Objective:To explore the mechanism of Kangguan decoction in the treatment of coronavirus disease 2019(COVID-19)and then perform preliminary verification.Methods:The effective compounds and target genes of Kangguan dec...Objective:To explore the mechanism of Kangguan decoction in the treatment of coronavirus disease 2019(COVID-19)and then perform preliminary verification.Methods:The effective compounds and target genes of Kangguan decoction were obtained from Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform.COVID-19 related target genes were searched in the GeneCards database.The active target genes of Kangguan decoction acting on COVID-19 were identified to perform GO function enrichment and KEGG pathway enrichment analysis.The compound-target network and protein-protein interaction were constructed;Molecular docking simulations of macromolecular protein target receptors and their corresponding compounds were performed.The clinical data of COVID-19 patients were retrieved from their electronic medical records of Nantong Third People's Hospital.Results:We screened out 137 effective compounds and 274 effective target genes of Kangguan decoction from TCMSP.The active target genes of Kangguan decoction were compared with the COVID-19 related target genes,and 63 active target genes for Kangguan decoction acting on COVID-19 were identified.GO function enrichment and KEGG pathway enrichment analysis were performed.The compound-target network and PPI network were constructed and the key compounds and key targets were selected to construct a key compound-target network.Finally,the binding of the target and its corresponding components was verified by molecular docking and two clinical cases with obvious clinical efficacy after Kangguan decoction application were demonstrated.Conclusion:The pharmacological mechanism of Kangguan decoction acting on COVID-19 has been explored,and the active compounds and targets of Kangguan decoction acting on COVID-19 and clinical efficacy for Kangguan decoction treating COVID-19 patients have been preliminarily verified.展开更多
BACKGROUND Left ventricular thrombus is a rare condition,for which appropriate treatments are not extensively studied.Although it can be treated by thrombectomy,such surgery can be difficult and risky,and not every pa...BACKGROUND Left ventricular thrombus is a rare condition,for which appropriate treatments are not extensively studied.Although it can be treated by thrombectomy,such surgery can be difficult and risky,and not every patient can tolerate the surgery.CASE SUMMARY We report a case of a middle-aged man receiving veno-arterial extracorporeal membrane oxygenation(VA-ECMO)for acute myocardial infarction who developed left ventricular thrombus despite systemic anticoagulation.After systemic thrombolysis with urokinase,the left ventricular thrombus disappeared,ECMO was successfully withdrawn 9 days later,and the patient recovered and was discharged from hospital.CONCLUSION Systemic thrombolysis is a treatment option for left ventricular thrombus in addition to anticoagulation and thrombectomy.展开更多
BACKGROUND Liver failure has high mortality and poor prognosis,and establishing new reliable markers for predicting its prognosis is necessary.Mucosal-associated invariant T(MAIT)cells are a novel population of innate...BACKGROUND Liver failure has high mortality and poor prognosis,and establishing new reliable markers for predicting its prognosis is necessary.Mucosal-associated invariant T(MAIT)cells are a novel population of innate-like lymphocytes involved in inflammatory liver disease,and their potential role in liver failure remains unclear.AIM To investigate alteration of circulating MAIT cells and assess its prognostic value in patients with hepatitis B virus(HBV)-related liver failure.METHODS We recruited 55 patients with HBV-related liver failure,48 patients with chronic hepatitis B and 40 healthy controls(HCs)from Nantong Third People’s Hospital Affiliated to Nantong University.Peripheral blood mononuclear cells were isolated,and the percentage and number of circulating MAIT cells were detected by flow cytometry.Plasma levels of interleukin(IL)-7,IL-12p70,IL-18 and interferon-αwere measured by Luminex assay.RESULTS Circulating MAIT cells were significantly decreased in HBV-related liver failure patients(percentage:2.00±1.22 vs 5.19±1.27%,P<0.0001;number:5.47±4.93 vs 84.43±19.59,P<0.0001)compared with HCs.More importantly,there was a significant reduction of MAIT cells in patients with middle/late-stage compared with early-stage liver failure.Circulating MAIT cells partially recovered after disease improvement,both in percentage(4.01±1.21 vs 2.04±0.95%,P<0.0001)and in cell count(17.24±8.56 vs 7.41±4.99,P<0.0001).The proportion(2.29±1.01 vs 1.58±1.38%,P<0.05)and number(7.30±5.70 vs 2.94±1.47,P<0.001)of circulating MAIT cells were significantly higher in the survival group than in the dead/liver transplantation group,and the Kaplan–Meier curve showed that lower expression of circulating MAIT cells(both percentage and cell count)predicted poor overall survival(P<0.01).Also,the levels of IL-12(20.26±5.42 pg/mL vs 17.76±2.79 pg/mL,P=0.01)and IL-18(1470.05±1525.38 pg/mL vs 362.99±109.64 pg/mL,P<0.0001)were dramatically increased in HBV-related liver failure patients compared with HCs.CONCLUSION Circulating MAIT cells may play an important role in the process of HBV-related liver failure and can be an important prognostic marker.展开更多
Objective:To explore the relationship among plasma 3-deoxyglucuronide (3-DG) level, severity of sepsis and clinical prognosis, and to provide references for the assessment of sepsis patients' condition and prognos...Objective:To explore the relationship among plasma 3-deoxyglucuronide (3-DG) level, severity of sepsis and clinical prognosis, and to provide references for the assessment of sepsis patients' condition and prognosis.Methods:120 sepsis patients and 50 health particapants in our hospital from January 2018 to December 2018 were enrolled in the observation group and the control group respectively. The plasma levels of 3-DG were measured and compared between the two groups at the time of admission. According to the 28-day prognosis of the patients in the observation group, they were divided into the survival group and the death group. The plasma 3-DG changes and acute physiology and chronic health scoring system II (APACHE II) and Glasgow coma score (GCS) were compared between the two groups at the time of enrollment, on the third day of admission, on the 7th day of admission, on the 14th day after admission. The correlation between plasma 3-DG and the severity score of sepsis patients was analyzed, and the value of plasma 3-DG in predicting the mortality of sepsis patients was analyzed by ROC.Results:The plasma concentration of 3-DG in the observation groupwas (296.38±52.97)μg/L, which was higher than that in the control group (91.06±22.38)μg/L, and the difference was statistically significant. After 28 d of hospitalization, 81 patients survived and 39 died in the observation group, with a fatality rate of 32.50%. The plasma levels of 3-DG in the survival group and the death group decreased continuously at the time of admission, the 3rd day of admission, the 7th day of admission and the 14th day of admission. The plasma 3-DG levels of survival group and fatality group decreased continuously at admission, 3rd day, 7th day and 14th day. The plasma 3-DG levels of the survival group were lower than those of the fatality group at admission, 3rd day, 7th day and 14th day. The scores of APACHE II, SOFA and MODS of the survival group and the fatality group decreased continuously at admission, 3rd day, 7th day, 14th day, and increased continuously. The scores of APACHE II, SOFA and MODS of the survival group and the fatality group were lower than those of the fatality group at admission, 3rd day, 7th day, 14th day, and their GCS scores were higher than those of the fatality group, with significant difference. Pearson correlation analysis showed that plasma 3-DG level was positively correlated with APACHE II, SOFA, MODS scores in sepsis patients, and negatively correlated with GCS scores. ROC curve showed that plasma 3-DG levels at admission, 3rd day of admission, 7th day of admission and 14th day of admission could effectively predict the mortality risk of sepsis patients ion were 82.22%, 80.35% and AUC was 0.871, respectively.Conclusion:The increase of plasma 3-DG level is accompanied by the aggravation of the severity of sepsis and the increase of the risk of fatality. Early detection of plasma 3-DG level is expected to guide the assessment of the condition and prognosis of sepsis patients.展开更多
基金the Research Grant of Jiangyin Hospital of Traditional Chinese Medicine(202013 to Jiang and 202014 to Zhang)the Nantong Science and Technology Bureau Plan Project(grant XG202003-4 to Li,grant XG202003-3 to Han).
文摘Objective:To explore the mechanism of Kangguan decoction in the treatment of coronavirus disease 2019(COVID-19)and then perform preliminary verification.Methods:The effective compounds and target genes of Kangguan decoction were obtained from Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform.COVID-19 related target genes were searched in the GeneCards database.The active target genes of Kangguan decoction acting on COVID-19 were identified to perform GO function enrichment and KEGG pathway enrichment analysis.The compound-target network and protein-protein interaction were constructed;Molecular docking simulations of macromolecular protein target receptors and their corresponding compounds were performed.The clinical data of COVID-19 patients were retrieved from their electronic medical records of Nantong Third People's Hospital.Results:We screened out 137 effective compounds and 274 effective target genes of Kangguan decoction from TCMSP.The active target genes of Kangguan decoction were compared with the COVID-19 related target genes,and 63 active target genes for Kangguan decoction acting on COVID-19 were identified.GO function enrichment and KEGG pathway enrichment analysis were performed.The compound-target network and PPI network were constructed and the key compounds and key targets were selected to construct a key compound-target network.Finally,the binding of the target and its corresponding components was verified by molecular docking and two clinical cases with obvious clinical efficacy after Kangguan decoction application were demonstrated.Conclusion:The pharmacological mechanism of Kangguan decoction acting on COVID-19 has been explored,and the active compounds and targets of Kangguan decoction acting on COVID-19 and clinical efficacy for Kangguan decoction treating COVID-19 patients have been preliminarily verified.
文摘BACKGROUND Left ventricular thrombus is a rare condition,for which appropriate treatments are not extensively studied.Although it can be treated by thrombectomy,such surgery can be difficult and risky,and not every patient can tolerate the surgery.CASE SUMMARY We report a case of a middle-aged man receiving veno-arterial extracorporeal membrane oxygenation(VA-ECMO)for acute myocardial infarction who developed left ventricular thrombus despite systemic anticoagulation.After systemic thrombolysis with urokinase,the left ventricular thrombus disappeared,ECMO was successfully withdrawn 9 days later,and the patient recovered and was discharged from hospital.CONCLUSION Systemic thrombolysis is a treatment option for left ventricular thrombus in addition to anticoagulation and thrombectomy.
基金Supported by National Natural Science Foundation of China,No.81600449Nantong Science and Technology Bureau,No.MS22018007,No.MSZ18130,and No.JCZ18036+2 种基金Six Peak Talents in Jiangsu Province,No.YY-177Project of Jiangsu Province Youth Medical Talent Development,No.QNRC2016400and Project of Nantong Youth Medical Talent Development,No.05.
文摘BACKGROUND Liver failure has high mortality and poor prognosis,and establishing new reliable markers for predicting its prognosis is necessary.Mucosal-associated invariant T(MAIT)cells are a novel population of innate-like lymphocytes involved in inflammatory liver disease,and their potential role in liver failure remains unclear.AIM To investigate alteration of circulating MAIT cells and assess its prognostic value in patients with hepatitis B virus(HBV)-related liver failure.METHODS We recruited 55 patients with HBV-related liver failure,48 patients with chronic hepatitis B and 40 healthy controls(HCs)from Nantong Third People’s Hospital Affiliated to Nantong University.Peripheral blood mononuclear cells were isolated,and the percentage and number of circulating MAIT cells were detected by flow cytometry.Plasma levels of interleukin(IL)-7,IL-12p70,IL-18 and interferon-αwere measured by Luminex assay.RESULTS Circulating MAIT cells were significantly decreased in HBV-related liver failure patients(percentage:2.00±1.22 vs 5.19±1.27%,P<0.0001;number:5.47±4.93 vs 84.43±19.59,P<0.0001)compared with HCs.More importantly,there was a significant reduction of MAIT cells in patients with middle/late-stage compared with early-stage liver failure.Circulating MAIT cells partially recovered after disease improvement,both in percentage(4.01±1.21 vs 2.04±0.95%,P<0.0001)and in cell count(17.24±8.56 vs 7.41±4.99,P<0.0001).The proportion(2.29±1.01 vs 1.58±1.38%,P<0.05)and number(7.30±5.70 vs 2.94±1.47,P<0.001)of circulating MAIT cells were significantly higher in the survival group than in the dead/liver transplantation group,and the Kaplan–Meier curve showed that lower expression of circulating MAIT cells(both percentage and cell count)predicted poor overall survival(P<0.01).Also,the levels of IL-12(20.26±5.42 pg/mL vs 17.76±2.79 pg/mL,P=0.01)and IL-18(1470.05±1525.38 pg/mL vs 362.99±109.64 pg/mL,P<0.0001)were dramatically increased in HBV-related liver failure patients compared with HCs.CONCLUSION Circulating MAIT cells may play an important role in the process of HBV-related liver failure and can be an important prognostic marker.
文摘Objective:To explore the relationship among plasma 3-deoxyglucuronide (3-DG) level, severity of sepsis and clinical prognosis, and to provide references for the assessment of sepsis patients' condition and prognosis.Methods:120 sepsis patients and 50 health particapants in our hospital from January 2018 to December 2018 were enrolled in the observation group and the control group respectively. The plasma levels of 3-DG were measured and compared between the two groups at the time of admission. According to the 28-day prognosis of the patients in the observation group, they were divided into the survival group and the death group. The plasma 3-DG changes and acute physiology and chronic health scoring system II (APACHE II) and Glasgow coma score (GCS) were compared between the two groups at the time of enrollment, on the third day of admission, on the 7th day of admission, on the 14th day after admission. The correlation between plasma 3-DG and the severity score of sepsis patients was analyzed, and the value of plasma 3-DG in predicting the mortality of sepsis patients was analyzed by ROC.Results:The plasma concentration of 3-DG in the observation groupwas (296.38±52.97)μg/L, which was higher than that in the control group (91.06±22.38)μg/L, and the difference was statistically significant. After 28 d of hospitalization, 81 patients survived and 39 died in the observation group, with a fatality rate of 32.50%. The plasma levels of 3-DG in the survival group and the death group decreased continuously at the time of admission, the 3rd day of admission, the 7th day of admission and the 14th day of admission. The plasma 3-DG levels of survival group and fatality group decreased continuously at admission, 3rd day, 7th day and 14th day. The plasma 3-DG levels of the survival group were lower than those of the fatality group at admission, 3rd day, 7th day and 14th day. The scores of APACHE II, SOFA and MODS of the survival group and the fatality group decreased continuously at admission, 3rd day, 7th day, 14th day, and increased continuously. The scores of APACHE II, SOFA and MODS of the survival group and the fatality group were lower than those of the fatality group at admission, 3rd day, 7th day, 14th day, and their GCS scores were higher than those of the fatality group, with significant difference. Pearson correlation analysis showed that plasma 3-DG level was positively correlated with APACHE II, SOFA, MODS scores in sepsis patients, and negatively correlated with GCS scores. ROC curve showed that plasma 3-DG levels at admission, 3rd day of admission, 7th day of admission and 14th day of admission could effectively predict the mortality risk of sepsis patients ion were 82.22%, 80.35% and AUC was 0.871, respectively.Conclusion:The increase of plasma 3-DG level is accompanied by the aggravation of the severity of sepsis and the increase of the risk of fatality. Early detection of plasma 3-DG level is expected to guide the assessment of the condition and prognosis of sepsis patients.
