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Objective:To investigate the clinical value of deep learning model based on contrast enhanced ultrasound (CEUS) video in the differential diagnosis of benign and malignant liver tumors.Methods:Between May 2010 and June 2022, 1 213 patients who underwent CEUS examination for liver masses in the Affiliated Hospital of Southwest Medical University were retrospectively collected, and the enrolled patients were divided into training and independent test cohorts with December 31, 2021 as the time cut-off. In the training cohort, the TimeSformer algorithm was used as the infrastructure, and multiple fixed-time segments were obtained from CEUS arterial videos by using the sliding window of the video, and the classification results of the entire video were obtained after fusing the features of multiple segments, so as to build a deep learning model based on CEUS videos. In the independent test cohort, ROC curves were used to verify the validity of the model and compared with three radiologists with different CEUS experience (R1, R2, and R3, with 3, 6, and 10 years of CEUS experience, respectively).Results:A total of 1 213 patients with liver masses were included in the study, including 1 066 patients in the training cohort (426 cases of malignancy) and 147 patients in the independent test cohort (50 cases of malignancy). The area under curve (AUC)value of deep learning model was 0.93±0.01 in the training cohort and 0.89±0.01 in the independent test cohort, and the accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 80.42%, 74.19%, 92.00%, 94.52% and 65.71%, respectively. Among the three radiologists, R1 had the lowest diagnostic performance, with accuracy, sensitivity, specificity, PPV and NPV of 67.83%, 51.61%, 98.00%, 97.96% and 52.13%, respectively, while the above indicators of R3 were 82.52%, 76.36%, 94.00%, 95.95% and 68.12%, respectively. McNemar′s test showed that the difference between R1 and the deep learning model was statistically significant ( P<0.001), while the differences between R2 and R3 and the deep learning model were not statistically significant ( P=0.720, 0.868). In addition, the analysis time of the model for a single case was (340.24±16.32)ms, while the average analysis time of radiologists was 62.9 s. Conclusions:The deep learning model based on CEUS can better identify benign and malignant liver masses, and may reach the diagnostic level of experienced radiologists.
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Objective:To evaluate the performance of machine learning (ML) based on automated breast volume scanner (ABVS) radiomics in distinguishing benign and malignant BI-RADS 4 lesions.Methods:Between May to December 2020, patients with BI-RADS 4 lesions from the Affiliated Hospital of Southwest Medical University (Center 1) and Guangdong Provincial Hospital of Traditional Chinese Medicine (Center 2) were prospectively collected and divided into training cohort (Center 1) and external validation cohort (Center 2). The radiomics features of BI-RADS 4 lesions were extracted from the axial, sagittal and coronal ABVS images by MaZda software. In the training cohort, 7 feature selection methods and thirteen ML algorithms were combined in pairs to construct different ML models, and the 6 models with the best performance were verified in the external validation cohort to determine the final ML model. Finally, the diagnostic performance and confidence (5-point scale) of radiologists (R1, R2 and R3, with 3, 6 and 10 years of experience, respectively) with or without the model were evaluated.Results:①A total of 251 BI-RADS 4 lesions were enrolled, including 178 lesions (91 benign, 87 malignant) in the training cohort and 73 lesions (44 benign, 29 malignant) in the external validation cases. ②In the training cohort, the 6 ML models (DNN-RFE, AdaBoost-RFE, LR-RFE, LDA-RFE, Bagging-RFE and SVM-RFE) had the best diagnostic performance, and their AUCs were 0.972, 0.969, 0.968, 0.968, 0.967 and 0.962, respectively. ③In the external validation cohort, the DNN-RFE still had the best performance with the AUC, accuracy, sensitivity, specificity, PPV and NPV were 0.886, 0.836, 0.934, 0.776, 86.8% and 82.5%, respectively. ④Before model assistance, R1 had the worst diagnostic performance with the accuracy, sensitivity, specificity, PPV and NPV were 0.680, 0.750, 0.640, 57% and 81%, respectively. After model assistance, the diagnostic performance of R1 was significantly improved ( P=0.039), and its diagnostic sensitivity, specificity, accuracy, PPV and NPV improved to 0.730, 0.810, 0.930, 68% and 94%; while the improvement of R2 and R3 were not significantly ( P=0.811, 0.752). Meanwhile, the overall diagnostic confidence of the 3 radiologists increased from 2.8 to 3.3 ( P<0.001). Conclusions:The performance of ML based on ABVS radiomics in distinguishing between benign and malignant BI-RADS 4 lesions is good, which may improve the diagnostic performance of inexperienced radiologists and enhance diagnostic confidence.
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ABSTRACT Purpose: To explore the role and mechanisms of octreotide in neurofunctional recovery in the traumatic brain injury (TBI) model. Methods: Rats were subjected to midline incision followed by TBI in the prefrontal cortex region. After 72 hours, the behavioural and neurological deficits tests were performed, which included memory testing on Morris water maze for 5 days. Octreotide (15 and 30 mg/kg i.p.) was administered 30 minutes before subjecting to TBI, and its administration was continued for three days. Results: In TBI-subjected rats, administration of octreotide restored on day 4 escape latency time (ELT) and increased the time spent in the target quadrant (TSTQ) on day 5, suggesting the improvement in learning and memory. It also increased the expression of H2S, Nrf2, and cystathionine-γ-lyase (CSE) in the prefrontal cortex, without any significant effect on cystathionine-β-synthase. Octreotide also decreased the TNF-α levels and neurological severity score. However, co-administration of CSE inhibitor (D,L-propargylglycine) abolished octreotide-mediated neurofunctional recovery, decreased the levels of H2S and Nrf2 and increased the levels of TNF-α. Conclusions: Octreotide improved the neurological functions in TBI-subjected rats, which may be due to up-regulation of H2S biosynthetic enzyme (CSE), levels of H2S and Nrf2 and down-regulation of neuroinflammation.
Subject(s)
Animals , Rats , Octreotide/pharmacology , Brain Injuries, Traumatic/drug therapy , Hydrogen Sulfide/metabolism , Hydrogen Sulfide/pharmacology , Tumor Necrosis Factor-alpha , NF-E2-Related Factor 2ABSTRACT
Objectives @#The purposes of this study were to evaluate the long-term mechanical property, bacteria-killing ability, protein resistance and cytotoxicity of a novel antibacterial methyl methacrylate (MMA) resin. @*Methods @#The 2-methacryloyloxyethyl phosphorylcholine (MPC) has been added into the MMA used for making Hawley orthodontic retener according to the mass percentage 0% (control group), 1.5%, 2.25%, 3%, 4.5% and 6%. Specimens from the control group and MPC group were water-aged for 1 d, 90 d and 180 d, and then the universal material testing machine was used to investigate the long-term mechanical properties of the modified MMA specimens in the oral environment. The biofilm metabolic activity, colony-forming unit (CFU) and live/dead staining assay of the biofilms in the control group and MPC group in the oral environment were tested using the dental plaque biofilm model. The micro-bicinchoninic acid (BCA) method was used to determine the amount of protein adsorbed on the specimens. The MTT method was used to evaluate the cytotoxicity of the control group and MPC group.@*Results @#In the simulated oral environment, the addition of 0% to 3% MPC had no significant effect on the mechanical properties of the MMA specimen (P > 0.05). The control group and the modified MMA specimens with 3%MPC were statistically significant in time and the interaction effects between the two groups (P < 0.05). With increasing intervention time, the mechanical strength of both groups decreased, and the effect of time varied with grouping. The protein adsorption on the surface of the modified MMA material after adding 3% MPC decreased by approximately 80%, the metabolic activity of the biofilm decreased by approximately 50%, and biofilm CFU counts decreased by approximately 70% (P < 0.05) compared with the control. There was no statistically significant difference in time or interaction effects between the two groups. The amount of live green bacteria in the 3% MPC group decreased significantly after 1, 90, and 180 d of water aging. There was no significant difference in cytotoxicity between the control group and the MPC group (P > 0.05). @*Conclusions @#The addition of MPC into the MMA resin did not compromise the mechanical properties of the resin and exhibited long-lasting antibacterial and protein-repellent effects.
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Objective@#To understand vitamin A level of middle and primary school students in Qiongzhong Area in Hainan Province implementing the "Nutritional Compulsory Education Student Nutrition Improvement Plan" (hereinafter referred to as "Student Nutrition Plan"), and to provide suggestions for the followup implementation of student nutrition improvement work.@*Methods@#The multi-stage cluster sampling method was used to select three junior high schools and elementary schools in Qiongzhong County, Hainan Province, and students from 1-2 classes from each grade were randomly selected as survey objects. In March 2014, November 2015, December 2016 and December 2017, fasting venous blood was collected from students and serum vitamin A (Retinol) levels were detected by high-performance liquid chromatography.@*Results@#From 2014 to 2017, vitamin A levels were (358.77±88.44) (333.54±81.91) (345.84±86.08) (370.70±87.94)μg/L respectively, the subclinical deficiency rate of vitamin A were 22.3%, 31.6%, 27.9%, 18.0%, the vitamin A level of elementary school students were (332.92±71.80) (315.34±73.41) (327.44±77.02) (356.84±80.88)μg/L, the vitamin A level of junior high school students were (412.20±95.56) (383.20±83.53) (396.63±89.48) (411.60±95.14)μg/L, the difference were statistically significant by year (F=26.43, 4.01, P<0.05); vitamin A level and vitamin A subclinical rate of primary school students showed differences by year in both gender. The deficiency rate was statistically significant regardless of the annual difference between men and women(P<0.05); there was no statistically significant difference in the annual rate of vitamin A deficiency and sub-clinical vitamin A deficiency among junior high school students of different grades and genders (χ2=0.85, 2.08, 1.40, 2.36, P>0.05).@*Conclusion@#The implementation of "Student Nutrition Plan" in Qiongzhong area of Hainan Province shows pasitive effect on the vitamin A nutritional status of students. It’s suggested that prevention should be further strengthened, and nutrition knowledge publicity should be promoted.
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SUMMARY A background of Pulmonary Hypertension (PH) indicates a progressive elevation of pulmonary vascular resistance, leading to overfilling, elevation of venous pressure, congestion in various organs, and edema in the venous system. This study aimed to investigate whether PH is a risk factor for deep vein thrombosis (DVT) of the lower extremities after hip and knee replacement surgery. METHODS A total of 238 patients who received joint replacement of lower extremities in our department of orthopedics from January 2009 to January 2012 were examined by echocardiography and Color Doppler flow imaging (CDFI) of the lower extremities. Based on pulmonary artery pressure (PAP), the patients were divided into a normal PAP group (n=214) and PH group (n=24). All the patients were re-examined by CDFI during post-operative care. RESULTS Among the 238 patients, 18 had DVT in the lower extremities after the operation. DVT total incidence rate was 7.56% (18/238). In the PH group, 11 patients had DVT (45.83%, 11/24), but in the normal PAP group, only 7 had DVT (3.27%, 7/214). The incidence of DVT was significantly lower in the normal PAP group than in the PH group (P<0.01). In addition, there was a positive correlation between PAP and the incidence of DVT. CONCLUSION PH could be a high-risk factor for the occurrence of DVT in patient's lower extremities after joint replacement surgeries.
RESUMO OBJETIVO A hipertensão pulmonar (HP) indica elevação progressiva da resistência vascular pulmonar, levando ao excesso de enchimento, elevação da pressão venosa, congestão em vários órgãos e edema no sistema venoso. Este estudo teve como objetivo investigar se a HP é um fator de risco para trombose venosa profunda (TVP) das extremidades inferiores após cirurgia de prótese de quadril e joelho. MÉTODOS Um total de 238 pacientes que receberam a substituição da articulação das extremidades inferiores em nosso departamento de ortopedia de janeiro de 2009 a junho de 2012 foi examinado por ecocardiograma e fluxo de imagem Doppler colorido (CDFI) dos membros inferiores. De acordo com a pressão arterial pulmonar (PAP), os pacientes foram divididos em grupo PAP normal (n=214) e grupo PH (n=24). Todos os pacientes foram reexaminados por CDFI durante os cuidados pós-operatórios. RESULTADOS Entre os 238 pacientes, 18 pacientes tiveram TVP nas extremidades inferiores após a operação. A taxa de incidência total de TVP foi de 7,56% (18/238). No grupo PH, 11 pacientes tiveram TVP (45,83%, 11/24), mas no grupo PAP normal, apenas sete pacientes tiveram TVP (3,27%, 7/214). A incidência de TVP foi significativamente menor no grupo PAP normal do que no grupo PH (P<0,01). Além disso, houve uma correlação positiva entre a PAP e a incidência de TVP. CONCLUSÃO A HP poderia ser um fator de alto risco para a ocorrência de TVP nas extremidades inferiores do paciente após cirurgias de substituição articular.
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Humans , Male , Female , Aged , Arthroplasty, Replacement, Hip/adverse effects , Arthroplasty, Replacement, Knee/adverse effects , Venous Thrombosis/etiology , Hypertension, Pulmonary/complications , Postoperative Complications/etiology , Reference Values , Echocardiography, Doppler , Retrospective Studies , Risk Factors , Venous Thrombosis/diagnostic imaging , Preoperative Period , Hip/blood supply , Hypertension, Pulmonary/diagnostic imaging , Knee/blood supplyABSTRACT
@# Objective: To validate the effect and the possible mechanism of human regulatory factor X1 (RFX1) over-expression on the proliferation and invasion of glioma F98 cells. Methods: RFX1-overexpressed F98 cells (F98-RFX1 group) were constructed by lentivirus transfection, a control group (F98-Vector group) and normal group (F98 group) were established. The effect of RFX1 over-expression on F98 cell proliferation was observed with counting method, cell apoptosis was determined by AnnexinV-PI staining, and the cell invasion was observed with Transwell method. Results: F98 cell line over-expressing RFX1 was successfully established. The proliferation capacity of F98-RFX1 group was significantly lower than that of F98 group (48 h: [12.08±2.17]×104/ml vs [23.67±4.51]×104/ ml, P<0.05] and F98-Vector group (96 h: [8.17±0.31]×104/ml vs [18.58±1.18]×104/ml, P<0.05); The apoptosis level of cells in F98RFX1 group was significantly increased ([21.89±2.33]% vs [3.38±1.39]%, [10.42±1.83]%, P<0.05]; The invasiveness of cells in F98RFX1 group was significantly reduced ([33.3±7.99] vs [56.5±13.9], [60.6±11.8], P<0.01). Conclusion: RFX1 can regulate the expression of genes related with proliferation and invasion, thereby inhibiting the proliferation and invasion ability of glioma cells and promote cell apoptosis.
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Purpose To perform MRI examination after the death of SD rat model due to cerebral infarction and to investigate the changing characteristics of cerebral infarction during postmortem examination. Materials and Methods Middle cerebral artery occlusion (MCAO) model was established on 21 SD rats by applying modified suture method. 13 to 56 h after modeling, 12 dead SD rats were collected for the experiment. The bodies were stored at an environment with a temperature of 10-15°C and relative humidity of 45%-55%. Head MRI was performed 12 h after modeling and at 8, 24, 48, 72 and 96 h after death respectively, and apparent diffusion coefficient (ADC) values of infarction and contralateral brain tissue were calculated. At each post-mortem time point, ADC values of bilateral cerebral hemispheres, ADC values of infarction and living infarction, and ADC values of non-infarcted brain and living non-infarcted zone were compared. Brain tissue was taken after scan for pathological diagnosis and compared with diagnostic results of postmortem MRI (pmMRI). Results The right cerebral signal of rats was abnormal 12 h after cerebral infarction and after death. Eight rats were found to have shifted cerebral middle-line structure to the left. ADC values of infarction at each time point after death were lower than that of non-infarction, the difference of which was statistically significant (P<0.05); ADC values of infarction were lower than that of living infarction, the difference of which was statistically significant (P<0.05); ADC value of non-infarcted area at each time point was lower than that of living non-infarcted area, the difference of which was statistically significant (P<0.05). Necrosis and disintegration of neurons, disintegration and liquefaction of glial fibers, infiltration of inflammatory cells and leakage of red blood cells were spotted in necrotic areas after receiving cerebral HE staining in rat. HE staining was consistent with the infarction zone indicated by pmMRI. Conclusion pmMRI can be used for the diagnosis of cerebral infarction via virtual necropsy.
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Hexafluoroisopropanol (HFIP)-induced sodium dodecyl sulfate/dodecyltrimethylammonium bromide (SDS/DTAB) catanionic surfactant coacervate extraction method coupled with high performance liquid chromatography (HPLC) was used to detect the migration of phthalates from disposable tablewares to drinking water. The concentration factors are larger than 82 and extraction recoveries over 53%for water samples spiked with 100 or 200 ng/mL phthalates. Limit of detection is in the range of 1.0–2.6 ng/mL. Good linearity with correlation coefficients larger than 0.9985 is obtained in the concentration of 20–1500 or 40–3000 ng/mL. Relative recoveries are from 82.4%to 123.6%for water samples spiked with 30/60, 250/500, and 1500/3000 ng/mL phthalates, respectively. Relative standard deviations (RSDs) are 0.4%–7.4% for intraday precision (n ? 5) and 0.6%–7.8% for interday precision (n ? 3). Four of studied phthalates are found in the drinking water samples prepared from four kinds of tablewares.
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OBJECTIVE: Evidence of the brain network involved in cognitive dysfunction has been inconsistent for major depressive disorder (MDD), especially during early stage of MDD. This study seeks to examine abnormal cognition connectivity network (CCN) in MDD within the whole brain. METHODS: Sixteen patients with MDD and 16 health controls were scanned during resting-state using 3.0 T functional magnetic resonance imaging (fMRI). All patients were first episode without any history of antidepressant treatment. Both the left and right dorsolateral prefrontal cortex (DLPFC) were used as individual seeds to identify CCN by the seed-target correlation analysis. Two sample t test was used to calculate between-group differences in CCN using fisher z-transformed correlation maps. RESULTS: The CCN was constructed by bilateral seed DLPFC in two groups separately. Depressed subjects exhibited significantly increased functional connectivity (FC) by left DLPFC in one cluster, overlapping middle frontal gyrus, BA7, BA43, precuneus, BA6, BA40, superior temporal gyrus, BA22, inferior parietal lobule, precentral gyrus, BA4 and cingulate gyrus in left cerebrum. Health controls did not show any cluster with significantly greater FC compared to depressed subjects in left DLPFC network. There was no significant difference of FC in right DLPFC network between depressed subjects and the health controls. CONCLUSION: There are differences in CCN during early stage of MDD, as identified by increased FCs among part of frontal gyrus, parietal cortex, cingulate cortex, and BA43, BA22, BA4 with left DLPFC. These brain areas might be involved in the underlying mechanisms of cognitive dysfunction in MDD.
Subject(s)
Humans , Brain , Cerebrum , Cognition , Depression , Depressive Disorder, Major , Gyrus Cinguli , Magnetic Resonance Imaging , Prefrontal Cortex , RabeprazoleABSTRACT
Objective To investigate the relationship between nasal colonization of Staphylococcus aureus(SA) and nosocomial infection in intensive care unit(ICU), and observe the therapeutic effect of Anerdian III in nasal decolonizaion. Methods Bacterial cultures were made by means of nasal swabs among inpatients whom the occurrence of nosocomial infection were observed.Patients with SA colonization were randomly divided into two groups:control and treatment.Control group were given regular treatment, and treatment group were administered Anerdian III in addition to regular treatment.Then the clearance rate of SA and the occurrence of nosocomial infection of two groups were observed. Results A total of 751 patients were enrolled, of whom 108(14.4%) were with nosocomial infection and 85(11.3%) with SA nasal colonization. Methicillin resistant Staphylococcus aureus ( MRSA ) was detected in 33 patients (4.4%).The nosocomial infection rate of patients with MRSA colonization was 51.5%, which was significantly higher than those in patients with other bacterial colonization(P<0.05).The SA clearance rate in treatment group was significantly higher than that in control group(81.4% vs.42.8%,P<0.05).The nosocomial infection rate in treatment group was significantly lower than that in control group ( 16 .3% vs. 40.5%,P <0.05).After decolonization treatment,the nosocomial infection rate of patients with MRSA colonization was significantly lower than that in control group(25.0% vs.76.5%,P <0.05). Conclusion The incidence rate of nosocomial infection in patients with MRSA nasal colonization is markedly increased in ICU, and the decolonization treatment by Anerdian III increases the clearance rate of nasal SA and decreases the incidence rate of nosocomial infection.
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[Objective] To investigate the effect of long term occupational exposure on the immune function of workers of a power plant . [ Methods] An exposure group of 200 workers in a power plant and a control group of 80 normal people of health checkup were examined for their cellular immunity and humoral immunity by flow cytometry instrument testing technology of the United States BD company and im-mune turbidimetric method. [Results] The abnormality rate (16.5%) of immune globulin in exposure group were significantly higher than that (7.5%) in control group (P<0.01).The values of CD3, CD4, CD8 positive T-lymphocytes and the ratio CD 4/CD8 were significantly lower in exposure group than those in control group (P<0.05).The levels of IgG and IgA in exposure group were significantly lower than those in control group (P<0.05). [Conclusion] It is indicated that long term occupational exposure in power plant may lower the values of CD 3, CD4, CD8 positive T-lymphocytes and the ratio of CD4/CD8 and reduce the function of humoral immunity .
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Objective] To study the effect of different placed time for vacutainer and specimen on the results of emergency electrolyte detection . [ Methods] With heparin lithium anticoagulation tube and common coagulation vacuum tube , electrolytes were detected at 30 minutes,one hour and two hours af-ter extracting blood . [ Results] At 30 minutes and one hour after extracting blood ,the levels of K +and Na+of the plasma group were significantly lower than those of the serum group (P<0.05).With the ex-tension of specimen placed time , the levels of K +and Na +of the plasma group were becoming higher than those previously ,and at two hours the difference had statistical significance ( P<0 .05 ) .There was not ob-vious difference found in the levels of K +, Na +and Cl -of the serum group at different placed times ( P>0.05).But the levels of CO2 of both the plasma group and the serum group were significantly lower than those previously with the extension of specimen placed time , and the difference had statistical significance (P<0.05). [Conclusion] It is indicated that the using of different vacutainers effects electrolyte de-tection.With the extension of specimen placed time , the levels of K +and Na +of the plasma group increase gradually , and the levels of CO 2 of the plasma group and the serum group both decrease gradually .
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Objective] To discuss comprehensive intervention effect on the control of hospital in-fections in the intensive care unit ( ICU ) of a hospital by monitoring Staphylococcus aureus infections and their drug resistance . [ Methods] Comparative analysis was done retrospectively in separation results of Staphylococcus aureus between 2011 and 2012 in ICU patients of a hospital . [ Results] Between 2011 and 2012, there was no obvious difference found in relevance ratio of Staphylococcus aureus(P>0.05), but that of methicillin resistant Staphylococcus aureus was on the decline significantly (P<0.05).The drug re-sistance rates of Staphylococcus aureus to oxacillin, ciprofloxacin, levofloxacin were on the decline signifi-cantly(P <0.05).The drug susceptibility rates of Staphylococcus aureus to vancomycin, teicoplanin, linezolid , nitrofurantoin and primaquine slave tianeptine/dafoe tianeptine were the highest , reaching up to 100.00%. [ Conclusion] By comprehensive intervention , Staphylococcus aureus infections in ICU have been improved and drug resistance rates on the decline as a whole .
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To investigate the rat intestinal absorption of stearic acid-octaarginine (SA-R8) modified solid lipid nanoparticles containing paclitaxel (SA-R8-PTX-SLN), compared with the commercially available preparation of PTX (Taxol) and PTX-loaded solid lipid nanoparticles (PTX-SLN), the in situ intestinal absorption of SA-R8-PTX-SLN was investigated by means of single-pass rat intestinal perfusion technique. The absorptions of the preparations were investigated at different intestinal segments, different drug concentrations and in the presence of P-glycoprotein inhibitor (verapamil). The results showed that PTX could be absorbed at each intestinal segment and the three preparations all showed maximum absorptions at the duodenum. The cumulative absorptions of three preparations at each intestinal segment appeared SA-R8-PTX-SLN > PTX-SLN > Taxol (P < 0.05). SA-R8-PTX-SLN showed a liner absorption manner at the duodenum in the examined drug concentration range. The cumulative absorptions of Taxol and PTX-SLN were significantly promoted after the addition of P-glycoprotein inhibitor (verapamil) into the preparation (P < 0.05), but absorption of SA-R8-PTX-SLN existed no significantly difference compared with the preparation without verapamil (P > 0.05). SA-R8 and SLN might both effectively improve the oral absorption of PTX in the intestinal tract.
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Animals , Male , Rats , ATP Binding Cassette Transporter, Subfamily B, Member 1 , Antineoplastic Agents, Phytogenic , Chemistry , Pharmacokinetics , Cell-Penetrating Peptides , Chemistry , Drug Carriers , Intestinal Absorption , Lipids , Chemistry , Nanoparticles , Oligopeptides , Chemistry , Paclitaxel , Chemistry , Pharmacokinetics , Perfusion , Rats, Sprague-Dawley , Stearic Acids , Chemistry , Verapamil , PharmacologyABSTRACT
Pacemaker lead infections are rare. There are only about 0.4%-1.1% of the patients who have been implanted permanent pacemakers suffering from serious infections which lead to endocarditis. Generally, removal of the infected pacemaker wire and lead, long-term anti-infection therapy, and implantation of a new pacemaker to another anatomic site are accepted approaches for these patients.
Subject(s)
Humans , Male , Middle Aged , Device Removal , Endocarditis , Drug Therapy , Mycoses , Drug Therapy , Pacemaker, Artificial , ScopulariopsisABSTRACT
Objective To analyze the risk factors and clinical features of stroke following off-pump coronary artery bypass grafting in patients with prior stroke. Methods From January 2006 to July 2009, the clinical information of 437 patients undergoing OPCABC in Anzhen Hospital was collected. The patients were divided into stroke group and non-stroke group according to whether stroke occurred after operation. Preoperative and operative variants were evaluated by univariate and multivariate logistic stepwise regression analysis. Results 32 of 437 patients (7.3% ) suffered from stroke after OPCABG, 32 cases were cerebral infarction and no case was cerebral hemorrhage. There were more patients whose left ventricular ejection fraction ≤0. 50 in stroke group than that in non-stroke group (12 of 32, 37.5% versus 69 of 405, 17.0% , P = 0. 004), more patients had atrial fibrillation after operation in stroke group than that in non-stroke group (9 of 32, 28. 1% versus 27 of 405,6.7% , P < 0.001), more patients had hypotension after operation in stroke group than that in non-stroke group (13 of 32,40.6% versus 42 of 405, 10. 4% ; P < 0. 001), more patients had ventilatory time and ICU time after operation in stroke group than that in non-stroke group(9 of 32, 28.1% versus 49 of 405, 12.1% , P =0.021; 14of 32,43.8% versus 97 of 405, 24.0% , P = 0.013), and patients in stroke group took longer to stay in hospital than that in non-stroke group (29.0 ±15. 8 versus 22. 9 ± 10. 4, P = 0. 002 ). Logistic stepwise regression analysis showed that left ventricular ejection fraction SS0.50(OR=2.837, 95%CI: 1.238-6.498), atrial fibrillation after operation( OR =3. 065, 95% CI: 1.157-8.118) and hypotension after operation (OR =4.209, 95%CI: 1.805 -9. 813) were independent risk factors of stroke following offpump coronary artery bypass grafting in patients with prior stroke. Conclusion This data suggest that left ventricular ejection fraction ≤0. 50, atrial fibrillation and hypotension after operation are risk factors for stroke following off-pump coronary artery bypass grafting in patients with prior stroke. These patients with stroke after operation took longer to extubate and stay in ICU and hospital.
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Objective The aim of the present study was not only to assess the retrograde degenerative changes in the dopaminergic neurons of the substantia nigra (SN) and ventral tegmental area (VTA) after injection of 6-hydroxydopamine (6-OHDA) into the striatum, but also to use this 6-OHDA model of Parkinson's disease to explore the possible neuroprotective effect of R-apomorphine (R-APO). Methods The partial lesion was obtained by intrastriatal administration of 6-OHDA. R-APO administration (10 mg/kg, s.c.) started 15 min prior to lesioning and continued daily for another 22 days post surgery. Testing was carried out 5 weeks after lesioning. We investigated the histology and associated behavior and neurochemical changes. Structural and functional deficits were quantified by tyrosine hydroxylase (TH) / Nissl-staining cell number counting, striatal dopamine (DA) content determination and amphetamine-induced rotation analysis. Results R-APO-treatment attenuated the amphetamine-induced ipsiversive rotation 5 weeks after the lesion induction. R-APO administration for 22 days significantly reduced the size of the lesion at the level of the SN from 50% (control group) to 69%. Moreover, the cell shape resembled that observed in the intact animals. R-APO treatment significantly increased the number of cells in both the lesion and the intact sides of VTA by 60%, suggesting selective neurotrophic effect of R-APO in this area. Finally, R-APO-treatment significantly attenuated the 6-OHDA-induced striatal DA depletion and normalized dihydroxyphenylacetic acid (DOPAC)/DA ratios. Conclusion We conclude that R-APO has neuroprotective and possible neurotrophic effect on a striatal lesion with 6-OHDA, suggesting that this drug may have rescuing properties in patients with early stage Parkinson's disease. These effects are more pronounced in VTA and enhance with duration of treatment.