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【Objective】 To explore the clinical value of thromboelas-tography, coagulation four items and platelet count in guiding platelet transfusion in critically ill patients. 【Methods】 A total of 188 critically ill patients in Intensive Care Unit of our hospital from January 2020 to January 2022 were selected as subjects, and were divided into study group(n=89) and the control(n=99) according to the presence of bleeding symptoms. T-test was used for comparative analysis between the two groups. Spearman was used to analyze the correlation between TEG, coagulation four items and platelet count, and binary Logistic regression analysis was used to predict the influential factors of bleeding in critically ill patients, ROC curve was used to analyze the guiding value of the above-mentioned indexes for platelet transfusion. 【Results】 1) K and PT values in the study group, above the normal range, were significantly higher than those in the control, while the Angle value, MA value, CI value, FIB value and platelet count were significantly lower than those of the control, among which MA value, CI value and platelet count were below the normal range. 2) TEG, coagulation four items and platelet count were correlated. MA and CI values were positively correlated with platelet count, instead, R and K values were negatively correlated. R value was positively correlated with PT and APTT, CI value, on the contrary, was negatively correlated, K value was positively correlated with PT, while Angle value and MA value were negatively correlated. 3) Binary Logistic regression analysis showed that decreased MA value and decreased platelet count were independent risk factors for predicting bleeding in critically ill patients(P<0.05). 4) ROC curve analysis showed that the areas under ROC curve corresponding to Angle value, MA value, CI value, FIB value and platelet count were 0.866, 0.932, 0.9, 0.838 and 0.987(P<0.05). The sensitivity was highest in platelet count and lowest in FIB. The specificity was highest in MA and lowest in Angle. Compared with the single index, the area under the curve of the combined index(K value, MA value, CI value, PT value and platelet count) was 0.995(P<0.05), Yoden index 0.944, sensitivity 100%, specificity 93.3%, all higher than the individual index. 【Conclusion】 Thromboelas-tography combined with coagulation four items and platelet count can be used to accurately predict the critically ill patients with bleeding risk. To guide clinical platelets transfusion, the combined use of indexes, including K value, MA, CI value, PT and platelet count, is superior to separate use of them as the former showed better sensitivity and specificity, demonstrating a good clinical value.
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Objective To investigate the association of distinct myositis specific autoantibodies (MSAs) with long-term survival of patients with polymyositis (PM) and dermatomyositis (DM).Methods We analyzed the clinical data and outcome of patients with PM and DM who were hospita-lized in the department of rheumatology of China-Japan Friendship hospital from 1994 to 2015,and evaluated the impact of MSAs on the prognosis of patients.Multivariate Cox regression analysis was used to identify the prognostic risk factors for PM/DM patients.Results A total of 383 PM/DM patients were followed up for 1-333 months.Cumulative survival and 10-year survival rate of all patients were 68.6％ and 76.2％,respectively.The survival rate of 80.4％ and 77.1％ at 3 and 5 years in patients with MSAs,which were lower than those of patients with-out MSAs,who had the survival rate of 90.1％ and 87.4％ at 3 and 5 years,respectively(x2=3.90 and 3.98,P＜0.05).There was significant difference for long-term survival in all MSAs positive groups (x2=40.654,P=0.000).Anti-MDA5 positive patients who had the 10-year survival rate of 28.7％ had the worst prognosis,while anti-HMGCR positive patients who had the l0-year survival rate of 100％ had the best outcome in all groups.Multivariate Cox regression analysis showed that independent risk factors associated with the long-term survival of patients were age of onset,complicated with malignancies,dysphagia,rapidly progress interstitial lung disease,antiMDA5 antibody positive,increased serum aspartate transferase and C reaction protein.Conclusion MSAs are strongly associated with the prognosis of patients with PM/DM.Patients with MSAs has worse 5-year overall survival than those without MSAs,which indicates that screening MSAs and aggressive treatment for PM/DM patients at very early stage of disease may improve the outcome.
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The formation of physique was influenced by many factors and was closely related to the disease, especially by the social and cultural factors. According to the characteristics of physique, physique conditioning was conducive to rehabilitation of the disease. It was also the internal evidence for individualized treatment of rehabilitation. Traditional Chinese medicine (TCM) rehabilitation advocated functional rehabilitation as the main treatment purpose. Attentions were paid to promoteqi circulation. The psychological characteristics of the rehabilitation subject were especially emphasized on, in order to improve the therapeutic effect of rehabilitation. There were many classifications of physical evaluations, which were widely used in a variety of clinical diseases rehabilitation. The pathological physique correction and adjustment cannot be ignored in rehabilitation. Therefore, the application of physical evaluation in the guidance of rehabilitation therapy can enrich the content of TCM rehabilitation evaluation. It further improved TCM physical evaluation system to meet the needs for clinical practice and TCM modernization.
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<p><b>BACKGROUND</b>SIRT3 is an important regulator in cell metabolism, and recent studies have shown that it may be involved in the pharmacological effects of metformin. However, the molecular mechanisms underlying this process are unclear.</p><p><b>METHODS</b>The effects of SIRT3 on the regulation of oxidative stress and insulin resistance in skeletal muscle were evaluated in vitro. Differentiated L6 skeletal muscle cells were treated with 750 µmol/L palmitic acid to induce insulin resistance. SIRT3 was knocked down and overexpressed in L6 cells. SIRT3, nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) p65, c-Jun N-terminal kinase 1 (JNK1), and superoxide dismutase 2 (SOD2) were evaluated by Western blotting.</p><p><b>RESULTS</b>Over expression of SIRT3 increased glucose uptake and decreased ROS production in L6-IR cells as well as in L6 cells. Knock-down of SIRT3 induced increased production of ROS while decreased glucose uptake in both L6 and L6-IR cells, and these effects were reversed by N-acetyl-L-cysteine (NAC). Metformin increased the expression of SIRT3 (1.5-fold) and SOD2 (2-fold) while down regulating NF-κB p65 (1.5-fold) and JNK1 (1.5-fold). Knockdown of SIRT3 (P < 0.05) reversed the metformin-induced decreases in NF-κB p65 and JNK1 and the metformin-induced increase in SOD2 (P < 0.05).</p><p><b>CONCLUSIONS</b>Upregulated SIRT3 is involved in the pharmacological mechanism by which metformin promotes glucose uptake. Additionally, SIRT3 may function as an important regulator of oxidative stress and a new alternative approach for targeting insulin resistance-related diseases.</p>
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Animals , Rats , Cell Line , Insulin Resistance , Physiology , Metformin , Pharmacology , Muscle Fibers, Skeletal , Metabolism , Oxidative Stress , Sirtuin 3 , Metabolism , Transcription Factor RelA , MetabolismABSTRACT
[Summary] Type 2 diabetic rat model accompanied by insulin resistance was established by high fat/high glucose diet and streptozotocin.Following metformin treatment for 4 weeks,realtime PCR and Western blot were used to detect the expressions of SIRT3 mRNA and protein in skeletal muscle tissue,respectively.The results showed that insulin sensitivity,superoxide dismutase (SOD),and glutathione (GSH) levels were significantly reduced in diabetic group compared with the control group (P＜0.05),while methane dicarboxylic aldehyde (MDA) level was increased (P＜0.05),along with the decreased expressions of SIRT3 mRNA and protein in skeletal muscles (P＜0.01).After metformin treatment,the insulin sensitivity,SOD,GSH,and SIRT3 mRNA and protein levels were significantly increased (P＜ 0.05 or P＜ 0.01),while MDA level was decreased (P ＜ 0.05),suggesting that metformin may ameliorate insulin resistance via upregulating SIRT3 expression in skeletal muscles of diabetic rats.
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Objective :To investigate relationship between the glossoscopy objectivised image and kidey-biopsy pathology type of patients with primary glomerulopathy.Methods: The tongue image(including color clustering of tongue images and tongue shapes) of 66 patients with primary glomerulopathy were taken by Snakes Algorithm of Tongue Image Handling System and pathology diagnosis of kidney was also done in the same time,t-test was adopted to analyse the correlation of the glossoscopy objectivised image and kidey-biopsy pathology type of patients.Result: The result show that there are significant differences among tongue images of different pathology types(P
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Objective: To study the anti-inflamation effect of Volatile oil of Centipesa minima and the mechanism of action. Method: The “Two-hit” animal model of acute lung injury in rats was induced by oleic acid and lipopolysaccharide, to observe the protective effect of VOCM on acute lung injury in rats. Result: VOCM was able to suppress lung edema and high numbers of neutrophils, decrease the expression of CD54 in the bronchial epithelium tissue in the acute lung injury animal models. Conclusion: VOCM has a protective effect on acute lung injury in rats. Decreasing the expression of CD54 in the bronchial epithelium tissue may be one of its mechanisms of against respiratory tract inflammation.
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Objective: To observe the protective effect of WenyangHuoxueFang on renal interstitial fibrosis in rats and try to explore the mechanism.Methods: The renal obstruction model of rats was established by unilateral ureteral obstruction(UUO) ,and then they were divided into four groups randomly,including UUOW group(treated with WenyangHuoxueFang),UUOF group(treated with Fosinopril),UUO group and the sham-operation group.The morphological changes of kidney tissue were observed,the level of RBP was detected by ELISA,the expression of MMP-3 and TIMP-1 was detected by immuno-histochemistry.Results: Compared with the sham-operation group,there were different degrees of kidney lesions in UUO group and the treatment groups.The level of RBP in UUO group was significantly higher than that in sham-operation group.Compared with UUO group,the RBP expression in UUOF group and UUOW group was significantly lower(P0.05).The expressions of MMP-3 and TIMP-1 in UUO group were increased,and the amplitude of increasing expression of TIMP-1 was higher than that of MMP-3.The treatment groups had higher expression of MMP-3(P