Objective:To explore the occurrence and influencing factors of serum uric acid elevation in patients with coronavirus disease 2019 (COVID-19) treated with favipiravir.Methods:Medical records of patients with COVID-19 who were hospitalized in Beijing Ditan Hospital between June 1, 2020 and June 30, 2021 and treated with the 5- or 10-day regimen of favipiravir were collected and retrospectively analyzed. After favipiravir withdrawal, if the elevation in serum uric acid was ≥30% of baseline level, it was defined as serum uric acid elevation. Then patients were divided into serum uric acid elevation group and non-serum uric acid elevation group. The clinical characteristics such as gender, age, body mass index, comorbidities, smoking and drinking behavior, COVID-19 grade, favipiravir regimen, and serum uric acid level and renal function before treatment in patients between the 2 groups were compared. Influencing factors of favipiravir-associated serum uric acid elevation was analyzed using multivariate logistic regression method.Results:A total of 179 patients were included in the analysis, including 104 (58.1%) males and 75 (41.9%) females, aged from 19 to 70 years with a median age of 43 years. The level of serum uric acid in 179 patients after favipiravir treatment was significantly higher than before [(451±119) μmol/L vs. (332±94) μmol/L, P<0.001]. The change rate of serum uric acid from baseline level ranged from -57.1% to 157.8% with the median of 38.6%. The elevation in serum uric acid of ≥ 30% of baseline level occurred in 108 (60.3%) patients. The incidences of serum uric acid elevation in patients treated with 5-day and 10-day regimens of favipiravir were 46.8% (36/77) and 70.6% (72/102), respectively, and the difference between them was significant ( P=0.001). Multivariate logistic regression analysis showed that body mass index 24.0 to <28.0 kg/m 2 ( OR=3.109, 95 %CI: 1.209-7.994, P=0.019) and 10-day regimen of favipiravir ( OR=3.017, 95 %CI: 1.526-5.964, P=0.001) were independent risk factors for favipiravir-associated serum uric acid elevation. Conclusions:More than half of COVID-19 patients treated with favipiravir can develop serum uric acid elevation. Overweight and 10-day regimen of favipiravir are independent risk factors for serum uric acid elevation in patients.

Objective:To explore the occurrence and influencing factors of serum uric acid elevation in patients with coronavirus disease 2019 (COVID-19) treated with favipiravir.Methods:Medical records of patients with COVID-19 who were hospitalized in Beijing Ditan Hospital between June 1, 2020 and June 30, 2021 and treated with the 5- or 10-day regimen of favipiravir were collected and retrospectively analyzed. After favipiravir withdrawal, if the elevation in serum uric acid was ≥30% of baseline level, it was defined as serum uric acid elevation. Then patients were divided into serum uric acid elevation group and non-serum uric acid elevation group. The clinical characteristics such as gender, age, body mass index, comorbidities, smoking and drinking behavior, COVID-19 grade, favipiravir regimen, and serum uric acid level and renal function before treatment in patients between the 2 groups were compared. Influencing factors of favipiravir-associated serum uric acid elevation was analyzed using multivariate logistic regression method.Results:A total of 179 patients were included in the analysis, including 104 (58.1%) males and 75 (41.9%) females, aged from 19 to 70 years with a median age of 43 years. The level of serum uric acid in 179 patients after favipiravir treatment was significantly higher than before [(451±119) μmol/L vs. (332±94) μmol/L, P<0.001]. The change rate of serum uric acid from baseline level ranged from -57.1% to 157.8% with the median of 38.6%. The elevation in serum uric acid of ≥ 30% of baseline level occurred in 108 (60.3%) patients. The incidences of serum uric acid elevation in patients treated with 5-day and 10-day regimens of favipiravir were 46.8% (36/77) and 70.6% (72/102), respectively, and the difference between them was significant ( P=0.001). Multivariate logistic regression analysis showed that body mass index 24.0 to <28.0 kg/m 2 ( OR=3.109, 95 %CI: 1.209-7.994, P=0.019) and 10-day regimen of favipiravir ( OR=3.017, 95 %CI: 1.526-5.964, P=0.001) were independent risk factors for favipiravir-associated serum uric acid elevation. Conclusions:More than half of COVID-19 patients treated with favipiravir can develop serum uric acid elevation. Overweight and 10-day regimen of favipiravir are independent risk factors for serum uric acid elevation in patients.

Objective:To investigate the influencing factors of hospitalization for pregnant women with influenza A.Methods:From December 2018 to February 2019, 261 pregnant women with influenza A were admitted to Beijing Ditan Hospital, Capital Medical University. The clinical data of age, gestational period, underlying diseases, time from onset to treatment, white blood cell count and lymphocyte count of these patients were collected. Data of out-patients were compared with those of inpatients. Chi-square test and multivariate logistic regression were used to analyze the influencing factors of hospitalization in pregnant women with influenza A.Results:Among the 261 cases of pregnancy with influenza A, 36 cases (13.79%) were hospitalized, of which 10 (27.78%) were hospitalized due to severe influenza complications, the other 26 cases (72.22%) were hospitalized due to pregnancy related adverse events. The proportions of hospitalized patients with age ≥30 years old, gestational period ≥28 weeks, combined with underlying diseases and lymphocyte count <1×10 9/L were 75.00%(27/36), 83.33%(30/36), 16.67%(6/36) and 50.00%(18/36), respectively, which were significantly higher than those of out-patients (47.11%(106/225), 35.56%(80/225), 0.89%(2/225) and 13.22%(16/121), respectively; χ2=9.66, 29.05, 26.00 and 22.12, respectively, all P<0.05). The proportions of inpatients and out-patients with white blood cell count ≥4×10 9/L were 97.22%(35/36) and 97.52%(118/121), respectively, and there was no significant difference ( χ2=0.01, P=0.921). Multivariate logistic regression analysis showed that age ≥30 years (odds ratio ( OR)=5.181, 95% confidence interval ( CI) 1.628-16.489, P=0.005), gestational period ≥28 weeks ( OR=11.054, 95% CI 3.233-37.796, P<0.01), lymphocyte count <1×10 9/L ( OR=6.864, 95% CI 2.237-20.729, P=0.001), and time from onset to treatment <24 h ( OR=0.076, 95% CI 0.012-0.468, P=0.005) were the influencing factors for hospitalization of pregnant women with influenza A. Conclusion:Age ≥30 years old, gestational period ≥28 weeks, lymphocyte count <1×10 9/L and time from onset to treatment <24 h are the influencing factors for hospitalization of pregnant women with influenza A.

Objective:To explore the application value and initial clinical experience of fluorescence-enhanced laparoscopy combined with indocyanine green in radical cystectomy with pelvic lymphadenectomy.Methods:A retrospective analysis was performed on the clinical data of a total of 8 patients admitted from May 2018 to August 2019 who underwent laparoscopic radical cystectomy with pelvic lymphadenectomy for muscle-invasive bladder cancer using the fluorescent laparoscopy system.There were 6 males and 2 females; aged 58 to 71 years, with an average of 65.8 years. The preoperative pathology was urothelial carcinoma, with 2 cases in T 2a stage, 4 cases in T 2b stage, and 2 cases in T 3a stage. The patient was injected a total of 2 ml of 2.5 mg/ml of indocyanine green through a rigid cystoscope using a 18 gauge cystoscope injection needle before surgery. The PINPOINT endoscopic fluorescence camera system performed surgery in real-time. A systematic examination of the surgical area under near-infrared fluorescence was performed every 5 minutes. Observation and recording of indocyanine green combined with fluorescence laparoscopy to mark the bladder tumor area and identify the sentinel drainage. Results:Eight cases were successfully completed under the fluorescence laparoscopic system.In terms of tumor markers, cystoscopy with indocyanine green allowed 7 of the 8 patients to successfully identify the tumor area under fluorescent laparoscopy. Six of the 8 patients with sentinel lymph nodes identified by indocyanine green lymphangiography were also successful, of which 3 were positive for lymph nodes. At the same time, intravenous indocyanine green was used to observe that the blood supply to the bladder and the end of the ureter was good. The operation time was 190-310 minutes, with an average of 235 minutes; the bleeding volume was 150-380 ml, with an average of 180 ml; the postoperative hospital stay was 10-22 days, with an average of 14.5 days. Postoperative pathological staging 2 cases in T 2a stage, 3 cases in T 2b stage, 3 cases in T 3a stage, with total number of lymph nodes 8-14, average 10. The 8 cases were followed-up for 4-12 months, average 5.5 months, without indocyanine green related complications. Conclusions:Indocyanine green fluorescent laparoscopy can accurately locate and identify the bladder tumor area and pelvic lymph nodes during radical cystectomy, which can reduce positive margins and unnecessary enlarged lymph node dissection.

Objective To evaluate the efficacy and safety of single flexible ureteroscope vs.flexible ureteroscope combined with intraoperative ultrasonography guided in the endogenous renal cyst incision and drainage.Methods Retrospective analysis of case data of 64 patients with endogenous renal cysts admitted from January 2015 to December 2017.All the patients undrwent contrast-enhanced CT,urinary tract imaging,ultrasound B to confirm bosniak classification Ⅰ and Ⅱ renal cyst.The patients (38 males,26 females) were divided into single flexible ureteroscope group [group A,32 cases of patients,average age (54.2 ±6.6) years,unilateral or bilateral cystic patients:19 cases/ 13cases,simple cyst of kidney or polycystic kidney:24 cases/8 cases,average maximum diameter of the renal cyst (5.4 ± 1.3) cm,combined with renal calculus:8 cases,combined with hydronephrosis:7 cases,1 case who had the history of laparoscopic renal cyst decapitation,1 case who had the history of percutaneous renal cyst puncture] and flexible ureteroscope group combined with intraoperative ultrasonography guided [group B,32 cases of patients,average age (52.3 ± 9.3) years,unilateral or bilateral cystic patients:21 cases/11 cases,simple cyst of kidney or polycystic kidney:25 cases/7 cases.Average maximum diameter of the renal cyst (5.3 ±1.2) cm,combined with renal calculus:9 cases,combined with hydronephrosis:8 cases,2 case who had the history of laparoscopic renal cyst decapitation,1 case who had the history of percutaneous renal cyst puncture].The double J stent was placed two weeks before the surgery into the body of patients.During the operation,the surgical procedure were used by the electronic flexible ureteroscope and holmium laser (0.8 J,20 Hz),combined with ultrasound B in the monitoring,to find the suitable incision position.It would be defined as the successful result if we could put the head of flexible ureteroscope into the inside of renal cyst and see the image of mist in the screen of ultrasound B.According to the standard,the result of operation wound be defined compared to before operation (success:shrink more than 80％ or maximum diameter was smaller than 1 cm;improvement:shrink about 50％-79％;ordinary result:shrink about 30％-49％;failure:shrink smaller than 30％).Effective rate =(success cases + improvement cases)/total cases.We compared the differences of two groups in the time,efficacy,safety and complication of surgery.Results Compared the results of single flexible ureteroscope groups vs flexible ureteroscope group combined with intraoperative ultrasonography guided in the success cases of surgery,after 8-30 months following-up,total operative complication rate was [8 cases(25％)vs.1 case(3.1％)],success rate of operation in 6 month later [(20 cases (62.5％) vs.28 cases (87.5％)].Flexible ureteroscope group combined with intraoperative ultrasonography guided had advantages statistically (P ＜ 0.05).However,there was no statistical difference for the two groups in the time of operation [(33.4 ± 6.7) min vs.(35.1 ± 8.6) min],single operative complication (intraoperative wounding bleeding:3 cases vs.1 case,postoperative urinary infection:3 cases vs.0 case,perinephric space effusion:2 cases vs.0 case,renal function impairment:1 case vs.0 case)(P ＞0.05).Conclusions Flexible ureteroscope combined with intraoperative ultrasonography guided can help the urologist can improve the success rate of surgery and reduce the chance of surgical injury intraoperatively.

Objective To evaluate the effect of comprehensive schistosomiasis control measures based on infection source control in Hanchuan City marshland and lake endemic regions . Methods The data of comprehensive schistosomiasis control in Hanchuan City from 2004 to 2013 were collected and the change trends of the Oncomelania hupensis snail status and the in?fection situation of human and livestock were analyzed to evaluate the control effect. Results After the implementation of the comprehensive measures the infection rates of residents and cattle decreased from 6.38%and 8.11%in 2004 to 0.16%and 0 in 2013 respectively. There were no acute schistosomiasis patients since 2007 no new infection cases since 2011 and no infected snails since 2012. Compared with 2004 the occurrence rate of frames with living snails and the average density of living snails decreased by 56.78%and 68.35% respectively but the snail area and susceptible area increased by 0.62%and 7.10% respec?tively. In 2013 all the 367 endemic villages in 26 townships reached the criteria of transmission controlled. Conclusions The comprehensive schistosomiasis control measures based on infection source control can control the schistosomiasis transmission effectively in marshland and lake endemic regions. When consolidating the achievement the snail area in inner embankment should be compressed to prevent the schistosome re?infection in human and livestock.

Objective To investigate the clinical value of the Classification of acute pancreatitis2012.Methods Medical records and clinical data of patients with acute pancreatitis (AP) who were admitted to First Affiliated Hospital of Guangxi Medical University between October 2009 and September 2012 were retrospectively reviewed and analyzed.Patients were divided into mild acute pancreatitis (MAP),moderately severe acute pancreatitis (MSAP),and severe acute pancreatitis (SAP) groups according to the Classification of acute pancreatitis-2012.The number of improved and cured patients,length of hospital stay,hospitalization costs,rate of ICU admission,length of ICU stay,incidence of SIRS,and length of SIRS continue,Ranson scores,APACHE Ⅱ scores,computed tomographic severity index (CTSI) scores among the 3 groups were compared.Results One hundred and sixty-six patients with AP (119 males and 47 females) were included,and 76 were MAP,65 MSAP and 25 SAP.The average interval between AP onset and hospital admission was (2.27 ± 1.46) d.The number of improved and cured patients,length of hospital stay,hospitalization costs,rate of ICU admission,length of ICU stay,incidence of SIRS,and length of SIRS continue,Ranson scores,APACHE Ⅱ scores,CTSI scores increased with the severity of AP.The corresponding values in SAP group were 21 cases (84.0％),(23.8 ± 13.6) d,(53900 ± 30260) Yuan,48.0％ (12/25) and (5.76 ± 13.8) d,96.0％ (24/25) and (5.00 ± 2.40) d,(3.76 ± 1.30) score,(8.52 ± 4.24) score,(5.44 ± 3.48) score.Seventy-nine patients developed local complications,among them 34 was acute peripancreatic fluid collection,45 was acute necrosis collection.The incidence of acute necrosis collection in SAP group was significantly higher than that in MSAP group (68.0％ vs 44.6％,P =0.047),but the incidence of acute peripancreatic fluid collection in SAP group was significantly lower than that in MSAP group (16.0％ vs 46.2％,P =0.016).Organ failure occurred in 42 patients,among them 35 cases were respiratory failure,2 cases were renal failure,and 5 cases were respiratary and renal failure.The incidence of organ failure in SAP and MSAP group was 100％ and 26.2％,the difference between the two groups was statistically significant (P ＜ 0.05).Conclusions Classification of acute pancreatitis-2012 is a simple and convenient system,which can predict the severity of AP and appropriate for clinical application.

Objective To observe the expression of ghrelin and growth hormone secretagogue receptor (GHSR) in pancreas of rats with acute necrotizing pancreatitis (ANP),and investigate the role of ghrelin in the pathogenesis of ANP.Methods Seventy SD rats were randomly divided into ANP group (n =35) and control group (n =35).ANP model was induced by retrograde injection of 4％ sodium taurocholate into the biliary and pancreatic duct.Rats in the control group underwent laparotomy with gentle pancreas manipulation only.At 3,6,12,24,48 h after ANP induction,the rats were sacrificed,and the serum level of amylase was determined,pathological changes in pancreatic tissue were routinely observed and scored.The expressions of ghrelin mRNA,protein and GHSR mRNA,protein in pancreas were evaluated by RT-PCR and Western blot.Results Serum amylase level began to increase at 3h after sodium taurocholate injection and reached the peak value at 6 h [(8244 ± 2950) U/L],which was significantly higher than that in control group (P ＜ 0.05).Pancreatic injuries was aggravated with time,the pathologic score at 24 h was (11.91 ± 1.31) score,which was significantly higher than (3.12 ± 1.60) score in the control group.The expressions of ghrelin mRNA and GHSR mRNA in pancreas of ANP group were increased gradually with time,and were significantly higher than those of control group at all time points,at 48 h,1.29 ±0.64 vs 0.58 ±0.05 and 0.94 ±0.16vs 0.19 ±0.03,P ＜ 0.05.The expressions of ghrelin protein and GHSR protein in pancreas of ANP group were significantly higher than that in control group at 12,24,48 h.at 48 h,3.05 ± 0.48 vs 2.18 ± 0.23 and 2.34 ± 0.32 vs 1.55 ± 0.10 (P ＜ 0.05).Conclusions The expressions of ghrelin mRNA,protein and GHSR mRNA,protein of pancreas are significantly increased in rats of ANP,and are associated with the severity of ANP.

Objective To explore the signal transduction pathway of cyst fluid of Echinococcus granalosus in anti-parasite mechanisms through investigating the effect of cyst fluid on the expression of Toll-like receptor(TLR) in cells. Methods Changes of TLR4 and TGF-β1 expression of 7404 liver cells were detected by quantitative PCR. Results After treatment with increasing concentration cyst fluid the expres-sion of TLR4 was reduced. TGF-β1 expression of liver cells increased with the dose. TLR2 expressions in each group were very low. Conclusion Cyst fluid can increase the expression of TLR4, suggesting that the TLR4 signal transduction pathway involve anti-cyst fluid of Echinococcus granulosus. High concentrations of cyst fluid contribute to TGF-β1 expression which plays a role in immune evasion.

OBJECTIVETo detect putative suppressor loci involved in tumor progressing or metastases.

METHODSThirty microsatellite marker primers were employed to amply the corresponding loci of the genome DNA from 83 patients with sporadic colorectal cancer. The PCR products were electrophoresed on a 377 PRISM sequencer and the fluorescent signals were analyzed by Genotyper and Genescan software.

RESULTSThe data were obtained from 24 loci, with an average LOH frequency of 15.16%. The LOH at D2S206 and D2S364 was more frequent than 30%, and was less than 20% at the rest loci. Significant difference was observed between the percentage of LOH and tumor staging or differentiation at D2S142 (2q24.1), D2S126 (2q35), D2S2211 (2p24.2), D2S305 (2p23.3). Occarrence of deletion at the later two loci was correlative.

CONCLUSIONSFrequent LOH was not observed at the loci around known mismatch repair genes on chr. 2. The region between D2S305 (2p23.3) and D2S2211 (2p24.2) deleted holistically, and was correlated to the stage and differentiation of tumor attended by D2S142 (2q24.1) and D2S126 (2q35) on 2q. It is suggested that unknown genes associated with tumor progressing or metastases reside in the two loci on 2q or the region on 2p.

Adult ; Aged ; Aged, 80 and over ; Cell Differentiation ; Chromosome Mapping ; Colorectal Neoplasms ; genetics ; pathology ; Female ; Humans ; Loss of Heterozygosity ; Male ; Microsatellite Repeats ; Middle Aged ; Neoplasm Metastasis