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Invasive Fungal Sinusitis in Immunocompromised Patients: A Multicenter, University Hospital Experience in Shiraz

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Advances in Infectious Diseases 2013年第4期3卷 263-268页

作者： Mohsen Moghadami Hossein Ruzbahani parisa badiee Abolhassan Faramarzi Payam Peymani Kamran Bagheri Lankarani Alborzi Clinical Microbiology Research Center Shiraz University of Medical Sciences Shiraz Iran Department of Internal Medicine Shiraz Uni- versity of Medical Sciences Shiraz Iran Department of Otolaryngology Shiraz University of Medical Sciences Shiraz Iran Health Policy Research Center Shiraz University of Medical Sciences Shiraz Iran

Objective: It is to determine the causes of invasive fungal sinusitis in patients of Shiraz University hospitals, Iran. Methods: This cross-sectional study was conducted during 18 months (from 21 March 2009 till 22 September 2010) in three Shiraz University Hospitals. Thirty-six patients with sings of invasive fungal sinusitis were enrolled, and tissue samples were investigated for histopathology, culture and antifungal susceptibility test. The laboratory results with host factor and sinus computed tomography scan were evaluated for classification of patients as proven, probable and possible invasive fungal sinusitis. Results: Thirty-five patients have involved with at least one risk factor (immune compromised disease, diabetes mellitus, or use of immune suppressed drugs). Radiological findings of parasinus invasion or necrosis were present in 20 patients. By histopathology, 21 patients were considered as proven, from these, 17 samples had positive growth. The culture aetiology agents were 4 Candida, 8 Aspergillus, and 5 Mucor. All positive culture samples were matched with histopathology findings. Significant associations were considered for radiologic finding and histopathology and culture (p 0.05). From 8 patients with mucormycosis histopathology, 6 suffered from diabetes mellitus. None of the antifungal agents were effective on these three types of infections. Conclusion: DM is the most common predisposing factor for IFS followed by ALL and AML. The most common aetiology of IFS was found to be Aspergillus fumigant followed by Mucormycosis and Candida. None of antifungal agents could successfully cover all the species.

关键词： Fungal Sinusitis Mucor Mycosis Aspergillus Invasive Fungal

Preparation, characterization and in vivo evaluation of alginate-coated chitosan and trimethylchitosan nanoparticles loaded with PR8 influenza virus for nasal immunization

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Asian Journal of Pharmaceutical Sciences 2019年第2期14卷 216-221页

作者： Jafar Mosafer Amir-Hossein Sabbaghi Ali badiee Solmaz Dehghan Mohsen Tafaghodi Research Center of Advanced Technologies in Medicine Torbat Heydariyeh University of Medical Sciences School of Pharmacy Mashhad University of Medical Sciences Student Research Committee Mashhad University of Medical Sciences Nanotechnology Research Center Pharmaceutical Technology Institute Mashhad University of Medical Sciences

For efficient mucosal vaccine delivery, nanoparticulate antigens are better taken by microfold cells in the nasal associated lymphoid tissue and also dendritic cells. Nanoparticles based on polymers such as chitosan(CHT) and its water soluble derivative, trimethylchitosan(TMC), could be successfully used as carrier/adjuvant for this purpose. Sodium alginate, a negatively charged biopolymer, could modify the immunostimulatory properties of CHT and TMC NPs and increase their stability. Sodium alginate(ALG)-coated chitosan(CHT)and trimethylchitosan(TMC) nanoparticles(NPs) loaded with inactivated PR8 influenza virus were successfully prepared by direct coating of the virus with CHT or TMC polymers to evaluate their immunoadjuvant potential after nasal immunization. After nasal immunizations in BALB/c mice, PR8-CHT formulation elicited higher IgG2 a and Ig G1 antibody titers compared with PR8-TMC. ALG coating of this formulation(PR8-CHT-ALG) significantly decreased the antibody titers and a less immune response was induced than PR8-TMC-ALG formulation. PR8-TMC-ALG formulation showed significantly higher Ig G2 a/Ig G1 ratio, as criteria for Th1-type immune response, compared with PR8-CHT-ALG and PR8 virus alone. Altogether, the PR8-TMC-ALG formulation could be considered as an efficient intranasal antigen delivery system for nasal vaccines.

关键词： Chitosan Trimethyl chitosan Alginate PR8 influenza virus Nasal immunization

口服消炎痛和布洛芬治疗早产儿动脉导管未闭的比较

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中国当代儿科杂志 2007年第5期9卷 399-403页

作者： Saed Hossein FAKHRAEE Zohreh badiee Saied MOJTAHEDZADEH Mohammad KAZEMIAN Roya KELISHADI Shahid Beheshti 大学医学院新生儿科德黑兰伊朗

目的静脉注射消炎痛是早产儿动脉导管未闭的常规治疗方法，但治疗过程中常出现一些副作用，如少尿、消化道出血、脑血流灌注减少。近年来，静脉注射布洛芬已用于治疗早产儿动脉导管未闭。布洛芬治疗不会减少脑血流灌注，也不会影响胃肠... 详细信息

目的静脉注射消炎痛是早产儿动脉导管未闭的常规治疗方法，但治疗过程中常出现一些副作用，如少尿、消化道出血、脑血流灌注减少。近年来，静脉注射布洛芬已用于治疗早产儿动脉导管未闭。布洛芬治疗不会减少脑血流灌注，也不会影响胃肠道和肾脏的血流动力学。伊朗目前尚无消炎痛和布洛芬的静脉制剂供应。该研究旨在比较这两种药的口服制剂治疗早产儿动脉导管未闭的疗效和安全性。方法36例胎龄小于34周经超声心动图确诊患有动脉导管未闭的早产儿被随机分为两组，每组18人。一组给予消炎痛口服，每次0．2mg／kg，24h给药1次，共3次。另一组给予布洛芬口服，共3次，间隔时间为24h，首剂为10mg／kg，随后两次各5mg／kg。用药后观察导管闭合率、副作用、并发症及临床过程。结果用药后布洛芬组18例患儿动脉导管都闭合（100％），而消炎痛组18例中有15例患儿动脉导管闭合（83．3％）（P〉0．05）。两组疗效差异统计学无显著性意义。治疗前后两组的血清尿素氮和肌酐含量差异也无显著性意义。消炎痛组发生了3例（16．6％）坏死性小肠结肠炎，布洛芬组则无，差异有显著性意义（P〈0．05）。治疗1个月后两组成活率均为94％（17／18）。消炎痛组1例死于坏死性小肠结肠炎，布洛芬组1例死于败血症。结论口服布洛芬治疗早产儿动脉导管未闭和口服消炎痛治疗一样有效，而且坏死性小肠结肠炎的发生率较口服消炎痛治疗低。

关键词：布洛芬消炎痛口服动脉导管未闭早产儿

Demographic Characteristics of Patients and Causes Leading to Chronic Renal Failure in Children Admitted to Mashhad Children Hospital

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Open Journal of Nephrology 2017年第2期7卷 47-55页

作者： Anoush Azarfar Mohammad Esmaeeli Yalda Ravanshad Mitra Naseri Shapour badiee Aval Fatemeh Ghanee Sharbaf Sahar Ravanshad Hassan Mehrad-Majd Zohreh Mohammadi Department of Pediatric Faculty of Medicine Mashhad University of Medical Sciences Mashhad Iran Clinical Research Unit Mashhad University of Medical Sciences Mashhad Iran Department of Acupuncture Faculty of Medicine Mashhad University of Medical Sciences Mashhad Iran Department of Internal Medicine Mashhad University of Medical Sciences Mashhad Iran

Background: An irreversible renal function impairment is called chronic renal failure (CRF) which finally leads to the “end-stage renal disease” (ESRD) and requires renal replacement therapies. The aim of this study is to evaluate the incidence, prevalence of epidemiological indicators (age, sex), and causes of chronic renal failure in children in Mashhad (one of the big cities of Iran). Methods: This is a cross-sectional study that was conducted on patients’ records over a seven-year period (2008-2014) in Doctor Sheikh Children’s Hospital of Mashhad. The inclusion criteria were all children under 20 years old diagnosed with ESRD, with a GFR less than 15 ml/min/1.73 m2 who were referred to the hospital during the study period. Patients’ information, such as age, gender, onset of dialysis, causes of constructing renal failure, and positive or negative antigen of hepatitis B was extracted from their records. Data were analyzed using SPSS 16 software. Results: A total of 326 patients were studied, of which, 56.4% were male. 45.1% were from 7 to 18 years. 56.4% of patients were on hemodialysis and others were on peritoneal dialysis. The most common cause of chronic renal failure in the study was respectively reflux nephropathy (32.9%), nephrotic syndrome (8.9%), neurogenic bladder (5.5%), stones (2.5%), glomerulopathy (2.1%) and cystinosis (1.5%) and (20.9%) had unknown cause. During the 7-year period of study considering the treatment outcomes, 69.3% of patients needed to continue the dialysis;10.4% underwent transplantation;10.4% unfortunately died despite of treatment and 1.5% were cured. Conclusions: It is hoped that considering the clinical symptoms of children with chronic renal failure and the diagnosis of the cause, we can reduce complications of the disease with a quick diagnosis and treatment, as well as appropriate follow-up.

关键词： Chronic Renal Failure Children Chronic Kidney Disease

NIHSS绝对值变化与NIHSS变化率对脑梗死患者残疾预测能力的比较研究

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中风与神经疾病杂志 2011年第2期28卷 156-158页

作者：王平平高颖刘璐马斌曹克刚辛喜艳张杨 ShaPour badiee Aval Baghyahi 北京中医药大学东直门医院神经内科北京100700

目的探讨美国国立卫生研究院卒中量表(NIHSS)绝对值的变化与NIHSS变化率对脑梗死患者功能残疾的预测价值。方法采用前瞻性设计对10个临床研究中心急性期脑梗死患者的数据进行分析,筛选出入院当天、发病90d NIHSS评分和BI数据资料完整患... 详细信息

目的探讨美国国立卫生研究院卒中量表(NIHSS)绝对值的变化与NIHSS变化率对脑梗死患者功能残疾的预测价值。方法采用前瞻性设计对10个临床研究中心急性期脑梗死患者的数据进行分析,筛选出入院当天、发病90d NIHSS评分和BI数据资料完整患者953例,按入院时NIHSS评分分为轻、中、重度,以BI作为功能残疾疗效判定"金标准",应用ROC比较NIHSS绝对值变化与NIHSS变化率对患者功能残疾的判断价值。结果轻、中、重度患者AUC曲线下面积分别为0.60、0.76、0.93,与AUC曲线下面积=0.50比较,中、重度患者差异有统计学意义(P<0.05)。NIHSS变化率在轻、中、重度患者中分别为0.76、0.85、0.97,与AUC曲线下面积=0.50比较,差异均有明显统计学意义(P<0.01)。脑梗死患者良好功能结局的最佳NIHSS绝对值变化的界值在轻、中、重度患者中分别为2.5、4.5、14.5;敏感性分别为0.57、0.92、1.00,特异性分别为0.61、0.50、0.89;NIHSS变化率的界值在轻、中、重度患者中分别为70.8%、74.7%、84.9%;敏感性分别为0.63、0.82、1.00,特异性分别为0.78、0.75、0.94。结论 NIHSS绝对值变化、NIHSS变化率对患者功能残疾的预测能力随着神经功能缺损程度的增加而增大,而后者对结局预测能力更佳。

关键词： NIHSS绝对值变化 NIHSS变化率脑梗死功能结局残疾

ROC曲线分析NIHSS的变化率预测脑梗死患者功能残疾的可行性

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中西医结合心脑血管病杂志 2011年第4期9卷 419-421页

作者：王平平高颖刘璐马斌曹克刚辛喜艳 Shapour badiee Aval Baghyahi 北京中医药大学东直门医院

目的通过对美国国立卫生研究院卒中量表（NIHSS）评分变化率的分析试图为脑梗死临床结局评价方法的选择提供一种新的思路与方法。方法本项研究采取前瞻性设计对来自10个临床研究中心急性期脑梗死住院患者的数据内容进行分析,筛选出入院... 详细信息

目的通过对美国国立卫生研究院卒中量表（NIHSS）评分变化率的分析试图为脑梗死临床结局评价方法的选择提供一种新的思路与方法。方法本项研究采取前瞻性设计对来自10个临床研究中心急性期脑梗死住院患者的数据内容进行分析,筛选出入院当天NIHSS评分、发病90 d NIHSS评分和BI数据资料完整患者953例,将患者按入院时NIHSS评分分为3级：轻度（〈7分）、中度（7分-15分）、重度（〉15分）,以BI作为功能残疾的疗效判定＂金标准＂,发病90 d BI≥95分为预后良好、BI〈95分为预后不良的分界点将BI转换为二分类变量（残疾与否）,应用ROC曲线了解NIHSS的变化率对脑梗死患者发病90天功能残疾的判断价值。结果本研究发现NIHSS变化率预测脑梗死患者发病90 d功能残疾的AUC曲线下面积均〉0.70,轻度患者为0.76、中度患者为0.85,重度患者为0.97,与AUC曲线下面积=0.50进行比较,差异有统计学意义（P≤0.001）。预测脑梗死患者良好功能结局的最佳NIHSS变化率的截断值在轻度、中度、重度神经功能缺损的患者分别为70.8%、74.7%、84.9%;其灵敏度在三者分别为63.0%、81.8%、100.0%,特异度分别为78.1%、75.4%、94.3%。结论 NIHSS的变化率对脑梗死患者发病90 d功能残疾具有较好的预测能力,且这种预测能力随着神经功能缺损程度的增加而增大。

关键词： NIHSS的变化率脑梗死功能结局残疾