Avian influenza H10N3 is a type of avian influenza virus that can occasionally infect humans and cause severe pneumonia and acute respiratory distress syndrome (ARDS). On December 25, 2024, a 23-year-old obese female patient with H10N3 avian influenza complicated with severe ARDS was admitted to the Fourth People's Hospital of Nanning. The patient was transferred to our department due to "fever, cough, and shortness of breath for 13 days". Physical examination revealed moist rales in bilateral lungs. Chest imaging showed large areas of ground-glass opacity and consolidation in both lungs. Based on the patient's medical history, clinical manifestations, and laboratory findings, she was diagnosed with human infection of H10N3 avian influenza, severe pneumonia, and severe ARDS. Supported by mechanical ventilation and extracorporeal membrane oxygenation (ECMO), daily monitoring of airway peak pressure, plateau pressure (Pplat), driving pressure (ΔP), and lung compliance was performed to guide the adjustment of tidal volume (VT) and positive end-expiratory pressure (PEEP) during invasive mechanical ventilation. Medications including anti-avian influenza virus agents, antibacterial drugs, and antifungals were administered. Eventually, the patient's condition improved gradually, and she was successfully weaned from ECMO. No ventilator-induced lung injury (VILI) or multiple organ dysfunction syndrome (MODS) related to ARDS occurred during ECMO support. However, during the final stage of ventilator weaning after the restoration of spontaneous breathing, a right pneumothorax occurred. Closed thoracic drainage was performed, after which the ventilator was successfully discontinued. The patient was successfully transferred out of the intensive care unit (ICU), recovered fully, and was discharged from the hospital. In the invasive mechanical ventilation management of patients infected with H10N3 avian influenza complicated by ARDS, monitoring airway peak pressure, Pplat, ΔP, and assessing pulmonary compliance may facilitate more standardized management of such ARDS patients and help reduce VILI.
Humans ; Female ; Influenza, Human/complications* ; Respiratory Distress Syndrome/complications* ; Respiration, Artificial/methods* ; Obesity/complications* ; Young Adult ; Extracorporeal Membrane Oxygenation ; Influenza A virus

Objective To investigate the effect of adjuvant therapy of Shenfu Injection on NOD-like receptor protein 3 (NLRP3)/cysteine-aspartic acid-specific protease 1 (Caspase-1) mediated pyroptosis signaling pathway and inflammatory factor levels in rats with acute myocardial infarction (AMI). Methods A total of 40 rats were randomly divided into sham operation group, model group, betaloc group (0.9 mg/kg), and combination group (0.9 mg/kg betaloc combined with 6 mL/kg Shenfu Injection), with 10 rats in each group. The rats were treated by gavage continuously for 3 weeks. The levels of serum troponin I (cTnI), creatine kinase-MB (CK-MB), interleukin (IL)-6, IL-1β, and tumor necrosis factor-α (TNF-α) in rats were detected before modeling, after modeling, and at 3 weeks of treatment. Echocardiographic parameters such as left ventricular ejection fraction (LVEF), left ventricular end-systolic diameter(LVESD), left ventricular end-diastolic diameter (LVEDD), and myocardial infarction area were compared among groups after modeling and at 3 weeks of treatment. Real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) and Western blot were used to detect the mRNA and protein expression levels of NLRP3 and Caspase-1 in the myocardium. Results Compared with the sham operation group, the levels of cTnI, CK-MB, IL-6, IL-1β, TNF-α, myocardial infarction area, and the expressions of NLRP3 mRNA and Caspase-1 mRNA in the model group were significantly increased after modeling and at 3 weeks of treatment (P < 0.05); compared with the model group, the levels of cTnI, CK-MB, IL-6, IL-1β, TNF-α, myocardial infarction area, and the expressions of NLRP3 mRNA and Caspase-1 mRNA in the betaloc group and the combination group were significantly decreased at 3 weeks of treatment, and the above indicators in the combination group were significantly lower than those in the betaloc group (P < 0.05). Conclusion Adjuvant therapy of Shenfu Injection for AMI can further alleviate myocardial cell injury, shorten infarction size, and inhibit inflammatory response and pyroptosis activity.

Objective : To explore the effect of long-chain non-coding RNA(lncRNA) SPINT1-AS1 on the growth and invasion of ovarian cancer cells and the molecular mechanism. Methods : The expression of lncRNA SPINT1-AS1 in ovarian cancer tissues and normal tissues was analyzed by GEPIA database.Fluorescence real-time quantitative polymerase chain reaction(qRT-PCR) method was used to determine the expression of lncRNA SPINT1-AS1 in ovarian cancer cell lines SKOV-3,A2780,OC3,HO-8910 and immortalized ovarian epithelial cell line IOSE80.The SKOV-3 cells were divided into si-SPINT1-AS1 group(transfected with lncRNA SPINT1-AS1 siRNA) and si-NC group(transfected with siRNA control).The effect of down-regulated lncRNA SPINT1-AS1 on the proliferation and invasion of SKOV-3 cells was determined by MTT method and Transwell chamber experiment.Western blot was used to detect the expression of proliferative phenotypic proteins(PCNA,CyclinD1) and metastatic phenotypic proteins(MMP2,MMP9).The dual luciferase reporter system was used to identify the targeting relationship between lncRNA SPINT1-AS1 and miR-211-5 p.The effect of down-regulated lncRNA SPINT1-AS1 on the expression of miR-211-5 p was detected by qRT-PCR. Results: Compared with normal tissues, the expression level of lncRNA SPINT1-AS1 in ovarian cancer tissues was higher(P<0.01).Compared with IOSE80 cells, the expression level of lncRNA SPINT1-AS1 in ovarian cancer cell lines SKOV-3,A2780,OC3,HO-8910 increased(P<0.05),and the expression level of lncRNA SPINT1-AS1 in SKOV-3 cells was the highest(P<0.01).Compared with the si-NC group, the absorbance of SKOV-3 cells in the si-SPINT1-AS1 group was reduced(P<0.05),the number of invasive cells was reduced(P<0.05),and the expression of proliferation phenotype proteins PCNA and CyclinD1 were reduced(P<0.01),the expression of metastatic phenotypic proteins MMP2 and MMP9 was reduced(P<0.01).lncRNA SPINT1-AS1 could directly bind to miR-211-5 p(P<0.01).Compared with the si-NC group, the expression level of miR-211-5 p in SKOV-3 cells of the si-SPINT1-AS1 group increased(P<0.01). Conclusion The expression of lncRNA SPINT1-AS1 in ovarian cancer tissues and cell lines increased.Down-regulation of lncRNA SPINT1-AS1 can inhibit the proliferation and invasion of ovarian cancer SKOV-3 cells by targeting up-regulation of miR-211-5 p.

BACKGROUND: Anaplastic lymphoma kinase (ALK) rearrangement is a common driver gene of non-small cell lung cancer (NSCLC). Ceritinib is a second-generation ALK inhibitor, which can bring survival benefits to ALK-positive metastatic NSCLC. However, few studies focus on the safety and efficacy of ceritinib in China. Therefore, this study intends to investigate the safety and preliminary efficacy of ceritinib 450 mg with meals in Chinese patients with ALK-positive NSCLC through a real world study. METHODS: From October 2018 to December 2019, patients with ALK-positive NSCLC from 8 medical centers in Sichuan province were recruited in this study. All of these participants received ceritinib 450 mg/d with food. The basic characteristics, adverse effects (AEs) and responses were collected and analyzed in order to evaluate the safety and efficacy of ceritinib. RESULTS: A total of 109 patients were included in this study. Data cutoff was January 23, 2020. The median duration of treatment exposure was 5.87 mon (range: 0.4 mon-15.7 mon). Total AEs were reported in 98 (89.9%) of 109 patients and grade 3 or 4 AEs were reported in 22.9% of patients. Most common AEs (mainly grade 1 or 2) were diarrhea (60.6%), elevated alanine aminotransferase (ALT)(38.5%) and aspartate aminotransferase (AST)(37.6%). As of data cutoff, 45 patients discontinued ceritinib. The overall response rate (ORR) was 37.6% (95%CI: 28.5%-47.4%) and disease control rate (DCR) was 86.2% (95%CI: 78.3%-92.1%). CONCLUSIONS The treatment of ceritinib 450 mg with food for Chinese ALK-positive NSCLC patients had a good safety profile and favorable DCR in real-world setting. However, this conclusion needs to be further verified by large sample, prospective trials.

Objective: To analysis the clinical characteristics and experiences in diagnosis and treatment of the patients with novel coronavirus pneumonia (NCP). Methods: Clinical data of 28 patients with NCP in Nanning Fourth People's Hospital from January 22 to February 5 in 2020 were collected. The clinical manifestations, epidemiological history, laboratory tests, imaging examinations and treatments of patients were analyzed retrospectively. Results: The 28 patients with confirmed viral pneumonia included 11 males and 17 females, ranging from 11 to 68 years. They all had history of epidemiological exposure and were all positive for 2019-nCoV nucleic acid in throat swabs. There were one mild case, 25 ordinary cases and two severe cases. There were four groups of family clusters. The illness onset ranged from 1 to 12 days after exposure, and the time from the symptom onset to the positive result of the nucleic acid test was 0 to 13 days. The clinical symptoms were mainly fever and cough, which progressed rapidly in a short period of time. Since the onset of illness, the peak values of axillary temperature of the 28 patients were 36.6~39.5 ℃, while five patients had no fever throughout the course of the disease with the peak temperature of ≤37 ℃. There were two patients presented with decreased white blood cell counts, five patients with elevated C reactive protein, six patients with abnormal alanine aminotransferase, three patients with abnormal aspartate aminotransferase,10 patients with elevated creatine kinase, three patients with elevated creatine kinase isoenzyme, four patients with elevated lactate dehydrogenase, and all with normal procalcitonin levels. The chest computed tomography examinations showed that the common features were ground glass shadows (21 cases), blurred edges (18 cases), speckles and patchy shadows (17 cases), thickening and disorder of some lung textures (7 cases), and visible band shadows (7 cases). Pulmonary lesions often progressed rapidly. One 11-year-old child was treated with alpha-interferon alone, and 27 patients were treated with alpha-interferon inhalation plus lopinavir/ritonavir with 4 withdrawal due to adverse reactions. Up to February 12, nine patients had been discharged from the hospital, who were ordinary cases, without death cases. Conclusions The NCP patients mostly present with fever and cough. Pulmonary lesions often progress rapidly. Respiratory pathogen testing should be conducted as early as possible and repeatedly. Disisolation should be cautious for suspected people who are negative for 2019-nCoV nucleic acid in pharynx swabs.

Objective:To analyze the clinical characteristics and experiences in diagnosis and treatment of the patients with novel coronavirus pneumonia (NCP).Methods:Clinical data of 28 patients with NCP in the Fourth People′s Hospital of Nanning from January 22 to February 5 in 2020 were collected. The clinical manifestations, epidemiological history, laboratory tests, imaging examinations and treatments of patients were analyzed retrospectively.Results:The 28 patients with NCP included one mild case, 25 ordinary cases and two severe cases. They were all positive for 2019 novel coronavirus (2019-nCoV) nucleic acid in throat swabs. There were four groups of family clusters. The clinical symptoms were mainly fever and cough, which progressed rapidly in a short period of time. Since the onset of illness, the peak values of axillary temperature of the 28 patients were 36.6 ℃ to 39.5 ℃, while five patients had no fever throughout the course of the disease with the peak temperature ≤37.0 ℃. The illness onset ranged from 1 to 12 days after exposure, and the time from the symptom onset to the positive results of the nucleic acid tests was 0 to 13 days. There were two patients presented with decreased white blood cell counts, five patients with elevated C reactive protein, six patients with abnormal alanine aminotransferase, three patients with abnormal aspartate aminotransferase, 10 patients with elevated creatine kinase, three patients with elevated creatine kinase isoenzyme, four patients with elevated lactate dehydrogenase, and all with normal procalcitonin levels. The chest computed tomography examinations showed that the common features of patients with NCP were ground glass shadows (21 cases), blurred edges (18 cases), speckles and patchy shadows (17 cases), thickening and disorder of some lung textures (seven cases), and visible band shadows (seven cases). Pulmonary lesions often progressed rapidly. A included 11-year-old child was treated with alpha-interferon alone. A total of 27 patients were treated with alpha-interferon inhalation and lopinavir/ritonavir, while four occured withdrawal due to adverse reactions. Up to February 12, nine patients had been cured and discharged who were all ordinary cases, without death cases.Conclusions:The NCP patients mostly present with fever and cough. Pulmonary lesions often progress rapidly. Respiratory pathogen testing should be conducted as early as possible and repeatedly. Disisolation should be cautious for suspected people who are negative for 2019-nCoV nucleic acid in pharynx swabs.

Objective:To explore the protective effect of the water-soluble total flavonoids from Isodon lophanthoides var.gerardia-nus (Benth.) H.Hara on LO2 cells damage.Methods:The cytotoxicity was evaluated by MTT cell viability determination to confirm the concentration range .Hepatocyte damage model was established by H 2 O2 treatment.After the oxidative stress hepatocyte was coin-cubated with WSTF at different concentrations for various times , the protective effect of WSTF on H 2 O2-induced hepatocyte damage was evaluated by MTT cell viability determination and the content determination of ALT , AST and MDA in cell supernatant .The inhibition of WSTF against H 2 O2-induced LO2 cells apoptosis was evaluated by the quantitative determination of Rhodamine 123 fluorescence and intracellular ROS.Results:The LO2 cells injured by 0.3 mmol· L-1 H2 O2 treatment for 4 h were used as the hepatocyte damage model.The concentration range of WSTF was 0.0312-0.125 mg· ml-1.WSTF could inhibit H2O2-induced injury in LO2 cells and obviously reduce ALT, AST and MDA.Moreover, WSTF could reverse mitochondrial membrane potential depolarization and decrease the amount of intracellular ROS .Conclusion:WSTF exhibits notable protective and curative effects on hepatocyte damage in vitro.

Objective To improve the quality of the management of the elderly patients with cancer in Sichuan province,and to understand the attitudes and perspectives of elderly surgeons and oncologists for the management and treatment of elderly patients with cancer.Methods A face-toface questionnaire interview was conducted with oncologists (n 64) and geriatricians (n =64).128 physicians were involved in this study.Results The cancer management and therapeutics were deemed appropriate at present by 9.38％ (6/64)of the geriatricians and 25.00％ (16/64)of the oncologists.The 39.06％ (25/64) of geriatricians used to notice geriatric syndromes,while 81.25％ (52/64)of oncologists never concerned about the geriatric syndrome(P=0.011).As for the causes of the therapy-associated toxicity,oncologist versus geriatrician payed an attention to malnutrition (100.00％ vs.100.00％ in both groups),to mobility disorders(65.63％ vs.65.63％,84/128 in both groups),to cognitive impairment/mood disorder (89.06％ in geriatrician group vs.75.00％ in oncologist group,P=0.038).For the factors affecting treatment decisions,a physical ability attention (oncologists vs geriatricians:70.31％ vs.92.19％;P =0.002),and comorbidity (oncologists vs geriatricians:62.50％ vs.79.69％,P =0.032) had statistically significant difference.In addition,lack of geriatrics knowledge was also reported by more oncologists.However,one hundred percent of participants wanted very much to cooperate with each other in their clinical work.When responding to the clinical scenario,the 10.94％ (7/64)of geriatricians and 32.81％ (21/64)of oncologists chose modified treatment for 65-74 years old patient with cancer(P =0.003).When the age of the patients was 75-84 years old,only 12.50 ％ (8/64) of geriatricians prefer end-of-life care,while 31.25 ％ (20/64) of oncologists chose it (P =0.010).Conclusions Selection of treatment decisions in the elderly patients with cancer affect by ageing.Both oncologists and geriatricians are concerned with the elderly patients with cancer,ageing syndrome,total sickness and functional status.And these doctors support an establishment of a multi disciplinary team cooperation for the elderly patients with cancer.Therefore,the establishment of mutual cooperation between the two professionals is necessary and feasible.

Objective: To observe the clinical effects of the Joint Active System on the treatment of joint dysfunction after deep burn. Methods: Twenty-two patients with joint dysfunction after deep burn were hospitalized in Institute of Burns of Tongren Hospital of Wuhan University & Wuhan Third Hospital from January 2015 to October 2016, involving 18 elbow joints with flexion disorder, 10 wrist joints with dorsal extension disorder, and 12 ankle joints with dorsal extension disorder. They were treated with the elbow joint activity training device, the wrist joint activity training device, and the ankle joint activity training device of the Joint Active System, respectively. The treatment was carried out 3 times each day with interval of 6 h, 30 minutes each time, and it lasted for four to seven months, with one month as a course of treatment. Before treatment and 1, 2, 3, 4 month (s) after, active motion range of each joint was measured by joint goniometer. Function improvement of each joint was evaluated, and the total effective ratio was calculated 4 months after treatment. Satisfaction degree of patients was assessed by the modified Likert Scale 1, 2, 3, 4 month (s) after treatment. Data were processed with one-way analysis of variance for repeated measurement and LSD test. Results: Before treatment and 1, 2, 3, 4 month (s) after, flexion active motion range of elbow joints were (61±23), (78±22), (89±20), (96±20), and (103±19)°; dorsal extension active motion range of wrist joints were (23±7), (31±6), (38±9), (44±5), and (49±8)°; dorsal extension active motion range of ankle joints were (-31±12), (-23±10), (-16±7), (-12±6), and (-8±4)°, respectively. The active motion range of each joint was obviously higher 1, 2, 3, 4 month (s) after treatment than the previous time point of the same joint (with P values below 0.01). Four months after treatment, the total effective ratios of function improvement of elbow joints, wrist joints, and ankle joints were 5/6, 9/10, and 2/3, respectively. Scores of satisfaction degree of the patients 1, 2, 3, 4 month (s) after treatment were (1.3±0.7), (2.2±1.0), (2.8±0.8), and (3.3±0.6) points, respectively. Scores of satisfaction degree of the patients were obviously higher 2, 3, 4 months after treatment than the previous time point (with P values below 0.05). Conclusions Joint Active System can improve the active range of motion of each joint obviously in treating joint dysfunction after deep burn, with total effective ratio of function improvement of each joint surpassing 0.66, and the majority of patients are quite satisfied with the curative effects.

Objective To investigate the emotional memory impairment in patients with primary insomnia (PI) and explore the neurobiological mechanisms underlying primary insomnia through emotional memory tasks involving different valance of emotional pictures.Methods Thirty patients with primary insomnia(PI group) and twenty healthy controls(HC group) were given emotional memory tasks using positive,neutral and negative valence images.The emotional memory was evaluated by the recognition of emotional pictures.Results Compared with healthy controls (positive (11.60±4.00) , neutral (11.05± 3.73) and negative (12.60± 2.06) , respectively), patients with PI (positive (11.30±3.75),neutral (11.47±3.21) and negative (11.43±4.12) ,respectively) showed no significant difference in appraisal of the emotional pictures (P＞0.05).Compared with healthy controls (43.40± 4.88) for the emotional images memorizing task,patients with PI (39.40±6.43) exhibited evident deficit of all emotional images (P＜0.05).Furthermore, the accuracy in recognizing both positive (12.60± 2.42) and neutral (12.87±3.18) valence pictures were significantly lower in patients with P1 than those in healthy controls(positive (14.05±2.19) and neutral (14.75± 1.80)) (P＜0.05).There was no significant difference in negative stimulus between PI group(13.93±1.76) and HC group(14.70±1.59) (P＞0.05).Conclusion The results suggest thant emotional memory is impaired in patients with PI.Moreover,the emotional memory for positive and neutral vanlence pictures is impaired but the emotional memory for negative is relatively spared in patients with primary insomnia.The results also indicate that impaired emotional memory with different valences may relate with distinct neuromechanisms.