Objective To sum up experiences in diagnosis and treatment for Hashimoto′s disease (HD). Methods Clinical records of 78 patients who underwent operations and were diagnosed as Hashimoto′s disease by histologic examination in our hospital from Jan. 1988 to Dec. 1998 were analyzed. Results Seventy females and 8 males, aged 9 to 70 years (average of 41.6 years). HD was coexistent with 10.3% of thyroid gland malignant tumor, 23.1% of adenoma and 30.8% of other thhroid gland diseases. The misdiagnosis rate was 35.9% and missed diagnosis rate was 46.2%. The clinical feature of HD and most common cause of misdiagnosis and missed diagnosis have been discussed. Conclusion It is emphasized that patients with diffuse goiter, palpable nodules, lighty color on scintillation scintigraphy, elevation of antimicosomiaux and antithyroglobuline but no finding on Bus should be highly suspected of having Hashimoto′s disease.
ObjectiveTo investigate the effect of interleukin (IL)-23 receptor (IL-23R) overexpression on the balance of T helper 17 (Th17 cells)/regulatory T cells (Treg cells) in experimental autoimmune uveitis (EAU) mice. MethodsTwelve 8-week-old female C57BL/6J mice were randomly divided into LV-Ctrl group and LV-IL-23R group, with 6 mice in each group. Two groups of mice were injected with LV-Ctrl and LV-IL-23Rlentiviruses through the tail vein, respectively; 7 days after injection, the EAU mouse model was established by active immunization with vitamin A-binding protein 1-20 between photoreceptors. Starting from 13 days after immunization, the fundus of the mice was observed by indirect ophthalmoscopy every 2 days and clinical scores were performed; 30 days after immunization, hematoxylin-eosin staining was used to observe the histopathological changes of mouse retina. The levels of IL-17 in serum of the two groups of mice were detected by enzyme-linked immunosorbent assay; the proportion of Th17 cells and Treg cells was detected by flow cytometry. The relative mRNA expression of IL-23R, IL-17, retinoic acid-related orphan receptor γt (RORγt), IL-10 and forkhead transcripyion factor p3 (Foxp3) were detected by real-time quantitative polymerase chain reaction. Comparisons between groups were performed using repeated measures analysis of variance, independent samples Mann-Whitney U test, and independent samples t test. ResultsCompared with the LV-Ctrlgroup, the retinal inflammatory reaction of the LV-IL-23R group was more severe. At 13 days after immunization, there was no significant difference in fundus inflammation scores between LV-IL-23R group and LV-Ctrl group (t=－2.001, P=0.058); 15-29 days after immunization. The fundus inflammation scores of LV-IL-23Rgroup were higher than those of LV-Ctrl group, and the difference was statistically significant (t=－4.429, －6.578, －7.768, －10.183, －6.325, －7.304, －4.841, －6.872; P＜0.001). Histopathological examination showed that the infiltration of inflammatory cells in the fundus increased, the retinal structure was damaged more seriously, and the histopathological score was significantly increased, and the difference was statistically significant (t=－4.339, P=0.001). Compared with the LV-Ctrl group, the relative expression of IL-23RmRNA in the spleen of the LV-IL-23R group was significantly increased, and the difference was statistically significant (Z=2.087, P=0.037). The relative expression of IL-17 and RORγt mRNA increased, while the relative expression of IL-10 and Foxp3 mRNA decreased, and the differences were statistically significant (t=－6.313,－5.922, 4.844, 7.572; P=0.003, 0.004, 0.008, 0.002). Compared with the LV-Ctrl group, the level of IL-17 in the serum of the mice in the LV-IL-23R group was significantly increased, and the difference was statistically significant (t=－5.423, P=0.002); the proportion of Th17 cells in the spleen and lymph nodes was significantly increased, whereas, the proportion of Treg cells was significantly reduced, and the difference was statistically significant (t=－4.290, 3.700; P=0.002, 0.006). ConclusionIL-23R overexpression can promote Th17/Treg imbalance in EAU mice, and aggravate the clinical and pathological manifestations of EAU.
Objective To explore the association between the preoperative systemic immune-inflammation index (SII) and prognosis in non-small cell lung cancer (NSCLC) patients. Methods A comprehensive literature survey was performed on PubMed, Web of Science, EMbase, The Cochrane Library, Wanfang, and CNKI databases to search the related studies from inception to December 2021. The hazard ratio (HR) and 95% confidence interval (CI) were combined to evaluate the correlation of the preoperative SII with overall survival (OS), disease-free survival (DFS), and recurrence-free survival (RFS) in NSCLC patients. Results A total of 11 studies involving 9 180 patients were eventually included. The combined analysis showed that high SII levels were significantly associated with worse OS (HR=1.61, 95%CI 1.36-1.90, P<0.001), DFS (HR=1.50, 95%CI 1.34-1.68, P<0.001), and RFS (HR=1.17, 95%CI 1.04-1.33, P<0.001). Subgroup analyses also further verified the above results. Conclusion Preoperative SII is a powerful prognostic biomarker for predicting outcome in patients with operable NSCLC and contribute to prognosis evaluation and treatment strategy formulation. However, more well-designed and prospective studies are warranted to verify our findings.
Objective To investigate the application effect of LEER (less pain, early move, early eat, and reassuring) mode in laparoscopic pancreaticoduodenectomy (LPD). Methods The clinical data of patients who underwent LPD in our hospital from March 2020 to March 2022 were retrospectively analyzed. Forty patients treated with the traditional mode during the perioperative period were classified as the traditional group, and 47 patients treated with the LEER mode were classified as the LEER group. The perioperative indicators, inflammatory stress indicators, immune indicators, nutritional indicators and postoperative complications were compared between the two groups. Results The visual analogue scale (VAS) score and hospitalization cost of the LEER group were lower than those of the traditional group (P<0.05). The postoperative ambulation time, anal exhaust/defecation time, drainage tube removal time, time to normal diet and hospital stay in the LEER group were shorter than those of the traditional group (P<0.05). Compared with preoperative, the WBC count and C-reactive protein (CRP) level of patients in the two groups increased after operation, but the changes of WBC count and CRP level in the LEER group were smaller than those in the traditional group (P<0.05). The IgA, IgM and IgG levels of patients in the two groups were not statistically different before and after operation (P>0.05), and the postoperative IgA, IgM and IgG of patients in the LEER group were higher than those in the traditional group (P<0.05). The change values of IgM and IgG in the LEER group were smaller than those of the traditional group (P<0.05), but there was no statistical difference in the change value of IgA between the two groups before and after operation (P>0.05). Compared with preoperative value, postoperative prealbumin (PA) and lymphocyte (LYM) levels in the two groups were decreased (P<0.05). The postoperative PA and LYM levels in the LEER group were higher than those in the traditional group (P<0.05). but the change value of PA before and after operation in the LEER group was smaller than that in the traditional group (P<0.05). There was no statistical difference in the change of LYM between the two groups before and after operation (P>0.05). The incidence of postoperative complications in the LEER group was 8.5% (4/47), and that in the traditional group was 35.0% (14/40). The incidence of postoperative complication in the LEER group was significantly lower than that in the traditional group (P=0.002). Conclusion Applying LEER mode in LPD can promote postoperative recovery of the patients, reduce postoperative stress response, improve nutritional status and protect immunity in the patients.
Objective To explore the role of high endothelial venule (HEV) in chronic obstructive pulmonary disease (COPD) at the single cell level. Methods A total of 219257 cells from the lung tissues of 18 COPD patients and 28 healthy controls in the GEO public database (GSE136831) were used to analyze the relationship between HEV with T lymphocytes, B lymphocytes, and dendritic cells. Results Endothelial cells were extracted using single cell analysis technique, and sorting out venous endothelium, CCL14, IGFBP7, POSTN were used as marker genes for HEV endothelial cells. The ratio of HEV endothelial cells was also identified as up-regulated expression in COPD. The function of the differential genes of HEV endothelial cells was analyzed, suggesting the presence of immune regulation. By trajectory analysis, it was suggested that the differential genes of HEV endothelial cells were enriched for extracellular matrix deposition in late development. Finally, by receptor-ligand pairing, it was suggested that HEV endothelial cells was recruited through a series of ligands with T lymphocytes, B lymphocytes, and dendritic cells. Conclusions HEV endothelial cells are elevated in COPD and have an immunomodulatory role by secreting a series of ligands after recruiting T lymphocytes, B lymphocytes as well as dendritic cells for immune action. HEV may be a potential target for the study of COPD therapy.
摘要:目的: 探討兒童慢性淋巴細胞性甲狀腺炎的臨床特點、診斷方法、治療及預后。 方法 : 對77例CLT患兒的臨床資料進行回顧性分析。 結果 : 77例CLT患兒男女比例1:67,平均年齡1021±233歲(5～15歲)。86％患兒有甲狀腺腫大;初診時表現甲亢患兒51例,甲低20例,甲功正常6例; TGAb陽性率的94％,TPOAb陽性率96％;1例甲狀腺細針吸取細胞學檢查診斷合并甲狀腺乳頭狀癌。治療隨訪1～39月,77例患兒中出現甲低37例。 結論 : 兒童CLT多見于青春期女性,兒童和青春期患者病初表現甲亢較成人多見,TGAb 和TPOAb是CLT診斷的重要指標,隨著病程延長,表現甲低患兒比例逐漸增高。Abstract: Objective: To study the clinical feature, diagnosis, treatment and prognosis of Chronic lymphocytic thyroiditis in children. Methods : Analyze the clinical data of 77 children with Chronic lymphocytic thyroiditis. Results : The proportion of men to women was 1:67 in all 77 children, and the mean age at diagnosis was 1021±233(age range 5~15 years). The percentage of positive TGAb and TPOAb were 94% and 96%, respectively in all the 77 children. One children was diagnosed Chronic lymphocytic thyroiditis coexistent with thyroid papillary carcinoma by FNAB. There were 37 children had hypothyrodism in all the 77 after 1～39 months. Conclusion : CLT is more frequent in females, and at the time of diagnosis more children and adolescents had hypethyrodism than adults. TGAb and TPOAb are important markers for the diagnosis of CLT. The percentage of children had hypothyrodism is increasing along with the course of disease.
ObjectivesTo evaluate the effects of short message service (SMS) intervention for improving antiretroviral treatment adherence in HIV patients by meta-analysis.MethodsDatabases including PubMed, EMbase, CINAHL, Web of Science, ScienceDirect, The Cochrane Library, CNKI, WanFang Data, VIP and CBM were searched electronically from January 2000 to December 2018 to collect randomized controlled trials (RCTs) on the efficacy of SMS intervention on HIV patients. Two reviewers independently screened literature, extracted data, and assessed risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software.ResultsA total of 10 RCTs with 2 411 patients were included. The meta-analysis showed that SMS intervention could improve significantly treatment adherence of HIV patients (RR=1.11, 95%CI 1.03 to 1.20, P<0.01). The subgroup analysis showed that weekly texting had an effect on treatment adherence (RR=1.15, 95%CI 1.00 to 1.33, P<0.05); personal sending (RR=1.17, 95%CI 0.99 to 1.38, P=0.06) and daily sending (RR=1.02, 95%CI 0.83 to 1.26, P=0.84) of SMS had no statistical significance on treatment adherence; the intervention duration of 6 months (RR=1.11, 95%CI 1.00 to 1.23, P=0.05) could improve the treatment adherence, while the intervention duration of 12 months (RR=1.07, 95%CI 0.98 to 1.17, P=0.13) had no statistical difference on treatment adherence; there was no statistical difference in CD4+ cell count before and after treatment (WMD=4.18, 95%CI ?39.33 to 47.69, P=0.85).ConclusionsBy comparing SMS intervention with routine nursing, sending SMS weekly for 6 months to remind HIV patients to take medicine can improve treatment adherence. Due to the limitation of quantity and quality of the included studies, the above conclusions are required to be assessed by more high-quality studies.
Objective
To summarize the clinical characteristics of interstitial pneumonia with autoimmune features (IPAF).
Methods
The interstitial lung disease (ILD) patients diagnosed in our department between January 2010 and August 2013 were retrospectively analyzed to screen out the patients with IPAF.The clinical manifestations, laboratory examination, imaging, pulmonary function and treatment were summarized.
Results
In 254 ILD patients, 25 patients met the diagnosis criteria of IPAF, and 26 patients were diagnosed with definite connective tissue diseases associated ILD (DCTD-ILD). There were differences in arthralgia, sicca symptoms, mechanic’s hand, positive antinuclear antibodies, anti-CCP antibodies and residual lung volume between the IPAF patients and the DCTD-ILD patients (all P < 0. 05). Five IPAF patients were revealed hug or “pancake” the diaphragm in their chest high resolution CT radiographs. The microscopic performance showed that diffuse thickened with collagen fiber, alveolar wall thickening with marked interstitial lymphocyte inflammatory cells infiltration, and granulation tissue that filled bronchiolar lumina. The patients were pathologically diagnosed with nonspecific interstitial pneumonia (NSIP) overlap organized pneumonia (OP). During following-up, the progression-free survival time of the IPAF patients was significant longer and that of the DCTD-ILD patients [(14.32±5.74)months vs. (10. 31± 3. 70) months, P < 0. 05].
Conclusions
If an ILD patient has mechanic’s hand, positive antinuclear antibodies or NISP overlap OP in image, the diagnosis of IPAF should be considered. IPAF have slower disease progression and better prognosis than DCTD-ILD.
Abstract: Objective To investigate the influence of cardiopul monary bypass(CPB) to the cellular immune function of T lymphocyte. Me th ods Among 500 patients operated from March 2006 to September 2006，30 patients with rheumatic heart disease were selected randomly as the CPB group, which would replace mitral valve; 30 patients with congenital patent ductus arte reriosus as the nonCPB group, which would ligate ductus arteriosus without CPB . The blood was sampled before operation, at the end of CPB or operation, and 24 hours after operation. After T lymphocyte was seperated, the quantum o f T lymphocyte, apoptosis of T lymphocyte, ability of T lymphocyte to kill tumou r cell were measured. Results The quantum of T lymphocyte i n CPB group at the end of CPB was decreased than that before operation （50.9% ±6.8% vs. 58.5%± 9.1%,Plt;0.05）; apoptosis of T lymphocyte at the end of CPB and 24 hou rs after operation were increased than that before operation （6.5%±2.2% vs. 0. 9%±1.1%, 5.6%±1.8% vs. 0.9%±1.1%;Plt;0.01）; ability to kill tumour cell b reakdown in CPB group at the end of CPB and 24 hours after operation was decrea sed than that before operation （30.4%±6.0% vs. 37.3%±8.6%, 29.0%±4.9% vs . 37 .3%±8.6%;Plt;0.05）. Ability to kill tumour cell breakdown in CPB group was lower than that in nonCPB group at the end of CPB （30.4%±6.0% vs. 33.6%±5. 3%, Plt;0.05）. Conclusion CPB can depress the cellular im mune function,which causes temporary immune depression to the body.
ObjectivesTo systematically review the efficacy of Bailing capsule for autoimmune antibodies in Hashimoto thyroiditis (HT).MethodsPubMed, EMbase, The Cochrane Library, CBM, WanFang Data and CNKI databases were electronically searched to collect the randomized controlled trials (RCTs) on Bailing capsule in treatment of HT from inception to January 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 7 RCTs involving 428 patients were included. The results of meta-analysis showed that the changes of TGAb and TPOAb in Bailing capsule combined with Euthyrox group were higher than that in control group (MD=?228.91, 95%CI ?398.61 to ?59.20, P=0.008; MD=?158.19, 95%CI ?222.44 to ?93.94, P<0.000 01); the changes of TGAb and TPOAb in Bailing capsule combined with Iodine modification diet group were higher than that in control group(MD=?499.27, 95%CI ?540.39 to ?458.15, P<0.000 01; MD=?407.37, 95%CI ?448.60 to ?366.14, P<0.000 01).ConclusionsCurrent evidence shows that Bailing capsule combined with other therapies can decrease the levels of TGAb and TPOAb in HT patients. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusion.
