A 22-year-old Chinese man presented with fever, cough, hoarseness, neck pain, acute heart failure and hemoptysis. Pulmonary tuberculosis was proved by sputum culture. Chest imaging showed an aortic arch pseudoaneurysm...A 22-year-old Chinese man presented with fever, cough, hoarseness, neck pain, acute heart failure and hemoptysis. Pulmonary tuberculosis was proved by sputum culture. Chest imaging showed an aortic arch pseudoaneurysm and bilateral ground glass opacities. Echocardiography confirmed cardiomyopathy. With anti-TB drugs, high-dose prednisone and surgery, the life of this patient was successfully prolonged for more than four months. The concomitant disorders of aortic pseudoaneurysm, alveolar hemorrhage and cardiomyopathy in pulmonary tuberculosis are intriguing. We postulate that immune-mediated small vessel vasculitis triggered by pathogens plays an important role in the pathogenesis of this disease, rather than a direct TB infection.展开更多
Tibetan kefir grains(TKGs)and their products are multi-functional health supplements.This study aimed to explore the diversity of microorganisms in Tibetan kefir grains(TKGs)and the protective effect of isolates on et...Tibetan kefir grains(TKGs)and their products are multi-functional health supplements.This study aimed to explore the diversity of microorganisms in Tibetan kefir grains(TKGs)and the protective effect of isolates on ethanol-treated HepG2 cells.Metagenomic sequencing showed that Lactobacillus Kefiranofaciens was the most abundant bacterial taxon,while Kluyveromyces marxianus was the most abundant fungal taxum in TKGs.Thirteen isolates belonging to the genera Lactobacillus(3),Fructobacillus(1),Lactococcus(1),Pediococcus(1),Acetobacter(3),and Kluyveromyces(4),were obtained by cultivation methods.KEGG pathway analysis revealed that K.marxianus contributed four KEGG pathways related to hepatic disease.LC-MS analysis revealed CFEs are rich sources of peptides amino acids,lipids and amino acids.Cell-free extracts(CFEs)prepared from K.marxianus protected HepG2 cells from ethanol-induced injury.Treatment with CFEs from isolates YG-4 and YK-6 significantly increased cell viability and reduced ethanol cytotoxicity.Also,YG-4 and YK-6 decreased reactive oxygen species,malondialdehyde and alanine aminotransferase,increased superoxide dismutase and catalase,and reduced apoptosis and loss of potential in mitochondria.In addition,CFEs,especially YG-4-derived CFEs,decreased ethanol-induced inflammatory cytokines(IL-6,IL-17 and TNF-α),while YG-4 and YK-6 CFEs upregulated the regulatory cytokine IL-4.Thus,YG-4 had the most significant anti-inflammatory effects by reducing ethanol-induced oxidative stress.These isolates’properties may provide new avenues to use K.maxianus in alcoholic liver disease.展开更多
Chronic disseminated intravascular coagulation （DIC） is a rare but devastating complication of aortic aneurysm （AA）. This study investigated the clinical manifestations, laboratory findings, and treatment of patie...Chronic disseminated intravascular coagulation （DIC） is a rare but devastating complication of aortic aneurysm （AA）. This study investigated the clinical manifestations, laboratory findings, and treatment of patients with AA-associated chronic DIC （AA-DIC） and explored the mechanisms, duration, and therapeutic response of AA-DIC. We retrospectively reviewed the medical records of 235 AA patients admitted at the Peking Union Medical College Hospital between September 2009 and January 2015. The patients were classified as those with DIC （AA-DIC） and those without DIC （non-DIC）. The AA-DIC group showed a significantly higher proportion of female patients and a significantly longer AA disease course than the non-DIC group did. The AA-DIC patients presented mural thrombi, dissecting aneurysms, a family history of AA, and diabetes significantly more frequently than the non-DIC patients did. Furthermore, multiple regression analyses revealed that sex, mural thrombus, aneurysm type, diabetes, and stent surgery are possible independent risk factors for AA-DIC patients. Fifty-two （22.1%） patients presented AA-DIC. Among these patients, 43 had non-typical DIC and 9 had typical DIC; the mortality rate of the latter was 22.2%. The mean age of the patients with typical DIC was significantly higher than of that of patients with non-typical DIC. The non-typical DIC patients also presented abnormal coagulation disorders of varying degrees. Furthermore, heparin or low-molecular-weight heparin improved the clinical symptoms and laboratory parameters in patients with AA and typical DIC. Thus, chronic DIC should be considered in patients with AA.展开更多
文摘A 22-year-old Chinese man presented with fever, cough, hoarseness, neck pain, acute heart failure and hemoptysis. Pulmonary tuberculosis was proved by sputum culture. Chest imaging showed an aortic arch pseudoaneurysm and bilateral ground glass opacities. Echocardiography confirmed cardiomyopathy. With anti-TB drugs, high-dose prednisone and surgery, the life of this patient was successfully prolonged for more than four months. The concomitant disorders of aortic pseudoaneurysm, alveolar hemorrhage and cardiomyopathy in pulmonary tuberculosis are intriguing. We postulate that immune-mediated small vessel vasculitis triggered by pathogens plays an important role in the pathogenesis of this disease, rather than a direct TB infection.
基金supported by the National 13th Five-Year Key Research and Development Program(2019YFC1606703).
文摘Tibetan kefir grains(TKGs)and their products are multi-functional health supplements.This study aimed to explore the diversity of microorganisms in Tibetan kefir grains(TKGs)and the protective effect of isolates on ethanol-treated HepG2 cells.Metagenomic sequencing showed that Lactobacillus Kefiranofaciens was the most abundant bacterial taxon,while Kluyveromyces marxianus was the most abundant fungal taxum in TKGs.Thirteen isolates belonging to the genera Lactobacillus(3),Fructobacillus(1),Lactococcus(1),Pediococcus(1),Acetobacter(3),and Kluyveromyces(4),were obtained by cultivation methods.KEGG pathway analysis revealed that K.marxianus contributed four KEGG pathways related to hepatic disease.LC-MS analysis revealed CFEs are rich sources of peptides amino acids,lipids and amino acids.Cell-free extracts(CFEs)prepared from K.marxianus protected HepG2 cells from ethanol-induced injury.Treatment with CFEs from isolates YG-4 and YK-6 significantly increased cell viability and reduced ethanol cytotoxicity.Also,YG-4 and YK-6 decreased reactive oxygen species,malondialdehyde and alanine aminotransferase,increased superoxide dismutase and catalase,and reduced apoptosis and loss of potential in mitochondria.In addition,CFEs,especially YG-4-derived CFEs,decreased ethanol-induced inflammatory cytokines(IL-6,IL-17 and TNF-α),while YG-4 and YK-6 CFEs upregulated the regulatory cytokine IL-4.Thus,YG-4 had the most significant anti-inflammatory effects by reducing ethanol-induced oxidative stress.These isolates’properties may provide new avenues to use K.maxianus in alcoholic liver disease.
文摘Chronic disseminated intravascular coagulation （DIC） is a rare but devastating complication of aortic aneurysm （AA）. This study investigated the clinical manifestations, laboratory findings, and treatment of patients with AA-associated chronic DIC （AA-DIC） and explored the mechanisms, duration, and therapeutic response of AA-DIC. We retrospectively reviewed the medical records of 235 AA patients admitted at the Peking Union Medical College Hospital between September 2009 and January 2015. The patients were classified as those with DIC （AA-DIC） and those without DIC （non-DIC）. The AA-DIC group showed a significantly higher proportion of female patients and a significantly longer AA disease course than the non-DIC group did. The AA-DIC patients presented mural thrombi, dissecting aneurysms, a family history of AA, and diabetes significantly more frequently than the non-DIC patients did. Furthermore, multiple regression analyses revealed that sex, mural thrombus, aneurysm type, diabetes, and stent surgery are possible independent risk factors for AA-DIC patients. Fifty-two （22.1%） patients presented AA-DIC. Among these patients, 43 had non-typical DIC and 9 had typical DIC; the mortality rate of the latter was 22.2%. The mean age of the patients with typical DIC was significantly higher than of that of patients with non-typical DIC. The non-typical DIC patients also presented abnormal coagulation disorders of varying degrees. Furthermore, heparin or low-molecular-weight heparin improved the clinical symptoms and laboratory parameters in patients with AA and typical DIC. Thus, chronic DIC should be considered in patients with AA.
