Objective:To investigate the clinical characteristics, risk factors, and prognosis of invasive pulmonary aspergillosis (IPA) in patients with dermatomyositis associated with positive anti-melanoma differentiation-associated gene 5 (MDA5-DM).Methods:A total of 55 patients with MDA5-DM were analyzed. Patients were divided into IPA (+) group (14 cases) and IPA (-) group (41 cases) based on the presence of IPA. Microbiological examination and clinical data were analyzed. Risk factor analysis was performed using Binary Logistic regression, and survival analysis was carried out using Kaplan-Meier method.Results:Aspergillus flavus (5/14, 35.7%) and Aspergillus fumigatus (4/14, 28.6%) were the most common species in MDA5-DM patients with IPA. Compared to the IPA (-) group, IPA (+) group had higher serum level of α-hydroxybutyrate dehydrogenase (246 U/L vs. 191 U/L, Z=-2.02, P=0.043) and ferritin [1 306.7(518.7, 2 977.8)ng/ml vs. 472.6(269.0, 792.1)ng/ml, Z=-2.09, P=0.036], lower CD8 + T lymphocyte counts {[111.5 (68.3, 214.0)]×10 6/L vs. [188.0(141.0, 270.0)]×10 6/L, Z=-2.18, P=0.029}, and more positive BALF GM tests [70.0%(7/10) vs. 18.9%(7/37), χ2=9.82, P=0.004]. Elevated serum ferritin was found to be an independent risk factor for IPA occurrence [adjusted OR (95% CI)=1.001 (1.000, 1.002), P=0.031)]. In addition, the 6-month cumulative survival rate was significantly lower in the IPA (+) group than in the IPA (-) group (78.6% vs. 97.6%, P=0.021). Conclusion:The mortality of MDA5-DM patients is increased after IPA infection. Elevated serum ferritin is an independent risk factor for IPA occurrence, and active prevention and treatment of IPA are expected to improve the prognosis of patients.

BACKGROUND: Managing acute postoperative pain is challenging for anesthesiologists, surgeons, and patients, leading to adverse events despite making significant progress. Patient-controlled intravenous analgesia (PCIA) is a recommended solution, where oxycodone has depicted unique advantages in recent years. However, controversy still exists in clinical practice and this study aimed to compare two drugs in PCIA. METHODS: We performed a literature search in PubMed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, Chinese National Knowledge Infrastructure, Wanfang, and VIP databases up to December 2020 to select specific randomized controlled trials (RCTs) comparing the efficacy of oxycodone with sufentanil in PCIA. The analgesic effect was the primary outcome and the secondary outcome included PCIA consumption, the Ramsay sedation scale, patients' satisfaction and side effects. RESULTS: Fifteen RCTs were included in the meta-analysis. Compared with sufentanil, oxycodone showed lower Numerical Rating Scale scores (mean difference [MD] = -0.71, 95% confidence interval [CI]: -1.01 to -0.41; P < 0.001; I2 = 93%), demonstrated better relief from visceral pain (MD = -1.22, 95% CI: -1.58 to -0.85; P < 0.001; I2 = 90%), promoted a deeper sedative level as confirmed by the Ramsay Score (MD = 0.77, 95% CI: 0.35-1.19; P < 0.001; I2 = 97%), and resulted in fewer side effects (odds ratio [OR] = 0.46, 95% CI: 0.35-0.60; P < 0.001; I2 = 11%). There was no statistical difference in the degree of patients' satisfaction (OR = 1.13, 95% CI: 0.88-1.44; P = 0.33; I2 = 72%) and drug consumption (MD = -5.55, 95% CI: -14.18 to 3.08; P = 0.21; I2 = 93%). CONCLUSION: Oxycodone improves postoperative analgesia and causes fewer adverse effects, and could be recommended for PCIA, especially after abdominal surgeries. REGISTRATION PROSPERO; https://www.crd.york.ac.uk/PROSPERO/; CRD42021229973.
Humans ; Oxycodone/therapeutic use* ; Sufentanil/therapeutic use* ; Randomized Controlled Trials as Topic ; Pain, Postoperative/drug therapy* ; Drug-Related Side Effects and Adverse Reactions ; Analgesia, Patient-Controlled

Objective: By analyzing the clinical features of patients with dengue fever in Guangzhou from 2015 to 2018 to furnish the reference evidences for the diagnoses and treatment of dengue fever. Methods: A total of 406 dengue fever patients admitted to Zhujiang hospital during 2015 to 2018 were analyzed for the clinical manifestations and laboratory examination results, retrospectively. ZIKV, CHIKV and the serotypes of DENV were detected in some samples. Results: DENV serotypes were tested in 96 dengue fever patients and 69 cases were positive. Among them, 58 cases (84.1%) were DENV-1, 10 cases (14.5%) were DENV-2, 1 case (1.5%) was DENV-3, DENV-4 was negative and no co-infection with different serotypes of dengue virus was found. Of all the 406 patients, 371 (91.4%) were diagnosed as dengue fever and 35 (8.6%) were severe cases. The most common manifestations included fever, weakness and rash. Significantly higher incidence (P<0.05) of bleeding, coughing, expectoration, vomiting and abdominal pain were found in severe dengue fever. The most common laboratory findings were leucopenia and thrombocytopenia. Significant increase(P<0.05) of total bilirubin, aspartate aminotransferase, serum creatinine, high-sensitivity C-reactive protein and procalcitonin were observed. ZIKV and CHIKV nucleic acids were tested in 380 dengue fever patients and the result were negative for both. Conclusions The incidence of dengue fever in Guangzhou increased in 2017 and 2018.Most cases of dengue fever were mild and DENV-1 was the dominant serotype.

Objective: To evaluate an assay permitting amplification of target 5′-untranslated region (5′-UTR) sequences directly from clinical specimens and distinction among serotypes of enterovirus (EV). Methods: A total of 518 rectal swabs and 148 nasal swabs tested positive by pan-enterovirus real-time PCR were collected. 5′-UTR and the viral protein 1 (VP1) gene fragments were amplified and sequenced separately for serotyping. The inconsistent samples by 5′-UTR and VP1 serotyping were further determined by using the serotype-specific RT-PCR. Results: A total of 553 (83.0%) samples were detected by 5′-UTR serotyping and 318 (47.7%) were detected by VP1 serotyping in all 666 positive specimens, and there was significant difference in the detection rates between two methods in rectal and nasal swabs (P<0.001). For the rectal swabs, the mainly detected serotypes were CoxA6 (217), CoxA16 (88), EVA71 (40), CoxA10 (28) and CoxA4 (27) by 5′-UTR serotyping. Compared with the VP1 serotyping, the sensitivity and specificity of 5′-UTR serotyping were 57.1%-100% and 67.4%-98.1% respectively, with varied consistence with serotypes (kappa value 0.214-0.283). For the nasal swabs, the most frequently detected serotype was EVD68, with the sensitivity of 100%, the specificity of 91.1%, and the poor consistence (kappa value 0.217). CoxA6, CoxA16, EVA71, CoxA10 and EVD68 were further confirmed by serotype-specific RT-PCR. Using VP1 serotyping combined with serotype-specific RT-PCR as a reference method , the effect of performance of 5′-UTR serotyping on diagnosis was increased. Conclusions The performances of 5′-UTR serotyping in enterovirus vary with serotypes. The application of 5′-UTR serotyping should be considered comprehensively according to the purpose of the study.

Objective:To ascertain whether the immune complexes (ICs) formed by Dengue virus 1 non-structure protein 1 (DENV1 NS1)and its IgG antibodies could mediate passive systemic anaphylaxis (PSA) and to explain the pathogenesis of Dengue hemorrhagic fever or Dengue shock syndrome (DHF/DSS).Methods:The monoclonal antibodies (mAbs) or mAb cocktails from 20 IgG mAbs of DENV1 NS1 prepared in this lab were screened to initiate PSA and passive cutaneous anaphylaxis (PCA) in mice.Meanwhile, the effects of GdCl3 and platelet activating factor ( PAF) antagonist CV-3988 on PSA induced by the NS1-IgG ICs were observed.Results:Two groups of monoclonal antibody cocktails with purified NS 1 were proved to be capable of provoking PCA and PSA in mice,whereas the other mAbs or mAb cocktails could be not .The murine PSA initiated by NS1-IgG(5D25+3B1) ICs could be sig-nificantly inhibited by in vivo treatment with GdCl3 or PAF antagonist CV-3988.Conclusion: The NS1-IgG ICs formed with DENV1 NS1 and IgG mAb cocktails can mediate PSA and PCA ,but not all of ICs formed by DENV 1 NS1 mAbs or mAb cocktails with DENV 1 NS1 can induce PSA ,indicating that it may be related to the special epitopes of DENV 1 NS1.The monocyte/macrophages and PAF may be as major effector cells and the major mediator for PSA induced by NS 1-IgG ICs,respectively.

Objective To develope a realtime system for ECG signals acquisition,amplification and network transmission.Methods The raw noisy ECG signals underwent gain amplification,denoising and filtering by a system developed by virtual instrument and LabVIEW,and network component programming was carried out based on TCP/IP.Then the processed ECG signals were transmitted to remote terminals with dual communication model.Results The system behaved well in easy operation,high reliability and man-machine interface,and could be used to realize remote realtime transmission and browsing of ECG signals between the hospital and medical communities.Conclusion The system may be a choice for ECG signals remote acquisition and transmission,and provides references for the development of telemedicine software.

Objective To evaluate the effects of network video in the continuing nursing care of discharged cervical cancer patients with postoperative catheter.Methods A number of 53 patients with cervical cancer underwent radical hysterectomy in Nantong Tumor Hospital from January to December 2016 were randomly recruited as the observation group. Another 53 patients with cervical cancer underwent radical hysterectomy from January 2012 to December 2015 were retrospectively studied as control group. Patients in the control group were discharged from the hospital with removal catheter after the professional nursing of 15 days. Patients in the observation group were discharged from the hospital with the indwelling catheter one week after the surgery, and the catheter was removed after one week of network video on continuation nursing care.Results After the removal catheter, there were two cases (4％) of increased residual urine, two cases (4％) of urinary retention, and eight cases (15％) of urinary tract infection in the observation group;one case (2％) of increased residual urine, two cases (4％) of urinary retention, and eight cases (15％) of urinary tract infection were found in the control group. No differences were observed between the two groups (P>0.05). The score of patients' satisfaction was (4.85±0.12) in the observation group and (4.82±0.10) in the control group, with no difference between the two groups (t=1.479,P>0.05).Conclusions The application of network video in continuing nursing care of patients with cervical cancer after radical hysterectomy is feasible, whereas the preparation before discharge is required.

Objective: To study the features of spontaneous isolated superior mesenteric artery dissection (SISMAD) by unexpected detection of renal artery dual-source CT (DSCT) imaging in hypertension patients. Methods: A total of 4107 patients with suspected secondary hypertension received renal artery DSCT examination in our hospital from 2010-03 to 2015-04 were studied and SISMAD was unexpectedly found in 12 patients. There were 3 patients with mild abdominal pain and the rest without obvious abdominal symptoms. The position and length, true and false lumens, detached tunica intimal flap and branch involvement of dissection, intestinal wall edema and ileus were recorded. Results: SISMAD in all 12 (0.3%) patients were found unexpectedly. Axial CT with post-processing technique clearly displayed the ruptured tunica intimal orifice, true and false lumens, detached intimal flap; the branches were all originated from true lumen. According to Sakamoto classification, all 12 patients were belong to Type I as the true and false lumens were with an entry and re-entry respectively, no filling defect in false lumen. The distance from orifice of dissection to root of abdominal aorta was (26.7 ± 11.3) mm and the length of dissection was (35.1 ± 11.7) mm.There were 10 patients with aneurysmal expansion with the diameter of (11.9 ± 2.5) mm. Conclusion: Unexpected detection of SISMAD by renal artery CT imaging was about 0.3%, radiologist should pay special attention to find superior mesenteric artery dissection in hypertension patients.

Objective To construct a recombinant expression vector for expression of the function-al domains of dengue virus serotype 1 ( DENV1 ) envelope ( E ) protein in native soluble form. Methods The genes encoding the functional domains of DENV1-E protein (1-394 aa) were amplified with PCR and then cloned into the Psectag2B-Fc eukaryotic expression vector.The 293T cells were transfected with the recombinant vector by cationic lipid-based delivery.The cell clones expressing the fusion DENV1-E-Fc protein were screened out with 2 mg/ml of Zeocin.Immunofluorescence assay ( IFA) was performed to analyze the antigenicity and integrity of the fusion protein.The fusion proteins were purified from cell lysate with Protein-G and further identified by Western blot assay.Results The soluble form of fusion protein with a molecular weight of about 90×103 was obtained at a yield of about 25 μg per 1×107 cells.The results of IFA indicated that the fusion protein kept its integrity with right conformational epitopes.The fusion protein was successfully expressed with the advantage of good specificity as indicated by IFA and Western blot assay. Conclusion The recombinant fusion protein in soluble form was successfully expressed in eukaryotic ex-pression system, which paved the way for further investigation on the function of DENV1 E protein and its protective epitopes.

Adult ; Humans ; Male ; Mediastinal Cyst