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Chen N, Jiang H, Chen HH, Zhu QY, Wu XL, Li JJ, Liang NX, Meng Q, Liu XH, Huang JH, Hou WX, Wang ZQ, Lan GH. [Immune reconstitution and influencing factors in HIV infected men who have sex with men with access to antiviral therapy in Guangxi Zhuang Autonomous Region from 2005 to 2021]. Zhonghua Liu Xing Bing Xue Za Zhi 2024; 45:529-535. [PMID: 38678348 DOI: 10.3760/cma.j.cn112338-20230719-00021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/29/2024]
Abstract
Objective: To analyze immune reconstitution and influencing factors in HIV infected men who have sex with men (MSM) with access to antiviral therapy (ART) in Guangxi Zhuang Autonomous Region (Guangxi) during 2005-2021. Methods: The data were collected from Chinese Disease Prevention and Control Information System. The study subjects were HIV infected MSM with access to the initial ART for ≥24 weeks in Guangxi from 2005 to 2021 and HIV RNA lower than the detection limit within 24 months. The proportion of infected MSM who had immune reconstitution after ART was calculated. Cox proportional hazard regression model was used to analyze the influencing factors of immune reconstitution. Software SPSS 24.0 was used for statistical analysis. Results: A total of 3 200 HIV infected MSM were enrolled, in whom 15.56 % (498/3 200) had no immune reconstitution, 14.78% (473/3 200) had moderate immune reconstitution, and the rate of complete immune reconstitution was 69.66% (2 229/3 200). The M (Q1, Q3) of ART time for immune reconstitution was 12 (5, 27) months. Multivariate Cox proportional risk regression model analysis results showed that compared with those with initial ART at age ≥30 years, WHO clinical stage Ⅲ/Ⅳ illness, baseline BMI <18.50 kg/m2 and baseline CD4+T lymphocyte (CD4) counts <200 cells/µl, HIV infected MSM with initial ART at age <30 years, WHO clinical stageⅠ/Ⅱ illness, baseline BMI≥24.00 kg/m2 and baseline CD4 counts ≥200 cells/µl were more likely to have complete immune reconstitution. Conclusions: In the HIV infected MSM in Guangxi, failures to achieve moderate and complete immune reconstitution were observed. Surveillance and ART regimen should be improved for key populations, such as those with older age and low baseline CD4 counts.
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Affiliation(s)
- N Chen
- School of Public Health and Management, Youjiang Medical University for Nationalities, Baise 533000, China
| | - H Jiang
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - H H Chen
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - Q Y Zhu
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - X L Wu
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - J J Li
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - N X Liang
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - Q Meng
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - X H Liu
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - J H Huang
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - W X Hou
- Guangxi University of Chinese Medicine, Nanning 530028, China
| | - Z Q Wang
- Guangxi University of Chinese Medicine, Nanning 530028, China
| | - G H Lan
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
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Li SS, Li K, Chen HH, Zhu QY, He JS, Feng Y, Lan GH, Shao YM. Evaluation of factors associated with high advanced HIV disease and mortality in Southwestern China: a retrospective cohort study, 2005-2020. Public Health 2024; 227:282-290. [PMID: 38238130 DOI: 10.1016/j.puhe.2023.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 10/27/2023] [Accepted: 11/10/2023] [Indexed: 02/18/2024]
Abstract
OBJECTIVES To assess the prevalence, all-cause mortality and determinants of advanced HIV disease (AHD) or severe immunosuppression (SIS) in the rural-urban communities of Southwestern China. STUDY DESIGN Retrospective cohort study. METHOD Data on HIV/AIDS cases reported in 2005-20 were collected from Case Report System. A binary logistic regression model assessed the risk factors of AHD/SIS prevalence. Survival curves across rural-urban regions were compared using Kaplan-Meier estimates and log-rank tests. Determinants of all-cause mortality were identified using the Cox proportional hazard model. RESULTS Among 14,533 newly diagnosed HIV/AIDS patients, 7497 (51.6%) presented with AHD and 2564 (17.6%) with SIS. Compared with urban patients, rural patients had a higher prevalence of AHD (56.7% vs 40.7%) and SIS (20.1% vs 12.4%), all-cause mortality (AHD 12.3 vs 5.6, SIS 16.3 vs 5.5, per 100 person-years). Their 5-year survival probability (AHD 59.5% vs 77.1%; SIS 54.4% vs 76.3%) and mean survival time (AHD 106.5 vs 140.6 months, SIS 95.3 vs 144.2 months, p < 0.0001) were lower. Rural patients had an increased risk of SIS prevalence (adjusted odds ratios 1.45, 95% confidence interval [CI] 1.28-1.64; p < 0.0001) and mortality of the total cohort (adjusted hazard ratios 1.41, 95% CI 1.29-1.55; p < 0.0001), AHD cohort (1.38, 1.24-1.54; p < 0.0001), and SIS cohort (1.49, 1.23-1.81; p < 0.0001). CONCLUSIONS A high prevalence of AHD/SIS was a severe phenomenon that caused high mortality in rural areas. A regional point-of-care strategy targeting AHD/SIS detection and management is essential for reducing the mortality risk.
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Affiliation(s)
- S S Li
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, China; State of Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - K Li
- State of Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - H H Chen
- Guangxi Key Laboratory of Major Infectious Disease Prevention and Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Q Y Zhu
- Guangxi Key Laboratory of Major Infectious Disease Prevention and Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China
| | - J S He
- State of Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Y Feng
- State of Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - G H Lan
- Guangxi Key Laboratory of Major Infectious Disease Prevention and Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China.
| | - Y M Shao
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, China; State of Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China; Guangxi Key Laboratory of Major Infectious Disease Prevention and Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China.
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Xu P, Tong W, Kuo CY, Chen HH, Wang RYL. The Upf1 protein restricts EV-A71 viral replication. Microbes Infect 2023; 25:105220. [PMID: 37734533 DOI: 10.1016/j.micinf.2023.105220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/07/2023] [Accepted: 09/15/2023] [Indexed: 09/23/2023]
Abstract
Enterovirus A71 (EV-A71) is transmitted through the respiratory tract, gastrointestinal system, and fecal-oral routes. The main symptoms caused by EV-A71 are hand, foot, and mouth disease (HFMD) or vesicular sore throat. Upf1 (Up-frameshift protein 1) was reported to degrade mRNA containing early stop codons, known as nonsense-mediated decay (NMD). Upf1 is also involved in the NMD mechanism as a host factor detrimental to viral replication. In this study, we dissected the potential roles of Upf1 in the EV-A71-infected cells. Upf1 was virulently down-regulated in three different EV-A71-infected cells, RD, Hela, and 293T, implying that Upf1 is a host protein unfavorable for EV-A71 replication. Knockdown of Upf1 protein resulted in increased viral RNA expression and production of progeny virus, and conversely, overexpression of Upf1 protein resulted in decreased viral RNA expression and production of progeny virus. Importantly, we observed increased RNA levels of asparagine synthetase (ASNS), one of the indicator substrates for the NMD mechanism, which indirectly suggests that EV-A71 infection of cells suppresses NMD activity in the host. The results shown in this study are useful for subsequent analysis of the relationship between the NMD/Upf1 mechanism and other picornaviruses, which may lead to the development of anti-picornavirus drugs.
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Affiliation(s)
- Peng Xu
- Xiangyang No. 1 People's Hospital and Hubei University of Medicine; Hubei Province, China
| | - Wei Tong
- Department of Clinical Laboratory, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - Chen-Yen Kuo
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial and Children's Hospital, Linkou 33305, Taiwan
| | - Han-Hsiang Chen
- Department of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Robert Y L Wang
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial and Children's Hospital, Linkou 33305, Taiwan; Department of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; Kidney Research Center and Department of Nephrology, Chang Gung Memorial Hospital, Linkou 33305, Taiwan.
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Zhou YS, Luo LH, Lin M, Chen HL, Huang JH, Zhu QY, Chen HH, Shen ZY, Li JJ, Feng Y, Li D, Liao LJ, Xing H, Shao YM, Ruan YH, Lan G. [Factors associated with death and attrition in HIV-infected children under initial antiretroviral therapy in Guangxi Zhuang Autonomous Region, 2004 - 2019]. Zhonghua Liu Xing Bing Xue Za Zhi 2022; 43:1430-1435. [PMID: 36117350 DOI: 10.3760/cma.j.cn112338-20220112-00027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To investigate death and attrition in HIV-infected children under initial antiretroviral therapy (ART) and associated factors in Guangxi Zhuang autonomous region. Methods: This retrospective cohort study was conducted in HIV-infected children under initial ART in Guangxi from 2004 to 2019, data from ART information system of National comprehensive AIDS prevention and treatment information system. Cox proportional hazards models were used to assess factors associated with the death and attrition. Results: In 943 HIV-infected children, the overall mortality and attrition rates were 1.00/100 person-years and 0.77/100 person-years, respectively. The mortality and attrition rates within the first year of ART were 3.90/100 person-years and 1.67/100 person-years, respectively. The cumulative survival rate during the first, second, fifth and tenth year after ART was 96.14%, 95.80%, 93.68% and 91.54%, respectively. Multivariate Cox proportional hazards models results showed that being female (aHR=2.00, 95%CI: 1.17-3.40), CD4+T lymphocytes (CD4) counts before ART <200 cells/μl (aHR=2.79, 95%CI: 1.54-5.06), weight-for-age Z score before ART <-2 (aHR=2.38, 95%CI: 1.32-4.26), hemoglobin before ART <80 g/L (aHR=2.47, 95%CI: 1.24-4.92), initial ART with LPV/r (aHR=5.05, 95%CI: 1.15-22.12) were significantly associated with death; being female (aHR=2.23, 95%CI: 1.22-4.07) and initial ART with LPV/r (aHR=2.02, 95%CI: 1.07-3.79) were significantly associated with attrition. Conclusions: The effect of ART in HIV-infected children in Guangxi was better, but the mortality and attrition rates were high within the first year of treatment. It is necessary to strengthen the training in medical staff and health education in HIV-infected children and their parents in order to improve the treatment effect.
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Affiliation(s)
- Y S Zhou
- State Key Laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - L H Luo
- Guangxi Key Laboratory for Major Infectious Diseases Prevention and Control and Biosafety Emergency Response,Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention,Nanning 530028, China
| | - M Lin
- Guangxi Key Laboratory for Major Infectious Diseases Prevention and Control and Biosafety Emergency Response,Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention,Nanning 530028, China
| | - H L Chen
- State Key Laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - J H Huang
- Guangxi Key Laboratory for Major Infectious Diseases Prevention and Control and Biosafety Emergency Response,Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention,Nanning 530028, China
| | - Q Y Zhu
- Guangxi Key Laboratory for Major Infectious Diseases Prevention and Control and Biosafety Emergency Response,Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention,Nanning 530028, China
| | - H H Chen
- Guangxi Key Laboratory for Major Infectious Diseases Prevention and Control and Biosafety Emergency Response,Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention,Nanning 530028, China
| | - Z Y Shen
- Guangxi Key Laboratory for Major Infectious Diseases Prevention and Control and Biosafety Emergency Response,Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention,Nanning 530028, China
| | - J J Li
- Guangxi Key Laboratory for Major Infectious Diseases Prevention and Control and Biosafety Emergency Response,Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention,Nanning 530028, China
| | - Y Feng
- State Key Laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - D Li
- State Key Laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - L J Liao
- State Key Laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - H Xing
- State Key Laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Y M Shao
- State Key Laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Y H Ruan
- State Key Laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Guanghua Lan
- Guangxi Key Laboratory for Major Infectious Diseases Prevention and Control and Biosafety Emergency Response,Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention,Nanning 530028, China
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Jiang H, Tang KL, Huang JH, Li JJ, Liang SS, Liu XH, Pang XW, Zhu QY, Chen HH, Zhou YJ, Lan GH. [Analysis of HIV transmission hotspots and characteristics of cross-regional transmission in Guangxi Zhuang Autonomous Region based on molecular network]. Zhonghua Liu Xing Bing Xue Za Zhi 2022; 43:1423-1429. [PMID: 36117349 DOI: 10.3760/cma.j.cn112338-20220424-00339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To analyze HIV transmission hotspots and characteristics of cross-regional transmission in Guangxi Zhuang autonomous region (Guangxi) based on the molecular network analysis, and provide evidence for optimization of precise AIDS prevention and control strategies. Methods: A total of 5 996 HIV pol sequences sampled from Guangxi between 1997 and 2020 were analyzed together with 165 534 published HIV pol sequences sampled from other regions. HIV-TRACE was used to construct molecular network in a pairwise genetic distance threshold of 0.5%. Results: The proportion of HIV sequences entering the molecular network of HIV transmission hotspots in Guangxi was 31.5% (1 886/5 996). In the molecular network of HIV cross-regional transmission, the links within Guangxi accounted for 51.6% (2 613/5 062), the links between Guangxi and other provinces in China accounted for 48.0% (2 430/5 062), and the links between Guangxi and other countries accounted for 0.4% (19/5 062). The main regions which had cross-regional linked with Guangxi were Guangdong (49.5%, 1 212/2 449), Beijing (17.5%, 430/2 449), Shanghai (6.9%, 168/2 449), Sichuan (5.7%, 140/2 449), Yunnan (4.2%, 102/2 449), Shaanxi (3.8%, 93/2 449), Zhejiang (2.8%, 69/2 449), Hainan (2.0%, 49/2 449), Anhui (1.5%, 37/2 449), Jiangsu (1.3%, 33/2 449), and other regions (each one <1.0%), respectively. The risk factors of entering the molecular network of HIV transmission hotspots in Guangxi included being aged ≥50 years (compared with being aged 25-49 years, aOR=1.68,95%CI:1.46-1.95), males (compared with females, aOR=1.21,95%CI:1.05-1.40), being single (compared with being married, aOR=1.18,95%CI:1.00-1.39), having education level of high school or above (compared with having education level of junior high school or below, aOR=1.21,95%CI:1.04-1.42), acquired HIV through homosexual intercourse (compared with acquired with HIV through heterosexual intercourse, aOR=1.77, 95%CI:1.48-2.12). The risk factors of cross-regional transmission included males (compared with females, aOR=1.74,95%CI:1.13-2.75), having education level of high school or above (compared with having education level of junior high school or below, aOR=1.96,95%CI:1.43-2.69), being freelancer/unemployed/retired (compared with being farmers, aOR=1.50,95%CI:1.07-2.11), acquired HIV through homosexual intercourse (compared with acquired with HIV through heterosexual intercourse, aOR=3.28,95%CI:2.30-4.72). Conclusion: There are HIV transmission hotspots in Guangxi. Guangxi and other provinces in China form a complex cross-regional transmission network. Future studies should carry out social network surveys in high-risk populations inferred from the molecular network analysis for the timely identification of hidden transmission chains and reduction of the second-generation transmission of HIV.
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Affiliation(s)
- H Jiang
- Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning 530028, China
| | - K L Tang
- Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning 530028, China
| | - J H Huang
- Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning 530028, China
| | - J J Li
- Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning 530028, China
| | - S S Liang
- Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning 530028, China
| | - X H Liu
- Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning 530028, China
| | - X W Pang
- Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning 530028, China
| | - Q Y Zhu
- Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning 530028, China
| | - H H Chen
- Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning 530028, China
| | - Y J Zhou
- Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning 530028, China
| | - G H Lan
- Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning 530028, China
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Chen HH, Deng Y, Li Z, Wang ZL, Run ZC, Zhang T, Cai YC, Zhang HW, Hu ZH, Chen JH, Tian LG, Li J. [Prevalence and risk factors of Giardia lamblia infections among colorectal cancer patients in Henan Province]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2022; 34:370-377. [PMID: 36116926 DOI: 10.16250/j.32.1374.2022054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To investigate the epidemiological characteristics and identify the risk factors of Giardia lamblia infections among patients with colorectal cancer in Henan Province. METHODS A cross-sectional study was performed for questionnaire surveys among colorectal cancer patients in Henan Cancer Hospital during the period from March to July, 2021. Patients' stool samples were collected, and the triosephosphate isomerase (tpi) gene of G. lamblia was amplified in stool samples using nested PCR assay to characterize the parasite genotype. Univariate analysis and multivariate logistic regression analyses were employed to identify the risk factors of G. lamblia infections among colorectal cancer patients. RESULTS A total of 307 colorectal cancer patients were investigated, including 176 males (57.3%) and 131 females (42.7%). PCR assay detected 8.1% [95% confidential interval (CI): (0.056, 0.117)] prevalence of G. lamblia infections among the study subjects, and there was no significant difference in the prevalence between men [9.1%, 95% CI: (0.057, 0.143)] and women [6.9%, 95% CI: (0.037, 0.125)] (χ2 = 0.495, P = 0.482). In addition, there was no age-specific prevalence of G. lamblia infections among the participants (χ2 = 1.534, P = 0.675). Multivariate logistic regression analysis identified use of septic tanks [odds ratio (OR) = 3.336, 95% CI: (1.201, 9.267)], daily use of well water [OR = 3.042, 95% CI: (1.093, 8.465)] and raising livestock [OR = 3.740, 95% CI: (1.154, 12.121)] as risk factors of G. lamblia infections among colorectal cancer patients, and the prevalence of abdominal pain was significantly greater in colorectal cancer patients with G. lamblia infections than in those without infections (P = 0.017). Among the 25 patients with G. lamblia infections, assemblage A was characterized in 24 (96.0%) cases and assemblage B in one case (4.0%). CONCLUSIONS The prevalence of G. lamblia is high among colorectal cancer patients in Henan Province, and assemblage A is the dominant genotype of G. lamblia. Use of septic tanks, daily use of well water and raising livestock are risk factors of G. lamblia infections among patients with colorectal cancer.
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Affiliation(s)
- H H Chen
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), National Health Commission Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, School of Global Health, Chinese Center for Tropical Diseases and Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
- Co-first authors
| | - Y Deng
- Henan Provincial Center for Disease Control and Prevention, Zhengzhou, Henan 450016, China
- Co-first authors
| | - Z Li
- Henan Cancer Hospital, Zhengzhou, Henan 450003, China
| | - Z L Wang
- Henan Cancer Hospital, Zhengzhou, Henan 450003, China
| | - Z C Run
- Henan Cancer Hospital, Zhengzhou, Henan 450003, China
| | - T Zhang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), National Health Commission Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, School of Global Health, Chinese Center for Tropical Diseases and Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - Y C Cai
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), National Health Commission Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, School of Global Health, Chinese Center for Tropical Diseases and Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - H W Zhang
- Henan Provincial Center for Disease Control and Prevention, Zhengzhou, Henan 450016, China
| | - Z H Hu
- Research Base of National Key Laboratory of Infectious Disease Prevention and Control, Key Laboratory of Animal Origin and Vector-borne Infectious Diseases of Jiangxi Province, Nanchang Center for Disease Control and Prevention, Jiangxi Province, China
| | - J H Chen
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), National Health Commission Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, School of Global Health, Chinese Center for Tropical Diseases and Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - L G Tian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), National Health Commission Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, School of Global Health, Chinese Center for Tropical Diseases and Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - J Li
- Henan Cancer Hospital, Zhengzhou, Henan 450003, China
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Wang SM, Chen HH. [Clinical anatomy for transoral minimally invasive surgery]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 57:661-665. [PMID: 35610694 DOI: 10.3760/cma.j.cn115330-20220109-00016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- S M Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - H H Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
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Young KM, Rodeheffer RJ, Chen HH, Oh JK, Kane G. Left ventricular diastolic dysfunction, including an impaired myocardial relaxation pattern, predicts long-term cardiovascular and non-cardiovascular mortality in the community. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background/Introduction
Prior studies have demonstrated abnormalities of diastolic function are independent predictors of heart failure and all-cause mortality. The optimal way to classify diastolic function has continued to evolve over time, particularly in those with preserved left ventricular ejection fraction. A notable change in the 2016 American Society of Echocardiography (ASE)/European Association of Cardiovascular Imaging (EACVI) guidelines is that individuals with impaired myocardial relaxation and normal filling pressure can be classified as normal diastolic function.
Purpose
To determine whether the association of diastolic dysfunction with increased risk of all-cause mortality is driven by cardiovascular or non-cardiovascular death. Second, to evaluate if the presence of an impaired myocardial relaxation inflow pattern without other diastolic abnormalities conveys a marker of increased risk.
Methods
This study utilized the Olmsted County Heart Function Study (OCHFS), a well characterized prospective adult community cohort with comprehensive echocardiography between 2001 and 2004 and long-term follow-up. Only individuals with measurable diastolic function were included (n = 1,104). Those with reduced left ventricular ejection fraction, more than moderate valve disease, or a clinical diagnosis of heart failure (n = 52); or indeterminate diastolic function (n = 47) were excluded. Diastolic function was assessed by the current Mayo Clinic diagnostic algorithm (Figure).
Results
A total of 695 individuals were classified as normal, 265 with impaired myocardial relaxation or grade 1 diastolic dysfunction, and 45 with grade 2-3 diastolic dysfunction. Those with diastolic dysfunction were older and had more comorbidities including diabetes, hypertension and coronary disease (Table). There were 264 deaths in the median follow up period of 15.2 years (IQR 14.4 – 18.0), including 173 non-cardiovascular and 81 cardiovascular deaths. Both cardiovascular and non-cardiovascular mortality were associated with the presence and grade of diastolic dysfunction (Table 1). Individuals classified as normal by 2016 ASE/EACVI criteria, but grade 1 by the Mayo algorithm had an increased risk of all-cause mortality after univariate analysis (HR 4.35, 95% CI (3.35, 5.65), p < 0.0001) compared to normal subjects and remained associated after adjustment for age (HR 1.55, 95% CI (1.15, 2.09), p < 0.0001. Subjects with a grade 1 pattern had a higher rate of cardiovascular mortality (ꭕ2 70.1, p < 0.0001).
Conclusions
Individuals with diastolic dysfunction, including those with an impaired relaxation mitral inflow, were at increased risk of mortality, particularly cardiovascular mortality. This study highlights the importance of separating grade 1 diastolic dysfunction from normal in the assessment of diastolic function as it represents a clinically significant risk marker of myocardial disease. Abstract Figure. Abstract Figure.
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Affiliation(s)
- KM Young
- Mayo Clinic, Rochester, United States of America
| | | | - HH Chen
- Mayo Clinic, Rochester, United States of America
| | - JK Oh
- Mayo Clinic, Rochester, United States of America
| | - G Kane
- Mayo Clinic, Rochester, United States of America
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Zhao XH, Guo YC, Chen HH, Li X, Wang Y, Ni WW, Xing MQ, Zhang R, Yu SC, Pan YG, Zhan RX, Luo GX. [Effects of porcine acellular dermal matrix combined with human epidermal stem cells on wound healing of full-thickness skin defect in nude mice]. Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi 2022; 38:45-56. [PMID: 34839596 DOI: 10.3760/cma.j.cn501120-20200920-00418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the effects of porcine acellular dermal matrix (ADM) combined with human epidermal stem cells (ESCs) on wound healing of full-thickness skin defect in nude mice. Methods: The morphology of porcine ADM was analyzed by photograph of digital camera, the cell residues in porcine ADM were observed by hematoxylin-eosin (HE) staining, the surface structure of porcine ADM was observed by scanning electron microscope, the secondary structure of porcine ADM was analyzed by infrared spectrometer, the porcine ADM particle size was analyzed by dynamic light scattering particle size analyzer, and the porcine ADM potential was analyzed by nano-particle size potentiometer. The morphology of porcine ADM was observed by inverted fluorescence microscope when it was placed in culture medium for 30 min, 1 d, and 5 d (n=2). The porcine ADM was divided into 5 min group, 10 min group, 20 min group, 30 min group, 60 min group, and 120 min group according to the random number table (the same grouping method below) in static state at normal temperature for the corresponding time to calculate the water absorption by weighing method (n=3). Swiss white mouse embryonic fibroblasts (Fbs) were divided into blank control group (culture medium only), and 50.0 g/L ADM extract group, 37.5 g/L ADM extract group, 25.0 g/L ADM extract group, 12.5 g/L ADM extract group, and 6.5 g/L ADM extract group which were added with the corresponding final concentrations of ADM extract respectively. At post culture hour (PCH) 24, 48, and 72, the cell survival rate was detected by cell counting kit 8 and the cytotoxicity was graded (n=5). The erythrocytes of a 6-week-old male Sprague-Dawley male rat were divided into normal saline group, ultra-pure water group, and 5 mg/mL ADM extract group, 10 mg/mL ADM extract group, and 15 mg/mL ADM extract group which were treated with the corresponding final concentrations of porcine ADM extract respectively. After reaction for 3 h, the absorbance value of hemoglobin was detected by microplate reader to represent the blood compatibility of porcine ADM (n=3). ESCs were isolated and cultured from the discarded prepuce of a 6-year-old healthy boy who was treated in the Department of Urology of the First Affiliated Hospital of Army Medical University (the Third Military Medical University) in July 2020, and then identified by flow cytometry. The porcine ADM particles of composite ESC (hereinafter referred to as ESC/ADM) were constructed by mixed culture. After 3 days of culture, the composite effect of ESC/ADM was observed by HE staining and laser scanning confocal microscope. Thirty-six 7-8-week-old male non-thymic nude mice were divided into phosphate buffer solution (PBS) alone group, ADM alone group, ESC alone group, and ESC/ADM group, with 9 mice in each group, and the wound model of full-thickness skin defect was established. Immediately after injury, the wounds were treated with the corresponding reagents at one time. On post injury day (PID) 1, 7, 11, and 15, the wound healing was observed and the wound healing rate was counted (n=3). On PID 7, the epithelialization of wounds was observed by HE staining and the length of un-epithelialized wound was measured (with this and the following sample numbers of 4). On PID 11, the dermal area and collagen deposition of wounds were observed by Masson staining and the dermal area of wound section was calculated, the number of cells expressing CD49f, a specific marker of ESC, was calculated with immunofluorescence staining, the mRNA expression of glyceraldehyde-3-phosphate dehydrogenase (GAPDH) in ESC after wound transplantation was detected by real-time fluorescence quantitative reverse transcription polymerase chain reaction. Data were statistically analyzed with independent sample t test, one-way analysis of variance, analysis of variance for repeated measurement, and least significant difference t test. Results: The porcine ADM was white particles and composed of reticular structure, with no cells inside, disordered structure, and rough surface. The absorption peak of porcine ADM appeared at the wave numbers of 1 659, 1 549, and 1 239 cm-1, respectively. The main particle size distribution of porcine ADM in solution was 500 to 700 nm, with negative charge on the surface. The morphology of porcine ADM in static state at 30 min and on 1 and 5 d was relatively stable. The water absorption of porcine ADM remained relatively high level in static state from 30 min to 120 min. The cytotoxicity of mouse embryonic Fbs in 6.5 g/L ADM extract group, 12.5 g/L ADM extract group, and 25.0 g/L ADM extract group was grade 1 at PCH 24, and the cytotoxicity of the other groups was 0 grade at each time point. After reaction for 3 h, the absorbance value of hemoglobin of erythrocytes in ultra-pure water group was significantly higher than the values in normal saline group and 15 mg/mL ADM extract group (with t values of 8.14 and 7.96, respectively, P<0.01). After 3 days of culture, the cells of the fourth passage showed pebble-like morphology, with low expression of CD71 and high expression of CD49f, which were identified as ESCs. There was ESC attachment and growth on porcine ADM particles. On PID 1, the wound sizes of nude mice were almost the same in PBS alone group, ADM alone group, ESC alone group, and ESC/ADM group. On PID 7, 11, and 15, the wound contraction of nude mice in each group was observed, especially in ADM alone group, ESC alone group, and ESC/ADM group. On PID 7, the wound healing rates of nude mice in ESC alone group and ESC/ADM group were significantly higher than the rate in PBS alone group (with t values of 2.83 and 4.72 respectively, P<0.05 or P<0.01). On PID 11, the wound healing rate of nude mice in ESC/ADM group was significantly higher than that in PBS alone group (t=4.86, P<0.01). On PID 15, the wound healing rates of nude mice in ADM alone group, ESC alone group, and ESC/ADM group were significantly higher than the rate in PBS alone group (with t values of 2.71, 2.90, and 3.23 respectively, P<0.05). On PID 7, the length of un-epithelialized wound of nude mice in ADM alone group, ESC alone group, and ESC/ADM group was (816±85), (635±66), and (163±32) μm, respectively, which were significantly shorter than (1 199±43) μm in PBS alone group (with t values of 5.69, 10.19, and 27.54 respectively, P<0.01). On PID 11, the dermal areas of wound section of nude mice in ADM alone group, ESC alone group, and ESC/ADM group were significantly larger than the area in PBS alone group (with t values of 27.14, 5.29, and 15.90 respectively, P<0.01); the collagen production of nude mice in ADM alone group and ESC/ADM group was more obvious than that in PBS alone group, and the collagen production of nude mice in ESC alone group and PBS alone group was similar. On PID 11, in the wounds of nude mice in ESC alone group and ESC/ADM group, the cells with positive expression of CD49f were respectively 135±7 and 185±15, and the mRNA expressions of GAPDH were positive; while there were no expressions of CD49f nor mRNA of GAPDH in the wounds of nude mice in PBS alone group and ADM alone group. Conclusions: ESC/ADM particles can promote the wound healing of full-thickness skin defects in nude mice, which may be related to the improved survival rate of ESCs after transplantation and the promotion of dermal structure rearrangement and angiogenesis by ADM.
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Affiliation(s)
- X H Zhao
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burn Research, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Chongqing 400038, China
| | - Y C Guo
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burn Research, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Chongqing 400038, China
| | - H H Chen
- Department of Stem Cell and Regenerative Medicine, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Chongqing 400038, China
| | - X Li
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burn Research, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Chongqing 400038, China
| | - Y Wang
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burn Research, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Chongqing 400038, China
| | - W W Ni
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burn Research, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Chongqing 400038, China
| | - M Q Xing
- Department of Mechanical Engineering, University of Manitoba, Winnipeg R3T2N2, Canada
| | - R Zhang
- Department of Stem Cell and Regenerative Medicine, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Chongqing 400038, China
| | - S C Yu
- Department of Stem Cell and Regenerative Medicine, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Chongqing 400038, China
| | - Y G Pan
- Department of Burns and Plastic Surgery, Qidong People's Hospital, Qidong 226200, China
| | - R X Zhan
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burn Research, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Chongqing 400038, China
| | - G X Luo
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burn Research, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Chongqing 400038, China
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10
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Ye YQ, Chen HH. [Advances in clinical anatomy of velopharyngeal muscles]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021; 56:783-787. [PMID: 34344112 DOI: 10.3760/cma.j.cn115330-20200820-00687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Y Q Ye
- Department of Otorhinolaryngology Head And Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - H H Chen
- Department of Otorhinolaryngology Head And Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
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Chen HH, Liu Q, Deng Y, Zhang HW, Tian LG. [Advances in the research of comorbidity of Blastocystis hominis infections and other diseases]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2021; 33:535-539. [PMID: 34791856 DOI: 10.16250/j.32.1374.2020204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Blastocystis hominis is a common intestinal protozoan parasite. Most individuals with B. hominis infections have no apparent clinical symptoms; however, a few patients, notably those with co-infections or impaired immune system function may present abdominal pain, diarrhea, nausea, vomiting, and even death. This paper reviews the co-infections of B. hominis and other pathogens and comorbidity of B. hominis infections and other diseases, so as to provide insights into the management of B. hominis infections.
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Affiliation(s)
- H H Chen
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, Key Laboratory on Parasite and Vector Biology, National Health Commission, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, School of Global Health, Chinese Center for Tropical Diseases, Jiaotong University School of Medicine, Shanghai 200025, China
| | - Q Liu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, Key Laboratory on Parasite and Vector Biology, National Health Commission, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, School of Global Health, Chinese Center for Tropical Diseases, Jiaotong University School of Medicine, Shanghai 200025, China
| | - Y Deng
- Henan Provincial Center for Disease Control and Prevention, China
| | - H W Zhang
- Henan Provincial Center for Disease Control and Prevention, China
| | - L G Tian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, Key Laboratory on Parasite and Vector Biology, National Health Commission, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, School of Global Health, Chinese Center for Tropical Diseases, Jiaotong University School of Medicine, Shanghai 200025, China
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Wang J, Chen HH, Deng CQ, Lu J, Tang HC, Wang F, Li XP. [Two cases of IgG4-related laryngopharyngeal lesions]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021; 56:85-88. [PMID: 33472309 DOI: 10.3760/cma.j.cn115330-20200528-00454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- J Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - H H Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - C Q Deng
- Department of Otorhinolaryngology Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - J Lu
- Department of Otorhinolaryngology Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - H C Tang
- Department of Otorhinolaryngology Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - F Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - X P Li
- Department of Otorhinolaryngology Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
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Hu ZH, Chen HH, Qian K, Ning CQ, Peng GH, Yu YF, Zhou XF, Chu YH, Xu D, Chen JX, Tian LG, Li H. [Prevalence and risk factors of Blastocystis hominis infections among AIDS patients in Nanchang City]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2020; 32:577-583. [PMID: 33325191 DOI: 10.16250/j.32.1374.2020208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate the prevalence and risk factors of Blastocystis hominis infections among AIDS patients in Nanchang City. METHODS A cross-sectional questionnaire survey was conducted among AIDS patients in Nanchang City during the period between May and September, 2016. B. hominis infection was detected in patients'stool samples using a PCR assay, and the CD4+ T cell count was measured in subjects'blood samples. In addition, the risk factors of B. hominis infection in AIDS patients were identified using univariate and multivariate logistic regression analyses. RESULTS A survey was conducted in Nanchang City from May to September 2016. A total of 505 AIDS patients were investigated, and the prevalence of B. hominis infection was 4.16%. Univariate analysis revealed that B. hominis infection correlated with the occupation (χ2 = 8.595, P = 0.049), education level (χ2 = 14.494, P = 0.001), type of daily drinking water (χ2 = 10.750, P = 0.020), root of HIV infections (χ2 = 8.755, P = 0.026) and receiving anti-HIV therapy (χ2 = 23.083, P = 0.001) among AIDS patients, and multivariate logistic regression analysis identified daily direct drinking of tap water as a risk factor of B. hominis infections [odds ratio (OR) = 7.988, 95% confidential interval (CI): (1.160, 55.004)] and anti-HIV therapy as a protective factor of B. hominis infection [OR = 0.183, 95% CI: (0.049, 0.685)]. CONCLUSIONS The prevalence of B. hominis is 4.16% among AIDS patients in Nanchang City. Daily direct drinking of tap water is a risk factor, and anti-HIV therapy is a protective factor of B. hominis infection among AIDS patients living in Nanchang City.
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Affiliation(s)
- Z H Hu
- Research Base of the National Key Laboratory of Infectious Disease Prevention and Control, Key Laboratory of Animal Origin and Vector-borne Infectious Diseases of Jiangxi Province, Nanchang Center for Disease Control and Prevention, Jiangxi Province, Nanchang 330038, China
| | - H H Chen
- National Institute of Parasitic Disease, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Disease Research, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasites and Vector Biology, National Health Commission, China.,▵Co-first author
| | - K Qian
- Research Base of the National Key Laboratory of Infectious Disease Prevention and Control, Key Laboratory of Animal Origin and Vector-borne Infectious Diseases of Jiangxi Province, Nanchang Center for Disease Control and Prevention, Jiangxi Province, Nanchang 330038, China
| | - C Q Ning
- National Institute of Parasitic Disease, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Disease Research, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasites and Vector Biology, National Health Commission, China
| | - G H Peng
- Research Base of the National Key Laboratory of Infectious Disease Prevention and Control, Key Laboratory of Animal Origin and Vector-borne Infectious Diseases of Jiangxi Province, Nanchang Center for Disease Control and Prevention, Jiangxi Province, Nanchang 330038, China
| | - Y F Yu
- National Institute of Parasitic Disease, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Disease Research, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasites and Vector Biology, National Health Commission, China
| | - X F Zhou
- Research Base of the National Key Laboratory of Infectious Disease Prevention and Control, Key Laboratory of Animal Origin and Vector-borne Infectious Diseases of Jiangxi Province, Nanchang Center for Disease Control and Prevention, Jiangxi Province, Nanchang 330038, China
| | - Y H Chu
- National Institute of Parasitic Disease, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Disease Research, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasites and Vector Biology, National Health Commission, China
| | - D Xu
- Research Base of the National Key Laboratory of Infectious Disease Prevention and Control, Key Laboratory of Animal Origin and Vector-borne Infectious Diseases of Jiangxi Province, Nanchang Center for Disease Control and Prevention, Jiangxi Province, Nanchang 330038, China
| | - J X Chen
- National Institute of Parasitic Disease, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Disease Research, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasites and Vector Biology, National Health Commission, China
| | - L G Tian
- National Institute of Parasitic Disease, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Disease Research, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasites and Vector Biology, National Health Commission, China
| | - H Li
- Nanchang Municipal Health Commission, Jiangxi Province, China
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Chen HH, Huang YS, Dong YR, Huang XX, Lu J, Ye YQ, Li XP. [Consistency analysis and influencing factors of performing VOTE scores for drug-induced sleep endoscopy]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2020; 55:1043-1049. [PMID: 33210884 DOI: 10.3760/cma.j.cn115330-20200604-00476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the consistency of Velum, Oropharygneal, Tongue base, Epiglottis (VOTE) scores between two surgeons with similar clinical experience in obstructive sleep apnea hypopnea syndrome (OSAHS) patients with different degree of disease, and to analyze the influencing factors leading to the difference in score. Methods: This was a cross-sectional study. 64 preoperative drug-induced sleep endoscopy (DISE) videos of OSAHS patients during December 2014 to July 2018, from Nanfang Hospital, Southern Medical University were analyzed. The VOTE score was assessed single-blind by two similar experienced surgeons, and the Kappa value between the two scorers was calculated by the third researcher. According to the characteristics of the case, Fisher's exact test or chi-square test method was used to further explore the factors that influenced the consistency. Results: Sixty-four patients were divided into four groups according to the severity of the disease, including mild (7 cases), moderate (30 cases), severe(18 cases), and extremely severe (9 cases). The scores evaluated between two researchers were analysed for consistency. For mild patients, the two scorers were completely consistent in the configuration and degree of obstruction in the velum and epiglottis (Kappa=1). There was no agreement on whether obstruction or not, obstructed configuration, obstructed degree of the oropharynx and tongue base, and presence of velum and epiglottis obstruction. For moderate patients, the two scorers had a good consistency in the configuration and degree of the velum (0.61≤Kappa≤0.80), and there was no consistency in the evaluation of the degree of tongue base and epiglottis (P>0.05). The consistency of the remaining obstructed conditions in the four planes was generally or moderate (0.21≤Kappa≤0.60). For patients with severe OSAHS, the two raters were completely consistent in the evaluation of palatopharyngeal and epiglottic planes for the presence of obstruction, but there was no consistency in the degree of obstruction. Although the degree of obstruction in the oropharyngeal plane can be assessed with good consistency, the consistency of whether the plane was blocked or not was generally not high. In the assessment of other obstructive conditions in the four planes of severe patients, the agreement between the two scorers was moderate or generally. For extremely severe patients, the two scorers were completely consistent in the evaluation of the velum obstruction, but there was no consistency in the degree of obstruction of the oropharynx and tongue base, and the obstruction configuration and degree of the epiglottis. The evaluation of other obstructed conditions in the four planes is good or moderate. Among the patients with severe OSAHS, the difference in the assessment of obstruction of the oropharynx was associated with tonsil size (P<0.05). Conclusion: When physicians with similar clinical experience scored VOTE, the consistency of whether the velum and oropharyngeal planes are obstructed is related to the severity of the disease. Better consistency is observed among more severe OSAHS patients. The reason for the poor consistency of the oropharyngeal plane in severe OSAHS patients OSAHS is due to the difference of the tonsils size. For severe OSAHS patients with small tonsils, the assessment of whether the oropharynx is obstructed should be more cautious.
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Affiliation(s)
- H H Chen
- Department of Otolaryngology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Y S Huang
- the First Clinical Medical College of Southern Medical University, Guangzhou 510515, China
| | - Y R Dong
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - X X Huang
- Department of Otolaryngology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - J Lu
- Department of Otolaryngology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Y Q Ye
- Department of Otolaryngology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - X P Li
- Department of Otolaryngology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
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Ning CQ, Kang JM, Li YT, Chen HH, Chu YH, Yu YF, Wu XP, Ai L, Chen JX, Tian LG, Liao QD. [Prevalence and risk factors of Blastocystis infections among primary school students in Jiangjin District, Chongqing City]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2020; 32:489-497. [PMID: 33185060 DOI: 10.16250/j.32.1374.2020189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate the prevalence and risk factors of Blastocystis infections among primary school students in Jiangjin District, Chongqing City. METHODS A cross-sectional questionnaire survey was conducted among students sampled from a primary school in Jiangjin District, Chongqing City on April, 2018, and their stool samples were collected for microscopic examinations, in vitro culture and PCR assays to analyze the prevalence of Blastocystis infections and subtype of the parasite. In addition, the risk factors of Blastocystis infections among primary school students were identified using univariate analysis and multivariate logistic regression analysis. RESULTS A total of 466 primary students were surveyed, and the subjects had a mean age of (9.81±1.66) years and included 236 males (50.64%) and 230 females (49.36%). The prevalence of Blastocystis infections was 15.24% (71/466) among the study students, and there was no significance difference in the prevalence between male and fe- male students (16.52% vs. 13.91%; χ2 = 0.616, P = 0.433). In addition, there was a significant difference in the prevalence of Blastocystis infections among grade 1 (6.35%, 4/63), grade 2 (5.17%, 3/58), grade 3 (21.74%, 15/69), grade 4 (25.30%, 21/83), grade 5 (10.19%, 11/108) and grade 6 students (20.00%, 17/85) (χ2 = 15.410, P = 0.009). There were four Blastocystis subtypes characterized (ST1, ST3, ST6 and ST7), in which ST6 was the most common subtype (45.07%, 32/71), followed by ST3 (25.35%, 18/71). Multivariate logistic regression analysis revealed that minority ethnicity [odds ratio (OR) = 4.259, 95% confidential inter- val (CI) : (1.161, 15.621)] and low maternal education level (primary school and below) [OR = 9.038, 95% CI: (1.125, 72.642)] were identified as risk factors of Blastocystis infection among primary school students in Jiangjin District, Chongqing City. CONCLUSIONS There is a high prevalence of Blastocystis infections detected among primary school students in Jiangjin District, Chongqing City, and ST6 and ST3 are predominant subtypes. Minority ethnicity and low maternal education level (primary school and below) are risk factors for Blastocystis infections in primary school students.
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Affiliation(s)
- C Q Ning
- National Institute of Parasitic Disease, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Disease Research, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasites and Vector Biology, National Health Commission, Shanghai 200025, China
| | - J M Kang
- Jiangjin District Center for Disease Control and Prevention, Chongqing City, China
| | - Y T Li
- National Institute of Parasitic Disease, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Disease Research, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasites and Vector Biology, National Health Commission, Shanghai 200025, China
| | - H H Chen
- National Institute of Parasitic Disease, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Disease Research, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasites and Vector Biology, National Health Commission, Shanghai 200025, China
| | - Y H Chu
- National Institute of Parasitic Disease, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Disease Research, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasites and Vector Biology, National Health Commission, Shanghai 200025, China
| | - Y F Yu
- National Institute of Parasitic Disease, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Disease Research, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasites and Vector Biology, National Health Commission, Shanghai 200025, China
| | - X P Wu
- National Institute of Parasitic Disease, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Disease Research, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasites and Vector Biology, National Health Commission, Shanghai 200025, China
| | - L Ai
- National Institute of Parasitic Disease, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Disease Research, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasites and Vector Biology, National Health Commission, Shanghai 200025, China
| | - J X Chen
- National Institute of Parasitic Disease, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Disease Research, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasites and Vector Biology, National Health Commission, Shanghai 200025, China
| | - L G Tian
- National Institute of Parasitic Disease, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Disease Research, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasites and Vector Biology, National Health Commission, Shanghai 200025, China
| | - Q D Liao
- Jiangjin District Center for Disease Control and Prevention, Chongqing City, China
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Ge XM, Yang WM, Shen ZY, Chen HH, Li B, Meng Q, Luo LH, Lu HX, Zhu JH, Lan GH, Zhu QY, Wu XL, Huang GH, Fu BT, Huang ZZ, Li JW, Chen JM, Chen ZQ, Yang J, Yan Y. [Influence on physical development of children aged 18 months from HIV-positive mothers for prevention mother to child transmission of HIV]. Zhonghua Liu Xing Bing Xue Za Zhi 2020; 41:354-357. [PMID: 32294834 DOI: 10.3760/cma.j.issn.0254-6450.2020.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore influence on physical development of children aged 18 months from HIV-positive mothers for prevention mother to child transmission of HIV (PMTCT) in Guangxi Zhuang autonomous region, and provide evidence for the improvement PMTCT program. Methods: This retrospective case control study was conducted in 554 HIV negative infants aged 18 months whose HIV positive mothers had received PMTCT services reported through PMTCT system database from January 1, 2010 to December 31, 2017 and 1 109 healthy infants born in 2017, whose mothers were healthy, in Lingshan, Luzhai, and Hengxian counties, ranking top three counties with high HIV infection prevalence, in Guangxi. PMTCT data and physical development data such as height, weight and head circumference of children aged 18 months were collected. The physical dysplasia in the infants was defined as at least one of the three main indicators of height, weight and head circumference below the normal range. Results: The number of HIV-positive mother and their infants in the case group were 667 and 554 respectively, and the PMTCT rates were 91.15% (608/667) and 96.57% (535/554) respectively. HIV positive rate, mortality rate and mother to child transmission rate of the infants aged 18 months were 1.44% (8/554), 3.07% (17/554) and 1.91% (8/418) respectively, and the physical examination results of the infants aged 18 months showed that the physical dysplasia rate was 30.51% (169/554). Among the 1 109 infants in the control group, the physical dysplasia rate was 9.83% (109/1 109). The difference between the case group and the control group was significant (P<0.01). Conclusion: The PMTCT rates of HIV positive mother and their children were more than 90.00%, respectively. However, poor physical development rate of infants aged 18 months were more than 30.00%. The possible influence of PMTCT on physical development of the infants aged 18 months of HIV positive mother's needs to be further studied.
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Affiliation(s)
- X M Ge
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - W M Yang
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - Z Y Shen
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - H H Chen
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - B Li
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - Q Meng
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - L H Luo
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - H X Lu
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - J H Zhu
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - G H Lan
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - Q Y Zhu
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - X L Wu
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - G H Huang
- Lingshan County Center for Disease Control and Prevention, Lingshan 535400, China
| | - B T Fu
- Luzhai County Center for Disease Control and Prevention, Luzhai 545600, China
| | - Z Z Huang
- Hengxian County Center for Disease Control and Prevention, Hengxian 530300, China
| | - J W Li
- Lingshan County Maternal and Child Health Care Center, Lingshan 535400, China
| | - J M Chen
- Lingshan County Center for Disease Control and Prevention, Lingshan 535400, China
| | - Z Q Chen
- Luzhai County Center for Disease Control and Prevention, Luzhai 545600, China
| | - J Yang
- Hengxian County Center for Disease Control and Prevention, Hengxian 530300, China
| | - Y Yan
- Lingshan County Maternal and Child Health Care Center, Lingshan 535400, China
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17
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Chiu WC, Powers DB, Hirshon JM, Shackelford SA, Hu PF, Chen SY, Chen HH, Mackenzie CF, Miller CH, DuBose JJ, Carroll C, Fang R, Scalea TM. Impact of trauma centre capacity and volume on the mortality risk of incoming new admissions. BMJ Mil Health 2020; 168:212-217. [PMID: 32474436 DOI: 10.1136/bmjmilitary-2020-001483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 04/13/2020] [Accepted: 04/14/2020] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Trauma centre capacity and surge volume may affect decisions on where to transport a critically injured patient and whether to bypass the closest facility. Our hypothesis was that overcrowding and high patient acuity would contribute to increase the mortality risk for incoming admissions. METHODS For a 6-year period, we merged and cross-correlated our institutional trauma registry with a database on Trauma Resuscitation Unit (TRU) patient admissions, movement and discharges, with average capacity of 12 trauma bays. The outcomes of overall hospital and 24 hours mortality for new trauma admissions (NEW) were assessed by multivariate logistic regression. RESULTS There were 42 003 (mean=7000/year) admissions having complete data sets, with 36 354 (87%) patients who were primary trauma admissions, age ≥18 and survival ≥15 min. In the logistic regression model for the entire cohort, NEW admission hospital mortality was only associated with NEW admission age and prehospital Glasgow Coma Scale (GCS) and Shock Index (SI) (all p<0.05). When TRU occupancy reached ≥16 patients, the factors associated with increased NEW admission hospital mortality were existing patients (TRU >1 hour) with SI ≥0.9, recent admissions (TRU ≤1 hour) with age ≥65, NEW admission age and prehospital GCS and SI (all p<0.05). CONCLUSION The mortality of incoming patients is not impacted by routine trauma centre overcapacity. In conditions of severe overcrowding, the number of admitted patients with shock physiology and a recent surge of elderly/debilitated patients may influence the mortality risk of a new trauma admission.
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Affiliation(s)
- William C Chiu
- R Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA
| | - D B Powers
- Director, Craniomaxillofacial Trauma Program, Duke University Hospital, Durham, North Carolina, USA
| | - J M Hirshon
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | | | - P F Hu
- University of Maryland Medical Center, Baltimore, Maryland, USA
| | - S Y Chen
- National Yunlin University of Science and Technology, Douliou, Taiwan
| | - H H Chen
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - C F Mackenzie
- Shock Trauma and Anesthesiology Research - Organized Research Center (STAR-ORC), University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - C H Miller
- US Air Force Materiel Command, Wright-Patterson AFB, Ohio, USA
| | - J J DuBose
- R Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA.,Center for Sustainment of Trauma and Readiness Skills - Baltimore, US Air Force Medical Service, Baltimore, Maryland, USA
| | | | - R Fang
- Surgery, Johns Hopkins Bayview Medical Center, Baltimore, Maryland, USA
| | - T M Scalea
- R Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA
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Abstract
Upon EV-A71 infection of a host cell, EV-A71 RNA is translated into a viral polyprotein. Although EV-A71 can use the cellular translation machinery to produce viral proteins, unlike cellular translation, which is cap-dependent, the viral RNA genome of EV-A71 does not contain a 5′ cap and the translation of EV-A71 protein is cap-independent, which is mediated by the internal ribosomal entry site (IRES) located in the 5′ UTR of EV-A71 mRNA. Like many other eukaryotic viruses, EV-A71 manipulates the host cell translation devices, using an elegant RNA-centric strategy in infected cells. During viral translation, viral RNA plays an important role in controlling the stage of protein synthesis. In addition, due to the cellular defense mechanism, viral replication is limited by down-regulating translation. EV-A71 also utilizes protein factors in the host to overcome antiviral responses or even use them to promote viral translation rather than host cell translation. In this review, we provide an introduction to the known strategies for EV-A71 to exploit cellular translation mechanisms.
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Affiliation(s)
- Ming-Chih Lai
- Department of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, 33302, Taiwan.,Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, 33302, Taiwan.,Department of Colorectal Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, 33305, Taiwan
| | - Han-Hsiang Chen
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, 33302, Taiwan
| | - Peng Xu
- Xiangyang No.1 People's Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China.
| | - Robert Y L Wang
- Department of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, 33302, Taiwan. .,Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, 33302, Taiwan. .,Division of Pediatric Infectious Disease, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, Taoyuan, 33305, Taiwan.
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19
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Chen HH, Huang XX, Dong YN, Huang YS, Lu J, Li XP. [Analyzed the related factors of VOTE score for drug-induced sleep endoscopy in patients with obstructive sleep apnea]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2019; 33:941-944. [PMID: 31623039 DOI: 10.13201/j.issn.1001-1781.2019.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Indexed: 11/12/2022]
Abstract
Objective:To analyze the related factors of VOTE score for drug-induced endoscopy(DISE) in patients with obstructive sleep apnea (OSA). Method:Fifty-four OSA patients, diagnosed by polysomnograph, underwent surgical treatment from Nov 2014 to Dec 2016 in our hospital. All patients underwent drug induced sleep endoscope, and then the collapse of pharyngeal space was evaluated. We analyzed the related factors with VOTE score. Result:The occlusion rates were significant statistical different in different spaces of 54 OSA patients undergoing DISE(P=0.000, velum 98.15%, oropharynx 81.48%, tongue base 40.47%, and epiglottis 11.11% respectively). The rateand of tongue base collapsing was related with Mallampatis(P<0.05) and Friedman stage(P<0.05). The VOTE score was weakly related with Friedman stage(r=0.297, P<0.05), medium related with BMI(r=0.376, P<0.05), AHI(r=0.312, P<0.05) and lowest SpO2(r=0.376, P<0.01). Conclusion:In the VOTE scoring system for DISE, the rate of collapse in tongue base was related with Mallampatis and Friedman stage. The VOTE score was medium related with BMI, AHI and Lowest SpO2, mild related with Friedman stage.
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Affiliation(s)
- H H Chen
- Department of Otorhinolaryngology,Southern Hospital,Southern Medical University,Guangzhou,510515,China
| | - X X Huang
- Department of Otorhinolaryngology,Southern Hospital,Southern Medical University,Guangzhou,510515,China
| | - Y N Dong
- Department of Anesthesiology,Southern Hospital,Southern Medical University
| | - Y S Huang
- Department of Otorhinolaryngology,Southern Hospital,Southern Medical University,Guangzhou,510515,China
| | - J Lu
- Department of Otorhinolaryngology,Southern Hospital,Southern Medical University,Guangzhou,510515,China
| | - X P Li
- Department of Otorhinolaryngology,Southern Hospital,Southern Medical University,Guangzhou,510515,China
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Cao ZQ, Yang WM, Zhu QY, Lan GH, Shen ZY, Liang SS, Li JJ, Chen HH, Feng Y, He X, Liao LJ, Xing H, Ruan YH, Shao YM. [HIV genetic subtypes and comparison of the first CD(4)(+)T cell counts in newly diagnosed HIV infected patients in Liuzhou, 1998-2012]. Zhonghua Liu Xing Bing Xue Za Zhi 2019; 40:580-584. [PMID: 31177742 DOI: 10.3760/cma.j.issn.0254-6450.2019.05.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the change trend of HIV genetic subtypes and compare the first CD(4)(+)T cell counts of newly diagnosed HIV infected patients in Liuzhou from 1998 to 2012, and provide a reference for AIDS prevention and control. Methods: Newly diagnosed HIV-infected patients from 1998 to 2012 in Liuzhou were selected through national HIV/ADIS comprehensive response information management system. Their plasma samples were used for RNA gene extraction, amplification, sequencing and genotyping. Coharan-Armitage trend test was used to analyze the ratio trend of genetic subtypes and phylogenetic clusters of HIV and Wilcoxon Rank Sum Test was used to compare the first CD(4)(+)T cell counts (CD(4)) of the different subtype HIV infected patients. Results: A total of 1 877 newly diagnosed HIV infected patients were included in the study. From 1998 to 2012, the proportions of CRF01_AE and CRF01_AE (Cluster 1) increased from 78.4% (76/97) to 91.5% (1 441/1 574), from 63.9% (62/97) to 74.0% (1 164/1 574), and the proportion of CRF07_BC decreased from 17.5% (17/97) to 4.6% (72/1 574), respectively (Z=4.632, P<0.001; Z=2.455, P=0.014; Z=-5.943, P<0.001). The median and interquartile range of the first CD(4) of the patients infected with subtype CRF01_AE (Cluster 1), CRF01_AE (Cluster 2), CRF07_BC and CRF08_BC were 230 (83-375), 215 (48-351), 365 (254-503) and 334 (206-479) cell/μl, respectively. The first CD(4) levels of the patients infected with subtype CRF01_AE (Cluster 1) or CRF01_AE (Cluster 2) were significantly lower than those of CRF07_BC (Z=-4.795, P<0.001; Z=-4.238, P<0.001). Conclusion: The genetic subtypes of HIV were mainly CRF01_AE in newly diagnosed HIV-infected patients and this subtype proportion was in increase and the first CD(4) levels of the patients were low in Liuzhou during 1998 to 2012.
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Affiliation(s)
- Z Q Cao
- National Center for ADIS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - W M Yang
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - Q Y Zhu
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - G H Lan
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - Z Y Shen
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - S S Liang
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - J J Li
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - H H Chen
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - Y Feng
- National Center for ADIS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - X He
- Guangdong Provincial Institute of Public Health, Guangzhou 511430, China
| | - L J Liao
- National Center for ADIS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - H Xing
- National Center for ADIS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Y H Ruan
- National Center for ADIS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Y M Shao
- Peking University Health Science Center, Beijing 100191, China
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21
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Chen YM, Hung WT, Liao YW, Hsu CY, Hsieh TY, Chen HH, Hsieh CW, Lin CT, Lai KL, Tang KT, Tseng CW, Huang WN, Chen YH. Combination immunosuppressant therapy and lupus nephritis outcome: a hospital-based study. Lupus 2019; 28:658-666. [PMID: 30971165 DOI: 10.1177/0961203319842663] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Lupus nephritis (LN) is the leading cause of mortality in lupus patients. This study aimed to investigate the treatment outcome and renal histological risk factors of LN in a tertiary referral center. Between 2006 and 2017, a retrospective observational study enrolled 148 biopsy-proven LN patients. After propensity score matching, 75 cases were included for further analysis. The classification and scoring of LN were assessed according to the International Society of Nephrology/Renal Pathology Society. Treatment response was evaluated by daily urine protein and urinalysis at two years after commencing induction treatment and the development of end-stage renal disease (ESRD). In total, 50.7% patients achieved complete remission (CR) or partial remission (PR), while 49.3% patients were categorized as nonresponders. Therapeutic responses in terms of CR/PR rates were associated with Systemic Lupus Erythematosus Disease Activity Index scores (odds ratio (OR): 1.34, 95% confidence interval (CI): 1.12-1.60, p = 0.001). Moreover, higher baseline creatinine levels (hazard ratio (HR): 2.10, 95% CI: 1.29-3.40, p = 0.003), higher renal activity index (HR: 1.30, 95% CI: 1.07-1.58, p = 0.008) and chronicity index (HR: 1.40, 95% CI: 1.06-1.85, p = 0.017) predicted ESRD. Among pathological scores, cellular crescents (HR: 4.42, 95% CI: 1.01-19.38, p = 0.049) and fibrous crescents (HR: 5.93, 95% CI: 1.41-24.92, p = 0.015) were independent risk factors for ESRD. In conclusion, higher lupus activity was a good prognostic marker for renal remission. Renal histology was predictive of ESRD. Large-scale prospective studies are required to verify the efficacy of mycophenolate in combination with azathioprine or cyclosporine in LN patients.
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Affiliation(s)
- Y M Chen
- 1 Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung.,2 Department of Medical Research, Taichung Veterans General Hospital, Taichung.,3 Faculty of Medicine, National Yang-Ming University, Taipei.,4 Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung
| | - W T Hung
- 1 Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung.,5 Department of Medical Education, Taichung Veterans General Hospital, Taichung.,6 Institute of Clinical Medicine, National Yang-Ming University, Taipei
| | - Y W Liao
- 1 Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung
| | - C Y Hsu
- 2 Department of Medical Research, Taichung Veterans General Hospital, Taichung
| | - T Y Hsieh
- 1 Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung.,5 Department of Medical Education, Taichung Veterans General Hospital, Taichung
| | - H H Chen
- 1 Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung.,2 Department of Medical Research, Taichung Veterans General Hospital, Taichung.,3 Faculty of Medicine, National Yang-Ming University, Taipei.,4 Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung
| | - C W Hsieh
- 1 Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung.,5 Department of Medical Education, Taichung Veterans General Hospital, Taichung
| | - C T Lin
- 1 Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung
| | - K L Lai
- 1 Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung
| | - K T Tang
- 1 Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung
| | - C W Tseng
- 1 Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung
| | - W N Huang
- 1 Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung.,3 Faculty of Medicine, National Yang-Ming University, Taipei
| | - Y H Chen
- 1 Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung.,3 Faculty of Medicine, National Yang-Ming University, Taipei
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Chang HY, Xie RX, Zhang L, Fu LZ, Zhang CT, Chen HH, Wang ZQ, Zhang Y, Quan FS. Overexpression of miR-101-2 in donor cells improves the early development of Holstein cow somatic cell nuclear transfer embryos. J Dairy Sci 2019; 102:4662-4673. [PMID: 30879805 DOI: 10.3168/jds.2018-15072] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 01/22/2019] [Indexed: 12/17/2022]
Abstract
Accumulating studies have suggested that microRNA play a part in regulating multiple cellular processes, such as cell proliferation, apoptosis, the cell cycle, and embryo development. This study explored the effects of miR-101-2 on donor cell physiological status and the development of Holstein cow somatic cell nuclear transfer (SCNT) embryos in vitro. Holstein cow bovine fetal fibroblasts (BFF) overexpressing miR-101-2 were used as donor cells to perform SCNT; then, cleavage rate, blastocyst rate, inner cell mass-to-trophectoderm ratio, and the expression of some development- and apoptosis-related genes in different groups were analyzed. The miR-101-2 suppressed the expression of inhibitor of growth protein 3 (ING3) at mRNA and protein levels, expedited cell proliferation, and decreased apoptosis in BFF, suggesting that ING3, a target gene of miR-101-2, is a potential player in this process. Moreover, by utilizing donor cells overexpressing miR-101-2, the development of bovine SCNT embryos in vitro was significantly enhanced; the apoptotic rate in SCNT blastocysts was reduced, and the inner cell mass-to-trophectoderm ratio and SOX2, POU5F1, and BCL2L1 expression significantly increased, whereas BAX and ING3 expression decreased. Collectively, these findings suggest that miR-101-2 promotes BFF proliferation and vitality, reduces their apoptosis, and improves the early development of SCNT embryos.
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Affiliation(s)
- H Y Chang
- Key Laboratory of Animal Biotechnology of the Ministry of Agriculture, Northwest A&F University, Yangling 712100, Shaanxi, China; College of Veterinary Medicine, Northwest A&F University, Yangling 712100, Shaanxi, China
| | - R X Xie
- Key Laboratory of Animal Biotechnology of the Ministry of Agriculture, Northwest A&F University, Yangling 712100, Shaanxi, China; College of Veterinary Medicine, Northwest A&F University, Yangling 712100, Shaanxi, China
| | - L Zhang
- Key Laboratory of Animal Biotechnology of the Ministry of Agriculture, Northwest A&F University, Yangling 712100, Shaanxi, China; College of Veterinary Medicine, Northwest A&F University, Yangling 712100, Shaanxi, China
| | - L Z Fu
- Key Laboratory of Animal Biotechnology of the Ministry of Agriculture, Northwest A&F University, Yangling 712100, Shaanxi, China; College of Veterinary Medicine, Northwest A&F University, Yangling 712100, Shaanxi, China
| | - C T Zhang
- Animal Husbandry and Veterinary Station of Xining, Xining 810003, Qinghai, China
| | - H H Chen
- Key Laboratory of Animal Biotechnology of the Ministry of Agriculture, Northwest A&F University, Yangling 712100, Shaanxi, China; College of Veterinary Medicine, Northwest A&F University, Yangling 712100, Shaanxi, China
| | - Z Q Wang
- Key Laboratory of Animal Biotechnology of the Ministry of Agriculture, Northwest A&F University, Yangling 712100, Shaanxi, China; College of Veterinary Medicine, Northwest A&F University, Yangling 712100, Shaanxi, China
| | - Y Zhang
- Key Laboratory of Animal Biotechnology of the Ministry of Agriculture, Northwest A&F University, Yangling 712100, Shaanxi, China; College of Veterinary Medicine, Northwest A&F University, Yangling 712100, Shaanxi, China.
| | - F S Quan
- Key Laboratory of Animal Biotechnology of the Ministry of Agriculture, Northwest A&F University, Yangling 712100, Shaanxi, China; College of Veterinary Medicine, Northwest A&F University, Yangling 712100, Shaanxi, China.
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Chiu MJ, Lue LF, Sabbagh MN, Chen TF, Chen HH, Yang SY. Long-Term Storage Effects on Stability of Aβ 1-40, Aβ 1-42, and Total Tau Proteins in Human Plasma Samples Measured with Immunomagnetic Reduction Assays. Dement Geriatr Cogn Dis Extra 2019; 9:77-86. [PMID: 31043966 PMCID: PMC6477481 DOI: 10.1159/000496099] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 12/07/2018] [Indexed: 11/20/2022] Open
Abstract
Background The stability of Alzheimer's disease (AD) biomarkers in plasma, measured by immunomagnetic reduction (IMR) after long-term storage at −80°C, has not been established before. Method Ninety-nine human plasma samples from 53 normal controls (NCs), 5 patients with amnestic mild cognitive impairment (aMCI), and 41 AD patients were collected. Each plasma sample was aliquoted and stored as single-use aliquots at −80°C. The baseline measurements for Aβ1–40, Aβ1–42, and total Tau protein (T-Tau) concentrations for each sample were done within 3 months of blood draw by IMR. They are referred to as baseline concentrations. A separate aliquot from each sample was assayed with IMR to assess the stability of the measured analytes during storage at −80°C between 1.1 and 5.4 years. This is referred to as a repeated result. Results IMR shows that plasma levels of Aβ1–40 and Aβ1–42 exhibit stability over 5-year storage at −80°C and that plasma levels of T-Tau are less stable (approximately 1.5 years). Conclusion Although the measured concentrations of T-Tau in human plasma may alter during storage, the diagnostic utility of the results are only slightly affected when the product of Aβ1–42 and T-Tau concentrations are used. The results show that the overall agreement between baseline and repeated measurements in the ability of discriminating NCs from aMCI/AD patients is higher than 80%.
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Affiliation(s)
- Ming-Jang Chiu
- Department of Neurology, College of Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Psychology, National Taiwan University, Taipei, Taiwan
| | - Lih-Fen Lue
- Laboratory of Neuroregeneration, Banner Sun Health Research Institute, Sun City, Arizona, USA.,Biodesign Institute, Banner Neurodegenerative Disease Research Center, Arizona State University, Tempe, Arizona, USA
| | - Marwan N Sabbagh
- Lou Ruvo Center for Brain Health Cleveland Clinic, Las Vegas, Nevada, USA
| | - Ta-Fu Chen
- Department of Neurology, College of Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
| | - H H Chen
- MagQu Co., Ltd, New Taipei City, Taiwan
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24
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Abstract
We report a 49-year-old woman who presented with a hypertensive crisis and acute heart failure and reduced left ventricular systolic function. An abdominal ultrasonography revealed a huge lobulated heterogeneous mass at the lower pole of the right kidney and a mass over the left suprarenal area, which were further delineated by magnetic resonance imaging. The patient underwent laparoscopic right radical nephrectomy and left adrenalectomy. Histopathological analysis confirmed the diagnoses of clear cell renal cell carcinoma of the right kidney with metastasis to the lung; and atypical pheochromocytoma of the left adrenal gland. Target therapy was initiated, which resulted in stabilization of the patient's tumors and the recovery of her heart function. To avoid a delayed diagnosis and catastrophic outcome, clinicians should consider such rare causes of acute decompensated heart failure.
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Affiliation(s)
- H H Chen
- School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - S T Wu
- Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Y C Lin
- Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - C S Lin
- Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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25
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Chen CY, Wu VC, Lin CJ, Lin CS, Pan CF, Chen HH, Lin YF, Huang TM, Chen L, Wu CJ. Improvement in Mortality and End-Stage Renal Disease in Patients With Type 2 Diabetes After Acute Kidney Injury Who Are Prescribed Dipeptidyl Peptidase-4 Inhibitors. Mayo Clin Proc 2018; 93:1760-1774. [PMID: 30343892 PMCID: PMC7126857 DOI: 10.1016/j.mayocp.2018.06.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 06/03/2018] [Accepted: 06/05/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To focus on the potential beneficial effects of the pleiotropic effects of dipeptidyl peptidase-4 inhibitors (DPP4is) on attenuating progression of diabetic kidney disease in reducing the long-term effect of the acute kidney injury (AKI) to chronic kidney disease (CKD) transition. PATIENTS AND METHODS Data from the National Health Insurance Research Database from January 1, 1999, to July 31, 2011, were analyzed, and patients with diabetes weaning from dialysis-requiring AKI were identified. Cox proportional hazards models and inverse-weighted estimates of the probability of treatment were used to adjust for treatment selection bias. The outcomes were incident end-stage renal disease (ESRD) and mortality, major adverse cardiovascular events, and hospitalized heart failure. RESULTS Of a total of 6165 patients with diabetes weaning from dialysis-requiring AKI identified, 5635 (91.4%) patients were DPP4i nonusers and 530 (8.6%) patients were DPP4i users. Compared with DPP4i nonusers, DPP4i users had a lower risk of ESRD (hazard ratio, 0.81; 95% CI, 0.70-0.94; P=.04) and all-cause mortality (hazard ratio, 0.28; 95% CI, 0.23-0.34; P<.001) after adjustments for CKD, advanced CKD, and angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker use. In contrast, the risk of major adverse cardiovascular events and hospitalized heart failure did not differ significantly between groups. CONCLUSION Dipeptidyl peptidase-4 inhibitor users had a lower risk of ESRD and mortality than did nonusers among patients with diabetes after weaning from dialysis-requiring AKI. Therefore, a prospective study of AKI to CKD transitions after episodes of AKI is needed to optimally target DPP4i interventions.
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Key Words
- aki, acute kidney injury
- aki-d, dialysis-requiring acute kidney injury
- ckd, chronic kidney disease
- dm, diabetes mellitus
- dpp4, dipeptidyl peptidase-4
- dpp4i, dipeptidyl peptidase-4 inhibitior
- esrd, end-stage renal disease
- hhf, hospitalized heart failure
- hr, hazard ratio
- icd-9-cm, international classification of diseases, ninth revision, clinical modification
- iptw, inverse probability of treatment weighting
- kim-1, kidney injury molecule-1
- mace, major adverse cardiovascular event
- mi, myocardial infarction
- mpr, medication possession ratio
- nhi, national health insurance
- nhird, national health insurance research database
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Affiliation(s)
- Cheng-Yi Chen
- Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Hsinchu, Taiwan; Department of Medicine, MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan; Department of Biological Science and Technology, National Chiao Tung University, Hsin-Chu, Taiwan
| | - Vin-Cent Wu
- Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Cheng-Jui Lin
- Department of Medicine, MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan; Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan; Medicine, Mackay Medical College, Taipei, Taiwan
| | - Chih-Sheng Lin
- Department of Biological Science and Technology, National Chiao Tung University, Hsin-Chu, Taiwan
| | - Chi-Feng Pan
- Department of Medicine, MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan; Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Han-Hsiang Chen
- Department of Medicine, MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan; Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Yu-Feng Lin
- Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Tao-Min Huang
- Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Likwang Chen
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Chih-Jen Wu
- Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan; Medicine, Mackay Medical College, Taipei, Taiwan; Graduate Institute of Medical Sciences and Department of Pharmacology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan.
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26
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Lin CJ, Chien YH, Lai TS, Shih HM, Chen YC, Pan CF, Chen HH, Hwu WL, Wu CJ. Results of Fabry Disease Screening in Male Pre-End Stage Renal Disease Patients with Unknown Etiology Found Through the Platform of a Chronic Kidney Disease Education Program in a Northern Taiwan Medical Center. Kidney Blood Press Res 2018; 43:1636-1645. [PMID: 30380558 DOI: 10.1159/000494678] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 10/19/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Fabry disease (FD), a rare x-lined genetic disorder is a cause of renal deterioration. The phenotype of FD is highly variable and nonspecific, and correct diagnosis has always been delayed. We aimed to explore the prevalence and clinical presentation of FD in this high-risk male population in a Northern Taiwan medical center. METHODS This is the first study to survey the incidence of FD in this high-risk population through the platform of a chronic kidney disease (CKD) education program in Asia. A total of 1,012 male patients with unknown CKD causes were screened using an assay of alpha-galactosidase A activity (α-Gal A) by dried blood spots (DBS). A final GLA gene analysis was also done for those with low enzyme activity. RESULTS We identified two new patients with classic FD and four patients with late-onset FD. One novel GLA mutation with c.413 G>A was found in one classic FD patient (index 5). The prevalence of FD is about 0.59 % (6 in 1,012) in the high-risk population group with CKD. The clinical symptoms of FD patients are nonspecific except in those with various degrees of renal failure. Those patients' correct diagnosis was delayed, taking years and even decades. Three patients received enzyme replacement therapy and one started regular hemodialysis due to persistent renal function deterioration. Another two patients were found from family screening through a new index. In addition, a false negative result occurred in one patient who was proved to have FD by his kidney pathology as determined by this screening. CONCLUSION FD is not such as rare a disease and its prevalence is greater in this high-risk male population. Clinicians need to be aware that FD should be included in the differential diagnosis in CKD with unknown etiology.
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Affiliation(s)
- Cheng-Jui Lin
- Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan.,Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Yin-Hsiu Chien
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan
| | - Thung-S Lai
- Graduate Institute of Biomedical Science, Mackay Medical College, New Taipei City, Taiwan
| | - Hong-Mou Shih
- Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Yi-Chou Chen
- Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Chi-Feng Pan
- Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Han-Hsiang Chen
- Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan.,Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Wuh-Liang Hwu
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan
| | - Chih-Jen Wu
- Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, .,Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, .,Graduate Institute of Medical Sciences and Department of Pharmacology, School of Medicine, College of Medicine, Taipei Medical University, Taipei,
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27
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Chen FD, Chen HH, Ke SC, Zheng LR, Zheng XY. SLC27A2 regulates miR-411 to affect chemo-resistance in ovarian cancer. Neoplasma 2018; 65:915-924. [PMID: 30334452 DOI: 10.4149/neo_2018_180122n48] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 05/02/2018] [Indexed: 11/08/2022]
Abstract
Although platinum-based chemotherapies have long been used as standard treatment in ovarian cancer, cisplatin resistance is a major problem that restricts its use. Herein, we investigate the biological function of SLC27A2 and its underlying mechanisms in regulating chemo-resistance in ovarian cancer. The findings show that SLC27A2 down-regulation in primary ovarian cancer tissues correlates with chemo-resistance and poor patient survival in our patient cohort. Significantly, we demonstrate that up-regulation of SLC27A2 by lentivirus-mediated p-SLC27A2 sensitizes ovarian cancer cells to cisplatin in vitro and in vivo via apoptosis. Mechanistic investigation reveals that miR-411 is the most strikingly over-expressed gene in response to ectopic expression of SLC27A2, but under-expressed in recurrent ovarian cancer tissues. Lower miR-411 expression contributes to ovarian cancer chemo-resistance in vitro and in vivo. Furthermore, SLC27A2 directly binds specific sites in the miR-411 promoter region and promoter activity decreases after mutation of putative SLC27A2-binding sites. This indicates that SLC27A2 is required for the transcriptional induction of miR-411. The luciferase assays also confirm that miR-411 directly targets ABCG2 in ovarian cancer, and overall findings establish the SLC27A2-miR-411-ABCG2 pathway in the regulation of ovarian cancer chemo-resistance with potential therapeutic applications.
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Affiliation(s)
- F D Chen
- Department of Obstetrics and Gynecology, the Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - H H Chen
- Department of Obstetrics and Gynecology, the Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - S C Ke
- Department of Obstetrics and Gynecology, the Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - L R Zheng
- Department of Obstetrics and Gynecology, the Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - X Y Zheng
- Department of Obstetrics and Gynecology, the Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Ichiki T, Schirger JA, Wanek JR, Heublein DM, Scott CG, Sangaralingham SJ, Chen HH, Burnett JC. P6528Cardiorenal protection by subcutaneous cenderitide in experimental heart failure: a novel and safe therapeutic for humans with LVAD support. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T Ichiki
- Mayo Clinic, Department of Cardiovascular Medicine, Rochester, United States of America
| | - J A Schirger
- Mayo Clinic, Department of Cardiovascular Medicine, Rochester, United States of America
| | - J R Wanek
- Mayo Clinic, Department of Cardiovascular Medicine, Rochester, United States of America
| | - D M Heublein
- Mayo Clinic, Department of Cardiovascular Medicine, Rochester, United States of America
| | - C G Scott
- Mayo Clinic, Department of Biomedical Statistics and Informatics, Rochester, United States of America
| | - S J Sangaralingham
- Mayo Clinic, Department of Cardiovascular Medicine, Rochester, United States of America
| | - H H Chen
- Mayo Clinic, Department of Cardiovascular Medicine, Rochester, United States of America
| | - J C Burnett
- Mayo Clinic, Department of Cardiovascular Medicine, Rochester, United States of America
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Wan SH, Ameenuddin S, Chen HH. P6513Cardiac and renal fibrosis and insulin administration in a rat model of diabetic cardiomyopathy. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S.-H Wan
- Mayo Clinic, Rochester, United States of America
| | - S Ameenuddin
- Mayo Clinic, Rochester, United States of America
| | - H H Chen
- Mayo Clinic, Rochester, United States of America
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30
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Chen HH, Fu BT, Zhu QY, Lu HX, Luo LH, Chen L, Liu XH, Zhou XJ, Huang JH, Feng XX, Shan GS, Shen ZY. [Dynamic variations of BMI and influencing factors among HIV/AIDS patients receiving highly active antiretroviral therapy in Liuzhou, Guangxi Zhuang Autonomous Region, 2013-2014]. Zhonghua Liu Xing Bing Xue Za Zhi 2018; 39:487-490. [PMID: 29699043 DOI: 10.3760/cma.j.issn.0254-6450.2018.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To understand the dynamic variation of BMI and influencing factors among HIV/AIDS patients receiving highly active anti-retroviral therapy (HAART) in Liuzhou, Guangxi Zhuang Autonomous Region (Guangxi). Methods: HIV/AIDS patients receiving HAART for the first time since 1 January 2013 were selected. Data on BMI was analyzed among patients receiving HAART at baseline,6 months and 12 months after treatment. By using the general linear model repeated measures of analysis of variance, BMI dynamic variations and influencing factors were described and analyzed. Results: The average BMI of 2 871 patients at baseline, 6th months and 12th months appeared as (20.65±3.32), (20.87±3.22) and (21.18±3.20), respectively, with differences all statistically significant (F=18.86, P<0.001). BMI were increasing over time with treatments (F=37.25, P<0.001). Main influencing factors were noticed as: age, sex, marital status, baseline data of CD(4)(+)T cells and the WHO classification on clinical stages. Conclusions: Higher proportion of BMI malnutrition counts was seen among patients before receiving HAART in Liuzhou. BMI of the patients that were on HAART seemed being influenced by many factors. It is necessary to select appropriate treatment protocols on different patients so as to improve the nutritional status of the patients.
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Affiliation(s)
- H H Chen
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - B T Fu
- Luzhai Center for Disease Control and Prevention, Luzhai 545600, China
| | - Q Y Zhu
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - H X Lu
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - L H Luo
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - L Chen
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - X H Liu
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - X J Zhou
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - J H Huang
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - X X Feng
- Liuzhou Center for Disease Control and Prevention, Liuzhou 455001, China
| | - G S Shan
- Liuzhou Center for Disease Control and Prevention, Liuzhou 455001, China
| | - Z Y Shen
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
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Yang PS, Liu CL, Liu TP, Chen HH, Wu CJ, Cheng SP. Parathyroidectomy decreases neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios. J Surg Res 2018; 224:169-175. [PMID: 29506836 DOI: 10.1016/j.jss.2017.12.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 11/19/2017] [Accepted: 12/13/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Systemic inflammation has been implicated in complications and heightened mortality of patients with secondary hyperparathyroidism. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are widely available surrogate markers of inflammation. This study sought to delineate the changes in NLR and PLR after parathyroidectomy. METHODS A total of 213 patients undergoing initial parathyroidectomy from 2010 to 2015 for secondary hyperparathyroidism were identified from a prospectively maintained clinical database. Among 183 patients free of persistent or recurrent disease, follow-up NLR and PLR were available for analysis in 85 patients. RESULTS In the whole study population, the baseline NLR was positively correlated with male sex, total white blood cell count, height, serum phosphorus, and calcium-phosphorus product levels. The baseline PLR was positively correlated with platelet count, serum phosphorus, and calcium-phosphorus product levels and negatively associated with patient age. Postoperative parathyroid hormone levels were positively correlated with NLR and PLR at follow-up. For patients who had successful parathyroidectomy, there was a decrease in NLR (P = 0.0006), PLR (P = 0.0003), and platelet count (P = 0.033), whereas hemoglobin significantly increased (P = 0.0002) after surgery. Those with persistent or recurrent hyperparathyroidism had no change in NLR, PLR, hemoglobin, total white blood cell, or platelet count. CONCLUSIONS Successful parathyroidectomy is associated with a decrease in NLR and PLR. The modulatory effects of parathyroidectomy on systemic inflammation may partially explain the benefits of surgery in secondary hyperparathyroidism.
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Affiliation(s)
- Po-Sheng Yang
- Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan
| | - Chien-Liang Liu
- Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan; Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
| | - Tsang-Pai Liu
- Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan; Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
| | - Han-Hsiang Chen
- Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan; Division of Nephrology, Department of Internal Medicine, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan
| | - Chih-Jen Wu
- Division of Nephrology, Department of Internal Medicine, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan; Department of Pharmacology, Graduate Institute of Medical Sciences, Taipei Medical University, Taipei, Taiwan
| | - Shih-Ping Cheng
- Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan; Department of Pharmacology, Graduate Institute of Medical Sciences, Taipei Medical University, Taipei, Taiwan.
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Lin CJ, Pan CF, Chuang CK, Liu HL, Huang SF, Chen HH, Wu CJ. Effects of Sevelamer Hydrochloride on Uremic Toxins Serum Indoxyl Sulfate and P-Cresyl Sulfate in Hemodialysis Patients. J Clin Med Res 2017; 9:765-770. [PMID: 28811853 PMCID: PMC5544481 DOI: 10.14740/jocmr1803e] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Accepted: 03/13/2014] [Indexed: 12/19/2022] Open
Abstract
Background Beside the phosphate binding effect, non-calcium non-aluminum phosphate binder, namely sevelamer hydrochloride (SH), has many other effects in dialysis patients. It can absorb many other compounds, decrease low-density lipoprotein cholesterol (LDL-C) level, and attenuate the progression of vascular calcification; it has been reported to have anti-inflammatory effect. However, it is not clear whether it has any effect on uremic toxins, i.e. serum indoxyl sulfate (IS) and p-cresyl sulfate, (PCS) in hemodialysis (HD) patients. This study was carried out to appraise the effect of sevelamer on serum IS and PCS in HD patients. Methods Five adult HD patients from a single medical center were enrolled in this study; these patients were treated with 800 mg of sevelamer thrice per day for 3 months; a series of biochemical parameters, serum IS and PCS were monitored concurrently. Results There was a significant reduction in the mean level of phosphate from 7.20 ± 0.70 mg/dL (mean ± SD) before treatment to 5.40 ± 0.50 mg/dL (mean ± SD) after treatment, total cholesterol from 151.00 ± 37.40 mg/dL (mean ± SD) before treatment to 119.20 ± 29.40 mg/dL (mean ± SD) after treatment, and PCS from 31.30 ± 10.60 mg/L (mean ± SD) before treatment to 19.70 ± 10.50 mg/L (mean ± SD) after treatment. On the contrary, this treatment had no effect on IS. Conclusion A statistically significant reduction of serum phosphate and PCS in HD patients treated with SH suggests that beside the action of lowering serum phosphate, sevelamer may have an important role in the treatment of uremic syndrome by decreasing the uremic toxin.
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Affiliation(s)
- Cheng-Jui Lin
- Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan, Republic of China.,Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan, Republic of China.,Institute of Biotechnology, National Taipei University of Technology, Taipei, Taiwan, Republic of China
| | - Chi-Feng Pan
- Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan, Republic of China.,Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan, Republic of China
| | - Chih-Kuang Chuang
- Institute of Biotechnology, National Taipei University of Technology, Taipei, Taiwan, Republic of China.,Division of Genetics and Metabolism, Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan, Republic of China.,College of Medicine, Fu-Jen Catholic University, Taipei County, Taiwan, Republic of China
| | - Hsuan-Liang Liu
- Institute of Biotechnology, National Taipei University of Technology, Taipei, Taiwan, Republic of China
| | - Sung-Fa Huang
- Department of Laboratory Medicine, Mackay Memorial Hospital, Taipei, Taiwan, Republic of China
| | - Han-Hsiang Chen
- Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan, Republic of China.,Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan, Republic of China
| | - Chih-Jen Wu
- Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan, Republic of China.,Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan, Republic of China.,Graduate Institute of Medical Science, Taipei Medical University, Taipei, Taiwan, Republic of China
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Deng YQ, Wang L, Chen HH, Tan JJ, Gao CK, Huang XX, Han XY, Li XP. [Expression and significance of pepsin in lingual tonsil hypertrophy]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017; 52:525-530. [PMID: 28728242 DOI: 10.3760/cma.j.issn.1673-0860.2017.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To discuss the relationship between lingual tonsil hypertrophy and laryngopharyngeal reflux. Methods: Ninety-two patients who received throat surgery in Nanfang Hospital between October 2015 and October 2016 were enrolled. Twenty-six healthy volunteers were recruited as normal controls. All participants were assessed with the reflux finding score(RFS) and the size of lingual tonsils were evaluated using a clinical grading system proposed by Friedman under electronic laryngoscope. The score of reflux symptom index(RSI), personal history and medical history were gathered. Biopsy specimens of lingual tonsils were taken from all participants for the immunohistochemical stain of pepsin.SPSS 19.0 software was used for statistical analysis. Results: There were 46.2% (12/26) pepsin-positive and 53.8% (14/26) pepsin-negative volunteers in normal controls. There were 87.0% (80/92) pepsin-positive and 13.0% (12/92) pepsin-negative patients in study group. The severity of lingual tonsil hypertrophy and expression intensity of pepsin in patients were significantly higher in volunteers (Z=-3.636, Z=-5.273, P<0.01). The severity of lingual tonsil hypertrophy was positively associated with the pepsin level in patients (r=0.556, P<0.01). The patients with pepsin-positive expression showed significant correlation between lingual tonsil hypertrophy and the positive rate of RSI and RFS (r=0.258, r=0.225, P<0.05). Analysis of correlated factors indicated that lingual tonsil hypertrophy was associated with smoking (χ(2)=8.502, P<0.05). Conclusions: The expression of pepsin can be detected in lingual tonsil tissues. The lingual tonsil hypertrophy is closely related to laryngopharyngeal reflux.
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Affiliation(s)
- Y Q Deng
- Department of Otorhinolaryngology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - L Wang
- Department of Otorhinolaryngology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - H H Chen
- Department of Otorhinolaryngology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - J J Tan
- Department of Otorhinolaryngology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - C K Gao
- Department of Otorhinolaryngology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - X X Huang
- Department of Otorhinolaryngology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - X Y Han
- Department of Otorhinolaryngology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - X P Li
- Department of Otorhinolaryngology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
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Wu CJ, Chen CY, Lai TS, Wu PC, Chuang CK, Sun FJ, Liu HL, Chen HH, Yeh HI, Lin CS, Lin CJ. The role of indoxyl sulfate in renal anemia in patients with chronic kidney disease. Oncotarget 2017; 8:83030-83037. [PMID: 29137321 PMCID: PMC5669947 DOI: 10.18632/oncotarget.18789] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 05/29/2017] [Indexed: 12/23/2022] Open
Abstract
Renal anemia is a common complication in patients with advanced chronic kidney disease. In vitro studies have shown that indoxyl sulfate decreases erythropoietin production. Whether this effect is seen in vivo remains unclear. Our goal was to explore the role of indoxyl sulfate in renal anemia. We found serum indoxyl sulfate levels are significantly and negatively associated with erythropoietin levels in human. A multiple stepwise linear regression analyses after adjustment for other independent parameters revealed that free indoxyl sulfate, and total indoxyl sulfate were significantly associated with erythropoietin levels. In animal studies, erythropoietin gene and protein expression were markedly inhibited in rats with chronic kidney disease; however, this effect was significantly reversed by lowering serum indoxyl sulfate with AST-120. Indoxyl sulfate may also inhibit erythropoietin expression in animal models with chronic kidney disease. These findings further support the role of indoxyl sulfate in the development of renal anemia.
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Affiliation(s)
- Chih-Jen Wu
- Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Mackay Medical College ,Taipei, Taiwan.,Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan.,Graduate Institute of Medical Sciences and Department of Pharmacology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Cheng-Yi Chen
- Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Mackay Medical College ,Taipei, Taiwan.,Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan.,Department of Biological Science and Technology, National Chaio Tung University, Hsinchu, Taiwan
| | - Thung-S Lai
- Graduate Institute of Biomedical Science, Mackay Medical College, New Taipei City, Taiwan
| | - Pei-Chen Wu
- Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Mackay Medical College ,Taipei, Taiwan
| | - Chih-Kuang Chuang
- Institute of Biotechnology, National Taipei University of Technology, Taipei, Taiwan.,Division of Genetics and Metabolism, Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan.,College of Medicine, Fu-Jen Catholic University, Taipei, Taiwan
| | - Fang-Ju Sun
- Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan.,Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan
| | - Hsuan-Liang Liu
- Institute of Biotechnology, National Taipei University of Technology, Taipei, Taiwan
| | - Han-Hsiang Chen
- Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Mackay Medical College ,Taipei, Taiwan.,Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Hung-I Yeh
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
| | - Chih-Sheng Lin
- Department of Biological Science and Technology, National Chaio Tung University, Hsinchu, Taiwan
| | - Cheng-Jui Lin
- Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Mackay Medical College ,Taipei, Taiwan.,Institute of Biotechnology, National Taipei University of Technology, Taipei, Taiwan.,Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
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Huang XX, Chen HH, Tang J, Lu J, Deng YQ, Li XP. [Comparative study of VOTE classification in obstructive sleep apnea hypopnea syndrome patients between awake and sleep state]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017; 31:918-924. [PMID: 29798412 DOI: 10.13201/j.issn.1001-1781.2017.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Indexed: 11/12/2022]
Abstract
Objective:To compare the differences of the sites of airway obstruction in OSAHS patients between awake and sleep state by using the VOTE classification system. Method:Forty OSAHS patients diagnosed by PSG underwent awake Müller's maneuver and drug-induced sleep endoscopy (DISE). Video and compare the observation. Its findings were described using the VOTE classification system which include the following features: level, degree and configuration of obstruction. Associations were analyzed between different degrees of obstruction, BMI, AHI, minimal SaO₂ and average SaO₂. Result:Our patients had 52.5% complete velum collapse and 30.0% complete oropharyngeal lateral wall collapse in awake Müller's maneuver. In DISE, airway closure of 95.0% cases related to velum occurred collapse in concentric configuration, and 90.0% cases showed completely obstructive. We found that 60.0% complete oropharyngeal lateral wall collapse and 17.5% complete tongue base collapse. There was a significant difference in the VOTE scores between DISE and awake Müller's maneuver, and the VOTE scores of DISE were higher in all levels (P<0.05). No association was found between degrees of obstruction, AHI, BMI, minimal SaO2 and average SaO₂ in Müller's maneuver (P>0.05). Complete velum collapse was just significantly associated with AHI and minimal SaO₂ in DISE (P<0.05). Conclusion:The VOTE scores of DISE were higher than awake Müller's maneuver, reflected by more obstructive levels and severe degree. The difference between different degrees of obstruction, BMI, AHI, minimal SaO₂ and average SaO₂ was not significant.
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Affiliation(s)
- X X Huang
- Department of Otorhinolaryngology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - H H Chen
- Department of Otorhinolaryngology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - J Tang
- Department of Otorhinolaryngology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - J Lu
- Department of Otorhinolaryngology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Y Q Deng
- Department of Otorhinolaryngology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - X P Li
- Department of Otorhinolaryngology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
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Lin CJ, Wu CJ, Wu PC, Pan CF, Wang TJ, Sun FJ, Liu HL, Chen HH, Yeh HI. Indoxyl Sulfate Impairs Endothelial Progenitor Cells and Might Contribute to Vascular Dysfunction in Patients with Chronic Kidney Disease. Kidney Blood Press Res 2016; 41:1025-1036. [DOI: 10.1159/000452604] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2016] [Indexed: 11/19/2022] Open
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Chen HH, Sun YS, Liu ML. [Association between ambulatory arterial stiffness index with left ventricular mass index in the elderly hypertensive patients]. Zhonghua Xin Xue Guan Bing Za Zhi 2016; 44:750-753. [PMID: 27667271 DOI: 10.3760/cma.j.issn.0253-3758.2016.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the relationship between ambulatory arterial stiffness index (AASI) and left ventricular mass index (LVMI) in the elderly hypertensive patients. Methods: This study population consisted of 332 elderly hypertensive patients, who hospitalized in our department from January 2012 to December 2014.AASI was calculated from 24 h ambulatory BP monitoring recordings and LVMI from echocardiography examination.According to the median value of AASI, patients were divided to less than the AASI median group (low AASI group) and equal to or above the AASI median group (high AASI group). Differences between two groups were evaluated using the Student's t-test and Chi-square test.Univariate association was assessed by the Pearson correlation analyses.Multivariate linear regression models were performed to analyze the correlation between AASI and LVMI. Results: LVMI was significantly higher in high AASI group compared with low AASI group ( (115.91±21.36) g/m2 vs.(104.11±17.24) g/m2,P=0.008). Pearson correlation analyses showed that AASI and 24 h pulse pressure were positively correlated to LVMI (r=0.332, P<0.001; r=0.169, P=0.002). In multivariate linear regression model, AASI(β=44.48, P<0.001), LDL-C(β=-5.97, P<0.001) and UA (β=0.02, P=0.045)showed significant association with LVMI. Conclusion: AASI independently associated with LVMI, and AASI might be one predictor of left ventricular hypertrophy in hospitalized elderly hypertensive patients.
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Affiliation(s)
- H H Chen
- Department of Geriatric, Peking University First Hospital, Beijing 100034, China
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Chen HH, Lu J, Guan YF, Li SJ, Hu TT, Xie ZS, Wang F, Peng XH, Liu X, Xu X, Zhao FP, Yu BL, Li XP. Estrogen/ERR-α signaling axis is associated with fiber-type conversion of upper airway muscles in patients with obstructive sleep apnea hypopnea syndrome. Sci Rep 2016; 6:27088. [PMID: 27250523 PMCID: PMC4890001 DOI: 10.1038/srep27088] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 05/10/2016] [Indexed: 12/20/2022] Open
Abstract
Estrogen is related with the low morbidity associated with obstructive sleep apnea hypopnea syndrome (OSAS) in women, but the underlying mechanisms remain largely unknown. In this study, we examined the relationship between OSAS and estrogen related receptor-α (ERR-α). We found that the expression levels of ERR-α and Myh7 were both downregulated in palatopharyngeal tissues from OSAS patients. In addition, we report that ERR-α is dynamically expressed during differentiation of C2C12 myoblasts. Knockdown of ERR-α via instant siRNA resulted in reduced expression of Myh7, but not Myh4. Furthermore, differentiation of C2C12 cells under 3% chronic intermittent hypoxia, a model resembling human OSAS, was impaired and accompanied by a obvious reduction in Myh7 expression levels. Moreover, activation of ERR-α with 17β-estradiol (E2) increased the expression of Myh7, whereas pretreatment with the ERR-α antagonist XCT790 reversed the E2-induced slow fiber-type switch. A rat ovariectomy model also demonstrated the switch to fast fiber type. Collectively, our findings suggest that ERR-α is involved in estrogen-mediated OSAS by regulating Myhc-slow expression. The present study illustrates an important role of the estrogen/ERR-α axis in the pathogenesis of OSAS, and may represent an attractive therapeutic target, especially in postmenopausal women.
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Affiliation(s)
- H H Chen
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - J Lu
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Y F Guan
- Department of Neurobiology, Southern Medical University, Guangzhou, China
| | - S J Li
- Department of Neurobiology, Southern Medical University, Guangzhou, China
| | - T T Hu
- Department of Anatamy, Southern Medical University, Guangzhou, China
| | - Z S Xie
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - F Wang
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - X H Peng
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - X Liu
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - X Xu
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - F P Zhao
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - B L Yu
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - X P Li
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Lee F, Lee JJ, Jan WC, Wu CJ, Chen HH, Cheng SP. Molecular pathways associated with transcriptional alterations in hyperparathyroidism. Oncol Lett 2016; 12:621-626. [PMID: 27347190 DOI: 10.3892/ol.2016.4623] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 05/12/2016] [Indexed: 12/11/2022] Open
Abstract
Hyperparathyroidism is characterized by the oversecretion of parathyroid hormone biochemically and increased cell proliferation histologically. Primary and secondary hyperparathyroidism exhibit distinct pathophysiology but share certain common microscopic features. The present study performed the first genome-wide expression analysis directly comparing the expression profile of primary and secondary hyperparathyroidism. Microarray gene expression analyses were performed in parathyroid tissues from 2 primary hyperparathyroidism patients and 3 secondary hyperparathyroidism patients. Unsupervised hierarchical clustering analysis identified two natural subgroups containing different types of hyperparathyroidism. Combined with additional data extracted from a publicly available database, a meta-signature was constructed to represent an intersection of two sets of differential expression profile. Multiple pathways were identified that are aberrantly regulated in hyperparathyroidism. In primary hyperparathyroidism, dysregulated pathways included cell adhesion molecules, peroxisome proliferator-activated receptor signaling pathway, and neuroactive ligand-receptor interaction. Pathways implicated in secondary hyperparathyroidism included tryptophan metabolism, tight junctions, renin-angiotensin system, steroid hormone biosynthesis, and O-glycan biosynthesis. The present study demonstrates that different pathophysiology is associated with differential gene profiling in hyperparathyroidism. Several pathways are involved in parathyroid dysregulation and may be future targets for therapeutic intervention.
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Affiliation(s)
- Fang Lee
- Department of Surgery, MacKay Memorial Hospital and MacKay Medical College, Taipei 10449, Taiwan, R.O.C
| | - Jie-Jen Lee
- Department of Surgery, MacKay Memorial Hospital and MacKay Medical College, Taipei 10449, Taiwan, R.O.C.; Department of Nursing, MacKay Junior College of Medicine, Nursing and Management, Tapei 11260, Taiwan, R.O.C.; Department of Pharmacology and Graduate Institute of Medical Sciences, Taipei Medical University, Taipei 11031, Taiwan, R.O.C
| | - Woan-Ching Jan
- Department of Nursing, MacKay Junior College of Medicine, Nursing and Management, Tapei 11260, Taiwan, R.O.C
| | - Chih-Jen Wu
- Department of Pharmacology and Graduate Institute of Medical Sciences, Taipei Medical University, Taipei 11031, Taiwan, R.O.C.; Department of Nephrology, MacKay Memorial Hospital and Mackay Medical College, Taipei 10449, Taiwan, R.O.C
| | - Han-Hsiang Chen
- Department of Pharmacology and Graduate Institute of Medical Sciences, Taipei Medical University, Taipei 11031, Taiwan, R.O.C.; Department of Nephrology, MacKay Memorial Hospital and Mackay Medical College, Taipei 10449, Taiwan, R.O.C
| | - Shih-Ping Cheng
- Department of Surgery, MacKay Memorial Hospital and MacKay Medical College, Taipei 10449, Taiwan, R.O.C.; Department of Pharmacology and Graduate Institute of Medical Sciences, Taipei Medical University, Taipei 11031, Taiwan, R.O.C
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Wang CZ, Feng GX, Zhang B, Zhou H, Shu JH, Gan XY, Lin RY, Chen HH. [Effect of blastocyst quality on the strategy of single blastocyst transfer in frozen-thawed cycles]. Zhonghua Fu Chan Ke Za Zhi 2016; 51:109-13. [PMID: 26917479 DOI: 10.3760/cma.j.issn.0529-567x.2016.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To investigate the effect of blastocyst quality on the strategy of single blastocyst transfer in frozen-thawed cycles. METHODS A retrospective analysis was performed in Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region on clinical data of single frozen-thawed blastocyst transfer cycles from January 2008 to December 2013. All cycles were divided into four groups (AA, AB/BA, BB, BC/CB) according to the blastocyst score, then the clinical outcomes were compared between groups. And on this basis, the clinical outcomes were further explored when the group of outcomes with single blastocyst transfer wasn't ideal, which would diverted to transfer two blastocyst. RESULTS In single frozen blastocyst transfer cycles, the clinical pregnancy rate of each group with the blastocyst scored AA, AB/BA, BB, BC/CB were 61.4% (470/765), 51.2% (330/645), 40.5% (407/1 005), 22.9% (60/262), live births rate in each group were 52.2% (399/765), 41.2% (266/645), 30.4% (306/1 005), 13.7% (36/262), and the abortion rate were 13.6% (64/470), 16.7% (55/330), 21.4% (87/407), 35.0%(21/60), separately. This showed that the clinical pregnancy rate and live births rate decreased significantly with the decline of blastocyst quality (P<0.01), but the abortion rate showed significant upward trend (P<0.01). When single blastocyst scored ≥BB grade transferred, an acceptable clinical pregnancy rate (>40%) and live births rate (>30%) could be obtained, however, the clinical pregnancy rate of 22.9% and live births rate of 13.7% could only be acquired when blastocyst scored BC/CB only transferred one embryo, which significant lower than those of each group scored ≥BB grade (P<0.01). So, after that, the blastocyst scored BC/CB were further divided into two groups (single blastocyst transferred versus two blastocyst transferred) to investigate, then the result showed that the clinical pregnancy rate [22.9% versus 38.5%(67/174),P<0.01] and live births rate [13.7% versus 30.5%(16/67),P<0.01] were significantly increased in the group of two blastocyst transferred compared with the group of one blastocyst transferred, and the abortion rate was also significantly decreased from 35.0% to 17.9% (12/67;P<0.05). So when two blastocyst scored BC/CB were transferred, the clinical outcomes were similar to the group of one blastocyst scored BB transferred (P>0.05). CONCLUSIONS Of single blastocyst transfer in frozen-thawed cycles, the clinical pregnancy rate and liver births rate showed significant upward trend, but the abortion rate showed significant downward trend, with the decline of blastocyst quality. When the blastocyst scored ≥BB grade, the single blastocyst transfer could be considered to be performed.
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Affiliation(s)
- C Z Wang
- Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning 530003, China
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Tang KT, Lin CH, Chen HH, Chen YH, Chen DY. Suicidal drug overdose in patients with systemic lupus erythematosus, a nationwide population-based case-control study. Lupus 2015; 25:199-203. [PMID: 26405026 DOI: 10.1177/0961203315608253] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 09/02/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE A four-fold increase of suicide mortality has been demonstrated in systemic lupus erythematosus (SLE) patients. Prior studies showed that the most common method of suicide attempts in SLE patients involves drug overdose. Therefore, we conducted a nationwide population-based case-control study to elucidate factors associated with drug overdose as suicide attempt in SLE patients. METHODS This study was based on the National Health Insurance Research Database in Taiwan. We identified all SLE patients from January 1, 2000 to December 31, 2010. Patients who had suicidal drug overdose (SDO) were selected as cases while age- and gender-matched patients who did not have SDO were selected as controls. RESULTS The incidence rate of SDO in SLE patients was 291 cases per 100,000 person-years, higher than that in the general population (160 cases per 100,000 person-years). In a multivariate logistic regression analysis, we observed that SDO was associated with psychiatric disorders such as depressive disorders (odds ratio: 8.36, 95% confidence interval (CI): 5.60-12.48) and insomnia (odds ratio: 2.71, 95% CI: 1.73-4.25), and lower monthly income (odds ratios: 2.74 to 3.50) in SLE patients. CONCLUSION SDO is associated with psychiatric disorders such as depressive disorders and insomnia, and lower monthly income in SLE patients.
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Affiliation(s)
- K T Tang
- Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan PhD Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan
| | - C H Lin
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - H H Chen
- Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan School of Medicine, National Yang-Ming University, Taipei, Taiwan Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taiwan
| | - Y H Chen
- Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - D Y Chen
- Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan School of Medicine, National Yang-Ming University, Taipei, Taiwan Institute of Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan Institute of Biomedical Science, National Chung Hsing University, Taichung, Taiwan
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Lin CJ, Liou TC, Pan CF, Wu PC, Sun FJ, Liu HL, Chen HH, Wu CJ. The Role of Liver in Determining Serum Colon-Derived Uremic Solutes. PLoS One 2015; 10:e0134590. [PMID: 26258409 PMCID: PMC4530864 DOI: 10.1371/journal.pone.0134590] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 07/13/2015] [Indexed: 12/20/2022] Open
Abstract
Evidence has shown that indoxyl sulfate (IS) and p-cresyl sulfate (PCS) may be alternative predictors of clinical outcomes in chronic kidney disease (CKD). Both toxins are derived from the gastrointestinal tract and metabolised in the liver. However, it is unclear whether the liver affects the production of IS and PCS. Here, we explore the association between IS and PCS levels in liver cirrhosis and a CKD-based cohort (N = 115). Liver and kidney function was assessed and classified by a Child-Pugh score (child A–C) and a modified version of the Modification of Diet in Renal Disease (MDRD) equation (Stages 1–4), respectively. An animal model was also used to confirm the two toxin levels in a case of liver fibrosis. In patients with early liver cirrhosis (child A), IS and PCS were significantly associated with CKD stages. In contrast, serum IS and PCS did not significantly change in advanced liver cirrhosis (child C). A stepwise multiple linear regression analysis also showed that T-PCS was significantly associated with stages of liver cirrhosis after adjusting for other confounding factors (B = -2.29, p = 0.012). Moreover, the serum and urine levels of T-PCS and T-IS were significantly lower in rats with liver failure than in those without (p<0.01, p<0.05 and p<0.01, p<0.05, respectively). These results indicated that in addition to the kidneys, the liver was an essential and independent organ in determining serum IS and PCS levels. The production rate of IS and PCS was lower in patients with advanced liver cirrhosis.
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Affiliation(s)
- Cheng-Jui Lin
- Division of Nephrology and Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
- Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
- Institute of Biotechnology, National Taipei University of Technology, Taipei, Taiwan
- * E-mail:
| | - Tai-Cherng Liou
- Division of Gastroenterology and Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
| | - Chi-Feng Pan
- Division of Nephrology and Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
- Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Pei-Chen Wu
- Division of Nephrology and Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Fang-Ju Sun
- Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
- Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan
| | - Hsuan-Liang Liu
- Institute of Biotechnology, National Taipei University of Technology, Taipei, Taiwan
| | - Han-Hsiang Chen
- Division of Nephrology and Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
- Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Chih-Jen Wu
- Division of Nephrology and Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
- Graduate Institute of Medical Science, Taipei Medical University, Taipei, Taiwan
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Cheng SP, Lee JJ, Liu TP, Chen HH, Wu CJ, Liu CL. Aluminum overload hampers symptom improvement following parathyroidectomy for secondary hyperparathyroidism. World J Surg 2015; 38:2838-44. [PMID: 25002247 DOI: 10.1007/s00268-014-2695-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Aluminum overload and accumulation in tissues may lead to skeletal, hematological, and neurological toxicity. The aim of this study was to assess the effects of serum aluminum levels on presentations, postoperative recovery, and symptom improvement in patients undergoing parathyroidectomy for secondary hyperparathyroidism. METHODS From 2008 to 2013, all patients with end-stage renal disease undergoing initial parathyroidectomy were included in the study. Serum aluminum level was measured preoperatively and/or within 1 week after surgery. Preoperative and postoperative biochemical profile and symptoms were compared between the low and high aluminum groups. RESULTS A total of 176 patients were included in the study. Of these, 38 (22 %) patients had serum aluminum levels higher than 20 μg/L. A higher percentage of patients in the high aluminum group were on peritoneal dialysis than in the low aluminum group (24 vs. 4 %, p = 0.001). Both groups had similar bone mineral density and changes in biochemical profiles. The preoperative parathyroidectomy assessment of symptoms (PAS) score was not associated with serum aluminum levels (p = 0.349), whereas the postoperative PAS score showed positive association (p = 0.005). There was a negative association between serum aluminum levels and the improvement of total PAS scores (p = 0.001). The high aluminum group had more residual symptoms in three aspects: bone pain (p = 0.038), difficulty getting out of a chair or car (p = 0.045), and pruritus (p = 0.041). CONCLUSIONS A high serum aluminum level was associated with reduced symptom improvement in patients undergoing parathyroidectomy for secondary hyperparathyroidism.
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Affiliation(s)
- Shih-Ping Cheng
- Department of Surgery, Mackay Memorial Hospital, Mackay Medical College, 92, Sec. 2, Zhongshan N. Rd, Taipei, 10449, Taiwan
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Wu HC, Wang WJ, Chen YW, Chen HH. The association between the duration of postoperative acute kidney injury and in-hospital mortality in critically ill patients after non-cardiac surgery: an observational cohort study. Ren Fail 2015; 37:985-93. [PMID: 25982008 DOI: 10.3109/0886022x.2015.1044755] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The severity of acute kidney injury (AKI) has been a well-known predictor for in-hospital mortality. Whether AKI duration could predict in-hospital mortality is not clear. This study determines the association between the in-hospital mortality and AKI duration in patients after non-cardiac surgery. MATERIALS AND METHODS Surgical patients who were admitted to the ICU were enrolled. AKI cases were defined using KDIGO guidelines and categorized according to the tertiles of AKI duration (1st tertile: 2 days, 2nd tertile: 3-6 days and 3rd tertile: 7 days). The adjusted hazard ratios (HRs) for in-hospital mortality are compared to those without AKI. The predictability of mortality is accessed by calculating the area under the curve (AUC) for the receiver operating characteristic (ROC) curve. RESULTS From a total of 318 postoperative patients, 98 developed AKI (1st tertile: 34 cases, 2nd tertile: 30 cases and 3rd tertile: 34 cases) and 220 had no AKI. The in-hospital mortality rates are 6.8% (non-AKI), 50% (1st tertile), 46.7% (2nd tertile) and 47% (3rd tertile). The HR's for in-hospital mortality are 7.92, 6.68 and 1.68, compared to the non-AKI group (p = 0.006, 0.021 and 0.476). Cumulative in-hospital survival rates are significantly different for the non-AKI group and the AKI groups (p < 0.001). The AUC for AKI duration and stage together (0.804) is higher than that for AKI stage and AKI duration alone (0.803 and 0.777) (both ps < 0.001). CONCLUSION In addition to severity, the duration of AKI may be a predictor of in-hospital mortality in patients, after non-cardiac surgery.
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Affiliation(s)
- Hung-Chieh Wu
- a Department of Nursing , Chang Gung University of Science and Technology , Taoyuan , Taiwan .,b Division of Nephrology, Department of Internal Medicine , Taoyuan General Hospital, Ministry of Health and Welfare , Taoyuan , Taiwan
| | - Wei-Jie Wang
- b Division of Nephrology, Department of Internal Medicine , Taoyuan General Hospital, Ministry of Health and Welfare , Taoyuan , Taiwan .,c Department of Biomedical Engineering , Chung Yuan Christian University , Taoyuan , Taiwan , and
| | - Yu-Wei Chen
- d Division of Nephrology, Department of Internal Medicine , Mackay Memorial Hospital , Taipei , Taiwan
| | - Han-Hsiang Chen
- d Division of Nephrology, Department of Internal Medicine , Mackay Memorial Hospital , Taipei , Taiwan
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Lin CJ, Lin J, Pan CF, Chuang CK, Liu HL, Sun FJ, Wang TJ, Chen HH, Wu CJ. Indoxyl Sulfate, Not P-Cresyl Sulfate, is Associated with Advanced Glycation end Products in Patients on Long-Term Hemodialysis. Kidney Blood Press Res 2015; 40:121-9. [DOI: 10.1159/000368488] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2015] [Indexed: 11/19/2022] Open
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Hsu CY, Yen AMF, Chen LS, Chen HH. Analysis of household data on influenza epidemic with Bayesian hierarchical model. Math Biosci 2015; 261:13-26. [PMID: 25484132 PMCID: PMC7094348 DOI: 10.1016/j.mbs.2014.11.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Revised: 11/14/2014] [Accepted: 11/22/2014] [Indexed: 11/25/2022]
Abstract
Data used for modelling the household transmission of infectious diseases, such as influenza, have inherent multilevel structures and correlated property, which make the widely used conventional infectious disease transmission models (including the Greenwood model and the Reed-Frost model) not directly applicable within the context of a household (due to the crowded domestic condition or socioeconomic status of the household). Thus, at the household level, the effects resulting from individual-level factors, such as vaccination, may be confounded or modified in some way. We proposed the Bayesian hierarchical random-effects (random intercepts and random slopes) model under the context of generalised linear model to capture heterogeneity and variation on the individual, generation, and household levels. It was applied to empirical surveillance data on the influenza epidemic in Taiwan. The parameters of interest were estimated by using the Markov chain Monte Carlo method in conjunction with the Bayesian directed acyclic graphical models. Comparisons between models were made using the deviance information criterion. Based on the result of the random-slope Bayesian hierarchical method under the context of the Reed-Frost transmission model, the regression coefficient regarding the protective effect of vaccination varied statistically significantly from household to household. The result of such a heterogeneity was robust to the use of different prior distributions (including non-informative, sceptical, and enthusiastic ones). By integrating out the uncertainty of the parameters of the posterior distribution, the predictive distribution was computed to forecast the number of influenza cases allowing for random-household effect.
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Affiliation(s)
- C Y Hsu
- Department of Emergency Medicine, Taipei City Hospital, Zhongxing Branch, Taipei, Taiwan ; Division of Biostatistics, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - A M F Yen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - L S Chen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - H H Chen
- Division of Biostatistics, College of Public Health, National Taiwan University, Taipei, Taiwan.
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Colton K, Yang S, Hu PF, Chen HH, Stansbury LG, Scalea TM, Stein DM. Responsiveness to therapy for increased intracranial pressure in traumatic brain injury is associated with neurological outcome. Injury 2014; 45:2084-8. [PMID: 25304159 DOI: 10.1016/j.injury.2014.08.041] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 07/26/2014] [Accepted: 08/28/2014] [Indexed: 02/02/2023]
Abstract
In patients with severe traumatic brain injury, increased intracranial pressure (ICP) is associated with poor functional outcome or death. Hypertonic saline (HTS) is a hyperosmolar therapy commonly used to treat increased ICP; this study aimed to measure initial patient response to HTS and look for association with patient outcome. Patients >17 years old, admitted and requiring ICP monitoring between 2008 and 2010 at a large urban tertiary care facility were retrospectively enrolled. The first dose of hypertonic saline administered after admission for ICP >19mmHg was recorded and correlated with vital signs recorded at the bedside. The absolute and relative change in ICP at 1 and 2h after HTS administration was calculated. Patients were stratified by mortality and long-term (≥6 months) functional neurological outcome. We identified 46 patients who received at least 1 dose of HTS for ICP>19, of whom 80% were male, mean age 34.4, with a median post-resuscitation GCS score of 6. All patients showed a significant decrease in ICP 1h after HTS administration. Two hours post-administration, survivors showed a further decrease in ICP (43% reduction from baseline), while ICP began to rebound in non-survivors (17% reduction from baseline). When patients were stratified for long-term neurological outcome, results were similar, with a significant difference in groups by 2h after HTS administration. In patients treated with HTS for intracranial hypertension, those who survived or had good neurological outcome, when compared to those who died or had poor outcomes, showed a significantly larger sustained decrease in ICP 2h after administration. This suggests that even early in a patient's treatment, treatment responsiveness is associated with mortality or poor functional outcome. While this work is preliminary, it suggests that early failure to obtain a sustainable response to hyperosmolar therapy may warrant greater treatment intensity or therapy escalation.
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Affiliation(s)
- K Colton
- Shock Trauma Anesthesia Research Organized Research Center, University of Maryland School of Medicine and R Adams Cowley Shock Trauma Center, Baltimore, MD, USA; Duke University School of Medicine, Durham, NC, USA.
| | - S Yang
- Shock Trauma Anesthesia Research Organized Research Center, University of Maryland School of Medicine and R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
| | - P F Hu
- Shock Trauma Anesthesia Research Organized Research Center, University of Maryland School of Medicine and R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
| | - H H Chen
- Shock Trauma Anesthesia Research Organized Research Center, University of Maryland School of Medicine and R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
| | - L G Stansbury
- Shock Trauma Anesthesia Research Organized Research Center, University of Maryland School of Medicine and R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
| | - T M Scalea
- Shock Trauma Anesthesia Research Organized Research Center, University of Maryland School of Medicine and R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
| | - D M Stein
- Shock Trauma Anesthesia Research Organized Research Center, University of Maryland School of Medicine and R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
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Colton K, Yang S, Hu PF, Chen HH, Bonds B, Stansbury LG, Scalea TM, Stein DM. Pharmacologic Treatment Reduces Pressure Times Time Dose and Relative Duration of Intracranial Hypertension. J Intensive Care Med 2014; 31:263-9. [PMID: 25320157 DOI: 10.1177/0885066614555692] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 09/18/2014] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Past work has shown the importance of the "pressure times time dose" (PTD) of intracranial hypertension (intracranial pressure [ICP] > 19 mm Hg) in predicting outcome after severe traumatic brain injury. We used automated data collection to measure the effect of common medications on the duration and dose of intracranial hypertension. METHODS Patients >17 years old, admitted and requiring ICP monitoring between 2008 and 2010 at a single, large urban tertiary care facility, were retrospectively enrolled. Timing and dose of ICP-directed therapy were recorded from paper and electronic medical records. The ICP data were collected automatically at 6-second intervals and averaged over 5 minutes. The percentage of time of intracranial hypertension (PTI) and PTD (mm Hg h) were calculated. RESULTS A total of 98 patients with 664 treatment instances were identified. Baseline PTD ranged from 27 (before administration of propofol and fentanyl) to 150 mm Hg h (before mannitol). A "small" dose of hypertonic saline (HTS; ≤250 mL 3%) reduced PTD by 38% in the first hour and 37% in the second hour and reduced the time with ICP >19 by 38% and 39% after 1 and 2 hours, respectively. A "large" dose of HTS reduced PTD by 40% in the first hour and 63% in the second (PTI reduction of 36% and 50%, respectively). An increased dose of propofol or fentanyl infusion failed to decrease PTD but reduced PTI between 14% (propofol alone) and 30% (combined increase in propofol and fentanyl, after 2 hours). Barbiturates failed to decrease PTD but decreased PTI by 30% up to 2 hours after administration. All reductions reported are significantly changed from baseline, P < .05. CONCLUSION Baseline PTD values before drug administration reflects varied patient criticality, with much higher values seen before the use of mannitol or barbiturates. Treatment with HTS reduced PTD and PTI burden significantly more than escalation of sedation or pain management, and this effect remained significant at 2 hours after administration.
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Affiliation(s)
- Katharine Colton
- Shock Trauma Anesthesia Research Organized Research Center, University of Maryland School of Medicine and R Adams Cowley Shock Trauma Center, Baltimore, MD, USA Duke University School of Medicine, Durham, NC, USA
| | - S Yang
- Shock Trauma Anesthesia Research Organized Research Center, University of Maryland School of Medicine and R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
| | - P F Hu
- Shock Trauma Anesthesia Research Organized Research Center, University of Maryland School of Medicine and R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
| | - H H Chen
- Shock Trauma Anesthesia Research Organized Research Center, University of Maryland School of Medicine and R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
| | - B Bonds
- Shock Trauma Anesthesia Research Organized Research Center, University of Maryland School of Medicine and R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
| | - L G Stansbury
- Shock Trauma Anesthesia Research Organized Research Center, University of Maryland School of Medicine and R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
| | - T M Scalea
- Shock Trauma Anesthesia Research Organized Research Center, University of Maryland School of Medicine and R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
| | - D M Stein
- Shock Trauma Anesthesia Research Organized Research Center, University of Maryland School of Medicine and R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
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Chen CY, Pan CF, Wu CJ, Chen HH, Chen YW. Bicarbonate can improve the prognostic value of the MELD score for critically ill patients with cirrhosis. Ren Fail 2014; 36:889-94. [PMID: 24601755 DOI: 10.3109/0886022x.2014.894765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The prognosis of critically ill patients with cirrhosis is poor. Our aim was to identify an objective variable that can improve the prognostic value of the Model of End-Stage Liver Disease (MELD) score in patients who have cirrhosis and are admitted to the intensive care unit (ICU). This retrospective cohort study included 177 patients who had liver cirrhosis and were admitted to the ICU. Data pertaining to arterial blood gas-related parameters and other variables were obtained on the day of ICU admission. The overall ICU mortality rate was 36.2%. The bicarbonate (HCO3) level was found to be an independent predictor of ICU mortality (odds ratio, 2.3; 95% confidence interval [CI], 1.0-4.8; p = 0.038). A new equation was constructed (MELD-Bicarbonate) by replacing total bilirubin by HCO3 in the original MELD score. The area under the receiver operating characteristic curve for predicting ICU mortality was 0.76 (95% CI, 0.69-0.84) for the MELD-Bicarbonate equation, 0.73 (95% CI, 0.65-0.81) for the MELD score, and 0.71 (95% CI, 0.63-0.80) for the Acute Physiology and Chronic Health Evaluation II score. Bicarbonate level assessment, as an objective and reproducible laboratory test, has significant predictive value in critically ill patients with cirrhosis. In contrast, the predictive value of total bilirubin is not as prominent in this setting. The MELD-Bicarbonate equation, which included three variables (international normalized ratio, creatinine level, and HCO3 level), showed better prognostic value than the original MELD score in critically ill patients with cirrhosis.
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Affiliation(s)
- Cheng-Yi Chen
- Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital , Taipei , Taiwan
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