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Xu H.-B.,Shanghai Tenth Peoples Hospital | Jiang R.-H.,Tongji University | Xiao H.-P.,Tongji University
Clinical Microbiology and Infection | Year: 2012

Clofazimine has shown activity against Mycobacterium tuberculosis, including multidrug-resistant strains in vitro and in animal studies. However, clinical experience with clofazimine in multidrug-resistant tuberculosis (MDR-TB) is scarce. We reported our clinical experience with 39 MDR-TB patients treated with combination regimens that included clofazimine. From January 2008 to March 2011, 39 patients received clofazimine for the treatment of MDR-TB in Shanghai Pulmonary Hospital. Patients had isolates resistant to a median of six drugs (range, 2-11 drugs). Of the 39 cases, 36 had cavitary changes noted on initial chest radiograph or chest computed tomography, and positive sputum-smear microscopy results at the time of MDR-TB diagnosis. At data censure, 15 of the 39 patients had successful therapy, with at least five consistently negative cultures documented for the final 12 months of treatment. Eleven continued to receive treatment. There were no deaths. Thirteen patients had a poor outcome, including four defaults and nine treatment failures. Culture conversion occurred in 22 cases at a median of 12weeks. Side-effects occurred in 34 patients, mainly including skin discolouration, ichthyosis and gastrointestinal adverse events. No patients reported significant toxicity likely to be attributable to clofazimine therapy. Adverse events were managed by combinations of dose adjustment and symptom management. In our experience, clofazimine was well tolerated and may have efficacy in the treatment of MDR-TB. © 2011 European Society of Clinical Microbiology and Infectious Diseases. Source

Xie X.,Northwest University, China | Xie X.,Institute of Integrated Medical Information | Wu X.,Shanghai Tenth Peoples Hospital | Cui J.,Northwest University, China | And 2 more authors.
Brain Research | Year: 2013

Subarachnoid hemorrhage (SAH) is a frequent occurrence in cerebrovascular accidents, and inflammation occurs in the subarachnoid space after SAH. Arachnoid cells have the capability to present antigens and active T-lymphocytes after stimulation by cerebrospinal fluid (CSF). However, the effect of CSF on T-lymphocytes and arachnoid cell adhesion was not clearly understood. In this study, we used ELISA to detected tumor necrosis factor-α (TNF-α) content in CSF of SAH patients. CSF or recombinant TNF-α were applied on arachnoid cells and T-lymphoctes, and RT-PCR and western blotting were performed to determine the expression of intercellular adhesion molecule-1 (ICAM-1) in arachnoid cells and Lymphocyte Function-Associated Antigen-1 (LFA-1) in T-lymphocytes, respectively. Meanwhile, the Matrix Metal Proteinase-9 (MMP-9) expression in these cells was also determined. We found that the content of TNF-α in the CSF was significantly increased in the CSF of SAH patients (from 22±8 pg/mL of healthy people to 436-450 pg/mL of SAH patients). Treatement with CSF could increase the expression of ICAM-1in arachnoid cells and that of LFA-1 in T-lymphocytes, mainly through the increased levels of TNF-α. We also found that the co-culture of arachnoid cells and T-lymphocytes increased the expression of MMP-9 in both cells through the interaction of ICAM-1 of and LFA-1. All of these results suggested that arachnoid cells are involved in the T-lymphocytes invasion in the subarachnoid space after SAH. © 2013 Elsevier B.V. Source

Gu G.F.,Shanghai Tenth Peoples Hospital
Zhonghua wai ke za zhi [Chinese journal of surgery] | Year: 2011

To investigate the clinical results of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for lumbar spinal stenosis with lumbar instability. Retrospective study was done on 42 cases of lumbar spinal stenosis with lumbar instability treated with bilateral decompression via unilateral approach and MIS-TLIF through an expandable tubular retractor from March 2010 to January 2011. There were 18 males and 24 females, and mean age was 61.7 years (rang, 48 - 79 years). The level of surgery was L(3-4) in 4 patients, L(4-5) in 26 patients, and L(5)-S(1) in 12 patients. All patients had symptoms of intermittent claudication. And 24 patients had symptoms of lower extremity pain and numbness in one side, and 18 patients had same symptoms in both legs. Operation time, intra-operative bleeding, postoperative hospital stay and complications were recorded. Visual analogue scale (VAS) scores for low back pain and leg pain were recorded before and after surgery. Oswestry disability index (ODI) scores were also recorded before and after surgery. The Bridwell criterion was used for evaluating the interbody fusion, and the MacNab criterion was used for assessment after surgery. The mean operative time was 150.4 minutes (range, 120 - 170 minutes), and mean blood loss was 147.1 ml (range, 50 - 400 ml). The hospitalization time after surgery was 5 - 18 d, an average of 8.8 d. All cases were followed-up for 6 - 14 months (average 11 months). VAS score of low back pain before surgery was 7.3 ± 1.0, and were 2.9 ± 0.8 and 2.0 ± 0.8 at three months after surgery and the last follow-up respectively. VAS score of leg pain before surgery was 7.9 ± 0.7, and were 2.0 ± 0.5 and 1.0 ± 0.7 at three months after surgery and the last follow-up respectively. ODI score was 75% ± 6% before surgery, were 16% ± 6% and 12% ± 5% at three months after surgery and the last follow-up respectively. VAS and ODI scores showed statistically significant improvements (t = 3.110 - 56.323, P < 0.01). There were 40 cases were grade I and II, according to the Bridwell criteria. The clinical results were excellent in 16 cases, good in 22 cases and fair in 4 cases to the MacNab criteria at the final follow-up. MIS-TLIF is an ideal surgical method for single segment lumbar spinal stenosis with lumbar instability, but close attention should be paid to specific patients, surgeons and hospitals. Source

Li Q.,Shanghai University | Zhang Z.,Shenyang University | Cai Z.,Shanghai Tenth Peoples Hospital
Spine | Year: 2011

STUDY DESIGN. Meta-analysis of literature. OBJECTIVE. To evaluate the effect of perioperative nonsteroidal anti-inflammatory drugs (NSAIDs) on the success rate of adult spinal fusion. SUMMARY OF BACKGROUND DATA. NSAIDs are commonly used to treat postsurgical orthopedic pain. Studies on animal models have shown a significant inhibiting effect of NSAIDs on osteogenesis process, on which spinal fusion also depends. Recently, great interest has been shown in the effect of NSAIDs on the success rate of adult spinal fusion. Clinical trials have tested the effect of perioperative NSAIDs in spinal fusion procedures. A cumulative result of these studies would give more credit to the final conclusions. METHODS. A systematic search of electronic databases and references from eligible articles was conducted. Comparative studies reporting on the results of primary spinal fusion including treatment group of NSAIDs perioperatively were regarded eligible. A pooled estimate of effect size was produced using both random and fixed effect model. RESULTS. Five retrospective comparative studies (n = 1403 participants) were included in the present study. The mean age of these patients was more than 40 years and none of them had NSAIDs for longer than 14 days following spinal fusion surgery. High-dose ketorolac showed a statistically significant adverse effect on spinal fusion (P = 0.001, RR = 2.87, 95% CI = 1.53 = - 5.38) with no statistical heterogeneity (I = 3%, P = 0.38), whereas normal-dose NSAIDs (ketorolac, diclofenac sodium, celecoxib, or rofecoxib) did not appear to produce inferior results than the no-NSAIDs group (P = 0.30, RR = 1.39, 95% CI = 0.74 - 2.61) with no statistical heterogeneity (I = 0%, P = 0.50). CONCLUSION. Although randomized controlled trials would be optimal for meta-analyses, the data of this review revealed that short-time (<14 days) exposure to normal-dose NSAIDs (ketorolac, diclofenac sodium, celecoxib, or rofecoxib) were safe after spinal fusion, whereas short-time (<14 days) exposure to high-dose ketorolac increased the risk of nonunion, which meant that the effect of perioperative NSAIDs on spinal fusion might be dose-dependent. Further studies would be needed to find out whether long-time exposure to normal-dose NSAIDs could also increase the risk of nonunion and which type of NSAIDs would like to have a worse effect on spinal fusion. © 2011 Lippincott Williams & Wilkins, Inc. Source

The present invention discloses a drug screening method, drugs promoting extracellular matrix protein crosslinking and their applications, the said drug screening method, is used to screen out materials promoting the expression of LOXL1 gene, wherein, the said drug screening method contains the following steps: A, Construct the 2nd generation lentiviral vector used to control the ZsGreen expression by human LOXL 1 gene promoter. B, Infect human fibroblasts with the 2nd generation lentiviral vector, and construct the new human fibroblasts which integrate PLOXL1-ZsGreen components. C, Drug screening: Inoculate the said human fibroblasts integrating PLOXL1-ZsGreen components into culture medium. Add the analyte into the cell culture medium containing human fibroblast cells. After culturing, detect the green fluorescence intensity of these fibroblast cells, then decide if the analyte promotes LOXL1 gene expression by checking if the green fluorescence intensity is increased. The method provided by the present invention is easy to operate and widely applicable.

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