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Background@#Data on the efficacy and incidence of adverse effects associated with dexmedetomidine (DEX) as a local anesthetic adjuvant for patient-controlled epidural analgesia (PCEA) are inconclusive. This meta-analysis assessed the efficacy and risks of DEX for PCEA using opioids as a reference. @*Methods@#Two researchers independently searched PubMed, Embase, Cochrane Library, and China Biology Medicine for randomized controlled trials comparing DEX and opioids as local anesthetic adjuvants in PCEA. @*Results@#In total, 636 patients from seven studies were included in this meta-analysis. Postoperative patients who received DEX had lower visual analog scale (VAS) scores than those who received opioids at 4–8 h (mean difference [MD]: 0.61, 95% CI [0.45, 0.76], P < 0.001, I2 = 0%), 12 h (MD: 0.85, 95% CI [0.61, 1.09], P < 0.001, I2 = 0%), 24 h (MD: 0.59, 95% CI [0.06, 1.12], P = 0.030, I2 = 82%), and 48 h (MD: 0.54, 95% CI [0.05, 1.02], P = 0.030, I2 = 91%). Additionally, patients who received DEX had a lower incidence of itching (odds ratio [OR]: 2.86, 95% CI [1.18, 6.95], P = 0.020, I2 = 0%) and nausea and vomiting (OR: 6.83, 95% CI [3.63, 12.84], P < 0.001, I2 = 24%). In labor analgesia, no significant differences in neonatal (pH and PaO2 of cord blood, fetal heart rate) or maternal outcomes (duration of labor stage, mode of delivery) were found between the DEX and opioid groups. @*Conclusions@#Compared with opioids, using DEX as a local anesthetic adjuvant in PCEA improved postoperative analgesia and reduced the incidence of itching and nausea and vomiting without increasing the incidence of adverse events.
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Objective To investigate the effects of cinnamaldehyde,the main active component of cinnamon,on benzene-induced immune injury in mice and the related mechanism.Methods Forty male BALB/c mice were randomly divided into the control group,model group(benzene 500 mg/kg),cinnamaldehyde low,medium and high dose groups(5,25,50 mg/kg),with 8 mice in each group.Except the control group,mice in each group were treated with benzene by intragastric administration daily to induce immune and oxidative stress damage,but the intervention group was treated with cinnamaldehyde 5 times/week for 3 weeks.After medication,peripheral blood was collected 24 h after the last gavage for blood cell count,and the changes in body weight of mice in each group were observed.The pathological structure of the spleen and thymus was observed via hematoxylin-eosin(HE)staining.Peripheral blood mononuclear cells(PBMCs)of mice were extracted and the amounts of reactive oxygen species(ROS)and ATP in mitochondria were measured.Plasma levels of malondialdehyde(MDA)were measured using the barbituric acid method,the activity of glutathione peroxidase(GSH-PX)in plasmawith the dithiodinitrobenzoic acid methodand the activity of total superoxide dismutase(SOD)in plasma using the hydroxylamine method.Results After exposure to benzene,the body weight of the model group became lower(P<0.05).The spleen and thymus were damaged,and the indexes of the spleen and thymus were decreased(P<0.05).Counts of peripheral white blood cells and lymphocyteswere decreased(P<0.05).The activities of GSH and SOD in plasma were decreased(P<0.05),but the content of MDA was increased(P<0.05).The amount of mitochondrial ROS in PBMC was increased,while the ATP content was decreased(P<0.05).The weight of mice increased after treatment with cinnamaldehyde.The spleen and thymus tissues recovered well,and the indexes of the spleen and thymus were increased(P<0.05).Counts of peripheral white blood cells and lymphocytesin the high dose cinnamaldehyde group were increased(P<0.05).The activities of GSH and SOD in plasma were increased,while the content of MDA was decreased(P<0.05).The amount of mitochondrial ROS in PBMC was decreased,but the ATP content was increased(P<0.05).Treatment with cinnamaldehyde could alleviate the damage to the mitochondrial function of PBMC induced by benzene in mice,and 50 mg/kg was the best dose(P<0.05).The therapeutic effect of cinnamaldehyde had a dose-response relationship.Conclusion Cinnamaldehyde can inhibit benzene-induced immune injury and oxidative stress injury in mice by delivering an antioxidant effect and improving mitochondrial enhancement of PBMC.
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【Objective】 To investigate the correlation between heart rate variability (HRV) and the degree of nervousness before blood donation. 【Methods】 The psychological state of 253 blood donors before blood donation was assessed by the self-rating anxiety scale (SAS) and the degree of nervousness and their HRV were measured. The correlation between the SAS score, the degree of nervousness and the HRV parameters was analyzed, and the differences were compared among different types of donors by multivariate linear regression. 【Results】 A total of 247 blood donors were included in the study. Five HRV parameters in blood donors aged 18-24 were higher than in those aged 25 years and above(all P<0.05), and the anxiety level was higher in female donors(SAS score 41-46) than in males(SAS score 35-43)(P<0.001); the pre-donation SAS score was consistent with the assessment of the tension level (r=0.970, P<0.001); the pre-donation tension level and the SAS score were all significantly negatively correlated with VLF in HRV parameters(r=0.179, P=0.005), and the associations were independent of confounders such as age, body mass index and gender (P<0.05). 【Conclusion】 Compared with SAS and tension assessment, HRV is more objective, and can be used as one of the tests for assessing the tension level of blood donors. The inclusion of HRV in the routine screening of blood donors deserves further study for its application in assessing the anxiety level of blood donors before blood donation, identifying people prone to blood donation-related vasovagal reaction (DRVR), preventing and reducing the risk of DRVR, and improving the safety of blood donation.
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The cognitive impairment of diabetes mellitus type 2(T2DM)is closely related to neurovascular coupling(NVC)changes,but the exact mechanism remains unclear.Functional MRI(fMRI)technology were able to jointly analyze NVC changes of T2DM,providing new ideas for revealing the mechanism of cognitive dysfunction caused by T2DM.The progresses of fMRI for exploring NVC changes in T2DM were reviewed in this article.
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Objective:To summarize the clinical features, pregnancy outcomes, and treatment strategies of pulmonary thromboembolism (PTE) in pregnant women and puerperae.Methods:Clinical data of 16 pregnant women or puerperae with PTE who were admitted to Beijing Anzhen Hospital from January 2012 to December 2022 were retrospectively collected. Descriptive statistical analysis was used to summarize the clinical features, treatment strategies, and pregnancy outcomes in these cases.Results:The average age of the 16 patients was (29.6±3.5) years (26-35 years) and the median onset time was 12 weeks (7-38 weeks) of gestation in six pregnant women and 4 d (16 h-40 d) after delivery in ten puerperae. There were two cases of high-risk type; nine cases of medium-risk type (six of medium-high risk and three of medium-low risk); and five cases of low-risk type. Definite high-risk factors were detected in four pregnant women (venous thromboembolism risk score ≤2) and nine puerperae (venous thromboembolism risk score of 2-9). None of the six pregnant women had any indications for preventive anticoagulant therapy and nine puerperae had indications but without preventive therapy. All the patients were treated with low molecular weight heparin and sequential administration of warfarin/rivaroxaban, in addition to that, two high-risk patients also received thrombolytic therapy. After therapy, all pregnant women terminated their pregnancies in time and then continued to receive anticoagulation treatment. All 16 patients survived. Among the six pregnant women, five who developed PTE in the first or second trimester underwent iatrogenic termination of pregnancy, and one who developed PTE in the third trimester gave live birth. Among the 10 puerperae, one had PTE after the termination of pregnancy in the second trimester due to intrauterine fetal death; one developed PTE after abortion in the first trimester; the other eight cases developed PTE after cesarean section in the third trimester, with all newborns surviving.Conclusions:Pregnant women and puerperae are at high risk of PTE and most have high-risk factors. Therefore, more attention should be paid to the screening of high-risk factors and the initiation of preventive anticoagulant therapy. Maternal outcomes are good after PTE treatment, but fetal outcomes depend on the time of onset.
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Liver cancer remains a challenge of global health, being the 4th leading cause of cancer death worldwide. Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer, and is usually precipitated by chronic viral infections (hepatitis B and C), non-alcoholic steatohepatitis, heavy alcohol use, and other factors which may lead to chronic inflammation and cirrhosis of the liver. There have been significant advances in the systemic treatment options for HCC over the past decades, with several approvals of both immune checkpoint inhibitors and tyrosine kinase inhibitors in patients with preserved liver function. These advances have led to improvement in survival outcomes, with expected survival of greater than 18 months, in those with sensitive tumors, adequate liver function, and those functionally fit to receive sequential therapies. Several ongoing and promising trials are now evaluating combinational strategies with novel systemic agents and combinations of systemic therapy with locoregional therapy. In view of these trials, further advances in the treatment of HCC are foreseen in the near future.
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To address the throughput limitations of digital nucleic acid analysis,a tricolor combination-based droplet coding technique was developed to achieve multiplex digital nucleic acid analysis with flexible throughput expansibility.To improve the analysis efficiency,a machine learning-based method was further developed for automatic decoding of color-coded droplet array.The machine learning algorithm empowered the computer program to automatically extract the color-position-quantity information of the droplets.By correlating this color-position-quantity of droplets before and after nucleic acid amplification,the proportion of positive droplets for each target was rapidly determined.This droplet decoding strategy was applied to multiplex digital nucleic acid analysis.The experimental results demonstrated that this droplet decoding method was fast and accurate,with a decoding process completed within 2 min.Furthermore,the droplet identification accuracy exceeded 99%.Additionally,the obtained nucleic acid quantification results exhibited a good correlation(R2＞0.99)with those reported by a commercial digital PCR instrument.
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ObjectiveTo investigate the mechanism of Baihuan Xiaoyao Decoction （Xiaoyaosan added with Lilii Bulbus and Albiziae Cortex） in alleviating depression-like behaviors of juvenile rats by regulating the polarization of microglia. MethodSixty juvenile SD rats were randomized into normal control， model， fluoxetine， and low-， medium-， and high-dose （5.36， 10.71， 21.42 g·kg-1， respectively） Baihuan Xiaoyao decoction groups. The rat model of juvenile depression was established by chronic unpredictable mild stress （CUMS）. The sucrose preference test （SPT） was carried out to examine the sucrose preference of rats. Forced swimming test （FST） was carried out to measure the immobility time of rats. The open field test （OFT） was conducted to measure the total distance， the central distance， the number of horizontal crossings， and the frequency of rearing. Morris water maze （MWM） was used to measure the escape latency and the number of crossing the platform. The immunofluorescence assay was employed to detect the expression of inducible nitric oxide synthase （iNOS， the polarization marker of M1 microglia） and CD206 （the polarization marker of M2 microglia）. Real-time polymerase chain reaction was employed to determine the mRNA levels of iNOS， CD206， pro-inflammatory cytokines ［tumor necrosis factor （TNF）-α， interleukin （IL）-1β， and IL-6］ and anti-inflammatory cytokines （IL-4 and IL-10） in the hippocampus. Western blotting was employed to determine the protein levels of iNOS and CD206 in the hippocampus. The levels of IL-4 and IL-6 in the hippocampus were detected by enzyme-linked immunosorbent assay. ResultCompared with the normal control group， the model rats showed a reduction in sucrose preference （P<0.05）， an increase in immobility time （P<0.05）， decreased motor and exploratory behaviors （P<0.05）， and weakened learning and spatial memory （P<0.05）. In addition， the model rats showed up-regulated mRNA and protein levels of iNOS and mRNA levels of IL-1β， IL-6， and TNF-α （P<0.05）. Compared with the model group， Baihuan Xiaoyao decoction increased the sucrose preference value （P<0.05）， shortened the immobility time （P<0.01）， increased the motor and exploratory behaviors （P<0.05）， and improved the learning and spatial memory （P<0.01）. Furthermore， the decoction down-regulated the positive expression and protein level of iNOS， lowered the levels of TNF-α， IL-1β， and IL-6 （P<0.01）， promoted the positive expression of CD206， and elevated the levels of IL-4 and IL-10 （P<0.01） in the hippocampus of the high dose group. Moreover， the high-dose Baihuan Xiaoyao decoction group had higher sucrose preference value （P<0.01）， shorter immobility time （P<0.01）， longer central distance （P<0.01）， stronger learning and spatial memory （P<0.01）， higher positive expression and protein level of iNOS （P<0.01）， lower levels of TNF-α， IL-1β， and IL-6 （P<0.05， P<0.01）， lower positive expression and mRNA level of iNOS （P<0.05）， and higher levels of IL-4 and IL-10 （P<0.05， P<0.01） than the fluoxetine group. ConclusionBaihuan Xiaoyao decoction can improve the depression-like behavior of juvenile rats by inhibiting the M1 polarization and promoting the M2 polarization of microglia in the hippocampus.
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Objective: To analyze the classification, diagnosis and treatment status of patients with pulmonary hypertension (PH) in Yunnan province. Methods: This was a retrospective study. Hospitalized patients with PH at Yan'an Affiliated Hospital of Kunming Medical University from January 2012 to December 2019 were enrolled. The clinical data of enrolled patients, including demographic data, comorbidities, targeted drug therapy, echocardiography and right heart catheterization results, were obtained through the electronic medical record system. The composition ratio of PH, diagnosis and treatment were analyzed. Results: A total of 13 590 patients with PH were enrolled, accounting for 3.09% (13 590/440 056) of the total number of hospitalizations during the same period. The composition of PH was predominantly pulmonary arterial hypertension (PAH) (55.50% (7 542/13 590)), followed by pulmonary hypertension (PH) caused by left heart disease (24.16% (3 284/13 590)). Among them, PAH could be subdivided into four types: idiopathic pulmonary arterial hypertension (IPAH), PAH associated with connective tissue disease, PAH associated with portal hypertension, and PAH associated with congenital heart disease (CHD-PAH), with CHD-PAH as the predominating type (98.09% (7 398/7 542). Patients with PAH were predominantly adolescents. In hospitalized patients with PH, from 2012 to 2019, the proportion of children and adolescents showed a decreasing trend from year to year, and the proportion of middle-aged and older adults showed a significant increasing trend, and the proportion of female patients showed a gradual decreasing trend, and the proportion of patients with comorbid hypertension, diabetes mellitus, coronary artery disease, arrhythmia, and pneumonia showed an increasing trend. A total of 1 034 patients (7.61% (1 034/13 590)) underwent right heart catheterization. The concordance rate between echocardiographic and right heart catheterization findings was (86.98% (875/1 006)). A total of 2 574 (18.94%) of PH patients were treated with PAH targeted drugs, of which 58.16% (1 497/2 574) were treated with monotherapy. Among the PH patients treated with PAH targeted drugs, the majority of patients were PAH patients (86.44% (2 225/2 574)), and 83.53% (2 150/2 574) patients treated with PAH targeted drugs were CHD-PAH. Conclusions: Hospitalized PH patients in our center between 2012 and 2019 are predominantly CHD-PAH, and the proportion of patients receiving right heart catheterization and targeted drug therapy is relatively low. The percentage of middle-aged and elderly PH patients shows an increasing trend from year to year, as well as the percentage of those with concomitant comorbidities.
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Child , Aged , Adolescent , Middle Aged , Humans , Female , Hypertension, Pulmonary/therapy , Retrospective Studies , China/epidemiology , Familial Primary Pulmonary Hypertension , Pulmonary Arterial Hypertension/complications , Heart Defects, Congenitalالملخص
Objective: To analyze the classification, diagnosis and treatment status of patients with pulmonary hypertension (PH) in Yunnan province. Methods: This was a retrospective study. Hospitalized patients with PH at Yan'an Affiliated Hospital of Kunming Medical University from January 2012 to December 2019 were enrolled. The clinical data of enrolled patients, including demographic data, comorbidities, targeted drug therapy, echocardiography and right heart catheterization results, were obtained through the electronic medical record system. The composition ratio of PH, diagnosis and treatment were analyzed. Results: A total of 13 590 patients with PH were enrolled, accounting for 3.09% (13 590/440 056) of the total number of hospitalizations during the same period. The composition of PH was predominantly pulmonary arterial hypertension (PAH) (55.50% (7 542/13 590)), followed by pulmonary hypertension (PH) caused by left heart disease (24.16% (3 284/13 590)). Among them, PAH could be subdivided into four types: idiopathic pulmonary arterial hypertension (IPAH), PAH associated with connective tissue disease, PAH associated with portal hypertension, and PAH associated with congenital heart disease (CHD-PAH), with CHD-PAH as the predominating type (98.09% (7 398/7 542). Patients with PAH were predominantly adolescents. In hospitalized patients with PH, from 2012 to 2019, the proportion of children and adolescents showed a decreasing trend from year to year, and the proportion of middle-aged and older adults showed a significant increasing trend, and the proportion of female patients showed a gradual decreasing trend, and the proportion of patients with comorbid hypertension, diabetes mellitus, coronary artery disease, arrhythmia, and pneumonia showed an increasing trend. A total of 1 034 patients (7.61% (1 034/13 590)) underwent right heart catheterization. The concordance rate between echocardiographic and right heart catheterization findings was (86.98% (875/1 006)). A total of 2 574 (18.94%) of PH patients were treated with PAH targeted drugs, of which 58.16% (1 497/2 574) were treated with monotherapy. Among the PH patients treated with PAH targeted drugs, the majority of patients were PAH patients (86.44% (2 225/2 574)), and 83.53% (2 150/2 574) patients treated with PAH targeted drugs were CHD-PAH. Conclusions: Hospitalized PH patients in our center between 2012 and 2019 are predominantly CHD-PAH, and the proportion of patients receiving right heart catheterization and targeted drug therapy is relatively low. The percentage of middle-aged and elderly PH patients shows an increasing trend from year to year, as well as the percentage of those with concomitant comorbidities.
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Child , Aged , Adolescent , Middle Aged , Humans , Female , Hypertension, Pulmonary/therapy , Retrospective Studies , China/epidemiology , Familial Primary Pulmonary Hypertension , Pulmonary Arterial Hypertension/complications , Heart Defects, Congenitalالملخص
OBJECTIVE@#To analysis and determine MR signs of Harris score ARCO stages 2-4 in osteonecrosis of femoral head (ONFH).@*METHODS@#Thirty-four patients with ONFH of ARCO stages 2 to 4 who underwent routine MR, T2 mapping, 3D-SPACE sequence examination and Harris score were retrospectively collected from January 2019 to June 2020, and 3 patients were excluded, and 31 patients were finally included, including 23 males and 8 females, aged from 18 to 62 years old with an average of(40.0±10.8) years old. Among them 21 patients with bilateral femoral head necrosis, totally 52 cases, including 17 with ARCO stage 2 patients, 24 ARCO stage 3, and 11 ARCO stage 4. MR imaging signs (femoral head collapse depth, ONFH index, bone marrow edema, hyperplasia, grade and T2 value of cartilage injury, and joint effusion) were scored and measured on the picture archiving and communication system (PACS) workstation, and the cartilage quantitative parameter T2 value was calculated and measured on Siemens postprocessing workstation. Pearson correlation analysis was used to evaluate the correlation between various MR signs and Harris score, and then multiple linear regression analysis was used to examine impact of MR signs on Harris hip score.@*RESULTS@#Femoral head collapse depth(r=-0.563, P=0.000), grade of cartilage injury(r=-0.500, P=0.000), and joint effusion (r=-0.535, P=0.000) were negatively correlated with Harris score by Pearson correlation analysis. Multiple linear regression analysis showed that joint effusion(β=-6.198, P=0.001) and femoral head collapse depth(β=-4.085, P=0.014) had a significant negative impact on Harris hip score.@*CONCLUSION@#Femoral head collapse depth and joint effusion both had significant negative relationship with Harris hip score. It is recommended to routinely evaluate femoral head collapse depth and joint effusion quantitatively and gradedly, so as to efficiently and accurately assist clinical diagnosis and treatment.
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Male , Female , Humans , Adolescent , Young Adult , Adult , Middle Aged , Femur Head Necrosis/diagnostic imaging , Retrospective Studies , Femur Head/diagnostic imaging , Bone Transplantation/methods , Magnetic Resonance Imaging , Treatment Outcomeالملخص
OBJECTIVE@#To investigate the efficacy and safety of colistin sulfate in the treatment of hematonosis patients infected by multidrug-resistant (MDR) gram-negative bacteria (GNB), and discuss the possible factors that affect the efficacy of colistin sulfate.@*METHODS@#The clinical data of 85 hematologic patients infected with MDR GNB in the Soochow Hopes Hematonosis Hospital from April 2022 to November 2022 were collected and divided into clinically effective group with 71 cases and ineffective group with 14 cases according to the therapeutic efficacy of colistin sulfate. The age, gender, type of hematologic disease, status of hematopoietic stem cell transplantation, infection sites, type of pathogen, timing of administration, daily dose and duration of colistin sulfate, and combination with other antibacterial agents of patients in two groups were compared. Logistic regression was used to analyze on the meaningful variables to study the influencing factors of colistin sulfate. The adverse reactions of colistin sulfate were also evaluated.@*RESULTS@#There were no significant differences in age, gender, type of hematologic disease, hematopoietic stem cell transplantation status, infection sites and pathogen type between the effective group and the ineffective group (P>0.05). Compared with the medication time more than 7 days, meropenem used within 7 days in the clinical effective group, and timely replacement with colistin sulfate could obtain better efficacy, the difference was statistically significant (P=0.018). The duration of tigacycline before colistin sulfate did not affect the efficacy, and there was no significant difference in efficacy between the effective and ineffective groups. The therapeutic effect of colistin sulfate at daily dose of 500 000 U q8h was better than that of 500 000 U q12h, the difference was statistically significant (P=0.035). The time of colistin sulfate use in the clinically effective group was longer than that in the ineffective group, which had a statistical difference (P=0.003). Compared with the clinical ineffective group, the efficacy of combination regimens with colistin sulfate was better than that of colistin sulfate monotherapy, and the difference was statistically significant (P=0.013). Multivariate logistic regression analysis was performed on the indicators with statistical differences in the two groups of patients, which suggested that the use time of colistin sulfate (B: 2.358; OR: 10.573; CI: 1.567-71.361; P=0.015) and the combination of colistin sulfate (B: 1.720; OR: 5.586; CI: 1.210-25.787; P=0.028) were influential factors in the efficacy of colistin sulfate. During the treatment, the incidence of nephrotoxicity, hepatotoxicity and peripheral neurotoxicity were 5.9%, 1.2% and 1.2%, respectively.@*CONCLUSION@#The use of colistin sulfate improves the clinical efficacy of MDR GNB infections in hematological patients, and the timing of colistin sulfate administration and the combination of drugs are independent factors affecting its clinical efficacy, and the safety during treatment is high.
الموضوعات
Humans , Colistin/adverse effects , Anti-Bacterial Agents/therapeutic use , Meropenem/adverse effects , Treatment Outcome , Gram-Negative Bacteria , Hematologic Diseasesالملخص
[Objective]To analyze the meaning of"body pain is like being punished with a rod"in Synopsis of the Golden Chamber·Yin Yang Pestilences,so as to better understand the meaning of Zhongjing.[Methods]By using the research method of combining the handed-down literature with the textual research of unearthed cultural relics,combining with the perspective of character and history,and there is one proved case attached.[Results]"Body pain is like being punished with a rod"is a vivid expression that people describe their personal experience."Rod"can be understood as"anything that can be held is called a rod"."Being punished with a rod"is divided into three cases including skin is swollen and bruised;damage occurs;dead by being punished.Pain may be caused by trauma(skin and muscle)or internal injury(viscera injury).Shengma Biejia Decoction is mainly used to detoxify and disperse evil,promote blood circulation,and give consideration to both Qi and blood.[Conclusion]In the era of Zhongjing,"body pain is like being punished with a rod"has a certain degree of differentiation,which is reflected in the differentiation of the way of applying the rod and the painful feeling.This paper discusses the concept of"body pain is like being punished with a rod"by combining literature and cultural relics research,so that readers can intuitively understand the meaning of Zhongjing in the social background at that time,and also provides a new way to learn Synopsis of the Golden Chamber.
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Single nucleotide polymorphisms(SNPs),third generation molecular genetic markers,have attracted extensive attention because of their importance in research on genetic diseases,gene evolution,adaptation,species,medicine and other fields.SNPs are found in large numbers,with a wide distribution,stable genetics and high throughput.Moreover,SNPs are suitable for rapid and large-scale screening.These genetic markers have been widely used in molecular typing for a variety of bacteria.Herein,the current status of SNP technology is discussed and compared with other typing methods,and its applica-tions in bacterial molecular typing are reviewed.
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Objective To detect the expressions of interleukin-1β(IL-1β)in peripheral blood and programmed death molecule 1(PD-1)in esophageal cancer tissues and to analyze their influence on clinicopathological features and prognosis of patients.Methods A total of 127 patients with esophageal cancer who underwent surgical treatment at the First Affiliated Hospital of Henan University of Science and Technology from January 2018 to May 2020 were collected and divided into two groups:the survival group(n= 95)and the death group(n= 32),based on their survival status 3 years after surgery.Clinical data of the patients were collected.The expressions of PD-1 and programmed death ligand 1(PD-L1)in esophageal cancer tissues were detected through immunohistochemistry,while the levels of IL-6,IL-1β,and tumor necrosis factor-α(TNF-α)in peripheral blood were measured using enzyme-linked immunosorbent assay(ELISA).Cox regression analysis was performed to identify the risk factors for death 3 years after surgery.The 3-year Kaplan-Meier survival curves of patients with different expressions of IL-1βand PD-1 were plotted,and the survival rates among the three groups were compared using the log-rank test.Results In the death group,the proportions of patients with age≥60 years old,lymph node metastasis,infiltration into the muscle layer,tumor diameter>3 cm,IL-1β high level,TNF-αhigh level,and PD-1 positive expression were higher than those in the survival group.Conversely,the proportions of patients with high IL-6 levels were lower than those in the survival group,with statistically significant differences between the groups(P<0.05).Infiltration into the myometrium,tumor diameter>3 cm,high IL-1β level,and PD-1 positive expression were identified as independent risk factors for postoperative death.The 3-year survival rates were 92.4%,13.3%,and 84.2%for patients in the normal IL-1β+PD-1 negative group,high IL-1β+PD-1 positive group,and normal IL-1β+PD-1 positive group/high IL-1β+PD-1 negative group,respectively.Significant differences existed between the groups(χ2=82.318,P<0.01),with the highest survival rate observed in the normal IL-1β+ PD-1 negative group and the lowest in the high IL-1β+ PD-1 positive group.Conclusion Positive expression of PD-1 and a high level of IL-1βwere identified as independent risk factors for death in patients with esophageal cancer.Notably,patients with positive expression of PD-1+high levels of IL-1βexhibited a low survival rate.
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Objective To compare the cost and effectiveness of the new oral anticoagulant rivaroxaban 15 mg or 20 mg once a day for the prevention of thrombosis in patients with nonvalvular atrial fibrillation,and to provide references for clinical rational use of drugs.Method The Markov model was used to simulate the survival status of the two dose groups within 30 years,and the cost and health output were calculated separately to obtain the incremental cost-utility ratio(ICUR).Take 3 times of per capita gross domestic product(GDP)in China in 2020 as the willingness-to-pay threshold(WTP)to judge its economy.Results During the simulation period,compared with the 15 mg dose group,the 20 mg dose group had cumulative utility improvement of 0.97 quality-adjusted life-year(QALY),had an ICUR of 119 855 Yuan/QALY,had higher GDP and lower WTP,and was economical.Single-factor sensitivity analysis showed that the price and discount rate of the two doses of drugs were the main factors affecting ICUR.The probability sensitivity analysis pointed out that when the WTP was 3 times the per capita GDP,the 20 mg dose was more acceptable(65.2％),and the standard dose of 20 mg had a greater cost-utility advantage.Conclusion For patients with nonvalvular atrial fibrillation who take rivaroxaban for a long time to prevent thrombosis,choosing the instructional dose of 20 mg once a day is more cost-effective advantageous than the smaller dose of 15 mg once a day.
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Objective To discuss the effect of Anemarrhenae Rhizoma with different proportions on the dissolution of 6 inorganic elements(K,Ti,Sr,Ba,Ca,Mg)in Gypsum Fibrosum under different compatibility based on grey correlation analysis and technique for order preference by similarity to an ideal solution(TOPSIS)method and to provide reference for clinical application.Methods Inductively coupled plasma mass spectrometry(ICP-MS)was established for simultaneous analysis of inorganic elements K,Ti,Sr,Ba,Ca,Mg in Gypsum Fibrosum-Anemarrhenae Rhizoma.The gray correlation ananlysis and TOPSIS method were used to comprehensively analyze the changes of six inorganic elements in Gypsum Fibrosum under different compatibility.Results The findings of the ICP-MS determination of inorganic elements in Gypsum Fibrosum-Anemarrhenae Rhizoma were good in terms of linearity,precision,repeatability and stability.The average recovery was 81.78％-104.13％,and the RSD was 2.10％-4.62％(n=6).The dissolution of six inorganic elements in Gypsum Fibrosum after compatibility with different proportions of Anemarrhena Rhizoma was significantly higher than that of Gypsum Fibrosum single decoction(P＜0.05).The dissolution scores of six inorganic elements in Gypsum Fibrosum were the highest when the compatibility proportion of Gypsum Fibrosum-Anemarrhenae Rhizoma was 30∶9.Conclusion ICP-MS is a sensitive and accurate method for determining K,Ti,Sr,Ba,Ca and Mg in Gypsum Fibrosum-Anemarrhenae Rhizoma.The best compatibility ratio of Gypsum Fibrosum-Anemarrhenae Rhizoma is 30:9,which can effectively improve the dissolution of six inorganic elements in Gypsum Fibrosum,and provide the basis for the further compatibility study of Gypsum Fibrosum and Anemarrhenae Rhizoma.
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Aim To rapidly prepare and purify hydrogen sulfide specific fluorescent probe (WSP-5), establish and optimize the fluorescent probe method for the determination of hydrogen sulfide in animal tissues, and verify the applicability of the method in the model of malignant pleural effusion. Methods The preparation solvent of fluorescent probe reaction solution, DMSO addition volume, pH, reaction solution solvent and reaction solution volume, sample pretreatment temperature, grinding times, and standing time after grinding were investigated. The mouses model of malignant pleural effusion was established with S-180 ascites tumor cells, and the concentration of hydrogen sulfide in various organs and tissues of the model animal was measured. Results After optimization, silica gel and dextran gel were used as stationary phases, dichloromethane methanol formic acid (60: 1: 0.1, V/V/V) and dichloromethane methanol (1: 1, V/V) were used as eluents for separation and purification, and the first eluting component was taken to prepare WSP-5 with a purity of more than 700 mg. Animal tissue samples and sodium hydrosulfide standard solution were added with 5 times of cold reaction solution, after low temperature vibration grinding, highspeed centrifugation, the supernatant was incubated in dark for 12 hours, the fluorescence intensity was measured by fluorescent microplate reader. Hydrogen sulfide concentration was calculated according to the standard curve. The LOD of this method was about 0. 6 |JLmol • L
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Dorsal root ganglia (DRG) is an essential part of the peripheral nervous system and the hub of the peripheral sensory afferent. The dynamic changes of neuronal cells and their gene expression during the development of dorsal root ganglion have been studied through single-cell RNAseq analysis, while the dynamic changes of non-neuronal cells have not been systematically studied. Using single cell RNA sequencing technology, we conducted a research on the non-neuronal cells in the dorsal root ganglia of rats at different developmental stage. In this study, primary cell suspension was obtained from using the dorsal root ganglions (DRGs, L4-L5) of ten 7-day-old rats and three 3-month-old rats. The 10×Genomics platform was used for single cell dissociation and RNA sequencing. Twenty cell subsets were acquired through cluster dimension reduction analysis, and the marker genes of different types of cells in DRG were identified according to previous researches about DRG single cell transcriptome sequencing. In order to find out the non-neuronal cell subsets with significant differences at different development stage, the cells were classified into different cell types according to markers collected from previous researches. We performed pseudotime analysis of 4 types Schwann cells. It was found that subtype Ⅱ Schwann cells emerged firstly, and then were subtype Ⅲ Schwann cells and subtype Ⅳ Schwann cells, while subtype Ⅰ Schwann cells existed during the whole development procedure. Pseudotime analysis indicated the essential genes influencing cell fate of different subtypes of Schwann cell in DRG, such as Ntrk2 and Pmp2, which affected cell fate of Schwann cells during the development period. GO analysis of differential expressed genes showed that the up-regulated genes, such as Cst3 and Spp1, were closely related to biological process of tissue homeostasis and multi-multicellular organism process. The down regulated key genes, such as Col3a1 and Col4a1, had close relationship with the progress of extracellular structure organization and negative regulation of cell adhesion. This suggested that the expression of genes enhancing cell homestasis increased, while the expression of related genes regulating ECM-receptor interaction pathway decreased during the development. The discovery provided valuable information and brand-new perspectives for the study on the physical and developmental mechanism of Schwann cell as well as the non-neuronal cell changes in DRG at different developmental stage. The differential gene expression results provided crucial references for the mechanism of somatosensory maturation during development.
الموضوعات
Rats , Animals , Ganglia, Spinal/metabolism , Rats, Sprague-Dawley , Transcriptome , Neurons/metabolism , Schwann Cells/physiologyالملخص
Cricothyroid membrane puncture and incision,the key techniques to save the lives of the patients in the Can't Intubate,Can't Oxygenate (CICO) emergency,need to be mastered by all the airway management staff.However,the decision to carry out cricothyroid membrane puncture or incision is often delayed due to the unfamiliarity with the adjacent anatomical structure of the cricothyroid membrane and the inability to accurately locate the cricothyroid membrane.As a result,serious complications and rescue failure occur.Therefore,airway management staff should be familiar with the adjacent structure and positioning methods of the cricothyroid membrane,so as to improve the success rate of emergency airway rescue,reduce complications,and protect the airway and life safety of the patients.