About 40% of IgG4-related disease (IgG4-RD) patients face recurrence, severely impacting their quality of life. We aimed to explore the characteristics of the perception of recurrence risk in patients with IgG4-RD. A qualitative study design with a descriptive phenomenological approach was used. Fourteen patients with IgG4-RD were recruited via purposive sampling, including six patients with first onset and eight patients experiencing recurrence. Semi-structured interviews were conducted to collect data, and transcripts were analysed by two independent researchers using Colaizzi's descriptive analysis framework. The COREQ checklist was followed. Data analysis identified nine subthemes falling into four themes: (a) perception of differential susceptibility to recurrence; (b) perception of crucial recurrence risk factors; (c) perception of recurrence warning signs and medical behaviours; (d) perception of multiple recurrence outcomes. We found that susceptibility perception formed the basis of recurrence risk perception. For patients with first onset, the main manifestations were misconception or evasion of the risk of recurrence, whereas patients experienced recurrence demonstrated a clear perception of recurrence risk and feelings of fear. Based on this, other themes emerged. Since the absence of accurate knowledge related to recurrence, the perception of recurrence risk in patients with IgG4-RD primarily manifested as misconception, evasion or feeling fear. Ultimately, they couldn't take appropriate actions to prevent recurrence. Healthcare professionals should develop comprehensive interventions for patients with IgG4-RD, integrating health education, disease consultation and psychological support, with the aim of enhancing awareness of recurrence risk and empowering them to manage their conditions in the long term.
Objective
To investigate the value of susceptibility weighted imaging (SWI) with T1ρ imaging in staging of hepatic fibrosis(HF) in rabbits.
Methods
Eighty selected white rabbits from New Zealand were randomly divided into the HF group (n=60) and the control group (n=20). Rabbits in the HF group were injected subcutaneously with 50% CCl4 oil solution to establish HF model,and the normal control rabbits were injected with saline solution subcutaneously.The HF group(n=15) and control group(n=5) were randomly selected at the 4th, 5th, 6th and 10th week after injection, to undergo liver MR scan. The liver signal intensity (SI liver), the muscle signal intensity (SI muscle),liver-to-muscle SI ratios (SIR) and liver T1ρ values were measured. Scheuer was adopted to stage the rabbits in HF.One-way analysis of variance was used to compare the differences between SIR and T1ρ values in different stages of HF pathological. Spearman correlation was used to analyze the correlation between SIR and T1ρ values in the different stage of HF pathological.The ROC were used to compare the efficacy between SIR and T1ρ values in the diagnosis of HF pathological stage.
Results
Among the final qualified 68 rabbits in the study, 17 in F0 phase, 11 in F1 phase, 16 in F2 phase, 11 in F3 phase, and 13 in F4 phase. The SIR were (0.977±0.013), (0.960±0.015), (0.802±0.026), (0.786±0.022), (0.541±0.116); T1ρ values were (22.301±1.849), (24.034±0.867), (25.374±1.309),(25.364±1.945),(30.948±2.925) ms.There were statistically significant in SIR between F0 and F2,F0 and F3,F0 and F4,F1 and F2,F1 and F3,F1 and F4,F2 and F4,F3 and F4 (P 0.966) ,and the AUC of the SIR was greater than T1ρ values in the other groups.
Conclusion
SWI and T1ρ values can provide an important objective basis in staging of HF. Both of them have great clinical application prospects but SIR diagnostic efficiency is slightly better than that of T1ρ values.
Key words:
Magnetic resonance imaging; Hepatic fibrosis; Magnetic susceptibility weighted imaging; T1ρrelaxation
Background As an X-linked recessive way, arginine vasopressin receptor 2 ( AVPR2) gene mutation resulted in a hereditary disease — congenital nephrogenic diabetes insipidus (CNDI). We found a suspect clinical CNDI pedigree. In order to identify the genetic etiology, we performed the genetic analysis. Methods The clinical features of the proband and his family members were recorded. The laboratory tests and imaging inspections were analyzed. The water deprivation and pituitrin loading test were performed in the proband and his brother. The genomic DNA of all the members of the pedigree was extracted and then PCR amplification on AVPR2 gene was carried out. Sequencing in both directions was performed to identify mutation on AVPR2 gene. Results Both the proband and his brother were diagnosed as CNDI, meanwhile the other members of this pedigree were normal. No severe biochemical abnormality was found in the two CNDI patients. Both the patients had moderate urinary retention, severe megaloureter and hydronephrosis, and mild renal insufficiency. Two mutations of AVPR2 gene were discovered in the 3rd exon in the patients, a silent mutation L309L and a nonsense mutation R337X. The AVPR2 gene R337X mutation was co-segregated with CNDI. R337X mutation was not a reported mutation in the mainland of China. Conclusion The AVPR2 gene R337X mutation was also a genetic etiology of CNDI patients in the mainland of China.
Acinetobacter baumannii is a major pathogen of nosocomial meningitis and ventriculitis. Due to very limited antibiotic treatment options, polymyxins are often used as a last-line therapy. To optimise polymyxin use in the intraventricular environment, cerebrospinal fluid (CSF) proteomics was employed to investigate host-pathogen-polymyxin interactions in a 69-year-old patient with multidrug-resistant A. baumannii ventriculitis treated with a combination of intrathecal (ITH; 50,000 IU q24h/q48h), intraventricular (IVT; 50,000 IU q48h), and intravenous (500,000 IU, q12h) polymyxin B. CSF was collected before the first ITH dose in the ICU (0 h) and at 24 h, Day 7 and Day 26. The proteome was quantified at each time point and proteins with Qvalue <0.05 and fold change >1.2 were considered differentially expressed. Within 24 h of ITH/IVT polymyxin B administration, the innate immune system and neuroimmunity were highly active, evidenced by up-regulation of various pathways related to pathogen invasion, endocytosis and neutrophil degranulation. Blood-brain barrier impairment had worsened at 24 h but signs of repair were evident on Day 7 and Day 26. This is the first CSF proteomic study with polymyxins. Our findings provide critical mechanistic insights into optimizing ITH/IVT polymyxin administration.
A proper dietary electrolyte balance (dEB) is essential to ensure optimal growth performance of piglets. In the low-protein diet, this balance may be affected by the reduction of soybean meal and the inclusion of high levels of synthetic amino acids. The objective of this experiment was to evaluate the optimal dEB of low-protein diets and its impact on the growth performance of piglets. A total of 108 piglets (35 days old) were randomly divided into 3 groups with 6 replicates of 6 pigs each: Low electrolyte diet (dEB = 150 mEq/kg; LE); Medium electrolyte diet (dEB = 250 mEq/kg; ME); High electrolyte diet (dEB = 350 mEq/kg; HE). Results indicated that the LE and HE diets significantly decreased the average daily gain (ADG), the ratio of weight gain to feed intake (G: F), and crude protein (CP) digestibility in piglets. Meanwhile, LE diets disrupted the structural integrity of the piglets' intestines and decreased jejunal tight junction protein (Occludin and Claudin-1) expression. Additionally, the pH and HCO3− of piglets in the LE group were lower than those in the ME and HE groups. Interestingly, the LE diet significantly increased lysine content in piglet serum, but decreased the levels of arginine, leucine, glutamic acid, and alanine, and inhibiting the mammalian target of rapamycin complex 1 (mTORC1) pathway, by decreasing the phosphorylation abundance of key proteins. In summary, the dietary electrolyte imbalance could inhibit the activation of the mTORC1 signaling pathway, which might be a key factor in the influence of dEB on piglet growth performance and intestinal health. Moreover, second-order polynomial (quadratic) regression analysis showed that the optimal dEB of piglets in the low-protein diet was 250~265 mEq/kg.
Abstract Retroperitoneal fibrosis (RPF) is a rare autoimmune disease with fibrous tissue growth and inflammation in retroperitoneum, whose development could encase surrounding organs and lead to severe conditions. Its current treatments involve long-term uptake of glucocorticoids (e.g., prednisone) for controlling inflammation; however, side effects are common, triggering search for replacement therapies. Here, we surveyed gene-disease databases and discovered that mTOR displayed significant changes in RPF, which we confirmed by immunohistological staining. Next, we inferred from drug-gene databases that mTOR inhibitor compound sirolimus could affect most biological pathways in RPF. We then designed a combined therapy in which a gradual reduction of prednisone was prescribed with a long-term, stable dosage of sirolimus. We implemented a single-arm clinical trial in RPF patients and assessed the treatment effects at three timepoints (0, 12 weeks and 48 weeks of treatment). By assessing fibrous tissue mass by computed tomography, inflammation markers and kidney functions by lab tests, immune cell types and abundances by flow cytometry, and plasma inflammation-related proteins by Olink proteomics, we revealed that our combined therapy resulted in significant fibrosis remission and an overall regression of the immune system towards healthy states. In addition, no obvious side effects were observed. We concluded that this new therapy had the potential to replace long-term steroid monotherapy for treating RPF.
To study the AIDS-related chronic diarrhea in traditional Chinese medicine (TCM) clinical manifestations and syndrome factors, explore the characteristics of syndrome.A multicenter, prospective collection of 311 cases of AIDS patients with chronic diarrhea, study the characteristics of TCM syndrome by using the method of descriptive statistics and exploratory factor analysis.The common clinical manifestation of TCM: fatigue (229 cases, 73.63%), bowel (229 cases, 68.81%), diarrhea (194 cases, 62.38%), thin fur (201 cases, 64.63%), pink tongue (166 cases, 53.38%), greasy fur, thready pulse (126 cases, 40.51%), sink vein (64 cases, 20.58%), slippery pulse. 17 common factors were extracted, common disease syndrome factor as the spleen, stomach, liver, gallbladder and colon syndrome factors of disease, Qi, Yang deficiency, Qi stagnation, dampness and heat evil.AIDS-related chronic diarrhea symptoms involving multiple organs, the disease belongs to deficiency and excess.
Dysregulation of long non-coding RNA zinc finger antisense 1 (ZFAS1) has been reported in many types of cancers. We performed a synthetic analysis to clarify its prognostic significance as a cancer molecular-marker. Several databases (including PubMed, Web of Science, Embase together with Wanfang and China National Knowledge Internet database) were retrieved to identify ZFAS1-related articles. A total of eight articles were included in this meta-analysis. Hazard ratios (HR) and 95% confidence intervals (CI) were applied to assess the association between ZFAS1 expression level and overall survival (OS). Odds ratios (OR) were calculated with RevMan 5.3 software to determine the relationship between ZFAS1 expression and clinicopathologic features. The pooled results of the meta-analysis indicated that high ZFAS1 expression level was positively correlated with poor OS (HR = 1.87, 95% CI: 1.38-2.36, p< 0.001) in human solid cancers. The statistical significance was also observed in subgroup analysis stratified by the cancer type, analysis method, sample size and follow-up time. Furthermore, the elevated ZFAS1 expression was significantly related to positive lymph node metastasis (OR = 4.18, 95% CI: 2.70-6.48, p< 0.001). The present results suggest that ZFAS1 might be served as a novel promising biomarker for prognosis in Chinese patients with solid cancers.
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