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He LX, Deng K, Wang J, Zhang X, Wang L, Zhang HP, Xie M, Chen ZH, Zhang J, Chen-Yu Hsu A, Zhang L, Oliver BG, Wark PAB, Qin L, Gao P, Wan HJ, Liu D, Luo FM, Li WM, Wang G, Gibson PG. Clinical Subtypes of Neutrophilic Asthma: A Cluster Analysis From Australasian Severe Asthma Network. J Allergy Clin Immunol Pract 2024; 12:686-698.e8. [PMID: 37778630 DOI: 10.1016/j.jaip.2023.09.023] [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] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/19/2023] [Accepted: 09/21/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Clinical heterogeneity may exist within asthma subtypes defined by inflammatory markers. However, the heterogeneity of neutrophilic asthma (NA) remains largely unexplored. OBJECTIVE To explore potential clusters and the stability of NA. METHODS Participants with NA from the Australasian Severe Asthma Network underwent a multidimensional assessment. They were then asked to participate in a 12-month longitudinal cohort study. We explored potential clusters using a hierarchical cluster analysis and validated the differential future risk of asthma exacerbations in the identified clusters. A decision tree analysis was developed to predict cluster assignments. Finally, the stability of prespecified clusters was examined within 1 month. RESULTS Three clusters were identified in 149 patients with NA. Cluster 1 (n = 99; 66.4%) was characterized by female-predominant nonsmokers with well-controlled NA, cluster 2 (n = 16; 10.7%) by individuals with comorbid anxiety/depressive symptoms with poorly controlled NA, and cluster 3 by older male smokers with late-onset NA. Cluster 2 had a greater proportion of participants with severe exacerbations (P = .005), hospitalization (P = .010), and unscheduled visits (P = .013) and a higher number of emergency room visits (P = .039) than that of the other two clusters. The decision tree assigned 92.6% of participants correctly. Most participants (87.5%; n = 7) in cluster 2 had a stable NA phenotype, whereas participants of clusters 1 and 3 had variable phenotypes. CONCLUSIONS We identified three clinical clusters of NA, in which cluster 2 represents an uncontrolled and stable NA subtype with an elevated risk of exacerbations. These findings have clinical implications for the management of NA.
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Affiliation(s)
- Li Xiu He
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China; State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, China; Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, China
| | - Ke Deng
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China; State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, China
| | - Ji Wang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China; State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, China
| | - Xin Zhang
- Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, China; Division of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Lei Wang
- Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, China; Division of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Hong Ping Zhang
- Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, China; Division of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Min Xie
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Zhi Hong Chen
- Shanghai Institute of Respiratory Disease, Respiratory Division of Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jie Zhang
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Jilin University, Changchun, Jilin, China
| | - Alan Chen-Yu Hsu
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore
| | - Li Zhang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China; State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, China; Division of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Brian G Oliver
- School of Life Sciences, University of Technology Sydney, Ultimo, New South Wales, Australia; Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Peter A B Wark
- Priority Research Center for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, University of Newcastle, Newcastle, New South Wales, Australia
| | - Ling Qin
- Department of Respiratory and Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Peng Gao
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Jilin University, Changchun, Jilin, China
| | - Hua Jing Wan
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, China
| | - Dan Liu
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China; State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, China; Respiratory Microbiome Laboratory, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan, China
| | - Feng Ming Luo
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China; State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, China
| | - Wei Min Li
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China; State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, China; Respiratory Microbiome Laboratory, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan, China.
| | - Gang Wang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China; State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, China.
| | - Peter Gerard Gibson
- Priority Research Center for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, University of Newcastle, Newcastle, New South Wales, Australia; National Health and Medical Research Council Center for Excellence in Severe Asthma, Newcastle, New South Wales, Australia
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He LX, Yang L, Liu T, Li YN, Huang TX, Zhang LL, Luo J, Liu CT. Group 3 innate lymphoid cells secret neutrophil chemoattractants and are insensitive to glucocorticoid via aberrant GR phosphorylation. Respir Res 2023; 24:90. [PMID: 36949482 PMCID: PMC10033286 DOI: 10.1186/s12931-023-02395-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 03/13/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Patients with neutrophil-mediated asthma have poor response to glucocorticoids. The roles and mechanisms of group 3 innate lymphoid cells (ILC3s) in inducing neutrophilic airway inflammation and glucocorticoid resistance in asthma have not been fully clarified. METHODS ILC3s in peripheral blood were measured by flow cytometry in patients with eosinophilic asthma (EA) and non-eosinophilic asthma (NEA). ILC3s were sorted and cultured in vitro for RNA sequencing. Cytokines production and signaling pathways in ILC3s after IL-1β stimulation and dexamethasone treatment were determined by real-time PCR, flow cytometry, ELISA and western blot. RESULTS The percentage and numbers of ILC3s in peripheral blood was higher in patients with NEA compared with EA, and negatively correlated with blood eosinophils. IL-1β stimulation significantly enhanced CXCL8 and CXCL1 production in ILC3s via activation of p65 NF-κB and p38/JNK MAPK signaling pathways. The expression of neutrophil chemoattractants from ILC3s was insensitive to dexamethasone treatment. Dexamethasone significantly increased phosphorylation of glucocorticoid receptor (GR) at Ser226 but only with a weak induction at Ser211 residues in ILC3s. Compared to human bronchial epithelial cell line (16HBE cells), the ratio of p-GR S226 to p-GR S211 (p-GR S226/S211) was significantly higher in ILC3s at baseline and after dexamethasone treatment. In addition, IL-1β could induce Ser226 phosphorylation and had a crosstalk effect to dexamethasone via NF-κB pathway. CONCLUSIONS ILC3s were elevated in patients with NEA, and associated with neutrophil inflammation by release of neutrophil chemoattractants and were glucocorticoid (GC) resistant. This paper provides a novel cellular and molecular mechanisms of neutrophil inflammation and GC-resistance in asthma. Trial registration The study has been prospectively registered in the World Health Organization International Clinical Trials Registry Platform (ChiCTR1900027125).
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Affiliation(s)
- Li Xiu He
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, 610041, China
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550001, Guizhou, China
| | - Ling Yang
- Clinical Trial Center, National Medical Products Administration Key Laboratory for Clinical Research and Evaluation of Innovative Drugs, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Ting Liu
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China
| | - Yi Na Li
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Ting Xuan Huang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Lan Lan Zhang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Jian Luo
- Respiratory Medicine Unit and National Institute for Health and Care Research (NIHR) Oxford Biomedical Research Centre, Nuffield Department of Medicine, Experimental Medicine, University of Oxford, Oxford, OX3 9DU, UK.
| | - Chun Tao Liu
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, 610041, China.
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3
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He LX, Liu CT. [Differential diagnosis of asthma and dysfunctional breathing and vocal cord dysfunction]. Zhonghua Jie He He Hu Xi Za Zhi 2022; 45:936-941. [PMID: 36097932 DOI: 10.3760/cma.j.cn112147-20220314-00202] [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
The clinical manifestations of bronchial asthma are complex and variable, which can easily be confused with other diseases. So misdiagnosis and missed diagnosis of asthma are common. In the differential diagnosis of asthma, organic diseases such as left ventricular dysfunction, chronic obstructive pulmonary disease, and upper airway obstruction are most often considered, but the understanding of functional disease is insufficient. In fact, GINA guidelines suggested that the differential diagnosis in adult patients with suspected asthma needed to prioritize functional diseases such as dysfunctional breathing (DB)/hyperventilation syndrome (HVS) and vocal cord dysfunction (VCD), rather than organic disease. Here we review the concepts of DB and VCD and their differentiation from asthma.
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Affiliation(s)
- L X He
- Department of Respiratory and Critical Care Medicine, West China Hospital Sichuan University, Chengdu 610041, China
| | - C T Liu
- Department of Respiratory and Critical Care Medicine, West China Hospital Sichuan University, Chengdu 610041, China
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4
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He LX. [Debate on impact of restriction on antimicrobial use on antimicrobial resistance rate: explanation and deliberation]. Zhonghua Yi Xue Za Zhi 2022; 102:1487-1491. [PMID: 35692063 DOI: 10.3760/cma.j.cn112137-20210912-02077] [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
Antimicrobial resistance (AMR) is a rising public health crisis worldwide. Antimicrobial stewardship, which core is restriction on antimicrobial use to decline selective pressure of AMR, becomes main strategy for tackling AMR. But there are lots of debates about beneficial impact of restriction to antimicrobial use on AMR in recent years. One of the important reasons of the debate is defects on research methodology, especially there are no differentiation between hospital antibiogram and surveillance antibiogram, because the former is used as a reference of empirical antibiotic therapy, and only the latter is appropriate for evaluating factors affecting resistance, including antibiotic use. Once bacteria develop drug resistance, there are both the fitness costs resulting its loss of competitiveness in evolution and restoration of sensitivity to antibiotics, and mechanism of compensatory evolution which allows AMR to persist in bacteria. It is suggested that only by deeply studying the molecular genetics and evolutionary mechanism of drug-resistant bacteria can we find the fundamental way to overcome AMR. At present, we need to adhere to and improve the antimicrobial stewardship, develop new anti-bacterial agents and therapies, connect the Healthy China strategy with the great health concept advocated by WHO and other international organizations, learn from international experience to curb AMR, and promote coordinated and sustainable economic and social development.
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Affiliation(s)
- L X He
- Department of Respiratory and Critical care Medicine of Zhongshan Hospital, Fudan University, Shanghai 200032, China
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5
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Chen LA, She DY, Liang ZX, Liang LL, Chen RC, Ye F, Li YP, Zhou Y, Chen XH, Fang SF, Lai GX, Hu Q, Xie BS, Yao XJ, Shi Y, Su X, He LX, Zhou JY, Zhong SC, Zhang QL, Xiong SD, Qu JM, Tong ZH, Jiang SJ, Liu J, Xu F, He B, Li ER, Yuan YD, Zhang XY, Sun TY, Liu YN. [A prospective multi-center clinical investigation of HIV-negative pulmonary cryptococcosis in China]. Zhonghua Jie He He Hu Xi Za Zhi 2021; 44:14-27. [PMID: 33412620 DOI: 10.3760/cma.j.cn112147-20200122-00034] [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: 11/05/2022]
Abstract
Objective: To investigate the current status of the diagnosis and treatment of pulmonary cryptococcosis in respiratory medicine and improve the understanding of the clinical characteristics of HIV-negative pulmonary cryptococcosis in China. Methods: A prospective multi-center open cohort study was designed to screen for pulmonary cryptococcosis in the general wards and intensive care units of the Department of Respiratory Diseases in 22 hospitals. The HIV-negative patients with positive cryptococcal etiological diagnosis based on smear culture, antigen detection and histopathology were enrolled in the study. The clinical data of enrolled patients were collected and analyzed. Results: A total of 457 cases of pulmonary cryptococcosis were enrolled, among which 3.28% (15/457) were disseminated infections. The case fatality rate was 0.88% (4/457). The majority of the cases were diagnosed by histopathological examinations (74.40%, 340/457) and cryptococcus antigen detection (37.64%, 172/457). Patients with pulmonary cryptococcosis accounted for 2.04‰ (457/223 748) of the total hospitalized patients in the Department of Respiratory Diseases during the same period, and the ratio was the highest in south and east China. Meanwhile, 70.24% (321/457) of the patients had no underlying diseases, while 87.75% (401/457) were found to have immunocompetent status. Cough and expectoration were the most common clinical symptoms in patients with pulmonary cryptococcosis. However, 25.16% (115/457) of the patients had no clinical symptom or physical signs. In terms of imaging features on pulmonary CT, multiple pulmonary lesions were more common than isolated lesions, and there were more subpleural lesions than perihilar or medial lesions. Morphologically, most of the lesions were middle-sized nodules (1-5 cm) or small-sized nodules (3 mm to 1 cm). The sensitivity of serum cryptococcus antigen test was 71.99% (203/282). Moreover, antigen-positive patients differed from antigen-negative patients in terms of basic immune status, clinical symptoms, imaging features and infection types. Meanwhile, immunocompromised patients differed from immunocompetent patients in terms of clinical symptoms, physical signs, infection-related inflammation indicator levels, imaging features, serum cryptococcus antigen positive rate and prognosis. Conclusions: The majority of cases of HIV-negative pulmonary cryptococcosis in China had no underlying disease or immunocompromised status, and the overrall prognosis was favorable. However, early diagnosis of HIV-negative pulmonary cryptococcosis remains challenging due to the complicated manifestations of the disease.
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Affiliation(s)
- L A Chen
- Department of Pulmonary and Critical Care Medicine, the First Medical Center of General Hospital of Chinese People's Liberation Army, Beijing 100853, China
| | - D Y She
- Department of Pulmonary and Critical Care Medicine, the First Medical Center of General Hospital of Chinese People's Liberation Army, Beijing 100853, China
| | - Z X Liang
- Department of Pulmonary and Critical Care Medicine, the First Medical Center of General Hospital of Chinese People's Liberation Army, Beijing 100853, China
| | - L L Liang
- Department of Pulmonary and Critical Care Medicine, the First Medical Center of General Hospital of Chinese People's Liberation Army, Beijing 100853, China
| | - R C Chen
- Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - F Ye
- Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Y P Li
- Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000, China
| | - Y Zhou
- Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000, China
| | - X H Chen
- Department of Pulmonary and Critical Care Medicine, Fuzhou Pulmonary Hospital of Fujian, Fuzhou 350008, China
| | - S F Fang
- Department of Pulmonary and Critical Care Medicine, Fuzhou Pulmonary Hospital of Fujian, Fuzhou 350008, China
| | - G X Lai
- Department of Pulmonary and Critical Care Medicine, 900 Hospital of the Joint Logistics Team Support Force,Fuzhou 350025, China
| | - Q Hu
- Department of Pulmonary and Critical Care Medicine, 900 Hospital of the Joint Logistics Team Support Force,Fuzhou 350025, China
| | - B S Xie
- Department of Pulmonary and Critical Care Medicine, Fujian Provincial Hospital,Fuzhou 350001, China
| | - X J Yao
- Department of Pulmonary and Critical Care Medicine, Fujian Provincial Hospital,Fuzhou 350001, China
| | - Y Shi
- Department of Pulmonary and Critical Care Medicine, the General Hospital of Eastern Theater Command;,Nanjing 210002, China
| | - X Su
- Department of Pulmonary and Critical Care Medicine, the General Hospital of Eastern Theater Command;,Nanjing 210002, China
| | - L X He
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University,Shanghai 200032, China
| | - J Y Zhou
- Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - S C Zhong
- Department of Pulmonary and Critical Care Medicine, Longyan First Hospital,Longyan 364000, China
| | - Q L Zhang
- Department of Neurology Medicine, Jiangxi Chest Hospital,Nanchang 330006, China
| | - S D Xiong
- Department of Pulmonary and Critical Care Medicine, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - J M Qu
- Department of Pulmonary and Critical Care Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China
| | - Z H Tong
- Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University,Beijing 100020, China
| | - S J Jiang
- Department of Pulmonary and Critical Care Medicine, Shandong Provincial Hospital,Jinan 250021, China
| | - J Liu
- Department of Pulmonary and Critical Care Medicine, the Second Hospital of Jilin University, Changchun 130041, China
| | - F Xu
- Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Nanchang University,Nanchang 330006, China
| | - B He
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital,Beijing 100191, China
| | - E R Li
- Department of Pulmonary and Critical Care Medicine, the First Hospital of China Medical University,Shenyang 110001, China
| | - Y D Yuan
- Department of Pulmonary and Critical Care Medicine, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
| | - X Y Zhang
- Department of Pulmonary and Critical Care Medicine, Guzhou Provincial People's Hospital,Guiyang 550002, China
| | - T Y Sun
- Department of Pulmonary and Critical Care Medicine, Beijing Hospital,Beijing 100730, China
| | - Y N Liu
- Department of Pulmonary and Critical Care Medicine, the First Medical Center of General Hospital of Chinese People's Liberation Army, Beijing 100853, China
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He LX. [Return of non-fluorinated quinolones: a novel landmark in the developing history of quinolone antimicrobial agents]. Zhonghua Nei Ke Za Zhi 2020; 59:99-103. [PMID: 32074682 DOI: 10.3760/cma.j.issn.0578-1426.2020.02.003] [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)
- L X He
- Department of Respiratory and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China
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7
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He LX. [Optimized process flow of diagnosis and treatment of patient with pneumonia: staging assessment strategy]. Zhonghua Jie He He Hu Xi Za Zhi 2019; 42:884-887. [PMID: 31826530 DOI: 10.3760/cma.j.issn.1001-0939.2019.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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8
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Cai JH, Shen ZA, Sun TJ, Li DJ, Deng HP, Li DW, Liu ZX, Wang L, He LX. [Establishment of a method for repairing extremities with extensively deep burn using fresh allogeneic scalp and autologous microskin and observation of its effect]. Zhonghua Shao Shang Za Zhi 2019; 35:253-260. [PMID: 31060172 DOI: 10.3760/cma.j.issn.1009-2587.2019.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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 establish a method for repairing extremities with extensively deep burn using large piece of fresh allogeneic scalp spliced by Meek glue combined with autologous microskin and observe its effect. Methods: Medical records of two male patients with extremely extensive deep burn admitted to our hospital from May to November in 2018 were retrospectively analyzed. Two patients aged 44 and 25 years respectively, with total burn area of 90% and 97% total body surface area (TBSA) and full-thickness burn area of 85% and 70% TBSA, respectively. Preoperatively, the surgical area on the extremities was calculated to estimate the necessary amount of allogeneic scalp and Meek miniature skin. The large piece of fresh allogeneic scalp spliced by Meek glue combined with autologous microskin was prepared according to the methods described as follows. Thin medium-thickness fresh scalps with 3% TBSA and 0.30-0.35 mm in depth were harvested from each donor and spliced into a large piece with epidermis upward by spraying Meek glue. Then the spliced scalp was punched after covered with a single-layer gauze. Autologous microskin was transported onto the dermis of fresh large piece of allogeneic scalp by traditional floating method. Bilateral extremities with full-thickness burn of two patients were selected for self-control. The left upper extremity was denoted as treatment group while the right upper extremity was denoted as control group in Patient 1. The right lower extremity was denoted as treatment group while the left lower extremity was denoted as control group in Patient 2. Wounds in the treatment group were treated with fresh large piece of allogeneic scalp spliced by Meek glue and autologous microskin with expansion ratio of 1∶15 after escharectomy, while wounds in control group received grafting of Meek miniature skin with expansion ratio of 1∶6 and or 1∶9 after escharectomy. The donors of allogeneic scalp were 32 males who were the relatives or friends of the patients, aged 21-50 years, with scalp area of (548±48) cm(2). The healing conditions of donor sites of scalp were observed on post operation day 10, and were followed up within 3 months after operation to observe whether forming alopecia and hypertrophic scar or not. Wound healing condition was evaluated during follow-up in post operation week (POW) 2-5 and 4 months after operation. Wound coverage rates were calculated in both treatment and control groups in POW 2, 3, 4, and 5. Results: The donor sites of all allogeneic scalp of donors healed completely on post operation day 10. There was no alopecia or hypertrophic scar within 3 months after operation for follow-up. In POW 2, allogeneic scalp grafts basically survived in treatment group without obvious exudation, and most of the Meek miniature skin survived in control group with obvious exudation. Part of allogeneic scalp grafts dissolved and detached in treatment group in POW 3, and the surviving grafts scabbed. The eschar detached and new epithelium was observed in treatment group in POW 4 and 5. In POW 3-5, surviving Meek miniature skin in control group creeped and was incorporated, and the wounds shrank. Hypertrophic scar was observed in both treatment and control groups 4 months after operation, without obvious difference in scar as a whole. The wound coverage rates were respectively 84%-98% and 76%-92% in treatment group of two patients in POW 2-5, close to or higher than those of control group (35%-97% and 28%-81%, respectively). Conclusions: The study establishes a novel method for splicing fresh allogeneic scalps into a large piece as the covering of microskin, which has good effect for repairing extensively deep burn wounds. Considering that allogeneic skin is scarce, this method may be a new option in clinical treatment for extensively deep burn patients.
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Affiliation(s)
- J H Cai
- Department of Burns and Plastic Surgery, the Fourth Medical Center of PLA General Hospital, Beijing 100048, China
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He LX. [Antibiotic use and anbiotic stewardship for hospital acquired pneumonia and ventilator associated pneumonia]. Zhonghua Jie He He Hu Xi Za Zhi 2018; 41:247-249. [PMID: 29690681 DOI: 10.3760/cma.j.issn.1001-0939.2018.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Cai JH, Deng HP, Shen ZA, Sun TJ, Li DJ, Li DW, He LX, Wang L, Jin X. [Effects of scar excision combined with negative-pressure on repair of hypertrophic scar in burn children]. Zhonghua Shao Shang Za Zhi 2017; 33:410-414. [PMID: 28763906 DOI: 10.3760/cma.j.issn.1009-2587.2017.07.003] [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: 06/07/2023]
Abstract
Objective: To explore the effects of scar excision combined with negative-pressure on repair of hypertrophic scar in burn children. Methods: From October 2010 to August 2016, 25 children with hypertrophic scar after deep burn were hospitalized, with scar course ranging from 3 months to 11 years and scar area ranging from 35 to 427 [83(51, 98)]cm(2). A total of 35 scars of 25 children were located in trunk (11 scars), upper limb (11 scars), and lower limb (13 scars). All children received scar excision operation and negative-pressure treatment (negative-pressure value ranged from -40 to -20 kPa), among which 6 cases received scar excision operation and negative-pressure treatment for two times for further removal of scars. After scar excision, electronic spring scale was used to measure the tension of the incision. The tension value of children ranged from 3.43 to 23.84 [7.16 (5.59, 9.12)] N, and then the incision was closed with appropriate suture according to the value of the tension. The incision with smaller tension was firstly opened on post operation day (POD) 8. After removing the suture, negative-pressure was conducted to POD 14. The incision with larger tension was firstly opened on POD 12. After removing the suture, biological semi-membrane was used to reduce tension to POD 16. All healed incisions were performed with anti-scar treatment for 1 year and relaxation and fixation for 3 months. General condition of the incision was observed after operation. The reduction percentage of scar area was calculated half-year after operation. The Patient and Observer Scar Assessment Scale was used to record the overall score of scar and scar score of trunk, upper limb, and lower limb before operation and half-year after operation. Data were processed with paired t test and Wilcoxon rank sum test. Results: After removing the suture, all incisions of children healed well without redness, effusion, and rupture. Half-year after operation, the appearance and deformity of incision were obviously improved, and the symptoms including pruritus and pain were basically relieved. Half-year after operation, the scar area of children ranged from 0 to 174 [21(9, 47)]cm(2,) which was significantly decreased as compared with that before operation (Z=-5.16, P<0.05). The reduction percentage of scar area ranged from 36% to 100% [(73±19)%]. Half-year after operation, the overall score of scar and scar score of trunk, upper limb, and lower limb of children were obviously decreased as compared with those before operation (with t values from 6.42 to 17.37, P values below 0.05). Conclusions: Scar excision combined with negative-pressure treatment has a good clinical effect on repair of hypertrophic scar in burn children, which is suitable for clinical application.
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Affiliation(s)
- J H Cai
- Burns Institute, the First Hospital Affiliated to the PLA General Hospital, Beijing 100048, China
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11
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Wang T, Yu HT, Wang W, Pan YY, He LX, Wang ZY. Genetic polymorphisms of cytochrome P450 and glutathione S-transferase associated with antituberculosis drug-induced hepatotoxicity in Chinese tuberculosis patients. J Int Med Res 2010; 38:977-86. [PMID: 20819434 DOI: 10.1177/147323001003800324] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study was designed to investigate the association of genetic polymorphisms of cytochrome P450 subtype 2E1 (CYP2E1) and glutathione S-transferase mu 1 (GSTM1) with susceptibility to antituberculosis drug-induced hepatotoxicity (ADIH) in Chinese tuberculosis patients. All patients were treated with a combination of isoniazid, rifampicin, pyrazinamide and ethambutol. Genomic DNA from 104 patients with ADIH and 111 without ADIH was analysed for the frequency of CYP2E1 RsaI and GSTM1 RsaI genotypes by polymerase chain reaction and restriction fragment length polymorphism. The association of polymorphisms with susceptibility to ADIH was calculated using the chi(2)-test and logistic regression analysis. The CYP2E1 RsaI polymorphisms were significantly associated with ADIH and the c1/c1 genotype was an independent risk factor for ADIH. Compared with the GSTM1 RsaI present genotype, the GSTM1 RsaI null genotype tended to increase susceptibility to ADIH, but the association with ADIH was not significant. The results indicate that CYP2E1 RsaI genotype c1/c1 is a potential risk factor for ADIH in the Chinese population. The tendency of the GSTM1 RsaI null genotype to increase susceptibility to ADIH needs further study.
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Affiliation(s)
- T Wang
- Tuberculosis Research Institute, 309 Hospital of the People's Liberation Army, Beijing, China
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He LX, Luo FM, Shao S. Tubal pregnancy may progress to term if it is converted to abdominal pregnancy by salpingostomy. Med Hypotheses 2010; 75:137-8. [PMID: 20378260 DOI: 10.1016/j.mehy.2010.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2010] [Revised: 03/09/2010] [Accepted: 03/13/2010] [Indexed: 11/24/2022]
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13
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Liu B, He LX, Qu JM, Hu BJ, Wang BQ, Li XY. [Immune response in Pneumocystis carinii pneumonia in rats]. Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi 2003; 18:40-2. [PMID: 12567474] [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: 02/28/2023]
Abstract
OBJECTIVE To study the inflammatory immune response to Pneumocystis canii pneumonia(PCP) in rats induced by glucocorticoid(GC). METHODS The model of PCP was set up by injecting GC subcutanously to SD rats. Lymphocyte proportion in peripheral blood, CD4+/CD8+ T cell ratio of PBL and lymphocyte proportion in the BALF were measured. The levels of sIL-2R and TNF-alpha in the BALF were detected. RESULTS 1. After the rats were immunospressed, the lymphocyte proportion in the peripheral blood and CD4+/CD8+ ratio of PBL, and the lymphocyte proportion in the BALF were decreased, and the levels of sIL-2R, TNF-alpha in BALF were reduced. 2. The lowest levels of TNF-alpha in BALF and CD4+/CD8+ T cells of PBL were observed in PCP group; 3. The lymphocyte proportion in the BALF was significantly higher in PCP group than in PC negative group. CONCLUSION The reduction in the level of TNF-alpha and CD4+/CD8+ T cell ratio in rats treated with GC might result in PCP infection under immunosuppressive condition.
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Affiliation(s)
- B Liu
- Department of Respiratory, Renji Hospital, Shanghai Second Medical University, Shanghai 200001
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Abstract
In a group of eight burn patients with a mean of 65.3 +/- 17.4 per cent TBSA burn injury (range 50-90 per cent TBSA), accompanied by a mean of 43.5 +/- 18.9 per cent TBSA full-thickness injury, it was shown that the evidence of global hypovolaemia had disappeared at 12 h after the injury following aggressive fluid resuscitation, while there was still a subnormal pHi of stomach at 48 h. As a prolonged period of inadequacy of oxygen delivery to the intestine might result in impairment of the intestinal mucosal barrier function, and then endogenous endotoxaemia might ensue, it seems to be important to correct intestinal hypoxia as early as possible. Since the inadequate perfusion to the gut wall is due to selective vasoconstriction of the mesenteric vasculature, logic dictates that the use of a vasodilator is in order. Anisodamine, an anticholinergic drug, was then given in six burn patients with comparable burn size and amount of fluid replenishment with the eight patients in the control group. It was clearly demonstrated that gastric pHi returned to normal before 48 h after injury. Plasma endotoxin and TNF contents were measured, and they were significantly lower than control values after 72 h. In conclusion, it is believed that anisodamine might be a valuable adjunct to the resuscitation regime of burn shock, and, therefore, a promising drug to abate endogenous endotoxaemia subsequent to splanchnic vasoconstriction due to hypovolaemia. The shortcomings of the drug were a mild abdominal distention and tachycardia after its administration.
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Affiliation(s)
- C Y Sheng
- Burn Center, 304th Hospital, Beijing, People's Republic of China
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15
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Qu JM, He LX, Hu BJ. [Uncomplicated bronchial tuberculosis]. Zhonghua Jie He He Hu Xi Za Zhi 1993; 16:350-1, 375. [PMID: 8033233] [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: 01/28/2023]
Abstract
Thirty four cases of uncomplicated bronchial tuberculosis proved by fiberobronchoscopy (FB) and operation in recent ten years were reported. The total diagnostic yield of FB was 85.6%. The preliminary results revealed some new characteristics of uncomplicated bronchial tuberculosis during antituberculosis chemotherapy era: uncomplicated bronchial tuberculosis accounted for great proportion among bronchial tuberculosis; the involvement of middle and lower bronchi was more common; positive rate of sputum smear for AFB was low. Among the fibrobron choscopic manifestations, the percentage of proliferative lesions in bronchi was high.
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Affiliation(s)
- J M Qu
- Department of Pulmonary Medicine, Zhongshan Hospital, Shanghai Medical University
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He LX, Lograsso T, Goldman AI. Twinned one-dimensional quasicrystals in Bridgman-grown Al-Si-Cu-Co alloys. Phys Rev B Condens Matter 1992; 46:115-119. [PMID: 10002188 DOI: 10.1103/physrevb.46.115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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17
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He LX. [Diagnosis of pulmonary infections by specific etiologic agents in secondary immunocompromised patients]. Zhonghua Jie He He Hu Xi Za Zhi 1991; 14:289-91, 320. [PMID: 1668066] [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: 12/28/2022]
Abstract
Ten cases of pulmonary infections by the specific etiologic agents in immunocompromised patients secondary to diseases and/or drugs were reported. Their infections included 5 tuberculosis, 4 pulmonary aspergillosis, 1 Pneumocystis Carinii and cytomegalovirus pneumonia. The early revelation of pulmonary abnormality, the sampling of non-contaminated diagnostic materials, the improvement of laboratory techniques, and a feasible scheme of clinical management for pulmonary infections in immunocompromised patient were discussed.
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Affiliation(s)
- L X He
- Department of Pulmonary Medicine, Zhongshan Hospital, Shanghai Medical University
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Zhai JM, He LX, Li XY. [Advances in the diagnosis Pneumocystis carinii pneumonia]. Zhonghua Jie He He Hu Xi Za Zhi 1991; 14:236-8. [PMID: 1802443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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19
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He LX. [Differential diagnosis between tuberculosis and cancer of lung. Analysis of 65 tuberculosis cases diagnosed by fiber-bronchoscopy]. Zhonghua Jie He He Hu Xi Za Zhi 1991; 14:69-70, 125. [PMID: 1879017] [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: 12/29/2022]
Abstract
A series of 65 broncho-pulmonary TB simulating lung cancer with negative AFB in sputum were diagnosed by fiber-bronchoscopy. 60% of the cases were at the age of forty and over. According to the radiographic features, they could be divided into 3 varieties: (1) 31 cases showed mass or nodal shadow. 7 of the 11 cases with cavities mimicked cancer origin in appearance. (2) 30 cases showed atelectasis and segmental shadows with 16 cases in nonpredisposing location of TB. (3) 4 cases with diffuse interstitial and micronodular shadows were different from miliary TB. Of a total of 65 cases, 7 accompanied with hilar/mediastinum adenopathy. Using fiber-bronchoscopy, bronchial lesions were found in 24 cases (36.9%). TB diagnosed by pathological and bacteriological examination were 89.2% and 32.2% respectively. TB combined with squamous cell cancer of the lung was found in one patient. These data indicated that TBB and TBLB provided an effective method in the differential diagnosis of TB and cancer of lung.
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Affiliation(s)
- L X He
- Zhongshan Hospital, Shanghai Medical University
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Wang QY, Huang DZ, He LX. [Hepatitis D virus RNA in serum from patients with hepatitis B]. Zhonghua Nei Ke Za Zhi 1990; 29:332-5, 381. [PMID: 2269030] [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: 12/31/2022]
Abstract
To clarify the correlation of hepatitis D virus (HDV) infection and viral replication in liver diseases, the authors detected HDV RNA and serological HDV markers in serum from 285 patients with hepatitis B and 45 asymptomatic carriers of HBsAg. With dot blot hybridization, serum HDV RNA was detected in 8.8% (29/330) of the patients with HBV infection. The positive rate of HDV RNA in fulminant hepatitis was higher than that in benign hepatitis (15/74 vs 3/47, P less than 0.05). 10 of the 139 patients with chronic active hepatitis and 1 of the 6 cases with cirrhosis were positive for HDV RNA. However, all of the 19 cases with chronic persistent hepatitis and 45 asymptomatic carriers of HBsAg were negative fo, HDV RNA. Serological HDV markers, HDAgr anti-HD and IgM-anti-HD, were determined with ELISA. HDV RNA was detected in all of the serum samples with positive HDAg and/or IgM-anti-HD, in 15 of the 26 cases with positive-anti-HD and in 8 cases without HDV markers. Our results showed that 40 of the 330 patients with HBsAg were infected by HDV. This investigation suggests that HDV is one of the etiological factors for fulminant hepatitis and chronic active hepatitis.
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Affiliation(s)
- Q Y Wang
- Beijing second Infectious Diseases Hospital
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Shu-yuan L, Xue-mei W, Li L, Dian-lin Z, He LX, Kuo KX. Anisotropic transport properties of a stable two-dimensional quasicrystal: Al62Si3Cu20Co15. Phys Rev B Condens Matter 1990; 41:9625-9627. [PMID: 9993333 DOI: 10.1103/physrevb.41.9625] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Dian-lin Z, Li L, Xue-mei W, Shu-yuan L, He LX, Kuo KH. Hall effect in a single two-dimensional quasicrystal: Al62Si3Cu20Co15. Phys Rev B Condens Matter 1990; 41:8557-8559. [PMID: 9993190 DOI: 10.1103/physrevb.41.8557] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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23
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He LX, Martin KP, Higgins RJ. Erratum: Phonon-assisted tunneling in persistent-photocurrent decay. Phys Rev B Condens Matter 1989; 40:9977. [PMID: 9991530 DOI: 10.1103/physrevb.40.9977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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24
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He LX, Martin KP, Higgins RJ. Phonon-assisted tunneling in persistent-photocurrent decay. Phys Rev B Condens Matter 1989; 39:13276-13285. [PMID: 9948228 DOI: 10.1103/physrevb.39.13276] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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25
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He LX, Martin KP, Higgins RJ. Infrared quenching of persistent photoconductivity in GaAs/AlxGa1-xAs heterostructures. Phys Rev B Condens Matter 1989; 39:1808-1818. [PMID: 9948397 DOI: 10.1103/physrevb.39.1808] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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He LX. [Selective bronchial arteriography and embolization in the diagnosis and treatment of massive hemoptysis]. Zhonghua Yi Xue Za Zhi 1987; 67:590-2, 34, 37. [PMID: 3129153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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28
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He LX, Martin KP, Higgins RJ. Persistent photocurrent decay mechanisms by capture of photoelectrons in GaAs-AlxGa1-xAs heterostructures. Phys Rev B Condens Matter 1987; 36:6508-6519. [PMID: 9942361 DOI: 10.1103/physrevb.36.6508] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
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29
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He LX, Li XY. [Evaluation of the bacteriological diagnosis of lower respiratory tract infections]. Zhonghua Jie He He Hu Xi Za Zhi 1987; 10:183-6. [PMID: 3329578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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30
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Jia WX, Mu JW, Cai MY, He LX, Jiang DX, Wang DR, Li MY, Yang SB, Lei YD, Chen ZP. [Studies on the distribution of HBV infection in voluntary blood donors]. Hua Xi Yi Ke Da Xue Xue Bao 1986; 17:277-9. [PMID: 3570261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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31
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Zhang J, He LX. [Determination of the structures of versicolactone B and versicolactone C in the root of Aristolochia versicolar S.M.Hwang]. Yao Xue Xue Bao 1986; 21:273-8. [PMID: 3788595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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32
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He LX. [A study on the diagnosis of the hematogenous disseminated pulmonary tuberculosis: an analysis of 35 cases with delayed diagnosis (author's transl)]. Zhonghua Jie He He Hu Xi Xi Ji Bing Za Zhi 1980; 3:31-34. [PMID: 7428574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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