Search

Objective To investigate the clinical characteristics， diagnosis and treatment of Goodpasture syndrome complicated with lung infection. Methods Clinical data of one case of Goodpasture syndrome complicated with pulmonary infection were retrospectively analyzed. Literature review was performed from PubMed， Embase， Web of Science， China National Knowledge Infrastructure （CNKI） and Wanfang Data Knowledge Service platform using “Goodpasture syndrome” and “infection” as search terms from the database inception date to September 2022. Clinical manifestations and prognosis of Goodpasture syndrome complicated with pulmonary infection were summarized. Results The 51-year-old male patient， was admitted to our hospital due to elevated serum creatinine level for more than one month and blood in sputum for over 10 d. The patient had a cough of yellow-green purulent sputum. Moist rales were heard in bilateral lungs. Renal biopsy showed crescentic glomerulonephritis， and anti-glomerular basement membrane IgG antibody was weakly positive. Chest CT scan revealed multiple inflammations in both lungs. The culture of bronchoalveolar lavage fluid showed the phenomenon of phagocytosis. Sputum fungal smear and fluorescent staining， alveolar lavage fluid culture， next-generation sequencing （NGS） of alveolar lavage fluid indicated a variety of microbial infections. The diagnosis of Goodpasture syndrome complicated with lung infection was considered. He was discharged after receiving renal replacement， immunosuppression， and anti-infection therapies. Three months later， the patient was transferred to ICU due to “severe pneumonia， septic shock， and respiratory failure” and eventually died. A total of 27 cases of Goodpasture syndrome complicated with pulmonary infection were researched. The common pathogens of pulmonary infection were invasive pulmonary Aspergillus， Pneumocystis carinii， Mycobacterium tuberculosis and cytomegalovirus， etc. Thirteen patients died， and 4 of them died of respiratory failure and/or respiratory infection. Conclusion Extensive attention should be diverted to the risk of infection in patients with Goodpasture syndrome， especially severe lung infection.

Background Both motoric cognitive risk (MCR) syndrome and subjective cognitive decline (SCD) are early stages of cognitive decline in the elderly. MCR syndrome is currently considered as a new effective predictor of preclinical dementia. Identifying the risk factors of dementia in older people with SCD by early MCR syndrome screening is of great significance for reducing the incidence of dementia and related adverse health events in this group. Objective To investigate the prevalence and influencing factors of MCR syndrome in the elderly with SCD in the community. Methods A long-term cohort study conducted from January 2019 to January 2022 in a community in Beijing selected 459 cases of the elderly (≥60 years old) with SCD as the study population. SCD was assessed using the memory-related questions in the Geriatric Depression Scale-15 and the Chinese version of Montreal Cognitive Assessment-Basic. The the 6-metre walking test was used to assess gait status. MCR syndrome was defined as SCD in combination with gait decline. A self-designed questionnaire was used to collect the demographic data, physiological factors, psychological factors, lifestyle indicators, psychological factors, nutritional status, conditions of illness and medication history. Stepwise multinomial Logistic regression was used to explore the influencing factors of MCR syndrome. Results The prevalence of MCR syndrome was 27.2% (125/459) . The elderly in the MCR and non-MCR groups were compared for age, basic activities of daily living (BADL) , instrumental activities of daily living (IADL) , weekly exercise hours, anxiety status, nutritional status, conditions of illness〔hypertension, chronic heart failure, arrhythmia, stroke/transient ischaemic attack (TIA) , multiple lacunar infarction, diabetes mellitus, peripheral vascular disease, cancers, osteoarthritis, history of fracture in the last 2 years, oculopathy, oral disease〕, and medication history, and the difference was statistically significant (P

Objectives: Due to the narrow therapeutic window of valproic acid (VPA), grievous adverse reactions such as hepatotoxicity, nephrotoxicity may occur in patients with epilepsy for a long time. This study aimed to explore the effect of VPA concentration on biochemical and routine blood test related to liver, renal, and hematology in epileptic outpatients treated with VPA alone or combined with other antiepileptic drugs., Methods: A total of 3 194 Chinese epileptic outpatients from Xiangya Hospital, were analyzed in a crude analysis after stratifying through dosage regimens. The plasma VPA concentration was detected by gas chromatography method and then standardized through dosage and body weight. Ten biochemical indexes related to liver, renal, and hematology were evaluated., Results: Of all patients, blood urea nitrogen (BUN), serum creatinine (SCr) level, and erythrocyte count (RBC) showed positive correlations with standardized VPA concentration ( r =0.494, r =0.157, r =0.596, respectively), while platelet specific volume (PCT) and blood platelet (PLT) showed negative correlations with standardized VPA concentration ( r =-5.500, r =-0.086, respectively). After stratifying through dosage regimens, significantly positive associations between SCr and standardized VPA concentration were found in the juvenile patients from the monotherapy group and combination therapy group ( r =1.800, r =0.352, respectively). In addition, PLT and leukocyte count (WBC) in the juvenile patients from the combination therapy group were negatively correlated with standardized VPA concentration ( r =-1.463, r =-0.079, respectively), while RBC showed a positive association with standardized VPA concentration in the juvenile patients from the monotherapy group ( r =0.068)., Conclusions: SCr level is significantly associated with plasma VPA concentration. Drug combination and age are important factors leading to hematological disorders. The finding provides potential theoretical guidance for the rational and safe clinical use of VPA.

Objective: To assess the diagnostic value of narrow-band imaging(NBI) in the diagnosis of central lung cancer., Methods: Patients (n = 153) suspected of having lung cancer underwent white light bronchoscopy(WLB), NBI and autofluorescence bronchoscopy(AFB) in turn. At least 3 biopsies in each case were taken from sites visualized as lesions. The sensitivity and specificity of NBI, AFB and combination of NBI and AFB were compared., Results: There were 106 male (69.3%) and 47 female patients (30.7%). By NBI, 91 and 62 cases were positive and negative respectively. The sensitivity and specificity of NBI were 63.5% (87/137) and 75.0% (12/16) respectively. By AFB, 140 and 13 cases were positive and negative respectively. The sensitivity and specificity of AFB were 94.2% (129/137) and 87.5% (5/16) respectively. By NBI combined with AFB, 133 and 20 cases were positive and negative respectively, the sensitivity and specificity being 95.6% (131/137) and 87.5% (14/16) respectively. The difference of specificity between NBI plus AFB and AFB alone was significant (P < 0.01), but the difference of sensitivity between NBI plus AFB and AFB alone(P > 0.05) was not. The difference of specificity between NBI plus AFB and NBI alone was significant (P < 0.01), but the P value of specificity between NBI plus AFB and NBI was 0.03., Conclusion: Combination of NBI and AFB could increase the specificity of lung cancer diagnosis compared to AFB alone.

Background: Narrow-band imaging (NBI) and autofluorescence imaging (AFI) are new bronchoscopy technologies that are important in lung cancer diagnosis. The aim of this study is to determine whether or not the combination of these two technologies can improve sensitivity and specificity of lung cancer diagnosis., Methods: A total of 137 patients who manifested symptoms of lung cancer were investigated in this project. All of the examinations were performed based on an Olympus Evis Lucera bronchoscopy system. The patients were examined by white light bronchoscopy (WLB), NBI and AFI. At least three biopsies from body parts visualized as lesions were obtained from each patient., Results: WLB sensitivity and specificity were 56.6% and 62.5%, respectively. NBI sensitivity and specificity were 71.3% and 75.0%, respectively. AFI sensitivity and specificity were 82.2% and 25.0%, respectively. The sensitivity and the specificity of the combined NBI and AFI were 94.6% and 87.5%, respectively. The sensitivity and the specificity of the combined NBI and AFI were significantly higher than those of AFI alone (P<0.01). Likewise, the sensitivity and the specificity of the combined NBI and AFI were significantly higher than those of NBI alone (P<0.05)., Conclusions: NBI or AFI exhibited higher sensitivity of lung cancer diagnosis than WLB. Combined NBI and AFI also showed significantly higher sensitivity and specificity than NBI or AFI.

A simple, precise and sensitive gas chromatography-mass spectrometry (GC-MS) method coupled with pulse splitless injection technique was developed for the determination of 10 sedative-hypnotics (barbital, amobarbital, phenobarbital, oxazepam, diazepam, nitrazepam, clonazepam, estazolam, alprazolam, triazolam) in human plasma. The drugs spiked in plasma were extracted with ethyl acetate after alkalization with 0.1 mol/L NaOH solution. The organic solvent was evaporated under nitrogen stream, and the residues were redissolved by ethyl acetate. The separation was performed on an HP-5MS column (30 m x 250 microm x 0.25 microm). The analytes were determined and identified using selected ion monitoring (SIM) mode and scan mode, respectively. The internal standard method was used for the determination. The target analytes were well separated from each other on their SIM chromatograms and also on the total ion current (TIC) chromatograms. The blank extract from human plasma gave no peaks that interfered with all the analytes on the chromatogram. The calibration curves for 10 sedative-hypnotics showed excellent linearity. The correlation coefficients of all the drugs were higher than 0.9954. The recoveries of the drugs spiked in human plasma ranged from 92.28% to 111.7%, and the relative standard deviations (RSDs) of intra-day and inter-day determinations were from 4.09% to 14.26%. The detection limits ranged from 2 to 20 microg/L. The method is simple, reliable, rapid and sensitive for the determination and the quantification of 10 sedative-hypnotics in human plasma and seems to be useful in the practice of clinical toxicological cases.

A method for the simultaneous determination of six pesticides in adzuki beans by high performance liquid chromatography-electrospray ion trap tandem mass spectrometry was developed and evaluated. The sample was extracted with 0.1 mol/L NH4HCO3 (pH 5)-methanol (70 : 30, v/v). The extract was partitioned with dichloromethane, and cleaned up with gel permeation chromatography. The separation was performed on an Inertsil ODS-3 column (150 mm x 2.1 mm, 5 microm) with the gradient elution of methanol and 1% acetic acid as mobile phase. The identification and quantification were performed by electrospray ion trap mass spectrometry with selected ion monitoring mode. The calibration curves of imidazolinone herbicides showed good linearities in the range of 10 - 200 microg/L (5 -100 microg/L for imazaquin) with the correlation coefficients between 0.998 7 and 0.999 7. The limits of detection ranged between 0.2 microg/kg and 0.5 microg/kg (S/N = 3). The average recoveries of six imidazolinone herbicides spiked in adzuki beans ranged between 81.6% and 99.4% (n = 6) with the relative standard deviations of 3.1% -7.8%. The method has been used for the determination of 6 imidazolinone herbicides simultaneously in adzuki beans with easy operation, high accuracy and good precision.