1.Effects of early electroacupuncture intervention on TDP-43 and HMGB1/RhoA signaling pathway in cere-bral cortex of mice with amyotrophic lateral sclerosis model
Yuanrong LU ; Junyang LIU ; Jie GUO
Chinese Journal of Rehabilitation Medicine 2024;39(3):312-319
Objective:To observe the effect of early electroacupuncture intervention on the expression of TARDNA bind-ing protein 43(TDP-43)and HMGB1/RhoA signaling pathway in the cerebral cortex of amyotrophic lateral sclerosis(ALS)mice,and to explore the potential mechanism of early electroacupuncture intervention in im-proving motor function in ALS mice. Method:SOD1G93A gene phenotype mice were randomly divided into model group(SOD1G93A),acupuncture in-tervention group(EA),riluzole group(Riluzole),and SOD1G93A negative mice in the same litter were blank control group(Control),with 15 mice in each group.The electroacupuncture group was given acupuncture of Baihui point,bilateral Tianzhu point,bilateral Tianshu point,5 times/7 days,7 days for a course of treat-ment,a total of 4 courses of treatment.The riluzole group was treated with riluzole 30 mg/(kg·d)by gavage,once a day,five times a week for two weeks.The motor function of mice in each group was evaluated by hind limb functional neurological score and rotarod fatigue test,and the rate of TDP-43 positive cells in cere-bral cortex was observed by immunofluorescence.The relative expression of Iba-1,HMGB1 or RhoA protein in cerebral cortex was detected by Western Blot.The levels of serum TNF-α and MCP-1 were detected by Elisa.The morphological changes of cerebral cortical neurons were observed by transmission electron microscopy. Result:Compared with the control group,the rotarod latency time was decreased and the neurological score was increased in the model group(P<0.01).The contents of serum MCP-1 and TNF-α,the expression of Iba-1,HMGB1 and RhoA protein in cerebral cortex and the rate of TDP-43 positive cells were increased in the model group(P<0.01).Compared with the model group,the rotarod latency time of the electroacupuncture group and the riluzole group increased and the neurological score decreased(P<0.01,P<0.05),the serum MCP-1,TNF-α content and the cerebral cortex Iba-1,HMGB1,RhoA protein expression and TDP-43 positive cell rate decreased(P<0.01,P<0.05).The results of electron microscopy showed that the structure of cortical neurons in the control group was normal,and the nerve cells in the model group exhibited obvious pathologi-cal changes.The damage of nerve cells in the electroacupuncture group and the riluzole group was reduced,the structure was relatively complete,and some normal organelles were detected. Conclusion:Electroacupuncture intervention can improve the motor function of ALS model mice.The mecha-nism may be related to the inhibition of HMGBl/RhoA signaling pathway and the reduction of microglia-in-duced neuroinflammation,and it is speculated that it has a positive effect on the reduction of ALS pathologi-cal substrate TDP-43 deposition.
2.Visualization Analysis on Research Literature about Acupuncture Treatment of Vascular Dementia from 2003 to 2023
Le LI ; Qiang WANG ; Yuan WANG ; Hui LI ; Junyang LIU ; Jie LI
Chinese Journal of Information on Traditional Chinese Medicine 2024;31(3):71-77
Objective To analyze the status and development direction of acupuncture treatment for vascular dementia from 2003 to 2023;To provide reference for related research.Methods Relevant literature on acupuncture treatment for vascular dementia was retrieved from CNKI,Wanfang Data,and VIP from January 2003 to September 2023.NoteExpress 3.7.0 and CiteSpace 5.7.R5 software were used to analyze keywords,authors,research institutions,and visualize knowledge maps.Results A total of 934 articles were included in the analysis,showing a slow fluctuating upward trend in publication volume.The study involved 653 authors,with prolific contributors such as Lai Xinsheng,Liu Zhibin,and Niu Wenmin.It included 449 research institutions,with prominent contributors being the First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Heilongjiang University of Chinese Medicine,and Guangzhou University of Chinese Medicine.Additionally,635 keywords were identified,forming 23 clusters.High-frequency keywords included"cognitive function","rats",and"hippocampus".Conclusion The protection and repair of nerves by acupuncture,the improvement of cognitive function,the comprehensive treatment mode,and the prevention of vascular dementia may be the research hotspots and trends in this field.
3.Interaction analysis of mismatch repair protein and adverse clinicopathological features on prognosis of colon cancer
Kexuan LI ; Fuqiang ZHAO ; Qingbin WU ; Junling ZHANG ; Shuangling LUO ; Shidong HU ; Bin WU ; Heli LI ; Guole LIN ; Huizhong QIU ; Junyang LU ; Lai XU ; Zheng WANG ; Xiaohui DU ; Liang KANG ; Xin WANG ; Ziqiang WANG ; Qian LIU ; Yi XIAO
Chinese Journal of Digestive Surgery 2024;23(6):826-835
Objective:To investigate the interactive effect of mismatch repair (MMR) protein status and adverse clinicopathological features on prognosis of stage Ⅰ-Ⅲ colon cancer.Methods:The retrospective cohort study was conducted. The clinicopathological data of 1 650 patients with colon cancer of stage Ⅰ-Ⅲ who were admitted to 7 hospitals in China from January 2016 to December 2017 were collected. There were 963 males and 687 females, aged 62(53,71)years. Patients were classified as 230 cases of MMR deficiency (dMMR) and 1 420 cases of MMR proficiency (pMMR) based on their MMR protein status. Observation indicators: (1) comparison of clinicopathological characteristics between patients of different MMR protein status; (2) analysis of factors affecting the survival outcomes of patients of dMMR; (3) analysis of factors affecting the survival outcomes of patients of pMMR; (4) interaction analysis of MMR and adverse clinicopathological features on survival outcomes. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data was conducted using the Mann-Whitney U test. The random forest interpolation method was used for missing values in data interpolation. Univariate analysis was conducted using the COX proportional risk regression model, and multivariate analysis was conducted using the COX stepwise regression with forward method. The coefficient of multiplication interaction effect was obtained using the interaction term coefficient of COX proportional risk regression model. Evaluation of additive interaction effects was conducted using the relative excess risk due to interaction ( RERI). Results:(1) Comparison of clinicopathological characteristics between patients of different MMR protein status. There were significant differences in age, T staging, the number of lymph node harvest, the number of lymph node harvest <12, high grade tumor between patients of dMMR and pMMR ( P<0.05). (2) Analysis of factors affecting the survival outcomes of patients of dMMR. Results of multivariate analysis showed that T staging, N staging, the number of lymph node harvest <12 were independent factors affecting the disease-free survival (DFS) of colon cancer patients of dMMR ( hazard ratio=3.548, 2.589, 6.702, 95% confidence interval as 1.460-8.620, 1.064-6.301, 1.886-23.813, P<0.05). Age and N staging were independent factors affecting the overall survival (OS) of colon cancer patients of dMMR ( hazard ratio=1.073, 10.684, 95% confidence interval as 1.021-1.126, 2.311-49.404, P<0.05). (3) Analysis of factors affecting the survival outcomes of patients of pMMR. Results of multivariate analysis showed that age, T staging, N staging, vascular tumor thrombus were independent factors affecting the DFS of colon cancer patients of pMMR ( hazard ratio=1.018, 2.214, 2.598, 1.549, 95% confidence interval as 1.006-1.030, 1.618-3.030, 1.921-3.513, 1.118-2.147, P<0.05). Age, T staging, N staging, high grade tumor were independent factors affecting the OS of colon cancer patients of pMMR ( hazard ratio=1.036, 2.080, 2.591, 1.615, 95% confidence interval as 1.020-1.052, 1.407-3.075, 1.791-3.748, 1.114-2.341, P<0.05). (4) Interaction analysis of MMR and adverse clinicopathological features on survival outcomes. Results of interaction analysis showed that the multiplication interaction effect between the number of lymph node harvest <12 and MMR protein status was significant on DFS of colon cancer patients ( hazard ratio=3.923, 95% confidence interval as 1.057-14.555, P<0.05). The additive interaction effects between age and MMR protein status, between high grade tumor and MMR protein status were significant on OS of colon cancer patients ( RERI=-0.033, -1.304, 95% confidence interval as -0.049 to -0.018, -2.462 to -0.146). Conclusions:There is an interaction between the MMR protein status and the adverse clinicopathological features (the number of lymph node harvest <12, high grade tumor) on prognosis of colon cancer patients of stage Ⅰ-Ⅲ. In patients of dMMR, the number of lymph node harvest <12 has a stronger predictive effect on poor prognosis. In patients of pMMR, the high grade tumor has a stronger predictive effect on poor prognosis.
4.Predictive value of vitamin and folic acid levels in gestational diabetes mellitus complicated by preeclampsia
Junyang CAO ; Chunxing MA ; Zhina LIU
Tianjin Medical Journal 2024;52(12):1278-1282
Objective To investigate the correlation between vitamin A,E,D and folic acid levels and concomitant preeclampsia(PE)in patients with gestational diabetes mellitus(GDM).Methods A total of 108 patients with GDM complicated with PE were used as the PE group,and another 108 GDM patients without PE were used as the GDM group.A total of 108 normal pregnant women with normal pregnancy test were used as the normal control group.The general information and vitamin A,E,D and folic acid levels were compared between the three groups.According to the severity of the disease,the PE group was subdivided into the mild-moderate PE group(62 cases)and the severe PE group(46 cases),and vitamin A,E,D and folic acid levels were compared between these two groups.Results Systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FBG),fasting insulin(FINS)were increased in turn in the normal control group,the GDM group and the PE groups(P<0.05),and vitamins A,E,D and folic acid levels were decreased in turn(P<0.05).Triglyceride,total cholesterol and glycated haemoglobin were higher in the PE group than those in the GDM group and the normal control,and high density lipoprotein(HDL)cholesterol was lower than that in the GDM group and the normal control group(P<0.05).Vitamin A,vitamin E,vitamin D and folic acid levels were lower in the severe PE group than those in the mild to moderate PE group(P<0.05).Higher levels of vitamin A,vitamin E,vitamin D and folate were protective factors for GDM patients with severe PE.Folic acid showed higher predictive efficacy and specificity in single indicator analysis.Vitamin A showed high predictive specificity.The combined prediction of four indicators for severe PE in GDM patients was more effective than each individual indicator.Conclusion Serum vitamin A,E,D and folate levels are significantly lower in patients with GDM complicated with PE,and the combination of all four may improve the predictive value of severe PE complicated with GDM.
5.Clinical efficacy and safety of bictegravir/emtricitabine/tenofovir alafenamide and lamivudine/dolutegravir in the treatment-na?ve patients with acquired immunodeficiency syndrome
Jiangrong WANG ; Jianjun SUN ; Junyang YANG ; Renfang ZHANG ; Li LIU ; Jun CHEN ; Yang TANG ; Tangkai QI ; Wei SONG ; Zhenyan WANG ; Yinzhong SHEN
Chinese Journal of Infectious Diseases 2024;42(3):147-153
Objective:To analyze the efficacy and safety of integrase inhibitor-based single-tablet regimens bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) and lamivudine/dolutegravir (3TC/DTG) in the treatment-na?ve patients with acquired immunodeficiency syndrome (AIDS).Methods:This study was a retrospective cohort study. The clinical data of treatment-na?ve AIDS patients initiating anti-retroviral therapy (ART) with B/F/TAF or 3TC/DTG and on ART for greater than or equal to 24 weeks from October 2020 to July 2023 in Shanghai Public Health Clinical Center, Fudan University were collected. The baseline human immunodeficiency virus (HIV)-1 RNA, CD4 + T lymphocyte counts at baseline and 12 weeks of treatment, and the rates of virological suppression and virological failure at 24 weeks of treatment, and levels of total cholesterol, serum creatinine, uric acid before and after treatment were compared between the B/F/TAF group and 3TC/DTG group. Independent sample t test, corrected t test, Mann-Whitney U test, Wilcoxon signed rank test, chi-square test were used for statistical analysis. Results:Among 189 treatment-na?ve AIDS patients, 141 cases were in B/F/TAF group and 48 cases in 3TC/DTG group. The HIV-1 RNA level at baseline was 1.77(0.78, 4.52)×10 5 copies/mL in the B/F/TAF group and 0.97(0.24, 2.20)×10 5 copies/mL in the 3TC/DTG group. There was a statistically significant difference between the two groups ( U=2 221.00, P=0.006).There were 77.3%(109/141) patients on B/F/TAF achieved complete virological suppression with no virological failure at week 24, and 85.4%(41/48) on 3TC/DTG achieved complete virological suppression with one (2.1%) virological failure at week 24. At 12 weeks of treatment, 92.2%(130/141) of the patients in the B/F/TAF group and 85.4%(41/48) of the patients in the 3TC/DTG group had an increase in CD4 + T lymphocyte count by more than 30% compared with baseline. The proportion of CD4 + T lymphocyte count increased by more than 100/μL from baseline in the B/F/TAF group was 67.4%(95/141), and that in the 3TC/DTG group was 52.1%(25/48). There were no significant differences between the two groups ( χ2=1.91 and 3.61, respectively, P=0.167 and 0.733).The levels of total cholesterol ( W=2 036.00, t=-5.42, respectively), serum creatinine ( W=1 098.00, 234.00, respectively), uric acid ( W=2 188.00, 299.00, respectively) and the proportion of patients with mild to moderate renal insufficiency ( χ2=22.29, 8.22, respectively) in the B/F/TAF group and 3TC/DTG group after 24 weeks of treatment were significantly higher than those before treatment (all P<0.01). Conclusions:Both B/F/TAF and 3TC/DTG are effective in terms of virological suppression and immunological recovery and have good safety profiles in treatment-na?ve patients with AIDS.
6.Changing trends of the pathogenic spectrum of pulmonary infections in patients with human immunodeficiency virus infection/acquired immunodeficiency syndrome from 2017 to 2022
Suyue HUANG ; Hong CHEN ; Wei SONG ; Tangkai QI ; Zhenyan WANG ; Li LIU ; Jianjun SUN ; Yang TANG ; Shuibao XU ; Junyang YANG ; Bihe ZHAO ; Jiangrong WANG ; Jun CHEN ; Renfang ZHANG ; Yinzhong SHEN
Chinese Journal of Infectious Diseases 2024;42(4):225-232
Objective:To analyze the changes of pathogen spectrum of pulmonary infection in human immunodeficiency virus (HIV) infection/acquired immunodeficiency syndrome (AIDS) patients before and during coronavirus disease 2019 (COVID-19) epidemic.Methods:The clinical data of hospitalized HIV infection/AIDS patients with pulmonary infection confirmed by etiology and/or imaging examinations in the Department of Infection and Immunity, Shanghai Public Health Clinical Center, Fudan University from January 2017 to December 2022 were collected, including the types of pathogens, the peripheral blood CD4 + T lymphocyte counts at admission due to pulmonary infection, and the treatment outcome of the patients at discharge. The changes of pathogen spectrum of pulmonary infection before COVID-19 epidemic (2017 to 2019) and during the epidemic (2020 to 2022) were analyzed, and their effects on adverse treatment outcomes (death during hospitalization or automatic discharge) were analyzed. Statistical analysis was performed using the chi-square test, trend chi-square test or Kruskal-Wallis test. Results:The proportion of patients with pulmonary infection during the epidemic was lower than that before the epidemic, the difference was statistically significant (23.01%(1 061/4 612) vs 28.68%(1 463/5 102), χ2=40.76, P<0.001). From 2017 to 2022, the proportion of hospitalized HIV infection/AIDS patients with pulmonary infection showed a downward trend ( χ2trend=8.81, P<0.001). Among the pathogens causing pulmonary infection from 2017 to 2022, bacteria, mycobacteria, and fungi were the three main pathogenic pathogens, accounting for 48.77%(1 231/2 524), 32.13%(811/2 524), and 14.34%(362/2 524), respectively. The proportion of bacterial infection decreased from 55.02%(805/1 463) before the epidemic to 40.15%(426/1 061) during the epidemic, and the proportion of fungal infection increased from 9.23%(135/1 463) to 21.39%(227/1 061), the differences were both statistically significant ( χ2=54.45 and 74.11, respectively, both P<0.001). There was no significant difference in the proportion of mycobacteria between before and during the epidemic ( P=0.169), but the proportion of Mycobacterium tuberculosis (MTB) infection decreased from 22.01%(322/1 463) before the epidemic to 15.08%(160/1 061) during the epidemic, while the proportion of nontuberculous mycobacterium (NTM) infection increased from 7.11%(104/463) to 11.78%(125/1 061), the differences were both statistically significant ( χ2=19.11 and 16.28, respectively, both P<0.001). There was a significant difference in the pathogen spectrum of pulmonary infection before and during the epidemic ( χ2=128.91, P<0.001). There was a significant difference in the peripheral blood CD4 + T lymphocyte counts of patients with MTB, NTM, Pnenmocystis, Talaromycosis marneffei and Cryptococcus infection ( H=71.92, P<0.001). There were 63.74%(109/171) of Pneumocystis infection and 67.65%(69/102) of Talaromycosis marneffei infection occurred in patients with CD4 + T lymphocyte count<50/μL. Among the patients with pulmonary infection, the proportion of patients with adverse treatment outcomes during the epidemic was higher than that before the epidemic, and the difference was statistically significant (13.29%(141/1 061) vs 10.39%(152/1 463), χ2=5.04, P=0.025). Among the patients with pulmonary infection who developed adverse treatment outcomes, the top three pathogens (from high to low) were bacteria (63.48%(186/293)), mycobacteria (27.65%(81/293)), and fungi (6.83%(20/293)). The proportion of adverse treatment outcomes caused by bacterial infection decreased during the epidemic compared with that of before the epidemic (71.71%(109/152) vs 54.61%(77/141), χ2=9.23, P=0.002), while the proportion of adverse treatment outcomes caused by fungal infection increased (2.63%(4/152) vs 11.35%(16/141), χ2=8.74, P=0.003), and the differences were both statistically significant. The proportion of adverse treatment outcomes caused by mycobacterial infection increased, but without statistically significant (23.03%(35/152) vs 32.62%(46/141), χ2=3.37, P=0.066), among which there was no difference in the proportion of adverse treatment outcomes caused by MTB infection (13.82%(21/152) vs 14.89%(21/141), χ2=0.07, P=0.793), while the proportion of adverse treatment outcomes caused by NTM infection increased (5.92%(9/152) vs 14.89%(21/141), χ2=6.41, P=0.011). There was a significant difference in the pathogen spectrum of pulmonary infection patients with adverse treatment outcomes before and during the epidemic ( χ2=12.22, P=0.007). Conclusions:Among the spectrum of pathogens causing pulmonary infection and adverse treatment outcomes of HIV infection/AIDS patients during the epidemic, compared with that before the epidemic, the proportion of bacterial decreases, while the proportion of fungi increases, and the proportion of mycobacteria remains stable with the proportion of NTM increasing. The proportion of MTB causing pulmonary infection decreases, while the proportion of MTB causing adverse treatment outcomes remains stable.
7.Changing trends of the clinical and epidemiological characteristics of acquired immunodeficiency syndrome-associated talaromycosis in Shanghai City
Hong CHEN ; Wei SONG ; Tangkai QI ; Li LIU ; Renfang ZHANG ; Zhenyan WANG ; Yang TANG ; Jun CHEN ; Jianjun SUN ; Shuibao XU ; Junyang YANG ; Jiangrong WANG ; Yinzhong SHEN
Chinese Journal of Infectious Diseases 2023;41(1):64-69
Objective:To analyze the clinical and epidemiological characteristics and changing trends of acquired immunodeficiency syndrome (AIDS)-associated talaromycosis in Shanghai City.Methods:The clinical data of patients with AIDS-associated talaromycosis hospitalized at Shanghai Public Health Clinical Center, Fudan University from Janauary 1, 2014 to December 31, 2021 were collected. The medical information included age, gender, place of origin, clinical symptoms, imaging manifestations, blood routine test, CD4 + T lymphocyte count. The chi-square test or Fisher exact probability test was used for statistical analysis. Univariate logistic regression was used to analyze the related risk factors for death. Results:From 2014 to 2021, a total of 12 165 AIDS patients were admitted, including 169 (1.4%) AIDS-assiociated talaromycosis patients. The proportions of AIDS-associated talaromycosis in AIDS inpatients from 2014 to 2021 were 1.8%(21/1 149), 1.1%(14/1 307), 1.3%(19/1 446), 0.9%(15/1 610), 1.2%(20/1 626), 1.2%(22/1 778), 1.7%(28/1 624) and 1.8%(30/1 625), respectively, which had not changed much. There was no statistically significant difference in the proportion of AIDS-associated talaromycosis in AIDS inpatients in different years ( χ2=9.50, P=0.218). Among the 169 patients, 157 cases (92.9%) were male, with the age of (37.9±12.2) years, and 35 were from Jiangxi Province, 31 from Shanghai Municipality, 29 from Zhejiang Province, 17 from Anhui Province, 14 from Fujian Province, 11 from Jiangsu Province, eight from Hunan Province, four from Heilongjiang Province, three cases each from Guangxi Zhuang Autonomous Region, Guizhou Province and Henan Province, two cases each from Hubei Province, Shandong Province, Shanxi Province, Yunnan Province and Guangdong Province, and one case from Chongqing Municipality. Patients from non-traditional endemic areas did not find a clear history of living in traditional endemic areas. Of 169 patients, 143(84.6%) cases had fever, 73(43.2%) had respiratory symptoms, and 26(15.4%) had rash during the course of the disease, 147(87.0%) had pulmonary imaging abnormalities, 94(55.6%) were complicated by other pathogens, and 44(26.0%) had hepatosplenomegaly, 137(81.1%) had CD4 + T lymphocyte count <50/μL. Twenty-three patients died, with the total fatality rate of 13.6%. The overall mortality rate showed a downward trend year by year. There was a statistically significant difference in the case fatality rate of AIDS-associated talaromycosis in different years (Fisher exact probability test, P=0.046). The result of univariate logistic regression model showed that patients with platelet count<50×10 9/L had an increased risk of death (odds ratio ( OR)=3.33, 95% confidence interval ( CI) 1.13 to 9.81, P=0.029). Conclusions:The overall change of AIDS-associated talaromycosis inpatients in Shanghai is not significant, while the prevalence rate has increased slightly in recent two years. The case fatality rate is declining year by year. The proportions of patients without a history of living in or traveling to epidemic areas and without rash as the first manifestation are high, and the main clinical manifestation is multi-system damage. Patients with platelet count<50×10 9/L have an increased risk of death.
8.Clinical characteristics of patients with acquired immunodeficiency syndrome complicated with nontuberculous mycobacteria disease
Shuibao XU ; Junyang YANG ; Wei SONG ; Yang TANG ; Zhenyan WANG ; Jianjun SUN ; Tangkai QI ; Li LIU ; Jun CHEN ; Renfang ZHANG ; Yinzhong SHEN ; Hongzhou LU
Chinese Journal of Infectious Diseases 2023;41(3):190-194
Objective:To explore the clinical characteristics of acquired immunodeficiency syndrome (AIDS) complicated with nontuberculous mycobacteria (NTM) disease.Methods:The clinical data of 190 patients with AIDS complicated with NTM disease diagnosed by Shanghai Public Health Clinical Center, Fudan University from January 1, 2019 to December 31, 2021 were analyzed retrospectively. NTM diseases were divided into disseminated NTM disease group and non-disseminated NTM disease group. The independent sample t test, Mann Whitney U test and chi-square test were used for statistical analysis. Results:The 190 patients with AIDS complicated with NTM disease included 182 males and eight females. The age was (42±13) years old, and the first hospital stay was 15(6, 26) days. Pneumocystis carinii pneumonia was the most common co-infection in 12.1%(23/190) of patients, 87 cases (45.8%) were disseminated NTM disease. The clinical symptoms of patients were common in fever (55.8%(106/190)), cough (50.0%(95/190)), and expectoration (28.9%(55/190)). The proportions of fatigue (31.0%(27/87) vs 7.8%(8/103)), poor appetite (21.8%(19/87) vs 10.7%(11/103)) in the AIDS patients with disseminated NTM disease group were higher than those in the non-disseminated NTM disease group, and the differences were statistically significant ( χ2=16.99, P<0.001 and χ2=4.42, P=0.036, respectively). There was no significant difference in the proportions of deaths between AIDS patients with disseminated NTM disease and those without disseminated NTM disease (17.2%(15/87) vs 12.6%(13/103), χ2=0.80, P=0.371). The most common NTM species was Mycobacterium avium (67.1%(49/190)), followed by Mycobacterium kansasii (15.1%(11/190)). Hemoglobin ((90.3±23.9) g/L vs (110.1±24.2) g/L), albumin ((29.7±5.5) g/L vs (34.7±5.6) g/L), CD4 + T lymphocyte count (11(5, 30)/μL vs 52(16, 96)/μL) and CD8 + T lymphocyte count ((362±320)/μL vs (496±352)/μL) in the disseminated NTM disease group were lower than those in non-disseminated NTM disease group ( t=-5.63, P<0.001; t=-6.18, P<0.001; Z=-5.90, P<0.001; and t=-2.73, P=0.007, respectively), while procalcitonin (0.24(0.10, 0.77) μg/L vs 0.10 (0.04, 0.51) μg/L) was higher than that in the non-disseminated NTM disease group ( Z=-3.09, P=0.002), with statistical significance. The most common imaging features were lung patch and strip shadow (67.4%(128/190)). Conclusions:The most common type of AIDS patients complicated with NTM disease is disseminated NTM disease, and Mycobacterium avium is the most common NTM species. The clinical manifestations (fatigue, anorexia) and laboratory tests (hemoglobin, albumin, procalcitonin, CD4 + T lymphocyte count, CD8 + T lymphocyte count) of AIDS patients with disseminated NTM disease and non-disseminated NTM disease are different, while the prognosis is not significantly different.
9.Construction of an acute toxoplasma encephalitis mouse model by the stereotaxic surgery with RH toxoplasma trophozoites
Kaiwei SI ; Jianxin LIU ; Feng WU ; Xiaoqi LI ; Zihao FU ; Jinhua GONG ; Junyang WANG ; Yanbin CHENG
Journal of Xi'an Jiaotong University(Medical Sciences) 2023;44(5):746-754
【Objective】 To construct an acute toxoplasma encephalitis mouse model by observing the pathological changes in the hippocampus of mice infected with Toxoplasma gondii strain RH. 【Methods】 The quantitative RH Toxoplasma gondii (100, 500, and 1 000 trophozoites) were injected into the hippocampal CA1 region of mice by the stereotaxic surgery; the survival status of mice was observed. Giemsa staining was used to observe the changes of toxoplasma in mouse ascites and brain tissue homogenates. Nissl staining and HE staining were used to observe the pathological changes of hippocampal nerve tissue. The distribution of Toxoplasma gondii in brain tissue was observed by immunohistochemical ABC method. 【Results】 The RH Toxoplasma gondii infected mice showed obvious symptoms such as arched back, bristling hair, abdominal distension, subtle tremor and hemiplegia on the fourth day of infection. The survival of mice in 100 trophozoites group was longer, no trophozoites of Toxoplasma gondii were found in ascites, a few pseudocysts were found in brain tissue homogenates after infected for 96 hours, and more trophozoites were found after death. Nysl staining and HE staining showed more tissue necrosis foci and loss of nerve cells in CA1 area after infected 144 h. The injury aggravated with the prolongation of infection time. Toxoplasma trophozoites were found in ascites and brain homogenates of mice in 500 and 1000 trophozoites groups. Nissl staining revealed neuronal loss and massive necrosis in the hippocampus. HE staining showed necrosis and inflammatory cell infiltration. The brain tissue injury significantly aggravated compared with 100 trophozoites group. The distribution of Toxoplasma gondii in the necrotic foci was confirmed by immunohistochemistry. 【Conclusion】 The survival of 100 trophozoite mice infected with Toxoplasma gondii strain RH was longer, and the pathological changes of brain tissue gradually aggravated. The damage was relatively confined to the brain tissue, and the mice showed typical symptoms of toxoplasma encephalitis. Therefore, the mouse model of acute toxoplasma encephalitis can be constructed by localized infection of 100 toxoplasma trophozoites, which can lay a foundation for future research on the mechanism of toxoplasma injury to cranial nerves.
10.Antiretroviral therapy-naïve people living with HIV tend to have more severe symptoms of COVID-19.
Jinfeng SUN ; Rui JIANG ; Yueming SHAO ; Jingjing HU ; Zhihang ZHENG ; Luling WU ; Li LIU ; Junyang YANG ; Yinzhong SHEN ; Renfang ZHANG ; Tangkai QI ; Jianjun SUN ; Zhenyan WANG ; Yang TANG ; Wei SONG ; Shuibao XU ; Bihe ZHAO ; Jun CHEN
Chinese Medical Journal 2023;136(22):2753-2755

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