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ObjectiveTo explore the possible mechanism of Tongdu Xingshen needling method （通督醒神针刺法） on post-stroke cognitive impairment. MethodsSD rats were randomly divided into a normal group （n=12）， a sham surgery group （n=12）， a model group （n=12）， and a electroacupuncture group （n=13）. The rats in the model group and electroacupuncture group were subjected to the wire bolus method to establish the rats model with learning memory impairment after cerebral ischaemia-reperfusion. After successful modelling， the rats in the electroacupuncture group were given electroacupuncture interventions at “Shenting （GV 24）” and “Baihui （GV 20）” once a day for 30 minutes for 14 days. The other three groups did not receive other interventions but grasp. A 5-day localisation navigation experiment was conducted on the 9th day of intervention， and a spatial exploration experiment was conducted on the 14th day of intervention to evaluate the learning and memory abilities of the rats. After the spatial exploration experiment， hippocampal tissues were taken from each group of rats， and the changes in the volume of cerebral infarction were observed by TTC staining； the changes in the morphology of pyramidal neurons and the density of dendritic spines in the CA1 area of the hippocampus were observed by Golgi staining； protein immunoblotting was used to detect the relative protein expression of the subunits of the α-amino-3-carboxy-5-methylisoxazole-4-propionic acid （AMPA） receptor including glutamate receptor 1 （GluR1）， glutamate receptor 2 （GluR2）， glutamate receptor 3 （GluR3） and auxiliary proteins TARPγ2， TARPγ8 in hippocampal tissues of rats in each group； the real-time fluorescence quantitative PCR was used to detect GluR1， GluR2， GluR3 mRNA levels in the hippocampal tissues of rats. ResultsIn the localisation navigation experiment， compared with the normal group and sham surgery group， the escape latency and total distance of rats in the model group were significantly extended （P＜0.05） at day 1， 2， 3， 4， and 5； and the escape latency and total distance of rats in the electroacupuncture group tended to be significantly shorter than those in the model group （P＜0.05）. In the spatial exploration experiment， compared with the normal group and the sham surgery group， the number of rats crossing the platform in the model group was significantly reduced （P＜0.05）， and the number of crossings of the platform in the electroacupuncture group increased significantly （P＜0.05）. The results of TTC staining showed that the volume of cerebral infarction increased clearly in the model group compared with the sham surgery group （P＜0.05）， and apparently decreased in the electroacupuncture group compared with the model group （P＜0.05）. Golgi staining showed that the number of dendritic branches of pyramidal neurons and dendritic spines in hippocampal CA1 region significantly decreased in the model group compared with the normal group and the sham surgery group （P＜0.05）. The number of dendritic branches of pyramidal neurons and the density of dendritic spines in hippocampal CA1 region significantly increased in the electroacupuncture group compared with the model group （P＜0.05）. The protein relative expression levels of GluR1， GluR2， GluR3， TARPγ2 and TARPγ8， and the mRNA levels of GluR1， GluR2 and GluR3 in hippocampus decreased in the model group compared with the normal group and the sham surgery group （P＜0.05）. The protein relative expression levels of GluR1， GluR2， GluR3， TARPγ2 and TARPγ8， and the mRNA levels of GluR1， GluR2 and GluR3 in hippocampus increased in the electroacupuncture group compared with model group （P＜0.05）. ConclusionThe Tongdu Xingshen needling method can improve learning memory impairment after cerebral ischaemia-reperfusion， which may be related to up-regulation of the expression of AMPA receptor and their auxiliary protein TARP， and promoting the synaptic plasticity of hippocampal tissues.
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Objective:To explore the current status of surgery for portal hypertension to grasp current status and future development of surgery in China.Methods:This study is jointly sponsored by China Hepatobiliary & Pancreatic Specialist Alliance & Portal Hypertension Alliance in China (CHESS).Comprehensive surveying is conducted for basic domestic situations of surgery for portal hypertension, including case load, surgical approaches, management of postoperative complications, primary effects, existing confusion and obstacles, liver transplantation(LT), laparoscopic procedures and transjugular intrahepatic portosystemic shunt(TIPS), etc.Results:A total of 8 512 cases of portal hypertension surgery are performed at 378 hospitals nationwide in 2021.Splenectomy plus devascularization predominated(53.0%)and laparoscopy accounted for 76.1%.Primary goal is preventing rebleeding(67.0%) and 72.8% of hospitals used preventive anticoagulants after conventional surgery.And 80.7% of teams believe that the formation of postoperative portal vein thrombosis is a surgical dilemma and 65.3% of hospitals practiced both laparoscopy and TIPS.The major reasons for patients with portal hypertension not receiving LT are due to a lack of qualifications for LT(69.3%)and economic factors(69.0%).Conclusions:Surgery is an integral part of management of portal hypertension in China.However, it is imperative to further standardize the grasp of surgical indications, the handling of surgical operation and the management of postoperative complications.Moreover, prospective, multi-center randomized controlled clinical studies should be performed.
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Background Steel workers are exposed to occupational hazardous factors such as dust, noise, and heat, and often work in shifts, making them prone to sleep disorders. Objective To explore potential influencing factors of sleep disorders among workers in a steel enterprise in Gansu Province, and provide a basis for reducing the risk of sleep disorders among them. Methods From January to March 2022, a self-made questionnaire combined with the Pittsburgh Sleep Quality Index (PSQI) were used to investigate the employees of a steel enterprise in Gansu Province. According to their PSQI scores, they were divided into a normal sleep group and a sleep disorder group. The general demographic variables of the two groups were balanced by 1∶1 propensity score matching (PSM). Multiple logistic regression was used to analyze the contributing factors of sleep disorders. Restricted cubic spline (RCS) model was used to analyze potential dose-response relationship between weekly working hours and sleep disorders. Results The prevalence of sleep disorders in the steel workers was 48.06% (6029/12544). After PSM, 5847 pairs were successfully matched, and the distributions of matched variables were well balanced between the two groups. The results of multiple logistic regression showed that hypertension (OR=1.39, 95%CI: 1.24, 1.56), diabetes mellitus (OR=1.34, 95%CI: 1.07, 1.66), three-shift system (OR=1.26, 95%CI: 1.12, 1.41), dust exposure (OR=1.14, 95%CI: 1.01, 1.29), noise exposure (OR=1.23, 95%CI: 1.09, 1.39), heat exposure (OR=1.16, 95%CI: 1.04, 1.29), and work injury (OR=1.22, 95%CI: 1.02, 1.46) increased the risk of sleep disorders. Compared with workers with < 10 years of service, those with 10-20 years (OR=1.31, 95%CI: 1.19, 1.44), 20-30 years (OR=1.34, 95%CI: 1.19, 1.52), and ≥30 years of service (OR=1.35, 95%CI: 1.19, 1.53) had a higher risk of sleep disorders. Compared with non-exercise workers, the risk of developing sleep disorders was lower in workers with occasional exercise (OR=0.61, 95%CI: 0.56, 0.66) and regular exercise (OR=0.55, 95%CI: 0.49, 0.62). The RCS model showed that the weekly working hours and sleep disorders in the steel workers showed a nonlinear dose-response relationship (P<0.05 for overall trend, P<0.05 for nonlinear test). The relationship between weekly working hours and sleep disorders showed a "U" shaped distribution, with a significant increase in the risk of sleep disorders when the weekly working hours exceeded 49 h. Conclusion The non-occupational influencing factors of sleep disorders of employees in the steel enterprise include hypertension, diabetes, physical exercise, and occupational influencing factors include length of service, weekly working hours, shifts, dust exposure, noise exposure, heat exposure, and work injuries. It is recommended to consider both occupational and non-occupational factors to formulate appropriate sleep disorder prevention and control measures for steel employees to reduce the risk of sleep disorders.
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Objective: To analyze the influencing factors of death in patients with coronavirus disease 2019 (COVID-19) and provide a reference for clinically reducing the mortality of patients with COVID-19. Methods: Based on the retrospective analysis of the case data of all patients with COVID-19 admitted in our hospital from January 17th to February 25th, 2020, and the sex, age, whether or not to take Chinese medicine preparations during hospitalization, clinical classification, comorbidities, nucleic acid test results, admission time, discharge and other relevant indicators were collected for statistical analysis. Results: During the period of COVID-19, the number of patients of COVID-19 in our hospital gradually increased. At the epidemic peak period, 904 patients with COVID-19 were treated simultaneously. From January 17th to February 25th, 2020, a total of 1 305 patients with COVID-19 were treated in our hospital, including 632 males and 673 females, and the male to female ratio was 1:1.06. The age distribution ranged from 7 to 111 years, with a median of 63 (51, 70) years old. There was no significant difference in the age distribution of patients between different genders (Z = 1.217, P = 0.224). The results of univariate analysis showed that the patient's gender, age, whether to take Chinese medicine preparations during treatment, clinical classification, whether combined with underlying diseases (hypertension, coronary heart disease, diabetes, tumors and uremia) and nucleic acid test results all could affect patients fatality rate. Logistics multivariate regression analysis found that taking traditional Chinese medicine preparations, clinical classification, and whether combined with underlying diseases were independent risk factors for death in patients with COVID-19. Conclusion: The death of patients with COVID-19 is related to various factors. Reducing the occurrence of critical illness, controlling underlying diseases, stabilizing blood pressure and blood sugar, actively improving cardio-cerebral vascular conditions, and stabilizing renal function are main measures to improve the therapeutic effect, and early application of traditional Chinese medicine treatment also plays a very important role in reducing the mortality of patients with COVID-19.
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Objective: To build a model to predict critically ill-patients with coronavirus disease 2019 (COVID-19), and provide a new idea for the rapid identification of clinical progression in the early stage of critically ill-patients. Methods: A retrospective analysis of the general data of 152 general patients and 323 critically ill-patients diagnosed with COVID-19 from Jan 17th, 2020 to Feb 25th, 2020 in Wuhan Third Hospital was carried out; At the same time, the differences in fever, blood routine, liver and kidney function, coagulation function, C-reactive protein (CRP), and nucleic acid reagent testing results from the day of admission were statistically analyzed. Factors with statistical significance were included in a multivariate logistic regression analysis to obtain independent relevant factors that affect the critical ill-patients with COVID-19. Then a prediction model was built based on these factors and its accuracy was evaluated by the receiver operating characteristic (ROC) curve. Results: The sensitivities of age, fever, neutrophil ratio, lymphocyte ratio, serum creatinine (Scr) and combined diagnosis were 0.664, 0.671, 0.607, 0.669, 0.302 and 0.710, respectively; The specificities were 0.669, 0.585, 0.795, 0.685, 0.895 and 0.802, respectively; The area under the curve (AUC) were 0.725, 0.628, 0.721, 0.681, 0.590 and 0.795, respectively; The AUC of combined diagnosis was higher than that of single diagnosis (P < 0.05). Conclusion: The logistic regression and combined with ROC curve model based on multi-factors, including age, fever status, neutrophil ratio, lymphocyte ratio, and Scr, can play a good role in predicting the occurrence of critically ill-patients with COVID-19, which is worthy of further promotion and application.
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Objective@#To explore the international development trends and research hotspots of outdoor activities affecting the progression of children’s myopia, and to provide a reference for researching on effective ways to prevent children’s myopia.@*Methods@#Totally 291 relevant documents included in the "Web of Science" core set database were used as research objects, and CiteSpace software was used for visual analysis.@*Results@#At present, the publications in this field were mainly in the United States(81), China(80), Australia(76), and Singapore(33); the top three research institutions were "Natl Univ Singapore"(29), "Australian Natl Univ"(27), "Capital Med Univ"(25); the main authors were "Saw SM", "Morgan IG", "Mitchell P". The field has been developed on the basis of "Ophthalmology", "Public, Environmental and Occupational Health", and has been integrated into 32 disciplines. The research content included "exploration of high risk factors for the progression of children’s myopia" and "outdoor activities", "intervention in children’s progression of myopia" and "longitudinal tracking of children’s vision development". Randomized clinical trials that longitudinally track the correlation between changes in eyeballs and the progression of myopia and the effects of outdoor activities on the biological characteristics of children’s eyeballs have become a hot topic in this field.@*Conclusion@#Research on the effects of outdoor activities on the progression of myopia in children has increased dramatically. The study of increasing outdoor activities to interfere with the progression of myopia in children and the vertical tracking of key factors affecting the biological characteristics of children’s eyeballs have become the current international trends.
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Objective Electrocardiographic (ECG) gated 4?dimensional CT angiography (4D?CTA) was performed to analyze the morphological characteristic differences between ruptured and unruptured intracranial aneurysms less than 5 mm to predict the rupture risk of small intracranial aneurysms. Methods A total of 118 patients with intracranial aneurysms less than 5 mm who underwent 4D?CTA examinations in our hospital from May 2014 to May 2017 were retrospectively analyzed. The whole study population was divided into ruptured group and unruptured group. Seventy?two patients were in the ruptured group and 46 patients were in the unruptured group. Original scanning data were reconstructed to produce 20 data sets of cardiac cycles with 5% time intervals. In addition, 20 groups of images and dynamic graphs were generated using three?dimensional software. We concluded the convex was point of impulse if small bubble or small pointed convex could be found in continuous three or more images at the same location. The morphological characteristics and clinical features of the two groups of aneurysms were firstly analyzed by univariate analysis, and then the meaningful indicators were analyzed by logistic regression, and the optimal diagnostic cutoff values were calculated using ROC curves. Results Univariate analysis showed that women, smoking history, location of aneurysm at the bifurcation, pulsation point, aspect ratio (AR) and size ratio (SR) were statistically significant different between the two groups of small aneurysms (P<0.05), but age, hypertension, type 2 diabetes, family history, history of multiple aneurysms, history of drinking, location, size, neck and tumor height had no significant differences between the two groups (P>0.05). Multivariate regression analysis showed that pulsation point (odds ratio=8.843, 95% confidence interval: 2.800—27.925) and large SR value (odds ratio=4.484, 95% confidence interval: 1.094—18.385) were independent risk factors for the aneurismal rupture. when the SR value was greater than 1.65, the area under the ROC curve was 0.832, the sensitivity to diagnose the risk of small aneurysm rupture was 76%, and the specificity is 70%. Conclusion The occurrence of pulsation point and SR value greater than 1.65 are independent predictors of the risk of intracranial aneurysm rupture less than 5 mm.
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The present study is establish the quantitative analysis of multi-component with single marker for determining three anthroic acids, (25S)-antcin K, (25R)-antcin K and (25S)-antcin C in the petri dish cultured Antrodia camphorata. The relative correction factors of (25S)-antcin K and (25R)-antcin K were established by high performance liquid chromatography with (25S)-antcin C as the internal reference. Relative correction factors were used to calculate the contents of (25S)-antcin K and (25R)-antcin K which were difficult to gain in abundance. At the same time, the contents of these three compounds were determined by external standard method. Two methods were compared to evaluate the accuracy and rationality of the multi-components with single marker method in the determination of the petri dish cultured A. camphorate. It was found that the quantitative method of multi-component with single marker and external standard method showed no significant difference. In summary, taking (25S)-antcin C as the internal reference, the method of multi-component with single marker can be applied to the quantitative analysis of (25S)-antcin K and (25R)-antcin K in the petri dish cultured A. camphorata.
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Antrodia , Chemistry , Biomarkers , Cholestenes , Chromatography, High Pressure LiquidABSTRACT
OBJECTIVE@#To observe the effect difference between blood-letting and cupping therapy combined with basic treatment and simple basic treatment for upper limb spasticity in the recovery phase of stroke.@*METHODS@#Sixty patients of upper limb spasticity in the recovery phase of stroke were randomly assigned into an observation group and a control group, 30 cases in each group. In the control group, the basic treatment, including the internal treatment, acupuncture and rehabilitation, was used for 2 weeks, 6 times a week, once a day. Based on the basic treatment, blood-letting, at 3 -well points each time, and cupping therapy were used at the most obvious spasm point in the belly of biceps muscle in the observation group for 2 weeks, 3 time a week, once every other day. The spasm score, passive traction value, and moter function score of upper limb were assessed in the two groups before and after treatment. The effects were compared between the two groups.@*RESULTS@#After treatment, the spasm scores and passive traction values were lower than those before treatment in the two groups (all <0.01), with better score and value as well as different values before and after treatment in the observation group (<0.05, <0.01). After treatment, the motor function scores were higher than those before treatment in the two groups (both <0.01), with better score and different value before and after treatment in the observation group (both <0.05). The total effective rate was 90.0% (27/30) in the observation group, which was better than 76.7% (23/30) in the control group (<0.05).@*CONCLUSION@#Based on the basic treatment, blood-letting combined with cupping therapy are effective for upper limb spasticity in the recovery phase of stroke.
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Humans , Acupuncture Therapy , Bloodletting , Muscle Spasticity , Stroke , Stroke Rehabilitation , Treatment Outcome , Upper ExtremityABSTRACT
Objective To observe the effect of Kidney-nourishing, Blood-activating, Phlegm-resolving and Resuscitation-inducing Decoction(KBPRD)on the expression of N-methyl-D-aspartate(NMDA)receptor subtype 1,2A,2B(NR1,NR2A,NR2B)in the cochlear spiral ganglion neurons(SGN)of tinnitus rats and to explore its mechanism, thus to provide experimental evidence for the treatment of tinnitus with KBPRD. Methods Sixty rats were randomly divided into normal group,model group,western medicine group,and low-,middle-,and high-dose Chinese medicine groups, 10 rats in each group. Rats were given intraperitoneal injection of sodium salicylate combined with water deprivation to induce tinnitus model. After successful establishment of the model, the rats in low-,middle-,and high-dose Chinese medicine groups were given gastric administration of KBPRD in the dosage of 5.5, 11, 22 g·kg-1·d-1 respectively, the rats in western medicine group were given gastric administration of 5 mg·kg-1·d-1 of carbamazepine,and rats in the model group and normal group were given gastric administration of 2 mL of normal saline,once every day,treatment time covering 8 weeks. The expression levels of NR1,NR2A,and NR2B in the cochlear SGN was detected by immunoblotting and real-time quantitative reverse transcription-polymerase chain reaction(qRT-PCR)after 8 weeks of treatment. Results Compared with the normal group,the expression levels of NR1, NR2A and NR2B in the model group were increased, the difference being significant (P < 0.05). Compared with the model group,the expression of NR1,NR2A and NR2B in low-,middle-,and high-dose Chinese medicine groups were significantly decreased(P<0.05).Conclusion KBPRD is effective on relieving tinnitus of rats, and its mechanism is correlated with lowering the increased expression of NR1,NR2A and NR2B in SGN of tinnitus rats.
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<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of Shengxue mixture combined with intraosseous blood infusion for treatment of aplastic anemia patients.</p><p><b>METHODS</b>From 2011 to 2015, Institute of blood diseases of Shaanxi Medical University admitted 53 patients with aplastic anemia. The patients were treated with shengxue mixture 200 ml, orally, twice a day. Stanozolol tablets, Adult 2 mg, three times a day, mycophenolate mofetil 1.0 g, twice a day. Intraosseous infusion of the following medicine were administered in patients: recombinant human EPO 10000 U, recombinant human G-CSF 450 µg, recombinant human IL-11 4.5 mg, dexmethasone 20 mg, once a week, a total of four times. One month later, the blood cell counts and bone marrow biopsy were performed. Consolidation treatment continued for 3 to 6 months after discharge, and therapeutic effect was observed and followed-up for more than a year.</p><p><b>RESULTS</b>After one month of treatment, 40 patients were basically cured (75.47%), 8 patients were remitted(15.09%), Hemoglobin level, white blood cell count and platelet count were significantly improved after treatment (P<0.01). The overall response rate was 90.57%(48 patients). Patients with bone marrow hyperplasia was 46 (86.79%), versus 9(16.98%) before treatment. There was a difference (P<0.05). After 3 to 6 months of treatment, 40 patients were cured (75.47%); 8 patients were remitted(15.09%); 3 patients were obviously improved(5.66%); 2 patients were ineffective(3.77%). The overall response rate was 96.23%(51 cases). No obvious side effects were observed. No patients were relapsed after one year.</p><p><b>CONCLUSION</b>Shengxue mixture combined with Intraosseous infusion is a fast, efficient, safe method for the treatment of aplastic anemia.</p>
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@#Objective To establish normal reference range of surface electromyography (sEMG) in related myoelectric activity when maximum isometric voluntary contraction of ankle dorsiflexors and plantarflexors in healthy middle to old people. Methods From Septem-ber to December, 2015, a total of 110 healthy people aged 41 to 75 years were divided into 41 to 50 years group, 51 to 60 years group and>60 years group according to age. The integral electrical values were measured in each subject by sEMG technique and analysis system under maximum isometric voluntary contraction of ankle dorsiflexors and plantarflexors. Results and Conclusion Under ankle dorsiflexion and plantar flexion movement modes, no significant difference was found in the integral electrical values of tibialis anterior muscle, long perone-al muscle, short tibial muscle and gastrocnemius among different groups (F<4.545, P>0.05). No significant difference was found in the inte-gral electrical values of different sides and different genders (F<7.028, P>0.05). Normal reference range for integral electrical values was es-tablished under maximum isometric voluntary contraction of ankle dorsiflexors and plantarflexors in healthy people.
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@#Objective To establish normal reference range of surface electromyography (sEMG) in related myoelectric activity when maximum isometric voluntary contraction of ankle dorsiflexors and plantarflexors in healthy middle to old people. Methods From Septem-ber to December, 2015, a total of 110 healthy people aged 41 to 75 years were divided into 41 to 50 years group, 51 to 60 years group and>60 years group according to age. The integral electrical values were measured in each subject by sEMG technique and analysis system under maximum isometric voluntary contraction of ankle dorsiflexors and plantarflexors. Results and Conclusion Under ankle dorsiflexion and plantar flexion movement modes, no significant difference was found in the integral electrical values of tibialis anterior muscle, long perone-al muscle, short tibial muscle and gastrocnemius among different groups (F<4.545, P>0.05). No significant difference was found in the inte-gral electrical values of different sides and different genders (F<7.028, P>0.05). Normal reference range for integral electrical values was es-tablished under maximum isometric voluntary contraction of ankle dorsiflexors and plantarflexors in healthy people.
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Objective To evaluate the electrocardiographic(ECG)-gated 4-dimensional computed tomographic angiography (4D-CTA) in the determination of pulsation of unruptured cerebral aneurysms (URCAs).Methods This study included 48 patients with 62 URCAs.Examinations of ECG gated 4D-CTA of dual-source CT were performed.Twenty sets of image data with the time intervals of 5％ in a cardiac cycle were obtained after postprocessing on the workstation.The convex was defined as the point of pulsation if small bubble or small pointed convex could be found in continuous three or more images at the same location.The 62 URCAs were divided into two groups based on whether having a point of pulsation.All the URCAs were scanned at the follow-up by 3D-CTA or ECG gated 4D-CTA more than 120 days later.The diameters of aneurysms and aspect ratio between the two groups were compared with independent t test,while neck of aneurysms and follow-up time were compared with two-independent samples Mann-Whitney U test.The other variables including history of hypertension,type 2 diabetes,smoking et al between the two groups were analyzed by x2 test.The sensitivity and specificity of aspect ratio for diagnosis of pulsation were analyzed by receiver operating characteristic (ROC) curve.Results Pulsation was observed in 28 of the 62 URCAs.Aspect ratios in whose pulsation was or was not detected were 1.5±0.3 and 1.1±0.3,respectivelyThe difference between the two groups was statistically significant (t=-2.274,P＜0.001).The sensitivity and specificity of the aspect ratio were 75.0％ and 70.6％.After follow-up more than 3 months,of the 28 URCAs in which pulsation was observed,11 showed a change in shape,while in 34 URCAs without visible pulsation,5 showed a change in shape.The aneurysms with detectable pulsation were more likely to show a change in shape (x2=4.891,P=0.027),with an odds ratio of 3.753.Conclusions URCAs with a large aspect ratio are easily to show the pulsation by ECG gated 4D-CTA.Besides,the aneurysms with visible pulsation are more likely to show a change in shape after follow-up,which suggests a higher risk of rupture.
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BACKGROUND:Shape memory polyurethane has good physical and chemical properties and compatibility, but there are relatively few reports on the compatibility of osteoblasts before and after the deformation-complex of the shape memory polyurethane. OBJECTIVE:To observe the compatibility of osteoblasts with shape memory polyurethane before and after the deformation-complex. METHODS: Shape memory polyurethane membranes were prepared, and its stretching-solid-complex was conducted under the experimental environment, to obtain the membrane materials after the deformation-complex. The Sprague-Dawley neonatal rat osteoblasts were inoculated on the shape memory polyurethane membranes before and after the deformation-complex. After 2 hours of culture, the number of adherent cels was counted, and cel spreading was observed; cel proliferation was determined after 1-11 days of culture. RESULTS AND CONCLUSION:The adhesion amount and proliferation activity of osteoblasts on shape memory polyurethane membranes after the deformation-complex were significantly higher than those before the deformation-complex (P < 0.05). The osteoblasts presented fusiform appearance on the shape memory polyurethane membranes after deformation-complex, and cel arrangement showed a clear orientation, but a smal spreading area; while the osteoblasts presented polygonal shape on the shape memory polyurethane membranes before deformation-complex, arranged in no particular direction, and spread largely. These findings show the shape memory polyurethane has better osteoblast compatibility after the deformation-complex.
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Cirrhotic portal hypertension is associated with both increased intrahepatic vascular resistance and hyperdynamic circulation.These two pathogical changes of portal hypertension can be contributed to the unusually high or unusually low levels of vasodilator in liver and splanchnic organs.Vascular hyporesponsiveness due to reactive oxygen species is also a key factor which accounts for portal hemodynamic abnormalities.Transcription factor nuclear factor E2-related factor 2 (Nrf2),known by its role in anti-oxygenation,can initiate and enhance transcription of antioxidant response element (ARE) when exposure to oxidative stress occures.Related influence on expression of nitric oxide,carbon monoxide and their coenzymes has also been demonstrated for decades.The potential clinical significance will be unfolded if changes of Nrf2 expression,as well as the way modulating Nrf2,are found in cirrhotic portal hypertension.
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Objective To explore the role of hydrogen peroxide in mesenteric artery contraction of cirrhotic rats with portal hypertension,which was induced by bile duct ligation.Possible mechanism in RhoA/ROCK signal pathway was also part of the focus.Methods The bile duct ligation-induced cirrhotic rats and normal rats (control group) were treated equally with PEG-catalase(10 000 U/kg-1 · d-1,ip.) or by its vehicle for 8 days.Then the level of H2O2 in mesenteric arteries was detected.The contractile response to norepinephrine of arterioles was analyzed by vascular perfusion system.The protein expressions of the α1 adrenergic receptor,β-arrestin-2 and Rho kinase-1 (ROCK-1),and the activity of ROCK-1 were measured by western blot.In addition,the interaction of α1-adrenergic receptor with β-arrestin-2 was assessed by co-immunoprecipitation.Results Compared to normal rats,the dose-response curve of the mesenteric arterioles in response to norepinephrine shifted to the right,and the EC 50 increased in the rats with portal hypertension.PEG-catalase treatment can decrease the hydrogen peroxide level in arteries,thus significantly lowered EC50 and improved the reactivity to norepinephrine of the mesenteric arterioles in portal hypertension rats.No significant difference in the α1-adrenergic receptor amounts was observed among groups.There was remarkable decreases in the protein expressions of β-arrestin-2 and its interaction with the α1-adrenergic receptor in cirrhotic rats with PEG-catalase treatment.PEG-catalase also increased the amount and activity of ROCK-1 in cirrhotic rats.Conclusions The level of hydrogen peroxide increases in the mesenteric arteries in bile duct ligation-induced cirrhotic rats.And it enhances the β-arrestin-2 expression and its interaction with the α1-adrenergic receptor,which subsequently decreases the amount and activity of ROCK as well as the contractility of mesenteric arteries in response to vasoconstrictors.
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<p><b>BACKGROUND</b>Thymectomy is an established treatment for myasthenia gravis (MG), and video-assisted thoracoscopic surgery (VATS) thymectomy has become an acceptable surgical procedure. This study aimed to compare the results of VATS thymectomy and open thymectomy and to identify the prognostic factors after thymectomy.</p><p><b>METHODS</b>The clinical data of 187 consecutive thymectomies performed between July 2000 and December 2009 were retrospectively reviewed; 75 open thymectomies and 112 VATS thymectomies. Clinical efficacy and variables influencing outcome were assessed by Kaplan-Meier survival curves and Cox proportional hazards regression analysis.</p><p><b>RESULTS</b>The operative blood loss in the VATS group was significantly less than that in the open group ((62.14 ± 55.43) ml vs. (137.87 ± 165.25) ml, P < 0.05). The postoperative crisis rate increased with the severity of preoperative MG and the prescription dose of anticholinesterase. Complete follow-up information of patients more than 12 months after the thymectomy was obtained on 151 cases, 89 cases from the VATS group and 62 cases from the open group, with a mean follow-up period of 59.3 months, range from 12 to 117 months. Complete stable remission (CSR) was the end point for evaluation of the treatment results. The overall five-year CSR rate was 57.5%. Two good prognostic factors were identified; preoperative prescription of anticholinesterase alone (P = 0.035) and non-thymomatous MG (P = 0.003). The five-year CSR rate of the ocular type of MG reached a high level of 67.4%.</p><p><b>CONCLUSIONS</b>Thymectomy can achieve good long-term CSR in MG, and VATS is an ideal alternative method. High-dose prescription of anticholinesterase and the advanced stage by Myasthenia Gravis Foundation of America (MGFA) classification have higher risks of postoperative crisis. Preoperative prescription of anticholinesterase alone and non-thymomatous MG are good prognostic factors. Thymectomy should also be considered for the ocular type of MG.</p>
Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Myasthenia Gravis , General Surgery , Proportional Hazards Models , Thoracic Surgery, Video-Assisted , Methods , Thymectomy , Methods , Time Factors , Treatment OutcomeABSTRACT
Objective To detect the variation of vascular endothelial growth factor (VEGF) in the splanchnic vessels under portal hypertension (PHT) and explore its mechanism and influence on the process of hyperdynamic circulation.Methods In humans,the level of VEGF pathway related proteins were detected in the splenic artery of PHT patients in clinical trials.In animal experiments,the following parameters were observed for rats in the control group (group N,n =7) and the CCl4 induced portal hypertension group (group PHT,n=7):portal vein diameter,portal vein blood flow velocity (PBV),portal vein blood flow (PBF),portal vein pressure (PP),norepinephrine (NE) reactivity in the isolated mesenteric artery microcirculation,contractile reactivity and degree of endothelial ni tric oxide synthase (eNOS) activation in the mesenteric artery by selectively inhibiting the VEGF signal pathway with SU5416.In cell experiments,primary culturing of arterial endothelial cells in vitro were used to verify the effects of VEGF on eNOS activation.Results The results showed that VEGF expression levels in the splenic artery of PHT patients significantly increased.In animal experiments,there was not a significant difference in portal vein diameter between group N and group PHT.How ever,the PBV and PBF of group PHT were lower than those of group N,and SU5416 had no clear effect on PBV and PBF in group PHT.PP of group PHT was much higher than that of group N,and SU5416 had little influence on reducing PP in group PHT.The contractile response of mesenteric artery microcirculation to NE in group PHT decreased significantly,EC50 increased a lot,and SU5416 improved this hypoergia partially.The protein levels of VEGF,VEGFR-2,eNOS,and p-eNOS in the mesentery artery of group PHT raised quite a lot compared to group N,and SU5416 decreased the protein level of VEGFR-2 and activation of eNOS significantly.Experiments in vitro confirmed that VEGF could promote the activation of eNOS.Conclusion The excessive VEGF produced in visceral arteries under PHT may participate in the process of hyperdynamic circulation partially through promoting the synthesis and activation of eNOS and then reducing visceral arteries' response to NE.
ABSTRACT
Objective To investigate the mechanisms of nitric oxide (NO) in decreasing intestinal mesenteric arterial hypocontractility in rats with hepatic cirrhosis and portal hypertension,and to analyze the interaction of NO and RhoA/ROCK pathway.Methods The levels of NO in the peripheral blood and mesenteric artery of normal rats (normal control group,5 rats),rats with portal hypertension (experimental control group,6 rats)and rats with portal hypertension treated by L-NAME (L-NAME group,6 rats) were detected.Mesenteric arteriole contractility to norepinephrine in the 3 groups was determined using a vessel perfusion system.The expressions of proteins of NO-cGMP-PKG pathway and RhoA/ROCK pathway in the 3 groups were detected by Western blot.All data were analyzed using the analysis of variance or LSD-t test.The changes of mesenteric arteriole contractility to norepinephrine was expressed in dose-response curve,and was analyzed using the nonlinear regression method,and the EC50 value was calculated.Results (1) The pressures of portal veins of the normal control group,experimental control group and L-NAME group were (6.2 ± 0.9)mm Hg (1 mm Hg =0.133 kPa),(13.9 ± 1.7)mm Hg and (16.6 ± 1.3) mm Hg,respectively,with a significant difference among the 3 groups (F =94.4,P ＜ 0.05).(2) The levels of NO in the normal control group,experimental control group and L-NAME group were (43 ± 5) μmol/L,(82 ± 16) μmol/L and (45 ± 9) μmol/L,respectively,with a significant difference among the 3 groups (F =24.77,P ＜ 0.05).The level of NO of the L-NAME group was significantly lower than that of the experimental control group (P ＜ 0.05).(3) The levels of NO in the mesenteric artery of the normal control group,experimental control group and L-NAME group were (236 ±41) μmol/g,(407 ± 82) μmol/g and (216 ± 42) μmol/g,respectively,with a significant difference among the 3 groups (F =20.29,P ＜ 0.05).The NO level of the L-NAME group was significantly lower than that of the experimental control group (P ＜ 0.05).(4) Compared with the experimental control group,the dose-response curve of mesenteric arterioles to norepinephrine shifted to the left,while it did not reach the level of the normal control group.The levels of EC50 of the normal control group,experimental control group and the L-NAME group were 6.458 × 10-7 mol,9.546 × 10-7 mol and 7.494 × 10-7 mol,respectively.There was a significant difference in the EC50 level between the L-NAME group and the other two group (t =2.726,3.112,P ＜ 0.05).(5) Compared with the normal control group,the protein expression levels of eNOS and p-VASP of mesenteric artery of the experimental control group were significantly increased (P ＜ 0.05),while they were decreased in the L-NAME group (P ＜ 0.05).The protein expression levels of eNOS and p-VASP of mesenteric artery of the L-NAME group were significantly higher than those of the normal control group (P ＜0.05).There were no obvious changes of protein expression levels of PKG-1,ROCK-1 and p-moesin in the 3 groups (P ＞ 0.05).(6) The activity of ROCK-1 was significantly increased with norepinephrine stimulation in the normal control group and the L-NAME group,while no obvious changes were detected in the experimental control group.Conclusions The NO expression is upregulated in mesenteric arteries in rats with hepatic cirrhosis and portal hypertension.Such changes induce ROCK activation via influencing the expression of vasoconstrictors.L-NAME can reduce the NO levels in the mesenteric arteries,which may improve RhoA/ROCK signal pathway transduction.This can help vasoconstrictors induce ROCK activation without affecting the protein expression of ROCK.