Objective To study the relation between the pathogenesis of gallstone and blood lipid and protein.Methods Then indexes of blood lipid and protein in 204 cases of gallstone patients were measured and analysed by statistical software SPSS. Results There was a significant difference between the gallstone group and control in the value of proalbumin, total cholesterol, high density lipoprotein and carrier protein B (Ｐ＜0.01), the value of total protein, triglyceride, low density lipoprotein cholesterol, very low density lipoprotein cholesterol and carrier protein A1 were higher than those in the control (Ｐ＜0.05). Conclusion The indexes mentioned above may play an important role in the gallstone formation.
ObjectiveTo observe the efficacy and safety of lacosamide (LCM) as a monotherapy or as an add-on in the treatment of focal epilepsy in children aged 4 months to 4 years. MethodsThe study included 20 children with focal epilepsy who received oral LCM monotherapy or add-on therapy in Children's Hospital Affiliated to Soochow University from March 2022 to September 2022, including 9 males and 11 females with an average age of (22.4±13.0) months. The curative effects and adverse reactions at 1, 2, 3, 4, and 6 months after LCM treatment were analyzed. The initial dose of LCM was 2 mg/(kg·d) and increased by 2 mg/(kg·d) every week, maintenance dose 6 ~ 12mg/(kg·d). Results During the follow-up period of this study, the total effective cases were 17 (85.00%), and the number of control-free cases was 15 (75.00%). Conclusion LCM can effectively reduce the frequency of epileptic seizures in the monotherapy or add-on treatment of infants and young children with focal epilepsy, with few adverse reactions and high retention rate, which has high clinical application value.
【Abstract】Objective To evaluate effect of artificial liver support system (ALSS) in liver failure and liver transplantation.Methods Forty-four patients with liver failure (including 12 undergoing liver transplantation) were treated with MARS or plasma exchange. The changes of toxic substances and cytokines in blood were detected before and after treatment. Results ALSS therapy achieved a remarkable improvement in clinical symptoms and physical signs. After ALSS treatment, there was a significant decrease in total bilirubin, total bile acid, alanine aminotransferase, creatinine, urea nitrogen, blood ammonia and endotoxin levels(P＜0.05); the levels of serum NO, TNF-α, IL-4 and IL-6 were significantly decreased(P＜0.05); there was no statistical change in erythrocytes, leukocytes and platelets. The survival rate of 30 liver failure patients caused by severe hepatitis B was 60.0%(18/30). Six patients with acute liver failure were successfully performed liver transplantation. Two patients in 6 with acute liver failure after liver transplantation survived. One patient in 2 with acute liver failure after pancreatoduodenectomy survived. Conclusion ALSS plays a positive role in treatment of liver failure by removing blood toxins, NO and cytokines. ALSS also plays a substitute role for liver failure patients who are waiting for liver transplantation.
ObjectiveTo observe the clinical efficacy and safety of Lacosamide (LCM) monotherapy in treating Benign epilepsy with centro-temporal spikes (BECT) at children. MethodsThe present research included 57 children with BECT who were treated with LCM monotherapy in the Children's Hospital Affiliated to Soochow University from June 2020 to June 2021. Among them, 26 were males and 31 were females, with an average age of (7.5±2.3) years. Analyze the efficacy and adverse reactions of 1, 2, 4, 6, 9 and 12 months after LCM treatment. The starting dose of LCM was 2 mg/(kg·d); increased 2 mg/(kg·d) every seven days; and titrated up to 4 ~ 8 mg/(kg·d) in children with weight ≥30 kg and <50 kg; titrated up to 6 ~ 12 mg/(kg·d) in children with weight ≥11 kg and <30 kg.ResultThe total effective rate was 94.12%; the cumulative control rate after 12-month medication was 86.27%; and the retention rate was 89.47%. Those all showed a higher rate. ConclusionLCM is significantly effective to BECT with less adverse reactions and more safety. It has high clinical application value.
ObjectiveIn order to evaluate the efficacy, safety and tolerability of adjunctive perampanel in children with refractory epilepsy. MethodsThis study collected medical records of 34 children with refractory epilepsy, who were admitted to Children’s Hospital of Soochow University from January 2020 to January 2021. By comparing the baseline status with the status at 4, 8, 12, 24, 36, and 48 weeks of follow-up, the efficacy and adverse reactions of perampanel were evaluated. ResultsThe mean age of the patients treated with perampanel was 8.1±4.1 years. The male-to-female ratio was 1: 1. After the addition of perampanel, the average responder rate at the 4th, 8th, 12th, 24th, 36th, 48th weeks were 37.5%, 46.7%, 50.0%, 47.4%, 53.8%, 42.9%. The adverse events were reported by 32.4%, and the retention rate was 88.2%. ConclusionsPerampanel has good efficacy, safety and tolerability in the treatment of refractory epilepsy. Moreover, personalized treatment and better baseline seizure control may increase the effectiveness and retention rate of perampanel.
Objective To explore the effect of cytotoxic T lymphocyte-associated antigen 4 (CTLA4-Ig) fusion protein on the function of orthotopic liver allograft. Methods Orthotopic liver allograft models of rhesus monkeys were established in this study. The survival time, liver function and morphologic changes of graft were observed, respectively. The levels of IL-2 and IL-10 were detected by ELISA. Apoptosis was monitored by TUNEL.Results The average survival of control group was 6.57 d, while the average survival of CTLA4-Ig group was 14.92 d, which was statistically prolonged (Plt;0.05). Serum ALT level was highly increased, and Alb level decreased obviously in control group. While the levels of ALT and Alb kept in normal in CTLA4-Ig group. After day 3-7, the expressions of IL-2 were highly expressed in control group, while the expressions of IL-10 in CTLA4-Ig group were higher than those of control group. The severity of rejection reaction after day 3 was weaker in CTLA4-Ig group than that of control group by histological assessment. The apoptosis index after day 3 in the liver cells was highly increased in control group as compared with the CTLA4-Ig group. Conclusions CTLA4-Ig fusion protein therapy can induce immunotolerance and prolong the survival of recipients. The increasing of cytokines IL-2 or the decreasing of cytokines IL-10 may be one of the laboratory indexes in monitoring immunotolerance of transplantation.
Objective To explore the relationship between acute rejection and expression levels of perforin mRNA in peripheral blood and bile after rat liver transplantation so as to look for a kind of noninvasive method to diagnose acute rejection. Methods Rat orthotopic liver transplantation model with biliary extra-drainage was established. They were divided into 4 groups: blank control group (n=20)， isograft group (n=30)， allograft plus cyclosporine A (CsA) group (n=30) and allograft group (n=30). Semi-quantatative RT-PCR was used to measure the expressions of perforin mRNA in bile and peripheral blood and the pathological changes of the graft were observed on postoperative days of 1, 3, 5, 7 and 10. Results Blank control group and isograft group showed no expression of perforin mRNA in peripheral blood. The expression of perforin mRNA of peripheral blood in allograft group could be detected on day 3 after transplantation and it gradually elevated on day 5 and remained in high level during 7-11 days. In allograft plus CsA group perforin mRNA of peripheral blood continuously expressed in a low level, and the level at the same time points was significantly different compared with allograft group (P＜0.05). The expression of perforin mRNA in peripheral blood was analogous with the severity degree of histologic damage. The expression of perforin mRNA can not be found in bile. Conclusion The expression of perforin mRNA in the peripheral blood offers a sensitive and noninvasive means of monitoring acute rejection.