Objective:To analyze the efficacy and prognosis of different treatment regimens in patients with uncomplicated brucellosis, and to provide guidance for clinical treatment.Methods:The patients diagnosed with brucellosis in the Sixth People′s Hospital of Shenyang from September 2014 to June 2019 were enrolled. The clinical data of patients with uncomplicated brucellosis were collected. The two most frequent treatment regimens were screened, after conducting propensity score matching with 1∶4, and the clinical characteristics, prognosis, and adverse reactions in patients with two regimens were retrospectively analyzed. The primary outcome was clinical cure. The secondary outcomes were disease progression and relapse. Statistical analysis was performed using chi-square test, Wilcoxon rank sum test and log-rank method.Results:A total of 1 570 patients clinically diagnosed with brucellosis were included, and 939(59.8%) showed uncomplicated infection. There were 608(38.7%) patients who received doxycycline and rifampicin treatment, and 65(4.1%) received doxycycline and levofloxacin treatment. By propensity score matching, 223 patients (DR group) who used doxycycline and rifampicin were included, while 65 patients (DL group) who used doxycycline and levofloxacin were included. The cure rate, progression rate, symptom persistence rate and recurrence rate of DR group were 94.6%(211/223), 1.8%(4/223), 2.2%(5/223) and 1.3%(3/223), respectively. In DL group, those were 95.4%(62/65), 3.1%(2/65), 1.5%(1/65) and 0(0/65), respectively. And there was no significant difference between the two groups ( χ2=0.18, P=0.632). No significant difference of symptom durations between the two groups was observed (29.0(28.0, 30.0) d vs 28.0(26.1, 29.9) d, hazard ratio ( HR)=0.966, 95% confidence interval ( CI) 0.723 to 1.290, χ2=1.01, P=0.315), while treatment course of DR group was statistically longer than DL group (90.0(84.1, 95.9) d vs 44.0(37.3, 50.7) d, HR=0.489, 95% CI 0.361 to 0.662, χ2=14.18, P<0.001). Procalcitonin (0.02(0.02, 0.05) μg/L and 0.02(0.02, 0.04) μg/L) and C-reactive protein (8(3, 17) mg/L and 18(7, 55) mg/L) levels in DR group and DL group had decreased significantly after treatment than before treatment (0.09(0.04, 0.16) μg/L and 0.19(0.08, 0.25) μg/L, 106(19, 274) mg/L and 255(50, 494) mg/L), and the differences were statistically significant ( W=2.55, 2.04, 3.66 and 2.19, respectively, all P<0.05). The adverse reaction (ADR) rate in DR group was 4.2%(8/191), and five patients showed liver function injury. The ADR rate in DL group was 2.0%(1/51), which showed liver function injury. There was no significant difference of ADR between the two groups ( P>0.05). Conclusions:Doxycycline combined with rifampicin and doxycycline combined with levofloxacin have similar efficacy and adverse reaction rates for treating uncomplicated brucellosis.

Brain Ischemia ; Cerebral Infarction ; Humans ; Subarachnoid Hemorrhage ; Vasospasm, Intracranial/etiology*

Objective To investigate the serum levels of dickkopf-related protein 1 (DKK1) and sclerostin (SOST) in patients with axial spondyloarthritis treated with selective cyclo-oxygenase 2 inhibitor and its relation to clinical efficacy.Methods A randomized double-blind controlled trial with axial spondyloarthritis (ax-SpA) was carried out in our hospital.The data from patients in a single center was collected and analyzed.Serum DKK1 and SOST levels were measured by enzyme-linked immuno sorbent assay (ELISA)method before and after 12 weeks treatment,then correlation analysis were conducted for DKK1 and SOST levels with erythrocyte sedimentation rate (ESR),C reactive protein (CRP),Bath ankylosing spondylitis disease activity index (BASDAI),Bath ankylosing spondylitis functional index (BASFI) and SPARCC of the sacroiliac joint inflammation score.Chi-square tests were used for analyzing of categorical data.Fisher exact tests were performed when the expected frequencies were less than 5.Two independent samples t-test was used to compare the difference between groups.Single sample t-test was used to ompare the differences between data before and after treatment.Pearson or Spearman correlation was used for correlation analysis.Results After 12 weeks of treatment,a total of 116 patients completed the follow-up,including 57 cases of imrecoxib group and 59 cases of the celecoxib group.There were no statistically significant difference between the two groups (P＞0.05).The level of serum DKK1 was significantly increased after treatment [(393±137) pg/ml,vs (542±274)pg/ml,P＜0.05].The serum level of SOST increased significantly [(39±19) pg/ml vs (57±36) pg/ml,t=5.814,P＞0.05],too.The difference between the two groups was not statistically significant (P＞0.05).Spearman correlation analysis showed that serum DKK1 was positively correlated with serum SOST (r=0.226,P=0.015).A significantcorrelation was found between SOST level and ESR,CRP,finger to floor distance,left and fight lumbar side flexion and Schober's test (ESR:r=-0.379,P＜0.01;r=-0.309,P=0.001;r=-0.225,P=0.015;r=0.185,P=0.047;r=0.247,P=0.008;r=0.214,P=0.021).Conclusion Imrecoxib and celecoxib have similar efficacy on relieving the signs and symptoms of patients with ax-SpA.Short-term application of selective COX-2 inhibitors can increase DKK1 and SOST and possibly delay radiographic progression.

Objective To investigate the sleep quality of patients with systemic lupus erythematosus (SLE) and to analyze its influencing factors. Methods A total of 156 patients with SLE who were treated in the Rheumatology Department of the First Affiliated Hospital of Zhengzhou University from October 2016 to January 2017 were selected as the research objects by convenience sampling method. All the participants were investigated by general information questionnaire, Pittsburgh sleep quality index (PSQI) scale and systemic lupus erythematosus disease activity index (SLEDAI). The influencing factors of patients' sleep quality was analyzed by single factor analysis and multiple linear regression analysis. Results The score of PSQI scale of SLE patients was (10.04±5.83). It was reported that 62.23% of patients had poor sleep quality. The main reason for night sleep disturbance were easy to wake up at night, night frequent urination and sensory heat. Single factor analysis showed that there was significant difference in total sleep quality among SLE patients with different age, education level, number of hospitalization, course of the disease, daily average dose of glucocorticoid and disease activity index (P< 0.05). Multiple linear regression analysis showed that age, course of the disease, daily average dose of glucocorticoid and disease activity index were the influencing factors of SLE patients' sleep quality (P<0.01). Conclusions The results indicate that sleep quality of SLE patients is influenced by age, course of disease, daily average dose of glucocorticoids and disease activity index. Medical staff should pay attention to patients' sleep problems and give sleep nursing interventions on the basis of treatment in order to improve the sleep quality and life quality of SLE patients.

Objective:To evaluate the changes of quality of life in patients with axial spondyloarthritis (ax-SpA) after treatment with non-steroidal anti-inflammatory drugs (NSAIDs) by the 36-item Short Form Health Survey (SF-36).Methods: 120 patients diagnosed with ax-SpA were collected in the first Affiliated Hospital of Zhengzhou University from October 2014 to September 2015.They all agreed to be treated with the special drugs and assessed by special scale.Then they all signed the agreement.In the 3 months,double-blind,parallel controlled trial patients were randomized to 200 mg twice daily (bid) imrecoxib,or 200 mg twice daily (bid) celecoxib.They were assessed for the changes of quality of life at enrollment and after three months of NSAIDs therapy by the SF-36 of Chinese edition.The correlation between quality of life and erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),Bath Ankylosing Spondylitis Disease Activity Index (BASDAI),Bath Ankylosing Spondylitis Functional Index (BASFI),Spondylo Arthritis Research Consortium of Canada (SPARCC) was analyzed.Results: A total of 116 ax-SpA patients completed the study and 4 patients were lost to follow-up.We used the SF-36 scale to assess the quality of life in patients with ax-SpA before and after 3 months,NSAIDs treatment.The treatment effects were not statistically significant difference between the two drugs (P>0.05).After all the patients were treated with NSAIDs for 3 months,there was statistically significant difference (P<0.05) of the physical functioning,role-physical,bodily pain,general health,social functioning,role-emotional;and there was no statistically significant difference (P>0.05) of vitality and mental health.The positively significant correlations had been identified between BASDAI and PF,RP,BP,GH,VT,SF,RE (P<0.05),while no significant correlation was found between BASDAI and MH (P>0.05).A positively significant correlation had been identified between BASFI and PF,RP,BP,GH,SF,RE,MH (P<0.05),while no significant correlation was found between BASFI and VT (P>0.05).The ESR was positively correlated with SF,RE (P<0.05);and CRP was positively correlated with SF,MH (P<0.05);and SPARCC was positively correlated with PF (P<0.05).BASDAI and BASFI were the important influence factors of PF (P<0.05);and BASDAI was the important influence factor of BP,GH,VT,RE(P<0.05);BASFI was the important influence factor of RP,SF,MH(P<0.05).Conclusion: Non-steroidal anti-inflammatory drugs can improve the quality of life of the ax-SpA patients.Imrecoxib and celecoxib have the equivalent curative effect.SF36 scale is suitable for the assessment of the quality of life in patients with ax-SpA.

Objective To acquire the prevalence and molecular identification data on Syphacia muris and provide reference for the revision of national standard. Methods 923 batches of 5199 SPF animals ( including one batch of 5 monkeys, 3 batches of 25 mini?pigs, 28 batches of 55 rabbits, 13 batches of 248 hamsters, 37 batches of 198 guinea pigs, 93 batches of 459 rats, 742 batches of 4179 mice, 5 batches of 25 chickens and one batch of 5 ducks) and 145 batches of 1389 clean animals ( including one batch of 3 rabbits, 4 batches of 31 hamsters, 16 batches of 157 guinea pigs, 32 batches of 268 rats and 92 batches of 930 mice ) came from 50 different manufactures in China. Direct microscopy real?time dynamic video recording techniques in combination with morphological identification method were applied to screen the Syphacia muris infestation. A multiple polymerase chain reaction ( multiple?PCR ) testing of the isolate based on amplification of the conserved portions of the Syphacia muris internal transcribed spacer (ITS), 28S ribosomal RNA (28S rRNA), NADH dehydrogenase subunits 1 (nad1) and cytochrome c oxidase subunit 1 (cox1) genes, and the molecular sequencing of the multiple?PCR amplicons was used to confirm the Syphacia muris infection. Results Syphacia muris eggs, larvae and adults were detected by using direct microscopy real?time dynamic video recording technique. Syphacia muris were detected based on the morphology and size of ovum, larvae, and female and male adult worms. Multiple?PCR and sequencing were performed to identify ITS, 28S rRNA, nad1 and cox1 genes of DNA extracted from the single egg, larva and adult parasite Syphacia muris. This approach allowed the specific identification with no amplicon being amplified from heterogeneous DNA samples, and sequencing confirmed the identity of the amplified sequences. Molecular characterization by multiple?PCR amplification and sequencing of the ITS, 28S rRNA, nad1 and cox1 genes demonstrated the presence of Syphacia muris. Multiple?PCR followed by sequencing confirmed 285 of 5199 SPF and 135 of 1389 clean animal samples classified as positive by using direct microscopy real?time dynamic video recording technique in the study as containing Syphacia muris?specific DNA. Comparison of the partial sequences of the ITS, 28S rRNA, nad1 and cox1 genes revealed 100% similarity amongst Syphacia muris from different animals. The prevalence of Syphacia muris infection in SPF and clean animals were 5?5% (285/5199) and 9?7% (135/1389), respectively. Conclusions Direct microscopy real?time dynamic video recording technique, multiple?PCR and sequencing can be used to rapidly detect and accurately identify Syphacia muris. The zoonotic nature of Syphacia muris can be regard as a public health alter, hence the good quality control of animal has an important role in protecting human health and safeguarding people safety. This is the first molecular identification and infection investigation of Syphacia muris in SPF and clean animals in China.

Objective To analyze the clinical characteristics of respiratory involvement in relapsing polychondritis(RPC). Methods The clinical data of 38 patients with respiratory (larynx, trachea and bronchus) involvement in RPC were retrospectively analyzed. Results The incidence of respiratory involvement in patients with RPC was 51.35%(38/74), and the most common symptoms were cough, wheezing, chest tightness and dyspnea. The incidences of erythrocyte sedimentation rate (ESR) increasing, C- reactive protein (CRP) increasing, fibrinogen increasing, D- dimer increased and rheumatoid factor (RF) positive in patients with respiratory involvement were significantly higher than those in patients without respiratory involvement: 47.37% (18/38) vs. 30.56% (11/36), 52.63% (20/38) vs. 33.33% (12/36), 31.58% (12/38) vs. 25.00% (9/36), 21.05% (8/38) vs. 13.89% (5/36) and 36.84%(14/38) vs. 5.56% (2/36), and there were statistical differences (P<0.05). CT was the main method to discover the respiratory involvement, and MRI could detect early cartilage inflammation lesions. Laryngoscope and bronchoscope could early detect mucosa and cartilage damage. Pathology was given priority to lymphocytes and neutrophils infiltration. Some patients had epithelium metaplasia and even canceration. Primary treatment methods were glucocorticoids combined with immunosuppressant. Airway stenosis and infection was the main factors influencing the prognosis of patients. Conclusions The respiratory involvement is not uncommon in RPC, and early CT, MRI, laryngoscope and bronchoscope examination is an important means of early diagnosis.Early glucocorticoid combined immunosuppressive therapy is the key to achieve good prognosis.

ObjectiveTo study the feasibility and reasonability of low-dose multi-slice CT(MSCT)with three dimensional rendering of the tendons of foot and ankle. The statistical methods including ANOVA and Kruskal-Wallis H was used. MethodsForty-five consecutive patients with fractures of foot and ankle were enrolled and evenly grouped into A (80 kV, 100 mAs), B(110 k V ,60 mAs) and C (130 kV,60 mAs).The MSCT scanning range was 6 slices of 1.0 mm. The CT value and standard deviation (SD) of the muscle and the CTDIvol were recorded. The image quality of volume rendering of the tendons was blindly evaluated.ResultsThe CT value of muscle in group A (71.6 ± 12.0) HU was significantly higher than group B [(66.8±9.2) HU, P=0.010]and C[(66. 1 ±7. 1) HU, P =0.004]. The SD average values were 11.9, 6. 1 and 7.0 HU for three groups, and there were significant differences among the three groups(F =37. 142, P=0. 0000). Group A had the highest SD value, group C had the lowest SD;CT1DIvol average value were (3.01 ± 0. 08) , (4. 63 ± 0. 11), (7.02 ± 0. 24) mGy respectively, which were significant different among the three groups (H =39. 185, P =0. 000). Group A had the lowest CTDIvol, while group C had the highest CTDIvol. Volume rendering of the tendons was evaluated as 2.3 ± 0. 5、3.7 ± 0. 5、4. 8 ±0. 4, and there were significant differences among the three groups (H = 72. 779, P = 0. 000). Group A had the worst VR images, while group C had the best VR images.All VR images in Group B were good for diagnosis. ConclusionThe protocol of 110 kV, 60 mAs, and 1 mm × 6 with three-dimensional volume rendering would be enough for evaluating the tendons of foot and ankle.

OBJECTIVEA highly sensitive and rapid high-performance liquid chromatography method with pre-column derivatization with 4-fluoro-7-nitrobenzofurazan was developed for determination of taurine in biological samples, including plasma, brain, and liver.

METHODSThe optimum derivatization reaction temperature was 70 °C, and at this temperature the reaction was complete within 3 min. The derivatized taurine was separated using phosphate buffer (0.02 mol/L, pH 6.0):acetonitrile (84:16, v/v) as the mobile phase at a flow rate of 1.0 mL/min, and a column temperature of 25 °C. The taurine derivatives were separated within 20 min (tR:14.5 min) and fluorometrically detected at 530 nm with excitation at 470 nm.

RESULTSThe intra- and the inter-day coefficients of variation for the method were 5.3% and 7.7%, respectively. The calibration curve was linear from 0.1 μmol/L to 30.0 μmol/L with a correlation coefficient of 0.9995.

CONCLUSIONThis method can be used to determine the taurine contents in plasma, brain, and liver from normal rats and human plasma.

4-Chloro-7-nitrobenzofurazan ; analogs & derivatives ; chemistry ; Acetonitriles ; chemistry ; Animals ; Brain Chemistry ; Chromatography, High Pressure Liquid ; Female ; Fluorescent Dyes ; chemistry ; Humans ; Hydrogen-Ion Concentration ; Liver ; chemistry ; Male ; Rats ; Rats, Wistar ; Solvents ; chemistry ; Taurine ; analysis ; blood ; Temperature

Objective To investigate the mechanism on JAK/STAT1 signal pathway in SAHA down-regulation of indoleamine 2,3-dioxygenase (IDO) in gallbladder carcinoma cells.MethodsWe treated gallbladder carcinoma SGC-996 cells with IFN-γ and SAHA.Western blotting was used to detect the expression of IDO,signal transducer and activator of transcription 1 (STAT1) phosphorylation and interferon regulatory factor genes-1 (IRF-1).Confocal microscopy analysis was used to detect STAT1 translocation.Transient transfections and reporter genes assay was used in detecting the activation of γ-activated sites (GAS) and interferon stimulated response elements (ISRE).ResultsIDO expressed in SGC-996 cells in dose- and time-dependent manners when stimulated with IFN-γ.SAHA down-regulated the expression of IDO induced by IFN-γ in a dose-dependent manner.SAHA blocked the expression of IRF-1 induced by IFN-γ.SAHA inhibited the IFN-γ-induced STAT1 phosphorylation and nuclear translocation.SAHA down-regulated IFN-γ-induced activation of GAS and ISRE.ConclusionsSAHA may down-regulate IDO expression through inhibiting the activation of members in JAK/STAT1 signal pathway.This may provide a new immunotherapeutic strategy to break tumor immune tolerance in gallbladder carcinoma.