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ObjectiveTo investigate the effect and mechanism of Taohong Siwutang (TSD) on myocardial ischemia reperfusion injury (MIRI) in ovariectomized (OVX) female mice. MethodAfter the OVX model of female mice was established, the estradiol (E2) level was detected by enzyme-linked immunosorbent assay (ELISA) to verify the model. Sixty OVX mice were randomly divided into six groups: Sham operation group, model group, low, medium, and high dose groups (9, 18, 36 g·kg-1) of TSD, and nuclear factor E2-related factor 2 (Nrf2) inhibitor group, with 10 mice in each group. The MIRI model was verified by a laser speckle flowmeter. The pathological changes in myocardial tissue were detected by 2,3, 5-triphenyltetrazolium chloride (TTC) and hematoxylin-eosin (HE) staining. Serum creatine kinase isoenzyme (CK-MB), cardiac troponin Ⅰ (CTnⅠ), malondialdehyde (MDA), superoxide dismutase (SOD), interleukin-6 (IL-6), and interleukin-10 (IL-10) levels were detected by ELISA. The expression of Nrf2 and heme oxygenase-1 (HO-1) were observed by immunofluorescence staining. The expressions of Nrf2, HO-1, apoptotic B-cell lymphomato-2 (Bcl-2), Bcl-2 associated X protein (Bax), inflammatory cytokines interleukin-18 (IL-18), and interleukin-1β (IL-1β) were detected by Western blot. ResultCompared with the sham operation group, the serum levels of CK-MB, CTnⅠ, MDA, and IL-6 in the model group were increased (P<0.01), and the levels of SOD and IL-10 were decreased (P<0.01). The damage scores of TTC and HE staining in myocardial tissue were increased (P<0.01). The expressions of Nrf2 and HO-1 in myocardial tissue by immunofluorescence were decreased (P<0.01), and the protein expressions of Nrf2, HO-1, and Bcl-2 in myocardial tissue were decreased. The protein expressions of Bax, IL-18, and IL-1β were increased (P<0.01). Compared with the model group, serum levels of CK-MB, CTnⅠ, MDA, and IL-6 of TSD groups were significantly decreased (P<0.05, P<0.01), and SOD and IL-10 were significantly increased (P<0.05, P<0.01). TTC staining and HE staining damage scores of myocardial tissue were significantly decreased (P<0.01). The expressions of Nrf2 and HO-1 in myocardial tissue by immunofluorescence were increased (P<0.01). The protein expressions of Nrf2, HO-1, and Bcl-2 were significantly increased (P<0.05, P<0.01), and those of Bax, IL-18, and IL-1β were significantly decreased (P<0.05, P<0.01). The effect of the high dose group of TSD was the most significant. The serum levels of CK-MB, CTnⅠ, MDA, and IL-6 in the Nrf2 inhibitor group were significantly increased (P<0.05, P<0.01), and the levels of SOD and IL-10 were significantly decreased (P<0.05, P<0.01). The damage scores of TTC and HE staining in myocardial tissue were significantly increased (P<0.01). The expressions of Nrf2 and HO-1 in myocardial tissue by immunofluorescence were significantly decreased (P<0.01). The protein expressions of Nrf2, HO-1, and Bcl-2 in myocardial tissue were significantly decreased, and those of Bax, IL-18, and IL-1β were significantly increased (P<0.01). ConclusionTSD can alleviate MIRI in OVX mice, reduce oxidative stress response and the release of inflammatory factors, and inhibit apoptosis, playing a protective role in OVX mice with MIRI, which may be related to the activation of Nrf2/HO-1 signaling pathway.
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BACKGROUND:Exosomes are vesicle-like structures secreted by cells into extracellular compartments in the form of cytosol,which contain a large amount of microRNAs with important intercellular communication roles.MicroRNAs in exosomes rely on exosome transport and are able to enter target cells to exert important biological regulatory effects.In common bone and joint diseases,abnormal or damaged bone metabolism releases a large number of exosomes,while some exosome-derived microRNAs also promote the progression of osteoarthritis.Therefore,exosome-derived microRNAs are closely related to the skeletal system and are important for the development as well as diagnosis and treatment of many osteoarticular diseases. OBJECTIVE:To review the research progress of exosome-derived microRNAs in bone metabolism and bone and joint diseases. METHODS:Using"exosomes,extracellular vesicle,microRNA,miRNA,bone,bone diseases,bone formation,bone regeneration,bone resorption,bone destruction"as Chinese and English search terms,articles were searched on CNKI,Metasys,and PubMed databases.Finally,86 articles were included for summarization. RESULTS AND CONCLUSION:Exosome-derived microRNAs can regulate bone metabolism by affecting bone formation and bone resorption,and are closely related to the development of bone and joint diseases such as fracture healing,osteoporosis,osteoarthritis,rheumatoid arthritis,osteonecrosis of the femoral head,and osteosarcoma.Exosome-derived microRNAs will be an effective means of diagnosis and treatment of certain bone and joint diseases in the future.However,the current research on exosome-derived microRNAs in osteoarthritic diseases is limited,and more explorations and researches are still needed to diagnose and treat osteoarthritic diseases using exosome-derived microRNAs.
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Objective:To investigate the predictive value of Pitt bacteremia score (PBS) on 28-day mortality of patients with extensively drug-resistant Klebsiella pneumoniae (XDR-KP) bloodstream infection.Methods:A retrospective cohort study was conducted to analyze the clinical characteristics of patients with XDR-KP bloodstream infection admitted to the Emergency Intensive Care Unit of Nanjing Drum Tower Hospital from January, 2018, to December, 2021. The patients were divided into the survival and non-survival groups according to the 28-day survival. Multivariate logistic regression analysis was performed to determine the risk factors of 28-day mortality of the patients. Receiver operating curve (ROC) curve was drawn to analyze the predictive value of PBS in 28-day mortality of patients with XDR-KP bloodstream infection. The correlations between PBS, and acute physiology and chronic health evaluation II (APACHE II) and sequential organ failure (SOFA) assessment were performed using Pearson correlation coefficient. The optimal cut-off value of PBS score was used as the boundary point to group the differences between APACHE II and SOFA scores in different groups. Kaplan-Meier method was used to analyze the prognosis of patients with XDR-KP bloodstream infection.Results:A total of 118 patients (82 males and 36 females) with XDR-KP bloodstream infection, aged (65.98±15.16) years, were included in this study. The 28-day mortality was 61.02%. The PBS was significant higher in the non-survival group than in the survival group [(5.68±1.86) vs. (2.48±1.02), P=0.011]. Multivariate logistic regression analysis showed that PBS ( OR=4.940, 95% CI: 2.720-8.968, P=0.008), APACHE II score ( OR=1.630, 95% CI: 1.361-1.952, P=0.010) and SOFA score ( OR=1.879, 95% CI: 1.451-2.422, P=0.009) were independently risk factors of 28-day mortality of patients with XDR-KP bloodstream infection. The area under the ROC curve of the PBS predicting 28-day mortality was 0.970 (95% CI: 0.945-0.995, P<0.001), and the optimal cut-of value was 3.5. In addition, PBS was significantly associated with APACHE II score ( r=0.916, P<0.001) and SOFA score ( r=0.829, P<0.001). Moreover, Kaplan-Meier analysis showed that the 28-day survival rate of patients with PBS <3.5 was significantly higher than that of patients with PBS >3.5 ( P=0.001). Conclusions:PBS is a significant, independent predictor of 28-day mortality in patients with XDR-KP bloodstream infection.
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Objective: To examine the feasibility of the modified gasless trans-subclavian approach endoscopic thyroidectomy for lateral neck dissection (LND) in papillary thyroid carcinoma (PTC). Methods: The clinical data of 31 patients with PTC who underwent modified gasless trans-subclavian approach endoscopic LND in the Department of Head and Neck Surgery, Run Run Shaw Hospital, from January to October 2022 were retrospectively analyzed. There were 2 males and 29 females, aged (32.6±8.3) years (range: 17 to 55 years). The maximum diameter of the primary thyroid lesion (M(IQR)) was 1.06 (1.16) cm (range: 0.53 to 2.44 cm), and the maximum diameter of the metastatic lymph node was (1.04±0.37) cm (range: 0.44 to 1.88 cm). Operation time, postoperative hospital stay, number of lymph nodes dissected, and postoperative complications were recorded. Outpatient follow-up was conducted until November 30, 2022. Results: All operations were successfully completed with the endoscopy approach without conversion to open surgery. The operation time was 160 (20) minutes (range: 100 to 215 minutes), and the postoperative hospital stay was 4 (2) days (range: 2 to 14 days). The number of lymph nodes obtained by dissection in the central and lateral compartment of the neck was 11 (12) (range: 0 to 37) and 34.7±14.8 (range: 15 to 69), respectively. Temporary hypoparathyroidism occurred in 4 cases and all recovered within 1 month after the operation. One case suffered from recurrent laryngeal nerve injury (continuing followed up to assess whether it is a temporary injury). The complication of LND included 1 case of chylous leakage that was recovered with conservative treatment, 1 case of Horner syndrome returned to normal 3 months after surgery. During follow-up, there was no residual tumor or recurrence. Conclusion: The modified gasless trans-subclavian approach endoscopic LND for PTC is feasible, with a thorough dissection and concealed incision.
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Objective To understand the current status of research on lung cancer immunotherapy to provide a reference for further investigation and future topic selection in this field. Methods CiteSpace visualization analysis software was used to analyze 400 Chinese studies in CNKI and 5 001 English studies in the Web of Science database from 2005 to 2021, with "lung cancer" and "immunotherapy" as keywords. Keyword co-occurrence analysis was performed on 17 English studies of "Lung Cancer" "Immunotherapy" and "Single cell sequencing" in the Web of Science database. Results "Non-small cell lung cancer" "immunosuppressants" "PD-L1" "dendritic cells" and "cytokine-induced killer cells" are current research hotspots in lung cancer immunotherapy. Monoclonal antibody drugs including nivolumab, pembrolizumab, atezolizumab, and durvalumab are hotspot drugs. Immunotherapy combined with chemotherapy as well as PD-L1 expression have become the focus of continuous research. The majority of studies on lung cancer immunotherapy are conducted in the United States, followed by China. Conclusion Lung cancer immunotherapy has gradually become a research hot spot in China. In the future, in-depth research is needed to provide cutting-edge directions for lung cancer immunotherapy.
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Objective@#To investigate the epidemiological characteristics of varicella in Yandu District, Yancheng City, Jiangsu Province from 2005 to 2021, so as to provide insights into the improvements of the varicella control strategy.@*Methods@#The data pertaining to cases in Yandu District from 2005 to 2021 were captured from the National Notifiable Diseases Network Reporting System, and the coverage of varicella vaccination in Yandu District from 2016 to 2021 was captured from the Jiangsu Provincial Immunization Planning System. The trends in incidence of varicella were analyzed using annual percent change (APC), the temporal, population and spatial distributions of varicella cases were descriptively analyzed, and the correlation between the cumulative first-dose varicella vaccination rate and incidence of varicella was examined among birth cohorts in Yandu District from 2005 to 2021.@*Results@#Totally 6 144 varicella cases were reported in Yandu District from 2005 to 2021, with annual mean reported incidence of 50.05/105. The incidence of varicella appeared a tendency towards a rise in Yandu District from 2012 to 2018, with APC of 77.97% (t=11.702, P<0.001), and the incidence appeared a tendency towards a decline from 2018 to 2021, with APC of -41.93% (t=-6.911, P<0.001). The incidence of varicella peaked during the period between November and January of the following year (45.95%), and during the period between May and June (20.35%). The mean incidence of varicella was higher among men than among women (54.72/105 vs. 45.00/105; χ2=57.858, P<0.001). The highest incidence of varicella was found among cases at ages of 6 to 9 years (543.78/105), and varicella predominantly occurred among primary school students (38.40%) and pre-school children (31.85%), with high annual mean incidence in the eastern urban areas (74.27/105).The cumulative first-dose varicella vaccination rate negatively correlated with the incidence of varicella among the birth cohorts in Yandu District in 2019 (r=-0.501, P<0.001), 2020 (r=-0.646, P<0.001) and 2021 (r=-0.602, P<0.001).@*Conclusions@#The incidence of varicella appeared a tendency towards a rise followed by a reduction in Yandu District from 2005 to 2021, and the incidence of varicella peaked in winter and at the turn from spring to summer, with varicella predominantly found among primary school students and preschool children.
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Genome-guided oncology refers to a new treatment concept that transcends histological classification and pathological ty-ping and uses drugs according to the genetic characteristics of tumors. New drug development technology and clinical trial design based on this concept provide new ideas for the clinical application of precision oncology. The multi-component and multi-target characteristics of Chinese medicine provide rich resources for the development of tumor-targeting drugs from natural products, and the design of the master protocol trial aiming at the characteristics of precision oncology supports the rapid clinical screening of effective tumor-targeting drugs. The emergence of the synthetic lethality strategy breaks through the bottleneck that the drug can only target the oncogene but cannot do anything to the tumor suppressor gene with the loss-of-function mutation in the past. With the rapid development of high-throughput sequencing technology, the cost of sequencing is also decreasing. For the development of tumor-targeting drugs, how to keep up with the update speed of target information is a difficult problem of concern. Based on the integration of innovative ideas and me-thods of precision oncology, network pharmacology, and synthetic lethality strategy on synthetic lethal interaction network of antitumor Chinese medicine compatibility formula design, and the combination of improvement of innovative clinical trial methods, such as master protocol trial, basket trial, and umbrella trial, unique advantages of Chinese medicine are expected to be exerted beyond the antibody-based drugs and small molecule-based drugs and corresponding targeted drugs are potentially developed for clinical application.
الموضوعات
Humans , Neoplasms/genetics , Medicine, Chinese Traditional , Precision Medicine/methods , Medical Oncology , Antineoplastic Agents/therapeutic useالملخص
BACKGROUND@#Epidemiological surveys on heart failure (HF) in Chinese community are relatively lacking. This study aimed to estimate the prevalence and incidence of HF among community residents in southern China.@*METHODS@#Baseline data of this prospective study was collected from 2015 to 2017 among 12,013 permanent residents aged ≥ 35 years in Guangzhou, China. The same survey process was carried out for individuals aged ≥ 65 years after a three-year follow-up.@*RESULTS@#The overall prevalence of HF in community residents aged ≥ 35 years was 1.06%. Male had significantly higher risk of HF prevalence [odds ratio (OR) = 1.50, P = 0.027]. The gender-adjusted risk of HF was 1.48 times higher per 10 years aging. HF prevalence was statistically associated with atrial fibrillation, valvular heart disease, hypertension and chronic obstructive pulmonary disease after adjusting for age and gender (OR = 8.30, 5.17, 1.11, 2.28, respectively; all P < 0.05). HF incidence in individuals aged ≥ 65 years were 847 per 100,000 person-years. Baseline atrial fibrillation, valvular heart disease, and diabetes mellitus were risk factors for HF incidence for individuals aged ≥ 65 years adjusting for age and gender (OR = 5.05, 3.99, 2.11, respectively; all P < 0.05). Besides, residents with new-onset atrial fibrillation and myocardial infarction were at significantly higher risk of progression to HF (OR = 14.41, 8.54, respectively; all P < 0.05).@*CONCLUSIONS@#Both pre-existing and new-onset cardiovascular diseases were associated with HF incidence in southern China. Management of related cardiovascular diseases may be helpful to reduce the incidence of HF.
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Hereditary gingival fibromatosis (HGF) is a rare inherited condition with fibromatoid hyperplasia of the gingival tissue that exhibits great genetic heterogeneity. Five distinct loci related to non-syndromic HGF have been identified; however, only two disease-causing genes, SOS1 and REST, inducing HGF have been identified at two loci, GINGF1 and GINGF5, respectively. Here, based on a family pedigree with 26 members, including nine patients with HGF, we identified double heterozygous pathogenic mutations in the ZNF513 (c.C748T, p.R250W) and KIF3C (c.G1229A, p.R410H) genes within the GINGF3 locus related to HGF. Functional studies demonstrated that the ZNF513 p.R250W and KIF3C p.R410H variants significantly increased the expression of ZNF513 and KIF3C in vitro and in vivo. ZNF513, a transcription factor, binds to KIF3C exon 1 and participates in the positive regulation of KIF3C expression in gingival fibroblasts. Furthermore, a knock-in mouse model confirmed that heterozygous or homozygous mutations within Zfp513 (p.R250W) or Kif3c (p.R412H) alone do not led to clear phenotypes with gingival fibromatosis, whereas the double mutations led to gingival hyperplasia phenotypes. In addition, we found that ZNF513 binds to the SOS1 promoter and plays an important positive role in regulating the expression of SOS1. Moreover, the KIF3C p.R410H mutation could activate the PI3K and KCNQ1 potassium channels. ZNF513 combined with KIF3C regulates gingival fibroblast proliferation, migration, and fibrosis response via the PI3K/AKT/mTOR and Ras/Raf/MEK/ERK pathways. In summary, these results demonstrate ZNF513 + KIF3C as an important genetic combination in HGF manifestation and suggest that ZNF513 mutation may be a major risk factor for HGF.
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Animals , Humans , Mice , Fibromatosis, Gingival/pathology , Gingiva , Kinesins/genetics , Mutation/genetics , Phosphatidylinositol 3-Kinases/geneticsالملخص
Objective:To investigate the efficacy and safety of percutaneous left atrial appendage occlusion in the treatment of nonvalvular atrial fibrillation.Methods:Eighty-eight patients with percutaneous left nonvalvular atrial fibrillation who received treatment in The Second Hospital of Anhui Medical University from January 2019 to January 2021 were included in this study. These patients were divided into three groups according to different anticoagulant methods: group A (percutaneous left atrial appendage occlusion), group B (livaraban), and group C (warfarin). The incidence of stroke, the incidence of bleeding events, the incidence of adverse cardiovascular events, and live and kidney function and coagulation function after 3 months of treatment were compared among the three groups.Results:There were no significant differences in the incidence of stroke and adverse cardiovascular events among the three groups ( P > 0.05). The incidence of bleeding events in groups A, B, and C was 9.3% (3/32), 15.0% (6/40), and 31.2% (5/16), respectively. There was a significant difference in the incidence of bleeding events among the three groups ( χ2 = 8.07, P = 0.001). After 3 months of treatment, there were no significant differences in prothrombin time, fibrinogen, prothrombin time-international normalized ratio, alanine aminotransferase, aspartate transaminase, and creatinine clearance among the three groups (all P > 0.05). Conclusion:Percutaneous left atrial appendage occlusion, warfarin, and rivaroxaban can prevent stroke in patients with nonvalvular atrial fibrillation. Percutaneous left atrial appendage occlusion is safer and more feasible than warfarin and rivaroxaban alone in the treatment of nonvalvular atrial fibrillation.
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OBJECTIVE To establish the fingerprint of total saponins from Mussaenda pubescens, and to study the spectrum- effect relationship of its hepatoprotective activity. METHODS Ten batches of total saponins from M. pubescens from different origins were prepared using 75% ethanol as solvent. High-performance liquid chromatography (HPLC) and the Similarity Evaluation System for Traditional Chinese Medicine Chromatographic Fingerprints (2012 edition) were used to draw the fingerprints of 10 batches of total saponins from M. pubescens. The similarity evaluation and identification of common peaks were conducted. The same HPLC method was adopted to determine the contents of five triterpenoid saponins (mussaendoside H, mussaendoside U, mussaglaoside C, mussaendoside G and mussaendoside O). The hepatoprotective effect of total saponins from M. pubescens was investigated by establishing carbon tetrachloride-induced acute liver injury model mice, and the spectrum-effect relationship was studied by using grey correlation analysis. RESULTS There were 11 common peaks in 10 batches of total saponins from M. pubescens, 5 of which were identified, i.e. mussaendoside H (peak 3), mussaendoside U (peak 7), mussaglaoside C (peak 8), mussaendoside G (peak 9) and mussaendoside O (peak 11); the similarities of 10 batches of samples ranged 0.940- 0.991. Average contents of mussaendoside H, mussaendoside U, mussaglaoside C, mussaendoside G, mussaendoside O were 0.01- 0.05, 0.10-0.21, 0.10-0.18, 0.03-0.08, 0.20-0.40 mg/g, respectively. Ten batches of total saponins from M. pubescens could generally reduce the contents of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in serum, and tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and IL-1β in liver tissue of model mice (P<0.05 or P<0.01). The E-mail:13878195336@139.com correlation between the common peak areas and the contents of ALT, AST, TNF-α, IL-6 and IL-1β were 0.602-0.757, 0.585-0.833, 0.593-0.795, 0.618-0.820, 0.607-0.804, respectively; the peaks with high correlation were peaks 11, 9 and 8 in order. CONCLUSIONS Ten batches of total saponins from M. pubescens have similar components, and the average contents of mussaendoside H, mussaendoside U, mussaglaoside C, mussaendoside G and mussaendoside O are different. The batches of samples have a certain degree of hepatoprotective effect; mussaendoside O, mussaendoside G and mussaglaoside C may be its main active components.
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OBJECTIVES@#This study aimed to compare the effectiveness of ultrasound and acoustic and laser cleaning of curved root canals.@*METHODS@#A total of 92 molars with independent root canals with a curvature of 20°-40° were prepared and standardized at 04 25# and stained with gentian violet solution for 72 h. Among them, 52 were randomly divi-ded into four groups for final rinsing (n=13): NI group, PUI group, EDDY group, and PIPS group. Ten samples in each group were cut horizontally along the long axis perpendicular to the root and divided into curved upper, curved, and apical segments. Images were taken with a stereomicroscope and Image J measurements were taken to calculate the depth of rinse penetration. The remaining three samples from each group were split along the long axis of the dentin, photographed by scanning electron microscope to record the dentin tubule exposure and staining layer, and scored for staining layer by double-blind method. SPSS 26.0 software was used to perform statistical analysis and select the best flushing method. An extra 40 samples were randomly divided into four groups for detection of flushing fluid penetration depth (n=10): 10, 20, 30, and 40 s.@*RESULTS@#In the upper part, the mean depth of infiltration was not significantly different between the experimental and control groups (P>0.05). The PIPS group had a significantly lower smear layer score than the control group and the EDDY group (P<0.01). In the curved segment, the mean depth of infiltration was significantly greater in the PUI group than in the control group (P<0.05); the tarnish layer score was lower in each experimental group than in the control group. At the top, the mean depth of infiltration was greater in the PUI and PIPS groups than in the control group (P<0.05), and the smear layer score was lower in the PIPS group than in the other groups (P<0.05). After the time was changed, the depth of infiltration of PUI increased only in the apical segment as the flushing time increased.@*CONCLUSIONS@#The PUI and PIPS methods facilitate the penetration of irrigation solution into the dentin canal in curved root canals, especially in the apical segment. The PIPS technique is effective in removing the smear layer in curved root canals.
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Humans , Dental Pulp Cavity , Microscopy, Electron, Scanning , Root Canal Irrigants , Root Canal Preparation/methods , Smear Layer , Sodium Hypochlorite , Therapeutic Irrigation/methods , Double-Blind Methodالملخص
Objective:To investigate the clinical efficacy of three-dimensional speckle tracking imaging in the dynamic evaluation of left ventricular systolic function in patients with pregnancy-induced hypertension.Methods:50 patients with pregnancy-induced hypertension, who received prenatal examination in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from July 2019 to June 2020 and finally gave birth, were included in the observation group. An additional 50 healthy pregnant women who concurrently received prenatal examination were included as controls. All participants underwent routine echocardiography and three-dimensional speckle tracking imaging examinations. Parameters related to left ventricular systolic function were recorded. Routine echocardiography parameters and three-dimensional speckle tracking imaging parameters were compared between the observation and control groups.Results:There were no significant differences in routine echocardiography parameters (including heart rate, left ventricular end-diastolic diameter, interventricular septum thickness in end-diastole, left ventricular posterior wall thickness in diastole, and left ventricular ejection fraction) between before treatment, after treatment, and 3 months after delivery in the observation group, and between observation and control groups before treatment (all P > 0.05). The absolute values of left ventricular global longitudinal strain (LVGLS) [(-18.41 ± 2.23)% vs. (-26.03 ± 2.79)%], left ventricular global circumferential strain (LVGCS) [(31.29 ± 3.09)% vs. (37.45 ± 3.68)%], left ventricular global radial strain (LVGRS) [(-19.37 ± 2.19)% vs. (-24.59 ± 2.74)%], and left ventricular global area peak systolic strain (LVGAS) [(-26.61 ± 3.18)% vs. (-39.23 ± 3.96)%] measured before treatment were significantly lower in the observation group than in the control group ( t = 6.31 -14.87, all P < 0.05). The absolute values of LVGLS, LVGCS, LVGRS, and LVGAS in the observation group were significantly higher after treatment [(-24.79 ± 2.68)%, (35.94 ± 3.25)%, (-22.48 ± 2.41)%, (-37.54 ± 3.38)%] and 3 months after delivery [(-25.64 ± 2.72)%, (36.63 ± 3.47)%, (-23.91 ± 2.69)%, (-38.49 ± 3.64)%] than before treatment ( t = 4.08 - 10.59, P < 0.05). There were no significant differences in LVGLS, LVGCS, LVGRS, and LVGAS between observation group and control groups at each time point studied ( t = 0.47 - 1.19, P = 0.182 - 0.652 > 0.05). The absolute svalues of LVGLS, LVGCS, LVGRS and LVGAS in patients with pregnancy-induced hypertension were positively correlated with left ventricular ejection fraction values ( r = 0.638 - 0.775, P = 0.009 - 0.041 < 0.05). Conclusion:Three-dimensional speckle tracking imaging can be used to dynamically evaluate the impairment of left ventricular systolic function in patients with pregnancy-induced hypertension. This technique helps guide early intervention and prognosis evaluation and has a high clinical application value.
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Objective: To examine the safety and feasibility of gasless submental-transoral combined appoach endoscopic thyroidectomy for papillary thyroid carcinoma (PTC). Methods: A retrospective analysis of the clinical data of 41 patients with PTC who underwent the gasless submental-transoral combined appoach endoscopic thyroidectomy at the Department of Head and Neck Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine from November 2020 to April 2021. There were 5 males and 36 females with the age of (35.0±8.7) years (range: 19 to 58 years). A horizontal incision with a length of 2.0 cm is made under the chin as an observation hole, a 10 mm Trocar and a self-developed retractor are inserted, and two 5 mm longitudinal incisions are made on the labial side in the vestibule of the oral cavity as an operation hole, each inserting a 5 mm Trocar, the operation direction is from the cranial side to the caudal side. The sensation of the lower lip and chin was measured on the first day and one month postoperative. The operation time, hospital stay, the number of lymph nodes dissected and postoperative complications were recorded. Results: Surgical procedures in all cases were successfully completed under endoscopic approach without transfering to open surgery. The operation time was (99±34) minutes (range: 50 to 180 minutes) and the postoperative hospital stay was (3.4±2.2) days (range: 2 to 16 days). The maximum diameter of PTC was (7.6±5.8) mm (range: 2 to 30 mm), and the number of lymph nodes of the central compartment dissection was 6(5) (M(IQR)) (range: 1 to 25). The duration of follow-up is 1 month after operation, and the follow-up method is adopted in outpatient clinic. Postoperation complications included 2 cases of transient hypoparathyroidism, One case of recurrent laryngeal nerve injury (continue to follow up to assess whether it is a temporary injury). Postoperative minor chyle leak, seroma, and local redness and swelling in 1 case each were cured after conservative treatment. 1 case of transient minor numbness of the lower lip was observed. No permanent hypoparathyroidism, postoperative bleeding and numbness of the chin was observed. Conclusion: The gasless submental-transoral combined appoach endoscopic thyroidectomy is a feasible approach in selected PTC patients and has clinical application value.
الموضوعات
Adult , Female , Humans , Male , Middle Aged , Young Adult , Endoscopy , Neck Dissection , Retrospective Studies , Thyroid Cancer, Papillary/surgery , Thyroid Neoplasms/surgery , Thyroidectomyالملخص
ObjectiveTo investigate the effect and mechanism of total flavones of Spatholobi Caulis (TFSC) against depression in rats. MethodThe fifty KM mice were randomly divided into the normal group and high-, medium-, and low-dose (1, 0.5, 0.25 g·kg-1) TFSC groups and gavaged with the corresponding drugs for 12 successive days. One hour after the last administration, the immobility time in forced swimming test and tail suspension test was recorded. The SD rats were randomly divided into the normal group, model group, fluoxetine (5 mg·kg-1) group, and high- and low-dose (1, 0.25 g·kg-1) TFSC groups. Following the exposure of rats to two different kinds of stimuli daily for inducing chronic unpredictable stress, they were administered with the corresponding drugs for 21 d. After the experiment, the levels of serum neurotransmitters and inflammatory factors in rats were detected by enzyme-linked immunosorbent assay (ELISA). The changes in hippocampal neurons of rats were observed by hematoxylin-eosin (HE) and Nissl staining. The mRNA expression levels of nuclear factor-κB (NF-κB) and tumor necrosis factor-α (TNF-α) in the hippocampus of rats were detected by real-time fluorescence quantitative polymerase chain reaction (Real-time PCR), and the protein expression levels of cAMP-response element binding protein (CREB), phosphorylated CREB (p-CREB), and brain-derived neurotrophic factor (BDNF) in hippocampal tissues by Western blot. ResultCompared with the normal group, TFSC significantly shortened the immobility time of mice in tail suspension and swimming tests (P<0.05). Compared with the normal group, the model group exhibited reduced sucrose intake and wilderness activity (P<0.01), decreased 5-HT, DA, NE (P<0.05, P<0.01), MAO, IL-6, TNF-α (P<0.05, P<0.01), damaged neurons, increased mRNA levels of TNF-α and NF-κB (P<0.01), and down-regulated BDNF and CREB protein expression (P<0.05). Compared with the model group, TFSC significantly enhanced sucrose intake and wilderness activity of rats (P<0.05), increased the serum 5-HT, DA and NE (P<0.05, P<0.01), and decreased the serum MAO, IL-6, and TNF-α (P<0.05, P<0.01) as well as NF-κB and TNF-α mRNA expression (P<0.01), up-regulated the protein expression levels of BDNF and CREB (P<0.01), and improved the pathological symptoms of hippocampus. ConclusionTFSC improved the hippocampal neurons of rats via CREB/BDNF signaling pathway and reduced depressive pathological damage, thus relieving depression.
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OBJECTIVE:To investigate the role of clinical pharmacists in the diagnosis and treatment of liposome-induced hand-food syndrome (HFS),and to provide reference for rational use of liposome preparation in clinic. METHODS :One case of elderly female patient with breast cancer ,admitted to our hospital suffered from HFS (grade 2)after treated with Doxorubicin hydrochloride liposome ;after successful therapy ,the patient had skin symptoms (grade 3)again due to Paclitaxel liposome ,and clinical pharmacist judged the recurrence of HFS. For symptomatic treatment ,stopping the treatment and external use of hormone was suggested ,and whole-process pharmaceutical care was provided. The pathogenesis ,differential diagnosis ,risk factors and therapeutic drugs of HFS were summarized based on literature review and 2 case reports in the database. RESULTS :The physicians adopted the suggestion of clinical pharmacists ;the patient ’s symptoms improved significantly on the third day and disappeared after 1 week. Combined with literature analysis and 2 case reports ,doxorubicin liposome metabolized more slowly than non liposomes in palms and soles of feet ,resulting in accumulation of doxorubicin in sweat duct and stratum corneum ,aggravating skin damage and leading to HFS. Sequential paclitaxel in liposome form may also lead to the accumulation in eccrine duct ,further caused skin damage and induced HFS. CONCLUSIONS :Clinical pharmacists actively participate in the diagnosis and treatment of ADR , which is conducive to the rehabilitation of patients. At same time ,combination or sequential of Paclitaxel liposome with PLD should be avoided ,as it can lead to ADR as HFS.
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Based on the clinical application data of medical X-ray computed tomography (CT) in the Shanghai Sixth People's Hospital, this study transformed it into the product reliability index requirements, and took the mechanical representative component-examination table (hereinafter referred to as "patient table") and the electronic representative component-DCB (data control board) as examples. Based on the relationship between failure characteristics and clinical application data, a complete set of closed-loop implementation methods from reliability index requirements to reliability design and verification are discussed.
الموضوعات
Humans , China , Reproducibility of Results , Tomography, X-Ray Computedالملخص
Objective: To evaluate the effectiveness of therapeutic massage (tuina) for treating knee osteoarthritis (KOA). Methods: Six English and Chinese databases, including Chinese National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang), Chongqing VIP Database (CQVIP), China Biology Medicine Disc (CBM), Cochrane Library and PubMed databases, were independently searched to identify appropriate randomized controlled trials (RCTs) studying therapeutic massage for KOA compared to oral non-steroidal anti-inflammatory drugs (NSAIDs) alone. The main outcome measures were total effectiveness and the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) score. Results: A total of 8 RCTs were included and they were of average quality. The results showed that therapeutic massage was more effective than NSAIDs comparing total effectiveness [risk ratio (RR)=1.14, 95% confidence interval (CI) (1.07, 1.21), P<0.0001]; compared with NSAIDs, therapeutic massage produced more significant improvements in pain [mean difference (MD)=-2.06, 95%CI (-2.75, -1.36), P<0.00001], stiffness intensity [MD=-0.90, 95%CI (-1.05, -0.75), P<0.00001] and joint function [MD=-12.48, 95%CI (-13.91, -11.05), P<0.00001]. Conclusion: Therapeutic massage was more effective than oral NSAIDs in treating KOA. In relieving pain and stiffness and improving the function of knee joint, therapeutic massage was superior to NSAIDs.
الملخص
Rheumatoid arthritis (RA), the most common inflammatory arthropathy word wild, is a systemic autoimmune disease that mainly affects the synovium of joints with a high disability rate. Metabolic mis-regulation has emerged as a fundamental pathogenesis of RA linked to immune cell dysfunction, while targeting immunometabolism provides a new and effective approach to regulate the immune responses and thus alleviate the symptom of RA. Recently, natural active compounds from traditional Chinese medicines (TCMs) have potential therapeutic effects on RA and regulating immunometabolism. In this review, in addition to updating the connection between cellular metabolism and cell function in immune cells of RA, we summarized that the anti-inflammatory mechanisms of the potential natural compounds from TCM by targeting metabolic reprogramming of immune cells, and discusses them as a rich resource for providing the new potential paradigm for the treatment of RA.
الملخص
Objective:To investigate the effects and mechanism of Gecko extract for treatment of depression in rats. Method:The depression rats were induced by intraperitoneal injection of reserpine (0.5 mg·kg<sup>-1</sup>). The successfully modeled rats were randomly divided into model group, fluoxetine group (1.8 mg·kg<sup>-1</sup>), high dose and low dose groups of Gecko extract (12, 6 g·kg<sup>-1</sup>). The rats were given corresponding dose of drugs once a day for 10 days. After administration, the levels of neurotransmitters and inflammatory factors in serum and prefrontal cortex of rats were detected by enzyme-linked immunosorbent assay (ELISA). The cell changes in hippocampal tissues were observed by hematoxylin-eosin (HE) staining. The mRNA levels of interleukin-6 (IL-6), nuclear factor-<italic>κ</italic>B (NF-<italic>κ</italic>B), and tumor necrosis factor (TNF-<italic>α</italic>) in the hippocampus of rats were detected by Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR). The protein levels of Toll-like receptor 4 (TLR4) and NF-<italic>κ</italic>B in hippocampal tissues of rats were detected by Western blot. Result:Compared with the normal group, Gecko extract significantly shortened the immobility time of tail suspension and swimming in mice. Compared with model group, Gecko extract significantly reduced blepharoptosis and retention time in circles for the rats (<italic>P</italic><0.05), increased the levels of 5-hydroxytryptamine (5-HT) and dopamine (DA) in serum (<italic>P</italic><0.05), decreased the levels of Monoamine oxidase (MAO), IL-6, and TNF-<italic>α</italic> in serum (<italic>P</italic><0.05) and prefrontal cortex (<italic>P</italic><0.05), decreased the mRNA levels of inflammatory cytokines IL-6, NF-<italic>κ</italic>B and TNF-<italic>α</italic> and the protein expressions of TLR4 and NF-<italic>κ</italic>B in the hippocampus of rats (<italic>P</italic><0.05,<italic> P</italic><0.01), and improved the pathological symptoms of the hippocampus. Conclusion:Gecko extract can significantly alleviate the pathological damage of depression and improve the symptoms of depression, and its mechanism may be due to inhibiting TLR4/NF-<italic>κ</italic>B signaling pathway and reducing the expression of NF-<italic>κ</italic>B, IL-6 and other inflammatory factors in the hippocampus of rats.