Abstract Background Duration of antituberculosis therapy (ATT) for managing female genital tuberculosis (FGTB) is controversial with the intermittent regimen no more advocated. We therefore conducted a prospective, real-world research to compare 6 months and 9 months of ATT. Methods Between 2012 and 2018, 109 drug-susceptible patients newly diagnosed with FGTB and/or tuberculous peritonitis (genital, 13; peritoneal, 34; mixed, 62) received naïve treatment for 9-12 months and further 18-month follow-up. Data on disease features at baseline and long-term outcome (intent-to-treat) were compared between group A (aged 18-35 yr) and group B (aged 36-81 yr). Efficacy and side effects of treatment were compared within each group 6 months and 9 months from ATT initiation (per-protocol), respectively. Results In contrast to group B at baseline, group A had more clinical evidence predicting active tuberculosis ( P < 0.05), severer performance of genital lesions and pelvic adhensions ( P < 0.05), more signs of active pulmonary tuberculosis ( P < 0.01), and less performance of only TBP ( P < 0.01). Intent-to-treat analysis showed higher incidence of overall single side effects and poor compliance in group B ( P < 0.05), and similar recurrence rate between 2 groups. Per-protocol analysis showed increased complete response rate ( P < 0.01) and similar incidence of side effects ( P > 0.05) in group A, similar complete response rate ( P > 0.05) and increased incidence of overall single side effects ( P < 0.05) in group B at 9-month duration. Conclusions Younger females with FGTB had a greater risk of systemic infection of tuberculosis compared to older ones. Nine-month ATT using daily therapy proved to be beneficial for younger patients at reproductive age. Six-month option was suitable for older patients for reducing side effects and poor compliance in the duration of treatment.
Abstract Growth differentiation factor 11 (GDF11) is a member of the transforming growth factor (TGF)-β superfamily. The rejuvenative effect of GDF11 has been called into question recently, and its role in liver regeneration is unclear. Here, we investigated the pathophysiologic role of GDF11, as well as its plausible signaling mechanisms in a mouse model of partial hepatectomy (PH). We demonstrated that both serum and hepatic GDF11 protein expression increased following PH. Treatment with adeno-associated viruses-GDF11 and recombinant GDF11 protein severely impaired liver regeneration, whereas inhibition of GDF11 activity with neutralizing antibodies significantly improved liver regeneration after PH. In vitro, GDF11 treatment significantly delayed cell proliferation and induced cell-cycle arrest in α mouse liver 12 (AML12) cells. Moreover, GDF11 activated TGF-β-SMAD2/3 signaling pathway. Inhibition of GDF11-induced SMAD2/3 activity significantly blocked GDF11-mediated reduction in cell proliferation both in vivo and in vitro. In the clinical setting, GDF11 levels were significantly elevated in patients after hepatectomy. Collectively, these results indicate that rather than a ‘rejuvenating’ agent, GDF11 impairs liver regeneration after PH. Suppression of cell-cycle progression via TGF-β-SMAD2/3 signaling pathway may be a key mechanism by which GDF11 inhibits liver regeneration.
Antibodies against human leukocyte antigen (anti-HLA Abs) are associated with an increased risk of allograft loss. Herein, we report the prospective follow-up for anti-HLA Abs formation in 103 patients with end-stage kidney disease on the waiting list for transplantation who underwent COVID-19 vaccination.Sera were tested before and after vaccination using Luminex technology. The cohort comprised of 62 males and 41 females with a mean age of 56 ± 14 years. The patients received BNT162b2 (80.4%), mRNA-1273 (18.5%), AZD1222 (0.40%), or ChAdOx1-S (0.80%) vaccine. Patients were tested before and within 119 ± 50, 95 ± 46 and 25 ± 26 days after the first, second, and third dose of the vaccine, respectively.No significant change in calculated panel reactive antibody (cPRA) after vaccination was seen. Although 98.1% of patients had no change in anti-HLA Abs profile or cPRA after vaccination, two patients (1.9%) developed de novo anti-HLA Abs against class I or II HLA antigens. In those two patients, the cPRA changed from 0% and 63% at baseline to 9% and 90% after vaccination, respectively. Both patients received the BNT162b2 mRNA-based vaccine. The earliest detected anti-HLA Abs was 18 days after the first dose.In rare cases, new anti-HLA antibodies were observed after COVID-19 vaccination, with potential implications for transplantation. The low incidence of this phenomenon is outweighed by the clinical benefits of vaccination.
Objective
To explore the effects of nursing specialty construction on vascular crisis in patients after replantation of severed finger.
Methods
A case control study was conducted, and 151 patients (203 fingers) of microsurgery in a hospital from January to December 2015 were selected as the observation group, and 143 patients (195 fingers) were selected as the control group. Patients in the control group received routine postoperative nursing, while patients in the observation group were given special and special nursing measures which included self-help pain management techniques decubitus nursing warm comfortable security technologies cut flush bloodletting technologies and five-love service through the construction of special nursing specialty; SPSS 17.0 statistical software was used to analyze the incidence rate of vascular crisis in two groups.
Results
In the observation group, 151 cases, 203 fingers received replantation, and the incidence rate of arterial crisis was 2.0%; the incidence rate of venous crisis was 2.5%. In the control group, 143 cases, 195 fingers received replantation and the incidence rate of arterial crisis was 7.7%; the incidence rate of venous crisis was 9.2%. According to the statistical analysis, there was significant difference between two groups (P<0.05).
Conclusions
Through the construction of nursing specialty, the implementation of special nursing technology and special nursing service, can effectively reduce the incidence of vascular crisis and improve the innovation ability and professional level of the nurses, and promote the sustainable development of nursing.
Key words:
Microsurgery; Replantation of amputated finger; Vascular crisis; Nursing specialty construction
Epithelial ovarian cancer (EOC) is the most deadly gynecologic malignancy worldwide due to its high recurrence rate after surgery and chemotherapy. There is a critical need for discovery of novel biomarkers for EOC recurrence providing higher prediction power than that of the present ones. Lipids have been reported to associate with development and progression of cancer. In the current study, we aim to identify and validate the lipids which were relevant to the ovarian cancer recurrence based on plasma lipidomics performed by ultra-performance liquid chromatography coupled with mass spectrometry. In order to fulfill this objective, plasma from 70 EOC patients with follow up information was obtained. The results revealed that patients with and without recurrence could be clearly distinguished based on their lipid profiles. Thirty-one lipid metabolites were identified as potential biomarkers for EOC recurrence. The AUC value of these metabolite combinations for predicting EOC recurrence was 0.897. In terms of clinical applicability, LysoPG(20:5) arose as a potential EOC recurrence predictive biomarker to increase the predictive power of clinical predictors from AUC value 0.739 to 0.875. Additionally, we still found that individuals with early relapses (< 6 months) had a distinctive metabolomic pattern compared with late EOC and non-EOC recurrence subjects. Interestingly, decreased levels of triglycerides (TGs) were found to be a specific metabolic feature foreshadowing an early relapse. In conclusion, plasma lipidomics study could be used for predicting EOC recurrences, as well as early and late recurrent cases. The lipid biomarker research improves the predictive power of clinical predictors and the identified biomarkers are of great prognostic and therapeutic potential.
To compare short- and long-term outcomes of laparoscopic hepatectomy (LH) in elderly and non-elderly patients with hepatocellular carcinoma (HCC).Clinical and follow-up data of patients with HCC who underwent LH in our Institute from January 2011 to December 2016 were retrospectively analyzed. The patients were divided into elderly (48 cases, 70 years old or older) or non-elderly group (97 cases, <70 years) according to their age at the time of operation. The short- and long-term outcomes of both groups were compared.The Charlson comorbidity index and American Society of Anesthesiologists (ASA) score of patients in the elderly group were higher than those of patients in the nonelderly group, and the rates of hepatitis virus infection and cirrhosis in the elderly group were lower than those in the non-elderly group. The rest of the preoperative data showed no statistical significance. Short-term outcomes, including operation time, intraoperative blood loss, transfer rate, length of hospital stay, incidence of complications and their severity within 30 days after surgery, and pathological findings, showed no significant difference between the elderly and non-elderly groups. Recurrence rates, treatment of the recurrence, overall survival (OS) rates, and disease-free survival (DFS) rates were similar in both groups. Multivariate analysis showed that age was not an independent predictor of OS and DFS.LH in elderly patients can achieve short- and long-term outcomes similar to those in non-elderly patients with liver cancer. Old age is not a contraindication for LH in patients with HCC.
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