Xiying LI ; Xiangmin LI ; Xiaofei LI ; Xiaojuan LI ; Zhiqiang LI ; Zhongjun LI ; Zunyan LI ; Huaqin LIANG ; Xiaohua LIANG ; Dongfa LIAO ; Qun LIAO ; Yan LIAO ; Jiajin LIN ; Chunxia LIU ; Fenghua LIU ; Peixian LIU ; Tiemei LIU ; Xiaoxin LIU ; Zhiwei LIU ; Zhongdi LIU ; Hua LU ; Jianfeng LUAN ; Jianjun LUO ; Qun LUO ; Dingfeng LYU ; Qi LYU ; Xianping LYU ; Aijun MA ; Liqiang MA ; Shuxuan MA ; Xainjun MA ; Xiaogang MA ; Xiaoli MA ; Guoqing MAO ; Shijie MU ; Shaolin NIE ; Shujuan OUYANG ; Xilin OUYANG ; Chunqiu PAN ; Jian PAN ; Xiaohua PAN ; Lei PENG ; Tao PENG ; Baohua QIAN ; Shu QIAO ; Li QIN ; Ying REN ; Zhaoqi REN ; Ruiming RONG ; Changshan SU ; Mingwei SUN ; Wenwu SUN ; Zhenwei SUN ; Haiping TANG ; Xiaofeng TANG ; Changjiu TANG ; Cuihua TAO ; Zhibin TIAN ; Juan WANG ; Baoyan WANG ; Chunyan WANG ; Gefei WANG ; Haiyan WANG ; Hongjie WANG ; Peng WANG ; Pengli WANG ; Qiushi WANG ; Xiaoning WANG ; Xinhua WANG ; Xuefeng WANG ; Yong WANG ; Yongjun WANG ; Yuanjie WANG ; Zhihua WANG ; Shaojun WEI ; Yaming WEI ; Jianbo WEN ; Jun WEN ; Jiang WU ; Jufeng WU ; Aijun XIA ; Fei XIA ; Rong XIA ; Jue XIE ; Yanchao XING ; Yan XIONG ; Feng XU ; Yongzhu XU ; Yongan XU ; Yonghe YAN ; Beizhan YAN ; Jiang YANG ; Jiangcun YANG ; Jun YANG ; Xinwen YANG ; Yongyi YANG ; Chunyan YAO ; Mingliang YE ; Changlin YIN ; Ming YIN ; Wen YIN ; Lianling YU ; Shuhong YU ; Zebo YU ; Yigang YU ; Anyong YU ; Hong YUAN ; Yi YUAN ; Chan ZHANG ; Jinjun ZHANG ; Jun ZHANG ; Kai ZHANG ; Leibing ZHANG ; Quan ZHANG ; Rongjiang ZHANG ; Sanming ZHANG ; Shengji ZHANG ; Shuo ZHANG ; Wei ZHANG ; Weidong ZHANG ; Xi ZHANG ; Xingwen ZHANG ; Guixi ZHANG ; Xiaojun ZHANG ; Guoqing ZHAO ; Jianpeng ZHAO ; Shuming ZHAO ; Beibei ZHENG ; Shangen ZHENG ; Huayou ZHOU ; Jicheng ZHOU ; Lihong ZHOU ; Mou ZHOU ; Xiaoyu ZHOU ; Xuelian ZHOU ; Yuan ZHOU ; Zheng ZHOU ; Zuhuang ZHOU ; Haiyan ZHU ; Peiyuan ZHU ; Changju ZHU ; Lili ZHU ; Zhengguo WANG ; Jianxin JIANG ; Deqing WANG ; Jiongcai LAN ; Quanli WANG ; Yang YU ; Lianyang ZHANG ; Aiqing WEN
Chinese Journal of Trauma 2024;40(10):865-881
Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.
3.Mediating role of sleep in association between maternal heat exposure during early pregnancy and risk of preterm birth
Xiaoxin ZHANG ; Wenjing WANG ; Zhenghong ZHU ; Kaipu WU ; Qianhong LIANG ; Yanqiu LI ; Wenjun MA ; Cunrui HUANG ; Qiong WANG
Journal of Environmental and Occupational Medicine 2022;39(3):281-288
Background Preterm birth-related complications are the leading cause of death in newborns and children under the age of 5 years. Maternal heat exposure has been associated with both sleep status during pregnancy and the increased risk of preterm birth. However, whether sleep status could mediate the association between heat exposure and preterm birth remains unclear. Objective To evaluate the association between maternal heat exposure in early pregnancy and preterm birth, and to further explore potential mediation effect of sleep status on the association between heat exposure and preterm birth. Methods A birth cohort was established in Guangzhou Panyu Maternal Child Health Hospital (Guangzhou Panyu District He Xian Memorial Hospital) from 2017 until now. Pregnant women (with gestational age between 8 and 13 weeks) were included in this study when they presented to the hospital for their first prenatal care visit and signed an informed consent. Then they were followed up until delivery. A total of 3 268 pregnant women were included for the final analysis. Questionnaires were distributed to collect the demographic characteristics, lifestyles, and sleep status of pregnant women. Daily meteorological data during the study period were collected from meteorological monitoring stations in Guangzhou and the average ambient mean temperature of four weeks before the survey was calculated and assigned for each pregnancy. The 75th, 80th, 85th, 90th, and 95th percentiles (P75, P80, P85, P90, and P95) of the average ambient temperature of all pregnant women were used as the thresholds to define heat exposure. Logistic regression was used to evaluate the effects of heat exposure in different definitions on preterm birth and sleep status (sleep duration, night sleep timing, and wake up timing). The mediation effects of sleep status on the relationship between heat exposure and preterm birth were also analyzed. Results Among all the included participants, 165 newborns were preterm births with an incidence rate of 5.0%. Heat exposures with thresholds of P90 and P95 increased the risk of preterm birth, with ORs (95%CIs) of 1.66 (1.04-2.57) and 1.90 (1.03-3.33), respectively (P<0.05). Heat exposures with thresholds of P75, P80, P85, P90, and P95 decreased the sleep duration (<9 h vs. ≥9 h, control group: ≥9 h), and the ORs (95%CIs) were 1.51 (1.25-1.83), 1.44 (1.17-1.77), 1.35 (1.08-1.70), 1.43 (1.09-1.87), and 1.45 (1.00-2.13), respectively. Heat exposures with P75 and P80 thresholds resulted in earlier wake up timing (<8: 00 vs. ≥8: 00, control group: <8: 00), with ORs (95%CIs) of 0.77 (0.63-0.93) and 0.76(0.61-0.93), respectively. No significant association was observed between heat exposure and night sleep timing. The mediation analyses showed that under heat exposure with P90 threshold, a statistically significant mediation effect was observed for sleep duration, and the proportion mediated was 6.07% (95%CI: 0.17%-25.00%) (P<0.05). No significant mediation effect was observed for night sleep timing and wake up timing. Conclusion An elevated risk of preterm birth after heat exposure in early pregnancy may be partly mediated through reducing sleep duration.
4.A new classification on location of hepatolithiasis in guiding treatment with percutaneous transhepatic choledochoscopic lithotripsy
Xiaoxin MU ; Chen WU ; Wei YOU ; Long ZHANG ; Chuanwei JIANG ; Hui ZHANG ; Yonghua ZHU ; Donghua LI ; Aihua YAO
Chinese Journal of Hepatobiliary Surgery 2022;28(3):185-189
Objective:To study the clinical application of a new classification on location of hepatolithiasis in guiding treatment using percutaneous transhepatic choledochoscopic lithotomy (PTCSL).Methods:The clinical data of 85 consecutive patients with preoperatively diagnosed hepatolithiasis who underwent PTCSL at the First Affiliated Hospital of Nanjing Medical University from January 2017 to July 2021 were prospectively collected. There were 27 males and 58 females, aged from 15 to 86(62±14) years. Hepatolithiasis was classified into five types of stone location based on preoperative imagings: type Ⅰ ( n=12) , stones located in central bile duct, including hilar bile duct and common hepatic duct; type Ⅱ ( n=17) in unilateral hepatic duct with multiple branches; type Ⅲ ( n=24) in unilateral hepatic duct with multiple branches plus central bile duct; type Ⅳ ( n=31) in bilateral hepatic ducts with multiple branches; and type Ⅴ ( n=1) in unilateral hepatic duct with a single branch. Fistulation path, number of procedures, number of bile duct fistula, and complications were recorded. The residual stone rate and stone recurrence rate were compared among the five types. The follow-up was performed to analyse prognosis. Results:A total of 99 biliary fistulae were performed, with one single tract created in 74 patients, two tracts in 9 patients, three tracts in 1 patient, and four tracts in 1 patient. The fistulation path was B2 in 12 patients, B3 in 18 patients, B4 in 1 patient, B5 in 4 patients, B6 in 10 patients, B7 in 4 patients, and B8 in 50 patients. Altogether, 151 choledochoscopic lithotomy procedures were performed (1-3 times per patient, mean 1.78 times). For the 9 patients with residual stones (10.6%, 9/85), there were 3 patients with type Ⅱ and 6 patients with type Ⅳ. There were significant differences in the residual stone rates among the 5 types (χ 2=11.13, P=0.025). Stone recurrence developed in 33 (38.8%) patients, including 2 patients with type Ⅰ, 7 patients with type Ⅱ, 10 patients with type Ⅲ and 14 patients with type Ⅳ (χ 2=9.07, P=0.046). The total intraoperative and postoperative complications rates was 28.2% (24/85). The follow-up period was 4-58 months with the median follow-up time of 30 months. Twelve patients died during the follow-up period, including 1 patient who died from postoperative bleeding, 3 cholangiocarcinoma, 7 biliary cirrhosis-related liver failure, and 1 stone-unrelated disease. Conclusion:Type Ⅳ in the location classification of hepatolithiasis based on PTCSL had significantly higher rates of residual stones and stone recurrence. This new classification is helpful for clinicaians to determine the optimal path using a smaller number of fistulation tracts to clear stones. It improved the efficacy of PTCSL in treating hepatolithiasis.
5.Application value of hepatic vein outflow tract reconstruction with ringed polytetrafluoroe-thylene vascular in right lobe living donor liver transplantation
Beicheng SUN ; Xiaoxin MU ; Guoqiang LI ; Chen WU ; Zhongming TAN
Chinese Journal of Digestive Surgery 2021;20(2):227-233
Objective:To investigate the application value of hepatic vein outflow tract reconstruction with ringed polytetrafluoroethylene vascular in right lobe living donor liver trans-plantation.Methods:The retrospective and descriptive study was conducted. The clinicopatho-logical data of 4 donors and 4 recipients undergoing right lobe living donor liver transplantation in Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School and 17 donors and 17 recipients undergoing right lobe living donor liver transplantation in the First Affiliated Hospital with Nanjing Medical University from June 2015 to August 2018 were collected. Of 21 donors, there were 10 males and 11 females, aged from 35 to 57 years, with a median age of 46 years. The median body mass of 21 donors were 64 kg, with a range from 56 to 72 kg. Of 21 recipients, there were 16 males and 5 females, aged from 21 to 68 years, with a median age of 42 years. The median body mass of 21 recipients were 63 kg, with a range from 47 to 77 kg. Observation indicators: (1) surgical and postoperative situations; (2) follow-up. Follow-up was conducted by outpatient examination or telephone interview to detect graft function, tumor recurrence, vascular graft complications, patency of vascular graft and survival of recipients up to August 2020. All recipients will be followed up for all their lives. Measurement data with normal distribution were represented as Mean±SD and measurement data with skewed distribution were represented as M (range). Count data were represented as absolute numbers or percentages. The Kaplan-Meier method was used to calculate patency rates of hepatic vein outflow tract and survival rates to draw patency curve and survival curve. Results:(1) Surgical and postoperative situations: the operation time, the weight of donor graft, graft to recipient weight ratio and duration of hospital stay of 21 donors were (367±72)minutes, (557±68)g, 0.89%±0.16% and (10+2)days, respectively. No major complication requiring reoperation or intervention occurred in any of the 21 donors. One donor undergoing mild bile leakage preserved peritoneal drainage for one week. All 21 recipients underwent classic orthotopic liver transplantation successfully. The time of hepatic vein outflow tract reconstruction in donor graft, operation time and time of anhepatic phase of 21 recipients were (24±4)minutes, (326±66)minutes and (42±6)minutes, respectively. The number of reconstructed middle hepatic vein in hepatic segment 5 and 8 were 18 and 15, with the diameter of (6.1±1.3)mm and (7.2±1.2)mm, respectively. The number of reconstructed inferior right hepatic vein were 10, with the diameter of (6.3±1.3)mm. The postoperative treatment time at intensive care unit and duration of hospital stay of 21 recipients were (1.5±0.9)days and (22.6±6.7)days, respectively. Ten of 21 recipients underwent postoperative complications. Five recipients underwent graft dysfunction including the level of alanine aminotransferase and aspartate aminotransferase >1 000 IU/L and the level of bilirubin slightly increasing, combined with increased ascites. Enhanced computed tomography scan showed congestion in the right anterior of graft and thrombosis in the middle hepatic vein of hepatic segment 5 and segment 8. All 5 recipients undergoing graft dysfunction recovered with normal liver function and ascites decreasing after symptomatic treatment including liver protection therapy, anticoagulation and albumin infusion. Two recipients underwent inferior vena cava thrombosis and intractable pleural effusion one month after operation. Vena cava venography examination showed thrombosis in the graft vascular. Of the 2 recipients, one case with collateral circulation formation recovered undergoing balloon dilatation and stent placement combined with anticoagulation therapy of warfarin. The other one case recovered after anticoagulation therapy of warfarin. One recipient undergoing bile leakage and abdominal infection with klebsiella pneumoniae recovered after symptomatic treatment. Two recipients undergoing abdominal infection or pulmonary infection recovered after symptomatic treatment. There was no serious complication or death during perioperative period. (2) Follow-up: all 21 recipients were followed up for 10 to 57 months, with a median follow-up time of 38 months. During the follow-up, no recipient underwent graft dysfunction and 2 recipients had tumor recurrence at postoperative 6 months. Six of the 21 recipients died within 2 years after operation including 3 cases dying of tumor recurrence, 2 cases dying of acute hemorrhage and 1 case dying of liver failure. There was no death caused by vascular graft complica-tions. The postoperative 1, 3, 6-month, and 1-year and 2-year potency rates of hepatic vein outflow tract in 21 recipients were 88.4%, 88.4%, 82.4%, 68.0% and 42.1%, respectively. The 6-month, 1-year and 2-year overall survival rates in 21 recipients were 100%, 94.4%, 71.4%, respectively.Conclusion:Application of hepatic vein outflow tract reconstruction with ringed polytetrafluoroethylene vascular in right lobe living donor liver transplantation is safe and feasible.
6.Effect of childhood psychological abuse and neglect and alexithymia on boredom proneness of college students
Jun ZHAO ; Rongkun SU ; Xiaoxin WU ; Qiaohua REN ; Lisha TAN
Chinese Journal of Behavioral Medicine and Brain Science 2021;30(1):71-76
Objective:To explore the influence of childhood psychological abuse, neglect and alexithymia on the boredom proneness of college students.Methods:The boredom proneness scale for college students(BPS), child psychological abuse and neglect scale (CPANS) and the Toronto alexithymia scale (TAS-20) were used to investigate 1 557 college students, and SPSS 22.0 was used for descriptive statistics, correlation analysis and regression analysis.Results:Childhood psychological abuse (26.540±8.985), neglect (32.665±10.651), recognition emotion in alexithymia dimension (19.359±4.835), description emotion dimension (14.173±3.001), extroverted thinking dimension in alexithymia (20.383±3.429) had positive correlation with the total score of boredom tendency (101.109±19.735) and the dimension of external stimulus (66.022±21.079)( r=0.160-0.559, all P<0.01). And there were negative correlations with the internal stimulus dimension (35.132±8.207)( r=-0.302--0.104, all P<0.01). The hierarchical regression analysis showed that after controlling the effects of gender and age, psychological abuse and neglect were the influencing factors of boredom proneness, internal stimulus and external stimulus, which explained 14.3%, 5.1% and 18.2% of the total variation (△ F=130.561, 41.968, 172.711, all P<0.01). Recognition of emotions, description of emotions and extroverted thinking in alexithymia were the influencing factors of boredom proneness, internal stimulus and external stimulus, which explained 17.5%, 9.9% and 25.5% of the total variation (△ F=134.274, 60.696, 234.383, all P<0.01). Conclusion:Childhood psychological abuse, neglect and alexithymia have significant effect on boredom proneness of college students, and mainly on external stimuli of boredom proneness. Among them, alexithymia has the greatest influence and the highest explanatory power.
7.The influence analysis of public health emergencies on mood fluctuations of depression and related factors in the elderly in Shanghai
Bei BAO ; Yuntao WU ; Xiaoxin SHI ; Dijun RONG ; Liren ZHU ; Yan WANG
Chinese Journal of Geriatrics 2021;40(2):227-231
Objective:To analysis the impact of public health emergencies on mood fluctuations of depression and the related factors in the elderly in Shanghai, in order to provide a new evidence for early psychological intervention.Methods:A cross-sectional survey was conducted among 983 elderly in the Department of Geriatrics of Xinhua Hospital Affiliated to Shanghai Jiaotong University and two communities in Changning and Hongkou Districts of Shanghai by using a self-compiled social life questionnaire and Geriatric Depression Scale(GDS-30)during corona virus disease(COVID)-19 outbreak from 1 February to 15 February 2020.The mood fluctuations of depression and the related influencing factors were analyzed by comparing the current GDS-30 scores with the scores within previous six months.Results:Of 983 questionnaires, 867 were valid.The incidence of mild fluctuations of depression was increased from 20.9%(181/867)to 27.2%(235/867)during the public health emergencies( P<0.05), with 3 cases of newly emerged severe depression.The GDS-30 scores were higher during the public health emergencies than before the emergencies(9.88±3.85 vs.7.67±3.54, P<0.05). The four risk factors inducing fluctuations of depression in the elderly were the number of coexisted chronic diseases ≥2( P=0.036), the lack of visits or communication from families( P=0.015), the family members exposing a risk to COVID-19( P<0.01), and the daily viewing of epidemic news more than 4 h( P=0.023). Linear regression analysis showed that cough, sore throat, dizziness, sleep disturbance and dyspnea were significantly related to the aggravation of depression(based on the increase of GDS-30 score)( P<0.05). Conclusions:Public health emergencies may exacerbate depression in the elderly.They are more likely to experience the aggravation of depression when they suffer from multiple chronic diseases, lack the child visits or communications, have the family members exposing a risk to COVID-19 and pay excessive attention to the epidemic.
8.Expression of IL-2/IL-15Rβ on memory CD3 + CD8 + CD45RO + T cells in chronic hepatitis B patients undergoing antiviral treatment and its significance
Wenzheng HAN ; Qing CHEN ; Jianghua YANG ; Xiaoxin WU ; Kezhou LIU ; Xiaoning LI
Chinese Journal of Clinical Infectious Diseases 2021;14(2):107-115
Objective:To investigate the expression of IL-2/IL-15 receptor β subunit (IL-2/IL-15Rβ) on memory CD3 + CD8 + CD45RO + T cells in patients with chronic hepatitis B (CHB) receiving antiviral treatment and its significance. Methods:Sixty-eight patients with chronic active hepatitis B (CAHB) and 47 asymptomatic hepatitis B virus (HBV) carriers attending in the Department of Infectious Diseases, the First Affiliated Hospital of Wannan Medical College from March 2019 to December 2020 were enrolled in the study; and 30 health subjects were also enrolled as healthy control group. Among 60 CAHB patients there were 30 cases with positive HBeAg and 30 cases with negative HBeAg. All CAHB patients received nucleos(t)ide analogue therapy, the HBV-related markers, Alanine aminotransferase (ALT) and the expression of IL-2/IL-15Rβ on CD3 + CD8 + CD45RO + T cells were determined and compared between HBeAg-positive and negative patients, before and after treatment. Normal distribution measurement data among 3 groups were compared with One-way ANOVA; normal distribution measurement data between 2 groups were compared with paired samples t test; non-normal distribution measurement data between the two groups were compared with Mann-Whitney U test; Pearson’s correlation coefficient was performed for correlation analysis. P<0.05 was considered statistically significant. Results:The proportion of CD8 + CD45RO + T cells on PBMC CD3 + T cells in CAHB group [(8.6±3.7)%] was higher than that of asymptomatic HBV carriers group [(5.7±2.5)%] and healthy control group [(5.5±1.5)%] (all P<0.05). The expression percentage of IL-2/IL-15Rβ on PBMC CD3 + CD8 + CD45RO + T cells in CAHB group [(6.8±4.7)%] was higher than that of asymptomatic HBV carriers group [(4.7±2.8)%] and healthy control group [(4.3±2.2)%] (all P<0.05). The MFI of IL-2/IL-15Rβ on PBMC CD3 + CD8 + CD45RO + T cells in CAHB group (243±168) was higher than those of asymptomatic HBV carriers group (160±91) and healthy control group [160±63] (all P<0.05). The expression percentage and MFI of IL-2/IL-15Rβ on PBMC CD3 + CD8 + CD45RO + T cells were positively correlated with the percentage of CD3 + CD8 + CD45RO + T cells in CAHB patients ( r=0.33 and 0.28, all P<0.05). The proliferation percentage of PBMC CD3 + CD8 + CD45RO + T cells in CAHB group[ (43.7±16.0)%] was higher than that of asymptomatic HBV carriers group [(29.1±9.4)%] and healthy control group [(26.8±9.6)%] after stimulation with Anti-CD3+ super-2 (all P<0.05). After the expression of IL-2/IL-15Rβ was blocked, the proliferation percentage of CD3 + CD8 + CD45RO + T cells was decreased [(11.2±6.3)%] compared with the untreated CAHB group ( P<0.05). The percentages of PBMC CD3 + CD8 + CD45RO + T cells secreting IFN-γ, IL-2 and TNF-α in CAHB group were (13.8±5.4)%, (14.0±4.3)% and (12.3±4.6)% respectively, which were higher than those of asymptomatic HBV carriers [(8.4±2.6)%, (9.4±3.2)% and (6.8±3.3)%] and healthy control group [(6.9±2.7)%, (9.9±3.0)% and (7.7±3.8)%] after stimulation with Anti-CD3+ super-2 (all P<0.05). After the expression of IL-2/IL-15Rβ was blocked, the percentages of PBMC CD3 + CD8 + CD45RO + T cells secreting IFN-γ [(2.4±1.6)%], IL-2 [(4.1±1.9)%] and TNF-α [(4.1±1.8)%] were decreased compared with the untreated CAHB group (all P<0.05). HBeAg, ALT, the expression percentage and MFI of IL-2/IL-15Rβ on CD3 + CD8 + CD45RO + T cells were 521.4 (68.9, 1 339.0) COI, 292 (160, 528) U/L, (6.4±3.2)% and (239±136) in 30 HBeAg-positive CAHB patients before treatment, which were higher than those after treatment [3.5(1.5, 17.5)COI、20(14, 31) U/L, (4.1±2.4)% and (134±58)] ( Z=5.337 and 6.403, t=3.229 and 3.892, all P<0.05). HBsAg, ALT, the expression percentage and MFI of IL-2/IL-15Rβ on CD3 + CD8 + CD45RO + T cells were (5 310±2 851) COI, (328±207) U/L, (7.1±5.8)% and (252±110) in 30 HBeAg-negative CAHB patients before treatment, which were higher than those after 48 weeks of treatment [(3 811±2 495) COI, (33±14) U/L, (4.6±2.9)% and (154±73)] ( t=2.167, 5.595, 2.116 and 2.383, all P<0.05). Conclusion:The study suggests that up-regulated expression of IL-2/IL-15Rβ is associated with elevated frequency, proliferation and secretion function of memory CD3 + CD8 + CD45RO + T cells in CAHB patients.
9.Investigation of dental caries and periodontal conditions in maintenance hemodialysis patients
WU Hongyu ; MA Xiaoxin ; LU Haixia ; FENG Xiping ; GU Qin ; YE Wei ; XIE Yingxin ; XIE Danshu ; WANG Wenji
Journal of Prevention and Treatment for Stomatological Diseases 2020;28(5):313-317
Objective:
To compare the prevalence of dental caries and periodontal disease in patients with end-stage renal disease treated with maintenance hemodialysis with that in healthy controls and to investigate the relationship between end-stage renal disease, dental caries and periodontal disease.
Methods :
A total of 82 maintenance hemodialysis patients who met the inclusion criteria were selected as the case group, and 86 healthy persons who underwent oral examination in the physical examination center were selected as the control group. Dental caries and periodontal conditions were examined in the two groups. The dental caries examination was conducted by determining the number of decayed-missing-filled teeth, which was recorded as recommended by the World Health Organization. The periodontal condition parameters included the plaque index, calculus index, bleeding on probing, periodontal pocket depth and clinical attachment loss.
Results:
The prevalence of dental caries in the case group and healthy control group was 87.8% and 81.4%, respectively, and there was no statistically significant difference between the two groups (P > 0.05). The periodontal indexes, including the plaque index, calculus index, probe bleeding index, periodontal pocket depth and clinical attachment level, in the case group were significantly higher than those in the control group (P < 0.05), and the prevalence of periodontitis in the case group was significantly higher than that in the control group (97.6% vs 88.4%, P < 0.05).
Conclusion
The dental caries conditions were comparable between the case group and the control group, but the prevalence and severity of periodontitis were significantly higher in the case group than in the control group.
10. Retrospective study of low-to-moderate dose glucocorticoids on viral clearance in patients with novel coronavirus pneumonia
Qin NI ; Cheng DING ; Yongtao LI ; Hong ZHAO ; Jun LIU ; Xuan ZHANG ; Yanfei CHEN ; Yongzheng GUO ; Liang YU ; Hongzhen JU ; Jingjing TAO ; Ping YI ; Guanjing LANG ; Junwei SU ; Ding SHI ; Wenrui WU ; Xiaoxin WU ; Ling YU ; Jifang SHENG ; Kaijin XU
Chinese Journal of Clinical Infectious Diseases 2020;13(0):E009-E009
Objective:
To study the effect of low-to-moderate dose glucocorticoid therapy on viral clearance time in patients with COVID-19.
Methods:
A total of 72 patients diagnosed with COVID-19 from January 19 to February 17, 2020 at the First Affiliated Hospital, School of Medicine, Zhejiang University were recruited. All patients received oral abidol and/or combined lopinavir/ritonavir, darunavir antiviral, and symptomatic supportive care. Among them, 51 patients received methylprednisolone (0.75-1.50 mg·kg-1·d-1) (glucocorticoid treatment group), and 21 patients who did not use glucocorticoid were the control group. The time of stable virologic conversion insputumand the time of radiologic recovery in lungsince onset were compared between the two groups and among the normal patients.The Kruskal-Wallis test or Fisher exact test was used to compare the difference between groups.
Results:
The median ages of the glucocorticoid group and the control group were 52 [interquartile range (IQR):45, 62] years and 46 (IQR: 32, 56)years, and the differences were significant (


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